Metabolic control in patients with type 2 diabetes mellitus in a public hospital in Peru: a cross-sectional study in a low-middle income country.

PubMed

Huayanay-Espinoza, Irma Elizabeth; Guerra-Castañon, Felix; Lazo-Porras, María; Castaneda-Guarderas, Ana; Thomas, Nimmy Josephine; Garcia-Guarniz, Ana-Lucia; Valdivia-Bustamante, Augusto A; Málaga, Germán

2016-01-01

The objective of this study was to assess patients' achievement of ADA (American Diabetes Association) guideline recommendations for glycosylated hemoglobin, lipid profile, and blood pressure in a type 2 diabetes mellitus (T2DM) outpatient clinic in a low-middle income country (LMIC) setting. This is a descriptive cross-sectional study with 123 ambulatory T2DM patients who are being treated at a public hospital in Lima, Peru. Data was gathered via standardized interviews, clinical surveys, and anthropomorphic measurements for each patient. Blood samples were drawn in fasting state for measures of glucose, glycosylated hemoglobin (HbA1c), and lipid profile. Laboratory parameters and blood pressure were evaluated according to ADA recommendations. Of the 123 patients, 81 were women and the mean age was 61.8 years. Glycemic control was abnormal in 82 (68.33%) participants, and 45 (37.50%) were unable to control their blood pressure. Lipid profile was abnormal in 73 (60.83%) participants. Only nine (7.50%) participants fulfilled ADA recommendations for glycemic, blood pressure, and lipid control. Amongst individuals with type 2 diabetes, there was poor attainment of the ADA recommendations (HbA1c, blood pressure and LDL-cholesterol) for ambulatory T2DM patients. Interventions are urgently needed in order to prevent long-term diabetic complications.

Metabolic control in patients with type 2 diabetes mellitus in a public hospital in Peru: a cross-sectional study in a low-middle income country

PubMed Central

Guerra-Castañon, Felix; Lazo-Porras, María; Castaneda-Guarderas, Ana; Thomas, Nimmy Josephine; Garcia-Guarniz, Ana-Lucia; Valdivia-Bustamante, Augusto A.; Málaga, Germán

2016-01-01

Objective The objective of this study was to assess patients’ achievement of ADA (American Diabetes Association) guideline recommendations for glycosylated hemoglobin, lipid profile, and blood pressure in a type 2 diabetes mellitus (T2DM) outpatient clinic in a low-middle income country (LMIC) setting. Methods This is a descriptive cross-sectional study with 123 ambulatory T2DM patients who are being treated at a public hospital in Lima, Peru. Data was gathered via standardized interviews, clinical surveys, and anthropomorphic measurements for each patient. Blood samples were drawn in fasting state for measures of glucose, glycosylated hemoglobin (HbA1c), and lipid profile. Laboratory parameters and blood pressure were evaluated according to ADA recommendations. Results Of the 123 patients, 81 were women and the mean age was 61.8 years. Glycemic control was abnormal in 82 (68.33%) participants, and 45 (37.50%) were unable to control their blood pressure. Lipid profile was abnormal in 73 (60.83%) participants. Only nine (7.50%) participants fulfilled ADA recommendations for glycemic, blood pressure, and lipid control. Conclusions Amongst individuals with type 2 diabetes, there was poor attainment of the ADA recommendations (HbA1c, blood pressure and LDL-cholesterol) for ambulatory T2DM patients. Interventions are urgently needed in order to prevent long-term diabetic complications. PMID:27761351

Verification of the Chesapeake Bay Model.

DTIC Science & Technology

1981-12-01

points on the model. Each inflow control unit consists of a pressure regulator , a digital flow control valve, and a flowmeter (Fig- ure 8). A mechanical...spring-type pressure regulator ensures constant pressure to the digital flow control valve. Each digital valve contains eight solenoid valve actuators...FT) =0.798 EEOC 1DGS 2.78 EPOCH (DEGS) - 11. 84 3 DATA TAKEN: AC(0) = 0. 11 38 F T A (0)= 0. 1653 FT 28 MAR 1978 RANGE (FT) - 1.638 RANGE (FT

Impact of masked hypertension on diabetic nephropathy in patients with type II diabetes: a KAMOGAWA-HBP study.

PubMed

Ushigome, Emi; Oyabu, Chikako; Tanaka, Toru; Hasegawa, Goji; Ohnishi, Masayoshi; Tsunoda, Sei; Ushigome, Hidetaka; Yokota, Isao; Nakamura, Naoto; Oda, Yohei; Asano, Mai; Tanaka, Muhei; Yamazaki, Masahiro; Fukui, Michiaki

2018-05-01

The prognostic significance of masked hypertension (MH) on the progression of diabetic nephropathy among patients with type II diabetes is not well documented. We examined the relationship between clinic systolic blood pressure (SBP) and morning home SBP measurements and progression to macroalbuminuria in patients with type II diabetes. We analyzed prospective cohort study data from 712 patients with type II diabetes. We classified the patients into the following four groups according to their clinic (130 mm Hg) and home (125 mm Hg) SBP measurements: controlled blood pressure group, white-coat hypertension group, MH group, and sustained hypertension (SH) group. The patients were instructed to perform triplicate morning and evening blood pressure measurements for 14 consecutive days. During the 2-year follow-up period, 23 patients progressed to macroalbuminuria. The unadjusted odds ratio (95% confidence interval) for progression to macroalbuminuria among the patients with MH was significantly higher than that among the patients with controlled blood pressure (8.89 [1.06-74.88]). No significant relationship was observed between white-coat hypertension or SH and progression to macroalbuminuria. In analyses adjusted for various potential confounders, the adjusted odds ratio for progression to macroalbuminuria in the MH group was more than 8-fold higher than that in the controlled blood pressure group. MH might be a predictor of progression to macroalbuminuria among patients with type II diabetes. This rate of progression is comparable with or greater than the results reported for patients with SH. Copyright © 2018 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.

Assessment of Correlation of Distal Mean Arterial Pressure with Aortic Blood Flow during Partial Resuscitative Endovascular Balloon Aortic Occlusion (P-REBOA) in a Swine (Sus scrofa) Controlled Hemorrhage Model

DTIC Science & Technology

2017-11-06

60th Medical Group (AMC), Travis AFB, CA INSTITUTIONAL ANIMAL CARE AND USE COMMITTEE (IACUC) FINAL REPORT SUMMARY (Please type all information. Use...Pressure with Aortic Blood Flow during Partial Resuscitative Endovascular Balloon Aortic Occlusion (P-REBOA) in a Swine (Sus scrofa) Controlled Hemorrhage...to Date Sus scrofa 8 8 2. PROTOCOL TYPE /CHARACTERISTICS: (Check all applicable terms in EACH column) _ Training: Live Animal Medical Readiness

Systolic Blood Pressure Control Among Individuals With Type 2 Diabetes: A Comparative Effectiveness Analysis of Three Interventions.

PubMed

Espeland, Mark A; Probstfield, Jeffery; Hire, Donald; Redmon, J Bruce; Evans, Gregory W; Coday, Mace; Lewis, Cora E; Johnson, Karen C; Wilmoth, Sharon; Bahnson, Judy; Dulin, Michael F; Green, Jennifer B; Knowler, William C; Kitabchi, Abbas; Murillo, Anne L; Osei, Kwame; Rehman, Shakaib U; Cushman, William C

2015-08-01

The relative effectiveness of 3 approaches to blood pressure control-(i) an intensive lifestyle intervention (ILI) focused on weight loss, (ii) frequent goal-based monitoring of blood pressure with pharmacological management, and (iii) education and support-has not been established among overweight and obese adults with type 2 diabetes who are appropriate for each intervention. Participants from the Action for Health in Diabetes (Look AHEAD) and the Action to Control Cardiovascular Risk in Diabetes (ACCORD) cohorts who met criteria for both clinical trials were identified. The proportions of these individuals with systolic blood pressure (SBP) <140 mm Hg from annual standardized assessments over time were compared with generalized estimating equations. Across 4 years among 480 Look AHEAD and 1,129 ACCORD participants with baseline SBPs between 130 and 159 mm Hg, ILI (OR = 1.46; 95% CI = [1.18-1.81]) and frequent goal-based monitoring with pharmacotherapy (OR = 1.51; 95% CI = [1.16-1.97]) yielded higher rates of blood pressure control compared to education and support. The intensive behavioral-based intervention may have been more effective among individuals with body mass index >30 kg/m2, while frequent goal-based monitoring with medication management may be more effective among individuals with lower body mass index (interaction P = 0.047). Among overweight and obese adults with type 2 diabetes, both ILI and frequent goal-based monitoring with pharmacological management can be successful strategies for blood pressure control. clinicaltrials.gov identifiers NCT00017953 (Look AHEAD) and NCT00000620 (ACCORD). © American Journal of Hypertension, Ltd 2015. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The pumping lid: investigating multi-material 3D printing for equipment-free, programmable generation of positive and negative pressures for microfluidic applications.

PubMed

Begolo, Stefano; Zhukov, Dmitriy V; Selck, David A; Li, Liang; Ismagilov, Rustem F

2014-12-21

Equipment-free pumping is a challenging problem and an active area of research in microfluidics, with applications for both laboratory and limited-resource settings. This paper describes the pumping lid method, a strategy to achieve equipment-free pumping by controlled generation of pressure. Pressure was generated using portable, lightweight, and disposable parts that can be integrated with existing microfluidic devices to simplify workflow and eliminate the need for pumping equipment. The development of this method was enabled by multi-material 3D printing, which allows fast prototyping, including composite parts that combine materials with different mechanical properties (e.g. both rigid and elastic materials in the same part). The first type of pumping lid we describe was used to produce predictable positive or negative pressures via controlled compression or expansion of gases. A model was developed to describe the pressures and flow rates generated with this approach and it was validated experimentally. Pressures were pre-programmed by the geometry of the parts and could be tuned further even while the experiment was in progress. Using multiple lids or a composite lid with different inlets enabled several solutions to be pumped independently in a single device. The second type of pumping lid, which relied on vapor-liquid equilibrium to generate pressure, was designed, modeled, and experimentally characterized. The pumping lid method was validated by controlling flow in different types of microfluidic applications, including the production of droplets, control of laminar flow profiles, and loading of SlipChip devices. We believe that applying the pumping lid methodology to existing microfluidic devices will enhance their use as portable diagnostic tools in limited resource settings as well as accelerate adoption of microfluidics in laboratories.

Systolic Blood Pressure Control Among Individuals With Type 2 Diabetes: A Comparative Effectiveness Analysis of Three Interventions

PubMed Central

Probstfield, Jeffery; Hire, Donald; Redmon, J. Bruce; Evans, Gregory W.; Coday, Mace; Lewis, Cora E.; Johnson, Karen C.; Wilmoth, Sharon; Bahnson, Judy; Dulin, Michael F.; Green, Jennifer B.; Knowler, William C.; Kitabchi, Abbas; Murillo, Anne L.; Osei, Kwame; Rehman, Shakaib U.; Cushman, William C.

2015-01-01

BACKGROUND The relative effectiveness of 3 approaches to blood pressure control—(i) an intensive lifestyle intervention (ILI) focused on weight loss, (ii) frequent goal-based monitoring of blood pressure with pharmacological management, and (iii) education and support—has not been established among overweight and obese adults with type 2 diabetes who are appropriate for each intervention. METHODS Participants from the Action for Health in Diabetes (Look AHEAD) and the Action to Control Cardiovascular Risk in Diabetes (ACCORD) cohorts who met criteria for both clinical trials were identified. The proportions of these individuals with systolic blood pressure (SBP) <140mm Hg from annual standardized assessments over time were compared with generalized estimating equations. RESULTS Across 4 years among 480 Look AHEAD and 1,129 ACCORD participants with baseline SBPs between 130 and 159mm Hg, ILI (OR = 1.46; 95% CI = [1.18–1.81]) and frequent goal-based monitoring with pharmacotherapy (OR = 1.51; 95% CI = [1.16–1.97]) yielded higher rates of blood pressure control compared to education and support. The intensive behavioral-based intervention may have been more effective among individuals with body mass index >30kg/m2, while frequent goal-based monitoring with medication management may be more effective among individuals with lower body mass index (interaction P = 0.047). CONCLUSIONS Among overweight and obese adults with type 2 diabetes, both ILI and frequent goal-based monitoring with pharmacological management can be successful strategies for blood pressure control. CLINICAL TRIALS REGISTRY clinicaltrials.gov identifiers NCT00017953 (Look AHEAD) and NCT00000620 (ACCORD). PMID:25666468

Effect of short-term administration of cinnamon on blood pressure in patients with prediabetes and type 2 diabetes.

PubMed

Akilen, Rajadurai; Pimlott, Zeller; Tsiami, Amalia; Robinson, Nicola

2013-10-01

The aim of this study was to systematically review and evaluate the effect of short-term administration of cinnamon on blood pressure regulation in patients with prediabetes and type 2 diabetes by performing a meta-analysis of randomized, placebo-controlled clinical trials. Medical literature for randomized controlled trials (RCTs) of the effect of cinnamon on blood pressure was systematically searched; three original articles published between January 2000 and September 2012 were identified from the MEDLINE database and a hand search of the reference lists of the articles obtained through MEDLINE. The search terms included cinnamon or blood pressure or systolic blood pressure (SBP) or diastolic blood pressure (DBP) or diabetes. A random effects model was used to calculate weighted mean difference and 95% confidence intervals (CI). The pooled estimate of the effect of cinnamon intake on SBP and DBP demonstrated that the use of cinnamon significantly decreased SBP and DBP by 5.39 mm Hg (95% CI, -6.89 to -3.89) and 2.6 mm Hg (95% CI, -4.53 to -0.66) respectively. Consumption of cinnamon (short term) is associated with a notable reduction in SBP and DBP. Although cinnamon shows hopeful effects on BP-lowering potential, it would be premature to recommend cinnamon for BP control because of the limited number of studies available. Thus, undoubtedly a long-term, adequately powered RCT involving a larger number of patients is needed to appraise the clinical potential of cinnamon on BP control among patients with type 2 diabetes mellitus. Copyright © 2013 Elsevier Inc. All rights reserved.

Implementing Low-Cost, Community-Based Exercise Programs for Middle-Aged and Older Patients with Type 2 Diabetes: What Are the Benefits for Glycemic Control and Cardiovascular Risk?

PubMed

Mendes, Romeu; Sousa, Nelson; Reis, Victor Machado; Themudo-Barata, Jose Luis

2017-09-13

The purpose of this study was to analyze the effects of a long-term, community-based, combined exercise program developed with low-cost exercise strategies on glycemic control and cardiovascular risk factors in middle-aged and older patients with type 2 diabetes. Participants ( n = 124; 63.25 ± 7.20 years old) engaged in either a 9-month supervised exercise program ( n = 39; consisting of combined aerobic, resistance, agility/balance, and flexibility exercise; three sessions per week; 70 min per session) or a control group ( n = 85) who maintained their usual care. Glycemic control, lipid profile, blood pressure, anthropometric profile, and the 10-year risk of coronary artery disease were assessed before and after the 9-month intervention. A significant time * group interaction effect ( p < 0.001) was identified in the values of the glycated hemoglobin, fasting plasma glucose, total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, systolic blood pressure, diastolic blood pressure, body mass index, waist circumference, and the 10-year risk of coronary artery disease. A long-term, community-based, combined exercise program developed with low-cost exercise strategies was effective in inducing significant benefits on glycemic control, lipid profile, blood pressure, anthropometric profile, and the 10-year risk of coronary artery disease in middle-aged and older patients with type 2 diabetes. Clinical Trial Identification Number: ISRCTN09240628.

Energy Monitoring and Control Systems Inspection Guidelines.

DTIC Science & Technology

1982-12-01

When the pressure port is exposed to atmosphere, the transducer will indicate zero PSIG. An absolute pressure transducer measures pressure referenced...Environment. dbm: A measure of absolute power values. Zero dbm equals one milliwatt. Data Transmission Transmission equipment including cables and Media (DTM...the four listed, type "K" is the most linear of the T/C’s and type "E" has the highest voltage per degree farenheit . Some advantages of thermo- couples

Pressure tracking control of vehicle ABS using piezo valve modulator

NASA Astrophysics Data System (ADS)

Jeon, Juncheol; Choi, Seung-Bok

2011-03-01

This paper presents a wheel slip control for the ABS(anti-lock brake system) of a passenger vehicle using a controllable piezo valve modulator. The ABS is designed to optimize for braking effectiveness and good steerability. As a first step, the principal design parameters of the piezo valve and pressure modulator are appropriately determined by considering the braking pressure variation during the ABS operation. The proposed piezo valve consists of a flapper, pneumatic circuit and a piezostack actuator. In order to get wide control range of the pressure, the pressure modulator is desired. The modulator consists of a dual-type cylinder filled with different substances (fluid and gas) and a piston rod moving vertical axis to transmit the force. Subsequently, a quarter car wheel slip model is formulated and integrated with the governing equation of the piezo valve modulator. A sliding mode controller to achieve the desired slip rate is then designed and implemented. Braking control performances such as brake pressure and slip rate are evaluated via computer simulations.

Food Insecurity and Metabolic Control Among U.S. Adults With Diabetes

PubMed Central

Berkowitz, Seth A.; Baggett, Travis P.; Wexler, Deborah J.; Huskey, Karen W.; Wee, Christina C.

2013-01-01

OBJECTIVE We sought to determine whether food insecurity is associated with worse glycemic, cholesterol, and blood pressure control in adults with diabetes. RESEARCH DESIGN AND METHODS We conducted a cross-sectional analysis of data from participants of the 1999–2008 National Health and Nutrition Examination Survey. All adults with diabetes (type 1 or type 2) by self-report or diabetes medication use were included. Food insecurity was measured by the Adult Food Security Survey Module. The outcomes of interest were proportion of patients with HbA1c >9.0% (75 mmol/mol), LDL cholesterol >100 mg/dL, and systolic blood pressure >140 mmHg or diastolic blood pressure >90 mmHg. We used multivariable logistic regression for analysis. RESULTS Among the 2,557 adults with diabetes in our sample, a higher proportion of those with food insecurity (27.0 vs. 13.3%, P < 0.001) had an HbA1c >9.0% (75 mmol/mol). After adjustment for age, sex, educational attainment, household income, insurance status and type, smoking status, BMI, duration of diabetes, diabetes medication use and type, and presence of a usual source of care, food insecurity remained significantly associated with poor glycemic control (odds ratio [OR] 1.53 [95% CI 1.07–2.19]). Food insecurity was also associated with poor LDL control before (68.8 vs. 49.8, P = 0.002) and after (1.86 [1.01–3.44]) adjustment. Food insecurity was not associated with blood pressure control. CONCLUSIONS Food insecurity is significantly associated with poor metabolic control in adults with diabetes. Interventions that address food security as well as clinical factors may be needed to successfully manage chronic disease in vulnerable adults. PMID:23757436

The relationship of parenting styles and social competency to Type A behavior in children.

PubMed

Harralson, T L; Lawler, K A

1992-10-01

This study examined parenting styles, Type A behavior in parents and children, and social competence in children. Fifty 1st-6th grade children, parents, and their teachers participated. Type A behavior in parents was associated with a controlling style of parenting, but not with pressuring the child to achieve. Parenting styles of achievement pressure and high control were related to impatient and aggressive behaviors in children, as measured by the MYTH, a teacher-scored Type A behavior instrument. In addition, impatience and aggressiveness in the children were negatively correlated with the child's social competency and ability to function in school. Parenting practices, Type A behavior, and social competency in children may play important roles in the origins of detrimental components of Type A behavior, such as impatience and aggression.

Association of ADIPOQ variants with type 2 diabetes mellitus susceptibility in ethnic Han Chinese from northeast China.

PubMed

Yao, Meidong; Wu, Yanhui; Fang, Qingxiao; Sun, Lulu; Li, Tingting; Qiao, Hong

2016-11-01

To investigate the association between two single nucleotide polymorphisms (SNPs; rs3774261 and rs822393) in the ADIPOQ gene and type 2 diabetes mellitus in Han Chinese from northeast China. The present study comprised 993 type 2 diabetes mellitus patients and 966 unrelated controls from northeastern China. Two SNPs were sequenced using SNPscan. The distribution of genotype frequencies of the two SNPs in ADIPOQ between cases and controls, and in subgroups stratified based on body mass index, were compared using logistic regression analysis. Linear regression was used to analyze the association between each SNP and clinical indicators. The GG genotype of rs3774261 increased the risk of type 2 diabetes mellitus compared with the AA genotype in participants with a body mass index <24 (P = 0.021; odds ratio 1.636, 95% CI 1.708-2.484). Rs822393 was correlated with glycosylated hemoglobin (P = 0.043) in controls. Rs3774261 had an association with diastolic blood pressure (P = 0.017) in controls, and in controls with a body mass index <24; rs3774261 also had an association with both systolic blood pressure (P = 0.025) and diastolic blood pressure (P = 0.043). The present results confirm the association between ADIPOQ variants and type 2 diabetes mellitus in northeastern China. However, additional larger replication studies are required to validate these findings. © 2016 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.

Tracking sensitive source areas of different weather pollution types using GRAPES-CUACE adjoint model

NASA Astrophysics Data System (ADS)

Wang, Chao; An, Xingqin; Zhai, Shixian; Hou, Qing; Sun, Zhaobin

2018-02-01

In this study, the sustained pollution processes were selected during which daily PM2.5 concentration exceeded 75 μg/m3 for three days continuously based on the hourly data of Beijing observation sites from July 2012 to December 2015. Using the China Meteorological Administration (CMA) MICAPS meteorological processing system, synoptic situation during PM2.5 pollution processes was classified into five weather types: low pressure and weak high pressure alternating control, weak high pressure, low pressure control, high rear, and uniform pressure field. Then, we chose the representative pollution cases corresponding to each type, adopted the GRAPES-CUACE adjoint model tracking the sensitive source areas of the five types, and analyzed the critical discharge periods of Beijing and neighboring provinces as well as their contribution to the PM2.5 peak concentration in Beijing. The results showed that the local source plays the main theme in the 30 h before the objective time, and prior to 72 h before the objective time contribution of local sources for the five pollution types are 37.5%, 25.0%, 39.4%, 31.2%, and 42.4%, respectively; the Hebei source contributes constantly in the 57 h ahead of the objective time with the contribution proportion ranging from 37% to 64%; the contribution period and rate of Tianjin and Shanxi sources are shorter and smaller. Based on the adjoint sensitivity analysis, we further discussed the effect of emission reduction control measures in different types, finding that the effect of local source reduction in the first 20 h of the objective time is better, and if the local source is reduced 50% within 72 h before the objective time, the decline rates of PM2.5 in the five types are 11.6%, 9.4%, 13.8%, 9.9% and 15.2% respectively. And the reduction effect of the neighboring sources is better within the 3-57 h before the objective time.

Who suggests drinking less? Demographic and national differences in informal social controls on drinking.

PubMed

Dietze, Paul; Ferris, Jason; Room, Robin

2013-11-01

The purpose of this study was to examine variation in reports of pressuring others to drink less, as a form of informal social control of drinking, across countries and different types of relationship to the respondent. A cross-sectional survey was administered to 19,945 respondents ages 18-69 years in 14 countries included in the data set of the Gender, Alcohol and Culture: An International Study (GENACIS). Outcome variables were respondents' reports of pressuring others to drink less (yes/no) across a variety of relationships (their partners, other family members, workmates, or friends). Multilevel, multivariable logistic regression analysis was carried out on each outcome variable. The fixed-effects components included the Level 1 (individual) covariates of respondent age, gender, drinking status, and education level as well as the Level 2 (country level) covariates of percentage female drinkers and purchasing power parity. The random-effects components included country and current drinking status. Respondents most frequently reported pressuring male friends to drink less (18%), followed by male family members (other than partners, 15%), partners (15%), work colleagues (12%), female friends (9%), female family members (other than partners, 6%), and children (5%). There was marked variation across countries, with pressuring frequently reported in Uganda, Costa Rica, and Nicaragua across most relationship types. Multivariable logistic regression revealed consistent effects of gender, with women more likely than men to report pressuring others to drink less across most relationship types. The patterns in relation to education status and age were less consistent and varied across relationship type. Informal social control of drinking varies dramatically according to whom is most likely to pressure whom to drink less as well as the country in which people live.

Who Suggests Drinking Less? Demographic and National Differences in Informal Social Controls on Drinking

PubMed Central

Dietze, Paul; Ferris, Jason; Room, Robin

2013-01-01

Objective: The purpose of this study was to examine variation in reports of pressuring others to drink less, as a form of informal social control of drinking, across countries and different types of relationship to the respondent. Method: A cross-sectional survey was administered to 19,945 respondents ages 18–69 years in 14 countries included in the data set of the Gender, Alcohol and Culture: An International Study (GENACIS). Outcome variables were respondents’ reports of pressuring others to drink less (yes/no) across a variety of relationships (their partners, other family members, workmates, or friends). Multilevel, multivariable logistic regression analysis was carried out on each outcome variable. The fixed-effects components included the Level 1 (individual) covariates of respondent age, gender, drinking status, and education level as well as the Level 2 (country level) covariates of percentage female drinkers and purchasing power parity. The random-effects components included country and current drinking status. Results: Respondents most frequently reported pressuring male friends to drink less (18%), followed by male family members (other than partners, 15%), partners (15%), work colleagues (12%), female friends (9%), female family members (other than partners, 6%), and children (5%). There was marked variation across countries, with pressuring frequently reported in Uganda, Costa Rica, and Nicaragua across most relationship types. Multivariable logistic regression revealed consistent effects of gender, with women more likely than men to report pressuring others to drink less across most relationship types. The patterns in relation to education status and age were less consistent and varied across relationship type. Conclusions: Informal social control of drinking varies dramatically according to whom is most likely to pressure whom to drink less as well as the country in which people live. PMID:24172112

Blood pressure control for diabetic retinopathy

PubMed Central

Do, Diana V; Wang, Xue; Vedula, Satyanarayana S; Marrone, Michael; Sleilati, Gina; Hawkins, Barbara S; Frank, Robert N

2015-01-01

Background Diabetic retinopathy is a common complication of diabetes and a leading cause of visual impairment and blindness. Research has established the importance of blood glucose control to prevent development and progression of the ocular complications of diabetes. Simultaneous blood pressure control has been advocated for the same purpose, but findings reported from individual studies have supported varying conclusions regarding the ocular benefit of interventions on blood pressure. Objectives The primary aim of this review was to summarize the existing evidence regarding the effect of interventions to control or reduce blood pressure levels among diabetics on incidence and progression of diabetic retinopathy, preservation of visual acuity, adverse events, quality of life, and costs. A secondary aim was to compare classes of anti-hypertensive medications with respect to the same outcomes. Search methods We searched a number of electronic databases including CENTRAL as well as ongoing trial registries. We last searched the electronic databases on 25 April 2014. We also reviewed reference lists of review articles and trial reports selected for inclusion. In addition, we contacted investigators of trials with potentially pertinent data. Selection criteria We included in this review randomized controlled trials (RCTs) in which either type 1 or type 2 diabetic participants, with or without hypertension, were assigned randomly to intense versus less intense blood pressure control, to blood pressure control versus usual care or no intervention on blood pressure, or to different classes of anti-hypertensive agents versus placebo. Data collection and analysis Pairs of review authors independently reviewed titles and abstracts from electronic and manual searches and the full text of any document that appeared to be relevant. We assessed included trials independently for risk of bias with respect to outcomes reported in this review. We extracted data regarding trial characteristics, incidence and progression of retinopathy, visual acuity, quality of life, and cost-effectiveness at annual intervals after study entry whenever provided in published reports and other documents available from included trials. Main results We included 15 RCTs, conducted primarily in North America and Europe, that had enrolled 4157 type 1 and 9512 type 2 diabetic participants, ranging from 16 to 2130 participants in individual trials. In 10 of the 15 RCTs, one group of participants was assigned to one or more anti-hypertensive agents and the control group received placebo. In three trials, intense blood pressure control was compared to less intense blood pressure control. In the remaining two trials, blood pressure control was compared with usual care. Five of the 15 trials enrolled type 1 diabetics, and 10 trials enrolled type 2 diabetics. Six trials were sponsored entirely by pharmaceutical companies, seven trials received partial support from pharmaceutical companies, and two studies received support from government-sponsored grants and institutional support. Study designs, populations, interventions, and lengths of follow-up (range one to nine years) varied among the included trials. Overall, the quality of the evidence for individual outcomes was low to moderate. For the primary outcomes, incidence and progression of retinopathy, the quality of evidence was downgraded due to inconsistency and imprecision of estimates from individual studies and differing characteristics of participants. For primary outcomes among type 1 diabetics, one of the five trials reported incidence of retinopathy and one trial reported progression of retinopathy after 4 to 5 years of treatment and follow-up; four of the five trials reported a combined outcome of incidence and progression over the same time interval. Among type 2 diabetics, 5 of the 10 trials reported incidence of diabetic retinopathy and 3 trials reported progression of retinopathy; one of the 10 trials reported a combined outcome of incidence and progression during a 4-to 5-year follow-up period. One trial in which type 2 diabetics participated had reported no primary (or secondary) outcome targeted for this review. The evidence from these trials supported a benefit of more intensive blood pressure control intervention with respect to 4- to 5-year incidence of diabetic retinopathy (estimated risk ratio (RR) 0.80; 95% confidence interval (CI) 0.71 to 0.92) and the combined outcome of incidence and progression (estimated RR 0.78; 95% CI 0.63 to 0.97). The available evidence provided less support for a benefit with respect to 4- to 5-year progression of diabetic retinopathy (point estimate was closer to 1 than point estimates for incidence and combined incidence and progression, and the CI overlapped 1; estimated RR 0.88; 95% CI 0.73 to 1.05). The available evidence regarding progression to proliferative diabetic retinopathy or clinically significant macular edema or moderate to severe loss of best-corrected visual acuity did not support a benefit of intervention on blood pressure: estimated RRs and 95% CIs 0.95 (0.83 to 1.09) and 1.06 (0.85 to 1.33), respectively, after 4 to 5 years of follow-up. Findings within subgroups of trial participants (type 1 and type 2 diabetics; participants with normal blood pressure levels at baseline and those with elevated levels) were similar to overall findings. The adverse event reported most often (7 of 15 trials) was death, yielding an estimated RR 0.86 (95% CI 0.64 to 1.14). Hypotension was reported from three trials; the estimated RR was 2.08 (95% CI 1.68 to 2.57). Other adverse ocular events were reported from single trials. Authors’ conclusions Hypertension is a well-known risk factor for several chronic conditions in which lowering blood pressure has proven to be beneficial. The available evidence supports a beneficial effect of intervention to reduce blood pressure with respect to preventing diabetic retinopathy for up to 4 to 5 years. However, the lack of evidence to support such intervention to slow progression of diabetic retinopathy or to prevent other outcomes considered in this review, along with the relatively modest support for the beneficial effect on incidence, weakens the conclusion regarding an overall benefit of intervening on blood pressure solely to prevent diabetic retinopathy. PMID:25637717

Procedures for controlling the effect of increased tire pressure on asphalt concrete pavement damage.

DOT National Transportation Integrated Search

1988-06-01

As the axle load increases, higher tire pressures become more popular for long-haul truck operators. To collect data on tire pressures and the types of tires in use, a survey was carried out at a weigh station located on Interstate 5 in Oregon during...

[Hypertension in Mexican adults: prevalence, diagnosis and type of treatment. Ensanut MC 2016.

PubMed

Campos-Nonato, Ismael; Hernández-Barrera, Lucía; Pedroza-Tobías, Andrea; Medina, Catalina; Barquera, Simón

2018-01-01

To describe the prevalence, awareness and proportion of adults with an adequate control of hypertension. Blood pressure was measured at 8 352 adults who participated in the Ensanut MC 2016. The adults who reported having diagnosis of hypertension or had systolic blood pressure values (TAS) ≥140mmHg or diastolic blood pressure (TAD) ≥90mmHg were classified as hypertensive. Hypertension was considered controlled when blood pressure was TAS <140mmHg and TAD <90mmHg. The prevalence of hypertension was 25.5%. Of these, 40.0% were unaware of having high blood pressure. Of the hypertensive adults who had previous diagnosis of hypertension and receiving drug treatment (79.3%), 45.6% had blood pressure under control. A high percentage of adults are unaware of having hypertension and nearly half have inadequate control. The relevance of current programmes for diagnosing hypertension should be assessed, as well as the effectiveness of their control strategies.

Effects of supervised exercise on lipid profiles and blood pressure control in people with type 2 diabetes mellitus: a meta-analysis of randomized controlled trials.

PubMed

Hayashino, Yasuaki; Jackson, Jeffrey L; Fukumori, Norio; Nakamura, Fumiaki; Fukuhara, Shunichi

2012-12-01

Our study's purpose was to perform a systematic review to assess the effect of supervised exercise interventions on lipid profiles and blood pressure control. We searched electronic databases and selected studies that evaluated the effect of supervised exercise intervention on cardiovascular risk factors in adult people with type 2 diabetes. We used random effect models to derive weighted mean differences of exercise on lipid profiles and blood pressure control. Forty-two RCTs (2808 subjects) met inclusion criteria and are included in our meta-analysis. Structured exercise was associated with a change in systolic blood pressure (SBP) of -2.42 mmHg (95% CI, -4.39 to -0.45 mmHg), diastolic blood pressure (DBP) of -2.23 mmHg (95% CI, -3.21 to -1.25 mmHg), high-density lipoprotein cholesterol (HDL-C) of 0.04 mmol/L (95% CI, 0.02-0.07 mmol/L), and low-density lipoprotein cholesterol (LDL-C) of -0.16 mmol/L (95% CI, -0.30 to -0.01 mmol/L). Heterogeneity was partially explained by age, dietary co-intervention and the duration and intensity of the exercise. Supervised exercise is effective in improving blood pressure control, lowering LDL-C, and elevating HDL-C levels in people with diabetes. Physicians should recommend exercise for their adult patients with diabetes who can safely do so. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Long term effects of guar gum on metabolic control, serum cholesterol and blood pressure levels in type 2 (non-insulin-dependent) diabetic patients with high blood pressure.

PubMed

Uusitupa, M; Tuomilehto, J; Karttunen, P; Wolf, E

1984-01-01

A double-blind, placebo-controlled trial was carried out in 17 Type 2 (non-insulin-dependent) diabetic patients, treated with diet therapy alone to study the effects of guar gum on metabolic control, serum lipids, and blood pressure levels. Thirteen of the patients had drug treatment for hypertension. Guar gum was taken with meals three times a day, and the dose was gradually increased to 21 g per day. A slight, but not significant improvement was found in the metabolic control of the patients after the guar gum treatment compared to the placebo. Serum total cholesterol was 11% (p greater than 0.01) lower after the guar gum but no significant differences were found in HDL-cholesterol or serum triglycerides during the guar gum treatment compared to the placebo. Diastolic blood pressure level was significantly lower during the guar gum treatment compared to placebo. No difference was observed in systolic blood pressure levels between the guar gum and placebo treatments. The reduction of diastolic blood pressure was independent of changes in fasting blood glucose level or body weight, but could in part be due to simultaneous reduction in serum cholesterol concentration. The changes associated with guar gum supplementation suggest a reduction in the risk for cardiovascular complications in diabetic patients.

Fluidically Controlled Cargo Hook

DTIC Science & Technology

1975-03-01

Final Breadboard Fluidic Circuit IT 6 External Cargo Handling System - Cü-Sk Type Aircraft 18 7 Back Pressure Switch Response Time - Switching...On 20 8 Back Pressure Switch Response Time - Switching Off 21 9 Hook Actuator - Pressure Rise Rate 22 10 Breadboard Fluidic System Component...LINE LENGTH* FT Figure 7« Back. Pressure Switch Response Time - Switching On. ! TABLE k. INTERFACE VALVE SIGNAL TIME

Self-Care Adherence and Psychological Functioning of Older Patients with Type 2 Diabetes: Effects of Persuasion, Social Pressure, and Self-Efficacy.

PubMed

Yang, Fang; Pang, Joyce S; Cheng, Wendy J Y

2016-12-01

This cross-sectional study examined the role of family members' use of persuasion versus pressure as distinct forms of social control by which family members attempt to encourage better diabetes management among older adults with type 2 diabetes mellitus (T2DM). The study also examined how self-efficacy might moderate the relationship between persuasion/pressure, psychological functioning, and self-care adherence. Participants were 96 men and 103 women with T2DM, with a mean age of 63.3 years. Regression results show that neither persuasion nor pressure was significantly related to self-care adherence, but persuasion and pressure were associated in complex ways with diabetes-related emotional distress and depressive symptoms for which significant interaction effects were found. Patients with lower self-efficacy benefited from persuasion, but were adversely affected by pressure. In contrast, patients with higher self-efficacy were adversely affected by persuasion, but were less negatively affected by pressure. Findings highlight the importance of reducing pressure-based social control, considering patients' self-efficacy when family members seek to influence patients' self-care behaviors, and targeting patient-family interactions in future interventions.

In situ x-ray diffraction observation of multiple texture turnovers in sputtered Cr films

NASA Astrophysics Data System (ADS)

Zhao, Z. B.; Rek, Z. U.; Yalisove, S. M.; Bilello, J. C.

2004-11-01

A series of Cr films were deposited onto native oxides of (100) Si substrates via a confocal deposition geometry in a magnetron sputter chamber. The film growth chamber was incorporated with an in situ x-ray diffraction system, which allowed the collection of x-ray diffraction data on the growing film in a quasi real time fashion without interruption of film deposition. The in situ x-ray diffraction, coupled with other ex situ characterization techniques, was used to study structural evolutions of the Cr films deposited at various Ar pressures. It was observed that the evolution of the crystallographic structures of Cr films was very sensitive to both deposition conditions and film thickness. With the confocal deposition geometry, the Cr films developed various types of out-of-plane textures. In addition to the (110) and (100) types of textures commonly reported for vapor deposited Cr films, the (111) and (112) types of textures were also observed. The film deposited at low Ar pressure (2 mTorr) developed strong (111) type texture. With the increase in either Ar pressure or film thickness, the Cr films tended to develop (112) and (100) types of texture. At high Ar pressures (>10 mTorr), several changes in texture type with increasing film thickness were observed. The sequence can be described as (110)-->(112)-->(100). The strong tendency for these films to ultimately assume the (100) type of texture could be related to significant rises in substrate temperatures during the late stages of film growth with high Ar pressures. The observation of the multiple texture type changes suggests that the evolution of Cr films is controlled by complex growth kinetics. The competitive growth of grains with different orientations can be altered not only by controllable deposition parameters such as Ar pressure, but also by the variations of in situ film attributes (e.g., residual stress and substrate temperature) occurring concurrently with film growth.

Functional Changes of Diaphragm Type Shunt Valves Induced by Pressure Pulsation

NASA Astrophysics Data System (ADS)

Lee, Chong-Sun; Suh, Chang-Min; Ra, Young-Shin

Shunt valves used to treat patients with hydrocephalus were tested to investigate influence of pressure pulsation on their flow control characteristics. Our focus was on flow dynamic and functional changes of the small and thin diaphragms in the valves that serve as the main flow control mechanism and are made from silicone elastomer. Firstly, pressure-flow control curves were compared under pulsed and steady flow (without pulsation) conditions. Secondly, functional changes of the valves were tested after a long-term continuous pulsation with a peristaltic pump. Thirdly, flushing procedures selectively conducted by neurosurgeons were simulated with a fingertip pressed on the dome of the valves. As 20cc/hr of flow rate was adjusted at a constant pressure, application of 40mmH2O of pressure pulse increased flow rate through shunt valves more than 60%. As a 90cm length silicone catheter was connected to the valve outlet, increase in the flow rate was substantially reduced to 17.5%. Pressure-flow control characteristics of some valves showed significant changes after twenty-eight days of pressure pulsation at 1.0 Hz under 50.0cc/hr of flow rate. Flushing simulation resulted in temporary decrease in the pressure level. It took three hours to fully recover the normal pressure-flow control characteristics after the flushing. Our results suggest that shunt valves with a thin elastic diaphragm as the main flow control mechanism are sensitive to intracranial pressure pulsation or pressure spikes enough to change their pressure-flow control characteristics.

Implementing Low-Cost, Community-Based Exercise Programs for Middle-Aged and Older Patients with Type 2 Diabetes: What Are the Benefits for Glycemic Control and Cardiovascular Risk?

PubMed Central

Reis, Victor Machado; Themudo-Barata, Jose Luis

2017-01-01

Background: The purpose of this study was to analyze the effects of a long-term, community-based, combined exercise program developed with low-cost exercise strategies on glycemic control and cardiovascular risk factors in middle-aged and older patients with type 2 diabetes. Methods: Participants (n = 124; 63.25 ± 7.20 years old) engaged in either a 9-month supervised exercise program (n = 39; consisting of combined aerobic, resistance, agility/balance, and flexibility exercise; three sessions per week; 70 min per session) or a control group (n = 85) who maintained their usual care. Glycemic control, lipid profile, blood pressure, anthropometric profile, and the 10-year risk of coronary artery disease were assessed before and after the 9-month intervention. Results: A significant time * group interaction effect (p < 0.001) was identified in the values of the glycated hemoglobin, fasting plasma glucose, total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, systolic blood pressure, diastolic blood pressure, body mass index, waist circumference, and the 10-year risk of coronary artery disease. Conclusions: A long-term, community-based, combined exercise program developed with low-cost exercise strategies was effective in inducing significant benefits on glycemic control, lipid profile, blood pressure, anthropometric profile, and the 10-year risk of coronary artery disease in middle-aged and older patients with type 2 diabetes. Clinical Trial Identification Number: ISRCTN09240628. PMID:28902144

Intensive systolic blood pressure control and incident chronic kidney disease in people with and without diabetes mellitus: secondary analyses of two randomised controlled trials.

PubMed

Beddhu, Srinivasan; Greene, Tom; Boucher, Robert; Cushman, William C; Wei, Guo; Stoddard, Gregory; Ix, Joachim H; Chonchol, Michel; Kramer, Holly; Cheung, Alfred K; Kimmel, Paul L; Whelton, Paul K; Chertow, Glenn M

2018-07-01

Guidelines, including the 2017 American College of Cardiology and American Heart Association blood pressure guideline, recommend tighter control of systolic blood pressure in people with type 2 diabetes. However, it is unclear whether intensive lowering of systolic blood pressure increases the incidence of chronic kidney disease in this population. We aimed to compare the effects of intensive systolic blood pressure control on incident chronic kidney disease in people with and without type 2 diabetes. The Systolic Blood Pressure Intervention Trial (SPRINT) tested the effects of a systolic blood pressure goal of less than 120 mm Hg (intensive intervention) versus a goal of less than 140 mm Hg (standard intervention) in people without diabetes. The Action to Control Cardiovascular Risk in Diabetes (ACCORD) blood pressure trial tested a similar systolic blood pressure intervention in people with type 2 diabetes. Our study is a secondary analysis of limited access datasets from SPRINT and the ACCORD trial obtained from the National Institutes of Health. In participants without chronic kidney disease at baseline (n=4311 in the ACCORD trial; n=6715 in SPRINT), we related systolic blood pressure interventions (intensive vs standard) to incident chronic kidney disease (defined as >30% decrease in estimated glomerular filtration rate [eGFR] to <60 mL/min per 1·73 m 2 ). These trials are registered with ClinicalTrials.gov, numbers NCT01206062 (SPRINT) and NCT00000620 (ACCORD trial). The average difference in systolic blood pressure between intensive and standard interventions was 13·9 mm Hg (95% CI 13·4-14·4) in the ACCORD trial and 15·2 mm Hg (14·8-15·6) in SPRINT. At 3 years, the cumulative incidence of chronic kidney disease in the ACCORD trial was 10·0% (95% CI 8·8-11·4) with the intensive intervention and 4·1% (3·3-5·1) with the standard intervention (absolute risk difference 5·9%, 95% CI 4·3-7·5). Corresponding values in SPRINT were 3·5% (95% CI 2·9-4·2) and 1·0% (0·7-1·4; absolute risk difference 2·5%, 95% CI 1·8-3·2). The absolute risk difference was significantly higher in the ACCORD trial than in SPRINT (p=0·0001 for interaction). Intensive lowering of systolic blood pressure increased the risk of incident chronic kidney disease in people with and without type 2 diabetes. However, the absolute risk of incident chronic kidney disease was higher in people with type 2 diabetes. Our findings suggest the need for vigilance in monitoring kidney function during intensive antihypertensive drug treatment, particularly in adults with diabetes. Long-term studies are needed to understand the clinical implications of antihypertensive treatment-related reductions in eGFR. National Institutes of Health. Copyright © 2018 Elsevier Ltd. All rights reserved.

Effect of aviation fuel type and fuel injection conditions on the spray characteristics of pressure swirl and hybrid air blast fuel injectors

NASA Astrophysics Data System (ADS)

Feddema, Rick

Feddema, Rick T. M.S.M.E., Purdue University, December 2013. Effect of Aviation Fuel Type and Fuel Injection Conditions on the Spray Characteristics of Pressure Swirl and Hybrid Air Blast Fuel Injectors. Major Professor: Dr. Paul E. Sojka, School of Mechanical Engineering Spray performance of pressure swirl and hybrid air blast fuel injectors are central to combustion stability, combustor heat management, and pollutant formation in aviation gas turbine engines. Next generation aviation gas turbine engines will optimize spray atomization characteristics of the fuel injector in order to achieve engine efficiency and emissions requirements. Fuel injector spray atomization performance is affected by the type of fuel injector, fuel liquid properties, fuel injection pressure, fuel injection temperature, and ambient pressure. Performance of pressure swirl atomizer and hybrid air blast nozzle type fuel injectors are compared in this study. Aviation jet fuels, JP-8, Jet A, JP-5, and JP-10 and their effect on fuel injector performance is investigated. Fuel injector set conditions involving fuel injector pressure, fuel temperature and ambient pressure are varied in order to compare each fuel type. One objective of this thesis is to contribute spray patternation measurements to the body of existing drop size data in the literature. Fuel droplet size tends to increase with decreasing fuel injection pressure, decreasing fuel injection temperature and increasing ambient injection pressure. The differences between fuel types at particular set conditions occur due to differences in liquid properties between fuels. Liquid viscosity and surface tension are identified to be fuel-specific properties that affect the drop size of the fuel. An open aspect of current research that this paper addresses is how much the type of aviation jet fuel affects spray atomization characteristics. Conventional aviation fuel specifications are becoming more important with new interest in alternative fuels. Optical patternation data and line of sight laser diffraction data show that there is significant difference between jet fuels. Particularly at low fuel injection pressures (0.345 MPa) and cold temperatures (-40 C), the patternation data shows that the total surface area in the spray at 38.1 mm from the pressure swirl injector for the JP-10 fuel type is one-sixth the amount of the JP-8. Finally, this study compares the atomizer performance of a pressure swirl nozzle to a hybrid air blast nozzle. The total surface area for both the hybrid air blast nozzle and the pressure swirl nozzle show a similar decline in atomization performance at low fuel injection pressures and cold temperatures. However, the optical patternator radial profile data and the line of sight laser diffraction data show that the droplet size and spray distribution data are less affected by injection conditions and fuel type in the hybrid air blast nozzle, than they are in the pressure swirl nozzle. One explanation is that the aerodynamic forces associated with the swirler on the hybrid air blast nozzle control the distribution droplets in the spray. This is in contrast to the pressure swirl nozzle droplet distribution that is controlled by internal geometry and droplet ballistics.

Chocolate Classification by an Electronic Nose with Pressure Controlled Generated Stimulation

PubMed Central

Valdez, Luis F.; Gutiérrez, Juan Manuel

2016-01-01

In this work, we will analyze the response of a Metal Oxide Gas Sensor (MOGS) array to a flow controlled stimulus generated in a pressure controlled canister produced by a homemade olfactometer to build an E-nose. The built E-nose is capable of chocolate identification between the 26 analyzed chocolate bar samples and four features recognition (chocolate type, extra ingredient, sweetener and expiration date status). The data analysis tools used were Principal Components Analysis (PCA) and Artificial Neural Networks (ANNs). The chocolate identification E-nose average classification rate was of 81.3% with 0.99 accuracy (Acc), 0.86 precision (Prc), 0.84 sensitivity (Sen) and 0.99 specificity (Spe) for test. The chocolate feature recognition E-nose gives a classification rate of 85.36% with 0.96 Acc, 0.86 Prc, 0.85 Sen and 0.96 Spe. In addition, a preliminary sample aging analysis was made. The results prove the pressure controlled generated stimulus is reliable for this type of studies. PMID:27775628

Chocolate Classification by an Electronic Nose with Pressure Controlled Generated Stimulation.

PubMed

Valdez, Luis F; Gutiérrez, Juan Manuel

2016-10-20

In this work, we will analyze the response of a Metal Oxide Gas Sensor (MOGS) array to a flow controlled stimulus generated in a pressure controlled canister produced by a homemade olfactometer to build an E-nose. The built E-nose is capable of chocolate identification between the 26 analyzed chocolate bar samples and four features recognition (chocolate type, extra ingredient, sweetener and expiration date status). The data analysis tools used were Principal Components Analysis (PCA) and Artificial Neural Networks (ANNs). The chocolate identification E-nose average classification rate was of 81.3% with 0.99 accuracy (Acc), 0.86 precision (Prc), 0.84 sensitivity (Sen) and 0.99 specificity (Spe) for test. The chocolate feature recognition E-nose gives a classification rate of 85.36% with 0.96 Acc, 0.86 Prc, 0.85 Sen and 0.96 Spe. In addition, a preliminary sample aging analysis was made. The results prove the pressure controlled generated stimulus is reliable for this type of studies.

Multi-stage versus single-stage inflation and deflation cycle for alternating low pressure air mattresses to prevent pressure ulcers in hospitalised patients: a randomised-controlled clinical trial.

PubMed

Demarré, L; Beeckman, D; Vanderwee, K; Defloor, T; Grypdonck, M; Verhaeghe, S

2012-04-01

The duration and the amount of pressure and shear must be reduced in order to minimize the risk of pressure ulcer development. Alternating low pressure air mattresses with multi-stage inflation and deflation cycle of the air cells have been developed to relieve pressure by sequentially inflating and deflating the air cells. Evidence about the effectiveness of this type of mattress in clinical practice is lacking. This study aimed to compare the effectiveness of an alternating low pressure air mattress that has a standard single-stage inflation and deflation cycle of the air cells with an alternating low pressure air mattress with multi-stage inflation and deflation cycle of the air cells. A randomised controlled trial was performed in a convenience sample of 25 wards in five hospitals in Belgium. In total, 610 patients were included and randomly assigned to the experimental group (n=298) or the control group (n=312). In the experimental group, patients were allocated to an alternating low pressure air mattress with multi-stage inflation and deflation cycle of the air cells. In the control group, patients were allocated to an alternating low pressure air mattress with a standard single-stage inflation and deflation cycle of the air cells. The outcome was defined as cumulative pressure ulcer incidence (Grade II-IV). An intention-to-treat analysis was performed. There was no significant difference in cumulative pressure ulcer incidence (Grade II-IV) between both groups (Exp.=5.7%, Contr.=5.8%, p=0.97). When patients developed a pressure ulcer, the median time was 5.0 days in the experimental group (IQR=3.0-8.5) and 8.0 days in the control group (IQR=3.0-8.5) (Mann-Whitney U-test=113, p=0.182). The probability to remain pressure ulcer free during the observation period in this trial did not differ significantly between the experimental group and the control group (log-rank χ(2)=0.013, df=1, p=0.911). An alternating low pressure air mattress with multi-stage inflation and deflation of the air cells does not result in a significantly lower pressure ulcer incidence compared to an alternating low pressure air mattress with a standard single-stage inflation and deflation cycle of the air cells. Both alternating mattress types are equally effective to prevent pressure ulcer development. © 2011 Elsevier Ltd. All rights reserved.

A biomechanical study of laparoscopic 4S-modified Roeder and Weston knot strength in 3-0 polyglactin 910 and 3-0 polydioxanone.

PubMed

Fugazzi, Russell W; Fransson, Boel A; Curran, Katie M; Davis, Howard M; Gay, John M

2013-02-01

To (1) evaluate biomechanical strength of 4 different laparoscopic knots using 2 suture types, and (2) evaluate carotid artery ligature bursting pressure of 2 knots using a single suture type. Biomechanical materials testing. Suture material (3-0 polydioxanone, 3-0 polyglactin 910). Four knot types were tested: 4S-modified Roeder (4SMR) Weston plus 3 square throws (W3S); Weston plus 3 granny throws (W3G); and a 4 square throw knot as a control (control); 24 specimens of each knot type were tied with 3-0 polyglactin 910 and 24 of 3 knot types (4SMR, W3S, control) were tied with 3-0 polydioxanone. Suture loop constructs were tested to 3 mm displacement failure and ultimate failure. Carotid artery ligation bursting pressure was tested using 10 samples each of 4SMR and W3S knots with 3-0 polyglactin 910. The W3S, W3G, and controls were similar. The 4SMR was similar to W3S using 3-0 PDS but the 4SMR had lower load to failure and greater elongation than the Weston using 3-0 polyglactin 910. The 4SMR had a higher slippage rate with 3-0 polyglactin 910. All ligatures withstood supraphysiologic pressures. Surgeons using 3-0 polyglactin 910 should consider using the Weston knot with added throws during laparoscopic procedures. © Copyright 2012 by The American College of Veterinary Surgeons.

Design and development of low pressure evaporator/condenser unit for water-based adsorption type climate control systems

NASA Astrophysics Data System (ADS)

Venkataramanan, Arjun; Rios Perez, Carlos A.; Hidrovo, Carlos H.

2016-11-01

Electric vehicles (EVs) are the future of clean transportation and driving range is one of the important parameters which dictates its marketability. In order to increase driving range, electrical battery energy consumption should be minimized. Vapor-compression refrigeration systems currently employed in EVs for climate control consume a significant fraction of the battery charge. Thus, by replacing this traditional heating ventilation and air-conditioning system with an adsorption based climate control system one can have the capability of increasing the drive range of EVs.The Advanced Thermo-adsorptive Battery (ATB) for climate control is a water-based adsorption type refrigeration cycle. An essential component of the ATB is a low pressure evaporator/condenser unit (ECU) which facilitates both the evaporation and condensation processes. The thermal design of the ECU relies predominantly on the accurate prediction of evaporation/boiling heat transfer coefficients since the standard correlations for predicting boiling heat transfer coefficients have large uncertainty at the low operating pressures of the ATB. This work describes the design and development of a low pressure ECU as well as the thermal performance of the actual ECU prototype.

Critical Differences between the Type-A Prone and Type-A Personalitites.

ERIC Educational Resources Information Center

Cassel, Russell N.; Cassel, Susie L.

1984-01-01

Type-A Prone and Type-A personalities were assessed on the basis of the Cassel Type-A Personality Assessment Profile. Statistical data analysis indicated differences in positive lifestyle, blood pressure, and self-control and no differences in negative lifestyle, pulse rate, or peripheral temperature. Type-A Prone and Type-A norm profiles were…

Design and Development of a Pressure Transducer for High Hydrostatic Pressure Measurements up to 200 MPa

NASA Astrophysics Data System (ADS)

Kumar, Anuj; Yadav, Sanjay; Agarwal, Ravinder

2017-08-01

A number of pressure transducers, based on strain gauge, capacitance/inductance type, frequency resonators, are commercially available and are being used for sensing and producing an electrical output proportional to applied pressure. These sensors have their own advantages and limitations due to operational ease, measurement uncertainty and the costs. Strain gauge type transducers are now well established devices for accurate and precise measurement of pressure within measurement uncertainty up to 0.1 % of full scale. In the present research work, an indigenous strain gauge pressure transducer has been designed, developed, tested and calibrated for pressure measurement up to 200 MPa. The measurement uncertainty estimated using the pressure transducer was found better than 0.1 % of full scale. This transducer was developed using four foil type strain gauges, bonded, two in axial direction while other two in radial direction, to the controlled stress zones of a tubular maraging steel active cylinder working also as diaphragm. The strain gages were then connected to a Wheatstone bridge arrangement to measure stress generated strains. The pressure was applied through matching connector designed in the same tubular transducer active element. The threaded unique design in a single piece through collar, ferule and tubing arrangement provides leak proof pressure connections with external devices without using additional seals. The calibration and performance checking of the pressure transducer was carried out using dead weight type national pressure standard using the internationally accepted calibration procedure.

Pressure-induced enhancement in the thermoelectric properties of monolayer and bilayer SnSe2

NASA Astrophysics Data System (ADS)

Zou, Daifeng; Yu, Chuanbin; Li, Yuhao; Ou, Yun; Gao, Yongyi

2018-03-01

The electronic structures of monolayer and bilayer SnSe2 under pressure were investigated by using first-principles calculations including van der Waals interactions. For monolayer SnSe2, the variation of electronic structure under pressure is controlled by pressure-dependent lattice parameters. For bilayer SnSe2, the changes in electronic structure under pressure are dominated by intralayer and interlayer atomic interactions. The n-type thermoelectric properties of monolayer and bilayer SnSe2 under pressure were calculated on the basis of the semi-classical Boltzmann transport theory. It was found that the electrical conductivity of monolayer and bilayer SnSe2 can be enhanced under pressure, and such dependence can be attributed to the pressure-induced changes of the Se-Sn antibonding states in conduction band. Finally, the doping dependence of power factors of n-type monolayer and bilayer SnSe2 at three different pressures were estimated, and the results unveiled that thermoelectric performance of n-type monolayer and bilayer SnSe2 can be improved by applying external pressure. This study benefits to understand the nature of the transport properties for monolayer and bilayer SnSe2 under pressure, and it offers valuable insight for designing high-performance thermoelectric few-layered SnSe2 through strain engineering induced by external pressure.

Pressure-induced enhancement in the thermoelectric properties of monolayer and bilayer SnSe2.

PubMed

Zou, Daifeng; Yu, Chuanbin; Li, Yuhao; Ou, Yun; Gao, Yongyi

2018-03-01

The electronic structures of monolayer and bilayer SnSe 2 under pressure were investigated by using first-principles calculations including van der Waals interactions. For monolayer SnSe 2 , the variation of electronic structure under pressure is controlled by pressure-dependent lattice parameters. For bilayer SnSe 2 , the changes in electronic structure under pressure are dominated by intralayer and interlayer atomic interactions. The n -type thermoelectric properties of monolayer and bilayer SnSe 2 under pressure were calculated on the basis of the semi-classical Boltzmann transport theory. It was found that the electrical conductivity of monolayer and bilayer SnSe 2 can be enhanced under pressure, and such dependence can be attributed to the pressure-induced changes of the Se-Sn antibonding states in conduction band. Finally, the doping dependence of power factors of n -type monolayer and bilayer SnSe 2 at three different pressures were estimated, and the results unveiled that thermoelectric performance of n -type monolayer and bilayer SnSe 2 can be improved by applying external pressure. This study benefits to understand the nature of the transport properties for monolayer and bilayer SnSe 2 under pressure, and it offers valuable insight for designing high-performance thermoelectric few-layered SnSe 2 through strain engineering induced by external pressure.

Stress-controlled thermoelectric module for energy harvesting and its application for the significant enhancement of the power factor of Bi2Te3-based thermoelectrics

NASA Astrophysics Data System (ADS)

Korobeinikov, Igor V.; Morozova, Natalia V.; Lukyanova, Lidia N.; Usov, Oleg A.; Kulbachinskii, Vladimir A.; Shchennikov, Vladimir V.; Ovsyannikov, Sergey V.

2018-01-01

We propose a model of a thermoelectric module in which the performance parameters can be controlled by applied tuneable stress. This model includes a miniature high-pressure anvil-type cell and a specially designed thermoelectric module that is compressed between two opposite anvils. High thermally conductive high-pressure anvils that can be made, for instance, of sintered technical diamonds with enhanced thermal conductivity, would enable efficient heat absorption or rejection from a thermoelectric module. Using a high-pressure cell as a prototype of a stress-controlled thermoelectric converter, we investigated the effect of applied high pressure on the power factors of several single-crystalline thermoelectrics, including binary p-type Bi2Te3, and multi-component (Bi,Sb)2Te3 and Bi2(Te,Se,S)3 solid solutions. We found that a moderate applied pressure of a few GPa significantly enhances the power factors of some of these thermoelectrics. Thus, they might be more efficiently utilized in stress-controlled thermoelectric modules. In the example of one of these thermoelectrics crystallizing in the same rhombohedral structure, we examined the crystal lattice stability under moderate high pressures. We uncovered an abnormal compression of the rhombohedral lattice of (Bi0.25,Sb0.75)2Te3 along the c-axis in a hexagonal unit cell, and detected two phase transitions to the C2/m and C2/c monoclinic structures above 9.5 and 18 GPa, respectively.

Widespread Pressure Pain Hypersensitivity Is Similar in Women With Frequent Episodic and Chronic Tension-Type Headache: A Blinded Case-Control Study.

PubMed

Palacios Ceña, María; Castaldo, Matteo; Kelun Wang; Torelli, Paola; Pillastrini, Paolo; Fernández-de-Las-Peñas, César; Arendt-Nielsen, Lars

2017-02-01

To investigate differences in widespread pressure pain hyperalgesia in the trigemino-cervical and extra-trigeminal (distant pain-free) regions in women with frequent episodic (FETTH) and chronic (CTTH) tension-type headache. It seems that people with tension-type headache exhibit central sensitization. No study has investigated differences between FETTH and CTTH in terms of widespread pressure pain hypersensitivity. Forty-three women with FETTH, 42 with CTTH, and 45 women without headache diagnosis were recruited. Pressure pain thresholds (PPTs) were bilaterally assessed over trigeminal area (ie, temporalis muscle), extra-trigeminal (ie, C5/C6 zygapophyseal joint), and two distant points (ie, second metacarpal and tibialis anterior muscle) by a blinded assessor. Clinical features of the headache were collected with a 4-week headache diary. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS). The ANCOVA revealed that PPTs were significantly decreased bilaterally over trigeminal (mean differences ranging from 97.5 to 101.5 kPa), extra-trigeminal (from 94.3 to 114.5 kPa), and distant points (from 99.4 to 208.6 kPa) in both FETTH and CTTH groups compared with controls (all, P < .001). No differences between FETTH and CTTH were observed (all points, P > .217). Anxiety (all, P > .803) or depression (P > .206) did not influence pressure pain hyperalgesia. No associations between widespread pressure hypersensitivity and headache features were observed (all, P > .110). Current results suggest the presence of similar local and widespread pressure hyperalgesia, not associated with anxiety or depression, in women with FETTH and CTTH supporting that localized and central manifestations are involved in both the episodic and chronic forms of tension-type headache. © 2016 American Headache Society.

Pressure effect on dissimilatory sulfate reduction

NASA Astrophysics Data System (ADS)

Williamson, A. J.; Carlson, H. K.; Coates, J. D.

2015-12-01

Biosouring is the production of H2S by sulfate reducing microorganisms (SRM) in-situ or in the produced fluids of oil reservoirs. Sulfide is explosive, toxic and corrosive which can trigger equipment and transportation failure, leading to environmental catastrophe. As oil exploration and reservoir development continue, subsequent enhanced recovery is occurring in progressively deeper formations and typical oil reservoir pressures range from 10-50 MPa. Therefore, an understanding of souring control effects will require an accurate understanding of the influence of pressure on SRM metabolism and the efficacy of souring control treatments at high pressure. Considerable work to date has focussed on souring control at ambient pressure; however, the influence of pressure on biogeochemical processes and souring treatments in oil reservoirs is poorly understood. To explore the impact of pressure on SRM, wild type Desulfovibrio alaskensis G20 (isolated from a producing oil well in Ventura County, California) was grown under a range of pressures (0.1-14 MPa) at 30 °C. Complete sulfate reduction occurred in all pressures tested within 3 days, but microbial growth was inhibited with increasing pressure. Bar-seq identified several genes associated with flagella biosynthesis (including FlhB) and assembly as important for survival at elevated pressure and fitness was confirmed using individual transposon mutants. Flagellar genes have previously been implicated with biofilm formation and confocal microscopy on glass slides incubated with wild type D. alaskensis G20 showed more biomass associated with surfaces under pressure, highlighting the link between pressure, flagellar and biofilm formation. To determine the effect of pressure on the efficacy of SRM inhibitors, IC50 experiments were conducted and D. alaskensis G20 showed a greater resistance to nitrate and the antibiotic chloramphenicol, but a lower resistance to perchlorate. These results will be discussed in the context of deep subsurface microbiology and oil reservoir biosouring. Overall, this work furthers our understanding of oil reservoir biogeochemistry and highlights the impact of pressure on biofilm formation and biosouring strategies.

Evaluation of anticipatory signal to steam generator pressure control program for 700 MWe Indian pressurized heavy water reactor

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

Pahari, S.; Hajela, S.; Rammohan, H. P.

2012-07-01

700 MWe Indian Pressurized Heavy Water Reactor (IPHWR) is horizontal channel type reactor with partial boiling at channel outlet. Due to boiling, it has a large volume of vapor present in the primary loops. It has two primary loops connected with the help of pressurizer surge line. The pressurizer has a large capacity and is partly filled by liquid and partly by vapor. Large vapor volume improves compressibility of the system. During turbine trip or load rejection, pressure builds up in Steam Generator (SG). This leads to pressurization of Primary Heat Transport System (PHTS). To control pressurization of SG andmore » PHTS, around 70% of the steam generated in SG is dumped into the condenser by opening Condenser Steam Dump Valves (CSDVs) and rest of the steam is released to the atmosphere by opening Atmospheric Steam Discharge Valves (ASDVs) immediately after sensing the event. This is accomplished by adding anticipatory signal to the output of SG pressure controller. Anticipatory signal is proportional to the thermal power of reactor and the proportionality constant is set so that SG pressure controller's output jacks up to ASDV opening range when operating at 100% FP. To simulate this behavior for 700 MWe IPHWR, Primary and secondary heat transport system is modeled. SG pressure control and other process control program have also been modeled to capture overall plant dynamics. Analysis has been carried out with 3-D neutron kinetics coupled thermal hydraulic computer code ATMIKA.T to evaluate the effect of the anticipatory signal on PHT pressure and over all plant dynamics during turbine trip in 700 MWe IPHWR. This paper brings out the results of the analysis with and without considering anticipatory signal in SG pressure control program during turbine trip. (authors)« less

The effect of different types of music on patients' preoperative anxiety: A randomized controlled trial.

PubMed

Uğraş, Gülay Altun; Yıldırım, Güven; Yüksel, Serpil; Öztürkçü, Yusuf; Kuzdere, Mustafa; Öztekin, Seher Deniz

2018-05-01

The purpose of this study was to determine effect of three different types of music on patients' preoperative anxiety. This randomized controlled trial included 180 patients who were randomly divided into four groups. While the control group didn't listen to music, the experimental groups respectively listened to natural sounds, Classical Turkish or Western Music for 30 min. The State Anxiety Inventory (STAI-S), systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR) and cortisol levels were checked. The post-music STAI-S, SBP, DBP, HR and cortisol levels of the patients in music groups were significantly lower than pre-music time. All types of music decreased STAI-S, SBP, and cortisol levels; additionally natural sounds reduced DBP; Classical Turkish Music also decreased DBP, and HR. All types of music had an effect on reducing patients' preoperative anxiety, and listening to Classical Turkish Music was particularly the most effective one. Copyright © 2018 Elsevier Ltd. All rights reserved.

Flow Control and Measurement in Electric Propulsion Systems: Towards an AIAA Reference Standard

NASA Technical Reports Server (NTRS)

Snyder, John Steven; Baldwin, Jeff; Frieman, Jason D.; Walker, Mitchell L. R.; Hicks, Nathan S.; Polzin, Kurt A.; Singleton, James T.

2013-01-01

Accurate control and measurement of propellant flow to a thruster is one of the most basic and fundamental requirements for operation of electric propulsion systems, whether they be in the laboratory or on flight spacecraft. Hence, it is important for the electric propulsion community to have a common understanding of typical methods for flow control and measurement. This paper addresses the topic of propellant flow primarily for the gaseous propellant systems which have dominated laboratory research and flight application over the last few decades, although other types of systems are also briefly discussed. While most flight systems have employed a type of pressure-fed flow restrictor for flow control, both thermal-based and pressure-based mass flow controllers are routinely used in laboratories. Fundamentals and theory of operation of these types of controllers are presented, along with sources of uncertainty associated with their use. Methods of calibration and recommendations for calibration processes are presented. Finally, details of uncertainty calculations are presented for some common calibration methods and for the linear fits to calibration data that are commonly used.

Community-based peer support significantly improves metabolic control in people with Type 2 diabetes in Yaoundé, Cameroon.

PubMed

Assah, F K; Atanga, E N; Enoru, S; Sobngwi, E; Mbanya, J C

2015-07-01

To examine the effectiveness of a community-based multilevel peer support intervention in addition to usual diabetes care on improving glycaemic levels, blood pressure and lipids in patients with Type 2 diabetes in Yaoundé, Cameroon. A total of 96 subjects with poorly controlled Type 2 diabetes (intervention group) and 96 age- and sex-matched controls were recruited and followed up over 6 months. The intervention subjects underwent a peer support intervention through peer-led group meetings, personal encounters and telephone calls. Both intervention subjects and controls continued their usual clinical care. HbA1c , blood pressure, blood lipids and self-care behaviours were measured at 0 and 6 months. There was significant reduction in HbA1c in the intervention group [-33 mmol/mol (-3.0%)] compared with controls [-14 mmol/mol (-1.3%)]; P < 0.001. Peer support also led to significant reductions in fasting blood sugar (-0.83 g/l P < 0.001), cholesterol (-0.54 g/l P < 0.001), HDL (-0.09 g/l, P < 0.001), BMI (-2.71 kg/m² P < 0.001) and diastolic pressure (-6.77 mmHg, P < 0.001) over the 6-month period. Also, diabetes self-care behaviours in the intervention group improved significantly over the 6 months of peer support. Community-based peer support, in addition to usual care, significantly improved metabolic control in patients with uncontrolled Type 2 diabetes in Yaoundé, Cameroon. This could provide a model for optimizing diabetes care and control in other settings with limited healthcare and financial resources. © 2015 The Authors. Diabetic Medicine © 2015 Diabetes UK.

Validation of two-phase CFD models for propellant tank self-pressurization: Crossing fluid types, scales, and gravity levels

NASA Astrophysics Data System (ADS)

Kassemi, Mohammad; Kartuzova, Olga; Hylton, Sonya

2018-01-01

This paper examines our computational ability to capture the transport and phase change phenomena that govern cryogenic storage tank pressurization and underscores our strengths and weaknesses in this area in terms of three computational-experimental validation case studies. In the first study, 1g pressurization of a simulant low-boiling point fluid in a small scale transparent tank is considered in the context of the Zero-Boil-Off Tank (ZBOT) Experiment to showcase the relatively strong capability that we have developed in modelling the coupling between the convective transport and stratification in the bulk phases with the interfacial evaporative and condensing heat and mass transfer that ultimately control self-pressurization in the storage tank. Here, we show that computational predictions exhibit excellent temporal and spatial fidelity under the moderate Ra number - high Bo number convective-phase distribution regimes. In the second example, we focus on 1g pressurization and pressure control of the large-scale K-site liquid hydrogen tank experiment where we show that by crossing fluid types and physical scales, we enter into high Bo number - high Ra number flow regimes that challenge our ability to predict turbulent heat and mass transfer and their impact on the tank pressurization correctly, especially, in the vapor domain. In the final example, we examine pressurization results from the small scale simulant fluid Tank Pressure Control Experiment (TCPE) performed in microgravity to underscore the fact that in crossing into a low Ra number - low Bo number regime in microgravity, the temporal evolution of the phase front as affected by the time-dependent residual gravity and impulse accelerations becomes an important consideration. In this case detailed acceleration data are needed to predict the correct rate of tank self-pressurization.

49 CFR 178.70 - Approval of UN pressure receptacles.

Code of Federal Regulations, 2010 CFR

2010-10-01

... facility as specified in § 178.69. (7) Design specifications and manufacturing drawings, showing components... compliance with the applicable pressure receptacle design standard. (8) Manufacturing procedures and any applicable standards that describe in detail the manufacturing processes and control. (9) Design type...

Acute baroreflex resetting: differential control of pressure and nerve activity.

PubMed

Drummond, H A; Seagard, J L

1996-03-01

This study evaluated acute resetting of carotid baroreflex control of arterial blood pressure and renal or thoracic sympathetic nerve activity in thiopental-anesthetized mongrel dogs with the use of a vascularly isolated carotid sinus preparation, the experimental model used previously to characterize acute resetting in carotid baroreceptor afferent fibers. Carotid baroreceptors were conditioned with a pulsatile pressure for 20 minutes at three pressure ranges: low (50 to 75 mm Hg), mid (100 to 125), or high (150 to 175). Blood pressure and nerve activity were recorded in response to slow ramp increases in sinus pressure; nonlinear regression and best-fit analyses were used for determination of curve fit parameters of the blood pressure and nerve activity versus sinus pressure response curves. Carotid sinus pressure thresholds for blood pressure and renal nerve activity responses at all conditioning pressures were significantly different; however, only the pressure threshold for thoracic nerve activity at the low conditioning pressure was significantly different from the responses at other conditioning pressures. Average renal activity resetting (0.506 +/- 0.072) was significantly greater than blood pressure resetting (0.335 +/- 0.046) in the same dogs, and thoracic activity (0.200 +/- 0.057) was not different from blood pressure resetting (0.194 +/- 0.031) in the same dogs. In a previous investigation, our laboratory had demonstrated that type 1 carotid baroreceptors acutely reset at a value of about 0.15. These results indicate that (1) renal and thoracic nerve activities and blood pressure acutely reset to a greater degree than type 1 carotid baroreceptors and that (2) renal activity acutely resets to a greater degree than blood pressure and thoracic nerve activity.

A microprocessor controlled pressure scanning system

NASA Technical Reports Server (NTRS)

Anderson, R. C.

1976-01-01

A microprocessor-based controller and data logger for pressure scanning systems is described. The microcomputer positions and manages data from as many as four 48-port electro-mechanical pressure scanners. The maximum scanning rate is 80 pressure measurements per second (20 ports per second on each of four scanners). The system features on-line calibration, position-directed data storage, and once-per-scan display in engineering units of data from a selected port. The system is designed to be interfaced to a facility computer through a shared memory. System hardware and software are described. Factors affecting measurement error in this type of system are also discussed.

Blood pressure directly correlates with blood viscosity in diabetes type 1 children but not in normals.

PubMed

Vázquez, Beatriz Y Salazar; Vázquez, Miguel A Salazar; Jáquez, Manuel Guajardo; Huemoeller, Antonio H Bracho; Intaglietta, Marcos; Cabrales, Pedro

2010-01-01

To determine the relationship between mean arterial blood pressure (MAP) and blood viscosity in diabetic type 1 children and healthy controls to investigate whether MAP is independent of blood viscosity in healthy children, and vice versa. Children with diabetes type 1 treated by insulin injection were studied. Controls were healthy children of both sexes. MAP was calculated from systolic and diastolic pressure measurements. Blood viscosity was determined indirectly by measuring blood hemoglobin (Hb) content. The relationship between Hb, hematocrit (Hct) and blood viscosity was determined in a subgroup of controls and diabetics selected at random. 21 (10.6+/-2.5 years) type 1 diabetic children treated with insulin and 25 healthy controls age 9.6+/-1.7 years were studied. Hb was 13.8+/-0.8 g/dl in normal children vs. 14.3+/-0.9 g/dl in the diabetic group (p<0.05). MAP was 71.4+/-8.2 in the normal vs. 82.9+/-7.2 mmHg in the diabetic group (p<0.001). Glucose was 89.3+/-10.6 vs. 202.4+/-87.4 mg/dl respectively. Diabetics had a positive MAP/Hb correlation (p=0.007), while normals showed a non significant (p=0.2) negative correlation. The blood viscosity/Hb relationship was studied in a subgroup of 8 healthy controls and 8 diabetic type 1 children. There was no significant difference in Hb and Hct between groups. Diabetics showed a trend of increasing blood viscosity (+7%, p=0.15). Normal children compensate for the increase in vascular resistance due to increased blood viscosity (increased Hb and Hct) while diabetic children do not, probably due to endothelial dysfunction.

29 CFR 1910.103 - Hydrogen.

Code of Federal Regulations, 2011 CFR

2011-07-01

... containers, pressure regulators, safety relief devices, manifolds, interconnecting piping and controls. The... against physical damage and against tampering. (d) Cabinets or housings containing hydrogen control or... valve shall be of the remote control type with no connections, flanges, or other appurtenances (other...

29 CFR 1910.103 - Hydrogen.

Code of Federal Regulations, 2012 CFR

2012-07-01

... containers, pressure regulators, safety relief devices, manifolds, interconnecting piping and controls. The... against physical damage and against tampering. (d) Cabinets or housings containing hydrogen control or... valve shall be of the remote control type with no connections, flanges, or other appurtenances (other...

Influence of cyclic hydrostatic pressure on fibrocartilaginous metaplasia of achilles tendon fibroblasts.

PubMed

Shim, J W; Elder, S H

2006-11-01

The goal of this study was to demonstrate whether cyclically imposed hydrostatic pressure, compressive in nature, could induce fibrocartilaginous metaplasia in a purely tendinous cell source in vitro. The effect of short-duration cyclic hydrostatic pressure on tendon fibroblasts (tenocytes) expanded from rat Achilles tendon was studied. Total RNA was isolated either immediately after loading or 24 h later. The mRNA expression of tendon and cartilage specific markers - Collagen types I and II, Sox9, and Aggrecan was quantified by real-time reverse transcription polymerase chain reaction over multiple biological samples (n=6). For immediately isolated RNA samples, there were statistically significant increases in mRNA expression of Aggrecan and Collagen type II, while Collagen type I significantly decreased. Noticeably, for RNA samples isolated 24 h later, there were further increases in mRNA expression of Aggrecan and Collagen type II, whereas Collagen type I increased roughly three-fold relative to the non-loaded control. These findings support the hypothesis that cyclic hydrostatic pressurization can induce fibrocartilaginous metaplasia in tenocytes by upregulation of cartilaginous gene expression. Also, it was demonstrated that changes in mRNA expression as a result of single 2 h pressurization persist even up to 24 h.

Experimental Studies of Active and Passive Flow Control Techniques Applied in a Twin Air-Intake

PubMed Central

Joshi, Shrey; Jindal, Aman; Maurya, Shivam P.; Jain, Anuj

2013-01-01

The flow control in twin air-intakes is necessary to improve the performance characteristics, since the flow traveling through curved and diffused paths becomes complex, especially after merging. The paper presents a comparison between two well-known techniques of flow control: active and passive. It presents an effective design of a vortex generator jet (VGJ) and a vane-type passive vortex generator (VG) and uses them in twin air-intake duct in different combinations to establish their effectiveness in improving the performance characteristics. The VGJ is designed to insert flow from side wall at pitch angle of 90 degrees and 45 degrees. Corotating (parallel) and counterrotating (V-shape) are the configuration of vane type VG. It is observed that VGJ has the potential to change the flow pattern drastically as compared to vane-type VG. While the VGJ is directed perpendicular to the side walls of the air-intake at a pitch angle of 90 degree, static pressure recovery is increased by 7.8% and total pressure loss is reduced by 40.7%, which is the best among all other cases tested for VGJ. For bigger-sized VG attached to the side walls of the air-intake, static pressure recovery is increased by 5.3%, but total pressure loss is reduced by only 4.5% as compared to all other cases of VG. PMID:23935422

Bridgman-type apparatus for the study of growth-property relationships - Arsenic vapor pressure-GaAs property relationship

NASA Technical Reports Server (NTRS)

Parsey, J. M.; Nanishi, Y.; Lagowski, J.; Gatos, H. C.

1982-01-01

A precision Bridgman-type apparatus is described which was designed and constructed for the investigation of relationships between crystal growth parameters and the properties of GaAs crystals. Several key features of the system are highlighted, such as the use of a heat pipe for precise arsenic vapor pressure control and seeding without the presence of a viewing window. Pertinent growth parameters, such as arsenic source temperature, thermal gradients in the growing crystal and in the melt, and the macroscopic growth velocity can be independently controlled. During operation, thermal stability better than + or - 0.02 C is realized; thermal gradients can be varied up to 30 C/cm in the crystal region, and up to 20 C/cm in the melt region; the macroscopic growth velocity can be varied from 50 microns/hr to 6.0 cm/hr. It was found that the density of dislocations depends critically on As partial pressure; and essentially dislocation-free, undoped, crystals were grown under As pressure precisely controlled by an As source maintained at 617 C. The free carrier concentration varied with As pressure variations. This variation in free carrier concentration was found to be associated with variations in the compensation ratio rather than with standard segregation phenomena.

An assessment of discriminatory power of office blood pressure measurements in predicting optimal ambulatory blood pressure control in people with type 2 diabetes.

PubMed

Kengne, Andre Pascal; Libend, Christelle Nong; Dzudie, Anastase; Menanga, Alain; Dehayem, Mesmin Yefou; Kingue, Samuel; Sobngwi, Eugene

2014-01-01

Ambulatory blood pressure (BP) measurements (ABPM) predict health outcomes better than office BP, and are recommended for assessing BP control, particularly in high-risk patients. We assessed the performance of office BP in predicting optimal ambulatory BP control in sub-Saharan Africans with type 2 diabetes (T2DM). Participants were a random sample of 51 T2DM patients (25 men) drug-treated for hypertension, receiving care in a referral diabetes clinic in Yaounde, Cameroon. A quality control group included 46 non-diabetic individuals with hypertension. Targets for BP control were systolic (and diastolic) BP. Mean age of diabetic participants was 60 years (standard deviation: 10) and median duration of diabetes was 6 years (min-max: 0-29). Correlation coefficients between each office-based variable and the 24-h ABPM equivalent (diabetic vs. non-diabetic participants) were 0.571 and 0.601 for systolic (SBP), 0.520 and 0.539 for diastolic (DBP), 0.631 and 0.549 for pulse pressure (PP), and 0.522 and 0.583 for mean arterial pressure (MAP). The c-statistic for the prediction of optimal ambulatory control from office-BP in diabetic participants was 0.717 for SBP, 0.494 for DBP, 0.712 for PP, 0.582 for MAP, and 0.721 for either SBP + DBP or PP + MAP. Equivalents in diabetes-free participants were 0.805, 0.763, 0.695, 0.801 and 0.813. Office DBP was ineffective in discriminating optimal ambulatory BP control in diabetic patients, and did not improve predictions based on office SBP alone. Targeting ABPM to those T2DM patients who are already at optimal office-based SBP would likely be more cost effective in this setting.

A/E/C CAD Standard, Release 5.0

DTIC Science & Technology

2012-12-01

System Control Panels Halon System Inert Gas Smoke/Pressurization Control Egress Requirements Fire Protection System Appendix A ... System Natural Gas System Miter Gates Makeup Air System Appendix A Model File Level/Layer Assignment Tables A54 Discipline: Mechanical Model...SWITCHES Element type: Symbol Electrical: STP14B SURFACE 1X4 STRIP BATTERY Element type: Symbol Electrical: SUBST A

Upgrading the Control Systems of Turbines of K-160-12.8 Type Produced by PAO Turboatom

NASA Astrophysics Data System (ADS)

Babayev, I. N.

2018-05-01

Steam turbines of a K-160-12.8 (PVK-150) type produced by PAO Turboatom are operated at thermal power plants from the 1960s and many of them still have the complete set that was installed at that time by the factory, but they have become out of date. For this reason, the problem of upgrading the turbines to bring their characteristics into compliance with modern requirements is relevant. This article describes the main technical decisions adopted by PAO Turboatom when upgrading the automatic control system (ACS) of a K-160-12.8 (PVK-150) turbine: replacing the control valves (CV); replacing the distributing mechanism; replacing the front support components, including the main servomotor and oil control pipes; and replacing the assembly of cutoff spools by separate spools of servomotors of high-pressure control valves and reheat control valves. The schematic diagram of the ACS and description of the structure of newly installed mechanisms are presented: the cutoff spools, the high-pressure CVs, the distribution mechanism, and the main servomotor. The particularity of the ACS is the presence of electromechanical converters, which are used in each cutoff spool. For improving operating reliability of the ACS by providing the actuation of servomotors of control valves for closing regardless of ACS commands, the connection of rods of the electromechanical converter and cutoff spools are made using spring-type uncoupling devices. For actuation of the protection system by the commands of the automatic electronic safety device, the separate actuator driven by an electromagnet is installed in the ACS. During further improvement of the protection system, it is recommended to replace the controller assembly by two-spool protection devices, remove the protection spool assembly, and increase the pressure in the protection lines up to power pressure. The upgrading during this project was carried out by the Dobrotvor TPP (Ukraine).

Automated Cryocooler Monitor and Control System Software

NASA Technical Reports Server (NTRS)

Britchcliffe, Michael J.; Conroy, Bruce L.; Anderson, Paul E.; Wilson, Ahmad

2011-01-01

This software is used in an automated cryogenic control system developed to monitor and control the operation of small-scale cryocoolers. The system was designed to automate the cryogenically cooled low-noise amplifier system described in "Automated Cryocooler Monitor and Control System" (NPO-47246), NASA Tech Briefs, Vol. 35, No. 5 (May 2011), page 7a. The software contains algorithms necessary to convert non-linear output voltages from the cryogenic diode-type thermometers and vacuum pressure and helium pressure sensors, to temperature and pressure units. The control function algorithms use the monitor data to control the cooler power, vacuum solenoid, vacuum pump, and electrical warm-up heaters. The control algorithms are based on a rule-based system that activates the required device based on the operating mode. The external interface is Web-based. It acts as a Web server, providing pages for monitor, control, and configuration. No client software from the external user is required.

Cerebrovasculoprotective effects of azilsartan medoxomil in diabetes.

PubMed

Abdelsaid, Mohammed; Coucha, Maha; Ergul, Adviye

2014-11-01

We have shown that Goto-Kakizaki (GK) rats, a lean model of type 2 diabetes, develop significant cerebrovascular remodeling by the age of 18 weeks, which is characterized by increased media thickness and matrix deposition. Although early glycemic control prevents diabetes-mediated remodeling of the cerebrovasculature, whether the remodeling can be reversed is unknown. Given that angiotensin II type 1 receptor blockers reverse pathologic vascular remodeling and function independent of changes in blood pressure in other vascular beds, we hypothesized that azilsartan medoxomil, a new angiotensin II type 1 receptor blocker, is vasculoprotective by preventing and reversing cerebrovascular remodeling in diabetes. Control Wistar and diabetic GK rats (n = 6-8 per group) were treated with vehicle (water) or azilsartan medoxomil (3 mg/kg/d) from the age of 14 to 18 or 18 to 22 weeks before or after vascular remodeling is established, respectively. Blood glucose and blood pressure were monitored and middle cerebral artery structure and function were evaluated using pressurized arteriography. Blood glucose was higher in GK rats compared with Wistar rats. Azilsartan treatment lowered blood glucose in diabetic animals with no effect on blood pressure. Diabetic animals exhibited lower myogenic tone, increased wall thickness, and cross-sectional area compared with control group animals, which were corrected by azilsartan treatment when started at the onset of diabetes or later after vascular remodeling is established. Azilsartan medoxomil offers preventive and therapeutic vasculoprotection in diabetes-induced cerebrovascular remodeling and myogenic dysfunction and this is independent of blood pressure. Published by Elsevier Inc.

Exploratory Investigation of the Effects of Boundary-Layer Control on the Pressure-Recovery Characteristics of a Circular Internal-Contraction Inlet with Translating Centerbody at Mach Numbers of 2.00 and 2.35

NASA Technical Reports Server (NTRS)

Martin, Norman J.

1959-01-01

Exploratory tests of a circular internal-contraction inlet were made at Mach numbers of 2.00 and 2.35 to determine the effect of a cowl-type boundary-layer control located downstream of the inlet throat. The inlet was designed for a Mach number of 2.5. Tests were also made of the inlet modified to correspond to design Mach numbers of 2.35 and 2.25. Surveys near the minimum area section of the inlet without boundary-layer control indicated maximum averaged pressure recoveries between 0.90 and 0.92 at a free-stream Mach number, M(sub infinity), of 2.35 for the inlets. Farther downstream, after partial subsonic diffusion, a maximum pressure recovery of 0.842 was obtained with the inlet at M(sub infinity) = 2.35. The pressure recovery of the inlet was increased by 0.03 at a Mach number of 2.35 and decreased by 0.02 at a Mach number of 2.00 by the application of cowl-type boundary-layer control. Further investigation with the inlet without bleed demonstrated that an increase of angle of attack from 0 deg to 3 deg reduced the pressure recovery 0.04. The effect of Reynolds number was to increase pressure recovery 0.07 (from 0.785 to 0.855) with an increase in Reynolds number (based on inlet diameter) from 0.79 x 10(exp 6) to 3.19 x 10(exp 6).

Theoretical Investigation of the Viscous Damping Coefficient of Hydraulic Actuators

NASA Astrophysics Data System (ADS)

Huang, Ming-Hui; Pan, Qing; Li, Yi-Bo; Ma, Peng-Da; Ma, Jun

2017-07-01

The viscous damping coefficient (VDC) of hydraulic actuators is crucial for system modeling, control and dynamic characteristic analysis. Currently, the researches on hydraulic actuators focus on behavior assessment, promotion of control performance and efficiency. However, the estimation of the VDC is difficult due to a lack of study. Firstly, using two types of hydraulic cylinders, behaviors of the VDC are experimentally examined with velocities and pressure variations. For the tested plunger type hydraulic cylinder, the exponential model B = α υ^{ - β } ,(α > 0,β > 0) or B = α1 e^{{ - β1 υ }} + α2 e^{{ - β2 υ }} (α1 ,α2 > 0,β1 ,β2 > 0), fits the relation between the VDC and velocities for a given pressure of chamber with high precision. The magnitude of the VDC decreases almost linearly under certain velocities when increasing the chamber pressure from 0.6 MPa to 6.0 MPa. Furthermore, the effects of the chamber pressures on the VDC of piston and plunge type hydraulic cylinders are different due to different sealing types. In order to investigate the VDC of a plunger type hydraulic actuator drastically, a steady-state numerical model has been developed to describe the mechanism incorporating tandem seal lubrication, back-up ring related friction behaviors and shear stress of fluid. It is shown that the simulated results of VDC agree with the measured results with a good accuracy. The proposed method provides an instruction to predict the VDC in system modeling and analysis.

Second measurement of morning systolic blood pressure is more closely associated with albuminuria.

PubMed

Sakabe, Kazumi; Fukui, Michiaki; Ushigome, Emi; Hamaguchi, Masahide; Tanaka, Toru; Atsuta, Haruhiko; Ohnishi, Masayoshi; Oda, Yohei; Hasegawa, Goji; Nakamura, Naoto

2012-08-01

It is important to control blood pressure as well as to control blood glucose for the prevention of diabetic nephropathy. However, to our knowledge, there are no reports investigating which blood pressure, including morning, evening and clinic, is more closely associated with albuminuria and whether one measurement is sufficient or not in patients with Type 2 diabetes. We measured morning, evening and clinic blood pressure and compared the area under the curve (AUC) of blood pressure for urinary albumin excretion equal to or more than 30 mg/g creatinine using receiver-operating characteristic curve analyses and odds ratio for albuminuria defined as urinary albumin excretion equal to or more than 30 mg/g creatinine in 858 patients with Type 2 diabetes. Odds ratio (95% confidence interval (CI)) of morning, evening and clinic systolic blood pressure for albuminuria was 1.034 (1.024 - 1.044), 1.033 (1.023 - 1.043) and 1.013 (1.055 - 1.021), respectively (p < 0.001 in all), and AUC of morning, evening and clinic systolic blood pressure was 0.644 (0.628 - 0.700) (p < 0.001 vs. clinic), 0.660 (0.623 - 0.696) (p < 0.001 vs. clinic) and 0.597 (0.559 - 0.636), respectively. AUC of the second morning systolic blood pressure was greater than the first (p = 0.033). The second measurement of morning systolic blood pressure is more closely associated with albuminuria than the first measurement of the morning in addition to clinic systolic blood pressure.

CPAP therapy for patients with sleep apnea and type 2 diabetes mellitus improves control of blood pressure.

PubMed

Lam, Jamie Chung Mei; Lai, Agnes Yuen Kwan; Tam, Terence Chi Chun; Yuen, Michele Mae Ann; Lam, Karen Siu Ling; Ip, Mary Sau Man

2017-05-01

Obstructive sleep apnea (OSA) is highly associated with type 2 diabetes mellitus (DM), and treatment of OSA may have a positive impact on cardiometabolic profile. This study investigates the effects of continuous positive airway pressure (CPAP) treatment on glycemic control and cardiometabolic parameters in patients with diabetes. Diabetic patients, who were newly diagnosed of OSA with an apnea hypopnea index (AHI) ≥15 and HbA1c ≥7%, were randomly assigned to either CPAP treatment or no treatment (control) for 3 months. Measurements included HbA1c, blood pressure, fasting glucose and lipids, urinary albumin, and peripheral arterial tonometry (to assess endothelial function). Sixty-four patients (52 men) were randomized, with mean (±SD) age of 55.0 ± 9.6 years, body mass index of 29.9 ± 5.3 kg/m 2 , HbA1c of 8.1 ± 1.1%, and AHI of 45.3 ± 23.2 events/h. In the intention-to-treat analysis, no significant change in HbA1c but reduction of systolic (10 mmHg (-18 to -2), p < 0.05) and diastolic (6 mmHg (-11 to -1), p < 0.05) blood pressures were found in the CPAP group compared to the control group. Excluding those with medication changes or initiated dietary program during the study period and those who dropped out, CPAP treatment decreased HbA1c (intervention group, n = 27; control group, n = 26) by 0.4% (-0.7 to -0.1), p = 0.027. In patients with type 2 DM and moderate to severe OSA, 3 months of CPAP therapy did not decrease HbA1c but lowered systolic and diastolic blood pressures. In view of a potentially limited effect size of CPAP treatment on glycemic control, sample size estimation for future randomized controlled studies must make adequate allowance for influence from external factors of medications/diet and CPAP use.

Influence of dyslipidemia in control of arterial hypertension among type-2 diabetics in the western region of the Republic of Macedonia.

PubMed

Jani, Ylber; Kamberi, Amet; Ferati, Fatmir; Rexhepi, Atila; Pocesta, Bekim; Orovcanec, Nikola; Lala, Dali; Polisi, Gafur; Iseni, Mair; Mirto, Arben; Zeqiri, Agim

2014-01-01

To determine the influence of dyslipidemia in control of blood pressure in patients with type 2 Diabetes. To test the hypothesis that, blood pressure and lipid levels are not sufficiently controlled in patients with type 2 Diabetes, in the western region of the Republic of Macedonia. Abnormalities of lipid and lipoprotein levels in the serum (dyslipidemia) are recognized as major modifiable cardiovascular disease risk factors and have been identified as independent risk factors for essential hypertension, giving rise to the term dyslipidemic hypertension. While patient-related data from primary care that demonstrate an under-treatment of blood pressure and dyslipidemia in type 2 Diabetics are vastly available in clinical practice, results from population-based studies are scarce. The study was conducted on outpatients in Primary Health Care Clinics in 8 cities on the western region of the Republic of Macedonia. Prospectively the tests were performed on 600 (45.6% women and 54.4% men) participants with a mean age of 62 ± 5.8. Study participants were selected among primary care patients, who were actively on therapy for diabetes mellitus and hypertension during the period of March 2013 - March 2014. Patients' demographic characteristics, clinical laboratory and drug usage data were obtained. The patients were classified according to the BP control, into 2 groups. A total of 600 patients, of which 45.6% female and 54.3% male, completed the survey and had data for a 1-year medical record review. It was observed that a high percentage, 65.3% of patients, did not have controlled blood pressure despite the ongoing medical treatment, according to evidence and current guidelines in a cohort of hypertensive diabetics. (Chi-square: 19.85, p<0.001). Among participants with controled BP, untreated or insufficiently treated dyslipidemia was recorded in 23% of them, whereas among participants with uncontrolled BP, untreated or insufficiently treated dyslipidemia was recorded in 67% of the participants. (Chi-square: 15.01, p=0.0001). A significant influence of dyslipidemia on the control of blood pressure in patients with type 2 Diabetes, was observed in our study. In a small country as Republic of Macedonia (with a population of around 2.000.000, especially the western region with approximately 1/2 of the overall population), this study highlights the considerable lack of awareness and insufficient management of the most important preventable and treatable cardiovascular risk factors (hypertension and dyslipidemia). These findings provide a possible explanation of the steadily high cardiovascular mortality rate despite the clinical and therapeutic progress and accessibility. Besides current hospital-based prevention and pharmaceutical control measures, mass education campaigns, lifestyle interventions etc., emphasis should be given to the role of family doctor as a primary-care health provider.

Control of intrauterine fluid pressure during operative hysteroscopy.

PubMed

Shirk, G J; Gimpelson, R J

1994-05-01

To evaluate the safety of a commonly used piston pump that controls the infusion pressure of low-viscosity fluids in a continuous-flow hysteroscopic system during operative hysteroscopy. Consecutive patients requiring operative hysteroscopy. Three hospital facilities in the Midwest. Sequential sample of 250 women who underwent operative hysteroscopy. Endometrial ablations, resection of submucosal or pedunculated uterine leiomyomata with or without endometrial ablation, polyp resections, metroplasty, and lysis of synechiae. The most serious complication of operative hysteroscopy is fluid overload due to intravasation into the patient's vascular system. Low-viscosity fluids were infused by the Zimmer Controlled Distention Irrigation System. The instrument uses a closed-feedback loop to monitor cavity pressure and automatically regulates the flow to maintain the set point pressure. It is designed to operate in a pressure range of 0 to 80 mm Hg and at flows in excess of 450 ml/minute. In 250 operative hysteroscopies no fluid complications occurred when intrauterine pressure was maintained below 80 mm Hg. No clinically significant differences in intravasation were seen in any type of operative hysteroscopy. This controlled mechanical pump system with exact intrauterine pressure measurement reduced many technical difficulties associated with low-viscosity media, and created a safe environment for the media's use in operative hysteroscopy.

Optimizing Injection Molding Parameters of Different Halloysites Type-Reinforced Thermoplastic Polyurethane Nanocomposites via Taguchi Complemented with ANOVA

PubMed Central

Gaaz, Tayser Sumer; Sulong, Abu Bakar; Kadhum, Abdul Amir H.; Nassir, Mohamed H.; Al-Amiery, Ahmed A.

2016-01-01

Halloysite nanotubes-thermoplastic polyurethane (HNTs-TPU) nanocomposites are attractive products due to increasing demands for specialized materials. This study attempts to optimize the parameters for injection just before marketing. The study shows the importance of the preparation of the samples and how well these parameters play their roles in the injection. The control parameters for injection are carefully determined to examine the mechanical properties and the density of the HNTs-TPU nanocomposites. Three types of modified HNTs were used as untreated HNTs (uHNTs), sulfuric acid treated (aHNTs) and a combined treatment of polyvinyl alcohol (PVA)-sodium dodecyl sulfate (SDS)-malonic acid (MA) (treatment (mHNTs)). It was found that mHNTs have the most influential effect of producing HNTs-TPU nanocomposites with the best qualities. One possible reason for this extraordinary result is the effect of SDS as a disperser and MA as a crosslinker between HNTs and PVA. For the highest tensile strength, the control parameters are demonstrated at 150 °C (injection temperature), 8 bar (injection pressure), 30 °C (mold temperature), 8 min (injection time), 2 wt % (HNTs loading) and mHNT (HNTs type). Meanwhile, the optimized combination of the levels for all six control parameters that provide the highest Young’s modulus and highest density was found to be 150 °C (injection temperature), 8 bar (injection pressure), 32 °C (mold temperature), 8 min (injection time), 3 wt % (HNTs loading) and mHNT (HNTs type). For the best tensile strain, the six control parameters are found to be 160 °C (injection temperature), 8 bar (injection pressure), 32 °C (mold temperature), 8 min (injection time), 2 wt % (HNTs loading) and mHNT (HNTs type). For the highest hardness, the best parameters are 140 °C (injection temperature), 6 bar (injection pressure), 30 °C (mold temperature), 8 min (injection time), 2 wt % (HNTs loading) and mHNT (HNTs type). The analyses are carried out by coordinating Taguchi and ANOVA approaches. Seemingly, mHNTs has shown its very important role in the resulting product. PMID:28774069

Optimizing Injection Molding Parameters of Different Halloysites Type-Reinforced Thermoplastic Polyurethane Nanocomposites via Taguchi Complemented with ANOVA.

PubMed

Gaaz, Tayser Sumer; Sulong, Abu Bakar; Kadhum, Abdul Amir H; Nassir, Mohamed H; Al-Amiery, Ahmed A

2016-11-22

Halloysite nanotubes-thermoplastic polyurethane (HNTs-TPU) nanocomposites are attractive products due to increasing demands for specialized materials. This study attempts to optimize the parameters for injection just before marketing. The study shows the importance of the preparation of the samples and how well these parameters play their roles in the injection. The control parameters for injection are carefully determined to examine the mechanical properties and the density of the HNTs-TPU nanocomposites. Three types of modified HNTs were used as untreated HNTs ( u HNTs), sulfuric acid treated ( a HNTs) and a combined treatment of polyvinyl alcohol (PVA)-sodium dodecyl sulfate (SDS)-malonic acid (MA) (treatment ( m HNTs)). It was found that m HNTs have the most influential effect of producing HNTs-TPU nanocomposites with the best qualities. One possible reason for this extraordinary result is the effect of SDS as a disperser and MA as a crosslinker between HNTs and PVA. For the highest tensile strength, the control parameters are demonstrated at 150 °C (injection temperature), 8 bar (injection pressure), 30 °C (mold temperature), 8 min (injection time), 2 wt % (HNTs loading) and m HNT (HNTs type). Meanwhile, the optimized combination of the levels for all six control parameters that provide the highest Young's modulus and highest density was found to be 150 °C (injection temperature), 8 bar (injection pressure), 32 °C (mold temperature), 8 min (injection time), 3 wt % (HNTs loading) and m HNT (HNTs type). For the best tensile strain, the six control parameters are found to be 160 °C (injection temperature), 8 bar (injection pressure), 32 °C (mold temperature), 8 min (injection time), 2 wt % (HNTs loading) and m HNT (HNTs type). For the highest hardness, the best parameters are 140 °C (injection temperature), 6 bar (injection pressure), 30 °C (mold temperature), 8 min (injection time), 2 wt % (HNTs loading) and m HNT (HNTs type). The analyses are carried out by coordinating Taguchi and ANOVA approaches. Seemingly, m HNTs has shown its very important role in the resulting product.

Hydrostatic pressure enhances chondrogenic differentiation of human bone marrow stromal cells in osteochondrogenic medium.

PubMed

Wagner, Diane R; Lindsey, Derek P; Li, Kelvin W; Tummala, Padmaja; Chandran, Sheena E; Smith, R Lane; Longaker, Michael T; Carter, Dennis R; Beaupre, Gary S

2008-05-01

This study demonstrated the chondrogenic effect of hydrostatic pressure on human bone marrow stromal cells (MSCs) cultured in a mixed medium containing osteogenic and chondrogenic factors. MSCs seeded in type I collagen sponges were exposed to 1 MPa of intermittent hydrostatic pressure at a frequency of 1 Hz for 4 h per day for 10 days, or remained in identical culture conditions but without exposure to pressure. Afterwards, we compared the proteoglycan content of loaded and control cell/scaffold constructs with Alcian blue staining. We also used real-time PCR to evaluate the change in mRNA expression of selected genes associated with chondrogenic and osteogenic differentiation (aggrecan, type I collagen, type II collagen, Runx2 (Cbfa-1), Sox9, and TGF-beta1). With the hydrostatic pressure loading regime, proteoglycan staining increased markedly. Correspondingly, the mRNA expression of chondrogenic genes such as aggrecan, type II collagen, and Sox9 increased significantly. We also saw a significant increase in the mRNA expression of type I collagen, but no change in the expression of Runx2 or TGF-beta1 mRNA. This study demonstrated that hydrostatic pressure enhanced differentiation of MSCs in the presence of multipotent differentiation factors in vitro, and suggests the critical role that this loading regime may play during cartilage development and regeneration in vivo.

40 CFR 63.923 - Standards-Container Level 2 controls.

Code of Federal Regulations, 2012 CFR

2012-07-01

... will be added to the container within 15 minutes, the person performing the loading operation leaves... minutes or the person performing the unloading operation leaves the immediate vicinity of the container...) Opening of a spring-loaded pressure-vacuum relief valve, conservation vent, or similar type of pressure...

40 CFR 63.923 - Standards-Container Level 2 controls.

Code of Federal Regulations, 2014 CFR

2014-07-01

... will be added to the container within 15 minutes, the person performing the loading operation leaves... minutes or the person performing the unloading operation leaves the immediate vicinity of the container...) Opening of a spring-loaded pressure-vacuum relief valve, conservation vent, or similar type of pressure...

40 CFR 63.923 - Standards-Container Level 2 controls.

Code of Federal Regulations, 2011 CFR

2011-07-01

... will be added to the container within 15 minutes, the person performing the loading operation leaves... minutes or the person performing the unloading operation leaves the immediate vicinity of the container...) Opening of a spring-loaded pressure-vacuum relief valve, conservation vent, or similar type of pressure...

40 CFR 63.923 - Standards-Container Level 2 controls.

Code of Federal Regulations, 2013 CFR

2013-07-01

... will be added to the container within 15 minutes, the person performing the loading operation leaves... minutes or the person performing the unloading operation leaves the immediate vicinity of the container...) Opening of a spring-loaded pressure-vacuum relief valve, conservation vent, or similar type of pressure...

40 CFR 60.275a - Test methods and procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... operator shall demonstrate compliance with § 60.272(a)(3) based on emissions from only the affected... used for negative-pressure fabric filters and other types of control devices and Method 5D shall be used for positive-pressure fabric filters to determine the particulate matter concentration and...

Achievement of national clinical practice recommendations among those in the Puerto Rican population with diabetes mellitus.

PubMed

Rodríguez-Vigil, Efraín; Rodríguez-Chacón, Migdalia; Trabanco, Cesar; Irizarry-Ramos, Jessica

2014-12-01

To analyze glycemic control among patients with diabetes mellitus (DM) in Puerto Rico (PR) using the 2011 American Diabetes Association (ADA) recommendations and glycemic goals as standards. We also explored other factors that are related to glycemic control. Glycemic data were obtained from 600 adults with DM from 5 different regions in PR. The patient's health insurance coverage, type of health care provider, type of diabetes treatment, gender, age, physical activity, weight, degree of hypertension and degree and type of dyslipidemia comorbidities (when one or both were applicable), and disease duration were variables of interest. Univariate and bivariate analyses were conducted to describe the population and determine the statistical differences in the glycemic control of the subjects. Fewer than half of the participants achieved the ADA-recommended levels for HbA1c (37.3%) and blood pressure (34%). However, relatively more participants met the goals for high-density lipoprotein cholesterol (51.7%), low-density lipoprotein cholesterol (59.9%), and triglycerides (61.5%). The percentage of participants reaching the HbA1c, blood pressure, and low-density lipoprotein cholesterol goals at the same time was 9.9%. Patients with private health insurance achieved better glycemic control than did patients in the public-managed healthcare system. Half of the population presented simultaneous hypertension, dyslipidemia, and DM comorbidities. Only 50% of the participants were physically active. In the sample population, glycemic control levels and blood pressure levels in adults with DM were far from the ADA-recommended standards. Physical activity levels, type of medical insurance, and type of DM medical treatment were the main modifiable factors associated with the goal of attaining glycemic control. Barriers that limit the achievement of this goal should be analyzed in more detail to improve the medical care for people with DM.

Self-blood pressure monitoring in an urban, ethnically diverse population: a randomized clinical trial utilizing the electronic health record.

PubMed

Yi, Stella S; Tabaei, Bahman P; Angell, Sonia Y; Rapin, Anne; Buck, Michael D; Pagano, William G; Maselli, Frank J; Simmons, Alvaro; Chamany, Shadi

2015-03-01

Hypertension is a leading risk factor for cardiovascular disease. Although control rates have improved over time, racial/ethnic disparities in hypertension control persist. Self-blood pressure monitoring, by itself, has been shown to be an effective tool in predominantly white populations, but less studied in minority, urban communities. These types of minimally intensive approaches are important to test in all populations, especially those experiencing related health disparities, for broad implementation with limited resources. The New York City Health Department in partnership with community clinic networks implemented a randomized clinical trial (n=900, 450 per arm) to investigate the effectiveness of self-blood pressure monitoring in medically underserved and largely black and Hispanic participants. Intervention participants received a home blood pressure monitor and training on use, whereas control participants received usual care. After 9 months, systolic blood pressure decreased (intervention, 14.7 mm Hg; control, 14.1 mm Hg; P=0.70). Similar results were observed when incorporating longitudinal data and calculating a mean slope over time. Control was achieved in 38.9% of intervention and 39.1% of control participants at the end of follow-up; the time-to-event experience of achieving blood pressure control in the intervention versus control groups were not different from each other (logrank P value =0.91). Self-blood pressure monitoring was not shown to improve control over usual care in this largely minority, urban population. The patient population in this study, which included a high proportion of Hispanics and uninsured persons, is understudied. Results indicate these groups may have additional meaningful barriers to achieving blood pressure control beyond access to the monitor itself. http://clinicaltrials.gov. Unique Identifier: NCT01123577. © 2015 American Heart Association, Inc.

Vibration Control by a Shear Type Semi-active Damper Using Magnetorheological Grease

NASA Astrophysics Data System (ADS)

Shiraishi, Toshihiko; Misaki, Hirotaka

2016-09-01

This paper describes semi-active vibration control by a controllable damper with high reliability and wide dynamic range using magnetorheological (MR) grease. Some types of cylindrical controllable dampers based on pressure difference between chambers in the dampers using “MR fluid”, whose rheological properties can be varied by applying a magnetic field, have been reported as a semi-active device. However, there are some challenging issues of them. One is to improve dispersion stability. The particles dispersed in MR fluid would make sedimentation after a period. Another is to expand dynamic range. Since cylindrical dampers require sealing elements because of pressure difference in the dampers, the dynamic range between the maximum and minimum damping force according to a magnetic field is reduced. In this study, a controllable damper using the MR effect was proposed and its performance was experimentally verified to improve the dispersion stability by using “MR grease”, which includes grease as the carrier of magnetic particles, and to expand the dynamic range by adopting a shear type structure not requiring sealing elements. Furthermore, semiactive vibration control experiments by the MR grease damper using a simple algorithm based on the skyhook damper scheme were conducted and its performance was investigated.

Control of magnetization reversal in oriented strontium ferrite thin films

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

Roy, Debangsu, E-mail: debangsu@physics.iisc.ernet.in; Anil Kumar, P. S.

2014-02-21

Oriented Strontium Ferrite films with the c axis orientation were deposited with varying oxygen partial pressure on Al{sub 2}O{sub 3}(0001) substrate using Pulsed Laser Deposition technique. The angle dependent magnetic hysteresis, remanent coercivity, and temperature dependent coercivity had been employed to understand the magnetization reversal of these films. It was found that the Strontium Ferrite thin film grown at lower (higher) oxygen partial pressure shows Stoner-Wohlfarth type (Kondorsky like) reversal. The relative importance of pinning and nucleation processes during magnetization reversal is used to explain the type of the magnetization reversal with different oxygen partial pressure during growth.

Development of a new type of high pressure calorimetric cell, mechanically agitated and equipped with a dynamic pressure control system: Application to the characterization of gas hydrates

NASA Astrophysics Data System (ADS)

Plantier, F.; Marlin, L.; Missima, D.; Torré, J.-P.

2013-12-01

A novel prototype of calorimetric cell has been developed allowing experiments under pressure with an in situ agitation system and a dynamic control of the pressure inside the cell. The use of such a system opens a wide range of potential practical applications for determining properties of complex fluids in both pressurized and agitated conditions. The technical details of this prototype and its calibration procedure are described, and an application devoted to the determination of phase equilibrium and phase change enthalpy of gas hydrates is presented. Our results, obtained with a good precision and reproducibility, were found in fairly good agreement with those found in literature, illustrate the various interests to use this novel apparatus.

The use of pneumatically generated water pressure signals for aquifer characterization

NASA Astrophysics Data System (ADS)

Fort, M.; Roberts, R.; Chace, D.

2013-12-01

The use of pneumatically generated pressure signals for aquifer characterization Hydraulic tests are the most reliable method of obtaining estimates of hydrologic properties, such as conductivity, that are essential for flow and transport modeling. The use of a sinusoidal signal for hydraulic testing is well established, with Streltsova (1988), Rasmussen (2003) and others having developed analytic solutions. Sinusoidal tests provide a unique easily distinguished signal that reduces ambiguity during analysis and we show that a sinusoidal pressure signal propagates farther into the formation than a standard slug-test signal. If a sinusoidal test is combined with a slug and/or a constant rate test, it can further reduce uncertainty in the estimated parameter values. We demonstrate how pneumatic pressure can be used to generate all three of these signals. By positioning pressure transducers both below the water level and in the head space above the water, we can monitor the total pressure acting on the formation and the changes in water level. From the changes in water level, it is possible to calculate the flow rate in and out of the well, assuming that the well diameter and water density are known. Using gas flow controllers with a Supervisory Control And Data Acquisition (SCADA) system we are able to precisely control the pressures in the well. The use of pneumatic pressure has the advantage that it requires less equipment (no pumps) and produces no water. We also show how the numerical well test analysis program nSIGHTS can be used to analyze all three types of tests simultaneously and to assess the relative contribution of each type of test to the parameter estimation. nSIGHTS was recently released as open source by Sandia National Laboratories and is available for free.

[Evaluation on programs regarding the community-based management of hypertension and type 2 diabetes mellitus patients in eight provinces, China].

PubMed

Li, Yuan; Ren, Duofu; Ding, Pingfei; Zhang, Qin; Zhang, Juan; Shi, Wenhui; Wu, Jing; Shi, Xiaoming; Liang, Xiaofeng

2014-01-01

To understand the situation and efficacy of community-based management programs on hypertension and type 2 diabetes mellitus patients in primary health service centers. In eight provinces being selected, a stratified multistage random sampling method was used to survey 5 116 cases of hypertension patients and 3 586 cases of type 2 diabetes mellitus patients aged over 35 years who had been under the management program for over 1 year. Face-to-face questionnaire interview and physical and biochemical examination were applied to collect related information, blood pressure and situation of glucose control. The rates of management on hypertension patients and type 2 diabetes mellitus patients were 23.6% (urban:17.1%, rural:28.1%, χ² = 27 195.33, P < 0.001)and 19.1% (urban:14.1%, rural:23.8%, χ² = 7 423.67, P < 0.001)while the standardized management rates were 61.1% (urban:63.3%, rural:58.6%, χ² = 11.82, P < 0.001)and 59.0% (urban:61.5%, rural:55.6%, χ² = 12.66, P < 0.001), respectively. Rate on blood pressure control among hypertension patients and the rate on fasting glucose control on type 2 diabetes mellitus patients were 50.3% (urban:62.0%, rural:36.6%, χ² = 329.31, P < 0.001)and 53.9% (urban:60.8%, rural:44.7%, χ² = 90.53, P < 0.001), respectively. Satisfaction rates for the management service of the hypertension patients and type 2 diabetes mellitus patients were 83.0% (urban:84.7% , rural: 80.7% , χ² = 13.42, P < 0.001) and 84.5% (urban:88.0% , rural:79.5% , χ² = 43.90, P < 0.001), respectively. Efficiency was achieved to some extent in managing hypertension and type 2 diabetes mellitus patients in primary health service centers. Further improvement was expected on rates regarding management, standardized management and control on both blood pressure and glucose.

A preliminary objective evaluation of leprosy footwear using in-shoe pressure measurement.

PubMed

Linge, K

1996-01-01

The primary function of leprosy shoes, insoles and podiatric orthoses is to provide an underfoot environment capable of distributing the inevitable vertical forces, so reducing areas of peak pressure and ideally the period through which they are applied. Many patients with Hansen's disease have both skeletal deformity and anesthetised feet and the presence of high plantar pressures is the key reason for foot ulceration. This objective investigation using in-shoe dynamic pressure measurements showed that the addition of a shank to control insole rigidity reduced the overall peak pressures under the foot. When a deep canvas shoe was used to test single- and double-thickness insoles of two different types of material it was found in each case that the double-thickness mode was advantageous overall. Microcellular rubber insoles in two types of leprosy shoe were replaced by the polymer Poron. The Poron proved to be superior to both microcellular rubbers. The peak pressure and pressure-time integral should be considered as complimentary variables when determining the efficacy of footwear.

NADPH Phagocyte Oxidase Knockout Mice Control Trypanosoma cruzi Proliferation, but Develop Circulatory Collapse and Succumb to Infection

PubMed Central

Macedo, Juan P.; Utsch, Lara; Tafuri, Wagner L.; Campagnole-Santos, Maria José; Alves, Rosana O.; Alves-Filho, José C. F.; Romanha, Alvaro J.; Cunha, Fernando Queiroz; Teixeira, Mauro M.; Radi, Rafael; Vieira, Leda Q.

2012-01-01

•NO is considered to be a key macrophage-derived cytotoxic effector during Trypanosoma cruzi infection. On the other hand, the microbicidal properties of reactive oxygen species (ROS) are well recognized, but little importance has been attributed to them during in vivo infection with T. cruzi. In order to investigate the role of ROS in T. cruzi infection, mice deficient in NADPH phagocyte oxidase (gp91phox −/− or phox KO) were infected with Y strain of T. cruzi and the course of infection was followed. phox KO mice had similar parasitemia, similar tissue parasitism and similar levels of IFN-γ and TNF in serum and spleen cell culture supernatants, when compared to wild-type controls. However, all phox KO mice succumbed to infection between day 15 and 21 after inoculation with the parasite, while 60% of wild-type mice were alive 50 days after infection. Further investigation demonstrated increased serum levels of nitrite and nitrate (NOx) at day 15 of infection in phox KO animals, associated with a drop in blood pressure. Treatment with a NOS2 inhibitor corrected the blood pressure, implicating NOS2 in this phenomenon. We postulate that superoxide reacts with •NO in vivo, preventing blood pressure drops in wild type mice. Hence, whilst superoxide from phagocytes did not play a critical role in parasite control in the phox KO animals, its production would have an important protective effect against blood pressure decline during infection with T. cruzi. PMID:22348160

Dramatic Changes in Thermoelectric Power of Germanium under Pressure: Printing n–p Junctions by Applied Stress

PubMed Central

Korobeinikov, Igor V.; Morozova, Natalia V.; Shchennikov, Vladimir V.; Ovsyannikov, Sergey V.

2017-01-01

Controlled tuning the electrical, optical, magnetic, mechanical and other characteristics of the leading semiconducting materials is one of the primary technological challenges. Here, we demonstrate that the electronic transport properties of conventional single-crystalline wafers of germanium may be dramatically tuned by application of moderate pressures. We investigated the thermoelectric power (Seebeck coefficient) of p– and n–type germanium under high pressure to 20 GPa. We established that an applied pressure of several GPa drastically shifts the electrical conduction to p–type. The p–type conduction is conserved across the semiconductor-metal phase transition at near 10 GPa. Upon pressure releasing, germanium transformed to a metastable st12 phase (Ge-III) with n–type semiconducting conductivity. We proposed that the unusual electronic properties of germanium in the original cubic-diamond-structured phase could result from a splitting of the “heavy” and “light” holes bands, and a related charge transfer between them. We suggested new innovative applications of germanium, e.g., in technologies of printing of n–p and n–p–n junctions by applied stress. Thus, our work has uncovered a new face of germanium as a ‘smart’ material. PMID:28290495

Modeling and control of diffusion and low-pressure chemical vapor deposition furnaces

NASA Astrophysics Data System (ADS)

De Waard, H.; De Koning, W. L.

1990-03-01

In this paper a study is made of the heat transfer inside cylindrical resistance diffusion and low-pressure chemical vapor deposition furnaces, aimed at developing an improved temperature controller. A model of the thermal behavior is derived which also covers the important class of furnaces equipped with semitransparent quartz process tubes. The model takes into account the thermal behavior of the thermocouples. It is shown that currently used temperature controllers are highly inefficient for very large scale integration applications. Based on the model an alternative temperature controller of the linear-quadratic-Gaussian type is proposed which features direct wafer temperature control. Some simulation results are given.

Pressure-controlled drainage of cerebrospinal fluid: clinical experience with a new type of ventricular catheter (Ventcontrol MTC)and an integrated Piezo-resistive sensor at its tip: technical note.

PubMed

Piek, J; Raes, P

1996-01-01

We described a new ventricular catheter that is the combination of a "classic" ventricular catheter with a piezo-resistive transducer at its tip. The device allows parallel recordings of intraventricular fluid pressure via a chip and a fluid-filled external transducer, drainage of cerebrospinal fluid from the ventricle or injection of fluid into the ventricle with simultaneous monitoring of intracranial pressure, and recording of brain tissue pressure in cases of misplacement or dislocation of the ventricular catheter or in cases of progressively narrowing ventricles caused by brain edema. Clinical tests in various situations at different pressure ranges (total recording time, 1356 h in 13 patients) gave excellent correlations of both pressures. Application of the device is especially indicated in clinical situations in which pressure-controlled drainage is desirable, occlusion of ventricular bolts is likely, or pressure-volume tests are needed.

ADVANCED DESIGNS OF MAGNETIC JACK-TYPE CONTROL ROD DRIVE

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

Young, J.N.

1959-11-01

The magnetic jack is a device for positioning the control rods In a nuclear reactor, especially in a reactor containing water under pressure. Magnetic actuation precludes the need for shaft seals and eliminates the problems associated with mechanisms operating in water. It consists of a pressure shell, four sets of external stationary magnet coils (hold, grip, lift, pull down), and one Internal moving part (ammature) that impants linear motion to a cluster of rods. (W.L.H.)

Fuel cell system shutdown with anode pressure control

DOEpatents

Clingerman, Bruce J.; Doan, Tien M.; Keskula, Donald H.

2002-01-01

A venting methodology and pressure sensing and vent valving arrangement for monitoring anode bypass valve operating during the normal shutdown of a fuel cell apparatus of the type used in vehicle propulsion systems. During a normal shutdown routine, the pressure differential between the anode inlet and anode outlet is monitored in real time in a period corresponding to the normal closing speed of the anode bypass valve and the pressure differential at the end of the closing cycle of the anode bypass valve is compared to the pressure differential at the beginning of the closing cycle. If the difference in pressure differential at the beginning and end of the anode bypass closing cycle indicates that the anode bypass valve has not properly closed, a system controller switches from a normal shutdown mode to a rapid shutdown mode in which the anode inlet is instantaneously vented by rapid vents.

Evidence-based medicine: pressure sores.

PubMed

Cushing, Carolyn A; Phillips, Linda G

2013-12-01

After studying this article, the participant should be able to: 1. Cite risk factors for pressure sore development. 2. Detail the pathophysiology of pressure sores. 3. List the types and classification of pressure sores. 4. Consider the various nonsurgical conservative wound management strategies. 5. Describe the appropriate surgical interventions for each pressure sore type. 6. Understand the causes of recurrent pressure sores and methods of avoiding recurrence. Pressure sores are the result of unrelieved pressure, usually over a bony prominence. With an estimated 2.5 million pressure ulcers treated annually in the United States at a cost of $11 billion, pressure sores represent a costly and labor-intensive challenge to the health care system. A comprehensive team approach can address both prevention and treatment of these recalcitrant wounds. Consideration must be given to the patient's medical and socioeconomic condition, as these factors are significantly related to outcomes. Mechanical prophylaxis, nutritional optimization, treatment of underlying infection, and spasm control are essential in management. A variety of pressure sore patterns exist, with surgical approaches directed to maximize future coverage options. A comprehensive approach is detailed in this article to provide the reader with the range of treatment options available.

Active Flow Separation Control of a Stator Vane Using Surface Injection in a Multistage Compressor Experiment

NASA Technical Reports Server (NTRS)

Culley, Dennis E.; Bright, Michelle M.; Prahst, Patricia S.; Strazisar, Anthony J.

2003-01-01

Micro-flow control actuation embedded in a stator vane was used to successfully control separation and improve near stall performance in a multistage compressor rig at NASA Glenn. Using specially designed stator vanes configured with internal actuation to deliver pulsating air through slots along the suction surface, a research study was performed to identify performance benefits using this microflow control approach. Pressure profiles and unsteady pressure measurements along the blade surface and at the shroud provided a dynamic look at the compressor during microflow air injection. These pressure measurements lead to a tracking algorithm to identify the onset of separation. The testing included steady air injection at various slot locations along the vane. The research also examined the benefit of pulsed injection and actively controlled air injection along the stator vane. Two types of actuation schemes were studied, including an embedded actuator for on-blade control. Successful application of an online detection and flow control scheme will be discussed. Testing showed dramatic performance benefit for flow reattachment and subsequent improvement in diffusion through the use of pulsed controlled injection. The paper will discuss the experimental setup, the blade configurations, and preliminary CFD results which guided the slot location along the blade. The paper will also show the pressure profiles and unsteady pressure measurements used to track flow control enhancement, and will conclude with the tracking algorithm for adjusting the control.

Pressure ulcer management in paraplegic patients with a novel negative pressure device: a randomised controlled trial.

PubMed

Dwivedi, M K; Srivastava, R N; Bhagat, A K; Agarwal, R; Baghel, K; Jain, A; Raj, S

2016-04-01

A randomised controlled trial to compare negative pressure wound therapy (NPWT) using our innovative negative pressure device (NPD) and the standard pressure ulcer (PU) wound dressing of in traumatic paraplegia patients. This study was conducted in the Department of Orthopaedic Surgery at King George's Medical University, Lucknow, India. Traumatic paraplegia patients with sacral pressure ulcers of stage 3 and 4 were randomised into two groups, receiving either standard wound dressings or NPWT with NPD. The outcomes monitored were length, width (surface area), depth of PU, exudates, discharge, tissue type (necrotic, slough and red granulating tissue), and cost-effectiveness during 0 to 9 weeks follow-up. Length and width were significantly (p<0.01) decreased in NPWT group as compared with standard care group at week 9. At weeks 1, 2 and 3, depth was significantly (p<0.05) higher in NPWT group, whereas at week 9 a significant reduction (p=0.01) was observed. Exudates were significantly (p=0.001) lower in NPWT group at weeks 4 and 9. Conversion of slough into red granulation tissue was significantly higher in NPWT group (p=0.001). Discharge became significantly (p=0.001) lower in NPWT at week 2 and no discharge was observed after week 6. In all parameters, decrease was larger in NPWT group compared with standard care, which was significant for exudates type (p=0.03) and tissue type (p=0.004). Our NPD is better than standard wound care procedures and cost-effective for management of PU.

A diabetes scorecard does not improve HbA(1c), blood pressure, lipids, aspirin usage, exercise and diabetes knowledge over 9 months: a randomized controlled trial.

PubMed

Irwig, M S; Sood, P; Ni, D; Amass, T; Khurana, P S; Jayanthi, V V; Wang, L; Adler, S M

2012-09-01

To test (1) whether a diabetes scorecard can improve glycaemic control, blood pressure control, LDL cholesterol, aspirin usage and exercise; (2) if the scorecard will motivate and/or educate patients to improve their scores for subsequent visits; and (3) whether the scorecard will improve rates of clinical inertia. Five physicians enrolled 103 patients ≥ 40 years old with uncontrolled Type 2 diabetes [HbA(1c) ≥ 64 mmol/mol (8.0%)] to randomly receive either a diabetes scorecard or not during four clinical visits over a 9-month period. The population was predominantly urban with a disproportionately higher percentage of black people than the general population. Our scorecard assigned points to six clinical variables, with a perfect total score of 100 points corresponding to meeting all targets. The primary outcomes were total scores and HbA(1c) in the scorecard and control groups at 9 months. There were no significant differences between the control and scorecard groups at visits 1 and 4 in total score, HbA(1c) , blood pressure, LDL cholesterol, aspirin usage, exercise or knowledge about diabetic targets. By visit 4 both the control and scorecard groups had statistically significant improvements with their mean total score (9 and 7 points, respectively), HbA(1c) [-9 mmol/mol (-0.8%) and -15 mmol/mol (-1.4%), respectively] and aspirin usage (33% increase and 16% increase, respectively). Rates of clinical inertia were low throughout the study. A diabetes scorecard did not improve glycaemic control, blood pressure control, LDL cholesterol, aspirin usage, exercise or diabetic knowledge in an urban population with uncontrolled Type 2 diabetes. © 2012 The Authors. Diabetic Medicine © 2012 Diabetes UK.

Peer support for patients with type 2 diabetes: cluster randomised controlled trial.

PubMed

Smith, S M; Paul, G; Kelly, A; Whitford, D L; O'Shea, E; O'Dowd, T

2011-02-15

To test the effectiveness of peer support for patients with type 2 diabetes. Cluster randomised controlled. 20 general practices in the east of the Republic of Ireland. 395 patients (192 in intervention group, 203 in control group) and 29 peer supporters with type 2 diabetes. All practices introduced a standardised diabetes care system. The peer support intervention ran over a two year period and contained four elements: the recruitment and training of peer supporters, nine group meetings led by peer supporters in participant's own general practice, and a retention plan for the peer supporters. HbA(1c); cholesterol concentration; systolic blood pressure; and wellbeing score. There was no difference between intervention and control patients at baseline. All practices and 85% (337) of patients were followed up. At two year follow-up, there were no significant differences in HbA(1c) (mean difference -0.08%, 95% confidence interval -0.35% to 0.18%), systolic blood pressure (-3.9 mm Hg, -8.9 to 1.1 mm Hg), total cholesterol concentration (-0.03 mmol/L, -0.28 to 0.22 mmol/L), or wellbeing scores (-0.7, -2.3 to 0.8). While there was a trend towards decreases in the proportion of patients with poorly controlled risk factors at follow-up, particularly for systolic blood pressure (52% (87/166) >130 mm Hg in intervention v 61% (103/169) >130 mm Hg in control), these changes were not significant. The process evaluation indicated that the intervention was generally delivered as intended, though 18% (35) of patients in the intervention group never attended any group meetings. A group based peer support intervention is feasible in general practice settings, but the intervention was not effective when targeted at all patients with type 2 diabetes. While there was a trend towards improvements of clinical outcomes, the results do not support the widespread adoption of peer support. Trial registration Current Controlled Trials ISRCTN42541690.

An investigation of the use of discharge valves and an intake control for improving the performance of N.A.C.A. Roots type supercharger

NASA Technical Reports Server (NTRS)

Schey, Oscar W; Wilson, Ernest E

1929-01-01

This report presents the results of an analytical investigation on the practicability of using mechanically operated discharge valves in conjunction with a manually operated intake control for improving the performance of N. A. C. A. Roots type superchargers. These valves, which may be either of the oscillating or rotating type, are placed in the discharge opening of the supercharger and are so shaped and synchronized with the supercharger impellers that they do not open until the air has been compressed to the delivery pressure. The intake control limits the quantity of air compressed to engine requirements by permitting the excess air to escape from the compression chamber before compression begins. The percentage power saving and the actual horsepower saved were computed for altitudes from 0 to 20,000 feet. These computations are based on the pressure-volume cards for the conventional and the modified roots type superchargers and on the results of laboratory tests of the conventional type. The use of discharge valves shows a power saving of approximately 26 per cent at a critical altitude of 20,000 feet. In addition, these valves reduce the amplitude of the discharge pulsations and increase the volumetric efficiency. With slow-speed roots blowers operating at high-pressure differences even better results would be expected. For aircraft engine superchargers operating at high speeds these discharge valves increase the performance as above, but have the disadvantages of increasing the weight and of adding a high-speed mechanism to a simple machine. (author)

Analysis of Experimental Sea-level Transient Data and Analog Method of Obtaining Altitude Response for Turbine-propeller Engine with Relay-type Speed Control

NASA Technical Reports Server (NTRS)

Vasu, George; Pack, George J

1951-01-01

Correlation has been established between transient engine and control data obtained experimentally and data obtained by simulating the engine and control with an analog computer. This correlation was established at sea-level conditions for a turbine-propeller engine with a relay-type speed control. The behavior of the controlled engine at altitudes of 20,000 and 35,000 feet was determined with an analog computer using the altitude pressure and temperature generalization factors to calculate the new engine constants for these altitudes. Because the engine response varies considerably at altitude some type of compensation appears desirable and four methods of compensation are discussed.

Liquid Bismuth Propellant Management System for the Very High Specific Impulse Thruster with Anode Layer

NASA Technical Reports Server (NTRS)

Polzin, K. A.; Markusic, T. E.; Stanojev, B. J.

2007-01-01

Two prototype bismuth propellant feed systems were constructed and operated in conjunction with a propellant vaporizer. One system provided bismuth to a vaporizer using gas pressurization but did not include a means to measure the flow rate. The second system incorporated an electromagnetic pump to provide fine control of the hydrostatic pressure and a new type of in-line flow sensor that was developed for accurate, real-time measurement of the mass flow rate. High-temperature material compatibility was a driving design requirement for the pump and flow sensor, leading to the selection of Macor for the main body of both components. Posttest inspections of both components revealed no degradation of the material. The gas pressurization system demonstrated continuous pressure control over a range from zero to 200 torr. In separate proof-of-concept experiments, the electromagnetic pump produced a linear pressure rise as a function of current that compared favorably with theoretical pump pressure predictions, producing a pressure rise of 10 kPa at 30 A. Preliminary flow sensor operation indicated a bismuth flow rate of 6 mg/s with an uncertainty of plus or minus 6%. An electronics suite containing a real-time controller was successfully used to control the entire system, simultaneously monitoring all power supplies and performing data acquisition duties.

Pressure-Distribution Measurements on O-2H Airplane in Flight

NASA Technical Reports Server (NTRS)

Pearson, H A

1937-01-01

Results are given of pressure-distribution measurements made over two different horizontal tail surfaces and the right wing cellule, including the slipstream area, of an observation-type biplane. Measurements were also taken of air speed, control-surface positions, control-stick forces, angular velocities, and accelerations during various abrupt maneuvers. These maneuvers consisted of push-downs and pull-ups from level flight, dive pull-outs, and aileron rolls with various thrust conditions. The results from the pressure-distribution measurements over the wing cellule are given on charts showing the variation of individual rib coefficients with wing coefficients; the data from the tail-surface pressure-distribution measurements are given mainly as total loads and moments. These data are supplemented by time histories of the measured quantities and isometric views of the rib pressure distributions occurring in abrupt maneuvers.

Integrated Liquid Bismuth Propellant Feed System

NASA Technical Reports Server (NTRS)

Polzin, Kurt A.; Markusic, Thomas E.; Stanojev, Boris J.

2006-01-01

A prototype bismuth propellant feed and control system was constructed and tested. An electromagnetic pump was used in this system to provide fine control of the hydrostatic pressure, and a new type of in-line flow sensor was developed to provide an accurate, real-time measurement of the mass flow rate. High-temperature material compatibility was a driving design requirement for the pump and flow sensor, leading to the selection of macor for the main body of both components. Post-test inspections of both components revealed no cracks or leaking in either. In separate proof-of-concept experiments, the pump produced a linear pressure rise as a function of current that compared favorably with theoretical pump pressure predictions, with a pressure of 10 kPa at 30 A. Flow sensing was successfully demonstrated in a bench-top test using gallium as a substitute liquid metal. A real-time controller was successfully used to control the entire system, simultaneously monitoring all power supplies and performing data acquisition duties.

Effect of a group-based rehabilitation programme on glycaemic control and cardiovascular risk factors in type 2 diabetes patients: the Copenhagen Type 2 Diabetes Rehabilitation Project.

PubMed

Vadstrup, Eva Soelberg; Frølich, Anne; Perrild, Hans; Borg, Eva; Røder, Michael

2011-08-01

To compare the effectiveness of a group-based rehabilitation programme with an individual counselling programme at improving glycaemic control and cardiovascular risk factors among patients with type 2 diabetes. We randomised 143 adult type 2 diabetes patients to either a 6-month multidisciplinary group-based rehabilitation programme or a 6-month individual counselling programme. Outcome measures included glycated haemoglobin (HbA(1c)), blood pressure, lipid profile, weight, and waist circumference. Mean HbA(1c) decreased 0.3%-point (95% confidence interval [CI] = -0.5, -0.1) in the rehabilitation group and 0.6%-point (95% CI = -0.8, -0.4) among individual counselling participants (p<0.05). Within both groups, equal reductions occurred in body weight, waist circumference, systolic blood pressure and diastolic blood pressure, but no significant between-group differences between occurred for any of the cardiovascular outcomes. The group-based rehabilitation programme consumed twice as many personnel resources. The group-based rehabilitation programme resulted in changes in glycaemic control and cardiovascular risk factor reduction that were equivalent or inferior to those of an individual counselling programme. The group-based rehabilitation programme, tested in the current design, did not offer additionally improved outcomes and consumed more personnel resources than the individual counselling programme; its broad implementation is not supported by this study. Trial registration Clinicaltrials.gov NCT00284609. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Circadian blood pressure variability in type 1 diabetes subjects and their nondiabetic siblings - influence of erythrocyte electron transfer.

PubMed

Matteucci, Elena; Consani, Cristina; Masoni, Maria Chiara; Giampietro, Ottavio

2010-10-05

Normotensive non-diabetic relatives of type 1 diabetes (T1D) patients have an abnormal blood pressure response to exercise testing that is associated with indices of metabolic syndrome and increased oxidative stress. The primary aim of this study was to investigate the circadian variability of blood pressure and the ambulatory arterial stiffness index (AASI) in healthy siblings of T1D patients vs healthy control subjects who had no first-degree relative with T1D. Secondary aims of the study were to explore the influence of both cardiovascular autonomic function and erythrocyte electron transfer activity as oxidative marker on the ambulatory blood pressure profile. Twenty-four hour ambulatory blood pressure monitoring (ABPM) was undertaken in 25 controls, 20 T1D patients and 20 siblings. In addition to laboratory examination (including homeostasis model assessment of insulin sensitivity) and clinical testing of autonomic function, we measured the rate of oxidant-induced erythrocyte electron transfer to extracellular ferricyanide (RBC vfcy). Systolic blood pressure (SBP) midline-estimating statistic of rhythm and pulse pressure were higher in T1D patients and correlated positively with diabetes duration and RBC vfcy; autonomic dysfunction was associated with diastolic BP ecphasia and increased AASI. Siblings had higher BMI, lower insulin sensitivity, larger SBP amplitude, and higher AASI than controls. Daytime SBP was positively, independently associated with BMI and RBC vfcy. Among non-diabetic people, there was a significant correlation between AASI and fasting plasma glucose. Siblings of T1D patients exhibited a cluster of sub-clinical metabolic abnormalities associated with consensual perturbations in BP variability. Moreover, our findings support, in a clinical setting, the proposed role of transplasma membrane electron transport systems in vascular pathobiology.

11. RW Meyer Sugar Mill: 18761889. Locomotive=type, firetube, portable boiler, ...

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

11. RW Meyer Sugar Mill: 1876-1889. Locomotive=type, fire-tube, portable boiler, model No. 1, Manufactured by Ames Iron Works, Oswego, New York, 1879. 120 lbs./sq. in. working pressure, 66 sq. ft. heating surface in tubes. View: the boiler provided steam for steam engine which in turn powered the centrifugals. View shows front fire box, end of boiler. Below fire-box,used for removing ashes, is a door. Circular openings at the rear of the fire-box are where fire-tubes connected with furnace. Column to right of fire-box carried pressure and water level gauges. Fluted chimney-type structure is steam-port, safety valve, and whistle. Weights originally sat on the arm extending from the top of the port and controlled the boiler pressure. - R. W. Meyer Sugar Mill, State Route 47, Kualapuu, Maui County, HI

Hypoxia-inducible factor-1α in vascular smooth muscle regulates blood pressure homeostasis through a peroxisome proliferator-activated receptor-γ-angiotensin II receptor type 1 axis.

PubMed

Huang, Yan; Di Lorenzo, Annarita; Jiang, Weidong; Cantalupo, Anna; Sessa, William C; Giordano, Frank J

2013-09-01

Hypertension is a major worldwide health issue for which only a small proportion of cases have a known mechanistic pathogenesis. Of the defined causes, none have been directly linked to heightened vasoconstrictor responsiveness, despite the fact that vasomotor tone in resistance vessels is a fundamental determinant of blood pressure. Here, we reported a previously undescribed role for smooth muscle hypoxia-inducible factor-1α (HIF-1α) in controlling blood pressure homeostasis. The lack of HIF-1α in smooth muscle caused hypertension in vivo and hyperresponsiveness of resistance vessels to angiotensin II stimulation ex vivo. These data correlated with an increased expression of angiotensin II receptor type I in the vasculature. Specifically, we show that HIF-1α, through peroxisome proliferator-activated receptor-γ, reciprocally defined angiotensin II receptor type I levels in the vessel wall. Indeed, pharmacological blockade of angiotensin II receptor type I by telmisartan abolished the hypertensive phenotype in smooth muscle cell-HIF-1α-KO mice. These data revealed a determinant role of a smooth muscle HIF-1α/peroxisome proliferator-activated receptor-γ/angiotensin II receptor type I axis in controlling vasomotor responsiveness and highlighted an important pathway, the alterations of which may be critical in a variety of hypertensive-based clinical settings.

Stereotypic Laryngeal and Respiratory Motor Patterns Generate Different Call Types in Rat Ultrasound Vocalization

PubMed Central

RIEDE, TOBIAS

2014-01-01

Rodents produce highly variable ultrasound whistles as communication signals unlike many other mammals, who employ flow-induced vocal fold oscillations to produce sound. The role of larynx muscles in controlling sound features across different call types in ultrasound vocalization (USV) was investigated using laryngeal muscle electromyographic (EMG) activity, subglottal pressure measurements and vocal sound output in awake and spontaneously behaving Sprague–Dawley rats. Results support the hypothesis that glottal shape determines fundamental frequency. EMG activities of thyroarytenoid and cricothyroid muscles were aligned with call duration. EMG intensity increased with fundamental frequency. Phasic activities of both muscles were aligned with fast changing fundamental frequency contours, for example in trills. Activities of the sternothyroid and sternohyoid muscles, two muscles involved in vocal production in other mammals, are not critical for the production of rat USV. To test how stereotypic laryngeal and respiratory activity are across call types and individuals, sets of ten EMG and subglottal pressure parameters were measured in six different call types from six rats. Using discriminant function analysis, on average 80% of parameter sets were correctly assigned to their respective call type. This was significantly higher than the chance level. Since fundamental frequency features of USV are tightly associated with stereotypic activity of intrinsic laryngeal muscles and muscles contributing to build-up of subglottal pressure, USV provide insight into the neurophysiological control of peripheral vocal motor patterns. PMID:23423862

Influence of dyslipidemia in control of arterial hypertension among type-2 diabetics in the western region of the Republic of Macedonia

PubMed Central

Jani, Ylber; Kamberi, Amet; Ferati, Fatmir; Rexhepi, Atila; Pocesta, Bekim; Orovcanec, Nikola; Lala, Dali; Polisi, Gafur; Iseni, Mair; Mirto, Arben; Zeqiri, Agim

2014-01-01

Objective: To determine the influence of dyslipidemia in control of blood pressure in patients with type 2 Diabetes. To test the hypothesis that, blood pressure and lipid levels are not sufficiently controlled in patients with type 2 Diabetes, in the western region of the Republic of Macedonia. Background: Abnormalities of lipid and lipoprotein levels in the serum (dyslipidemia) are recognized as major modifiable cardiovascular disease risk factors and have been identified as independent risk factors for essential hypertension, giving rise to the term dyslipidemic hypertension. While patient-related data from primary care that demonstrate an under-treatment of blood pressure and dyslipidemia in type 2 Diabetics are vastly available in clinical practice, results from population-based studies are scarce. Material and methods: The study was conducted on outpatients in Primary Health Care Clinics in 8 cities on the western region of the Republic of Macedonia. Prospectively the tests were performed on 600 (45.6% women and 54.4% men) participants with a mean age of 62 ± 5.8. Study participants were selected among primary care patients, who were actively on therapy for diabetes mellitus and hypertension during the period of March 2013 - March 2014. Patients’ demographic characteristics, clinical laboratory and drug usage data were obtained. The patients were classified according to the BP control, into 2 groups. Results: A total of 600 patients, of which 45.6% female and 54.3% male, completed the survey and had data for a 1-year medical record review. It was observed that a high percentage, 65.3% of patients, did not have controlled blood pressure despite the ongoing medical treatment, according to evidence and current guidelines in a cohort of hypertensive diabetics. (Chi-square: 19.85, p<0.001). Among participants with controled BP, untreated or insufficiently treated dyslipidemia was recorded in 23% of them, whereas among participants with uncontrolled BP, untreated or insufficiently treated dyslipidemia was recorded in 67% of the participants. (Chi-square: 15.01, p=0.0001). Conclusion: A significant influence of dyslipidemia on the control of blood pressure in patients with type 2 Diabetes, was observed in our study. In a small country as Republic of Macedonia (with a population of around 2.000.000, especially the western region with approximately 1/2 of the overall population), this study highlights the considerable lack of awareness and insufficient management of the most important preventable and treatable cardiovascular risk factors (hypertension and dyslipidemia). These findings provide a possible explanation of the steadily high cardiovascular mortality rate despite the clinical and therapeutic progress and accessibility. Besides current hospital-based prevention and pharmaceutical control measures, mass education campaigns, lifestyle interventions etc., emphasis should be given to the role of family doctor as a primary-care health provider. PMID:25006533

The effect of a dietary portfolio compared to a DASH-type diet on blood pressure.

PubMed

Jenkins, D J A; Jones, P J; Frohlich, J; Lamarche, B; Ireland, C; Nishi, S K; Srichaikul, K; Galange, P; Pellini, C; Faulkner, D; de Souza, R J; Sievenpiper, J L; Mirrahimi, A; Jayalath, V H; Augustin, L S; Bashyam, B; Leiter, L A; Josse, R; Couture, P; Ramprasath, V; Kendall, C W C

2015-12-01

Compared to a DASH-type diet, an intensively applied dietary portfolio reduced diastolic blood pressure at 24 weeks as a secondary outcome in a previous study. Due to the importance of strategies to reduce blood pressure, we performed an exploratory analysis pooling data from intensively and routinely applied portfolio treatments from the same study to assess the effect over time on systolic, diastolic and mean arterial pressure (MAP), and the relation to sodium (Na(+)), potassium (K(+)), and portfolio components. 241 participants with hyperlipidemia, from four academic centers across Canada were randomized and completed either a DASH-type diet (control n = 82) or a dietary portfolio that included, soy protein, viscous fibers and nuts (n = 159) for 24 weeks. Fasting measures and 7-day food records were obtained at weeks 0, 12 and 24, with 24-h urines at weeks 0 and 24. The dietary portfolio reduced systolic, diastolic and mean arterial blood pressure compared to the control by 2.1 mm Hg (95% CI, 4.2 to -0.1 mm Hg) (p = 0.056), 1.8 mm Hg (CI, 3.2 to 0.4 mm Hg) (p = 0.013) and 1.9 mm Hg (CI, 3.4 to 0.4 mm Hg) (p = 0.015), respectively. Blood pressure reductions were small at 12 weeks and only reached significance at 24 weeks. Nuts, soy and viscous fiber all related negatively to change in mean arterial pressure (ρ = -0.15 to -0.17, p ≤ 0.016) as did urinary potassium (ρ = -0.25, p = 0.001), while the Na(+)/K(+) ratio was positively associated (ρ = 0.20, p = 0.010). Consumption of a cholesterol-lowering dietary portfolio also decreased blood pressure by comparison with a healthy DASH-type diet. CLINICAL TRIAL REG. NO.: NCT00438425, clinicaltrials.gov. Copyright © 2015 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

Vibration and recoil control of pneumatic hammers. [by air flow pressure regulation

NASA Technical Reports Server (NTRS)

Constantinescu, I. N.; Darabont, A. V.

1974-01-01

Vibration sources are described for pneumatic hammers used in the mining industry (pick hammers), in boiler shops (riveting hammers), etc., bringing to light the fact that the principal vibration source is the variation in air pressure inside the cylinder. The present state of the art of vibration control of pneumatic hammers as it is practiced abroad, and the solutions adopted for this purpose, are discussed. A new type of pneumatic hammer with a low noise and vibration level is presented.

The investigation of parachute fabric permeability under an unsteady pressure differential

NASA Astrophysics Data System (ADS)

Rondeau, Nichole C.

An apparatus for assessing permeability of textiles subjected to time-varying pressure differentials is presented. A Computer Numerically Controlled Piston Permeability Apparatus (CNC-PPA) that can control the volume flow rate through a fabric has been designed and built. This test device has been developed in an effort to improve the understanding and design choices for aerodynamic decelerators. Preliminary results for a low permeability fabric (PIA-C-44378, Type IV) under both steady and unsteady loads are presented. The results from this investigation do indicate a small effect of unsteady pressure differential on the fabric permeability. The fabric permeability is slightly higher than the static permeability when the pressure differential is increasing with respect to time and the opposite is true when the pressure differential is decreasing. This change in permeability is more pronounced as the pressure is higher and the pressure changes more rapidly with respect to time, suggesting dynamic permeability likely affects highly unsteady phenomena such as parachute opening.

A liquid-delivery device that provides precise reward control for neurophysiological and behavioral experiments.

PubMed

Mitz, Andrew R

2005-10-15

Behavioral neurophysiology and other kinds of behavioral research often involve the delivery of liquid rewards to experimental subjects performing some kind of operant task. Available systems use gravity or pumps to deliver these fluids, but such methods are poorly suited to moment-to-moment control of the volume, timing, and type of fluid delivered. The design described here overcomes these limitations using an electronic control unit, a pressurized reservoir unit, and an electronically controlled solenoid. The control unit monitors reservoir pressure and provides precisely timed solenoid activation signals. It also stores calibration tables and does on-the-fly interpolation to support computer-controlled delivery calibrated directly in milliliters. The reservoir provides pressurized liquid to a solenoid mounted near the subject. Multiple solenoids, each supplied by a separate reservoir unit and control unit, can be stacked in close proximity to allow instantaneous selection of which liquid reward is delivered. The precision of droplet delivery was verified by weighing discharged droplets on a commercial analytical balance.

A New Type of Motor: Pneumatic Step Motor

PubMed Central

Stoianovici, Dan; Patriciu, Alexandru; Petrisor, Doru; Mazilu, Dumitru; Kavoussi, Louis

2011-01-01

This paper presents a new type of pneumatic motor, a pneumatic step motor (PneuStep). Directional rotary motion of discrete displacement is achieved by sequentially pressurizing the three ports of the motor. Pulsed pressure waves are generated by a remote pneumatic distributor. The motor assembly includes a motor, gearhead, and incremental position encoder in a compact, central bore construction. A special electronic driver is used to control the new motor with electric stepper indexers and standard motion control cards. The motor accepts open-loop step operation as well as closed-loop control with position feedback from the enclosed sensor. A special control feature is implemented to adapt classic control algorithms to the new motor, and is experimentally validated. The speed performance of the motor degrades with the length of the pneumatic hoses between the distributor and motor. Experimental results are presented to reveal this behavior and set the expectation level. Nevertheless, the stepper achieves easily controllable precise motion unlike other pneumatic motors. The motor was designed to be compatible with magnetic resonance medical imaging equipment, for actuating an image-guided intervention robot, for medical applications. For this reason, the motors were entirely made of nonmagnetic and dielectric materials such as plastics, ceramics, and rubbers. Encoding was performed with fiber optics, so that the motors are electricity free, exclusively using pressure and light. PneuStep is readily applicable to other pneumatic or hydraulic precision-motion applications. PMID:21528106

[The effect of trandolapril, in monotherapy and associated with verapamil, on arterial pressure, albuminuria, and metabolic control in hypertensive patients with type 2 diabetes and albuminuria].

PubMed

Fernández González, R; García Robles, R; Rodríguez Pérez, J C; Gómez Pajuelo, C; Moreno Carretero, E

2001-01-01

The aim of this study was to analyse the effect of the ACE-1, Trandolapril, alone or with Verapamil on blood pressure, albuminuria and metabolic profile in type 2 diabetic patients with hypertension and albuminuria. It was an open multicenter, consecutive and prospective study conducted in 281 patients. There was a four-week wash-out period of antihypertensive drugs, after which we carried out a measurement over a 24-h period of the urinary excretion of albumina (UEA). Blood pressure was recorded after at least 5 minutes of rest in the sitting position at 1 to 3 minute intervals with a mercury sphygmomanometer in good condition. Average BP was obtained from three consecutive readings. Within treatment changes were analysed using descriptive statistics and t-tests on the change from baseline. Analysis of variance, chi-square and Mc Nemar tests were also used. If after 8 weeks of treatment with Trandolapril 2 mg o.q.d. the patients were non-responders (mean blood pressure reduction of 5 mmHg or less) or their blood pressure remained uncontrolled (blood pressure > or = 140/90 mmHg), Verapamil 180 mg o.q.d. was added. Two hundred and thirty patients completed the 12 weeks study. Population included 157 (55.9%) males with an average of 61.7 +/- 9.2 years. Baseline measurements were systolic 165.4 +/- 14.6 and diastolic 94.8 +/- 8.5 mmHg blood pressures, fasting glucose 162.7 +/- 43.9 mg/dL, glycosylated hemoglobin (HbAlc) 6.8 +/- 1.2%, and albuminuria 520.9 +/- 602 mg/day. UEA fell significantly (p < 0.001) after treatment to 177.9 +/- 24.3 mg/day (CI 95%, 129.9 to 225.8). The percent reduction reached 29.6%. Albuminuria was lower than 30 mg/day in 47 patients. Blood pressure was completely controlled in 125 (54%) patients. Glucemia fell significantly (p < 0.001) to 153.2 +/- 42.7 mg/dL, and the HbAlc to 6.5 +/- 1.3% (p = 0.012). In summary, in those diabetic type 2 patients with arterial hypertension and proteinuria, Trandolapril alone or associated with Verapamil significant lowered albuminuria and blood pressure facilitated the control or their metabolic profile.

Development of a theoretical framework for analyzing cerebrospinal fluid dynamics

PubMed Central

Cohen, Benjamin; Voorhees, Abram; Vedel, Søren; Wei, Timothy

2009-01-01

Background To date hydrocephalus researchers acknowledge the need for rigorous but utilitarian fluid mechanics understanding and methodologies in studying normal and hydrocephalic intracranial dynamics. Pressure volume models and electric circuit analogs introduced pressure into volume conservation; but control volume analysis enforces independent conditions on pressure and volume. Previously, utilization of clinical measurements has been limited to understanding of the relative amplitude and timing of flow, volume and pressure waveforms; qualitative approaches without a clear framework for meaningful quantitative comparison. Methods Control volume analysis is presented to introduce the reader to the theoretical background of this foundational fluid mechanics technique for application to general control volumes. This approach is able to directly incorporate the diverse measurements obtained by clinicians to better elucidate intracranial dynamics and progression to disorder. Results Several examples of meaningful intracranial control volumes and the particular measurement sets needed for the analysis are discussed. Conclusion Control volume analysis provides a framework to guide the type and location of measurements and also a way to interpret the resulting data within a fundamental fluid physics analysis. PMID:19772652

Effect of diacerein on renal function and inflammatory cytokines in participants with type 2 diabetes mellitus and chronic kidney disease: A randomized controlled trial

PubMed Central

Piovesan, Fabiana; Tres, Glaucia S.; Moreira, Leila B.; Andrades, Michael E.; Lisboa, Hugo K.

2017-01-01

Diacerein seems to improve metabolic control and reduce inflammatory marker levels in individuals with type 2 diabetes mellitus (Type 2 DM), but for participants with chronic kidney disease (CKD) its effect is unknown. This study aimed to evaluate the effect of diacerein vs. placebo on urinary albumin/creatinine ratio (ACR), glomerular filtration rate (GFR), and inflammatory cytokines in type 2 DM participants with CKD. Blood pressure (BP) and metabolic control were secondary outcomes. This randomized, placebo-controlled, parallel trial of adjuvant treatment of type 2 DM with diacerein enrolled seventy-two participants with CKD, aged 30–80 years, with glycated hemoglobin levels from 53–97 mmol/mol (7.0–11.0%), receiving angiotensin-converting enzyme inhibitors or angiotensin receptor blockers and antidiabetic agents. Participants randomized to diacerein or placebo were followed-up up to 90 days. Both groups had a marked reduction in ACR, but there was no effect on glomerular filtration rate. While the diacerein group had reduced TNF-α levels at the 75th percentile with a borderline significance (P = 0.05), there were no changes in the IL levels at the 75th percentile. Diacerein prevented the increase in blood glucose to the level observed in the placebo group (P = 0.04), improving metabolic control by 74%, reducing 24-hour diastolic BP, nighttime systolic and diastolic BP compared to the placebo group. In conclusion, among patients with type 2 DM and CKD, diacerein does not have an effect on ACR or GFR, but slows metabolic control deterioration and is associated with lower nighttime systolic and diastolic blood pressure. Trial registration: Brazilian Clinical Trials Registry (Registro Brasileiro de Ensaios Clinicos; ReBeC) U1111-1156-0255 PMID:29049415

Effect of diacerein on renal function and inflammatory cytokines in participants with type 2 diabetes mellitus and chronic kidney disease: A randomized controlled trial.

PubMed

Piovesan, Fabiana; Tres, Glaucia S; Moreira, Leila B; Andrades, Michael E; Lisboa, Hugo K; Fuchs, Sandra C

2017-01-01

Diacerein seems to improve metabolic control and reduce inflammatory marker levels in individuals with type 2 diabetes mellitus (Type 2 DM), but for participants with chronic kidney disease (CKD) its effect is unknown. This study aimed to evaluate the effect of diacerein vs. placebo on urinary albumin/creatinine ratio (ACR), glomerular filtration rate (GFR), and inflammatory cytokines in type 2 DM participants with CKD. Blood pressure (BP) and metabolic control were secondary outcomes. This randomized, placebo-controlled, parallel trial of adjuvant treatment of type 2 DM with diacerein enrolled seventy-two participants with CKD, aged 30-80 years, with glycated hemoglobin levels from 53-97 mmol/mol (7.0-11.0%), receiving angiotensin-converting enzyme inhibitors or angiotensin receptor blockers and antidiabetic agents. Participants randomized to diacerein or placebo were followed-up up to 90 days. Both groups had a marked reduction in ACR, but there was no effect on glomerular filtration rate. While the diacerein group had reduced TNF-α levels at the 75th percentile with a borderline significance (P = 0.05), there were no changes in the IL levels at the 75th percentile. Diacerein prevented the increase in blood glucose to the level observed in the placebo group (P = 0.04), improving metabolic control by 74%, reducing 24-hour diastolic BP, nighttime systolic and diastolic BP compared to the placebo group. In conclusion, among patients with type 2 DM and CKD, diacerein does not have an effect on ACR or GFR, but slows metabolic control deterioration and is associated with lower nighttime systolic and diastolic blood pressure. Brazilian Clinical Trials Registry (Registro Brasileiro de Ensaios Clinicos; ReBeC) U1111-1156-0255.

Cerebrovasculoprotective Effects of Azilsartan Medoxomil in Diabetes

PubMed Central

Abdelsaid, Mohammed; Coucha, Maha; Ergul, Adviye

2014-01-01

We have shown that Goto-Kakizaki (GK) rats, a lean model of type 2 diabetes, develop significant cerebrovascular remodeling by 18 weeks of age, which is characterized by increased media thickness and matrix deposition. While early glycemic control prevents diabetes-mediated remodeling of the cerebrovasculature, whether the remodeling can be reversed is unknown. Given that angiotensin II Type 1 receptor blockers (ARBs) reverse pathological vascular remodeling and function independent of changes in blood pressure in other vascular beds, we hypothesized that azilsartan medoxomil, a new ARB, is vasculoprotective by preventing and reversing cerebrovascular remodeling in diabetes. Control Wistar and diabetic GK rats (n=6–8/group), were treated with vehicle (water) or azilsartan medoxomil (3 mg/kg/day) from 14 to 18 or 18 to 22 weeks of age before or after vascular remodeling is established, respectively. Blood glucose and blood pressure were monitored and middle cerebral artery structure and function were evaluated using pressurized arteriography. Blood glucose was higher in GK rats compared to Wistar rats. Azilsartan treatment lowered blood glucose in diabetes with no effect on blood pressure. Diabetic animals exhibited lower myogenic tone, increased wall thickness, and cross sectional area compared to controls, which were corrected by azilsartan treatment when started at the onset of diabetes or later after vascular remodeling is established. Azilsartan medoxomil offers preventive and therapeutic vasculoprotection in diabetes-induced cerebrovascular remodeling and myogenic dysfunction and this is independent of blood pressure. PMID:24999268

Method for solid state crystal growth

DOEpatents

Nolas, George S.; Beekman, Matthew K.

2013-04-09

A novel method for high quality crystal growth of intermetallic clathrates is presented. The synthesis of high quality pure phase crystals has been complicated by the simultaneous formation of both clathrate type-I and clathrate type-II structures. It was found that selective, phase pure, single-crystal growth of type-I and type-II clathrates can be achieved by maintaining sufficient partial pressure of a chemical constituent during slow, controlled deprivation of the chemical constituent from the primary reactant. The chemical constituent is slowly removed from the primary reactant by the reaction of the chemical constituent vapor with a secondary reactant, spatially separated from the primary reactant, in a closed volume under uniaxial pressure and heat to form the single phase pure crystals.

Embedding piezoresistive pressure sensors to obtain online pressure profiles inside fiber composite laminates.

PubMed

Moghaddam, Maryam Kahali; Breede, Arne; Brauner, Christian; Lang, Walter

2015-03-27

The production of large and complex parts using fiber composite materials is costly due to the frequent formation of voids, porosity and waste products. By embedding different types of sensors and monitoring the process in real time, the amount of wastage can be significantly reduced. This work focuses on developing a knowledge-based method to improve and ensure complete impregnation of the fibers before initiation of the resin cure. Piezoresistive and capacitive pressure sensors were embedded in fiber composite laminates to measure the real-time the pressure values inside the laminate. A change of pressure indicates resin infusion. The sensors were placed in the laminate and the resin was infused by vacuum. The embedded piezoresistive pressure sensors were able to track the vacuum pressure in the fiber composite laminate setup, as well as the arrival of the resin at the sensor. The pressure increase due to closing the resin inlet was also measured. In contrast, the capacitive type of sensor was found to be inappropriate for measuring these quantities. The following study demonstrates real-time monitoring of pressure changes inside the fiber composite laminate, which validate the use of Darcy's law in porous media to control the resin flow during infusion.

Development of an Accident Reproduction Simulator System Using a Hemodialysis Extracorporeal Circulation System.

PubMed

Nishite, Yoshiaki; Takesawa, Shingo

2016-01-01

Accidents that occur during dialysis treatment are notified to the medical staff via alarms raised by the dialysis apparatus. Similar to such real accidents, apparatus activation or accidents can be reproduced by simulating a treatment situation. An alarm that corresponds to such accidents can be utilized in the simulation model. The aim of this study was to create an extracorporeal circulation system (hereinafter, the circulation system) for dialysis machines so that it sets off five types of alarms for: 1) decreased arterial pressure, 2) increased arterial pressure, 3) decreased venous pressure, 4) increased venous pressure, and 5) blood leakage, according to the five types of accidents chosen based on their frequency of occurrence and the degree of severity. In order to verify the alarm from the dialysis apparatus connected to the circulation system and the accident corresponding to it, an evaluation of the alarm for its reproducibility of an accident was performed under normal treatment circumstances. The method involved testing whether the dialysis apparatus raised the desired alarm from the moment of control of the circulation system, and measuring the time it took until the desired alarm was activated. This was tested on five main models from four dialyzer manufacturers that are currently used in Japan. The results of the tests demonstrated successful activation of the alarms by the dialysis apparatus, which were appropriate for each of the five types of accidents. The time between the control of the circulatory system to the alarm signal was as follows, 1) venous pressure lower limit alarm: 7 seconds; 2) venous pressure lower limit: 8 seconds; 3) venous pressure upper limit: 7 seconds; 4) venous pressure lower limit alarm: 2 seconds; and 5) blood leakage alarm: 19 seconds. All alarms were set off in under 20 seconds. Thus, we can conclude that a simulator system using an extracorporeal circulation system can be set to different models of dialyzers, and that the reproduced treatment scenarios can be used for simulation training.

Management of Hypertension in Diabetic Nephropathy: How Low Should We Go?

PubMed

Sternlicht, Hillel; Bakris, George L

2016-01-01

Hypertension is a frequent comorbidity often following the development of diabetic nephropathy among individuals with type 1 diabetes and affecting most patients with type 2 diabetes at the time of diagnosis. Multiple prospective randomized placebo-controlled trials demonstrate that tight blood pressure control among patients with diabetic nephropathy reduces the rates of macrovascular and microvascular complications. While randomized trials exist and support a blood pressure goal of <140/90 mm Hg for patients with nondiabetic kidney disease, there are no prospective data regarding a specific blood pressure goal on progression of diabetic nephropathy. Retrospective data analyses from trials show a linear relationship between either baseline or achieved study blood pressure and progression of nephropathy. Very high albuminuria is a hallmark of diabetic nephropathy with reductions by either angiotensin converting enzyme inhibitors (ACEi) or angiotensin receptor blocker (ARB) monotherapy associated with slowed nephropathy progression. However, combination antihypertensive therapy, while decreasing proteinuria, augments the risk of hyperkalemia, hypotension, and kidney dysfunction. Given the lack of trial data for a BP goal among patients with diabetic nephropathy, prospective trials are needed to define the optimal blood pressure necessary to preserve kidney function. At present, guideline blood pressure goals of less than 140/90 mm Hg and the use of ACEi or ARB therapy for those with more than 300 mg of albuminuria are mandated. © 2016 S. Karger AG, Basel.

Fine-touch pressure thresholds in the adult penis.

PubMed

Sorrells, Morris L; Snyder, James L; Reiss, Mark D; Eden, Christopher; Milos, Marilyn F; Wilcox, Norma; Van Howe, Robert S

2007-04-01

To map the fine-touch pressure thresholds of the adult penis in circumcised and uncircumcised men, and to compare the two populations. Adult male volunteers with no history of penile pathology or diabetes were evaluated with a Semmes-Weinstein monofilament touch-test to map the fine-touch pressure thresholds of the penis. Circumcised and uncircumcised men were compared using mixed models for repeated data, controlling for age, type of underwear worn, time since last ejaculation, ethnicity, country of birth, and level of education. The glans of the uncircumcised men had significantly lower mean (sem) pressure thresholds than that of the circumcised men, at 0.161 (0.078) g (P = 0.040) when controlled for age, location of measurement, type of underwear worn, and ethnicity. There were significant differences in pressure thresholds by location on the penis (P < 0.001). The most sensitive location on the circumcised penis was the circumcision scar on the ventral surface. Five locations on the uncircumcised penis that are routinely removed at circumcision had lower pressure thresholds than the ventral scar of the circumcised penis. The glans of the circumcised penis is less sensitive to fine touch than the glans of the uncircumcised penis. The transitional region from the external to the internal prepuce is the most sensitive region of the uncircumcised penis and more sensitive than the most sensitive region of the circumcised penis. Circumcision ablates the most sensitive parts of the penis.

Effect of angiotensin converting enzyme inhibitor on glomerular hyperfiltration in patients with type 1 diabetes

PubMed Central

Naqvi, S. A. Jaffar; Ahsan, Shahid; Fawwad, Asher; Basit, Abdul; Shera, A Samad

2016-01-01

Objective: To assess the effect of angiotensin converting enzyme inhibition on glomerular filtration rate (GFR) in normotensive patient with type 1 diabetes. Methods: A two year non-placebo control prospective study was conducted after ethical approval at Diabetes Centre of Diabetic Association of Pakistan, a WHO collaborating centre in Karachi, Pakistan. All patients with type 1 diabetes visited the out-patients department from August 2009 till July 2011 and those who fulfilled the inclusion criteria were invited to participate. A total of 121 people aged ≥18 years and ≥ 5 years of diabetes were included. Pregnant and lactating woman and those aged <18 years were excluded. GFR was calculated by using CKD-EPI formula (eGFR) at baseline and after two year. On the basis of estimated GFR, patients at baseline were divided according to KDIGO classification of chronic kidney diseases into, hyperfiltration (eGFR ≥ 100 ml/min) and normal filtration group (eGFR < 100 ml/min). All subjects in hyperfiltration group received ACE inhibitor (treatment group) while patients with normal filtration did not receive ACE inhibitor (control group). Results: Fifty two patients (43%) were in the treatment and sixty nine (57%) were in the control group. At baseline eGFR, systolic and diastolic blood pressures between groups were non-significantly different. After two years, compared to baseline, eGFR of the treatment group declined and the control group increased significantly. No significant difference in systolic while diastolic blood pressure of the treatment group increased significantly after two years compared to baseline. In contrast both systolic and diastolic blood pressure of control group increased significantly after two years compared to their baseline values. Conclusion: Present study demonstrated that initiation of ACEI in hyperfiltration stage declined GFR and keep blood pressure within normal range. PMID:27375689

A Responsive Battery with Controlled Energy Release.

PubMed

Wang, Xiaopeng; Gao, Jian; Cheng, Zhihua; Chen, Nan; Qu, Liangti

2016-11-14

A new type of responsive battery with the fascinating feature of pressure perceptibility has been developed, which can spontaneously, timely and reliably control the power outputs (e.g., current and voltage) in response to pressure changes. The device design is based on the structure of the Zn-air battery, in which graphene-coated sponge serves as pressure-sensitive air cathode that endows the whole system with the capability of self-controlled energy release. The responsive batteries exhibit superior battery performance with high open-circuit voltage (1.3 V), and competitive areal capacity of 1.25 mAh cm -2 . This work presents an important move towards next-generation intelligent energy storage devices with energy management function. © 2016 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

[Effects of gap junction blocking on the oxygen partial pressure in acupoints of the bladder meridian].

PubMed

Wang, Qi; Yu, Wei-Chang; Jiang, Hong-Zhi; Chen, Sheng-Li; Zhang, Ming-Min; Kong, E-Sheng; Huang, Guang-Ying

2010-12-01

To explore the relation between gap junction and meridian phenomenon. The oxygen partial pressure in acupoints [see text for formula] and in their corresponding non-acupoints of the Bladder Meridian was observed with the needle-type tissue oxygen tension sensor in the gap junction blocking goats by 1-Heptanol injection and the Connexin 43 (Cx43) gene knockout mice. (1) The oxygen partial pressure in acupoints of Bladder Meridian on goats was higher than that in non-acupoints after 1-Heptanol injection with significant differences between them (both P < 0.01). (2) The oxygen partial pressure in acupoints of Bladder Meridian on goats increased significantly after injecting 1-Heptanol as compare with that either injecting normal saline or injecting nothing with significant differences between them (all P < 0.01). (3) The oxygen partial pressure in acupoints of the Bladder Meridian was significantly higher than that in the non-acupoint controls in Cx43 wild type (WT) mice (all P < 0.01). In Cx43 heterozygote (HT) mice, the oxygen partial pressure between acupoints and non-acupoint controls showed no significant differences (all P > 0.05). (4) In acupoints, the oxygen partial pressure in Cx43 WT mice was significantly higher than that in Cx43 HT mice (all P < 0.05), while in the corresponding non-acupoints, this difference had no statistically significant (all P > 0.05). Gap junction maybe the essential factor in signal transduction of acupuncture.

Some Factors Affecting the Reproducibility of Penetration and the Cut-Off of Oil Sprays for Fuel-injection Engines

NASA Technical Reports Server (NTRS)

Beardsley, E G

1928-01-01

This investigation was undertaken at the Langley Memorial Aeronautical Laboratory in connection with a general research on fuel-injection for aircraft. The purpose of the investigation was to determine the factors controlling the reproducibility of spray penetration and secondary discharges after cut-off. The development of single sprays from automatic injection valves was recorded by means of special high-speed photographic apparatus capable of taking 25 consecutive pictures of the moving spray at a rate of 4,000 per second. The effect of two types of injection valves, injection-valve tube length, initial pressure in the injection-valve tube, speed of the injection control mechanism, and time of spray cut-off, on the reproducibility of spray penetration, and on secondary discharges were investigated. It was found that neither type of injection valve materially affected spray reproducibility. The initial pressure in the injection-valve tube controlled the reproducibility of spray penetrations. An increase in the initial pressure or in the length of the injection-valve tube slightly increased the spray penetration within the limits of this investigation. The speed of the injection-control mechanism did not affect the penetration. Analysis of the results indicates that secondary discharges were caused in this apparatus by pressure waves initiated by the rapid opening of the cut-off valve. The secondary discharges were eliminated in this investigation by increasing the length of the injection-valve tube. (author)

Turbulent Motion of Liquids in Hydraulic Resistances with a Linear Cylindrical Slide-Valve

PubMed Central

Velescu, C.; Popa, N. C.

2015-01-01

We analyze the motion of viscous and incompressible liquids in the annular space of controllable hydraulic resistances with a cylindrical linear slide-valve. This theoretical study focuses on the turbulent and steady-state motion regimes. The hydraulic resistances mentioned above are the most frequent type of hydraulic resistances used in hydraulic actuators and automation systems. To study the liquids' motion in the controllable hydraulic resistances with a linear cylindrical slide-valve, the report proposes an original analytic method. This study can similarly be applied to any other type of hydraulic resistance. Another purpose of this study is to determine certain mathematical relationships useful to approach the theoretical functionality of hydraulic resistances with magnetic controllable fluids as incompressible fluids in the presence of a controllable magnetic field. In this report, we established general analytic equations to calculate (i) velocity and pressure distributions, (ii) average velocity, (iii) volume flow rate of the liquid, (iv) pressures difference, and (v) radial clearance. PMID:26167532

Turbulent Motion of Liquids in Hydraulic Resistances with a Linear Cylindrical Slide-Valve.

PubMed

Velescu, C; Popa, N C

2015-01-01

We analyze the motion of viscous and incompressible liquids in the annular space of controllable hydraulic resistances with a cylindrical linear slide-valve. This theoretical study focuses on the turbulent and steady-state motion regimes. The hydraulic resistances mentioned above are the most frequent type of hydraulic resistances used in hydraulic actuators and automation systems. To study the liquids' motion in the controllable hydraulic resistances with a linear cylindrical slide-valve, the report proposes an original analytic method. This study can similarly be applied to any other type of hydraulic resistance. Another purpose of this study is to determine certain mathematical relationships useful to approach the theoretical functionality of hydraulic resistances with magnetic controllable fluids as incompressible fluids in the presence of a controllable magnetic field. In this report, we established general analytic equations to calculate (i) velocity and pressure distributions, (ii) average velocity, (iii) volume flow rate of the liquid, (iv) pressures difference, and (v) radial clearance.

The association between PAI-1 -675 4G/5G polymorphism and type 2 diabetes mellitus.

PubMed

Chen, L; Li, S-Y; Liu, M

2017-08-15

In this study, we aimed to analyze the association between plasminogen activator inhibitor 1 (PAI-1) -675 4G/5G polymorphism and type 2 diabetes mellitus (T2DM) risk. We included in 187 T2DM patients and 186 heathy controls between 2014 and 2017 from Tianjin Gong An Hospital, China. All patients and controls were ethnically Chinese Han population. The primers and polymerase chain reaction (PCR) conditions were performed. Results from this case-control study suggested that PAI-1 -675 4G/5G polymorphism was not associated with T2DM risk in four genetic models. Additionally, PAI-1 -675 4G/5G polymorphism was not associated with clinical and laboratory characteristics, such as age, gender, body mass index, systolic blood pressure, diastolic blood pressure, total cholesterol, triglycerides, and HbA1c. In conclusion, this case-control study suggested that PAI-1 -675 4G/5G polymorphism was not associated with T2DM risk in this population.

The values of intrapleural pressure before the removal of chest tube in non-complicated pulmonary lobectomies.

PubMed

Refai, Majed; Brunelli, Alessandro; Varela, Gonzalo; Novoa, Nuria; Pompili, Cecilia; Jimenez, Marcelo F; Aranda, José Luis; Sabbatini, Armando

2012-04-01

Digitalized chest drainage systems allow for quantification of air leak and measurement of intrapleural pressure. Little is known about the value of intrapleural pressure during the postoperative phase and its role in the recovering process after pulmonary resection. The objective of this investigation was to measure the values of pleural pressure immediately before the removal of chest tube after different types of pulmonary lobectomy. Prospective observational analysis on 203 consecutive patients submitted to pulmonary lobectomy during a 12-month period at two centres. Multiple measurements were recorded in the last hour before the removal of chest tube and averaged for the analysis. All patients were seated in bed in a 45° up-right position or in a chair, had a single chest tube and were not connected to suction during the evaluation period. Analysis of variance (ANOVA) was used to assess the differences in pleural pressure between different types of lobectomies. The average maximum, minimum and differential pressures were -6.1, -19.5 and 13.3 cmH(2)O, respectively. The average pressures were similar in all types of lobectomies (ANOVA, P = 0.2) and ranged from -11 to -13 cmH(2)O, with the exception of right upper bilobectomy (-20 cmH(2)O, all P-values vs. other types of lobectomies <0.05). Similar values were also recorded for maximum pressures (range -4.4 to -8.4 cmH(2)O) and minimum pressures (-31.6 cmH(2)O vs. ranged from -15.4 to -20.5 cmH(2)O, all P-values <0.01). The average pleural pressure was not associated with FEV1 (P = 0.9), DLCO (P = 0.2) or FEV1/FVC ratio (P = 0.6), when tested with linear regression. Similarly, the average pleural pressure was similar in patients with and without COPD (-12.1 vs. -13.0 cmH(2)O, P = 0.4). The ANOVA test was used to assess differences in pressures between different lobectomies. The so-called water seal status may actually correspond to intrapleural pressures ranging from -13 to -20 cmH(2)O. Modern electronic chest drainage devices allow a stable control of the intrapleural pressure. Thus, the values found in this study may be used as target pressures for different types of lobectomies, in order to favour lung recovery after surgery.

Blood pressure control, hypertension, awareness, and treatment in adults with diabetes in the United States-Mexico border region.

PubMed

Vijayaraghavan, Maya; He, Guozhong; Stoddard, Pamela; Schillinger, Dean

2010-09-01

To determine prevalence of blood pressure control, hypertension, hypertension awareness, and antihypertensive treatment among adults (> 18 years old) with diabetes living in the border region between the United States of America and Mexico, and to explore variation in those variables between all adults on the Mexican side of the border ("Mexicans") and three groups on the U.S. side of the border ("all U.S. adults," "U.S.-born Hispanics," and "Mexican immigrants"). Using data from Phase I (February 2001-October 2002) of the U.S.-Mexico Border Diabetes Prevention and Control Project, a prevalence study of type 2 diabetes and its risk factors, age-adjusted prevalence of hypertension-related variables was calculated for the sample (n = 682) and differences between the border groups were examined through logistic regression. Less than one-third of the sample had controlled blood pressure (< 130/80 mm Hg), almost half had hypertension (≥140/90 mm Hg), and hypertension awareness and treatment were inadequate. After adjusting for demographics, body mass index, and access to health care, there were no differences in blood pressure control, hypertension, hypertension awareness, or treatment between Mexicans and both U.S. adults and Mexican immigrants. However, compared to Mexicans and Mexican immigrants, U.S.-born Hispanics, particularly younger individuals, had the lowest rates of blood pressure control (17.3%) and the highest rates of coexisting hypertension (54.8%). Compared to Mexicans, U.S.-born Hispanics had lower odds of controlled blood pressure (odds ratio [OR] 0.30, 95% confidence interval [CI] 0.09-0.95) and greater odds of hypertension (OR 3.75, 95% CI 1.51-9.29) and hypertension awareness (OR 6.19, 95% CI 1.46-26.15). Co-occurrence of diabetes and hypertension is a major public health problem among U.S.-Mexico border residents. The low rate of blood pressure control among various border groups, especially younger U.S.-born Hispanics, suggests that initiatives should aggressively target blood pressure control.

Selective deletion of Connexin 40 in renin-producing cells impairs renal baroreceptor function and is associated with arterial hypertension

PubMed Central

Wagner, Charlotte; Jobs, Alexander; Schweda, Frank; Kurtz, Lisa; Kurt, Birguel; Sequeira Lopez, Maria L.; Gomez, R. Ariel; van Veen, Toon A.B.; de Wit, Cor; Kurtz, Armin

2011-01-01

Renin-producing juxtaglomerular cells are connected to each other and to endothelial cells of afferent arterioles by gap junctions containing Connexin 40 (Cx40), abundantly expressed by these two cell types. Here, we generated mice with cell-specific deletion of Cx40 in endothelial and in renin-producing cells, as its global deletion caused local dissociation of renin-producing cells from endothelial cells, renin hypersecretion, and hypertension. In mice lacking endothelial Cx40, the blood pressure, renin-producing cell distribution, and the control of renin secretion were similar to wild-type mice. In contrast, mice deficient for Cx40 in renin-producing cells were hypertensive and these cells were ectopically localized. Although plasma renin activity and kidney renin mRNA levels of these mice were not different from controls, the negative regulation of renin secretion by pressure was inverted to a positive feedback in kidneys lacking Cx40 in renin-producing cells. Thus, our findings show that endothelial Cx40 is not essential for the control of renin expression and/or release. Cx40 in renin-producing cells is required for their correct positioning in the juxtaglomerular area and the control of renin secretion by pressure. PMID:20686449

Feedback Regulation of Intracellular Hydrostatic Pressure in Surface Cells of the Lens

PubMed Central

Gao, Junyuan; Sun, Xiurong; White, Thomas W.; Delamere, Nicholas A.; Mathias, Richard T.

2015-01-01

In wild-type lenses from various species, an intracellular hydrostatic pressure gradient goes from ∼340 mmHg in central fiber cells to 0 mmHg in surface cells. This gradient drives a center-to-surface flow of intracellular fluid. In lenses in which gap-junction coupling is increased, the central pressure is lower, whereas if gap-junction coupling is reduced, the central pressure is higher but surface pressure is always zero. Recently, we found that surface cell pressure was elevated in PTEN null lenses. This suggested disruption of a feedback control system that normally maintained zero surface cell pressure. Our purpose in this study was to investigate and characterize this feedback control system. We measured intracellular hydrostatic pressures in mouse lenses using a microelectrode/manometer-based system. We found that all feedback went through transport by the Na/K ATPase, which adjusted surface cell osmolarity such that pressure was maintained at zero. We traced the regulation of Na/K ATPase activity back to either TRPV4, which sensed positive pressure and stimulated activity, or TRPV1, which sensed negative pressure and inhibited activity. The inhibitory effect of TRPV1 on Na/K pumps was shown to signal through activation of the PI3K/AKT axis. The stimulatory effect of TRPV4 was shown in previous studies to go through a different signal transduction path. Thus, there is a local two-legged feedback control system for pressure in lens surface cells. The surface pressure provides a pedestal on which the pressure gradient sits, so surface pressure determines the absolute value of pressure at each radial location. We speculate that the absolute value of intracellular pressure may set the radial gradient in the refractive index, which is essential for visual acuity. PMID:26536260

Does chocolate reduce blood pressure? A meta-analysis.

PubMed

Ried, Karin; Sullivan, Thomas; Fakler, Peter; Frank, Oliver R; Stocks, Nigel P

2010-06-28

Dark chocolate and flavanol-rich cocoa products have attracted interest as an alternative treatment option for hypertension, a known risk factor for cardiovascular disease. Previous meta-analyses concluded that cocoa-rich foods may reduce blood pressure. Recently, several additional trials have been conducted with conflicting results. Our study summarises current evidence on the effect of flavanol-rich cocoa products on blood pressure in hypertensive and normotensive individuals. We searched Medline, Cochrane and international trial registries between 1955 and 2009 for randomised controlled trials investigating the effect of cocoa as food or drink compared with placebo on systolic and diastolic blood pressure (SBP/DBP) for a minimum duration of 2 weeks. We conducted random effects meta-analysis of all studies fitting the inclusion criteria, as well as subgroup analysis by baseline blood pressure (hypertensive/normotensive). Meta-regression analysis explored the association between type of treatment, dosage, duration or baseline blood pressure and blood pressure outcome. Statistical significance was set at P < 0.05. Fifteen trial arms of 13 assessed studies met the inclusion criteria. Pooled meta-analysis of all trials revealed a significant blood pressure-reducing effect of cocoa-chocolate compared with control (mean BP change +/- SE: SBP: -3.2 +/- 1.9 mmHg, P = 0.001; DBP: -2.0 +/- 1.3 mmHg, P = 0.003). However, subgroup meta-analysis was significant only for the hypertensive or prehypertensive subgroups (SBP: -5.0 +/- 3.0 mmHg; P = 0.0009; DBP: -2.7 +/- 2.2 mm Hg, P = 0.01), while BP was not significantly reduced in the normotensive subgroups (SBP: -1.6 +/- 2.3 mmHg, P = 0.17; DBP: -1.3 +/- 1.6 mmHg, P = 0.12). Nine trials used chocolate containing 50% to 70% cocoa compared with white chocolate or other cocoa-free controls, while six trials compared high- with low-flavanol cocoa products. Daily flavanol dosages ranged from 30 mg to 1000 mg in the active treatment groups, and interventions ran for 2 to 18 weeks. Meta-regression analysis found study design and type of control to be borderline significant but possibly indirect predictors for blood pressure outcome. Our meta-analysis suggests that dark chocolate is superior to placebo in reducing systolic hypertension or diastolic prehypertension. Flavanol-rich chocolate did not significantly reduce mean blood pressure below 140 mmHg systolic or 80 mmHg diastolic.

Critical Buckling Pressure in Mouse Carotid Arteries with Altered Elastic Fibers

PubMed Central

Luetkemeyer, Callan M.; James, Rhys H.; Devarakonda, Siva Teja; Le, Victoria P.; Liu, Qin; Han, Hai-Chao; Wagenseil, Jessica E.

2015-01-01

Arteries can buckle axially under applied critical buckling pressure due to a mechanical instability. Buckling can cause arterial tortuosity leading to flow irregularities and stroke. Genetic mutations in elastic fiber proteins are associated with arterial tortuosity in humans and mice, and may be the result of alterations in critical buckling pressure. Hence, the objective of this study is to investigate how genetic defects in elastic fibers affect buckling pressure. We use mouse models of human disease with reduced amounts of elastin (Eln+/−) and with defects in elastic fiber assembly due to the absence of fibulin-5 (Fbln5−/−). We find that Eln+/− arteries have reduced buckling pressure compared to their wild-type controls. Fbln5−/− arteries have similar buckling pressure to wild-type at low axial stretch, but increased buckling pressure at high stretch. We fit material parameters to mechanical test data for Eln+/−, Fbln5−/− and wild-type arteries using Fung and four-fiber strain energy functions. Fitted parameters are used to predict theoretical buckling pressure based on equilibrium of an inflated, buckled, thick-walled cylinder. In general, the theoretical predictions underestimate the buckling pressure at low axial stretch and overestimate the buckling pressure at high stretch. The theoretical predictions with both models replicate the increased buckling pressure at high stretch for Fbln5−/− arteries, but the four-fiber model predictions best match the experimental trends in buckling pressure changes with axial stretch. This study provides experimental and theoretical methods for further investigating the influence of genetic mutations in elastic fibers on buckling behavior and the development of arterial tortuosity. PMID:25771258

Method of controlling a variable geometry type turbocharger

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

Hirabayashi, Y.

1988-08-23

This patent describes a method of controlling the supercharging pressure of a variable geometry type turbocharger having a bypass, comprising the following steps which are carried out successively: receiving signals from an engine speed sensor and from an engine knocking sensor; receiving a signal from a throttle valve sensor; judging whether or not an engine is being accelerated, and proceeding to step below if the engine is being accelerated and to step below if the engine is not being accelerated, i.e., if the engine is in a constant speed operation; determining a first correction value and proceeding to step below;more » judging whether or not the engine is knocking, and proceeding to step (d) if knocking is occurring and to step (f) below if no knocking is occurring; determining a second correction value and proceeding to step; receiving signals from the engine speed sensor and from an airflow meter which measures the quantity of airflow to be supplied to the engine; calculating an airflow rate per engine revolution; determining a duty valve according to the calculated airflow rate; transmitting the corrected duty value to control means for controlling the geometry of the variable geometry type turbocharger and the opening of bypass of the turbocharger, thereby controlling the supercharging pressure of the turbocharger.« less

Solenoid Driven Pressure Valve System: Toward Versatile Fluidic Control in Paper Microfluidics.

PubMed

Kim, Taehoon H; Hahn, Young Ki; Lee, Jungmin; van Noort, Danny; Kim, Minseok S

2018-02-20

As paper-based diagnostics has become predominantly driven by more advanced microfluidic technology, many of the research efforts are still focused on developing reliable and versatile fluidic control devices, apart from improving sensitivity and reproducibility. In this work, we introduce a novel and robust paper fluidic control system enabling versatile fluidic control. The system comprises a linear push-pull solenoid and an Arduino Uno microcontroller. The precisely controlled pressure exerted on the paper stops the flow. We first determined the stroke distance of the solenoid to obtain a constant pressure while examining the fluidic time delay as a function of the pressure. Results showed that strips of grade 1 chromatography paper had superior reproducibility in fluid transport. Next, we characterized the reproducibility of the fluidic velocity which depends on the type and grade of paper used. As such, we were able to control the flow velocity on the paper and also achieve a complete stop of flow with a pressure over 2.0 MPa. Notably, after the actuation of the pressure driven valve (PDV), the previously pressed area regained its original flow properties. This means that, even on a previously pressed area, multiple valve operations can be successfully conducted. To the best of our knowledge, this is the first demonstration of an active and repetitive valve operation in paper microfluidics. As a proof of concept, we have chosen to perform a multistep detection system in the form of an enzyme-linked immunosorbent assay with mouse IgG as the target analyte.

VALVES FOR THE HIGH PRESSURE-HIGH TEMPERATURE (HP-HT) FLUORINATION SYSTEM. (Engineering Materials)

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

None

1963-10-31

This package contains two drawings of valves which eliminate errors in the gravimetric oxide dilution procedure of U/sup 235/ measurement. Isotopic contaminatioNonen in the high pressure fluorination reactor was corrected by changing the manner in which the Cu tubing joins the valve and by modification of the bellows. The compact inlet system was modified to improve the precision of the spectrometer analyses. Changes were raade in the basic leak and the air operator, which is a diaphragm-type valve, so that the setting of the flow level is controlled by the closure spring adjustment screw. This capillary-type leak has increased controlmore » range and sraooth control characteristics. It is simple to construct, is remotely operated and is free from corrosion failure. (F.S.)« less

Postoperative outcomes after fluocinolone acetonide implant surgery in patients with birdshot chorioretinitis and other types of posterior and panuveitis.

PubMed

Burkholder, Bryn M; Wang, Jiangxia; Dunn, James P; Nguyen, Quan D; Thorne, Jennifer E

2013-09-01

To evaluate outcomes after placement of fluocinolone acetonide (FA) implants in eyes with birdshot chorioretinitis and to compare these outcomes with eyes with posterior and panuveitis. This is a retrospective cohort study of 48 eyes from patients with posterior and panuveitis treated with FA implants from 2006 to 2010. Outcome measures include visual acuity, intraocular pressure, need for glaucoma surgery, postoperative complications, and control of inflammation. All eyes treated with FA implants achieved improved control of inflammation and decreased reliance on adjunctive therapy. Birdshot chorioretinitis eyes had a statistically significant increase in intraocular pressure in the first 4 months after FA implantation (P = 0.04) compared with baseline intraocular pressure. A higher percentage of eyes with birdshot chorioretinitis required glaucoma surgery and after a shorter time period after FA implantation than did eyes with other forms of posterior and panuveitis (0.42/eye-year vs. 0.11/eye-year; median time to glaucoma surgery: 15.5 months vs. 31.5 months respectively, hazard ratio, 3.4; 95% confidence interval, 1.0-10.8, P = 0.04). Although the FA implant is effective in controlling inflammation and reducing the need for systemic immunosuppressive therapy, eyes of patients with birdshot chorioretinitis tend to have a more robust intraocular pressure response to the FA implant than eyes with other types of posterior and panuveitis.

[Lixisenatide in patients with type 2 diabetes and obesity: Beyond glycaemic control].

PubMed

Roca-Rodríguez, M Mar; Muros de Fuentes, María Teresa; Piédrola-Maroto, Gonzalo; Quesada-Charneco, Miguel; Maraver-Selfa, Silvia; Tinahones, Francisco J; Mancha-Doblas, Isabel

2017-05-01

To evaluate tolerance to lixisenatide and its effects on weight and metabolic control in type2 diabetes and obese patients. Prospective study. Endocrinology clinics in Almeria, Granada and Malaga. Patients with type2 diabetes and obesity. Response and tolerance to lixisenatide treatment. Clinical and analytical data of the subjects were evaluated at baseline and after treatment. The study included 104 patients (51% women) with type2 diabetes and obesity (Almeria 18.3%; Granada 40.4%; Malaga 41.3%). The mean age was 58.4±10.5years, and the mean duration of diabetes was 11.2±6.7years. The patients were re-evaluated at 3.8±1.6months after treatment with lixisenatide. Significant improvements were found in weight (P<.001), body mass index (P<.001), waist circumference (P=.002), systolic blood pressure (P<.001), diastolic blood pressure (P=.001), fasting glucose (P<.001), HbA1c (P=.022), Total cholesterol (P<.001), LDL-cholesterol (P=.046), triglycerides (P=.020), hypertension drugs (P<.001), and lipids drugs (P<.001). No changes were observed in levels of amylase related to lixisenatide treatment, and 7.9% of patients did not tolerate it. Lixisenatide achieved significant improvements in anthropometric parameters, glycaemic control (fasting glucose and HbA1c), blood pressure and lipids. It was safe and well tolerated in most patients. In addition, there was a significant increase in the use of antihypertensive and lipid-lowering therapy. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Effect of Multifactorial Treatment Targets and Relative Importance of Hemoglobin A1c, Blood Pressure, and Low-Density Lipoprotein-Cholesterol on Cardiovascular Diseases in Chinese Primary Care Patients With Type 2 Diabetes Mellitus: A Population-Based Retrospective Cohort Study.

PubMed

Wan, Eric Yuk Fai; Fung, Colman Siu Cheung; Yu, Esther Yee Tak; Chin, Weng Yee; Fong, Daniel Yee Tak; Chan, Anca Ka Chun; Lam, Cindy Lo Kuen

2017-08-17

The relative effect of hemoglobin A1c, blood pressure, and low-density lipoprotein-cholesterol (LDL-C) ("ABC" factors) on the prevention of cardiovascular diseases (CVD) among patients with type 2 diabetes mellitus is poorly understood. This study aimed to evaluate the association of key clinical parameters on CVD risk using a multifactorial optimal control approach in Chinese primary care patients with type 2 diabetes mellitus. A population-based retrospective cohort study was conducted on 144 271 Chinese type 2 diabetes mellitus primary care patients, aged 18 to 79 and without prior clinical diagnosis of CVD in 2008-2011. Cox regressions were conducted to examine the association between the combinations of ABC targets (hemoglobin A1c <7%, blood pressure <130/90 mm Hg, and LDL-C <2.6 mmol/L) and risks of CVD (overall), coronary heart disease, stroke, and heart failure. Achieving more ABC targets incrementally reduced the incidence of total CVD and individual disease including coronary heart disease, stroke, and heart failure, irrespective of other patient characteristics. Compared with suboptimal control in all ABC levels, achieving any 1, 2, and all 3 ABC targets reduced the relative risk of CVD by 13% to 42%, 31% to 52%, and 55%, respectively. Among those achieving only 1 ABC target, LDL-C reduction was associated with the greatest CVD risk reduction (42%), followed by blood pressure reduction (18%), and hemoglobin A1c reduction (13%). To achieve the greatest risk reduction for the incidence of CVD, the ultimate goal of treatment should be to achieve target control of hemoglobin A1c, blood pressure, and LDL-C. If it is not possible to achieve all 3 targets, efforts should be prioritized on treating the LDL-C to minimize CVD risk. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Intraoperative Sac Pressure Measurement During Endovascular Abdominal Aortic Aneurysm Repair

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

Ishibashi, Hiroyuki, E-mail: ishibash@aichi-med-u.ac.j; Ishiguchi, Tsuneo; Ohta, Takashi

2010-10-15

PurposeIntraoperative sac pressure was measured during endovascular abdominal aortic aneurysm repair (EVAR) to evaluate the clinical significance of sac pressure measurement.MethodsA microcatheter was placed in an aneurysm sac from the contralateral femoral artery, and sac pressure was measured during EVAR procedures in 47 patients. Aortic blood pressure was measured as a control by a catheter from the left brachial artery.ResultsThe systolic sac pressure index (SPI) was 0.87 {+-} 0.10 after main-body deployment, 0.63 {+-} 0.12 after leg deployment (P < 0.01), and 0.56 {+-} 0.12 after completion of the procedure (P < 0.01). Pulse pressure was 55 {+-} 21 mmHg,more » 23 {+-} 15 mmHg (P < 0.01), and 16 {+-} 12 mmHg (P < 0.01), respectively. SPI showed no significant differences between the Zenith and Excluder stent grafts (0.56 {+-} 0.13 vs. 0.54 {+-} 0.10, NS). Type I endoleak was found in seven patients (15%), and the SPI decreased from 0.62 {+-} 0.10 to 0.55 {+-} 0.10 (P = 0.10) after fixing procedures. Type II endoleak was found in 12 patients (26%) by completion angiography. The SPI showed no difference between type II endoleak positive and negative (0.58 {+-} 0.12 vs. 0.55 {+-} 0.12, NS). There were no significant differences between the final SPI of abdominal aortic aneurysms in which the diameter decreased in the follow-up and that of abdominal aortic aneurysms in which the diameter did not change (0.53 {+-} 0.12 vs. 0.57 {+-} 0.12, NS).ConclusionsSac pressure measurement was useful for instant hemodynamic evaluation of the EVAR procedure, especially in type I endoleaks. However, on the basis of this small study, the SPI cannot be used to reliably predict sac growth or regression.« less

Powered orthosis and attachable power-assist device with Hydraulic Bilateral Servo System.

PubMed

Ohnishi, Kengo; Saito, Yukio; Oshima, Toru; Higashihara, Takanori

2013-01-01

This paper discusses the developments and control strategies of exoskeleton-type robot systems for the application of an upper limb powered orthosis and an attachable power-assist device for care-givers. Hydraulic Bilateral Servo System, which consist of a computer controlled motor, parallel connected hydraulic actuators, position sensors, and pressure sensors, are installed in the system to derive the joint motion of the exoskeleton arm. The types of hydraulic component structure and the control strategy are discussed in relation to the design philosophy and target joints motions.

Gene delivery by direct injection (microinjection) using a controlled-flow system.

PubMed

Dean, David A

2006-12-01

INTRODUCTIONThis protocol describes a method for constant-flow microinjection using the Pneumatic PicoPump (World Precision Instruments). This type of system is very simple and can be assembled on a relatively low budget. In this method, a constant flow of sample is delivered from the tip of the pipette, and the amount of sample injected into the cell is determined by how long the pipette remains in the cell. A typical system is composed of a pressure regulator that can be adjusted for two pressures (back pressure and injection pressure), a capillary holder, and a coarse and fine micromanipulator.

Methicillin-resistant Staphylococcus aureus nasal colonization in a level III neonatal intensive care unit: Incidence and risk factors.

PubMed

Giuffrè, Mario; Amodio, Emanuele; Bonura, Celestino; Geraci, Daniela M; Saporito, Laura; Ortolano, Rita; Corsello, Giovanni; Mammina, Caterina

2015-05-01

To describe epidemiologic features and identify risk factors for methicillin-resistant Staphylococcus aureus (MRSA) acquisition in a level III neonatal intensive care unit (NICU). A prospective, cohort study in a university-affiliated NICU with an infection control program including weekly nasal cultures of all neonates. Demographic, clinical, and microbiologic data were prospectively collected between June 2009 and June 2013. Molecular characterization of MRSA isolates was done by multilocus variable number tandem repeat fingerprinting, staphylococcal cassette chromosome mec typing, and on representative isolates by multilocus sequence typing and spa typing. Of 949 neonates, 217 (22.87%) had a culture growing MRSA, including 117 neonates testing positive at their first sampling. Of these latter infants, 96 (82.05%) were inborn and 59 (50.43%) had been transferred from the nursery. Length of stay and colonization pressure were strong independent predictors of MRSA acquisition. Among MRSA isolates, 7 sequence types were identified, with ST22-IVa, spa type t223, being the predominant strain. In an endemic area, early MRSA acquisition and high colonization pressure, likely related to an influx of colonized infants from a well-infant nursery, can support persistence of MRSA in NICUs. Surveillance, molecular tracking of strains, and reinforcement of infection control practices, involving well-infant nurseries in a comprehensive infection control program, could be helpful in containing MRSA transmission. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Control of sound radiation from a wavepacket over a curved surface

NASA Technical Reports Server (NTRS)

Maestrello, Lucio; El Hady, Nabil M.

1989-01-01

Active control of acoustic pressure in the far field resulting from the growth and decay of a wavepacket convecting in a boundary layer over a concave-convex surface is investigated numerically using direct computations of the Navier-Stokes equations. The resulting sound radiation is computed using linearized Euler equations with the pressure from the Navier-Stokes solution as a time-dependent boundary condition. The acoustic far field exhibits directivity type of behavior that points upstream to the flow direction. A fixed control algorithm is used where the attenuation signal is synthesized by a filter which actively adapt it to the amplitude-time response of the outgoing acoustic wave.

Study on a linear relationship between limited pressure difference and coil current of on/off valve and its influential factors.

PubMed

Zhang, Junzhi; Lv, Chen; Yue, Xiaowei; Li, Yutong; Yuan, Ye

2014-01-01

On/off solenoid valves with PWM control are widely used in all types of vehicle electro-hydraulic control systems respecting to their desirable properties of reliable, low cost and fast acting. However, it can hardly achieve a linear hydraulic modulation by using on/off valves mainly due to the nonlinear behaviors of valve dynamics and fluid, which affects the control accuracy significantly. In this paper, a linear relationship between limited pressure difference and coil current of an on/off valve in its critical closed state is proposed and illustrated, which has a great potential to be applied to improve hydraulic control performance. The hydraulic braking system of case study is modeled. The linear correspondence between limited pressure difference and coil current of the inlet valve is simulated and further verified experimentally. Based on validated simulation models, the impacts of key parameters are researched. The limited pressure difference affected by environmental temperatures is experimentally studied, and the amended linear relation is given according to the test data. © 2013 ISA. Published by Elsevier Ltd. All rights reserved.

Design and performance of heart assist or artificial heart control systems

NASA Technical Reports Server (NTRS)

Webb, J. A., Jr.; Gebben, V. D.

1978-01-01

The factors leading to the design of a controlled driving system for either a heart assist pump or artificial heart are discussed. The system provides square pressure waveform to drive a pneumatic-type blood pump. For assist usage the system uses an R-wave detector circuit that can detect the R-wave of the electrocardiogram in the presence of electrical disturbances. This circuit provides a signal useful for synchronizing an assist pump with the natural heart. It synchronizes a square wave circuit, the output of which is converted into square waveforms of pneumatic pressure suitable for driving both assist device and artificial heart. The pressure levels of the driving waveforms are controlled by means of feedback channels to maintain physiological regulation of the artificial heart's output flow. A more compact system that could achieve similar regulatory characteristics is also discussed.

Noninvasive ventilation.

PubMed

Rabatin, J T; Gay, P C

1999-08-01

Noninvasive ventilation refers to the delivery of assisted ventilatory support without the use of an endotracheal tube. Noninvasive positive pressure ventilation (NPPV) can be delivered by using a volume-controlled ventilator, a pressure-controlled ventilator, a bilevel positive airway pressure ventilator, or a continuous positive airway pressure device. During the past decade, there has been a resurgence in the use of noninvasive ventilation, fueled by advances in technology and clinical trials evaluating its use. Several manufacturers produce portable devices that are simple to operate. This review describes the equipment, techniques, and complications associated with NPPV and also the indications for both short-term and long-term applications. NPPV clearly represents an important addition to the techniques available to manage patients with respiratory failure. Future clinical trials evaluating its many clinical applications will help to define populations of patients most apt to benefit from this type of treatment.

The effects of intermittent use of the SGLT-2 inhibitor, dapagliflozin, in overweight patients with type 2 diabetes in Japan: a randomized, crossover, controlled clinical trial.

PubMed

Kato, Kanako; Suzuki, Kunihiro; Aoki, Chie; Sagara, Masaaki; Niitani, Takafumi; Wakamatsu, Sho; Yanagi, Kazunori; Aso, Yoshimasa

2017-06-01

This study examined the effects of short-term administration of the sodium glucose cotransporter 2 (SGLT-2) inhibitor, dapagliflozin, on visceral fat area (VFA) in Japanese patients with type 2 diabetes. In this randomized, crossover, controlled clinical trial, overweight patients with type 2 diabetes were randomized to treatment with 5 mg dapagliflozin for the first (n = 27) or second 12-week study period (n = 29). The parameters evaluated at baseline and after 12 and 24 weeks included blood pressure, hemoglobin A1c (HbA1c), body composition, VFA, and subcutaneous fat area (SFA). In both groups, dapagliflozin administration improved the levels of HbA1c, body weight, blood pressure, total fat mass, and VFA. Cessation of dapagliflozin, however, reversed the improvements in HbA1c, blood pressure, body weight, and SFA levels, whereas reductions in VFA and total fat mass levels were somewhat maintained even after 12 weeks without treatment. Dapagliflozin led to decreases in VFA and, consequently, body weight after a short treatment period. However, these effects were largely reversed by the cessation of dapagliflozin, suggesting that this agent should be administered continuously to maintain clinical usefulness in overweight patients with type 2 diabetes.

Comparative Study of the Effects of a 1-Year Dietary Intervention of a Low-Carbohydrate Diet Versus a Low-Fat Diet on Weight and Glycemic Control in Type 2 Diabetes

PubMed Central

Davis, Nichola J.; Tomuta, Nora; Schechter, Clyde; Isasi, Carmen R.; Segal-Isaacson, C.J.; Stein, Daniel; Zonszein, Joel; Wylie-Rosett, Judith

2009-01-01

OBJECTIVE To compare the effects of a 1-year intervention with a low-carbohydrate and a low-fat diet on weight loss and glycemic control in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS This study is a randomized clinical trial of 105 overweight adults with type 2 diabetes. Primary outcomes were weight and A1C. Secondary outcomes included blood pressure and lipids. Outcome measures were obtained at 3, 6, and 12 months. RESULTS The greatest reduction in weight and A1C occurred within the first 3 months. Weight loss occurred faster in the low-carbohydrate group than in the low-fat group (P = 0.005), but at 1 year a similar 3.4% weight reduction was seen in both dietary groups. There was no significant change in A1C in either group at 1 year. There was no change in blood pressure, but a greater increase in HDL was observed in the low-carbohydrate group (P = 0.002). CONCLUSIONS Among patients with type 2 diabetes, after 1 year a low-carbohydrate diet had effects on weight and A1C similar to those seen with a low-fat diet. There was no significant effect on blood pressure, but the low-carbohydrate diet produced a greater increase in HDL cholesterol. PMID:19366978

Influence of Air Discontinuity and Wall Effects on the Measurements of Hydraulic Parameters Under Dynamic Conditions

NASA Astrophysics Data System (ADS)

Looms, M. C.; Jensen, K. H.; Wildenschild, D.; Christensen, B. S.; Gudbjerg, J.

2003-12-01

Both dynamic (one-step) and semi-static (syringe pump) outflow experiments were carried out in the lab to test whether the resulting retention characteristics differed according to experiment type. Three sands of varying uniformity and coarseness were packed in a cylindrical sample holder. Compressed air was used to control the air phase pressure, while water was allowed to drain at atmospheric pressure from the outlet at the bottom of the sample. During the outflow experiments the capillary pressure was measured within the sample holder using a tensiometer connected to a pressure transducer. A medical CT-scanner was used to visualize and quantify the outflow patterns within the sand matrix during selected outflow experiments. Positive vertical shifts in capillary pressure during dynamic experiments were found in all three sand types at saturations close to porosity. The size and shape of the shifts corresponded with the dynamic effects found in previous work on the topic. Furthermore, the shifts were slightly greater in the coarsest and most uniform sand type. Numerical simulations of the one-step experiments using HYDRUS1D and T2VOC showed, however, that one of the basic assumptions when calculating the capillary pressure was most likely violated. The air phase could not be considered to be continuous at all times, and assuming this to be the case would result in positive shifts of the retention curves when running T2VOC. The results of using the CT-scanner showed the importance of achieving a homogeneous packing, since the investigated sand packing turned out to have an area at the edge of the sample holder with a higher porosity. This caused the edge to control the initial drainage. Therefore, the data collected at high saturations could not be expected to adequately describe the hydraulic properties of the inner sand. We also found that the time at which the inner sand commenced drainage coincided with a jump in capillary pressure for the resulting measured retention curve.

Effectiveness of contextual education for self-management in Thai Muslims with type 2 diabetes mellitus during Ramadan.

PubMed

Susilparat, Prakaitip; Pattaraarchachai, Junya; Songchitsomboon, Sriwatana; Ongroongruang, Savanit

2014-08-01

Fasting in Ramadan has adverse effects on health of Muslims with diabetes. Key strategies to prepare the patients are to provide appropriate health education to the patients prior to Ramadan and to adjust anti-diabetic medicines during Ramadan. To study outcomes of the specific health care services that providing health education in parallel with counseling by Islamic leader The Thai Muslims with type 2 diabetes mellitus were divided into two groups. There were 62patients in experimental group that was provided with specific health care service for Thai Muslims with diabetes in which health education prior to Ramadan and adjustment ofanti-diabetic medicine applied. The other was control group with 28patients that was provided only with original health care service. The results were monitored after Ramadan by interviews, weight and waist measurements, blood pressure measurement and blood tests. Both mean systolic and diastolic blood pressure were well controlled in both groups and slightly decreased after Ramnadan. The mean diastolic blood pressure of the experimental group decreased after Ramadan (p-value = 0.041). From behavior point of view, it was found that the patients in the experimental group had consumed less sweetenedfood (p-value = 0.002). There was no incidence ofsevere hypoglycemia in either experimental or control group. The number and portion of patients with hypoglycemic symptoms in experimental group were lower than those in controlled group (p-value = 0.013). Specific health care service by providing health education prior to Ramadan and adjustment ofanti-diabetic medicine application resulted in a positive effect as the patients tended to consume less sweetenedfood to keep blood sugar level in control. Fasting could affect the patients 'health in apositive way as it helps to control blood pressure, while in parallel, adjustment of anti-diabetic medicine application helps to prevent hypoglycemia. This health care service, which can be achieved in collaboration with a health care team and Islamic leaders, is useful and suitable for Thai Muslims with diabetes mellitus type 2.

Apparatus for material tests using an internal loading system in high-pressure gas at room temperature.

PubMed

Imade, M; Fukuyama, S; Yokogawa, K

2008-07-01

A new type of apparatus for material tests using an internal loading system in high-pressure gas up to 100 MPa at room temperature without conventional material testing equipment was developed. The apparatus consists of a high-pressure control system and a pressure vessel, in which a piston is installed in the cylinder of the pressure vessel. The load caused by the pressure difference between spaces separated by the piston in the vessel cylinder is applied on the specimen connected to the piston in the vessel cylinder. The actual load on the specimen is directly measured by an external load cell and the displacement of the specimen is also measured by an external extensometer. As an example of the application of the apparatus, a tensile test on SUS316 stainless steel the Japanese Industrial Standard (JIS) G4303, which is comparable to the type 316 stainless steel ASTM A276, was conducted in 90 MPa hydrogen and argon. Hydrogen showed a marked effect on the tensile property of the material. The hydrogen gas embrittlement of the material was briefly discussed.

Apparatus for material tests using an internal loading system in high-pressure gas at room temperature

NASA Astrophysics Data System (ADS)

Imade, M.; Fukuyama, S.; Yokogawa, K.

2008-07-01

A new type of apparatus for material tests using an internal loading system in high-pressure gas up to 100MPa at room temperature without conventional material testing equipment was developed. The apparatus consists of a high-pressure control system and a pressure vessel, in which a piston is installed in the cylinder of the pressure vessel. The load caused by the pressure difference between spaces separated by the piston in the vessel cylinder is applied on the specimen connected to the piston in the vessel cylinder. The actual load on the specimen is directly measured by an external load cell and the displacement of the specimen is also measured by an external extensometer. As an example of the application of the apparatus, a tensile test on SUS316 stainless steel the Japanese Industrial Standard (JIS) G4303, which is comparable to the type 316 stainless steel ASTM A276, was conducted in 90MPa hydrogen and argon. Hydrogen showed a marked effect on the tensile property of the material. The hydrogen gas embrittlement of the material was briefly discussed.

Pneumatic load compensating or controlling system

NASA Technical Reports Server (NTRS)

Rogers, J. R. (Inventor)

1975-01-01

A pneumatic load compensating or controlling system for restraining a load with a predetermined force or applying a predetermined force to the load is described; it includes a source of pressurized air, a one-way pneumatic actuator operatively connected to a load, and a fluid conduit fluidically connecting the actuator with the source of pressurized air. The actuator is of the piston and cylinder type, and the end of the fluid conduit is connected to the upper or lower portion of the cylinder whereby the actuator alternatively and selectively restrains the load with a predetermined force or apply a predetermined force to the load. Pressure regulators are included within the system for variably selectively adjusting the pressurized fluid to predetermined values as desired or required; a pressure amplifier is included within the system for multiplying the pressurized values so as to achieve greater load forces. An accumulator is incorporated within the system as a failsafe operating mechanism, and visual and aural alarm devices, operatively associated with pressure detecting apparatus, readily indicate the proper or improper functioning of the system.

Performance of the craniocervical flexion test, forward head posture, and headache clinical parameters in patients with chronic tension-type headache: a pilot study.

PubMed

Fernandez-de-las-Peñas, César; Pérez-de-Heredia, Marta; Molero-Sánchez, Alberto; Miangolarra-Page, Juan Carlos

2007-02-01

Case-control, descriptive pilot study. To describe the differences in the performance of the craniocervical flexion test (CCFT) between individuals with chronic tension-type headache (CTTH) and healthy controls. To assess the relationship between the CCFT, forward head posture, and several clinical variables related to the intensity and temporal profile of headache. Musculoskeletal impairments of the craniocervical region might play an important role on the pathogenesis of CTTH. Deficits in the performance of the CCFT have been reported in patients with cervicogenic headache, nonspecific neck pain, and whiplash injury, but not in individuals with CTTH. Ten patients with CTTH and 10 comparable controls without headache were studied. A headache diary was kept for 4 weeks to substantiate the diagnosis and to record the pain history. The CCFT was performed with the subject supine and required performing a gentle head-nodding action of craniocervical flexion. The activation pressure score (pressure that the subject can achieve and hold for 10 seconds), the performance pressure index (calculated by multiplying the activation pressure score by the number of successful repetitions), and the highest pressure score (the highest level that each subject was able to hold for 10 seconds from 20 to 30 mm Hg) were measured. Side-view pictures of each subject were taken in both sitting and standing positions to assess forward head posture (FHP) by measuring the craniovertebral angle. All measures were taken by an assessor blinded to the subject's condition. Patients with CTTH had significantly lower values in both active pressure score and performance pressure index (P < .001), but not in the highest pressure score (P = .057), compared to controls. Patients with CTTH had a smaller craniovertebral angle (mean +/- SD, 42.0 degrees +/- 6.6 degrees), indicating a more FHP than controls (48.8 degrees +/- 2.5 degrees), in the standing position (P < .01); but not in the sitting position (CTTH, 39 degrees +/- 8.9 degrees; controls, 42.8 degrees +/- 8.9 degrees, P = .10). No association between FHP and any of the CCFT variables was found (P >.05). Headache intensity and frequency did not seem to be related to the CCFT variables, but there was a positive association between headache duration and activation pressure score (r(s), = 0.746, P = .02) and highest pressure score (r(s), = 0.743, P = .02). These findings suggest possible impairments of the musculoskeletal system in individuals with CTTH, although it is not possible to determine if these impairments contributed to the etiology of CTTH or are as a result of the chronic headache condition.

Aortic Aneurysm Statistics

MedlinePlus

... commit" type="submit" value="Submit" /> Related CDC Web Sites Heart Disease Stroke High Blood Pressure Salt ... to Prevent and Control Chronic Diseases Million Hearts® Web Sites with More Information About Aortic Aneurysm For ...

ENVIRONMENTAL TECHNOLOGY VERIFICATIONTEST REPORT OF CONTROL OF BIOAEROSOLS IN HVAC SYSTEMS AAF INTERNATIONAL BIOCEL I (TYPE SH)

EPA Science Inventory

The Environmental Technology Verification report discusses the technology and performance of the BioCel I (Type SH) air filter for dust and bioaerosol filtration manufactured by AAF International. The pressure drop across the filter was 236 Pa clean and 478 Pa dust loaded, and th...

Embedding Piezoresistive Pressure Sensors to Obtain Online Pressure Profiles Inside Fiber Composite Laminates

PubMed Central

Kahali Moghaddam, Maryam; Breede, Arne; Brauner, Christian; Lang, Walter

2015-01-01

The production of large and complex parts using fiber composite materials is costly due to the frequent formation of voids, porosity and waste products. By embedding different types of sensors and monitoring the process in real time, the amount of wastage can be significantly reduced. This work focuses on developing a knowledge-based method to improve and ensure complete impregnation of the fibers before initiation of the resin cure. Piezoresistive and capacitive pressure sensors were embedded in fiber composite laminates to measure the real-time the pressure values inside the laminate. A change of pressure indicates resin infusion. The sensors were placed in the laminate and the resin was infused by vacuum. The embedded piezoresistive pressure sensors were able to track the vacuum pressure in the fiber composite laminate setup, as well as the arrival of the resin at the sensor. The pressure increase due to closing the resin inlet was also measured. In contrast, the capacitive type of sensor was found to be inappropriate for measuring these quantities. The following study demonstrates real-time monitoring of pressure changes inside the fiber composite laminate, which validate the use of Darcy’s law in porous media to control the resin flow during infusion. PMID:25825973

The production and measurement of sub-bandage pressure: Laplace's Law revisited.

PubMed

Thomas, S

2014-05-01

The present study was undertaken to demonstrate that the pressures produced by multiple layers of compression bandages applied to artificial limbs of known circumference with predetermined levels of tension can be predicted accurately using the modified Laplace equation. Up to four layers of different bandage types were applied in a carefully controlled fashion to cylinders of known circumference, with tensions ranging from around 200-2000 grams/10cm width. The pressures generated were measured using pneumatic pressure sensors previously shown to possess the required degree of accuracy for this type of experimental system. Good correlation was observed between the mean and standard deviation of each pair of experimental and calculated pressure values for all combinations of bandage type, application tension and cylinder circumference. Over the clinically relevant range of pressures, the difference between data sets was generally less than 1.0mmHg. The results of this experimental study unequivocally prove that provided accurate values for all the relevant variables are known, it is possible to predict the pressure that will be developed by a compression bandage on a limb of known size. However, it is important to recognise that other factors such as the elastomeric properties of the fabric will have a major effect upon the ability of a bandage system to sustain initial compression values. Furthermore, the variation in radius of curvature around a limb will mean that point pressures readings recorded at individual locations around the circumference may vary dramatically from the average value predicted by the modified Laplace equation, calling into question the value of sub-bandage pressure measuring devices for this application.

Trends in Hypertension Prevalence, Awareness, Treatment and Control in an Adult Type 2 Diabetes Spanish Population between 2003 and 2009

PubMed Central

de Burgos-Lunar, Carmen; Jiménez-García, Rodrigo; Salinero-Fort, Miguel A.; Gómez-Campelo, Paloma; Gil, Ángel; Abánades-Herranz, Juan C.; Cárdenas-Valladolid, Juan; del Cura-González, Isabel

2014-01-01

In patients with type 2 diabetes, the prevalence of hypertension is higher than in non-diabetic subjects. Despite the high cardiovascular risk involving hypertension in these patients, its prevalence and control are not well known. The aims of this study were: to estimate the hypertension prevalence, awareness, treatment and control in Spanish adults with type 2 diabetes attended in Primary Care; and to analyse its time trend from 2003 to 2009. A serial cross-sectional study from 2003 to 2009 was performed in 21 Primary Care Centres in Madrid. The study population comprised all patients with diagnosed type 2 diabetes in their computerised medical history. Overall annual prevalence during the period 2003–2009 was calculated from and according to sex and age groups. Linear trend tests, regression lines and coefficients of determination were used. In 2003 89.78% (CI 87.92–91.64) of patients with type 2 diabetes suffered hypertension and 94.76% (CI: 92.85–96.67) in 2009. This percentage was greater for women and for patients over 65 years old. 30% of patients suffered previously undiagnosed hypertension in 2003 and 23.1% in 2009. 97% of diagnosed patients received pharmacological treatment and 28.79% reached the blood pressure objective in 2009. The average number of antihypertensive drugs taken was 2.72 in 2003 and 3.27 in 2009. Only 5.2% of patients with type 2 diabetes show blood pressure levels below 130/80 mmHg. Although significant improvements have been achieved in the diagnosis and control of hypertension in people with type 2 diabetes, these continue to remain far from optimum. PMID:24475171

Deleterious effects of increased body weight associated with intensive insulin therapy for type 1 diabetes: increased blood pressure and worsened lipid profile partially negate improvements in life expectancy.

PubMed

Palmer, Andrew J; Roze, Stéphane; Valentine, William J; Minshall, Michael E; Lammert, Morten; Nicklasson, Lars; Spinas, Giatgen A

2004-08-01

Weight gain is an unwanted side effect of improved glycaemic control in type 1 diabetes, associated with increased blood pressure (BP) and worsening lipid profiles. While improved glycaemic control per se should improve long-term patient outcomes, increases in BP and worsening lipid profiles may counteract these benefits. The aim of this modelling study was to assess whether the increased body weight and associated worsening of lipid profile and blood pressure would negate the improvements in glycaemic control seen with intensive therapy in patients with type 1 diabetes. A validated diabetes model projected life expectancy (LE), quality-adjusted LE (QALE) and total lifetime costs of complications in type 1 diabetes cohorts with the characteristics of patients from the Diabetes Control and Complications Trial (DCCT). The following four cohorts (A-D) were created based on increased body weight under either conventional or intensive therapy: A) conventional glycaemic control in the subgroup with lowest weight-gain quartile after 6.5 years (HbA1c increased by 11% from baseline); B) conventional control in the highest weight-gain quartile (no change in HbA1c from baseline); C) intensive control in the lowest quartile of weight gain (with 16.1% decrease in HbA1c, but no increase in weight or associated BP, and improved lipid profile); D) intensive control in the highest quartile of weight gain (with 21% decrease in HbA1c, increased systolic BP of 6 mmHg, and worsened lipid profile). Data were derived from DCCT and other published sources. Intensive control, even with weight gain, led to major improvements in LE and QALE, and reduction in costs of complications versus conventional therapy. Intensive therapy with no weight increase led to a higher LE (increased by 0.57 years) and higher QALE (increased by 0.28 years) and lower costs of complications (reduced by 523 dollars/patient), compared to intensive therapy with the highest quartile of weight gain. Concerns about weight gain should not deter intensive insulin therapy. However, the value of improving glycaemic control without increasing body weight (and associated increased BP and worsening of lipid profile) has been confirmed.

Measuring Blast-Related Intracranial Pressure Within the Human Head

DTIC Science & Technology

2011-02-01

AWARD NUMBER: W81XWH-09- 1 -0498 TITLE: Measuring Blast-Related Intracranial Pressure Within...REPORT DOCUMENTATION PAGE Form Approved OMB No. 0704-0188 Public reporting burden for this collection of information is estimated to average 1 hour...valid OMB control number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. 1 . REPORT DATE 1 February 2011 2. REPORT TYPE Final 3. DATES

High-temperature microelectromechanical pressure sensors based on a SOI heterostructure for an electronic automatic aircraft engine control system

NASA Astrophysics Data System (ADS)

Sokolov, Leonid V.

2010-08-01

There is a need of measuring distributed pressure on the aircraft engine inlet with high precision within a wide operating temperature range in the severe environment to improve the efficiency of aircraft engine control. The basic solutions and principles of designing high-temperature (to 523K) microelectromechanical pressure sensors based on a membrane-type SOI heterostructure with a monolithic integral tensoframe (MEMS-SOIMT) are proposed in accordance with the developed concept, which excludes the use of electric p-n junctions in semiconductor microelectromechanical sensors. The MEMS-SOIMT technology relies on the group processes of microelectronics and micromechanics for high-precision microprofiling of a three-dimension micromechanical structure, which exclude high-temperature silicon doping processes.

Data and Statistics: Heart Failure

MedlinePlus

... commit" type="submit" value="Submit" /> Related CDC Web Sites Heart Disease Stroke High Blood Pressure Salt ... to Prevent and Control Chronic Diseases Million Hearts® Web Sites with More Information About Heart Failure For ...

NUCLEAR REACTOR

DOEpatents

Treshow, M.

1958-08-19

A neuclear reactor is described of the heterogeneous type and employing replaceable tubular fuel elements and heavy water as a coolant and moderator. A pluraltty of fuel tubesa having their axes parallel, extend through a tank type pressure vessel which contatns the liquid moderator. The fuel elements are disposed within the fuel tubes in the reaetive portion of the pressure vessel during normal operation and the fuel tubes have removable plug members at each end to permit charging and discharging of the fuel elements. The fuel elements are cylindrical strands of jacketed fissionable material having helical exterior ribs. A bundle of fuel elements are held within each fuel tube with their longitudinal axes parallel, the ribs serving to space them apart along their lengths. Coolant liquid is circulated through the fuel tubes between the spaced fuel elements. Suitable control rod and monitoring means are provided for controlling the reactor.

Baseline characteristics and interim (3-month) efficacy and safety data from STELLA-LONG TERM, a long-term post-marketing surveillance study of ipragliflozin in Japanese patients with type 2 diabetes in real-world clinical practice.

PubMed

Maegawa, Hiroshi; Tobe, Kazuyuki; Tabuchi, Hiromi; Nakamura, Ichiro

2016-10-01

To evaluate the efficacy and safety of ipragliflozin in real-world clinical practice in Japanese patients with type 2 diabetes. We conducted interim analyses at 3 months of a 3-year prospective study of patients who were first prescribed ipragliflozin between 17 July 2014 and 16 October 2015, and whose data were locked by 16 January 2016. Changes in glycemic control, blood pressure, and laboratory variables from baseline, and incidence of adverse drug reactions (ADRs). Of 11,412 patients initially registered, efficacy and safety data were available for 3481 (30.5%) and 4360 (38.2%) patients, respectively. Hemoglobin A1c and fasting plasma glucose decreased by 0.67% and 28.8 mg/dL, respectively, at 3 months/last assessment (both P < .001) from baseline (8.00% and 166.4 mg/dL, respectively). Blood pressure and lipid levels also improved significantly. There were 258 ADRs in 194 patients. The ADRs included 'renal and urinary disorders' (system organ class) in 110 patients (2.5%). These 3-month interim results indicate that ipragliflozin improved glycemic control, lipids, and blood pressure with low rates of ADRs in Japanese patients with type 2 diabetes in real-world clinical practice. The results were consistent with those of placebo-controlled, randomized clinical trials. Clinicaltrials.gov identifier: NCT02479399.

Simulation of proportional control of hydraulic actuator using digital hydraulic valves

NASA Astrophysics Data System (ADS)

Raghuraman, D. R. S.; Senthil Kumar, S.; Kalaiarasan, G.

2017-11-01

Fluid power systems using oil hydraulics in earth moving and construction equipment have been using proportional and servo control valves for a long time to achieve precise and accurate position control backed by system performance. Such valves are having feedback control in them and exhibit good response, sensitivity and fine control of the actuators. Servo valves and proportional valves are possessing less hysteresis when compared to on-off type valves, but when the servo valve spools get stuck in one position, a high frequency called as jitter is employed to bring the spool back, whereas in on-off type valves it requires lesser technology to retract the spool. Hence on-off type valves are used in a technology known as digital valve technology, which caters to precise control on slow moving loads with fast switching times and with good flow and pressure control mimicking the performance of an equivalent “proportional valve” or “servo valve”.

Gestational hypoxia induces preeclampsia-like symptoms via heightened endothelin-1 signaling in pregnant rats.

PubMed

Zhou, Jianjun; Xiao, Daliao; Hu, Yali; Wang, Zhiqun; Paradis, Alexandra; Mata-Greenwood, Eugenia; Zhang, Lubo

2013-09-01

Preeclampsia is a life-threatening pregnancy disorder. However, its pathogenesis remains unclear. We tested the hypothesis that gestational hypoxia induces preeclampsia-like symptoms via heightened endothelin-1 (ET-1) signaling. Time-dated pregnant and nonpregnant rats were divided into normoxic and hypoxic (10.5% O2 from the gestational day 6-21) groups. Chronic hypoxia had no significant effect on blood pressure or proteinuria in nonpregnant rats but significantly increased blood pressure on day 12 (systolic blood pressure, 111.7 ± 6.1 versus 138.5 ± 3.5 mm Hg; P=0.004) and day 20 (systolic blood pressure, 103.4 ± 4.6 versus 125.1 ± 6.1 mm Hg; P=0.02) in pregnant rats and urine protein (μg/μL)/creatinine (nmol/μL) ratio on day 20 (0.10 ± 0.01 versus 0.20 ± 0.04; P=0.04), as compared with the normoxic control group. This was accompanied with asymmetrical fetal growth restriction. Hypoxia resulted in impaired trophoblast invasion and uteroplacental vascular remodeling. In addition, plasma ET-1 levels, as well as the abundance of prepro-ET-1 mRNA, ET-1 type A receptor and angiotensin II type 1 receptor protein in the kidney and placenta were significantly increased in the chronic hypoxic group, as compared with the control animals. Treatment with the ET-1 type A receptor antagonist, BQ123, during the course of hypoxia exposure significantly attenuated the hypoxia-induced hypertension and other preeclampsia-like features. The results demonstrate that chronic hypoxia during gestation induces preeclamptic symptoms in pregnant rats via heightened ET-1 and ET-1 type A receptor-mediated signaling, providing a molecular mechanism linking gestational hypoxia and increased risk of preeclampsia.

In vitro analysis of type II endoleaks and aneurysm sac pressurization on longitudinal stent-graft displacement.

PubMed

Knowles, Martyn; Pellisar, Tiago; Murphy, Erin H; Stanley, Gregory A; Hashmi, Abraham F; Arko, M Zachary; Arko, Frank R

2011-08-01

To evaluate the effects of type II endoleaks and sac pressurization on stent-graft displacement following endovascular aneurysm repair (EVAR). Experimental silicone infrarenal aneurysm (6-cm) models were "treated" with a Talent stent-graft deployed with 20-mm proximal and distal landing zones. Inflow and outflow vessels were created as part of the silicone model to control flow into the aneurysm sac. All aneurysm models were uniform, with a diameter neck of 31 mm, a neck length of 20 mm, and iliac artery diameters of 16 mm. The aortic model was secured in a water bath to a pulsatile pump under physiological conditions; the output phase ratio (%systole/%diastole) was set at 65/35 with a pump rate of 80 beats per minute. Commercially available bifurcated stent-grafts were then displaced in vitro utilizing a linear motion apparatus attached to a force gauge. The mean arterial pressure (MAP) and pulse pressure (PP) at the aortic inflow were 60.1 ± 3.1 and 38.3 ± 7.8 mmHg, respectively. Peak force to cause initial stent-graft migration with and without a type II endoleak was recorded and compared. In aneurysm sacs with no endoleak, the MAP and sac PP were 32 ± 6.4 and 6 ± 1.3 mmHg, respectively (p<0.01). In aneurysm sacs with a type II endoleak, the MAP and sac PP were 54.1 ± 9.7 and 16.1 ± 4.1 mmHg, respectively (p<0.02). Peak force to initiate migration was 16.0 ± 1.41 N (range 15-18) with no endoleak vs. 23.2 ± 2.2 N (range 20-25) in those with a type IIa endoleak and 23.5 ± 2.5 N (range 20-26) in those with a type IIb endoleak (p<0.001). Type II endoleaks are associated with a significantly increased sac pressure. Increased sac pressurization from type II endoleaks results in a significantly greater force to displace a stent-graft longitudinally. Type II endoleaks may therefore inhibit migration and offer a benefit following EVAR; however, clinical correlation of these results is required.

Human GRK4γ142V Variant Promotes Angiotensin II Type I Receptor-Mediated Hypertension via Renal Histone Deacetylase Type 1 Inhibition.

PubMed

Wang, Zheng; Zeng, Chunyu; Villar, Van Anthony M; Chen, Shi-You; Konkalmatt, Prasad; Wang, Xiaoyan; Asico, Laureano D; Jones, John E; Yang, Yu; Sanada, Hironobu; Felder, Robin A; Eisner, Gilbert M; Weir, Matthew R; Armando, Ines; Jose, Pedro A

2016-02-01

The influence of a single gene on the pathogenesis of essential hypertension may be difficult to ascertain, unless the gene interacts with other genes that are germane to blood pressure regulation. G-protein-coupled receptor kinase type 4 (GRK4) is one such gene. We have reported that the expression of its variant hGRK4γ(142V) in mice results in hypertension because of impaired dopamine D1 receptor. Signaling through dopamine D1 receptor and angiotensin II type I receptor (AT1R) reciprocally modulates renal sodium excretion and blood pressure. Here, we demonstrate the ability of the hGRK4γ(142V) to increase the expression and activity of the AT1R. We show that hGRK4γ(142V) phosphorylates histone deacetylase type 1 and promotes its nuclear export to the cytoplasm, resulting in increased AT1R expression and greater pressor response to angiotensin II. AT1R blockade and the deletion of the Agtr1a gene normalize the hypertension in hGRK4γ(142V) mice. These findings illustrate the unique role of GRK4 by targeting receptors with opposite physiological activity for the same goal of maintaining blood pressure homeostasis, and thus making the GRK4 a relevant therapeutic target to control blood pressure. © 2015 American Heart Association, Inc.

Hydrostatic pressure and shear stress affect endothelin-1 and nitric oxide release by endothelial cells in bioreactors.

PubMed

Vozzi, Federico; Bianchi, Francesca; Ahluwalia, Arti; Domenici, Claudio

2014-01-01

Abundant experimental evidence demonstrates that endothelial cells are sensitive to flow; however, the effect of fluid pressure or pressure gradients that are used to drive viscous flow is not well understood. There are two principal physical forces exerted on the blood vessel wall by the passage of intra-luminal blood: pressure and shear. To analyze the effects of pressure and shear independently, these two stresses were applied to cultured cells in two different types of bioreactors: a pressure-controlled bioreactor and a laminar flow bioreactor, in which controlled levels of pressure or shear stress, respectively, can be generated. Using these bioreactor systems, endothelin-1 (ET-1) and nitric oxide (NO) release from human umbilical vein endothelial cells were measured under various shear stress and pressure conditions. Compared to the controls, a decrease of ET-1 production by the cells cultured in both bioreactors was observed, whereas NO synthesis was up-regulated in cells under shear stress, but was not modulated by hydrostatic pressure. These results show that the two hemodynamic forces acting on blood vessels affect endothelial cell function in different ways, and that both should be considered when planning in vitro experiments in the presence of flow. Understanding the individual and synergic effects of the two forces could provide important insights into physiological and pathological processes involved in vascular remodeling and adaptation. Copyright © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Does teacher evaluation based on student performance predict motivation, well-being, and ill-being?

PubMed

Cuevas, Ricardo; Ntoumanis, Nikos; Fernandez-Bustos, Juan G; Bartholomew, Kimberley

2018-06-01

This study tests an explanatory model based on self-determination theory, which posits that pressure experienced by teachers when they are evaluated based on their students' academic performance will differentially predict teacher adaptive and maladaptive motivation, well-being, and ill-being. A total of 360 Spanish physical education teachers completed a multi-scale inventory. We found support for a structural equation model that showed that perceived pressure predicted teacher autonomous motivation negatively, predicted amotivation positively, and was unrelated to controlled motivation. In addition, autonomous motivation predicted vitality positively and exhaustion negatively, whereas controlled motivation and amotivation predicted vitality negatively and exhaustion positively. Amotivation significantly mediated the relation between pressure and vitality and between pressure and exhaustion. The results underline the potential negative impact of pressure felt by teachers due to this type of evaluation on teacher motivation and psychological health. Copyright © 2018 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

Flow restrictor silicon membrane microvalve actuated by optically controlled paraffin phase transition

NASA Astrophysics Data System (ADS)

Kolari, K.; Havia, T.; Stuns, I.; Hjort, K.

2014-08-01

Restrictor valves allow proportional control of fluid flow but are rarely integrated in microfluidic systems. In this study, an optically actuated silicon membrane restrictor microvalve is demonstrated. Its actuation is based on the phase transition of paraffin, using a paraffin wax mixed with a suitable concentration of optically absorbing nanographite particles. Backing up the membrane with oil (the melted paraffin) allows for a compliant yet strong contact to the valve seat, which enables handling of high pressures. At flow rates up to 30 µL min-1 and at a pressure of 2 bars, the valve can successfully be closed and control the flow level by restriction. The use of this paraffin composite as an adhesive layer sandwiched between the silicon valve and glass eases fabrication. This type of restrictor valve is best suited for high pressure, low volume flow silicon-based nanofluidic systems.

Numerical assessment of pulsating water jet in the conical diffusers

NASA Astrophysics Data System (ADS)

Tanasa, Constantin; Ciocan, Tiberiu; Muntean, Sebastian

2017-11-01

The hydraulic fluctuations associated with partial load operating conditions of Francis turbines are often periodic and characterized by the presence of a vortex rope. Two types of pressure fluctuations associated with the draft tube surge are identified in the literature. The first is an asynchronous (rotating) pressure fluctuation due to the precession of the helical vortex around the axis of the draft tube. The second type of fluctuation is a synchronous (plunging) fluctuation. The plunging fluctuations correspond to the flow field oscillations in the whole hydraulic passage, and are generally propagated overall in the hydraulic system. The paper introduced a new control method, which consists in injecting a pulsating axial water jet along to the draft tube axis. Nevertheless, the great calling of this control method is to mitigate the vortex rope effects targeting the vortex sheet and corresponding plunging component. In this paper, is presented our 3D numerical investigations with and without pulsating axial water jet control method in order to evaluate the concept.

Free-piston reciprocating cryogenic expander utilizing phase controller

NASA Astrophysics Data System (ADS)

Cha, Jeongmin; Park, Jiho; Kim, Kyungjoong; Jeong, Sangkwon

2017-02-01

In a free-piston expander which eliminates mechanical linkages, a prescribed behaviour of the free-piston movement is the key to an expander performance. In this paper, we have proposed an idea of reducing complexity of the free-piston expander. It is to replace both multiple solenoid valves and reservoirs that are indispensable in a previous machine with a combination of a single orifice-reservoir assembly. It functions as a phase controller like that of a pulse tube refrigerator so that it generates time-delay of pressure variation between the warm-end and the reservoir resulting in the intended expansion of the cold-end volume down to the pre-set reservoir pressure. The modeling of this unique free-piston reciprocating expander utilizing phase controller is developed to understand and predict the performance of the new-type expander. Additionally, the operating parameters are analysed at the specified conditions to enable one to develop a more efficient free-piston type cryogenic expander.

Development of an Accident Reproduction Simulator System Using a Hemodialysis Extracorporeal Circulation System

PubMed Central

Nishite, Yoshiaki; Takesawa, Shingo

2016-01-01

Background: Accidents that occur during dialysis treatment are notified to the medical staff via alarms raised by the dialysis apparatus. Similar to such real accidents, apparatus activation or accidents can be reproduced by simulating a treatment situation. An alarm that corresponds to such accidents can be utilized in the simulation model. Objectives: The aim of this study was to create an extracorporeal circulation system (hereinafter, the circulation system) for dialysis machines so that it sets off five types of alarms for: 1) decreased arterial pressure, 2) increased arterial pressure, 3) decreased venous pressure, 4) increased venous pressure, and 5) blood leakage, according to the five types of accidents chosen based on their frequency of occurrence and the degree of severity. Materials and Methods: In order to verify the alarm from the dialysis apparatus connected to the circulation system and the accident corresponding to it, an evaluation of the alarm for its reproducibility of an accident was performed under normal treatment circumstances. The method involved testing whether the dialysis apparatus raised the desired alarm from the moment of control of the circulation system, and measuring the time it took until the desired alarm was activated. This was tested on five main models from four dialyzer manufacturers that are currently used in Japan. Results: The results of the tests demonstrated successful activation of the alarms by the dialysis apparatus, which were appropriate for each of the five types of accidents. The time between the control of the circulatory system to the alarm signal was as follows, 1) venous pressure lower limit alarm: 7 seconds; 2) venous pressure lower limit: 8 seconds; 3) venous pressure upper limit: 7 seconds; 4) venous pressure lower limit alarm: 2 seconds; and 5) blood leakage alarm: 19 seconds. All alarms were set off in under 20 seconds. Conclusions: Thus, we can conclude that a simulator system using an extracorporeal circulation system can be set to different models of dialyzers, and that the reproduced treatment scenarios can be used for simulation training. PMID:26981503

Risk Factors for Incident Peripheral Arterial Disease in Type 2 Diabetes: Results From the Bypass Angioplasty Revascularization Investigation in Type 2 Diabetes (BARI 2D) Trial

PubMed Central

Althouse, Andrew D.; Abbott, J. Dawn; Forker, Alan D.; Bertolet, Marnie; Barinas-Mitchell, Emma; Thurston, Rebecca C.; Mulukutla, Suresh; Aboyans, Victor; Brooks, Maria Mori

2014-01-01

OBJECTIVE The aim of this article was to define risk factors for incidence of peripheral arterial disease (PAD) in a large cohort of patients with type 2 diabetes mellitus (T2DM), overall and within the context of differing glycemic control strategies. RESEARCH DESIGN AND METHODS The Bypass Angioplasty Revascularization Investigation in Type 2 Diabetes (BARI 2D) randomized controlled trial assigned participants to insulin-sensitizing (IS) therapy versus insulin-providing (IP) therapy. A total of 1,479 participants with normal ankle-brachial index (ABI) at study entry were eligible for analysis. PAD outcomes included new ABI ≤0.9 with decrease at least 0.1 from baseline, lower extremity revascularization, or lower extremity amputation. Baseline risk factors within the overall cohort and time-varying risk factors within each assigned glycemic control arm were assessed using Cox proportional hazards models. RESULTS During an average 4.6 years of follow-up, 303 participants (20.5%) experienced an incident case of PAD. Age, sex, race, and baseline smoking status were all significantly associated with incident PAD in the BARI 2D cohort. Additional baseline risk factors included pulse pressure, HbA1c, and albumin-to-creatinine ratio (P < 0.05 for each). In stratified analyses of time-varying covariates, changes in BMI, LDL, HDL, systolic blood pressure, and pulse pressure were most predictive among IS patients, while change in HbA1c was most predictive among IP patients. CONCLUSIONS Among patients with T2DM, traditional cardiovascular risk factors were the main predictors of incident PAD cases. Stratified analyses showed different risk factors were predictive for patients treated with IS medications versus those treated with IP medications. PMID:24595631

Risk factors for incident peripheral arterial disease in type 2 diabetes: results from the Bypass Angioplasty Revascularization Investigation in type 2 Diabetes (BARI 2D) Trial.

PubMed

Althouse, Andrew D; Abbott, J Dawn; Forker, Alan D; Bertolet, Marnie; Barinas-Mitchell, Emma; Thurston, Rebecca C; Mulukutla, Suresh; Aboyans, Victor; Brooks, Maria Mori

2014-01-01

The aim of this article was to define risk factors for incidence of peripheral arterial disease (PAD) in a large cohort of patients with type 2 diabetes mellitus (T2DM), overall and within the context of differing glycemic control strategies. The Bypass Angioplasty Revascularization Investigation in Type 2 Diabetes (BARI 2D) randomized controlled trial assigned participants to insulin-sensitizing (IS) therapy versus insulin-providing (IP) therapy. A total of 1,479 participants with normal ankle-brachial index (ABI) at study entry were eligible for analysis. PAD outcomes included new ABI ≤0.9 with decrease at least 0.1 from baseline, lower extremity revascularization, or lower extremity amputation. Baseline risk factors within the overall cohort and time-varying risk factors within each assigned glycemic control arm were assessed using Cox proportional hazards models. During an average 4.6 years of follow-up, 303 participants (20.5%) experienced an incident case of PAD. Age, sex, race, and baseline smoking status were all significantly associated with incident PAD in the BARI 2D cohort. Additional baseline risk factors included pulse pressure, HbA1c, and albumin-to-creatinine ratio (P < 0.05 for each). In stratified analyses of time-varying covariates, changes in BMI, LDL, HDL, systolic blood pressure, and pulse pressure were most predictive among IS patients, while change in HbA1c was most predictive among IP patients. Among patients with T2DM, traditional cardiovascular risk factors were the main predictors of incident PAD cases. Stratified analyses showed different risk factors were predictive for patients treated with IS medications versus those treated with IP medications.

The Functional Lumen Imaging Probe Detects Esophageal Contractility Not Observed With Manometry in Patients With Achalasia.

PubMed

Carlson, Dustin A; Lin, Zhiyue; Kahrilas, Peter J; Sternbach, Joel; Donnan, Erica N; Friesen, Laurel; Listernick, Zoe; Mogni, Benjamin; Pandolfino, John E

2015-12-01

The functional lumen imaging probe (FLIP) could improve the characterization of achalasia subtypes by detecting nonocclusive esophageal contractions not observed with standard manometry. We aimed to evaluate esophageal contractions during volumetric distention in patients with achalasia using FLIP topography. Fifty-one treatment-naive patients with achalasia, defined and subclassified by high-resolution esophageal pressure topography, and 10 asymptomatic individuals (controls) were evaluated with the FLIP during endoscopy. During stepwise distension, simultaneous intrabag pressures and 16 channels of cross-sectional areas were measured; data were exported to software that generated FLIP topography plots. Esophageal contractility was identified by noting periods of reduced luminal diameter. Esophageal contractions were characterized further by propagation direction, repetitiveness, and based on whether they were occluding or nonoccluding. Esophageal contractility was detected in all 10 controls: 8 of 10 had repetitive antegrade contractions and 9 of 10 had occluding contractions. Contractility was detected in 27% (4 of 15) of patients with type I achalasia and in 65% (18 of 26, including 9 with occluding contractions) of patients with type II achalasia. Contractility was detected in all 10 patients with type III achalasia; 8 of these patients had a pattern of contractility that was not observed in controls (repetitive retrograde contractions). Esophageal contractility not observed with manometry can be detected in patients with achalasia using FLIP topography. The presence and patterns of contractility detected with FLIP topography may represent variations in pathophysiology, such as mechanisms of panesophageal pressurization in patients with type II achalasia. These findings could have implications for additional subclassification to supplement prediction of the achalasia disease course. Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.

The Functional Lumen Imaging Probe Detects Esophageal Contractility not Observed with Manometry in Patients with Achalasia

PubMed Central

Carlson, Dustin A.; Lin, Zhiyue; Kahrilas, Peter J.; Sternbach, Joel; Donnan, Erica N.; Friesen, Laurel; Listernick, Zoe; Mogni, Benjamin; Pandolfino, John E.

2015-01-01

Background & Aims The functional lumen imaging probe (FLIP) could improve characterization of achalasia subtypes by detecting non-occlusive esophageal contractions not observed with standard manometry. We aimed to evaluate for esophageal contractions during volumetric distention in patients with achalasia using FLIP topography. Methods Fifty one treatment-naïve patients with achalasia, defined and sub-classified by high-resolution esophageal pressure topography, and 10 asymptomatic individuals (controls) were evaluated with the FLIP during endoscopy. During stepwise distension, simultaneous intra-bag pressures and 16 channels of cross-sectional areas were measured; data were exported to software that generated FLIP topography plots. Esophageal contractility was identified by noting periods of reduced luminal diameter. Esophageal contractions were further characterized by propagation direction, repetitiveness, and based on whether they were occluding or non-occluding. Results Esophageal contractility was detected in all 10 controls: 8/10 had repetitive, antegrade, contractions and 9/10 had occluding contractions. Contractility was detected in 27% (4/15) of patients with type I achalasia and 65% (18/26, including 9 with occluding contractions) of patients with type II achalasia. Contractility was detected in all 10 patients with type III achalasia; 8 of these patients had a pattern of contractility not observed in controls (repetitive, retrograde contractions). Conclusions Esophageal contractility not observed with manometry can be detected in patients with achalasia using FLIP topography. The presence and patterns of contractility detected with FLIP topography may represent variations in pathophysiology, such as mechanisms of pan-esophageal pressurization in patients with type II achalasia. These findings could have implications for additional sub-classification to supplement prediction of the achalasia disease course. PMID:26278501

In vitro performance and principles of anti-siphoning devices.

PubMed

Freimann, Florian Baptist; Kimura, Takaoki; Stockhammer, Florian; Schulz, Matthias; Rohde, Veit; Thomale, Ulrich-Wilhelm

2014-11-01

Anti-siphon devices (ASDs) of various working principles were developed to overcome overdrainage-related complications associated with ventriculoperitoneal shunting. We aimed to provide comparative data on the pressure and flow characteristics of six different types of ASDs (gravity-assisted, membrane-controlled, and flow-regulated) in order to achieve a better understanding of these devices and their potential clinical application. We analyzed three gravity-dependent ASDs (ShuntAssistant [SA], Miethke; Gravity Compensating Accessory [GCA], Integra; SiphonX [SX], Sophysa), two membrane-controlled ASDs (Anti-Siphon Device [IASD], Integra; Delta Chamber [DC], Medtronic), and one flow-regulated ASD (SiphonGuard [SG], Codman). Defined pressure conditions within a simulated shunt system were generated (differential pressure 10-80 cmH2O), and the specific flow and pressure characteristics were measured. In addition, the gravity-dependent ASDs were measured in defined spatial positions (0-90°). The flow characteristics of the three gravity-assisted ASDs were largely dependent upon differential pressure and on their spatial position. All three devices were able to reduce the siphoning effect, but each to a different extent (flow at inflow pressure: 10 cmH2O, siphoning -20 cmH2O at 0°/90°: SA, 7.1 ± 1.2*/2.3 ±  0.5* ml/min; GCA, 10.5 ± 0.8/3.4 ± 0.4* ml/min; SX, 9.5 ± 1.2*/4.7 ± 1.9* ml/min, compared to control, 11.1 ± 0.4 ml/min [*p < 0.05]). The flow characteristics of the remaining ASDs were primarily dependent upon the inflow pressure effect (flow at 10 cmH2O, siphoning 0 cmH2O/ siphoning -20cmH2O: DC, 2.6 ± 0.1/ 4 ± 0.3* ml/min; IASD, 2.5 ± 0.2/ 0.8 ± 0.4* ml/min; SG, 0.8 ± 0.2*/ 0.2 ± 0.1* ml/min [*p < 0.05 vs. control, respectively]). The tested ASDs were able to control the siphoning effect within a simulated shunt system to differing degrees. Future comparative trials are needed to determine the type of device that is superior for clinical application.

Cardiovascular risk education and social support (CaRESS): report of a randomized controlled trial from the Kentucky Ambulatory Network (KAN).

PubMed

Pearce, Kevin A; Love, Margaret M; Shelton, Brent J; Schoenberg, Nancy E; Williamson, Mary A; Barron, Mary A; Houlihan, Jessica M

2008-01-01

Test a practice-based intervention to foster involvement of a relative or friend for the reduction of cardiovascular risk in patients with type 2 diabetes. We enrolled in a randomized controlled trial 199 patients and 108 support persons (SPs) from 18 practices within a practice-based research network. All patient participants had type 2 diabetes with suboptimal blood pressure control and were prepared to designate a SP. A subset of the patients also had dyslipidemia. All study visits were conducted at the practice sites where staff took standardized blood pressure measurements and collected blood samples. All patients completed one education session and received newsletters aimed at improving key health behaviors. Intervention group patients included their chosen SP in the education session and the SPs received newsletters. After 9 to 12 months, the intervention had no significant effect on systolic blood pressure, HbA1C, health-related quality of life, patient satisfaction, medication adherence, or perceived health competence. Power was insufficient to detect an effect on low-density lipoprotein cholesterol. Baseline cardiovascular risk values were not very high, with mean systolic blood pressure at 140 mm Hg; mean HbA1C at 7.6%; and mean low-density lipoprotein at 137 mg/dL. Patient health care satisfaction was high. This practice-based intervention to foster social support for chronic care management among diabetics had no significant impact on the targeted outcomes.

Microfluidic chest cavities reveal that transmural pressure controls the rate of lung development.

PubMed

Nelson, Celeste M; Gleghorn, Jason P; Pang, Mei-Fong; Jaslove, Jacob M; Goodwin, Katharine; Varner, Victor D; Miller, Erin; Radisky, Derek C; Stone, Howard A

2017-12-01

Mechanical forces are increasingly recognized to regulate morphogenesis, but how this is accomplished in the context of the multiple tissue types present within a developing organ remains unclear. Here, we use bioengineered 'microfluidic chest cavities' to precisely control the mechanical environment of the fetal lung. We show that transmural pressure controls airway branching morphogenesis, the frequency of airway smooth muscle contraction, and the rate of developmental maturation of the lungs, as assessed by transcriptional analyses. Time-lapse imaging reveals that branching events are synchronized across distant locations within the lung, and are preceded by long-duration waves of airway smooth muscle contraction. Higher transmural pressure decreases the interval between systemic smooth muscle contractions and increases the rate of morphogenesis of the airway epithelium. These data reveal that the mechanical properties of the microenvironment instruct crosstalk between different tissues to control the development of the embryonic lung. © 2017. Published by The Company of Biologists Ltd.

Follow-up of blood-pressure lowering and glucose control in type 2 diabetes.

PubMed

Zoungas, Sophia; Chalmers, John; Neal, Bruce; Billot, Laurent; Li, Qiang; Hirakawa, Yoichiro; Arima, Hisatomi; Monaghan, Helen; Joshi, Rohina; Colagiuri, Stephen; Cooper, Mark E; Glasziou, Paul; Grobbee, Diederick; Hamet, Pavel; Harrap, Stephen; Heller, Simon; Lisheng, Liu; Mancia, Giuseppe; Marre, Michel; Matthews, David R; Mogensen, Carl E; Perkovic, Vlado; Poulter, Neil; Rodgers, Anthony; Williams, Bryan; MacMahon, Stephen; Patel, Anushka; Woodward, Mark

2014-10-09

In the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE) factorial trial, the combination of perindopril and indapamide reduced mortality among patients with type 2 diabetes, but intensive glucose control, targeting a glycated hemoglobin level of less than 6.5%, did not. We now report results of the 6-year post-trial follow-up. We invited surviving participants, who had previously been assigned to perindopril-indapamide or placebo and to intensive or standard glucose control (with the glucose-control comparison extending for an additional 6 months), to participate in a post-trial follow-up evaluation. The primary end points were death from any cause and major macrovascular events. The baseline characteristics were similar among the 11,140 patients who originally underwent randomization and the 8494 patients who participated in the post-trial follow-up for a median of 5.9 years (blood-pressure-lowering comparison) or 5.4 years (glucose-control comparison). Between-group differences in blood pressure and glycated hemoglobin levels during the trial were no longer evident by the first post-trial visit. The reductions in the risk of death from any cause and of death from cardiovascular causes that had been observed in the group receiving active blood-pressure-lowering treatment during the trial were attenuated but significant at the end of the post-trial follow-up; the hazard ratios were 0.91 (95% confidence interval [CI], 0.84 to 0.99; P=0.03) and 0.88 (95% CI, 0.77 to 0.99; P=0.04), respectively. No differences were observed during follow-up in the risk of death from any cause or major macrovascular events between the intensive-glucose-control group and the standard-glucose-control group; the hazard ratios were 1.00 (95% CI, 0.92 to 1.08) and 1.00 (95% CI, 0.92 to 1.08), respectively. The benefits with respect to mortality that had been observed among patients originally assigned to blood-pressure-lowering therapy were attenuated but still evident at the end of follow-up. There was no evidence that intensive glucose control during the trial led to long-term benefits with respect to mortality or macrovascular events. (Funded by the National Health and Medical Research Council of Australia and others; ADVANCE-ON ClinicalTrials.gov number, NCT00949286.).

Effect of Gum Arabic (Acacia Senegal) supplementation on visceral adiposity index (VAI) and blood pressure in patients with type 2 diabetes mellitus as indicators of cardiovascular disease (CVD): a randomized and placebo-controlled clinical trial.

PubMed

Babiker, Rasha; Elmusharaf, Khalifa; Keogh, Michael B; Saeed, Amal M

2018-03-20

There is a strong association between cardiometabolic risk and adipose tissue dysfunction with great consequences on type 2 diabetic patients. Visceral Adiposity Index (VAI) is an indirect clinical marker of adipose tissue dysfunction. Gum Arabic (GA) is a safe dietary fiber, an exudate of Acacia Senegal. Gum Arabic had shown lipid lowering effect in both humans and animals. The aim of this trial was to determine the effect of GA supplementation on anthropometric obesity marker, Visceral Adiposity Index (VAI) and blood pressure in patients with type 2 diabetes mellitus. This randomized, double blinded, placebo controlled trial recruited a total of 91 type 2 diabetic patients (73 females, 18 males), age (mean ± SD) 50.09 ± 9.3 years on hypoglycemic agents and were randomly assigned into two groups, either to consume 30 g of GA or 5 g of placebo daily for 3 months. Anthropometric obesity markers were measured and indices were calculated. Blood pressure was measured and high density lipoprotein (HDL) and triglycerides (TG) were determined in fasting blood samples at the start and end of the study period. After intervention, Gum Arabic decreased BMI and VAI significantly (P < 0.05) in GA group by 2 and 23.7% respectively. Body adiposity index significantly decreased by 3.9% in GA group while there were no significant changes in waist circumference or waist-to-hip ratio (WHR). Systolic blood pressure significantly decreased by 7.6% in GA group and by 2.7% in placebo group from baseline with no significant changes in diastolic blood pressure in the two groups. Gum Arabic consumption at a dose of 30 g/d for 3 months may play an effective role in preventing weight gain and modulating adipose tissue dysfunction in type 2 diabetic patients, although no effect has been shown in waist-to-hip ratio. The trial had been registered as prospective interventional clinical trials in the Pan African Clinical Trial Registry (PACTR) PACTR201403000785219 , on 7th March 2014.

Thalidomide ameliorates portal hypertension via nitric oxide synthase independent reduced systolic blood pressure

PubMed Central

Theodorakis, Nicholas G; Wang, Yining N; Korshunov, Vyacheslav A; Maluccio, Mary A; Skill, Nicholas J

2015-01-01

AIM: Portal hypertension is a common complication of liver cirrhosis and significantly increases mortality and morbidity. Previous reports have suggested that the compound thalidomide attenuates portal hypertension (PHT). However, the mechanism for this action is not fully elucidated. One hypothesis is that thalidomide destabilizes tumor necrosis factor α (TNFα) mRNA and therefore diminishes TNFα induction of nitric oxide synthase (NOS) and the production of nitric oxide (NO). To examine this hypothesis, we utilized the murine partial portal vein ligation (PVL) PHT model in combination with endothelial or inducible NOS isoform gene knockout mice. METHODS: Wild type, inducible nitric oxide synthase (iNOS)-/- and endothelial nitric oxide synthase (eNOS)-/- mice received either PVL or sham surgery and were given either thalidomide or vehicle. Serum nitrate (total nitrate, NOx) was measured daily for 7 d as a surrogate of NO synthesis. Serum TNFα level was quantified by enzyme-linked immunosorbent assay. TNFα mRNA was quantified in liver and aorta tissue by reverse transcription-polymerase chain reaction. PHT was determined by recording splenic pulp pressure (SPP) and abdominal aortic flow after 0-7 d. Response to thalidomide was determined by measurement of SPP and mean arterial pressure (MAP). RESULTS: SPP, abdominal aortic flow (Qao) and plasma NOx were increased in wild type and iNOS-/- PVL mice when compared to sham operated control mice. In contrast, SPP, Qao and plasma NOx were not increased in eNOS-/- PVL mice when compared to sham controls. Serum TNFα level in both sham and PVL mice was below the detection limit of the commercial ELISA used. Therefore, the effect of thalidomide on serum TNFα levels was undetermined in wild type, eNOS-/- or iNOS-/- mice. Thalidomide acutely increased plasma NOx in wild type and eNOS-/- mice but not iNOS-/- mice. Moreover, thalidomide temporarily (0-90 min) decreased mean arterial pressure, SPP and Qao in wild type, eNOS-/- and iNOS-/- PVL mice, after which time levels returned to the respective baseline. CONCLUSION: Thalidomide does not reduce portal pressure in the murine PVL model by modulation of NO biosynthesis. Rather, thalidomide reduces PHT by decreasing MAP by an undetermined mechanism. PMID:25892862

Thalidomide ameliorates portal hypertension via nitric oxide synthase independent reduced systolic blood pressure.

PubMed

Theodorakis, Nicholas G; Wang, Yining N; Korshunov, Vyacheslav A; Maluccio, Mary A; Skill, Nicholas J

2015-04-14

Portal hypertension is a common complication of liver cirrhosis and significantly increases mortality and morbidity. Previous reports have suggested that the compound thalidomide attenuates portal hypertension (PHT). However, the mechanism for this action is not fully elucidated. One hypothesis is that thalidomide destabilizes tumor necrosis factor α (TNFα) mRNA and therefore diminishes TNFα induction of nitric oxide synthase (NOS) and the production of nitric oxide (NO). To examine this hypothesis, we utilized the murine partial portal vein ligation (PVL) PHT model in combination with endothelial or inducible NOS isoform gene knockout mice. Wild type, inducible nitric oxide synthase (iNOS)(-/-) and endothelial nitric oxide synthase (eNOS)(-/-) mice received either PVL or sham surgery and were given either thalidomide or vehicle. Serum nitrate (total nitrate, NOx) was measured daily for 7 d as a surrogate of NO synthesis. Serum TNFα level was quantified by enzyme-linked immunosorbent assay. TNFα mRNA was quantified in liver and aorta tissue by reverse transcription-polymerase chain reaction. PHT was determined by recording splenic pulp pressure (SPP) and abdominal aortic flow after 0-7 d. Response to thalidomide was determined by measurement of SPP and mean arterial pressure (MAP). SPP, abdominal aortic flow (Qao) and plasma NOx were increased in wild type and iNOS(-/-) PVL mice when compared to sham operated control mice. In contrast, SPP, Qao and plasma NOx were not increased in eNOS(-/-) PVL mice when compared to sham controls. Serum TNFα level in both sham and PVL mice was below the detection limit of the commercial ELISA used. Therefore, the effect of thalidomide on serum TNFα levels was undetermined in wild type, eNOS(-/-) or iNOS(-/-) mice. Thalidomide acutely increased plasma NOx in wild type and eNOS(-/-) mice but not iNOS(-/-) mice. Moreover, thalidomide temporarily (0-90 min) decreased mean arterial pressure, SPP and Qao in wild type, eNOS(-/-) and iNOS(-/-) PVL mice, after which time levels returned to the respective baseline. Thalidomide does not reduce portal pressure in the murine PVL model by modulation of NO biosynthesis. Rather, thalidomide reduces PHT by decreasing MAP by an undetermined mechanism.

Effects of medical therapies on retinopathy progression in type 2 diabetes.

PubMed

Chew, Emily Y; Ambrosius, Walter T; Davis, Matthew D; Danis, Ronald P; Gangaputra, Sapna; Greven, Craig M; Hubbard, Larry; Esser, Barbara A; Lovato, James F; Perdue, Letitia H; Goff, David C; Cushman, William C; Ginsberg, Henry N; Elam, Marshall B; Genuth, Saul; Gerstein, Hertzel C; Schubart, Ulrich; Fine, Lawrence J

2010-07-15

We investigated whether intensive glycemic control, combination therapy for dyslipidemia, and intensive blood-pressure control would limit the progression of diabetic retinopathy in persons with type 2 diabetes. Previous data suggest that these systemic factors may be important in the development and progression of diabetic retinopathy. In a randomized trial, we enrolled 10,251 participants with type 2 diabetes who were at high risk for cardiovascular disease to receive either intensive or standard treatment for glycemia (target glycated hemoglobin level, <6.0% or 7.0 to 7.9%, respectively) and also for dyslipidemia (160 mg daily of fenofibrate plus simvastatin or placebo plus simvastatin) or for systolic blood-pressure control (target, <120 or <140 mm Hg). A subgroup of 2856 participants was evaluated for the effects of these interventions at 4 years on the progression of diabetic retinopathy by 3 or more steps on the Early Treatment Diabetic Retinopathy Study Severity Scale (as assessed from seven-field stereoscopic fundus photographs, with 17 possible steps and a higher number of steps indicating greater severity) or the development of diabetic retinopathy necessitating laser photocoagulation or vitrectomy. At 4 years, the rates of progression of diabetic retinopathy were 7.3% with intensive glycemia treatment, versus 10.4% with standard therapy (adjusted odds ratio, 0.67; 95% confidence interval [CI], 0.51 to 0.87; P=0.003); 6.5% with fenofibrate for intensive dyslipidemia therapy, versus 10.2% with placebo (adjusted odds ratio, 0.60; 95% CI, 0.42 to 0.87; P=0.006); and 10.4% with intensive blood-pressure therapy, versus 8.8% with standard therapy (adjusted odds ratio, 1.23; 95% CI, 0.84 to 1.79; P=0.29). Intensive glycemic control and intensive combination treatment of dyslipidemia, but not intensive blood-pressure control, reduced the rate of progression of diabetic retinopathy. (Funded by the National Heart, Lung, and Blood Institute and others; ClinicalTrials.gov numbers, NCT00000620 for the ACCORD study and NCT00542178 for the ACCORD Eye study.) 2010 Massachusetts Medical Society

Effect of nurse-directed hypertension treatment among First Nations people with existing hypertension and diabetes mellitus: the Diabetes Risk Evaluation and Microalbuminuria (DREAM 3) randomized controlled trial.

PubMed

Tobe, Sheldon W; Pylypchuk, George; Wentworth, Joan; Kiss, Alexander; Szalai, John Paul; Perkins, Nancy; Hartman, Susan; Ironstand, Laurie; Hoppe, Jacqueline

2006-04-25

First Nations people with diabetes mellitus and hypertension are at greater risk of renal and cardiovascular complications than are non-native patients because of barriers to health care services. We conducted this randomized controlled trial to assess whether a community-based treatment strategy implemented by home care nurses would be effective in controlling hypertension in First Nations people with existing hypertension and type 2 diabetes. We compared 2 community-based strategies for controlling hypertension in First Nations people with existing hypertension and diabetes. In the intervention group, a home care nurse followed a predefined treatment algorithm of pharmacologic antihypertensive therapy. In the control group, treatment decisions were made by each subject's primary care physician. The primary outcome measure was the difference between the 2 groups in the change in systolic blood pressure after 12 months. Secondary outcome measures were the change in diastolic blood pressure over time, the change in urine albumin status and the incidence of adverse events. Both groups experienced a significant reduction in systolic blood pressure by the final visit (by 24.0 [standard deviation (SD) 13.5] mm Hg in the intervention group and by 17.0 [SD 18.6] mm Hg in the control group); p < 0.001 in each case). However, the difference between the 2 groups in this change was not significant. Patients in the intervention group had a larger decrease in diastolic blood pressure over time than did those in the control group (by 11.6 [SD 10.6] mm Hg v. 6.8 [SD 11.1] mm Hg respectively; p = 0.05). The groups did not differ significantly in terms of changes in urine albumin excretion or incidence of adverse events. High rates of blood pressure control in the community were achieved in both groups in the DREAM 3 study. The addition of a home care nurse to implement a treatment strategy for blood pressure control was more effective in lowering diastolic than systolic blood pressure compared with home care visits for blood pressure monitoring alone and follow-up treatment by a family physician.

Health Insurance Type and Control of Hypertension Among US Women Living With and Without HIV Infection in the Women's Interagency HIV Study.

PubMed

Ludema, Christina; Cole, Stephen R; Eron, Joseph J; Holmes, G Mark; Anastos, Kathryn; Cocohoba, Jennifer; Cohen, Marge H; Cooper, Hannah L F; Golub, Elizabeth T; Kassaye, Seble; Konkle-Parker, Deborah; Metsch, Lisa; Milam, Joel; Wilson, Tracey E; Adimora, Adaora A

2017-06-01

Health care access is an important determinant of health. We assessed the effect of health insurance status and type on blood pressure control among US women living with (WLWH) and without HIV. We used longitudinal cohort data from the Women's Interagency HIV Study (WIHS). WIHS participants were included at their first study visit since 2001 with incident uncontrolled blood pressure (BP) (i.e., BP ≥140/90 and at which BP at the prior visit was controlled (i.e., <135/85). We assessed time to regained BP control using inverse Kaplan-Meier curves and Cox proportional hazard models. Confounding and selection bias were accounted for using inverse probability-of-exposure-and-censoring weights. Most of the 1,130 WLWH and 422 HIV-uninfected WIHS participants who had an elevated systolic or diastolic measurement were insured via Medicaid, were African-American, and had a yearly income ≤$12,000. Among participants living with HIV, comparing the uninsured to those with Medicaid yielded an 18-month BP control risk difference of 0.16 (95% CI: 0.10, 0.23). This translates into a number-needed-to-treat (or insure) of 6; to reduce the caseload of WLWH with uncontrolled BP by one case, five individuals without insurance would need to be insured via Medicaid. Blood pressure control was similar among WLWH with private insurance and Medicaid. There were no differences observed by health insurance status on 18-month risk of BP control among the HIV-uninfected participants. These results underscore the importance of health insurance for hypertension control-especially for people living with HIV. © American Journal of Hypertension, Ltd 2017. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Insulin resistance and metabolic syndrome in children of parents with diabetes mellitus.

PubMed

Altinli, Sebnem; Elevli, Murat; Ozkul, Ayse Ayaz; Kara, Pinar Gizem; Karsidag, Kubilay; Dogru, Macit

2007-03-01

The aim of this prospective study was to research features of insulin resistance and metabolic syndrome in offspring of diabetic parents and to find out whether there is a risk of developing type 2 diabetes mellitus (DM) in these children. Study participants were 30 children of parents with type 1 DM (DM1) (Group I) and 11 children of parents with type 2 DM (DM2) (Group II) who were being followed up in the Diabetes Department of Haseki Research and Training Hospital. The results were compared with a control group of 17 children in the same age group (Group III). There were no statistically significant differences between the Group I and the control group in fasting blood glucose, oral glucose tolerance test values, 1st 2nd and hour insulin, homeostasis model assessment (HOMA) values, body mass index (BMI), systolic and diastolic blood pressure, and lipid parameters, i.e. HDL-cholesterol, LDL-cholesterol, VLDL-cholesterol, total cholesterol, and triglycerides. Fasting, 1st and 2nd hour blood insulin levels, HOMA values, BMI, and systolic blood pressure values were significantly higher in Group II compared to the control group (p < 0.05). There were no statistically significant differences between Group II and the control group in lipid parameters, fasting blood glucose, OGTT values, or diastolic blood pressure. We conclude that in our population there is a tendency of insulin resistance and metabolic syndrome in the offspring of parents with DM2, and a risk for developing DM2. Thus, children of patients with DM2 should be followed up so as to recognize early metabolic defects of glucose metabolism and to plan effective preventive efforts to reduce cardiovascular and atherosclerotic risk factors.

Resistance of a rodent malaria parasite to a thymidylate synthase inhibitor induces an apoptotic parasite death and imposes a huge cost of fitness.

PubMed

Muregi, Francis W; Ohta, Isao; Masato, Uchijima; Kino, Hideto; Ishih, Akira

2011-01-01

The greatest impediment to effective malaria control is drug resistance in Plasmodium falciparum, and thus understanding how resistance impacts on the parasite's fitness and pathogenicity may aid in malaria control strategy. To generate resistance, P. berghei NK65 was subjected to 5-fluoroorotate (FOA, an inhibitor of thymidylate synthase, TS) pressure in mice. After 15 generations of drug pressure, the 2% DT (the delay time for proliferation of parasites to 2% parasitaemia, relative to untreated wild-type controls) reduced from 8 days to 4, equalling the controls. Drug sensitivity studies confirmed that FOA-resistance was stable. During serial passaging in the absence of drug, resistant parasite maintained low growth rates (parasitaemia, 15.5%±2.9, 7 dpi) relative to the wild-type (45.6%±8.4), translating into resistance cost of fitness of 66.0%. The resistant parasite showed an apoptosis-like death, as confirmed by light and transmission electron microscopy and corroborated by oligonucleosomal DNA fragmentation. The resistant parasite was less fit than the wild-type, which implies that in the absence of drug pressure in the field, the wild-type alleles may expand and allow drugs withdrawn due to resistance to be reintroduced. FOA resistance led to depleted dTTP pools, causing thymineless parasite death via apoptosis. This supports the tenet that unicellular eukaryotes, like metazoans, also undergo apoptosis. This is the first report where resistance to a chemical stimulus and not the stimulus itself is shown to induce apoptosis in a unicellular parasite. This finding is relevant in cancer therapy, since thymineless cell death induced by resistance to TS-inhibitors can further be optimized via inhibition of pyrimidine salvage enzymes, thus providing a synergistic impact. We conclude that since apoptosis is a process that can be pharmacologically modulated, the parasite's apoptotic machinery may be exploited as a novel drug target in malaria and other protozoan diseases of medical importance.

Control of blood pressure, appetite, and glucose by leptin in mice lacking leptin receptors in proopiomelanocortin neurons.

PubMed

do Carmo, Jussara M; da Silva, Alexandre A; Cai, Zhengwei; Lin, Shuying; Dubinion, John H; Hall, John E

2011-05-01

Although the central nervous system melanocortin system is an important regulator of energy balance, the role of proopiomelanocortin (POMC) neurons in mediating the chronic effects of leptin on appetite, blood pressure, and glucose regulation is unknown. Using Cre/loxP technology we tested whether leptin receptor deletion in POMC neurons (LepR(flox/flox)/POMC-Cre mice) attenuates the chronic effects of leptin to increase mean arterial pressure (MAP), enhance glucose use and oxygen consumption, and reduce appetite. LepR(flox/flox)/POMC-Cre, wild-type, LepR(flox/flox), and POMC-Cre mice were instrumented for MAP and heart rate measurement by telemetry and venous catheters for infusions. LepR(flox/flox)/POMC-Cre mice were heavier, hyperglycemic, hyperinsulinemic, and hyperleptinemic compared with wild-type, LepR(flox/flox), and POMC-Cre mice. Despite exhibiting features of metabolic syndrome, LepR(flox/flox)/POMC-Cre mice had normal MAP and heart rate compared with LepR(flox/flox) but lower MAP and heart rate compared with wild-type mice. After a 5-day control period, leptin was infused (2 μg/kg per minute, IV) for 7 days. In control mice, leptin increased MAP by ≈5 mm Hg despite decreasing food intake by ≈35%. In contrast, leptin infusion in LepR(flox/flox)/POMC-Cre mice reduced MAP by ≈3 mm Hg and food intake by ≈28%. Leptin significantly decreased insulin and glucose levels in control mice but not in LepR(flox/flox)/POMC-Cre mice. Leptin increased oxygen consumption in LepR(flox/flox)/POMC-Cre and wild-type mice. Activation of POMC neurons is necessary for the chronic effects of leptin to raise MAP and reduce insulin and glucose levels, whereas leptin receptors in other areas of the brain other than POMC neurons appear to play a key role in mediating the chronic effects of leptin on appetite and oxygen consumption.

Interarm blood pressure difference in people with diabetes: measurement and vascular and mortality implications: a cohort study.

PubMed

Clark, Christopher E; Steele, Anna M; Taylor, Rod S; Shore, Angela C; Ukoumunne, Obioha C; Campbell, John L

2014-06-01

Differences in blood pressure between arms are associated with vascular disease and increased mortality; this has not been reported in diabetes. We explored these associations, and assessed reference standard and pragmatic measurement techniques, in people with diabetes and in nondiabetic controls. A prospective cohort study in Devon, England, recruited 727 people with type 1 or type 2 diabetes and 285 nondiabetic controls. Simultaneous repeated measurements of bilateral blood pressure were made at recruitment. Data were used to inform a pragmatic measurement strategy. Interarm differences were examined for cross-sectional associations with target organ disease and prospective mortality associations (median follow-up 52 months). We found 8.6% of participants with diabetes and 2.9% of controls had systolic interarm differences ≥10 mmHg. Single pairs of blood pressure measurements had high negative predictive values (97-99%) for excluding interarm differences. Systolic interarm differences ≥10 mmHg in diabetes were associated with peripheral arterial disease (odds ratio [OR] 3.4 [95% CI 1.2-9.3]). Differences ≥15 mmHg were associated with diabetic retinopathy (OR 5.7 [1.5-21.6]) and chronic kidney disease (OR 7.0 [1.7-29.8]). Systolic interarm differences were associated prospectively with increased cardiovascular mortality: hazard ratios 3.5 (1.0-13.0) for ≥10 mmHg and 9.0 (2.0-41.0) for ≥15 mmHg. Blood pressure should be measured in both arms during initial assessment in diabetes. Systolic interarm differences can be excluded with a single pair of measurements. In the population with diabetes, systolic differences may be associated with an increased risk of morbidity and mortality. © 2014 by the American Diabetes Association.

ADVANCE--Action in Diabetes and Vascular Disease: patient recruitment and characteristics of the study population at baseline.

PubMed

2005-07-01

The primary aim of ADVANCE is to determine the effects on macrovascular and microvascular disease of blood pressure lowering (with an ACE inhibitor-diuretic combination), irrespective of initial blood pressure level; and of intensive glucose lowering, in high-risk individuals with Type 2 diabetes. The study is a 2 x 2 factorial randomized controlled trial. Following 6 weeks on active perindopril-indapamide combination, eligible participants were randomized to perindopril/indapamide (initially 2.0/0.625 mg daily, increasing to 4.0/1.25 mg daily after 3 months) or matching placebo; and to an intensive gliclazide MR-based glucose control regimen aiming for a haemoglobin A1c (HbA1c) value of 6.5% or lower, or local standard therapy. The study is being conducted in 215 centres in 20 countries within Australasia, Asia, Europe and North America. Recruitment commenced in June 2001 and was completed in March 2003, with the inclusion of 11,140 randomized participants. Fifty-seven per cent of participants are male and the mean age at baseline was 66 years. On average, the diagnosis of diabetes was made 8 years before study entry. At baseline 32 and 10% of patients had a history of macrovascular and microvascular disease, respectively. The mean blood pressure at baseline was 145/81 mmHg; the mean HbA1c concentration was 7.5%. While blood pressure and HbA1c values were broadly similar, certain characteristics of randomized participants varied between countries. With successful worldwide recruitment completed, ADVANCE should provide reliable and broadly generalizable results on the effects of routine blood pressure lowering and intensive glucose control in high-risk individuals with Type 2 diabetes.

Glycated haemoglobin and blood pressure-lowering effect of cinnamon in multi-ethnic Type 2 diabetic patients in the UK: a randomized, placebo-controlled, double-blind clinical trial.

PubMed

Akilen, R; Tsiami, A; Devendra, D; Robinson, N

2010-10-01

To determine the blood glucose lowering effect of cinnamon on HbA1c, blood pressure and lipid profiles in people with type 2 diabetes. 58 type 2 diabetic patients (25 males and 33 females), aged 54.9 ± 9.8, treated only with hypoglycemic agents and with an HbA1c more than 7% were randomly assigned to receive either 2g of cinnamon or placebo daily for 12 weeks. After intervention, the mean HbA1c was significantly decreased (P<0.005) in the cinnamon group (8.22% to 7.86%) compared with placebo group (8.55% to 8.68%). Mean systolic and diastolic blood pressures (SBP and DBP) were also significantly reduced (P<0.001) after 12 weeks in the cinnamon group (SBP: 132.6 to 129.2 mmHg and DBP: 85.2 to 80.2 mmHg) compared with the placebo group (SBP: 134.5 to 134.9 mmHg and DBP: 86.8 to 86.1 mmHg). A significant reduction in fasting plasma glucose (FPG), waist circumference and body mass index (BMI) was observed at week 12 compared to baseline in the cinnamon group, however, the changes were not significant when compared to placebo group. There were no significant differences in serum lipid profiles of total cholesterol, triglycerides, HDL and LDL cholesterols neither between nor within the groups. Intake of 2g of cinnamon for 12 weeks significantly reduces the HbA1c, SBP and DBP among poorly controlled type 2 diabetes patients. Cinnamon supplementation could be considered as an additional dietary supplement option to regulate blood glucose and blood pressure levels along with conventional medications to treat type 2 diabetes mellitus. © 2010 The Authors. Diabetic Medicine © 2010 Diabetes UK.

Pressure-induced Polarization Reversal in Z-type Hexaferrite Single Crystal

NASA Astrophysics Data System (ADS)

Jeon, Byung-Gu; Chun, Sae Hwan; Kim, Kee Hoon

2012-02-01

Multiferroic materials with a gigantic magnetoelectric (ME) coupling at room temperature have been searched for applications to novel devices. Recently, large direct and converse ME effects were realized at room temperature in the so-called Z-type hexaferrite (Ba,Sr)3Co2Fe24O41 single crystals [1,2]. To obtain a new control parameter for realizing a sensitive ME tuning, we studied ME properties of the crystals under uniaxial pressure. Upon applying a tiny uniaxial pressure of about 0.6 GPa, magnetic field-driven electric polarization reversal and anomaly in a M-H loop start to appear at 10 K and gradually disappear at higher temperature above 130 K. By comparing those results with longitudinal magnetostriction at ambient pressure, we propose the pressure-dependent variations of transverse conical spin configuration as well as its domain structure under small magnetic field bias, and point out the possibility of having two different physical origins of the ME coupling in this system. [1] Y. Kitagawa et al., Nat. Mater. 9, 797 (2010) [2] S. H. Chun et al., submitted.

Prospective, nonrandomized controlled trials to compare the effect of a silk-like fabric to standard hospital linens on the rate of hospital-acquired pressure ulcers.

PubMed

Coladonato, Joseph; Smith, Annette; Watson, Nancy; Brown, Anne T; McNichol, Laurie L; Clegg, Amy; Griffin, Tracy; McPhail, Lora; Montgomery, Terry G

2012-10-01

Hospital bedding and gowns influence skin moisture, temperature, friction, and shear, which in turn may affect the development of pressure ulcers. To evaluate the effect of a new silk-like synthetic fabric on the incidence of pressure ulcers in an acute care setting, two consecutive 6-month clinical trials were conducted among 307 consecutively admitted patients in a Medical Renal Unit (August 2008 and March 2010) and in 275 patients admitted to a Surgical Intensive Care Unit (ICU) (September 2009 to March 2010). During the first 8 weeks, all patients used standard hospital bed linens, reusable underpads, and gowns. During the second 8 weeks, all admitted patients used the intervention linens (a silk-like fabric) followed by another 8 weeks of control (standard linen) use. Demographic variables and the prevalence of pressure ulcers on admission were statistically similar for control and intervention groups in both study populations with the exception of gender in the Renal Unit study (13% higher proportion of men in intervention group). Average Braden Scores were also similar and low (<18) in all study patients. Upon admission to the Medical Renal Unit, 21 of 154 patients (13.6%) in the control and 26 of 153 patients (17.0%) in the intervention group had a pressure ulcer. The incidence of new ulcers was 12.3% in the control and 4.6% in the intervention group (P = 0.01); average length of stay was 5.97 days (σ = 4.0) for control and 5.31 days (σ = 3.8) for intervention patients (P = 0.07). In the Surgical ICU group, 18 of 199 patients in the control (9.1%) and four of 76 patients in the intervention group (5.3%) were admitted with a pressure ulcer; the incidence of new pressure ulcers was 7.5 % in the control and 0% in the intervention group (P = 0.01). Average length of stay was 4.5 days and 4.33 days in the control and intervention groups, respectively (P = 0.33). The significant differences between the control and intervention group in the rate of pressure ulcer development suggests that the type of linens used affect pressure ulcer risk and that this silk-like synthetic fabric technology may help reduce the incidence of pressure ulcers in high-risk patients. Controlled clinical studies in other patient populations are warranted.

Nutritional status, glycemic control and its associated risk factors among a sample of type 2 diabetic individuals, a pilot study.

PubMed

Firouzi, Somayyeh; Barakatun-Nisak, Mohd Yusof; Azmi, Kamaruddin Nor

2015-01-01

The prevalence of type 2 diabetes is increasing in Malaysia, with most patients poorly controlled. Hence, this study aimed to determine nutritional and metabolic status as well as blood pressure of Malaysian patients with type 2 diabetes mellitus and identify associated risk factors for poor glycemic control. A total of 104 type 2 diabetic patients were recruited and completed a questionnaire covering socio-demographic status, 3-day diet records, and physical activity. Anthropometry and glycemic control parameters, lipid profile and blood pressure were also measured. Subjects were on average 56.7±9.9 years old with a mean duration of diabetes of 6.5 ± 5.0 years. The mean hemoglobin A1c of the subjects was 7.6% ± 1.4%, with only 20.2% achieving the target goal of <6.5% with no significant differences between genders. The mean body mass index was 26.9 ± 4.7 kg/m(2), with 86.5% either were overweight or obese. Only 10.6% of the subjects exercised daily. The proportions of macronutrients relative to total energy intake were consistent with the recommendations of most diabetes associations. The adjusted odds of having poor glycemic control were 3.235 (1.043-10.397) (P < 0.05) higher among those who had high density lipoprotein cholesterol levels below the normal range. Those taking one or two types of oral anti-diabetic drugs had 19.9 (2.959-87.391) (P < 0.01) and 14.3 (2.647-77.500) (P < 0.01) higher odds of poor glycemic control respectively compared to those who were being treated by diet alone. Poor glycemic control was prevalent among Malaysian diabetic patients, and this could be associated with low levels of HDL and being treated with oral anti-diabetes agents.

Nutritional status, glycemic control and its associated risk factors among a sample of type 2 diabetic individuals, a pilot study

PubMed Central

Firouzi, Somayyeh; Barakatun-Nisak, Mohd Yusof; Azmi, Kamaruddin Nor

2015-01-01

Background: The prevalence of type 2 diabetes is increasing in Malaysia, with most patients poorly controlled. Hence, this study aimed to determine nutritional and metabolic status as well as blood pressure of Malaysian patients with type 2 diabetes mellitus and identify associated risk factors for poor glycemic control. Materials and Methods: A total of 104 type 2 diabetic patients were recruited and completed a questionnaire covering socio-demographic status, 3-day diet records, and physical activity. Anthropometry and glycemic control parameters, lipid profile and blood pressure were also measured. Results: Subjects were on average 56.7±9.9 years old with a mean duration of diabetes of 6.5 ± 5.0 years. The mean hemoglobin A1c of the subjects was 7.6% ± 1.4%, with only 20.2% achieving the target goal of <6.5% with no significant differences between genders. The mean body mass index was 26.9 ± 4.7 kg/m2, with 86.5% either were overweight or obese. Only 10.6% of the subjects exercised daily. The proportions of macronutrients relative to total energy intake were consistent with the recommendations of most diabetes associations. The adjusted odds of having poor glycemic control were 3.235 (1.043-10.397) (P < 0.05) higher among those who had high density lipoprotein cholesterol levels below the normal range. Those taking one or two types of oral anti-diabetic drugs had 19.9 (2.959-87.391) (P < 0.01) and 14.3 (2.647-77.500) (P < 0.01) higher odds of poor glycemic control respectively compared to those who were being treated by diet alone. Conclusion: Poor glycemic control was prevalent among Malaysian diabetic patients, and this could be associated with low levels of HDL and being treated with oral anti-diabetes agents. PMID:25767521

Active Control of Sound Radiation due to Subsonic Wave Scattering from Discontinuities on Thin Elastic Beams.

NASA Astrophysics Data System (ADS)

Guigou, Catherine Renee J.

1992-01-01

Much progress has been made in recent years in active control of sound radiation from vibrating structures. Reduction of the far-field acoustic radiation can be obtained by directly modifying the response of the structure by applying structural inputs rather than by adding acoustic sources. Discontinuities, which are present in many structures are often important in terms of sound radiation due to wave scattering behavior at their location. In this thesis, an edge or boundary type discontinuity (clamped edge) and a point discontinuity (blocking mass) are analytically studied in terms of sound radiation. When subsonic vibrational waves impinge on these discontinuities, large scattered sound levels are radiated. Active control is then achieved by applying either control forces, which approximate shakers, or pairs of control moments, which approximate piezoelectric actuators, near the discontinuity. Active control of sound radiation from a simply-supported beam is also examined. For a single frequency, the flexural response of the beam subject to an incident wave or an input force (disturbance) and to control forces or control moments is expressed in terms of waves of both propagating and near-field types. The far-field radiated pressure is then evaluated in terms of the structural response, using Rayleigh's formula or a stationary phase approach, depending upon the application. The control force and control moment magnitudes are determined by optimizing a quadratic cost function, which is directly related to the control performance. On determining the optimal control complex amplitudes, these can be resubstituted in the constitutive equations for the system under study and the minimized radiated fields can be evaluated. High attenuation in radiated sound power and radiated acoustic pressure is found to be possible when one or two active control actuators are located near the discontinuity, as is shown to be mostly associated with local changes in beam response near the discontinuity. The effect of the control actuators on the far-field radiated pressure, the wavenumber spectrum, the flexural displacement and the near-field time averaged intensity and pressure distributions are studied in order to further understand the control mechanisms. The influence of the near-field structural waves is investigated as well. Some experimental results are presented for comparison.

Pressure profiles in detonation cells with rectangular and diagonal structures

NASA Astrophysics Data System (ADS)

Hanana, M.; Lefebvre, M. H.

Experimental results presented in this work enable us to classify the three-dimensional structure of the detonation into two fundamental types: a rectangular structure and a diagonal structure. The rectangular structure is well documented in the literature and consists of orthogonal waves travelling independently from each another. The soot record in this case shows the classical diamond detonation cell exhibiting `slapping waves'. The experiments indicate that the diagonal structure is a structure with the triple point intersections moving along the diagonal line of the tube cross section. The axes of the transverse waves are canted at 45 degrees to the wall, accounting for the lack of slapping waves. It is possible to reproduce these diagonal structures by appropriately controlling the experimental ignition procedure. The characteristics of the diagonal structure show some similarities with detonation structure in round tube. Pressure measurements recorded along the central axis of the cellular structure show a series of pressure peaks, depending on the type of structure and the position inside the detonation cell. Pressure profiles measured for the whole length of the two types of detonation cells show that the intensity of the shock front is higher and the length of the detonation cell is shorter for the diagonal structures.

Shot and bead peening control

NASA Astrophysics Data System (ADS)

John, R.

The merits of the peening effect in improving the fatigue resistance of ferrous and non-ferrous media is discussed. The machines that perform the peening task are also discussed, including the rotating-wheel plant, pressure-type air-assisted peening machines, and suction systems. The peening process itself is discussed briefly, and an outline of the parameters that affect the product specification is presented. The merits of the Almen test strip as a measure of correct treatment are evaluated, and the two types of devices are discussed for monitoring the flow of peening media. The two types of feed control devices (one for ferrous media and the other for non-ferrous media) for accurately controlling the feed of peening media are also briefly examined.

How prescriptive support affects weight loss in weight-loss intervention participants and their untreated spouses.

PubMed

Cornelius, Talea; Gettens, Katelyn; Lenz, Erin; Wojtanowski, Alexis C; Foster, Gary D; Gorin, Amy A

2018-06-21

Controlling or prescriptive support styles (e.g., pressure) often hinder weight loss, but can sometimes be beneficial. This secondary analysis of data from a randomized controlled trial examined persuasion, pressure, and indirect social control among cohabiting couples and the effect of these supports on weight loss. Couples ( N Couples = 130) were randomized to either Weight Watchers (WW) or a self-guided control condition (SG). Only one member of each couple received the intervention; the other member of the couple was untreated. Couples were weighed and completed study measures at baseline, 3, and 6 months. Dyadic multilevel models examined BMI change and differences across role (treated participant/untreated spouse) and condition (WW/SG). Prescriptive support predicted BMI change for treated participants in the WW condition only. For treated WW participants, there was no significant decrease in BMI when pressure was high (+1 SD ), B = -.25, p = .22, but a significant decrease when pressure was low (0), B = -.96, p < .001. Additionally, high levels of indirect social control (+1 SD ) predicted greater decreases in BMI compared to low (-1 SD ) indirect social control, B = -.91, p < .001, and, B = -.41, p < .01. Considering both the type and context of support for weight management is worthwhile. Intervention participants had access to treatment resources that may have engendered more effective responses to spouses' concerns or a sense of obligation to their spouse (indirect social control), whereas pressures to lose weight-while engaged in treatment-may have undermined behavior-change efforts. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Investigation of the part-load performance of two 1.12 MW regenerative marine gas turbines

NASA Astrophysics Data System (ADS)

Korakianitis, T.; Beier, K. J.

1994-04-01

Regenerative and intercooled-regenerative gas turbine engines with low pressure ratio have significant efficiency advantages over traditional aero-derivative engines of higher pressure ratios, and can compete with modern diesel engines for marine propulsion. Their performance is extremely sensitive to thermodynamic-cycle parameter choices and the type of components. The performances of two 1.12 MW (1500 hp) regenerative gas turbines are predicted with computer simulations. One engine has a single-shaft configuration, and the other has a gas-generator/power-turbine combination. The latter arrangement is essential for wide off-design operating regime. The performance of each engine driving fixed-pitch and controllable-pitch propellers, or an AC electric bus (for electric-motor-driven propellers) is investigated. For commercial applications the controllable-pitch propeller may have efficiency advantages (depending on engine type and shaft arrangements). For military applications the electric drive provides better operational flexibility.

Blood Pressure Measurement: Clinic, Home, Ambulatory, and Beyond

PubMed Central

Drawz, Paul E.; Abdalla, Mohamed; Rahman, Mahboob

2014-01-01

Blood pressure has traditionally been measured in the clinic setting using the auscultory method and a mercury sphygmomanometer. Technological advances have led to improvements in measuring clinic blood pressure and allowed for measuring blood pressures outside the clinic. This review outlines various methods for evaluating blood pressure and the clinical utility of each type of measurement. Home blood pressures and 24 hour ambulatory blood pressures have improved our ability to evaluate risk for target organ damage and hypertension related morbidity and mortality. Measuring home blood pressures may lead to more active participation in health care by patients and has the potential to improve blood pressure control. Ambulatory blood pressure monitoring enables the measuring nighttime blood pressures and diurnal changes, which may be the most accurate predictors of risk associated with elevated blood pressure. Additionally, reducing nighttime blood pressure is feasible and may be an important component of effective antihypertensive therapy. Finally, estimating central aortic pressures and pulse wave velocity are two of the newer methods for assessing blood pressure and hypertension related target organ damage. PMID:22521624

Effects of Combined Spinal-Epidural Analgesia during Labor on Postpartum Electrophysiological Function of Maternal Pelvic Floor Muscle: A Randomized Controlled Trial.

PubMed

Xing, Ji-Juan; Liu, Xiu-Fen; Xiong, Xiao-Ming; Huang, Li; Lao, Cheng-Yi; Yang, Mei; Gao, Shan; Huang, Qiong-Yan; Yang, Wei; Zhu, Yun-Feng; Zhang, Di-Hua

2015-01-01

Combined spinal-epidural analgesia (CSEA) is sometimes used for difficult births, but whether it contributes to postpartum pelvic muscle disorder is unclear. This randomized controlled trial examined whether CSEA given during labor affects the electrophysiological index of postpartum pelvic floor muscle function. A consecutive sample of primiparous women who delivered vaginally at term were randomly assigned to a CSEA group (n = 143) and control group (n = 142) between June 2013 and June 2014. All were assessed 6-8 weeks later for electrophysiological function of pelvic floor muscle. The two groups were similar in the degree of muscle strength, muscle fatigue, and pelvic dynamic pressure of pelvic floor muscle. The CSEA and control groups showed similar proportions of women with normal muscle strength (score ≥4) in type I pelvic fibers (23.1% vs. 14.1%, P = 0.051) and type II pelvic fibers (28.0% vs. 24.6%, P = 0.524). The groups also contained similar proportions of women who showed no fatigue in type I fibers (54.5% vs. 48.6%, P = 0.315) or type II fibers (88.8% vs. 87.3%, P = 0.699). Similarly low proportions of women in the CSEA group and control group showed normal pelvic dynamic pressure (11.2% vs. 7.7%, P = 0.321). However, women in the CSEA group spent significantly less time in labor than those in the control group (7.25 vs. 9.52 h, P <0.001). CSEA did not affect the risk of postpartum pelvic muscle disorder in this cohort of primiparous women who gave birth vaginally. A significant shorter duration of labour was observed in the CSEA-group. ClinicalTrials.gov NCT02334150.

Effects of Combined Spinal-Epidural Analgesia during Labor on Postpartum Electrophysiological Function of Maternal Pelvic Floor Muscle: A Randomized Controlled Trial

PubMed Central

Xiong, Xiao-Ming; Huang, Li; Lao, Cheng-Yi; Yang, Mei; Gao, Shan; Huang, Qiong-Yan; Yang, Wei; Zhu, Yun-Feng; Zhang, Di-Hua

2015-01-01

Objective Combined spinal-epidural analgesia (CSEA) is sometimes used for difficult births, but whether it contributes to postpartum pelvic muscle disorder is unclear. This randomized controlled trial examined whether CSEA given during labor affects the electrophysiological index of postpartum pelvic floor muscle function. Methods A consecutive sample of primiparous women who delivered vaginally at term were randomly assigned to a CSEA group (n = 143) and control group (n = 142) between June 2013 and June 2014. All were assessed 6–8 weeks later for electrophysiological function of pelvic floor muscle. Results The two groups were similar in the degree of muscle strength, muscle fatigue, and pelvic dynamic pressure of pelvic floor muscle. The CSEA and control groups showed similar proportions of women with normal muscle strength (score ≥4) in type I pelvic fibers (23.1% vs. 14.1%, P = 0.051) and type II pelvic fibers (28.0% vs. 24.6%, P = 0.524). The groups also contained similar proportions of women who showed no fatigue in type I fibers (54.5% vs. 48.6%, P = 0.315) or type II fibers (88.8% vs. 87.3%, P = 0.699). Similarly low proportions of women in the CSEA group and control group showed normal pelvic dynamic pressure (11.2% vs. 7.7%, P = 0.321). However, women in the CSEA group spent significantly less time in labor than those in the control group (7.25 vs. 9.52 h, P <0.001). Conclusions CSEA did not affect the risk of postpartum pelvic muscle disorder in this cohort of primiparous women who gave birth vaginally. A significant shorter duration of labour was observed in the CSEA-group. Trial Registration ClinicalTrials.gov NCT02334150 PMID:26340002

High-cocoa polyphenol-rich chocolate improves blood pressure in patients with diabetes and hypertension

PubMed Central

Rostami, Ali; Khalili, Mohammad; Haghighat, Neda; Eghtesadi, Shahryar; Shidfar, Farzad; Heidari, Iraj; Ebrahimpour-Koujan, Soraiya; Eghtesadi, Maryam

2015-01-01

BACKGROUND The aim was to examine the effects of high-cocoa polyphenol-rich chocolate on lipid profiles, weight, blood pressure, glycemic control, and inflammation in individuals with Type 2 diabetes and hypertension. METHODS Sixty individuals [32 in dark chocolate group (DCG) and 28 in white chocolate group (WCG)] with Type 2 diabetes on stable medication were enrolled in a randomized, placebo-controlled double-blind study. Subjects were randomized to consume 25 g DCG or WCG for 8 weeks. Changes in weight, blood pressure, glycemic control, lipid profile, and high sensitive C-reactive protein (hsCRP) were measured at the beginning and end of the intervention. This clinical trial was registered at the Iranian registry of clinical trials. RESULTS In DCC group, compared with baseline, serum levels of Apo A-1 (P = 0.045) was increased and fasting blood sugar (FBS) (P = 0.027), hemoglobin A1c (HbA1c) (P = 0.025), Apo B (P = 0.012) and Log of hsCRP (P = 0.043) levels were decreased at the end of study. No changes were seen within the WCG in studied parameters. High polyphenol chocolate consumption compared to white chocolate resulted in significant decrease in of systolic (−5.93 ± 6.25 vs. −1.07 ± 7.97 mmHg, P = 0.004) and diastolic blood pressure (−6.4 ± 6.25 vs. 0.17 ± 7.9 mmHg, P = 0.002), FBS (−7.84 ± 19.15 vs. 4.00 ± 20.58 mg/dl, P = 0.019) over the course of 8 weeks of daily chocolate consumption neither weight nor body mass index and TG levels altered from baseline. CONCLUSION High polyphenol chocolate is effective in improving TG levels in hypertensive patients with diabetes and decreasing blood pressure and FBS without affecting weight, inflammatory markers, insulin resistance or glycemic control. PMID:26089927

High-cocoa polyphenol-rich chocolate improves blood pressure in patients with diabetes and hypertension.

PubMed

Rostami, Ali; Khalili, Mohammad; Haghighat, Neda; Eghtesadi, Shahryar; Shidfar, Farzad; Heidari, Iraj; Ebrahimpour-Koujan, Soraiya; Eghtesadi, Maryam

2015-01-01

The aim was to examine the effects of high-cocoa polyphenol-rich chocolate on lipid profiles, weight, blood pressure, glycemic control, and inflammation in individuals with Type 2 diabetes and hypertension. Sixty individuals [32 in dark chocolate group (DCG) and 28 in white chocolate group (WCG)] with Type 2 diabetes on stable medication were enrolled in a randomized, placebo-controlled double-blind study. Subjects were randomized to consume 25 g DCG or WCG for 8 weeks. Changes in weight, blood pressure, glycemic control, lipid profile, and high sensitive C-reactive protein (hsCRP) were measured at the beginning and end of the intervention. This clinical trial was registered at the Iranian registry of clinical trials. In DCC group, compared with baseline, serum levels of Apo A-1 (P = 0.045) was increased and fasting blood sugar (FBS) (P = 0.027), hemoglobin A1c (HbA1c) (P = 0.025), Apo B (P = 0.012) and Log of hsCRP (P = 0.043) levels were decreased at the end of study. No changes were seen within the WCG in studied parameters. High polyphenol chocolate consumption compared to white chocolate resulted in significant decrease in of systolic (-5.93 ± 6.25 vs. -1.07 ± 7.97 mmHg, P = 0.004) and diastolic blood pressure (-6.4 ± 6.25 vs. 0.17 ± 7.9 mmHg, P = 0.002), FBS (-7.84 ± 19.15 vs. 4.00 ± 20.58 mg/dl, P = 0.019) over the course of 8 weeks of daily chocolate consumption neither weight nor body mass index and TG levels altered from baseline. High polyphenol chocolate is effective in improving TG levels in hypertensive patients with diabetes and decreasing blood pressure and FBS without affecting weight, inflammatory markers, insulin resistance or glycemic control.

Creatinine plasma at uncontrolled type 2 diabetes mellitus and controlled type 2 diabetes mellitus patients at primary health care in Binjai city, Indonesia

NASA Astrophysics Data System (ADS)

Rusdiana; Savira, M.; Syahputra, M.; Santoso, A.

2018-03-01

The aim of the study knowing the comparison creatinine plasma levels at uncontrolled type 2 diabetes mellitus and controlled type 2 diabetes mellitus patients at Primary Health Care in Binjai city of North Sumatera in Indonesia. This cross-sectional study was conductedon 40 type 2 Diabetes Mellitus patients who attended Primary Health Care in Binjai. Patients with age > 40 years old, (both sexes) were included in the study. We recorded different demographic parameter as age, Body Mass Index, Blood Pressure, and personal history status. And we examined the biochemicalparameters including Hba1c, Fasting Blood Sugar Levels (FBL) and creatinine serum. We separated into two groups base on HbA1c test, controlled type 2 diabetes mellitus and uncontrolled type 2 diabetes mellitus. We measured FBL by using the portable measuring instrument, and Thamrin clinical laboratory measured Hba1c, andwe measured creatinine plasmaby spectrophotometry in Biochemistry laboratory. With statistical analysis using T-test found that there was asignificant differencein creatinine plasma levels between uncontrolled type 2 diabetes mellitus with controlled type 2 diabetes mellitus (p<0.005).

Update on Prevention of Cardiovascular Disease in Adults With Type 2 Diabetes Mellitus in Light of Recent Evidence: A Scientific Statement From the American Heart Association and the American Diabetes Association

PubMed Central

Golden, Sherita Hill; Anderson, Cheryl; Bray, George A.; Burke, Lora E.; de Boer, Ian H.; Deedwania, Prakash; Eckel, Robert H.; Ershow, Abby G.; Fradkin, Judith; Inzucchi, Silvio E.; Kosiborod, Mikhail; Nelson, Robert G.; Patel, Mahesh J.; Pignone, Michael; Quinn, Laurie; Schauer, Philip R.; Selvin, Elizabeth; Vafiadis, Dorothea K.

2015-01-01

Cardiovascular disease risk factor control as primary prevention in patients with type 2 diabetes mellitus has changed substantially in the past few years. The purpose of this scientific statement is to review the current literature and key clinical trials pertaining to blood pressure and blood glucose control, cholesterol management, aspirin therapy, and lifestyle modification. We present a synthesis of the recent literature, new guidelines, and clinical targets, including screening for kidney and subclinical cardiovascular disease for the contemporary management of patients with type 2 diabetes mellitus. PMID:26246459

U.S. Foreign Assistance: Creating a Toolbox for the Twenty-First Century

DTIC Science & Technology

1999-01-01

can presumably afford unsubsidized birth control , likely to be affected? Was rt in the U.S. interest for Nigeria’s birth rate to ciimb? Under pressure...most challenging type of foreign aid to I2 Atd promoting birth control has proved successful as noted n Carol Graham and Michael O’Hanlon, “Making

Pressure-specific and multiple pressure response of fish assemblages in European running waters☆

PubMed Central

Schinegger, Rafaela; Trautwein, Clemens; Schmutz, Stefan

2013-01-01

We classified homogenous river types across Europe and searched for fish metrics qualified to show responses to specific pressures (hydromorphological pressures or water quality pressures) vs. multiple pressures in these river types. We analysed fish taxa lists from 3105 sites in 16 ecoregions and 14 countries. Sites were pre-classified for 15 selected pressures to separate unimpacted from impacted sites. Hierarchical cluster analysis was used to split unimpacted sites into four homogenous river types based on species composition and geographical location. Classification trees were employed to predict associated river types for impacted sites with four environmental variables. We defined a set of 129 candidate fish metrics to select the best reacting metrics for each river type. The candidate metrics represented tolerances/intolerances of species associated with six metric types: habitat, migration, water quality sensitivity, reproduction, trophic level and biodiversity. The results showed that 17 uncorrelated metrics reacted to pressures in the four river types. Metrics responded specifically to water quality pressures and hydromorphological pressures in three river types and to multiple pressures in all river types. Four metrics associated with water quality sensitivity showed a significant reaction in up to three river types, whereas 13 metrics were specific to individual river types. Our results contribute to the better understanding of fish assemblage response to human pressures at a pan-European scale. The results are especially important for European river management and restoration, as it is necessary to uncover underlying processes and effects of human pressures on aquatic communities. PMID:24003262

Exercise excess pressure and exercise-induced albuminuria in patients with type 2 diabetes mellitus.

PubMed

Climie, Rachel E D; Srikanth, Velandai; Keith, Laura J; Davies, Justin E; Sharman, James E

2015-05-01

Exercise-induced albuminuria is common in patients with type 2 diabetes mellitus (T2DM) in response to maximal exercise, but the response to light-moderate exercise is unclear. Patients with T2DM have abnormal central hemodynamics and greater propensity for exercise hypertension. This study sought to determine the relationship between light-moderate exercise central hemodynamics (including aortic reservoir and excess pressure) and exercise-induced albuminuria. Thirty-nine T2DM (62 ± 9 yr; 49% male) and 39 nondiabetic controls (53 ± 9 yr; 51% male) were examined at rest and during 20 min of light-moderate cycle exercise (30 W; 50 revolutions/min). Albuminuria was assessed by the albumin-creatinine ratio (ACR) at rest and 30 min postexercise. Hemodynamics recorded included brachial and central blood pressure (BP), aortic stiffness, augmented pressure (AP), aortic reservoir pressure, and excess pressure integral (Pexcess). There was no difference in ACR between groups before exercise (P > 0.05). Exercise induced a significant rise in ACR in T2DM but not controls (1.73 ± 1.43 vs. 0.53 ± 1.0 mg/mol, P = 0.002). All central hemodynamic variables were significantly higher during exercise in T2DM (i.e., Pexcess, systolic BP and AP; P < 0.01 all). In T2DM (but not controls), exercise Pexcess was associated with postexercise ACR (r = 0.51, P = 0.002), and this relationship was independent of age, sex, body mass index, heart rate, aortic stiffness, antihypertensive medication, and ambulatory daytime systolic BP (β = 0.003, P = 0.003). Light-moderate exercise induced a significant rise in ACR in T2DM, and this was independently associated with Pexcess, a potential marker of vascular dysfunction. These novel findings suggest that Pexcess could be important for appropriate renal function in T2DM. Copyright © 2015 the American Physiological Society.

Towards a more efficient diabetes control in primary care: six-monthly monitoring compared with three-monthly monitoring in type 2 diabetes - The EFFIMODI trial. Design of a randomised controlled patient-preference equivalence trial in primary care.

PubMed

Wermeling, Paulien R; van den Donk, Maureen; Gorter, Kees J; Ardine de Wit, G; van der Graaf, Yolanda; Rutten, Guy Ehm

2010-05-11

Scientific evidence for the frequency of monitoring of type 2 diabetes patients is lacking. If three-monthly control in general practice could be reduced to six-monthly control in some patients, this would on the one hand reduce the use of medical services including involvement of practice nurses, and thus reduce costs, and on the other hand alleviate the burden of people with type 2 diabetes. The goal of this study is to make primary diabetes care as efficient as possible for patients and health care providers. Therefore, we want to determine whether six-monthly monitoring of well-controlled type 2 diabetes patients in primary care leads to equivalent cardiometabolic control compared to the generally recommended three-monthly monitoring. The study is a randomised controlled patient-preference equivalence trial. Participants are asked if they prefer three-monthly (usual care) or six-monthly diabetes monitoring. If they do not have a preference, they are randomised to a three-monthly or six-monthly monitoring group. Patients are eligible for the study if they are between 40 and 80 years old, diagnosed with type 2 diabetes more than one year ago, treated by a general practitioner, not on insulin treatment, and with HbA1c < or = 7.5%, systolic blood pressure < or = 145 mmHg and total cholesterol < or = 5.2 mmol/l. The intervention group (six-monthly monitoring) will receive the same treatment with the same treatment targets as the control group (three-monthly monitoring). The intervention period will last one and a half year. After the intervention, the three-monthly and six-monthly monitoring groups are compared on equivalence of cardiometabolic control. Secondary outcome measures are HbA1c, blood pressure, cholesterol level, Body Mass Index, smoking behaviour, physical activity, loss of work due to illness, health status, diabetes-specific distress, satisfaction with treatment and adherence to medications. We will use intention-to-treat analysis with repeated measures. For outcomes that have only baseline and final measurements, we will use ANCOVA. Depending on the results, a cost-minimisation analysis or an incremental cost-effectiveness analysis will be done. This study will provide valuable information on the most efficient control frequency of well-controlled type 2 diabetes patients in primary care.

Effectiveness of Standardized Nursing Care Plans in Health Outcomes in Patients with Type 2 Diabetes Mellitus: A Two-Year Prospective Follow-Up Study

PubMed Central

Cárdenas-Valladolid, Juan; Salinero-Fort, Miguel A.; Gómez-Campelo, Paloma; de Burgos-Lunar, Carmen; Abánades-Herranz, Juan C.; Arnal-Selfa, Rosa; Andrés, Ana López-

2012-01-01

Background Implementation of a standardized language in Nursing Care Plans (SNCP) allows for increased efficiency in nursing data management. However, the potential relationship with patientś health outcomes remains uncertain. The aim of this study was to evaluate the effectiveness of SNCP implementation, based on North American Nursing Diagnosis Association (NANDA) and Nursing Interventions Classification (NIC), in the improvement of metabolic, weight, and blood pressure control of Type 2 Diabetes Mellitus (T2DM) patients. Methods A two-year prospective follow-up study, in routine clinical practice conditions. 31 primary health care centers (Spain) participated with 24,124 T2DM outpatients. Data was collected from Computerized Clinical Records; SNCP were identified using NANDA and NIC taxonomies. Descriptive and ANCOVA analyses were conducted. Results 18,320 patients were identified in the Usual Nursing Care (UNC) group and 5,168 in the SNCP group. At the two-year follow-up, the SNCP group improved all parameters except LDL cholesterol and diastolic blood pressure. We analyzed data adjustming by the baseline value for these variables and variables with statistically significant differences between groups at baseline visit. Results indicated a lowering of all parameters except HbA1c, but a statistically significant reduction was only observed with diastolic blood pressure results. However, the adjusted reduction of diastolic blood pressure is of little clinical relevance. Greater differences of control values for diastolic blood pressure, HbA1c, LDL-cholesterol and Body Mass Index were found in the SNCP group, but only reached statistical significance for HbA1c. A greater proportion of patients with baseline HbA1c ≥7 decreased to <7% at the two-year follow-up in the SNCP group than in the UNC group (16.9% vs. 15%; respectively; p = 0.01). Conclusions Utilization of SNCP was helpful in achieving glycemic control targets in poorly controlled patients with T2DM (HbA1c ≥7%). Diastolic blood pressure results were slightly improved in the SNCP group compared to the UNC group. Trial Registration ClinicalTrials.gov NCT01482481 PMID:22952794

Effects of meal preparation training on body weight, glycemia, and blood pressure: results of a phase 2 trial in type 2 diabetes.

PubMed

Dasgupta, Kaberi; Hajna, Samantha; Joseph, Lawrence; Da Costa, Deborah; Christopoulos, Stavroula; Gougeon, Rejeanne

2012-10-17

Modest reductions in weight and small increases in step- related activity (e.g., walking) can improve glycemic and blood pressure control in type 2 diabetes mellitus (DM2). We examined changes in these parameters following training in time- efficient preparation of balanced, low- energy meals combined with pedometer- based step count monitoring. Seventy- two adults with DM2 were enrolled in a 24- week program (i.e., 15 three- hour group sessions). They prepared meals under a chef's supervision, and discussed eating behaviours/nutrition with a registered dietitian. They maintained a record of pedometer- assessed step counts. We evaluated changes from baseline to 24 weeks in terms of weight, step counts, hemoglobin A1c (HbA1c, glycemic control), blood pressure, and eating control ability (Weight Efficacy Lifestyle WEL Questionnaire). 53 participants (73.6%) completed assessments. There were improvements in eating control (11.2 point WEL score change, 95% CI 4.7 to 17.8), step counts (mean change 869 steps/day, 95% CI 198 to 1,540), weight (mean change -2.2%; 95% CI -3.6 to -0.8), and HbA1c (mean change -0.3% HbA1c, 95% CI -0.6 to -0.1), as well as suggestion of systolic blood pressure reduction (mean change -3.5 mm Hg, 95% CI -7.8 to 0.9). Findings were not attributable to medication changes. In linear regression models (adjusted for age, sex, ethnicity, insulin use, season), a -2.5% weight change was associated with a -0.3% HbA1c change (95% CI -0.4 to -0.2) and a -3.5% systolic blood pressure change (95% CI -5.5 to -1.4). In this 'proof of concept' study, persistence with the program led to improvements in eating and physical activity habits, glycemia reductions, and suggestion of blood pressure lowering effects. The strategy thus merits further study and development to expand the range of options for vascular risk reduction in DM2.

Exercise-induced albuminuria vs circadian variations in blood pressure in type 1 diabetes.

PubMed

Tadida Meli, Isabelle Hota; Tankeu, Aurel T; Dehayem, Mesmin Y; Chelo, David; Noubiap, Jean Jacques N; Sobngwi, Eugene

2017-02-15

To investigated the relationship between exercise-induced ambulatory blood pressure measurement (ABPM) abnormalities in type 1 diabetes mellitus (T1DM) adolescents. We conducted a case-control at the National Obesity Center of the Yaoundé Central Hospital, Cameroon. We compared 24 h ABPM and urinary albumin-to-creatinine ratio (ACR) at rest and after a standardized treadmill exercise between 20 Cameroonian T1DM patients and 20 matched controls. T1DM adolescents were aged 12-18 years, with diabetes for at least one year, without proteinuria, with normal office blood pressure (BP) and renal function according to the general reference population. Non-diabetic controls were adolescents of general population matched for sex, age and BMI. Mean duration of diabetes was 4.2 ± 2.8 years. The mean 24 h systolic blood pressure (SBP) and diastolic blood pressure (DBP) were respectively 116 ± 9 mmHg in the diabetic group vs 111 ± 8 mmHg in the non-diabetic ( P = 0.06), and 69 ± 7 mm Hg vs 66 ± 5 mm Hg ( P = 0.19). There was no difference in the diurnal pattern of BP in diabetes patients and non-diabetic controls (SBP: 118 ± 10 mmHg vs 114 ± 10 mmHg, P = 0.11; DBP: 71 ± 7 mmHg vs 68 ± 6 mmHg, P = 0.22). Nighttime BP was higher in the diabetic group with respect to SBP (112 ± 11 mmHg vs 106 ± 7 mmHg, P = 0.06) and to the mean arterial pressure (MAP) (89 ± 9 mmHg vs 81 ± 6 mmHg, P = 0.06). ACR at rest was similar in both groups (5.5 mg/g vs 5.5 mg/g, P = 0.74), but significantly higher in diabetes patients after exercise (10.5 mg/g vs 5.5 mg/g, P = 0.03). SBP was higher in patients having exercise-induced albuminuria (116 ± 10 mmHg vs 108 ± 10 mmHg, P = 0.09). Exercise-induced albuminuria could be useful for early diagnosis of kidney damage in adolescents with T1DM.

Effectiveness of standardized Nursing Care Plans in health outcomes in patients with type 2 Diabetes Mellitus: a two-year prospective follow-up study.

PubMed

Cárdenas-Valladolid, Juan; Salinero-Fort, Miguel A; Gómez-Campelo, Paloma; de Burgos-Lunar, Carmen; Abánades-Herranz, Juan C; Arnal-Selfa, Rosa; Andrés, Ana López-

2012-01-01

Implementation of a standardized language in Nursing Care Plans (SNCP) allows for increased efficiency in nursing data management. However, the potential relationship with patientś health outcomes remains uncertain. The aim of this study was to evaluate the effectiveness of SNCP implementation, based on North American Nursing Diagnosis Association (NANDA) and Nursing Interventions Classification (NIC), in the improvement of metabolic, weight, and blood pressure control of Type 2 Diabetes Mellitus (T2DM) patients. A two-year prospective follow-up study, in routine clinical practice conditions. 31 primary health care centers (Spain) participated with 24,124 T2DM outpatients. Data was collected from Computerized Clinical Records; SNCP were identified using NANDA and NIC taxonomies. Descriptive and ANCOVA analyses were conducted. 18,320 patients were identified in the Usual Nursing Care (UNC) group and 5,168 in the SNCP group. At the two-year follow-up, the SNCP group improved all parameters except LDL cholesterol and diastolic blood pressure. We analyzed data adjustming by the baseline value for these variables and variables with statistically significant differences between groups at baseline visit. Results indicated a lowering of all parameters except HbA1c, but a statistically significant reduction was only observed with diastolic blood pressure results. However, the adjusted reduction of diastolic blood pressure is of little clinical relevance. Greater differences of control values for diastolic blood pressure, HbA1c, LDL-cholesterol and Body Mass Index were found in the SNCP group, but only reached statistical significance for HbA1c. A greater proportion of patients with baseline HbA1c ≥7 decreased to <7% at the two-year follow-up in the SNCP group than in the UNC group (16.9% vs. 15%; respectively; p = 0.01). Utilization of SNCP was helpful in achieving glycemic control targets in poorly controlled patients with T2DM (HbA1c ≥7%). Diastolic blood pressure results were slightly improved in the SNCP group compared to the UNC group. ClinicalTrials.gov NCT01482481.

Adaptive Controls Method Demonstrated for the Active Suppression of Instabilities in Engine Combustors

NASA Technical Reports Server (NTRS)

Kopasakis, George

2004-01-01

An adaptive feedback control method was demonstrated that suppresses thermoacoustic instabilities in a liquid-fueled combustor of a type used in aircraft engines. Extensive research has been done to develop lean-burning (low fuel-to-air ratio) combustors that can reduce emissions throughout the mission cycle to reduce the environmental impact of aerospace propulsion systems. However, these lean-burning combustors are susceptible to thermoacoustic instabilities (high-frequency pressure waves), which can fatigue combustor components and even the downstream turbine blades. This can significantly decrease the safe operating lives of the combustor and turbine. Thus, suppressing the thermoacoustic combustor instabilities is an enabling technology for lean, low-emissions combustors under NASA's Propulsion and Power Program. This control methodology has been developed and tested in a partnership of the NASA Glenn Research Center, Pratt & Whitney, United Technologies Research Center, and the Georgia Institute of Technology. Initial combustor rig testing of the controls algorithm was completed during 2002. Subsequently, the test results were analyzed and improvements to the method were incorporated in 2003, which culminated in the final status of this controls algorithm. This control methodology is based on adaptive phase shifting. The combustor pressure oscillations are sensed and phase shifted, and a high-frequency fuel valve is actuated to put pressure oscillations into the combustor to cancel pressure oscillations produced by the instability.

Advances in wound healing: topical negative pressure therapy

PubMed Central

Jones, S; Banwell, P; Shakespeare, P

2005-01-01

In clinical practice many wounds are slow to heal and difficult to manage. The recently introduced technique of topical negative pressure therapy (TNP) has been developed to try to overcome some of these difficulties. TNP applies a controlled negative pressure to the surface of a wound that has potential advantages for wound treatment and management. Although the concept itself, of using suction in wound management is not new, the technique of applying a negative pressure at the surface of the wound is. This paper explores the origins and proposed mechanisms of action of TNP therapy and discusses the types of wounds that are thought to benefit most from use of this system. PMID:15937199

Intermittent hypoxia increases arterial blood pressure in humans through a Renin-Angiotensin system-dependent mechanism.

PubMed

Foster, Glen E; Hanly, Patrick J; Ahmed, Sofia B; Beaudin, Andrew E; Pialoux, Vincent; Poulin, Marc J

2010-09-01

Intermittent hypoxia (IH) is believed to contribute to the pathogenesis of hypertension in obstructive sleep apnea through mechanisms that include activation of the renin-angiotensin system. The objective of this study was to assess the role of the type I angiotensin II receptor in mediating an increase in arterial pressure associated with a single 6-hour IH exposure. Using a double-blind, placebo-controlled, randomized, crossover study design, we exposed 9 healthy male subjects to sham IH, IH with placebo medication, and IH with the type I angiotensin II receptor antagonist losartan. We measured blood pressure, cerebral blood flow, and ventilation at baseline and after exposure to 6 hours of IH. An acute isocapnic hypoxia experimental protocol was conducted immediately before and after exposure to IH. IH with placebo increased resting mean arterial pressure by 7.9+/-1.6 mm Hg, but mean arterial pressure did not increase with sham IH (1.9+/-1.5 mm Hg) or with losartan IH (-0.2+/-2.4 mm Hg; P<0.05). Exposure to IH prevented the diurnal decrease in the cerebral blood flow response to hypoxia, independently of the renin-angiotensin system. Finally, in contrast to other models of IH, the acute hypoxic ventilatory response did not change throughout the protocol. IH increases arterial blood pressure through activation of the type I angiotensin II receptor, without a demonstrable impact on the cerebrovascular or ventilatory response to acute hypoxia.

[Effects of long time different negative pressures on osteogenic differentiation of rabbit bone mesenchymal stem cells].

PubMed

Zhao, Bowen; Zhang, Hongwei; Xu, Qiang; Ge, Quanhu; Li, Bolong; Peng, Xinyu; Wu, Xiangwei

2017-05-01

To investigate the effects of long time different negative pressures on osteogenic diffe-rentiation of rabbit bone mesenchymal stem cells (BMSCs). The rabbit BMSCs were isolated and cultured by density gradient centrifugation. Flow cytometry was used to analyze expression of surface markers. The third passage cells cultured under condition of osteogenic induction and under different negative pressure of 0 mm Hg (control group), 75 mm Hg (low negative pressure group), and 150 mm Hg (high negative pressure group) (1 mm Hg=0.133 kPa), and the negative pressure time was 30 min/h. Cell growth was observed under phase contrast microscopy, and the growth curve was drawn; alkaline phosphatase (ALP) activity was detected by ELISA after induced for 3, 7, and 14 days. The mRNA and protein expressions of collagen type I (COL-I) and osteocalcin (OC) in BMSCs were analyzed by real-time fluorescence quantitative PCR and Western blot. The cultured cells were identified as BMSCs by flow cytometry. The third passage BMSCs exhibited typical long shuttle and irregular shape. Cell proliferation was inhibited with the increase of negative pressure. After induced for 4 days, the cell number of high negative pressure group was significantly less than that in control group and low negative pressure group ( P <0.05), but there was no significant difference between the low negative pressure group and the control group ( P >0.05); at 5-7 days, the cell number showed significant difference between 3 groups ( P <0.05). The greater the negative pressure was, the greater the inhibition of cell proliferation was. There was no significant difference in ALP activity between groups at 3 days after induction ( P >0.05); the ALP activity showed significant difference ( P <0.05) between the high negative pressure group and the control group at 7 days after induction; and significant difference was found in the ALP activity between 3 groups at 14 days after induction ( P <0.05). The greater the negative pressure was, the higher the ALP activity was. Real-time fluorescence quantitative PCR and Western blot detection showed that the mRNA and protein expressions of COL-I and OC protein were significantly higher in low negative pressure group and high negative pressure group than control group ( P <0.05), and in the high negative pressure group than the low negative pressure group ( P <0.05). With the increase of the negative pressure, the osteogenic differentiation ability of BMSCs increases gradually, but the cell proliferation is inhibited.

Flap Edge Noise Reduction Fins

NASA Technical Reports Server (NTRS)

Khorrami, Mehdi R. (Inventor); Choudhan, Meelan M. (Inventor)

2015-01-01

A flap of the type that is movably connected to an aircraft wing to provide control of an aircraft in flight includes opposite ends, wherein at least a first opposite end includes a plurality of substantially rigid, laterally extending protrusions that are spaced apart to form a plurality of fluidly interconnected passageways. The passageways have openings adjacent to upper and lower sides of the flap, and the passageways include a plurality of bends such that high pressure fluid flows from a high pressure region to a low pressure region to provide a boundary condition that inhibits noise resulting from airflow around the end of the flap.

Dynamic mechanical properties and anisotropy of synthetic shales with different clay minerals under confining pressure

NASA Astrophysics Data System (ADS)

Gong, Fei; Di, Bangrang; Wei, Jianxin; Ding, Pinbo; Shuai, Da

2018-03-01

The presence of clay minerals can alter the elastic behaviour of reservoir rocks significantly as the type of clay minerals, their volume and distribution, and their orientation control the shale's intrinsic anisotropic behaviours. Clay minerals are the most abundant materials in shale, and it has been proven extremely difficult to measure the elastic properties of natural shale by means of a single variable (in this case, the type of clay minerals), due to the influences of multiple factors, including water, TOC content and complex mineral compositions. We used quartz, clay (kaolinite, illite and smectite), carbonate and kerogen extract as the primary materials to construct synthetic shale with different clay minerals. Ultrasonic experiments were conducted to investigate the anisotropy of velocity and mechanical properties in dry synthetic and natural shale as a function of confining pressure. Velocities in synthetic shale are sensitive to the type of clay minerals, possibly due to the different structures of the clay minerals. The velocities increase with confining pressure and show higher rate of velocity increase at low pressures, and P-wave velocity is usually more sensitive than S-wave velocity to confining pressure according to our results. Similarly, the dynamic Young's modulus and Poisson's ratio increase with applied pressure, and the results also reveal that E11 is always larger than E33 and ν31 is smaller than ν12. Velocity and mechanical anisotropy decrease with increasing stress, and are sensitive to stress and the type of clay minerals. However, the changes of mechanical anisotropy with applied stress are larger compared with the velocity anisotropy, indicating that mechanical properties are more sensitive to the change of rock properties.

Effect of Angiotensin-Converting Enzyme Inhibitor/Calcium Antagonist Combination Therapy on Renal Function in Hypertensive Patients With Chronic Kidney Disease: Chikushi Anti-Hypertension Trial - Benidipine and Perindopril.

PubMed

Okuda, Tetsu; Okamura, Keisuke; Shirai, Kazuyuki; Urata, Hidenori

2018-02-01

Appropriate blood pressure control suppresses progression of chronic kidney disease (CKD). If an angiotensin-converting enzyme (ACE) inhibitor is ineffective, adding a calcium antagonist is recommended. We compared the long-term effect of two ACE inhibitor/calcium antagonist combinations on renal function in hypertensive patients with CKD. Patients who failed to achieve the target blood pressure (systolic/diastolic: < 130/80 mm Hg) with perindopril monotherapy were randomized to either combined therapy with perindopril and the L-type calcium antagonist amlodipine (group A) or perindopril and the T/L type calcium antagonist benidipine (group B). The primary endpoint was the change of the estimated glomerular filtration rate (eGFR) after 2 years. Eligible patients had a systolic pressure ≥ 130 mm Hg and/or diastolic pressure ≥ 80 mm Hg and CKD (urine protein (+) or higher, eGFR < 60 min/mL/1.73 m 2 ). After excluding 38 patients achieving the target blood pressure with perindopril monotherapy, 121 patients were analyzed (62 in group A and 59 in group B). Blood pressure decreased significantly in both groups, but there was no significant change of the eGFR. However, among patients with diabetes, eGFR unchanged in group B (n = 37, 59.1 ± 15.1 vs. 61.2 ± 27.9, P = 0.273), whereas decreased significantly in group A (n = 31, 57.3 ± 16.0 vs. 53.7 ± 16.7, P = 0.005). In hypertensive patients with diabetic nephropathy, combined therapy with an ACE inhibitor and T/L type calcium antagonist may prevent deterioration of renal function more effectively than an ACE inhibitor/L type calcium antagonist combination.

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

Snepvangers, J.J.M.

Equipment and results are described connected with irradiation studies of UO/sub 2/ fuels, fuel element testing in pressurized water loops, graphite irradiation, and steel irradiations with and without temperature control. The apparatus described is associated with a 20-Mw pool-type research reactor. (T.F.H.)

Central sensitization in tension-type headache--possible pathophysiological mechanisms.

PubMed

Bendtsen, L

2000-06-01

The aim of the present thesis was to investigate the pathophysiology of chronic tension-type headache with special reference to central mechanisms. Increased tenderness to palpation of pericranial myofascial tissues is the most apparent abnormality in patients with tension-type headache. A new piece of equipment, a so-called palpometer, that makes it possible to control the pressure intensity exerted during palpation, was developed. Thereafter, it was demonstrated that the measurement of tenderness could be compared between two observers if the palpation pressure was controlled, and that the Total Tenderness Scoring system was well suited for the scoring of tenderness during manual palpation. Subsequently, it was found that pressure pain detection and tolerance thresholds were significantly decreased in the finger and tended to be decreased in the temporal region in chronic tension-type headache patients compared with controls. In addition, the electrical pain threshold in the cephalic region was significantly decreased in patients. It was concluded that the central pain sensitivity was increased in the patients probably due to sensitization of supraspinal neurones. The stimulus-response function for palpation pressure vs. pain was found to be qualitatively altered in chronic tension-type headache patients compared with controls. The abnormality was related to the degree of tenderness and not to the diagnosis of tension-type headache. In support of this, the stimulus-response function was found to be qualitatively altered also in patients with fibromyalgia. It was concluded that the qualitatively altered nociception was probably due to central sensitization at the level of the spinal dorsal horn/trigeminal nucleus. Thereafter, the prophylactic effect of amitriptyline, a non-selective serotonin (5-HT) reuptake inhibitor, and of citalopram, a highly selective 5-HT reuptake inhibitor, was examined in patients with chronic tension-type headache. Amitriptyline reduced headache significantly more than placebo, while citalopram had only a slight and insignificant effect. It was concluded that the blockade of 5-HT reuptake could only partly explain the efficacy of amitriptyline in tension-type headache, and that also other actions of amitriptyline, e.g. reduction of central sensitization, were involved. Finally, the plasma 5-HT level, the platelet 5-HT level and the number of platelet 5-HT transporters were found to be normal in chronic tension-type headache. On the basis of the present and previous studies, a pathophysiological model for tension-type headache is presented. According to the model, the main problem in chronic tension-type headache is central sensitization at the level of the spinal dorsal horn/trigeminal nucleus due to prolonged nociceptive inputs from pericranial myofascial tissues. The increased nociceptive input to supraspinal structures may in turn result in supraspinal sensitization. The central neuroplastic changes may affect the regulation of peripheral mechanisms and thereby lead to, for example, increased pericranial muscle activity or release of neurotransmitters in the myofascial tissues. By such mechanisms the central sensitization may be maintained even after the initial eliciting factors have been normalized, resulting in the conversion of episodic into chronic tension-type headache. Future basic and clinical research should aim at identifying the source of peripheral nociception in order to prevent the development of central sensitization and at ways of reducing established sensitization. This may lead to a much needed improvement in the treatment of chronic tension-type headache and other chronic myofascial pain conditions.

Shock position sensor for supersonic inlets. [measuring pressure in the throat of a supersonic inlet

NASA Technical Reports Server (NTRS)

Dustin, M. O. (Inventor)

1975-01-01

Static pressure taps or ports are provided in the throat of a supersonic inlet, and signals indicative of the pressure at each of the ports is fed to respective comparators. Means are also provided for directing a signal indicative of the total throat pressure to the comparators. A periodic signal is superimposed on the total throat pressure so that the signal from the static pressure tabs is compared to a varying scan signal rather than to total throat pressure only. This type of comparison causes each comparator to provide a pulse width modulated output which may vary from 0% 'time on' to 100% 'time on'. The pulse width modulated outputs of the comparators are summed, filtered, and directed to a controller which operates a bypass valve such as a door whereby air is dumped from the inlet to prevent the shock wave from being expelled out the front.

Noxious inhibition of temporal summation is impaired in chronic tension-type headache.

PubMed

Cathcart, Stuart; Winefield, Anthony H; Lushington, Kurt; Rolan, Paul

2010-03-01

To examine effects of stress on noxious inhibition and temporal summation (TS) in tension-type headache. Stress is the most commonly reported trigger of a chronic tension-type headache (CTH) episode; however, the mechanisms underlying this are unclear. Stress affects pain processing throughout the central nervous system, including, potentially, mechanisms of TS and diffuse noxious inhibitory controls (DNIC), both of which may be abnormal in CTH sufferers (CTH-S). No studies have examined TS of pressure pain or DNIC of TS in CTH-S to date. Similarly, effects of stress on TS or DNIC of TS have not been reported in healthy subjects or CTH-S to date. The present study measured TS and DNIC of TS in CTH-S and healthy controls (CNT) exposed to an hour-long stressful mental task, and in CTH-S exposed to an hour-long neutral condition. TS was elicited at finger and shoulder via 10 pulses from a pressure algometer, applied before and during stimulation from an occlusion cuff at painful intensity. Algometer pain ratings increased more in the CTH compared with the CNT group, and were inhibited during occlusion cuff more in the CNT compared with CTH groups. Task effects on TS or DNIC were not significant. The results indicate increased TS to pressure pain and impaired DNIC of TS in CTH-S. Stress does not appear to aggravate abnormal TS or DNIC mechanisms in CTH-S.

Advanced glycation end products are associated with pulse pressure in type 1 diabetes: the EURODIAB Prospective Complications Study.

PubMed

Schram, Miranda T; Schalkwijk, Casper G; Bootsma, Aart H; Fuller, John H; Chaturvedi, Nish; Stehouwer, Coen D A

2005-07-01

We investigated the associations of pulse pressure (a measure of arterial stiffness) with the early glycation products hemoglobin A1c (HbA1c) and Amadori albumin and the advanced glycation end products pentosidine, Nepsilon-(carboxymethyl)lysine and Nepsilon-(carboxyethyl)lysine in a large group of type 1 diabetic individuals of the EURODIAB Prospective Complications Study. We did a cross-sectional nested case-control study from the EURODIAB Prospective Complications Study of 543 (278 men) European individuals with type 1 diabetes diagnosed at <36 years of age. We used linear regression analyses to investigate the association of pulse pressure with glycation products. Pulse pressure was significantly associated with plasma levels of Nepsilon-(carboxymethyl)lysine and Nepsilon-(carboxyethyl)lysine but not with HbA1c, Amadori albumin, and urinary levels of pentosidine. Regression coefficients adjusted for age, sex, mean arterial pressure, and duration of diabetes were 0.09 mm Hg (P=0.003) per 1 microM/M lysine Nepsilon-(carboxymethyl)lysine; 0.24 mm Hg (P=0.001) and -0.03 mm Hg (P=0.62) per 1 microM/M lysine Nepsilon-(carboxyethyl)lysine (in individuals with and without complications, respectively; P interaction=0.002); and 0.50 mm Hg (P=0.16) per 1% HbA1c; 0.07 mm Hg (P=0.12) per 1 U/mL Amadori albumin; and 0.77 mm Hg (P=0.48) per 1 nmol/mmol creatinine pentosidine. In young type 1 diabetic individuals, arterial stiffness is strongly associated with the advanced glycation end products Nepsilon-(carboxymethyl)lysine and Nepsilon-(carboxyethyl)lysine. These findings suggest that the formation of advanced glycation end products is an important pathway in the development of arterial stiffness in young type 1 diabetic individuals.

Dynamic Measurement of Extra Long Stroke Cylinder in the Pneumatic System

NASA Astrophysics Data System (ADS)

Chang, Ho; Lan, Chou-wei; Chen, Liang-Chia

2006-10-01

This paper sets up the measure and control system of the dynamic characteristics of the extra long stroke cylinder. In the different types of the control conditions (e.g. different control law, operating pressure and direct control valves), using the measure and control system to measure the relation between the pressure and the velocity of the motion of the long stroke cylinder and to observe the stick slip phenomenon of the motion of the long stroke cylinder. In the innovate measurement system, two pressure sensors are set on the long stroke cylinder to measure the difference of the pressure between the inlet and the exhaust of the long stroke cylinder. In additions, a draw line encoder is set on the system to measure the position and the velocity of the motion of the long stroke cylinder. The measuring data of the measure system is transferred to the computer via A/D interface card and counter card, and Home-made program of Haptic Interface Device is used to control the system, saving the data of the motion of the long stroke cylinder. The system uses different types of direction control valve to control the motion of the long stroke cylinder and compares the difference of the motion of the long stroke cylinder. The results show that the motion of the cylinder that pauses in the middle of the cylinder stroke and causes the stick slip phenomenon is more violent than the stick slip phenomenon in other position. When the length of the pause time reaches the some range, the acceleration of the motion of the cylinder will be rised substantially. This paper not only focuses on the testing method of the dynamic characteristics of the motion of the long stroke cylinder, but also includes the analysis of the dynamic characteristics of the motion of the long stroke cylinder. It provides the data of the dynamic characteristics of the motion of the long stroke cylinder to improve and design the pneumatic system of the long stroke cylinder.

Impact of Magnetic Field on Pressures of Programmable Cerebrospinal Fluid Shunts: An Experimental Study.

PubMed

Altun, Idiris; Yuksel, Kasim Zafer; Mert, Tufan

2017-01-01

To investigate whether programmable cerebrospinal fluid (CSF) shunts are influenced by exposure to the magnetic field and to compare the effects of magnetic field in 4 different brands of programmable CSF shunts. This experimental study was performed in the laboratory using a novel design of magnetic field. Four types of programmable CSF shunts (Miethke®, Medtronic®, Sophysa® and Codman®Hakim®) were exposed to the magnetic field generated by an apparatus consisting of Helmholtz coil for 5 minutes. In every CSF shunt, initial pressures were adjusted to 110 mm H2O and pressures after exposure to magnetic field were noted. These measurements were implemented at frequencies of 5 Hz, 20 Hz, 30 Hz, 40 Hz, 60 Hz and 80 Hz. In each type, three shunts were utilized and evaluations were made twice for every shunt. At 5, 30, 40 and 60 Hz, Groups 1, 2 and 3 had significantly higher average pressures than Group 4. At 20 and 80 Hz, Groups 1 and 2 had notably different pressure values than Groups 3 and 4. Group 3 displayed the highest pressure, while Group 4 demonstrated the lowest pressure. Exposure to magnetic fields may affect the pressures of programmable CSF shunts. However, further controlled, clinical trials are warranted to elucidate the in-vivo effects of magnetic field exposure.

Source-receptor relationships for PM2.5 during typical pollution episodes in the Pearl River Delta city cluster, China

NASA Astrophysics Data System (ADS)

Fan, Q.; Liu, Y.; Hong, Y.; Wang, X.; Chan, P.; Chen, X.; Lai, A.; Wang, M.; Chen, X.

2017-12-01

Located in the Southern China monsoon region, pollution days in Pearl River Delta (PRD) were classified into "Western type", "Central type" or "Eastern type", with a relative percentage of 67%, 24% and 9%, respectively. Using this classification system, three typical pollution events were selected for numerical simulations using the WRF-Chem model. The source sensitivity method for anthropogenic emissions of PM2.5 and its precursors was applied to identify the source-receptor relationships for PM2.5 among 9 cities in PRD. For "Western type" case, the PRD region was under control of a high-pressure system with easterly prevailing winds. The PM2.5 concentrations in the western PRD region were higher than those in the eastern region, with emissions from cities in the eastern PRD region having higher contributions. Within the PRD's urban cluster, PM2.5 in Huizhou, Dongguan and Shenzhen was mainly derived from local emissions, whereas the PM2.5 in the other cities was primarily derived from external transport. For "Eastern type" case, the PRD was influenced by Typhoon Soulik with westerly prevailing winds. Emissions from cities in the western PRD region had the highest impacts on the overall PM2.5 concentration. PM2.5 in Jiangmen and Foshan was primarily derived from local emissions. Regarding "Central type" case, the PRD region was under control of a uniform pressure field with low wind speed. PM2.5 concentrations of each city were primarily caused by local emissions. Overall, wind flows played a significant role in the transport and spatial distribution of PM2.5 across the PRD region. Ideally, local governments would be wise to establish joint prevention and control measures to reduce regional atmospheric pollution, especially for "Western type" pollution.

A study on the relationship between genetic and environmental factors of type 2 diabetes mellitus in humans.

PubMed

Chen, Yu; Zhou, Ling; Xu, Yaochu; Shen, Hongbing; Niu, Juying

2002-05-01

To study the relationship between the inheritable factor and environmental factors of type 2 diabetes mellitus in humans. A case-control study based on 154 type 2 diabetes mellitus and 130 healthy controls was carried out in Jiangsu Province in 1997. The age, family history of diabetes mellitus, hypertension history, high waist/hip ratio (WHR), high systolic blood pressure, huge fetus history, and the genotype of beta(3)-adrenergic receptor (beta(3)-AR) were the risk factors of type 2 diabetes mellitus; while occupational physical activity was protective factor of type 2 diabetes mellitus. The risk for diabetes mellitus distinctly increased while genetic factor and obesity, beta(3)-AR mutation were coexisting. Type 2 diabetes mellitus is caused by the effect of both genetic and environmental factors.

Longitudinal Patterns of Glycemic Control and Blood Pressure in Pregnant Women with Type 1 Diabetes Mellitus: Phenotypes from Functional Data Analysis.

PubMed

Szczesniak, Rhonda D; Li, Dan; Duan, Leo L; Altaye, Mekibib; Miodovnik, Menachem; Khoury, Jane C

2016-11-01

Objective  To identify phenotypes of type 1 diabetes control and associations with maternal/neonatal characteristics based on blood pressure (BP), glucose, and insulin curves during gestation, using a novel functional data analysis approach that accounts for sparse longitudinal patterns of medical monitoring during pregnancy. Methods  We performed a retrospective longitudinal cohort study of women with type 1 diabetes whose BP, glucose, and insulin requirements were monitored throughout gestation as part of a program-project grant. Scores from sparse functional principal component analysis (fPCA) were used to classify gestational profiles according to the degree of control for each monitored measure. Phenotypes created using fPCA were compared with respect to maternal and neonatal characteristics and outcome. Results  Most of the gestational profile variation in the monitored measures was explained by the first principal component (82-94%). Profiles clustered into three subgroups of high, moderate, or low heterogeneity, relative to the overall mean response. Phenotypes were associated with baseline characteristics, longitudinal changes in glycohemoglobin A1 and weight, and to pregnancy-related outcomes. Conclusion  Three distinct longitudinal patterns of glucose, insulin, and BP control were found. By identifying these phenotypes, interventions can be targeted for subgroups at highest risk for compromised outcome, to optimize diabetes management during pregnancy. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Effect of Aerobic Training on Glucose Control and Blood Pressure in T2DDM East African Males

PubMed Central

Prista, Antonio; Ranadive, Sushant M.; Damasceno, Albertino; Caupers, Paula; Kanaley, Jill A.; Fernhall, Bo

2014-01-01

Background. Exercise training intervention is underused in the management of type 2 diabetes mellitus in East Africa. Methods. 41 physically-active males with type 2 diabetes mellitus living in Mozambique were recruited and randomly assigned to 12 weeks of supervised exercise of low intensity exercise (LEX), vigorous intensity exercise (VEX), or to a control group (CON). Since there were no differences for any outcome variables between the exercise groups, VEX and LEX were combined into one exercise group (EX). Results. Age and baseline body weight were similar between EX and CON. Plasma glucose at 120 min following glucose load (Glu 120) was significantly reduced in the EX group after training (Glu 120 : 17.3 mmol/L to 15.0 mmol/L, P < 0.05), whereas Glu 120 remained unchanged in the CON (Glu 120 : 16.6 mmol/L to 18.7 mmol/L). After controlling for baseline blood pressure (BP), posttraining systolic BP and diastolic BP were lower in the EX group than in the CON group (EX: 129/77 mm Hg, CON: 152/83 mm Hg, P < 0.05). Conclusion. Adding exercise to already active African men with type 2 diabetes improved glucose control and BP levels without concomitant changes in weight. PMID:24729886

Sleep Related Changes in Blood Pressure in Hypocretin-Deficient Narcoleptic Mice

PubMed Central

Bastianini, Stefano; Silvani, Alessandro; Berteotti, Chiara; Elghozi, Jean-Luc; Franzini, Carlo; Lenzi, Pierluigi; Lo, Martire Viviana; Zoccoli, Giovanna

2011-01-01

Study Objectives: Although blood pressure during sleep and the difference in blood pressure between sleep and wakefulness carry prognostic information, little is known on their central neural mechanisms. Hypothalamic neurons releasing hypocretin (orexin) peptides control wake-sleep behavior and autonomic functions and are lost in narcolepsy-cataplexy. We investigated whether chronic lack of hypocretin signaling alters blood pressure during sleep. Design: Comparison of blood pressure as a function of the wake-sleep behavior between 2 different hypocretin-deficient mouse models and control mice with the same genetic background. Setting: N/A. Subjects: Hypocretin-ataxin3 transgenic mice with genetic ablation of hypocretin neurons (TG, n = 12); hypocretin gene knock-out mice (KO, n = 8); congenic wild-type controls (WT, n = 10). Interventions: Instrumentation with electrodes for sleep recordings and a telemetric blood pressure transducer. Measurements and Results: Blood pressure was significantly higher in either TG or KO than in WT during non–rapid eye movement sleep (NREMS; 4 ± 2 and 7 ± 2 mm Hg, respectively) and rapid eye movement sleep (REMS; 11 ± 2 and 12 ± 3 mm Hg, respectively), whereas it did not differ significantly between groups during wakefulness. Accordingly, the decrease in blood pressure between either NREMS or REMS and wakefulness was significantly blunted in TG and KO with respect to WT. Conclusions: Chronic lack of hypocretin signaling may entail consequences on blood pressure that are potentially adverse and that vary widely among wake-sleep states. Citation: Bastianini S; Silvani A; Berteotti C; Elghozi JL; Franzini C; Lenzi P; Lo Martire V; Zoccoli G. Sleep related changes in blood pressure in hypocretin-deficient narcoleptic mice. SLEEP 2011;34(2):213-218. PMID:21286242

Association of angiotensin-converting enzyme DD genotype with 24-h blood pressure abnormalities in normoalbuminuric children and adolescents with Type 1 diabetes.

PubMed

Barkai, L; Soós, A; Vámosi, I

2005-08-01

To assess the distribution of the insertion/deletion (I/D) polymorphism of the angiotensin-converting enzyme (ACE) gene in children and adolescents with Type 1 diabetes and to evaluate the association between ACE genotype and blood pressure (BP). ACE genotypes were assessed in 124 normoalbuminuric, clinically normotensive Type 1 diabetic children and adolescents and 120 non-diabetic controls using polymerase chain reaction. Twenty-four-hour ambulatory BP monitoring was undertaken in all patients. ACE genotypes distributed in patients as follows: 34 (27%) DD, 57 (46%) ID, 33 (27%) II. The distribution was similar in the control group: DD in 28% (33), ID in 45% (54), and II in 27% (33). Patients with DD genotype had higher mean 24-h diastolic BP (73.8 +/- 6.2 vs. 70.2 +/- 5.0 and 69.7 +/- 6.3 mmHg; P = 0.005) and lower diurnal variation in BP (11.8 +/- 4.6 vs. 14.2 +/- 4.2 and 14.8 +/- 4.3%; P = 0.011) compared with ID and II groups. Four patients in the DD group proved to be non-dipper compared with one in the ID and none in the II group (P = 0.026). Twenty-four-hour diastolic blood pressure was independently predictive for AER as dependent variable in the DD genotype patient group (r(2) = 0.12, P = 0.03). Children and adolescents with Type 1 diabetes do not differ from the non-diabetic population regarding the I/D polymorphism of the ACE gene. ACE gene polymorphism is associated with BP abnormalities in normotensive and normoalbuminuric children and adolescents with Type 1 diabetes.

Dual therapy of vildagliptin and telmisartan on diabetic nephropathy in experimentally induced type 2 diabetes mellitus rats.

PubMed

Sharma, Ashish Kumar; Kanawat, Devendra Singh; Mishra, Akanksha; Dhakad, Prashant Kumar; Sharma, Prashant; Srivastava, Varnika; Joshi, Sneha; Joshi, Megha; Raikwar, Sachin Kumar; Kurmi, Muneem Kumar; Srinivasan, Bharthu Parthsarthi

2014-12-01

The objective of this article is to investigate the combination of telmisartan with vildagliptin therapy versus monotherapy of vildagliptin and telmisartan on diabetic nephropathy in type 2 diabetes mellitus rats. In adult rats streptozotocin (65 mg/kg) and nicotinamide (110 mg/kg) were injected intraperitoneally to produce diabetic nephropathy. Rats of either sex allotted to the following groups: (i) triple therapy: metformin (120 mg/kg, o.d.) + pioglitazone (1.25 mg/kg, o.d.) + glimepiride (0.7 mg/kg, o.d.); (ii) dual therapy: vildagliptin (8.76 mg/kg, o.d.) + telmisartan (6.48 mg/kg, o.d.); (iii) vildagliptin (8.76 mg/kg, o.d.); and (iv) telmisartan (6.48 mg/kg, o.d.); therapy was carried out for 35 days orally. Weekly at days 7, 14, 21, 28 and 35, blood pressure, blood glucose level, body weight, blood serum creatinine level, protein albumin level in urine, and blood urea nitrogen (BUN) were estimated. Renal structural changes were observed. Blood pressure, blood glucose level, blood serum creatinine level, protein albumin level in urine, BUN and renal deterioration increased significantly in diabetic rats compared with normal control rats. The vildagliptin + telmisartan treatment group showed no weight gain and controlled blood pressure, renovascular structural and biochemical parameters in diabetic neuropathy rats. The addition of telmisartan to vildagliptin demonstrated the best control over blood pressure, glycemia and diabetic nephropathy markers, renal structural changes and improvement of renal function as opposed to monotherapy with either drug, possibly because of the dual inhibitory effect on the renin-angiotensin system. © The Author(s) 2013.

The effectiveness of dry-cupping in preventing post-operative nausea and vomiting by P6 acupoint stimulation: A randomized controlled trial.

PubMed

Farhadi, Khosro; Choubsaz, Mansour; Setayeshi, Khosro; Kameli, Mohammad; Bazargan-Hejazi, Shahrzad; Heidari Zadie, Zahra; Ahmadi, Alireza

2016-09-01

Postoperative nausea and vomiting (PONV) is a common complication after general anesthesia, and the prevalence ranges between 25% and 30%. The aim of this study was to determine the preventive effects of dry cupping on PONV by stimulating point P6 in the wrist. This was a randomized controlled trial conducted at the Imam Reza Hospital in Kermanshah, Iran. The final study sample included 206 patients (107 experimental and 99 controls). Inclusion criteria included the following: female sex; age>18 years; ASA Class I-II; type of surgery: laparoscopic cholecystectomy; type of anesthesia: general anesthesia. Exclusion criteria included: change in the type of surgery, that is, from laparoscopic cholecystectomy to laparotomy, and ASA-classification III or more. Interventions are as follows: pre surgery, before the induction of anesthesia, the experimental group received dry cupping on point P6 of the dominant hand's wrist with activation of intermittent negative pressure. The sham group received cupping without activation of negative pressure at the same point. Main outcome was that the visual analogue scale was used to measure the severity of PONV. The experimental group who received dry cupping had significantly lower levels of PONV severity after surgery (P < 0.001) than the control group. The differences in measure were maintained after controlling for age and ASA in regression models (P < 0.01). Traditional dry cupping delivered in an operation room setting prevented PONV in laparoscopic cholecystectomy patients.

Redifferentiation of chondrocytes and cartilage formation under intermittent hydrostatic pressure.

PubMed

Heyland, Jan; Wiegandt, Katharina; Goepfert, Christiane; Nagel-Heyer, Stefanie; Ilinich, Eduard; Schumacher, Udo; Pörtner, Ralf

2006-10-01

Since articular cartilage is subjected to varying loads in vivo and undergoes cyclic hydrostatic pressure during periods of loading, it is hypothesized that mimicking these in vivo conditions can enhance synthesis of important matrix components during cultivation in vitro. Thus, the influence of intermittent loading during redifferentiation of chondrocytes in alginate beads, and during cartilage formation was investigated. A statistically significant increased synthesis of glycosaminoglycan and collagen type II during redifferentiation of chondrocytes embedded in alginate beads, as well as an increase in glycosaminoglycan content of tissue-engineered cartilage, was found compared to control without load. Immunohistological staining indicated qualitatively a high expression of collagen type II for both cases.

Experimental Investigation of Actuators for Flow Control in Inlet Ducts

NASA Astrophysics Data System (ADS)

Vaccaro, John; Elimelech, Yossef; Amitay, Michael

2010-11-01

Attractive to aircraft designers are compact inlets, which implement curved flow paths to the compressor face. These curved flow paths could be employed for multiple reasons. One of which is to connect the air intake to the engine embedded in the aircraft body. A compromise must be made between the compactness of the inlet and its aerodynamic performance. The aerodynamic purpose of inlets is to decelerate the oncoming flow before reaching the engine while minimizing total pressure loss, unsteadiness and distortion. Low length-to-diameter ratio inlets have a high degree of curvature, which inevitably causes flow separation and secondary flows. Currently, the length of the propulsion system is constraining the overall size of Unmanned Air Vehicles (UAVs), thus, smaller more efficient aircrafts could be realized if the propulsion system could be shortened. Therefore, active flow control is studied in a compact (L/D=1.5) inlet to improve performance metrics. Actuation from a spanwise varying coanda type ejector actuator and a hybrid coanda type ejector / vortex generator jet actuator is investigated. Special attention will be given to the pressure recovery at the AIP along with unsteady pressure signatures along the inlet surface and at the AIP.

Portable tester for determining gas content within a core sample

DOEpatents

Garcia, Jr., Fred; Schatzel, Steven J.

1998-01-01

A portable tester is provided for reading and displaying the pressure of a gas released from a rock core sample stored within a sealed container and for taking a sample of the released pressurized gas for chemical analysis thereof for subsequent use in a modified direct method test which determines the volume of gas and specific type of gas contained within the core sample. The portable tester includes a pair of low and high range electrical pressure transducers for detecting a gas pressure; a pair of low and high range display units for displaying the pressure of the detected gas- a selector valve connected to the low and high range pressure transducers, a selector knob for selecting gas flow to one of the flow paths; control valve having an inlet connection to the sealed container, and outlets connected to: a sample gas canister, a second outlet port connected to the selector valve means for reading the pressure of the gas from the sealed container to either the low range or high range pressure transducers, and a connection for venting gas contained within the sealed container to the atmosphere. A battery is electrically connected to and supplies the power for operating the unit. The pressure transducers, display units, selector and control valve means and the battery is mounted to and housed within a protective casing for portable transport and use.

Portable tester for determining gas content within a core sample

DOEpatents

Garcia, F. Jr.; Schatzel, S.J.

1998-04-21

A portable tester is provided for reading and displaying the pressure of a gas released from a rock core sample stored within a sealed container and for taking a sample of the released pressurized gas for chemical analysis thereof for subsequent use in a modified direct method test which determines the volume of gas and specific type of gas contained within the core sample. The portable tester includes a pair of low and high range electrical pressure transducers for detecting a gas pressure; a pair of low and high range display units for displaying the pressure of the detected gas; a selector valve connected to the low and high range pressure transducers and a selector knob for selecting gas flow to one of the flow paths; control valve having an inlet connection to the sealed container; and outlets connected to: a sample gas canister, a second outlet port connected to the selector valve means for reading the pressure of the gas from the sealed container to either the low range or high range pressure transducers, and a connection for venting gas contained within the sealed container to the atmosphere. A battery is electrically connected to and supplies the power for operating the unit. The pressure transducers, display units, selector and control valve means and the battery is mounted to and housed within a protective casing for portable transport and use. 5 figs.

Intra-ocular pressure normalization technique and equipment

NASA Technical Reports Server (NTRS)

Mcgannon, W. J. (Inventor)

1980-01-01

A method and apparatus for safely reducing abnormally high intraocular pressure in an eye during a predetermined time interval is presented. This allows maintenance of normal intraocular pressure during glaucoma surgery. According to the invention, a pressure regulator of the spring biased diaphragm type is provided with additional bias by a column of liquid. The height of the column of liquid is selected such that the pressure at a hypodermic needle connected to the output of the pressure regulator is equal to the measured pressure of the eye. The hypodermic needle can then be safely inserted into the anterior chamber of the eye. Liquid is then bled out of the column to reduce the bias on the diaphragm of the pressure regulator and, consequently, the output pressure of the regulator. This lowering pressure of the regulator also occurs in the eye by means of a small second bleed path provided between the pressure regulator and the hypodermic needle. Alternately, a second hypodermic needle may be inserted into the eye to provide a controlled leak off path for excessive pressure and clouded fluid from the anterior chamber.

Oronasal Masks Require a Higher Pressure than Nasal and Nasal Pillow Masks for the Treatment of Obstructive Sleep Apnea.

PubMed

Deshpande, Sheetal; Joosten, Simon; Turton, Anthony; Edwards, Bradley A; Landry, Shane; Mansfield, Darren R; Hamilton, Garun S

2016-09-15

Oronasal masks are frequently used for continuous positive airway pressure (CPAP) treatment in patients with obstructive sleep apnea (OSA). The aim of this study was to (1) determine if CPAP requirements are higher for oronasal masks compared to nasal mask interfaces and (2) assess whether polysomnography and patient characteristics differed among mask preference groups. Retrospective analysis of all CPAP implementation polysomnograms between July 2013 and June 2014. Prescribed CPAP level, polysomnography results and patient data were compared according to mask type (n = 358). Oronasal masks were used in 46%, nasal masks in 35% and nasal pillow masks in 19%. There was no difference according to mask type for baseline apnea-hypopnea index (AHI), body mass index (BMI), waist or neck circumference. CPAP level was higher for oronasal masks, 12 (10-15.5) cm H2O compared to nasal pillow masks, 11 (8-12.5) cm H2O and nasal masks, 10 (8-12) cm H2O, p < 0.0001 (Median [interquartile range]). Oronasal mask type, AHI, age, and BMI were independent predictors of a higher CPAP pressure (p < 0.0005, adjusted R(2) = 0.26.). For patients with CPAP ≥ 15 cm H2O, there was an odds ratio of 4.5 (95% CI 2.5-8.0) for having an oronasal compared to a nasal or nasal pillow mask. Residual median AHI was higher for oronasal masks (11.3 events/h) than for nasal masks (6.4 events/h) and nasal pillows (6.7 events/h), p < 0.001. Compared to nasal mask types, oronasal masks are associated with higher CPAP pressures (particularly pressures ≥ 15 cm H2O) and a higher residual AHI. Further evaluation with a randomized control trial is required to definitively establish the effect of mask type on pressure requirements. A commentary on this article appears in this issue on page 1209. © 2016 American Academy of Sleep Medicine.

Chronic kidney disease and diabetes in the national health service: a cross-sectional survey of the U.K. national diabetes audit.

PubMed

Hill, C J; Cardwell, C R; Patterson, C C; Maxwell, A P; Magee, G M; Young, R J; Matthews, B; O'Donoghue, D J; Fogarty, D G

2014-04-01

We investigated the prevalence of chronic kidney disease and attainment of therapeutic targets for HbA1c and blood pressure in a large U.K.-based diabetes population. The U.K. National Diabetes Audit provided data from 1 January 2007 to 31 March 2008. Inclusion criteria were a documented urinary albumin:creatinine ratio and serum creatinine. Patients were stratified according to chronic kidney disease stage and albuminuria status. Chronic kidney disease was defined as an estimated glomerular filtration rate < 60 ml min(-1) 1.73 m(-2) , albuminuria or both. The proportions of patients achieving nationally defined glycaemic and systolic blood pressure targets were determined. The cohort comprised 1,423,669 patients, of whom 868,616 (61%) met inclusion criteria. Of the patients analysed, 92.2% had Type 2 diabetes. A higher proportion of people with Type 2 diabetes (42.3%) had renal dysfunction compared with those with Type 1 diabetes (32.4%). Achievement of systolic blood pressure and HbA1c targets was poor. Among people with Type 1 diabetes, 67.8% failed to achieve an HbA1c < 58 mmol/mol (7.5%). Of all people with diabetes, 37.8% failed to achieve a systolic blood pressure < 140 mmHg. Blood pressure control was poor in advanced chronic kidney disease. For example, mean (standard deviation) systolic blood pressure rose from 128.6 (15.4) mmHg among people with Type 1 diabetes and normal renal function to 141.0 (23.6) mmHg in those with chronic kidney disease stage 5 and macroalbuminuria. The high prevalence of chronic kidney disease and poor attainment of treatment targets highlights a large subset of the diabetes population at increased risk of cardiovascular mortality or progressive kidney disease. © 2013 The Authors. Diabetic Medicine © 2013 Diabetes UK.

The regional effect of spinal manipulation on the pressure pain threshold in asymptomatic subjects: a systematic literature review.

PubMed

Honoré, Margaux; Leboeuf-Yde, Charlotte; Gagey, Olivier

2018-01-01

Spinal manipulation (SM) has been shown to have an effect on pain perception. More knowledge is needed on this phenomenon and it would be relevant to study its effect in asymptomatic subjects. To compare regional effect of SM on pressure pain threshold (PPT) vs. sham, inactive control, mobilisation, another SM, and some type of physical therapy. In addition, we reported the results for the three different spinal regions. A systematic search of literature was done using PubMed, Embase and Cochrane. Search terms were ((spinal manipulation) AND (experimental pain)); ((spinal manipulative therapy OR spinal manipulation) AND ((experimental pain OR quantitative sensory testing OR pressure pain threshold OR pain threshold)) (Final search: June 13th 2017). The inclusion criteria were SM performed anywhere in the spine; the use of PPT, PPT tested in an asymptomatic region and on the same day as the SM. Studies had to be experimental with at least one external or internal control group. Studies on only spinal motion or tenderness, other reviews, case reports, and less than 15 invited participants in each group were excluded. Evidence tables were constructed with information relevant to each research question and by spinal region. Results were reported in relation to statistical significance and were interpreted taking into account their quality. Only 12 articles of 946 were accepted. The quality of studies was generally good. In 8 sham controlled studies, a psychologically and physiologically "credible" sham was found in only 2 studies. A significant difference was noted between SM vs. Sham, and between SM and an inactive control. No significant difference in PPT was found between SM and another SM, mobilisation or some type of physical therapy. The cervical region more often obtained significant findings as compared to studies in the thoracic or lumbar regions. SM has an effect regionally on pressure pain threshold in asymptomatic subjects. The clinical significance of this must be quantified. More knowledge is needed in relation to the comparison of different spinal regions and different types of interventions.

Optical Constituents at the Mouth of the Columbia River: Variability and Signature in Remotely Sensed Reflectance

DTIC Science & Technology

2013-09-30

constructed at BIO, carried the new Machine Vision Floc Camera (MVFC), a Sequoia Scientific LISST 100x Type B, an RBR CTD, and two pressure-actuated...WetStar CDOM fluorometer, a Sequoia Scientific flow control switch, and a SeaBird 37 CTD. The flow-control switch allows the ac- 9 to collect 0.2-um

Pressure gradient induced generation of microbubbles

NASA Astrophysics Data System (ADS)

Evangelio, Alvaro; Campo-Cortes, Francisco; Gordillo, Jose Manuel

2015-11-01

It is well known that the controlled production of monodisperse bubbles possesses uncountable applications in medicine, pharmacy and industry. Here we provide with a detailed physical description of the bubble formation processes taking place in a type of flow where the liquid pressure gradient can be straightforwardly controlled. In our experiments, a gas flow rate discharges through a cylindrical needle into a pressurized chamber. The pressure gradient created from the exit of the injection needle towards the entrance of a extraction duct promotes the stretching of the gas ligament downstream. In our analysis, which is supported by an exhaustive experimental study in which the liquid viscosity is varied by three orders of magnitude, different regimes can be distinguished depending mainly on the Reynolds number. Through our physical modeling, we provide closed expressions for both the bubbling frequencies and for the bubble diameters as well as the conditions under which a monodisperse generation is obtained in all regimes found. The excellent agreement between our expressions and the experimental data fully validates our physical modeling.

Connective Tissue Reflex Massage for Type 2 Diabetic Patients with Peripheral Arterial Disease: Randomized Controlled Trial

PubMed Central

Castro-Sánchez, Adelaida María; Moreno-Lorenzo, Carmen; Matarán-Peñarrocha, Guillermo A.; Feriche-Fernández-Castanys, Belen; Granados-Gámez, Genoveva; Quesada-Rubio, José Manuel

2011-01-01

The objective of this study was to evaluate the efficacy of connective tissue massage to improve blood circulation and intermittent claudication symptoms in type 2 diabetic patients. A randomized, placebo-controlled trial was undertaken. Ninety-eight type 2 diabetes patients with stage I or II-a peripheral arterial disease (PAD) (Leriche-Fontaine classification) were randomly assigned to a massage group or to a placebo group treated using disconnected magnetotherapy equipment. Peripheral arterial circulation was determined by measuring differential segmental arterial pressure, heart rate, skin temperature, oxygen saturation and skin blood flow. Measurements were taken before and at 30 min, 6 months and 1 year after the 15-week treatment. After the 15-week program, the groups differed (P < .05) in differential segmental arterial pressure in right lower limb (lower one-third of thigh, upper and lower one-third of leg) and left lower limb (lower one-third of thigh and upper and lower one-third of leg). A significant difference (P < .05) was also observed in skin blood flow in digits 1 and 4 of right foot and digits 2, 4 and 5 of left foot. ANOVA results were significant (P < .05) for right and left foot oxygen saturation but not for heart rate and temperature. At 6 months and 1 year, the groups differed in differential segmental arterial pressure in upper third of left and right legs. Connective tissue massage improves blood circulation in the lower limbs of type 2 diabetic patients at stage I or II-a and may be useful to slow the progression of PAD. PMID:19933770

Oxidative stress and acute-phase response in patients with pressure sores.

PubMed

Cordeiro, Maria Bernarda Cavalcanti; Antonelli, Elida Juliana; da Cunha, Daniel Ferreira; Júnior, Alceu Afonso Jordão; Júnior, Virmondes Rodrigues; Vannucchi, Helio

2005-09-01

We investigated the relation between oxidative stress and the occurrence of the acute-phase response with serum ascorbic acid and alpha-tocopherol levels in patients with pressure sores. The following groups of patients were studied: 1) those who had patients with pressure sores, 2) those who had pneumonia, and 3) those who did not develop pressure sores or any type of infection (control). Concentrations of total proteins, albumin, creatinine, iron, ferritin, transferrin, C-reactive protein, alpha1-acid glycoprotein, total iron-binding capacity, ascorbic acid, alpha-tocopherol, and malondialdehyde were measured during the first days of hospitalization. Albumin concentrations were significantly lower (P < 0.05) and C-reactive protein concentrations were significantly higher (P < 0.05) in patients with pressure sores compared with controls. Concentrations of ascorbic acid and alpha-tocopherol were significantly decreased (P < 0.05) in patients who had pressure sores or infection, whereas malondialdehyde concentrations were significantly increased (P < 0.05) compared with control patients. Five of 11 patients (55.56%) with pressure sores and 10 of 12 patients (83.33%) with pneumonia presented serum ascorbic acid concentrations below the reference value (34 to 91 micromol/L). Concentrations of ascorbic acid and alpha-tocopherol versus malondialdehyde were significantly correlated in the three patient groups (r = -0.44, P < 0.05; r = -0.55, P < 0.01, respectively). Patients with pressure sores and acute infection present a systemic inflammatory response accompanied by an increase in lipid peroxidation that is associated with decreased serum ascorbic acid and alpha-tocopherol levels, suggesting that these patients may be at risk for important nutritional deficiencies.

NEUTRONIC REACTOR SYSTEM

DOEpatents

Treshow, M.

1959-02-10

A reactor system incorporating a reactor of the heterogeneous boiling water type is described. The reactor is comprised essentially of a core submerged adwater in the lower half of a pressure vessel and two distribution rings connected to a source of water are disposed within the pressure vessel above the reactor core, the lower distribution ring being submerged adjacent to the uppcr end of the reactor core and the other distribution ring being located adjacent to the top of the pressure vessel. A feed-water control valve, responsive to the steam demand of the load, is provided in the feedwater line to the distribution rings and regulates the amount of feed water flowing to each distribution ring, the proportion of water flowing to the submerged distribution ring being proportional to the steam demand of the load. This invention provides an automatic means exterior to the reactor to control the reactivity of the reactor over relatively long periods of time without relying upon movement of control rods or of other moving parts within the reactor structure.

Propranolol medication among coronary patients: relationship to type A behavior and cardiovascular response.

PubMed

Krantz, D S; Durel, L A; Davia, J E; Shaffer, R T; Arabian, J M; Dembroski, T M; MacDougall, J M

1982-09-01

The present correlational study compared behavioral and psychophysiological characteristics of coronary patients who were either medicated or not medicated with the beta-adrenergic blocking drug propranolol. Eighty-eight patients were given a structured Type A interview (SI) and a history quiz while heart rate and blood pressure were monitored. Data were analyzed controlling for age, sex, extent of coronary artery disease, and history of angina. Results indicated that patients taking propranolol (n = 65) were significantly lower in intensity of Type A behavior than patients not taking propranolol (n = 23). No effects were obtained for patients medicated or not medicated with diuretics, nitrates, or other CNS active drugs. Propranolol patients also showed lesser heart rate and rate-pressure product responses to the interview, but did not differ in blood pressure responses. Components of Type A which were lower in propranolol patients included speech stylistics (loud/explosive, rapid/accelerated, potential for hostility). Content of responses to the SI and scores on the Jenkins Activity Survey did not differ between the groups. An explanation for these results is offered in terms of the effects of propranolol on peripheral sympathetic responses, and evidence for a physiological substrate for Type A behavior. A conceptualization of the Type A pattern in terms of cognitive and physiological components is advanced, and implications for clinical intervention are discussed.

Analytical study of mixed electroosmotic-pressure-driven flow in rectangular micro-channels

NASA Astrophysics Data System (ADS)

Movahed, Saeid; Kamali, Reza; Eghtesad, Mohammad; Khosravifard, Amir

2013-09-01

Operational state of many miniaturized devices deals with flow field in microchannels. Pressure-driven flow (PDF) and electroosmotic flow (EOF) can be recognized as the two most important types of the flow field in such channels. EOF has many advantages in comparison with PDF, such as being vibration free and not requiring any external mechanical pumps or moving parts. However, the disadvantages of this type of flow such as Joule heating, electrophoresis demixing, and not being suitable for mobile devices must be taken into consideration carefully. By using mixed electroosmotic/pressure-driven flow, the role of EOF in producing desired velocity profile will be reduced. In this way, the advantages of EOF can be exploited, and its disadvantages can be prevented. Induced pressure gradient can be utilized in order to control the separation in the system. Furthermore, in many complicated geometries such as T-shape microchannels, turns may induce pressure gradient to the electroosmotic velocity. While analytical formulas are completely essential for analysis and control of any industrial and laboratory microdevices, lack of such formulas in the literature for solving Poisson-Boltzmann equation and predicting electroosmotic velocity field in rectangular domains is evident. In the present study, first a novel method is proposed to solve Poisson-Boltzmann equation (PBE). Subsequently, this solution is utilized to find the electroosmotic and the mixed electroosmotic/pressure-driven velocity profile in a rectangular domain of the microchannels. To demonstrate the accuracy of the presented analytical method in solving PBE and finding electroosmotic velocity, a general nondimensional example is analyzed, and the results are compared with the solution of boundary element method. Additionally, the effects of different nondimensional parameters and also aspect ratio of channels on the electroosmotic part of the flow field will be investigated.

Clinical significance of stress-related increase in blood pressure: current evidence in office and out-of-office settings.

PubMed

Munakata, Masanori

2018-05-29

High blood pressure is the most significant risk factor of cardiovascular and cerebrovascular diseases worldwide. Blood pressure and its variability are recognized as risk factors. Thus, hypertension control should focus not only on maintaining optimal levels but also on achieving less variability in blood pressure. Psychosocial stress is known to contribute to the development and worsening of hypertension. Stress is perceived by the brain and induces neuroendocrine responses in either a rapid or long-term manner. Moreover, endothelial dysfunction and inflammation might be further involved in the modulation of blood pressure elevation associated with stress. White-coat hypertension, defined as high clinic blood pressure but normal out-of-office blood pressure, is the most popular stress-related blood pressure response. Careful follow-up is necessary for this type of hypertensive patients because some show organ damage or a worse prognosis. On the other hand, masked hypertension, defined as high out-of-office blood pressure but normal office blood pressure, has received considerable interest as a poor prognostic condition. The cause of masked hypertension is complex, but evidence suggests that chronic stress at the workplace or home could be involved. Chronic psychological stress could be associated with distorted lifestyle and mental distress as well as long-lasting allostatic load, contributing to the maintenance of blood pressure elevation. Stress issues are common in patients in modern society. Considering psychosocial stress as the pathogenesis of blood pressure elevation is useful for achieving an individual-focused approach and 24-h blood pressure control.

Fluidic origami with embedded pressure dependent multi-stability: a plant inspired innovation

PubMed Central

Li, Suyi; Wang, K. W.

2015-01-01

Inspired by the impulsive movements in plants, this research investigates the physics of a novel fluidic origami concept for its pressure-dependent multi-stability. In this innovation, fluid-filled tubular cells are synthesized by integrating different Miura-Ori sheets into a three-dimensional topological system, where the internal pressures are strategically controlled similar to the motor cells in plants. Fluidic origami incorporates two crucial physiological features observed in nature: one is distributed, pressurized cellular organization, and the other is embedded multi-stability. For a single fluidic origami cell, two stable folding configurations can coexist due to the nonlinear relationships among folding, crease material deformation and internal volume change. When multiple origami cells are integrated, additional multi-stability characteristics could occur via the interactions between pressurized cells. Changes in the fluid pressure can tailor the existence and shapes of these stable folding configurations. As a result, fluidic origami can switch between being mono-stable, bistable and multi-stable with pressure control, and provide a rapid ‘snap-through’ type of shape change based on the similar principles as in plants. The outcomes of this research could lead to the development of new adaptive materials or structures, and provide insights for future plant physiology studies at the cellular level. PMID:26400197

Fluidic origami with embedded pressure dependent multi-stability: a plant inspired innovation.

PubMed

Li, Suyi; Wang, K W

2015-10-06

Inspired by the impulsive movements in plants, this research investigates the physics of a novel fluidic origami concept for its pressure-dependent multi-stability. In this innovation, fluid-filled tubular cells are synthesized by integrating different Miura-Ori sheets into a three-dimensional topological system, where the internal pressures are strategically controlled similar to the motor cells in plants. Fluidic origami incorporates two crucial physiological features observed in nature: one is distributed, pressurized cellular organization, and the other is embedded multi-stability. For a single fluidic origami cell, two stable folding configurations can coexist due to the nonlinear relationships among folding, crease material deformation and internal volume change. When multiple origami cells are integrated, additional multi-stability characteristics could occur via the interactions between pressurized cells. Changes in the fluid pressure can tailor the existence and shapes of these stable folding configurations. As a result, fluidic origami can switch between being mono-stable, bistable and multi-stable with pressure control, and provide a rapid 'snap-through' type of shape change based on the similar principles as in plants. The outcomes of this research could lead to the development of new adaptive materials or structures, and provide insights for future plant physiology studies at the cellular level. © 2015 The Author(s).

Stress distribution and pressure-bearing capacity of a high-pressure split-cylinder die with prism cavity

NASA Astrophysics Data System (ADS)

Zhao, Liang; Li, Mingzhe; Wang, Liyan; Qu, Erhu; Yi, Zhuo

2018-03-01

A novel high-pressure belt-type die with a split-type cylinder is investigated with respect to extending its lifetime and improving its pressure bearing capacity. Specifically, a tungsten carbide cylinder is split into several parts along the radial direction with a prism-type cavity. In this paper, the cylinders with different split numbers are chosen to study the stress distribution and compare them with the traditional belt-type die. The simulation results indicate that the split cylinder has much smaller stress than those in the belt-type cylinder, and the statistical analysis reveals that the split-pressure cylinder is able to bear higher pressure. Experimental tests also show that the high-pressure die with a split cylinder and prism cavity has a stronger pressure-bearing capacity than a belt-type die. The split cylinder has advantages of easy manufacturing, high pressure bearing capacity, and replaceable performance.

Update on Prevention of Cardiovascular Disease in Adults With Type 2 Diabetes Mellitus in Light of Recent Evidence: A Scientific Statement From the American Heart Association and the American Diabetes Association.

PubMed

Fox, Caroline S; Golden, Sherita Hill; Anderson, Cheryl; Bray, George A; Burke, Lora E; de Boer, Ian H; Deedwania, Prakash; Eckel, Robert H; Ershow, Abby G; Fradkin, Judith; Inzucchi, Silvio E; Kosiborod, Mikhail; Nelson, Robert G; Patel, Mahesh J; Pignone, Michael; Quinn, Laurie; Schauer, Philip R; Selvin, Elizabeth; Vafiadis, Dorothea K

2015-08-25

Cardiovascular disease risk factor control as primary prevention in patients with type 2 diabetes mellitus has changed substantially in the past few years. The purpose of this scientific statement is to review the current literature and key clinical trials pertaining to blood pressure and blood glucose control, cholesterol management, aspirin therapy, and lifestyle modification. We present a synthesis of the recent literature, new guidelines, and clinical targets, including screening for kidney and subclinical cardiovascular disease for the contemporary management of patients with type 2 diabetes mellitus. © 2015 American Heart Association, Inc.

Sodium-glucose co-transporter type 2 inhibitors reduce evening home blood pressure in type 2 diabetes with nephropathy.

PubMed

Takenaka, Tsuneo; Kishimoto, Miyako; Ohta, Mari; Tomonaga, Osamu; Suzuki, Hiromichi

2017-05-01

The effects of sodium-glucose co-transporter type 2 inhibitors on home blood pressure were examined in type 2 diabetes with nephropathy. The patients with diabetic nephropathy were screened from medical records in our hospitals. Among them, 52 patients who measured home blood pressure and started to take sodium-glucose co-transporter type 2 inhibitors were selected. Clinical parameters including estimated glomerular filtration rate, albuminuria and home blood pressure for 6 months were analysed. Sodium-glucose co-transporter type 2 inhibitors (luseogliflozin 5 mg/day or canagliflozin 100 mg/day) reduced body weight, HbA1c, albuminuria, estimated glomerular filtration rate and office blood pressure. Although sodium-glucose co-transporter type 2 inhibitors did not alter morning blood pressure, it reduced evening systolic blood pressure. Regression analyses revealed that decreases in evening blood pressure predicted decrements in albuminuria. The present data suggest that sodium-glucose co-transporter type 2 inhibitors suppress sodium overload during daytime to reduce evening blood pressure and albuminuria.

Mitochondrial division/mitophagy inhibitor (Mdivi) Ameliorates Pressure Overload Induced Heart Failure

PubMed Central

Givvimani, Srikanth; Munjal, Charu; Tyagi, Neetu; Sen, Utpal; Metreveli, Naira; Tyagi, Suresh C.

2012-01-01

Background We have previously reported the role of anti-angiogenic factors in inducing the transition from compensatory cardiac hypertrophy to heart failure and the significance of MMP-9 and TIMP-3 in promoting this process during pressure overload hemodynamic stress. Several studies reported the evidence of cardiac autophagy, involving removal of cellular organelles like mitochondria (mitophagy), peroxisomes etc., in the pathogenesis of heart failure. However, little is known regarding the therapeutic role of mitochondrial division inhibitor (Mdivi) in the pressure overload induced heart failure. We hypothesize that treatment with mitochondrial division inhibitor (Mdivi) inhibits abnormal mitophagy in a pressure overload heart and thus ameliorates heart failure condition. Materials and Methods To verify this, ascending aortic banding was done in wild type mice to create pressure overload induced heart failure and then treated with Mdivi and compared with vehicle treated controls. Results Expression of MMP-2, vascular endothelial growth factor, CD31, was increased, while expression of anti angiogenic factors like endostatin and angiostatin along with MMP-9, TIMP-3 was reduced in Mdivi treated AB 8 weeks mice compared to vehicle treated controls. Expression of mitophagy markers like LC3 and p62 was decreased in Mdivi treated mice compared to controls. Cardiac functional status assessed by echocardiography showed improvement and there is also a decrease in the deposition of fibrosis in Mdivi treated mice compared to controls. Conclusion Above results suggest that Mdivi inhibits the abnormal cardiac mitophagy response during sustained pressure overload stress and propose the novel therapeutic role of Mdivi in ameliorating heart failure. PMID:22479323

Type 2 diabetes management in nurse-led primary healthcare settings in urban and rural Cameroon.

PubMed

Kengne, Andre Pascal; Fezeu, Leopold; Sobngwi, Eugene; Awah, Paschal Kum; Aspray, Terence J; Unwin, Nigel C; Mbanya, Jean-Claude

2009-08-01

To implement a protocol-driven primary nurse-led care for type 2 diabetes in rural and urban Cameroon. We set-up three primary healthcare clinics in Yaounde (Capital city) and two in the Bafut rural health district. Participants were 225 (17% rural) patients with known or newly diagnosed type 2 diabetes, not requiring insulin, referred either from a baseline survey (38 patients, 17%), or secondarily attracted to the clinics. Protocol-driven glucose and blood pressure control were delivered by trained nurses. The main outcomes were trajectories of fasting capillary glucose and blood pressure indices, and differences in the mean levels between baseline and final visits. The total duration of follow-up was 1110 patient-months. During follow-up, there was a significant downward trend in fasting capillary glucose overall (p<0.001) and in most subgroups of participants. Between baseline and final visits, mean fasting capillary glucose dropped by 1.6 mmol/L (95% CI: 0.8-2.3; p< or =0.001). Among those with hypertension, blood pressure also decreased significantly for systolic and marginally for diastolic blood pressure. No major significant change was noticed for body weight. Nurses may be potential alternatives to improve access to diabetes care in settings where physicians are not available.

The effects of soy bean flour enriched bread intake on anthropometric indices and blood pressure in type 2 diabetic women: a crossover randomized controlled clinical trial.

PubMed

Salari Moghaddam, Asma; Entezari, Mohammad Hassan; Iraj, Bijan; Askari, Gholamreza; Sharifi Zahabi, Elham; Maracy, Mohammad Reza

2014-01-01

Previous studies showed that soy bean has the potential to improve many aspects of diabetes state and provide metabolic benefits that aid in weight management. We aimed to determine the effects of soy bean flour enriched bread on anthropometric indices and blood pressure among type 2 diabetic patients. This randomized, crossover, clinical trial was performed in 30 type 2 diabetic women. There were two trial periods for 6 weeks and a wash-out period for 4 weeks. In the soy bread diet period, 120 g of soy bean flour enriched bread was consumed each day instead of the same amount of their usual bread or other cereal products. After a 4-week wash-out period, participants were crossed over for another 6 weeks. Mean (±SD) age of study participants was 45.7 ± 3.8 years. The results of our study showed no significant effects of soy bean flour enriched bread on anthropometric indices and blood pressure among diabetic patients. Despite the slight reduction in BMI, waist circumference, and percent of body fat, there were no significant differences in changes of these values between two groups. No significant changes in waist to hip ratio and blood pressure were seen.

The Effects of Soy Bean Flour Enriched Bread Intake on Anthropometric Indices and Blood Pressure in Type 2 Diabetic Women: A Crossover Randomized Controlled Clinical Trial

PubMed Central

Salari Moghaddam, Asma; Entezari, Mohammad Hassan; Iraj, Bijan; Askari, Gholamreza; Sharifi Zahabi, Elham; Maracy, Mohammad Reza

2014-01-01

Previous studies showed that soy bean has the potential to improve many aspects of diabetes state and provide metabolic benefits that aid in weight management. We aimed to determine the effects of soy bean flour enriched bread on anthropometric indices and blood pressure among type 2 diabetic patients. This randomized, crossover, clinical trial was performed in 30 type 2 diabetic women. There were two trial periods for 6 weeks and a wash-out period for 4 weeks. In the soy bread diet period, 120 g of soy bean flour enriched bread was consumed each day instead of the same amount of their usual bread or other cereal products. After a 4-week wash-out period, participants were crossed over for another 6 weeks. Mean (±SD) age of study participants was 45.7 ± 3.8 years. The results of our study showed no significant effects of soy bean flour enriched bread on anthropometric indices and blood pressure among diabetic patients. Despite the slight reduction in BMI, waist circumference, and percent of body fat, there were no significant differences in changes of these values between two groups. No significant changes in waist to hip ratio and blood pressure were seen. PMID:25276127

40 CFR 1042.230 - Engine families.

Code of Federal Regulations, 2013 CFR

2013-07-01

... example, raw-water vs. separate-circuit cooling). (3) Method of air aspiration. (4) Method of exhaust... (i.e., mechanical or electronic). (9) Application (commercial or recreational). (10) Numerical level... injection pressure. (17) The type of fuel injection system controls (i.e., mechanical or electronic). (18...

Type of delivery and gestational age is not affected by pregnant Latin-American women engaging in vigorous exercise: a secondary analysis of data from a controlled randomized trial.

PubMed

Pinzón, Diana C; Zamora, Katherine; Martínez, Jorge H; Floréz-López, María E; de Plata, Ana C Aguilar; Mosquera, Mildrey; Ramírez-Vélez, Robinson

2012-10-01

There is controversy concerning whether exercise during pregnancy may increase preterm delivery risk and type of delivery. The effect of pregnant Latin-American women engaging in vigorous exercise during the second and third trimester was examined regarding type of delivery and gestational age. This was a secondary analysis of data from a controlled randomized trial for determining the influence of physical exercise on pregnant women's endothelial function. The study included 35 nulliparous women, gestational week 16-20 attending prenatal care at three tertiary hospitals in Colombia, who were randomly assigned to one of two groups. The experimental group engaged in aerobic exercise involving 55 % - 75 % maximum heart rate for 60 min, three times a week for 12 weeks. The control group engaged in their usual physical activity. Maternal weight, height, weight gain, blood pressure and type of delivery were recorded; gender, abdominal and head circumference (cm), weight (g), height (cm), vitality (Apgar score at 1 and 5 min) and gestational age at the time of delivery (in weeks, days) were recorded for the newborn. There was no difference in type of delivery by the end of the 12-week program (p > 0.05), nor regarding newborn anthropometric variables, Apgar score, or maternal variables concerning weight, height, relative weight gain, blood pressure or weeks of gestation (p>0.05). The potential public health benefits of vigorous exercise were enormous. This study supported existing guidelines indicating that Latin-American women may begin or maintain an on-going exercise program during pregnancy. NCT00741312.

Effects of intensive blood-pressure control in type 2 diabetes mellitus.

PubMed

Cushman, William C; Evans, Gregory W; Byington, Robert P; Goff, David C; Grimm, Richard H; Cutler, Jeffrey A; Simons-Morton, Denise G; Basile, Jan N; Corson, Marshall A; Probstfield, Jeffrey L; Katz, Lois; Peterson, Kevin A; Friedewald, William T; Buse, John B; Bigger, J Thomas; Gerstein, Hertzel C; Ismail-Beigi, Faramarz

2010-04-29

There is no evidence from randomized trials to support a strategy of lowering systolic blood pressure below 135 to 140 mm Hg in persons with type 2 diabetes mellitus. We investigated whether therapy targeting normal systolic pressure (i.e., <120 mm Hg) reduces major cardiovascular events in participants with type 2 diabetes at high risk for cardiovascular events. A total of 4733 participants with type 2 diabetes were randomly assigned to intensive therapy, targeting a systolic pressure of less than 120 mm Hg, or standard therapy, targeting a systolic pressure of less than 140 mm Hg. The primary composite outcome was nonfatal myocardial infarction, nonfatal stroke, or death from cardiovascular causes. The mean follow-up was 4.7 years. After 1 year, the mean systolic blood pressure was 119.3 mm Hg in the intensive-therapy group and 133.5 mm Hg in the standard-therapy group. The annual rate of the primary outcome was 1.87% in the intensive-therapy group and 2.09% in the standard-therapy group (hazard ratio with intensive therapy, 0.88; 95% confidence interval [CI], 0.73 to 1.06; P=0.20). The annual rates of death from any cause were 1.28% and 1.19% in the two groups, respectively (hazard ratio, 1.07; 95% CI, 0.85 to 1.35; P=0.55). The annual rates of stroke, a prespecified secondary outcome, were 0.32% and 0.53% in the two groups, respectively (hazard ratio, 0.59; 95% CI, 0.39 to 0.89; P=0.01). Serious adverse events attributed to antihypertensive treatment occurred in 77 of the 2362 participants in the intensive-therapy group (3.3%) and 30 of the 2371 participants in the standard-therapy group (1.3%) (P<0.001). In patients with type 2 diabetes at high risk for cardiovascular events, targeting a systolic blood pressure of less than 120 mm Hg, as compared with less than 140 mm Hg, did not reduce the rate of a composite outcome of fatal and nonfatal major cardiovascular events. (ClinicalTrials.gov number, NCT00000620.) 2010 Massachusetts Medical Society

Development of a Pressure Switched Microfluidic Cell Sorter

NASA Astrophysics Data System (ADS)

Ozbay, Baris; Jones, Alex; Gibson, Emily

2009-10-01

Lab on a chip technology allows for the replacement of traditional cell sorters with microfluidic devices which can be produced less expensively and are more compact. Additionally, the compact nature of microfluidic cell sorters may lead to the realization of their application in point-of-care medical devices. Though techniques have been demonstrated previously for sorting in microfluidic devices with optical or electro-osmotic switching, both of these techniques are expensive and more difficult to implement than pressure switching. This microfluidic cell sorter design also allows for easy integration with optical spectroscopy for identification of cell type. Our current microfluidic device was fabricated with polydimethylsiloxane (PDMS), a polymer that houses the channels, which is then chemically bonded to a glass slide. The flow of fluid through the device is controlled by pressure controllers, and the switching of the cells is accomplished with the use of a high performance pressure controller interfaced with a computer. The cells are fed through the channels with the use of hydrodynamic focusing techniques. Once the experimental setup is fully functional the objective will be to determine switching rates, explore techniques to optimize these rates, and experiment with sorting of other biomolecules including DNA.

Serum Progranulin Levels in Type 2 Diabetic Patients with Metabolic Syndrome.

PubMed

Shafaei, Azam; Marjani, Abdoljalal; Khoshnia, Masoud

2016-12-01

The role of progranulin in individuals with metabolic syndrome is not exactly clear.We aimed to assess the serum level of progranulin in type 2 diabetic patients with and without metabolic syndrome and compare them with healthy controls. The study included 60 patients with type 2 diabetes and 30 healthy individuals as control groups. Biochemical parameters and progranulin levels were determined. Subjects with metabolic syndrome showed significantly higher levels of triglyceride, waist circumference, BMI, systolic and diastolic blood pressure than subjects without metabolic syndrome and the control groups, while HDL-cholesterol level was significantly lower in subjects with metabolic syndrome. Fasting blood sugar was significantly higher in type 2 diabetic patients than in the control groups. Serum level of progranulin was slightly increased in subjects with metabolic syndrome. Serum progranulin level had no significant relationship with metabolic syndrome components. Serum progranulin was also not dependent on cardiometabolic risk factors for subjects with metabolic syndrome, but it could be considered for the management of type 2 diabetes mellitus. Further studies are recommended to explain the effect of progranulin on the pathogenesis of metabolic risk factors.

Development of hemoglobin typing control materials for laboratory investigation of thalassemia and hemoglobinopathies.

PubMed

Pornprasert, Sakorn; Tookjai, Monthathip; Punyamung, Manoo; Pongpunyayuen, Panida; Jaiping, Kanokwan

2016-01-01

To date, the hemoglobin (Hb) typing control materials for laboratory investigation of thalassemia with low (1.8%-3.2%) and high (4%-6%) levels of HbA2 are available but there are no Hb typing quality control materials for analysis of thalassemia and hemoglobinopathies which are highly prevalent in South-East Asian countries. The main aim of the present study was to develop the lyophilized Hb typing control materials for laboratory investigation of thalassemia and hemoglobinopathies that are commonly found in South-East Asia. Erythrocytes of blood samples containing Hb Bart's, HbH, HbE, HbF, Hb Constant Spring (CS), Hb Hope, and Hb Q-Thailand were washed and dialysed with 0.85% saline solution. The erythrocytes were then lysed in 5% sucrose solution. The lyophilized Hb typing control materials were prepared by using a freeze drying (lyophilization) method. The high performance liquid chromatography (HPLC) analysis of lyophilized Hb was performed after the storage at -20 °C for 1 year and also after reconstitution and storage at 4 or -20 °C for 30 days. In addition, the Hb analysis was compared between the three different methods of HPLC, low pressure liquid chromatography (LPLC) and capillary electrophoresis (CE). Following a year of storage at -20 °C, the HPLC chromatograms of lyophilized Hb typing control materials showed similar patterns to the equivalent fresh whole blood. The stability of reconstituted Hb typing control materials was also observed through 30 days after reconstitution and storage at -20 °C. Moreover, the Hb typing control materials could be analyzed by three methods, HPLC, LPLC and CE. Even a degraded peak of HbCS was found on CE electropherogram. The lyophilized Hb typing control materials could be developed and used as control materials for investigation of thalassemia and hemoglobinopathies.

The Potential of Computational Fluid Dynamics Simulation on Serial Monitoring of Hemodynamic Change in Type B Aortic Dissection

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

Yu, Simon C. H., E-mail: simonyu@cuhk.edu.hk; Liu, Wen; Wong, Randolph H. L.

PurposeWe aimed to assess the potential of computational fluid dynamics simulation (CFD) in detecting changes in pressure and flow velocity in response to morphological changes in type B aortic dissection.Materials and MethodsPressure and velocity in four morphological models of type B aortic dissection before and after closure of the entry tear were calculated with CFD and analyzed for changes among the different scenarios. The control model (Model 1) was patient specific and built from the DICOM data of CTA, which bore one entry tear and three re-entry tears. Models 2–4 were modifications of Model 1, with two re-entry tears lessmore » in Model 2, one re-entry tear more in Model 3, and a larger entry tear in Model 4.ResultsThe pressure and velocity pertaining to each of the morphological models were unique. Changes in pressure and velocity findings were accountable by the changes in morphological features of the different models. There was no blood flow in the false lumen across the entry tear after its closure, the blood flow direction across the re-entry tears was reversed after closure of the entry tear.ConclusionCFD simulation is probably useful to detect hemodynamic changes in the true and false lumens of type B aortic dissection in response to morphological changes, it may potentially be developed into a non-invasive and patient-specific tool for serial monitoring of hemodynamic changes of type B aortic dissection before and after treatment.« less

Evaluation of blood and serum markers in spinal cord injured patients with pressure sores.

PubMed

Gurcay, Eda; Bal, Ajda; Gurcay, Ahmet G; Cakci, Aytul

2009-03-01

To evaluate blood and serum markers in traumatic spinal cord injured (SCI) patients, with and without pressure sores. This cross-sectional study was performed at the Ministry of Health Diskapi Yildirim Beyazit, and Numune Education and Research Hospitals, Ankara, Turkey, from 2006-2008. A total of 23 SCI patients with pressure sores (group I) and a control group of 25 SCI patients without pressure sores (group II) were evaluated. Characteristics of sores were examined with respect to duration, location, grade, tissue types, surface area, and exudate amount. Recorded laboratory parameters included erythrocyte sedimentation rates (ESR), C-reactive protein (CRP), hemoglobin (Hb), hematocrit (Htc), lymphocytes, white blood cells (WBC), red blood cells (RBC), serum iron, transferrin, total iron-binding capacity (TIBC), ferritin, total protein, albumin, vitamin B12, and zinc. The most common pressure sore location was the sacrum (38%). Compared to the control group, the patients with pressure sores showed anemia with reduced serum iron, transferrin, TIBC, and increased ferritin. They also had increased ESR, CRP, and WBC and reduced lymphocytes, total protein, albumin and zinc. Statistically significant correlations were found between CRP, Hb, Htc, lymphocytes, RBC, WBC, and serum protein levels, and grade of pressure sores. Clinicians should regularly screen patients with respect to blood and serum markers, in order to determine any risks for pressure sores, and they should perform immediate preventive measures based on the patient's condition.

Hypertension increases urinary excretion of immunoglobulin G, ceruloplasmin and transferrin in normoalbuminuric patients with type 2 diabetes mellitus.

PubMed

Ohara, Nobumasa; Hanyu, Osamu; Hirayama, Satoshi; Nakagawa, Osamu; Aizawa, Yoshifusa; Ito, Seiki; Sone, Hirohito

2014-02-01

Increased urinary excretion of certain plasma proteins, such as immunoglobulin G (IgG), ceruloplasmin and transferrin, with different molecular radii of 55 Å or less and different isoelectric points have been reported to precede development of microalbuminuria in patients who have diabetes mellitus with hypertension. We examined how hypertension affects these urinary proteins in a diabetic state. Excretion of IgG, ceruloplasmin, transferrin, albumin, α2-macroglobulin with a large molecular radius of 88 Å and N-acetylglucosaminidase in first-morning urine samples were measured in normoalbuminuric patients (urinary albumin-to-creatinine ratio < 15 mg/g) with hypertension and nondiabetes mellitus (group hypertension, n = 32), type 2 diabetes mellitus and normotension (group diabetes mellitus, n = 52) and type 2 diabetes mellitus and hypertension (group Both, n =45), and in age-matched controls (n = 72). Urinary IgG, ceruloplasmin, transferrin, albumin and N-acetylglucosaminidase and estimated glomerular filtration rate (eGFR) were significantly elevated in groups diabetes mellitus and Both compared with controls. Furthermore, urinary IgG, ceruloplasmin and transferrin in group Both were significantly higher than those in group diabetes mellitus. These exhibited a positive and relatively strong association with eGFR compared with controls. No significant difference in urinary albumin or N-acetylglucosaminidase was found between the two diabetic groups. In contrast, group hypertension had elevated urinary transferrin without any changes in the other compounds. Urinary α2-macroglobulin did not differ among the four groups. These findings suggest that normoalbuminuric diabetic patients without hypertension have both glomerular hemodynamic changes such as increased intraglomerular hydraulic pressure and altered proximal tubules, and that hypertension increases intraglomerular hydraulic pressure. Increased urinary IgG, ceruloplasmin and transferrin may reflect an increase in intraglomerular hydraulic pressure.

Combustion performance and heat transfer characterization of LOX/hydrocarbon type propellants. Task 3: Data dump

NASA Technical Reports Server (NTRS)

Hart, S. W.

1982-01-01

A preliminary characterization of Orbital Maneuvering System (OMS) and Reaction Control System (RCS) engine point designs over a range of thrust and chamber pressure for several hydrocarbon fuels is reported. OMS and RCS engine point designs were established in two phases comprising baseline and parametric designs. Interface pressures, performance and operating parameters, combustion chamber cooling and turboprop requirements, component weights and envelopes, and propellant conditioning requirements for liquid to vapor phase engine operation are defined.

Effects of 12 weeks combined aerobic and resistance exercise on heart rate variability in type 2 diabetes mellitus patients.

PubMed

Kang, Seol-Jung; Ko, Kwang-Jun; Baek, Un-Hyo

2016-07-01

[Purpose] This study evaluated the effects of 12 weeks combined aerobic and resistance exercise on heart rate variability in patients with Type 2 diabetes mellitus. [Subjects and Methods] The subjects were 16 female patients with Type 2 diabetes mellitus selected among the participants of a chronic disease management exercise class at C Region Public Health Center in South Korea. Subjects were randomly assigned to the exercise group (n=8; age, 55.97 ± 7.37) or the control group (n=8; age, 57.53 ± 4.63) The exercise group performed aerobic and resistance exercises for 60 minutes per day, 3 times per week for 12 weeks. Anthropometric measurements, biochemical markers, physical fitness, and heart rate variability were examined. [Results] After 12 weeks of exercise, weight, body fat percentage, waist circumference, blood glucose, insulin resistance, glycated hemoglobin level, systolic blood pressure, and diastolic blood pressure significantly decreased and cardiorespiratory fitness and muscular strength significantly increased in the exercise group. Although heart rate variability measures showed favorable changes with the exercise program, none were significant. [Conclusion] Although the exercise program did not show notable changes in heart rate variability in patients with Type 2 diabetes within the timeframe of the study, exercise may contribute to the prevention and control of cardiovascular autonomic neuropathy.

Impact of a Pay-for-Performance Program on Care for Black Patients with Hypertension: Important Answers in the Era of the Affordable Care Act.

PubMed

Petersen, Laura A; Ramos, Kate Simpson; Pietz, Kenneth; Woodard, LeChauncy D

2017-06-01

Evaluate the effect of a pay-for-performance intervention on the quality of hypertension care provided to black patients and determine whether it produced risk selection. Primary data collected between 2007 and 2009 from Veterans Affairs physicians and their primary care panels. Nested study within a cluster randomized controlled trial of three types of financial incentives and no incentives (control). We compared the proportion of physicians' black patients meeting hypertension performance measures for baseline and final performance periods. We measured risk selection by comparing the proportion of patients who switched providers, patient visit frequency, and panel turnover. Due to limited power, we prespecified in the analysis plan combining the three incentive groups and oversampling black patients. Data collected electronically and by chart review. The proportion of black patients who achieved blood pressure control or received an appropriate response to uncontrolled blood pressure in the final period was 6.3 percent (95 percent confidence interval, 0.8-11.7 percent) greater for physicians who received an incentive than for controls. There was no difference between intervention and controls in the proportion of patients who switched providers, visit frequency, or panel turnover. A pay-for-performance intervention improved blood pressure control or appropriate response to uncontrolled blood pressure in black patients and did not produce risk selection. © Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

Lipid and liver abnormalities in haemoglobin A1c-defined prediabetes and type 2 diabetes.

PubMed

Calanna, S; Scicali, R; Di Pino, A; Knop, F K; Piro, S; Rabuazzo, A M; Purrello, F

2014-06-01

We aimed to investigate lipid abnormalities and liver steatosis in patients with HbA1c-defined prediabetes and type 2 diabetes compared to individuals with HbA1c-defined normoglycaemia. Ninety-one subjects with prediabetes according to HbA1c, i.e. from 5.7 to 6.4% (39-46 mmol/mol), 50 newly diagnosed patients with HbA1c-defined type 2 diabetes (HbA1c ≥6.5% [≥48 mmol/mol]), and 67 controls with HbA1c lower than 5.7% (<39 mmol/mol), were studied. Fasting blood samples for lipid profiles, fatty liver index (FLI), bioimpedance analysis, ultrasound scan of the liver, and BARD (body mass index, aspartate aminotransferase/alanine aminotransferase ratio, diabetes) score for evaluation of liver fibrosis, were performed in all subjects. In comparison to controls, subjects with prediabetes were characterised by: lower apolipoprotein AI and HDL cholesterol levels, higher blood pressure, triglycerides levels and apolipoprotein B/apolipoprotein AI ratio, higher FLI, increased prevalence of and more severe hepatic steatosis, similar BARD score, and higher total body fat mass. In comparison to subjects with diabetes, subjects with prediabetes exhibited: similar blood pressure and apolipoprotein B/apolipoprotein AI ratio, similar FLI, reduced prevalence of and less severe hepatic steatosis, lower BARD score, increased percent fat and lower total body muscle mass. In comparison to controls, subjects with diabetes showed: lower apolipoprotein AI and HDL cholesterol levels, higher blood pressure and triglycerides levels, higher FLI, increased prevalence of and more severe hepatic steatosis, higher BARD score, and higher total body muscle mass. Moreover, HbA1c was correlated with BMI, HOMA-IR, triglycerides, HDL cholesterol, AST, and ALT. Subjects with HbA1c-defined prediabetes and type 2 diabetes, respectively, are characterised by abnormalities in lipid profile and liver steatosis, thus exhibiting a severe risk profile for cardiovascular and liver diseases. Copyright © 2014 Elsevier B.V. All rights reserved.

A first attempt at few coils and low-coverage resistive wall mode stabilization of EXTRAP T2R

NASA Astrophysics Data System (ADS)

Olofsson, K. Erik J.; Brunsell, Per R.; Drake, James R.; Frassinetti, Lorenzo

2012-09-01

The reversed-field pinch features resistive-shell-type instabilities at any (vanishing and finite) plasma pressure. An attempt to stabilize the full spectrum of these modes using both (i) incomplete coverage and (ii) few coils is presented. Two empirically derived model-based control algorithms are compared with a baseline guaranteed suboptimal intelligent-shell-type (IS) feedback. Experimental stabilization could not be achieved for the coil array subset sizes considered by this first study. But the model-based controllers appear to significantly outperform the decentralized IS method.

Feeding behaviors of low-income mothers: Directive control relateds to a lower BMI in children, and a nondirective control relates to a healthier diet in preschoolers

USDA-ARS?s Scientific Manuscript database

The objective of this study was to explore whether and how directive (external, observable pressure on the child to eat a healthy diet) and nondirective (motivating the child to eat a healthy diet through praising, asking questions, and organizing the home food environment) type of parental feeding ...

Optical sensors and multiplexing for aircraft engine control

NASA Astrophysics Data System (ADS)

Berkcan, Ertugrul

1993-02-01

Time division multiplexing of spectral modulation fiber optic sensors for aircraft engine control is presented. The paper addresses the architectural properties, the accuracy, the benefits and problems of different type of sources, the spectral stability and update times using these sources, the size, weight, and power issues, and finally the technology needs regarding FADEC mountability. The fiber optic sensors include temperature, pressure, and position spectral modulation sensors.

Implantable device for in-vivo intracranial and cerebrospinal fluid pressure monitoring

DOEpatents

Ericson, Milton N.; McKnight, Timothy E.; Smith, Stephen F.; Hylton, James O.

2003-01-01

The present invention relates to a completely implantable intracranial pressure monitor, which can couple to existing fluid shunting systems as well as other internal monitoring probes. The implant sensor produces an analog data signal which is then converted electronically to a digital pulse by generation of a spreading code signal and then transmitted to a location outside the patient by a radio-frequency transmitter to an external receiver. The implanted device can receive power from an internal source as well as an inductive external source. Remote control of the implant is also provided by a control receiver which passes commands from an external source to the implant system logic. Alarm parameters can be programmed into the device which are capable of producing an audible or visual alarm signal. The utility of the monitor can be greatly expanded by using multiple pressure sensors simultaneously or by combining sensors of various physiological types.

Supported Telemonitoring and Glycemic Control in People with Type 2 Diabetes: The Telescot Diabetes Pragmatic Multicenter Randomized Controlled Trial

PubMed Central

Wild, Sarah H.; Hanley, Janet; Lewis, Stephanie C.; McKnight, John A.; Padfield, Paul L.; Parker, Richard A.; Pinnock, Hilary; Sheikh, Aziz; McKinstry, Brian

2016-01-01

Background Self-monitoring of blood glucose among people with type 2 diabetes not treated with insulin does not appear to be effective in improving glycemic control. We investigated whether health professional review of telemetrically transmitted self-monitored glucose results in improved glycemic control in people with poorly controlled type 2 diabetes. Methods and Findings We performed a randomized, parallel, investigator-blind controlled trial with centralized randomization in family practices in four regions of the United Kingdom among 321 people with type 2 diabetes and glycated hemoglobin (HbA1c) >58 mmol/mol. The supported telemonitoring intervention involved self-measurement and transmission to a secure website of twice-weekly morning and evening glucose for review by family practice clinicians who were not blinded to allocation group. The control group received usual care, with at least annual review and more frequent reviews for people with poor glycemic or blood pressure control. HbA1c assessed at 9 mo was the primary outcome. Intention-to-treat analyses were performed. 160 people were randomized to the intervention group and 161 to the usual care group between June 6, 2011, and July 19, 2013. HbA1c data at follow-up were available for 146 people in the intervention group and 139 people in the control group. The mean (SD) HbA1c at follow-up was 63.0 (15.5) mmol/mol in the intervention group and 67.8 (14.7) mmol/mol in the usual care group. For primary analysis, adjusted mean HbA1c was 5.60 mmol/mol / 0.51% lower (95% CI 2.38 to 8.81 mmol/mol/ 95% CI 0.22% to 0.81%, p = 0·0007). For secondary analyses, adjusted mean ambulatory systolic blood pressure was 3.06 mmHg lower (95% CI 0.56–5.56 mmHg, p = 0.017) and mean ambulatory diastolic blood pressure was 2.17 mmHg lower (95% CI 0.62–3.72, p = 0.006) among people in the intervention group when compared with usual care after adjustment for baseline differences and minimization strata. No significant differences were identified between groups in weight, treatment pattern, adherence to medication, or quality of life in secondary analyses. There were few adverse events and these were equally distributed between the intervention and control groups. In secondary analysis, there was a greater number of telephone calls between practice nurses and patients in the intervention compared with control group (rate ratio 7.50 (95% CI 4.45–12.65, p < 0.0001) but no other significant differences between groups in use of health services were identified between groups. Key limitations include potential lack of representativeness of trial participants, inability to blind participants and health professionals, and uncertainty about the mechanism, the duration of the effect, and the optimal length of the intervention. Conclusions Supported telemonitoring resulted in clinically important improvements in control of glycaemia in patients with type 2 diabetes in family practice. Current Controlled Trials, registration number ISRCTN71674628. Trial Registration Current Controlled Trials ISRCTN 71674628 PMID:27458809

Short-term effect of add on bell pepper (Capsicum annuum var. grossum) juice with integrated approach of yoga therapy on blood glucose levels and cardiovascular functions in patients with type 2 diabetes mellitus: A randomized controlled study.

PubMed

Nagasukeerthi, Padakandla; Mooventhan, A; Manjunath, N K

2017-10-01

Type 2 diabetes mellitus (T2DM) is a major global health problem. Though various studies have reported the beneficial effect of Yoga in patient with T2DM, there is a lack of study in combination with bell pepper and yoga. Hence, the present study aims at evaluating short-term effect of add on bell pepper juice with integrated approach of yoga therapy (IAYT) on blood glucose levels and cardiovascular variables in patients with T2DM. Fifty T2DM subjects with the age varied from 34 to 69-years were recruited and randomly divided into either study group or control group. The study group received 100-ml of bell pepper juice (twice/day) along with IAYT while the control group received only IAYT for 4-consecutive days. Baseline and post-test assessments were taken before and after the intervention. Statistical analysis was performed using statistical package for the social sciences, version-16. Results of this study showed no significant difference in overall (fasting and post prandial) blood glucose level in the study group compared with control group. However, a significant reduction in Post prandial blood glucose (PPBG), systolic blood pressure (SBP), pulse pressure (PP), rate pressure product (RPP) and Double product (Do-P) was observed in the study group compared with control group. Results of this study suggest that though an addition of 100-ml of bell pepper juice (twice/day) along with IAYT is not more effective in reducing fasting blood glucose, it may be more effective in reducing PPBG, SBP, PP, RPP and Do-P than IAYT alone. Copyright © 2017 Elsevier Ltd. All rights reserved.

Longitudinal Study of Hypertensive Subjects With Type 2 Diabetes Mellitus: Overall and Cardiovascular Risk.

PubMed

Safar, Michel E; Gnakaméné, Jean-Barthélémy; Bahous, Sola Aoun; Yannoutsos, Alexandra; Thomas, Frédérique

2017-06-01

Despite adequate glycemic and blood pressure control, treated type 2 diabetic hypertensive subjects have a significantly elevated overall/cardiovascular risk. We studied 244 816 normotensive and 99 720 hypertensive subjects (including 7480 type 2 diabetics) attending medical checkups between 1992 and 2011. We sought to identify significant differences in overall/cardiovascular risk between hypertension with and without diabetes mellitus. Mean follow-up was 12.7 years; 14 050 all-cause deaths were reported. From normotensive to hypertensive populations, a significant progression in overall/cardiovascular mortality was observed. Mortality was significantly greater among diabetic than nondiabetic hypertensive subjects (all-cause mortality, 14.05% versus 7.43%; and cardiovascular mortality, 1.28% versus 0.7%). No interaction was observed between hemodynamic measurements and overall/cardiovascular risk, suggesting that blood pressure factors, even during drug therapy, could not explain the differences in mortality rates between diabetic and nondiabetic hypertensive patients. Using cross-sectional regression models, a significant association was observed between higher education levels, lower levels of anxiety and depression, and reduced overall mortality in diabetic hypertensive subjects, while impaired renal function, a history of stroke and myocardial infarction, and increased alcohol and tobacco consumption were significantly associated with increased mortality. Blood pressure and glycemic control alone cannot reverse overall/cardiovascular risk in diabetics with hypertension. Together with cardiovascular measures, overall prevention should include recommendations to reduce alcohol and tobacco consumption and improve stress, education levels, and physical activity. © 2017 American Heart Association, Inc.

Does periodic vehicle inspection reduce car crash injury? Evidence from the Auckland Car Crash Injury Study.

PubMed

Blows, Stephanie; Ivers, Rebecca Q; Connor, Jennie; Ameratunga, Shanthi; Norton, Robyn

2003-01-01

This paper examines the association between periodic motor vehicle inspection and frequent tire pressure checks, and the risk of car crash injury. Data were analysed from the Auckland Car Crash Injury Study, a population-based case-control study in Auckland, NZ, where vehicles are required to undergo six-monthly safety inspections. Cases were all cars involved in crashes in which at least one occupant was hospitalised or killed, which represented 571 drivers. Controls were randomly selected cars on Auckland roads (588 drivers). Participants completed a structured interview. Vehicles that did not have a current certificate of inspection had significantly greater odds of being involved in a crash where someone was injured or killed compared with cars that had a current certificate, after adjustment for age, sex, marijuana use, ethnicity and licence type (OR 3.08, 95% CI 1.87-5.05). Vehicles that had not had their tire pressure checked within the past three months also had significantly greater odds of being involved in a crash compared with those that had a tire pressure check, after adjustment for age, sex, ethnicity, seatbelt use, licence type, self-reported speed and hours per week of driving exposure (OR 1.89, 95% CI 1.16-3.08). This study provides new evidence, using rigorous epidemiological methods and controlling for multiple confounding variables, of an association between periodic vehicle inspections and three-monthly tire pressure checks and reduced risk of car crash injury. This research suggests that vehicle inspection programs should be continued where they already exist and contributes evidence in support of introducing such programs to other areas.

A comparison of cleat types during two football-specific tasks on FieldTurf.

PubMed

Queen, R M; Charnock, B L; Garrett, W E; Hardaker, W M; Sims, E L; Moorman, C T

2008-04-01

To examine the effect of different cleat plate configurations on plantar pressure during two tasks. Thirty-six athletes ran an agility course 5 times while wearing 4 different types of Nike Vitoria cleats: (1) bladed, (2) elliptical firm ground, (3) hard ground and (4) turf. Plantar pressure data were recorded during a side cut and a cross cut using Pedar-X insoles. Controlled laboratory study No history of lower extremity injury in the past 6 months, no previous foot or ankle surgery, not currently wearing foot orthotics and play a cleated sport at least twice a week. Total foot contact time, contact area, maximum force, peak pressure and the force-time integral (FTI) in the medial, middle and lateral regions of the forefoot were collected. A 1x4 ANOVA (alpha = 0.05) was performed on each dependent variable. A Bonferroni adjustment was conducted (alpha = 0.008). In the cross cut task, statistical differences between cleats were observed in three variables: total foot peak pressure, lateral forefoot FTI, and lateral forefoot normalised maximum force. In the side cut task, statistical differences between cleats were observed in 4 variables: total foot peak pressure, the medial and middle forefoot FTI, and the medial and middle forefoot normalised maximum force. Significant differences in forefoot loading patterns existed between cleat types. Based on the results of this study, it might be beneficial to increase the forefoot cushioning in cleats in an attempt to decrease loading in these regions of the foot.

Performance of Several Combustion Chambers Designed for Aircraft Oil Engines

NASA Technical Reports Server (NTRS)

Joachim, William F; Kemper, Carlton

1928-01-01

Several investigations have been made on single-cylinder test engines to determine the performance characteristics of four types of combustion chambers designed for aircraft oil engines. Two of the combustion chambers studied were bulb-type precombustion chambers, the connecting orifice of one having been designed to produce high turbulence by tangential air flow in both the precombustion chamber and the cylinder. The other two were integral combustion chambers, one being dome-shaped and the other pent-roof shaped. The injection systems used included cam and eccentric driven fuel pumps, and diaphragm and spring-loaded fuel-injection valves. A diaphragm type maximum cylinder pressure indicator was used in part of these investigations with which the cylinder pressures were controlled to definite valves. The performance of the engines when equipped with each of the combustion chambers is discussed. The best performance for the tests reported was obtained with a bulb-type combustion chamber designed to give a high degree of turbulence within the bulb and cylinder. (author)

The effect of combination therapy with an L/N-Type Ca(2+) channel blocker, cilnidipine, and an angiotensin II receptor blocker on the blood pressure and heart rate in Japanese hypertensive patients: an observational study conducted in Japan.

PubMed

Nagahama, Shinobu; Norimatsu, Takeo; Maki, Toshio; Yasuda, Masaharu; Tanaka, Shinsuke

2007-09-01

Recently, the use of combination therapy with a calcium channel blocker (CCB) and an angiotensin II receptor blocker (ARB) has been rapidly increasing. Although this combination therapy is accepted as a standard treatment hypertension, there have been few large-scale, multicenter studies examining its safety and efficacy. The present study was designed to investigate the safety and efficacy of adding cilnidipine, a dual L/N-type CCB, to the regimen of patients whose blood pressure had been poorly controlled (systolic blood pressure [SBP] >140 mmHg or diastolic blood pressure [DBP] >90 mmHg) by antihypertensive monotherapy with an ARB. The percentage achievement of the blood pressure goals recommended by the JSH 2000 guidelines was also assessed for at least 12 weeks of treatment. A total of 2,920 patients were enrolled in the study at 471 institutions in Japan from February 2003 to July 2004. The incidence of adverse reactions related to cilnidipine was as low as 2.5%. A significant reduction from the baseline was found both in SBP (from 164.1 +/- 15.3 to 139.2 +/- 15.3 mmHg, p<0.0001) and DBP (from 91.7 +/- 11.4 to 79.3 +/- 10.7 mmHg, p<0.0001). A total of 31.5% of the patients achieved the blood pressure goals recommended by the JSH 2000 guidelines. Moreover, the heart rate also significantly decreased in these patients, particularly in those with a higher baseline heart rate. Our results indicate that cilnidipine can be used in combination with an ARB to control blood pressure without any significant adverse effects, and also that cilnidipine successfully reduces elevated heart rate, which is a possible risk factor for cardiovascular events.

The effectiveness of dry-cupping in preventing post-operative nausea and vomiting by P6 acupoint stimulation

PubMed Central

Farhadi, Khosro; Choubsaz, Mansour; Setayeshi, Khosro; Kameli, Mohammad; Bazargan-Hejazi, Shahrzad; Zadie, Zahra H.; Ahmadi, Alireza

2016-01-01

Abstract Background: Postoperative nausea and vomiting (PONV) is a common complication after general anesthesia, and the prevalence ranges between 25% and 30%. The aim of this study was to determine the preventive effects of dry cupping on PONV by stimulating point P6 in the wrist. Methods: This was a randomized controlled trial conducted at the Imam Reza Hospital in Kermanshah, Iran. The final study sample included 206 patients (107 experimental and 99 controls). Inclusion criteria included the following: female sex; age>18 years; ASA Class I-II; type of surgery: laparoscopic cholecystectomy; type of anesthesia: general anesthesia. Exclusion criteria included: change in the type of surgery, that is, from laparoscopic cholecystectomy to laparotomy, and ASA-classification III or more. Interventions are as follows: pre surgery, before the induction of anesthesia, the experimental group received dry cupping on point P6 of the dominant hand's wrist with activation of intermittent negative pressure. The sham group received cupping without activation of negative pressure at the same point. Main outcome was that the visual analogue scale was used to measure the severity of PONV. Results: The experimental group who received dry cupping had significantly lower levels of PONV severity after surgery (P < 0.001) than the control group. The differences in measure were maintained after controlling for age and ASA in regression models (P < 0.01). Conclusion: Traditional dry cupping delivered in an operation room setting prevented PONV in laparoscopic cholecystectomy patients. PMID:27661022

Correlation between polymorphism of FTO gene and type 2 diabetes mellitus in Uygur people from northwest China.

PubMed

Xiao, Shan; Zeng, Xiaoyun; Quan, Li; Zhu, Jun

2015-01-01

To explore the correlation between FTO (fat mass and obesity associated) gene, which is associated with 3 single nucleotide polymorphisms (SNP) of fat mass and obesity, type 2 diabetes and body mass index (BMI) in the Uygur population in northwest China. A total of 849 Uygur patients with type 2 diabetes mellitus were selected from the hospitalized patients in the First Affiliated Hospital of Xinjiang Medical University, the First People's Hospital of Kashi and the hospitals in the Turpan areas. At the same time, 873 cases of healthy persons who conducted a medical checkup in the physical examination centre of the above hospitals were enrolled as controls. The present investigation used the case-control research method, and physical examination and biochemical index determination were carried out. The Sequenom MassARRAY technology was employed in the detection of 3 SNP loci of the FTO gene. The representative population of each SNP in the control group was analyzed by Hardy-Weinberg law. The differences of each clinical parameter in the two groups were analyzed by t-test analysis. The differences of genotype and allele of each SNP in the two groups were analyzed by χ(2) test. BMI, waistline (WL), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), total cholesterol (TC), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in the type 2 diabetes group were higher than those in the control group, while the high density lipoprotein (HDL) and low density lipoprotein (LDL) were lower than those of the control group; 2. The allele frequency of A of rs8050136 and rs9939609 in the type 2 diabetes mellitus group was higher than that of the control group. The BMI of the whole population and type 2 diabetes group with genotype C/A+A/A of rs8050136 was higher than that in C/C group, and the BMI with genotype T/A+A/A of rs9939609 was higher than that in group T/T. Stratification was conducted on BMI according to the normal, overweight and obesity criteria. There were significant differences in the distribution of genotype frequency of rs9939609 in the type 2 diabetes group and the control group of the normal BMI group. Single nucleotide mutation of rs7195539 in FTO gene may be a protective factor against the Uygur type 2 diabetes. Single nucleotide mutations of rs8050136 and rs9939609 may be associated with the Uygur type 2 diabetes and obesity, with A as a potential risk allele. The gene polymorphism of rs8050136 may correlate with type 2 diabetes mellitus through the function of BMI, while the correlation between rs9939609 gene polymorphism and type 2 diabetes is not depending from BMI.

Comparative Performance of a Powerplus Vane-type Supercharger and an N.A.C.A. Roots-type Supercharger

NASA Technical Reports Server (NTRS)

Schey, Oscar W; Ellerbrock, Herman H , R

1932-01-01

This report presents the results of tests of a Power plus supercharger and a comparison of its performance with the performance previously obtained with an N.A.C.A. Roots-type supercharger. The Powerplus supercharger is a positive displacement blower of the vane type having mechanically operated vanes, the movement of which is controlled by slots and eccentrics. The supercharger was tested at a range of pressure differences from 0 to 15 inches of mercury and at speeds from 500 to 2,500 r.p.m. The pressure difference across the supercharger was obtained by throttling the intake of a depression tank which was interposed in the air duct between the supercharger and the Durley orifice box used for measuring the air. The results of these tests show that at low pressure differences and at all speeds the power required by the Powerplus supercharger to compress a definite quantity of air per second is considerably higher than that required by the Roots. At pressure differences from 10 to 14 inches of mercury and at speeds over 2,000 r.p.m. the power requirements of the two superchargers are practically the same. At a pressure difference of 15 inches of mercury or greater and at a speed of 2,500 r.p.m. or greater the performance of the Powerplus supercharger is slightly better than that of the Roots. Because the Powerplus supercharger cannot be operated at a speed greater than 3,000 r.p.m. as compared with 7,000 r.p.m. for the Roots, its capacity is approximately one-half that of the Roots for the same bulk. The Powerplus supercharger is more complicated and less reliable than the Roots supercharger.

A 2-year comparative study of mold and bacterial counts in air samples from neutral and positive pressure rooms in 2 tertiary care hospitals.

PubMed

Ryan, Laura; O'Mara, Niall; Tansey, Sana; Slattery, Tom; Hanahoe, Belinda; Vellinga, Akke; Doyle, Maeve; Cormican, Martin

2018-05-01

Immunocompromised patients are at risk of invasive fungal infection. These high-risk patients are nursed in protective isolation to reduce the risk of nosocomial aspergillosis while in hospital-ideally in a positive pressure single room with high-efficiency particulate air filtration. However, neutral pressure rooms are a potential alternative, especially for patients requiring both protective and source isolation. This study examined mold and bacterial concentrations in air samples from positive and neutral pressure rooms to assess whether neutral pressure rooms offer a similar environment to that of positive pressure rooms in terms of mold concentrations in the air. Mold concentrations were found to be similar in the positive and neutral pressure room types examined in this study. These results add to the paucity of literature in this area. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Probiotic supplementation for management of cardiovascular risk factors in adults with type II diabetes: A systematic review and meta-analysis.

PubMed

Hendijani, Fatemeh; Akbari, Vajihe

2018-04-01

The effectiveness of probiotics in control of hypertension and dyslipidemia in diabetic patients remains unclear. Therefore, we systematically reviewed relevant data to elucidate the effects of probiotics on blood pressure and lipid profile of type 2 diabetic patients. We searched PubMed, ISI Web of Knowledge, Scopus, The Cochrane Library, ClinicalTrials.gov, ProQuest Dissertations and Theses databases until May 2016. The primary outcomes were systolic blood pressure (SBP) and diastolic blood pressure (DBP), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglycerides (TG). Other biochemical response and adverse effects were considered as secondary outcomes. Data was extracted from included studies and pooled in meta-analysis whenever possible (both standardized mean difference (SMD) analysis and weighted mean difference (WMD) analysis were performed). Eleven eligible randomized controlled trial (n = 641) were identified. Pooling data from these trials demonstrated probiotic consumption significantly decreased SBP (WMD, -3.28 mmHg; 95% confidence interval [CI], -5.38 to -1.18), DBP (WMD, -2.13 mmHg; 95% CI, -4.5 to 0.24), LDL-C (WMD, 8.32 mg/dl; 95% CI, -15.24 to -1.4), TC (WMD, -12.19 mg/dl; 955 CI -17.62 to -6.75) and TG (WMD, -24.48 mg/dl; 95% CI, -33.77 to -11.18) in type 2 diabetic patients compared with placebo. The methodological quality varied across trials included in this study. This systematic review suggests probiotics supplementation may be helpful for control of dyslipidemia and hypertension in type 2 diabetic patients. Conducting more trails with large sample size and long follow-up time still is necessary to develop clinical practice guidelines for management of cardiovascular risk factors in patient with type 2 diabetes. Copyright © 2017 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

[The clinical research of aviatic nasal diseases with medical evaluation prevention and control intervention].

PubMed

Wang, Binru; Xu, Xianrong; Jin, Zhangguo; Zhang, Yang

2015-03-01

Exploring the clinical features of aviatic nasal diseases to provide references for medical evaluation, prevention and control measures in aircrew. To analysis and summary 605 cases with 503 pilots of nasal diseases in aircrew during 1966 to 2013. (1) There were 605 cases of aviatic nasal diseases, including 550 cases of general diseases and 55 cases of specific diseases. The general nasal diseases included 140 cases of anatomical abnormalities in nasal cavity type, 290 cases of inflammation in nasal cavity, 73 cases of allergy type, 47 cases of cyst and tumor type, and the specific nasal diseases were 55 cases of sinus barotrauma (SB). (2) The, constituent ratio of SB, which was happened in frontal sinus and /or maxillary sinus, was 95.55%. (3) The constituent ratio of cyst and tumor type in nasal cavity was easier causing to SB than anatomical abnormalities, inflammation, allergy disease in nasal cavity (P < 0.05). (4) The grounded constituent ratio of secondary SB was higher than anatomical abnormalities, inflammation, allergy, cyst and tumor disease in nasal cavity (P < 0.05). (5) The ways of hypobaric chamber tests were different for the kinds of aircrew. The qualified adjustment function of sinuses for barometric pressure was an essential condition for aircrew to continue flying. (6) The key point for the treatment of aviatic nasal diseases was to remove pathological change in nasal cavity and sinus and restore sinus ostium patency. The key point for the medical evaluation was to restore normal sinus pressure balance function. The key point of medical evaluation about aviatic nasal diseases is to assess the sinus pressure balance function in hypobaric chamber tests. Normative treatment and medical evaluation can effectively avoid flight accidents and improve the attendance rate for aircrew.

Wide topical negative pressure wound dressing treatment for patients undergoing abdominal dermolipectomy following massive weight loss.

PubMed

Dragu, Adrian; Schnürer, Stefan; Unglaub, Frank; Wolf, Maya B; Beier, Justus P; Kneser, Ulrich; Horch, Raymund E

2011-11-01

Postbariatric plastic surgery is considered to be a high-risk procedure, which entails such frequent minor complications as postoperative seroma, bleeding and wound dehiscence. These occur with a high incidence, especially, following postbariatric abdominal dermolipectomy. In order to reduce these complication rates, a new type of dressing with wide abdominal topical negative pressure (TNP) application was applied. We performed abdominal dermolipectomy in 23 obese patients. The average body mass index was 32.8 kg/m(2), and the median age of the patients was 42.9 years. Ten patients received conventional standard dressings (control group I), whereas the other 13 patients received a wide TNP dressing including the ventral and lateral trunk (negative pressure group II). Postoperative exudate volumes were collected, tallied and documented for each group separately until all drains could be removed. The conventionally treated control group (I) showed a significantly higher postoperative secretion volume compared with the negative pressure group (II). In addition, the average time to postoperative final drain removal was significantly lower in the negative pressure group (II) compared with the control group (I). The results indicate that widely applied external TNP wound dressing on the ventral and lateral trunk following postbariatric abdominal dermolipectomy leads to a significant reduction in exudate formation, enables early drain removal and thus, decreases length of hospitalization.

A new 6-axis apparatus to squeeze the Kawai-cell of sintered diamond cubes

NASA Astrophysics Data System (ADS)

Ito, Eiji; Katsura, Tomoo; Yamazaki, Daisuke; Yoneda, Akira; Tado, Masashi; Ochi, Takahiro; Nishibara, Eiichi; Nakamura, Akihiro

2009-05-01

In order to overcome disadvantages of the DIA type press in squeezing the Kawai-cell, such as uneven compression between the upper and lower anvils and the four surrounding anvils and frictional loss of applied load in the guide block, we have developed a new 6-axis apparatus in which the movements of the six anvils are controlled by a servo mechanism. It is possible to keep the Kawai-cell cubic within an accuracy of ±2 μm during compression and decompression. Pressure generation using sintered diamond cubic anvils with edge length of 14.0 mm and a truncation of 1.5 mm has been carried out up to ca. 60 GPa by measuring electrical resistance of GaP, Zr, and Fe 2O 3. The results are compared with our previous calibration, carried out using an almost the same sample setup for identical anvils at SPring-8, by means of in situ X-ray observation. It is demonstrated that a significant amount of the applied load is lost by friction when the Kawai-cell is squeezed in the DIA type press. The load loss increases with increasing load, or pressure, and amounts to 45% at ca. 60 GPa. Therefore the 6-axis apparatus is very advantageous to generate higher pressures in the Kawai-cell. However, individual control of the anvils sometimes induces a runaway advancement of the anvils which brings about an abrupt increase of pressure.

Carbon dioxide/brine wettability of porous sandstone versus solid quartz: An experimental and theoretical investigation.

PubMed

Alnili, Firas; Al-Yaseri, Ahmed; Roshan, Hamid; Rahman, Taufiq; Verall, Michael; Lebedev, Maxim; Sarmadivaleh, Mohammad; Iglauer, Stefan; Barifcani, Ahmed

2018-08-15

Wettability plays an important role in underground geological storage of carbon dioxide because the fluid flow and distribution mechanism within porous media is controlled by this phenomenon. CO 2 pressure, temperature, brine composition, and mineral type have significant effects on wettability. Despite past research on this subject, the factors that control the wettability variation for CO 2 /water/minerals, particularly the effects of pores in the porous substrate on the contact angle at different pressures, temperatures, and salinities, as well as the physical processes involved are not fully understood. We measured the contact angle of deionised water and brine/CO 2 /porous sandstone samples at different pressures, temperatures, and salinities. Then, we compared the results with those of pure quartz. Finally, we developed a physical model to explain the observed phenomena. The measured contact angle of sandstone was systematically greater than that of pure quartz because of the pores present in sandstone. Moreover, the effect of pressure and temperature on the contact angle of sandstone was similar to that of pure quartz. The results showed that the contact angle increases with increase in temperature and pressure and decreases with increase in salinity. Copyright © 2018 Elsevier Inc. All rights reserved.

Medical care of type 2 diabetes in German disease management programmes: a population-based evaluation.

PubMed

Stark, Reneé G; Schunk, Michaela V; Meisinger, Christine; Rathmann, Wolfgang; Leidl, Reiner; Holle, Rolf

2011-05-01

Type 2 diabetes disease management programmes (DDMPs) are offered by German social health insurance to promote healthcare consistent with evidence-based medical guidelines. The aim of this study was to compare healthcare quality and medical endpoints between diabetes management programme participants and patients receiving usual care designated as controls. All patients with type 2 diabetes (age range: 36-81) in a cross-sectional survey of a cohort study, performed by the Cooperative Health Research in the Region of Augsburg, received a self-administered questionnaire regarding their diabetes care. Physical examination and laboratory tests were also performed. The analysis only included patients with social health insurance and whose participation status in a diabetes disease management program was validated by the primary physician (n = 166). Regression analyses, adjusting for age, sex, education, diabetes duration, baseline waist circumference and clustering regarding primary physician were conducted. Evaluation of healthcare processes showed that those in diabetes disease management programmes (n = 89) reported medical examination of eyes and feet and medical advice regarding diet [odds ratio (OR): 2.39] and physical activity (OR: 2.87) more frequently, received anti-diabetic medications (OR: 3.77) and diabetes education more often (OR: 2.66) than controls. Both groups had satisfactory HbA(1c) control but poor low-density lipoprotein cholesterol control. Blood pressure goals (<140/90 mmHg) were achieved more frequently by patients in diabetes disease management programmes (OR: 2.21). German diabetes disease management programmes are associated with improved healthcare processes and blood pressure control. Low-density lipoprotein cholesterol control must be improved for all patients with diabetes. Further research will be required to assess the long-term effects of this diabetes disease management programme. Copyright © 2011 John Wiley & Sons, Ltd.

A SURVEY OF THE CORROSION OF MARTENSITIC AND FERRITIC STAINLESS STEELS IN PRESSURIZED WATER

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

Beaver, R.J.; Leitten, C.F. Jr.

1963-07-16

>The corrosion resistance of mantensitic and ferritic austenitic stainless steels and carbon steels in pressurized water at 500 to 600 deg F is compared. Included are specific out-of-pile data for austenitic stainless steels, AISI types types 410, 420, 431, and 440C; the ferritic AISI types 430, 442, and 446; the precipitation-hardening type 17-4PH; and carbon steels, ASTM 212 A and B. Available corrosion results obtained under irradiation at exposures in the range of 7 x 10/sup 16/ to 3 x 10/sup 19/ nvt are also included for types 304, types of martensitic and ferritic stainless steels which were evaluated domore » not contain nickel. For application where it is desirable to minimize Co/sup 58/ activity produced from nickel, selection of a martensitic or ferritic stainless steel may be more appropriate than choosing the more popular nickel-bearing austenitic stainless steel or a fuel-element cladding material. Interpretation of the data indicates that, on the average, martensitic and ferritic stainless steels corrode more rapidly than austenitic alloys but more slowly than carbon and low-alloy steels. Under selected controlled water conditions or under irradiation, the corrosion of the nickel-free stainless steels appears to differ little from the austenitics. The corrosion of martensitic and ferritic stainless steels in pressurized-water systems therefore does not appear of such magnitude as to rule out development of these materials as the cladding fuel elements for specific applications. (auth)« less

High protein weight loss diets in obese subjects with type 2 diabetes mellitus.

PubMed

Pedersen, E; Jesudason, D R; Clifton, P M

2014-05-01

Diets where carbohydrate has been partially exchanged for protein have shown beneficial changes in persons with type 2 diabetes but no studies have enrolled people with albuminuria. We aim to determine if a high protein to carbohydrate ratio (HPD) in an energy reduced diet has a beneficial effect on metabolic control and cardiovascular risk factors without negatively affecting renal function. Adult, overweight participants with type 2 diabetes, with albuminuria (30-600 mg/24 h or an albumin-to-creatinine ratio of 3.0-60 mg/mmol), and estimated GFR of >40 ml/min/1.73 m(2) were enrolled. Participants were randomized to an HPD or an SPD. Protein:fat:carbohydrate ratio was 30:30:40% of energy for the HPD and 20:30:50% for the SPD. Main outcomes were renal function, weight loss, blood pressure, serum lipids and glycaemic control. We recruited 76 volunteers and 45 (35 men and 10 women) finished. There were no overall changes in renal function at 12 months and no significant differences in weight loss between groups (9.7 ± 2.9 kg and 6.6 ± 1.4 kg HPD and SPD group respectively; p = 0.32). Fasting blood glucose decreased significantly with no treatment effect. The decrease in HbA1c differed between treatments at 6 months (HPD -0.9 vs. SPD -0.3%; p = 0.039) but not at 12 months. HDL increased significantly with no treatment effects. There were no changes in LDL or blood pressure overall but DBP was lower in the HPD group (p = 0.024) at 12 months. Weight loss improved overall metabolic control in this group of well controlled participants with type 2 diabetes regardless of diet composition. Copyright © 2013 Elsevier B.V. All rights reserved.

Journal of Chemical Education: Software.

ERIC Educational Resources Information Center

Journal of Chemical Education, 1989

1989-01-01

Discusses a visual database of information about chemical elements. Uses a single sided 12-inch, 30-minute, CAV-type videodisk. Contains a picture of almost every element in its stable form at room temperature and normal atmospheric pressure. Can be used with the video controller from "KC? Discoverer." (MVL)

Update on Prevention of Cardiovascular Disease in Adults With Type 2 Diabetes Mellitus in Light of Recent Evidence: A Scientific Statement From the American Heart Association and the American Diabetes Association.

PubMed

Fox, Caroline S; Golden, Sherita Hill; Anderson, Cheryl; Bray, George A; Burke, Lora E; de Boer, Ian H; Deedwania, Prakash; Eckel, Robert H; Ershow, Abby G; Fradkin, Judith; Inzucchi, Silvio E; Kosiborod, Mikhail; Nelson, Robert G; Patel, Mahesh J; Pignone, Michael; Quinn, Laurie; Schauer, Philip R; Selvin, Elizabeth; Vafiadis, Dorothea K

2015-09-01

Cardiovascular disease risk factor control as primary prevention in patients with type 2 diabetes mellitus has changed substantially in the past few years. The purpose of this scientific statement is to review the current literature and key clinical trials pertaining to blood pressure and blood glucose control, cholesterol management, aspirin therapy, and lifestyle modification. We present a synthesis of the recent literature, new guidelines, and clinical targets, including screening for kidney and subclinical cardiovascular disease for the contemporary management of patients with type 2 diabetes mellitus. © 2015 by the American Diabetes Association and the American Heart Association, Inc.

Alternative Future Scenarios: Development of a Modeling Information System

DTIC Science & Technology

2003-04-22

the Nation’s population by the year 2020. Riverside County is of particular concern to Joshua Tree National Park because of the rapid rate of...not display a currently valid OMB control number. 1. REPORT DATE 22 APR 2003 2. REPORT TYPE 3. DATES COVERED 00-00-2003 to 00-00-2003 4. TITLE...4 DoD cannot afford to ignore the hierarchical effects of development pressures........................ 5 TYPES OF MODELS/MODEL ENVIRONMENT

Air pressure changes in the creation and bursting of the type-1 big bubble in deep anterior lamellar keratoplasty: an ex vivo study.

PubMed

AlTaan, S L; Mohammed, I; Said, D G; Dua, H S

2018-01-01

PurposeTo measure the pressure and volume of air required to create a big bubble (BB) in simulated deep anterior lamellar keratoplasty (DALK) in donor eyes and ascertain the bursting pressure of the BB.Patients and methodsTwenty-two human sclera-corneal discs were used. Air was injected into the corneal stroma to create a BB and the pressure measured by means of a pressure converter attached to the system via a side port. A special clamp was designed to prevent air leak from the periphery of the discs. The pressure at which air emerged in the corneal tissue; the bursting pressure measured after advancing the needle into the bubble cavity and injecting more air; the volume of air required to create a BB and the volume of the BB were ascertained.ResultsType-1 BB were achieved in 19 and type-2 BB in 3 eyes. The maximum pressure reached to create a BB was 96.25+/- 21.61 kpa; the mean type-1 intrabubble pressure was 10.16 +/- 3.65 kpa. The mean bursting pressure of a type-1 BB was 66.65 +/- 18.65 kpa, while that of a type-2 BB was 14.77 +/- 2.44 kpa. The volume of air required to create a type-1 BB was 0.54 ml and the volume of a type-1 BB was consistently 0.1 ml.ConclusionsDua's layer baring DALK can withstand high intraoperative pressures compared to Descemet's membrane baring DALK. The study suggests that it could be safe to undertake procedures such as DALK-triple with a type-1 BB but not with a type-2 BB.

Study of the human postural control system during quiet standing using detrended fluctuation analysis

NASA Astrophysics Data System (ADS)

Teresa Blázquez, M.; Anguiano, Marta; de Saavedra, Fernando Arias; Lallena, Antonio M.; Carpena, Pedro

2009-05-01

The detrended fluctuation analysis is used to study the behavior of different time series obtained from the trajectory of the center of pressure, the output of the activity of the human postural control system. The results suggest that these trajectories present two different regimes in their scaling properties: persistent (for high frequencies, short-range time scale) to antipersistent (for low frequencies, long-range time scale) behaviors. The similitude between the results obtained for the measurements, done with both eyes open and eyes closed, indicate either that the visual system may be disregarded by the postural control system while maintaining the quiet standing, or that the control mechanisms associated with each type of information (visual, vestibular and somatosensory) cannot be disentangled with the type of analysis performed here.

[Cuff pressure control at the intersinve care unit: influence of nursing professionals' training].

PubMed

Velasco Sanz, T R; Ronda Delgado de la Fuente, M; Sánchez de la Ventana, A B; Reyes Merino Martínez, M

2015-01-01

To analyze proper control of endotracheal cuff pressure in an intensive care unit. The specific objective is to verify whether training of nursing professionals improves monitoring endotracheal cuff pressure. the study type is descriptive, observational and retrospective. All patients were admitted to the Critical Unit II of the Clínico San Carlos Hospital between May 2010-November 2011, requiring either a tracheal tube or tracheal cannula. Studied variables were: number of in range measures, number of intubated patients, or with tracheal cannula and register. Four cuts were made on all admitted patients admitted during the study period in order to measure endotracheal cuff pressure. Two cuts were performed before the professional nurses training and the other two cuts after a specific training with respect to endotracheal cuff pressure and Zero pneumonia. There were 74 measurements. The first cut obtained 40.74% of measures in range. In the second cut 61.90% of measures were identified in range. In the third cut, it was found that 85.7% of measures were in range and in the fourth court, it was noted the 89.47% of measures were in range. Monitoring of the endotracheal cuff pressure was inadequate before specific training of professionals. Nursing professionals training facilitates the correct measurement of the endotracheal cuff pressure, which improves patient safety. Copyright © 2013 Elsevier España, S.L.U. y SEEIUC. All rights reserved.

Body mass index, triglycerides, glucose, and blood pressure as predictors of type 2 diabetes in a middle-aged Norwegian cohort of men and women.

PubMed

Hjellvik, Vidar; Sakshaug, Solveig; Strøm, Hanne

2012-01-01

Obesity, hypertension, and hypertriglyceridemia are important risk factors for type 2 diabetes (T2D). We wanted to assess the risk associated with these three factors alone and in combination, and the relative importance of these and several other risk factors (eg, nonfasting glucose) as predictors of T2D. Risk factors in a Norwegian population (n = 109,796) aged 40-45 years were measured in health studies in 1995-1999. Blood glucose-lowering drugs dispensed in 2004-2009 were used to estimate the incidence of T2D. Groups based on combinations of body mass index (BMI), diastolic blood pressure, and triglycerides were defined by using the 50% and 90% quantiles for each variable for men and women. The relative importance of BMI, triglycerides, total cholesterol, high-density lipoprotein cholesterol, glucose, blood pressure, and year of birth for predicting T2D was assessed using deviance from univariate and multivariate logistic regression models. Height, weight, and blood pressure were measured. All biomarkers were measured in nonfasting blood samples. In the various groups of BMI, triglycerides, and diastolic blood pressure, the incidence of T2D ranged from 0.5% to 19.7% in men and from 0.15% to 21.8% in women. BMI was the strongest predictor of incident T2D, followed by triglyceride levels in women and glucose levels in men. The inclusion of risk factors other than BMI, glucose, triglycerides, and blood pressure in multivariate models only marginally improved the prediction. BMI was the strongest predictor of type 2 diabetes. At defined levels of BMI, the incidence of T2D varied substantially with triglyceride levels and blood pressure. Thus, controlling triglycerides and blood pressure in middle-aged individuals should be targeted to prevent later onset of T2D.

[Face protective patches do not reduce facial pressure ulcers in a simulated model of non-invasive ventilation].

PubMed

Riquelme M, Hugo; Wood V, David; Martínez F, Santiago; Carmona M, Fernando; Peña V, Axel; Wegner A, Adriana

2017-06-01

Noninvasive ventilation (NIV) frequently involves the development of facial pressure ulcers (FPU). Its prevention considers the empirical use of protective patches between skin and mask, in order to reduce the pressure exerted by it. To evaluate the effect of protective patches on the pressure exerted by the facial mask, and its impact on the programmed ventilatory parameters. Bilevel NIV simulated model using full face mask in phantom with a physiological airway (ALS PRO +) in supine position. Forehead, chin and cheekbones pressure were measured using 3 types of standard protective patches versus a control group using pressure sensors (Interlinks Electronics®). The values obtained with the protective patches-mask model were evaluated in the programmed variables maximum inspiratory flow (MIF)), expired tidal volume (Vte) and positive inspiratory pressure (IPAP), with Trilogy 100 ventilator, Respironics®. The programming and recording of the variables was carried out in 8 opportunities in each group by independent operators. There was no decrease in facial pressure with any of the protective patches compared to the control group. Moltopren increased facial pressure at all support points (p < 0.001), increased leakage, it decreased MIF, Vte and IPAP (p < 0.001). Hydrocolloid patches increased facial pressure only in the left cheekbone, increased leakage and decreased MIF. Polyurethane patches did not produce changes in facial pressure or ventilatory variables. The use of protective patches of moltopren, hydrocolloid and polyurethane transparent did not contribute to the decrease of the facial pressure. A deleterious effect of the moltopren and hydrocolloid patches was observed on the administration of ventilatory variables, concluding that the non-use of the protective patches allowed a better administration of the programmed parameters.

The effects of sustained manual pressure stimulation according to Vojta Therapy on heart rate variability.

PubMed

Opavsky, Jaroslav; Slachtova, Martina; Kutin, Miroslav; Hok, Pavel; Uhlir, Petr; Opavska, Hana; Hlustik, Petr

2018-05-23

The physiotherapeutic technique of Vojta reflex locomotion is often accompanied by various autonomic activity changes and unpleasant sensations. It is unknown whether these effects are specific to Vojta Therapy. Therefore, the aim of this study was to compare changes in cardiac autonomic control after Vojta reflex locomotion stimulation and after an appropriate sham stimulation. A total of 28 young healthy adults (20.4 - 25.7 years) were enrolled in this single-blind randomized cross-over study. Participants underwent two modes of 20-minute sustained manual pressure stimulation on the surface of the foot on two separate visits. One mode used manual pressure on the lateral heel, i.e., in a zone employed in the Vojta Therapy (active stimulation). The other mode used pressure on the lateral ankle (control), in an area not included among the active zones used by Vojta Therapy and whose activation does not evoke manifestations of reflex locomotion. Autonomic nervous system activity was evaluated using spectral analysis of heart rate variability before and after the intervention. The active stimulation was perceived as more unpleasant than the control stimulation. Heart rate variability parameters demonstrated almost identical autonomic responses after both stimulation types, showing either modest increase in parasympathetic activity, or increased heart rate variability with similar contribution of parasympathetic and sympathetic activity. The results demonstrate changes of cardiac autonomic control in both active and control stimulation, without evidence for a significant difference between the two.

Hybrid LES/RANS Simulation of the Effects of Boundary Layer Control Devices Using Immersed Boundary Methods

DTIC Science & Technology

2010-02-22

any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a... its use in simulating the effects of different types of flow control devices: micro vortex generators, bleed-hole arrays, aero- elastically...large scale, and that local pressure differences can lead to periodic blowing / suction even in “active” control devices [5], it appears that

Transient Simulation of Pressure Oscillations in the Fuel Feedline of the Fastrac Engine Thrust Chamber

NASA Technical Reports Server (NTRS)

Bullard, Brad

1998-01-01

During mainstage testing of the 60,000 lbf thrust Fastrac thrust chamber at MSFC's Test Stand 116 (TS 116), sustained, large amplitude oscillations near 530 Hz were observed in the pressure data. These oscillations were detected both in the RP-1 feedline, downstream of the cavitating venturi, and in the combustion chamber. The driver of the instability is believed to be feedline excitation driven by either periodic cavity collapse at the exit of the cavitating venturi or combustion instability. In covitating venturi, static pressure drops as the flow passes through a constriction resembling a converging-diverging nozzle until the vapor pressure is reached. At the venturi throat, the flow is essentially choked, which is why these devices are typically used for mass flow rate control and disturbance isolation. Typically, a total pressure drop of 15% or more across the venturi is required for cavitation. For much larger pressure differentials, unstable cavities can form and subsequently collapse downstream of the throat. Although the disturbances generated by cavitating venturis is generally considered to be broad-band, this type of phenomena could generate periodic behavior capable of exciting the feedline. An excitation brought about by combustion instability would result from the coupling of a combustion chamber acoustic mode and a feedline resonance frequency. This type of coupling is referred to as "buzz" and is not uncommon for engines in this thrust range.

Structural State and Elastic Properties of Perovskites in the Earth's Mantle

NASA Astrophysics Data System (ADS)

Ross, N. L.; Angel, R. J.; Zhao, J.

2005-12-01

Recent advances in laboratory-based single-crystal X-ray diffraction techniques for measuring the intensities of diffraction from crystals held in situ at high pressures in the diamond-anvil cell have been used to determine the role of polyhedral compression in the response of 2:4 and 3:3 GdFeO3-type perovskites to high pressure [1]. These new data clearly demonstrate that, contrary to previous belief, the compression of the octahedral sites is significant and that the evolution of the perovskite structure with pressure is controlled by a new principle; that of equipartition of bond-valence strain across the structure [2]. This new paradigm, together with the minimal information available from high- pressure powder diffraction studies, may provide the possibility of predicting the structural state and elastic properties of perovskites of any composition at mantle pressures and temperatures. Cation partioning between silicate perovskites and other phases should then be predictable through the application of a Brice-style model [3]. The geochemical implications of this type of analysis will be presented as well as the possibility for extending these measurements to higher pressures. References [1] e.g. Zhao, Ross & Angel (2004) Phys Chem Miner. 31: 299; Ross, Zhao,. & Angel (2004). J. Solid State Chemistry 177:1276. [2] Zhao, Ross, & Angel (2004). Acta Cryst. B60:263 [3] e.g Walter et al. (2004) Geochim Cosmochim Acta 68:4267; Blundy & Wood (1994) Nature 372:452

The effect of nitric oxide releasing cream on healing pressure ulcers

PubMed Central

Saidkhani, Vahid; Asadizaker, Marziyeh; Khodayar, Mohammad Javad; Latifi, Sayed Mahmoud

2016-01-01

Background: Pressure ulcer is one of the main concerns of nurses in medical centers around the world, which, if untreated, causes irreparable problems for patients. In recent years, nitric oxide (NO) has been proposed as an effective method for wound healing. This study was conducted to determine the effect of nitric oxide on pressure ulcer healing. Materials and Methods: In this clinical trial, 58 patients with pressure ulcer at hospitals affiliated to Ahvaz Jundishapur University of Medical Sciences were homogenized and later divided randomly into two groups of treatment (nitric oxide cream; n = 29) and control (placebo cream; n = 29). In this research, the data collection tool was the Pressure Ulcer Scale for Healing (PUSH). At the outset of the study (before using the cream), the patients' ulcers were examined weekly in terms of size, amount of exudates, and tissue type using the PUSH tool for 3 weeks. By integrating these three factors, wound healing was determined. Data were analyzed using SPSS. Results: Although no significant difference was found in terms of the mean of score size, the amount of exudates, and the tissue type between the two groups, the mean of total score (healing) between the two groups was statistically significant (P = 0.04). Conclusions: Nitric oxide cream seems to accelerate wound healing. Therefore, considering its easy availability and cost-effectiveness, it can be used for treating pressure ulcers in the future. PMID:27186212

Sex- and age-related differences in the chronic pressure-natriuresis relationship: role of the angiotensin type 2 receptor.

PubMed

Mirabito, Katrina M; Hilliard, Lucinda M; Kett, Michelle M; Brown, Russell D; Booth, Sean C; Widdop, Robert E; Moritz, Karen M; Evans, Roger G; Denton, Kate M

2014-10-15

Sex hormones regulate the renin-angiotensin system. For example, estrogen enhances expression of the angiotensin type 2 receptor. We hypothesized that activation of the angiotensin type 2 receptor shifts the chronic pressure-natriuresis relationship leftward in females compared with males and that this effect is lost with age. Mean arterial pressure was measured by radiotelemetry in adult (4 mo old) and aged (14 mo old) wild-type and angiotensin type 2 receptor knockout male and female mice. Chronic pressure-natriuresis curves were constructed while mice were maintained on a normal-salt (0.26%) diet and following 6 days of high salt (5.0%) diet. Mean arterial pressure was lower in adult wild-type females than males (88 ± 1 and 97 ± 1 mmHg, respectively), a difference that was maintained with age, but was absent in adult knockout mice. In wild-type females, the chronic pressure-natriuresis relationship was shifted leftward compared with knockout females, an effect that was lost with age. In males, the chronic pressure-natriuresis relationship was not influenced by angiotensin type 2 receptor deficiency. Compared with age-matched females, the chronic pressure-natriuresis relationships in male mice were shifted rightward. Renal expression of the angiotensin type 2 receptor was fourfold greater in adult wild-type females than males. With age, the angiotensin type 2 receptor-to-angiotensin type 1 receptor balance was reduced in females. Conversely, in males, angiotensin receptor expression did not vary significantly with age. In conclusion, the angiotensin type 2 receptor modulates the chronic pressure-natriuresis relationship in an age- and sex-dependent manner. Copyright © 2014 the American Physiological Society.

Pressure-induced metal-insulator transitions in chalcogenide NiS2-xSex

NASA Astrophysics Data System (ADS)

Hussain, Tayyaba; Oh, Myeong-jun; Nauman, Muhammad; Jo, Younjung; Han, Garam; Kim, Changyoung; Kang, Woun

2018-05-01

We report the temperature-dependent resistivity ρ(T) of chalcogenide NiS2-xSex (x = 0.1) using hydrostatic pressure as a control parameter in the temperature range of 4-300 K. The insulating behavior of ρ(T) survives at low temperatures in the pressure regime below 7.5 kbar, whereas a clear insulator-to-metallic transition is observed above 7.5 kbar. Two types of magnetic transitions, from the paramagnetic (PM) to the antiferromagnetic (AFM) state and from the AFM state to the weak ferromagnetic (WF) state, were evaluated and confirmed by magnetization measurement. According to the temperature-pressure phase diagram, the WF phase survives up to 7.5 kbar, and the transition temperature of the WF transition decreases as the pressure increases, whereas the metal-insulator transition temperature increases up to 9.4 kbar. We analyzed the metallic behavior and proposed Fermi-liquid behavior of NiS1.9Se0.1.

Electroosmotically Driven Liquid Flows in Complex Micro-Geometries

NASA Astrophysics Data System (ADS)

Dutta, Prashanta; Warburton, Timothy C.; Beskok, Ali

1999-11-01

Electroosmotically driven flows in micro-channels are analyzed analytically and numerically by using a high-order h/p type spectral element simulation suite, Nektar. The high-resolution characteristic of the spectral element method enables us to resolve the sharp electric double layers with successive p-type mesh refinements. For electric double layers that are much smaller than the channel height, the Helmholtz Smoluchowski velocity is used to develop semi-analytical relations for the velocity and the pressure distributions in micro channels. Analytical relations for wall shear stress and pressure distributions are also obtained. These relations show amplification of the normal and shear stresses on the micro-channel walls. Finally, flow through a step-channel is analyzed to document the interaction of the electroosmotic forces with the adverse pressure gradients. Depending on the direction and the magnitude of the electroosmotic force, enhancement or elimination of the separation bubble is observed. These findings can be used to develop innovative strategies for flow control with no moving components and for promotion of mixing in micro-scale geometries.

Thermal conductance of metal–diamond interfaces at high pressure

DOE PAGES

Hohensee, Gregory T.; Wilson, R. B.; Cahill, David G.

2015-03-06

The thermal conductance of interfaces between metals and diamond, which has a comparatively high Debye temperature, is often greater than can be accounted for by two phonon-processes. The high pressures achievable in a diamond anvil cell can significantly extend the metal phonon density of states to higher frequencies, and can also suppress extrinsic effects by greatly stiffening interface bonding. Here we report time-domain thermoreflectance measurements of metal-diamond interface thermal conductance up to 50 GPa in the DAC for Pb, Au 0.95Pd 0.05, Pt, and Al films deposited on Type 1A natural [100] and Type 2A synthetic [110] diamond anvils. Inmore » all cases, the thermal conductances increase weakly or saturate to similar values at high pressure. Lastly, our results suggest that anharmonic conductance at metal-diamond interfaces is controlled by partial transmission processes, where a diamond phonon that inelastically scatters at the interface absorbs or emits a metal phonon.« less

Impacts of sodium-glucose co-transporter type 2 inhibitors on central blood pressure.

PubMed

Takenaka, Tsuneo; Ohno, Yoichi; Suzuki, Hiromichi

2018-03-01

To assess the effects of sodium-glucose co-transporter type 2 inhibitors on central blood pressure, an important determinant of cardiovascular events. Canagliflozin, Empagliflozin or Luseogliflozin was given for 102 type 2 diabetic patients with hypertension and nephropathy. Central blood pressure was evaluated by radial tonometry. Clinical parameters were followed for 6 months. Three differing sodium-glucose co-transporter type 2 inhibitors similarly reduced brachial and central blood pressures, casual blood sugar, haemoglobin A1c, estimated glomerular filtration rate and albuminuria without significant changes in pulse rate and lipid profiles. Central systolic blood pressure was associated with the decreases in albuminuria by sodium-glucose co-transporter type 2 inhibitors. Comparable influences of various sodium-glucose co-transporter type 2 inhibitors on central blood pressure suggest class effects.

CONSENSUS STATEMENT BY THE AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY ON THE COMPREHENSIVE TYPE 2 DIABETES MANAGEMENT ALGORITHM - 2017 EXECUTIVE SUMMARY.

PubMed

Garber, Alan J; Abrahamson, Martin J; Barzilay, Joshua I; Blonde, Lawrence; Bloomgarden, Zachary T; Bush, Michael A; Dagogo-Jack, Samuel; DeFronzo, Ralph A; Einhorn, Daniel; Fonseca, Vivian A; Garber, Jeffrey R; Garvey, W Timothy; Grunberger, George; Handelsman, Yehuda; Hirsch, Irl B; Jellinger, Paul S; McGill, Janet B; Mechanick, Jeffrey I; Rosenblit, Paul D; Umpierrez, Guillermo E

2017-02-01

A1C = hemoglobin A1C AACE = American Association of Clinical Endocrinologists ACCORD = Action to Control Cardiovascular Risk in Diabetes ACCORD BP = Action to Control Cardiovascular Risk in Diabetes Blood Pressure ACEI = angiotensin-converting enzyme inhibitor ADVANCE = Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation AGI = alpha-glucosidase inhibitor apo B = apolipoprotein B ASCVD = atherosclerotic cardiovascular disease BAS = bile acid sequestrant BMI = body mass index BP = blood pressure CHD = coronary heart disease CKD = chronic kidney disease CVD = cardiovascular disease DASH = Dietary Approaches to Stop Hypertension DPP-4 = dipeptidyl peptidase 4 eGFR = estimated glomerular filtration rate FDA = Food and Drug Administration GLP-1 = glucagon-like peptide 1 HDL-C = high-density lipoprotein cholesterol IMPROVE-IT = Improved Reduction of Outcomes: Vytorin Efficacy International Trial LDL-C = low-density lipoprotein cholesterol LDL-P = low-density lipoprotein particle Look AHEAD = Look Action for Health in Diabetes NPH = neutral protamine Hagedorn OSA = obstructive sleep apnea SFU = sulfonylurea SGLT-2 = sodium glucose cotransporter-2 SMBG = self-monitoring of blood glucose T2D = type 2 diabetes TZD = thiazolidinedione VADT = Veterans Affairs Diabetes Trial.

Development of a smart type motor operated valve for nuclear power plants

NASA Astrophysics Data System (ADS)

Kim, Chang-Hwoi; Park, Joo-Hyun; Lee, Dong-young; Koo, In-Soo

2005-12-01

In this paper, the design concept of the smart type motor operator valve for nuclear power plant was described. The development objective of the smart valve is to achieve superior accuracy, long-term reliability, and ease of use. In this reasons, developed smart valve has fieldbus communication such as deviceNet and Profibus-DP, auto-tuning PID controller, self-diagnostics, and on-line calibration capabilities. And also, to achieve pressure, temperature, and flow control with internal PID controller, the pressure sensor and transmitter were included in this valve. And, temperature and flow signal acquisition port was prepared. The developed smart valve will be performed equipment qualification test such as environment, EMI/EMC, and vibration in Korea Test Lab. And, the valve performance is tested in a test loop which is located in Seoul National University Lab. To apply nuclear power plant, the software is being developed according to software life cycle. The developed software is verified by independent software V and V team. It is expected that the smart valve can be applied to an existing NPPs for replacing or to a new nuclear power plants. The design and fabrication of smart valve is now being processed.

The Alteration of the Epidermal Basement Membrane Complex of Human Nevus Tissue and Keratinocyte Attachment after High Hydrostatic Pressurization.

PubMed

Morimoto, Naoki; Jinno, Chizuru; Mahara, Atsushi; Sakamoto, Michiharu; Kakudo, Natsuko; Inoie, Masukazu; Fujisato, Toshia; Suzuki, Shigehiko; Kusumoto, Kenji; Yamaoka, Tetsuji

2016-01-01

We previously reported that human nevus tissue was inactivated after high hydrostatic pressure (HHP) higher than 200 MPa and that human cultured epidermis (hCE) engrafted on the pressurized nevus at 200 MPa but not at 1000 MPa. In this study, we explore the changes to the epidermal basement membrane in detail and elucidate the cause of the difference in hCE engraftment. Nevus specimens of 8 mm in diameter were divided into five groups (control and 100, 200, 500, and 1000 MPa). Immediately after HHP, immunohistochemical staining was performed to detect the presence of laminin-332 and type VII collagen, and the specimens were observed by transmission electron microscopy (TEM). hCE was placed on the pressurized nevus specimens in the 200, 500, and 1000 MPa groups and implanted into the subcutis of nude mice; the specimens were harvested at 14 days after implantation. Then, human keratinocytes were seeded on the pressurized nevus and the attachment was evaluated. The immunohistochemical staining results revealed that the control and 100 MPa, 200 MPa, and 500 MPa groups were positive for type VII collagen and laminin-332 immediately after HHP. TEM showed that, in all of the groups, the lamina densa existed; however, anchoring fibrils were not clearly observed in the 500 or 1000 MPa groups. Although the hCE took in the 200 and 500 MPa groups, keratinocyte attachment was only confirmed in the 200 MPa group. This result indicates that HHP at 200 MPa is preferable for inactivating nevus tissue to allow its reuse for skin reconstruction in the clinical setting.

Barefoot Plantar Pressure Indicates Progressive Neurological Damage in Patients with Human T-Cell Lymphotropic Virus Type 1 Infection.

PubMed

Vasconcelos, Beatriz Helena B; Souza, Givago S; Barroso, Tatiana G C P; Silveira, Luiz Carlos L; Sousa, Rita Catarina M; Callegari, Bianca; Xavier, Marília B

2016-01-01

The human T-Cell Lymphotropic Virus Type 1 (HTLV-1) is a retrovirus associated with neurological alterations; individuals with HTLV-1 infection may develop HTLV-1 associated myelopathy / tropical spastic paraparesis (HAM/TSP). Frequent neurological complaints include foot numbness and leg weakness. In this study, we compared the distribution of the body weight on different areas of the foot in HTLV-1 patients with HAM/TSP, asymptomatic HTLV-1 patients, and healthy individuals. We studied 36 HTLV-1 infected patients, who were divided in two groups of 18 patients each based on whether or not they had been diagnosed with HAM/TSP, and 17 control subjects. The evaluation included an interview on the patient's clinical history and examinations of the patient's reflexes, foot skin tactile sensitivity, and risk of falling. The pressure distribution on different areas of the foot was measured with baropodometry, using a pressure platform, while the patients had their eyes open or closed. The prevalence of neurological disturbances-altered reflexes and skin tactile sensitivity and increased risk of falling-was higher in HTLV-1 HAM/TSP patients than in HTLV-1 asymptomatic patients. The medium and maximum pressure values were higher in the forefoot than in the midfoot and hindfoot in both HTLV-1 groups. In addition, the pressure on the hindfoot was lower in HAM/TSP patients compared to control subjects. The neurological disturbances associated with HTLV-1 infection gradually worsened from HTLV-1 asymptomatic patients to HAM/TSP patients. Baropodometry is a valuable tool to establish the extent of neurological damage in patients suffering from HTLV-1 infection.

The effects of time pressure on chess skill: an investigation into fast and slow processes underlying expert performance.

PubMed

van Harreveld, Frenk; Wagenmakers, Eric-Jan; van der Maas, Han L J

2007-09-01

The ability to play chess is generally assumed to depend on two types of processes: slow processes such as search, and fast processes such as pattern recognition. It has been argued that an increase in time pressure during a game selectively hinders the ability to engage in slow processes. Here we study the effect of time pressure on expert chess performance in order to test the hypothesis that compared to weak players, strong players depend relatively heavily on fast processes. In the first study we examine the performance of players of various strengths at an online chess server, for games played under different time controls. In a second study we examine the effect of time controls on performance in world championship matches. Both studies consistently show that skill differences between players become less predictive of the game outcome as the time controls are tightened. This result indicates that slow processes are at least as important for strong players as they are for weak players. Our findings pose a challenge for current theorizing in the field of expertise and chess.

Antioxidative and antihypertensive effects of Welsh onion on rats fed with a high-fat high-sucrose diet.

PubMed

Yamamoto, Yukiko; Aoyama, Sakiko; Hamaguchi, Noriko; Rhi, Gyou-Sei

2005-07-01

The effects of Welsh onion on the development of hypertension and autoxidation were studied in 6-week-old male Sprague-Dawley rats. The rats were fed with a control diet or a high-fat high-sucrose (HFS) diet with or without 5% Welsh onion (green-leafy type or white-sheath type) for 4 weeks. The systolic blood pressure was elevated and the thiobarbituric acid reactive substances (TBARS) in plasma were increased in the rats fed with the HFS diet without Welsh onion. The rats fed with the HFS diet containing Welsh onion, especially the green-leafy type, had lower blood pressure. They also had a higher level of nitric oxide (NO) metabolites in both the urine and plasma, lower activity of NADH/NADPH oxidase in the aorta, and suppressed angiotensin II production. The effect of white Welsh onion on decreasing the blood pressure was not significant, although the effects on increasing NO metabolites in the urine and decreasing NADH oxidase activity in the aorta were significant. The TBARS value in the plasma was lowered in the rats fed with either green or white Welsh onion, but the in vitro radical scavenging and ferric reducing antioxidative activities were much higher with green Welsh onion than with the white type. These results suggest that the green-leafy Welsh onion, but not the white type, reduced superoxide generation by suppressing the angiotensine II production and then the NADH/NADPH oxidase activity, increasing the NO availability in the aorta, and consequently lowering the blood pressure in the rats fed with the HFS diet. The radical scavenging and reducing antioxidative activities of green Welsh onion may also be effective in decreasing superoxide.

HUMAN GRK4γ142V VARIANT PROMOTES AT1R-MEDIATED HYPERTENSION VIA RENAL HDAC1 INHIBITION

PubMed Central

Wang, Zheng; Zeng, Chunyu; Villar, Van Anthony M.; Chen, Shi-You; Konkalmatt, Prasad; Wang, Xiaoyan; Asico, Laureano D.; Jones, John E.; Yang, Yu; Sanada, Hironobu; Felder, Robin A.; Eisner, Gilbert M.; Weir, Matthew R.; Armando, Ines; Jose, Pedro A.

2015-01-01

The influence of a single gene on the etiology of essential hypertension may be difficult to ascertain, unless the gene interacts with other genes that are germane to blood pressure regulation. G protein-coupled receptor kinase type 4 (GRK4) is one such gene. We have reported that the expression of its variant hGRK4γ142V in mice results in hypertension due to impaired dopamine D1 receptor (D1R). Signaling through D1R and angiotensin II type I receptor (AT1R) reciprocally modulates renal sodium excretion and blood pressure. Here, we demonstrate the ability of the hGRK4γ142V to increase the expression and activity of the AT1R. We show that hGRK4γ142V phosphorylates histone deacetylase type 1 and promotes its nuclear export to the cytoplasm, resulting in increased AT1R expression and greater pressor response to angiotensin II. AT1R blockade and the deletion of the Agtr1a gene normalize the hypertension in hGRK4γ142V mice. These findings illustrate the unique role of GRK4 by targeting receptors with opposite physiological activity for the same goal of maintaining blood pressure homeostasis, and thus making the GRK4 a relevant therapeutic target to control blood pressure. PMID:26667412

Evaluating selection and efficacy of pressure-relieving equipment.

PubMed

Chaloner, Donna; Stevens, Jenny

2003-06-01

The drive towards evidence-based practice has highlighted the lack of randomized controlled trials that compare interventions such as pressure-relieving medical devices. This may influence practitioners, particularly purchasing practitioners, to consider other types of evidence when appraising literature to determine clinical practice and support recommendations and local guidelines. This article will illustrate the development of an audit tool used to evaluate nurses' knowledge and skills in patient assessment, selection and installation of appropriate pressure-relieving equipment. The tool also assists in assessing clinical effectiveness and user satisfaction of equipment. This article focuses on a small audit of the Karomed Ltd Transair 1500 (also known as the 3-Comm) mattress replacement system.

Effects of different computer typing speeds on acceleration and peak contact pressure of the fingertips during computer typing.

PubMed

Yoo, Won-Gyu

2015-01-01

[Purpose] This study showed the effects of different computer typing speeds on acceleration and peak contact pressure of the fingertips during computer typing. [Subjects] Twenty-one male computer workers voluntarily consented to participate in this study. They consisted of 7 workers who could type 200-300 characteristics/minute, 7 workers who could type 300-400 characteristics/minute, and 7 workers who could type 400-500 chracteristics/minute. [Methods] This study was used to measure the acceleration and peak contact pressure of the fingertips for different typing speed groups using an accelerometer and CONFORMat system. [Results] The fingertip contact pressure was increased in the high typing speed group compared with the low and medium typing speed groups. The fingertip acceleration was increased in the high typing speed group compared with the low and medium typing speed groups. [Conclusion] The results of the present study indicate that a fast typing speed cause continuous pressure stress to be applied to the fingers, thereby creating pain in the fingers.

49 CFR 571.122 - Standard No. 122; Motorcycle brake systems.

Code of Federal Regulations, 2012 CFR

2012-10-01

... mile before any brake application. Skid number means the frictional resistance of a pavement measured... control designed so that a leakage-type failure of a pressure component in a single subsystem (except... pounds). S5.8Service brake system design durability. Each motorcycle shall be capable of completing all...

21 CFR 876.1620 - Urodynamics measurement system.

Code of Federal Regulations, 2011 CFR

2011-04-01

... and pressure in the urinary bladder when it is filled through a catheter with carbon dioxide or water. The device controls the supply of carbon dioxide or water and may also record the electrical activity... electromyography. This generic type of device includes the cystometric gas (carbon dioxide) device, the cystometric...

Understanding the Quality Chasm for Hypertension Control in Diabetes: A Structured Review of “Co-maneuvers” Used in Clinical Trials

PubMed Central

Naik, Aanand D.; Issac, Tim T.; Street, Richard L.; Kunik, Mark E.

2010-01-01

Background Observational studies routinely describe a significant gap between rates of blood pressure control in routine diabetes care compared with those achieved in randomized controlled trials (RCTs). Methods We performed a systematic review of the literature to identify co-maneuvers used in RCTs, defined as ancillary activities or agents administered before, during, or immediately after the main agent under investigation (ie, principal maneuver), but not effectively translated to routine diabetes care. We searched multiple databases for RCTs evaluating the efficacy of treatments for hypertension control in adults with type 2 diabetes mellitus. We considered only phase III human studies of interventions that achieved blood pressure control and scrutinized all elements related to the implementation of the principal maneuver in each candidate study. These elements were then sorted into a taxonomy of co-maneuvers. Results Nearly all eligible RCTs used highly consistent groups of co-maneuvers. These typically began with (1) the use of consensual and clearly stated blood pressure goals; (2) frequent visits in which blood pressure levels were measured and compared with predefined goals; and, if the goal was not attained, (3) modifications to the treatment based on a detailed action plan that included communication of adverse events. Patient education, feedback to clinicians, and interventions for medication adherence were not commonly used among eligible trials. Conclusions Clinicians should translate key behavioral co-maneuvers along with clinically proven treatments for hypertension control in diabetes. These co-maneuvers are conceptually similar to collaborative goal setting and action planning interventions used in innovative chronic care programs. PMID:17823464

Filament-reinforced metal composite pressure vessel evaluation and performance demonstration

NASA Technical Reports Server (NTRS)

Landes, R. E.

1976-01-01

Two different Kevlar-49 filament-reinforced metal sphere designs were developed, and six vessels of each type were fabricated and subjected to fatigue cycling, sustained loading, and hydrostatic burst. The 61 cm (24 inch) diameter Kevlar-49/cryoformed 301 stainless steel pressure vessels demonstrated the required pressure cycle capability, burst factor of safety, and a maximum pressure times volume divided by weight (pV/W) performance of 210 J/g (834 000 in-lb/lbm) at burst; this represented a 25 to 30% weight saving over the lightest weight comparable, 6A1-4V Ti, homogeneous pressure vessel. Both the Kevlar/stainless steel design and the 97 cm (38 inch) diameter Kevlar-49/2219-T62 aluminum sphere design demonstrated nonfragmentation and controlled failure mode features when pressure cycled to failure at operating pressure. When failure occurred during pressure cycling, the mode was localized leakage and not catastrophic. Kevlar/stainless steel vessels utilized a unique conical boss design, and Kevlar/aluminum vessels incorporated a tie-rod to carry port loads; both styles of polar fittings performed as designed during operational testing of the vessels.

Relationships of the systolic blood pressure response during exercise with insulin resistance, obesity, and endurance fitness in men with type 2 diabetes mellitus.

PubMed

Kumagai, S; Kai, Y; Hanada, H; Uezono, K; Sasaki, H

2002-10-01

The purpose of the present study was to investigate the relationships among the resting systolic (SBP) and diastolic blood pressure (DBP) or SBP response during exercise with insulin resistance evaluated by a homeostasis model (HOMA-IR), abdominal fat accumulation (visceral fat area [VFA], subcutaneous fat area [SFA]) by computed tomography (CT), and an estimation of the maximal oxygen uptake (V*O2max) in 63 Japanese middle-aged male patients with type 2 diabetes mellitus (type 2 DM). Body mass index (BMI) and waist-to-hip ratio (WHR) in type 2 DM subjects were significantly higher than in age-matched healthy male control subjects (n = 135) with normal glucose tolerance. Resting SBP (127.7 +/- 16.2 mm Hg v 119.4 +/- 13.0 mm Hg) and DBP (82.2 +/- 11.9mmHg v 76.8 +/- 9.4 mm Hg) levels, and the percentage of hypertension (20.6% v 1.5%) in type 2 DM subjects were significantly higher than in the control subjects (P <.05). According to a multiple regression analysis for resting blood pressure in type 2 DM, VFA was found to be an independent predictor of SBP, while V*O2max and HOMA-IR were independent predictors of DBP. In the controls, however, HOMA-IR was not found to be a significantly independent predictor for either resting SBP or resting DBP. Measurement of the SBP response during graded exercise using a ramp test was performed by an electrical braked cycle ergometer in 54 patients with type 2 DM only. The SBP was measured at 15-second intervals during exercise. The exercise intensity at the double product breaking point (DPBP), which strongly correlated with the exercise intensity at the lactate threshold, was used as an index for the SBP response to standardized exercise intensity. The SBP corresponding to exercise intensity at DPBP (SBP@DPBP) was evaluated as an index of the SBP response to standardized exercise intensity. The change in SBP (deltaSBP = SBP@DPBP - resting SBP) was significantly and positively associated with log area under the curve for glucose (log AUCPG) during a 75-g oral glucose tolerance test (OGTT). In addition, deltaSBP significantly and negatively correlated with the log area under the curve for insulin (log AUCIRI) and log AUCIRI/log AUCPG. Based on these results, insulin resistance was suggested to be independently associated with the resting DBP and SBP response to standardized exercise intensity in type 2 DM patients. Copyright 2002, Elsevier Science (USA). All rights reserved.

Source-receptor relationships for PM2.5 during typical pollution episodes in the Pearl River Delta city cluster, China.

PubMed

Liu, Yiming; Hong, Yingying; Fan, Qi; Wang, Xuemei; Chan, Pakwai; Chen, Xiaoyang; Lai, Anqi; Wang, Mingjie; Chen, Xunlai

2017-10-15

Located in the Southern China monsoon region, pollution days in Pearl River Delta (PRD) were classified into "Western type", "Central type" or "Eastern type", with a relative percentage of 67%, 24% and 9%, respectively. Using this classification system, three typical pollution events were selected for numerical simulations using the WRF-Chem model. The source sensitivity method for anthropogenic emissions of PM 2.5 and its precursors was applied to identify the source-receptor relationships for PM 2.5 among 9 cities in PRD. For "Western type" case, the PRD region was under control of a high-pressure system with easterly prevailing winds. The PM 2.5 concentrations in the western PRD region were higher than those in the eastern region, with emissions from cities in the eastern PRD region having higher contributions. Within the PRD's urban cluster, PM 2.5 in Huizhou, Dongguan and Shenzhen was mainly derived from local emissions, whereas the PM 2.5 in the other cities was primarily derived from external transport. For "Eastern type" case, the PRD was influenced by Typhoon Soulik with westerly prevailing winds. Emissions from cities in the western PRD region had the highest impacts on the overall PM 2.5 concentration. PM 2.5 in Jiangmen and Foshan was primarily derived from local emissions. Regarding "Central type" case, the PRD region was under control of a uniform pressure field with low wind speed. PM 2.5 concentrations of each city were primarily caused by local emissions. Overall, wind flows played a significant role in the transport and spatial distribution of PM 2.5 across the PRD region. Ideally, local governments would be wise to establish joint prevention and control measures to reduce regional atmospheric pollution, especially for "Western type" pollution. Copyright © 2017 Elsevier B.V. All rights reserved.

Optimal type 2 diabetes mellitus management: the randomised controlled OPTIMISE benchmarking study: baseline results from six European countries.

PubMed

Hermans, Michel P; Brotons, Carlos; Elisaf, Moses; Michel, Georges; Muls, Erik; Nobels, Frank

2013-12-01

Micro- and macrovascular complications of type 2 diabetes have an adverse impact on survival, quality of life and healthcare costs. The OPTIMISE (OPtimal Type 2 dIabetes Management Including benchmarking and Standard trEatment) trial comparing physicians' individual performances with a peer group evaluates the hypothesis that benchmarking, using assessments of change in three critical quality indicators of vascular risk: glycated haemoglobin (HbA1c), low-density lipoprotein-cholesterol (LDL-C) and systolic blood pressure (SBP), may improve quality of care in type 2 diabetes in the primary care setting. This was a randomised, controlled study of 3980 patients with type 2 diabetes. Six European countries participated in the OPTIMISE study (NCT00681850). Quality of care was assessed by the percentage of patients achieving pre-set targets for the three critical quality indicators over 12 months. Physicians were randomly assigned to receive either benchmarked or non-benchmarked feedback. All physicians received feedback on six of their patients' modifiable outcome indicators (HbA1c, fasting glycaemia, total cholesterol, high-density lipoprotein-cholesterol (HDL-C), LDL-C and triglycerides). Physicians in the benchmarking group additionally received information on levels of control achieved for the three critical quality indicators compared with colleagues. At baseline, the percentage of evaluable patients (N = 3980) achieving pre-set targets was 51.2% (HbA1c; n = 2028/3964); 34.9% (LDL-C; n = 1350/3865); 27.3% (systolic blood pressure; n = 911/3337). OPTIMISE confirms that target achievement in the primary care setting is suboptimal for all three critical quality indicators. This represents an unmet but modifiable need to revisit the mechanisms and management of improving care in type 2 diabetes. OPTIMISE will help to assess whether benchmarking is a useful clinical tool for improving outcomes in type 2 diabetes.

Intensive Versus Standard Blood Pressure Control in SPRINT-Eligible Participants of ACCORD-BP.

PubMed

Buckley, Leo F; Dixon, Dave L; Wohlford, George F; Wijesinghe, Dayanjan S; Baker, William L; Van Tassell, Benjamin W

2017-12-01

We sought to determine the effect of intensive blood pressure (BP) control on cardiovascular outcomes in participants with type 2 diabetes mellitus (T2DM) and additional risk factors for cardiovascular disease (CVD). This study was a post hoc, multivariate, subgroup analysis of ACCORD-BP (Action to Control Cardiovascular Risk in Diabetes Blood Pressure) participants. Participants were eligible for the analysis if they were in the standard glucose control arm of ACCORD-BP and also had the additional CVD risk factors required for SPRINT (Systolic Blood Pressure Intervention Trial) eligibility. We used a Cox proportional hazards regression model to compare the effect of intensive versus standard BP control on CVD outcomes. The "SPRINT-eligible" ACCORD-BP participants were pooled with SPRINT participants to determine whether the effects of intensive BP control interacted with T2DM. The mean baseline Framingham 10-year CVD risk scores were 14.5% and 14.8%, respectively, in the intensive and standard BP control groups. The mean achieved systolic BP values were 120 and 134 mmHg in the intensive and standard BP control groups ( P < 0.001). Intensive BP control reduced the composite of CVD death, nonfatal myocardial infarction (MI), nonfatal stroke, any revascularization, and heart failure (hazard ratio 0.79; 95% CI 0.65-0.96; P = 0.02). Intensive BP control also reduced CVD death, nonfatal MI, and nonfatal stroke (hazard ratio 0.69; 95% CI 0.51-0.93; P = 0.01). Treatment-related adverse events occurred more frequently in participants receiving intensive BP control (4.1% vs. 2.1%; P = 0.003). The effect of intensive BP control on CVD outcomes did not differ between patients with and without T2DM ( P > 0.62). Intensive BP control reduced CVD outcomes in a cohort of participants with T2DM and additional CVD risk factors. © 2017 by the American Diabetes Association.

Augmented endothelial l-arginine transport ameliorates pressure-overload-induced cardiac hypertrophy.

PubMed

Rajapakse, Niwanthi W; Johnston, Tamara; Kiriazis, Helen; Chin-Dusting, Jaye P; Du, Xiao-Jun; Kaye, David M

2015-07-01

What is the central question of this study? What is the potential role of endothelial NO production via overexpression of the l-arginine transporter, CAT1, as a mitigator of cardiac hypertrophy? What is the main finding and its importance? Augmentation of endothelium-specific l-arginine transport via CAT1 can attenuate pressure-overload-dependent cardiac hypertrophy and fibrosis. Our findings support the conclusion that interventions that improve endothelial l-arginine transport may provide therapeutic utility in the setting of myocardial hypertrophy. Such modifications may be introduced by exercise training or locally delivered gene therapy, but further experimental and clinical studies are required. Endothelial dysfunction has been postulated to play a central role in the development of cardiac hypertrophy, probably as a result of reduced NO bioavailability. We tested the hypothesis that increased endothelial NO production, mediated by increased l-arginine transport, could attenuate pressure-overload-induced cardiac hypertrophy. Echocardiography and blood pressure measurements were performed 15 weeks after transverse aortic constriction (TAC) in wild-type (WT) mice (n = 12) and in mice with endothelium-specific overexpression of the l-arginine transporter, CAT1 (CAT+; n = 12). Transverse aortic constriction induced greater increases in heart weight to body weight ratio in WT (by 47%) than CAT+ mice (by 25%) compared with the respective controls (P ≤ 0.05). Likewise, the increase in left ventricular wall thickness induced by TAC was significantly attenuated in CAT+ mice (P = 0.05). Cardiac collagen type I mRNA expression was greater in WT mice with TAC (by 22%; P = 0.03), but not in CAT+ mice with TAC, compared with the respective controls. Transverse aortic constriction also induced lesser increases in β-myosin heavy chain mRNA expression in CAT+ mice compared with WT (P ≤ 0.05). Left ventricular systolic pressure after TAC was 36 and 39% greater in WT and CAT+ mice, respectively, compared with the respective controls (P ≤ 0.001). Transverse aortic constriction had little effect on left ventricular end-diastolic pressure in both genotypes. Taken together, these data indicate that augmenting endothelial function by overexpression of l-arginine transport can attenuate pressure-overload-induced cardiac hypertrophy. © 2015 The Authors. Experimental Physiology © 2015 The Physiological Society.

Blood pressure as a therapeutic target in stroke.

PubMed

Armario, Pedro; de la Sierra, Alejandro

2009-01-01

Stroke, as a clinical manifestation of the cardiovascular diseases, is one of the leading causes of death and disability in both developed and developing countries. Hypertension is by far, the most important risk factor for stroke. Epidemiological data indicate that the risk of stroke increases with both systolic and diastolic blood pressure elevation, from levels of 115/75 mmHg. It is also evident that most adults worldwide have values above these limits, thus emphasizing the importance of blood pressure as a risk factor for stroke. Clinical trials of antihypertensive treatment, both in studies that have compared active drugs against placebo or in those comparing different types of drugs have clearly demonstrated a protective effect of blood pressure reduction in the prevention of stroke. The degree of protection is directly related to blood pressure reduction and, the lower the level, the better the prognosis. Although data on secondary stroke prevention are scarcer, studies also seem to indicate that lowering blood pressure with antihypertensive treatment protects against stroke recurrence. At the present moment there is still uncertainty on 2 different aspects regarding the relationship between antihypertensive treatment and stroke. First, the blood pressure management during acute stroke has not adequately investigated in clinical trials. Second, the possibility of a protective role of specific types of antihypertensive drugs beyond blood pressure reduction is a matter of debate. Independently of these unresolved issues, prevention of hypertension development by lifestyle changes and adequate treatment and control to the hypertensive population will be a very effective measure in reducing stroke incidence, stroke recurrence, and stroke mortality.

High-Reynolds Number Active Blowing Semi-Span Force Measurement System Development

NASA Technical Reports Server (NTRS)

Lynn, Keith C.; Rhew, Ray D.; Acheson, Michael J.; Jones, Gregory S.; Milholen, William E.; Goodliff, Scott L.

2012-01-01

Recent wind-tunnel tests at the NASA Langley Research Center National Transonic Facility utilized high-pressure bellows to route air to the model for evaluating aircraft circulation control. The introduction of these bellows within the Sidewall Model Support System significantly impacted the performance of the external sidewall mounted semi-span balance. As a result of this impact on the semi-span balance measurement performance, it became apparent that a new capability needed to be built into the National Transonic Facility s infrastructure to allow for performing pressure tare calibrations on the balance in order to properly characterize its performance under the influence of static bellows pressure tare loads and bellows thermal effects. The objective of this study was to design both mechanical calibration hardware and an experimental calibration design that can be employed at the facility in order to efficiently and precisely perform the necessary loadings in order to characterize the semi-span balance under the influence of multiple calibration factors (balance forces/moments and bellows pressure/temperature). Using statistical design of experiments, an experimental design was developed allowing for strategically characterizing the behavior of the semi-span balance for use in circulation control and propulsion-type flow control testing at the National Transonic Facility.

Chemistry experience in the primary heat transport circuits of Kraftwerk Union pressurized water reactors

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

Riess, R.

Chosen for this description of the selected Kraftwerk Union (KWU) pressurized water reactor units were Obrigheim (KWO, 345 MW(e)), Stade (KKS, 662 (MW(e)), Borselle (KCB, 477 MW(e)), and Biblis (KWB-A, 1204 MW(e)). The experience at these plants shows that with a special startup procedure and a proper chemical control of the primary heat transport system that influences general corrosion, selective types of corrosion, corrosion product activity transport and resulting contamination, and radiation-induced decomposition, KWU units have no basic problems.

Assessment of Serum VASPIN Levels among Type 2 Diabetes Mellitus Patients with or without Acute Coronary Syndrome

PubMed Central

Sathyaseelan, Aswathy Jaya; Wyawahare, Mukta; Saya, Rama Prakasha

2016-01-01

Introduction Type 2 Diabetes Mellitus (DM) is on the verge of becoming a pandemic in India. Type 2 DM patient have two to four times increased risk of carotid artery disease. Adipokines have been regarded recently as direct link between diabetes and atherosclerosis. Visceral Adipose Tissue Derived Serine Protease Inhibitor (VASPIN); one of the most recently discovered adipokine, inhibits the proteases responsible for insulin resistance, carotid plaque development and rupture. In literature, few studies have addressed the role of VASPIN in pathogenesis of Acute Coronary Syndrome (ACS) in patients with type 2 DM. Aim To find association between serum VASPIN with lipid profile, creatine kinase-total, creatine kinase-MB, troponin-I, age, height, weight, blood pressure, smoking, family history of ACS and to prove the hypothesis of low serum VASPIN level as predictor of ACS in patients with type 2 DM. Materials and Methods Forty-one type 2 DM patients (controls) and 41 type 2 DM patients with ACS (cases) were enrolled in the study. Anthropometric measurements were performed and fasting serum biochemical parameters and VASPIN were measured. The results of cases and controls were compared by student t-test or Mann–Whitney test. All the parameters were correlated with serum VASPIN by Pearson’s or Spearman’s correlation. Results Fasting serum VASPIN concentration was significantly (p< 0.0001) lower in the cases (0.43±0.22 pg/ml) than in the controls (0.83±0.29 pg/ml). Correlation analysis undertaken on all type 2 DM showed that serum VASPIN concentration was negatively correlated with age, waist circumference, hip circumference, systolic and diastolic blood pressure, duration of diabetes, serum Creative Kinase-Total, CK-MB and urea (p< 0.05). Utilizing Receiver Operating Characteristic (ROC) curve, the serum VASPIN level of less than 0.594pg/ml showed greatest risk of ACS among type 2 DM patients (p< 0.0001). Conclusion Type 2 DM patients with low serum vaspin concentration were at risk of ACS independent of other cardiovascular risk factors. PMID:28208842

Modelling and control of a diffusion/LPCVD furnace

NASA Astrophysics Data System (ADS)

Dewaard, H.; Dekoning, W. L.

1988-12-01

Heat transfer inside a cylindrical resistance diffusion/Low Pressure Chemical Vapor Deposition (LPCVD) furnace is studied with the aim of developing an improved temperature controller. A model of the thermal behavior is derived, which covers the important class of furnaces equipped with semitransparent quartz process tubes. The model takes into account the thermal behavior of the thermocouples. Currently used temperature controllers are shown to be highly inefficient for very large scale integration applications. Based on the model an alternative temperature controller of the LQG (linear quadratic Gaussian) type is proposed which features direct wafer temperature control. Some simulation results are given.

Relationship of Early Spontaneous Type V Blood Pressure Fluctuation after Thrombolysis in Acute Cerebral Infarction Patients and the Prognosis

PubMed Central

Zuo, Lian; Wan, Ting; Xu, Xiahong; Liu, Feifeng; Li, Changsong; Li, Ying; Zhang, Yue; Zhang, Jing; Bao, Huan; Li, Gang

2016-01-01

We examined the relationship between an early spontaneous type V blood pressure fluctuation and the post-thrombolysis prognosis of patients with acute cerebral infarction. Patients were admitted consecutively. All patients were categorized into the type V blood pressure fluctuation group or non-type V blood pressure group. Their blood pressure was monitored before thrombolysis and until 6 h after thrombolysis. Baseline data and clinical outcomes were compared. Of 170 patients, 43 (25.2%) had an early type V blood pressure fluctuation. The National Institute of Health Stroke Scale (NIHSS) score before thrombolysis and 24 h after thrombolysis, and the modified Rankin scale score at 90 days differed significantly between the two groups (P < 0.05). Multiple logistic regression analysis showed that an unfavorable prognosis at 3 months was associated with the NIHSS score before thrombolysis (P = 0.000) but probably not with this blood pressure fluctuation (P = 0.058). An early spontaneous type V blood pressure fluctuation is common in patients with acute cerebral infarction who received venous thrombolysis, especially if they have a higher NIHSS score before thrombolysis. The type V blood pressure fluctuation may not influence patients’ prognosis; however, this needs to be confirmed in future trials. PMID:27278121

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

Jiskoot, R.J.J.

Accurate and reliable sampling systems are imperative when confirming natural gas' commercial value. Buyers and sellers need accurate hydrocarbon-composition information to conduct fair sale transactions. Because of poor sample extraction, preparation or analysis can invalidate the sale, more attention should be directed toward improving representative sampling. Consider all sampling components, i.e., gas types, line pressure and temperature, equipment maintenance and service needs, etc. The paper discusses gas sampling, design considerations (location, probe type, extraction devices, controller, and receivers), operating requirements, and system integration.

Relationships between the risk of cardiovascular disease in type 2 diabetes patients and both visit-to-visit variability and time-to-effect differences in blood pressure.

PubMed

Takao, Toshiko; Kimura, Kumiko; Suka, Machi; Yanagisawa, Hiroyuki; Kikuchi, Masatoshi; Kawazu, Shoji; Matsuyama, Yutaka

2015-07-01

To determine whether visit-to-visit blood pressure (BP) variability can predict cardiovascular disease (CVD) incidence in type 2 diabetes patients independently of mean BP, and to analyze the time-to-effect relationship between BP and CVD risk. We retrospectively enrolled 629 type 2 diabetes patients with no history of CVD who first visited our hospital between 1995 and 1996, made at least one hospital visit per year, were followed-up for at least 1 year, and had undergone four or more BP measurements. The patients were followed until June 2012 at the latest. CVD occurred in 66 patients. Variability in systolic or diastolic BP (SBP and DBP, respectively) was a significant predictor of CVD incidence, independent of mean SBP or DBP. CVD incidence was significantly associated with SBP during the preceding 3-5 years, with the highest risk occurring during the preceding 3 years. Visit-to-visit BP variability independently predicts CVD incidence in type 2 diabetes patients. Increased SBP over the preceding 3-5 years indicated a significant CVD risk. To prevent CVD, BP management should focus on stable and well-timed control. In particular, BP stabilization at an early phase and BP control during late phases are important. Copyright © 2015 Elsevier Inc. All rights reserved.

Cashew Nut Consumption Increases HDL Cholesterol and Reduces Systolic Blood Pressure in Asian Indians with Type 2 Diabetes: A 12-Week Randomized Controlled Trial.

PubMed

Mohan, Viswanathan; Gayathri, Rajagopal; Jaacks, Lindsay M; Lakshmipriya, Nagarajan; Anjana, Ranjit Mohan; Spiegelman, Donna; Jeevan, Raman Ganesh; Balasubramaniam, Kandappa K; Shobana, Shanmugam; Jayanthan, Mathialagan; Gopinath, Viswanathan; Divya, Selvakumar; Kavitha, Vasudevan; Vijayalakshmi, Parthasarathy; Bai R, Mookambika Ramya; Unnikrishnan, Ranjit; Sudha, Vasudevan; Krishnaswamy, Kamala; Salas-Salvadó, Jordi; Willett, Walter C

2018-01-01

There is increasing evidence that nut consumption decreases the risk of cardiovascular disease. However, there are few data on the health effects of cashew nuts among adults with type 2 diabetes (T2DM). The study aimed to investigate the effects of cashew nut supplementation on glycemia, body weight, blood pressure, and lipid profile in Asian Indians with T2DM. In a parallel-arm, randomized controlled trial, 300 adults with T2DM [mean ± SD age: 51 ± 9.3 y; body mass index (BMI; in kg/m2): 26.0 ± 3.4; 55% male] were randomly assigned to receive advice to follow a standard diabetic diet (control) or similar advice plus 30 g cashew nuts/d (intervention) for 12 wk. The macronutrient composition of the prescribed diabetic diet was 60-65% energy from carbohydrates, 15-25% from fat, and the rest from protein. Differences between groups in changes in anthropometric and biochemical variables were analyzed using linear models with robust variance estimation under an assumed independence working correlation. Participants in the intervention group had a greater decrease in systolic blood pressure from baseline to 12 wk than did controls (-4.9 ± 13.7 compared with -1.7 ± 11.6 mm Hg; P = 0.04) and a greater increase in plasma HDL cholesterol compared with controls (+1.7 ± 5.6 compared with +0.1 ± 4.6 mg/dL; P = 0.01). There were no differences between the groups with respect to changes in body weight, BMI, blood lipid, and glycemic variables. Plasma oleic acid concentrations and self-reported dietary intake of nuts, oleic acid, and monounsaturated fatty acids suggested excellent compliance with the nut consumption. Cashew nut supplementation in Asian Indians with T2DM reduced systolic blood pressure and increased HDL cholesterol concentrations with no deleterious effects on body weight, glycemia, or other lipid variables. This study was registered at the clinical trial registry of India as CTRI/2017/07/009022. © 2018 American Society for Nutrition. All rights reserved.

Cyclic tensile strain and cyclic hydrostatic pressure differentially regulate expression of hypertrophic markers in primary chondrocytes.

PubMed

Wong, Marcy; Siegrist, Mark; Goodwin, Kelly

2003-10-01

Endochondral ossification is regulated by many factors, including mechanical stimuli, which can suppress or accelerate chondrocyte maturation. Mathematical models of endochondral ossification have suggested that tension (or shear stress) can accelerate the formation of endochondral bone, while hydrostatic stress preserves the cartilage phenotype. The goal of this study was to test this hypothesis by examining the expression of hypertrophic chondrocyte markers (transcription factor Cbfa1, MMP-13, type X collagen, VEGF, CTGF) and cartilage matrix proteins under cyclic tension and cyclic hydrostatic pressure. Chondrocyte-seeded alginate constructs were exposed to one of the two loading modes for a period of 3 h per day for 3 days. Gene expression was analyzed using real-time RT-PCR. Cyclic tension upregulated the expression of Cbfa1, MMP-13, CTGF, type X collagen and VEGF and downregulated the expression of TIMP-1. Cyclic tension also upregulated the expression of type 2 collagen, COMP and lubricin, but did not change the expression of SOX9 and aggrecan. Cyclic hydrostatic pressure downregulated the expression of MMP-13 and type I collagen and upregulated expression of TIMP-1 compared to the unloaded controls. Hydrostatic pressure may slow chondrocyte differentiation and have a chondroprotective, anti-angiogenic influence on cartilage tissue. Our results suggest that cyclic tension activates the Cbfa1/MMP-13 pathway and increases the expression of terminal differentiation hypertrophic markers. Mammalian chondrocytes appear to have evolved complex mechanoresponsive mechanisms, the effects of which can be observed in the histomorphologic establishment of the cartilaginous skeleton during development and maturation.

The usefulness of carotid sinus massage in different patient groups.

PubMed

Kumar, Narasimhan Pradeep; Thomas, Alan; Mudd, Paul; Morris, Robert O; Masud, Tahir

2003-11-01

to determine the positive yield of carotid sinus massage in different patient groups: unexplained syncope, falls, dizziness and controls. observational study. teaching hospital. we studied consecutive patients over the age of 60 years referred to the 'falls clinic' with a history of unexplained syncope, unexplained falls and unexplained dizziness. We also studied asymptomatic control subjects recruited from a general practice register aged 60 years and over. All patients and control subjects underwent a full clinical assessment (comprehensive history and detailed clinical examination including supine and erect blood pressure measurements) and 12-lead electrocardiography. We performed carotid sinus massage in the supine position for 5 seconds separately on both sides followed by repeating the procedure in the upright positions using a motorised tilt table. Heart rate and blood pressure were recorded using a cardiac monitor and digital plethysmography respectively. The test was considered positive if carotid sinus massage produced asystole with more than a 3 second pause (cardioinhibitory type of carotid sinus syndrome), or a fall in systolic blood pressure of more than 50 mmHg in the absence of significant cardioinhibition (vasodepressor type of carotid sinus syndrome) or where there was evidence of both vasodepressor and cardio-inhibition as above (mixed type). we studied 44 asymptomatic control subjects and 221 symptomatic patients (130 with unexplained syncope, 41 with unexplained falls and 50 with unexplained dizziness). In the overall symptomatic patient group, the positive yield (any type of carotid sinus syndrome) was 17.6% (95% CI = 12.7-22.5). The positive yield in men (26.3% (95% CI = 16.4-36.2)) was twice that in women (13.1% (95% CI = 7.6-18.6)) (P = 0.014). Overall any type of carotid sinus syndrome was present in 22.3% (n = 29) of the syncope group, 17.1% (n = 7) in the unexplained fallers group and 6% (n = 3) in the dizziness group. We also found that no women with unexplained dizziness had a positive carotid sinus massage test. None of the controls demonstrated a positive response. None of the subjects suffered any complications during or after the test. the positive yield of carotid sinus massage in symptomatic patients was 17.6% with the yield in men being twice that in women. None of the asymptomatic control subjects demonstrated a positive response. The yields in unexplained syncope and unexplained falls patients were around 4-fold and 3-fold higher respectively than in unexplained dizziness patients. The positive yield in women with unexplained dizziness (without a definite history of syncope and falls) is zero. Hence, carotid sinus massage in older adults should particularly be targeted at patients with unexplained syncope and unexplained falls.

Oronasal Masks Require a Higher Pressure than Nasal and Nasal Pillow Masks for the Treatment of Obstructive Sleep Apnea

PubMed Central

Deshpande, Sheetal; Joosten, Simon; Turton, Anthony; Edwards, Bradley A.; Landry, Shane; Mansfield, Darren R.; Hamilton, Garun S.

2016-01-01

Study Objectives: Oronasal masks are frequently used for continuous positive airway pressure (CPAP) treatment in patients with obstructive sleep apnea (OSA). The aim of this study was to (1) determine if CPAP requirements are higher for oronasal masks compared to nasal mask interfaces and (2) assess whether polysomnography and patient characteristics differed among mask preference groups. Methods: Retrospective analysis of all CPAP implementation polysomnograms between July 2013 and June 2014. Prescribed CPAP level, polysomnography results and patient data were compared according to mask type (n = 358). Results: Oronasal masks were used in 46%, nasal masks in 35% and nasal pillow masks in 19%. There was no difference according to mask type for baseline apnea-hypopnea index (AHI), body mass index (BMI), waist or neck circumference. CPAP level was higher for oronasal masks, 12 (10–15.5) cm H2O compared to nasal pillow masks, 11 (8–12.5) cm H2O and nasal masks, 10 (8–12) cm H2O, p < 0.0001 (Median [interquartile range]). Oronasal mask type, AHI, age, and BMI were independent predictors of a higher CPAP pressure (p < 0.0005, adjusted R2 = 0.26.). For patients with CPAP ≥ 15 cm H2O, there was an odds ratio of 4.5 (95% CI 2.5–8.0) for having an oronasal compared to a nasal or nasal pillow mask. Residual median AHI was higher for oronasal masks (11.3 events/h) than for nasal masks (6.4 events/h) and nasal pillows (6.7 events/h), p < 0.001. Conclusions: Compared to nasal mask types, oronasal masks are associated with higher CPAP pressures (particularly pressures ≥ 15 cm H2O) and a higher residual AHI. Further evaluation with a randomized control trial is required to definitively establish the effect of mask type on pressure requirements. Commentary: A commentary on this article appears in this issue on page 1209. Citation: Deshpande S, Joosten S, Turton A, Edwards BA, Landry S, Mansfield DR, Hamilton GS. Oronasal masks require a higher pressure than nasal and nasal pillow masks for the treatment of obstructive sleep apnea. J Clin Sleep Med 2016;12(9):1263–1268. PMID:27448430

Plenum response to simulated disturbances of the model and fan inlet guide vanes in a transonic tunnel

NASA Technical Reports Server (NTRS)

Gloss, B. B.

1980-01-01

In order to aid in the design of the National Transonic Facility (NTF) control system, test section/plenum response studies were carried out in a 0.186 scale model of the NTF high speed duct. Two types of disturbances, those induced by the model and those induced by the compressor inlet guide vanes were simulated. Some observations with regard to the test section/plenum response tests are summarized as follows. A resonance frequency for the test section/plenum area of the tunnel of approximately 50 Hz was observed for Mach numbers from 0.40 to 0.90. However, since the plenum is 3.1 times (based on volume) too large for the scaled size of the test section, care must be taken in extrapolating these data to NTF conditions. The plenum pressure data indicate the existence of pressure gradients in the plenum. The test results indicate that the difference between test section static pressure and plenum pressure is dependent on test section flow conditions. Plenum response to inlet guide vane type disturbances appears to be slower than plenum response to test section disturbances.

An emergency response mobile robot for operations in combustible atmospheres

NASA Technical Reports Server (NTRS)

Stone, Henry W. (Inventor); Ohm, Timothy R. (Inventor)

1993-01-01

A mobile, self-powered, self-contained, and remote-controlled robot is presented. The robot is capable of safely operating in a combustible atmosphere and providing information about the atmosphere to the operator. The robot includes non-sparking and non-arcing electro-mechanical and electronic components designed to prevent the robot from igniting the combustible atmosphere. The robot also includes positively pressurized enclosures that house the electromechanical and electronic components of the robot and prevent intrusion of the combustible atmosphere into the enclosures. The enclosures are interconnected such that a pressurized gas injected into any one of the enclosures is routed to all the other enclosures through the interconnections. It is preferred that one or more sealed internal channels through structures intervening between the enclosures be employed. Pressure transducers for detecting if the pressure within the enclosures falls below a predetermined level are included. The robot also has a sensing device for determining the types of combustible substances in the surrounding atmosphere, as well as the concentrations of each type of substance relative to a pre-determined lower explosive limit (LEL). In addition, the sensing device can determine the percent level of oxygen present in the surrounding atmosphere.

Emergency response mobile robot for operations in combustible atmospheres

NASA Technical Reports Server (NTRS)

Stone, Henry W. (Inventor); Ohm, Timothy R. (Inventor)

1995-01-01

A mobile, self-powered, self-contained, and remote-controlled robot is presented. The robot is capable of safely operating in a combustible atmosphere and providing information about the atmosphere to the operator. The robot includes non-sparking and non-arcing electro-mechanical and electronic components designed to prevent the robot from igniting the combustible atmosphere. The robot also includes positively pressurized enclosures that house the electromechanical and electronic components of the robot and prevent intrusion of the combustible atmosphere into the enclosures. The enclosures are interconnected such that a pressurized gas injected into any one of the enclosures is routed to all the other enclosures through the interconnections. It is preferred that one or more sealed internal channels through structures intervening between the enclosures be employed. Pressure transducers for detecting if the pressure within the enclosures falls below a predetermined level are included. The robot also has a sensing device for determining the types of combustible substances in the surrounding atmosphere, as well as the concentrations of each type of substance relative to a pre-determined lower explosive limit (LEL). In addition, the sensing device can determine the percent level of oxygen present in the surrounding atmosphere.

An emergency response mobile robot for operations in combustible atmospheres

NASA Astrophysics Data System (ADS)

Stone, Henry W.; Ohm, Timothy R.

1993-11-01

A mobile, self-powered, self-contained, and remote-controlled robot is presented. The robot is capable of safely operating in a combustible atmosphere and providing information about the atmosphere to the operator. The robot includes non-sparking and non-arcing electro-mechanical and electronic components designed to prevent the robot from igniting the combustible atmosphere. The robot also includes positively pressurized enclosures that house the electromechanical and electronic components of the robot and prevent intrusion of the combustible atmosphere into the enclosures. The enclosures are interconnected such that a pressurized gas injected into any one of the enclosures is routed to all the other enclosures through the interconnections. It is preferred that one or more sealed internal channels through structures intervening between the enclosures be employed. Pressure transducers for detecting if the pressure within the enclosures falls below a predetermined level are included. The robot also has a sensing device for determining the types of combustible substances in the surrounding atmosphere, as well as the concentrations of each type of substance relative to a pre-determined lower explosive limit (LEL). In addition, the sensing device can determine the percent level of oxygen present in the surrounding atmosphere.

Emergency response mobile robot for operations in combustible atmospheres

NASA Astrophysics Data System (ADS)

Stone, Henry W.; Ohm, Timothy R.

1995-08-01

A mobile, self-powered, self-contained, and remote-controlled robot is presented. The robot is capable of safely operating in a combustible atmosphere and providing information about the atmosphere to the operator. The robot includes non-sparking and non-arcing electro-mechanical and electronic components designed to prevent the robot from igniting the combustible atmosphere. The robot also includes positively pressurized enclosures that house the electromechanical and electronic components of the robot and prevent intrusion of the combustible atmosphere into the enclosures. The enclosures are interconnected such that a pressurized gas injected into any one of the enclosures is routed to all the other enclosures through the interconnections. It is preferred that one or more sealed internal channels through structures intervening between the enclosures be employed. Pressure transducers for detecting if the pressure within the enclosures falls below a predetermined level are included. The robot also has a sensing device for determining the types of combustible substances in the surrounding atmosphere, as well as the concentrations of each type of substance relative to a pre-determined lower explosive limit (LEL). In addition, the sensing device can determine the percent level of oxygen present in the surrounding atmosphere.

Regional foot pressure during running, cutting, jumping, and landing.

PubMed

Orendurff, Michael S; Rohr, Eric S; Segal, Ava D; Medley, Jonathan W; Green, John R; Kadel, Nancy J

2008-03-01

Evaluating shoes during sport-related movements may provide a better assessment of plantar loads associated with repetitive injury and provide more specific data for comparing shoe cushioning characteristics. Accelerating, cutting, and jumping pressures will be higher than in straight running, differentiating regional shoe cushioning performance in sport-specific movements. Controlled laboratory study. Peak pressures on seven anatomic regions of the foot were assessed in 10 male college athletes during running straight ahead, accelerating, cutting left, cutting right, jump take-off, and jump landing wearing Speed TD and Air Pro Turf Low shoes (Nike, Beaverton, Ore). Pedar insoles (Novel, Munich, Germany) were sampled at 99 Hz during the 6 movements. Cutting and jumping movements demonstrated more than double the pressure at the heel compared with running straight, regardless of shoe type. The Air Pro Turf showed overall lower pressure for all movement types (P<.0377). Cutting to the left, the Air Pro Turf shoe had lower heel pressures (36.6 +/- 12.5 N/cm(2)) than the Speed TD (50.3 +/- 11.2 N/cm(2)) (P<.0001), and the Air Pro Turf had lower great toe pressures than the Speed TD (44.8 +/- 8.1 N/cm(2) vs 54.4 +/- 8.4 N/cm(2); P= .0002). The Air Pro Turf also had significantly lower pressures than the Speed TD at the central forefoot during acceleration (38.2 +/- 8.3 N/cm(2) vs 50.8 +/- 7.4 N/cm(2); P<.0001). Sport-related movements load the plantar surface of the foot more than running straight. Shoe cushioning characteristics were more robustly assessed during sport-related movements (4 significant results detected) compared with running straight (1 significant result detected). There is an interaction between shoe cushioning characteristics and sport-related movements that may influence plantar pressure and repetitive stress injuries.

Active control: an investigation method for combustion instabilities

NASA Astrophysics Data System (ADS)

Poinsot, T.; Yip, B.; Veynante, D.; Trouvé, A.; Samaniego, J. M.; Candel, S.

1992-07-01

Closed-loop active control methods and their application to combustion instabilities are discussed. In these methods the instability development is impeded with a feedback control loop: the signal provided by a sensor monitoring the flame or pressure oscillations is processed and sent back to actuators mounted on the combustor or on the feeding system. Different active control systems tested on a non-premixed multiple-flame turbulent combustor are described. These systems can suppress all unstable plane modes of oscillation (i.e. low frequency modes). The active instability control (AIC) also constitutes an original and powerful technique for studies of mechanisms leading to instability or resulting from the instability. Two basic applications of this kind are described. In the first case the flame is initially controlled with AIC, the feedback loop is then switched off and the growth of the instability is analysed through high speed Schlieren cinematography and simultaneous sound pressure and reaction rate measurements. Three phases are identified during th growth of the oscillations: (1) a linear phase where acoustic waves induce a flapping motion of the flame sheets without interaction between sheets, (2) a modulation phase, where flame sheets interact randomly and (3) a nonlinear phase where the flame sheets are broken and a limit cycle is reached. In the second case we investigate different types of flame extinctions associated with combustion instability. It is shown that pressure oscillations may lead to partial or total extinctions. Extinctions occur in various forms but usually follow a rapid growth of pressure oscillations. The flame is extinguished during the modulation phase observed in the initiation experiments. In these studies devoted to transient instability phenomena, the control system constitutes a unique investigation tool because it is difficult to obtain the same information by other means. Implications for modelling and prediction of combustion instabilities are discussed.

What are the health benefits of physical activity in type 1 diabetes mellitus? A literature review.

PubMed

Chimen, M; Kennedy, A; Nirantharakumar, K; Pang, T T; Andrews, R; Narendran, P

2012-03-01

Physical activity improves well-being and reduces the risk of heart disease, cancer and type 2 diabetes mellitus in the general population. In individuals with established type 2 diabetes, physical activity improves glucose and lipid levels, reduces weight and improves insulin resistance. In type 1 diabetes mellitus, however, the benefits of physical activity are less clear. There is poor evidence for a beneficial effect of physical activity on glycaemic control and microvascular complications, and significant risk of harm through hypoglycaemia. Here we review the literature relating to physical activity and health in type 1 diabetes. We examine its effect on a number of outcomes, including glycaemic control, lipids, blood pressure, diabetic complications, well-being and overall mortality. We conclude that whilst there is sufficient evidence to recommend physical activity in the management of type 1 diabetes, it is still unclear as to what form, duration and intensity should be recommended and whether there is benefit for many of the outcomes examined.

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

PubMed

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

2017-05-01

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

Management of diabetes mellitus and associated cardiovascular risk factors in Brazil – the Brazilian study on the practice of diabetes care

PubMed Central

2013-01-01

Background The Brazilian Study on the Practice of Diabetes Care main objective was to provide an epidemiological profile of individuals with type 1 and 2 diabetes mellitus (DM) in Brazil, concerning therapy and adherence to international guidelines in the medical practice. Methods This observational, cross-sectional, multicenter study collected and analyzed data from individuals with type 1 and 2 DM attending public or private clinics in Brazil. Each investigator included the first 10 patients with type 2 DM who visited his/her office, and the first 5 patients with type 1 DM. Results A total of 1,358 patients were analyzed; 375 (27.6%) had type 1 and 983 (72.4%) had type 2 DM. Most individuals were women, Caucasian, and private health care users. High prevalence rates of hypertension, dyslipidemia and central obesity were observed, particularly in type 2 DM. Only 7.3% and 5.1% of the individuals with types 1 and 2 DM, respectively, had optimal control of blood pressure, plasma glucose and lipids. The absence of hypertension and female sex were associated with better control of type 1 DM and other cardiovascular risk factors. In type 2 DM, older age was also associated with better control. Conclusions Female sex, older age, and absence of hypertension were associated with better metabolic control. An optimal control of plasma glucose and other cardiovascular risk factors are obtained only in a minority of individuals with diabetes. Local numbers, compared to those from other countries are worse. PMID:23972112

Effects of Sacubitril/Valsartan (LCZ696) on Natriuresis, Diuresis, Blood Pressures, and NT-proBNP in Salt-Sensitive Hypertension.

PubMed

Wang, Tzung-Dau; Tan, Ru-San; Lee, Hae-Young; Ihm, Sang-Hyun; Rhee, Moo-Yong; Tomlinson, Brian; Pal, Parasar; Yang, Fan; Hirschhorn, Elizabeth; Prescott, Margaret F; Hinder, Markus; Langenickel, Thomas H

2017-01-01

Salt-sensitive hypertension (SSH) is characterized by impaired sodium excretion and subnormal vasodilatory response to salt loading. Sacubitril/valsartan (LCZ696) was hypothesized to increase natriuresis and diuresis and result in superior blood pressure control compared with valsartan in Asian patients with SSH. In this randomized, double-blind, crossover study, 72 patients with SSH received sacubitril/valsartan 400 mg and valsartan 320 mg once daily for 4 weeks each. SSH was diagnosed if the mean arterial pressure increased by ≥10% when patients switched from low (50 mmol/d) to high (320 mmol/d) sodium diet. The primary outcome was cumulative 6- and 24-hour sodium excretion after first dose administration. Compared with valsartan, sacubitril/valsartan was associated with a significant increase in natriuresis (adjusted treatment difference: 24.5 mmol/6 hours, 50.3 mmol/24 hours, both P<0.001) and diuresis (adjusted treatment difference: 291.2 mL/6 hours, P<0.001; 356.4 mL/24 hours, P=0.002) on day 1, but not on day 28, and greater reductions in office and ambulatory blood pressure on day 28. Despite morning dosing of both drugs, ambulatory blood pressure reductions were more pronounced at nighttime than at daytime or the 24-hour average. Compared with valsartan, sacubitril/valsartan significantly reduced N-terminal pro B-type natriuretic peptide levels on day 28 (adjusted treatment difference: -20%; P=0.001). Sacubitril/valsartan and valsartan were safe and well tolerated with no significant changes in body weight or serum sodium and potassium levels with either treatments. In conclusion, sacubitril/valsartan compared with valsartan was associated with short-term increases in natriuresis and diuresis, superior office and ambulatory blood pressure control, and significantly reduced N-terminal pro B-type natriuretic peptide levels in Asian patients with SSH. URL: http://www.clinicaltrials.gov. Unique identifier: NCT01681576. © 2016 American Heart Association, Inc.

New Density Functional Approach for Solid-Liquid-Vapor Transitions in Pure Materials

NASA Astrophysics Data System (ADS)

Kocher, Gabriel; Provatas, Nikolas

2015-04-01

A new phase field crystal (PFC) type theory is presented, which accounts for the full spectrum of solid-liquid-vapor phase transitions within the framework of a single density order parameter. Its equilibrium properties show the most quantitative features to date in PFC modeling of pure substances, and full consistency with thermodynamics in pressure-volume-temperature space is demonstrated. A method to control either the volume or the pressure of the system is also introduced. Nonequilibrium simulations show that 2- and 3-phase growth of solid, vapor, and liquid can be achieved, while our formalism also allows for a full range of pressure-induced transformations. This model opens up a new window for the study of pressure driven interactions of condensed phases with vapor, an experimentally relevant paradigm previously missing from phase field crystal theories.

ENGINEERING TEST REACTOR

DOEpatents

De Boisblanc, D.R.; Thomas, M.E.; Jones, R.M.; Hanson, G.H.

1958-10-21

Heterogeneous reactors of the type which is both cooled and moderated by the same fluid, preferably water, and employs highly enriched fuel are reported. In this design, an inner pressure vessel is located within a main outer pressure vessel. The reactor core and its surrounding reflector are disposed in the inner pressure vessel which in turn is surrounded by a thermal shield, Coolant fluid enters the main pressure vessel, fiows downward into the inner vessel where it passes through the core containing tbe fissionable fuel assemblies and control rods, through the reflector, thence out through the bottom of the inner vessel and up past the thermal shield to the discharge port in the main vessel. The fuel assemblles are arranged in the core in the form of a cross having an opening extending therethrough to serve as a high fast flux test facility.

Effects of candesartan in hypertensive patients with type 2 diabetes mellitus on inflammatory parameters and their relationship to pulse pressure

PubMed Central

2012-01-01

Background Angiotensin receptor blockers (ARBs) are reported to provide direct protection to many organs by controlling inflammation and decreasing oxidant stress in patients without arteriosclerosis. This study aimed to evaluate (1) whether an ARB (candesartan) decreases values for inflammatory parameters in hypertensive patients with type 2 diabetes mellitus of long duration accompanied by arteriosclerosis and (2) whether there any predictors of which patients would receive the benefits of organ protection by candesartan. Methods We administered candesartan therapy (12 mg daily) for 6 months and evaluated whether there was improvement in serum inflammatory parameters high molecular weight adiponectin (HMW-ADN), plasminogen activator inhibitor-1 (PAI-1), highly sensitive C-reactive protein (Hs-CRP), vascular cell adhesion molecule-1 (VCAM-1) in serum and urinary-8-hydroxydeoxyguanosine (U-8-OHdG). We then analyzed the relationship between the degree of lowering of blood pressure and inflammatory factors and the relationship between pulse pressure and inflammatory factors. Finally, we analyzed predictive factors in patients who received the protective benefit of candesartan. Results After 6 months of treatment, significant improvements from baseline values were observed in all patients in HMW-ADN and PAI-1 but not in Hs-CRP, VCAM-1 and U-8-OHdG. Multilinear regression analysis was performed to determine which factors could best predict changes in HMW-ADN and PAI-1. Changes in blood pressure were not significant predictors of changes in metabolic factors in all patients. We found that the group with baseline pulse pressure <60 mmHg had improved HMW-ADN and PAI-1 values compared with the group with baseline pulse pressure ≥ 60 mmHg. These results suggest that pulse pressure at baseline could be predictive of changes in HMW-ADN and PAI-1. Conclusions Candesartan improved inflammatory parameters (HMW-ADN and PAI-1) in hypertensive patients with type 2 diabetes mellitus of long duration independent of blood pressure changes. Patients with pulse pressure <60 mmHg might receive protective benefits by candesartan. Trial registration UMIN000007921 PMID:23034088

HWCTR CONTROL ROD AND SAFETY ROD DRIVE SYSTEMS

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

Kale, S.H.

1963-07-01

The Heavy Water Components Test Reactor (HWCTR) is a pressurized, D/sub 2/O reactor designed for operation up to 70 Mw at 1500 psig and 3l5 deg C. It has 18 control rods and six safety rods, each driven by an electric motor through a rack and pinion gear train. Racks, pinions, and bearings are located inside individual pressure housings that are penetrated by means of floating ring labyrinth seals. The drives are mounted on the reactor vessel top head. Safety rods have electromagnetic clutches and fall into the reactor when scrammed. The reliability and performance of the rod drives aremore » very good. Seal leakage is well within design limits. Recent inspections of seals and control rod plants showed no evidence of crud buildup or stress corrosion cracking of type 17- 4PH'' stainless steel components. (auth)« less

Pm-1 Reactor Core Final Design Report

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

Bagley, R. O.; Cox, F. H.; Carnasale, A.

1962-01-01

The PM-1 water cooled and moderated core contains 741 highly enriched stainless steel cermet tubular fuel elements and 90 lumped B stainless steel burnable poison elements, and it is controlled by 6 Y-shaped europium titanate movable control rods. The core has a lifetime of 1.95 years when operated at its design power level of 9.37 mw of thermal energy. The control of the core is designed so that there is a positive shutdown margin at all times with either one rod stuck completely out or the core or with two rods stuck in the operating condition. The core power ismore » removed by 2125 gpm of pressurized water at an average temperature of 463 deg F and pressure of 1300 psia. In reactors of this type, the core is stable with a negative temperature coefficient of approximately 2.5 x 10/sup -4/ DELTA K/K/ deg F.« less

Power coupling mode transitions induced by tailored voltage waveforms in capacitive oxygen discharges

NASA Astrophysics Data System (ADS)

Derzsi, Aranka; Bruneau, Bastien; Gibson, Andrew Robert; Johnson, Erik; O'Connell, Deborah; Gans, Timo; Booth, Jean-Paul; Donkó, Zoltán

2017-03-01

Low-pressure capacitively coupled radio frequency discharges operated in O2 and driven by tailored voltage waveforms are investigated experimentally and by means of kinetic simulations. Pulse-type (peaks/valleys) and sawtooth-type voltage waveforms that consist of up to four consecutive harmonics of the fundamental frequency are used to study the amplitude asymmetry effect as well as the slope asymmetry effect at different fundamental frequencies (5, 10, and 15 MHz) and at different pressures (50-700 mTorr). Values of the DC self-bias determined experimentally and spatio-temporal excitation rates derived from phase resolved optical emission spectroscopy measurements are compared with particle-in-cell/Monte Carlo collisions simulations. The spatio-temporal distributions of the excitation rate obtained from experiments are well reproduced by the simulations. Transitions of the discharge electron heating mode from the drift-ambipolar mode to the α-mode are induced by changing the number of consecutive harmonics included in the driving voltage waveform or by changing the gas pressure. Changing the number of harmonics in the waveform has a strong effect on the electronegativity of the discharge, on the generation of the DC self-bias and on the control of ion properties at the electrodes, both for pulse-type, as well as sawtooth-type driving voltage waveforms The effect of the surface quenching rate of oxygen singlet delta metastable molecules on the spatio-temporal excitation patterns is also investigated.

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

Kawasaki, Tadahiro; PRESTO-JST, 4-1-8 Honcho, Kawaguchi, Saitama 332-0012; Ueda, Kouta

We have developed an improved, windowed type environmental-cell (E-cell) transmission electron microscope (TEM) for in situ observation of gas-solid interactions, such as catalytic reactions at atmospheric pressure. Our E-cell TEM includes a compact E-cell specimen holder with mechanical stability, resulting in smoother introduction of the desired gases compared with previous E-cell TEMs. In addition, the gas control unit was simplified by omitting the pressure control function of the TEM pre-evacuation chamber. This simplification was due to the successful development of remarkably tough thin carbon films as the window material. These films, with a thickness of <10 nm, were found tomore » withstand pressure differences >2 atm. Appropriate arrangement of the specimen position inside the E-cell provided quantitatively analyzable TEM images, with no disturbances caused by the windowed films. As an application, we used this E-cell TEM to observe the dynamic shape change in a catalytic gold nanoparticle supported on TiO{sub 2} during the oxidation of CO gas.« less

Spool-type control valve assembly with reduced spool stroke for hydraulic belt-and-pulley type continuously variable transmission

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

Itoh, H.; Akashi, T.; Takada, M.

1987-03-31

This patent describes a hydraulic control system for controlling a speed ratio of a hydraulically-operated continuously variable transmission of belt-and-pulley type having a variable-diameter pulley and a hydraulic cylinder for changing an effective diameter of the variable diameter-pulley of the transmission. The hydraulic control system includes a speed-ratio control valve assembly for controlling the supply and discharge of a pressurized fluid to and from the hydraulic cylinder to thereby change the speed ratio of the transmission. The speed-ratio control valve assembly comprises: a shift-direction switching valve unit disposed in fluid supply and discharge conduits communicating with the hydraulic cylinder, formore » controlling a direction in which the speed ratio of the transmission is varied; a shift-speed control valve unit of spool-valve type connected to the shift-direction switching valve unit. The shift-speed control valve unit is selectively placed in a first state in which the fluid supply and discharge flows to and from the hydraulic cylinder through the conduits are permitted, or in a second state in which the fluid supply flow is restricted while the fluid discharge flow is inhibited; an actuator means for placing the shift speed control valve unit alternately in the first and second states to control a rate of variation in the speed ratio of the transmission in the direction established by the shift-direction switching valve unit.« less

40 CFR 86.605-88 - Maintenance of records; submittal of information.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., pressure increase across the pump, and the temperature set point of the temperature control system. (2... samples are being collected. (3) Humidity of dilution air. (4) Manufacturer, model, type and serial number..., ambient temperature and humidity. (2) Data and time of day. (ii) In lieu of recording test equipment...

40 CFR 86.605-88 - Maintenance of records; submittal of information.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., pressure increase across the pump, and the temperature set point of the temperature control system. (2... samples are being collected. (3) Humidity of dilution air. (4) Manufacturer, model, type and serial number..., ambient temperature and humidity. (2) Data and time of day. (ii) In lieu of recording test equipment...

40 CFR 86.605-88 - Maintenance of records; submittal of information.

Code of Federal Regulations, 2013 CFR

2013-07-01

..., pressure increase across the pump, and the temperature set point of the temperature control system. (2... samples are being collected. (3) Humidity of dilution air. (4) Manufacturer, model, type and serial number..., ambient temperature and humidity. (2) Data and time of day. (ii) In lieu of recording test equipment...

49 CFR 571.122 - Standard No. 122; Motorcycle brake systems.

Code of Federal Regulations, 2011 CFR

2011-10-01

... mile before any brake application. Skid number means the frictional resistance of a pavement measured... subsystems actuated by a single control designed so that a leakage-type failure of a pressure component in a...), but not less than 0 Newtons (0 pounds). S5.8Service brake system design durability. Each motorcycle...

49 CFR 571.122 - Standard No. 122; Motorcycle brake systems.

Code of Federal Regulations, 2010 CFR

2010-10-01

... mile before any brake application. Skid number means the frictional resistance of a pavement measured... subsystems actuated by a single control designed so that a leakage-type failure of a pressure component in a...), but not less than 0 Newtons (0 pounds). S5.8Service brake system design durability. Each motorcycle...

Evaluating the effect of the new incentive system for high-risk pressure ulcer patients on wound healing and cost-effectiveness: a cohort study.

PubMed

Sanada, Hiromi; Nakagami, Gojiro; Mizokami, Yuko; Minami, Yukiko; Yamamoto, Aya; Oe, Makoto; Kaitani, Toshiko; Iizaka, Shinji

2010-03-01

To evaluate the effectiveness and cost-effectiveness of new incentive system for pressure ulcer management, which focused on skilled nurse staffing in terms of rate of healing and medical costs. A prospective cohort study included two types of groups: 39 institutions, which introduced the new incentive system, and 20 non-introduced groups (control). Sixty-seven patients suffering from severe pressure ulcers in the introduced group and 38 patients in the non-introduced group were included. Wound healing and medical costs were monitored weekly for three weeks by their skilled nurses in charge. Healing status and related medical costs. The introduced group showed significantly higher rate of healing compared with the control group at each weekly assessment. Multiple regression analysis revealed that the introduction of the new incentive system was independently associated with the faster healing rate (beta=3.44, P<.001). The budget impact analysis demonstrated that introducing this system could reduce cost of treating severe pressure ulcers by 1.776 billion yen per year. The new incentive system for the management of pressure ulcers, which focused on staffing with skilled nurses can improve healing rate with reduced medical cost. Copyright 2009 Elsevier Ltd. All rights reserved.

[Does autonomic diabetic neuropathy influence microcirculation reactivity in adolescents with diabetes type 1?].

PubMed

Urban, Mirosława; Peczyńska, Jadwiga; Kowalewski, Marek; Głowińska-Olszewska, Barbara

2007-01-01

Microcirculation is known to be disturbed in many organs of diabetic patients. Retinopathy, nephropathy and neuropathy might be considered as the cause of the functional and morphological changes at the level of microcirculation. The aim of the study was to assess by means of dynamic capillaroscopy the influence of autonomic diabetic nephropathy (CAN) in adolescents with type 1 diabetes mellitus on capillary blood flow (CBV) in skin microcirculation. The study group consisted of 18 patients with type 1 diabetes mellitus (mean age 15+/-2 years). In 9 of them the diagnosis of CAN was made on the basis of Ewing tests. The control group consisted of 10 healthy persons aged 15+/-1.5 years. CBV was measured in capillars of the nailfold of the fourth finger during rest and after 2 minutes of arterial occlusion (the occlusion pressure - above 20 mmHg systolic blood pressure - was obtained by the occlusion of brachial artery using sphygnomanometer cuff). The resting CBV did not differ between patients with CAN, without CAN and healthy controls (0.39+/-0.06, 0.41+0.05 i 0.42+/-0.07). The values of the peak CBV significantly differ between the examined groups (CAN: 0.75+0.1; without CAN: 0.86+/-0.11; control group: 0.98+/-0.09, p<0.01). The obtained results indicate that the presence of the autonomic diabetic neuropathy significantly influences the regulatory function of microcirculation, which may predispose to occurrence of different late diabetic complications.

Changes in the electro-physical properties of MCT epitaxial films affected by a plasma volume discharge induced by an avalanche beam in atmospheric-pressure air

NASA Astrophysics Data System (ADS)

Grigoryev, D. V.; Voitsekhovskii, A. V.; Lozovoy, K. A.; Tarasenko, V. F.; Shulepov, M. A.

2015-11-01

In this paper the influence of the plasma volume discharge of nanosecond duration formed in a non-uniform electric field at atmospheric pressure on samples of epitaxial films HgCdTe (MCT) films are discussed. The experimental data show that the action of pulses of nanosecond volume discharge in air at atmospheric pressure leads to changes in the electrophysical properties of MCT epitaxial films due to formation of a near-surface high- conductivity layer of the n-type conduction. The preliminary results show that it is possible to use such actions in the development of technologies for the controlled change of the properties of MCT.

The effects of intermittent vitamin D3 supplementation on muscle strength and metabolic parameters in postmenopausal women with type 2 diabetes: a randomized controlled study

PubMed Central

Cavalcante, Roseane; Maia, Juliana; Henrique, Rafael; Griz, Luiz; Bandeira, Maria P.; Bandeira, Francisco

2015-01-01

Background: The aim of this study was to evaluate the effect of weekly vitamin D3 supplementation on metabolic parameters and muscle strength of postmenopausal women with type 2 diabetes. Methods: A total of 38 patients with serum 25-hydroxy vitamin D [25(OH)D] below 30 ng/ml and hand strength below 20 kg were randomly assigned to oral vitamin D3 (6600 IU/week in 2 cc oil preparation) or 2 cc olive oil weekly for 3 months. Results: There were nonsignificant increases in serum 25(OH)D in the intervention group to 22.98 ± 4.23 ng/ml and nonsignificant decreases in the control group to 22.84 ± 3.88 (26% of the intervention and 48% of the control groups had 25(OH)D < 20 ng/ml). Handgrip strength improved significantly in the intervention group (right arm 17.4 ± 2.68 to 19.9 ± 3.53 kg, p = 0.002; left arm 16.31 ± 2.6 to 18.46 ± 3.2 kg, p < 0.001) but not in the control group (right arm 16.87 ± 3.99 to 17.93 ± 4.91 kg, p = 0.1; left arm 16.13 ± 4.29 to 16.86 ± 4.79 kg, p < 0.2). More patients in the control group became obese at the end of the study period (p = 0.014). There were no significant changes in mean fasting glucose, glycated haemoglobin (HbA1c), serum triglycerides and blood pressure with vitamin D supplementation. Systolic blood pressure increased significantly in the control group from 136.6 ± 18.6 to 141.4 ± 17.6 mmHg, p = 0.04). Conclusions: Vitamin D3 supplementation in doses equivalent to 942 IU/day improved isometric handgrip strength, but had no effect on glycaemic control in postmenopausal women with longstanding type 2 diabetes. PMID:26301064

Characteristics associated with glycemic control among family medicine patients with type 2 diabetes.

PubMed

Kirk, Julienne K; Davis, Stephen W; Hildebrandt, Carol A; Strachan, Elizabeth N; Peechara, Madhavi L; Lord, Richard

2011-01-01

As new payment models are developed for chronic diseases such as diabetes, there is a need to understand which patient characteristics impact glycemic control. This study examines the relationship between patient variables and glycemic control, defined as a hemoglobin A1c (A1c) level of <7%, in a cohort of family medicine patients with type 2 diabetes. A total of 1,398 medical charts were selected using International Classification of Diseases, Ninth Revision, Clinical Modification codes for diabetes. To gather information not available through chart review, a survey was used to collect data on individual-level characteristics. Information included marital status, education level, income level, insurance status, activity level, receipt of diabetes education, living arrangement, employment status, and annual income. A cross-sectional design was used to obtain, via chart review, data about diabetes outcomes (ie, A1c level, blood pressure, and low-density lipoprotein cholesterol [LDL-C] level). A mailed survey was completed by 669 patients (response rate, 47.9%). Almost half of patients in this sample achieved the goal A1c level, LDL-C level (ie, <100 mg/dL), and/or blood pressure (ie, <130/<80 mm Hg). Medicare insurance (odds ratio [OR], 2.16 [95% confidence interval {CI}, 1.18-3.96]) and female sex (OR, 1.61 [95% CI, 1.01-2.56]) were associated with glycemic control. Other variables, such as annual income, education level, and receipt of diabetes education, that were expected to impact glycemic control were not significantly associated with an A1c level of <7%. The survey response rate was <50%, the study was conducted at a single site, and the chart data were retrospective. Our findings indicate that Medicare insurance and female sex were associated with glycemic control. Further evaluation is needed to identify determinants that lead to achievement of optimal glycemic control among individuals with type 2 diabetes.

The Usability of a Pressure-Indicating Film to Measure the Teat Load Caused by a Collapsing Liner

PubMed Central

Demba, Susanne; Elsholz, Sabrina; Ammon, Christian; Rose-Meierhöfer, Sandra

2016-01-01

Prevention of damage to the teat and mastitis requires determination of the teat load caused by a collapsing liner. The aim of this study was to test a pressure-indicating film designed to measure the pressure between a collapsing liner and artificial teats. The Ultra Super Low and the Extreme Low pressure-indicating films were tested on two types of artificial teat. The experiments were performed with a conventional milking cluster equipped with round silicone liners. For each teat and film type, 30 repetitions were performed. Each repetition was performed with a new piece of film. Kruskal-Wallis tests were performed to detect differences between the pressure values for the different teats. The area of regions where pressure-indication color developed was calculated to determine the most suitable film type. Both film types measured the pressure applied to both artificial teats by the teat cup liner. Thus, the pressure-indicating films can be used to measure the pressure between a collapsing liner and an artificial teat. Based on the results of the present investigation, a pressure-indicating film with the measurement ranges of both film types combined would be an optimal tool to measure the overall pressure between an artificial teat and a collapsing liner. PMID:27690033

Individualization of a Manualized Pressure Ulcer Prevention Program: Targeting Risky Life Circumstances Through a Community-Based Intervention for People with Spinal Cord Injury

PubMed Central

Vaishampayan, Ashwini; Clark, Florence; Carlson, Mike; Blanche, Erna Imperatore

2012-01-01

Purpose To sensitize practitioners working with individuals with spinal cord injury to the complex life circumstances that are implicated in the development of pressure ulcers, and to document the ways that interventions can be adapted to target individual needs. Methods Content analysis of weekly fidelity/ quality control meetings that were undertaken as part of a lifestyle intervention for pressure ulcer prevention in community-dwelling adults with spinal cord injury. Results Four types of lifestyle-relevant challenges to ulcer prevention were identified: risk-elevating life circumstances, communication difficulties, equipment problems, and individual personality issues. Intervention flexibility was achieved by changing the order of treatment modules, altering the intervention content or delivery approach, or going beyond the stipulated content. Conclusion Attention to recurrent types of individual needs, along with explicit strategies for tailoring manualized interventions, has potential to enhance pressure ulcer prevention efforts for adults with spinal cord injury. Target audience This continuing education article is intended for practitioners interested in learning about a comprehensive, context-sensitive, community-based pressure ulcer prevention program for people with spinal cord injury. Objectives After reading this article, the reader should be able to: Describe some of the contextual factors that increase pressure ulcer risk in people with spinal cord injury living in the community.Distinguish between tailored and individualized intervention approaches.Identify the issues that must be taken into account to design context-sensitive, community-based pressure ulcer prevention programs for people with spinal cord injury.Describe approaches that can be used to individualize manualized interventions. PMID:21586911

Novel high-pressure phase of ZrO{sub 2}: An ab initio prediction

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

Durandurdu, Murat, E-mail: murat.durandurdu@agu.edu.tr

2015-10-15

The high-pressure behavior of the orthorhombic cotunnite type ZrO{sub 2} is explored using an ab initio constant pressure technique. For the first time, a novel hexagonal phase (Ni{sub 2}In type) within P6{sub 3}/mmc symmetry is predicted through the simulation. The Ni{sub 2}In type crystal is the densest high-pressure phase of ZrO{sub 2} proposed so far and has not been observed in other metal dioxides at high pressure before. The phase transformation is accompanied by a small volume drop and likely to occur around 380 GPa in experiment. - Graphical abstract: Post-cotunnite Ni{sub 2}In type hexagonal phase forms in zirconia atmore » high pressure. - Highlights: • A post-cotunnite phase is predicted for ZrO{sub 2} through an ab initio simulation. • Cotunnite ZrO{sub 2} adopts the Ni{sub 2}In type structure at high pressure. • The Ni{sub 2}In type structure is the densest high-pressure phase of ZrO{sub 2} proposed so far. • The preferred mechanism in ZrO{sub 2} differs from the other metal dioxides.« less

Peak pressure data and pressure-time integral in the contralateral limb in patients with diabetes and a trans-tibial prosthesis.

PubMed

Borg, Jael; Mizzi, Stephen; Formosa, Cynthia

2018-05-19

Clinicians currently rely on observational clinical data pertaining to the biomechanics of the diabetic foot. However, advances in technology can objectively describe this. A thorough understanding of the functional and mechanical consequences following trans-tibial amputations is lacking. Does a trans-tibial prostheses significantly increase peak plantar pressures and pressure time integrals in the intact foot of patients with type-2 diabetes and neuropathy? A prospective quantitative matched-subject design was employed. Twenty participants living with diabetes and peripheral sensory neuropathy were recruited. Ten participants presented with a trans-tibial amputation and 10 had intact feet. Participants were matched for gender, age, foot type and BMI. Peak plantar pressure and pressure time integral data were recorded using the Tekscan HR™ pressure mat system, using the two-step gait protocol. The Shapiro-Wilk test was used to determine normality of data. The Independent Samples t-test and the Mann Whitney U test were carried out to reject the null hypothesis. Although no significant differences (p < 0.05) in mean peak plantar pressures were observed in all the foot masks analysed between the amputee and the control group, a significant difference (p = 0.002) in mean pressure time integrals was recorded with highest pressure time integral (PTI) values under the 2nd-4th metatarsophalangeal joint (MTP joint) for the trans-tibial amputee group. Cumulative exposure of both pressure and time can lead to tissue damage. PTI could be considered as an important contributory factor in determining ulcer formation. Elevated PTI under the 2nd-4th MTP joints sustained in the intact contralateral limb in patients using below knee prosthesis could possibly be due to gait alterations in this population. The preservation of the contralateral limb is of great concern and importance as this might impact patient's mobility and quality of life. Copyright © 2018 Elsevier B.V. All rights reserved.

Prevalence, Awareness, Treatment and Influence of Socioeconomic Variables on Control of High Blood Pressure: Results of the ELSA-Brasil Study

PubMed Central

Chor, Dóra; Pinho Ribeiro, Antonio Luiz; Sá Carvalho, Marilia; Duncan, Bruce Bartholow; Andrade Lotufo, Paulo; Araújo Nobre, Aline; de Aquino, Estela Mota Lima Leão; Schmidt, Maria Inês; Griep, Rosane Härter; Molina, Maria Del Carmen Bisi; Barreto, Sandhi Maria; Passos, Valéria Maria de Azeredo; Benseñor, Isabela Judith Martins; Matos, Sheila Maria Alvim; Mill, José Geraldo

2015-01-01

High blood pressure (HBP) is the leading risk factor for years of life lost in Brazil. Factors associated with HBP awareness, treatment and control need to be understood better. Our aim is to estimate prevalence, awareness, and types of anti-hypertensive treatment and to investigate the association of HBP control with social position. Data of 15,103 (54% female) civil servants in six Brazilian state capitals collected at the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) baseline (2008-2010) were used to estimate prevalence and cross-sectional association of HBP control with education, per capita family income and self-reported race, using multiple logistic regression. Blood pressure was measured by the oscillometric method. 35.8% were classified as presenting HBP; 76.8% of these used anti-hypertensive medication. Women were more aware than men (84.8% v. 75.8%) and more often using medication (83.1% v. 70.7%). Adjusted HBP prevalence was, in ascending order, Whites (30.3%), Browns (38.2%) and Blacks (49.3%). The therapeutic schemes most used were angiotensin-converting enzyme inhibitors, in isolation (12.4%) or combined with diuretics (13.3%). Among those in drug treatment, controlled blood pressure was more likely in the (postgraduate) higher education group than among participants with less than secondary school education (PR = 1.21; 95% CI: 1.14–1.28), and among Asian (PR = 1.21; 95% CI: 1.12–1.32) and ‘Whites (PR = 1.19; 95% CI: 1.12–1.26) compared to Blacks. Socioeconomic and racial inequality—as measured by different indicators—are strongly associated with HBP control, beyond the expected influence of health services access. PMID:26102079

Energy-Saving Control of a Novel Hydraulic Drive System for Field Walking Robot

NASA Astrophysics Data System (ADS)

Fang, Delei; Shang, Jianzhong; Xue, Yong; Yang, Junhong; Wang, Zhuo

2018-01-01

To improve the efficiency of the hydraulic drive system in field walking robot, this paper proposed a novel hydraulic system based on two-stage pressure source. Based on the analysis of low efficiency of robot single-stage hydraulic system, the paper firstly introduces the concept and design of two-stage pressure source drive system. Then, the new hydraulic system energy-saving control is planned according to the characteristics of walking robot. The feasibility of the new hydraulic system is proved by the simulation of the walking robot squatting. Finally, the efficiencies of two types hydraulic system are calculated, indicating that the novel hydraulic system can increase the efficiency by 41.5%, which can contribute to enhance knowledge about hydraulic drive system for field walking robot.

The Role of Liuwei Dihuang Pills and Ginkgo Leaf Tablets in Treating Diabetic Complications.

PubMed

Zhao, Yue; Yu, Jiangyi; Liu, Jingshun; An, Xiaofei

2016-01-01

Objective. To observe the clinical prophylactic and therapeutic efficacy of Liuwei Dihuang Pills and Ginkgo Leaf Tablets for type 2 diabetic vascular complications. Methods. It was a randomized, double-blind and placebo-controlled clinical trial. 140 outpatients with type 2 diabetes were recruited and randomly divided into the treatment group and control group. The two groups were given basic therapy (management of blood sugar, blood pressure, etc.). Additionally, the treatment group was given Liuwei Dihuang Pills and Ginkgo Leaf Tablets, while the control group was given Liuwei Dihuang Pills and Ginkgo Leaf Tablets placebos. All subjects were followed up for consecutive 36 months and observed monthly. The clinical data as urinary microalbumin to urinary creatinine ratio (Umalb/cr), carotid intima-media thickness (IMT), diabetic nephropathy (DN) and diabetic retinopathy (DR) prevalence, cardiovascular and cerebrovascular events, blood glucose, and blood pressure were collected and analyzed statistically. Results. After 36-month treatment, the Umalb/cr level and DN and DR prevalence in treatment group were all significantly lower than control group ( P < 0.05). However, the IMT level and the incidence of cardiovascular and cerebrovascular events were not significantly different between the two groups ( P > 0.05). Conclusions. Liuwei Dihuang Pills and Ginkgo Leaf Tablets are beneficial to diabetic microvascular complications, while the efficacy to diabetic macrovascular complications needs more observations.

Lower cognitive performance among long-term type 1 diabetes survivors: A case-control study.

PubMed

Awad, Anna; Lundqvist, Robert; Rolandsson, Olov; Sundström, Anna; Eliasson, Mats

2017-08-01

Patients with type 1 diabetes (T1D) have an increased risk of cognitive dysfunction. The cognitive decrement is believed to depend on macro- and microvascular complications and long disease duration. Some patients do not develop these complications, but still report cognitive symptoms. We examined if long-standing T1D without complications is associated with lower cognitive performance. A group of patients (n=43) with long-standing T1D (>30years) without micro- or macro vascular complications was compared with a non-diabetic control group (n=86) on six cognitive tests which probed episodic memory, semantic memory, episodic short-term memory, visual attention and psychomotor speed. Each patient was matched with two controls regarding age, gender and education. A linear mixed effect model was used to analyze the data. The mean age was 57years and mean duration was 41years. Patients with diabetes had lower diastolic blood pressure but BMI, waist circumference, systolic blood pressure and smoking did not differ between groups. Patients had lower results than non-diabetic controls in episodic short-term memory (p<0.001) and also lower values on a test that mirrors visual attention and psychomotor speed (p=0.019). Long-standing T1D was associated with lower cognitive performance, regardless of other diabetes-related complications. Copyright © 2017 Elsevier Inc. All rights reserved.

Quality of Care for Patients with Type 2 Diabetes Mellitus in Dubai: A HEDIS-Like Assessment

PubMed Central

Szabo, Shelagh M.; Osenenko, Katherine M.; Qatami, Lara; Korenblat Donato, Bonnie M.; Korol, Ellen E.; Al Madani, Abdulrazzaq A.; Al Awadi, Fatheya F.; Al-Ansari, Jaber; Maclean, Ross; Levy, Adrian R.

2015-01-01

Objective. As little data are available on the quality of type 2 diabetes mellitus (T2DM) care in the Arabian Gulf States, we estimated the proportion of patients receiving recommended monitoring at the Dubai Hospital for T2DM over one year. Methods. Charts from 150 adults with T2DM were systematically sampled and quality of care was assessed during one calendar year, using a Healthcare Effectiveness Data and Information Set- (HEDIS-) like assessment. Screening for glycosylated haemoglobin (HbA1c), low-density lipoprotein (LDL), blood pressure, retinopathy, and nephropathy was considered. Patients were classified based on their most recent test in the period, and predictors of receiving quality care were examined. Results. Mean age was 58 years (standard deviation (SD): 12.4 years) and 33% were males. Over the year, 98% underwent HbA1c screening (50% had control and 28% displayed poor control); 91% underwent LDL screening (65% had control); 55% had blood pressure control; 30% had retinopathy screening; and 22% received attention for nephropathy. No individual characteristics examined predicted receiving quality care. Conclusion. Some guideline monitoring was conducted for most patients; and rates of monitoring for selected measures were comparable to benchmarks from the United States. Greater understanding of factors leading to high adherence would be useful for other areas of preventive care and other jurisdictions. PMID:26089885

Quality of Care for Patients with Type 2 Diabetes Mellitus in Dubai: A HEDIS-Like Assessment.

PubMed

Szabo, Shelagh M; Osenenko, Katherine M; Qatami, Lara; Korenblat Donato, Bonnie M; Korol, Ellen E; Al Madani, Abdulrazzaq A; Al Awadi, Fatheya F; Al-Ansari, Jaber; Maclean, Ross; Levy, Adrian R

2015-01-01

Objective. As little data are available on the quality of type 2 diabetes mellitus (T2DM) care in the Arabian Gulf States, we estimated the proportion of patients receiving recommended monitoring at the Dubai Hospital for T2DM over one year. Methods. Charts from 150 adults with T2DM were systematically sampled and quality of care was assessed during one calendar year, using a Healthcare Effectiveness Data and Information Set- (HEDIS-) like assessment. Screening for glycosylated haemoglobin (HbA1c), low-density lipoprotein (LDL), blood pressure, retinopathy, and nephropathy was considered. Patients were classified based on their most recent test in the period, and predictors of receiving quality care were examined. Results. Mean age was 58 years (standard deviation (SD): 12.4 years) and 33% were males. Over the year, 98% underwent HbA1c screening (50% had control and 28% displayed poor control); 91% underwent LDL screening (65% had control); 55% had blood pressure control; 30% had retinopathy screening; and 22% received attention for nephropathy. No individual characteristics examined predicted receiving quality care. Conclusion. Some guideline monitoring was conducted for most patients; and rates of monitoring for selected measures were comparable to benchmarks from the United States. Greater understanding of factors leading to high adherence would be useful for other areas of preventive care and other jurisdictions.

The association between the pulse pressure gradient at the cranio-cervical junction derived from phase-contrast magnetic resonance imaging and invasively measured pulsatile intracranial pressure in symptomatic patients with Chiari malformation type 1.

PubMed

Frič, Radek; Lindstrøm, Erika Kristina; Ringstad, Geir Andre; Mardal, Kent-André; Eide, Per Kristian

2016-12-01

In symptomatic Chiari malformation type 1 (CMI), impaired intracranial compliance (ICC) is associated with an increased cranio-spinal pulsatile pressure gradient. Phase-contrast magnetic resonance imaging (MRI) represents a non-invasive modality for the assessment of the pulse pressure gradient at the cranio-cervical junction (CCJ). We wished to explore how the MRI-derived pulse pressure gradient (MRI-dP) compares with invasively measured pulsatile intracranial pressure (ICP) in CMI, and with healthy controls. From phase-contrast MRI of CMI patients and healthy controls, we computed cerebrospinal fluid (CSF) flow velocities and MRI-dP at the CCJ. We assessed bidirectional flow and compared the flow between the anterior and the posterior subarachnoid space at the CCJ. We computed total intracranial volume (ICV), ventricular CSF volume (VV), and posterior cranial fossa volume (PCFV). We analyzed the static and pulsatile ICP scores from overnight monitoring in CMI patients. Five CMI patients and four healthy subjects were included. The CMI group had a significantly larger extent of tonsillar ectopia, smaller PCFV, and a smaller area of CSF in the FM. The pulsatile ICP (mean ICP wave amplitude, MWA) was abnormally increased in 4/5 CMI patients and correlated positively with MRI-dP. However, the MRI-dP as well as the CSF flow velocities did not differ significantly between CMI and healthy subjects. Moreover, bidirectional flow was observed in both CMI as well as healthy subjects, with no significant difference. In symptomatic CMI patients, we found a significant association between the pulse pressure gradient at the CCJ derived from phase-contrast MRI and the pulsatile ICP (MWA) measured invasively. However, the MRI-dP was close to identical in CMI patients and healthy subjects. Moreover, the CSF flow velocities at the CCJ and the occurrence of bidirectional flow were not different in CMI patients and healthy individuals. Further studies are required to determine the diagnostic role of phase-contrast MRI in CMI patients.

Diaphragm opening effects on shock wave formation and acceleration in a rectangular cross section channel

NASA Astrophysics Data System (ADS)

Pakdaman, S. A.; Garcia, M.; Teh, E.; Lincoln, D.; Trivedi, M.; Alves, M.; Johansen, C.

2016-11-01

Shock wave formation and acceleration in a high-aspect ratio cross section shock tube were studied experimentally and numerically. The relative importance of geometric effects and diaphragm opening time on shock formation are assessed. The diaphragm opening time was controlled through the use of slit-type (fast opening time) and petal-type (slow opening time) diaphragms. A novel method of fabricating the petal-type diaphragms, which results in a consistent burst pressure and symmetric opening without fragmentation, is presented. High-speed schlieren photography was used to visualize the unsteady propagation of the lead shock wave and trailing gas dynamic structures. Surface-mounted pressure sensors were used to capture the spatial and temporal development of the pressure field. Unsteady Reynolds-Averaged Navier-Stokes simulation predictions using the shear-stress-transport turbulence model are compared to the experimental data. Simulation results are used to explain the presence of high-frequency pressure oscillations observed experimentally in the driver section as well as the cause of the initial acceleration and subsequent rapid decay of shock velocity measured along the top and bottom channel surfaces. A one-dimensional theoretical model predicting the effect of the finite opening time of the diaphragm on the rate of driver depressurization and shock acceleration is proposed. The model removes the large amount of empiricism that accompanies existing models published in the literature. Model accuracy is assessed through comparisons with experiments and simulations. Limitations of and potential improvements in the model are discussed.

Favourable effects of consuming a Palaeolithic-type diet on characteristics of the metabolic syndrome: a randomized controlled pilot-study.

PubMed

Boers, Inge; Muskiet, Frits Aj; Berkelaar, Evert; Schut, Erik; Penders, Ria; Hoenderdos, Karine; Wichers, Harry J; Jong, Miek C

2014-10-11

The main goal of this randomized controlled single-blinded pilot study was to study whether, independent of weight loss, a Palaeolithic-type diet alters characteristics of the metabolic syndrome. Next we searched for outcome variables that might become favourably influenced by a Paleolithic-type diet and may provide new insights in the pathophysiological mechanisms underlying the metabolic syndrome. In addition, more information on feasibility and designing an innovative dietary research program on the basis of a Palaeolithic-type diet was obtained. Thirty-four subjects, with at least two characteristics of the metabolic syndrome, were randomized to a two weeks Palaeolithic-type diet (n = 18) or an isoenergetic healthy reference diet, based on the guidelines of the Dutch Health Council (n = 14). Thirty-two subjects completed the study. Measures were taken to keep bodyweight stable. As primary outcomes oral glucose tolerance and characteristics of the metabolic syndrome (abdominal circumference, blood pressure, glucose, lipids) were measured. Secondary outcomes were intestinal permeability, inflammation and salivary cortisol. Data were collected at baseline and after the intervention. Subjects were 53.5 (SD9.7) year old men (n = 9) and women (n = 25) with mean BMI of 31.8 (SD5.7) kg/m2. The Palaeolithic-type diet resulted in lower systolic blood pressure (-9.1 mmHg; P = 0.015), diastolic blood pressure (-5.2 mmHg; P = 0.038), total cholesterol (-0.52 mmol/l; P = 0.037), triglycerides (-0.89 mmol/l; P = 0.001) and higher HDL-cholesterol (+0.15 mmol/l; P = 0.013), compared to reference. The number of characteristics of the metabolic syndrome decreased with 1.07 (P = 0.010) upon the Palaeolithic-type diet, compared to reference. Despite efforts to keep bodyweight stable, it decreased in the Palaeolithic group compared to reference (-1.32 kg; P = 0.012). However, favourable effects remained after post-hoc adjustments for this unintended weight loss. No changes were observed for intestinal permeability, inflammation and salivary cortisol. We conclude that consuming a Palaeolithic-type diet for two weeks improved several cardiovascular risk factors compared to a healthy reference diet in subjects with the metabolic syndrome. Nederlands Trial Register NTR3002.

X-ray diffraction and spectroscopy study of nano-Eu 2O 3 structural transformation under high pressure

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

Yu, Zhenhai; Wang, Qinglin; Ma, Yanzhang

Nanoscale materials exhibit properties that are quite distinct from those of bulk materials because of their size restricted nature. Here, we investigated the high-pressure structural stability of cubic (C-type) nano-Eu2O3 using in situ synchrotron X-ray diffraction (XRD), Raman and luminescence spectroscopy, and impedance spectra techniques. Our high-pressure XRD experimental results revealed a pressure-induced structural phase transition in nano-Eu2O3 from the C-type phase (space group: Ia-3) to a hexagonal phase (A-type, space group: P-3m1). Our reported transition pressure (9.3 GPa) in nano-Eu2O3 is higher than that of the corresponding bulk-Eu2O3 (5.0 GPa), which is contrary to the preceding reported experimental result.more » After pressure release, the A-type phase of Eu2O3 transforms into a new monoclinic phase (B-type, space group: C2/m). Compared with bulk-Eu2O3, C-type and A-type nano-Eu2O3 exhibits a larger bulk modulus. Our Raman and luminescence findings and XRD data provide consistent evidence of a pressure-induced structural phase transition in nano-Eu2O3. To our knowledge, we have performed the first high-pressure impedance spectra investigation on nano-Eu2O3 to examine the effect of the structural phase transition on its transport properties. We propose that the resistance inflection exhibited at ~12 GPa results from the phase boundary between the C-type and A-type phases. Besides, we summarized and discussed the structural evolution process by the phase diagram of lanthanide sesquioxides (Ln2O3) under high pressure.« less

Reliability of intraventricular pressure measurement with fiberoptic or solid-state transducers: avoidance of a methodological error.

PubMed

Raabe, A; Stöckel, R; Hohrein, D; Schöche, J

1998-01-01

The failure of intraventricular pressure measurement in cases of catheter blockage or dislodgement is thought to be eliminated by using intraventricular microtransducers. We report on an avoidable methodological error that may affect the reliability of intraventricular pressure measurement with these devices. Intraventricular fiberoptic or solid-state devices were implanted in 43 patients considered to be at risk for developing catheter occlusion. Two different types were used, i.e., devices in which the transducer is placed inside the ventriculostomy catheter (Type A) and devices in which the transducer is integrated in the external surface of the catheter (Type B). Type A devices were used in 15 patients and Type B devices in 28 patients. Pressure recordings were checked at bedside for the validity and reliability of the measurement. Of the 15 patients treated with Type A devices, no reliable pressure recordings were able to be obtained in three patients in whom ventricular punctures were not successful. In 4 of the remaining 12 patients, periods of erroneous pressure readings were detected. After opening of cerebrospinal fluid drainage, all Type A devices failed to reflect real intraventricular pressure. In patients treated with Type B devices, no erroneous pressure recordings were able to be identified, irrespective of whether cerebrospinal fluid drainage was performed. Even when ventricular puncture failed, pressure measurement was correct each time. Transducers that are simply placed inside the ventriculostomy catheter require fluid-coupling. They may fail, either during cerebrospinal fluid drainage or when the catheter is blocked or placed within the parenchyma.

ATC contingency operations in the en-route flight regime

NASA Technical Reports Server (NTRS)

Lyman, E. G.

1981-01-01

Air traffic control (ATC) operations were examined to learn what factors of controller performance should be given consideration in the design and development of future automation systems enhancing ATC. Contingencies were of two types: those constraining airspace usage or traffic flow (i.e., weather); and those related to system and equipment usage (i.e., radar/radio status). Examination of controller response to contingencies and workload pressures showed differing effects on controller allocations of effort among the three primary function of planning, monitoring, and informaton transfer. Automation advancements oriented towards aiding the controller in performing monitoring tasks may offer the most substantial safety benefit.

Anthropogenic chemical cues can alter the swimming behaviour of juvenile stages of a temperate fish.

PubMed

Díaz-Gil, Carlos; Cotgrove, Lucy; Smee, Sarah Louise; Simón-Otegui, David; Hinz, Hilmar; Grau, Amalia; Palmer, Miquel; Catalán, Ignacio A

2017-04-01

Human pressure on coastal areas is affecting essential ecosystems including fish nursery habitats. Among these anthropogenic uses, the seasonal increment in the pressure due to leisure activities such as coastal tourism and yachting is an important environmental stressor in many coastal zones. These pressures may elicit understudied impacts due to, for example, sunscreens or other seasonal pollutants. The island of Majorca, northwest Mediterranean Sea, experiences one of the highest number of tourist visits per capita in the world, thus the surrounding coastal habitat is subject to high anthropogenic seasonal stress. Studies on early stages of fishes have observed responses to coastal chemical cues for the selection or avoidance of habitats. However, the potential interferences of human impacts on these signals are largely unknown. A choice chamber was used to determine water type preference and behaviour in naïve settled juvenile gilt-head sea bream (Sparus aurata), a temperate species of commercial interest. Fish were tested individually for behavioural changes with respect to water types from potential beneficial habitats, such as seawater with extract of the endemic seagrass Posidonia oceanica, anthropogenically influenced habitats such as water extracted from a commercial and recreational harbour and seawater mixed with sunscreen at concentrations observed in coastal waters. Using a Bayesian approach, we investigated a) water type preference; b) mean speed; and c) variance in the movement (as an indicator of burst swimming activity, or "sprint" behaviour) as behavioural descriptors with respect to water type. Fish spent similar percentage of time in treatment and control water types. However, movement descriptors showed that fish in sunscreen water moved slower (98.43% probability of being slower) and performed fewer sprints (90.1% probability of having less burst in speed) compared to control water. Less evident increases in sprints were observed in harbour water (73.56% more sprints), and seagrass (79.03% more) in comparison to control water. When seagrass water was tested against harbour water, the latter elicited a higher number of sprints (91.66% increase). We show that juvenile gilt-head seabream are able to react to a selection of naturally occurring chemically different odourscapes, including the increasingly important presence of sunscreen products, and provide a plausible interpretation of the observed behavioural patterns. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effect of Wrist Posture on Carpal Tunnel Pressure while Typing

PubMed Central

Rempel, David M.; Keir, Peter J.; Bach, Joel M.

2009-01-01

Long weekly hours of keyboard use may lead to or aggravate carpal tunnel syndrome. The effects of typing on fluid pressure in the carpal tunnel, a possible mediator of carpal tunnel syndrome, are unknown. Twenty healthy subjects participated in a laboratory study to investigate the effects of typing at different wrist postures on carpal tunnel pressure of the right hand. Changes in wrist flexion/extension angle (p = 0.01) and radial/ulnar deviation angle (p = 0.03) independently altered carpal tunnel pressure; wrist deviations in extension or radial deviation were associated with an increase in pressure. The activity of typing independently elevated carpal tunnel pressure (p= 0.001) relative to the static hand held in the same posture. This information can guide the design and use of keyboards and workstations in order to minimize carpal tunnel pressure while typing. The findings may also be useful to clinicians and ergonomists in the management of patients with carpal tunnel syndrome who use a keyboard. PMID:18383144

Microclimate and development of pressure ulcers and superficial skin changes.

PubMed

Yusuf, Saldy; Okuwa, Mayumi; Shigeta, Yoshie; Dai, Misako; Iuchi, Terumi; Rahman, Sulaiman; Usman, Awaluddin; Kasim, Sukmawati; Sugama, Junko; Nakatani, Toshio; Sanada, Hiromi

2015-02-01

This study aims to evaluate the microclimate and development of pressure ulcers and superficial skin changes. A prospective cohort study was conducted in an acute care ward in Indonesia. Risk factors for pressure ulcers and superficial skin changes were identified based on the Bergstrom Braden conceptual model. Microclimate data were collected every 3 days for 15 days while the development of pressure ulcers and superficial skin changes was observed every day. Pressure ulcers and superficial skin changes were developed in 20 of the 71 participants. Total mean difference in skin temperature was higher for patients with pressure ulcers and superficial skin changes (0·9 ± 0·6°C) compared with controls (0·6 ± 0·8°C) (P = 0·071). Binary logistic regression predictor values for pressure ulcers and superficial skin changes were 0·111 for type of sheet and 0·347 for Braden Scale results. In conclusion, difference in skin temperature seems to be a predictor for pressure ulcer development and superficial skin changes, while synthetic fibre sheets are able to maintain a beneficial microclimate. © 2013 The Authors. International Wound Journal © 2013 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Computer-aided technique for automatic determination of the relationship between transglottal pressure change and voice fundamental frequency.

PubMed

Deguchi, Shinji; Kawashima, Kazutaka; Washio, Seiichi

2008-12-01

The effect of artificially altered transglottal pressures on the voice fundamental frequency (F0) is known to be associated with vocal fold stiffness. Its measurement, though useful as a potential diagnostic tool for noncontact assessment of vocal fold stiffness, often requires manual and painstaking determination of an unstable F0 of voice. Here, we provide a computer-aided technique that enables one to carry out the determination easily and accurately. Human subjects vocalized in accordance with a series of reference sounds from a speaker controlled by a computer. Transglottal pressures were altered by means of a valve embedded in a mouthpiece. Time-varying vocal F0 was extracted, without manual procedures, from a specific range of the voice spectrum determined on the basis of the controlled reference sounds. The validity of the proposed technique was assessed for 11 healthy subjects. Fluctuating voice F0 was tracked automatically during experiments, providing the relationship between transglottal pressure change and F0 on the computer. The proposed technique overcomes the difficulty in automatic determination of the voice F0, which tends to be transient both in normal voice and in some types of pathological voice.

Facile control of nanoporosity in Cellulose Acetate using Nickel(II) nitrate additive and water pressure treatment for highly efficient battery gel separators.

PubMed

Lee, Woong Gi; Kim, Do Hyeong; Jeon, Woo Cheol; Kwak, Sang Kyu; Kang, Seok Ju; Kang, Sang Wook

2017-04-28

We succeed in fabricating nearly straight nanopores in cellulose acetate (CA) polymers for use as battery gel separators by utilizing an inorganic hexahydrate (Ni(NO 3 ) 2 ·6H 2 O) complex and isostatic water pressure treatment. The continuous nanopores are generated when the polymer film is exposed to isostatic water pressure after complexing the nickel(II) nitrate hexahydrate (Ni(NO 3 ) 2 ·6H 2 O) with the CA. These results can be attributed to the manner in which the polymer chains are weakened because of the plasticization effect of the Ni(NO 3 ) 2 ·6H 2 O that is incorporated into the CA. Furthermore, we performed extensive molecular dynamics simulation for confirming the interaction between electrolyte and CA separator. The well controlled CA membrane after water pressure treatment enables fabrication of highly reliable cell by utilizing 2032-type coin cell structure. The resulting cell performance exhibits not only the effect of the physical morphology of CA separator, but also the chemical interaction of electrolyte with CA polymer which facilitates the Li-ion in the cell.

SPERT I DESTRUCTIVE TEST PROGRAM SAFETY ANALYSIS REPORT

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

Spano, A.H.; Miller, R.W.

1962-06-15

The water-moderated core used for destructive experiments is mounted in the Spent I open-type reactor vessel, which has no provision for pressurization or forced coolant flow. The core is an array of highly enriched aluminum clad, plate-type fuel assemblies, using four bladetype, gang-operated control rods. Reactor transients are initiated at ambient temperature by step-insentions of reactivity, using a control rod which can be quickly ejected from the core. Following an initial series of static measurements to determine the basic- reactor properties of the test core, a series of nondestructive, self-limiting power excursion tests was performed, which covered a reactor periodmore » range down to the point where minor fuel plate damage first occurred -approximately for a 10- msec period test. These tests provided power, temperature, and pressure data. Additional kinetic teste in the period region between 10 and 5 msec were completed to explore the region of limited core damage. Fuel plate damage results included plate distortion, cladding cracking, and fuel melting. These exploratory tests were valuable in revealing unexpected changes in the dependence of pressure, temperature, burst energy, and burst shape parameters on reactor period, although the dependence of peak power on reactor period was not significantly changed. An evaluation of hazards involved in conducting the 2- msec test, based on pessimistic assumptions regarding fission product release and weather conditions, indicates that with the procedural controls normally exercised in the conduct of any transient test at Spent and the special controls to be in effect during the destructive test series, no significant hazard to personnel or to the general public will be obtained. All nuclear operation is conducted remotely approximately 1/2 mile from the reactor building. Discussion is also given of the supervision and control of personnel during and after each destructive test, and of the plans for re-entry, cleanup, and restoration of the facility. (auth)« less

Finite element analysis and experiment on high pressure apparatus with split cylinder

NASA Astrophysics Data System (ADS)

Zhao, Liang; Li, Mingzhe; Yang, Yunfei; Wang, Bolong; Li, Yi

2017-07-01

Ultra-high pressure belt-type die was designed with a large sample volume prism cavity and a split cylinder which was divided into eight segments to eliminate circumferential stress. The cylinder of this type die has no cambered surface on inner wall, and the inner hole is a hexagonal prism-type cavity. The divided bodies squeeze with each other, providing the massive support and lateral support effect of the cylinder. Simulation results indicate that the split cylinder with the prism cavity possesses much smaller stress and more uniform stress distribution. The split cylinder with the prism cavity has been shown to bear larger compressive stresses in radial, circumferential and axial directions due to its structure, and tungsten carbide is most effective in pure compression so this type cylinder could bear higher pressure. Experimental results prove that the high pressure apparatus with a prism-type cavity could bear higher pressure. The apparatus with a prism cavity could bear 52.2% more pressure than the belt-type die.

Analysis of High Speed Jets Produced by a Servo Tube Driven Liquid Jet Injector

NASA Astrophysics Data System (ADS)

Portaro, Rocco; Ng, Hoi Dick

2017-11-01

In today's healthcare environment many types of medication must be administered through the use of hypodermic needles. Although this practice has been in use for many years, drawbacks such as accidental needle stick injuries, transmission of deadly viruses and bio-hazardous waste are still present. This study focuses on improving a needle free technology known as liquid jet injection, through the implementation of a linear servo tube actuator for the construction of a fully closed loop liquid jet injection system. This device has the ability to deliver both micro- and macro- molecules, high viscosity fluids whilst providing real time control of the jet pressure profile for accurate depth and dispersion control. The experiments are conducted using a prototype that consists of a 3 kW servo tube actuator, coupled to a specially designed injection head allowing nozzle size and injection volume to be varied. The device is controlled via a high speed servo amplifier and FPGA. The high speed jets emanating from the injector are assessed via high speed photography and through the use of a force transducer. Preliminary results indicate that the system allows for accurate shaping of the jet pressure profile, making it possible to target different tissue depths/types accurately.

Optimization of impedance spectroscopy techniques for measuring cutaneous micropore formation after microneedle treatment in an elderly population.

PubMed

Kelchen, Megan N; Holdren, Grant O; Farley, Matthew J; Zimmerman, M Bridget; Fairley, Janet A; Brogden, Nicole K

2014-12-01

The objective of this study was to optimize a reproducible impedance spectroscopy method in elderly subjects as a means to evaluate the effects of microneedles on aging skin. Human volunteers were treated with microneedles at six sites on the upper arm. Repeated impedance measurements were taken pre- and post-microneedle insertion. Two electrode types were evaluated (dry vs. gel), using either light or direct pressure to maintain contact between the electrode and skin surface. Transepidermal water loss (TEWL) was measured as a complementary technique. Five control subjects and nine elderly subjects completed the study. Microneedle insertion produced a significant decrease in impedance from baseline in all subjects (p < 0.05, regardless of electrode type or pressure application), confirming micropore formation. This was supported by a complementary significant increase in TEWL (p < 0.05). The gel*direct condition produced the lowest variability between measurements, as demonstrated by a coefficient of variation of 3.8% and 3.5% (control and elderly subjects, respectively). This was lower than variation between TEWL measurements at the same sites: 19.8% and 21.6% (control and elderly subjects, respectively). Impedance spectroscopy reproducibly measures micropore formation in elderly subjects, which will be essential for future studies describing microneedle-assisted transdermal delivery in aging populations.

Investigation of Convection and Pressure Treatment with Splitting Techniques

NASA Technical Reports Server (NTRS)

Thakur, Siddharth; Shyy, Wei; Liou, Meng-Sing

1995-01-01

Treatment of convective and pressure fluxes in the Euler and Navier-Stokes equations using splitting formulas for convective velocity and pressure is investigated. Two schemes - controlled variation scheme (CVS) and advection upstream splitting method (AUSM) - are explored for their accuracy in resolving sharp gradients in flows involving moving or reflecting shock waves as well as a one-dimensional combusting flow with a strong heat release source term. For two-dimensional compressible flow computations, these two schemes are implemented in one of the pressure-based algorithms, whose very basis is the separate treatment of convective and pressure fluxes. For the convective fluxes in the momentum equations as well as the estimation of mass fluxes in the pressure correction equation (which is derived from the momentum and continuity equations) of the present algorithm, both first- and second-order (with minmod limiter) flux estimations are employed. Some issues resulting from the conventional use in pressure-based methods of a staggered grid, for the location of velocity components and pressure, are also addressed. Using the second-order fluxes, both CVS and AUSM type schemes exhibit sharp resolution. Overall, the combination of upwinding and splitting for the convective and pressure fluxes separately exhibits robust performance for a variety of flows and is particularly amenable for adoption in pressure-based methods.

Muscular subaortic stenosis: the initial left ventricular inflow tract pressure as evidence of outflow tract obstruction.

PubMed

Wigle, E D; Auger, P; Marquis, Y

1966-10-15

Two types of intraventricular pressure differences within the left ventricle of man are described. The first is encountered in cases of muscular (or fibrous) subaortic stenosis, in which the outflow tract pressure distal to the stenosis (and proximal to the aortic valve) is low, whereas all pressures recorded in the left ventricle proximal to the stenosis, including that just inside the mitral valve (the initial inflow tract pressure) are high.The second type of intraventricular pressure difference may be recorded in patients without muscular subaortic stenosis when a heart catheter is advanced to the left ventricular wall in such a manner that it becomes imbedded or entrapped by cardiac muscle in systole. Such an entrapped catheter records a high intraventricular pressure that is believed to reflect intramyocardial tissue pressure, which normally exceeds intracavitary pressure. In such cases the initial inflow tract pressure is not high and is precisely equal to the outflow tract systolic pressure, i.e. both are recording intracavity pressure. This type of intramyocardial to intracavitary pressure difference may also be encountered in the left ventricle of dogs.The recent suggestion that intraventricular pressure differences in the left ventricle of cases of muscular subaortic stenosis are due to catheter entrapment by cardiac muscle is refuted by using the initial inflow tract pressure as the means of differentiation between the two types of intraventricular pressure differences outlined.

Generalized Hyperalgesia in Children and Adults Diagnosed With Hypermobility Syndrome and Ehlers-Danlos Syndrome Hypermobility Type: A Discriminative Analysis.

PubMed

Scheper, M C; Pacey, V; Rombaut, L; Adams, R D; Tofts, L; Calders, P; Nicholson, L L; Engelbert, R H H

2017-03-01

Lowered pressure-pain thresholds have been demonstrated in adults with Ehlers-Danlos syndrome hypermobility type (EDS-HT), but whether these findings are also present in children is unclear. Therefore, the objectives of the study were to determine whether generalized hyperalgesia is present in children with hypermobility syndrome (HMS)/EDS-HT, explore potential differences in pressure-pain thresholds between children and adults with HMS/EDS-HT, and determine the discriminative value of generalized hyperalgesia. Patients were classified in 1 of 3 groups: HMS/EDS-HT, hypermobile (Beighton score ≥4 of 9), and healthy controls. Descriptive data of age, sex, body mass index, Beighton score, skin laxity, and medication usage were collected. Generalized hyperalgesia was quantified by the average pressure-pain thresholds collected from 12 locations. Confounders collected were pain locations/intensity, fatigue, and psychological distress. Comparisons between children with HMS/EDS-HT and normative values, between children and adults with HMS/EDS-HT, and corrected confounders were analyzed with multivariate analysis of covariance. The discriminative value of generalized hyperalgesia employed to differentiate between HMS/EDS-HT, hypermobility, and controls was quantified with logistic regression. Significantly lower pressure-pain thresholds were found in children with HMS/EDS-HT compared to normative values (range -22.0% to -59.0%; P ≤ 0.05). When applying a threshold of 30.8 N/cm 2 for males and 29.0 N/cm 2 for females, the presence of generalized hyperalgesia discriminated between individuals with HMS/EDS-HT, hypermobility, and healthy controls (odds ratio 6.0). Children and adults with HMS/EDS-HT are characterized by hypermobility, chronic pain, and generalized hyperalgesia. The presence of generalized hyperalgesia may indicate involvement of the central nervous system in the development of chronic pain. © 2016, American College of Rheumatology.

Comparison of anti-siphon devices-how do they affect CSF dynamics in supine and upright posture?

PubMed

Gehlen, Manuel; Eklund, Anders; Kurtcuoglu, Vartan; Malm, Jan; Schmid Daners, Marianne

2017-08-01

Three different types of anti-siphon devices (ASDs) have been developed to counteract siphoning-induced overdrainage in upright posture. However, it is not known how the different ASDs affect CSF dynamics under the complex pressure environment seen in clinic due to postural changes. We investigated which ASDs can avoid overdrainage in upright posture best without leading to CSF accumulation. Three shunts each of the types Codman Hakim with SiphonGuard (flow-regulated), Miethke miniNAV with proSA (gravitational), and Medtronic Delta (membrane controlled) were tested. The shunts were compared on a novel in vitro setup that actively emulates the physiology of a shunted patient. This testing method allows determining the CSF drainage rates, resulting CSF volume, and intracranial pressure in the supine, sitting, and standing posture. The flow-regulated ASDs avoided increased drainage by closing their primary flow path when drainage exceeded 1.39 ± 0.42 mL/min. However, with intraperitoneal pressure increased in standing posture, we observed reopening of the ASD in 3 out of 18 experiment repetitions. The adjustable gravitational ASDs allow independent opening pressures in horizontal and vertical orientation, but they did not provide constant drainage in upright posture (0.37 ± 0.03 mL/min and 0.26 ± 0.03 mL/min in sitting and standing posture, respectively). Consequently, adaptation to the individual patient is critical. The membrane-controlled ASDs stopped drainage in upright posture. This eliminates the risk of overdrainage, but leads to CSF accumulation up to the volume observed without shunting when the patient is upright. While all tested ASDs reduced overdrainage, their actual performance will depend on a patient's specific needs because of the large variation in the way the ASDs influence CSF dynamics: while the flow-regulated shunts provide continuous drainage in upright posture, the gravitational ASDs allow and require additional adaptation, and the membrane-controlled ASDs show robust siphon prevention by a total stop of drainage.

Study protocol: a randomised placebo-controlled clinical trial to study the effect of vitamin D supplementation on glycaemic control in type 2 Diabetes Mellitus SUNNY trial.

PubMed

Krul-Poel, Yvonne H M; van Wijland, Hans; Stam, Frank; ten Boekel, Edwin; Lips, Paul; Simsek, Suat

2014-07-17

Besides the classical role of vitamin D on calcium and bone homeostasis, vitamin D deficiency has recently been identified as a contributing factor in the onset of insulin resistance in type 2 diabetes mellitus. However, it is uncertain whether vitamin D deficiency and poor glycaemic control are causally interrelated or that they constitute two independent features of type 2 diabetes mellitus. There are limited clinical trials carried out which measured the effect of vitamin D supplementation on glycaemic control.The objective of this study is to investigate the effect of vitamin D supplementation on glycaemic control and quality of life in patients with type 2 diabetes mellitus. In a randomised double-blind placebo-controlled trial conducted in five general practices in the Netherlands three hundred patients with type 2 diabetes mellitus treated with lifestyle advises or metformin or sulphonylurea-derivatives are randomised to receive either placebo or 50,000 IU Vitamin D3 at monthly intervals. The primary outcome measure is the change in glycated haemoglobin level between baseline and six months. Secondary outcome measures include blood pressure, anthropometric parameters, lipid profile, insulin resistance, quality of life, advanced glycation end products and safety profiles. Quality of life will be measured by The Short Form (SF-36) Health Survey questionnaire. Advanced glycation end products are measured by an AGE-reader. This trial will be the first study exploring the effect of vitamin D supplementation on both glycaemic control and quality of life in patients with type 2 diabetes mellitus. Our findings will contribute to the knowledge of the relationship between vitamin D status and insulin resistance in patients with type 2 diabetes mellitus. The Netherlands trial register: NTR3154.

Renal Vascular Clamp Placement: A Potential Cause of Incomplete Hilar Control during Partial Nephrectomy.

PubMed

Tryon, David; Myklak, Kristene; Alsyouf, Muhannad; Conceicao, Carol; Peplinski, Brandon; Arenas, Javier L; Faaborg, Daniel; Ruckle, Herbert C; Baldwin, D Duane

2016-03-01

Previous benchtop studies have shown that robotic bulldog clamps provide incomplete vascular control of a Penrose drain. We determined the efficacy of robotic and laparoscopic bulldog clamps to ensure hemostasis on the human renal artery. The effect of clamp position on vascular control was also examined. Fresh human cadaveric renal arteries were used to determine the leak point pressure of 7 bulldog clamps from a total of 3 manufacturers. Five trials were performed per clamp at 4 locations, including the fulcrum, proximal, middle and distal positions. Comparison was done using the Kruskal-Wallis test with p <0.05 considered significant. None of the bulldog clamps leaked at a pressure less than 215 mm Hg when applied at the proximal, middle or distal position. In general leak point pressure decreased as the artery was positioned more distal along the clamp. The exception was when the vessel was placed at the fulcrum position. At that position 80% to 100% of trials with the Klein laparoscopic, 100% with the Klein robotic (Klein Robotic, San Antonio, Texas) and 60% to 80% with the Scanlan robotic (Scanlan International, Saint Paul, Minnesota) clamp leaked at pressure below 215 mm Hg. Each vascular clamp adequately occluded flow at physiological pressure when placed at the proximal, middle or distal position. Furthermore, these results demonstrate that there is leakage at physiological pressure when the artery is placed at the fulcrum of certain clamp types. These results suggest that applying a bulldog clamp at the fulcrum could potentially lead to inadequate vessel occlusion and intraoperative bleeding. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

[Experimental model for the examination of inner pressure tolerance of telescopic anastomosis and other frequently performed anastomosis types of the esophagus].

PubMed

Szúcs, G; Tóth, I; Bráth, E; Gyáni, K; Miko, I

2001-08-01

We have good results with telescopic anastomosis technique in partial oesophagectomies and gastrectomies. As we could not find data about the healing process of telescopic anastomoses so we started experimenting. Inside pressure tolerance was examined immediately after performing anastomoses by measuring the bursting pressure using the organs of pigs slaughtered in the meat industry. Both oesophago-gastrostomies and oesophago-jejunostomies were performed with telescopic, single layer interrupted, single layer continuous, double layer interrupted and double layer continuous-interrupted technique, 9 of each anastomosis. A series of oesophago-jejunostomies were performed with EEA stapler. 99 anastomoses of 11 types were investigated. We found, that the inner pressure tolerance of telescopic oesophago-gastrostomy is better than any other single layer type variant. On the other hand the double layer type variants have much better pressure tolerance than the telescopic and other two type single layer anastomoses. The difference is statistically significant. In oesophago-jejunostomies the pressure tolerance of telescopic anastomosis is better than of the single layer interrupted type but the difference between the telescopic and single layer continuous type anastomoses is not significant. The pressure tolerance of double layer anastomosis is higher than the telescopic one but the difference is significant only in the continuous-interrupted type. The inner pressure tolerance of telescopic and EEA stapler anastomoses are equal. The investigation of additional features in anastomosis healing is in progress.

Mean Blood Pressure Difference among Adolescents Based on Dyssomnia Types.

PubMed

Sembiring, Krisnarta; Ramayani, Oke Rina; Lubis, Munar

2018-02-15

Dyssomnia is the most frequent sleep disturbance and associated with increased blood pressure. There has been no study determining the difference in mean blood pressure based on dyssomnia types among adolescents. To determine the difference in mean blood pressure among adolescents based on dyssomnia types. Cross-sectional study was conducted in SMP Negeri 1 Muara Batang Gadis in April 2016. Samples were students having sleep disturbance based on Sleep Disturbance Scale for Children (SDSC) questionnaire. Stature and blood pressure data were collected along with demographic data and sleep disorder questionnaire. Analyses were done with Kruskal-Wallis test and logistic regression. P - value < 0.05 was considered significant. Seventy-six samples were obtained with mean age 13.9 (SD 1.14) years - old. Dyssomnia proportion and hypertension were 72/76 and 20/76 respectively. Mean systolic (SBP) and diastolic blood pressure (DBP) was 111.1 (SD 16.46) mmHg and 70.3 (SD 11.98) mmHg respectively. Mean SDSC score was 49.7 (SD 8.96), and the most frequent dyssomnia type was disorders of initiating and maintaining sleep. Age and sex were not the risk factors of hypertension in dyssomnia. There was a significant difference in mean SBP (P = 0.006) and DBP (P = 0.022) based on dyssomnia types. Combination dyssomnia type had the highest mean blood pressure among dyssomnia types. There is a significant difference in mean blood pressure among adolescents based on dyssomnia types.

The effect of green tea and sour tea on blood pressure of patients with type 2 diabetes: a randomized clinical trial.

PubMed

Mozaffari-Khosravi, Hassan; Ahadi, Zeinab; Barzegar, Kazem

2013-06-01

The use of herbal medicines including different types of tea is among the different strategies for preventing and controlling the side-effects of diabetes. The aim of the present study was to compare the effect of sour tea and green tea on mildly hypertensive patients with diabetes. The present study was a randomized clinical trial in which 100 mildly hypertensive patients with diabetes were randomly assigned into sour tea group (ST) and green tea group (GT). They were instructed to drink sour tea and green tea infusion, respectively, three times a day 2 hr after each meal for 4 weeks. The participants' blood pressure was measured at days 1, 15, and at the end of study. The systolic pressure of both groups statistically decreased at the end of the study; it decreased from 123.1 ± 15.5 to 116.8 ± 16.3 mmHg in the ST and from 119.4 ± 15.1 to 114.8 ± 15.9 mmHg in the GT. The diastolic pressure of both groups statistically decreased by the end of the study; it decreased from 79.4 ± 11.1 to 74.5 ± 9.3 mmHg in the ST and from 78.9 ± 8.3 to 75.3 ± 7.7 mmHg in the GT. The therapeutic effectiveness of tea drinking by the end of intervention was 43.5% in the ST and 39.6% in the GT compared to the beginning. The present study revealed that mildly hypertensive type 2 diabetic individuals who drink three glasses of green or sour tea daily for 4 weeks show significant decreased systolic and diastolic blood pressures.

Ultrasonic sludge pretreatment under pressure.

PubMed

Le, Ngoc Tuan; Julcour-Lebigue, Carine; Delmas, Henri

2013-09-01

The objective of this work was to optimize the ultrasound (US) pretreatment of sludge. Three types of sewage sludge were examined: mixed, secondary and secondary after partial methanisation ("digested" sludge). Thereby, several main process parameters were varied separately or simultaneously: stirrer speed, total solid content of sludge (TS), thermal operating conditions (adiabatic vs. isothermal), ultrasonic power input (PUS), specific energy input (ES), and for the first time external pressure. This parametric study was mainly performed for the mixed sludge. Five different TS concentrations of sludge (12-36 g/L) were tested for different values of ES (7000-75,000 kJ/kgTS) and 28 g/L was found as the optimum value according to the solubilized chemical oxygen demand in the liquid phase (SCOD). PUS of 75-150 W was investigated under controlled temperature and the "high power input - short duration" procedure was the most effective at a given ES. The temperature increase in adiabatic US application significantly improved SCOD compared to isothermal conditions. With PUS of 150 W, the effect of external pressure was investigated in the range of 1-16 bar under isothermal and adiabatic conditions for two types of sludge: an optimum pressure of about 2 bar was found regardless of temperature conditions and ES values. Under isothermal conditions, the resulting improvement of sludge disintegration efficacy as compared to atmospheric pressure was by 22-67% and 26-37% for mixed and secondary sludge, respectively. Besides, mean particle diameter (D[4,3]) of the three sludge types decreased respectively from 408, 117, and 110 μm to about 94-97, 37-42, and 36-40 μm regardless of sonication conditions, and the size reduction process was much faster than COD extraction. Copyright © 2013 Elsevier B.V. All rights reserved.

Prevalence of glomerular hyperfiltration and nephromegaly in normo- and microalbuminuric type 2 diabetic patients.

PubMed

Gragnoli, G; Signorini, A M; Tanganelli, I; Fondelli, C; Borgogni, P; Borgogni, L; Vattimo, A; Ferrari, F; Guercia, M

1993-01-01

Glomerular hyperfiltration, correlated with nephromegaly, is a frequent finding in type 1 (insulin-dependent) diabetes. In type 2 (non-insulin-dependent) diabetes, very few studies have been performed, and the results have been inconclusive. Glomerular filtration rate (GFR) and kidney volume, using 99mTc-DTPA scintigraphy and ultrasonography, respectively, were evaluated in 58 control subjects and 163 type 2 diabetic patients; 79 of whom were normoalbuminuric and 84 microalbuminuric. In the two groups of patients, these parameters did not differ significantly from those of controls, even when hypertensive subjects were excluded. Glomerular hyperfiltration was observed in 10 cases; all were normotensive (9.8%), of whom 7 were normoalbuminuric and 3 microalbuminuric. Nephromegaly was observed in 3 other normotensive microalbuminuric diabetic patients. Hypertensive subjects showed a lower GFR than normotensive patients and control subjects. Multivariate analysis showed a negative correlation between glomerular filtrate and systolic blood pressure (BP) in the overall population of patients and in normo- and microalbuminuric patients taken separately. It is concluded that the relationship between these variables forms a continuum in our type 2 diabetic patients; it may also be important in determining the low prevalence of hyperfiltration and nephromegaly found in our patients, who had BP levels higher than those of controls.

[Cardiovascular risk factor control in a population with longstanding diabetes attending endocrinology departments].

PubMed

Comi-Diaz, Cristina; Miralles-García, José M; Cabrerizo, Lucio; Pérez, María; Masramon, Xavier; De Pablos-Velasco, Pedro

2010-12-01

To determine the degree of control of cardiovascular risk factors (CVRF) in a sample of patients with diabetes mellitus (DM) attending Endocrinology and Nutrition Departments in Spain. An epidemiological, cross-sectional, multicenter and observational study involving 41 Departments of Endocrinology and Nutrition in Spain. Each department selected patients with DM with over 10 years of evolution, which were treated in outpatient settings. Demographic, anthropometric, clinical and biochemical data, including medication, were collected for each participant. 1159 patients who met the inclusion criteria were recruited. 52% of the participants were patients with type 2 DM. The mean duration of DM was 19.6 years. A proportion of 37%, 44%, 27.6% and 25.5% had good control of their blood pressure (BP), low density cholesterol (LDLc), lipids and glucose, respectively, and only 4.3% did well in all factors evaluated. The percentage of poorly controlled BP was four times higher in type 2 than in type 1 DM. Obesity, low cultural level and aggregation of cardiovascular risk factors were associated with poorer control. The degree of control of CVRF in diabetic patients with long disease duration is insufficient. Copyright © 2010 SEEN. Published by Elsevier Espana. All rights reserved.

The use of pressure controlled Fabry-Pérot interferometer with linear scanning of data for Brillouin-type experiments

NASA Astrophysics Data System (ADS)

Błachowicz, Tomasz

2000-08-01

The article presents results from work with Fabry-Pérot interferometers in Brillouin laser light scattering experiments, where optical signals of very low level intensity are observed. The information presented here can be useful in other types of optical experiments where scanning in the Fabry-Pérot interferometer spectral range has to be used. In such situations the shape of spectral lines as well as their relative distances can be detected. The key to the solution presented here is the use of a silicon-membrane pressure sensor coupled to a pressure chamber. It makes it possible to view spectral lines equally spaced after nonlinear flow of air from a chamber where the Fabry-Pérot interferometer is placed. Linear scanning in the spectral range equal to a frequency of about 150 GHz is possible. The method can be applied to Fabry-Pérot's etalons, very frequently produced some years ago. Now it should find new fields of application, in a simple and cost effective way, in student laboratories as well as in other research institutions.

Effects of High-Intensity Interval Training on People Living with Type 2 Diabetes: A Narrative Review.

PubMed

Wormgoor, Shohn G; Dalleck, Lance C; Zinn, Caryn; Harris, Nigel K

2017-10-01

People with type 2 diabetes typically present with comorbidities, such as elevated blood pressure, high cholesterol, high blood glucose, obesity and decreased fitness, all contributive to increased risk for cardiovascular complications. Determination of effective exercise modalities for the management of such complications is important. One such modality is high-intensity interval training (HIIT). To conduct the review, PubMed and EBSCOHost databases were searched through June 1, 2016, for all HIIT intervention studies conducted in people living with type 2 diabetes. Thereafter, the central characteristics of HIIT were analyzed to obtain a broader understanding of the cardiometabolic benefits achievable by HIIT. Fourteen studies were included for review, but the heterogeneity of the participants with type 2 diabetes, the training equipment and HIIT parameters, accompanied by variations in supervision, dietary advice and medications, prevented direct comparisons. However HIIT, regardless of the specific parameters employed, was a suitable option in pursuing improved glycemic control, body composition, aerobic fitness, blood pressure and lipidemia measures in individuals with type 2 diabetes. HIIT is a therapy with at least equivalent benefit to moderate-intensity continuous training; hence, HIIT should be considered when prescribing exercise interventions for people living with type 2 diabetes. Copyright © 2017 Diabetes Canada. Published by Elsevier Inc. All rights reserved.

Encountered-Type Haptic Interface for Representation of Shape and Rigidity of 3D Virtual Objects.

PubMed

Takizawa, Naoki; Yano, Hiroaki; Iwata, Hiroo; Oshiro, Yukio; Ohkohchi, Nobuhiro

2017-01-01

This paper describes the development of an encountered-type haptic interface that can generate the physical characteristics, such as shape and rigidity, of three-dimensional (3D) virtual objects using an array of newly developed non-expandable balloons. To alter the rigidity of each non-expandable balloon, the volume of air in it is controlled through a linear actuator and a pressure sensor based on Hooke's law. Furthermore, to change the volume of each balloon, its exposed surface area is controlled by using another linear actuator with a trumpet-shaped tube. A position control mechanism is constructed to display virtual objects using the balloons. The 3D position of each balloon is controlled using a flexible tube and a string. The performance of the system is tested and the results confirm the effectiveness of the proposed principle and interface.

Turning the Waiting Room into a Classroom: Weekly Classes Using a Vegan or a Portion-Controlled Eating Plan Improve Diabetes Control in a Randomized Translational Study.

PubMed

Barnard, Neal D; Levin, Susan M; Gloede, Lise; Flores, Rosendo

2018-06-01

In research settings, plant-based (vegan) eating plans improve diabetes management, typically reducing weight, glycemia, and low-density lipoprotein (LDL) cholesterol concentrations to a greater extent than has been shown with portion-controlled eating plans. The study aimed to test whether similar benefits could be found using weekly nutrition classes in a typical endocrinology practice, hypothesizing that a vegan eating plan would improve glycemic control, weight, lipid concentrations, blood pressure, and renal function and would do so more effectively than a portion-controlled eating plan. In a 20-week trial, participants were randomly assigned to a low-fat vegan or portion-controlled eating plan. Individuals with type 2 diabetes treated in a single endocrinology practice in Washington, DC, participated (45 starters, 40 completers). Participants attended weekly after-hours classes in the office waiting room. The vegan plan excluded animal products and added oils and favored low-glycemic index foods. The portion-controlled plan included energy intake limits for weight loss (typically a deficit of 500 calories/day) and provided guidance on portion sizes. Body weight, hemoglobin A1c (HbA1c), plasma lipids, urinary albumin, and blood pressure were measured. For normally distributed data, t tests were used; for skewed outcomes, rank-based approaches were implemented (Wilcoxon signed-rank test for within-group changes, Wilcoxon two-sample test for between-group comparisons, and exact Hodges-Lehmann estimation to estimate effect sizes). Although participants were in generally good metabolic control at baseline, body weight, HbA1c, and LDL cholesterol improved significantly within each group, with no significant differences between the two eating plans (weight: -6.3 kg vegan, -4.4 kg portion-controlled, between-group P=0.10; HbA1c, -0.40 percentage point in both groups, P=0.68; LDL cholesterol -11.9 mg/dL vegan, -12.7 mg/dL portion-controlled, P=0.89). Mean urinary albumin was normal at baseline and did not meaningfully change. Blood pressure changes were not significant. Weekly classes, integrated into a clinical practice and using either a low-fat vegan or portion-controlled eating plan, led to clinical improvements in individuals with type 2 diabetes. Copyright © 2018 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

A Hydraulic Blowdown Servo System For Launch Vehicle

NASA Astrophysics Data System (ADS)

Chen, Anping; Deng, Tao

2016-07-01

This paper introduced a hydraulic blowdown servo system developed for a solid launch vehicle of the family of Chinese Long March Vehicles. It's the thrust vector control (TVC) system for the first stage. This system is a cold gas blowdown hydraulic servo system and consist of gas vessel, hydraulic reservoir, servo actuator, digital control unit (DCU), electric explosion valve, and pressure regulator etc. A brief description of the main assemblies and characteristics follows. a) Gas vessel is a resin/carbon fiber composite over wrapped pressure vessel with a titanium liner, The volume of the vessel is about 30 liters. b) Hydraulic reservoir is a titanium alloy piston type reservoir with a magnetostrictive sensor as the fluid level indicator. The volume of the reservoir is about 30 liters. c) Servo actuator is a equal area linear piston actuator with a 2-stage low null leakage servo valve and a linear variable differential transducer (LVDT) feedback the piston position, Its stall force is about 120kN. d) Digital control unit (DCU) is a compact digital controller based on digital signal processor (DSP), and deployed dual redundant 1553B digital busses to communicate with the on board computer. e) Electric explosion valve is a normally closed valve to confine the high pressure helium gas. f) Pressure regulator is a spring-loaded poppet pressure valve, and regulates the gas pressure from about 60MPa to about 24MPa. g) The whole system is mounted in the aft skirt of the vehicle. h) This system delivers approximately 40kW hydraulic power, by contrast, the total mass is less than 190kg. the power mass ratio is about 0.21. Have finished the development and the system test. Bench and motor static firing tests verified that all of the performances have met the design requirements. This servo system is complaint to use of the solid launch vehicle.

Patterns of Care and Treatment Target Success among Persons with Type 2 Diabetes Mellitus in Dubai: A Retrospective Cohort Study.

PubMed

Osenenko, Katherine M; Szabo, Shelagh M; Qatami, Lara; Korenblat Donato, Bonnie M; Al Madani, Abdulrazzak Ali; Al Awadi, Fatheya Fardallah; Al-Ansari, Jaber; Maclean, Ross; Levy, Adrian R

2015-09-01

Despite the high prevalence of type 2 diabetes mellitus (T2DM), few data exist describing its management in Dubai. This study characterized the treatment and estimated levels of glycemic, lipid, and blood pressure control among a sample with T2DM at a large Dubai Hospital. This retrospective cohort study systematically sampled charts from adults seeking care for T2DM from October 2009 to March 2010 until the target (N = 250) was reached. Data on patient characteristics, pharmacotherapy, complications, and laboratory testing were abstracted until September 2011. The frequency of treatments and modifications over the period was calculated, and measures of glycosylated hemoglobin A 1c , low-density lipoprotein, and blood pressure control were compared with guideline targets. Frequencies of complications were compared according to treatment type. One-third of the cohort comprised men, and the mean age was 58 years. At enrolment, the mean time from T2DM diagnosis was nearly 15 years and 74% had received insulin. During the study period, the most common regimens were insulin + oral combinations (55%) and oral combination therapy (39%). Overall, 67% received any insulin therapy during the study; and by study end, 78% had received insulin at any time. At the most recent assessment, guideline targets for glycosylated hemoglobin A 1c , blood pressure, and low-density lipoprotein were met by 23%, 29%, and 71%, respectively. Complications were more frequent among those treated with combination or insulin therapies. This study provides baseline data from Dubai for future comparisons of the effectiveness of new treatments, and to better understand the humanistic and economic burden of T2DM and its complications. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Natriuretic peptides buffer renin-dependent hypertension.

PubMed

Demerath, Theo; Staffel, Janina; Schreiber, Andrea; Valletta, Daniela; Schweda, Frank

2014-06-15

The renin-angiotensin-aldosterone system and cardiac natriuretic peptides [atrial natriuretic peptide (ANP) and B-type natriuretic peptide (BNP)] are opposing control mechanisms for arterial blood pressure. Accordingly, an inverse relationship between plasma renin concentration (PRC) and ANP exists in most circumstances. However, PRC and ANP levels are both elevated in renovascular hypertension. Because ANP can directly suppress renin release, we used ANP knockout (ANP(-/-)) mice to investigate whether high ANP levels attenuate the increase in PRC in response to renal hypoperfusion, thus buffering renovascular hypertension. ANP(-/-) mice were hypertensive and had reduced PRC compared with that in wild-type ANP(+/+) mice under control conditions. Unilateral renal artery stenosis (2-kidney, 1-clip) for 1 wk induced similar increases in blood pressure and PRC in both genotypes. Unexpectedly, plasma BNP concentrations in ANP(-/-) mice significantly increased in response to two-kidney, one-clip treatment, potentially compensating for the lack of ANP. In fact, in mice lacking guanylyl cyclase A (GC-A(-/-) mice), which is the common receptor for both ANP and BNP, renovascular hypertension was markedly augmented compared with that in wild-type GC-A(+/+) mice. However, the higher blood pressure in GC-A(-/-) mice was not caused by disinhibition of the renin system because PRC and renal renin synthesis were significantly lower in GC-A(-/-) mice than in GC-A(+/+) mice. Thus, natriuretic peptides buffer renal vascular hypertension via renin-independent effects, such as vasorelaxation. The latter possibility is supported by experiments in isolated perfused mouse kidneys, in which physiological concentrations of ANP and BNP elicited renal vasodilatation and attenuated renal vasoconstriction in response to angiotensin II. Copyright © 2014 the American Physiological Society.

Muscular Subaortic Stenosis

PubMed Central

Wigle, E. Douglas; Auger, Pierre; Marquis, Yves

1966-01-01

Two types of intraventricular pressure differences within the left ventricle of man are described. The first is encountered in cases of muscular (or fibrous) subaortic stenosis, in which the outflow tract pressure distal to the stenosis (and proximal to the aortic valve) is low, whereas all pressures recorded in the left ventricle proximal to the stenosis, including that just inside the mitral valve (the initial inflow tract pressure) are high. The second type of intraventricular pressure difference may be recorded in patients without muscular subaortic stenosis when a heart catheter is advanced to the left ventricular wall in such a manner that it becomes imbedded or entrapped by cardiac muscle in systole. Such an entrapped catheter records a high intraventricular pressure that is believed to reflect intramyocardial tissue pressure, which normally exceeds intracavitary pressure. In such cases the initial inflow tract pressure is not high and is precisely equal to the outflow tract systolic pressure, i.e. both are recording intracavity pressure. This type of intramyocardial to intracavitary pressure difference may also be encountered in the left ventricle of dogs. The recent suggestion that intraventricular pressure differences in the left ventricle of cases of muscular subaortic stenosis are due to catheter entrapment by cardiac muscle is refuted by using the initial inflow tract pressure as the means of differentiation between the two types of intraventricular pressure differences outlined. PMID:5951625

Effect of exposure time and organic matter on efficacy of antimicrobial compounds against Shiga Toxin-producing Escherichia coli and Salmonella

USDA-ARS?s Scientific Manuscript database

Several antimicrobial compounds are in commercial meat processing plants for the purpose of pathogens control on beef carcasses. However, the efficacy of the method used is influenced by a number of factors such as spray pressure, temperature, type of chemical and concentration, exposure time, metho...

AAHD's Health Promotion and Wellness: Part 1--Obesity and Disability

ERIC Educational Resources Information Center

Exceptional Parent, 2011

2011-01-01

Obesity increases the risk of many health conditions, including heart disease, type 2 diabetes, cancers, high blood pressure, lipid disorders, stroke and more. While obesity affects more than one third of all adult Americans, people with disabilities are more likely to be overweight or obese and often have fewer tools for controlling weight at…

Plantar Pressure Distribution among Older Persons with Different Types of Foot and Its Correlation with Functional Reach Distance

PubMed Central

2016-01-01

Background. Changes in biomechanical structures of human foot are common in the older person, which may lead to alteration of foot type and plantar pressure distribution. We aimed to examine how foot type affects the plantar pressure distribution and to determine the relationship between plantar pressure distribution and functional reach distance in older persons. Methods. Fifty community-dwelling older persons (age: 69.98 ± 5.84) were categorized into three groups based on the Foot Posture Index. The plantar pressure (max⁡P) and contact area were analyzed using Footscan® RSScan platform. The Kruskal-Wallis test was used to compare the plantar pressure between foot types and Spearman's correlation coefficient was used to correlate plantar pressure with the functional reach distance. Results. There were significant differences of max⁡P in the forefoot area across all foot types. The post hoc analysis found significantly lower max⁡P in the pronated foot compared to the supinated foot. A high linear rank correlation was found between functional reach distance and max⁡P of the rearfoot region of the supinated foot. Conclusions. These findings suggested that types of the foot affect the plantar maximal pressure in older persons with functional reach distance showing some associations. PMID:27980874

Renal mitochondrial impairment is attenuated by AT1 blockade in experimental Type I diabetes.

PubMed

de Cavanagh, Elena M V; Ferder, León; Toblli, Jorge E; Piotrkowski, Bárbara; Stella, Inés; Fraga, Cesar G; Inserra, Felipe

2008-01-01

To investigate whether ANG II type 1 (AT(1)) receptor blockade could protect kidney mitochondria in streptozotocin-induced Type 1 diabetes, we treated 8-wk-old male Sprague-Dawley rats with a single streptozotocin injection (65 mg/kg ip; STZ group), streptozotocin and drinking water containing either losartan (30 mg.kg(-1).day(-1); STZ+Los group) or amlodipine (3 mg.kg(-1).day(-1); STZ+Amlo group), or saline (intraperitoneally) and pure water (control group). Four-month-long losartan or amlodipine treatments started 30 days before streptozotocin injection to improve the antioxidant defenses. The number of renal lesions, plasma glucose and lipid levels, and proteinuria were higher and creatinine clearance was lower in STZ and STZ+Amlo compared with STZ+Los and control groups. Glycemia was higher in STZ+Los compared with control. Blood pressure, basal mitochondrial membrane potential and mitochondrial pyruvate content, and renal oxidized glutathione levels were higher and NADH/cytochrome c oxidoreductase activity was lower in STZ compared with the other groups. In STZ and STZ+Amlo groups, mitochondrial H(2)O(2) production rate was higher and uncoupling protein-2 content, cytochrome c oxidase activity, and renal glutathione level were lower than in STZ+Los and control groups. Mitochondrial nitric oxide synthase activity was higher in STZ+Amlo compared with the other groups. Mitochondrial pyruvate content and H(2)O(2) production rate negatively contributed to electron transfer capacity and positively contributed to renal lesions. Uncoupling protein-2 content negatively contributed to mitochondrial H(2)O(2) production rate and renal lesions. Renal glutathione reduction potential positively contributed to mitochondria electron transfer capacity. In conclusion, AT(1) blockade protects kidney mitochondria and kidney structure in streptozotocin-induced diabetes independently of blood pressure and glycemia.

Effects of Low Dose Metformin in Adolescents with Type I Diabetes Mellitus: A Randomized, Double-Blinded Placebo-Controlled Study

PubMed Central

Nadeau, Kristen; Chow, Kelsey; Alam, Lyla; Lindquist, Kara; Cambell, Sarah; McFann, Kim; Klingensmith, Georgeanna; Walravens, Phillipe

2014-01-01

Background Insulin resistance increases during adolescence in those with type 1 diabetes (T1DM), complicating glycemic control and potentially increasing cardiovascular disease (CVD) risk. Metformin, typically used in type 2 diabetes (T2DM), is a possible adjunct therapy in T1DM to help improve glycemic control and insulin sensitivity. Objective We hypothesized that metformin would improve metabolic parameters in adolescents with T1DM. Design, Setting, and Participants This randomized, double-blinded, placebo-controlled trial included 74 pubertal adolescents (ages 13–20 years) with T1DM. Participants were randomized to receive either metformin or placebo for six months. HbA1c, insulin dose, waist circumference, BMI, and blood pressure were measured at baseline, 3 and 6 months, with fasting lipids measured at baseline and 6 months. Results Total daily insulin dose, BMI Z-score and waist circumference significantly decreased at 3 and 6 months compared to baseline within the metformin group, even among normal-weight participants. In placebo group, total insulin dose and systolic blood pressure increased significantly at 3 months and total insulin dose increased significantly at 6 months. No significant change was observed in HbA1c at any time point between metformin and placebo groups or within either group. Conclusions Low-dose metformin likely improves BMI as well as insulin sensitivity in T1DM adolescents, as indicated by a decrease in total daily insulin dose. The decrease in waist circumference indicates that fat distribution is also likely impacted by metformin in T1DM. Further studies with higher metformin doses and more detailed measurements are needed to confirm these results, their underlying mechanisms, and potential impact on CVD in T1DM youth. PMID:24698216

Control of supersonic axisymmetric base flows using passive splitter plates and pulsed plasma actuators

NASA Astrophysics Data System (ADS)

Reedy, Todd Mitchell

An experimental investigation evaluating the effects of flow control on the near-wake downstream of a blunt-based axisymmetric body in supersonic flow has been conducted. To better understand and control the physical phenomena that govern these massively separated high-speed flows, this research examined both passive and active flow-control methodologies designed to alter the stability characteristics and structure of the near-wake. The passive control investigation consisted of inserting splitter plates into the recirculation region. The active control technique utilized energy deposition from multiple electric-arc plasma discharges placed around the base. The flow-control authority of both methodologies was evaluated with experimental diagnostics including particle image velocimetry, schlieren photography, surface flow visualization, pressure-sensitive paint, and discrete surface pressure measurements. Using a blowdown-type wind tunnel reconstructed specifically for these studies, baseline axisymmetric experiments without control were conducted for a nominal approach Mach number of 2.5. In addition to traditional base pressure measurements, mean velocity and turbulence quantities were acquired using two-component, planar particle image velocimetry. As a result, substantial insight was gained regarding the time-averaged and instantaneous near-wake flow fields. This dataset will supplement the previous benchmark point-wise laser Doppler velocimetry data of Herrin and Dutton (1994) for comparison with new computational predictive techniques. Next, experiments were conducted to study the effects of passive triangular splitter plates placed in the recirculation region behind a blunt-based axisymmetric body. By dividing the near-wake into 1/2, 1/3, and 1/4 cylindrical regions, the time-averaged base pressure distribution, time-series pressure fluctuations, and presumably the stability characteristics were altered. While the spatial base pressure distribution was influenced considerably, the area-integrated pressure was only slightly affected. Normalized RMS levels indicate that base pressure fluctuations were significantly reduced with the addition of the splitter plates. Power-spectral-density estimates revealed a spectral broadening of fluctuating energy for the 1/2 cylinder configuration and a bimodal distribution for the 1/3 and 1/4 cylinder configurations. It was concluded that the recirculation region is not the most sensitive location to apply flow control; rather, the shear layer may be a more influential site for implementing flow control methodologies. For active flow control, pulsed plasma-driven fluidic actuators were investigated. Initially, the performance of two plasma actuator designs was characterized to determine their potential as supersonic flow control devices. For the first actuator considered, the pulsed plasma jet, electro-thermal heating from an electric discharge heats and pressurizes gas in a small cavity which is exhausted through a circular orifice forming a synthetic jet. Depending on the electrical energy addition, peak jet velocities ranged between 130 to nearly 500 m/s when exhausted to quiescent, ambient conditions. The second plasma actuator investigated is the localized arc filament plasma actuator (LAFPA), which created fluidic perturbations through the rapid, local thermal heating, generated from an electric arc discharge between two electrodes within a shallow open cavity. Electrical and emission properties of the LAFPA were first documented as a function of pressure in a quiescent, no-flow environment. Rotational and vibrational temperatures from N2 spectra were obtained for select plasma conditions and ambient pressures. Results further validate that the assumption of optically thin conditions for these electric arc plasmas is not necessary valid, even at low ambient pressure. Breakdown voltage, sustained plasma voltage, power, and energy per pulse were demonstrated to decrease with decreasing pressure. Implementing an array of eight electric arcs circumferentially around the base near the corner expansion, the LAFPA actuators were shown to produce significant disturbances to the separating shear layer of the base flow and cause modest influences on the base pressure when actuated over a range of high frequencies (O(kHz)), forcing modes, duty cycles, and electrical currents. To tailor the plasma actuator toward the specific flow control application of the separated base flow, several actuator geometries and energy additions were evaluated. Displaying the ability to produce disturbances in the shear layer, an open cavity actuator design outperformed the other geometries consisting of a confined cavity with an exhaust orifice. Increases in duty cycle (between 2% and 6%) and in plasma current (1/4 to 4 amps) were shown to produce large velocity disturbances causing a decrease in average base pressure. At 4 amps and a maximum duty cycle of 6%, the largest measured change in area-weighted base pressure, near -1.5%, was observed for the axisymmetric forcing mode. Positive changes in base pressure were experienced (as much as 1% increase from the no-control) for the vertical and horizontal flapping modes.

Sources of financial pressure and up coding behavior in French public hospitals.

PubMed

Georgescu, Irène; Hartmann, Frank G H

2013-05-01

Drawing upon role theory and the literature concerning unintended consequences of financial pressure, this study investigates the effects of health care decision pressure from the hospital's administration and from the professional peer group on physician's inclination to engage in up coding. We explore two kinds of up coding, information-related and action-related, and develop hypothesis that connect these kinds of data manipulation to the sources of pressure via the intermediate effect of role conflict. Qualitative data from initial interviews with physicians and subsequent questionnaire evidence from 578 physicians in 14 French hospitals suggest that the source of pressure is a relevant predictor of physicians' inclination to engage in data-manipulation. We further find that this effect is partly explained by the extent to which these pressures create role conflict. Given the concern about up coding in treatment-based reimbursement systems worldwide, our analysis adds to understanding how the design of the hospital's management control system may enhance this undesired type of behavior. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

[Level at which control objectives are reached in patients in different population groups with type 2 diabetes].

PubMed

Herrero, A; Pinillos, J; Sabio, P; Martín, J L; Garzón, G; Gil, Á

There is evidence of increased macro- and micro-vascular risk in diabetic patients. The objective of this study was to determine the level of control in patients in different population groups with type 2 diabetes. Descriptive cross-sectional study. Primary care. Madrid Health Service. Year: 2014. Patients over 14 years with type 2 diabetes. Number of patientes: n=6674. Variables on the degree of control (HbA1c, systolic blood pressure [SBP], diastolic blood pressure [DBP], LDL-c) and variables on patient characteristics (demographic, other cardiovascular risk factors, complications). The mean age of patients with controlled HbA1c was 67.8 years vs. 62.9 years in the uncontrolled (P<.001). Patients diagnosed with hypertension have a higher percentage of control with respect to the undiagnosed in HbA1c, SBP, DBP and LDL-c: 51 vs. 37%, 62 vs. 43%, 75 vs. 47% and 57 vs. 44% respectively; diagnosed with dyslipidaemia: 51 vs. 39%, 60 vs. 49%, 70 vs. 56% and 56 vs. 46%. With a diagnosis of macroangiopathy: 46 vs. 45%, 58 vs. 54%, 71 vs. 62% and 15 vs. 60%. All differences were statistically significant (P<.001). Over 50% of patients without a diagnosis of hypertension had an SBP> 140mmHg or DBP> 90mmHg. Over 25% of patients with hypertension or DL and uncontrolled levels were not receiving drug treatment. Control was improved in all groups, especially in younger patients, with particularly high cardiovascular risk by the presence of other cardiovascular risk factors or macroangiopathy. A significant percentage of patients with uncontrolled BP and cLDL were not diagnosed or receiving drug treatment. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

New well testing applications of the pressure derivative

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

Onur, M.

1989-01-01

This work presents new derivative type curves based on a new derivative group which is equal to the dimensionless pressure group divided by its logarithmic derivative with respect to dimensionless time group. One major advantage of these type curves is that the type-curve match of field pressure/pressure-derivative data with the new derivative type curves is accomplished by moving the field data plot in only the horizontal direction. This type-curve match fixes time match-point values. The pressure change versus time data is then matched with the dimensionless pressure solution to determine match-point values. Well/reservoir parameters can then be estimated in themore » standard way. This two step type-curve matching procedure increases the likelihood of obtaining a unique match. Moreover, the unique correspondence between the ordinate of the field data plot and the new derivative type curves should prove useful in determining whether given field data actually represents the well/reservoir model assumed by a selected type curve solution. It is also shown that the basic idea used in construction the type curves can be used to ensure that proper semilog straight lines are chosen when analyzing pressure data by semilog methods. Analysis of both drawdown and buildup data is considered and actual field cases are analyzed using the new derivative type curves and the semilog identification method. This work also presents new methods based on the pressure derivative to analyze buildup data obtained at a well (fracture or unfractured) produced to pseudosteady-state prior to shut-in. By using a method of analysis based on the pressure derivative, it is shown that a well's drainage area at the instant of shut-in and the flow capacity can be computed directly from buildup data even in cases where conventional semilog straight lines are not well-defined.« less

Telemedicine compared with standard care in type 2 diabetes mellitus: A randomized trial in an outpatient clinic.

PubMed

Rasmussen, Ole W; Lauszus, F F; Loekke, M

2016-09-01

Good metabolic control is important in type 2 diabetes mellitus to improve quality of life, work ability and life expectancy, and the use of telemedicine has proved efficient as an add-on to the usual treatment. However, few studies in type 2 diabetes patients have directly compared telemedicine with conventional outpatient treatment, and we wanted to evaluate whether telemedicine, compared with standard care, provides equivalent clinical outcomes. Forty patients with type 2 diabetes mellitus allocated from October 2011-July 2012 were randomized to either treatment at home by video conferences only or standard outpatient treatment. Primary outcomes were HbA1c and blood glucose levels and secondary outcomes were 24-hour blood pressure, cholesterol levels and albuminuria. The video-telephone was a broadband solution installed and serviced by the Danish Telephone Company (TDC). The improvements in the two treatments, given as changes in percentage of telemedicine vs standard, showed significant differences in HbA1c (-15 vs -11%), mean blood glucose (-18 vs -13%) and in cholesterol (-7 vs -6%). No differences in LDL (-4 vs -6%), weight (-1 vs 2%), diastolic diurnal blood pressure (-1 vs -7%), and systolic diurnal blood pressure (0 vs -1%) were found. Nine consultations were missed in the standard outpatient group and none in the telemedicine group. In the direct comparison of home video consultations vs standard outpatient treatment in type 2 diabetes mellitus, telemedicine was a safe and available option with favourable outcomes after six months treatment. © The Author(s) 2015.

Improving management of type 2 diabetes in South Asian patients: a systematic review of intervention studies

PubMed Central

Bhurji, N; Javer, J; Gasevic, D; Khan, N A

2016-01-01

Objectives Optimal control of type 2 diabetes is challenging in many patient populations including in South Asian patients. We systematically reviewed studies on the effect of diabetes management interventions targeted at South Asian patients with type 2 diabetes on glycaemic control. Design Systematic review of MEDLINE, EMBASE and CINAHL databases for randomised controlled trials (RCTs) and pre-post-test studies (January 1990 to February 2014). Studies were stratified by where interventions were conducted (South Asia vs Western countries). Participants Patients originating from Pakistan, Bangladesh or India with type 2 diabetes. Primary outcome Change in glycated haemoglobin (HbA1c). Secondary end points included change in blood pressure, lipid levels, anthropomorphics and knowledge. Results 23 studies (15 RCTs) met criteria for analysis with 7 from Western countries (n=2532) and 16 from South Asia (n=1081). Interventions in Western countries included translated diabetes education, additional clinical care, written materials, visual aids, and bilingual community-based peers and/or health professionals. Interventions conducted in South Asia included yoga, meditation or exercise, community-based peers, health professionals and dietary education (cooking exercises). Among RCTs in India (5 trials; n=390), 4 demonstrated significant reductions in HbA1c in the intervention group compared with usual care (yoga and exercise interventions). Among the 4 RCTs conducted in Europe (n=2161), only 1 study, an education intervention of 113 patients, reported a significant reduction in HbA1c with the intervention. Lipids, blood pressure and knowledge improved in both groups with studies from India more often reporting reductions in body mass index and waist circumference. Conclusions Overall, there was little improvement in HbA1c level in diabetes management interventions targeted at South Asians living in Europe compared with usual care, although other outcomes did improve. The smaller studies in India demonstrated significant improvements in glycaemic and other end points. Novel strategies are needed to improve glycaemic control in South Asians living outside of India. PMID:27098819

The impact of fasting during Ramadan on the glycemic control of patients with type 2 diabetes mellitus.

PubMed

Sahin, S B; Ayaz, T; Ozyurt, N; Ilkkilic, K; Kirvar, A; Sezgin, H

2013-10-01

Millions of Muslims fast from dawn until dusk during the annual Islamic holy month of Ramadan. Most of the studies evaluating biochemical changes in diabetic patients during Ramadan showed little changes in the glycemic control. In this study, our aim was to assess the impact of fasting during Ramadan on glycemic control in patients with type 2 diabetes. We examined 122 patients with type 2 diabetes (82 female, 40 male, age 56.93 ± 9.57 years) before and after the Ramadan. 66.4% of the patients were treated with oral antidiabetic (OAD) alone, 6.5% with a combination of insulin plus OAD and 19.7% with insulin alone. 88 of 122 patients fasted during Ramadan (26.98 ± 5.93 days). Weight, body mass index (BMI), waist circumference, blood pressure, fasting plasma glucose (FPG), postprandial glucose (PPG), fructosamine, HbA1c, fasting insulin and lipid parameters were measured. The frequencies of both severe hyperglycemia and hypoglycemia were higher in the fasting group, but the difference was not significant (p=0.18). Weight, BMI, waist circumference, blood pressure, FPG (143.38 ± 52.04 vs. 139.31 ± 43.47 mg/dl) PPG (213.40 ± 98.56 vs. 215.66+109.31 mg/dl), fructosamine (314.18 ± 75.40 vs. 314.49 ± 68.36 µmol/l), HbA1c (6.33 ± 0.98 vs. 6.22 ± 0.92%) and fasting insulin (12.61 ± 8.94 vs. 10.51 ± 6.26 µU/ml) were unchanged in patients who fasted during Ramadan. Microalbuminuria significantly decreased during Ramadan (132.85 ± 197.11 vs. 45.03 ± 73.11 mg/dl). In this study, we concluded that fasting during Ramadan did not worsen the glycemic control of patients with type 2 diabetes. © J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York.

The effects of alcohol on ambulatory blood pressure and other cardiovascular risk factors in type 2 diabetes: a randomized intervention.

PubMed

Mori, Trevor A; Burke, Valerie; Zilkens, Renate R; Hodgson, Jonathan M; Beilin, Lawrence J; Puddey, Ian B

2016-03-01

Although prospective studies suggest light-to-moderate chronic alcohol intake protects against coronary artery disease in type 2 diabetic patients, the balance of effects on individual cardiovascular risk factors needs further assessment. We examined the effects of alcohol consumption on 24-h ambulatory blood pressure (BP) and heart rate (HR), high-density lipoprotein cholesterol, fibrinogen, C-reactive protein, homocysteine, and glycaemic control in well controlled type 2 diabetes. Twenty-four participants aged 49-66 year were randomized to a three-period crossover study with women drinking red wine 230  ml/day (∼24  g alcohol/day) and men drinking red wine 300  ml/day (∼31  g alcohol/day), or equivalent volumes of dealcoholized red wine (DRW) or water, each for 4 weeks. Ambulatory BP and HR were monitored every 30  min for 24  h at the end of each period. Home blood glucose monitoring was carried out twice weekly throughout. Red wine increased awake SBP and DBP relative to water by 2.5 ± 1.2 /1.9 ± 0.7  mmHg (P = 0.033, P = 0.008, respectively), with a similar nonsignificant trend relative to DRW. Asleep DBP fell with red wine relative to DRW (2.0 ± 0.8  mmHg, P = 0.016) with a similar nonsignificant trend relative to water. Red wine increased 24-h, awake and asleep HR relative to water and DRW. Relative to DRW, red wine did not affect glycaemic control or any other cardiovascular risk factor. In well controlled type 2 diabetic individuals 24-31  g alcohol/day (∼2-3 standard drinks) raises awake BP and 24-h HR and lowers asleep BP but does not otherwise favourably or adversely modify cardiovascular risk factors.

ICP measurement accuracy: the effect of temperature drift. Design of a laboratory test for assessment of ICP transducers.

PubMed

Morgalla, M H; Mettenleiter, H; Katzenberger, T

1999-01-01

Intracranial pressure (ICP) monitoring has become the mainstay of multimodal neuromonitoring of comatous patients after head injury. In the presence of rising ICP and faced with pressures, difficult to control, aggressive measures, such as hypothermia may be used. The ICP readings should not be influenced by temperature changes. A laboratory test was designed to simulate temperature variations between 20 degrees C and 45 degrees C at different pressure levels under physiological conditions. Five types of transducers were examined: Epidyn Braun Melsungen, ICT/B-Titan Gaeltec, Camino-OLM-110-4B, Codman MicroSensor ICP-Transducer, Neurovent ICP transducer Rehau Ag+Co. Tests were performed at 6 different pressure levels between 0 mmHg and 50 mmHg. The results show very low drifts of less than 0.15 mmHg degree C-1 for Codman, Epidyn and Neurovent. Gaeltec and Camino exhibited higher drifts of 0.18 mmHg and 0.2 mmHg degree C-1 respectively. Within the temperature range from 35 degrees C to 42 degrees C all probes tested show insignificant temperature drift. Whether these results also apply to other types of transducers needs further evaluation. Problems and requirements related to the design of a laboratory test for the in vitro assessment of ICP transducers are discussed in detail.

30 CFR 250.1611 - Blowout preventer systems tests, actuations, inspections, and maintenance.

Code of Federal Regulations, 2010 CFR

2010-07-01

... conducting high-pressure tests, all BOP systems shall be tested to a pressure of 200 to 300 psi. (b) Ram-type BOP's and the choke manifold shall be pressure tested with water to rated working pressure or as otherwise approved by the District Manager. Annular type BOP's shall be pressure tested with water to 70...

Pressure-induced depression of synaptic transmission in the cerebellar parallel fibre synapse involves suppression of presynaptic N-type Ca2+ channels.

PubMed

Etzion, Y; Grossman, Y

2000-11-01

High pressure induces CNS hyperexcitability while markedly depressing synaptic transmitter release. We studied the effect of pressure (up to 10.1 MPa) on the parallel fibre (PF) synaptic response in biplanar cerebellar slices of adult guinea pigs. Pressure mildly reduced the PF volley amplitude and to a greater extent depressed the excitatory field postsynaptic potential (fPSP). The depression of the PF volley was noted even at supramaximal stimulus intensities, indicating an effect of pressure on the amplitude of the action potential in each axon. Low concentrations of TTX mimicked the effects of pressure on the PF volley without affecting the fPSP. Application omega-conotoxin GVIA (omega-CgTx) reduced the synaptic efficacy by 34.3+/-2.7%. However, in the presence of omega-CgTx the synaptic depression at pressure was significantly reduced. Reduced Ca2+ entry by application of Cd2+ or low [Ca2+]o did not have a similar influence on the effects of pressure. Application of omega-AGA IVA, omega-AGA TK and Funnel-web spider toxin did not affect the synaptic response in concentrations that usually block P-type Ca2+ channels, whilst the N/P/Q-type blocker omega-conotoxin MVIIC reduced the response to 52.7+/-5.0% indicating the involvement of Q-type channels and R-type channels in the non-N-type fraction of Ca2+ entry. The results demonstrate that N-type Ca2+ channels play a crucial role in the induction of PF synaptic depression at pressure. This finding suggests a coherent mechanism for the induction of CNS hyperexcitability at pressure.

Impact of a structured multicomponent educational intervention program on metabolic control of patients with type 2 diabetes.

PubMed

do Rosário Pinto, Maria; Parreira, Pedro Miguel Dinis Santos; Basto, Marta Lima; Dos Santos Mendes Mónico, Lisete

2017-12-15

Diabetes is one of the most common metabolic disorders, with a high prevalence of patients with poor metabolic control. Worldwide, evidence highlights the importance of developing and implementing educational interventions that can reduce this burden. The main objective of this study was to analyse the impact of a lifestyle centred intervention on glycaemic control of poorly controlled type 2 diabetic patients, followed in a Community Care Centre. A type 2 experimental design was conducted over 6 months, including 122 adults with HbA1c ≥ 7.5%, randomly allocated into Experimental group (EG) or Control Group (CG). EG patients attended a specific Educational Program while CG patients frequented usual care. Personal and health characterization variables, clinical metrics and self-care activities were measured before and after the implementation of the intervention. Analysis was done by comparing gains between groups (CG vs EG) through differential calculations (post minus pre-test results) and Longitudinal analysis. Statistical differences were obtained between groups for HbA1c and BMI: EG had a decrease in 11% more (effect-size r2 = .11) than CG for HbA1c (p < .001) and 4% more (effect-size r2 = .04) in BMI (p < .05). When controlling for socioeconomic characteristics and comorbidities that showed to be associated to each parameter in pre-test, from pre to post-test only EG participants significantly decreased HbA1c [Wilks' ʎ = .702; F(1,57) = 24.16; p < .001; ηp2 = .298; observed power = .998]; BMI values [Wilks' ʎ = .900; F(1,59) = 6.57; p = .013; ηp2 = .100; observed power = .713]; systolic Blood pressure [Wilks' ʎ = .735; F(1,61) = 21.94; p < .001; ηp2 = .265; observed power = .996] and diastolic Blood pressure [Wilks' ʎ = .795; F(1,59) = 15.20; p < .001; ηp2 = .205; observed power = .970]. The impact of a structured multicomponent educational intervention program by itself, beyond standard educational approach alone, supported in a Longitudinal analysis that controlled variables statistically associated with clinical metrics in pre-test measures, has demonstrated its effectiveness in improving HbA1c, BMI and Blood pressure values. RBR-8ns8pb . (Retrospectively registered: October 30,2017).

Artificial arterial blood pressure artifact models and an evaluation of a robust blood pressure and heart rate estimator

PubMed Central

Li, Qiao; Mark, Roger G; Clifford, Gari D

2009-01-01

Background Within the intensive care unit (ICU), arterial blood pressure (ABP) is typically recorded at different (and sometimes uneven) sampling frequencies, and from different sensors, and is often corrupted by different artifacts and noise which are often non-Gaussian, nonlinear and nonstationary. Extracting robust parameters from such signals, and providing confidences in the estimates is therefore difficult and requires an adaptive filtering approach which accounts for artifact types. Methods Using a large ICU database, and over 6000 hours of simultaneously acquired electrocardiogram (ECG) and ABP waveforms sampled at 125 Hz from a 437 patient subset, we documented six general types of ABP artifact. We describe a new ABP signal quality index (SQI), based upon the combination of two previously reported signal quality measures weighted together. One index measures morphological normality, and the other degradation due to noise. After extracting a 6084-hour subset of clean data using our SQI, we evaluated a new robust tracking algorithm for estimating blood pressure and heart rate (HR) based upon a Kalman Filter (KF) with an update sequence modified by the KF innovation sequence and the value of the SQI. In order to do this, we have created six novel models of different categories of artifacts that we have identified in our ABP waveform data. These artifact models were then injected into clean ABP waveforms in a controlled manner. Clinical blood pressure (systolic, mean and diastolic) estimates were then made from the ABP waveforms for both clean and corrupted data. The mean absolute error for systolic, mean and diastolic blood pressure was then calculated for different levels of artifact pollution to provide estimates of expected errors given a single value of the SQI. Results Our artifact models demonstrate that artifact types have differing effects on systolic, diastolic and mean ABP estimates. We show that, for most artifact types, diastolic ABP estimates are less noise-sensitive than mean ABP estimates, which in turn are more robust than systolic ABP estimates. We also show that our SQI can provide error bounds for both HR and ABP estimates. Conclusion The KF/SQI-fusion method described in this article was shown to provide an accurate estimate of blood pressure and HR derived from the ABP waveform even in the presence of high levels of persistent noise and artifact, and during extreme bradycardia and tachycardia. Differences in error between artifact types, measurement sensors and the quality of the source signal can be factored into physiological estimation using an unbiased adaptive filter, signal innovation and signal quality measures. PMID:19586547

Microalbuminuria among Type 1 and Type 2 diabetic patients of African origin in Dar Es Salaam, Tanzania

PubMed Central

Lutale, Janet Joy Kachuchuru; Thordarson, Hrafnkell; Abbas, Zulfiqarali Gulam; Vetvik, Kåre

2007-01-01

Background The prevalences and risk factors of microalbuminuria are not full described among black African diabetic patients. This study aimed at determining the prevalence of microalbuminuria among African diabetes patients in Dar es Salaam, Tanzania, and relate to socio-demographic features as well as clinical parameters. Methods Cross sectional study on 91 Type 1 and 153 Type 2 diabetic patients. Two overnight urine samples per patient were analysed. Albumin concentration was measured by an automated immunoturbidity assay. Average albumin excretion rate (AER) was used and were categorised as normalbuminuria (AER < 20 ug/min), microalbuminuria (AER 20–200 ug/min), and macroalbuminuria (AER > 200 ug/min). Information obtained also included age, diabetes duration, sex, body mass index, blood pressure, serum total cholesterol, high-density and low-density lipoprotein cholesterol, triglycerides, serum creatinine, and glycated hemoglobin A1c. Results Overall prevalence of microalbuminuria was 10.7% and macroalbuminuria 4.9%. In Type 1 patients microalbuminuria was 12% and macroalbuminuria 1%. Among Type 2 patients, 9.8% had microalbuminuria, and 7.2% had macroalbuminuria. Type 2 patients with abnormal albumin excretion rate had significantly longer diabetes duration 7.5 (0.2–24 yrs) than those with normal albumin excretion rate 3 (0–25 yrs), p < 0.001. Systolic and diastolic blood pressure among Type 2 patients with abnormal albumin excretion rate were significantly higher than in those with normal albumin excretion rate, (p < 0.001). No significant differences in body mass index, glycaemic control, and cholesterol levels was found among patients with normal compared with those with elevated albumin excretion rate either in Type 1 or Type 2 patients. A stepwise multiple linear regression analysis among Type 2 patients, revealed AER (natural log AER) as the dependent variable to be predicted by [odds ratio (95% confidence interval)] diabetes duration 0.090 (0.049, 0.131), p < 0.0001, systolic blood pressure 0.012 (0.003–0.021), p < 0.010 and serum creatinine 0.021 (0.012, 0.030). Conclusion The prevalence of micro and macroalbuminuria is higher among African Type 1 patients with relatively short diabetes duration compared with prevalences among Caucasians. In Type 2 patients, the prevalence is in accordance with findings in Caucasians. The present study detects, however, a much lower prevalence than previously demonstrated in studies from sub-Saharan Africa. Abnormal AER was significantly related to diabetes duration and systolic blood pressure. PMID:17224056

An ultrasound-based liquid pressure measurement method in small diameter pipelines considering the installation and temperature.

PubMed

Li, Xue; Song, Zhengxiang

2015-04-09

Liquid pressure is a key parameter for detecting and judging faults in hydraulic mechanisms, but traditional measurement methods have many deficiencies. An effective non-intrusive method using an ultrasound-based technique to measure liquid pressure in small diameter (less than 15 mm) pipelines is presented in this paper. The proposed method is based on the principle that the transmission speed of an ultrasonic wave in a Kneser liquid correlates with liquid pressure. Liquid pressure was calculated using the variation of ultrasonic propagation time in a liquid under different pressures: 0 Pa and X Pa. In this research the time difference was obtained by an electrical processing approach and was accurately measured to the nanosecond level through a high-resolution time measurement module. Because installation differences and liquid temperatures could influence the measurement accuracy, a special type of circuit called automatic gain control (AGC) circuit and a new back propagation network (BPN) model accounting for liquid temperature were employed to improve the measurement results. The corresponding pressure values were finally obtained by utilizing the relationship between time difference, transient temperature and liquid pressure. An experimental pressure measurement platform was built and the experimental results confirm that the proposed method has good measurement accuracy.

The digital compensation technology system for automotive pressure sensor

NASA Astrophysics Data System (ADS)

Guo, Bin; Li, Quanling; Lu, Yi; Luo, Zai

2011-05-01

Piezoresistive pressure sensor be made of semiconductor silicon based on Piezoresistive phenomenon, has many characteristics. But since the temperature effect of semiconductor, the performance of silicon sensor is also changed by temperature, and the pressure sensor without temperature drift can not be produced at present. This paper briefly describe the principles of sensors, the function of pressure sensor and the various types of compensation method, design the detailed digital compensation program for automotive pressure sensor. Simulation-Digital mixed signal conditioning is used in this dissertation, adopt signal conditioning chip MAX1452. AVR singlechip ATMEGA128 and other apparatus; fulfill the design of digital pressure sensor hardware circuit and singlechip hardware circuit; simultaneously design the singlechip software; Digital pressure sensor hardware circuit is used to implementing the correction and compensation of sensor; singlechip hardware circuit is used to implementing to controll the correction and compensation of pressure sensor; singlechip software is used to implementing to fulfill compensation arithmetic. In the end, it implement to measure the output of sensor, and contrast to the data of non-compensation, the outcome indicates that the compensation precision of compensated sensor output is obviously better than non-compensation sensor, not only improving the compensation precision but also increasing the stabilization of pressure sensor.

Influence of cyclopropane fatty acids on heat, high pressure, acid and oxidative resistance in Escherichia coli.

PubMed

Chen, Yuan Yao; Gänzle, Michael G

2016-04-02

Heat and high pressure resistant strains of Escherichia coli are a challenge to food safety. This study investigated effects of cyclopropane fatty acids (CFAs) on stress tolerance in the heat- and pressure-resistant strain E. coli AW1.7 and the sensitive strain E. coli MG1655. The role of CFAs was explored by disruption of cfa coding for CFA synthase with an in-frame, unmarked deletion method. Both wild-type strains consumed all the unsaturated fatty acids (C16:1 and C18:1) that were mostly converted to CFAs and a low proportion to saturated fatty acid (C16:0). Moreover, E. coli AW1.7 contained a higher proportion of membrane C19:0 cyclopropane fatty acid than E. coli MG1655 (P<0.05). The Δcfa mutant strains did not produce CFAs, and the corresponding substrates C16:1 and C18:1 accumulated in membrane lipids. The deletion of cfa did not alter resistance to H2O2 but increased the lethality of heat, high pressure and acid treatments in E. coli AW1.7, and E. coli MG1655. E. coli AW1.7 and its Δcfa mutant were more resistant to pressure and heat but less resistant to acid stress than E. coli MG1655. Heat resistance of wild-type strains and their Δcfa mutant was also assessed in beef patties grilled to an internal temperature of 71 °C. After treatment, cell counts of wild type strains were higher than those of the Δcfa mutant strains. In conclusion, CFA synthesis in E. coli increases heat, high pressure and acid resistance, and increases heat resistance in food. This knowledge on mechanisms of stress resistance will facilitate the design of intervention methods for improved pathogen control in food production. Copyright © 2016 Elsevier B.V. All rights reserved.

Heterogeneous behavior of lipids according to HbA1c levels undermines the plausibility of metabolic syndrome in type 1 diabetes: data from a nationwide multicenter survey

PubMed Central

2012-01-01

Background Cardiovascular risk factors (CVRF) may cluster in type 1 diabetes, analogously to the metabolic syndrome described in type 2 diabetes. The threshold of HbA1c above which lipid variables start changing behavior is unclear. This study aims to 1) assess the behavior of dyslipidemia according to HbA1c values; 2) detect a threshold of HbA1c beyond which lipids start to change and 3) compare the clustering of lipids and other non-lipid CVRF among strata of HbA1c individuals with type 1 diabetes. Methods Effects of HbA1c quintiles (1st: ≤7.4%; 2nd: 7.5-8.5%; 3rd: 8.6-9.6%; 4th: 9.7-11.3%; and 5th: >11.5%) and covariates (gender, BMI, blood pressure, insulin daily dose, lipids, statin use, diabetes duration) on dyslipidemia were studied in 1275 individuals from the Brazilian multi-centre type 1 diabetes study and 171 normal controls. Results Body size and blood pressure were not correlated to lipids and glycemic control. OR (99% CI) for high-LDL were 2.07 (1.21-3.54) and 2.51 (1.46-4.31), in the 4th and 5th HbA1c quintiles, respectively. Hypertriglyceridemia increased in the 5th quintile of HbA1c, OR 2.76 (1.20-6.37). OR of low-HDL-cholesterol were 0.48 (0.24-0.98) and 0.41 (0.19-0.85) in the 3rd and 4th HbA1c quintiles, respectively. HDL-cholesterol correlated positively (0.437) with HbA1c in the 3rd quintile. HDL-cholesterol and insulin dose correlated inversely in all levels of glycemic control. Conclusions Correlation of serum lipids with HbA1c is heterogeneous across the spectrum of glycemic control in type 1 diabetes individuals. LDL-cholesterol and triglycerides worsened alongside HbA1c with distinct thresholds. Association of lower HDL-cholesterol with higher daily insulin dose is consistent and it points out to a role of exogenous hyperinsulinemia in the pathophysiology of the CVRF clustering. These data suggest diverse pathophysiological processes depending on HbA1c, refuting a unified explanation for cardiovascular risk in type 1 diabetes. PMID:23270560

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

More, R.M.

A new statistical model (the quantum-statistical model (QSM)) was recently introduced by Kalitkin and Kuzmina for the calculation of thermodynamic properties of compressed matter. This paper examines the QSM and gives (i) a numerical QSM calculation of pressure and energy for aluminum and comparison to existing augmented-plane-wave data; (ii) display of separate kinetic, exchange, and quantum pressure terms; (iii) a study of electron density at the nucleus; (iv) a study of the effects of the Kirzhnitz-Weizsacker parameter controlling the gradient terms; (v) an analytic expansion for very high densities; and (vi) rigorous pressure theorems including a general version of themore » virial theorem which applies to an arbitrary microscopic volume. It is concluded that the QSM represents the most accurate and consistent theory of the Thomas-Fermi type.« less

Porphyry-copper ore shells form at stable pressure-temperature fronts within dynamic fluid plumes.

PubMed

Weis, P; Driesner, T; Heinrich, C A

2012-12-21

Porphyry-type ore deposits are major resources of copper and gold, precipitated from fluids expelled by crustal magma chambers. The metals are typically concentrated in confined ore shells within vertically extensive vein networks, formed through hydraulic fracturing of rock by ascending fluids. Numerical modeling shows that dynamic permeability responses to magmatic fluid expulsion can stabilize a front of metal precipitation at the boundary between lithostatically pressured up-flow of hot magmatic fluids and hydrostatically pressured convection of cooler meteoric fluids. The balance between focused heat advection and lateral cooling controls the most important economic characteristics, including size, shape, and ore grade. This self-sustaining process may extend to epithermal gold deposits, venting at active volcanoes, and regions with the potential for geothermal energy production.

Porphyry-Copper Ore Shells Form at Stable Pressure-Temperature Fronts Within Dynamic Fluid Plumes

NASA Astrophysics Data System (ADS)

Weis, P.; Driesner, T.; Heinrich, C. A.

2012-12-01

Porphyry-type ore deposits are major resources of copper and gold, precipitated from fluids expelled by crustal magma chambers. The metals are typically concentrated in confined ore shells within vertically extensive vein networks, formed through hydraulic fracturing of rock by ascending fluids. Numerical modeling shows that dynamic permeability responses to magmatic fluid expulsion can stabilize a front of metal precipitation at the boundary between lithostatically pressured up-flow of hot magmatic fluids and hydrostatically pressured convection of cooler meteoric fluids. The balance between focused heat advection and lateral cooling controls the most important economic characteristics, including size, shape, and ore grade. This self-sustaining process may extend to epithermal gold deposits, venting at active volcanoes, and regions with the potential for geothermal energy production.

Using farmers' attitude and social pressures to design voluntary Bluetongue vaccination strategies.

PubMed

Sok, J; Hogeveen, H; Elbers, A R W; Oude Lansink, A G J M

2016-10-01

Understanding the context and drivers of farmers' decision-making is critical to designing successful voluntary disease control interventions. This study uses a questionnaire based on the Reasoned Action Approach framework to assess the determinants of farmers' intention to participate in a hypothetical reactive vaccination scheme against Bluetongue. Results suggest that farmers' attitude and social pressures best explained intention. A mix of policy instruments can be used in a complementary way to motivate voluntary vaccination based on the finding that participation is influenced by both internal and external motivation. Next to informational and incentive-based instruments, social pressures, which stem from different type of perceived norms, can spur farmers' vaccination behaviour and serve as catalysts in voluntary vaccination schemes. Copyright © 2016 Elsevier B.V. All rights reserved.

A high-protein low-fat diet is more effective in improving blood pressure and triglycerides in calorie-restricted obese individuals with newly diagnosed type 2 diabetes.

PubMed

Papakonstantinou, E; Triantafillidou, D; Panagiotakos, D B; Koutsovasilis, A; Saliaris, M; Manolis, A; Melidonis, A; Zampelas, A

2010-06-01

There is controversy over dietary protein's effects on cardiovascular disease risk factors in diabetic subjects. It is unclear whether observed effects are due to increased protein or reduced carbohydrate content of the consumed diets. The aim of this study was to compare the effects of two diets differing in protein to fat ratios on cardiovascular disease risk factors. A total of 17 obese (body mass index (BMI) ranging from 31 to 45 kg/m(2)) volunteers with type 2 diabetes (DM2), aged 46+/-3 years, consumed two diets, each for 4 weeks, with 3 weeks of washout period in a random, blind, crossover design. The diets were: (1) a high-protein low-fat diet (HP-LF, with 30% protein, 50% carbohydrates and 20% fat) and (2) a low-protein high-fat diet (LP-HF, with 15% protein, 50% carbohydrates and 35% fat). Their effects on fasting glycemic control, lipid levels and blood pressure, and on postprandial glucose and insulin responses after a standard test meal at the beginning and end of each dietary intervention were analyzed. Both diets were equally effective in promoting weight loss and fat loss and in improving fasting glycemic control, total cholesterol and low-density lipoprotein (LDL) cholesterol, but the HP-LF diet decreased to a greater extent triglyceride (TG) levels (P=0.04) when compared with the LP-HF diet. HP-LF diet improved significantly both systolic and diastolic blood pressure when compared with the LP-HF diet (P<0.001 and P<0.001, respectively). No differences were observed in postprandial glucose and insulin responses. A protein to fat ratio of 1.5 in diets significantly improves blood pressure and TG concentrations in obese individuals with DM2.

Occluder closing behavior: a key factor in mechanical heart valve cavitation.

PubMed

Wu, Z J; Wang, Y; Hwang, N H

1994-04-01

A laser sweeping technique developed in this laboratory was found to be capable of monitoring the leaflet closing motion with microsecond precision. The leaflet closing velocity was measured inside the last three degrees before impact. Mechanical heart valve (MHV) leaflets were observed to close with a three-phase motion; the approaching phase, the decelerating phase, and the rebound phase, all of which take place within one to two milliseconds. The leaflet closing behavior depends mainly on the leaflet design and the hinge mechanism. Bileaflet and monoleaflet types of mechanical heart valves were tested in the mitral position in a physiologic mock circulatory flow loop, which incorporated a computer-controlled magnetic drive and an adjustable afterload system. The test loop was tuned to produce physiologic ventricular and aortic pressure wave forms at 70-120 beats/min, with the maximum ventricular dp/dt varying between 1500-5600 mmHg/sec. The experiments were conducted by controlling the cardiac output at a constant level between 2.0-9.0 liters/min. The measured time-displacement curve of each tested MHV leaflet and its geometry were taken as the input for computation of the squeeze flow field in the narrow gap space between the approaching leaflet and the valve housing. The results indicated rapid build-up of both the pressure and velocity in the gap field within microsecs before the impact. The pressure build-up in the gap space is apparently responsible for the leaflet deceleration before the impact. When the concurrent water hammer pressure reduction at closure was combined with the high energy squeeze jet ejected from the gap space, there were strong indications of the environment which favors micro cavitation inceptions in certain types of MHV.

GRAAL - Griggs-type Apparatus equipped with Acoustics in the Laboratory: a new instrument to explore the rheology of rocks at high pressure

NASA Astrophysics Data System (ADS)

Schubnel, A.; Champallier, R.; Precigout, J.; Pinquier, Y.; Ferrand, T. P.; Incel, S.; Hilairet, N.; Labrousse, L.; Renner, J.; Green, H. W., II; Stunitz, H.; Jolivet, L.

2015-12-01

Two new generation solid-medium Griggs-type apparatus have been set up at the Laboratoire de Géologie of ENS PARIS, and the Institut des Sciences de la Terre d'Orléans (ISTO). These new set-ups allow to perform controlled rock deformation experiments on large volume samples, up to 5 GPa and 1300°C. Careful pressure - stress calibration will be performed (using D-DIA and/or Paterson-type experiments as standards), strain-stress-pressure will be measured using modern techniques and state of the art salt assemblies. Focusing on rheology, the pressure vessel at ISTO has been designed in a goal of deforming large sample diameter (8 mm) at confining pressure of up to 3 GPa. Thanks to this large sample size, this new vessel will allow to explore the microstructures related to the deformation processes occurring at pressures of the deep lithosphere and in subduction zones. In this new apparatus, we moreover included a room below the pressure vessel in order to develop a basal load cell as close as possible to the sample. This new design, in progress, aims at significantly improving the accuracy of stress measurements in the Griggs-type apparatus. The ultimate goal is to set up a new technique able to routinely quantify the rheology of natural rocks between 0.5 and 5 GPa. Although fundamental to document the rheology of the lithosphere, such a technique is still missing in rock mechanics. Focusing on the evolution of physical and mechanical properties during mineral phase transformations, the vessel at ENS is equipped with continuous acoustic emission (AE) multi-sensor monitoring in order to "listen" to the sample during deformation. Indeed, these continuous recordings enable to detect regular AE like signals during dynamic crack propagation, as well as non-impulsive signals, which might be instrumental to identify laboratory analogs to non-volcanic tremor and low frequency earthquake signals. P and S elastic wave velocities will also be measured contemporaneously during deformation. Indeed, elastic wave velocities may be a good non-destructive proxy to track mineral reaction extent, under in-situ conditions. Attempts will also be performed to develop a tool to measure P and S wave anisotropy, at least along certain directions. Both data might prove of crucial interest to interpret the latest generation of tomographic imaging.

Vegetarian Diets in the Prevention and Management of Diabetes and Its Complications.

PubMed

Pawlak, Roman

2017-05-01

IN BRIEF Epidemiological studies have found a lower prevalence of type 2 diabetes among vegetarians compared to nonvegetarians. This reduced risk is likely a function of improved weight status, higher intake of dietary fiber, and the absence of animal protein and heme iron in the diet. Interventional studies have shown that vegetarian diets, especially a vegan diet, are effective tools in glycemic control and that these diets control plasma glucose to a greater level than do control diets, including diets traditionally recommended for patients with diabetes (e.g., diets based on carbohydrate counting). Vegetarian diets are associated with improvement in secondary outcomes such as weight reduction, serum lipid profile, and blood pressure. Studies indicate that vegetarian diets can be universally used in type 2 diabetes prevention and as tools to improve blood glucose management.

Membrane Based Thermal Control Development

NASA Technical Reports Server (NTRS)

Murdoch, Karen

1997-01-01

The investigation of the feasibility of using a membrane device as a water boiler for thermal control is reported. The membrane device permits water vapor to escape to the vacuum of space but prevents the loss of liquid water. The vaporization of the water provides cooling to the water loop. This type of cooling device would have application for various types of short duration cooling needs where expenditure of water is allowed and a low pressure source is available such as in space or on a planet's surface. A variety of membrane samples, both hydrophilic and hydrophobic, were purchased to test for this thermal control application. An initial screening test determined if the membrane could pose a sufficient barrier to maintain water against vacuum. Further testing compared the heat transfer performance of those membranes that passed the screening test.

Vegetarian Diets in the Prevention and Management of Diabetes and Its Complications

PubMed Central

2017-01-01

IN BRIEF Epidemiological studies have found a lower prevalence of type 2 diabetes among vegetarians compared to nonvegetarians. This reduced risk is likely a function of improved weight status, higher intake of dietary fiber, and the absence of animal protein and heme iron in the diet. Interventional studies have shown that vegetarian diets, especially a vegan diet, are effective tools in glycemic control and that these diets control plasma glucose to a greater level than do control diets, including diets traditionally recommended for patients with diabetes (e.g., diets based on carbohydrate counting). Vegetarian diets are associated with improvement in secondary outcomes such as weight reduction, serum lipid profile, and blood pressure. Studies indicate that vegetarian diets can be universally used in type 2 diabetes prevention and as tools to improve blood glucose management. PMID:28588373

Cluster randomised controlled trial of a theory-based multiple behaviour change intervention aimed at healthcare professionals to improve their management of type 2 diabetes in primary care.

PubMed

Presseau, Justin; Mackintosh, Joan; Hawthorne, Gillian; Francis, Jill J; Johnston, Marie; Grimshaw, Jeremy M; Steen, Nick; Coulthard, Tom; Brown, Heather; Kaner, Eileen; Elovainio, Marko; Sniehotta, Falko F

2018-05-02

National diabetes audits in the UK show room for improvement in the quality of care delivered to people with type 2 diabetes in primary care. Systematic reviews of quality improvement interventions show that such approaches can be effective but there is wide variability between trials and little understanding concerning what explains this variability. A national cohort study of primary care across 99 UK practices identified modifiable predictors of healthcare professionals' prescribing, advising and foot examination. Our objective was to evaluate the effectiveness of an implementation intervention to improve six guideline-recommended health professional behaviours in managing type 2 diabetes in primary care: prescribing for blood pressure and glycaemic control, providing physical activity and nutrition advice and providing updated diabetes education and foot examination. Two-armed cluster randomised trial involving 44 general practices. Primary outcomes (at 12 months follow-up): from electronic medical records, the proportion of patients receiving additional prescriptions for blood pressure and insulin initiation for glycaemic control and having a foot examination; and from a patient survey of a random sample of 100 patients per practice, reported receipt of updated diabetes education and physical activity and nutrition advice. The implementation intervention did not lead to statistically significant improvement on any of the six clinical behaviours. 1,138,105 prescriptions were assessed. Intervention (29% to 37% patients) and control arms (31% to 35%) increased insulin initiation relative to baseline but were not statistically significantly different at follow-up (IRR 1.18, 95%CI 0.95-1.48). Intervention (45% to 53%) and control practices (45% to 50%) increased blood pressure prescription from baseline to follow-up but were not statistically significantly different at follow-up (IRR 1.05, 95%CI 0.96 to 1.16). Intervention (75 to 78%) and control practices (74 to 79%) increased foot examination relative to baseline; control practices increased statistically significantly more (OR 0.84, 95%CI 0.75-0.94). Fewer patients in intervention (33%) than control practices (40%) reported receiving updated diabetes education (OR = 0.74, 95%CI 0.57-0.97). No statistically significant differences were observed in patient reports of having had a discussion about nutrition (intervention = 73%; control = 72%; OR = 0.98, 95%CI 0.59-1.64) or physical activity (intervention = 57%; control = 62%; OR = 0.79, 95%CI 0.56-1.11). Development and delivery of the intervention cost £1191 per practice. There was no measurable benefit to practices' participation in this intervention. Despite widespread use of outreach interventions worldwide, there is a need to better understand which techniques at which intensity are optimally suited to address the multiple clinical behaviours involved in improving care for type 2 diabetes. ISRCTN, ISRCTN66498413 . Registered April 4, 2013.

Attenuation of foot pressure during running on four different surfaces: asphalt, concrete, rubber, and natural grass.

PubMed

Tessutti, Vitor; Ribeiro, Ana Paula; Trombini-Souza, Francis; Sacco, Isabel C N

2012-01-01

The practice of running has consistently increased worldwide, and with it, related lower limb injuries. The type of running surface has been associated with running injury etiology, in addition other factors, such as the relationship between the amount and intensity of training. There is still controversy in the literature regarding the biomechanical effects of different types of running surfaces on foot-floor interaction. The aim of this study was to investigate the influence of running on asphalt, concrete, natural grass, and rubber on in-shoe pressure patterns in adult recreational runners. Forty-seven adult recreational runners ran twice for 40 m on all four different surfaces at 12 ± 5% km · h(-1). Peak pressure, pressure-time integral, and contact time were recorded by Pedar X insoles. Asphalt and concrete were similar for all plantar variables and pressure zones. Running on grass produced peak pressures 9.3% to 16.6% lower (P < 0.001) than the other surfaces in the rearfoot and 4.7% to 12.3% (P < 0.05) lower in the forefoot. The contact time on rubber was greater than on concrete for the rearfoot and midfoot. The behaviour of rubber was similar to that obtained for the rigid surfaces - concrete and asphalt - possibly because of its time of usage (five years). Running on natural grass attenuates in-shoe plantar pressures in recreational runners. If a runner controls the amount and intensity of practice, running on grass may reduce the total stress on the musculoskeletal system compared with the total musculoskeletal stress when running on more rigid surfaces, such as asphalt and concrete.

Soccer training improves cardiac function in men with type 2 diabetes.

PubMed

Schmidt, Jakob Friis; Andersen, Thomas Rostgaard; Horton, Joshua; Brix, Jonathan; Tarnow, Lise; Krustrup, Peter; Andersen, Lars Juel; Bangsbo, Jens; Hansen, Peter Riis

2013-12-01

Patients with type 2 diabetes mellitus (T2DM) have an increased risk of cardiovascular disease, which is worsened by physical inactivity. Subclinical myocardial dysfunction is associated with increased risk of heart failure and impaired prognosis in T2DM; however, it is not clear if exercise training can counteract the early signs of diabetic heart disease. This study aimed to evaluate the effects of soccer training on cardiac function, exercise capacity, and blood pressure in middle-age men with T2DM. Twenty-one men age 49.8 ± 1.7 yr with T2DM and no history of cardiovascular disease participated in a soccer training group (n = 12) that trained 1 h twice a week or a control group (n = 9) with no change in lifestyle. Examinations included comprehensive transthoracic echocardiography, measurements of blood pressure, maximal oxygen consumption (V(˙)O(2max)), and intermittent endurance capacity before and after 12 and 24 wk. Two-way repeated-measures ANOVA was applied. After 24 wk of soccer training, left ventricular (LV) end-diastolic diameter and volume were increased (P < 0.001) compared to baseline. LV longitudinal systolic displacement was augmented by 23% (P < 0.001) and global longitudinal two-dimensional strain increased by 10% (P < 0.05). LV diastolic function, determined by mitral inflow (E/A ratio) and peak diastolic velocity E', was increased by 18% (P < 0.01) and 29% (P < 0.001), respectively, whereas LV filling pressure E/E' was reduced by 15% (P = 0.05). Systolic, diastolic, and mean arterial pressures were all reduced by 8 mm Hg (P < 0.01, P < 0.001, and P < 0.001, respectively). V(˙)O(2max) and intermittent endurance capacity was 12% and 42% (P < 0.001) higher, respectively. No changes in any of the measured parameters were observed in control group. Regular soccer training improves cardiac function, increases exercise capacity, and lowers blood pressure in men with T2DM.

Effects of canagliflozin, a sodium glucose co-transporter 2 inhibitor, on blood pressure and markers of arterial stiffness in patients with type 2 diabetes mellitus: a post hoc analysis.

PubMed

Pfeifer, Michael; Townsend, Raymond R; Davies, Michael J; Vijapurkar, Ujjwala; Ren, Jimmy

2017-02-27

Physiologic determinants, such as pulse pressure [difference between systolic blood pressure (SBP) and diastolic BP (DBP)], mean arterial pressure (2/3 DBP + 1/3 SBP), and double product [beats per minute (bpm) × SBP], are linked to cardiovascular outcomes. The effects of canagliflozin, a sodium glucose co-transporter 2 (SGLT2) inhibitor, on pulse pressure, mean arterial pressure, and double product were assessed in patients with type 2 diabetes mellitus (T2DM). This post hoc analysis was based on pooled data from four 26-week, randomized, double-blind, placebo-controlled studies evaluating canagliflozin in patients with T2DM (N = 2313) and a 6-week, randomized, double-blind, placebo-controlled, ambulatory BP monitoring (ABPM) study evaluating canagliflozin in patients with T2DM and hypertension (N = 169). Changes from baseline in SBP, DBP, pulse pressure, mean arterial pressure, and double product were assessed using seated BP measurements (pooled studies) or averaged 24-h BP assessments (ABPM study). Safety was assessed based on adverse event reports. In the pooled studies, canagliflozin 100 and 300 mg reduced SBP (-4.3 and -5.0 vs -0.3 mmHg) and DBP (-2.5 and -2.4 vs -0.6 mmHg) versus placebo at week 26. Reductions in pulse pressure (-1.8 and -2.6 vs 0.2 mmHg), mean arterial pressure (-3.1 and -3.3 vs -0.5 mmHg), and double product (-381 and -416 vs -30 bpm × mmHg) were also seen with canagliflozin 100 and 300 mg versus placebo. In the ABPM study, canagliflozin 100 and 300 mg reduced mean 24-h SBP (-4.5 and -6.2 vs -1.2 mmHg) and DBP (-2.2 and -3.2 vs -0.3 mmHg) versus placebo at week 6. Canagliflozin 300 mg provided reductions in pulse pressure (-3.3 vs -0.8 mmHg) and mean arterial pressure (-4.2 vs -0.6 mmHg) compared with placebo, while canagliflozin 100 mg had more modest effects on these parameters. Canagliflozin was generally well tolerated in both study populations. Canagliflozin improved all three cardiovascular physiologic markers, consistent with the hypothesis that canagliflozin may have beneficial effects on some cardiovascular outcomes in patients with T2DM. Trial registration ClinicalTrials.gov Identifier: NCT01081834 (registered March 2010); NCT01106677 (registered April 2010); NCT01106625 (registered April 2010); NCT01106690 (registered April 2010); NCT01939496 (registered September 2013).

42 CFR 84.157 - Airflow resistance test; Type C supplied-air respirator, pressure-demand class; minimum...

Code of Federal Regulations, 2012 CFR

2012-10-01

... test; Type C supplied-air respirator, pressure-demand class; minimum requirements. (a) The static... 42 Public Health 1 2012-10-01 2012-10-01 false Airflow resistance test; Type C supplied-air respirator, pressure-demand class; minimum requirements. 84.157 Section 84.157 Public Health PUBLIC HEALTH...

42 CFR 84.157 - Airflow resistance test; Type C supplied-air respirator, pressure-demand class; minimum...

Code of Federal Regulations, 2013 CFR

2013-10-01

... test; Type C supplied-air respirator, pressure-demand class; minimum requirements. (a) The static... 42 Public Health 1 2013-10-01 2013-10-01 false Airflow resistance test; Type C supplied-air respirator, pressure-demand class; minimum requirements. 84.157 Section 84.157 Public Health PUBLIC HEALTH...

42 CFR 84.157 - Airflow resistance test; Type C supplied-air respirator, pressure-demand class; minimum...

Code of Federal Regulations, 2014 CFR

2014-10-01

... test; Type C supplied-air respirator, pressure-demand class; minimum requirements. (a) The static... 42 Public Health 1 2014-10-01 2014-10-01 false Airflow resistance test; Type C supplied-air respirator, pressure-demand class; minimum requirements. 84.157 Section 84.157 Public Health PUBLIC HEALTH...

Development of an Inlet Pressure Sensor for Control in a Left Ventricular Assist Device

PubMed Central

Fritz, Bryan; Cysyk, Joshua; Newswanger, Ray; Weiss, William; Rosenberg, Gerson

2010-01-01

A Tesla type continuous flow left ventricular assist device (VAD) has been designed by Penn State and Advanced Bionics, Inc. (ABI). When a continuous flow device is employed, care must be taken to limit low pressures in the ventricle that can produce an obstruction to the inlet cannula or trigger arrhythmias. Design of an inexpensive, semi-conductor strain gage inlet pressure sensor to detect suction has been completed. The research and design analysis included finite element modeling of the sensing region. Sensitivity, step-response, temperature dependence and hysteresis tests have been performed on prototype units. All sensors were able to withstand the maximum expected strain of 82 μin/in at 500 mmHg internal pressure. Average sensitivity was 0.52 ±0.24 μV/mmHg with 0.5 V excitation (n=5 units). Step response time for a 0 to 90 mmHg step change averaged 22 milliseconds. Hysteresis was measured by applying and holding 75mmHg internal pressure for 4 hours, followed by a zero pressure measurement, and ranged from -15 mmHg to 4.1 mmHg (n=3 units). Offset drift varied between 180 and -140 mmHg over a four week period. (n=2 units). Span temperature sensitivity ranged from 18 to -21 μV/°C (n=5 units). Gain temperature sensitivity ranged from -7.4 to 4.9 μV/°C (n=5 units). With the inherent drift, it is currently not possible to use the transducer to measure actual pressures, but it can easily be used to measure pressure changes throughout the cardiac cycle. This signal can then be used in the control system to avoid ventricular suction events. PMID:20335797

A multi-scale residual-based anti-hourglass control for compatible staggered Lagrangian hydrodynamics

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

Kucharik, M.; Scovazzi, Guglielmo; Shashkov, Mikhail Jurievich

Hourglassing is a well-known pathological numerical artifact affecting the robustness and accuracy of Lagrangian methods. There exist a large number of hourglass control/suppression strategies. In the community of the staggered compatible Lagrangian methods, the approach of sub-zonal pressure forces is among the most widely used. However, this approach is known to add numerical strength to the solution, which can cause potential problems in certain types of simulations, for instance in simulations of various instabilities. To avoid this complication, we have adapted the multi-scale residual-based stabilization typically used in the finite element approach for staggered compatible framework. In this study, wemore » describe two discretizations of the new approach and demonstrate their properties and compare with the method of sub-zonal pressure forces on selected numerical problems.« less

A multi-scale residual-based anti-hourglass control for compatible staggered Lagrangian hydrodynamics

DOE PAGES

Kucharik, M.; Scovazzi, Guglielmo; Shashkov, Mikhail Jurievich; ...

2017-10-28

Hourglassing is a well-known pathological numerical artifact affecting the robustness and accuracy of Lagrangian methods. There exist a large number of hourglass control/suppression strategies. In the community of the staggered compatible Lagrangian methods, the approach of sub-zonal pressure forces is among the most widely used. However, this approach is known to add numerical strength to the solution, which can cause potential problems in certain types of simulations, for instance in simulations of various instabilities. To avoid this complication, we have adapted the multi-scale residual-based stabilization typically used in the finite element approach for staggered compatible framework. In this study, wemore » describe two discretizations of the new approach and demonstrate their properties and compare with the method of sub-zonal pressure forces on selected numerical problems.« less

Choosing an Oronasal Mask to Deliver Continuous Positive Airway Pressure May Cause More Upper Airway Obstruction or Lead to Higher Continuous Positive Airway Pressure Requirements than a Nasal Mask in Some Patients: A Case Series.

PubMed

Ng, Justin R; Aiyappan, Vinod; Mercer, Jeremy; Catcheside, Peter G; Chai-Coetzer, Ching Li; McEvoy, R Doug; Antic, Nick

2016-09-15

The choice of mask interface used with continuous positive airway pressure (CPAP) therapy can affect the control of upper airway obstruction (UAO) in obstructive sleep apnea (OSA). We describe a case series of four patients with paradoxical worsening of UAO with an oronasal mask and the effect of changing to a nasal mask. We retrospectively reviewed the case histories of 4 patients and recorded patient demographics, in-laboratory and ambulatory CPAP titration data, CPAP therapy data, type of mask interface used and potential confounding factors. The 4 cases (mean ± SD: age = 59 ± 16 y; BMI = 30.5 ± 4.5 kg/m(2)) had a high residual apnoea-hypopnea index (AHI) (43 ± 14.2 events/h) and high CPAP pressure requirements (14.9 ± 6.6 cmH2O) with an oronasal mask. Changing to a nasal mask allowed adequate control of UAO with a significant reduction in the average residual AHI (3.1 ± 1.5 events/h). In two of the four cases, it was demonstrated that control of UAO was obtained at a much lower CPAP pressure compared to the oronasal mask (Case one = 17.5 cmH2O vs 12cmH2O; Case two = 17.9 cmH2O vs 7.8 cmH2O). Other potential confounding factors were unchanged. There are various physiological observations that may explain these findings but it is uncertain which individuals are susceptible to these mechanisms. If patients have OSA incompletely controlled by CPAP with evidence of residual UAO and/or are requiring surprisingly high CPAP pressure to control OSA with an oronasal mask, the choice of mask should be reviewed and consideration be given to a trial of a nasal mask. A commentary on this article appears in this issue on page 1209. © 2016 American Academy of Sleep Medicine.

Roles for the sympathetic nervous system, renal nerves, and CNS melanocortin-4 receptor in the elevated blood pressure in hyperandrogenemic female rats.

PubMed

Maranon, Rodrigo; Lima, Roberta; Spradley, Frank T; do Carmo, Jussara M; Zhang, Howei; Smith, Andrew D; Bui, Elizabeth; Thomas, R Lucas; Moulana, Mohadetheh; Hall, John E; Granger, Joey P; Reckelhoff, Jane F

2015-04-15

Women with polycystic ovary syndrome (PCOS) have hyperandrogenemia and increased prevalence of risk factors for cardiovascular disease, including elevated blood pressure. We recently characterized a hyperandrogenemic female rat (HAF) model of PCOS [chronic dihydrotestosterone (DHT) beginning at 4 wk of age] that exhibits similar characteristics as women with PCOS. In the present studies we tested the hypotheses that the elevated blood pressure in HAF rats is mediated in part by sympathetic activation, renal nerves, and melanocortin-4 receptor (MC4R) activation. Adrenergic blockade with terazosin and propranolol or renal denervation reduced mean arterial pressure (MAP by telemetry) in HAF rats but not controls. Hypothalamic MC4R expression was higher in HAF rats than controls, and central nervous system MC4R antagonism with SHU-9119 (1 nmol/h icv) reduced MAP in HAF rats. Taking a genetic approach, MC4R null and wild-type (WT) female rats were treated with DHT or placebo from 5 to 16 wk of age. MC4R null rats were obese and had higher MAP than WT control rats, and while DHT increased MAP in WT controls, DHT failed to further increase MAP in MC4R null rats. These data suggest that increases in MAP with chronic hyperandrogenemia in female rats are due, in part, to activation of the sympathetic nervous system, renal nerves, and MC4R and may provide novel insights into the mechanisms responsible for hypertension in women with hyperandrogenemia such as PCOS. Copyright © 2015 the American Physiological Society.

[Psychosomatic aspects of stress].

PubMed

Okuse, S; Anzai, T

1992-03-01

We established the Bromocriptine test for the dopaminergic function of the hypothalamopituitary gland. The secretion patterns of plasma GH and PRL to 2.5 mg Bromocriptine, a dopamine receptor agonist, were classified into two types; a response type and a non-response type. The former showed an increase in plasma GH levels and suppression of PRL secretion; the latter showed no change in GH after Bromocriptine administration. The response type cases corresponded to psychosocial stress by neurotic and maladaptive behavior. The non-response type cases corresponded to psychosocial stress by alexithymic and over adaptive behaviors. Case Presentation 1. Essential Hypertension: a. 56-year old male, response type, blood pressure elevated by stress in daily life. Psychosomatic treatment: advice about blood pressure measurement at his home, brief psychotherapy and drug therapy. b. 53-year-old male, non-response type, type A behavior. Psychosomatic treatment: advice to increase awareness of body-mind relationships of his disorder, self-control training and drug therapy. 2. Gastric ulcers: a. 40-year-old male, response type, CMI IV region (Neurotic tendencies). Psychosomatic treatment: autogenic training and drug therapy. b. 28-year-old male, non-response type, high JAS scores(Over adaptative behavior). Psychosomatic treatment: advice to increase awareness of body-mind relationships of occurrence of his ulcers, to induce change in his perceptions of way of life, to encourage taking rest. 3. Technostress syndrome: a. 23-year-old female, response type, technoanxiety. Psychosomatic treatment: advice to make her take rest, and change in arrangements at her working place. b. 27-year-old male, non-response type, technodependent. Psychosomatic treatment: Fasting therapy. This therapy changed the non-response pattern to normal.

Blood Pressure and Metabolic Effects of Acetyl-l-Carnitine in Type 2 Diabetes: DIABASI Randomized Controlled Trial.

PubMed

Parvanova, Aneliya; Trillini, Matias; Podestà, Manuel A; Iliev, Ilian P; Aparicio, Carolina; Perna, Annalisa; Peraro, Francesco; Rubis, Nadia; Gaspari, Flavio; Cannata, Antonio; Ferrari, Silvia; Bossi, Antonio C; Trevisan, Roberto; Parameswaran, Sreejith; Chávez-Iñiguez, Jonathan S; Masnic, Fahrudin; Seck, Sidy Mohamed; Jiamjariyaporn, Teerayuth; Cortinovis, Monica; Perico, Luca; Sharma, Kanishka; Remuzzi, Giuseppe; Ruggenenti, Piero; Warnock, David G

2018-05-01

Acetyl-l-carnitine (ALC), a mitochondrial carrier involved in lipid oxidation and glucose metabolism, decreased systolic blood pressure (SBP), and ameliorated insulin sensitivity in hypertensive nondiabetic subjects at high cardiovascular risk. To assess the effects of ALC on SBP and glycemic and lipid control in patients with hypertension, type 2 diabetes mellitus (T2D), and dyslipidemia on background statin therapy. After 4-week run-in period and stratification according to previous statin therapy, patients were randomized to 6-month, double-blind treatment with ALC or placebo added-on simvastatin. Five diabetology units and one clinical research center in Italy. Two hundred twenty-nine patients with hypertension and dyslipidemic T2D >40 years with stable background antihypertensive, hypoglycemic, and statin therapy and serum creatinine <1.5 mg/dL. Oral ALC 1000 mg or placebo twice daily on top of stable simvastatin therapy. Primary outcome was SBP. Secondary outcomes included lipid and glycemic profiles. Total-body glucose disposal rate and glomerular filtration rate were measured in subgroups by hyperinsulinemic-euglycemic clamp and iohexol plasma clearance, respectively. SBP did not significantly change after 6-month treatment with ALC compared with placebo (-2.09 mm Hg vs -3.57 mm Hg, P = 0.9539). Serum cholesterol, triglycerides, and lipoprotein(a), as well as blood glucose, glycated hemoglobin, fasting insulin levels, homeostatic model assessment of insulin resistance index, glucose disposal rate, and glomerular filtration rate did not significantly differ between treatments. Adverse events were comparable between groups. Six-month oral ALC supplementation did not affect blood pressure, lipid and glycemic control, insulin sensitivity and kidney function in hypertensive normoalbuminuric and microalbuminuric T2D patients on background statin therapy.

Semaglutide for type 2 diabetes mellitus: a systematic review and meta-analysis.

PubMed

Andreadis, Panagiotis; Karagiannis, Thomas; Malandris, Konstantinos; Avgerinos, Ioannis; Liakos, Aris; Manolopoulos, Apostolos; Bekiari, Eleni; Matthews, David R; Tsapas, Apostolos

2018-05-13

To assess the efficacy and safety of semaglutide, a recently approved glucagon-like peptide 1 receptor agonist (GLP-1 RA) for type 2 diabetes. We searched major electronic databases and grey literature sources for randomised controlled trials comparing semaglutide with placebo or other antidiabetic agents. Primary outcome was change from baseline in HbA 1c . Secondary endpoints included change from baseline in body weight, blood pressure, heart rate, and incidence of hypoglycaemia, gastrointestinal adverse effects, pancreatitis and diabetic retinopathy. Six placebo-controlled and seven active-controlled studies with subcutaneous semaglutide were included. We identified only one trial with oral semaglutide. Compared with placebo, subcutaneous semaglutide 0.5 and 1 mg reduced HbA 1c by 1.01% (95% CI 0.56 to 1.47) and 1.38% (1.05 to 1.70) respectively. Both doses demonstrated superior glycaemic efficacy compared to other antidiabetic agents, including sitagliptin, exenatide, liraglutide, dulaglutide and insulin glargine. Semaglutide also had a beneficial effect on body weight (mean difference versus placebo -4.11 kg, 95% CI -4.85 to -3.37 for semaglutide 1 mg) and systolic blood pressure. We did not observe increased hypoglycaemia rates with semaglutide; nevertheless, we noted an increased incidence of nausea, vomiting and diarrhoea. Cases of pancreatitis were infrequent and odds ratio for diabetic retinopathy compared with placebo was 1.32 (95% CI 0.98 to 1.77). Semaglutide is a potent once-weekly GLP-1 RA, reducing significantly HbA 1c , body weight and systolic blood pressure. However, it is associated with increased incidence of gastrointestinal adverse events. Results for pancreatitis and retinopathy require further assessment in post-approval pharmacovigilance studies. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

[Three-dimensional finite element analysis of maxillary anterior teeth retraction force system in light wire technique].

PubMed

Zhang, Xiangfeng; Wang, Chao; Xia, Xi; Deng, Feng; Zhang, Yi

2015-06-01

This study aims to construct a three-dimensional finite element model of a maxillary anterior teeth retraction force system in light wire technique and to investigate the difference of hydrostatic pressure and initial displacement of upper anterior teeth under different torque values of tip back bend. A geometric three-dimensional model of the maxillary bone, including all the upper teeth, was achieved via CT scan. To construct the force model system, lingual brackets and wire were constructed by using the Solidworks. Brackets software, and wire were assembled to the teeth. ANASYS was used to calculate the hydrostatic pressure and the initial displacement of maxillary anterior teeth under different tip-back bend moments of 15, 30, 45, 60, and 75 Nmm when the class II elastic force was 0.556 N. Hydrostatic pressure was concentrated in the root apices and cervical margin of upper anterior teeth. Distal tipping and relative intrusive displacement were observed. The hydrostatic pressure and initial displacement of upper canine were greater than in the central and lateral incisors. This hydrostatic pressure and initial intrusive displacement increased with an increase in tip-back bend moment. Lingual retraction force system of maxillary anterior teeth in light wire technique can be applied safely and controllably. The type and quantity of teeth movement can be controlled by the alteration of tip-back bend moment.

ASRDI oxygen technology survey. Volume 8: Pressure measurement

NASA Technical Reports Server (NTRS)

Arvidson, J. M.; Brennan, J. A.

1975-01-01

Pressure transducers and their current uses with gaseous or liquid oxygen are reviewed. All transducer types such as strain gage, capacitance, potentiometric, piezoelectric, etc., are included. Topics covered include: cryogenic pressure measurement; material compatibility with gaseous and liquid oxygen; cleaning procedures; pressure tap connections; transducer types and descriptions; and calibration techniques.

Association between Knowledge-Attitude-Practices and Control of Blood Glucose, Blood Pressure, and Blood Lipids in Patients with Type 2 Diabetes in Shanghai, China: A Cross-Sectional Study.

PubMed

Yang, Hua; Gao, Jian; Ren, Limin; Li, Shuyu; Chen, Zhangyan; Huang, Junfang; Zhu, Shanzhu; Pan, Zhigang

2017-01-01

Knowledge-attitude-practices (KAP) significantly impact the outcome of self-management in patients with diabetes, yet the association between KAP and the combined control of the levels of blood glucose, blood pressure, and blood lipids in these patients remains uncertain. This community-based cross-sectional study was conducted from December 2014 to December 2016 on 3977 patients with type 2 diabetes in Shanghai. KAP were evaluated using the modified Chinese version of the Diabetes, Hypertension and Hyperlipidemia (DHL) Knowledge Instrument, Diabetes Empowerment Scale-Short Form (DES-SF), and Summary of Diabetes Self-Care Activities (SDSCA). Clinical and biochemical measurements were performed at each sampling site. The association between KAP scores and achieving the combined target goal was assessed by multiple logistic regression. Patients having a higher score of knowledge were more likely to achieve the combined target goal. Furthermore, a turning point of knowledge score was found that the possibility of achieving the combined target goal presented a sharp increase when the knowledge score was more than 70. However, the scores of attitude and practices had no significant relations with achieving the combined target goal. Health intervention strategies, especially increasing integrated diabetes knowledge, should be targeted to patients with type 2 diabetes in communities.

The effect of closed system suction on airway pressures when using the Servo 300 ventilator.

PubMed

Frengley, R W; Closey, D N; Sleigh, J W; Torrance, J M

2001-12-01

To measure airway pressures during closed system suctioning with the ventilator set to three differing modes of ventilation. Closed system suctioning was conducted in 16 patients following cardiac surgery. Suctioning was performed using a 14 French catheter with a vacuum level of -500 cmH2O through an 8.0 mm internal diameter endotracheal tube. The lungs were mechanically ventilated with a Servo 300 ventilator set to one of three ventilation modes: volume-control, pressure-control or CPAP/pressure support. Airway pressures were measured via a 4 French electronic pressure transducer in both proximal and distal airways. Following insertion of the suction catheter, end-expiratory pressure increased significantly (p < 0.001) in both pressure-control and volume-control ventilation. This increase was greatest (p = 0.018) in volume-control mode (2.7 +/- 1.7 cmH2O). On performing a five second suction, airway pressure decreased in all modes, however the lowest airway pressure in volume-control mode (-4.9 +/- 4.0 cmH2O) was significantly (p = 0.001) less than the lowest airway pressure recorded in either pressure-control (0.8 +/- 1.9 cmH2O) or CPAP/pressure support (0.4 +/- 2.8 cmH2O) modes. In CPAP/pressure support mode, 13 of the 16 patients experienced a positive pressure 'breath' at the end of suctioning with airway pressures rising to 21 +/- 1.6 cmH2O. Closed system suctioning in volume control ventilation may result in elevations of end-expiratory pressure following catheter insertion and subatmospheric airway pressures during suctioning. Pressure control ventilation produces less elevation of end-expiratory pressure following catheter insertion and is less likely to be associated with subatmospheric airway pressures during suctioning. CPAP/pressure support has no effect on end-expiratory pressure following catheter insertion and subatmospheric airway pressures are largely avoided during suctioning.

Boundary-Layer-Ingesting Inlet Flow Control

NASA Technical Reports Server (NTRS)

Owens, Lewis R.; Allan, Brian G.; Gorton, Susan A.

2006-01-01

This paper gives an overview of a research study conducted in support of the small-scale demonstration of an active flow control system for a boundary-layer-ingesting (BLI) inlet. The effectiveness of active flow control in reducing engine inlet circumferential distortion was assessed using a 2.5% scale model of a 35% boundary-layer-ingesting flush-mounted, offset, diffusing inlet. This experiment was conducted in the NASA Langley 0.3-meter Transonic Cryogenic Tunnel at flight Mach numbers with a model inlet specifically designed for this type of testing. High mass flow actuators controlled the flow through distributed control jets providing the active flow control. A vortex generator point design configuration was also tested for comparison purposes and to provide a means to examine a hybrid vortex generator and control jets configuration. Measurements were made of the onset boundary layer, the duct surface static pressures, and the mass flow through the duct and the actuators. The distortion and pressure recovery were determined by 40 total pressure measurements on 8 rake arms each separated by 45 degrees and were located at the aerodynamic interface plane. The test matrix was limited to a maximum free-stream Mach number of 0.85 with scaled mass flows through the inlet for that condition. The data show that the flow control jets alone can reduce circumferential distortion (DPCP(sub avg)) from 0.055 to about 0.015 using about 2.5% of inlet mass flow. The vortex generators also reduced the circumferential distortion from 0.055 to 0.010 near the inlet mass flow design point. Lower inlet mass flow settings with the vortex generator configuration produced higher distortion levels that were reduced to acceptable levels using a hybrid vortex generator/control jets configuration that required less than 1% of the inlet mass flow.

Boundary-Layer-Ingesting Inlet Flow Control

NASA Technical Reports Server (NTRS)

Owens, Lewis R.; Allan, Brian G.; Gorton, Susan A.

2006-01-01

This paper gives an overview of a research study conducted in support of the small-scale demonstration of an active flow control system for a boundary-layer-ingesting (BLI) inlet. The effectiveness of active flow control in reducing engine inlet circumferential distortion was assessed using a 2.5% scale model of a 35% boundary-layer-ingesting flush-mounted, offset, diffusing inlet. This experiment was conducted in the NASA Langley 0.3-meter Transonic Cryogenic Tunnel at flight Mach numbers with a model inlet specifically designed for this type of testing. High mass flow actuators controlled the flow through distributed control jets providing the active flow control. A vortex generator point design configuration was also tested for comparison purposes and to provide a means to examine a hybrid vortex generator and control jets configuration. Measurements were made of the onset boundary layer, the duct surface static pressures, and the mass flow through the duct and the actuators. The distortion and pressure recovery were determined by 40 total pressure measurements on 8 rake arms each separated by 45 degrees and were located at the aerodynamic interface plane. The test matrix was limited to a maximum free-stream Mach number of 0.85 with scaled mass flows through the inlet for that condition. The data show that the flow control jets alone can reduce circumferential distortion (DPCPavg) from 0.055 to about 0.015 using about 2.5% of inlet mass flow. The vortex generators also reduced the circumferential distortion from 0.055 to 0.010 near the inlet mass flow design point. Lower inlet mass flow settings with the vortex generator configuration produced higher distortion levels that were reduced to acceptable levels using a hybrid vortex generator/control jets configuration that required less than 1% of the inlet mass flow.

FPGA-based multiprocessor system for injection molding control.

PubMed

Muñoz-Barron, Benigno; Morales-Velazquez, Luis; Romero-Troncoso, Rene J; Rodriguez-Donate, Carlos; Trejo-Hernandez, Miguel; Benitez-Rangel, Juan P; Osornio-Rios, Roque A

2012-10-18

The plastic industry is a very important manufacturing sector and injection molding is a widely used forming method in that industry. The contribution of this work is the development of a strategy to retrofit control of an injection molding machine based on an embedded system microprocessors sensor network on a field programmable gate array (FPGA) device. Six types of embedded processors are included in the system: a smart-sensor processor, a micro fuzzy logic controller, a programmable logic controller, a system manager, an IO processor and a communication processor. Temperature, pressure and position are controlled by the proposed system and experimentation results show its feasibility and robustness. As validation of the present work, a particular sample was successfully injected.