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Sample records for primary blast type

  1. Spectrum of abdominal organ injury in a primary blast type

    PubMed Central

    2009-01-01

    Introduction Abdominal organ injury in a primary blast type is always challenging for diagnosis. Air containing abdominal viscera is most vulnerable to effects of primary blast injury. In any patient exposed to a primary blast wave who presents with an acute abdomen, an abdominal organ injury is to be kept in a clinical suspicion. Aim Study various abdominal organ injuries occurring in a primary type of blast injury. Material and methods: All those who had exploratory laparotomy for abdominal organ injuries after a primary blast injury for a period of 10 years from January 1998 - January 2008 were included in this retrospective study. Results Total 154 patients had laparotomy for abdominal organ injuries with a primary blast type of injury. Small intestine was damaged in 48 patients (31.1%) followed by spleen in 22.7% cases. 54 patients (35.06%) had more than one organ injured. Liver laceration was present in 30 patients (19.48%). Multiple small gut perforations were present in 37 patients (77.08%). Negative laparotomy was found in 5 patients (3.24%) whereas 3 (1.94%) had re-exploration. Mortality was present in 6 patients (3.89%). Conclusions Primary blast injury causes varied abdominal organ injuries. Single or multiple organ damage can be there. Small intestine is commonest viscera injured. Laparotomy gives final diagnosis. PMID:20025766

  2. Primary Blast Injuries in the Open and in Foxholes Resulting from Nuclear Type Detonations

    DTIC Science & Technology

    1991-07-01

    22 16 Liver from sheep, a seven-minute death. Upper photo is of the parietal surface showing subcapsular hematomas . Lower photo of...organs, including the liver (Figure 16), spleen and kidneys, ranges from light subcapsular contusions to subcapsular hematomas to rupture. Rupture or...these may injure nearby solid organs, such as the heart, liver and spleen. The short survival time of animal and human victims of blast is attribut- ed

  3. Brain Injury Risk from Primary Blast

    DTIC Science & Technology

    2012-02-29

    combined abdominal and thoracic protection that reduced blast levels to an order of magnitude below pulmonary injury threshold. The results were scaled to... contusions typically on or around the brainstem though there were no skull fractures for any blast intensity. Risk functions were developed that...primary blast exposure to the brain was found to be more than twice the pulmonary fatality injury risk. However, the blast level for 50% risk of mild

  4. The pathology of primary blast overpressure injury.

    PubMed

    Mayorga, M A

    1997-07-25

    Primary blast injury occurs in civilian and military detonations and from the firing of weapon systems. The pathology of primary blast injury has been reported for the last 70 years and has primarily been limited to descriptions of gross pathology and histology. Commonly accepted tenets have not been confirmed as blast overpressure experiments in enclosures and with multiple detonations have been conducted. Organ systems other than the ear and the lung are playing a greater role in injury definition and research importance. This paper is an overview and update of the current understanding of the pathology of primary blast injury.

  5. Abdominal trauma in primary blast injury.

    PubMed

    Owers, C; Morgan, J L; Garner, J P

    2011-02-01

    Blast injury is uncommon, and remains poorly understood by most clinicians outside regions of active warfare. Primary blast injury (PBI) results from the interaction of the blast wave with the body, and typically affects gas-containing organs such as the ear, lungs and gastrointestinal tract. This review investigates the mechanisms and injuries sustained to the abdomen following blast exposure. MEDLINE was searched using the keywords 'primary blast injury', 'abdominal blast' and 'abdominal blast injury' to identify English language reports of abdominal PBI. Clinical reports providing sufficient data were used to calculate the incidence of abdominal PBI in hospitalized survivors of air blast, and in open- and enclosed-space detonations. Sixty-one articles were identified that primarily reported clinical or experimental abdominal PBI. Nine clinical reports provided sufficient data to calculate an incidence of abdominal PBI; 31 (3·0 per cent) of 1040 hospitalized survivors of air blast suffered abdominal PBI, the incidence ranging from 1·3 to 33 per cent. The incidence for open- and enclosed-space detonations was 5·6 and 6·7 per cent respectively. The terminal ileum and caecum were the most commonly affected organs. Surgical management of abdominal PBI is similar to that of abdominal trauma of other causes. Abdominal PBI is uncommon but has the potential for significant mortality and morbidity, which may present many days after blast exposure. It is commoner after blast in enclosed spaces and under water. Copyright © 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

  6. Effect of Human and Sheep Lung Orientation on Primary Blast Injury Induced by Single Blast

    DTIC Science & Technology

    2010-09-01

    may be injured by m ore than one of these mechanisms in any given event. Primary blast in juries ( PBI ) are exclusively caused by the blast...overpressure. A PBI usually affects air-containing organs such as t he lung, ears and gastrointestinal tract. Secon dary blast injuries are caused by...orientation on blast injuries predicted in human and sheep models. From th is study, it is predicted that the greatest reduction in lung PBI may be

  7. Neuro-glial and systemic mechanisms of pathological responses in rat models of primary blast overpressure compared to "composite" blast.

    PubMed

    Svetlov, Stanislav I; Prima, Victor; Glushakova, Olena; Svetlov, Artem; Kirk, Daniel R; Gutierrez, Hector; Serebruany, Victor L; Curley, Kenneth C; Wang, Kevin K W; Hayes, Ronald L

    2012-01-01

    A number of experimental models of blast brain injury have been implemented in rodents and larger animals. However, the variety of blast sources and the complexity of blast wave biophysics have made data on injury mechanisms and biomarkers difficult to analyze and compare. Recently, we showed the importance of rat position toward blast generated by an external shock tube. In this study, we further characterized blast producing moderate traumatic brain injury and defined "composite" blast and primary blast exposure set-ups. Schlieren optics visualized interaction between the head and a shock wave generated by external shock tube, revealing strong head acceleration upon positioning the rat on-axis with the shock tube (composite blast), but negligible skull movement upon peak overpressure exposure off-axis (primary blast). Brain injury signatures of a primary blast hitting the frontal head were assessed and compared to damage produced by composite blast. Low to negligible levels of neurodegeneration were found following primary blast compared to composite blast by silver staining. However, persistent gliosis in hippocampus and accumulation of GFAP/CNPase in circulation was detected after both primary and composite blast. Also, markers of vascular/endothelial inflammation integrin alpha/beta, soluble intercellular adhesion molecule-1, and L-selectin along with neurotrophic factor nerve growth factor-beta were increased in serum within 6 h post-blasts and persisted for 7 days thereafter. In contrast, systemic IL-1, IL-10, fractalkine, neuroendocrine peptide Orexin A, and VEGF receptor Neuropilin-2 (NRP-2) were raised predominantly after primary blast exposure. In conclusion, biomarkers of major pathological pathways were elevated at all blast set-ups. The most significant and persistent changes in neuro-glial markers were found after composite blast, while primary blast instigated prominent systemic cytokine/chemokine, Orexin A, and Neuropilin-2 release

  8. Simulations of Porcine Eye Exposure to Primary Blast Insult

    PubMed Central

    Watson, Richard; Gray, Walt; Sponsel, William E.; Lund, Brian J.; Glickman, Randolph D.; Groth, Sylvia L.; Reilly, Matthew A.

    2015-01-01

    Purpose A computational model of the porcine eye was developed to simulate primary blast exposure. This model facilitates understanding of blast-induced injury mechanisms. Methods A computational model of the porcine eye was used to simulate the effects of primary blast loading for comparison with experimental findings from shock tube experiments. The eye model was exposed to overpressure-time histories measured during physical experiments. Deformations and mechanical stresses within various ocular tissues were then examined for correlation with pathological findings in the experiments. Results Stresses and strains experienced in the eye during a primary blast event increase as the severity of the blast exposure increases. Peak stresses in the model occurred in locations in which damage was most often observed in the physical experiments. Conclusions Blast injuries to the anterior chamber may be due to inertial displacement of the lens and ciliary body while posterior damage may arise due to contrecoup interactions of the vitreous and retina. Correlation of modeling predictions with physical experiments lends confidence that the model accurately represents the conditions found in the physical experiments. Translational Relevance This computational model offers insights into the mechanisms of ocular injuries arising due to primary blast and may be used to simulate the effects of new protective eyewear designs. PMID:26336633

  9. Primary blast injury causes cognitive impairments and hippocampal circuit alterations.

    PubMed

    Beamer, Matthew; Tummala, Shanti R; Gullotti, David; Kopil, Catherine; Gorka, Samuel; Ted Abel; Bass, Cameron R Dale; Morrison, Barclay; Cohen, Akiva S; Meaney, David F

    2016-09-01

    Blast-induced traumatic brain injury (bTBI) and its long term consequences are a major health concern among veterans. Despite recent work enhancing our knowledge about bTBI, very little is known about the contribution of the blast wave alone to the observed sequelae. Herein, we isolated its contribution in a mouse model by constraining the animals' heads during exposure to a shockwave (primary blast). Our results show that exposure to primary blast alone results in changes in hippocampus-dependent behaviors that correspond with electrophysiological changes in area CA1 and are accompanied by reactive gliosis. Specifically, five days after exposure, behavior in an open field and performance in a spatial object recognition (SOR) task were significantly different from sham. Network electrophysiology, also performed five days after injury, demonstrated a significant decrease in excitability and increase in inhibitory tone. Immunohistochemistry for GFAP and Iba1 performed ten days after injury showed a significant increase in staining. Interestingly, a threefold increase in the impulse of the primary blast wave did not exacerbate these measures. However, we observed a significant reduction in the contribution of the NMDA receptors to the field EPSP at the highest blast exposure level. Our results emphasize the need to account for the effects of primary blast loading when studying the sequelae of bTBI.

  10. White matter compromise in veterans exposed to primary blast forces.

    PubMed

    Taber, Katherine H; Hurley, Robin A; Haswell, Courtney C; Rowland, Jared A; Hurt, Susan D; Lamar, Cory D; Morey, Rajendra A

    2015-01-01

    Use diffusion tensor imaging to investigate white matter alterations associated with blast exposure with or without acute symptoms of traumatic brain injury (TBI). Forty-five veterans of the recent military conflicts included 23 exposed to primary blast without TBI symptoms, 6 having primary blast with mild TBI, and 16 unexposed to blast. Cross-sectional case-control study. Neuropsychological testing and diffusion tensor imaging metrics that quantified the number of voxel clusters with altered fractional anisotropy (FA) radial diffusivity, and axial diffusivity, regardless of their spatial location. Significantly lower FA and higher radial diffusivity were observed in veterans exposed to primary blast with and without mild TBI relative to blast-unexposed veterans. Voxel clusters of lower FA were spatially dispersed and heterogeneous across affected individuals. These results suggest that lack of clear TBI symptoms following primary blast exposure may not accurately reflect the extent of brain injury. If confirmed, our findings would argue for supplementing the established approach of making diagnoses based purely on clinical history and observable acute symptoms with novel neuroimaging-based diagnostic criteria that "look below the surface" for pathology.

  11. Primary blast injury causes cognitive impairments and hippocampal circuit alterations

    PubMed Central

    Beamer, Matthew; Tummala, Shanti R.; Gullotti, David; Kopil, Kathryn; Gorka, Samuel; Abel, Ted; “Dale” Bass, Cameron R.; Morrison, Barclay; Cohen, Akiva S.; Meaney, David F.

    2016-01-01

    Blast-induced traumatic brain injury (bTBI) and its long term consequences are a major health concern among veterans. Despite recent work enhancing our knowledge about bTBI, very little is known about the contribution of the blast wave alone to the observed sequelae. Herein, we isolated its contribution in a mouse model by constraining the animals' heads during exposure to a shockwave (primary blast). Our results show that exposure to primary blast alone results in changes in hippocampus-dependent behaviors that correspond with electro-physiological changes in area CA1 and are accompanied by reactive gliosis. Specifically, five days after exposure, behavior in an open field and performance in a spatial object recognition (SOR) task were significantly different from sham. Network electrophysiology, also performed five days after injury, demonstrated a significant decrease in excitability and increase in inhibitory tone. Immunohistochemistry for GFAP and Iba1 performed ten days after injury showed a significant increase in staining. Interestingly, a threefold increase in the impulse of the primary blast wave did not exacerbate these measures. However, we observed a significant reduction in the contribution of the NMDA receptors to the field EPSP at the highest blast exposure level. Our results emphasize the need to account for the effects of primary blast loading when studying the sequelae of bTBI. PMID:27246999

  12. Computational modeling of human head under blast in confined and open spaces: primary blast injury.

    PubMed

    Rezaei, A; Salimi Jazi, M; Karami, G

    2014-01-01

    In this paper, a computational modeling for biomechanical analysis of primary blast injuries is presented. The responses of the brain in terms of mechanical parameters under different blast spaces including open, semi-confined, and confined environments are studied. In the study, the effect of direct and indirect blast waves from the neighboring walls in the confined environments will be taken into consideration. A 50th percentile finite element head model is exposed to blast waves of different intensities. In the open space, the head experiences a sudden intracranial pressure (ICP) change, which vanishes in a matter of a few milliseconds. The situation is similar in semi-confined space, but in the confined space, the reflections from the walls will create a number of subsequent peaks in ICP with a longer duration. The analysis procedure is based on a simultaneous interaction simulation of the deformable head and its components with the blast wave propagations. It is concluded that compared with the open and semi-confined space settings, the walls in the confined space scenario enhance the risk of primary blast injuries considerably because of indirect blast waves transferring a larger amount of damaging energy to the head.

  13. Effects of Primary Blast Overpressure on Retina and Optic Tract in Rats.

    PubMed

    DeMar, James; Sharrow, Keith; Hill, Miya; Berman, Jonathan; Oliver, Thomas; Long, Joseph

    2016-01-01

    Blast has been the leading cause of injury, particularly traumatic brain injury and visual system injury, in combat operations in Iraq and Afghanistan. We determined the effect of shock tube-generated primary blast on retinal electrophysiology and on retinal and brain optic tract histopathology in a rat model. The amplitude of a- and b-waves on the electroretinogram (ERG) for both right and left eyes were measured prior to a battlefield simulation Friedlander-type blast wave and on 1, 7, and 14 days thereafter. Histopathologic findings of the right and left retina and the right and left optic tracts (2.8 mm postoptic chiasm) were evaluated 14 days after the blast. For two experiments in which the right eye was oriented to the blast, the amplitude of ERG a- and b-waves at 7 days post blast on the right side but not on the left side was diminished compared to that of sham animals (P = 0.005-0.01) Histopathologic injury scores at 14 days post blast for the right retina but not the left retina were higher than for sham animals (P = 0.01), and histopathologic injury scores at 14 days for both optic tracts were markedly higher than for shams (P < 0.0001). Exposure of one eye to a blast wave, comparable to that causing human injury, produced injury to the retina as determined by ERG and histopathology, and to both postchiasmatic optic tracts as determined by histopathology. This model may be useful for analyzing the effect of therapeutic interventions on retinal damage due to primary blast waves.

  14. Effects of Primary Blast Overpressure on Retina and Optic Tract in Rats

    PubMed Central

    DeMar, James; Sharrow, Keith; Hill, Miya; Berman, Jonathan; Oliver, Thomas; Long, Joseph

    2016-01-01

    Blast has been the leading cause of injury, particularly traumatic brain injury and visual system injury, in combat operations in Iraq and Afghanistan. We determined the effect of shock tube-generated primary blast on retinal electrophysiology and on retinal and brain optic tract histopathology in a rat model. The amplitude of a- and b-waves on the electroretinogram (ERG) for both right and left eyes were measured prior to a battlefield simulation Friedlander-type blast wave and on 1, 7, and 14 days thereafter. Histopathologic findings of the right and left retina and the right and left optic tracts (2.8 mm postoptic chiasm) were evaluated 14 days after the blast. For two experiments in which the right eye was oriented to the blast, the amplitude of ERG a- and b-waves at 7 days post blast on the right side but not on the left side was diminished compared to that of sham animals (P = 0.005–0.01) Histopathologic injury scores at 14 days post blast for the right retina but not the left retina were higher than for sham animals (P = 0.01), and histopathologic injury scores at 14 days for both optic tracts were markedly higher than for shams (P < 0.0001). Exposure of one eye to a blast wave, comparable to that causing human injury, produced injury to the retina as determined by ERG and histopathology, and to both postchiasmatic optic tracts as determined by histopathology. This model may be useful for analyzing the effect of therapeutic interventions on retinal damage due to primary blast waves. PMID:27199884

  15. Blast-Induced Acceleration in a Shock Tube: Distinguishing Primary and Tertiary Blast Injury

    DTIC Science & Technology

    2014-10-01

    account for angular accelerations as part of blast induced motion. Similar articulations were seen with recordings of suspended rat cadavers (fig 7...of unrestrained rat cadaver during BOP exposure. The image on the right was recorded 40 msec after the image on the left. types of experiments...articulating manikins, and rat cadavers were successfully employed to assess blast-induced motion and establish scaling for model assessments of rat TBI. These

  16. Unusual primary and secondary facial blast injuries.

    PubMed

    Koren, Ilan; Shimonove, Mordechai; Shvero, Yaacov; Feinmesser, Raphael

    2003-01-01

    To discuss unusual facial injuries resulting from a bomb blast. In March 1997, a bomb consisting of a bag of nails was detonated in a coffee shop in Tel Aviv. Two of the wounded were brought to our level 1 Trauma Center with unique facial injuries. Computed tomography (CT) scan and CT angiogram were performed. The blast occurred to the immediate right of the victims who were sitting in an open cafe. Both had tympanic perforation. The first patient showed indirect damage to the facial nerve from a piece of shrapnel located anterior to the carotid artery and medial to the right mandibular angle. The second had a piece of shrapnel lodged in the parapharyngeal space that was initially missed and discovered only on reexamination 3 days later after the patient complained of pain in the temporomandibular joint; there was no facial nerve deficit. The port of entry was probably a small wound in the anterior wall of the external ear canal. The wounds are probably attributable to the spalling effect of the shrapnel passing through the parotid gland, which has mixed-density tissue. These cases show that nerves are susceptible to damage even in the absence of direct engagement and that the emergency room physician should be alert to even small skin imperfections in blast victims to avoid missing penetrating wounds. Copyright 2003, Elsevier Science (USA). All rights reserved.)

  17. Neuro-Glial and Systemic Mechanisms of Pathological Responses in Rat Models of Primary Blast Overpressure Compared to “Composite” Blast

    PubMed Central

    Svetlov, Stanislav I.; Prima, Victor; Glushakova, Olena; Svetlov, Artem; Kirk, Daniel R.; Gutierrez, Hector; Serebruany, Victor L.; Curley, Kenneth C.; Wang, Kevin K. W.; Hayes, Ronald L.

    2012-01-01

    A number of experimental models of blast brain injury have been implemented in rodents and larger animals. However, the variety of blast sources and the complexity of blast wave biophysics have made data on injury mechanisms and biomarkers difficult to analyze and compare. Recently, we showed the importance of rat position toward blast generated by an external shock tube. In this study, we further characterized blast producing moderate traumatic brain injury and defined “composite” blast and primary blast exposure set-ups. Schlieren optics visualized interaction between the head and a shock wave generated by external shock tube, revealing strong head acceleration upon positioning the rat on-axis with the shock tube (composite blast), but negligible skull movement upon peak overpressure exposure off-axis (primary blast). Brain injury signatures of a primary blast hitting the frontal head were assessed and compared to damage produced by composite blast. Low to negligible levels of neurodegeneration were found following primary blast compared to composite blast by silver staining. However, persistent gliosis in hippocampus and accumulation of GFAP/CNPase in circulation was detected after both primary and composite blast. Also, markers of vascular/endothelial inflammation integrin alpha/beta, soluble intercellular adhesion molecule-1, and L-selectin along with neurotrophic factor nerve growth factor-beta were increased in serum within 6 h post-blasts and persisted for 7 days thereafter. In contrast, systemic IL-1, IL-10, fractalkine, neuroendocrine peptide Orexin A, and VEGF receptor Neuropilin-2 (NRP-2) were raised predominantly after primary blast exposure. In conclusion, biomarkers of major pathological pathways were elevated at all blast set-ups. The most significant and persistent changes in neuro-glial markers were found after composite blast, while primary blast instigated prominent systemic cytokine/chemokine, Orexin A, and Neuropilin-2 release

  18. Low-Level Primary Blast Causes Acute Ocular Trauma in Rabbits.

    PubMed

    Jones, Kirstin; Choi, Jae-Hyek; Sponsel, William E; Gray, Walt; Groth, Sylvia L; Glickman, Randolph D; Lund, Brian J; Reilly, Matthew A

    2016-07-01

    The objective of this study was to determine whether clinically significant ocular trauma can be induced by a survivable isolated primary blast using a live animal model. Both eyes of 18 Dutch Belted rabbits were exposed to various survivable low-level blast overpressures in a large-scale shock tube simulating a primary blast similar to an improvised explosive device. Eyes of the blast-exposed rabbits (as well as five control rabbits) were thoroughly examined before and after blast to detect changes. Clinically significant changes in corneal thickness arose immediately after blast and were sustained through 48 h, suggesting possible disruption of endothelial function. Retinal thickness (RT) increased with increasing specific impulse immediately after exposure. Intraocular pressure (IOP) was inversely correlated with the specific impulse of the blast wave. These findings clearly indicate that survivable primary blast causes ocular injuries with likely visual functional sequelae of clinical and military relevance.

  19. Incidence of Primary Blast Injury in US Military Overseas Contingency Operations: A Retrospective Study

    DTIC Science & Technology

    2010-06-01

    872.61 (open wound of ear drum ) in an explosion-injured patient. Since pneumothorax and/or pulmonary hemorrhages have been described as resulting from...frequently described effects of the blast wave are tympanic membrane rupture , blast lung injury, and intestinal blast injury.22 The injurious effects of the... rupture among 120 wounded patients to be 7%.33 The present retrospective study was performed to determine the incidence of primary blast injury and

  20. Primary Blast Injury Depressed Hippocampal Long-Term Potentiation through Disruption of Synaptic Proteins.

    PubMed

    Vogel, Edward W; Rwema, Steve H; Meaney, David F; Bass, Cameron R Dale; Morrison, Barclay

    2017-03-01

    Blast-induced traumatic brain injury (bTBI) is a major threat to United States service members in military conflicts worldwide. The effects of primary blast, caused by the supersonic shockwave interacting with the skull and brain, remain unclear. Our group has previously reported that in vitro primary blast exposure can reduce long-term potentiation (LTP), the electrophysiological correlate of learning and memory, in rat organotypic hippocampal slice cultures (OHSCs) without significant changes to cell viability or basal, evoked neuronal function. We investigated the time course of primary blast-induced deficits in LTP and the molecular mechanisms that could underlie these deficits. We found that pure primary blast exposure induced LTP deficits in a delayed manner, requiring longer than 1 hour to develop, and that these deficits spontaneously recovered by 10 days following exposure depending on blast intensity. Additionally, we observed that primary blast exposure reduced total α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) glutamate receptor 1 (GluR1) subunit expression and phosphorylation of the GluR1 subunit at the serine-831 site. Blast also reduced the expression of postsynaptic density protein-95 (PSD-95) and phosphorylation of stargazin protein at the serine-239/240 site. Finally, we found that modulation of the cyclic adenosine monophosphate (cAMP) pathway ameliorated electrophysiological and protein-expression changes caused by blast. These findings could inform the development of novel therapies to treat blast-induced loss of neuronal function.

  1. Isolated Primary Blast Inhibits Long-Term Potentiation in Organotypic Hippocampal Slice Cultures.

    PubMed

    Vogel, Edward W; Effgen, Gwen B; Patel, Tapan P; Meaney, David F; Bass, Cameron R Dale; Morrison, Barclay

    2016-04-01

    Over the last 13 years, traumatic brain injury (TBI) has affected over 230,000 U.S. service members through the conflicts in Iraq and Afghanistan, mostly as a result of exposure to blast events. Blast-induced TBI (bTBI) is multi-phasic, with the penetrating and inertia-driven phases having been extensively studied. The effects of primary blast injury, caused by the shockwave interacting with the brain, remain unclear. Earlier in vivo studies in mice and rats have reported mixed results for primary blast effects on behavior and memory. Using a previously developed shock tube and in vitro sample receiver, we investigated the effect of isolated primary blast on the electrophysiological function of rat organotypic hippocampal slice cultures (OHSC). We found that pure primary blast exposure inhibited long-term potentiation (LTP), the electrophysiological correlate of memory, with a threshold between 9 and 39 kPa·ms impulse. This deficit occurred well below a previously identified threshold for cell death (184 kPa·ms), supporting our previously published finding that primary blast can cause changes in brain function in the absence of cell death. Other functional measures such as spontaneous activity, network synchronization, stimulus-response curves, and paired-pulse ratios (PPRs) were less affected by primary blast exposure, as compared with LTP. This is the first study to identify a tissue-level tolerance threshold for electrophysiological changes in neuronal function to isolated primary blast.

  2. Primary Blast Exposure Increases Hippocampal Vulnerability to Subsequent Exposure: Reducing Long-Term Potentiation.

    PubMed

    Effgen, Gwen B; Ong, Tiffany; Nammalwar, Shruthi; Ortuño, Andrea I; Meaney, David F; 'Dale' Bass, Cameron R; Morrison, Barclay

    2016-10-15

    Up to 80% of injuries sustained by U.S. soldiers in Operation Enduring Freedom and Operation Iraqi Freedom were the result of blast exposure from improvised explosive devices. Some soldiers experience multiple blasts while on duty, and it has been suggested that symptoms of repetitive blast are similar to those that follow multiple non-blast concussions, such as sport-related concussion. Despite the interest in the effects of repetitive blast exposure, it remains unknown whether an initial blast renders the brain more vulnerable to subsequent exposure, resulting in a synergistic injury response. To investigate the effect of multiple primary blasts on the brain, organotypic hippocampal slice cultures were exposed to single or repetitive (two or three total) primary blasts of varying intensities. Long-term potentiation was significantly reduced following two Level 2 (92.7 kPa, 1.4 msec, 38.5 kPa·msec) blasts delivered 24 h apart without altering basal evoked response. This deficit persisted when the interval between injuries was increased to 72 h but not when the interval was extended to 144 h. The repeated blast exposure with a 24 h interval increased microglia staining and activation significantly but did not significantly increase cell death or damage axons, dendrites, or principal cell layers. Lack of overt structural damage and change in basal stimulated neuron response suggest that injury from repetitive primary blast exposure may specifically affect long-term potentiation. Our studies suggest repetitive primary blasts can exacerbate injury dependent on the injury severity and interval between exposures.

  3. Blast-Induced Acceleration in a Shock Tube: Distinguishing Primary and Tertiary Blast Injury

    DTIC Science & Technology

    2015-10-01

    below, substantial progress was made to record acceleration /displacement of the experimental subjects under different flow conditions and compare...the question being asked. By 8 Fig 4: Angular velocity and acceleration of the rat head during blast exposure incorporating blast physics expertise...DATA: Target velocity and acceleration curves: Blast can create injuries by a number of mechanisms. Direct injuries from blast waves interacting

  4. A case of frontal neuropsychological and neuroimaging signs following multiple primary-blast exposure

    PubMed Central

    Hayes, Jasmeet Pannu; Morey, Rajendra A.; Tupler, Larry A.

    2013-01-01

    Blast-related traumatic brain injury (TBI) from the Afghanistan and Iraq wars represents a significant medical concern for troops and veterans. To better understand the consequences of primary-blast injury in humans, we present a case of a Marine exposed to multiple primary blasts during his 14-year military career. The neuropsychological profile of this formerly high-functioning veteran suggested primarily executive dysfunction. Diffusion-tensor imaging revealed white-matter pathology in long fiber tracks compared with a composite fractional-anisotropy template derived from a veteran reference control group without TBI. This study supports the existence of primary blast-induced neurotrauma in humans and introduces a neuroimaging technique with potential to discriminate multiple-blast TBI. PMID:21879996

  5. Modelling primary blast lung injury: current capability and future direction.

    PubMed

    Scott, Timothy; Hulse, E; Haque, M; Kirkman, E; Hardman, J; Mahoney, P

    2017-04-01

    Primary blast lung injury frequently complicates military conflict and terrorist attacks on civilian populations. The fact that it occurs in areas of conflict or unpredictable mass casualty events makes clinical study in human casualties implausible. Research in this field is therefore reliant on the use of some form of biological or non-biological surrogate model. This article briefly reviews the modelling work undertaken in this field until now and describes the rationale behind the generation of an in silico physiological model. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  6. Primary Blast Traumatic Brain Injury in the Rat: Relating Diffusion Tensor Imaging and Behavior

    PubMed Central

    Budde, Matthew D.; Shah, Alok; McCrea, Michael; Cullinan, William E.; Pintar, Frank A.; Stemper, Brian D.

    2013-01-01

    The incidence of traumatic brain injury (TBI) among military personnel is at its highest point in U.S. history. Experimental animal models of blast have provided a wealth of insight into blast injury. The mechanisms of neurotrauma caused by blast, however, are still under debate. Specifically, it is unclear whether the blast shockwave in the absence of head motion is sufficient to induce brain trauma. In this study, the consequences of blast injury were investigated in a rat model of primary blast TBI. Animals were exposed to blast shockwaves with peak reflected overpressures of either 100 or 450 kPa (39 and 110 kPa incident pressure, respectively) and subsequently underwent a battery of behavioral tests. Diffusion tensor imaging (DTI), a promising method to detect blast injury in humans, was performed on fixed brains to detect and visualize the spatial dependence of blast injury. Blast TBI caused significant deficits in memory function as evidenced by the Morris Water Maze, but limited emotional deficits as evidenced by the Open Field Test and Elevated Plus Maze. Fractional anisotropy, a metric derived from DTI, revealed significant brain abnormalities in blast-exposed animals. A significant relationship between memory deficits and brain microstructure was evident in the hippocampus, consistent with its role in memory function. The results provide fundamental insight into the neurological consequences of blast TBI, including the evolution of injury during the sub-acute phase and the spatially dependent pattern of injury. The relationship between memory dysfunction and microstructural brain abnormalities may provide insight into the persistent cognitive difficulties experienced by soldiers exposed to blast neurotrauma and may be important to guide therapeutic and rehabilitative efforts. PMID:24133481

  7. Computational Study of Human Head Response to Primary Blast Waves of Five Levels from Three Directions

    PubMed Central

    Wang, Chenzhi; Pahk, Jae Bum; Balaban, Carey D.; Miller, Mark C.; Wood, Adam R.; Vipperman, Jeffrey S.

    2014-01-01

    Human exposure to blast waves without any fragment impacts can still result in primary blast-induced traumatic brain injury (bTBI). To investigate the mechanical response of human brain to primary blast waves and to identify the injury mechanisms of bTBI, a three-dimensional finite element head model consisting of the scalp, skull, cerebrospinal fluid, nasal cavity, and brain was developed from the imaging data set of a human female. The finite element head model was partially validated and was subjected to the blast waves of five blast intensities from the anterior, right lateral, and posterior directions at a stand-off distance of one meter from the detonation center. Simulation results show that the blast wave directly transmits into the head and causes a pressure wave propagating through the brain tissue. Intracranial pressure (ICP) is predicted to have the highest magnitude from a posterior blast wave in comparison with a blast wave from any of the other two directions with same blast intensity. The brain model predicts higher positive pressure at the site proximal to blast wave than that at the distal site. The intracranial pressure wave invariably travels into the posterior fossa and vertebral column, causing high pressures in these regions. The severities of cerebral contusions at different cerebral locations are estimated using an ICP based injury criterion. Von Mises stress prevails in the cortex with a much higher magnitude than in the internal parenchyma. According to an axonal injury criterion based on von Mises stress, axonal injury is not predicted to be a cause of primary brain injury from blasts. PMID:25409326

  8. Computational study of human head response to primary blast waves of five levels from three directions.

    PubMed

    Wang, Chenzhi; Pahk, Jae Bum; Balaban, Carey D; Miller, Mark C; Wood, Adam R; Vipperman, Jeffrey S

    2014-01-01

    Human exposure to blast waves without any fragment impacts can still result in primary blast-induced traumatic brain injury (bTBI). To investigate the mechanical response of human brain to primary blast waves and to identify the injury mechanisms of bTBI, a three-dimensional finite element head model consisting of the scalp, skull, cerebrospinal fluid, nasal cavity, and brain was developed from the imaging data set of a human female. The finite element head model was partially validated and was subjected to the blast waves of five blast intensities from the anterior, right lateral, and posterior directions at a stand-off distance of one meter from the detonation center. Simulation results show that the blast wave directly transmits into the head and causes a pressure wave propagating through the brain tissue. Intracranial pressure (ICP) is predicted to have the highest magnitude from a posterior blast wave in comparison with a blast wave from any of the other two directions with same blast intensity. The brain model predicts higher positive pressure at the site proximal to blast wave than that at the distal site. The intracranial pressure wave invariably travels into the posterior fossa and vertebral column, causing high pressures in these regions. The severities of cerebral contusions at different cerebral locations are estimated using an ICP based injury criterion. Von Mises stress prevails in the cortex with a much higher magnitude than in the internal parenchyma. According to an axonal injury criterion based on von Mises stress, axonal injury is not predicted to be a cause of primary brain injury from blasts.

  9. Effects of repetitive low-pressure explosive blast on primary neurons and mixed cultures.

    PubMed

    Zander, Nicole E; Piehler, Thuvan; Banton, Rohan; Benjamin, Richard

    2016-09-01

    Repetitive mild traumatic brain injury represents a considerable health concern, particularly for athletes and military personnel. For blast-induced brain injury, threshold shock-impulse levels required to induce such injuries and cumulative effects with single and/or multiple exposures are not well characterized. Currently, there is no established in vitro experimental model with blast pressure waves generated by live explosives. This study presents results of primary neurons and mixed cultures subjected to our unique in vitro indoor experimental platform that uses real military explosive charges to probe the effects of primary explosive blast at the cellular level. The effects of the blast on membrane permeability, generation of reactive oxygen species (ROS), uptake of sodium ions, intracellular calcium, and release of glutamate were probed 2 and 24 hr postblast. Significant changes in membrane permeability and sodium uptake among the sham, single-blast-injured, and triple-blast-injured samples were observed. A significant increase in ROS and glutamate release was observed for the triple-blast-injured samples compared with the sham. Changes in intracellular calcium were not significant. These results suggest that blast exposure disrupts the integrity of the plasma membrane, leading to the upset of ion homeostasis, formation of ROS, and glutamate release. Published 2016. †This article is a U.S. Government work and is in the public domain in the USA.

  10. Primary Blast Injury Criteria for Animal/Human TBI Models using Field Validated Shock Tubes

    DTIC Science & Technology

    2016-09-01

    AWARD NUMBER: W81XWH-15-1-0303 TITLE: Primary Blast Injury Criteria for Animal/ Human TBI Models using Field Validated Shock Tubes PRINCIPAL...2015 - 14 Aug 2016 4. TITLE AND SUBTITLE Primary Blast Injury Criteria for Animal/ Human TBI Models using Field Validated Shock Tubes 5a. CONTRACT...Mail: namas.chandra@njit.edu 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) AND ADDRESS(ES) 8. PERFORMING ORGANIZATION REPORT

  11. Survival risk assessment for primary blast exposures to the head.

    PubMed

    Rafaels, Karin; Bass, Cameron R Dale; Salzar, Robert S; Panzer, Matthew B; Woods, William; Feldman, Sanford; Cummings, Thomas; Capehart, Bruce

    2011-11-01

    Many soldiers returning from the current conflicts in Iraq and Afghanistan have had at least one exposure to an explosive event and a significant number have symptoms consistent with traumatic brain injury. Although blast injury risk functions have been determined and validated for pulmonary injury, there is little information on the blast levels necessary to cause blast brain injury. Anesthetized male New Zealand White rabbits were exposed to varying levels of shock tube blast exposure focused on the head, while their thoraces were protected. The specimens were euthanized and evaluated when the blast resulted in respiratory arrest that was non-responsive to resuscitation or at 4?h post-exposure. Injury was evaluated by gross examination and histological evaluation. The fatality data from brain injury were then analyzed using Fisher's exact test to determine a brain fatality risk function. Greater blast intensity was associated with post-blast apnea and the need for mechanical ventilation. Gross examination revealed multifocal subdural hemorrhages, most often near the brainstem, at more intense levels of exposure. Histological evaluation revealed subdural and subarachnoid hemorrhages in the non-responsive respiratory-arrested specimens. A fatality risk function from blast exposure to the head was determined for the rabbit specimens with an LD(50) at a peak overpressure of 750?kPa. Scaling techniques were used to predict injury risk at other blast overpressure/duration combinations. The fatality risk function showed that the blast level needed to cause fatality from an overpressure wave exposure to the head was greater than the peak overpressure needed to cause fatality from pulmonary injury. This risk function can be used to guide future research for blast brain injury by providing a realistic fatality risk to guide the design of protection or to evaluate injury.

  12. EXAMINING LETHALITY RISK FOR RODENT STUDIES OF PRIMARY BLAST LUNG INJURY

    PubMed Central

    Hubbard, William Brad; Hall, Christina; Sajja, Venkata Siva Sai Sujith; Lavik, Erin; VandeVord, Pamela

    2015-01-01

    While protective measures have been taken to mitigate injury to the thorax during a blast exposure, primary blast lung injury (PBLI) is still evident in mounted/in vehicle cases during military conflicts. Moreover, civilians, who are unprotected from blast exposure, can be severely harmed by terrorist attacks that use improvised explosive devices (IEDs). Since the lungs are the most susceptible organ due to their air-filled nature, PBLI is one of the most serious injuries seen in civilian blast cases. Determining lethality threshold for rodent studies is crucial to guide experimental designs centered on therapies for survival after PBLI or mechanistic understanding of the injury itself. Using an Advanced Blast Simulator, unprotected rats were exposed to a whole body blast to induce PBLI. The one-hour survival rate was assessed to determine operating conditions for a 50% lethality rate. Macroscopic and histological analysis of lung was conducted using hematoxylin and eosin staining. Results demonstrated lethality risk trends based on static blast overpressure (BOP) for rodent models, which may help standardized animal studies and contribute to scaling to the human level. The need for a standardized method of producing PBLI is pressing and establishing standard curves, such as a lethality risk curve for lung blasts, is crucial for this condensing of BOP methods. PMID:25405409

  13. Primary blast injury-induced lesions in the retina of adult rats

    PubMed Central

    2013-01-01

    Background The effect of primary blast exposure on the brain is widely reported but its effects on the eye remains unclear. Here, we aim to examine the effects of primary blast exposure on the retina. Methods Adult male Sprague–Dawley rats were exposed to primary blast high and low injury and sacrificed at 24 h, 72 h, and 2 weeks post injury. The retina was subjected to western analysis for vascular endothelial growth factor (VEGF), aquaporin-4 (AQP4), glutamine synthethase (GS), inducible nitric oxide synthase (NOS), endothelial NOS, neuronal NOS and nestin expression; ELISA analysis for cytokines and chemokines; and immunofluorescence for glial fibrillary acidic protein (GFAP)/VEGF, GFAP/AQP4, GFAP/nestin, GS/AQP4, lectin/iNOS, and TUNEL. Results The retina showed a blast severity-dependent increase in VEGF, iNOS, eNOS, nNOS, and nestin expression with corresponding increases in inflammatory cytokines and chemokines. There was also increased AQP4 expression and retinal thickness after primary blast exposure that was severity-dependent. Finally, a significant increase in TUNEL+ and Caspase-3+ cells was observed. These changes were observed at 24 h post-injury and sustained up to 2 weeks post injury. Conclusions Primary blast resulted in severity-dependent pathological changes in the retina, manifested by the increased expression of a variety of proteins involved in inflammation, edema, and apoptosis. These changes were observed immediately after blast exposure and sustained up to 2 weeks suggesting acute and chronic injury mechanisms. These changes were most obvious in the astrocytes and Müller cells and suggest important roles for these cells in retina pathophysiology after blast. PMID:23819902

  14. Posttraumatic Stress Disorder in Combat Casualties With Burns Sustaining Primary Blast and Concussive Injuries

    DTIC Science & Technology

    2009-04-01

    Problems (ICD) used to identify the presence of primary blast were as follows: 872.61 for open wound of ear drum , 860 for traumatic pneumothorax closed...in close proximity to the blast center, can result in eardrum damage ( rupture of the tympanic membrane TM), lung damage (pulmonary or alveolar...septa rupture ), or visceral damage without causing death. Research focusing on explosion injuries demonstrates a notable incidence (16– 35%) of TM

  15. Neuroinflammation in primary blast neurotrauma: Time course and prevention by torso shielding.

    PubMed

    Xu, Leyan; Schaefer, Michele L; Linville, Raleigh M; Aggarwal, Ayushi; Mbuguiro, Wangui; Wester, Brock A; Koliatsos, Vassilis E

    2016-03-01

    Mechanisms of primary blast injury caused by overpressure are not fully understood. In particular, the presence and time course of neuroinflammation are unknown and so are the signatures of reactive inflammatory cells, especially the neuroprotective versus injurious roles of microglia. In general, chronic microglial activation in the injured brain suggests a pro-degenerative role for these reactive cells. In this study, we investigated the temporal dynamics of microglial activation in the brain of mice exposed to mild-moderate blast in a shock tube. Because, in our previous work, we had found that torso shielding with rigid Plexiglas attenuates traumatic axonal injury in the brain, we also evaluated neuroinflammatory microglial responses in animals with torso protection at 7 days post blast injury. Because of the prominent involvement of the visual system in blast TBI in rodents, activated microglial cells were counted in the optic tract at various time points post-injury with stereological methods. Cell counts (activated microglial cell densities) from subjects exposed to blast TBI were compared with counts from corresponding sham animals. We found that mild-moderate blast injury causes focal activation of microglia in certain white matter tracts, including the visual pathway. In the optic tract, the density of activated microglial profiles gradually intensified from 3 to 15 days post-injury and then became attenuated at 30 days. Torso protection significantly reduced microglial activation at 7 days. These findings shed light into mechanisms of primary blast neurotrauma and may suggest novel diagnostic and monitoring methods for patients. They leave open the question of whether microglial activation post blast is protective or detrimental, although response is time limited. Finally, our findings confirm the protective role of torso shielding and stress the importance of improved or optimized body gear for warfighters or other individuals at risk for blast exposure

  16. Blast-Induced Acceleration in a Shock Tube: Distinguishing Primary and Tertiary Blast Injury

    DTIC Science & Technology

    2016-10-01

    broadened interest in the study of mild TBI of all causes, the basic mechanisms of blast induced brain injury are for the most part still undefined...of bTBI. We hypothesize that explosion flow conditions can cause head acceleration sufficient to injure the brain , and that these inertial...conditions to assess relevant brain injury mechanisms. Ongoing controversies and confusion concerning the contributions of blast-induced head acceleration

  17. Cerebellar white matter abnormalities following primary blast injury in US military personnel.

    PubMed

    Mac Donald, Christine; Johnson, Ann; Cooper, Dana; Malone, Thomas; Sorrell, James; Shimony, Joshua; Parsons, Matthew; Snyder, Abraham; Raichle, Marcus; Fang, Raymond; Flaherty, Stephen; Russell, Michael; Brody, David L

    2013-01-01

    Little is known about the effects of blast exposure on the human brain in the absence of head impact. Clinical reports, experimental animal studies, and computational modeling of blast exposure have suggested effects on the cerebellum and brainstem. In US military personnel with isolated, primary blast-related 'mild' traumatic brain injury and no other known insult, we found diffusion tensor MRI abnormalities consistent with cerebellar white matter injury in 3 of 4 subjects. No abnormalities in other brain regions were detected. These findings add to the evidence supporting the hypothesis that primary blast exposure contributes to brain injury in the absence of head impact and that the cerebellum may be particularly vulnerable. However, the clinical effects of these abnormalities cannot be determined with certainty; none of the subjects had ataxia or other detected evidence of cerebellar dysfunction. The details of the blast events themselves cannot be disclosed at this time, thus additional animal and computational modeling will be required to dissect the mechanisms underlying primary blast-related traumatic brain injury. Furthermore, the effects of possible subconcussive impacts and other military-related exposures cannot be determined from the data presented. Thus many aspects of topic will require further investigation.

  18. Cerebellar White Matter Abnormalities following Primary Blast Injury in US Military Personnel

    PubMed Central

    Mac Donald, Christine; Johnson, Ann; Cooper, Dana; Malone, Thomas; Sorrell, James; Shimony, Joshua; Parsons, Matthew; Snyder, Abraham; Raichle, Marcus; Fang, Raymond; Flaherty, Stephen; Russell, Michael; Brody, David L.

    2013-01-01

    Little is known about the effects of blast exposure on the human brain in the absence of head impact. Clinical reports, experimental animal studies, and computational modeling of blast exposure have suggested effects on the cerebellum and brainstem. In US military personnel with isolated, primary blast-related ‘mild’ traumatic brain injury and no other known insult, we found diffusion tensor MRI abnormalities consistent with cerebellar white matter injury in 3 of 4 subjects. No abnormalities in other brain regions were detected. These findings add to the evidence supporting the hypothesis that primary blast exposure contributes to brain injury in the absence of head impact and that the cerebellum may be particularly vulnerable. However, the clinical effects of these abnormalities cannot be determined with certainty; none of the subjects had ataxia or other detected evidence of cerebellar dysfunction. The details of the blast events themselves cannot be disclosed at this time, thus additional animal and computational modeling will be required to dissect the mechanisms underlying primary blast-related traumatic brain injury. Furthermore, the effects of possible subconcussive impacts and other military-related exposures cannot be determined from the data presented. Thus many aspects of topic will require further investigation. PMID:23409052

  19. Disaster preparedness, pediatric considerations in primary blast injury, chemical, and biological terrorism

    PubMed Central

    Hamele, Mitchell; Poss, William Bradley; Sweney, Jill

    2014-01-01

    Both domestic and foreign terror incidents are an unfortunate outgrowth of our modern times from the Oklahoma City bombings, Sarin gas attacks in Japan, the Madrid train bombing, anthrax spores in the mail, to the World Trade Center on September 11th, 2001. The modalities used to perpetrate these terrorist acts range from conventional weapons to high explosives, chemical weapons, and biological weapons all of which have been used in the recent past. While these weapons platforms can cause significant injury requiring critical care the mechanism of injury, pathophysiology and treatment of these injuries are unfamiliar to many critical care providers. Additionally the pediatric population is particularly vulnerable to these types of attacks. In the event of a mass casualty incident both adult and pediatric critical care practitioners will likely be called upon to care for children and adults alike. We will review the presentation, pathophysiology, and treatment of victims of blast injury, chemical weapons, and biological weapons. The focus will be on those injuries not commonly encountered in critical care practice, primary blast injuries, category A pathogens likely to be used in terrorist incidents, and chemical weapons including nerve agents, vesicants, pulmonary agents, cyanide, and riot control agents with special attention paid to pediatric specific considerations. PMID:24834398

  20. Computational Model of the Eye for Primary and Secondary Blast Trauma

    DTIC Science & Technology

    2015-10-01

    the 15 mmHg physiologic IOP for a healthy eye . The von Mises stresses were calculated largest in the sclera wall at the site of muscle attachments...Award Number: W81XWH-10-1-0766 TITLE: “Computational Model of the Eye for Primary and Secondary Blast Trauma” PRINCIPAL INVESTIGATOR: Thao D...valid OMB control number. October 2015 Annual 28Sep2014 - 27Sep2015 A Comp“Computational Model of the Eye for Primary and Secondary Blast Trauma”uta

  1. Catastrophic eruptions of the directed-blast type at Mount St. Helens, bezymianny and Shiveluch volcanoes

    USGS Publications Warehouse

    Bogoyavlenskaya, G.E.; Braitseva, O.A.; Melekestsev, I.V.; Kiriyanov, V. Yu; Dan, Miller C.

    1985-01-01

    This paper describes catastrophic eruptions of Mount St. Helens (1980), Bezymianny (1955-1956), and Shiveluch (1964) volcanoes. A detailed description of eruption stages and their products, as well as the quantitative characteristics of the eruptive process are given. The eruptions under study belong to the directed-blast type. This type is characterized by the catastrophic character of the climatic stage during which a directed blast, accompanied by edifice destruction, the profound ejection of juvenile pyroclastics and the formation of pyroclastic flows, occur. The climatic stage of all three eruptions has similar characteristics, such as duration, kinetic energy of blast (1017-1018 J), the initial velocity of debris ejection, morphology and size of newly-formed craters. But there are also certain differences. At Mount St. Helens the directed blast was preceeded by failure of the edifice and these events produced separable deposits, namely debris avalanche and directed blast deposits which are composed of different materials and have different volumes, thickness and distribution. At Bezymianny, failure did not precede the blast and the whole mass of debris of the old edifice was outburst only by blast. The resulting deposits, represented by the directed blast agglomerate and sand facies, have characteristics of both the debris avalanche and the blast deposit at Mount St. Helens. At Shiveluch directed-blast deposits are represented only by the directed-blast agglomerate; the directed-blast sand facies, or blast proper, seen at Mount St. Helens is absent. During the period of Plinian activity, the total volumes of juvenile material erupted at Mount St. Helens and at Besymianny were roughly comparable and exceeded the volume of juvenile material erupted at Shiveluch, However, the volume of pyroclastic-flow deposits erupted at Mount St. Helens was much less. The heat energy of all three eruptions is comparable: 1.3 ?? 1018, 3.8-4.8 ?? 1018 and 1 ?? 1017 J for

  2. High-Fidelity Simulation of Primary Blast: Direct Effects on the Head.

    PubMed

    Sawyer, Thomas W; Wang, Yushan; Ritzel, David V; Josey, Tyson; Villanueva, Mercy; Shei, Yimin; Nelson, Peggy; Hennes, Grant; Weiss, Tracy; Vair, Cory; Fan, Changyang; Barnes, Julia

    2016-07-01

    The role of primary blast in blast-induced traumatic brain injury (bTBI) is controversial in part due to the technical difficulties of generating free-field blast conditions in the laboratory. The use of traditional shock tubes often results in artifacts, particularly of dynamic pressure, whereas the forces affecting the head are dependent on where the animal is placed relative to the tube, whether the exposure is whole-body or head-only, and on how the head is actually exposed to the insult (restrained or not). An advanced blast simulator (ABS) has been developed that enables high-fidelity simulation of free-field blastwaves, including sharply defined static and dynamic overpressure rise times, underpressures, and secondary shockwaves. Rats were exposed in head-only fashion to single-pulse blastwaves of 15 to 30 psi static overpressure. Head restraints were configured so as to eliminate concussive and minimize whiplash forces exerted on the head, as shown by kinematic analysis. No overt signs of trauma were present in the animals post-exposure. However, significant changes in brain 2',3'-cyclic nucleotide 3'-phosphohydrolase (CNPase) and neurofilament heavy chain levels were evident by 7 days. In contrast to most studies of primary blast-induced TBI (PbTBI), no elevation of glial fibrillary acidic protein (GFAP) levels was noted when head movement was minimized. The ABS described in this article enables the generation of shockwaves highly representative of free-field blast. The use of this technology, in concert with head-only exposure, minimized head movement, and the kinematic analysis of the forces exerted on the head provide convincing evidence that primary blast directly causes changes in brain function and that GFAP may not be an appropriate biomarker of PbTBI.

  3. Helmet liner evaluation to mitigate head response from primary blast exposure.

    PubMed

    Lockhart, Philip A; Cronin, Duane S

    2015-01-01

    Head injury resulting from blast loading, including mild traumatic brain injury, has been identified as an important blast-related injury in modern conflict zones. A study was undertaken to investigate potential protective ballistic helmet liner materials to mitigate primary blast injury using a detailed sagittal plane head finite element model, developed and validated against previous studies of head kinematics resulting from blast exposure. Five measures reflecting the potential for brain injury that were investigated included intracranial pressure, brain tissue strain, head acceleration (linear and rotational) and the head injury criterion. In simulations, these measures provided consistent predictions for typical blast loading scenarios. Considering mitigation, various characteristics of foam material response were investigated and a factor analysis was performed which showed that the four most significant were the interaction effects between modulus and hysteretic response, stress-strain response, damping factor and density. Candidate materials were then identified using the predicted optimal material values. Polymeric foam was found to meet the density and modulus requirements; however, for all significant parameters, higher strength foams, such as aluminum foam, were found to provide the highest reduction in the potential for injury when compared against the unprotected head.

  4. Primary Blast-Induced Changes in Akt and GSK3β Phosphorylation in Rat Hippocampus

    PubMed Central

    Wang, Yushan; Sawyer, Thomas W.; Tse, Yiu Chung; Fan, Changyang; Hennes, Grant; Barnes, Julia; Josey, Tyson; Weiss, Tracy; Nelson, Peggy; Wong, Tak Pan

    2017-01-01

    Traumatic brain injury (TBI) due to blast from improvised explosive devices has been a leading cause of morbidity and mortality in recent conflicts in Iraq and Afghanistan. However, the mechanisms of primary blast-induced TBI are not well understood. The Akt signal transduction pathway has been implicated in various brain pathologies including TBI. In the present study, the effects of simulated primary blast waves on the phosphorylation status of Akt and its downstream effector kinase, glycogen synthase kinase 3β (GSK3β), in rat hippocampus, were investigated. Male Sprague-Dawley (SD) rats (350–400 g) were exposed to a single pulse shock wave (25 psi; ~7 ms duration) and sacrificed 1 day, 1 week, or 6 weeks after exposure. Total and phosphorylated Akt, as well as phosphorylation of its downstream effector kinase GSK3β (at serine 9), were detected with western blot analysis and immunohistochemistry. Results showed that Akt phosphorylation at both serine 473 and threonine 308 was increased 1 day after blast on the ipsilateral side of the hippocampus, and this elevation persisted until at least 6 weeks postexposure. Similarly, phosphorylation of GSK3β at serine 9, which inhibits GSK3β activity, was also increased starting at 1 day and persisted until at least 6 weeks after primary blast on the ipsilateral side. In contrast, p-Akt was increased at 1 and 6 weeks on the contralateral side, while p-GSK3β was increased 1 day and 1 week after primary blast exposure. No significant changes in total protein levels of Akt and GSK were observed on either side of the hippocampus at any time points. Immunohistochemical results showed that increased p-Akt was mainly of neuronal origin in the CA1 region of the hippocampus and once phosphorylated, the majority was translocated to the dendritic and plasma membranes. Finally, electrophysiological data showed that evoked synaptic N-methyl-d-aspartate (NMDA) receptor activity was significantly increased

  5. Primary blast causes mild, moderate, severe and lethal TBI with increasing blast overpressures: Experimental rat injury model

    NASA Astrophysics Data System (ADS)

    Mishra, Vikas; Skotak, Maciej; Schuetz, Heather; Heller, Abi; Haorah, James; Chandra, Namas

    2016-06-01

    Injury severity in blast induced Traumatic Brain Injury (bTBI) increases with blast overpressure (BOP) and impulse in dose-dependent manner. Pure primary blast waves were simulated in compressed gas shock-tubes in discrete increments. Present work demonstrates 24 hour survival of rats in 0–450 kPa (0–800 Pa•s impulse) range at 10 discrete levels (60, 100, 130, 160, 190, 230, 250, 290, 350 and 420 kPa) and determines the mortality rate as a non-linear function of BOP. Using logistic regression model, predicted mortality rate (PMR) function was calculated, and used to establish TBI severities. We determined a BOP of 145 kPa as upper mild TBI threshold (5% PMR). Also we determined 146–220 kPa and 221–290 kPa levels as moderate and severe TBI based on 35%, and 70% PMR, respectively, while BOP above 290 kPa is lethal. Since there are no standards for animal bTBI injury severity, these thresholds need further refinements using histopathology, immunohistochemistry and behavior. Further, we specifically investigated mild TBI range (0–145 kPa) using physiological (heart rate), pathological (lung injury), immuno-histochemical (oxidative/nitrosative and blood-brain barrier markers) as well as blood borne biomarkers. With these additional data, we conclude that mild bTBI occurs in rats when the BOP is in the range of 85–145 kPa.

  6. Primary blast causes mild, moderate, severe and lethal TBI with increasing blast overpressures: Experimental rat injury model

    PubMed Central

    Mishra, Vikas; Skotak, Maciej; Schuetz, Heather; Heller, Abi; Haorah, James; Chandra, Namas

    2016-01-01

    Injury severity in blast induced Traumatic Brain Injury (bTBI) increases with blast overpressure (BOP) and impulse in dose-dependent manner. Pure primary blast waves were simulated in compressed gas shock-tubes in discrete increments. Present work demonstrates 24 hour survival of rats in 0–450 kPa (0–800 Pa∙s impulse) range at 10 discrete levels (60, 100, 130, 160, 190, 230, 250, 290, 350 and 420 kPa) and determines the mortality rate as a non-linear function of BOP. Using logistic regression model, predicted mortality rate (PMR) function was calculated, and used to establish TBI severities. We determined a BOP of 145 kPa as upper mild TBI threshold (5% PMR). Also we determined 146–220 kPa and 221–290 kPa levels as moderate and severe TBI based on 35%, and 70% PMR, respectively, while BOP above 290 kPa is lethal. Since there are no standards for animal bTBI injury severity, these thresholds need further refinements using histopathology, immunohistochemistry and behavior. Further, we specifically investigated mild TBI range (0–145 kPa) using physiological (heart rate), pathological (lung injury), immuno-histochemical (oxidative/nitrosative and blood-brain barrier markers) as well as blood borne biomarkers. With these additional data, we conclude that mild bTBI occurs in rats when the BOP is in the range of 85–145 kPa. PMID:27270403

  7. Radiation resistance of primary clonogenic blasts from children with acute lymphoblastic leukemia

    SciTech Connect

    Uckun, F.M. Childrens Cancer Group, Arcadia, CA ); Aeppli, D.; Song, C.W. )

    1993-11-15

    Detailed comparative analyses of the radiation sensitivity of primary clonogenic blasts from children with acute lymphoblastic leukemia (ALL) were performed to achieve a better understanding of clinical radiation resistance in ALL. The radiation sensitivity of primary clonogenic blasts from 74 children with newly diagnosed ALL was analyzed using leukemic progenitor cell (LPC) assays. Primary bone marrow blasts from all 74 patients were exposed to ionizing radiation and subsequently assayed for LPC-derived blast colony formation. Radiation survival curves of LPC were constructed for each of the newly diagnosed patients using computer programs for the single-hit multitarget as well as the linear quadratic models of cell survival. A marked interpatient variation in intrinsic radiation sensitivity was observed between LPC populations. The SF[sub 2] values ranged from 0.01 to 1.00. Patients were divided into groups according to their sex, age, WBC at diagnosis, cell cycle distribution of leukemic blasts, and immunophenotype. Only immunophenotype provided a significant correlation with the intrinsic radiation sensitivity of LPC. Patients with B-lineage ALL had higher SF[sub 2] and smaller [alpha] values than T-lineage ALL patients, consistent with greater intrinsic radiation resistance at the level of LPC. Notably, 43% of B-lineage ALL cases, but only 27% of T-lineage ALL cases had LPC with SF[sub 2] [ge] 0.5. Similarly, 66% of B-lineage ALL cases, but only 37% of T-lineage ALL cases had LPC with [alpha] values [le] 0.4 Gy[sup [minus]1]. Combining the two indicators of radiation resistance, they found that only 34% of the B-lineage ALL patients had none of the two parameters in the respective critical regions, while 63% of the T-lineage patients had none. In multivariate analyses, the immunophenotypic B-lineage affiliation was the only significant predictor of radiation resistance at the level of LPC. 42 refs., 1 fig., 2 tabs.

  8. Primary Blast-Induced Traumatic Brain Injury in Rats Leads to Increased Prion Protein in Plasma: A Potential Biomarker for Blast-Induced Traumatic Brain Injury

    PubMed Central

    Pham, Nam; Sawyer, Thomas W.; Wang, Yushan; Jazii, Ferdous Rastgar; Vair, Cory

    2015-01-01

    Abstract Traumatic brain injury (TBI) is deemed the “signature injury” of recent military conflicts in Afghanistan and Iraq, largely because of increased blast exposure. Injuries to the brain can often be misdiagnosed, leading to further complications in the future. Therefore, the use of protein biomarkers for the screening and diagnosis of TBI is urgently needed. In the present study, we have investigated the plasma levels of soluble cellular prion protein (PrPC) as a novel biomarker for the diagnosis of primary blast-induced TBI (bTBI). We hypothesize that the primary blast wave can disrupt the brain and dislodge extracellular localized PrPC, leading to a rise in concentration within the systemic circulation. Adult male Sprague–Dawley rats were exposed to single pulse shockwave overpressures of varying intensities (15-30 psi or 103.4–206.8 kPa] using an advanced blast simulator. Blood plasma was collected 24 h after insult, and PrPC concentration was determined with a modified commercial enzyme-linked immunosorbent assay (ELISA) specific for PrPC. We provide the first report that mean PrPC concentration in primary blast exposed rats (3.97 ng/mL±0.13 SE) is significantly increased compared with controls (2.46 ng/mL±0.14 SE; two tailed test p<0.0001). Furthermore, we report a mild positive rank correlation between PrPC concentration and increasing blast intensity (psi) reflecting a plateaued response at higher pressure magnitudes, which may have implications for all military service members exposed to blast events. In conclusion, it appears that plasma levels of PrPC may be a novel biomarker for the detection of primary bTBI. PMID:25058115

  9. Primary blast-induced traumatic brain injury in rats leads to increased prion protein in plasma: a potential biomarker for blast-induced traumatic brain injury.

    PubMed

    Pham, Nam; Sawyer, Thomas W; Wang, Yushan; Jazii, Ferdous Rastgar; Vair, Cory; Taghibiglou, Changiz

    2015-01-01

    Traumatic brain injury (TBI) is deemed the "signature injury" of recent military conflicts in Afghanistan and Iraq, largely because of increased blast exposure. Injuries to the brain can often be misdiagnosed, leading to further complications in the future. Therefore, the use of protein biomarkers for the screening and diagnosis of TBI is urgently needed. In the present study, we have investigated the plasma levels of soluble cellular prion protein (PrPC) as a novel biomarker for the diagnosis of primary blast-induced TBI (bTBI). We hypothesize that the primary blast wave can disrupt the brain and dislodge extracellular localized PrPC, leading to a rise in concentration within the systemic circulation. Adult male Sprague-Dawley rats were exposed to single pulse shockwave overpressures of varying intensities (15-30 psi or 103.4-206.8 kPa] using an advanced blast simulator. Blood plasma was collected 24 h after insult, and PrPC concentration was determined with a modified commercial enzyme-linked immunosorbent assay (ELISA) specific for PrPC. We provide the first report that mean PrPC concentration in primary blast exposed rats (3.97 ng/mL ± 0.13 SE) is significantly increased compared with controls (2.46 ng/mL ± 0.14 SE; two tailed test p < 0.0001). Furthermore, we report a mild positive rank correlation between PrPC concentration and increasing blast intensity (psi) reflecting a plateaued response at higher pressure magnitudes, which may have implications for all military service members exposed to blast events. In conclusion, it appears that plasma levels of PrPC may be a novel biomarker for the detection of primary bTBI.

  10. Primary Blast Causes Delayed Effects without Cell Death in Shell-Encased Brain Cell Aggregates.

    PubMed

    Sawyer, Thomas W; Ritzel, David V; Wang, Yushan; Josey, Tyson; Villanueva, Mercy; Nelson, Peggy; Song, Yanfeng; Shei, Yimin; Hennes, Grant; Vair, Cory; Parks, Steve; Fan, Changyang; McLaws, Lori

    2017-09-14

    Previous work in this laboratory used underwater explosive exposures to isolate the effects of shock-induced principle stress without shear on rat brain aggregate cultures. The current study has utilized simulated air blast to expose aggregates in suspension and enclosed within a spherical shell, enabling the examination of a much more complex biomechanical insult. Culture medium-filled spheres were exposed to single pulse overpressures of 15-30 psi (∼6-7 msec duration) and measurements within the sphere at defined sites showed complex and spatially dependent pressure changes. When brain aggregates were exposed to similar conditions, no cell death was observed and no changes in several commonly used biomarkers of traumatic brain injury (TBI) were noted. However, similarly to underwater blast, immediate and transient increases in the protein kinase B signaling pathway were observed at early time-points (3 days). In contrast, the oligodendrocyte marker 2',3'-cyclic nucleotide 3'-phosphodiesterase, as well as vascular endothelial growth factor, both displayed markedly delayed (14-28 days) and pressure-dependent responses. The imposition of a spherical shell between the single pulse shock wave and the target brain tissue introduces greatly increased complexity to the insult. This work shows that brain tissue can not only discriminate the nature of the pressure changes it experiences, but that a portion of its response is significantly delayed. These results have mechanistic implications for the study of primary blast-induced TBI and also highlight the importance of rigorously characterizing the actual pressure variations experienced by target tissue in primary blast studies.

  11. Suppression of blast pressure and noise from implosive-type connectors

    SciTech Connect

    Contestabile, E.; Thomas, C. |

    1995-12-31

    Implosive-type electrical/mechanical connectors such as XECONEX have been used extensively for joining electrical transmission lines. This implosive action of explosives has also been applied to other forms of high energy metal working with excellent results. However, as with many other products, the inherent blast energy of these units has caused some environmental concerns especially when used in proximity to inhabited areas. This paper identifies the problem associated with the use of this type of connector in inhabited areas and details the efforts directed toward its solution. A test program was designed in which various materials and configurations were evaluated as potential candidates for reducing the blast pressure. The explosive charges were in two configurations; linear charges assembled with detonating cord and steel pipes wrapped with detonating cord. Various materials of varying densities and sizes were then used as a wrap around the explosive charge. The effectiveness of these wraps as blast suppressing mediums was established by monitoring the blast pressure and sound levels. Although, a complete solution was not found within the performance requirements, materials such as vermiculite and cardboard were found to be particularly useful in suppressing blast overpressures. Plotted against scaled distance on a TNT output curve, the data indicates the effectiveness of these materials. Also practical are the plots showing the mitigation of blast pressure as the suppressant material thickness is varied.

  12. The Complexity of Biomechanics Causing Primary Blast-Induced Traumatic Brain Injury: A Review of Potential Mechanisms

    PubMed Central

    Courtney, Amy; Courtney, Michael

    2015-01-01

    Primary blast-induced traumatic brain injury (bTBI) is a prevalent battlefield injury in recent conflicts, yet biomechanical mechanisms of bTBI remain unclear. Elucidating specific biomechanical mechanisms is essential to developing animal models for testing candidate therapies and for improving protective equipment. Three hypothetical mechanisms of primary bTBI have received the most attention. Because translational and rotational head accelerations are primary contributors to TBI from non-penetrating blunt force head trauma, the acceleration hypothesis suggests that blast-induced head accelerations may cause bTBI. The hypothesis of direct cranial transmission suggests that a pressure transient traverses the skull into the brain and directly injures brain tissue. The thoracic hypothesis of bTBI suggests that some combination of a pressure transient reaching the brain via the thorax and a vagally mediated reflex result in bTBI. These three mechanisms may not be mutually exclusive, and quantifying exposure thresholds (for blasts of a given duration) is essential for determining which mechanisms may be contributing for a level of blast exposure. Progress has been hindered by experimental designs, which do not effectively expose animal models to a single mechanism and by over-reliance on poorly validated computational models. The path forward should be predictive validation of computational models by quantitative confirmation with blast experiments in animal models, human cadavers, and biofidelic human surrogates over a range of relevant blast magnitudes and durations coupled with experimental designs, which isolate a single injury mechanism. PMID:26539158

  13. Brain Response to Primary Blast Wave Using Validated Finite Element Models of Human Head and Advanced Combat Helmet

    PubMed Central

    Zhang, Liying; Makwana, Rahul; Sharma, Sumit

    2013-01-01

    Blast-induced traumatic brain injury has emerged as a “signature injury” in combat casualty care. Present combat helmets are designed primarily to protect against ballistic and blunt impacts, but the current issue with helmets is protection concerning blasts. In order to delineate the blast wave attenuating capability of the Advanced Combat Helmet (ACH), a finite element (FE) study was undertaken to evaluate the head response against blast loadings with and without helmet using a partially validated FE model of the human head and ACH. Four levels of overpressures (0.27–0.66 MPa) from the Bowen’s lung iso-damage threshold curves were used to simulate blast insults. Effectiveness of the helmet with respect to head orientation was also investigated. The resulting biomechanical responses of the brain to blast threats were compared for human head with and without the helmet. For all Bowen’s cases, the peak intracranial pressures (ICP) in the head ranged from 0.68 to 1.8 MPa in the coup cortical region. ACH was found to mitigate ICP in the head by 10–35%. Helmeted head resulted in 30% lower average peak brain strains and product of strain and strain rate. Among three blast loading directions with ACH, highest reduction in peak ICP (44%) was due to backward blasts whereas the lowest reduction in peak ICP and brain strains was due to forward blast (27%). The biomechanical responses of a human head to primary blast insult exhibited directional sensitivity owing to the different geometry contours and coverage of the helmet construction and asymmetric anatomy of the head. Thus, direction-specific tolerances are needed in helmet design in order to offer omni-directional protection for the human head. The blasts of varying peak overpressures and durations that are believed to produce the same level of lung injury produce different levels of mechanical responses in the brain, and hence “iso-damage” curves for brain injury are likely different than the Bowen

  14. Marble-type glass based on blast furnace slag

    SciTech Connect

    Sarkisov, P.D.; Smirnov, V.G.; Trifonova, T.E.; Sergeev, Yu.N.

    1987-01-01

    This paper discusses the recovery and use of blast furnace wastes as coloring agents in the manufacture of imitation marble glass. The slags consist of a series of metal oxides each of which is tested for the color it generates when reacted and annealed with the molten glass. Comparative tests were also run against non-waste coloring agents and it was found that the waste-derived colorants were equal or superior both in process behavior and in generating the appropriate optical properties in the finished glass.

  15. Primary blast injury to the eye and orbit: finite element modeling.

    PubMed

    Rossi, Tommaso; Boccassini, Barbara; Esposito, Luca; Clemente, Chiara; Iossa, Mario; Placentino, Luca; Bonora, Nicola

    2012-12-07

    Primary blast injury (PBI) mostly affects air-filled organs, although it is sporadically reported in fluid-filled organs, including the eye. The purpose of the present paper is to explain orbit blast injury mechanisms through finite element modeling (FEM). FEM meshes of the eye, orbit, and skull were generated. Pressure, strain, and strain rates were calculated at the cornea, vitreous base, equator, macula, and orbit apex for pressures known to cause tympanic rupture, lung damage, and 50% chance of mortality. Pressures within the orbit ranged between +0.25 and -1.4 MegaPascal (MPa) for tympanic rupture, +3 and -1 MPa for lung damage, and +20 and -6 MPa for 50% mortality. Higher trinitrotoluene (TNT) quantity and closer explosion caused significantly higher pressures, and the impact angle significantly influenced pressure at all locations. Pressure waves reflected and amplified to create steady waves resonating within the orbit. Strain reached 20% along multiple axes, and strain rates exceeded 30,000 s(-1) at all locations even for the smallest amount of TNT. The orbit's pyramidlike shape with bony walls and the mechanical impedance mismatch between fluidlike content and anterior air-tissue interface determine pressure wave reflection and amplification. The resulting steady wave resonates within the orbit and can explain both macular holes and optic nerve damage after ocular PBI.

  16. Olefin unit primary fractionator on-line Petro-Blast Lancing

    SciTech Connect

    Adams, W.D.; Rutan, C.R.

    1994-12-31

    Today`s commodity chemicals market forces companies to find innovative ways to extend unit on line operation between turnarounds such that they will remain economically competitive. At the OxyChem Chocolate Bayou facility the Primary Fractionator, quench oil column, fouling defined the length of the run between Olefin Unit turnarounds. Polymer growth on the valve trays restricted vapor flow through the column. This increased the column pressure drop which resulted in severe flooding. The inability to cool the furnace effluent while separating the fuel oil and gasoline components would cause premature shutdowns. Fouling locations were defined using gamma scan techniques and pressure surveys. Nozzles were welded and hot tapped at strategic locations around the column. A high pressure Petro-Blast Lancing technique, inserted through the nozzles, was then used to clean the trays. The operation has extended the unit run length although the column may require additional Petro-Blast Lancing before the next scheduled plant turnaround. If this schedule holds, a two year extension in the unit run length will be realized.

  17. Brain injuries from blast.

    PubMed

    Bass, Cameron R; Panzer, Matthew B; Rafaels, Karen A; Wood, Garrett; Shridharani, Jay; Capehart, Bruce

    2012-01-01

    Traumatic brain injury (TBI) from blast produces a number of conundrums. This review focuses on five fundamental questions including: (1) What are the physical correlates for blast TBI in humans? (2) Why is there limited evidence of traditional pulmonary injury from blast in current military field epidemiology? (3) What are the primary blast brain injury mechanisms in humans? (4) If TBI can present with clinical symptoms similar to those of Post-Traumatic Stress Disorder (PTSD), how do we clinically differentiate blast TBI from PTSD and other psychiatric conditions? (5) How do we scale experimental animal models to human response? The preponderance of the evidence from a combination of clinical practice and experimental models suggests that blast TBI from direct blast exposure occurs on the modern battlefield. Progress has been made in establishing injury risk functions in terms of blast overpressure time histories, and there is strong experimental evidence in animal models that mild brain injuries occur at blast intensities that are similar to the pulmonary injury threshold. Enhanced thoracic protection from ballistic protective body armor likely plays a role in the occurrence of blast TBI by preventing lung injuries at blast intensities that could cause TBI. Principal areas of uncertainty include the need for a more comprehensive injury assessment for mild blast injuries in humans, an improved understanding of blast TBI pathophysiology of blast TBI in animal models and humans, the relationship between clinical manifestations of PTSD and mild TBI from blunt or blast trauma including possible synergistic effects, and scaling between animals models and human exposure to blasts in wartime and terrorist attacks. Experimental methodologies, including location of the animal model relative to the shock or blast source, should be carefully designed to provide a realistic blast experiment with conditions comparable to blasts on humans. If traditional blast scaling is

  18. Novel method to dynamically load cells in 3D-gel culture for primary blast injury studies

    NASA Astrophysics Data System (ADS)

    Sory, David; Cepa-Areias, Anabela; Overby, Darryl; Proud, William; Institute of Shock Physics, Department of Bioengineering; Royal British Legion CentreBlast I Collaboration

    2015-06-01

    For at least a century explosive devices have been reported as one of the most important causes of injuries on battlefield in military conflicts as well as in terrorist attacks. Although significant experimental and modelling efforts have been focussed on blast injury at the organ or tissue level, few studies have investigated the mechanism of blast injury at the cellular level. This paper introduces an in vitro method compatible with living cells to examine the effects of high stress and short-duration pulses similar to those observed in blast waves. The experimental phase involved high strain rate axial compression of biological cylindrical specimens within a hermetically sealed sample holder made of a biocompatible polymer. Numerical simulations were performed in order to characterize the loading path within the sample and assess the loading conditions. A proof of concept is presented so as to establish a new window to address fundamental questions regarding primary blast injury at the cellular level. The Institute of Shock Physics acknowledges the support of AWE, Aldermaston, UK and Imperial College London. The Centre for Blast Injury Studies acknowledges the support of the Royal British Legion and Imperial College London.

  19. High-speed imaging and small-scale explosive characterization techniques to understand effects of primary blast-induced injury on nerve cell structure and function

    NASA Astrophysics Data System (ADS)

    Piehler, T.; Banton, R.; Zander, N.; Duckworth, J.; Benjamin, R.; Sparks, R.

    2017-08-01

    Traumatic brain injury (TBI) is often associated with blast exposure. Even in the absence of penetrating injury or evidence of tissue injury on imaging, blast TBI may trigger a series of neural/glial cellular and functional changes. Unfortunately, the diagnosis and proper treatment of mild traumatic brain injury (mTBI) caused by explosive blast is challenging, as it is not easy to clinically distinguish blast from non-blast TBI on the basis of patient symptoms. Damage to brain tissue, cell, and subcellular structures continues to occur slowly and in a manner undetectable by conventional imaging techniques. The threshold shock impulse levels required to induce damage and the cumulative effects upon multiple exposures are not well characterized. Understanding how functional and structural damage from realistic blast impact at cellular and tissue levels at variable timescales after mTBI events may be vital for understanding this injury phenomenon and for linking mechanically induced structural changes with measurable effects on the nervous system. Our working hypothesis is that there is some transient physiological dysfunction occurring at cellular and subcellular levels within the central nervous system due to primary blast exposure. We have developed a novel in vitro indoor experimental system that uses real military explosive charges to more accurately represent military blast exposure and to probe the effects of primary explosive blast on dissociated neurons. We believe this system offers a controlled experimental method to analyze and characterize primary explosive blast-induced cellular injury and to understand threshold injury phenomenon. This paper will also focus on the modeling aspect of our work and how it relates to the experimental work.

  20. Generating Peripheral Blood Derived Lymphocytes Reacting Against Autologous Primary AML Blasts

    PubMed Central

    Mehta, Rohtesh S.; Chen, Xiaohua; Antony, Jeyaraj; Boyiadzis, Michael; Szabolcs, Paul

    2015-01-01

    Expanding on our prior studies with cord blood T-cells, we hypothesized that primary AML-reactive autologous T-cells could be generated ex vivo under immunomodulatory conditions. We purified AML and T-cells from 8 newly diagnosed high-risk patients. After 2 weeks expansion, T-cells were stimulated with IFN-γ treated autologous AML weekly X 3, IL-15 and agonistic anti-CD28 antibody. CTL and ELISpot assays tested functionality; RT-qPCR tested AML and T-cell gene expression profiles. Based on combined positive ELIspot and CTL assays, T-cells reactive against AML were generated in 5/8 patients. Treg proportion declined post-co-cultures in reactive T-cell samples. AML-reactive T-cells displayed an activated gene expression profile. “Resistant” AML blasts displayed genes associated with immunosuppressive MDSC. We discuss our approach to creating primary AML-reactive autologous T-cell and limitations that require further work. Our study provides a platform for future research targeting on generating autologous leukemia reactive T-cells. PMID:26849076

  1. Development of a new biomechanical indicator for primary blast-induced brain injury.

    PubMed

    Zhu, Feng; Chou, Cliff-C; Yang, King-H; King, Albert-I

    2015-01-01

    Primary blast-induced traumatic brain injury (bTBI) has been observed at the boundary of brain tissue and cerebrospinal fluid (CSF). Such injury can hardly be explained by using the theory of compressive wave propagation, since both the solid and fuid materials have similar compressibility and thus the intracranial pressure (ICP) has a continuous distribution across the boundary. Since they have completely different shear properties, it is hypothesized the injury at the interface is caused by shear wave. In the present study, a preliminary combined numerical and theoretical analysis was conducted based on the theory of shear wave propagation/reflection. Simulation results show that higher lateral acceleration of brain tissue particles is concentrated in the boundary region. Based on this fnding, a new biomechanical vector, termed as strain gradient, was suggested for primary bTBI. The subsequent simple theoretical analysis reveals that this parameter is proportional to the value of lateral acceleration. At the boundary of lateral ventricles, high spatial strain gradient implies that the brain tissue in this area (where neuron cells may be contained) undergo significantly different strains and large velocity discontinuity, which may result in mechanical damage of the neuron cells.

  2. Generating Peripheral Blood Derived Lymphocytes Reacting Against Autologous Primary AML Blasts.

    PubMed

    Mehta, Rohtesh S; Chen, Xiaohua; Antony, Jeyaraj; Boyiadzis, Michael; Szabolcs, Paul

    2016-01-01

    Expanding on our prior studies with cord blood T cells, we hypothesized that primary acute myeloid leukemia (AML)-reactive autologous T cells could be generated ex vivo under immunomodulatory conditions. We purified AML and T cells from 8 newly diagnosed high-risk patients. After 2 weeks expansion, T cells were stimulated with interferon-γ-treated autologous AML weekly × 3, interleukin-15, and agonistic anti-CD28 antibody. Cytotoxic T cells and ELISpot assays tested functionality; reverse transcriptase quantitative polymerase chain reaction tested AML and T-cell gene expression profiles. On the basis of combined positive ELIspot and cytotoxic T cells assays, T cells reactive against AML were generated in 5 of 8 patients. Treg proportion declined after cocultures in reactive T-cell samples. AML-reactive T cells displayed an activated gene expression profile. "Resistant" AML blasts displayed genes associated with immunosuppressive myeloid-derived suppressor cells. We discuss our approach to creating primary AML-reactive autologous T cell and limitations that require further work. Our study provides a platform for future research targeting on generating autologous leukemia-reactive T cells.

  3. Chronic traumatic encephalopathy in blast-exposed military veterans and a blast neurotrauma mouse model.

    PubMed

    Goldstein, Lee E; Fisher, Andrew M; Tagge, Chad A; Zhang, Xiao-Lei; Velisek, Libor; Sullivan, John A; Upreti, Chirag; Kracht, Jonathan M; Ericsson, Maria; Wojnarowicz, Mark W; Goletiani, Cezar J; Maglakelidze, Giorgi M; Casey, Noel; Moncaster, Juliet A; Minaeva, Olga; Moir, Robert D; Nowinski, Christopher J; Stern, Robert A; Cantu, Robert C; Geiling, James; Blusztajn, Jan K; Wolozin, Benjamin L; Ikezu, Tsuneya; Stein, Thor D; Budson, Andrew E; Kowall, Neil W; Chargin, David; Sharon, Andre; Saman, Sudad; Hall, Garth F; Moss, William C; Cleveland, Robin O; Tanzi, Rudolph E; Stanton, Patric K; McKee, Ann C

    2012-05-16

    Blast exposure is associated with traumatic brain injury (TBI), neuropsychiatric symptoms, and long-term cognitive disability. We examined a case series of postmortem brains from U.S. military veterans exposed to blast and/or concussive injury. We found evidence of chronic traumatic encephalopathy (CTE), a tau protein-linked neurodegenerative disease, that was similar to the CTE neuropathology observed in young amateur American football players and a professional wrestler with histories of concussive injuries. We developed a blast neurotrauma mouse model that recapitulated CTE-linked neuropathology in wild-type C57BL/6 mice 2 weeks after exposure to a single blast. Blast-exposed mice demonstrated phosphorylated tauopathy, myelinated axonopathy, microvasculopathy, chronic neuroinflammation, and neurodegeneration in the absence of macroscopic tissue damage or hemorrhage. Blast exposure induced persistent hippocampal-dependent learning and memory deficits that persisted for at least 1 month and correlated with impaired axonal conduction and defective activity-dependent long-term potentiation of synaptic transmission. Intracerebral pressure recordings demonstrated that shock waves traversed the mouse brain with minimal change and without thoracic contributions. Kinematic analysis revealed blast-induced head oscillation at accelerations sufficient to cause brain injury. Head immobilization during blast exposure prevented blast-induced learning and memory deficits. The contribution of blast wind to injurious head acceleration may be a primary injury mechanism leading to blast-related TBI and CTE. These results identify common pathogenic determinants leading to CTE in blast-exposed military veterans and head-injured athletes and additionally provide mechanistic evidence linking blast exposure to persistent impairments in neurophysiological function, learning, and memory.

  4. Chronic Traumatic Encephalopathy in Blast-Exposed Military Veterans and a Blast Neurotrauma Mouse Model

    PubMed Central

    Goldstein, Lee E.; Fisher, Andrew M.; Tagge, Chad A.; Zhang, Xiao-Lei; Velisek, Libor; Sullivan, John A.; Upreti, Chirag; Kracht, Jonathan M.; Ericsson, Maria; Wojnarowicz, Mark W.; Goletiani, Cezar J.; Maglakelidze, Giorgi M.; Casey, Noel; Moncaster, Juliet A.; Minaeva, Olga; Moir, Robert D.; Nowinski, Christopher J.; Stern, Robert A.; Cantu, Robert C.; Geiling, James; Blusztajn, Jan K.; Wolozin, Benjamin L.; Ikezu, Tsuneya; Stein, Thor D.; Budson, Andrew E.; Kowall, Neil W.; Chargin, David; Sharon, Andre; Saman, Sudad; Hall, Garth F.; Moss, William C.; Cleveland, Robin O.; Tanzi, Rudolph E.; Stanton, Patric K.; McKee, Ann C.

    2013-01-01

    Blast exposure is associated with traumatic brain injury (TBI), neuropsychiatric symptoms, and long-term cognitive disability. We examined a case series of postmortem brains from U.S. military veterans exposed to blast and/or concussive injury. We found evidence of chronic traumatic encephalopathy (CTE), a tau protein–linked neurodegenerative disease, that was similar to the CTE neuropathology observed in young amateur American football players and a professional wrestler with histories of concussive injuries. We developed a blast neurotrauma mouse model that recapitulated CTE-linked neuropathology in wild-type C57BL/6 mice 2 weeks after exposure to a single blast. Blast-exposed mice demonstrated phosphorylated tauopathy, myelinated axonopathy, microvasculopathy, chronic neuroinflammation, and neurodegeneration in the absence of macroscopic tissue damage or hemorrhage. Blast exposure induced persistent hippocampal-dependent learning and memory deficits that persisted for at least 1 month and correlated with impaired axonal conduction and defective activity-dependent long-term potentiation of synaptic transmission. Intracerebral pressure recordings demonstrated that shock waves traversed the mouse brain with minimal change and without thoracic contributions. Kinematic analysis revealed blast-induced head oscillation at accelerations sufficient to cause brain injury. Head immobilization during blast exposure prevented blast-induced learning and memory deficits. The contribution of blast wind to injurious head acceleration may be a primary injury mechanism leading to blast-related TBI and CTE. These results identify common pathogenic determinants leading to CTE in blast-exposed military veterans and head-injured athletes and additionally provide mechanistic evidence linking blast exposure to persistent impairments in neurophysiological function, learning, and memory. PMID:22593173

  5. Development and analysis of a leak-based blast attenuator and scaling laws for primary blast peak overpressure for a large caliber muzzleloaded cannon

    NASA Astrophysics Data System (ADS)

    Carson, Robert Andrew

    One of the primary aspects of the research and development work carried out at Benet Laboratories is the Soldier. Maintenance of their health in the field is the first priority while the second priority is the enhancement of their performance. Therefore, a new concept for a weapon system that targets these two priorities is highly desirable. This is the case with a new concept that can reduce the peak overpressure without the use of a muzzle device for a muzzle loaded cannon system. Such a novel concept was developed in this thesis through the application of propellant leak into the precursor region, i.e., when the projectile is still in the bore. A 3D hydrocode (ALE3D) was employed to predict the blast overpressure for the baseline and propellant leak configurations. However, a 3D hydrocode is computationally very expensive to predict peak overpressure in the far-field and an efficient method to predict peak overpressure in the far-field is of significance. Therefore, scaling laws for primary blast peak overpressure were also developed in this thesis. Initially, two propellant leak concepts were examined. A bulge leak method and a channel leak method, which were compared to the baseline configuration. The initial channel leak configuration (referred to as CLM-1) significantly reduced the exit pressure ratio during projectile ejection, and thereby, resulted in a weaker blast. This in-turn substantially attenuated the peak overpressure to the rear of the muzzle without the aid of a muzzle device while having a marginal loss in the projectile exit velocity. For CLM-1, at one monitored location with the largest peak overpressure, a reduction of about 38% in peak overpressure was observed as compared to the baseline case. In order to compare different leak configurations, a performance metric was defined by comparing the ratio of peak overpressure and projectile exit velocity for a leak configuration to that for the baseline configuration. This metric was referred to

  6. Primary Blast Traumatic Brain Injury in the Rat: Relating Diffusion Tensor Imaging and Behavior

    DTIC Science & Technology

    2013-10-14

    collegiate football players: the NCAA concussion study. JAMA (2003) 290:2556–63. doi:10.1001/ jama.290.19.2556 6. DePalma RG, Burris DG, Champion HR... concussions in retired pro- fessional football players. Am J Sports Med (2012) 40:2206–12. doi: 10.1177/0363546512456193 10. Verfaellie M, Lafleche G...low-blast exposures and limited excur- sions during high-blast exposures. Angular accelerations were well below the threshold for mild concussion in

  7. Optimizing the Primary Prevention of Type-2 Diabetes in Primary Health Care

    ClinicalTrials.gov

    2017-08-18

    Interprofessional Relations; Primary Health Care/Organization & Administration; Diabetes Mellitus, Type 2/Prevention & Control; Primary Prevention/Methods; Risk Reduction Behavior; Randomized Controlled Trial; Life Style

  8. Rat Injury Model under Controlled Field-Relevant Primary Blast Conditions: Acute Response to a Wide Range of Peak Overpressures

    PubMed Central

    Skotak, Maciej; Wang, Fang; Alai, Aaron; Holmberg, Aaron; Harris, Seth; Switzer, Robert C.

    2013-01-01

    Abstract We evaluated the acute (up to 24 h) pathophysiological response to primary blast using a rat model and helium driven shock tube. The shock tube generates animal loadings with controlled pure primary blast parameters over a wide range and field-relevant conditions. We studied the biomechanical loading with a set of pressure gauges mounted on the surface of the nose, in the cranial space, and in the thoracic cavity of cadaver rats. Anesthetized rats were exposed to a single blast at precisely controlled five peak overpressures over a wide range (130, 190, 230, 250, and 290 kPa). We observed 0% mortality rates in 130 and 230 kPa groups, and 30%, 24%, and 100% mortality rates in 190, 250, and 290 kPa groups, respectively. The body weight loss was statistically significant in 190 and 250 kPa groups 24 h after exposure. The data analysis showed the magnitude of peak-to-peak amplitude of intracranial pressure (ICP) fluctuations correlates well with mortality rates. The ICP oscillations recorded for 190, 250, and 290 kPa are characterized by higher frequency (10–20 kHz) than in other two groups (7–8 kHz). We noted acute bradycardia and lung hemorrhage in all groups of rats subjected to the blast. We established the onset of both corresponds to 110 kPa peak overpressure. The immunostaining against immunoglobulin G (IgG) of brain sections of rats sacrificed 24-h post-exposure indicated the diffuse blood-brain barrier breakdown in the brain parenchyma. At high blast intensities (peak overpressure of 190 kPa or more), the IgG uptake by neurons was evident, but there was no evidence of neurodegeneration after 24 h post-exposure, as indicated by cupric silver staining. We observed that the acute response as well as mortality is a non-linear function over the peak overpressure and impulse ranges explored in this work. PMID:23362798

  9. Analysis of In-Flight Collision Process During V-Type Firing Pattern in Surface Blasting Using Simple Physics

    NASA Astrophysics Data System (ADS)

    Chouhan, Lalit Singh; Raina, Avtar K.

    2015-10-01

    Blasting is a unit operation in Mine-Mill Fragmentation System (MMFS) and plays a vital role in mining cost. One of the goals of MMFS is to achieve optimum fragment size at minimal cost. Blast fragmentation optimization is known to result in better explosive energy utilization. Fragmentation depends on the rock, explosive and blast design variables. If burden, spacing and type of explosive used in a mine are kept constant, the firing sequence of blast-holes plays a vital role in rock fragmentation. To obtain smaller fragmentation size, mining professionals and relevant publications recommend V- or extended V-pattern of firing sequence. In doing so, it is assumed that the in-flight air collision breaks larger rock fragments into smaller ones, thus aiding further fragmentation. There is very little support to the phenomenon of breakage during in-flight collision of fragments during blasting in published literature. In order to assess the breakage of in-flight fragments due to collision, a mathematical simulation was carried over using basic principles of physics. The calculations revealed that the collision breakage is dependent on velocity of fragments, mass of fragments, the strength of the rock and the area of fragments over which collision takes place. For higher strength rocks, the in-flight collision breakage is very difficult to achieve. This leads to the conclusion that the concept demands an in-depth investigation and validation.

  10. Performance Optimization of Cold Rolled Type 316L Stainless Steel by Sand Blasting and Surface Linishing Treatment

    NASA Astrophysics Data System (ADS)

    Krawczyk, B.; Heine, B.; Engelberg, D. L.

    2016-03-01

    Sand blasting followed by a surface linishing treatment was applied to optimize the near-surface microstructure of cold rolled type 316L stainless steel. The introduction of cold rolling led to the formation of α-martensite. Specimens with large thickness reductions (40, 53%) were more susceptible to localized corrosion. The application of sand blasting produced a near-surface deformation layer containing compressive residual stresses with significantly increased surface roughness, resulting in reduced corrosion resistance. The most resistant microstructure was obtained with the application of a final linishing treatment after sand blasting. This treatment produced microstructures with compressive near-surface residual stresses, reduced surface roughness, and increased resistance to localized corrosion.

  11. Impact of Moderate Blast Exposures on Thrombin Biomarkers Assessed by Calibrated Automated Thrombography in Rats

    PubMed Central

    Serebruany, Victor L.; Svetlov, Artem; Hayes, Ronald L.

    2013-01-01

    Abstract Severe blast exposures are frequently complicated with fatal intracranial hemorrhages. However, many more sustain low level blasts without tissue damage detectable by brain imaging. To investigate effects of nonlethal blast on thrombin-related biomarkers, rats were subjected to two different types of head-directed blast: 1) moderate “composite” blast with strong head acceleration or 2) moderate primary blast, without head acceleration. Thrombin generation (TG) ex vivo after blast was studied by calibrated automated thrombography (CAT). In the same blood samples, we assessed maximal concentration of TG (TGmax), start time, peak time, mean time, and concentrations of protein markers for vascular/hemostatic dysfunctions: integrin α/β, soluble endothelial selectin (sE-selectin), soluble intercellular cell adhesion molecule-1 (sICAM-1), and matrix metalloproteinases (MMP)-2, MMP-8, and MMP-13. Blast remarkably affected all TG indices. In animals exposed to “composite” blast, TGmax peaked at 6 h (∼4.5-fold vs. control), sustained at day 1 (∼3.8-fold increase), and declined to a 2-fold increase over control at day 7 post-blast. After primary blast, TGmax also rose to ∼4.2-fold of control at 6 h, dropped to ∼1.7-fold of control at day 1, and then exhibited a slight secondary increase at 2-fold of control at day 7. Other TG indices did not differ significantly between two types of blast exposure. The changes were also observed in other microvascular/inflammatory/hemostatic biomarkers. Integrin α/β and sICAM-1 levels were elevated after both “composite” and primary blast at 6 h, 1 day, and 7 days. sE-selectin exhibited near normal levels after “composite” blast, but increased significantly at 7 days after primary blast; MMP-2, MMP-8, and MMP-13 slightly rose after “composite” blast and significantly increased (∼2-4-fold) after primary blast. In summary, CAT may have a clinical diagnostic utility in combination with selected

  12. Mechanical and histological characterization of trachea tissue subjected to blast-type pressures

    NASA Astrophysics Data System (ADS)

    Butler, B. J.; Bo, C.; Tucker, A. W.; Jardine, A. P.; Proud, W. G.; Williams, A.; Brown, K. A.

    2014-05-01

    Injuries to the respiratory system can be a component of polytrauma in blast-loading injuries. Tissues located at air-liquid interfaces, including such tissues in the respiratory system, are particularly vulnerable to damage by blast overpressures. There is a lack of information about the mechanical and cellular responses that contribute to the damage of this class of tissues subjected to the high strain rates associated with blast loading. Here, we describe the results of dynamic blast-like pressure loading tests at high strain rates on freshly harvested ex vivo trachea tissue specimens.

  13. Parametric analysis of the biomechanical response of head subjected to the primary blast loading--a data mining approach.

    PubMed

    Zhu, Feng; Kalra, Anil; Saif, Tal; Yang, Zaihan; Yang, King H; King, Albert I

    2016-01-01

    Traumatic brain injury due to primary blast loading has become a signature injury in recent military conflicts and terrorist activities. Extensive experimental and computational investigations have been conducted to study the interrelationships between intracranial pressure response and intrinsic or 'input' parameters such as the head geometry and loading conditions. However, these relationships are very complicated and are usually implicit and 'hidden' in a large amount of simulation/test data. In this study, a data mining method is proposed to explore such underlying information from the numerical simulation results. The heads of different species are described as a highly simplified two-part (skull and brain) finite element model with varying geometric parameters. The parameters considered include peak incident pressure, skull thickness, brain radius and snout length. Their interrelationship and coupling effect are discovered by developing a decision tree based on the large simulation data-set. The results show that the proposed data-driven method is superior to the conventional linear regression method and is comparable to the nonlinear regression method. Considering its capability of exploring implicit information and the relatively simple relationships between response and input variables, the data mining method is considered to be a good tool for an in-depth understanding of the mechanisms of blast-induced brain injury. As a general method, this approach can also be applied to other nonlinear complex biomechanical systems.

  14. Numerical Study of Primary Blast Injury to Human and Sheep Lung Induced by Simple and Complex Blast Loadings

    DTIC Science & Technology

    2009-12-01

    ont été soumis à des ondes de choc de types simple et complexe. Le but principal de cette étude est de vérifier si les dommages observés dans les...poumons du mouton correspondent à ceux de l’humain. Dans le cas d’ondes de choc simples, neuf courbes qui représentent le niveau de seuil, 1 % et 50...poumons du mouton dépendent plus de la durée et de l’orientation de l’onde de choc . Dans le cas d’ondes de choc complexes, trois courbes ont été

  15. Structural and biochemical abnormalities in the absence of acute deficits in mild primary blast-induced head trauma.

    PubMed

    Walls, Michael K; Race, Nicholas; Zheng, Lingxing; Vega-Alvarez, Sasha M; Acosta, Glen; Park, Jonghyuck; Shi, Riyi

    2016-03-01

    Blast-induced neurotrauma (BINT), if not fatal, is nonetheless potentially crippling. It can produce a wide array of acute symptoms in moderate-to-severe exposures, but mild BINT (mBINT) is characterized by the distinct absence of acute clinical abnormalities. The lack of observable indications for mBINT is particularly alarming, as these injuries have been linked to severe long-term psychiatric and degenerative neurological dysfunction. Although the long-term sequelae of BINT are extensively documented, the underlying mechanisms of injury remain poorly understood, impeding the development of diagnostic and treatment strategies. The primary goal of this research was to recapitulate primary mBINT in rodents in order to facilitate well-controlled, long-term investigations of blast-induced pathological neurological sequelae and identify potential mechanisms by which ongoing damage may occur postinjury. A validated, open-ended shock tube model was used to deliver blast overpressure (150 kPa) to anesthetized rats with body shielding and head fixation, simulating the protective effects of military-grade body armor and isolating a shock wave injury from confounding systemic injury responses, head acceleration, and other elements of explosive events. Evans Blue-labeled albumin was used to visualize blood-brain barrier (BBB) compromise at 4 hours postinjury. Iba1 staining was used to visualize activated microglia and infiltrating macrophages in areas of peak BBB compromise. Acrolein, a potent posttraumatic neurotoxin, was quantified in brain tissue by immunoblotting and in urine through liquid chromatography with tandem mass spectrometry at 1, 2, 3, and 5 days postinjury. Locomotor behavior, motor performance, and short-term memory were assessed with open field, rotarod, and novel object recognition (NOR) paradigms at 24 and 48 hours after the blast. Average speed, maximum speed, and distance traveled in an open-field exploration paradigm did not show significant

  16. Model primary content type for multipurpose internet mail extensions

    SciTech Connect

    Nelson, S.; Parks, C.

    1997-01-01

    The purpose of this memo is to propose an update to Internet RFC 2045 to include a new primary content-type to be known as `model`. RFC 2045 [1] describes mechanisms for specifying and describing the format of Internet Message Bodies via content-type/subtype pairs. We believe that `model` defines a fundamental type of content with unique presentational, hardware, and processing aspects. Various subtypes of this primary type are immediately anticipated but will be covered under separate documents.

  17. Stroke in primary hyperoxaluria type I.

    PubMed

    Rao, Neal M; Yallapragada, Anil; Winden, Kellen D; Saver, Jeffrey; Liebeskind, David S

    2014-01-01

    We report the case of a 27-year-old man with a history of previously undiagnosed renal disease that presented with multiple cerebrovascular infarctions. Workup for traditional causes of cerebrovascular infarction including cardiac telemetry, multiple echocardiograms, and hypercoagulative workup was negative. However, a transcranial Doppler detected circulating microemboli at the rate of 14 per hour. A serum oxalate level greater than the supersaturation point of calcium oxalate was detected, providing a potential source of the microemboli. Furthermore, serial imaging recorded rapid mineralization of the infarcted territories. In the absence of any proximal vessel irregularities, atherosclerosis, valvular abnormalities, arrhythmias, or systemic shunt as potential stroke etiology in this patient, we propose that circulating oxalate precipitate may be a potential mechanism for stroke in patients with primary oxalosis.

  18. Direct Comparison of the Primary Blast Response of a Physical Head Model with Post-mortem Human Subjects

    DTIC Science & Technology

    2014-02-27

    Finally, external pressure fields from the blast wave generator experiments are compared to full scale free-field tests...rying locatio g very thin w ified to ensur ll scale blast 6 accelerome rotational acc parison of int ible; The natu ead orientatio nstrumentat the...sensor eter. It has th mely small. d to be ve n, FISO d ing the fibe 0 mm radiu not provid mation abou 1: The Blast-I TAL METH truction, mate for

  19. Attenuation of blast pressure behind ballistic protective vests.

    PubMed

    Wood, Garrett W; Panzer, Matthew B; Shridharani, Jay K; Matthews, Kyle A; Capehart, Bruce P; Myers, Barry S; Bass, Cameron R

    2013-02-01

    Clinical studies increasingly report brain injury and not pulmonary injury following blast exposures, despite the increased frequency of exposure to explosive devices. The goal of this study was to determine the effect of personal body armour use on the potential for primary blast injury and to determine the risk of brain and pulmonary injury following a blast and its impact on the clinical care of patients with a history of blast exposure. A shock tube was used to generate blast overpressures on soft ballistic protective vests (NIJ Level-2) and hard protective vests (NIJ Level-4) while overpressure was recorded behind the vest. Both types of vest were found to significantly decrease pulmonary injury risk following a blast for a wide range of conditions. At the highest tested blast overpressure, the soft vest decreased the behind armour overpressure by a factor of 14.2, and the hard vest decreased behind armour overpressure by a factor of 56.8. Addition of body armour increased the 50th percentile pulmonary death tolerance of both vests to higher levels than the 50th percentile for brain injury. These results suggest that ballistic protective body armour vests, especially hard body armour plates, provide substantial chest protection in primary blasts and explain the increased frequency of head injuries, without the presence of pulmonary injuries, in protected subjects reporting a history of blast exposure. These results suggest increased clinical suspicion for mild to severe brain injury is warranted in persons wearing body armour exposed to a blast with or without pulmonary injury.

  20. Blast injury with particular reference to recent terrorist bombing incidents.

    PubMed Central

    Hill, J. F.

    1979-01-01

    The aetiology of primary blast lung is discussed with reference to the biodynamics of blast injury, and the clinical and pathological features of the condition are described. An analysis of casualties from bomb blast incidents occurring in Northern Ireland leads to the following conclusions concerning the injuries found in persons exposed to explosions: (1) there is a predominance of head and neck trauma, including fractures, lacerations, burns, and eye and ear injuries; (2) fractures and traumatic amputations are common and often multiple; (3) penetrating trunk wounds carry a grave prognosis; and (4) primary blast lung is rare. A comparison of four bombing incidents in England in 1973 and 1974 shows how the type and severity of injury are related to the place in which the explosion occurs. The administrative and clinical aspects of the management of casualties resulting from terrorist bombing activities are discussed. PMID:369445

  1. Preparation and Optimization of Vanadium Titanomagnetite Carbon Composite Hot Briquette: A New Type of Blast Furnace Burden

    NASA Astrophysics Data System (ADS)

    Zhao, W.; Wang, H. T.; Liu, Z. G.; Chu, M. S.; Ying, Z. W.; Tang, J.

    2017-10-01

    A new type of blast furnace burden, named VTM-CCB (vanadium titanomagnetite carbon composite hot briquette), is proposed and optimized in this paper. The preparation process of VTM-CCB includes two components, hot briquetting and heat treatment. The hot-briquetting and heat-treatment parameters are systematically optimized based on the Taguchi method and single-factor experiment. The optimized preparation parameters of VTM-CCB include a hot-briquetting temperature of 300°C, a coal particle size of <0.075 mm, a vanadium titanomagnetite particle size of <0.075 mm, a coal-added ratio of 28.52%, a heat-treatment temperature of 500°C and a heat-treatment time of 3 h. The compressive strength of VTM-CCB, based on the optimized parameters, reaches 2450 N, which meets the requirement of blast furnace ironmaking. These integrated parameters provide a theoretical basis for the production and application of a blast furnace smelting VTM-CCB.

  2. Preparation and Optimization of Vanadium Titanomagnetite Carbon Composite Hot Briquette: A New Type of Blast Furnace Burden

    NASA Astrophysics Data System (ADS)

    Zhao, W.; Wang, H. T.; Liu, Z. G.; Chu, M. S.; Ying, Z. W.; Tang, J.

    2017-04-01

    A new type of blast furnace burden, named VTM-CCB (vanadium titanomagnetite carbon composite hot briquette), is proposed and optimized in this paper. The preparation process of VTM-CCB includes two components, hot briquetting and heat treatment. The hot-briquetting and heat-treatment parameters are systematically optimized based on the Taguchi method and single-factor experiment. The optimized preparation parameters of VTM-CCB include a hot-briquetting temperature of 300°C, a coal particle size of <0.075 mm, a vanadium titanomagnetite particle size of <0.075 mm, a coal-added ratio of 28.52%, a heat-treatment temperature of 500°C and a heat-treatment time of 3 h. The compressive strength of VTM-CCB, based on the optimized parameters, reaches 2450 N, which meets the requirement of blast furnace ironmaking. These integrated parameters provide a theoretical basis for the production and application of a blast furnace smelting VTM-CCB.

  3. Blast injury research models

    PubMed Central

    Kirkman, E.; Watts, S.; Cooper, G.

    2011-01-01

    Blast injuries are an increasing problem in both military and civilian practice. Primary blast injury to the lungs (blast lung) is found in a clinically significant proportion of casualties from explosions even in an open environment, and in a high proportion of severely injured casualties following explosions in confined spaces. Blast casualties also commonly suffer secondary and tertiary blast injuries resulting in significant blood loss. The presence of hypoxaemia owing to blast lung complicates the process of fluid resuscitation. Consequently, prolonged hypotensive resuscitation was found to be incompatible with survival after combined blast lung and haemorrhage. This article describes studies addressing new forward resuscitation strategies involving a hybrid blood pressure profile (initially hypotensive followed later by normotensive resuscitation) and the use of supplemental oxygen to increase survival and reduce physiological deterioration during prolonged resuscitation. Surprisingly, hypertonic saline dextran was found to be inferior to normal saline after combined blast injury and haemorrhage. New strategies have therefore been developed to address the needs of blast-injured casualties and are likely to be particularly useful under circumstances of enforced delayed evacuation to surgical care. PMID:21149352

  4. Adaptive reconfigurable V-BLAST type equalizer for cognitive MIMO-OFDM radios

    NASA Astrophysics Data System (ADS)

    Ozden, Mehmet Tahir

    2015-12-01

    An adaptive channel shortening equalizer design for multiple input multiple output-orthogonal frequency division multiplexing (MIMO-OFDM) radio receivers is considered in this presentation. The proposed receiver has desirable features for cognitive and software defined radio implementations. It consists of two sections: MIMO decision feedback equalizer (MIMO-DFE) and adaptive multiple Viterbi detection. In MIMO-DFE section, a complete modified Gram-Schmidt orthogonalization of multichannel input data is accomplished using sequential processing multichannel Givens lattice stages, so that a Vertical Bell Laboratories Layered Space Time (V-BLAST) type MIMO-DFE is realized at the front-end section of the channel shortening equalizer. Matrix operations, a major bottleneck for receiver operations, are accordingly avoided, and only scalar operations are used. A highly modular and regular radio receiver architecture that has a suitable structure for digital signal processing (DSP) chip and field programable gate array (FPGA) implementations, which are important for software defined radio realizations, is achieved. The MIMO-DFE section of the proposed receiver can also be reconfigured for spectrum sensing and positioning functions, which are important tasks for cognitive radio applications. In connection with adaptive multiple Viterbi detection section, a systolic array implementation for each channel is performed so that a receiver architecture with high computational concurrency is attained. The total computational complexity is given in terms of equalizer and desired response filter lengths, alphabet size, and number of antennas. The performance of the proposed receiver is presented for two-channel case by means of mean squared error (MSE) and probability of error evaluations, which are conducted for time-invariant and time-variant channel conditions, orthogonal and nonorthogonal transmissions, and two different modulation schemes.

  5. Neuronal and glial changes in the brain resulting from explosive blast in an experimental model.

    PubMed

    Goodrich, James A; Kim, Jung H; Situ, Robert; Taylor, Wesley; Westmoreland, Ted; Du, Fu; Parks, Steven; Ling, Geoffrey; Hwang, Jung Y; Rapuano, Amedeo; Bandak, Faris A; de Lanerolle, Nihal C

    2016-11-24

    Mild traumatic brain injury (mTBI) is the signature injury in warfighters exposed to explosive blasts. The pathology underlying mTBI is poorly understood, as this condition is rarely fatal and thus postmortem brains are difficult to obtain for neuropathological studies. Here we report on studies of an experimental model with a gyrencephalic brain that is exposed to single and multiple explosive blast pressure waves. To determine injuries to the brain resulting from the primary blast, experimental conditions were controlled to eliminate any secondary or tertiary injury from blasts. We found small but significant levels of neuronal loss in the hippocampus, a brain area that is important for cognitive functions. Furthermore, neuronal loss increased with multiple blasts and the degree of neuronal injury worsened with time post-blast. This is consistent with our findings in the blast-exposed human brain based on magnetic resonance spectroscopic imaging. The studies on this experimental model thus confirm what has been presumed to be the case with the warfighter, namely that exposure to multiple blasts causes increased brain injury. Additionally, as in other studies of both explosive blast as well as closed head mTBI, we found astrocyte activation. Activated microglia were also prominent in white matter tracts, particularly in animals exposed to multiple blasts and at long post-blast intervals, even though injured axons (i.e. β-APP positive) were not found in these areas. Microglial activation appears to be a delayed response, though whether they may contribute to inflammation related injury mechanism at even longer post-blast times than we tested here, remains to be explored. Petechial hemorrhages or other gross signs of vascular injury were not observed in our study. These findings confirm the development of neuropathological changes due to blast exposure. The activation of astrocytes and microglia, cell types potentially involved in inflammatory processes, suggest an

  6. A Novel Preclinical Model of Moderate Primary Blast-Induced Traumatic Brain Injury.

    PubMed

    Divani, Afshin A; Murphy, Amanda J; Meints, Joyce; Sadeghi-Bazargani, Homayoun; Nordberg, Jessica; Monga, Manoj; Low, Walter C; Bhatia, Prerana M; Beilman, Greg J; SantaCruz, Karen S

    2015-07-15

    Blast-induced traumatic brain injury (bTBI) is the "signature" injury of the recent Iraq and Afghanistan wars. Here, we present a novel method to induce bTBI using shock wave (SW) lithotripsy. Using a lithotripsy machine, Wistar rats (N = 70; 408.3 ± 93 g) received five SW pulses to the right side of the frontal cortex at 24 kV and a frequency of 60 Hz. Animals were then randomly divided into three study endpoints: 24 h (n = 25), 72 h (n = 19) and 168 h (n = 26). Neurological and behavioral assessments (Garcia's test, beam walking, Rotarod, and elevated plus maze) were performed at the baseline, and further assessments followed at 3, 6, 24, 72, and 168 h post-injury, if applicable. We performed digital subtraction angiography (DSA) to assess presence of cerebral vasospasm due to induced bTBI. Damage to brain tissue was assessed by an overall histological severity (OHS) score based on depth of injury, area of hemorrhage, and extent of axonal injury. Except for beam walking, OHS was significantly correlated with the other three outcome measures with at least one of their assessments during the first 6 h after the experiment. OHS manifested the highest absolute correlation coefficients with anxiety at the baseline and 6 h post-injury (r(baseline) = -0.75, r(6hrs) = 0.85; p<0.05). Median hemispheric differences for contrast peak values (obtained from DSA studies) for 24, 72, and 168 h endpoints were 3.45%, 3.05% and 0.2%, respectively, with statistically significant differences at 1 versus 7 d (p<0.05) and 3 versus 7 d (p<0.01). In this study, we successfully established a preclinical rat model of bTBI with characteristics similar to those observed in clinical cases. This new method may be useful for future investigations aimed at understanding bTBI pathophysiology.

  7. Combined Effects of Primary and Tertiary Blast on Rat Brain: Characterization of a Model of Blast-induced Mild Traumatic Brain Injury

    DTIC Science & Technology

    2015-03-01

    proposals submitted to the CDMRP, DMRP, and MRMC BAA during this reporting period. The research proposal “Assessment and Treatment of Blast...I (1994) Alzheimer paired helical filaments. Restoration of the biological activity by dephosphorylation. FEBS Lett 349:104-108. Wang JZ, Grundke...Iqbal I, Iqbal K (1996) Restoration of biological activity of Alzheimer abnormally phosphorylated tau by dephosphorylation with protein phosphatase-2A

  8. Antisymmetric and Symmetric Functionally Graded Plate-Type Structures Impacted by Blast Loading

    DTIC Science & Technology

    2010-09-13

    IMPACTED BY BLAST LOADING Terry Hause, Ph.D. Research Mechanical Engineer U.S. Army RDECOM-TARDEC Warren, MI 48397 Sudhakar, Arepally Deputy...CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Terry Hause, Ph.D.; Sudhakar, Arepally 5d. PROJECT NUMBER 5e. TASK NUMBER

  9. The Effect of Underwater Blast on Aggregating Brain Cell Cultures.

    PubMed

    Sawyer, Thomas W; Lee, Julian J; Villanueva, Mercy; Wang, Yushan; Nelson, Peggy; Song, Yanfeng; Fan, Chengyang; Barnes, Julia; McLaws, Lori

    2017-01-15

    Although the deleterious effects of primary blast on gas-filled organs are well accepted, the effect of blast-induced shock waves on the brain is less clear because of factors that complicate the interpretation of clinical and experimental data. Brain cell aggregate cultures are comprised of multiple differentiated brain cell types and were used to examine the effects of underwater blast. Suspensions of these cultures encased in dialysis tubing were exposed to explosive-generated underwater blasts of low (∼300 kPa), medium (∼2,700 kPa), or high (∼14,000 kPa) intensities and harvested at 1-28 days post-exposure. No changes in gross morphology were noted immediately or weeks after blast wave exposure, and no increases in either apoptotic (caspase-3) or necrotic (lactate dehydrogenase) cell death were observed. Changes in neuronal (neurofilament H, acetylcholinesterase, and choline acetyltransferase) and glial (glial fibrillary acidic protein, glutamine synthetase) endpoints did not occur. However, significant time- and pressure-related increases in Akt (protein kinase B) phosphorylation were noted, as well as declines in vascular endothelial growth factor levels, implicating pathways involved in cellular survival mechanisms. The free-floating nature of the aggregates during blast wave exposure, coupled with their highly hydrolyzed dialysis tubing containment, results in minimized boundary effects, thus enabling accurate assessment of brain cell response to a simplified shock-induced stress wave. This work shows that, at its simplest, blast-induced shock waves produce subtle changes in brain tissue. This study has mechanistic implications for the study of primary blast-induced traumatic brain injury and supports the thesis that underwater blast may cause subtle changes in the brains of submerged individuals.

  10. 46 CFR 169.513 - Types of primary equipment.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 7 2012-10-01 2012-10-01 false Types of primary equipment. 169.513 Section 169.513 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) NAUTICAL SCHOOLS SAILING SCHOOL VESSELS... the vessel, and is in good and serviceable condition. (c) Life floats. Each lifefloat must be of a...

  11. 46 CFR 169.513 - Types of primary equipment.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 7 2014-10-01 2014-10-01 false Types of primary equipment. 169.513 Section 169.513 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) NAUTICAL SCHOOLS SAILING SCHOOL VESSELS... the vessel, and is in good and serviceable condition. (c) Life floats. Each lifefloat must be of a...

  12. 46 CFR 169.513 - Types of primary equipment.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Types of primary equipment. 169.513 Section 169.513 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) NAUTICAL SCHOOLS SAILING SCHOOL VESSELS... the vessel, and is in good and serviceable condition. (c) Life floats. Each lifefloat must be of a...

  13. 46 CFR 169.513 - Types of primary equipment.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 7 2013-10-01 2013-10-01 false Types of primary equipment. 169.513 Section 169.513 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) NAUTICAL SCHOOLS SAILING SCHOOL VESSELS... the vessel, and is in good and serviceable condition. (c) Life floats. Each lifefloat must be of a...

  14. Intrathoracic pressure variations in an anthropomorphic dummy exposed to air blast, blunt impact, and missiles.

    PubMed

    Jönsson, A; Arvebo, E; Schantz, B

    1988-01-01

    Experiments with an anthropomorphic dummy for blast research demonstrated that pressures recorded in the lung model of the dummy could be correlated to primary air blast effects on the lungs of experimental animals. The results presented here were obtained with a dummy of the type mentioned above, but with the lung model modified to improve geometric similarity to man. Blast experiments were performed in a shock tube, and impact experiments in a special impact machine. Experiments with nonpenetrating missiles were performed with small-caliber firearms and the dummy protected by body armor. Severity indices derived from the blast experiments were related to established criteria for primary lung injury in man. Impacts delivered in the impact machine and by nonpenetrating missiles are compared. Relationships between severity of impact based on experiments with animals and primary lung injury in man are discussed.

  15. Heart failure therapeutics on the basis of a biased ligand of the angiotensin-2 type 1 receptor. Rationale and design of the BLAST-AHF study (Biased Ligand of the Angiotensin Receptor Study in Acute Heart Failure).

    PubMed

    Felker, G Michael; Butler, Javed; Collins, Sean P; Cotter, Gad; Davison, Beth A; Ezekowitz, Justin A; Filippatos, Gerasimos; Levy, Phillip D; Metra, Marco; Ponikowski, Piotr; Soergel, David G; Teerlink, John R; Violin, Jonathan D; Voors, Adriaan A; Pang, Peter S

    2015-03-01

    The BLAST-AHF (Biased Ligand of the Angiotensin Receptor Study in Acute Heart Failure) study is designed to test the efficacy and safety of TRV027, a novel biased ligand of the angiotensin-2 type 1 receptor, in patients with acute heart failure (AHF). AHF remains a major public health problem, and no currently-available therapies have been shown to favorably affect outcomes. TRV027 is a novel biased ligand of the angiotensin-2 type 1 receptor that antagonizes angiotensin-stimulated G-protein activation while stimulating β-arrestin. In animal models, these effects reduce afterload while increasing cardiac performance and maintaining stroke volume. In initial human studies, TRV027 appears to be hemodynamically active primarily in patients with activation of the renin-angiotensin-aldosterone system, a potentially attractive profile for an AHF therapeutic. BLAST-AHF is an international prospective, randomized, phase IIb, dose-ranging study that will randomize up to 500 AHF patients with systolic blood pressure ≥120 mm Hg and ≤200 mm Hg within 24 h of initial presentation to 1 of 3 doses of intravenous TRV027 (1, 5, or 25 mg/h) or matching placebo (1:1:1:1) for at least 48 h and up to 96 h. The primary endpoint is a composite of 5 clinical endpoints (dyspnea, worsening heart failure, length of hospital stay, 30-day rehospitalization, and 30-day mortality) combined using an average z-score. Secondary endpoints will include the assessment of dyspnea and change in amino-terminal pro-B-type natriuretic peptide. The BLAST-AHF study will assess the efficacy and safety of a novel biased ligand of the angiotensin-2 type 1 receptor in AHF.

  16. Insulin as a Primary Autoantigen for Type 1A Diabetes

    PubMed Central

    Jasinski, J. M.; Eisenbarth, G. S.

    2005-01-01

    Type 1A diabetes mellitus is caused by specific and progressive autoimmune destruction of the beta cells in the islets of Langerhans whereas the other cell types in the islet (alpha, delta, and PP) are spared. The autoantigens of Type 1A diabetes may be divided into subgroups based on their tissue distributions: Beta-cell-specific antigens like insulin, insulin derivatives, and IGRP (Islet-specific Glucose-6-phosphatase catalytic subunit Related Peptide); neurendocrine antigens such as carboxypeptidase H, insulinoma-associated antigen (IA-2), glutamic acid decarboxylase (GAD65), and carboxypeptidase E; and those expressed ubiquitously like heat shock protein 60 (a putative autoantigen for type 1 diabetes). This review will focus specifically on insulin as a primary autoantigen, an essentia l target for disease, in type 1A diabetes mellitus. In particular, immunization with insulin peptide B:9-23 can be used to induce insulin autoantibodies and diabetes in animal models or used to prevent diabetes. Genetic manipulation of the insulin 1 and 2 genes reciprocally alters development of diabetes in the NOD mouse, and insulin gene polymorphisms are important determinants of childhood diabetes. We are pursuing the hypothesis that insulin is a primary autoantigen for type 1 diabetes, and thus the pathogenesis of the disease relates to specific recognition of one or more peptides. PMID:16295523

  17. Primary Salivary Gland Type Tumors of the Thymus.

    PubMed

    Kalhor, Neda; Weissferdt, Annikka; Moran, Cesar A

    2017-01-01

    The existence of primary salivary gland type tumors (SGTs), similar to those occurring in the major salivary glands, is well known in the thoracic cavity. When they occur in this anatomic area, these tumors more commonly arise from the lung. However, the existence of these tumors primarily affecting the thymus, although recognized in the literature, is rather not well documented or known. In addition, contrary to the primary lung SGTs, which are predominantly of the malignant type, these tumors when occur in thymus encompass a wider spectrum of biology ranging from benign to low grade, and high grade malignancy. The recognition of SGTs in the thymus, even though rare, is important to properly address treatment and prognosis. Herein, we will discuss the numerous benign a malignant SGTs that have been described in the thymus and highlight the difficulty that these tumors may pose when occurring in the thymic area.

  18. Oral findings associated with primary hyperoxaluria type I.

    PubMed

    Mitsimponas, K T; Wehrhan, T; Falk, S; Wehrhan, F; Neukam, F W; Schlegel, K A

    2012-12-01

    In the present paper we report the oral findings of a patient who was diagnosed with hyperoxaluria. Hyperoxalurias can basically be classified as primary and secondary, with the first being inborn errors of metabolism and the second a result of excessive oxalate intake. Primary hyperoxalurias form a rare group of metabolic diseases that are inherited in the autosomal recessive fashion. The affected genes code for specific hepatic enzymes that are involved in glyoxylate metabolism and their deficiency results in overproduction of oxalate. Two different types are described: Primary hyperoxaluria type I results from a deficiency of peroxisomal enzyme alanine-glyoxylate aminotransferase and the more rare type II from a deficiency of cytosolic enzyme D-glycerate dehydrogenase. Since oxalate is primarily excreted through the kidneys, abnormally high concentration of oxalate in the urine occurs. This can in turn result in recurrent kidney stones and parenchymal renal damage and end-stage renal disease (ESRD). Inability to further excrete oxalate through the kidneys leads to its deposition in various organs (oxalosis). Several oral findings have been described in patients with oxalosis, most important of whose are bone resorption in the jaws, external root resorption and rapidly progressive dental mobility, as well as dental pain associated with deposition of oxalate in the dentine and the pulp.

  19. Grading of symptoms in hyperleukocytic leukaemia: a clinical model for the role of different blast types and promyelocytes in the development of leukostasis syndrome.

    PubMed

    Novotny, J R; Müller-Beissenhirtz, H; Herget-Rosenthal, S; Kribben, A; Dührsen, U

    2005-06-01

    Patients with hyperleukocytic leukaemia were graded according to the severity of symptoms possibly caused by leukostasis to evaluate the effectiveness of therapy and to test the relative contribution of blast type and count of blasts and promyelocytes in the development of leukostasis syndrome. Ninety-five patients (59 male, 36 female, median age 52 yr) with hyperleukocytic leukaemia [leukocytes above 50 x 10(9)/L, 48 acute myeloid leukaemia (AML), 31 chronic myeloid leukaemia (CML), 13 acute lymphoblastic leukaemia (ALL), three chronic myelomonocytic leukaemia (CMML)] were grouped according to the presence or absence and severity of neurologic, pulmonary and other symptoms into four categories (no, possible, probable and highly probable leukostasis syndrome). Age, white blood count (WBC), haemoglobin, blast count and total of blasts plus promyelocytes of these groups were compared by Mann-Whitney U-test. Patients with myeloid leukaemia (AML M1/M2, CML) which scored as highly probable leukostasis showed significantly higher WBC (P = 0.011), lower haemoglobin (P = 0.004), higher peripheral blast counts (P = 0.004) and higher total of peripheral blasts plus promyelocytes (P < 0.001) compared with the lower probability groups. In leukaemia involving the monocytic lineage (AML M4/M5, CMML) no significant differences were found in any of these factors between patients with highly probable leukostasis and the other patients. Our results show that a four-stage clinical grading scale is a valuable tool for analysing hyperleukocytic patient populations and evaluate the effectiveness of therapy more precisely. We further demonstrate that the mechanisms of leukostasis are different in myeloid leukaemia as compared with leukaemia with involvement of the monocytic lineage.

  20. Primary and secondary prevention of Type 1 diabetes.

    PubMed

    Skyler, J S

    2013-02-01

    Since type 1 diabetes is an immunologically mediated disease, immune intervention should alter the natural history of the disease. This article reviews prevention studies undertaken either prior to any evidence of autoimmunity (primary prevention) or after the development of islet autoantibodies (secondary prevention). Most immune intervention studies have been conducted in recent-onset type 1 diabetes (tertiary prevention), and these are not reviewed herein. The goal of primary and secondary intervention is to arrest the immune process and thus prevent or delay clinical disease. Primary prevention studies have been conducted in infants with high genetic risk. Interventions tested include several dietary manipulations, including infant formulas free of either cow's milk or of bovine insulin, infant formula supplemented with the omega-3-fatty acid docosahexaenoic acid, delayed introduction of gluten-containing foods, and vitamin D supplementation. Secondary prevention studies have been conducted in both children and adults with diabetes autoantibodies. Interventions tested include nicotinamide, insulin injections, oral insulin, nasal insulin, glutamic acid decarboxylase, and cyclosporine. Underway are secondary prevention studies with teplizumab and with abatacept. © 2012 The Author. Diabetic Medicine © 2012 Diabetes UK.

  1. Primary prevention of type 2 diabetes: integrative public health and primary care opportunities, challenges and strategies

    PubMed Central

    Green, Lawrence W; Brancati, Frederick L; Albright, Ann

    2012-01-01

    Type 2 diabetes imposes a large and growing burden on the public’s health. This burden, combined with the growing evidence for primary prevention from randomized controlled trials of structured lifestyle programs leads to recommendations to include caloric reduction, increased physical activity and specific assistance to patients in problem solving to achieve modest weight loss as well as pharmacotherapy. These recommendations demand exploration of new ways to implement such primary prevention strategies through more integrated community organization, medical practice and policy. The US experience with control of tobacco use and high blood pressure offers valuable lessons for policy, such as taxation on products, and for practice in a variety of settings, such as coordination of referrals for lifestyle supports. We acknowledge also some notable exceptions to their generalizability. This paper presents possible actions proposed by an expert panel, summarized in Table 1 as recommendations for immediate action, strategic action and research. The collaboration of primary care and public health systems will be required to make many of these recommendations a reality. This paper also provides information on the progress made in recent years by the Division of Diabetes Translation at the US Centers for Disease Control and Prevention (CDC) to implement or facilitate such integration of primary care and public health for primary prevention. PMID:22399542

  2. Effectiveness of eye armor during blast loading.

    PubMed

    Bailoor, Shantanu; Bhardwaj, Rajneesh; Nguyen, Thao D

    2015-11-01

    Ocular trauma is one of the most common types of combat injuries resulting from the interaction of military personnel with improvised explosive devices. Ocular blast injury mechanisms are complex, and trauma may occur through various injury mechanisms. However, primary blast injuries (PBI) are an important cause of ocular trauma that may go unnoticed and result in significant damage to internal ocular tissues and visual impairment. Further, the effectiveness of commonly employed eye armor, designed for ballistic and laser protection, in lessening the severity of adverse blast overpressures (BOP) is unknown. In this paper, we employed a three-dimensional (3D) fluid-structure interaction computational model for assessing effectiveness of the eye armor during blast loading on human eyes and validated results against free field blast measurements by Bentz and Grimm (2013). Numerical simulations show that the blast waves focused on the ocular region because of reflections from surrounding facial features and resulted in considerable increase in BOP. We evaluated the effectiveness of spectacles and goggles in mitigating the pressure loading using the computational model. Our results corroborate experimental measurements showing that the goggles were more effective than spectacles in mitigating BOP loading on the eye. Numerical results confirmed that the goggles significantly reduced blast wave penetration in the space between the armor and the eyes and provided larger clearance space for blast wave expansion after penetration than the spectacles. The spectacles as well as the goggles were more effective in reducing reflected BOP at higher charge mass because of the larger decrease in dynamic pressures after the impact. The goggles provided greater benefit of reducing the peak pressure than the spectacles for lower charge mass. However, the goggles resulted in moderate, sustained elevated pressure loading on the eye, that became 50-100% larger than the pressure loading

  3. Pulsed magnetic field excitation sensitivity of match-type electric blasting caps.

    PubMed

    Parson, Jonathan; Dickens, James; Walter, John; Neuber, Andreas A

    2010-10-01

    This paper presents a study on energy deposition and electromagnetic compatibility of match-type electroexplosive devices (EEDs), which recently have found more usage in pulsed power environments with high electromagnetic interference (EMI) background. The sensitivity of these devices makes them dangerous to intended and unintended radiation produced by devices commonly used in pulsed power environments. Match-type EEDs have been found to be susceptible to such low levels of energy (7-8 mJ) that safe operation of these EEDs is vital when in use near devices that produce high levels of pulsed EMI. The scope of this paper is to provide an investigation that incorporates results of similar studies to provide detonation characteristics of these EEDs. The three topics included in this study are sensitivity testing, modeling of the thermodynamic heat propagation, and electromagnetic compatibility from pulsed electromagnetic radiation. The thermodynamic joule heating of the primary explosive has been modeled by a solution to the 1D heat equation. A simple pulsed generator, Marx generator with an inductive load, was used for the electromagnetic compatibility assessment of the coupled field between the pulse generator and shorted EED. The results of the electromagnetic compatibility assessment relate the resistive, inductive, and capacitive components of the pulse generator to the area of the shorted EED.

  4. Passive blast pressure sensor

    DOEpatents

    King, Michael J.; Sanchez, Roberto J.; Moss, William C.

    2013-03-19

    A passive blast pressure sensor for detecting blast overpressures of at least a predetermined minimum threshold pressure. The blast pressure sensor includes a piston-cylinder arrangement with one end of the piston having a detection surface exposed to a blast event monitored medium through one end of the cylinder and the other end of the piston having a striker surface positioned to impact a contact stress sensitive film that is positioned against a strike surface of a rigid body, such as a backing plate. The contact stress sensitive film is of a type which changes color in response to at least a predetermined minimum contact stress which is defined as a product of the predetermined minimum threshold pressure and an amplification factor of the piston. In this manner, a color change in the film arising from impact of the piston accelerated by a blast event provides visual indication that a blast overpressure encountered from the blast event was not less than the predetermined minimum threshold pressure.

  5. T regulatory cells distinguish two types of primary hypophysitis.

    PubMed

    Mirocha, S; Elagin, R B; Salamat, S; Jaume, J C

    2009-03-01

    Numerous cases of primary hypophysitis have been described over the past 25 years with, however, little insight into the cause(s) of this disease. In order to guide treatment, a better understanding of the pathogenesis is needed. We studied the pathogenesis of primary hypophysitis by analysing systematically the immune response at the pituitary tissue level of consecutive cases of 'lymphocytic' hypophysitis who underwent pituitary biopsy. In order to investigate further the pathogenesis of their diseases we characterized two cases at clinical, cellular and molecular levels. We show here, for the first time, that lymphocytic hypophysitis probably encompasses at least two separate entities. One entity, in agreement with the classical description of lymphocytic hypophysitis, demonstrates an autoimmune process with T helper 17 cell dominance and lack of T regulatory cells. The other entity represents a process in which T regulatory cells seem to control the immune response, which may not be self- but foreign-targeted. Our data suggest that it may be necessary to biopsy suspected primary hypophysitis and to analyse pituitary tissue with immune markers to guide treatment. Based on our results, hypophysitis driven by an immune homeostatic process should not be treated with immunosuppression, while autoimmune-defined hypophysitis may benefit from it. We show here for the first time two different pathogenic processes classified under one disease type and how to distinguish them. Because of our findings, changes in current diagnostic and therapeutic approaches may need to be considered.

  6. The management of type 1 diabetes in Australian primary schools.

    PubMed

    Marks, Anne; Wilson, Valerie; Crisp, Jackie

    2014-09-01

    The aim of this study was to explore the management of type 1 diabetes in Australian primary schools: kindergarten-Year 2, from the parent's perspective. The study questions were: What diabetes treatment is being delivered? Who is providing the treatment? Where is the treatment given? A cross sectional, descriptive approach was used to collect data from parents (66) of children with type 1 diabetes attending an Australian primary school (kindergarten-Year 2). An online self-administered questionnaire was designed in Survey Monkey and was available via a dedicated Facebook page. Data were analysed using statistical analysis (SPSSv21). Blood glucose testing was occurring for all children, with 49% of children self testing. 77% of children were receiving an insulin bolus or injection at school. 34% was provided by the child and 53% of insulin was given via pump. Teachers, parents and teacher's aides also provided insulin at school. There was a statistically significant association between the number of children receiving insulin at school and the insulin delivery device, χ(2 )= 16.75, df = 1, p ≤ 0.000). Children using insulin pump therapy were more likely (97%) to receive insulin at school than children who used injections (55%). Children who were able to self-administer insulin were more likely to receive insulin (93%) at school than children who were unable to self-administer insulin (65%) (χ(2 )= 7.38, df = 1, p = 0.007) 81% of children received diabetes treatment in the classroom, with the remainder in the school administration office. Insulin administration across Australian primary schools was inconsistent. Not all children were receiving the recommended insulin treatment. Insulin pump therapy appears to increase access to this treatment at school.

  7. Blast Technologies

    DTIC Science & Technology

    2011-06-27

    Team Leader Risa Scherer Blast Mitigation Interior and Laboratory Team Leader Blast Technologies POC’s Government Point Of Contacts (POCs): To...to yield injury assessments at higher fidelities and with higher confidence UNCLASSIFIED UNCLASSIFIED Risa Scherer Blast Mitigation Interior and

  8. Renal function status in patients with primary osteoporosis (type 2).

    PubMed

    Nava-Bringas, Tania Inés; Chávez-Arias, Daniel David; del Pilar Diez-García, María; Miranda-Duarte, Antonio

    2009-01-01

    Several studies correlate renal function with lower bone mineral density (BMD); however, the relationship between early stages of renal dysfunction and BMD has not been clearly defined. Our objective was to determine renal function in patients with primary osteoporosis (type 2) and its relationship with BMD. Patients with primary osteoporosis diagnosed using DEXA were evaluated in this cross-sectional analysis. Renal function was estimated according to the modification of diet in renal disease (MDRD) equation and classified according to the National Kidney Foundation for chronic kidney disease (CKD). The relationship between renal function and BMD was analyzed. Included in the study were 120 women with a mean age 67.9 + or - 6.56 years. There was a positive relationship between spine BMD and moderate affection of renal function (F = 4.860, p = 0.009). No relationship was found between hip BMD or fracture with renal function (p = 0.223). Although women with poor renal function have significantly lower spine BMD, no relationship between early stages of CKD and low BMD has been demonstrated.

  9. Diagnostic criteria for primary neuronal degeneration of the Alzheimer's type.

    PubMed

    Eisdorfer, C; Cohen, D

    1980-10-01

    The diagnosis of patients presenting with memory or attentional deficits characteristic of dementia is a growing problem. Dementia may be symptomatic of a range of reversible medical and psychiatric conditions which appear to be indistinguishable from primary neuronal degeneration of the Alzheimer's type. While Alzheimer's disease is a neuropathological diagnosis, the importance of establishing a presumptive diagnosis which can be employed for investigational as well as clinical use is underscored. This paper proposes a diagnostic schema which reflects the current understanding of this disorder. There must be evidence of gradual progressive mental deterioration in attention, learning, memory, cognitive style, motivation, and higher order thinking. A comprehensive medical and psychiatric evaluation is obligatory to eliminate reversible physical illness, psychiatric disorder, or cerebrovascular condition as underlying causes of cognitive dysfunction.

  10. Simulation of primary-slag melting behavior in the cohesive zone of a blast furnace, considering the effect of Al{sub 2}O{sub 3}, Fe{sub t}O, and basicity in the sinter ore

    SciTech Connect

    Hino, Mitsutaka; Nagasaka, Tetsuya; Katsumata, Akitoshi; Higuchi, Kenichi; Yamaguchi, Kazuyoshi; Kon-No, Norimitsu

    1999-08-01

    The alumina content in the iron ore imported to Japan is increasing year by year, and some problems in blast furnace operation, due to the use of the high-alumina-containing sinter, have already been reported. In order to clarify the mechanism of the harmful effect of alumina on the blast furnace operation, the behavior of the primary melt, which is formed in the sinter at the cohesive zone of the blast furnace, has been simulated by dripping slag through an iron or oxide funnel. The effects of basicity, Al{sub 2}O{sub 3}, and Fe{sub t}O contents in the five slag systems on the dripping temperature and weight of slag remaining on the funnel have been discussed. It was found that the eutectic melt formed in the sinter would play an important role in the dripping behavior of the slag in the blast furnace through the fine porosity of the reduced iron and ore particles. Al{sub 2}O{sub 3} increased the weight of the slag remaining on the funnel, and its effect became very significant in the acidic and low-Fe{sub t}O-containing slag. It was estimated that the increase of the weight of the slag remaining on the funnel by Al{sub 2}O{sub 3} in the ore could result in a harmful effect on the permeability resistance and an indirect reduction rate of the sinter in the blast furnace.

  11. Antileukemic activity of sulforaphane in primary blasts from patients affected by myelo- and lympho-proliferative disorders and in hypoxic conditions.

    PubMed

    Fimognari, Carmela; Turrini, Eleonora; Sestili, Piero; Calcabrini, Cinzia; Carulli, Giovanni; Fontanelli, Giulia; Rousseau, Martina; Cantelli-Forti, Giorgio; Hrelia, Patrizia

    2014-01-01

    Sulforaphane is a dietary isothiocyanate found in cruciferous vegetables showing antileukemic activity. With the purpose of extending the potential clinical impact of sulforaphane in the oncological field, we investigated the antileukemic effect of sulforaphane on blasts from patients affected by different types of leukemia and, taking into account the intrinsically hypoxic nature of bone marrow, on a leukemia cell line (REH) maintained in hypoxic conditions. In particular, we tested sulforaphane on patients with chronic lymphocytic leukemia, acute myeloid leukemia, T-cell acute lymphoblastic leukemia, B-cell acute lymphoblastic leukemia, and blastic NK cell leukemia. Sulforaphane caused a dose-dependent induction of apoptosis in blasts from patients diagnosed with acute lymphoblastic or myeloid leukemia. Moreover, it was able to cause apoptosis and to inhibit proliferation in hypoxic conditions on REH cells. As to its cytotoxic mechanism, we found that sulforaphane creates an oxidative cellular environment that induces DNA damage and Bax and p53 gene activation, which in turn helps trigger apoptosis. On the whole, our results raise hopes that sulforaphane might set the stage for a novel therapeutic principle complementing our growing armature against malignancies and advocate the exploration of sulforaphane in a broader population of leukemic patients.

  12. Interferon type I responses in primary and secondary infections.

    PubMed

    Alsharifi, Mohammed; Müllbacher, Arno; Regner, Matthias

    2008-01-01

    The mammalian host responds to a microbial infection with a rapid innate immune reaction that is dominated by type I interferon (IFN-I) release. Most cells of vertebrates can respond to microbial attack with IFN-I production, but the cell type responsible for most of the systemic IFN-I release is thought to be plasmacytoid dendritic cells (pDCs). Besides its anti-microbial and especially anti-viral properties IFN-I also exerts a regulatory role on many facets of the sequential adaptive immune response. One of these is being the recently described partial, systemic activation of the vast majority of B and T lymphocytes in mice, irrespective of antigen reactivity. The biological significance of this partial activation of lymphocytes is at present speculative. Secondary infections occurring within a short time span of a primary infection fail to elicit a similar lymphocyte activation response due to a refractory period in systemic IFN-I production. This period of exhaustion in IFN-I responses is associated with an increased susceptibility of the host to secondary infections. The latter correlates with well-established clinical observations of heightened susceptibility of patients to secondary microbial infections after viral episodes.

  13. 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

  14. Behavioral Outcomes Differ between Rotational Acceleration and Blast Mechanisms of Mild Traumatic Brain Injury

    PubMed Central

    Stemper, Brian D.; Shah, Alok S.; Budde, Matthew D.; Olsen, Christopher M.; Glavaski-Joksimovic, Aleksandra; Kurpad, Shekar N.; McCrea, Michael; Pintar, Frank A.

    2016-01-01

    Mild traumatic brain injury (mTBI) can result from a number of mechanisms, including blunt impact, head rotational acceleration, exposure to blast, and penetration of projectiles. Mechanism is likely to influence the type, severity, and chronicity of outcomes. The objective of this study was to determine differences in the severity and time course of behavioral outcomes following blast and rotational mTBI. The Medical College of Wisconsin (MCW) Rotational Injury model and a shock tube model of primary blast injury were used to induce mTBI in rats and behavioral assessments were conducted within the first week, as well as 30 and 60 days following injury. Acute recovery time demonstrated similar increases over protocol-matched shams, indicating acute injury severity equivalence between the two mechanisms. Post-injury behavior in the elevated plus maze demonstrated differing trends, with rotationally injured rats acutely demonstrating greater activity, whereas blast-injured rats had decreased activity that developed at chronic time points. Similarly, blast-injured rats demonstrated trends associated with cognitive deficits that were not apparent following rotational injuries. These findings demonstrate that rotational and blast injury result in behavioral changes with different qualitative and temporal manifestations. Whereas rotational injury was characterized by a rapidly emerging phenotype consistent with behavioral disinhibition, blast injury was associated with emotional and cognitive differences that were not evident acutely, but developed later, with an anxiety-like phenotype still present in injured animals at our most chronic measurements. PMID:27014184

  15. Behavioral Outcomes Differ between Rotational Acceleration and Blast Mechanisms of Mild Traumatic Brain Injury.

    PubMed

    Stemper, Brian D; Shah, Alok S; Budde, Matthew D; Olsen, Christopher M; Glavaski-Joksimovic, Aleksandra; Kurpad, Shekar N; McCrea, Michael; Pintar, Frank A

    2016-01-01

    Mild traumatic brain injury (mTBI) can result from a number of mechanisms, including blunt impact, head rotational acceleration, exposure to blast, and penetration of projectiles. Mechanism is likely to influence the type, severity, and chronicity of outcomes. The objective of this study was to determine differences in the severity and time course of behavioral outcomes following blast and rotational mTBI. The Medical College of Wisconsin (MCW) Rotational Injury model and a shock tube model of primary blast injury were used to induce mTBI in rats and behavioral assessments were conducted within the first week, as well as 30 and 60 days following injury. Acute recovery time demonstrated similar increases over protocol-matched shams, indicating acute injury severity equivalence between the two mechanisms. Post-injury behavior in the elevated plus maze demonstrated differing trends, with rotationally injured rats acutely demonstrating greater activity, whereas blast-injured rats had decreased activity that developed at chronic time points. Similarly, blast-injured rats demonstrated trends associated with cognitive deficits that were not apparent following rotational injuries. These findings demonstrate that rotational and blast injury result in behavioral changes with different qualitative and temporal manifestations. Whereas rotational injury was characterized by a rapidly emerging phenotype consistent with behavioral disinhibition, blast injury was associated with emotional and cognitive differences that were not evident acutely, but developed later, with an anxiety-like phenotype still present in injured animals at our most chronic measurements.

  16. Recurrent primary hyperparathyroidism due to Type 1 parathyromatosis.

    PubMed

    Jain, Monica; Krasne, David L; Singer, Frederick R; Giuliano, Armando E

    2017-02-01

    Parathyromatosis is a rare condition consisting of multiple nodules of benign hyperfunctioning parathyroid tissue scattered throughout the neck and superior mediastinum. As a potential cause of recurrent or persistent hyperparathyroidism, parathyromatosis is a challenging condition to diagnose and treat. The optimal evaluation and management of patients with parathyromatosis is not well established. The reported case involves a patient who was initially diagnosed with primary hyperparathyroidism. The diagnosis of Type 1 parathyromatosis was made after the patient developed recurrent hyperparathyroidism with hypercalcemia and osteoporosis 17 years after the initial operation and underwent two additional operations. The majority of parathyromatosis cases are diagnosed in the setting of secondary hyperparathyroidism. Consensus regarding the preoperative diagnosis and evaluation is lacking due to the paucity of cases of this rare clinical entity. Management involves complete surgical extirpation of all identifiable rests of parathyroid tissue. Intra-operative parathyroid hormone level monitoring and frozen section examination are excellent tools that could increase the rates of initial operative success. Despite this, long-term disease remission is rare, and medical therapy, including calcimimetics and bisphosphonates, may be required for postoperative or non-operative management.

  17. Primary hyperoxaluria type 1: practical and ethical issues.

    PubMed

    Cochat, Pierre; Groothoff, Jaap

    2013-12-01

    Primary hyperoxaluria type 1 (PH1) is a rare inborn error of glyoxylate metabolism of autosomal recessive inheritance, leading to progressive systemic oxalate storage (named 'oxalosis') with a high rate of morbidity and mortality, as well as an unacceptable quality of life for most patients. The adverse outcome, however, is partly due to issues that can be overcome. First, the diagnosis of PH is often delayed due to a general lack of knowledge of the disease among physicians. This accounts specifically for patients with pyridoxine sensitive PH, a group that is paradoxically most easy to treat. Second, lack of adherence to a strict conduction of conservative treatment and optimal urological management may enhance an adverse outcome of the disease. Third, specific techniques to establish PH1 and specific therapies are currently often not available in several low-resources countries with a high prevalence of PH. The management of patients with advanced disease is extremely difficult and warrants a tailor-made approach in most cases. Comprehensive programs for education of local physicians, installation of national centers of expertise, European support of low-resources countries for the management of PH patients and intensified international collaboration on the management of current patients, as well as on conduction of clinical studies, may further improve outcome of PH.

  18. [De novo (type 3) primary intraosseous carcinoma of the jaws].

    PubMed

    Ray, A C; Foletti, J M; Graillon, N; Guyot, L; Chossegros, C

    2016-12-01

    Primary intraosseous carcinoma (PIOC) of the jaws is a rare epidermoid carcinoma from epithelial origin and initially strictly localized within the bone. Histologically, type 3 PIOC (PIOC3) is a de novo primary intraosseous carcinoma. Because of the rarity of this illness, we propose an analysis of a personal case and a revue of the literature. Two search engines (Pubmed(®), Sciencedirect(®)) were questioned over the period 1976-February 2016 by using following keywords carcinoma, intraosseous, jaws, squamous cell carcinoma. Articles reporting proven PIOC3 and mentioning a precise treatment were selected. Thirty articles concerning 54 patients (sex ratio: 2.4; mean age: 56.8; extreme: 24-78) met the inclusion criterions. The most common symptoms were swelling (53%), pain (44.9%) and infra-alveolar nerve paresthesia (30.6%). The time to diagnosis was 13 weeks. Classification of Zwetyenga et al. showed more than 80% of T2 and T3 stages. The lesions were predominantly mandibular (85.2%) and posterior. Less than a third of patients had lymph node and 10% had distant metastasis. Treatment consisted mostly in a combination of surgery and radiotherapy. With a mean follow-up of 74.8 months, 70.8% were in remission with no evidence of recurrence. We report the case of a 58-year-old patient, with no medical history, complaining since several months about periodontitis with teeth mobility in the right mandibular area. The panoramic X-ray showed a bone lysis at the place of tooth No. 46. In the absence of alveolar healing after extraction and antibiotherapy, a biopsy was made that diagnosed a differentiated keratinizing squamous cell carcinoma. CT scan and MRI showed a mandibular cortical bone loss with involvement of adjacent structures and lymphadenopathy in the ipsilateral IB area. The patient was treated with a combination of chemotherapy and surgery. Postoperative chemo- and radiotherapy is still going on. The PIOC3 is a rare tumor, mainly arising in males around 50

  19. Optimized Battery-Type Reactor Primary System Design Utilizing Lead

    SciTech Connect

    Yu, Yong H.; Son, Hyoung M.; Lee, Il S.; Suh, Kune Y.

    2006-07-01

    A number of small and medium size reactors are being developed worldwide as well as large electricity generation reactors for co-generation, district heating or desalination. The Seoul National University has started to develop 23 MWth BORIS (Battery Optimized Reactor Integral System) as a multi-purpose reactor. BORIS is an integral-type optimized fast reactor with an ultra long life core. BORIS is being designed to meet the Generation IV nuclear energy system goals of sustainability, safety, reliability and economics. Major features of BORIS include 20 consecutive years of operation without refueling; elimination of an intermediate heat transport loop and main coolant pump; open core without individual subassemblies; inherent negative reactivity feedback; and inherent load following capability. Its one mission is to provide incremental electricity generation to match the needs of developing nations and especially remote communities without major electrical grid connections. BORIS consists of a reactor module, heat exchanger, coolant module, guard vessel, reactor vessel auxiliary cooling system (RVACS), secondary system, containment and the seismic isolation. BORIS is designed to generate 10 MWe with the resulting thermal efficiency of 45 %. BORIS uses lead as the primary system coolant because of the inherent safety of the material. BORIS is coupled with a supercritical carbon dioxide Brayton cycle as the secondary system to gain a high cycle efficiency in the range of 45 %. The reference core consists of 757 fuel rods without assembly with an active core height of 0.8 m. The BORIS core consists of single enrichment zone composed of a Pu-MA (minor actinides)-U-N fuel and a ferritic-martensitic stainless steel clad. This study is intended to set up appropriate reactor vessel geometry by performing thermal hydraulic analysis on RVACS using computational fluid dynamics codes; to examine the liquid metal coolant behavior along the subchannels; to find out whether the

  20. Expanding the Range of Text Types Used in the Primary Grades

    ERIC Educational Resources Information Center

    Strachan, Stephanie L.

    2015-01-01

    Primary-grade students' experiences with text should prepare them to critically read an extensive range of text types throughout their schooling and career, a primary goal of the Common Core State Standards (CCSS). However, research demonstrates that narrative text overshadows other text types in the primary grades. The purpose of this…

  1. Expanding the Range of Text Types Used in the Primary Grades

    ERIC Educational Resources Information Center

    Strachan, Stephanie L.

    2015-01-01

    Primary-grade students' experiences with text should prepare them to critically read an extensive range of text types throughout their schooling and career, a primary goal of the Common Core State Standards (CCSS). However, research demonstrates that narrative text overshadows other text types in the primary grades. The purpose of this…

  2. Types of Primary Insomnia: Is Hyperarousal Also Present during Napping?

    PubMed Central

    Pérusse, Alexandra D.; Turcotte, Isabelle; St-Jean, Geneviève; Ellis, Jason; Hudon, Carol; Bastien, Célyne H.

    2013-01-01

    Study Objectives: The objective of this study was to identify if hyperarousal is a 24-hour phenomenon in insomnia by comparing sleep during napping between good sleepers (GS) and Insomnia sufferers (INS) (subdivided into paradoxical “PARA-I” and psychophysiological “PSY-I”) following a mentally challenging battery of cognitive tests. Design: Cross-sectional comparisons of GS, PSY-I, and PARA-I. Setting: Participants slept for 4 consecutive nights in the laboratory where PSG was recorded. Upon awakening on mornings 2 and 3, cognitive testing (lasting 90-120 min) was administered, followed by a 20-minute nap. Participants: Fourteen PSY-I, 12 PARA-I, and 23 GS completed the study, comprising home questionnaires, clinical interviews, night PSG recordings, cognitive testing, and nap PSG recordings. All participants were between 25 and 50 years of age and met inclusion criteria for PSY-I, PARA-I, or GS. Interventions: N/A. Measurements and Results: On objective nap parameters, GS had a longer total sleep time (TST; p = 0.008) and better sleep efficiency (SE; p = 0.009), than PSY-I and PARA-I, and both groups of INS were awake significantly longer than GS (p = 0.003). Also, PARA-I took significantly more time than GS to fall asleep (p = 0.014). Subjectively reported sleepiness was comparable across the three groups. Positive relationships were observed between SE over the night and SE over the nap the following day. Conclusions: Results show that GS sleep better than INS during naps following prolonged cognitive testing, suggesting that, in INS, hyperarousal predominates over mental fatigue resulting from these tests. These results may parallel what is observed at night when INS experience increased cognitive load but are unable to fall asleep. Citation: Pérusse AD; Turcotte I; St-Jean G; Ellis J; Hudon C; Bastien CH. Types of primary insomnia: is hyperarousal also present during napping? J Clin Sleep Med 2013;9(12):1273-1280. PMID:24340289

  3. [Cloning and analyzing of rice blast resistance gene Pi-ta+ allele from Jinghong erect type of common wild rice (Oryza rufipogon Griff) in Yunnan].

    PubMed

    Geng, Xian-Sheng; Yang, Ming-Zhi; Huang, Xing-Qi; Cheng, Zai-Quan; Fu, Jian; Sun, Tao; Li, Jun

    2008-01-01

    A 4,672 bp DNA sequence including the whole coding region and partial non-coding region of rice blast resistance gene Pi-ta+ has been cloned from Jinghong erect type of common wild rice (Oryza rufipogon Griff) in Yunnan by polymerase chain reaction method. The coding region shares 99.86% and 98.78% identity with the corresponding regions of the reported cultivated rice Yashiro-mochi and Yuanjiang type of common wild rice respectively. There are 4 nucleotides difference in the coding region and 6 in intron of the cloned Pi-ta+ gene,compared with Pi-ta from Yashiro-mochi. Pi-ta+ gene in Jinghong erect type of common wild rice has been proved to be a rare existing Pi-ta+ allele, because there was a alanine rather than a serine at the position 918 within the predicted amino acid sequence of PITA. Pi-ta+ allele can cause disease resistance response to rice blast pathogens in plant cells. Differences in DNA sequence, deduced amino acid sequence and antibacterial spectrum may make the Pi-ta+ allele new resistant characteristics. Finding and cloning of Pi-ta+ allele from Jinghong erect type of common wild rice in Yunnan provides a basement for further utilization of the wild rice resources.

  4. A novel closed-head model of mild traumatic brain injury caused by primary overpressure blast to the cranium produces sustained emotional deficits in mice.

    PubMed

    Heldt, Scott A; Elberger, Andrea J; Deng, Yunping; Guley, Natalie H; Del Mar, Nobel; Rogers, Joshua; Choi, Gy Won; Ferrell, Jessica; Rex, Tonia S; Honig, Marcia G; Reiner, Anton

    2014-01-01

    Emotional disorders are a common outcome from mild traumatic brain injury (TBI) in humans, but their pathophysiological basis is poorly understood. We have developed a mouse model of closed-head blast injury using an air pressure wave delivered to a small area on one side of the cranium, to create mild TBI. We found that 20-psi blasts in 3-month-old C57BL/6 male mice yielded no obvious behavioral or histological evidence of brain injury, while 25-40 psi blasts produced transient anxiety in an open field arena but little histological evidence of brain damage. By contrast, 50-60 psi blasts resulted in anxiety-like behavior in an open field arena that became more evident with time after blast. In additional behavioral tests conducted 2-8 weeks after blast, 50-60 psi mice also demonstrated increased acoustic startle, perseverance of learned fear, and enhanced contextual fear, as well as depression-like behavior and diminished prepulse inhibition. We found no evident cerebral pathology, but did observe scattered axonal degeneration in brain sections from 50 to 60 psi mice 3-8 weeks after blast. Thus, the TBI caused by single 50-60 psi blasts in mice exhibits the minimal neuronal loss coupled to "diffuse" axonal injury characteristic of human mild TBI. A reduction in the abundance of a subpopulation of excitatory projection neurons in basolateral amygdala enriched in Thy1 was, however, observed. The reported link of this neuronal population to fear suppression suggests their damage by mild TBI may contribute to the heightened anxiety and fearfulness observed after blast in our mice. Our overpressure air blast model of concussion in mice will enable further studies of the mechanisms underlying the diverse emotional deficits seen after mild TBI.

  5. A Novel Closed-Head Model of Mild Traumatic Brain Injury Caused by Primary Overpressure Blast to the Cranium Produces Sustained Emotional Deficits in Mice

    PubMed Central

    Heldt, Scott A.; Elberger, Andrea J.; Deng, Yunping; Guley, Natalie H.; Del Mar, Nobel; Rogers, Joshua; Choi, Gy Won; Ferrell, Jessica; Rex, Tonia S.; Honig, Marcia G.; Reiner, Anton

    2014-01-01

    Emotional disorders are a common outcome from mild traumatic brain injury (TBI) in humans, but their pathophysiological basis is poorly understood. We have developed a mouse model of closed-head blast injury using an air pressure wave delivered to a small area on one side of the cranium, to create mild TBI. We found that 20-psi blasts in 3-month-old C57BL/6 male mice yielded no obvious behavioral or histological evidence of brain injury, while 25–40 psi blasts produced transient anxiety in an open field arena but little histological evidence of brain damage. By contrast, 50–60 psi blasts resulted in anxiety-like behavior in an open field arena that became more evident with time after blast. In additional behavioral tests conducted 2–8 weeks after blast, 50–60 psi mice also demonstrated increased acoustic startle, perseverance of learned fear, and enhanced contextual fear, as well as depression-like behavior and diminished prepulse inhibition. We found no evident cerebral pathology, but did observe scattered axonal degeneration in brain sections from 50 to 60 psi mice 3–8 weeks after blast. Thus, the TBI caused by single 50–60 psi blasts in mice exhibits the minimal neuronal loss coupled to “diffuse” axonal injury characteristic of human mild TBI. A reduction in the abundance of a subpopulation of excitatory projection neurons in basolateral amygdala enriched in Thy1 was, however, observed. The reported link of this neuronal population to fear suppression suggests their damage by mild TBI may contribute to the heightened anxiety and fearfulness observed after blast in our mice. Our overpressure air blast model of concussion in mice will enable further studies of the mechanisms underlying the diverse emotional deficits seen after mild TBI. PMID:24478749

  6. Protrusions Beyond the Blast Waves of Young Type Ia Supernova Remnants: Hydrodynamic Instabilities or Ejecta Bullets?

    NASA Astrophysics Data System (ADS)

    Dyer, Ashton; Blondin, J. M.; Reynolds, S. P.

    2014-01-01

    High resolution imaging of two young Type Ia supernova remnants (SNRs), Tycho and SN 1006, has revealed several morphological features which have resisted explanation with numerical simulations. One such feature is the presence of shocked ejecta blobs protruding beyond the mean forward shock radius. Two current theories explain the presence of such ejecta: highly dense ejecta shrapnel produced in the explosion penetrating the forward shock, or plumes generated by hydrodynamic instabilities long after the initial explosion. We investigate the shrapnel theory through hydrodynamic simulations in 2D and 3D of the evolution of dense ejecta clumps embedded in an exponential density profile, appropriate for Type Ia supernovae. We use high-resolution 2D simulations to identify relevant clump parameters which we investigate further in 3D. In contradiction to some former work, we find that sufficiently resolved clumps in 2D models shatter upon collision with the forward shock, yielding new protrusion features. In both 2D and 3D, shrapnel is capable of penetrating the forward shock, but the resultant protrusions in 3D simulations vary significantly from those in similar 2D runs, implying 2D simulations may not be an accurate method of investigating the shrapnel theory. We compare the our simulations with Chandra observations of projections seen in Tycho and SN 1006. This work was performed as part of NC State University's Undergraduate Research in Computational Astrophysics (URCA) program, an REU program supported by the National Science Foundation through award AST-1032736.

  7. Dripping and evolution behavior of primary slag bearing TiO2 through the coke packed bed in a blast-furnace hearth

    NASA Astrophysics Data System (ADS)

    Liu, Yan-xiang; Zhang, Jian-liang; Wang, Zhi-yu; Jiao, Ke-xin; Zhang, Guo-hua; Chou, Kuo-chih

    2017-02-01

    To investigate the flow of primary slag bearing TiO2 in the cohesive zone of blast furnaces, experiments were carried out based on the laboratory-scale packed bed systems. It is concluded that the initial temperature of slag dripping increases with decreasing FeO content and increasing TiO2 content. The slag holdup decreases when the FeO content is in the range of 5wt%-10wt%, whereas it increases when the FeO content exceeds 10wt%. Meanwhile, the slag holdup decreases when the TiO2 content increases from 5wt% to 10wt% but increases when the TiO2 content exceeds 10wt%. Moreover, slag/coke interface analysis shows that the reaction between FeO and TiO2 occurs between the slag and the coke. The slag/coke interface is divided into three layers: slag layer, iron-rich layer, and coke layer. TiO2 in the slag is reduced by carbon, and the generated Ti diffuses into iron.

  8. Explaining Different Types of Computer Use among Primary School Teachers

    ERIC Educational Resources Information Center

    van Braak, Johan; Tondeur, Jo; Valcke, Martin

    2004-01-01

    In order to identify differences in determinants of supportive and class use of computers, path modelling was applied in a sample of 468 primary school teachers. Independent variables were categorised in three levels: demographics (age and gender), computer experience (computer training, computer experience expressed over time, intensity of…

  9. Simulation of blast-induced, early-time intracranial wave physics leading to traumatic brain injury.

    SciTech Connect

    Taylor, Paul Allen; Ford, Corey C.

    2008-04-01

    U.S. soldiers are surviving blast and impacts due to effective body armor, trauma evacuation and care. Blast injuries are the leading cause of traumatic brain injury (TBI) in military personnel returning from combat. Understanding of Primary Blast Injury may be needed to develop better means of blast mitigation strategies. The objective of this paper is to investigate the effects of blast direction and strength on the resulting mechanical stress and wave energy distributions generated in the brain.

  10. Investigation of Primary School Teachers' Perception of Discipline Types They Use for Classroom Management

    ERIC Educational Resources Information Center

    Bayraktar, Hatice Vatansever; Dogan, M. Cihangir

    2017-01-01

    The objective of this study is to examine the primary school teachers' the perceptions of discipline types they use for classroom management; and also to find out if there is a statistically significant difference between the perceptions of discipline types used in classroom management according to the demographic characteristics of primary school…

  11. A Parametric Approach to Shape Field-Relevant Blast Wave Profiles in Compressed-Gas-Driven Shock Tube

    PubMed Central

    Sundaramurthy, Aravind; Chandra, Namas

    2014-01-01

    Detonation of a high-explosive produces shock-blast wave, shrapnel, and gaseous products. While direct exposure to blast is a concern near the epicenter, shock-blast can affect subjects, even at farther distances. When a pure shock-blast wave encounters the subject, in the absence of shrapnels, fall, or gaseous products the loading is termed as primary blast loading and is the subject of this paper. The wave profile is characterized by blast overpressure, positive time duration, and impulse and called herein as shock-blast wave parameters (SWPs). These parameters in turn are uniquely determined by the strength of high explosive and the distance of the human subjects from the epicenter. The shape and magnitude of the profile determine the severity of injury to the subjects. As shown in some of our recent works (1–3), the profile not only determines the survival of the subjects (e.g., animals) but also the acute and chronic biomechanical injuries along with the following bio-chemical sequelae. It is extremely important to carefully design and operate the shock tube to produce field-relevant SWPs. Furthermore, it is vital to identify and eliminate the artifacts that are inadvertently introduced in the shock-blast profile that may affect the results. In this work, we examine the relationship between shock tube adjustable parameters (SAPs) and SWPs that can be used to control the blast profile; the results can be easily applied to many of the laboratory shock tubes. Further, replication of shock profile (magnitude and shape) can be related to field explosions and can be a standard in comparing results across different laboratories. Forty experiments are carried out by judiciously varying SAPs such as membrane thickness, breech length (66.68–1209.68 mm), measurement location, and type of driver gas (nitrogen, helium). The effects SAPs have on the resulting shock-blast profiles are shown. Also, the shock-blast profiles of a TNT explosion from ConWep software is

  12. A parametric approach to shape field-relevant blast wave profiles in compressed-gas-driven shock tube.

    PubMed

    Sundaramurthy, Aravind; Chandra, Namas

    2014-01-01

    Detonation of a high-explosive produces shock-blast wave, shrapnel, and gaseous products. While direct exposure to blast is a concern near the epicenter, shock-blast can affect subjects, even at farther distances. When a pure shock-blast wave encounters the subject, in the absence of shrapnels, fall, or gaseous products the loading is termed as primary blast loading and is the subject of this paper. The wave profile is characterized by blast overpressure, positive time duration, and impulse and called herein as shock-blast wave parameters (SWPs). These parameters in turn are uniquely determined by the strength of high explosive and the distance of the human subjects from the epicenter. The shape and magnitude of the profile determine the severity of injury to the subjects. As shown in some of our recent works (1-3), the profile not only determines the survival of the subjects (e.g., animals) but also the acute and chronic biomechanical injuries along with the following bio-chemical sequelae. It is extremely important to carefully design and operate the shock tube to produce field-relevant SWPs. Furthermore, it is vital to identify and eliminate the artifacts that are inadvertently introduced in the shock-blast profile that may affect the results. In this work, we examine the relationship between shock tube adjustable parameters (SAPs) and SWPs that can be used to control the blast profile; the results can be easily applied to many of the laboratory shock tubes. Further, replication of shock profile (magnitude and shape) can be related to field explosions and can be a standard in comparing results across different laboratories. Forty experiments are carried out by judiciously varying SAPs such as membrane thickness, breech length (66.68-1209.68 mm), measurement location, and type of driver gas (nitrogen, helium). The effects SAPs have on the resulting shock-blast profiles are shown. Also, the shock-blast profiles of a TNT explosion from ConWep software is compared

  13. Different presentation types of primary Brucella epididimo-orchitis.

    PubMed

    Aydemir, Huseyin; Budak, Gokcen; Budak, Salih; Celik, Orcun; Yalbuzdag, Okan; Keles, Ibrahim

    2015-07-07

    Brucellosis is a zoonotic disease that involved genitourinary system in 2-20% and most commonly cause single sided epididymo-orchitis. In our country Brucella is an endemic disease and causes serious and different diagnosis of acute scrotum and epididymo-orchitis. In this paper six cases of epididymo-orchitis cases which were resistant to classical treatment were discussed according to clinical and laboratory findings. We describe different types of presentation of Brucella epididymo-orchitis with diagnosis and treatment modalities.

  14. The effect of explosive blast loading on human neuroblastoma cells.

    PubMed

    Zander, Nicole E; Piehler, Thuvan; Banton, Rohan; Boggs, Mary

    2016-07-01

    Diagnosis of mild to moderate traumatic brain injury is challenging because brain tissue damage progresses slowly and is not readily detectable by conventional imaging techniques. We have developed a novel in vitro model to study primary blast loading on dissociated neurons using nitroamine explosives such as those used on the battlefield. Human neuroblastoma cells were exposed to single and triple 50-psi explosive blasts and single 100-psi blasts. Changes in membrane permeability and oxidative stress showed a significant increase for the single and triple 100-psi blast conditions compared with single 50-psi blast and controls. Published by Elsevier Inc.

  15. Tailoring the Blast Exposure Conditions in the Shock Tube for Generating Pure, Primary Shock Waves: The End Plate Facilitates Elimination of Secondary Loading of the Specimen.

    PubMed

    Kuriakose, Matthew; Skotak, Maciej; Misistia, Anthony; Kahali, Sudeepto; Sundaramurthy, Aravind; Chandra, Namas

    2016-01-01

    The end plate mounted at the mouth of the shock tube is a versatile and effective implement to control and mitigate the end effects. We have performed a series of measurements of incident shock wave velocities and overpressures followed by quantification of impulse values (integral of pressure in time domain) for four different end plate configurations (0.625, 2, 4 inches, and an open end). Shock wave characteristics were monitored by high response rate pressure sensors allocated in six positions along the length of 6 meters long 229 mm square cross section shock tube. Tests were performed at three shock wave intensities, which was controlled by varying the Mylar membrane thickness (0.02, 0.04 and 0.06 inch). The end reflector plate installed at the exit of the shock tube allows precise control over the intensity of reflected waves penetrating into the shock tube. At the optimized distance of the tube to end plate gap the secondary waves were entirely eliminated from the test section, which was confirmed by pressure sensor at T4 location. This is pronounced finding for implementation of pure primary blast wave animal model. These data also suggest only deep in the shock tube experimental conditions allow exposure to a single shock wave free of artifacts. Our results provide detailed insight into spatiotemporal dynamics of shock waves with Friedlander waveform generated using helium as a driver gas and propagating in the air inside medium sized tube. Diffusion of driver gas (helium) inside the shock tube was responsible for velocity increase of reflected shock waves. Numerical simulations combined with experimental data suggest the shock wave attenuation mechanism is simply the expansion of the internal pressure. In the absence of any other postulated shock wave decay mechanisms, which were not implemented in the model the agreement between theory and experimental data is excellent.

  16. Tailoring the Blast Exposure Conditions in the Shock Tube for Generating Pure, Primary Shock Waves: The End Plate Facilitates Elimination of Secondary Loading of the Specimen

    PubMed Central

    Misistia, Anthony; Kahali, Sudeepto; Sundaramurthy, Aravind; Chandra, Namas

    2016-01-01

    The end plate mounted at the mouth of the shock tube is a versatile and effective implement to control and mitigate the end effects. We have performed a series of measurements of incident shock wave velocities and overpressures followed by quantification of impulse values (integral of pressure in time domain) for four different end plate configurations (0.625, 2, 4 inches, and an open end). Shock wave characteristics were monitored by high response rate pressure sensors allocated in six positions along the length of 6 meters long 229 mm square cross section shock tube. Tests were performed at three shock wave intensities, which was controlled by varying the Mylar membrane thickness (0.02, 0.04 and 0.06 inch). The end reflector plate installed at the exit of the shock tube allows precise control over the intensity of reflected waves penetrating into the shock tube. At the optimized distance of the tube to end plate gap the secondary waves were entirely eliminated from the test section, which was confirmed by pressure sensor at T4 location. This is pronounced finding for implementation of pure primary blast wave animal model. These data also suggest only deep in the shock tube experimental conditions allow exposure to a single shock wave free of artifacts. Our results provide detailed insight into spatiotemporal dynamics of shock waves with Friedlander waveform generated using helium as a driver gas and propagating in the air inside medium sized tube. Diffusion of driver gas (helium) inside the shock tube was responsible for velocity increase of reflected shock waves. Numerical simulations combined with experimental data suggest the shock wave attenuation mechanism is simply the expansion of the internal pressure. In the absence of any other postulated shock wave decay mechanisms, which were not implemented in the model the agreement between theory and experimental data is excellent. PMID:27603017

  17. Primary prevention of type-2 diabetes in developing countries.

    PubMed

    Dagogo-Jack, Samuel

    2006-03-01

    Although diabetes is now a worldwide epidemic, the rate of increase in its prevalence in developing countries is alarming. By the year 2025, more than three-quarters of all persons with diabetes will reside in developing countries. India and China are leading this surge in diabetes, and sub-Saharan Africa is currently at a lower prevalence rate. However, the estimated increase is substantial among African descendants in the Americas, West Indies and throughout the diaspora. There are compelling reasons why aggressive efforts must be directed toward primary prevention of diabetes in developing countries. Once diabetes develops, the cost of caring for patients is prohibitive. Poorly managed diabetes leads to several complications (e.g., end-stage renal failure, blindness, amputation and heart disease) that many developing countries are ill equipped to tackle. In landmark trials, lifestyle modification approaches are more efficacious than expensive medications in the prevention of diabetes. This is fortunate because lifestyle modification can be implemented locally, whereas medications often need to be imported at high cost. The first task is the education of policymakers on the urgent need for timely action to prevent the looming epidemic of diabetes. Once governments become convinced of its critical value, the translation of diabetes prevention through dietary modification and increased physical activity would require careful planning, extensive piloting and creativity in the allocation of scant resources. External support, foreign aid, debt forgiveness and other forms of creative financing will almost certainly be needed to implement widespread diabetes prevention programs in developing countries.

  18. A Novel Closed-Head Model of Mild Traumatic Brain Injury Using Focal Primary Overpressure Blast to the Cranium in Mice

    PubMed Central

    Guley, Natalie H.; Rogers, Joshua T.; Del Mar, Nobel A.; Deng, Yunping; Islam, Rafiqul M.; D'Surney, Lauren; Ferrell, Jessica; Deng, Bowei; Hines-Beard, Jessica; Bu, Wei; Ren, Huiling; Elberger, Andrea J.; Marchetta, Jeffrey G.; Rex, Tonia S.; Honig, Marcia G.

    2016-01-01

    Abstract Mild traumatic brain injury (TBI) from focal head impact is the most common form of TBI in humans. Animal models, however, typically use direct impact to the exposed dura or skull, or blast to the entire head. We present a detailed characterization of a novel overpressure blast system to create focal closed-head mild TBI in mice. A high-pressure air pulse limited to a 7.5 mm diameter area on the left side of the head overlying the forebrain is delivered to anesthetized mice. The mouse eyes and ears are shielded, and its head and body are cushioned to minimize movement. This approach creates mild TBI by a pressure wave that acts on the brain, with minimal accompanying head acceleration-deceleration. A single 20-psi blast yields no functional deficits or brain injury, while a single 25–40 psi blast yields only slight motor deficits and brain damage. By contrast, a single 50–60 psi blast produces significant visual, motor, and neuropsychiatric impairments and axonal damage and microglial activation in major fiber tracts, but no contusive brain injury. This model thus reproduces the widespread axonal injury and functional impairments characteristic of closed-head mild TBI, without the complications of systemic or ocular blast effects or head acceleration that typically occur in other blast or impact models of closed-skull mild TBI. Accordingly, our model provides a simple way to examine the biomechanics, pathophysiology, and functional deficits that result from TBI and can serve as a reliable platform for testing therapies that reduce brain pathology and deficits. PMID:26414413

  19. A Novel Closed-Head Model of Mild Traumatic Brain Injury Using Focal Primary Overpressure Blast to the Cranium in Mice.

    PubMed

    Guley, Natalie H; Rogers, Joshua T; Del Mar, Nobel A; Deng, Yunping; Islam, Rafiqul M; D'Surney, Lauren; Ferrell, Jessica; Deng, Bowei; Hines-Beard, Jessica; Bu, Wei; Ren, Huiling; Elberger, Andrea J; Marchetta, Jeffrey G; Rex, Tonia S; Honig, Marcia G; Reiner, Anton

    2016-02-15

    Mild traumatic brain injury (TBI) from focal head impact is the most common form of TBI in humans. Animal models, however, typically use direct impact to the exposed dura or skull, or blast to the entire head. We present a detailed characterization of a novel overpressure blast system to create focal closed-head mild TBI in mice. A high-pressure air pulse limited to a 7.5 mm diameter area on the left side of the head overlying the forebrain is delivered to anesthetized mice. The mouse eyes and ears are shielded, and its head and body are cushioned to minimize movement. This approach creates mild TBI by a pressure wave that acts on the brain, with minimal accompanying head acceleration-deceleration. A single 20-psi blast yields no functional deficits or brain injury, while a single 25-40 psi blast yields only slight motor deficits and brain damage. By contrast, a single 50-60 psi blast produces significant visual, motor, and neuropsychiatric impairments and axonal damage and microglial activation in major fiber tracts, but no contusive brain injury. This model thus reproduces the widespread axonal injury and functional impairments characteristic of closed-head mild TBI, without the complications of systemic or ocular blast effects or head acceleration that typically occur in other blast or impact models of closed-skull mild TBI. Accordingly, our model provides a simple way to examine the biomechanics, pathophysiology, and functional deficits that result from TBI and can serve as a reliable platform for testing therapies that reduce brain pathology and deficits.

  20. Blast Injuries: From Improvised Explosive Device Blasts to the Boston Marathon Bombing.

    PubMed

    Singh, Ajay K; Ditkofsky, Noah G; York, John D; Abujudeh, Hani H; Avery, Laura A; Brunner, John F; Sodickson, Aaron D; Lev, Michael H

    2016-01-01

    Although most trauma centers have experience with the imaging and management of gunshot wounds, in most regions blast wounds such as the ones encountered in terrorist attacks with the use of improvised explosive devices (IEDs) are infrequently encountered outside the battlefield. As global terrorism becomes a greater concern, it is important that radiologists, particularly those working in urban trauma centers, be aware of the mechanisms of injury and the spectrum of primary, secondary, tertiary, and quaternary blast injury patterns. Primary blast injuries are caused by barotrauma from the initial increased pressure of the explosive detonation and the rarefaction of the atmosphere immediately afterward. Secondary blast injuries are caused by debris carried by the blast wind and most often result in penetrating trauma from small shrapnel. Tertiary blast injuries are caused by the physical displacement of the victim and the wide variety of blunt or penetrating trauma sustained as a result of the patient impacting immovable objects such as surrounding cars, walls, or fences. Quaternary blast injuries include all other injuries, such as burns, crush injuries, and inhalational injuries. Radiography is considered the initial imaging modality for assessment of shrapnel and fractures. Computed tomography is the optimal test to assess penetrating chest, abdominal, and head trauma. The mechanism of blast injuries and the imaging experience of the victims of the Boston Marathon bombing are detailed, as well as musculoskeletal, neurologic, gastrointestinal, and pulmonary injury patterns from blast injuries. ©RSNA, 2016.

  1. Evaluation of Plastic Media Blasting Equipment

    DTIC Science & Technology

    1987-04-01

    Class II, Division II , NEMA Type 9 enclosures, unless the operating area requires a more stringent electrical classification. H. Use of thln-walled, wire...blasting equipment when the doors are open. Electrical equipment located outside of the blasting enclosure should be housed in Class II, Division II , NEMA

  2. Primary types of Chinese longhorned woodboring beetles (Coleoptera: Cerambycidae: and Disteniidae) of the Smithsonian Institution

    USDA-ARS?s Scientific Manuscript database

    The primary types of Chinese (mainland China, Taiwan, and Tibet) longhorned woodboring beetles (Coleoptera: Cerambycidae, Disteniidae) of the Smithsonian Institution are catalogued and figured, current through 2012. Data on the original combination, current name, current tribal classification, and ...

  3. Primary types of longhorned woodboring beetles (Coleoptera: Cerambycidae and Disteniidae) of the Smithsonian Institution

    USDA-ARS?s Scientific Manuscript database

    The primary types of longhorned woodboring beetles (Coleoptera: Cerambycidae, Disteniidae) of the National Museum of Natural History (Smithsonian Institution) are catalogued and figured, current through 2012 (but also including some 2013 holotypes). Data on the original combination, current combina...

  4. Primary types of Chinese longhorned woodboring beetles (Coleoptera: Cerambycidae: and Disteniidae) of the Smithsonian Institution

    USDA-ARS?s Scientific Manuscript database

    The primary types of Chinese (mainland China, Taiwan, and Tibet) longhorned woodboring beetles (Coleoptera: Cerambycidae, Disteniidae) of the Smithsonian Institution are catalogued and figured, current through 2012. Data on the original combination, current name, current tribal classification, and ...

  5. In-Vitro Approaches for Studying Blast-Induced Traumatic Brain Injury

    PubMed Central

    Chen, Yung Chia; Smith, Douglas H.

    2009-01-01

    Abstract Traumatic brain injury caused by explosive or blast events is currently divided into four phases: primary, secondary, tertiary, and quaternary blast injury. These phases of blast-induced traumatic brain injury (bTBI) are biomechanically distinct, and can be modeled in both in-vivo and in-vitro systems. The purpose of this review is to consider the mechanical phases of bTBI, how these phases are reproduced with in-vitro models, and to review findings from these models to assess how each phase of bTBI can be examined in more detail. Highlighted are some important gaps in the literature that may be addressed in the future to better identify the exact contributing mechanisms for bTBI. These in-vitro models, viewed in combination with in-vivo models and clinical studies, can be used to assess both the mechanisms and possible treatments for this type of trauma. PMID:19397424

  6. Application of silver sulfadiazine cream with early surgical intervention in patients suffering from combined burn-blast injury facial tattoos.

    PubMed

    Ebrahimi, Ali; Kalantar Motamedi, Mohammad Hosein

    2012-01-01

    Severe combined burn-blast injury is a great challenge to surgical teams due to its high mortality. It also results in unsightly traumatic tattoos. The aims of these case reports were to clarify the clinical characteristic of the dynamite explosion burn-blast facial injuries and discuss appropriate management of these patients. We report two patients suffering from facial burn-blast injury following dynamite explosion in which after primary stabilization, silver sulfadiazine cream was applied to the wounds and 12 hours later the wounds were cleaned under general anesthesia with vigorous saline solution irrigation and brushing. The foreign particles were meticulously removed from wounds and simultaneous repairing of defects was done with nylon 6-0 sutures. We conclude application of silver sulfadiazine cream on facial burn-blast injury tattoos several hours before surgical removal of particles is highly efficacious in facilitating particle removal and attaining a good result following surgical intervention, and primary repair. Treatment of combined burn-blast tattoos is different from other types of tattoos not associated with burns. Debridement and removal of foreign particles under general anesthesia from skin immediately and primary reconstruction of wounds is essential. We recommend application of the topical agent silver sulfadiazine to wounds about 12 hours before surgical intervention.

  7. Application of Silver Sulfadiazine Cream With Early Surgical Intervention in Patients Suffering From Combined Burn-Blast Injury Facial Tattoos

    PubMed Central

    Ebrahimi, Ali; Kalantar Motamedi, Mohammad Hosein

    2012-01-01

    Severe combined burn-blast injury is a great challenge to surgical teams due to its high mortality. It also results in unsightly traumatic tattoos. The aims of these case reports were to clarify the clinical characteristic of the dynamite explosion burn-blast facial injuries and discuss appropriate management of these patients. We report two patients suffering from facial burn-blast injury following dynamite explosion in which after primary stabilization, silver sulfadiazine cream was applied to the wounds and 12 hours later the wounds were cleaned under general anesthesia with vigorous saline solution irrigation and brushing. The foreign particles were meticulously removed from wounds and simultaneous repairing of defects was done with nylon 6-0 sutures. We conclude application of silver sulfadiazine cream on facial burn-blast injury tattoos several hours before surgical removal of particles is highly efficacious in facilitating particle removal and attaining a good result following surgical intervention, and primary repair. Treatment of combined burn-blast tattoos is different from other types of tattoos not associated with burns. Debridement and removal of foreign particles under general anesthesia from skin immediately and primary reconstruction of wounds is essential. We recommend application of the topical agent silver sulfadiazine to wounds about 12 hours before surgical intervention. PMID:24829894

  8. Acute death of astrocytes in blast-exposed rat organotypic hippocampal slice cultures

    PubMed Central

    Miller, Anna P.; Shah, Alok S.; Aperi, Brandy V.; Kurpad, Shekar N.; Stemper, Brian D.; Glavaski-Joksimovic, Aleksandra

    2017-01-01

    Blast traumatic brain injury (bTBI) affects civilians, soldiers, and veterans worldwide and presents significant health concerns. The mechanisms of neurodegeneration following bTBI remain elusive and current therapies are largely ineffective. It is important to better characterize blast-evoked cellular changes and underlying mechanisms in order to develop more effective therapies. In the present study, our group utilized rat organotypic hippocampal slice cultures (OHCs) as an in vitro system to model bTBI. OHCs were exposed to either 138 ± 22 kPa (low) or 273 ± 23 kPa (high) overpressures using an open-ended helium-driven shock tube, or were assigned to sham control group. At 2 hours (h) following injury, we have characterized the astrocytic response to a blast overpressure. Immunostaining against the astrocytic marker glial fibrillary acidic protein (GFAP) revealed acute shearing and morphological changes in astrocytes, including clasmatodendrosis. Moreover, overlap of GFAP immunostaining and propidium iodide (PI) indicated astrocytic death. Quantification of the number of dead astrocytes per counting area in the hippocampal cornu Ammonis 1 region (CA1), demonstrated a significant increase in dead astrocytes in the low- and high-blast, compared to sham control OHCs. However only a small number of GFAP-expressing astrocytes were co-labeled with the apoptotic marker Annexin V, suggesting necrosis as the primary type of cell death in the acute phase following blast exposure. Moreover, western blot analyses revealed calpain mediated breakdown of GFAP. The dextran exclusion additionally indicated membrane disruption as a potential mechanism of acute astrocytic death. Furthermore, although blast exposure did not evoke significant changes in glutamate transporter 1 (GLT-1) expression, loss of GLT-1-expressing astrocytes suggests dysregulation of glutamate uptake following injury. Our data illustrate the profound effect of blast overpressure on astrocytes in OHCs at 2 h

  9. Acute death of astrocytes in blast-exposed rat organotypic hippocampal slice cultures.

    PubMed

    Miller, Anna P; Shah, Alok S; Aperi, Brandy V; Kurpad, Shekar N; Stemper, Brian D; Glavaski-Joksimovic, Aleksandra

    2017-01-01

    Blast traumatic brain injury (bTBI) affects civilians, soldiers, and veterans worldwide and presents significant health concerns. The mechanisms of neurodegeneration following bTBI remain elusive and current therapies are largely ineffective. It is important to better characterize blast-evoked cellular changes and underlying mechanisms in order to develop more effective therapies. In the present study, our group utilized rat organotypic hippocampal slice cultures (OHCs) as an in vitro system to model bTBI. OHCs were exposed to either 138 ± 22 kPa (low) or 273 ± 23 kPa (high) overpressures using an open-ended helium-driven shock tube, or were assigned to sham control group. At 2 hours (h) following injury, we have characterized the astrocytic response to a blast overpressure. Immunostaining against the astrocytic marker glial fibrillary acidic protein (GFAP) revealed acute shearing and morphological changes in astrocytes, including clasmatodendrosis. Moreover, overlap of GFAP immunostaining and propidium iodide (PI) indicated astrocytic death. Quantification of the number of dead astrocytes per counting area in the hippocampal cornu Ammonis 1 region (CA1), demonstrated a significant increase in dead astrocytes in the low- and high-blast, compared to sham control OHCs. However only a small number of GFAP-expressing astrocytes were co-labeled with the apoptotic marker Annexin V, suggesting necrosis as the primary type of cell death in the acute phase following blast exposure. Moreover, western blot analyses revealed calpain mediated breakdown of GFAP. The dextran exclusion additionally indicated membrane disruption as a potential mechanism of acute astrocytic death. Furthermore, although blast exposure did not evoke significant changes in glutamate transporter 1 (GLT-1) expression, loss of GLT-1-expressing astrocytes suggests dysregulation of glutamate uptake following injury. Our data illustrate the profound effect of blast overpressure on astrocytes in OHCs at 2 h

  10. Lasting retinal injury in a mouse model of blast-induced trauma

    USDA-ARS?s Scientific Manuscript database

    Traumatic brain injury (TBI) due to blast exposure is currently the most prevalent of war injuries. While secondary ocular blast injuries due to flying debris are more common, primary ocular blast exposure has been reported among survivors of explosions, but with limited understanding of the resulti...

  11. Blast Injury

    PubMed Central

    de Candole, C. A.

    1967-01-01

    The shock wave generated by an explosion (“blast wave”) may cause injury in any or all of the following: (1) direct impact on the tissues of variations in environmental pressure; (2) flying glass and other debris set in motion by it; (3) propulsion of the body. Injuries in the first category affect gas-containing organs (ears, lungs and intestines), and acute death is attributed to air forced into the coronary vessels via damaged pulmonary alveoli. It is estimated that overpressure sufficient to cause lung injury may occur up to five miles from a 20-megaton nuclear explosion. The greatest single hazard from blast is, however, flying glass, and serious wounding from this cause is possible up to 12 miles from an explosion of this magnitude. PMID:6015742

  12. Automated Blast Cleaner

    NASA Technical Reports Server (NTRS)

    Pickett, Isaiah R.; Yulfo, Alyce R.

    1992-01-01

    Automatic grit-blasting machine removes melted-layer residue from electrical-discharge-machined surfaces of turbine blades. Automatic control system of machine provides steady flow of grit and maintains blast nozzles at proper distance and in correct orientation perpendicular to surface being blasted, regardless of contour. Eliminates localized excessive blasting and consequent excessive removal of underlying material, blasting of adjacent surfaces, and missed areas.

  13. Calorimetric Analysis to Infer Primary Circuit Flow in Integral and Pool-Type Reactors

    NASA Astrophysics Data System (ADS)

    Coble, Jamie; Tarver, Ryan; Hines, J. Wesley

    2017-02-01

    Primary system flow rate is a key parameter for monitoring and controlling thermal power in a nuclear power plant. The existing fleet of large light water reactors uses direct measurements of primary flow rate with the application of venturi meters, orifice plates, and magnetic flowmeters in primary loop piping. Integral light water reactors and pool-type advanced reactor designs, however, have largely eliminated primary loop piping to improve the inherent safety characteristics of these reactors. Furthermore, longer operating cycles between maintenance opportunities (typically 4 to 40 years) limit the applicability of these direct measurement methods over the operating period. Methods to infer the primary flow rate based on other, easily measured parameters are needed to ensure the operability of integral and pool-type reactors. Calorimetric analysis across the intermediate heat exchanger was investigated for real-time inference of primary flow rate. Heat balance equations were applied to an experimental forced flow loop to evaluate the efficacy of this approach. When appropriate time delays and heat losses are accounted for, the primary flow rate was inferred with accuracy and 95% prediction variance of 1.57 and 4.80 % mean value, respectively.

  14. Membrane characteristics for biological blast overpressure testing using blast simulators.

    PubMed

    Alphonse, Vanessa D; Siva Sai Sujith Sajja, Venkata; Kemper, Andrew R; Rizel, Dave V; Duma, Stefan M; VandeVord, Pamela J

    2014-01-01

    Blast simulators often use passive-rupture membranes to generate shock waves similar to free-field blasts. The purpose of this study was to compare rupture patterns and pressure traces of three distinct membrane materials for biological and biomechanical blast studies. An Advanced Blast Simulator (ABS) located at the Center for Injury Biomechanics at Virginia Tech was used to test membrane characteristics. Acetate, Mylar, and aluminum sheets with different thicknesses were used to obtain pressures between 70–210 kPa. Static pressure was measured inside the tube at the test section using piezoelectric pressure sensors. Peak overpressure, positive duration, and positive impulse were calculated for each test. Rupture patterns and characteristic pressure traces were unique to each membrane type and thickness. Shock wave speed ranged between 1.2-1.8 Mach for static overpressures of 70–210 kPa. Acetate membranes fragmented sending pieces down the tube, but produced ideal (Friedlander) pressure traces. Mylar membranes bulged without fragmenting, but produced less-than-ideal pressure traces. Aluminum membranes did not fragment and produced ideal pressure traces. However, the cost of manufacturing and characterizing aluminum membranes should be considered during membrane selection. This study illustrates the advantages and disadvantages of using Mylar, acetate, and aluminum for passive rupture membranes for blast simulators.

  15. Initial manifestation of primary hyperoxaluria type I in adults-- recognition, diagnosis, and management.

    PubMed Central

    Kuiper, J J

    1996-01-01

    Primary hyperoxaluria type I may initially manifest as urolithiasis, renal insufficiency, or symptoms of systemic oxalosis. This hereditary disorder was fatal until effective therapies evolved during the past two decades. Difficulty in recognizing and diagnosing this disorder in adults is illustrated in a report of a patient eventually restored to good health by high-flux dialysis and combined renal and hepatic transplantation. I explore the molecular processes of the genetic defect and discuss clinical indicators of primary hyperoxaluria type I, manifestations of oxalosis, the pathogenesis of chronic oxalate nephropathy, and the diagnosis and management of this disease. Images Figure 2. Figure 3. Figure 4. PMID:8779202

  16. 30 CFR 816.68 - Use of explosives: Records of blasting operations.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... § 816.67(e). (e) Weather conditions, including those which may cause possible adverse blasting effects. (f) Type of material blasted. (g) Sketches of the blast pattern including number of holes, burden, spacing, decks, and delay pattern. (h) Diameter and depth of holes. (i) Types of explosives used....

  17. 30 CFR 817.68 - Use of explosives: Records of blasting operations.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... § 817.67 (e). (e) Weather conditions, including those which may cause possible adverse blasting effects. (f) Type of material blasted. (g) Sketches of the blast pattern including number of holes, burden, spacing, decks, and delay pattern. (h) Diameter and depth of holes. (i) Types of explosives used....

  18. 30 CFR 817.68 - Use of explosives: Records of blasting operations.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... § 817.67 (e). (e) Weather conditions, including those which may cause possible adverse blasting effects. (f) Type of material blasted. (g) Sketches of the blast pattern including number of holes, burden, spacing, decks, and delay pattern. (h) Diameter and depth of holes. (i) Types of explosives used....

  19. 30 CFR 816.68 - Use of explosives: Records of blasting operations.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... § 816.67(e). (e) Weather conditions, including those which may cause possible adverse blasting effects. (f) Type of material blasted. (g) Sketches of the blast pattern including number of holes, burden, spacing, decks, and delay pattern. (h) Diameter and depth of holes. (i) Types of explosives used....

  20. 30 CFR 817.68 - Use of explosives: Records of blasting operations.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... § 817.67 (e). (e) Weather conditions, including those which may cause possible adverse blasting effects. (f) Type of material blasted. (g) Sketches of the blast pattern including number of holes, burden, spacing, decks, and delay pattern. (h) Diameter and depth of holes. (i) Types of explosives used....

  1. 30 CFR 816.68 - Use of explosives: Records of blasting operations.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... § 816.67(e). (e) Weather conditions, including those which may cause possible adverse blasting effects. (f) Type of material blasted. (g) Sketches of the blast pattern including number of holes, burden, spacing, decks, and delay pattern. (h) Diameter and depth of holes. (i) Types of explosives used....

  2. 14 CFR 21.24 - Issuance of type certificate: primary category aircraft.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... aircraft in the primary category if— (1) The aircraft— (i) Is unpowered; is an airplane powered by a single... category aircraft. 21.24 Section 21.24 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT CERTIFICATION PROCEDURES FOR PRODUCTS AND PARTS Type Certificates § 21.24 Issuance...

  3. 14 CFR 21.24 - Issuance of type certificate: primary category aircraft.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... aircraft in the primary category if— (1) The aircraft— (i) Is unpowered; is an airplane powered by a single... category aircraft. 21.24 Section 21.24 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT CERTIFICATION PROCEDURES FOR PRODUCTS AND PARTS Type Certificates § 21.24 Issuance...

  4. Class Size Effects on the Number and Types of Student-Teacher Interactions in Primary Classrooms

    ERIC Educational Resources Information Center

    Folmer-Annevelink, Elvira; Doolaard, Simone; Mascareno, Mayra; Bosker, Roel J.

    2010-01-01

    This paper addresses the relationship between class size and student-teacher interactions as an explanation for effects of class size on achievement. Observations were conducted in kindergarten and Grade 1 classes from 46 Dutch primary schools in order to address the effect of class size on the amount and type of student-teacher interactions. The…

  5. Class Size Effects on the Number and Types of Student-Teacher Interactions in Primary Classrooms

    ERIC Educational Resources Information Center

    Folmer-Annevelink, Elvira; Doolaard, Simone; Mascareno, Mayra; Bosker, Roel J.

    2010-01-01

    This paper addresses the relationship between class size and student-teacher interactions as an explanation for effects of class size on achievement. Observations were conducted in kindergarten and Grade 1 classes from 46 Dutch primary schools in order to address the effect of class size on the amount and type of student-teacher interactions. The…

  6. Type of health insurance and the quality of primary care experience.

    PubMed Central

    Shi, L

    2000-01-01

    OBJECTIVES: This study examined the association between type of health insurance coverage and quality of primary care as measured by its distinguishing attributes--first contact, longitudinality, comprehensiveness, and coordination. METHODS: The household component of the 1996 Medical Expenditure Panel Survey was used for this study. The analysis primarily focused on subjects aged younger than 65 years who identified a usual source of care. Logistic regressions were used to examine the independent effects of insurance status on primary care attributes while individual sociodemographic characteristics were controlled for. RESULTS: The experience of primary care varies according to insurance status. The insured are able to obtain better primary care than the uninsured, and the privately insured are able to obtain better primary care than the publicly insured. Those insured through fee-for-service coverage experience better longitudinal care and less of a barrier to access than those insured through health maintenance organizations (HMOs). CONCLUSIONS: While expanding insurance coverage is important for establishing access to care, efforts are needed to enhance the quality of primary health care, particularly for the publicly insured. Policymakers should closely monitor the quality of primary care provided by HMOs. PMID:11111255

  7. Primary signet ring cell carcinoma of gall bladder: report of an extremely rare histological type of primary gall bladder carcinoma.

    PubMed

    Ahmad, Zubair; Qureshi, Asim

    2010-09-07

    Signet ring cell carcinoma is an extremely rare type of gall bladder carcinoma composed overwhelmingly (90%) of signet ring cells. It is necessary to exclude a gastric or colonic signet ring cell carcinoma secondarily involving the gall bladder. The primary aim of this case report is to describe the histopathological aspects of this tumour. Primary signet ring cell carcinoma of gall bladder shows dysplastic surface gall bladder epithelium with infiltration of gall bladder wall. It is also necessary to exclude benign signet ring change, which sometimes occurs in the gall bladder. However, it is always confined to the mucosa and does not infiltrate the wall. This case showed grossly diffuse thickening of the gall bladder wall and dysplastic surface epithelium of the gall bladder on histology, with sheets of signet ring cells infiltrating full thickness of the wall. It is also necessary to exclude benign signet ring cell change, which sometimes occurs in the gall bladder. However it is always confined to the mucosa and does not infiltrate the wall.

  8. Reactivity of alveolar epithelial cells in primary culture with type I cell monoclonal antibodies.

    PubMed

    Danto, S I; Zabski, S M; Crandall, E D

    1992-03-01

    An understanding of the process of alveolar epithelial cell growth and differentiation requires the ability to trace and analyze the phenotypic transitions that the cells undergo. This analysis demands specific phenotypic probes to type II and, especially, type I pneumocytes. To this end, monoclonal antibodies have been generated to type I alveolar epithelial cells using an approach designed to enhance production of lung-specific clones from a crude lung membrane preparation. The monoclonal antibodies were screened by a combination of enzyme-linked immunosorbent assay and immunohistochemical techniques, with the determination of type I cell specificity resting primarily on immunoelectron microscopic localization. Two of these new markers of the type I pneumocyte phenotype (II F1 and VIII B2) were used to analyze primary cultures of type II cells growing on standard tissue culture plastic and on a variety of substrata reported to affect the morphology of these cells in culture. On tissue culture plastic, the antibodies fail to react with early (days 1 to 3) type II cell cultures. The cells become progressively more reactive with time in culture to a plateau of approximately 6 times background by day 8, with a maximum rate of increase between days 3 and 5. This finding is consistent with the hypothesis that type II cells in primary culture undergo at least partial differentiation into type I cells. Type II cells grown on laminin, which reportedly delays the loss of type II cell appearance, and on fibronectin, which has been reported to facilitate cell spreading and loss of type II cell features, develop the type I cell markers during cultivation in vitro with kinetics similar to those on uncoated tissue culture plastic. Cells on type I collagen and on tissue culture-treated Nuclepore filters, which have been reported to support monolayers with type I cell-like morphology, also increase their expression of the II F1 and VIII B2 epitopes around days 3 to 5. Taken

  9. Dry media blasting with wheat starch

    NASA Astrophysics Data System (ADS)

    Foster, Terry

    1995-04-01

    The brand name TECHNOSTRIP covers several types of installations and facilities. These were developed mainly to meet the requirements of customers in the aeronautic field. The range of products includes: complete self-supporting and semi-automated system for aircraft stripping; large-size blasting booth for semi-automatic stripping; manual blasting booth; and sealed and portable manual stripping head. Wheat starch media was developed for particle blasting stripping and is used in TECHNOSTRIP. This paper reviews its origins and use as well as use of automated facilities, reliability, effects on materials, effects on environment, and utilization examples.

  10. secureBLAST.

    PubMed

    Wiezer, Arnim; Merkl, Rainer

    2003-01-01

    secureBLAST supplements NCBI wwwblast with features necessary to control in an easy manageable way usage of BLAST data sets and their update. The concept we implemented allows to offer on a single BLAST server several data sets with individually configurable access rights. Security is provided by user authentication and encryption of the http traffic via SSL. By using secureBLAST, the administration of users and databases can be done via a web interface. Therefore, secureBLAST is valuable for institutions that have to restrict access to their datasets or just want to administer BLAST servers via a web interface.

  11. Porcine Head Response to Blast

    PubMed Central

    Shridharani, Jay K.; Wood, Garrett W.; Panzer, Matthew B.; Capehart, Bruce P.; Nyein, Michelle K.; Radovitzky, Raul A.; Bass, Cameron R. ‘Dale’

    2012-01-01

    Recent studies have shown an increase in the frequency of traumatic brain injuries related to blast exposure. However, the mechanisms that cause blast neurotrauma are unknown. Blast neurotrauma research using computational models has been one method to elucidate that response of the brain in blast, and to identify possible mechanical correlates of injury. However, model validation against experimental data is required to ensure that the model output is representative of in vivo biomechanical response. This study exposes porcine subjects to primary blast overpressures generated using a compressed-gas shock tube. Shock tube blasts were directed to the unprotected head of each animal while the lungs and thorax were protected using ballistic protective vests similar to those employed in theater. The test conditions ranged from 110 to 740 kPa peak incident overpressure with scaled durations from 1.3 to 6.9 ms and correspond approximately with a 50% injury risk for brain bleeding and apnea in a ferret model scaled to porcine exposure. Instrumentation was placed on the porcine head to measure bulk acceleration, pressure at the surface of the head, and pressure inside the cranial cavity. Immediately after the blast, 5 of the 20 animals tested were apneic. Three subjects recovered without intervention within 30 s and the remaining two recovered within 8 min following respiratory assistance and administration of the respiratory stimulant doxapram. Gross examination of the brain revealed no indication of bleeding. Intracranial pressures ranged from 80 to 390 kPa as a result of the blast and were notably lower than the shock tube reflected pressures of 300–2830 kPa, indicating pressure attenuation by the skull up to a factor of 8.4. Peak head accelerations were measured from 385 to 3845 G’s and were well correlated with peak incident overpressure (R2 = 0.90). One SD corridors for the surface pressure, intracranial pressure (ICP), and head acceleration are

  12. Adenylate Cyclase Type III Is Not a Ubiquitous Marker for All Primary Cilia during Development

    PubMed Central

    Antal, Maria Cristina; Bénardais, Karelle; Samama, Brigitte; Auger, Cyril; Schini-Kerth, Valérie; Ghandour, Said; Boehm, Nelly

    2017-01-01

    Adenylate cyclase type III (AC3) is localized in plasma membrane of neuronal primary cilium and can be used as a marker of this cilium. AC3 has also been detected in some other primary cilia such as those of fibroblasts, synoviocytes or astrocytes. Despite the presence of a cilium in almost all cell types, we show that AC3 is not a common marker of all primary cilia of different human and mouse tissues during development. In peripheral organs, AC3 is present mainly in primary cilia in cells of the mesenchymal lineage (fibroblasts, chondroblasts, osteoblasts-osteocytes, odontoblasts, muscle cells and endothelial cells). In epithelia, the apical cilium of renal and pancreatic tubules and of ductal plate in liver is AC3-negative whereas the cilium of basal cells of stratified epithelia is AC3-positive. Using fibroblasts cell culture, we show that AC3 appears at the plasma membrane of the primary cilium as soon as this organelle develops. The functional significance of AC3 localization at the cilium membrane in some cells but not others has to be investigated in relationship with cell physiology and expression at the cilium plasma membrane of specific upstream receptors. PMID:28122017

  13. Adenylate Cyclase Type III Is Not a Ubiquitous Marker for All Primary Cilia during Development.

    PubMed

    Antal, Maria Cristina; Bénardais, Karelle; Samama, Brigitte; Auger, Cyril; Schini-Kerth, Valérie; Ghandour, Said; Boehm, Nelly

    2017-01-01

    Adenylate cyclase type III (AC3) is localized in plasma membrane of neuronal primary cilium and can be used as a marker of this cilium. AC3 has also been detected in some other primary cilia such as those of fibroblasts, synoviocytes or astrocytes. Despite the presence of a cilium in almost all cell types, we show that AC3 is not a common marker of all primary cilia of different human and mouse tissues during development. In peripheral organs, AC3 is present mainly in primary cilia in cells of the mesenchymal lineage (fibroblasts, chondroblasts, osteoblasts-osteocytes, odontoblasts, muscle cells and endothelial cells). In epithelia, the apical cilium of renal and pancreatic tubules and of ductal plate in liver is AC3-negative whereas the cilium of basal cells of stratified epithelia is AC3-positive. Using fibroblasts cell culture, we show that AC3 appears at the plasma membrane of the primary cilium as soon as this organelle develops. The functional significance of AC3 localization at the cilium membrane in some cells but not others has to be investigated in relationship with cell physiology and expression at the cilium plasma membrane of specific upstream receptors.

  14. Impaired primary immune response in type-1 diabetes: results from a controlled vaccination study.

    PubMed

    Eibl, Nicole; Spatz, Martin; Fischer, Gottfried F; Mayr, Wolfgang R; Samstag, Aysen; Wolf, Hermann M; Schernthaner, Guntram; Eibl, Martha M

    2002-06-01

    Patients with diabetes have an increased risk for infections, but information on their adoptive immunity is incomplete and contradictory. Twenty patients with diabetes type-1 and 20 patients with type-2 diabetes were vaccinated with T-cell-dependent primary protein antigens (hepatitis A viral antigen, HAV; diphtheria toxoid) and a T-cell-independent polysaccharide antigen (pneumococcal polysaccharide). In parallel, the proliferative response of CD4+ T-cells to the primary protein antigens keyhole limpet hemocyanin (KLH) and sperm whale myoglobin (SWM) was measured in vitro using monocyte-derived dendritic cells (MDDC) as antigen-presenting cells. Compared to healthy controls, type-1 diabetes patients mounted a significantly impaired primary antibody response to hepatitis A vaccine (median HAV antibody titer after the first vaccination, 53 IU/L in diabetic patients vs 212 IU/L in the controls, P = 0.017) and diphtheria toxoid (median serum antibodies after vaccination, patients, 0.94 IU/ml, controls, 6.38 IU/ml, P = 0.004), while the response to pneumococcal polysaccharide was normal. Type-2 diabetes patients had a comparable metabolic dysregulation but showed a normal antibody response following vaccination, demonstrating that the effect was not due to hyperglycemia. Antigen-induced interferon-gamma and interleukin-13 release was reduced in type-1 diabetes patients, localizing the impairment to the level of antigen-presenting cell-T-cell interaction. In addition, the proliferative response of CD4+ T-cells derived from type-1 diabetes patients to KLH and SWM was significantly reduced (P < or = 0.01). FACS analysis of CD80 (B7.1), CD86 (B7.2), and HLA-DR expression on MDDC could not demonstrate significant differences in the expression of these molecules between type-1 and type-2 diabetes patients and healthy controls. An association of low HAV antibody response with HLA-DR3,4 expression in the patients was shown. Our results indicate that the primary antibody

  15. Histological and Ultrastructure Analysis of Dentin Dysplasia Type I in Primary Teeth: A Case Report.

    PubMed

    Pintor, Andrea; Alexandria, Adilis; Marques, Andrea; Abrahao, Aline; Guedes, Fabio; Primo, Laura

    2015-01-01

    Dentin dysplasia type I (DD-I) is a rare human dentin disorder that may affect both the primary and permanent dentitions. The teeth present crowns with normal morphology but short or absent roots. Pulp chamber obliteration and early exfoliation of primary teeth are also observed. We describe herein the typical and atypical features of DD-I presented by a 6-year-old patient, the diagnostic rationale and assessment emphasizing the histological and scanning electron microscopic analysis and the therapeutic approach. The DD-I diagnosis in patients in the mixed dentition period is challenging, especially when only some teeth are affected.

  16. Primary care physician supply, insurance type, and late-stage cancer diagnosis.

    PubMed

    Plascak, Jesse J; Fisher, James L; Paskett, Electra D

    2015-02-01

    Understanding the joint effects of insurance type and primary care physician density on stage at diagnosis is essential to elucidating the healthcare access and late-stage cancer relationship. To determine if the relationship between primary care physician density and odds of late-stage cancer are modified by insurance type at diagnosis. Case patients were Ohio adults diagnosed between 1996 and 2008 with cancer of one of the following sites: female breast, cervix, colon/rectum, lung/bronchus, melanoma of the skin, oral cavity and pharynx, or prostate (N=376,425). County-level physician density was obtained from the Ohio Department of Health. Multilevel logistic regression models estimated odds ratios of late-stage cancer diagnosis associated with increases in primary care physician density by insurance type. Analyses were conducted in 2014. Decreases in late-stage diagnosis of cancers of the breast, prostate, melanoma of the skin, oral cavity and pharynx, or lung/bronchus associated with increases in primary care physician density were strongest among those with private insurance, whereas those with Medicare (prostate, oral cavity and pharynx, lung/bronchus), Medicaid (lung/bronchus), uninsured (prostate), and other/unknown (prostate, oral cavity and pharynx, lung/bronchus) did not benefit as greatly, or experienced significant increases in late-stage cancer diagnosis (other/unknown [female breast], Medicaid [melanoma of the skin], and uninsured [colon/rectum]). As primary care physician density increases, those with private insurance consistently benefit the most in terms of late-stage cancer diagnosis, whereas those with several other insurance types experience flatter decreases or significantly higher odds of late-stage cancer diagnosis. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  17. Primary Care Physician Supply, Insurance Type, and Late-Stage Cancer Diagnosis

    PubMed Central

    Plascak, Jesse J.; Fisher, James L.; Paskett, Electra D.

    2014-01-01

    Background Understanding the joint effects of insurance type and primary care physician density on stage at diagnosis is essential to elucidating the healthcare access and late-stage cancer relationship. Purpose To determine if the relationship between primary care physician density and odds of late-stage cancer is modified by insurance type at diagnosis. Methods Case patients were Ohio adults, diagnosed between 1996 and 2008 with cancer of one of the following sites: the female breast, cervix, colon/rectum, lung/bronchus, melanoma of the skin, oral cavity and pharynx, or prostate (N=376,425). County-level physician density was from Ohio Department of Health. Multilevel logistic regression models estimated odds ratios of latestage cancer diagnosis associated with increases in primary care physician density by insurance type. Analyses were conducted in 2014. Results Decreases in late-stage diagnosis of cancers of the breast, prostate, melanoma of the skin, oral cavity and pharynx, or lung/bronchus associated with increases in primary care physician density were strongest among those with private insurance, whereas those with Medicare (prostate, oral cavity and pharynx, lung/bronchus), Medicaid (lung/bronchus), uninsured (prostate), and other/unknown (prostate, oral cavity and pharynx, lung/bronchus) did not benefit as greatly or experienced significant increases in late-stage cancer diagnosis (other/unknown [female breast], Medicaid [melanoma of the skin], and uninsured [colon/rectum]). Conclusions As primary care physician density increases, those with private insurance consistently benefit the most, in terms of late-stage cancer diagnosis, whereas those with several other insurance types experience flatter decreases or significantly higher odds of late-stage cancer diagnosis. PMID:25441233

  18. Experimental animal models for studies on the mechanisms of blast-induced neurotrauma.

    PubMed

    Risling, Mårten; Davidsson, Johan

    2012-01-01

    A blast injury is a complex type of physical trauma resulting from the detonation of explosive compounds and has become an important issue due to the use of improvised explosive devices (IED) in current military conflicts. Blast-induced neurotrauma (BINT) is a major concern in contemporary military medicine and includes a variety of injuries that range from mild to lethal. Extreme forces and their complex propagation characterize BINT. Modern body protection and the development of armored military vehicles can be assumed to have changed the outcome of BINT. Primary blast injuries are caused by overpressure waves whereas secondary, tertiary, and quaternary blast injuries can have more varied origins such as the impact of fragments, abnormal movements, or heat. The characteristics of the blast wave can be assumed to be significantly different in open field detonations compared to explosions in a confined space, such an armored vehicle. Important parameters include peak pressure, duration, and shape of the pulse. Reflections from walls and armor can make the prediction of effects in individual cases very complex. Epidemiological data do not contain information of the comparative importance of the different blast mechanisms. It is therefore important to generate data in carefully designed animal models. Such models can be selective reproductions of a primary blast, penetrating injuries from fragments, acceleration movements, or combinations of such mechanisms. It is of crucial importance that the physical parameters of the employed models are well characterized so that the experiments can be reproduced in different laboratory settings. Ideally, pressure recordings should be calibrated by using the same equipment in several laboratories. With carefully designed models and thoroughly evaluated animal data it should be possible to achieve a translation of data between animal and clinical data. Imaging and computer simulation represent a possible link between experiments

  19. Experimental Animal Models for Studies on the Mechanisms of Blast-Induced Neurotrauma

    PubMed Central

    Risling, Mårten; Davidsson, Johan

    2012-01-01

    A blast injury is a complex type of physical trauma resulting from the detonation of explosive compounds and has become an important issue due to the use of improvised explosive devices (IED) in current military conflicts. Blast-induced neurotrauma (BINT) is a major concern in contemporary military medicine and includes a variety of injuries that range from mild to lethal. Extreme forces and their complex propagation characterize BINT. Modern body protection and the development of armored military vehicles can be assumed to have changed the outcome of BINT. Primary blast injuries are caused by overpressure waves whereas secondary, tertiary, and quaternary blast injuries can have more varied origins such as the impact of fragments, abnormal movements, or heat. The characteristics of the blast wave can be assumed to be significantly different in open field detonations compared to explosions in a confined space, such an armored vehicle. Important parameters include peak pressure, duration, and shape of the pulse. Reflections from walls and armor can make the prediction of effects in individual cases very complex. Epidemiological data do not contain information of the comparative importance of the different blast mechanisms. It is therefore important to generate data in carefully designed animal models. Such models can be selective reproductions of a primary blast, penetrating injuries from fragments, acceleration movements, or combinations of such mechanisms. It is of crucial importance that the physical parameters of the employed models are well characterized so that the experiments can be reproduced in different laboratory settings. Ideally, pressure recordings should be calibrated by using the same equipment in several laboratories. With carefully designed models and thoroughly evaluated animal data it should be possible to achieve a translation of data between animal and clinical data. Imaging and computer simulation represent a possible link between experiments

  20. Blast investigation by fast multispectral radiometric analysis

    NASA Astrophysics Data System (ADS)

    Devir, A. D.; Bushlin, Y.; Mendelewicz, I.; Lessin, A. B.; Engel, M.

    2011-06-01

    Knowledge regarding the processes involved in blasts and detonations is required in various applications, e.g. missile interception, blasts of high-explosive materials, final ballistics and IED identification. Blasts release large amount of energy in short time duration. Some part of this energy is released as intense radiation in the optical spectral bands. This paper proposes to measure the blast radiation by a fast multispectral radiometer. The measurement is made, simultaneously, in appropriately chosen spectral bands. These spectral bands provide extensive information on the physical and chemical processes that govern the blast through the time-dependence of the molecular and aerosol contributions to the detonation products. Multi-spectral blast measurements are performed in the visible, SWIR and MWIR spectral bands. Analysis of the cross-correlation between the measured multi-spectral signals gives the time dependence of the temperature, aerosol and gas composition of the blast. Farther analysis of the development of these quantities in time may indicate on the order of the detonation and amount and type of explosive materials. Examples of analysis of measured explosions are presented to demonstrate the power of the suggested fast multispectral radiometric analysis approach.

  1. Effect of biopsy type on outcomes in the treatment of primary cutaneous melanoma.

    PubMed

    Mills, Jane K; White, Ian; Diggs, Brian; Fortino, Jeanine; Vetto, John T

    2013-05-01

    Surgical excision remains the primary and only potentially curative treatment for melanoma. Although current guidelines recommend excisional biopsy as the technique of choice for evaluating lesions suspected of being primary melanomas, other biopsy types are commonly used. We sought to determine the impact of biopsy type (excisional, shave, or punch) on outcomes in melanoma. A prospectively collected, institutional review board-approved database of primary clinically node-negative melanomas (stages cT1-4N0) was reviewed to determine the impact of biopsy type on T-staging accuracy, wide local excision (WLE) area (cm(2)), sentinel lymph node biopsy (SLNB) identification rates and results, tumor recurrence, and patient survival. Seven hundred nine patients were diagnosed by punch biopsy (23%), shave biopsy (34%), and excisional biopsy (43%). Shave biopsy results showed significantly more positive deep margins (P < .001). Both shave and punch biopsy results showed more positive peripheral margins (P < .001) and a higher risk of finding residual tumor (with resulting tumor upstaging) in the WLE (P < .001), compared with excisional biopsy. Punch biopsy resulted in a larger mean WLE area compared with shave and excisional biopsies (P = .030), and this result was sustained on multivariate analysis. SLNB accuracy was 98.5% and was not affected by biopsy type. Similarly, biopsy type did not confer survival advantage or impact tumor recurrence; the finding of residual tumor in the WLE impacted survival on univariate but not multivariate analysis. Both shave and punch biopsies demonstrated a significant risk of finding residual tumor in the WLE, with pathologic upstaging of the WLE. Punch biopsy also led to a larger mean WLE area compared with other biopsy types. However, biopsy type did not impact SLNB accuracy or results, tumor recurrence, or disease-specific survival (DSS). Punch and shave biopsies, when used appropriately, should not be discouraged for the diagnosis of

  2. Oral microbial community typing of caries and pigment in primary dentition.

    PubMed

    Li, Yanhui; Zou, Cheng-Gang; Fu, Yu; Li, Yanhong; Zhou, Qing; Liu, Bo; Zhang, Zhigang; Liu, Juan

    2016-08-05

    Black extrinsic discoloration in primary dentition is a common clinical and aesthetic problem that can co-occur with dental caries, the most common oral diseases in childhood. Although the role of bacteria in the formation of pigment and caries in primary dentition is important, their basic features still remain a further mystery. Using targeted sequencing of the V1-V3 hypervariable regions of bacterial 16S ribosomal RNA (rRNA) genes, we obtained a dataset consisting of 831,381 sequences from 111 saliva samples and 110 supragingival plaque samples from 40 patients with pigment (black extrinsic stain), 20 with caries (obvious decay), and 25 with both pigment and caries and from 26 healthy individuals. We applied a Dirichlet multinomial mixture (DMM)-based community typing approach to investigate oral microbial community types. Our results revealed significant structural segregation of microbial communities, as indicated by the identification of two plaque community types (A and B) and three saliva community types (C-E). We found that the independent occurrence of the two plaque community types, A and B, was potentially associated with our oral diseases of interest. For type A, three co-occurring bacterial genus pairs could separately play a potential role in the formation of pigment (Leptotrichia and Fusobacterium), caries (unclassified Gemellales and Granulicatella), and mixed caries and pigment (Streptococcus and Mogibacterium). For type B, three co-occurring bacterial genera (unclassified Clostridiaceae, Peptostreptococcus, and Clostridium) were related to mixed pigment and caries. Three dominant bacterial genera (Selenomonas, Gemella, and Streptobacillus) were linked to the presence of caries. Our study demonstrates that plaque-associated oral microbial communities could majorly contribute to the formation of pigment and caries in primary dentition and suggests potential clinical applications of monitoring oral microbiota as an indicator for disease diagnosis

  3. Development and characterization of an open-ended shock tube for the study of blast mtbi.

    PubMed

    Shah Ms, Alok S; Stemper Phd, Brian D; Pintar Phd, Frank A

    2012-01-01

    Shock tubes can be used to study traumatic brain injuries due to blast waves in a laboratory setting without the use of explosives. A literature review shows that several shock tubes used in these type of studies are large in size and have a high cost of conducting tests and maintaining the device. The purpose of this study was to design and characterize small shock tubes to simulate open field blast waves, which can be used in a laboratory with limited space and has low cost of operation. In addition, the shock tube can be used to induce localized blast in a small region to study the injury mechanisms in the desired region. Furthermore, the animal is placed outside of the shock tube, which provides the ability to expose the animal to a pure primary blast wave. A helium-driven shock tube with driven length of 3.04 m and driver length of 0.30 m was used in the present study. Transducers were placed at multiple locations and distances to characterize the blast wave outside the shock tube. The versatile design of the shock tube can generate a wide range of peak overpressure, rise times and durations. The shock tube was able to generate peak overpressure ranging from 25 kPa to 508 kPa and positive durations ranging from 97 µs to 797 µs. The literature review also showed several studies where the data were collected and analyzed improperly. The under-sampling or improper filtering can significantly affect the data. Additionally, the orientation of the transducer with respect to the shock wave can also affect the recorded peak overpressure. This paper reports various peak overpressures, durations and rise-times that can be developed with a small open-ended shock tube and the methodology to properly collect and analyze blast wave data generated by the shock tube.

  4. Relationship between orientation to a blast and pressure wave propagation inside the rat brain.

    PubMed

    Chavko, Mikulas; Watanabe, Tomas; Adeeb, Saleena; Lankasky, Jason; Ahlers, Stephen T; McCarron, Richard M

    2011-01-30

    Exposure to a blast wave generated during an explosion may result in brain damage and related neurological impairments. Several mechanisms by which the primary blast wave can damage the brain have been proposed, including: (1) a direct effect of the shock wave on the brain causing tissue damage by skull flexure and propagation of stress and shear forces; and (2) an indirect transfer of kinetic energy from the blast, through large blood vessels and cerebrospinal fluid (CSF), to the central nervous system. To address a basic question related to the mechanisms of blast brain injury, pressure was measured inside the brains of rats exposed to a low level of blast (~35kPa), while positioned in three different orientations with respect to the primary blast wave; head facing blast, right side exposed to blast and head facing away from blast. Data show different patterns and durations of the pressure traces inside the brain, depending on the rat orientation to blast. Frontal exposures (head facing blast) resulted in pressure traces of higher amplitude and longer duration, suggesting direct transmission and reflection of the pressure inside the brain (dynamic pressure transfer). The pattern of the pressure wave inside the brain in the head facing away from blast exposures assumes contribution of the static pressure, similar to hydrodynamic pressure to the pressure wave inside the brain. Published by Elsevier B.V.

  5. Comparison of Some Blast Vibration Predictors for Blasting in Underground Drifts and Some Observations

    NASA Astrophysics Data System (ADS)

    Bhagwat, Vaibhab Pramod; Dey, Kaushik

    2016-04-01

    Drilling and blasting are the most economical excavation techniques in underground drifts driven through hard rock formation. Burn cut is the most popular drill pattern, used in this case, to achieve longer advance per blast round. The ground vibration generated due to the propagation of blast waves on the detonation of explosive during blasting is the principal cause for structural and rock damage. Thus, ground vibration is a point of concern for the blasting engineers. The ground vibration from a blast is measured using a seismograph placed at the blast monitoring station. The measured vibrations, in terms of peak particle velocity, are related to the maximum charge detonated at one instant and the distance of seismograph from the blast point. The ground vibrations from a number of blast rounds of varying charge/delay and distances are monitored. A number of scaling factors of these dependencies (viz. Distance and maximum charge/delay) have been proposed by different researchers, namely, square root, cube root, CMRI, Langefors and Kihlstrom, Ghosh-Daemon, Indian standard etc. Scaling factors of desired type are computed for all the measured blast rounds. Regression analysis is carried out between the scaling factors and peak particle velocities to establish the coefficients of the vibration predictor equation. Then, the developed predictor equation is used for designing the blast henceforth. Director General of Mine Safety, India, specified that ground vibrations from eight to ten blast rounds of varying charge/delay and distances should be monitored to develop a predictor equation; however, there is no guideline about the type of scaling factor to be used. Further to this, from the statistical point of view, a regression analysis on a small sample population cannot be accepted without the testing of hypothesis. To show the importance of the above, in this paper, seven scaling factors are considered for blast data set of a hard-rock underground drift using burn

  6. Primary focal and segmental glomerulosclerosis and soluble factor urokinase-type plasminogen activator receptor

    PubMed Central

    Trimarchi, Hernán

    2013-01-01

    Primary focal and segmental glomerulosclerosis (FSGS) may be due to genetic or acquired etiologies and is a common cause of nephrotic syndrome with high morbidity that often leads to end-stage renal failure. The different available therapeutic approaches are unsuccessful, in part due to partially deciphered heterogeneous and complex pathophysiological mechanisms. Moreover, the term FSGS, even in its primary form, comprises a histological description shared by a number of different causes with completely different molecular pathways of disease. This review focuses on the latest developments regarding the pathophysiology of primary acquired FSGS caused by soluble factor urokinase type plasminogen activator receptor, a circulating permeability factor involved in proteinuria and edema formation, and describes recent advances with potential success in therapy. PMID:24255893

  7. Type of primary education is associated with condom use at sexual debut among Chilean adolescents.

    PubMed

    Huneeus, Andrea; Deardorff, Julianna; Lahiff, Maureen; Guendelman, Sylvia

    2014-05-01

    Although condom use in adolescence is related to higher lifetime educational attainment, the association between primary education (from kindergarten to eighth grade) and adolescent sexual behavior is not well understood. This study examined the association between type of school in which primary education was completed-public, charter, or private-and condom use at sexual debut among Chilean adolescents. Drawing on the 2009 Chilean National Youth Survey, a population-based sample of general community youth aged 15 to 29 years, we conducted a study of the 4217 participants who reported onset of sexual activity during adolescence. Bivariate and multple logistic regression was used to examine the relationship between type of primary school attended (60.1% public, 30.3% charter, and 9.6% private) and condom use at sexual debut while controlling for sociodemographic characteristics and sexual behavior. Compared with students who completed their primary education in private or charter schools, students who completed their primary education in public schools had 1.85 (95% confidence interval, 1.12-3.04) and 1.67 (95% confidence interval, 1.26-2.23) higher odds, respectively, of not using condoms at sexual debut. Odds were similar for students living in urban settings, whereas there were too few students attending private schools in rural areas to allow meaningful estimates. Independent of household income, primary schooling is associated with sexual health behaviors among Chilean adolescents living in urban areas and can serve as a target for public health interventions designed to prevent sexually transmitted infections in adolescence.

  8. Herpes simplex virus type 2 infection increases human immunodeficiency virus type 1 entry into human primary macrophages.

    PubMed

    Sartori, Elena; Calistri, Arianna; Salata, Cristiano; Del Vecchio, Claudia; Palù, Giorgio; Parolin, Cristina

    2011-04-12

    Epidemiological and clinical data indicate that genital ulcer disease (GUD) pathogens are associated with an increased risk of human immunodeficiency virus type 1 (HIV-1) acquisition and/or transmission. Among them, genital herpes simplex virus type 2 (HSV-2) seems to play a relevant role. Indeed, the ability of HSV-2 to induce massive infiltration at the genital level of cells which are potential targets for HIV-1 infection may represent one of the mechanisms involved in this process. Here we show that infection of human primary macrophages (MDMs) by HSV-2 results in an increase of CCR5 expression levels on cell surface and allows higher efficiency of MDMs to support entry of R5 HIV-1 strains. This finding could strengthen, at the molecular level, the evidence linking HSV-2 infection to an increased susceptibility to HIV-1 acquisition.

  9. Human Immunodeficiency Virus Type 1 Coat Protein Neurotoxicity Mediated by Nitric Oxide in Primary Cortical Cultures

    NASA Astrophysics Data System (ADS)

    Dawson, Valina L.; Dawson, Ted M.; Uhl, George R.; Snyder, Solomon H.

    1993-04-01

    The human immunodeficiency virus type 1 coat protein, gp120, kills neurons in primary cortical cultures at low picomolar concentrations. The toxicity requires external glutamate and calcium and is blocked by glutamate receptor antagonists. Nitric oxide (NO) contributes to gp120 toxicity, since nitroarginine, an inhibitor of NO synthase, prevents toxicity as does deletion of arginine from the incubation medium and hemoglobin, which binds NO. Superoxide dismutase also attenuates toxicity, implying a role for superoxide anions.

  10. Giant primary synchronously bilateral mesenteric dedifferentiated liposarcoma with hyperparathyroidism, hyperthyroidism, type-2 diabetes mellitus and hypertension.

    PubMed

    Korukluoglu, Birol; Ergul, Emre; Sisman, Ibrahim Cagatay; Yalcin, Samet; Kusdemir, Ahmet

    2009-08-01

    Liposarcomas represent the single most common type of soft tissue sarcoma, occurring most commonly in the extremities and retroperitoneum. There is no relation between liposarcomas and multiple endocrine syndromes. We presented a 61-year old woman with giant primary synchronously bilateral mesenteric dedifferentiated liposarcoma with hyperparathyroidism, hyperthyroidism, Type-2 diabetes mellitus (T2DM) and hypertension. The mesenteric liposarcoma was reported neither synchronously bilateral nor with endocrine disorders. We must note if the patients' presentation was a co-incidence or an undescribed syndrome, waiting to be discovered.

  11. Enhanced proliferation of primary rat type II pneumocytes by Jaagsiekte sheep retrovirus envelope protein

    SciTech Connect

    Johnson, Chassidy; Jahid, Sohail; Voelker, Dennis R.; Fan Hung

    2011-04-10

    Jaagsiekte sheep retrovirus (JSRV) is the causative agent of a contagious lung cancer in sheep. The envelope protein (Env) is the oncogene, as it can transform cell lines in culture and induce tumors in animals, although the mechanisms for transformation are not yet clear because a system to perform transformation assays in differentiated type II pneumocytes does not exist. In this study we report culture of primary rat type II pneumocytes in conditions that favor prolonged expression of markers for type II pneumocytes. Env-expressing cultures formed more colonies that were larger in size and were viable for longer periods of time compared to vector control samples. The cells that remained in culture longer were confirmed to be derived from type II pneumocytes because they expressed surfactant protein C, cytokeratin, displayed alkaline phosphatase activity and were positive for Nile red. This system will be useful to study JSRV Env in the targets of transformation.

  12. A primary pure pancreatic-type acinar cell carcinoma of the stomach: a case report.

    PubMed

    Kim, Kyoung Min; Kim, Chan Young; Hong, Seung-Mo; Jang, Kyu Yun

    2017-01-19

    Acinar cell carcinoma represents only 1-2% of exocrine pancreatic neoplasms. On exceptionally rare occasions, primary acinar cell carcinoma can occur in ectopic locations. Herein, we report a case of pure pancreatic-type acinar cell carcinoma arising in the stomach. A 54-year-old male presented with a gastric submucosal mass detected by endoscopic examination. Laparoscopic wedge resection was performed. Macroscopically, the 2.7 cm yellowish mass was located in the submucosa of the stomach. Microscopically, the tumor was well circumscribed and had a homogeneous acinar architecture. The tumor cells were small and had a minimal amount of cytoplasm. The nuclei of the tumor cells were round to oval with finely dispersed chromatin. The tumor cells were strongly positive for α1-antitrypsin, chymotrypsin, and α1-antichymotrypsin immunostaining, consistent with pancreatic exocrine differentiation. There was no clinical or radiologic evidence of primary pancreatic or head and neck tumors. After surgical resection of the tumor, there was no recurrence or metastasis during 33 months follow-up. In this report, we have presented a rare case of primary pure pancreatic-type acinar cell carcinoma arising in the stomach and suggest that it could be helpful if the pathologist were aware that pancreatic-type acinar cell carcinoma could arise in the stomach as a polypoid submucosal tumor in the routine diagnostic field of gastric endoscopy.

  13. Prevalence of depression in patients with type 2 diabetes attended in primary care in Spain.

    PubMed

    Cols-Sagarra, Cèlia; López-Simarro, Flora; Alonso-Fernández, Margarita; Mancera-Romero, José; Pérez-Unanua, M Paz; Mediavilla-Bravo, José Javier; Barquilla-García, Alfonso; Miravet-Jiménez, Sònia

    2016-10-01

    To estimate the prevalence of known and undiagnosed depression in patients with type 2 diabetes attended in primary care setting in Spain, and to determine the factors associated with the presence of depression. This was a cross-sectional and multicenter study performed in a random sample of patients with type 2 diabetes attended in 21 primary care centers. Depressive symptoms were measured with the self-administered Patient Health Questionnaire (PHQ-9). A total of 411 patients were analyzed (mean age 70.8 (SD 10.3) years; 53.8% women). 29.2% of patients met the diagnostic criteria of depression, of whom 17% had known depression and 12.2% undiagnosed depression (PHQ-9 score ≥10, without a previous diagnosis of depression). Depression was more common in women (43.4%; 95% confidence interval [CI] 34.5-52.3%), widow (33.3%; 95% CI 27.9-38.7%), and hypothyroidism (12.5%; 95% CI 8.7-16.3%). Cardiovascular risk factors, the degree of control, complications related to diabetes, antidiabetic therapy and the number of drugs were not associated with the presence of depression. The prevalence of depression was high in patients with type 2 diabetes. However, in approximately 40% of patients depression was undiagnosed. The complications related to diabetes and antidiabetic therapy were not associated with the presence of depression. Copyright © 2016 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

  14. Role of NSO compounds during primary cracking of a Type II kerogen and a Type III lignite

    USGS Publications Warehouse

    Behar, F.; Lorant, F.; Lewan, M.

    2008-01-01

    The aim of this work is to follow the generation of NSO compounds during the artificial maturation of an immature Type II kerogen and a Type III lignite in order to determine the different sources of the petroleum potential during primary cracking. Experiments were carried out in closed system pyrolysis in the temperature range from 225 to 350 ??C. Two types of NSOs were recovered: one is soluble in n-pentane and the second in dichloromethane. A kinetic scheme was optimised including both kerogen and NSO cracking. It was validated by complementary experiments carried out on isolated asphaltenes generated from the Type II kerogen and on the total n-pentane and DCM extracts generated from the Type III lignite. Results show that kerogen and lignite first decompose into DCM NSOs with minor generation of hydrocarbons. Then, the main source of petroleum potential originates from secondary cracking of both DCM and n-pentane NSOs through successive decomposition reactions. These results confirm the model proposed by Tissot [Tissot, B., 1969. Premie??res donne??es sur les me??canismes et la cine??tique de la formation du pe??trole dans les bassins se??dimentaires. Simulation d'un sche??ma re??actionnel sur ordinateur. Oil and Gas Science and Technology 24, 470-501] in which the main source of hydrocarbons is not the insoluble organic matter, but the NSO fraction. As secondary cracking of the NSOs largely overlaps that of the kerogen, it was demonstrated that bulk kinetics in open system is a result of both kerogen and NSO cracking. Thus, another kinetic scheme for primary cracking in open system was built as a combination of kerogen and NSO cracking. This new kinetic scheme accounts for both the rate and amounts of hydrocarbons generated in a closed pyrolysis system. Thus, the concept of successive steps for hydrocarbon generation is valid for the two types of pyrolysis system and, for the first time, a common kinetic scheme is available for extrapolating results to natural

  15. Quality of coal for blast furnace injection

    SciTech Connect

    Hutny, W.P.; Giroux, L.; MacPhee, J.A.; Price, J.T.

    1996-12-31

    CANMET Energy Technology Centre (CETC) has been involved in a research program to evaluate the suitability of various coals for blast furnace injection. The primary objectives of this program are to provide essential information on coal combustion in the blast furnace and to establish proper criteria for evaluating and selecting coals for blast furnace injection. The program comprises three parts. Parts one and two have been completed. To date, the program has encompassed both a theoretical assessment of cooling and coke replacement characteristics of coals using CETC`s computer model and an experimental determination of the combustibility of coals of different ranks and particle sizes as well as the influence of oxygen enrichment on burnout. The experimental part was conducted in CETC`s pilot-scale injection unit that simulates blast furnace blowpipe-tuyere conditions. Part three now being developed will incorporate results of experimental trials into a blast furnace raceway model in order to predict total combustibility of coals at different blast furnace operating conditions. This paper describes CETC`s facility and methodology of work, and presents and discusses results.

  16. Community governance in primary health care: towards an international Ideal Type.

    PubMed

    Meads, Geoffrey; Russell, Grant; Lees, Amanda

    2016-05-27

    Against a global background of increased resource management responsibilities for primary health care agencies, general medical practices, in particular, are increasingly being required to demonstrate the legitimacy of their decision making in market oriented environments. In this context a scoping review explores the potential utility for health managers in primary health care of community governance as a policy concept. The review of recent research suggests that applied learning from international health systems with enhanced approaches to public and patient involvement may contribute to meeting this requirement. Such approaches often characterise local health systems in Latin America and North West Europe where innovative models are beginning to respond effectively to the growing demands on general practice. The study design draws on documentary and secondary data analyses to identify common components of community governance from the countries in these regions, supplemented by other relevant international studies and sources where appropriate. Within a comprehensive framework of collaborative governance the components are aggregated in an Ideal Type format to provide a point of reference for possible adaptation and transferable learning across market oriented health systems. Each component is illustrated with international exemplars from recent organisational practices in primary health care. The application of community governance is considered for the particular contexts of GP led Clinical Commissioning Groups in England and Primary Health Networks in Australia. Some components of the Ideal Type possess potentially powerful negative as well as positive motivational effects, with PPI at practice levels sometimes hindering the development of effective local governance. This highlights the importance of careful and competent management of the growing resources attributed to primary health care agencies, which possess an increasingly diverse range of non

  17. Facility type and primary care performance in sub-district health promotion hospitals in Northern Thailand

    PubMed Central

    Kitreerawutiwong, Nithra; Jordan, Sue; Hughes, David

    2017-01-01

    Background Poor and middle-income Thai people rely heavily on primary care health services. These are staffed by a range of professionals. However, it is unknown whether the performance of primary care varies according to the staffing and organization of local service delivery units. Tambon (sub-district) health promotion hospitals (THPHs) were introduced in 2009 to upgrade the services offered by the previous health centres, but were faced with continuing shortages of doctors and nurses. The Ministry of Public Health (MoPH) designated three categories of THPH, defined according to whether they were regularly staffed by a medical practitioner, a qualified nurse or non-clinical public health officers. This study aimed to compare the performance of primary care offered by the three different types of primary care facilities in one public health region of Northern Thailand (Public Health Region 2). Methods A cross-sectional survey was undertaken in 2013. Data were collected on accessibility, continuity, comprehensiveness, co-ordination and community orientation of care from 825 patients attending 23 primary care facilities. These were selected to include the three officially-designated types of Tambon (sub-district) health promotion hospitals (THPHs) led by medical, nursing or public health personnel. Survey scores were compared in unadjusted and adjusted analyses. Results THPHs staffed only by public health officers achieved the highest performance score (Mean = 85.14, SD. = 7.30), followed by THPHs staffed by qualified nurses (Mean = 82.86, SD. = 7.06). THPHs staffed by a doctor on rotation returned the lowest scores (Mean = 81.63, SD. = 7.22). Conclusions Differences in overall scores resulted mainly from differences in reported accessibility, continuity, and comprehensiveness of care, rather than staff skill-mix per se. Policy on quality improvement should therefore focus on improving performance in these areas. PMID:28339494

  18. Facility type and primary care performance in sub-district health promotion hospitals in Northern Thailand.

    PubMed

    Kitreerawutiwong, Nithra; Jordan, Sue; Hughes, David

    2017-01-01

    Poor and middle-income Thai people rely heavily on primary care health services. These are staffed by a range of professionals. However, it is unknown whether the performance of primary care varies according to the staffing and organization of local service delivery units. Tambon (sub-district) health promotion hospitals (THPHs) were introduced in 2009 to upgrade the services offered by the previous health centres, but were faced with continuing shortages of doctors and nurses. The Ministry of Public Health (MoPH) designated three categories of THPH, defined according to whether they were regularly staffed by a medical practitioner, a qualified nurse or non-clinical public health officers. This study aimed to compare the performance of primary care offered by the three different types of primary care facilities in one public health region of Northern Thailand (Public Health Region 2). A cross-sectional survey was undertaken in 2013. Data were collected on accessibility, continuity, comprehensiveness, co-ordination and community orientation of care from 825 patients attending 23 primary care facilities. These were selected to include the three officially-designated types of Tambon (sub-district) health promotion hospitals (THPHs) led by medical, nursing or public health personnel. Survey scores were compared in unadjusted and adjusted analyses. THPHs staffed only by public health officers achieved the highest performance score (Mean = 85.14, SD. = 7.30), followed by THPHs staffed by qualified nurses (Mean = 82.86, SD. = 7.06). THPHs staffed by a doctor on rotation returned the lowest scores (Mean = 81.63, SD. = 7.22). Differences in overall scores resulted mainly from differences in reported accessibility, continuity, and comprehensiveness of care, rather than staff skill-mix per se. Policy on quality improvement should therefore focus on improving performance in these areas.

  19. A primary intervention program (pilot study) for Mexican American children at risk for type 2 diabetes.

    PubMed

    McKenzie, S B; O'Connell, J; Smith, L A; Ottinger, W E

    1998-01-01

    Many chronic diseases that are leading causes of morbidity and mortality can be prevented or controlled by primary or secondary interventions. Type 2 diabetes with its complications constitutes a major health problem, especially among Mexican Americans. The purpose of this pilot study was to develop an age- and culturally appropriate primary intervention program for Mexican American children at risk of type 2 diabetes. The sample included 37 Mexican American children ages 7 to 12 years who had at least one parent or grandparent with type 2 diabetes. A health screen of physiologic risk factors, a nutritional assessment, and a diabetes knowledge test were administered before and after the program. The eight-session activity oriented educational program focused on nutrition, exercise, and diabetes knowledge. Due to small sample size and limited study time, changes in physiologic factors and diet were not analyzed for statistical significance. Analysis of individual factors showed a trend toward more normal values. Results of this pilot program indicated that health intervention projects may be effective in helping children at risk of type 2 diabetes adopt healthier lifestyles.

  20. Automatic laboratory-based strategy to improve the diagnosis of type 2 diabetes in primary care

    PubMed Central

    Salinas, Maria; López-Garrigós, Maite; Flores, Emilio; Leiva-Salinas, Maria; Lugo, Javier; Pomares, Francisco J; Asencio, Alberto; Ahumada, Miguel; Leiva-Salinas, Carlos

    2016-01-01

    Introduction To study the pre-design and success of a strategy based on the addition of hemoglobin A1c (HbA1c) in the blood samples of certain primary care patients to detect new cases of type 2 diabetes. Materials and methods In a first step, we retrospectively calculated the number of HbA1c that would have been measured in one year if HbA1c would have been processed, according to the guidelines of the American Diabetes Association (ADA). Based on those results we decided to prospectively measure HbA1c in every primary care patient above 45 years, with no HbA1c in the previous 3 years, and glucose concentration between 5.6-6.9 mmol/L, during an 18 months period. We calculated the number of HbA1c that were automatically added by the LIS based on our strategy, we evaluated the medical record of such subjects to confirm whether type 2 diabetes was finally confirmed, and we calculated the cost of our intervention. Results In a first stage, according to the guidelines, Hb1Ac should have been added to the blood samples of 13,085 patients, resulting in a cost of 14,973€. In the prospective study, the laboratory added Hb1Ac to 2092 patients, leading to an expense of 2393€. 314 patients had an HbA1c value ≥ 6.5% (48 mmol/mol). 82 were finally diagnosed as type 2 diabetes; 28 thanks to our strategy, with an individual cost of 85.4€; and 54 due to the request of HbA1c by the general practitioners (GPs), with a cost of 47.5€. Conclusion The automatic laboratory-based strategy detected patients with type 2 diabetes in primary care, at a cost of 85.4€ per new case. PMID:26981026

  1. Automatic laboratory-based strategy to improve the diagnosis of type 2 diabetes in primary care.

    PubMed

    Salinas, Maria; López-Garrigós, Maite; Flores, Emilio; Leiva-Salinas, Maria; Lugo, Javier; Pomares, Francisco J; Asencio, Alberto; Ahumada, Miguel; Leiva-Salinas, Carlos

    2016-01-01

    To study the pre-design and success of a strategy based on the addition of hemoglobin A1c (HbA1c) in the blood samples of certain primary care patients to detect new cases of type 2 diabetes. In a first step, we retrospectively calculated the number of HbA1c that would have been measured in one year if HbA1c would have been processed, according to the guidelines of the American Diabetes Association (ADA). Based on those results we decided to prospectively measure HbA1c in every primary care patient above 45 years, with no HbA1c in the previous 3 years, and glucose concentration between 5.6-6.9 mmol/L, during an 18 months period. We calculated the number of HbA1c that were automatically added by the LIS based on our strategy, we evaluated the medical record of such subjects to confirm whether type 2 diabetes was finally confirmed, and we calculated the cost of our intervention. In a first stage, according to the guidelines, Hb1Ac should have been added to the blood samples of 13,085 patients, resulting in a cost of 14,973€. In the prospective study, the laboratory added Hb1Ac to 2092 patients, leading to an expense of 2393€. 314 patients had an HbA1c value ≥ 6.5% (48 mmol/mol). 82 were finally diagnosed as type 2 diabetes; 28 thanks to our strategy, with an individual cost of 85.4€; and 54 due to the request of HbA1c by the general practitioners (GPs), with a cost of 47.5€. The automatic laboratory-based strategy detected patients with type 2 diabetes in primary care, at a cost of 85.4€ per new case.

  2. Pharmacists on primary care teams: Effect on antihypertensive medication management in patients with type 2 diabetes.

    PubMed

    Omran, Dima; Majumdar, Sumit R; Johnson, Jeffrey A; Tsuyuki, Ross T; Lewanczuk, Richard Z; Guirguis, Lisa M; Makowsky, Mark; Simpson, Scot H

    2015-01-01

    To identify which activities produced a significant improvement in blood pressure control in patients with type 2 diabetes when pharmacists were added to primary care teams. This prespecified, secondary analysis evaluated medication management data from a randomized controlled trial. The primary outcome was a change in treatment, defined as addition, dosage increase, or switching of an antihypertensive medication during the 1-year study period. The secondary outcome was a change in antihypertensive medication adherence using the medication possession ratio (MPR). The 200 evaluable trial patients had a mean age of 59 (SD, 11) years, 44% were men, and mean blood pressure was 130 (SD, 16)/74 (SD, 10) mm Hg at baseline. Treatment changes occurred in 45 (42%) of 107 patients in the intervention group and 24 (26%) of 93 patients in the control group (RR, 1.63; 95% CI, 1.08-2.46). Addition of a new medication was the most common type of change, occurring in 34 (32%) patients in the intervention group and 17 (18%) patients in the control group (P = 0.029). Adherence to antihypertensive medication was high at baseline (MPR, 93%). Although medication adherence improved in the intervention group (MPR, 97%) and declined in the control group (MPR, 91%), the difference between groups was not significant (P = 0.21). The observed improvement in blood pressure control when pharmacists were added to primary care teams was likely achieved through antihypertensive treatment changes and not through improvements in antihypertensive medication adherence.

  3. Environmental DNA metabarcoding reveals primary chemical contaminants in freshwater sediments from different land-use types.

    PubMed

    Xie, Yuwei; Wang, Jizhong; Yang, Jianghua; Giesy, John P; Yu, Hongxia; Zhang, Xiaowei

    2017-04-01

    Land-use intensification threatens freshwater biodiversity. Freshwater eukaryotic communities are affected by multiple chemical contaminants with a land-use specific manner. However, biodiversities of eukaryotes and their associations with multiple chemical contaminants are largely unknown. This study characterized in situ eukaryotic communities in sediments exposed to mixtures of chemical contaminants and assessed relationships between various environmental variables and eukaryotic communities in sediments from the Nanfei River. Eukaryotic communities in the sediment samples were dominated by Annelida, Arthropoda, Rotifera, Ochrophyta, Chlorophyta and Ciliophora. Alpha-diversities (Shannon entropy) and structures of eukaryotic communities were significantly different between land-use types. According to the results of multiple statistical tests (PCoA, distLM, Mantel and network analysis), dissimilarity of eukaryotic community structures revealed the key effects of pyrethroid insecticides, manganese, zinc, lead, chromium and polycyclic aromatic hydrocarbons (PAHs) on eukaryotic communities in the sediment samples from the Nanfei River. Furthermore, taxa associated with land-use types were identified and several sensitive eukaryotic taxa to some of the primary contaminants were identified as potential indicators to monitor effects of the primary chemical contaminants. Overall, environmental DNA metabarcoding on in situ eukaryotic communities provided a powerful tool for biomonitoring and identifying primary contaminants and their complex effects on benthic eukaryotic communities in freshwater sediments. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. The correlation analysis of primary liver cancer with Type 2 diabetes.

    PubMed

    Su, Q; Sun, F; Li, J; Zhang, H; Wang, M; Zhou, H; Qiao, L

    2015-12-01

    To explore the relationship between Type 2 diabetes and primary liver cancer. In the period from December 2008 to December 2014, all blood sugar data of patients in our hospital was collected, and the total number is 18213. Except for repeatedly hospitalized diabetic person, newborn stress status, or venous transfusion blood glucose, gestational diabetes, etc., By retrieving the medical record information of patients in the hospital, and using telephone or letter follow-up the patients, we collected 127 people with type 1 diabetes and found no liver cancer patients; Type 2 diabetes, 10,794 cases of patient information, 59 with primary liver cancer. For data analysis, Stata11.0 ratio was used as the main analysis indicators, using Chi-square test and statistical analysis. About 10,794 Type 2 diabetes cases with 59 primary liver cancer, the incidence is 54.66/10,000, men liver cancer incidence (92.78/10,000) than women (27.13/10,000), with significant difference (χ2 = 26.621, P < 0.001). As the growth of the age, the possibility of liver cancer in patients with diabetes increased significantly (χ2 = 19.961, P = 0.001). The rate was highest for 50-60-year-old men, and the women at age 70, and older incidence is highest. Irrespective of men or women with diabetes as the growth of the age, the possibility of liver cancer had significantly increased (P = 0.001, P = 0.002). Hepatitis B or hepatitis C incidence was 2.94%, but diabetes incidence of hepatitis men (3.98%) and women (2.01%) did not find significant differences (χ2 = 0.3361, P = 0.562). Three hundred and seventeen cases of Type 2 diabetes with hepatitis, the incidence of primary liver cancer was 11.67%, the liver cancer incidence of diabetes patients with hepatitis men (17.78%) than women (3.97%), with significant difference (χ2 = 37.429, P < 0.001). With the growth of age, the overall risk of getting liver cancer (χ2 =15.023, P = 0.01) of diabetes and hepatitis patients is significantly increased, and

  5. 30 CFR 780.13 - Operation plan: Blasting.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... operator will meet with regard to ground vibration and airblast, the bases for those limitations, and the methods to be applied in controlling the adverse effects of blasting operations. (b) Monitoring system... standards of § 816.67 including the type, capability, and sensitivity of any blast-monitoring equipment...

  6. 30 CFR 780.13 - Operation plan: Blasting.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... operator will meet with regard to ground vibration and airblast, the bases for those limitations, and the methods to be applied in controlling the adverse effects of blasting operations. (b) Monitoring system... standards of § 816.67 including the type, capability, and sensitivity of any blast-monitoring equipment...

  7. 30 CFR 780.13 - Operation plan: Blasting.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... operator will meet with regard to ground vibration and airblast, the bases for those limitations, and the methods to be applied in controlling the adverse effects of blasting operations. (b) Monitoring system... standards of § 816.67 including the type, capability, and sensitivity of any blast-monitoring equipment...

  8. 30 CFR 780.13 - Operation plan: Blasting.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... operator will meet with regard to ground vibration and airblast, the bases for those limitations, and the methods to be applied in controlling the adverse effects of blasting operations. (b) Monitoring system... standards of § 816.67 including the type, capability, and sensitivity of any blast-monitoring equipment...

  9. 30 CFR 780.13 - Operation plan: Blasting.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... operator will meet with regard to ground vibration and airblast, the bases for those limitations, and the methods to be applied in controlling the adverse effects of blasting operations. (b) Monitoring system... standards of § 816.67 including the type, capability, and sensitivity of any blast-monitoring equipment...

  10. Primary Meningococcal Type C Arthritis: A Case Report and Literature Review

    PubMed Central

    Catalan, Jaime; Sato, Yoshiro; Hinzpeter, Jaime

    2017-01-01

    Acute septic arthritis is a common clinical problem in emergency departments. Primary meningococcal arthritis (PMA) is very rare and few cases are reported in literature. D. B. M. consulted the emergency department for knee pain and fever; analysis showed that the cause was a Neisseria meningitidis type C infection. He received a treatment consisting of 2 arthroscopies and 5 weeks of antibiotics. At five weeks he returned to work and at 2 months he resumed sports (jogging and soccer) without complaints. Primary arthritis of the knee caused by Neisseria meningitidis is very rare. It has a very good response to antibiotics and arthroscopy procedure. Short-term follow-up and functional results are often good or excellent. PMID:28487799

  11. Large cell variant of small cell carcinoma, hypercalcemic type, of primary peritoneal origin.

    PubMed

    Popiolek, Dorota A; Kumar, Asok R; Mittal, Khush

    2005-01-01

    Large cell variant of small cell carcinoma hypercalcemic type (SCC-HT) is extremely rare. All reported cases involved an ovary, and one with primary peritoneal origin has not been described. Also, convincing neuroendocrine granules have not been illustrated. A 35-year-old woman underwent an exploratory laparotomy for leiomyomas. Intraoperative impression of peritoneal carcinomatosis was confirmed on frozen section. TAH/BSO, debulking/omentectomy followed. The tumor was present on the pelvic/abdominal peritoneum. The normal-sized ovaries were free of tumor grossly. The tumor had features of large cell variant of SCC-HT, described in the ovary. Furthermore, unequivocal neuroendocrine granules were present. The patient received standard chemotherapy for SCC. At 22 months she is NED. SCC-HT should be considered in the differential diagnosis of primary neoplasms of the peritoneum.

  12. Modelling human eye under blast loading.

    PubMed

    Esposito, L; Clemente, C; Bonora, N; Rossi, T

    2015-01-01

    Primary blast injury (PBI) is the general term that refers to injuries resulting from the mere interaction of a blast wave with the body. Although few instances of primary ocular blast injury, without a concomitant secondary blast injury from debris, are documented, some experimental studies demonstrate its occurrence. In order to investigate PBI to the eye, a finite element model of the human eye using simple constitutive models was developed. The material parameters were calibrated by a multi-objective optimisation performed on available eye impact test data. The behaviour of the human eye and the dynamics of mechanisms occurring under PBI loading conditions were modelled. For the generation of the blast waves, different combinations of explosive (trinitrotoluene) mass charge and distance from the eye were analysed. An interpretation of the resulting pressure, based on the propagation and reflection of the waves inside the eye bulb and orbit, is proposed. The peculiar geometry of the bony orbit (similar to a frustum cone) can induce a resonance cavity effect and generate a pressure standing wave potentially hurtful for eye tissues.

  13. Blast assessment and optimization for high quarry face-blasting

    SciTech Connect

    Sames, F.; O`Meara, R.

    1996-12-01

    Where applicable, high production benches can improve efficiency in quarrying. Quality control, geological, cost or other considerations might result in the development of quarry benches higher than 30 m and sometimes up to 60 m. Production blasts on high quarry faces require a confident blast design with respect to safety, cost efficiency and minimized environmental effects. Careful pre-blast assessment of the design parameters, blast monitoring of the product performance and the environmental effects and post-blast assessment of the overall blast performance are essential for the successful implementation of the blast design. The blast geometry for high quarry faces and a blast design that often includes multiple explosive charges in a blasthole, make a reliable assessment of the blast parameters difficult. Assessment techniques, their applications and limitations are described and discussed. This will include such methods as blast surveying using laser profiling and borehole deviation measurements, blast monitoring using continuous velocity of detonation measurement systems, high speed photography and seismographs for blast performance and environmental effects. Observations of low frequency airblast and high standard deviations in ground vibration measurements are described and discussed against a background of timing assessment and frequency spectra analysis. Approaches where an optimized design was implemented based on the blast parameter assessment and modeling are presented. An improvement in blast efficiency lies in the combination of blast assessment and blast modeling, whilst adequate documentation supports the process of designing and implementing successful blasts.

  14. Pancreatic-type Acinar Cell Carcinoma of the Stomach Included in Multiple Primary Carcinomas.

    PubMed

    Yonenaga, Yoshikuni; Kurosawa, Manabu; Mise, Masahiro; Yamagishi, Miki; Higashide, Shunichi

    2016-06-01

    Pancreatic-type acinar cell carcinoma (ACC) in the stomach is extraordinarily rare. We pathologically examined two cases with multiple primary carcinomas, including gastric tumors. Gastric cancer specimens were examined by immunostaining and electron microscopy. Both cases had cancer cells with acinar patterns, resembling pancreatic ACC. The cancer cells in the first case were positive for exocrine markers, including chymotrypsin, lipase and alpha-1 antichymotrypsin (ACT), as well as neuroendocrine markers, including chromogranin A and synaptophysin. The cancer cells in the second case were positive for chymotrypsin and alpha-1 ACT, while being slightly positive for chromogranin A and synaptophysin. Ultrastructurally, cancer cells contained zymogen granules in both cases. The final diagnosis was pancreatic mixed acinar-neuroendocrine carcinoma and pure pancreatic ACC, respectively. We confirmed two cases with gastric pancreatic-type ACC included in multiple primary carcinomas. This type of double cancer has not been reported previously. Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  15. Primary Hyperoxaluria Type 1: A Cause for Infantile Renal Failure and Massive Nephrocalcinosis.

    PubMed

    Kurt-Sukur, E D; Özçakar, Z B; Fitöz, S; Yilmaz, S; Hoppe, B; Yalçinkaya, F

    2015-09-01

    Primary hyperoxaluria type 1 is a rare autosomal-recessive disease caused by the deficient activity of the liver specific enzyme alanine-glyoxylate aminotransferase. Increased endogenous oxalate production induces severe hyperoxaluria, recurrent urolithiasis, progressive nephrocalcinosis and renal failure. Here we report a 6 month old boy who presented with vomiting and decreased urine volume. He was diagnosed with chronic kidney failure at 4 months of age and peritoneal dialysis was introduced at a local hospital. His parents were third degree cousins and family history revealed 2 maternal cousins who developed end stage renal disease during childhood. When he was admitted to our hospital, laboratory studies were consistent with end stage renal disease, ultrasound showed bilateral massive nephrocalcinosis. As clinical presentation was suggestive for primary hyperoxaluria type 1, plasma oxalate was determined and found extremely elevated. Genetic testing proved diagnosis by showing a disease causing homozygous mutation (AGXT-gene: c.971_972delT). The patient was put on pyridoxine treatment and aggressive dialysis programme. In conclusion; progressive renal failure in infancy with massive nephrocalcinosis, especially if accompanied by consanguinity and family history, should always raise the suspicion of PH type 1. Increased awareness of the disease would help physicians in both treating the patients and guiding the families who have diseased children and plan to have further pregnancies.

  16. Botulinum Toxin Type A for the Treatment of Primary Hyperhidrosis: A Prospective Study of 52 Patients.

    PubMed

    Martí, N; Ramón, D; Gámez, L; Reig, I; García-Pérez, M Á; Alonso, V; Jordá, E

    2010-09-01

    Primary hyperhidrosis is characterized by excessive sweating in a defined region of the body. It should not be considered a purely cosmetic problem as it has a significant impact on the social and professional relationships of affected individuals. The aim of this study was to determine the clinical profile of patients with primary hyperhidrosis and assess the results obtained with the use of botulinum toxin type A (BTX-A) in clinical practice. The study included 52 patients (39 women and 13 men) with a diagnosis of primary hyperhidrosis treated for the first time with BTX-A. All patients completed a questionnaire that included the following information: age; sex; profession; age at onset, family history, and site of hyperhidrosis; accompanying signs and symptoms, and previous treatment; time to effect of BTX-A; local or systemic side effects; and severity of hyperhidrosis before and after BTX-A treatment. Primary hyperhidrosis began during puberty in 61.5% of the patients included in the study, 75% were women, and the mean age was 29.9 years. In 36.5% of patients, first-degree relatives also had primary hyperhidrosis. Hyperhidrosis was classified as palmar in 61.5% of cases, plantar in 53.8%, and axillary in 59.6%. Other sites were affected less frequently. The most common accompanying symptoms were facial erythema (32.7%), palpitations (30.7%), muscle tension (28.8%), shivering (23%), and headache (17.3%). Treatment with BTX-A was well tolerated and there was a highly significant reduction in the severity of hyperhidrosis 2 months after performing the treatment (P<0.001). Copyright © 2009 Elsevier España, S.L. y AEDV. All rights reserved.

  17. [Effect of metformin on ventricular remodeling in patients with primary hypertension and type 2 diabetes mellitus].

    PubMed

    Wu, Yueyang; Zhao, Wei; Zhang, Youyi; Feng, Xinheng; Li, Zhaoping; Gao, Wei

    2015-11-24

    To explore the effects of metformin on left ventricular remodeling in patients with primary hypertension and type 2 diabetes mellitus, and to investigate the effects of hypertension duration and duration of drug administration on metformin's cardiac action. The clinical and echocardiographic data of 176 patients with primary hypertension and type 2 diabetes mellitus who were admitted to department of cardiology from January to December 2012 were retrospectively analyzed. The follow-up period was 6 to 24 months (the median follow-up time was 11 months). The patients were classified into two groups according to the usage of metformin: metformin group (n=84) and control group (n=92). The clinical data and echocardiography findings were evaluated both at baseline and follow-up. Subgroup analyses were used to assess the effects of hypertension duration and duration of drug medication on metfomin's action. At baseline, there was no significant difference in interventricular septum depth (IVSD), left ventricular posterior wall depth (LVPWD), and left ventricular mass index (LVMI) between the two groups. At the follow-up period, IVSD (P=0.001), LVPWD (P=0.04) and LVMI (P=0.01) were lower in metformin group. Multiple linear regression indicated that metformin had significant influence on LVPWD (P=0.02) and LVMI (P=0.04). At the follow-up period, LVMI was lower in two metformin subgroups. Additionally, LVMI was lower in the group which the patients took metformin for more than one year than that in control group (P=0.04). For patients whose hypertension duration was not shorter than 5 years, IVSD (P=0.01) and LVMI (P=0.02) were lower in metformin group at the follow-up period, compared with control group. Metformin may attenuate hypertrophy of left ventricular in patients with primary hypertension and type 2 diabetes mellitus. In patients with longer hypertension duration and longer duration of metformin use, metformin may show more obvious effects.

  18. Familial Hypocalciuric Hypercalcemia Types 1 and 3 and Primary Hyperparathyroidism: Similarities and Differences.

    PubMed

    Vargas-Poussou, Rosa; Mansour-Hendili, Lamisse; Baron, Stéphanie; Bertocchio, Jean-Philippe; Travers, Caroline; Simian, Christophe; Treard, Cyrielle; Baudouin, Véronique; Beltran, Sonia; Broux, Françoise; Camard, Odile; Cloarec, Sylvie; Cormier, Catherine; Debussche, Xavier; Dubosclard, Emmanuelle; Eid, Celine; Haymann, Jean-Philippe; Kiando, Soto Romuald; Kuhn, Jean-Marc; Lefort, Guy; Linglart, Agnes; Lucas-Pouliquen, Bernadette; Macher, Marie-Alice; Maruani, Gérard; Ouzounian, Sophie; Polak, Michel; Requeda, Elisabeth; Robier, Dominique; Silve, Caroline; Souberbielle, Jean-Claude; Tack, Ivan; Vezzosi, Delphine; Jeunemaitre, Xavier; Houillier, Pascal

    2016-05-01

    Familial hypocalciuric hypercalcemia (FHH) is a genetically heterogeneous condition resembling primary hyperparathyroidism (PHPT) but not curable by surgery; FHH types 1, 2, and 3 are due to loss-of-function mutations of the CASR, GNA11, or AP2S1 genes, respectively. This study aimed to compare the phenotypes of patients with genetically proven FHH types 1 or 3 or PHPT. This was a mutation analysis in a large cohort, a cross-sectional comparison of 52 patients with FHH type 1, 22 patients with FHH type 3, 60 with PHPT, and 24 normal adults. There were no interventions. Abnormalities of the CASR, GNA11, and AP2S1 genes, blood calcium, phosphate, and PTH concentrations, urinary calcium excretion were measured. In 133 families, we detected 101 mutations in the CASR gene, 68 of which were previously unknown, and in 19 families, the three recurrent AP2S1 mutations. No mutation was detected in the GNA11 gene. Patients with FHH type 3 had higher plasma calcium concentrations than patients with FHH type 1, despite having similar PTH concentrations and urinary calcium excretion. Renal tubular calcium reabsorption levels were higher in patients with FHH type 3 than in those with FHH type 1. Plasma calcium concentration was higher whereas PTH concentration and urinary calcium excretion were lower in FHH patients than in PHPT patients. In patients with FHH or PHPT, all data groups partially overlapped. In our population, AP2S1 mutations affect calcium homeostasis more severely than CASR mutations. Due to overlap, the risk of confusion between FHH and PHPT is high.

  19. Isolation of Highly Pure Primary Mouse Alveolar Epithelial Type II Cells by Flow Cytometric Cell Sorting

    PubMed Central

    Lowell, Clifford A.

    2017-01-01

    In this protocol, we describe the method for isolating highly pure primary alveolar epithelial type II (ATII) cells from lungs of naïve mice. The method combines negative selection for a variety of lineage markers along with positive selection for EpCAM, a pan-epithelial cell marker. This method yields 2-3 × 106 ATII cells per mouse lung. The cell preps are highly pure and viable and can be used for genomic or proteomic analyses or cultured ex vivo to understand their roles in various biological processes. PMID:28180137

  20. Effects of variable blast pressures on blood flow and oxygen saturation in rat brain as evidenced using MRI.

    PubMed

    Bir, Cynthia; Vandevord, Pamela; Shen, Yimin; Raza, Waqar; Haacke, E Mark

    2012-05-01

    It has been recognized that primary blast waves may result in neurotrauma in soldiers in theater. A new type of contrast used in magnetic resonance imaging (MRI), susceptibility-weighted imaging (SWI), has been developed that is based on the different susceptibility levels in diverse tissues and can detect decreases in cerebral blood flow (CBF) using inferred oxygen saturation changes in tissue. In addition, a continuous arterial spin-labeled (ASL) MRI sequence was used as a direct measure of regional CBF within the brain tissue. Animals were subjected to whole-body blast exposures of various overpressures within a gas-driven shock tube. When exposed to low levels of overpressure, most rats demonstrated no obvious changes between pre- and postexposure in the conventional MR images. CBF changes measured by SWI and ASL were significantly higher for the overpressure exposed groups as compared to the sham group and tended to increase with pressure increases at the highest two pressures. In the hippocampus, all blast animals had a reduction in the CBF consistently in the range of 0-27%. In summary, low levels of primary blast pressure exposure demonstrated a significant physiologic effect to the brain up to 72 h postexposure. Copyright © 2012 Elsevier Inc. All rights reserved.

  1. SURFACE PREPARATION OF STEEL SUBSTRATES USING GRIT-BLASTING

    SciTech Connect

    Donna Post Guillen; D. J. Varacalle, Jr.; D. Deason; W. Rhodaberger; E. Sampson

    2005-05-01

    The primary purpose of grit blasting for thermal spray applications is to ensure a strong mechanical bond between the substrate and the coating by the enhanced roughening of the substrate material. This study presents statistically designed experiments that were accomplished to investigate the effect of abrasives on roughness for A36/1020 steel. The experiments were conducted using a Box statistical design of experiment (SDE) approach. Three grit blasting parameters and their effect on the resultant substrate roughness were investigated. These include blast media, blast pressure, and working distance. The substrates were characterized for roughness using surface profilometry. These attributes were correlated with the changes in operating parameters. Twin-Wire Electric Arc (TWEA) coatings of aluminum and zinc/aluminum were deposited on the grit-blasted substrates. These coatings were then tested for bond strength. Bond strength studies were conducted utilizing a portable adhesion tester following ASTM standard D4541.

  2. Attenuation Analysis of Quarry Blast Vibrations

    NASA Astrophysics Data System (ADS)

    Brooks, T.; Courtier, A. M.

    2009-12-01

    In this study we analyzed seismograms created by rock quarry blasts and the effect of rock composition and structure on the attenuation of seismic energy. Luck Stone, a well-known rock quarry company in Virginia, provided the seismic database with the goal of analyzing rates of attenuation at their Boscobel and Leesburg sites, which consist of different rock types (granite and diabase, respectively). Over the years, the sites where these quarries are located have become progressively more residential. As a result, public awareness of quarry blasting has increased, and vibrations in residential areas are increasingly reported. Luck Stone operates seismometers throughout the region and closely monitors vibrations. We analyzed changes in amplitude and frequency content of quarry blast seismograms using power spectra, and compare the rate of attenuation with the propagation distance and local rock type. Our results improve the understanding of how these different rocks types attenuate energy and may help quarries develop specific approaches to further diminish blast vibrations at these locations. We also briefly discuss a comparison of the quarry blast data with attenuation of seismic energy from local earthquakes in similar rock types.

  3. Clonal Evolution and Blast Crisis Correlate with Enhanced Proteolytic Activity of Separase in BCR-ABL b3a2 Fusion Type CML under Imatinib Therapy

    PubMed Central

    Haaß, Wiltrud; Kleiner, Helga; Weiß, Christel; Haferlach, Claudia; Schlegelberger, Brigitte; Müller, Martin C.; Hehlmann, Rüdiger; Hofmann, Wolf-Karsten; Fabarius, Alice; Seifarth, Wolfgang

    2015-01-01

    Unbalanced (major route) additional cytogenetic aberrations (ACA) at diagnosis of chronic myeloid leukemia (CML) indicate an increased risk of progression and shorter survival. Moreover, newly arising ACA under imatinib treatment and clonal evolution are considered features of acceleration and define failure of therapy according to the European LeukemiaNet (ELN) recommendations. On the basis of 1151 Philadelphia chromosome positive chronic phase patients of the randomized CML-study IV, we examined the incidence of newly arising ACA under imatinib treatment with regard to the p210BCR-ABL breakpoint variants b2a2 and b3a2. We found a preferential acquisition of unbalanced ACA in patients with b3a2 vs. b2a2 fusion type (ratio: 6.3 vs. 1.6, p = 0.0246) concurring with a faster progress to blast crisis for b3a2 patients (p = 0.0124). ESPL1/Separase, a cysteine endopeptidase, is a key player in chromosomal segregation during mitosis. Separase overexpression and/or hyperactivity has been reported from a wide range of cancers and cause defective mitotic spindles, chromosome missegregation and aneuploidy. We investigated the influence of p210BCR-ABL breakpoint variants and imatinib treatment on expression and proteolytic activity of Separase as measured with a specific fluorogenic assay on CML cell lines (b2a2: KCL-22, BV-173; b3a2: K562, LAMA-84). Despite a drop in Separase protein levels an up to 5.4-fold increase of Separase activity under imatinib treatment was observed exclusively in b3a2 but not in b2a2 cell lines. Mimicking the influence of imatinib on BV-173 and LAMA-84 cells by ESPL1 silencing stimulated Separase proteolytic activity in both b3a2 and b2a2 cell lines. Our data suggest the existence of a fusion type-related feedback mechanism that posttranslationally stimulates Separase proteolytic activity after therapy-induced decreases in Separase protein levels. This could render b3a2 CML cells more prone to aneuploidy and clonal evolution than b2a2 progenitors

  4. Clonal Evolution and Blast Crisis Correlate with Enhanced Proteolytic Activity of Separase in BCR-ABL b3a2 Fusion Type CML under Imatinib Therapy.

    PubMed

    Haaß, Wiltrud; Kleiner, Helga; Weiß, Christel; Haferlach, Claudia; Schlegelberger, Brigitte; Müller, Martin C; Hehlmann, Rüdiger; Hofmann, Wolf-Karsten; Fabarius, Alice; Seifarth, Wolfgang

    2015-01-01

    Unbalanced (major route) additional cytogenetic aberrations (ACA) at diagnosis of chronic myeloid leukemia (CML) indicate an increased risk of progression and shorter survival. Moreover, newly arising ACA under imatinib treatment and clonal evolution are considered features of acceleration and define failure of therapy according to the European LeukemiaNet (ELN) recommendations. On the basis of 1151 Philadelphia chromosome positive chronic phase patients of the randomized CML-study IV, we examined the incidence of newly arising ACA under imatinib treatment with regard to the p210BCR-ABL breakpoint variants b2a2 and b3a2. We found a preferential acquisition of unbalanced ACA in patients with b3a2 vs. b2a2 fusion type (ratio: 6.3 vs. 1.6, p = 0.0246) concurring with a faster progress to blast crisis for b3a2 patients (p = 0.0124). ESPL1/Separase, a cysteine endopeptidase, is a key player in chromosomal segregation during mitosis. Separase overexpression and/or hyperactivity has been reported from a wide range of cancers and cause defective mitotic spindles, chromosome missegregation and aneuploidy. We investigated the influence of p210BCR-ABL breakpoint variants and imatinib treatment on expression and proteolytic activity of Separase as measured with a specific fluorogenic assay on CML cell lines (b2a2: KCL-22, BV-173; b3a2: K562, LAMA-84). Despite a drop in Separase protein levels an up to 5.4-fold increase of Separase activity under imatinib treatment was observed exclusively in b3a2 but not in b2a2 cell lines. Mimicking the influence of imatinib on BV-173 and LAMA-84 cells by ESPL1 silencing stimulated Separase proteolytic activity in both b3a2 and b2a2 cell lines. Our data suggest the existence of a fusion type-related feedback mechanism that posttranslationally stimulates Separase proteolytic activity after therapy-induced decreases in Separase protein levels. This could render b3a2 CML cells more prone to aneuploidy and clonal evolution than b2a2 progenitors

  5. Primary NK/T cell lymphoma nasal type of the colon.

    PubMed

    Mahuad, Carolina Valeria; Bilbao, Erica Rojas; Garate, Gonzalo Martín; de Los Ángeles Vicente Repáraz, María; Del Olmo, Mercedes; Casali, Claudia Érica; Zerga, Marta Elisa; Chirife, Ana María; Cicco, Juan Alberto

    2013-02-11

    Since nasal NK/T-cell lymphoma and NK/T-cell lymphoma nasal type are rare diseases, colonic involvement has seldom been seen. We report a case of a patient with a primary NK/T-cell lymphoma nasal type of the colon. The patient had no history of malignant diseases and was diagnosed after exhaustive study in the context of fever of unknown origin. The first therapeutic approach followed the DA-EPOCH-protocol: etoposide, prednisone, doxor-rubicin, vincristine and cyclophosphamide. The persistence of constitutional symptoms after the first treatment course motivated the switch to a second line following the SMILE-protocol: dexamethasone, metotrexate, ifosfamide, E.coli L-asparaginase, and etoposide. Despite intensive chemotherapy, the patient died 2 months after the diagnose of an extranodal NK/T-cell lymphoma of the colon and 4 months after the first symptomatic appearance of disease.

  6. Primary NK/T cell lymphoma nasal type of the colon

    PubMed Central

    Mahuad, Carolina Valeria; Bilbao, Érica Rojas; Garate, Gonzalo Martín; de los Ángeles Vicente Repáraz, María; del Olmo, Mercedes; Casali, Claudia Érica; Zerga, Marta Elisa; Chirife, Ana María; Cicco, Juan Alberto

    2013-01-01

    Since nasal NK/T-cell lymphoma and NK/T-cell lymphoma nasal type are rare diseases, colonic involvement has seldom been seen. We report a case of a patient with a primary NK/T-cell lymphoma nasal type of the colon. The patient had no history of malignant diseases and was diagnosed after exhaustive study in the context of fever of unknown origin. The first therapeutic approach followed the DA-EPOCH-protocol: etoposide, prednisone, doxor-rubicin, vincristine and cyclophosphamide. The persistence of constitutional symptoms after the first treatment course motivated the switch to a second line following the SMILE-protocol: dexamethasone, metotrexate, ifosfamide, E.coli L-asparaginase, and etoposide. Despite intensive chemotherapy, the patient died 2 months after the diagnose of an extranodal NK/T-cell lymphoma of the colon and 4 months after the first symptomatic appearance of disease. PMID:23772308

  7. Primary photoluminescence in as-neutron (electron) -irradiated n-type 6H-SiC

    NASA Astrophysics Data System (ADS)

    Zhong, Z. Q.; Wu, D. X.; Gong, M.; Wang, O.; Shi, S. L.; Xu, S. J.; Chen, X. D.; Ling, C. C.; Fung, S.; Beling, C. D.; Brauer, G.; Anwand, W.; Skorupa, W.

    2006-05-01

    Low-temperature photoluminescence spectroscopy has revealed a series of features labeled S1, S2, S3 in n-type 6H-SiC after neutron and electron irradiation. Thermal annealing studies showed that the defects S1, S2, S3 disappeared at 500 °C. However, the well-known D1 center was only detected for annealing temperatures over 700 °C. This experimental observation not only indicated that the defects S1, S2, S3 were a set of primary defects and the D1 center was a kind of secondary defect, but also showed that the D1 center and the E1, E2 observed using deep level transient spectroscopy might not be the same type of defects arising from the same physical origin.

  8. Novel findings in patients with primary hyperoxaluria type III and implications for advanced molecular testing strategies

    PubMed Central

    Beck, Bodo B; Baasner, Anne; Buescher, Anja; Habbig, Sandra; Reintjes, Nadine; Kemper, Markus J; Sikora, Przemyslaw; Mache, Christoph; Pohl, Martin; Stahl, Mirjam; Toenshoff, Burkhard; Pape, Lars; Fehrenbach, Henry; Jacob, Dorrit E; Grohe, Bernd; Wolf, Matthias T; Nürnberg, Gudrun; Yigit, Gökhan; Salido, Eduardo C; Hoppe, Bernd

    2013-01-01

    Identification of mutations in the HOGA1 gene as the cause of autosomal recessive primary hyperoxaluria (PH) type III has revitalized research in the field of PH and related stone disease. In contrast to the well-characterized entities of PH type I and type II, the pathophysiology and prevalence of type III is largely unknown. In this study, we analyzed a large cohort of subjects previously tested negative for type I/II by complete HOGA1 sequencing. Seven distinct mutations, among them four novel, were found in 15 patients. In patients of non-consanguineous European descent the previously reported c.700+5G>T splice-site mutation was predominant and represents a potential founder mutation, while in consanguineous families private homozygous mutations were identified throughout the gene. Furthermore, we identified a family where a homozygous mutation in HOGA1 (p.P190L) segregated in two siblings with an additional AGXT mutation (p.D201E). The two girls exhibiting triallelic inheritance presented a more severe phenotype than their only mildly affected p.P190L homozygous father. In silico analysis of five mutations reveals that HOGA1 deficiency is causing type III, yet reduced HOGA1 expression or aberrant subcellular protein targeting is unlikely to be the responsible pathomechanism. Our results strongly suggest HOGA1 as a major cause of PH, indicate a greater genetic heterogeneity of hyperoxaluria, and point to a favorable outcome of type III in the context of PH despite incomplete or absent biochemical remission. Multiallelic inheritance could have implications for genetic testing strategies and might represent an unrecognized mechanism for phenotype variability in PH. PMID:22781098

  9. Novel findings in patients with primary hyperoxaluria type III and implications for advanced molecular testing strategies.

    PubMed

    Beck, Bodo B; Baasner, Anne; Buescher, Anja; Habbig, Sandra; Reintjes, Nadine; Kemper, Markus J; Sikora, Przemyslaw; Mache, Christoph; Pohl, Martin; Stahl, Mirjam; Toenshoff, Burkhard; Pape, Lars; Fehrenbach, Henry; Jacob, Dorrit E; Grohe, Bernd; Wolf, Matthias T; Nürnberg, Gudrun; Yigit, Gökhan; Salido, Eduardo C; Hoppe, Bernd

    2013-02-01

    Identification of mutations in the HOGA1 gene as the cause of autosomal recessive primary hyperoxaluria (PH) type III has revitalized research in the field of PH and related stone disease. In contrast to the well-characterized entities of PH type I and type II, the pathophysiology and prevalence of type III is largely unknown. In this study, we analyzed a large cohort of subjects previously tested negative for type I/II by complete HOGA1 sequencing. Seven distinct mutations, among them four novel, were found in 15 patients. In patients of non-consanguineous European descent the previously reported c.700+5G>T splice-site mutation was predominant and represents a potential founder mutation, while in consanguineous families private homozygous mutations were identified throughout the gene. Furthermore, we identified a family where a homozygous mutation in HOGA1 (p.P190L) segregated in two siblings with an additional AGXT mutation (p.D201E). The two girls exhibiting triallelic inheritance presented a more severe phenotype than their only mildly affected p.P190L homozygous father. In silico analysis of five mutations reveals that HOGA1 deficiency is causing type III, yet reduced HOGA1 expression or aberrant subcellular protein targeting is unlikely to be the responsible pathomechanism. Our results strongly suggest HOGA1 as a major cause of PH, indicate a greater genetic heterogeneity of hyperoxaluria, and point to a favorable outcome of type III in the context of PH despite incomplete or absent biochemical remission. Multiallelic inheritance could have implications for genetic testing strategies and might represent an unrecognized mechanism for phenotype variability in PH.

  10. Recurrent peptic ulcer disease in a pediatric patient with type 1 neurofibromatosis and primary ciliary dyskinesia.

    PubMed

    Lionetti, E; Francavilla, R; Ruggieri, M; Di Stefano, V; Principi, M B; Pavone, L

    2009-10-01

    Neurofibromatosis type 1 is an autosomal dominant neurocutaneous disorder with characteristic features of skin and central nervous system involvement. Gastrointestinal complications are rare, especially during childhood. In adults, only two cases of peptic ulcer have been reported in neurofibromatosis, both due to Zollinger-Ellison syndrome. Peptic ulcer disease (PUD) may be primary or secondary in nature and it may be life threatening in the acute phase due to the risk of perforation. A case of recurrent gastrointestinal hemorrhage in a child with systemic neurofibromatosis and primary ciliary dyskinesia (PCD) is presented. The upper gastrointestinal endoscopy revealed the presence of multiple gastric ulcers. The ulcers scarred after the long-term administration of a proton pump inhibitor (PPI), but recurred after the suspension. Laboratory and imaging studies excluded Zollinger-Ellison syndrome and other known causes of PUD, suggesting a potential role of neurofibromatosis itself and primary ciliary dyskinesia in developing of recurrent PUD. As early diagnosis of PUD is vital for patient survival, this case report highlights the possible association of neurofibromatosis and PCD with this condition, responsive to PPI therapy and the potential need of gastric protection before complications arise.

  11. Endothelial progenitor dysfunction associates with a type I interferon signature in primary antiphospholipid syndrome.

    PubMed

    Grenn, Robert C; Yalavarthi, Srilakshmi; Gandhi, Alex A; Kazzaz, Nayef M; Núñez-Álvarez, Carlos; Hernández-Ramírez, Diego; Cabral, Antonio R; McCune, W Joseph; Bockenstedt, Paula L; Knight, Jason S

    2017-02-01

    Patients with antiphospholipid syndrome (APS) are at risk for subclinical endothelial injury, as well as accelerated atherosclerosis. In the related disease systemic lupus erythematosus, there is a well-established defect in circulating endothelial progenitors, which leads to an accrual of endothelial damage over time. This defect has been at least partially attributed to exaggerated expression of type I interferons (IFNs). We sought to determine whether these pathways are important in APS. We studied 68 patients with primary APS. Endothelial progenitors were assessed by flow cytometry and functional assay. Type I IFN activity was determined by a well-accepted bioassay, while peripheral blood mononuclear cells were scored for expression of IFN-responsive genes. Endothelial progenitors from patients with APS demonstrated a marked defect in the ability to differentiate into endothelial cells, a phenotype which could be mimicked by treating control progenitors with APS sera. Elevated type I IFN activity was detected in the circulation of patients with APS (a finding that was then replicated in an independent cohort). While IgG depletion from APS sera did not rescue endothelial progenitor function, the dysfunction was successfully reversed by a type I IFN receptor-neutralising antibody. We describe, for the first time to our knowledge, an IFN signature in primary APS and show that this promotes impaired endothelial progenitor function. This work opens the door to novel approaches that may mitigate vascular damage in APS, such as anti-IFN drugs. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  12. Paint removal using wheat starch blast media

    NASA Astrophysics Data System (ADS)

    Foster, Terry; Oestreich, John

    1993-03-01

    A review of the Wheat Starch Blasting technology is presented. Laboratory evaluations covering Almen Arc testing on bare 2024-T3 aluminum and magnesium, as well as crack detection on 7075-T6 bare aluminum, are discussed. Comparisons with Type V plastic media show lower residual stresses are achieved on aluminum and magnesium with wheat starch media. Dry blasting effects on the detection of cracks confirms better crack visibility with wheat starch media versus Type V or Type II plastic media. Testing of wheat starch media in several composite test programs, including fiberglass, Kevlar, and graphite-epoxy composites, showed no fiber damage. Process developments and production experience at the first U.S. aircraft stripping facility are also reviewed. Corporate and regional aircraft are being stripped in this three nozzle dry blast hanger.

  13. Evolution of interacting binaries with a B type primary at birth

    NASA Astrophysics Data System (ADS)

    van Rensbergen, W.; De Loore, C.; Jansen, K.

    2006-02-01

    We revisited the analytical expression for the mass ratio distribution for non-evolved binaries with a B type primary. Selection effects governing the observations were taken into account in order to compare theory with observations. Theory was optimized so as to fit best with the observed q-distribution of SB1s and SB2s. The accuracy of this theoretical mass ratio distribution function is severely hindered by the uncertainties on the observations. We present a library of evolutionary computations for binaries with a B type primary at birth. Some liberal computations including loss of mass and angular momentum during binary evolution are added to an extensive grid of conservative calculations. Our computations are compared statistically to the observed distributions of orbital periods and mass ratios of Algols. Conservative Roche Lobe Over Flow (RLOF) reproduces the observed distribution of orbital periods but fails to explain the observed mass ratios in the range q in [0.4-1]. In order to obtain a better fit the binaries have to lose a significant amount of matter, without losing much angular momentum.

  14. Prevalence, types and comorbidity of mental disorders in a Kenyan primary health centre.

    PubMed

    Aillon, Jean-Louis; Ndetei, David M; Khasakhala, Lincoln; Ngari, Washington Njogu; Achola, Hesbon Otieno; Akinyi, Selestine; Ribero, Simone

    2014-08-01

    To estimate the prevalence, types and comorbidity of the most common mental disorders and the spread of suicide risk in a primary care practice in Kenya. This was a cross-sectional descriptive study. A total of 300 adult outpatients were randomly selected while they were consulting their general practitioner. The M.I.N.I. Plus interview five was used to diagnose psychiatric disorders and suicide risk. Thus, 56.3 % of the sample (n = 169) presented one or more psychiatric disorders. The most prevalent disorders were Affective (39.0 %), Anxiety (31.3 %), and Somatoform (13.0 %). Regarding specific disorders, the most common were Major Depressive Disorder (26.3 %), Agoraphobia (16.7 %), Pain Disorder (12.5 %), Generalized Anxiety Disorder (9.3 %) and Bipolar Disorder (9 %). We found three cases of Bulimia Nervosa (1 %); 29.7 % had more than one current mental disorder. Suicide risk was present in 12.7 % of participants. No associations were identified between socio-demographic factors and the presence of mental disorder. Suicide risk was higher in women and in patients who came from slum areas. Gastric pain was positively associated with presence of mental disorder. High prevalence of mental disorders and suicide risk calls for integrating mental health services in primary health care; in particular, this study highlights the importance of differentiating between specific types of mental disorders (which require different therapeutic approaches), and of diagnosing comorbidities.

  15. Protein Homeostasis Defects of Alanine-Glyoxylate Aminotransferase: New Therapeutic Strategies in Primary Hyperoxaluria Type I

    PubMed Central

    Pey, Angel L.; Albert, Armando; Salido, Eduardo

    2013-01-01

    Alanine-glyoxylate aminotransferase catalyzes the transamination between L-alanine and glyoxylate to produce pyruvate and glycine using pyridoxal 5′-phosphate (PLP) as cofactor. Human alanine-glyoxylate aminotransferase is a peroxisomal enzyme expressed in the hepatocytes, the main site of glyoxylate detoxification. Its deficit causes primary hyperoxaluria type I, a rare but severe inborn error of metabolism. Single amino acid changes are the main type of mutation causing this disease, and considerable effort has been dedicated to the understanding of the molecular consequences of such missense mutations. In this review, we summarize the role of protein homeostasis in the basic mechanisms of primary hyperoxaluria. Intrinsic physicochemical properties of polypeptide chains such as thermodynamic stability, folding, unfolding, and misfolding rates as well as the interaction of different folding states with protein homeostasis networks are essential to understand this disease. The view presented has important implications for the development of new therapeutic strategies based on targeting specific elements of alanine-glyoxylate aminotransferase homeostasis. PMID:23956997

  16. Modeling pathogenesis of primary liver cancer in lineage-specific mouse cell types.

    PubMed

    Holczbauer, Agnes; Factor, Valentina M; Andersen, Jesper B; Marquardt, Jens U; Kleiner, David E; Raggi, Chiara; Kitade, Mitsuteru; Seo, Daekwan; Akita, Hirofumi; Durkin, Marian E; Thorgeirsson, Snorri S

    2013-07-01

    Human primary liver cancer is classified into biologically distinct subgroups based on cellular origin. Liver cancer stem cells (CSCs) have been recently described. We investigated the ability of distinct lineages of hepatic cells to become liver CSCs and the phenotypic and genetic heterogeneity of primary liver cancer. We transduced mouse primary hepatic progenitor cells, lineage-committed hepatoblasts, and differentiated adult hepatocytes with transgenes encoding oncogenic H-Ras and SV40LT. The CSC properties of transduced cells and their ability to form tumors were tested by standard in vitro and in vivo assays and transcriptome profiling. Irrespective of origin, all transduced cells acquired markers of CSC/progenitor cells, side populations, and self-renewal capacity in vitro. They also formed a broad spectrum of liver tumors, ranging from cholangiocarcinoma to hepatocellular carcinoma, which resembled human liver tumors, based on genomic and histologic analyses. The tumor cells coexpressed hepatocyte (hepatocyte nuclear factor 4α), progenitor/biliary (keratin 19, epithelial cell adhesion molecule, A6), and mesenchymal (vimentin) markers and showed dysregulation of genes that control the epithelial-mesenchymal transition. Gene expression analyses could distinguish tumors of different cellular origin, indicating the contribution of lineage stage-dependent genetic changes to malignant transformation. Activation of c-Myc and its target genes was required to reprogram adult hepatocytes into CSCs and for tumors to develop. Stable knockdown of c-Myc in transformed adult hepatocytes reduced their CSC properties in vitro and suppressed growth of tumors in immunodeficient mice. Any cell type in the mouse hepatic lineage can undergo oncogenic reprogramming into a CSC by activating different cell type-specific pathways. Identification of common and cell of origin-specific phenotypic and genetic changes could provide new therapeutic targets for liver cancer. Copyright

  17. Preliminary research on syndrome types of Chinese medicine in children with primary nephrotic syndrome.

    PubMed

    Sun, Wen; Yu, Jian; Zeng, Gu-Lan; Zhang, Bing-Feng

    2017-08-17

    To provide an objective reference for the syndrome types of Chinese medicine (CM) associated with pediatric primary nephrotic syndrome (PNS). A cross-sectional study was performed. Data on clinical symptoms, CM syndrome types, biochemical indices, and medications used were collected from 98 children with PNS. Then, the correlation between CM syndromes and biochemical indices, as well as medications used, was analyzed. The four most common symptoms in children with PNS were brown urine, red tongue, excessive sweating, and swelling of the face and limbs. The syndromes of qi deficiency of Fei (Lung) and Shen (Kidney) (FSQD) and yin deficiency of Gan (Liver) and Shen (GSYD) were the most common main CM syndrome types. FSQD syndrome score correlated significantly with the total cholesterol level, urine protein/creatinine ratio, and urine IgG and albumin levels (P<0.01 or P<0.05). The use of maintenance glucocorticoids combined with immunosuppressive agents correlated with FSQD syndrome, and the use of maintenance glucocorticoids alone correlated with GSYD syndrome (P<0.05). Two of the most common CM syndrome types were FSQD and GSYD syndromes. FSQD syndrome may be caused by some factors related to lipid levels, protein loss, and the use of immunosuppressive agents. The use of maintenance glucocorticoids may cause GSYD syndrome.

  18. A search for the primary abnormality in adult-onset type II citrullinemia

    SciTech Connect

    Kobayashi, Keiko; Shaheen, Nazma; Saheki, Takeyori ); Kumashiro, Ryukichi; Tanikawa, Kyuichi ); O'Brien, W.E.; Beaudet, A.L. )

    1993-11-01

    Deficiency of argininosuccinate synthetase (ASS) causes citrullinemia in human beings. Type II citrullinemia is found in most patients with adult-onset citrullinemia in Japan, and ASS deficiency is found specifically in the liver. Previous studies have shown that the decrease of hepatic ASS activity is caused by a decrease in enzyme protein with normal kinetic properties and that there were no apparent abnormalities in the amount, translational activity, and gross structure of hepatic ASS mRNA. In the present work, the authors show by sequencing analysis that there was no mutation in the ASS mRNA from two patients with type II citrullinemia. The authors also report RFLP analysis of a consanguineous family with type II citrullinemia, by using three DNA polymorphisms located within the ASS gene locus. In spite of having consanguineous parents, the patient was not a homozygous haplotype for the ASS gene. The RFLP analysis of 16 affected patients from consanguineous parents showed that 5 of 16 patients had the heterozygous pattern for one of the three DNA probes and that the frequency of the heterozygous haplotype was not different from the control frequency. These results suggest that the primary defect of type II citrullinemia is not within the ASS gene locus. 29 refs., 1 fig., 3 tabs.

  19. Blast Loading Experiments of Surrogate Models for Tbi Scenarios

    NASA Astrophysics Data System (ADS)

    Alley, M. D.; Son, S. F.

    2009-12-01

    This study aims to characterize the interaction of explosive blast waves through simulated anatomical models. We have developed physical models and a systematic approach for testing traumatic brain injury (TBI) mechanisms and occurrences. A simplified series of models consisting of spherical PMMA shells housing synthetic gelatins as brain simulants have been utilized. A series of experiments was conducted to compare the sensitivity of the system response to mechanical properties of the simulants under high strain-rate explosive blasts. Small explosive charges were directed at the models to produce a realistic blast wave in a scaled laboratory test cell setting. Blast profiles were measured and analyzed to compare system response severity. High-speed shadowgraph imaging captured blast wave interaction with the head model while particle tracking captured internal response for displacement and strain correlation. The results suggest amplification of shock waves inside the head near material interfaces due to impedance mismatches. In addition, significant relative displacement was observed between the interacting materials suggesting large strain values of nearly 5%. Further quantitative results were obtained through shadowgraph imaging of the blasts confirming a separation of time scales between blast interaction and bulk movement. These results lead to the conclusion that primary blast effects could cause TBI occurrences.

  20. Prognostic implication of human papillomavirus types and species in cervical cancer patients undergoing primary treatment.

    PubMed

    Lau, Yat Ming; Cheung, Tak Hong; Yeo, Winnie; Mo, Frankie; Yu, Mei Yung; Lee, Kun Min; Ho, Wendy C S; Yeung, Apple C M; Law, Priscilla T Y; Chan, Paul K S

    2015-01-01

    High-risk human papillomavirus (HPV) types are associated with cervical cancer. It is well established that individual HPV types vary in oncogenicity, but current data on their prognostic implication remain controversial. We examined the association between HPV types/species and the survival of 236 Chinese women aged 26-87 (mean 54.4) years after receiving primary treatment for cervical cancer. Overall, 45.8% were of FIGO stage I, 41.9% stage II, and 12.3% stage III. The four most prevalent types found were HPV-16 (60.2%), HPV-18 (21.6%), HPV-52 (11.9%), and HPV-58 (9.3%). Overall, 19.5% of patients had multiple-type infections, 78.4% harboured one or more alpha-9 species, and 28.8% harboured one or more alpha-7 species. After a median follow-up of 8.0 years, 156 (66.1%) patients survived. The 3-year overall survival rate was 75.5%. Factors independently associated with a poorer 3-year overall survival were age >60 years, tumour size >4 cm, lymph node involvement and treatment with radiotherapy+/-chemotherapy. Univariate analysis showed HPV-16 single-type infection was associated with a marginally poorer disease-specific survival (71.6% vs. 87.0%, HR: 1.71, 95% CI = 1.01-2.90), whereas non-HPV-16 alpha-9 species was associated with a better disease-specific survival (90.0% vs. 76.2%, HR: 0.36, 95% CI = 0.16-0.79). However, on multivariate analysis, HPV infection status irrespective of different grouping methods, including individual types, species, single-type or co-infection, did not carry any significant prognostic significance. In conclusion, we did not observe any association between infection with a particular HPV type/species and survival. An HPV type-based stratification in treatment and follow-up plan could not be recommended.

  1. High content screening application for cell-type specific behaviour in heterogeneous primary breast epithelial subpopulations.

    PubMed

    Johnston, Rebecca L; Wockner, Leesa; McCart Reed, Amy E; Wiegmans, Adrian; Chenevix-Trench, Georgia; Khanna, Kum Kum; Lakhani, Sunil R; Smart, Chanel E

    2016-02-09

    The complex interaction between multiple cell types and the microenvironment underlies the diverse pathways to carcinogenesis and necessitates sophisticated approaches to in vitro hypotheses testing. The combination of mixed culture format with high content immunofluorescence screening technology provides a powerful platform for observation of cell type specific behavior. We have developed a versatile, high-throughput method for assessing cell-type specific responses. In addition to the specificity and sensitivity offered traditionally by immunofluorescent detection in flow cytometry, the 'in-cell' analysis method we describe provides the added benefits of higher throughput and the ability to analyse protein subcellular localisation in situ. Furthermore, elimination of the cell dissociation step allows for more immediate analysis of responses to specific extrinsic stimuli. We applied this method to investigate ionising radiation treatment response in normal breast epithelial cells, measuring growth rate, cell cycle response and double-strand DNA breaks. The 'in-cell' analysis approach elucidated several interesting donor and cell-type specific differences. Notably, in response to ionizing radiation we observed differential expression in luminal and basal-like cells of a member of the APOBEC enzyme family, recently identified as a critical driver of an oncogenic signature. Our findings suggest that this enzyme is active in the normal breast epithelium during DNA damage response. We demonstrate the practical application of a new method for assessing cell-type specific change in mixed cultures, especially the analysis of normal primary cultures, overcoming a major technical issue of dissecting the response of multiple cell types in a heterogeneous population.

  2. Dry ice blasting

    NASA Astrophysics Data System (ADS)

    Lonergan, Jeffrey M.

    1992-04-01

    As legal and societal pressures against the use of hazardous waste generating materials has increased, so has the motivation to find safe, effective, and permanent replacements. Dry ice blasting is a technology which uses CO2 pellets as a blasting medium. The use of CO2 for cleaning and stripping operations offers potential for significant environmental, safety, and productivity improvements over grit blasting, plastic media blasting, and chemical solvent cleaning. Because CO2 pellets break up and sublime upon impact, there is no expended media to dispose of. Unlike grit or plastic media blasting which produce large quantities of expended media, the only waste produced by CO2 blasting is the material removed. The quantity of hazardous waste produced, and thus the cost of hazardous waste disposal is significantly reduced.

  3. Toxicology of blast overpressure.

    PubMed

    Elsayed, N M

    1997-07-25

    Blast overpressure (BOP) or high energy impulse noise, is the sharp instantaneous rise in ambient atmospheric pressure resulting from explosive detonation or firing of weapons. Blasts that were once confined to military and to a lesser extent, occupational settings, are becoming more universal as the civilian population is now increasingly at risk of exposure to BOP from terrorist bombings that are occurring worldwide with greater frequency. Exposure to incident BOP waves can cause auditory and non-auditory damage. The primary targets for BOP damage are the hollow organs, ear, lung and gastrointestinal tract. In addition, solid organs such as heart, spleen and brain can also be injured upon exposure. However, the lung is more sensitive to damage and its injury can lead to death. The pathophysiological responses, and mortality have been extensively studied, but little attention, was given to the biochemical manifestations, and molecular mechanism(s) of injury. The injury from BOP has been, generally, attributed to its external physical impact on the body causing internal mechanical damage. However, a new hypothesis has been proposed based on experiments conducted in the Department of Respiratory Research, Walter Reed Army Institute of Research, and later in the Department of Occupational Health, University of Pittsburgh. This hypothesis suggests that subtle biochemical changes namely, free radical-mediated oxidative stress occur and contribute to BOP-induced injury. Understanding the etiology of these changes may shed new light on the molecular mechanism(s) of injury, and can potentially offer new strategies for treatment. In this symposium. BOP research involving auditory, non-auditory, physiological, pathological, behavioral, and biochemical manifestations as well as predictive modeling and current treatment modalities of BOP-induced injury are discussed.

  4. A multi-mode shock tube for investigation of blast-induced traumatic brain injury.

    PubMed

    Reneer, Dexter V; Hisel, Richard D; Hoffman, Joshua M; Kryscio, Richard J; Lusk, Braden T; Geddes, James W

    2011-01-01

    Blast-induced mild traumatic brain injury (bTBI) has become increasingly common in recent military conflicts. The mechanisms by which non-impact blast exposure results in bTBI are incompletely understood. Current small animal bTBI models predominantly utilize compressed air-driven membrane rupture as their blast wave source, while large animal models use chemical explosives. The pressure-time signature of each blast mode is unique, making it difficult to evaluate the contributions of the different components of the blast wave to bTBI when using a single blast source. We utilized a multi-mode shock tube, the McMillan blast device, capable of utilizing compressed air- and compressed helium-driven membrane rupture, and the explosives oxyhydrogen and cyclotrimethylenetrinitramine (RDX, the primary component of C-4 plastic explosives) as the driving source. At similar maximal blast overpressures, the positive pressure phase of compressed air-driven blasts was longer, and the positive impulse was greater, than those observed for shockwaves produced by other driving sources. Helium-driven shockwaves more closely resembled RDX blasts, but by displacing air created a hypoxic environment within the shock tube. Pressure-time traces from oxyhydrogen-driven shockwaves were very similar those produced by RDX, although they resulted in elevated carbon monoxide levels due to combustion of the polyethylene bag used to contain the gases within the shock tube prior to detonation. Rats exposed to compressed air-driven blasts had more pronounced vascular damage than those exposed to oxyhydrogen-driven blasts of the same peak overpressure, indicating that differences in blast wave characteristics other than peak overpressure may influence the extent of bTBI. Use of this multi-mode shock tube in small animal models will enable comparison of the extent of brain injury with the pressure-time signature produced using each blast mode, facilitating evaluation of the blast wave components

  5. A Multi-Mode Shock Tube for Investigation of Blast-Induced Traumatic Brain Injury

    PubMed Central

    Reneer, Dexter V.; Hisel, Richard D.; Hoffman, Joshua M.; Kryscio, Richard J.; Lusk, Braden T.

    2011-01-01

    Abstract Blast-induced mild traumatic brain injury (bTBI) has become increasingly common in recent military conflicts. The mechanisms by which non-impact blast exposure results in bTBI are incompletely understood. Current small animal bTBI models predominantly utilize compressed air-driven membrane rupture as their blast wave source, while large animal models use chemical explosives. The pressure-time signature of each blast mode is unique, making it difficult to evaluate the contributions of the different components of the blast wave to bTBI when using a single blast source. We utilized a multi-mode shock tube, the McMillan blast device, capable of utilizing compressed air- and compressed helium-driven membrane rupture, and the explosives oxyhydrogen and cyclotrimethylenetrinitramine (RDX, the primary component of C-4 plastic explosives) as the driving source. At similar maximal blast overpressures, the positive pressure phase of compressed air-driven blasts was longer, and the positive impulse was greater, than those observed for shockwaves produced by other driving sources. Helium-driven shockwaves more closely resembled RDX blasts, but by displacing air created a hypoxic environment within the shock tube. Pressure-time traces from oxyhydrogen-driven shockwaves were very similar those produced by RDX, although they resulted in elevated carbon monoxide levels due to combustion of the polyethylene bag used to contain the gases within the shock tube prior to detonation. Rats exposed to compressed air-driven blasts had more pronounced vascular damage than those exposed to oxyhydrogen-driven blasts of the same peak overpressure, indicating that differences in blast wave characteristics other than peak overpressure may influence the extent of bTBI. Use of this multi-mode shock tube in small animal models will enable comparison of the extent of brain injury with the pressure-time signature produced using each blast mode, facilitating evaluation of the blast wave

  6. Blast furnace stove control

    SciTech Connect

    Muske, K.R.; Hansen, G.A.; Howse, J.W.; Cagliostro, D.J.; Chaubal, P.C.

    1998-12-31

    This paper outlines the process model and model-based control techniques implemented on the hot blast stoves for the No. 7 Blast Furnace at the Inland Steel facility in East Chicago, Indiana. A detailed heat transfer model of the stoves is developed. It is then used as part of a predictive control scheme to determine the minimum amount of fuel necessary to achieve the blast air requirements. The controller also considers maximum and minimum temperature constraints within the stove.

  7. Shared decision making for patients with type 2 diabetes: a randomized trial in primary care

    PubMed Central

    2013-01-01

    Background Patient-centered diabetes care requires shared decision making (SDM). Decision aids promote SDM, but their efficacy in nonacademic and rural primary care clinics is unclear. Methods We cluster-randomized 10 practices in a concealed fashion to implement either a decision aid (DA) about starting statins or one about choosing antihyperglycemic agents. Each practice served as a control group for another practice implementing the other type of DA. From April 2011 to July 2012, 103 (DA=53) patients with type 2 diabetes participated in the trial. We used patient and clinician surveys administered after the clinical encounter to collect decisional outcomes (patient knowledge and comfort with decision making, patient and clinician satisfaction). Medical records provided data on metabolic control. Pharmacy fill profiles provided data for estimating adherence to therapy. Results Compared to usual care, patients receiving the DA were more likely to report discussing medications (77% vs. 45%, p<.001), were more likely to answer knowledge questions correctly (risk reduction with statins 61% vs. 33%, p=.07; knowledge about options 57% vs. 33%, p=.002) and were more engaged by their clinicians in decision making (50. vs. 28, difference 21.4 (95% CI 6.4, 36.3), p=.01). We found no significant impact on patient satisfaction, medication starts, adherence or clinical outcomes, in part due to limited statistical power. Conclusion DAs improved decisional outcomes without significant effect on clinical outcomes. DAs designed for point-of-care use with type 2 diabetes patients promoted shared decision making in nonacademic and rural primary care practices. Trial Registration NCT01029288 PMID:23927490

  8. Barriers to effective management of type 2 diabetes in primary care: qualitative systematic review.

    PubMed

    Rushforth, Bruno; McCrorie, Carolyn; Glidewell, Liz; Midgley, Eleanor; Foy, Robbie

    2016-02-01

    Despite the availability of evidence-based guidance, many patients with type 2 diabetes do not achieve treatment goals. To guide quality improvement strategies for type 2 diabetes by synthesising qualitative evidence on primary care physicians' and nurses' perceived influences on care. Systematic review of qualitative studies with findings organised using the Theoretical Domains Framework. Databases searched were MEDLINE, Embase, CINAHL, PsycInfo, and ASSIA from 1980 until March 2014. Studies included were English-language qualitative studies in primary care of physicians' or nurses' perceived influences on treatment goals for type 2 diabetes. A total of 32 studies were included: 17 address general diabetes care, 11 glycaemic control, three blood pressure, and one cholesterol control. Clinicians struggle to meet evolving treatment targets within limited time and resources, and are frustrated with resulting compromises. They lack confidence in knowledge of guidelines and skills, notably initiating insulin and facilitating patient behaviour change. Changing professional boundaries have resulted in uncertainty about where clinical responsibility resides. Accounts are often couched in emotional terms, especially frustrations over patient compliance and anxieties about treatment intensification. Although resources are important, many barriers to improving care are amenable to behaviour change strategies. Improvement strategies need to account for differences between clinical targets and consider tailored rather than 'one size fits all' approaches. Training targeting knowledge is necessary but insufficient to bring about major change; approaches to improve diabetes care need to delineate roles and responsibilities, and address clinicians' skills and emotions around treatment intensification and facilitation of patient behaviour change. © British Journal of General Practice 2016.

  9. Adult T-cell leukemia/lymphoma: a case report of primary cutaneous tumoral type

    PubMed Central

    Lyra-da-Silva, Julia Ocampo; de Mello Gonzaga, Yung Bruno; de Melo Espíndola, Otávio; de Andrada-Serpa, Maria José; Dib, Cassio; Jeunon, Thiago

    2012-01-01

    Background: Adult T-cell leukemia/lymphoma (ATLL) is a distinctive peripheral T- lymphocytic malignancy associated with human T-cell lymphotropic virus type 1 (HTLV-1). It may closely resemble other skin lymphomas, particularly mycosis fungoides (MF). Case report: A 38-year-old woman presented some ellipsoid scaling patches lasting 18 months and developed a large tumoral lesion in the abdomen, which were previously diagnosed as MF. Although histopathologic and immunohistochemistry findings were in consonance with this diagnosis, the fast progression of the disease raised the suspicion that it could represent another type of T-cell lymphoma. The work-up revealed a positive anti-HTLV-1 serology and molecular studies confirmed the monoclonal integration of HTLV-1 provirus into neoplastic cells of the skin, but not into circulating lymphocytes. Extensive investigations were unable to demonstrate any systemic involvement. The final diagnosis was of primary cutaneous type of ATLL. The patient was submitted to a chemotherapy regimen with cyclophosphamide, doxorubicin, vincristine and prednisone, later to conjugated dexamethasone and surgical cytoreduction and then to a second line treatment with gemcitabine, resulting in partial response. A bone marrow heterologous transplantation was performed, but failed to achieve a sustained remission. Discussion: ATLL is a rare lymphoid malignancy in non-endemic HTLV-1 areas, the diagnosis of which could be missed if not highly suspected. In addition to the four subtypes of Shimoyama classification (acute, lymphomatous, chronic and smoldering), a fifth one denominated primary cutaneous and characterized by presence of lesions only in the skin had been proposed and is herein exemplified. PMID:23785591

  10. Barriers to effective management of type 2 diabetes in primary care: qualitative systematic review

    PubMed Central

    Rushforth, Bruno; McCrorie, Carolyn; Glidewell, Liz; Midgley, Eleanor; Foy, Robbie

    2016-01-01

    Background Despite the availability of evidence-based guidance, many patients with type 2 diabetes do not achieve treatment goals. Aim To guide quality improvement strategies for type 2 diabetes by synthesising qualitative evidence on primary care physicians’ and nurses’ perceived influences on care. Design and setting Systematic review of qualitative studies with findings organised using the Theoretical Domains Framework. Method Databases searched were MEDLINE, Embase, CINAHL, PsycInfo, and ASSIA from 1980 until March 2014. Studies included were English-language qualitative studies in primary care of physicians’ or nurses’ perceived influences on treatment goals for type 2 diabetes. Results A total of 32 studies were included: 17 address general diabetes care, 11 glycaemic control, three blood pressure, and one cholesterol control. Clinicians struggle to meet evolving treatment targets within limited time and resources, and are frustrated with resulting compromises. They lack confidence in knowledge of guidelines and skills, notably initiating insulin and facilitating patient behaviour change. Changing professional boundaries have resulted in uncertainty about where clinical responsibility resides. Accounts are often couched in emotional terms, especially frustrations over patient compliance and anxieties about treatment intensification. Conclusion Although resources are important, many barriers to improving care are amenable to behaviour change strategies. Improvement strategies need to account for differences between clinical targets and consider tailored rather than ‘one size fits all’ approaches. Training targeting knowledge is necessary but insufficient to bring about major change; approaches to improve diabetes care need to delineate roles and responsibilities, and address clinicians’ skills and emotions around treatment intensification and facilitation of patient behaviour change. PMID:26823263

  11. Treatment persistence after initiating basal insulin in type 2 diabetes patients: A primary care database analysis.

    PubMed

    Pscherer, Stefan; Chou, Engels; Dippel, Franz-Werner; Rathmann, Wolfgang; Kostev, Karel

    2015-10-01

    To compare persistence and its predictors in type 2 diabetes patients in primary care, initiating either basal supported oral therapy (BOT) or intensified conventional therapy (ICT) with glargine, detemir, or NPH insulin. In the BOT cohort, 1398 glargine (mean age: 68 years), 292 detemir (66 years), and 874 NPH (65 years) users from 918 practices were retrospectively analyzed (Disease Analyzer, Germany: 2008-2012). The ICT group incorporated 866 glargine (64 years), 512 detemir (60 years), and 1794 NPH (64 years) new users. Persistence was defined as proportion of patients remaining on the initial basal insulin (glargine, detemir and NPH insulin) over 2 years. Persistence was evaluated by Kaplan-Meier curves (log-rank tests) and Cox regression adjusting for age, sex, diabetes duration, antidiabetic co-therapy, comorbidities, specialist care, and private health insurance. In BOT, two-year persistence was 65%, 53%, and 59% in glargine, detemir, and NPH users, respectively (p<0.001). In ICT, persistence was higher without differences between groups: 84%, 85%, 86% in glargine, detemir, and NPH, respectively (p=0.536). In BOT, detemir and NPH users were more likely to discontinue basal insulin compared with glargine (detemir vs. glargine: adjusted Hazard Ratio; 95% CI: 1.56; 1.31-1.87; NPH vs. glargine: 1.22; 1.07-1.38). Heart failure (1.39; 1.16-1.67) was another predictor of non-persistence, whereas higher age (per year: 0.99; 0.98-0.99), metformin (0.61; 0.54-0.69), and sulfonylurea co-medication (0.86; 0.77-0.97) were associated with lower discontinuation. In BOT, treatment persistence among type 2 diabetes patients initiating basal insulin is influenced by type of insulin, antidiabetic co-medication, and patient characteristics. Copyright © 2015 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

  12. General view of blast furnace plant, with blast furnace "A" ...

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

    General view of blast furnace plant, with blast furnace "A" (built in 1907) to the left; in the foreground is the turbo-blower and blast furnace gas-powered electric generating station (built in 1919), looking northwest - Bethlehem Steel Corporation, South Bethlehem Works, Blast Furnace "A", Along Lehigh River, North of Fourth Street, West of Minsi Trail Bridge, Bethlehem, Northampton County, PA

  13. [Prevalence of renal involvement in a population of type Ii diabetics followed up in primary care].

    PubMed

    Marín, R; Coca, A; Tranche, S; Rodríguez Mañas, L; Abellán, J; Moyá, A

    2002-01-01

    Patients with type 2 diabetes use to be managed in their primary care settings during the early stages of the disease. The main objective of the study was to determine renal impairment prevalence, and to assess its significance, within type 2 diabetics controlled by their family physicians. Transverse observation of patients with type 2 diabetes who were the first 20 unselected cases seen by 183 family physicians from 16 of the 17 Autonomic Communities of our country. The following variables were determined: serum creatinine, glucose, and HbA1c concentrations, proteinuria (dipstick test in a first-voided morning urine sample), blood pressure levels, and associated cardiovascular disease. Data from 3,583 type 2 diabetic subjects were evaluated. Mean age was 64 +/- 10 years and 45% were male. A serum creatinine > or = 1.2 mg/dl was observed in 523 (15.5%) patients. Proteinuria was present in 794 (23.5%) cases, being > or = 2 + in 215 (6.5%) subjects. Patients with a serum creatinine > or = 1.2 mg/dl were older, shower higher blood pressure levels, and suffered from more cardiovascular disease (32.0 vs 19.5%) than those with a serum creatinine < 1.2 mg/dl. In a multivariate analysis, this difference continued to be significant (OR 1.47; 95% CI 1.14 to 1.90; p = 0.002. Patients with proteinuria showed a higher prevalence of cardiovascular disease (OR 1.83; 95% CI 1.47 to 2.27; p < 0.0001) than those without proteinuria. This association was continuous through no proteinuria to the > or = 2 + proteinuria (p < 0.001). Blood pressure level was > or = 140/90 mmHg in 69% of the cases, being < 130/85 mmHg in only 8% of the subjects. There is a high prevalence of renal impairment, approximately of 25% within type 2 diabetic patients seen at the primary care level. Optimal blood pressure level seems to be extremely infrequent bearing in mind the diagnosis of diabetes and the associated cardiovascular disease.

  14. [Better coordination between primary care, community settings and diabetes outpatient clinic for patients with type 2 diabetes].

    PubMed

    Gjessing, Hans Jørgen; Jørgensen, Ulla Linding; Møller, Charlotte Chrois; Huge, Lis; Dalgaard, Anne Mette; Nielsen, Kristian Wendelboe; Thomsen, Lis; Buch, Martin Sandberg

    2014-06-02

    Integrated care programmes for patients with type 2 diabetes can be successfully implemented by planning the programmes in coordination between the sectors primary care, community settings and diabetes outpatient clinic, and with involvement of leaders and employees. Our project has resulted in: 1) more patients with type 2 diabetes receiving diabetes management courses, 2) improved diabetes management of primary care, and 3) improved confidence and respect between sectors involved in diabetes care.

  15. Diffusion of digital breast tomosynthesis among women in primary care: associations with insurance type.

    PubMed

    Clark, Cheryl R; Tosteson, Tor D; Tosteson, Anna N A; Onega, Tracy; Weiss, Julie E; Harris, Kimberly A; Haas, Jennifer S

    2017-04-04

    Digital breast tomosynthesis (DBT) has shown potential to improve breast cancer screening and diagnosis compared to digital mammography (DM). The FDA approved DBT use in conjunction with conventional DM in 2011, but coverage was approved by CMS recently in 2015. Given changes in coverage policies, it is important to monitor diffusion of DBT by insurance type. This study examined DBT trends and estimated associations with insurance type. From June 2011 to September 2014, DBT use in 22 primary care centers in the Dartmouth -Brigham and Women's Hospital Population-based Research Optimizing Screening through Personalized Regimens research center (PROSPR) was examined among women aged 40-89. A longitudinal repeated measures analysis estimated the proportion of DBT performed for screening or diagnostic indications over time and by insurance type. During the study period, 93,182 mammograms were performed on 48,234 women. Of these exams, 16,506 DBT tests were performed for screening (18.1%) and 2537 were performed for diagnosis (15.7%). Between 2011 and 2014, DBT utilization increased in all insurance groups. However, by the latest observed period, screening DBT was used more frequently under private insurance (43.4%) than Medicaid (36.2%), Medicare (37.8%), other (38.6%), or no insurance (32.9%; P < 0.0001). No sustained differences in use of DBT for diagnostic testing were seen by insurance type. DBT is increasingly used for breast cancer screening and diagnosis. Use of screening DBT may be associated with insurance type. Surveillance is required to ensure that disparities in breast cancer screening are minimized as DBT becomes more widely available.

  16. Blasting response of the Eiffel Tower

    NASA Astrophysics Data System (ADS)

    Horlyck, Lachlan; Hayes, Kieran; Caetano, Ryan; Tahmasebinia, Faham; Ansourian, Peter; Alonso-Marroquin, Fernando

    2016-08-01

    A finite element model of the Eiffel Tower was constructed using Strand7 software. The model replicates the existing tower, with dimensions justified through the use of original design drawings. A static and dynamic analysis was conducted to determine the actions of the tower under permanent, imposed and wind loadings, as well as under blast pressure loads and earthquake loads due to an explosion. It was observed that the tower utilises the full axial capacity of individual members by acting as a `truss of trusses'. As such, permanent and imposed loads are efficiently transferred to the primary columns through compression, while wind loads induce tensile forces in the windward legs and compressive forces in the leeward. Under blast loading, the tower experienced both ground vibrations and blast pressures. Ground vibrations induced a negligibly small earthquake loading into the structure which was ignored in subsequent analyses. The blast pressure was significant, and a dynamic analysis of this revealed that further research is required into the damping qualities of the structure due to soil and mechanical properties. In the worst case scenario, the blast was assumed to completely destroy several members in the adjacent leg. Despite this weakened condition, it was observed that the tower would still be able to sustain static loads, at least for enough time for occupant evacuation. Further, an optimised design revealed the structure was structurally sound under a 46% reduction of the metal tower's mass.

  17. [Intimate partner violence. Types and risk in primary care health users in Cancun, Quintana Roo, Mexico].

    PubMed

    Sandoval-Jurado, Luis; Jiménez-Báez, María Valeria; Rovira Alcocer, Gloria; Vital Hernandez, Omar; Pat Espadas, Fany Guadalupe

    2017-10-01

    To identify the prevalence and type of intimate partner violence in women assigned at primary care health and estimates the risks for violence. Case (incident cases)-control. Primary health care unit in Cancun, Quintana Roo, Mexico. Women over 18years old living in couple at last 12months. Validated violence scale for Mexican population was evaluated: total partner violence, physical, psychological and sexual violence. History of violence and sociodemographic variables. Chi square for categorical variables and odds ratio (OR) for risk estimate was determined. The total intimate partner violence was 15.05%, psychological violence in 37.3%. Overall violence, age differences, socioeconomic status, marital status, history of violence and alcohol intake by the partner (P<.05) were observed. The risk increased in over 40 years old (OR: 2.09; 95%CI: 1.07 to 4.11), history of violence (OR: 5.9; 95%CI: 2.8 to 12.44) and alcohol intake by partner (OR=12.38; 95%CI: 2.15 to 29.59). Low socioeconomic status (OR: 0.384; 95%CI: 0.19 to 0.74) and free union (OR: 0.507; 95%CI: 0.27 to 0.95) were relation factors to lower intimate violence partner. Sexual violence predominated among users of primary health care and the risk that present this behavior increases with the consumption of alcoholic beverages in the couple and a history of violence, but the free union and socioeconomic status were possibility protected for violence. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  18. [Compliance with process indicators in people with type 2 diabetes and linking incentives in Primary Care].

    PubMed

    Pascual de la Pisa, Beatriz; Márquez Calzada, Cristina; Cuberos Sánchez, Carla; Cruces Jiménez, José Miguel; Fernández Gamaza, Manuel; Martínez Martínez, María Isabel

    2015-03-01

    Pay-for-performance programs to improve the quality of health care are extending gradually, particularly en Primary Health Care. Our aim was to explore the relationship between the degree of compliance with the process indicators (PrI) of type 2 diabetes (T2DM) in Primary Care and linkage to incentives. Cross-sectional, descriptive, observational study. Six Primary Health Care centers in Seville Aljarafe District randomly selected and stratified by population size. From 3.647 adults included in Integrated Healthcare Process of T2DM during 2008, 366 patients were included according sample size calculation by stratified random sampling. PrI: eye and feet examination, glycated hemoglobin, lipid profile, microalbuminuria and electrocardiogram. Confounding: Age, gender, characteristics town for patients and professional variables. The mean age was 66.36 years (standard deviation [DE]: 11,56); 48.9% were women. PrI with better compliance were feet examination, glycated hemoglobin and lipid profile (59.6%, 44.3% and 44%, respectively). 2.7% of patients had simultaneous compliance of the six PrI and 11.74% of patients three PrI linkage to incentives. Statistical association was observed in the compliance of the PrI incentives linked or not (P=.001). The degree of compliance with the PrI for screening chronic complications of T2DM is mostly low but this was higher on indicators linked to incentives. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

  19. Association of types of dyspnea including 'bendopnea' with cardiopulmonary disease in primary care.

    PubMed

    Martínez Cerón, Diana María; Garcia Rosa, Maria Luiza; Lagoeiro Jorge, Antônio Jose; de Andrade Martins, Wolney; Tinoco Mesquita, Evandro; Di Calafriori Freire, Monica; da Silva Correia, Dayse Mary; Kang, Hye Chung

    2017-03-01

    Dyspnea is the symptom most commonly reported by patients with heart failure (HF) and/or pulmonary disease, the obese and the elderly. Recently 'bendopnea' (shortness of breath when bending forward) has been described in patients with HF. To determine the association of exertional dyspnea, orthopnea, paroxysmal nocturnal dyspnea and bendopnea with chronic disease, especially heart failure, and their phenotypes in primary care. This cross-sectional study included 633 individuals aged between 45 and 99 years enrolled in a primary care program in Niteroi, Brazil. Participants underwent clinical assessment and laboratory tests and completed a questionnaire, all on the same day. Paroxysmal nocturnal dyspnea and bendopnea were associated with HF (unadjusted OR 2.42, 95% CI 1.10-5.29 and OR 2.59, 95% CI 1.52-4.44, respectively). In multivariate models, chronic obstructive pulmonary disease, coronary heart disease and myocardial infarction were not associated with bendopnea. Bendopnea was the only type of dyspnea not linked to respiratory disease or coronary heart disease. Even after adjusting for depression and body mass index, the association remained with HF with or without preserved ejection fraction, and bendopnea thus appears to be a promising symptom to differentiate HF from the other two disease groups. Copyright © 2016 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. Incidence and types of complications after ablative oral cancer surgery with primary microvascular free flap reconstruction.

    PubMed

    Lodders, Johannes N; Parmar, Satyesh; Stienen, Niki L M; Martin, Timothy J; Karagozoglu, K Hakki; Heymans, Martijn W; Nandra, Baljeet; Forouzanfar, Tymour

    2015-11-01

    The aims of the study were 1) to evaluate the incidence and types of postoperative complications after ablative oral cancer surgery with primary free flap reconstruction and 2) identify prognostic variables for postoperative complications. Desired data was retrieved from a computer database at the department of Oral and Maxillofacial Department, Queen Elisabeth hospital Birmingham, United Kingdom, between June 2007 and October 2012. Logistic regression was used to study relationships between preoperative variables and postoperative outcomes. The study population consisted 184 patients, comprising 189 composite resections with reconstruction. Complications developed in 40.2% of the patients. Three patients (1.6%) died, 11.1% returned to the operating room, 5.3% developed donor site complications and 6.9% flap complications of which 3.2% total flap failure. In the multivariable analysis systemic complications were associated with anaesthesia time and hospital stay with red cell transfusion. A significant proportion of the patients with primary free flap reconstructions after oral cancer surgery develops postoperative complications. Prolonged anaesthesia time and red cell transfusion are possible predictors for systemic complications and hospital stay respectively. Preoperative screening for risk factors is advocated for patient selection and to have realistic information and expectations.

  1. Primary headache in children and adolescents: update on pharmacotherapy of migraine and tension-type headache.

    PubMed

    Bonfert, Michaela; Straube, Andreas; Schroeder, Andreas Sebastian; Reilich, Peter; Ebinger, Friedrich; Heinen, Florian

    2013-02-01

    Primary headache disorders are frequently encountered in the pediatric population. The therapeutic approach consists of a multimodal program, including lifestyle modification, psychotherapeutic intervention, pharmacotherapy, and complementary measures. This systematic review focuses on the pharmacotherapy of pediatric migraine and tension-type headache (TTH). In addition to the general treatment principles, the results of 33 clinical reports published on the topic since 2008 are outlined in detail. Furthermore, a tabular summary of previously investigated agents not studied since 2008 is given, as is an overview of promising pharmacologic approaches so far only evaluated in adults. A variety of pharmacologic options is available, but high-quality evidence is limited to single agents. At this time, approval is restricted to four triptans and flupirtine for the symptomatic treatment of pediatric acute migraine and TTH, respectively. No agent has been approved for the prevention of pediatric primary headaches. This review does not grade the drugs hierarchically because the complex profiles of many agents differ only slightly or even overlap. However, a detailed expert opinion is provided. On the basis of the outlined facts, the team of physician, patient, and parents has to decide on the most appropriate regimen for the individual situation in the sense of personalized medicine. Georg Thieme Verlag KG Stuttgart · New York.

  2. Replication of human immunodeficiency virus type 1 in primary dendritic cell cultures.

    PubMed Central

    Langhoff, E; Terwilliger, E F; Bos, H J; Kalland, K H; Poznansky, M C; Bacon, O M; Haseltine, W A

    1991-01-01

    The ability of the human immunodeficiency virus type 1 (HIV-1) to replicate in primary blood dendritic cells was investigated. Dendritic cells compose less than 1% of the circulating leukocytes and are nondividing cells. Highly purified preparations of dendritic cells were obtained using recent advances in cell fractionation. The results of these experiments show that dendritic cells, in contrast to monocytes and T cells, support the active replication of all strains of HIV-1 tested, including T-cell tropic and monocyte/macrophage tropic isolates. The dendritic cell cultures supported much more virus production than did cultures of primary unseparated T cells, CD4+ T cells, and adherent as well as nonadherent monocytes. Replication of HIV-1 in dendritic cells produces no noticeable cytopathic effect nor does it decrease total cell number. The ability of the nonreplicating dendritic cells to support high levels of replication of HIV-1 suggests that this antigen-presenting cell population, which is also capable of supporting clonal T-cell growth, may play a central role in HIV pathogenesis, serving as a source of continued infection of CD4+ T cells and as a reservoir of virus infection. Images PMID:1910172

  3. Incidence and types of complications after ablative oral cancer surgery with primary microvascular free flap reconstruction

    PubMed Central

    Lodders, Johannes N.; Parmar, Satyesh; Stienen, Niki LM.; Martin, Timothy J.; Karagozoglu, K. Hakki; Heymans, Martijn W.; Nandra, Baljeet

    2015-01-01

    Background The aims of the study were 1) to evaluate the incidence and types of postoperative complications after ablative oral cancer surgery with primary free flap reconstruction and 2) identify prognostic variables for postoperative complications. Material and Methods Desired data was retrieved from a computer database at the department of Oral and Maxillofacial Department, Queen Elisabeth hospital Birmingham, United Kingdom, between June 2007 and October 2012. Logistic regression was used to study relationships between preoperative variables and postoperative outcomes. Results The study population consisted 184 patients, comprising 189 composite resections with reconstruction. Complications developed in 40.2% of the patients. Three patients (1.6%) died, 11.1% returned to the operating room, 5.3% developed donor site complications and 6.9% flap complications of which 3.2% total flap failure. In the multivariable analysis systemic complications were associated with anaesthesia time and hospital stay with red cell transfusion. Conclusions A significant proportion of the patients with primary free flap reconstructions after oral cancer surgery develops postoperative complications. Prolonged anaesthesia time and red cell transfusion are possible predictors for systemic complications and hospital stay respectively. Preoperative screening for risk factors is advocated for patient selection and to have realistic information and expectations. Key words:Free flap, complications, oral cancer, risk factors, reconstruction. PMID:26116846

  4. [Barometer of type 2 diabetes in primary care. Metabolic control, styles of life and morbidity profile].

    PubMed

    Pérez-Manchón, David; Rodríguez-Álvarez, María Lorena; Alcívar-Arteaga, Claudia; Redondo-Pico, Mercedes; Ramos-Quirós, Elena

    2016-12-28

    Knowing the profile of cardiovascular morbidity, degree of control and lifestyles in type 2 diabetes. Randomized multicenter cross-sectional study conducted in 2015 in primary care with 129 diabetics. It included sociodemographic variables, microvascular and macrovascular complications, organic damage, comorbidity and lifestyles of smoking, exercise and adherence to Mediterranean diet. Metabolic control was assessed with the latest annual glycosylated haemoglobin. 57% were men and 43% women. Metabolic control was acceptable (HbAc1%, 7.15%) without differences by town. 74.4% had cardiovascular comorbidity and the 99.2% risk factors. 23% were smokers and 41% sedentary with a 56% adherence to Mediterranean diet. The cardiometabolic profile of diabetes includes retinopathy, peripheral arterial disease, comorbidity of hypertension and cardiovascular risk factors. Individual or group health education in self-care and healthy lifestyles can improve metabolic control. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  5. A Rare Type of Primary Internal Hernia Causing Small Intestinal Obstruction

    PubMed Central

    Mohapatra, Vandana; Rath, Pratap Kumar

    2016-01-01

    Primary internal hernias are extremely rare in adults. They are an important cause of small intestinal obstruction and lead to high morbidity and mortality if left untreated. Clinical presentation of internal hernia is nonspecific. Imaging has been of limited utility in cases of acute intestinal obstruction; moreover, interpretation of imaging features is operator dependant. Thus, internal hernias are usually detected at laparotomy and preoperative diagnosis in an emergency setting is either difficult or most of the time not suspected. We report herein a case of a 45-year-old male who presented with acute intestinal obstruction which was attributed later to a very rare type of internal hernia on exploratory laparotomy. A loop of ileum was found to enter the retroperitoneum through a hernia gate which was located lateral to the sigmoid colon in the left paracolic gutter. The segment of intestine was reduced and the hernial defect was closed. Our finding represents an extremely rare variant of retroperitoneal hernias. PMID:27999703

  6. Aortopulmonary window parathyroid gland causing primary hyperparathyroidism in men type 1 syndrome.

    PubMed

    Tonelli, Francesco; Biagini, Carlo; Giudici, Francesco; Cioppi, Federica; Brandi, Maria Luisa

    2016-01-01

    Primary hyperparathyroidism (HPT) is the most common endocrinopathy in Multiple Endocrine Neoplasia type 1 (MEN1) syndrome. Supernumerary and/or ectopic parathyroid glands, potentially causes of persistent or recurrent HPT after surgery, have been previously described. However, this is the first ever described case of ectopic parathyroid gland localized in the aortopulmunary window causing HPT in MEN1. After a consistent concordant pre-operative imaging assessment the patient, a 16 years old male affected by a severe hypercalcemia, underwent surgery. The parathyroid was found very deeply near the tracheal bifurcation, hidden by the aortic arch itself and for this reason not visible at the beginning of the dissection but only after being identified by palpation for its typical consistence. The intraoperative PTH decreased at normal level 10 min after removal of the ectopic gland. The patient remained with normal value of calcemia and PTH during the 10 months of follow-up.

  7. Primary hyperoxaluria Type 1: indications for screening and guidance for diagnosis and treatment.

    PubMed

    Cochat, Pierre; Hulton, Sally-Anne; Acquaviva, Cécile; Danpure, Christopher J; Daudon, Michel; De Marchi, Mario; Fargue, Sonia; Groothoff, Jaap; Harambat, Jérôme; Hoppe, Bernd; Jamieson, Neville V; Kemper, Markus J; Mandrile, Giorgia; Marangella, Martino; Picca, Stefano; Rumsby, Gill; Salido, Eduardo; Straub, Michael; van Woerden, Christiaan S

    2012-05-01

    Primary hyperoxaluria Type 1 is a rare autosomal recessive inborn error of glyoxylate metabolism, caused by a deficiency of the liver-specific enzyme alanine:glyoxylate aminotransferase. The disorder results in overproduction and excessive urinary excretion of oxalate, causing recurrent urolithiasis and nephrocalcinosis. As glomerular filtration rate declines due to progressive renal involvement, oxalate accumulates leading to systemic oxalosis. The diagnosis is based on clinical and sonographic findings, urine oxalate assessment, enzymology and/or DNA analysis. Early initiation of conservative treatment (high fluid intake, pyridoxine, inhibitors of calcium oxalate crystallization) aims at maintaining renal function. In chronic kidney disease Stages 4 and 5, the best outcomes to date were achieved with combined liver-kidney transplantation.

  8. HCMV Displays a Unique Transcriptome of Immunomodulatory Genes in Primary Monocyte-Derived Cell Types

    PubMed Central

    Van Damme, Ellen; Thys, Kim; Tuefferd, Marianne; Van Hove, Carl; Aerssens, Jeroen; Van Loock, Marnix

    2016-01-01

    Human cytomegalovirus (HCMV) is a betaherpesvirus which rarely presents problems in healthy individuals, yet may result in severe morbidity in immunocompromised patients and in immune-naïve neonates. HCMV has a large 235 kb genome with a coding capacity of at least 165 open reading frames (ORFs). This large genome allows complex gene regulation resulting in different sets of transcripts during lytic and latent infection. While latent virus mainly resides within monocytes and CD34+ progenitor cells, reactivation to lytic infection is driven by differentiation towards terminally differentiated myeloid dendritic cells and macrophages. Consequently, it has been suggested that macrophages and dendritic cells contribute to viral spread in vivo. Thus far only limited knowledge is available on the expression of HCMV genes in terminally differentiated myeloid primary cells and whether or not the virus exhibits a different set of lytic genes in primary cells compared with lytic infection in NHDF fibroblasts. To address these questions, we used Illumina next generation sequencing to determine the HCMV transcriptome in macrophages and dendritic cells during lytic infection and compared it to the transcriptome in NHDF fibroblasts. Here, we demonstrate unique expression profiles in macrophages and dendritic cells which significantly differ from the transcriptome in fibroblasts mainly by modulating the expression of viral transcripts involved in immune modulation, cell tropism and viral spread. In a head to head comparison between macrophages and dendritic cells, we observed that factors involved in viral spread and virion composition are differentially regulated suggesting that the plasticity of the virion facilitates the infection of surrounding cells. Taken together, this study provides the full transcript expression analysis of lytic HCMV genes in monocyte-derived type 1 and type 2 macrophages as well as in monocyte-derived dendritic cells. Thereby underlining the potential

  9. MCP-1 expression by rat type II alveolar epithelial cells in primary culture.

    PubMed

    Paine, R; Rolfe, M W; Standiford, T J; Burdick, M D; Rollins, B J; Strieter, R M

    1993-05-15

    Recruitment and activation of mononuclear phagocytes are potentially critical regulatory events for control of pulmonary inflammation. Located at the boundary between the alveolar airspace and the interstitium, alveolar epithelial cells are ideally situated to regulate the recruitment and activation of mononuclear phagocytes through the production of cytokines in response to inflammatory stimulation from the alveolar space. To test this hypothesis, we investigated the production of monocyte chemotactic polypeptide-1 (MCP-1), a protein that is chemotactic for and that activates monocytes, by rat type II alveolar epithelial cells in primary culture. Immunocytochemical staining using anti-murine JE, an antibody recognizing rat MCP-1, demonstrated cell-associated MCP-1 Ag throughout the monolayer. The intensity of staining was increased in response to IL-1 beta. When type II epithelial cells formed a tight monolayer on a filter support, there was polar secretion of MCP-1 Ag into the apical compartment by both control and IL-1-stimulated cells as measured by specific MCP-1 ELISA. Northern blot analysis revealed that IL-1 and TNF-alpha stimulated MCP-1 mRNA expression in a dose-dependent manner, whereas dexamethasone blocked MCP-1 expression by cells stimulated with IL-1. In contrast to previous results using transformed epithelial cell lines, MCP-1 mRNA was induced in these primary cultures directly by stimulation with LPS. These data suggest that alveolar epithelial cells may have an important and previously unrecognized role in the initiation and maintenance of inflammatory processes in the lung by recruiting and activating circulating monocytes through the production of MCP-1.

  10. Safety climate and its association with office type and team involvement in primary care.

    PubMed

    Gehring, Katrin; Schwappach, David L B; Battaglia, Markus; Buff, Roman; Huber, Felix; Sauter, Peter; Wieser, Markus

    2013-09-01

    To assess differences in safety climate perceptions between occupational groups and types of office organization in primary care. Primary care physicians and nurses working in outpatient offices were surveyed about safety climate. Explorative factor analysis was performed to determine the factorial structure. Differences in mean climate scores between staff groups and types of office were tested. Logistic regression analysis was conducted to determine predictors for a 'favorable' safety climate. 630 individuals returned the survey (response rate, 50%). Differences between occupational groups were observed in the means of the 'team-based error prevention'-scale (physician 4.0 vs. nurse 3.8, P < 0.001). Medical centers scored higher compared with single-handed offices and joint practices on the 'team-based error prevention'-scale (4.3 vs. 3.8 vs. 3.9, P < 0.001) but less favorable on the 'rules and risks'-scale (3.5 vs. 3.9 vs. 3.7, P < 0.001). Characteristics on the individual and office level predicted favorable 'team-based error prevention'-scores. Physicians (OR = 0.4, P = 0.01) and less experienced staff (OR 0.52, P = 0.04) were less likely to provide favorable scores. Individuals working at medical centers were more likely to provide positive scores compared with single-handed offices (OR 3.33, P = 0.001). The largest positive effect was associated with at least monthly team meetings (OR 6.2, P < 0.001) and participation in quality circles (OR 4.49, P < 0.001). Results indicate that frequent quality circle participation and team meetings involving all team members are effective ways to strengthen safety climate in terms of team-based strategies and activities in error prevention.

  11. Anaemia and type 2 diabetes: implications from a retrospectively studied primary care case series.

    PubMed

    Chen, C Xr; Li, Y C; Chan, S L; Chan, K H

    2013-06-01

    OBJECTIVES. To identify the prevalence of anaemia in Chinese type 2 diabetic patients managed in a primary care setting and to explore its associations with cardiovascular complications and kidney disease. DESIGN. Retrospective case series study. SETTING. General Out-patient Clinic of Hospital Authority, Hong Kong. PATIENTS. Chinese type 2 diabetic patients who had annual assessments between 1 January 2010 and 31 December 2011 were recruited. Their complete blood picture, serum creatinine, estimated glomerular filtration rate (calculated by Modification of Diet in Renal Disease method), haemoglobin A1c, and urine albumin-creatinine ratio were retrieved. Anaemia was defined as a haemoglobin level of <130 g/L in men and <120 g/L in women (World Health Organization criteria). Student's t test and analysis of variance were used to analyse continuous variables and the Chi squared test for categorical data. Pearson's correlation coefficient and multivariate logistic regression were used to examine associations between haemoglobin level and different variables including age, gender, serum creatinine level, estimated glomerular filtration rate, and urine albumin-creatinine ratio. All statistical tests were two-sided, and a P value of <0.05 was considered significant. RESULTS. Among 6325 Chinese type 2 diabetic patients fulfilling the inclusion criteria, 1441 were found to have anaemia with a period prevalence of 22.8%. The prevalence of anaemia increased significantly with deterioration of renal function. Compared with diabetic patients with normal haemoglobin levels, anaemic diabetic patients had a higher co-morbidity rate for stroke, ischaemic heart disease, hypertension, and chronic kidney disease (P<0.001). Independent predictors for haemoglobin level among diabetic patients were age, gender, serum creatinine level, estimated glomerular filtration rate, haemoglobin A1c, and urine albumin-creatinine ratio (P<0.001). Multivariate analysis showed that male gender, old age

  12. Understanding of blood pressure by people with type 2 diabetes: a primary care focus group study

    PubMed Central

    Stewart, Jane; Brown, Ken; Kendrick, Denise; Dyas, Jane

    2005-01-01

    Background For many people with type 2 diabetes most care is provided in primary care. While people with both diabetes and hypertension are at increased risk of complications, little is known about their understanding of blood pressure. Aim To explore the understanding and beliefs about the importance of blood pressure held by people with type 2 diabetes. Design of study Framework analysis of qualitative research using focus groups. Setting Thirty-two participants were recruited from four general practices and a religious meeting group in Nottingham. Discussions took place in five community centres providing familiar surroundings for participants. Method In order to get views expressed fully, white, Asian, and African–Caribbean participants met in five separate groups. Facilitators were fluent in the appropriate language and one member of the research team was present at all focus groups. Results Some participants, including those with raised blood pressure, were not aware of the increased importance of achieving good blood pressure control. No participants mentioned the increased risk of eye or kidney disease as a result of the combination of diabetes and raised blood pressure. Participants' perceptions regarding the control of blood sugar and blood pressure were different: blood sugar control was seen as their responsibility but blood pressure control was seen as the responsibility of the doctor. There was scepticism regarding the diagnosis of raised blood pressure, of targets and the management of blood pressure. There was also scepticism about the advice and education about diabetes given in primary care. Conclusions People with type 2 diabetes require more knowledge of the increased risks they have from raised blood pressure, although this alone is unlikely to improve blood-pressure control. Strategies to increase the degree of control over and responsibility taken for the control of blood pressure need development and may require the specific development of

  13. Primary Isolation Strain Determines Both Phage Type and Receptors Recognised by Campylobacter jejuni Bacteriophages

    PubMed Central

    Sørensen, Martine C. Holst; Gencay, Yilmaz Emre; Birk, Tina; Baldvinsson, Signe Berg; Jäckel, Claudia; Hammerl, Jens A.; Vegge, Christina S.; Neve, Horst; Brøndsted, Lone

    2015-01-01

    In this study we isolated novel bacteriophages, infecting the zoonotic bacterium Campylobacter jejuni. These phages may be used in phage therapy of C. jejuni colonized poultry to prevent spreading of the bacteria to meat products causing disease in humans. Many C. jejuni phages have been isolated using NCTC12662 as the indicator strain, which may have biased the selection of phages. A large group of C. jejuni phages rely on the highly diverse capsular polysaccharide (CPS) for infection and recent work identified the O-methyl phosphoramidate modification (MeOPN) of CPS as a phage receptor. We therefore chose seven C. jejuni strains each expressing different CPS structures as indicator strains in a large screening for phages in samples collected from free-range poultry farms. Forty-three phages were isolated using C. jejuni NCTC12658, NCTC12662 and RM1221 as host strains and 20 distinct phages were identified based on host range analysis and genome restriction profiles. Most phages were isolated using C. jejuni strains NCTC12662 and RM1221 and interestingly phage genome size (140 kb vs. 190 kb), host range and morphological appearance correlated with the isolation strain. Thus, according to C. jejuni phage grouping, NCTC12662 and NCTC12658 selected for CP81-type phages, while RM1221 selected for CP220-type phages. Furthermore, using acapsular ∆kpsM mutants we demonstrated that phages isolated on NCTC12658 and NCTC12662 were dependent on the capsule for infection. In contrast, CP220-type phages isolated on RM1221 were unable to infect non-motile ∆motA mutants, hence requiring motility for successful infection. Hence, the primary phage isolation strain determines both phage type (CP81 or CP220) as well as receptors (CPS or flagella) recognised by the isolated phages. PMID:25585385

  14. Primary isolation strain determines both phage type and receptors recognised by Campylobacter jejuni bacteriophages.

    PubMed

    Sørensen, Martine C Holst; Gencay, Yilmaz Emre; Birk, Tina; Baldvinsson, Signe Berg; Jäckel, Claudia; Hammerl, Jens A; Vegge, Christina S; Neve, Horst; Brøndsted, Lone

    2015-01-01

    In this study we isolated novel bacteriophages, infecting the zoonotic bacterium Campylobacter jejuni. These phages may be used in phage therapy of C. jejuni colonized poultry to prevent spreading of the bacteria to meat products causing disease in humans. Many C. jejuni phages have been isolated using NCTC12662 as the indicator strain, which may have biased the selection of phages. A large group of C. jejuni phages rely on the highly diverse capsular polysaccharide (CPS) for infection and recent work identified the O-methyl phosphoramidate modification (MeOPN) of CPS as a phage receptor. We therefore chose seven C. jejuni strains each expressing different CPS structures as indicator strains in a large screening for phages in samples collected from free-range poultry farms. Forty-three phages were isolated using C. jejuni NCTC12658, NCTC12662 and RM1221 as host strains and 20 distinct phages were identified based on host range analysis and genome restriction profiles. Most phages were isolated using C. jejuni strains NCTC12662 and RM1221 and interestingly phage genome size (140 kb vs. 190 kb), host range and morphological appearance correlated with the isolation strain. Thus, according to C. jejuni phage grouping, NCTC12662 and NCTC12658 selected for CP81-type phages, while RM1221 selected for CP220-type phages. Furthermore, using acapsular ∆kpsM mutants we demonstrated that phages isolated on NCTC12658 and NCTC12662 were dependent on the capsule for infection. In contrast, CP220-type phages isolated on RM1221 were unable to infect non-motile ∆motA mutants, hence requiring motility for successful infection. Hence, the primary phage isolation strain determines both phage type (CP81 or CP220) as well as receptors (CPS or flagella) recognised by the isolated phages.

  15. Prolonged excretion of type-2 poliovirus from a primary immune deficient patient during the transition to a type-2 poliovirus-free world, Israel, 2016

    PubMed Central

    Weil, Merav; Shulman, Lester M; Heiman, Sophia; Stauber, Tali; Alfandari, Jacqueline; Weiss, Leah; Silberstein, Ilana; Indenbaum, Viki; Mendelson, Ella; Sofer, Danit

    2016-01-01

    Wild poliovirus type-2 has been eradicated, use of live type-2 vaccine has been terminated globally, and all type-2 polioviruses are under strict laboratory containment protocols. Re-emergence may arise from prolonged asymptomatic excretion of poliovirus by hospitalised primary immune deficient (PID) patients, as described here, through repeated exposure of close contacts to high titres of infected material. At this transition time, PID patients should be screened and hospital containment protocols updated in parallel with laboratory containment. PMID:27918258

  16. Cell-Type-Specific Cytokinin Distribution within the Arabidopsis Primary Root Apex.

    PubMed

    Antoniadi, Ioanna; Plačková, Lenka; Simonovik, Biljana; Doležal, Karel; Turnbull, Colin; Ljung, Karin; Novák, Ondřej

    2015-07-01

    Cytokinins (CKs) play a crucial role in many physiological and developmental processes at the levels of individual plant components (cells, tissues, and organs) and by coordinating activities across these parts. High-resolution measurements of intracellular CKs in different plant tissues can therefore provide insights into their metabolism and mode of action. Here, we applied fluorescence-activated cell sorting of green fluorescent protein (GFP)-marked cell types, combined with solid-phase microextraction and an ultra-high-sensitivity mass spectrometry (MS) method for analysis of CK biosynthesis and homeostasis at cellular resolution. This method was validated by series of control experiments, establishing that protoplast isolation and cell sorting procedures did not greatly alter endogenous CK levels. The MS-based method facilitated the quantification of all the well known CK isoprenoid metabolites in four different transgenic Arabidopsis thaliana lines expressing GFP in specific cell populations within the primary root apex. Our results revealed the presence of a CK gradient within the Arabidopsis root tip, with a concentration maximum in the lateral root cap, columella, columella initials, and quiescent center cells. This distribution, when compared with previously published auxin gradients, implies that the well known antagonistic interactions between the two hormone groups are cell type specific. © 2015 American Society of Plant Biologists. All rights reserved.

  17. Mental ability performance among adults with type 2 diabetes in primary care

    PubMed Central

    2009-01-01

    Aim and method The present university-based outpatient clinic, cross-sectional study assessed cognitive performance in a sample of 137 adults, with the primary objective of determining differences in cognitive performance as a function of gender and hypertension status in a type 2 diabetes cohort. Results Approximately 64% of the sample was 65 years old and younger, and 50 subjects had > 13 years of education. Global mental ability scores were relatively similar by age grouping, and higher-ordered cognitive functioning and reading literacy were strongly correlated, r (98) = 0.62, P < 0.01. Approximately 30% of the sample posted global mental ability scores in the slow learner range on tasks measuring attention, immediate memory and verbal reasoning. Males achieved higher cognitive functioning scores compared to females on multiple mental ability tasks. The presence of hypertension was associated with significantly worse cognitive performance compared to those subjects without hypertension, t = 2.11, P = 0.03. Approximately 57% of the hypertension group was classified as mild cognitive impaired. Conclusion While approximately half of the general population can be expected to demonstrate an average range of performance on cognitive ability measures, such an expectation could be inappropriately generalised to persons diagnosed with type 2 diabetes, even among those who were high school educated. PMID:22477898

  18. The management of type 1 diabetes in primary school: review of the literature.

    PubMed

    Marks, Anne; Wilson, Valerie; Crisp, Jackie

    2013-01-01

    Type 1 diabetes is one of the most common chronic health conditions in childhood. The introduction of intensive insulin therapy and the rising prevalence of diabetes in younger children has increased the need for involvement of diabetes educators and school personnel in school diabetes care. School encompasses a significant proportion of a child's day, therefore diabetes treatment at school needs to be optimal or the child will have poor metabolic control. The aim of this literature review is to examine diabetes management in the early primary school setting. The main areas of diabetes management explored are: type, provision, and location of treatment, the impact on the child, and the role of the credentialed diabetes educator. The review identifies that the majority of children are not receiving intensive diabetes treatment at school. Younger children require more assistance with care and may be disadvantaged due to lack of appropriate school staff support. Most schools do not have nurses to assist with diabetes care, therefore teaching and administration staff are utilized. The use of insulin pump therapy may increase access to insulin at school, as children and teaching staff appear more confident with this method of delivery than injections. Treatment is frequently performed away from the classroom and can impact on class attendance, metabolic control, and emergencies. Diabetes educators need to work in collaboration with children, parents, and school personnel to ensure diabetes care is fully integrated into the school day.

  19. Mental ability performance among adults with type 2 diabetes in primary care.

    PubMed

    Mount, David L; Lambert, Michael C

    2009-06-01

    Aim and method The present university-based outpatient clinic, cross-sectional study assessed cognitive performance in a sample of 137 adults, with the primary objective of determining differences in cognitive performance as a function of gender and hypertension status in a type 2 diabetes cohort.Results Approximately 64% of the sample was 65 years old and younger, and 50 subjects had > 13 years of education. Global mental ability scores were relatively similar by age grouping, and higher-ordered cognitive functioning and reading literacy were strongly correlated, r (98) = 0.62, P < 0.01. Approximately 30% of the sample posted global mental ability scores in the slow learner range on tasks measuring attention, immediate memory and verbal reasoning. Males achieved higher cognitive functioning scores compared to females on multiple mental ability tasks. The presence of hypertension was associated with significantly worse cognitive performance compared to those subjects without hypertension, t = 2.11, P = 0.03. Approximately 57% of the hypertension group was classified as mild cognitive impaired.Conclusion While approximately half of the general population can be expected to demonstrate an average range of performance on cognitive ability measures, such an expectation could be inappropriately generalised to persons diagnosed with type 2 diabetes, even among those who were high school educated.

  20. Robotic Water Blast Cleaner

    NASA Technical Reports Server (NTRS)

    Sharpe, M. H.; Roberts, M. L.; Hill, W. E.; Jackson, C. H.

    1983-01-01

    Water blasting system under development removes hard, dense, extraneous material from surfaces. High pressure pump forces water at supersonic speed through nozzle manipulated by robot. Impact of water blasts away unwanted material from workpiece rotated on air bearing turntable. Designed for removing thermal-protection material, system is adaptable to such industrial processes as cleaning iron or steel castings.

  1. Lightweight blast shield

    DOEpatents

    Mixon, Larry C.; Snyder, George W.; Hill, Scott D.; Johnson, Gregory L.; Wlodarski, J. Frank; von Spakovsky, Alexis P.; Emerson, John D.; Cole, James M.; Tipton, John P.

    1991-01-01

    A tandem warhead missile arrangement that has a composite material housing structure with a first warhead mounted at one end and a second warhead mounted near another end of the composite structure with a dome shaped composite material blast shield mounted between the warheads to protect the second warhead from the blast of the first warhead.

  2. Robotic Water Blast Cleaner

    NASA Technical Reports Server (NTRS)

    Sharpe, M. H.; Roberts, M. L.; Hill, W. E.; Jackson, C. H.

    1983-01-01

    Water blasting system under development removes hard, dense, extraneous material from surfaces. High pressure pump forces water at supersonic speed through nozzle manipulated by robot. Impact of water blasts away unwanted material from workpiece rotated on air bearing turntable. Designed for removing thermal-protection material, system is adaptable to such industrial processes as cleaning iron or steel castings.

  3. Moderate blast exposure results in increased IL-6 and TNFα in peripheral blood.

    PubMed

    Gill, Jessica; Motamedi, Vida; Osier, Nicole; Dell, Kristine; Arcurio, Lindsay; Carr, Walter; Walker, Peter; Ahlers, Stephen; LoPresti, Mathew; Yarnell, Angela

    2017-10-01

    A unique cohort of military personnel exposed to isolated blast was studied to explore acute peripheral cytokine levels, with the aim of identifying blast-specific biomarkers. Several cytokines, including interleukin (IL) 6, IL-10 and tumor necrosis factor alpha (TNFα) have been linked to pre-clinical blast exposure, but remained unstudied in clinical blast exposure. To address this gap, blood samples from 62 military personnel were obtained at baseline, and daily, during a 10-day blast-related training program; changes in the peripheral concentrations of IL-6, IL-10 and TNFα were evaluated using an ultrasensitive assay. Two groups of trainees were matched on age, duration of military service, and previous history of blast exposure(s), resulting in moderate blast cases and no/low blast controls. Blast exposures were measured using helmet sensors that determined the average peak pressure in pounds per square inch (psi). Moderate blast cases had significantly elevated concentrations of IL-6 (F1,60=18.81, p<0.01) and TNFα (F1,60=12.03, p<0.01) compared to no/low blast controls; levels rebounded to baseline levels the day after blast. On the day of the moderate blast exposure, the extent of the overpressure (psi) in those exposed correlated with IL-6 (r=0.46, p<0.05) concentrations. These findings indicate that moderate primary blast exposure results in changes, specifically acute and transient increases in peripheral inflammatory markers which may have implications for neuronal health. Published by Elsevier Inc.

  4. Multifactorial control and treatment intensity of type-2 diabetes in primary care settings in Catalonia

    PubMed Central

    2010-01-01

    Background Many studies on diabetes have demonstrated that an intensive control of glycaemia and the main associated risk factors (hypertension, dislipidaemia, obesity and smoking) reduce cardiovascular morbi-mortality. Different scientific societies have proposed a multifactorial approach to type 2 diabetes. The objective of this study was to identify the degree of control of glycosylated haemoglobin (HbA1c) and of cardiovascular risk factors in type 2 diabetic patients, using the GedapS 2004 guidelines, and to analyse the type and intensity of drug treatment. Methods This cross-sectional, multicentre, epidemiological study was conducted in a primary care setting in Vallès Occidental South, Catalonia. Data were collected of 393 patients aged 18 and above who were diagnosed with diabetes mellitus type 2. Biodemographic and clinical data, cardiovascular risk factors, associated cardiovascular disease, and treatment were assessed. Descriptive and multivariable analysis with logistic regression was realized. Results A total of 392 patients with a mean age of 66.8 years (SD = 10.6) (45.4% male patients) were analyzed. The duration of diabetes was 8.4 years (SD = 7.6). The degree of multifactorial control of risk factors was only 2.6%, although in more than 50% individual cardiovascular risk factor was controlled, except for LDL cholesterol (40.6%) and systolic blood pressure (29.6%). Furthermore, only 13.0% of subjects had an optimal BMI, 27.5% an optimal waist circumference. Treatment for diabetes was prescribed in 82.7% of patients, for hypertension 70.7%, for dyslipidaemia 47.2% and 40.1% were taking antiplatelets. Conclusion Over 50% of type 2 diabetic patients presented optimal control of the majority of individual cardiovascular risk factors, although the degree of multifactorial control of diabetes was insufficient (2.6%) and should be improved. Drug treatment can be intensified using a larger number of combinations, particularly in patients with target organ

  5. Racial/Ethnic Disparities in Primary Care Quality Among Type 2 Diabetes Patients, Medical Expenditure Panel Survey, 2012

    PubMed Central

    Hu, Ruwei; Shi, Leiyu; Liang, Hailun; Haile, Geraldine Pierre

    2016-01-01

    Introduction Racial and ethnic disparities exist in diabetes prevalence, access to diabetes care, diabetes-related complications and mortality rates, and the quality of diabetes care among Americans. We explored racial and ethnic disparities in primary care quality among Americans with type 2 diabetes. Methods We analyzed data on adults with type 2 diabetes derived from the household component of the 2012 Medical Expenditure Panel Survey. Multiple regression and multivariate logistic regressions were used to examine the association between race/ethnicity and primary care attributes related to first contact, longitudinality, comprehensiveness, and coordination, and clusters of confounding factors were added sequentially. Results Preliminary findings indicated differences in primary care quality between racial/ethnic minorities and whites across measures of first contact, longitudinality, comprehensiveness, and coordination. After controlling for confounding factors, these differences were no longer apparent; all racial/ethnic categories showed similar rates of primary care quality according to the 4 primary care domains of interest in the study. Conclusion Results indicate equitable primary care quality for type 2 diabetes patients across 4 key domains of primary care after controlling for socioeconomic characteristics. Additional research is necessary to support these findings, particularly when considering smaller racial/ethnic groups and investigating outcomes related to diabetes. PMID:27490365

  6. Blast-induced neurotrauma in whales.

    PubMed

    Knudsen, Siri K; Øen, Egil O

    2003-07-01

    A majority of investigations on primary blast injuries have focused on gas-containing organs, while the likelihood of blast-induced neurotrauma remains underrated. In Norway minke whales (Balaenoptera acutorostrata) are hunted using small fishing boats rigged with harpoon guns, which fire harpoons tipped with a grenade containing a charge of 30-g penthrite. The grenade detonates 60-70 cm inside the animal. The present study was undertaken to characterize the neuropathological changes caused by the penthrite blast and evaluate its role in the loss of consciousness and death in hunted whales. The study included 37 minke whales that were examined shipboard. The brains were later subjected to gross and light microscopy examination. The results showed that intra-body detonation of the grenade in near vicinity of the brain resulted in trauma similar to severe traumatic brain injury associated with a direct blow to the head. Detonation in more distant areas of the body resulted in injuries resembling acceleration-induced diffuse traumatic brain injury. The authors conclude that even if several vital organs were fatally injured in most whales, the neurotrauma induced by the blast-generated pressure waves were the primary cause for the immediate or very rapid loss of consciousness and death.

  7. Serotyping of primary human immunodeficiency virus type 1 isolates from diverse geographic locations by flow cytometry.

    PubMed Central

    Zolla-Pazner, S; O'Leary, J; Burda, S; Gorny, M K; Kim, M; Mascola, J; McCutchan, F

    1995-01-01

    The immunologic relatedness of the various human immunodeficiency virus type 1 (HIV-1) clades was determined with 13 human anti-HIV-1 monoclonal antibodies (MAbs) to six immunogenic regions of the HIV-1 structural proteins. The immunoreactivity of the native, oligomeric viral envelope glycoproteins expressed on the surfaces of human peripheral blood mononuclear cells infected in vitro with primary isolates from clades A through E was determined by flow cytometry. Some epitopes in the immunodominant region of gp41 and the C terminus of gp120 appear to be HIV-1 group specific in that they are expressed on the surfaces of cells in cultures infected with the majority of viruses tested from clades A to E. Epitopes within the V3 region appear to be clade restricted. Surprisingly, one MAb to an epitope in the C terminus of gp120 was entirely clade B specific. Staining with anti-V2 and anti-CD4 binding domain (CD4bd) reagents was infrequently detected. Anti-CD4bd MAbs stained only CD4-negative T cells because the CD4bd of gp120 appeared to be complexed with membrane CD4. When present, the epitopes of V2 and the CD4bd appeared to be expressed on cells infected with various clades. Thus, the results suggest that MAbs to gp41, the C terminus, and the V3 loop of gp120 are most useful in serotyping primary isolates of HIV-1, providing group-specific, clade-restricted, and clade-specific reagents. The use of the immunofluorescent method with the reagents described herein distinguishes infection with clade B from that with all other HIV-1 clades. With additional MAbs, this technique will allow a broadly applicable, reproducible, and practical method for serotyping HIV-1. PMID:7745728

  8. [Analysis of serum neutralizing antibody response in patients with primary dengue virus type 1 infection].

    PubMed

    Hu, Dongmei; Li, Jie; Wang, Dahu; DI, Biao; Qiu, Liwen; Wang, Yadi; Ding, Xixia; Che, Xiaoyan

    2012-12-01

    To investigate the characteristics and dynamic changes of serum neutralizing antibody response in patients with primary infection of dengue virus type 1 (DENV-1). Serum samples were obtained from the same patients with primary infection of DENV-1 within 2 weeks after symptom onset in 2006 and in 2010. A group-specific DENV NS1 capture ELISA-based micro-neutralizing test (ELISA-MNT) capable of detecting neutralizing antibodies against all the 4 serotypes of DENV was used to test the neutralizing antibody titers against DENV in the serum samples. The neutralizing antibody titers against a standard strain and 2 clinically isolated strains of DENV-1 were detected in serum samples collected in 2010. Cross-reactive neutralizing antibody response against all the 4 serotypes of DENV was found in both of the serum samples collected in 2006 and 2010, but the samples collected in 2006 showed stronger cross-reactive neutralizing antibody responses. The neutralizing antibody against DENV-2, rather than the anticipated DENV-1 antibody, had the highest titer in the samples collected in 2006, whereas the antibody against homologous DENV-1 had the highest titer in the samples obtained in 2010. The neutralizing antibody titers against the homologous DENV-1 was significantly higher in samples collected in 2010 (U=86.500, P=0.000), which also demonstrated significantly different neutralizing antibody titers against the 3 different strains of DENV-1 (Χ(2)=12.123, P=0.002). The production of cross-reactive neutralizing antibodies between the 4 serotypes of DENV is a characteristic of DENV infection, particularly during early infection, but only the homologous neutralizing antibody increases obviously over time. The titers of the neutralizing antibodies against different strains, even of the same serotype, may differ distinctly.

  9. Health literacy and nurses' communication with type 2 diabetes patients in primary care settings.

    PubMed

    Al Sayah, Fatima; Williams, Beverly; Pederson, Jenelle L; Majumdar, Sumit R; Johnson, Jeffrey A

    2014-01-01

    The use of the interactive communication loop has been recommended as an effective method to enhance patient understanding and recall of information. The aim of the study was to examine the application of interactive communication loops, use of jargon, and the impact of health literacy (HL) when nurses provide education and counseling to patients with type 2 diabetes in the primary care setting in Alberta, Canada. Encounters between nurses and patients with type 2 diabetes were audio recorded, and a patient survey including a HL measure was administered. Topics within each interaction were coded based on five key components of the communication loop and categories of jargon. Nine nurses participated in this study, and encounters with 36 patients were recorded. A complete communication loop was noted in only 11% of the encounters. Clarifying health information was the most commonly applied component (58% often used), followed by repeating health information (33% often used). Checking for understanding was the least applied (81% never used), followed by asking for understanding (42% never used). Medical jargon and mismatched language were often used in 17% and 25% of the encounters, respectively. Patients' HL did not materially affect patterns of communication in terms of using communication loops; however, nurses used less jargon and mismatched words with patients with inadequate HL. The overuse of medical jargon accompanied with underuse of communication loop components jeopardizes patients' comprehension and retention of information that they need to know to properly self-manage their diabetes. Nurses need to develop more effective ways to communicate concepts critical to chronic diabetes self-care education and management.

  10. Augmentation of virus secretion by the human immunodeficiency virus type 1 Vpu protein is cell type independent and occurs in cultured human primary macrophages and lymphocytes.

    PubMed Central

    Schubert, U; Clouse, K A; Strebel, K

    1995-01-01

    The human immunodeficiency virus type 1-specific Vpu protein is a small integral membrane phosphoprotein that induces degradation of the virus receptor CD4 in the endoplasmic reticulum and, independently, increases the release of progeny virions from infected cells. To address the importance of Vpu for virus replication in primary human cells such as peripheral blood mononuclear cells (PBMC) and monocyte-derived macrophages (MDM), we used three different sets of monocyte-tropic molecular clones of human immunodeficiency virus type 1: a primary isolate, AD8+, and two chimeric variants of the T-cell-tropic isolate NL4-3 carrying the env determinants of either AD8+ or SF162 monocyte-tropic primary isolates. Isogenic variants of these chimeric viruses were constructed to express either wild-type Vpu or various mutants of Vpu. The effects of these mutations in the vpu gene on virus particle secretion from infected MDM or PBMC were assessed by determination of the release of virion-associated reverse transcriptase into culture supernatants, Western blot (immunoblot) analysis of pelleted virions, and steady-state or pulse-chase metabolic labeling. Wild-type Vpu increased virus release four- to sixfold in MDM and two- to threefold in PBMC, while nonphosphorylated Vpu and a C-terminal truncation mutant of Vpu were partially active on virus release in primary cells. These results demonstrate that Vpu regulates virus release in primary lymphocyte and macrophage cultures in a similar manner and to a similar extent to those previously observed in HeLa cells or CD4+ T-cell lines. Thus, our findings provide evidence that Vpu functions in a variety of human cells, both primary cells and continuous cell lines, and mutations in Vpu affect its biological activity independent of the cell type and virus isolate used. PMID:7494279

  11. Use of oral combination therapy for type 2 diabetes in primary care: Meeting individualized patient goals.

    PubMed

    Lavernia, Frank; Adkins, Sarah E; Shubrook, Jay H

    2015-01-01

    The management of type 2 diabetes mellitus (T2DM) by primary care physicians (PCPs) has become increasingly complex due to limitations on consultation time, an increasing array of drug treatment options, and issues of comorbidities and polypharmacy. Diabetes is a progressive condition and treatment with a single glucose-lowering agent can only address limited pathophysiologic targets and does not provide adequate glycemic control in many cases. Consequently, most patients with T2DM will eventually require treatment with multiple glucose-lowering medications. Oral combination therapy in T2DM may be given as multiple-pills, or as single-pill, fixed-dose combinations (FDCs), the latter of which offer convenience, ease of administration, and a reduction in the medication burden. Therefore, FDCs can potentially improve patients' treatment adherence and optimize achievement and maintenance of glycemic targets. However, cost factors also need to be considered. An understanding of the issues associated with the use of combination therapy in T2DM will help PCPs to guide patient-centered decision making and promote the effective management of T2DM.

  12. Characterization of coagulation factor synthesis in nine human primary cell types

    PubMed Central

    Dashty, Monireh; Akbarkhanzadeh, Vishtaseb; Zeebregts, Clark J.; Spek, C. Arnold; Sijbrands, Eric J.; Peppelenbosch, Maikel P.; Rezaee, Farhad

    2012-01-01

    The coagulation/fibrinolysis system is essential for wound healing after vascular injury. According to the standard paradigm, the synthesis of most coagulation factors is restricted to liver, platelets and endothelium. We challenged this interpretation by measuring coagulation factors in nine human primary cell types. FX mRNA was expressed by fibroblasts, visceral preadipocytes/adipocytes and hepatocytes, but not in macrophages or other cells. All cells expressed FVIII except endothelial cells. Fibroblasts, endothelial cells and macrophages produced thrombomodulin but not FV. Interestingly, vascular-related cells (platelets/monocytes) that expressed FV did not express FX and vice versa. Monocytes expressed FV, FVIII and FXIIIA, which are positive regulators of clot formation, but these cells also contained thrombomodulin, a negative regulator of coagulation. Our data show that the expression of coagulation factors is much more complex than previously thought, and we speculate that this intricate regulation of coagulation factor expression is necessary for correct fine-tuning of fibrinogenesis versus fibrinolysis. PMID:23145311

  13. [Results of a telemedicine program for primary care patients with type 2 diabetes].

    PubMed

    López-Torres, Jesús; Rabanales, Joseba; Fernández, Rafael; López, Francisco J; Panadés, Llanos; Romero, Victoria

    2015-01-01

    To evaluate the impact of a telemedicine program on self-perceived health in patients with type 2 diabetes in primary care, as well as patient acceptance of and satisfaction with this program. We conducted an 18-month follow-up through telemedicine in 52 diabetic patients. The study design was non-experimental (before and after). In addition to weekly electronic transmission of fasting glucose levels, we regularly provided advice to patients about healthy habits. No statistically significant differences were observed when mean blood glucose values were compared during follow-up. However, at the end of participation, the mean score in self-perceived health was significantly higher than at the initial assessment (70.5±12.8 vs. 62.8±15.0, p=0.02). After 18 months of participation in the telemedicine program, 57.7% of patients were satisfied and 38.5% were very satisfied. Although glycemic control did not improve during the follow-up, electronic transmission of information was found to be feasible and satisfactory for patients. The patients reported a higher level of self-perceived health. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

  14. An institutional experience of pre-emptive liver transplantation for pediatric primary hyperoxaluria type 1.

    PubMed

    Khorsandi, Shirin Elizabeth; Samyn, Marianne; Hassan, Akhila; Vilca-Melendez, Hector; Waller, Simon; Shroff, Rukshana; Koffman, Geoff; Van't Hoff, William; Baker, Alastair; Dhawan, Anil; Heaton, Nigel

    2016-06-01

    Primary hyperoxaluria type 1 (PH1) is an inherited metabolic disease that culminates in ESRF. Pre-emptive liver transplantation (pLTx) treats the metabolic defect and avoids the need for kidney transplantation (KTx). An institutional experience of pediatric PH1 LTx is reported and compared to the literature. Between 2004 and 2015, eight children underwent pLTx for PH1. Three underwent pLTx with a median GFR of 40 (30-46) mL/min/1.73 m(2) and five underwent sequential combined liver-kidney transplantation (cLKTx); all were on RRT at the time of cLKTx. In one case of pLTx, KTx was required eight and a half yr later. pLTx was performed in older (median 8 vs. 2 yr) and larger children (median 27 vs. 7.75 kg) that had a milder PH1 phenotype. In pediatric PH1, pLTx, ideally, should be performed before renal and extrarenal systemic oxalosis complications have occurred, and pLTx can be used "early" or "late." Early is when renal function is preserved with the aim to avoid renal replacement. However, in late (GFR < 30 mL/min/1.73 m(2) ), the aim is to stabilize renal function and delay the need for KTx. Ultimately, transplant strategy depends on PH1 phenotype, disease stage, child size, and organ availability. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Helper-dependent adenoviral vectors for liver-directed gene therapy of primary hyperoxaluria type 1

    PubMed Central

    Castello, Raffaele; Borzone, Roberta; D’Aria, Stefania; Annunziata, Patrizia; Piccolo, Pasquale; Brunetti-Pierri, Nicola

    2015-01-01

    Primary hyperoxaluria type 1 (PH1) is an inborn error of liver metabolism due to deficiency of the peroxisomal enzyme alanine:glyoxylate aminotransferase (AGT) which catalyzes conversion of glyoxylate into glycine. AGT deficiency results in overproduction of oxalate which ultimately leads to end-stage renal disease and death. Organ transplantation as either preemptive liver transplantation or combined liver/kidney transplantation is the only available therapy to prevent disease progression. Gene therapy is an attractive option to provide an alternative treatment for PH1. Towards this goal, we investigated helper-dependent adenoviral (HDAd) vectors for liver-directed gene therapy of PH1. Compared to saline controls, AGT-deficient mice injected with an HDAd encoding the AGT under the control of a liver-specific promoter showed a significant reduction of hyperoxaluria and less increase of urinary oxalate following challenge with Ethylene Glycol (EG), a precursor of glyoxylate. These studies may thus pave the way to clinical application of HDAd for PH1 gene therapy. PMID:26609667

  16. Primary Effusion Lymphoma-like Lymphoma in a Patient with Neurofibromatosis Type 1.

    PubMed

    Oki, Masayuki; Nanao, Tomihisa; Shinoda, Takuma; Tsuda, Ayumi; Yasuda, Atsushi; Seki, Toshiro; Ozawa, Hideki; Nakamura, Naoya; Takagi, Atsushi

    2016-09-20

    To date, there are only 15 case reports of lymphoma in patients with neurofibromatosis type 1 (NF1), a common autosomal dominant tumor predisposition syndrome. Here, we present the first report of a primary effusion lymphoma (PEL)-like lymphoma (PEL-L), which is a human herpes virus 8/Kaposi sarcoma herpes virus-unrelated PEL, in a 73-year-old woman with NF1. The woman presented with pleural effusion following surgery for a small intestinal gastrointestinal stromal tumor and a malignant peripheral nerve sheath tumor. We prepared cellblocks to accurately differentiate between PEL, PEL-L, and pyothorax-associated lymphoma, for establishing a starting point for treatment and for prolonging survival. Attention should be paid to malignant neoplasms in NF1 patients. Diffuse large B-cell lymphoma may not be a rare complication in these patients, although how NF1 promotes its development remains to be determined. PEL-L should be suspected when body cavity effusion is observed in elderly patients. If feasible, it should be treated via rituximab-containing chemotherapy, which according to the literature, results in longer survival times than does drainage or regimens consisting of cyclophosphamide, doxorubicin, vincristine, and prednisone.

  17. Helper-dependent adenoviral vectors for liver-directed gene therapy of primary hyperoxaluria type 1.

    PubMed

    Castello, R; Borzone, R; D'Aria, S; Annunziata, P; Piccolo, P; Brunetti-Pierri, N

    2016-02-01

    Primary hyperoxaluria type 1 (PH1) is an inborn error of liver metabolism due to deficiency of the peroxisomal enzyme alanine:glyoxylate aminotransferase (AGT), which catalyzes conversion of glyoxylate into glycine. AGT deficiency results in overproduction of oxalate that ultimately leads to end-stage renal disease and death. Organ transplantation as either preemptive liver transplantation or combined liver/kidney transplantation is the only available therapy to prevent disease progression. Gene therapy is an attractive option to provide an alternative treatment for PH1. Toward this goal, we investigated helper-dependent adenoviral (HDAd) vectors for liver-directed gene therapy of PH1. Compared with saline controls, AGT-deficient mice injected with an HDAd encoding the AGT under the control of a liver-specific promoter showed a significant reduction of hyperoxaluria and less increase of urinary oxalate following challenge with ethylene glycol, a precursor of glyoxylate. These studies may thus pave the way to clinical application of HDAd for PH1 gene therapy.

  18. Particle Dynamics in a Maxwell's Ring-Type Configuration with a Radiating Central Primary

    NASA Astrophysics Data System (ADS)

    Kalvouridis, T. J.; Hadjifotinou, K. G.

    2011-05-01

    Maxwell's ring-type configuration (i.e. an N-body model where the ν = Ν - 1 bodies have equal masses and are located at the vertices of a regular ν-gon while the N-th body with a different mass is located at the center of mass of the system) has attracted special attention during the last 15 years and many aspects of it have been studied by considering Newtonian and post-Newtonian potentials (Mioc and Stavinschi 1998, 1999), homographic solutions (Arribas et al . 2007) and relative equilibrium solutions (Elmabsout 1996), etc. An equally interesting problem, known as the ring problem of ( N + 1) bodies, deals with the dynamics of a small body in the combined force field produced by such a configuration. This is the problem we are dealing with in the present paper and our aim is to investigate the variations in the dynamics of the small body in the case that the central primary is also a radiating source and therefore acts on the particle with both gravitation and radiation. Based on the general outlines of Radzievskii's model, we study the permitted and the existing trapping regions of the particle, its equilibrium locations and their parametric variations as well as the existence of focal points in the zero-velocity diagrams. The distribution of the characteristic curves of families of planar symmetric periodic orbits and their stability for various values of the radiation coefficient of the central body is additionally investigated.

  19. The Effect of Sleep Quality on the Development of Type 2 Diabetes in Primary Care Patients.

    PubMed

    Lee, Jung Ah; Sunwoo, Sung; Kim, Young Sik; Yu, Byung Yeon; Park, Hoon Ki; Jeon, Tae Hee; Yoo, Byung Wook

    2016-02-01

    Sleep has important effects on physical and mental health, and sleep disorders are associated with increased mortality and morbidity. This study was conducted to evaluate the relationship between sleep duration or sleep quality and the risk of type 2 diabetes. The FACTS (FAmily CohorT Study in primary care) was established to investigate the relations between familial environment and health which was conducted at 22 family medicine outpatient clinics in general hospitals. Total 563 patients without diabetes who received ≥1 year follow-up examination were included in the analysis. We used the Pittsburgh Sleep Quality Index to determine sleep quality, and a score of ≥5 was considered to define poor sleep quality. Patients taking oral hypoglycemic agents, having a fasting glucose level of >126 mg/dL, or diagnosed with diabetes by physicians were classified as having diabetes. The median follow-up period was 2.5 years. Poor sleep quality was associated with a higher risk of diabetes after adjusting for age, sex, body mass index, income, physical activity, and family history of diabetes (relative risk=2.64; 95% confidence interval, 1.03-6.78). As a risk factor for the development of diabetes, poor sleep quality may independently increase the incidence of diabetes.

  20. Toxic effect of cooking oil fumes in primary fetal pulmonary type II-like epithelial cells.

    PubMed

    Cao, Jiyu; Ding, Rui; Wang, Yong; Chen, Daojun; Guo, Dongmei; Liang, Chunmei; Feng, Zhewei; Che, Zhen

    2013-09-01

    Epidemiological studies indicated that there is an increased risk of respiratory tract cancer among cooks and bakers. The cooking oil fumes are believed to conduct this risk, and many studies have focused on evaluating the mutagenicity and finding the mutagenic components in oil fumes. COFs contains two major classes of compounds. One class consists of polycyclic aromatic hydrocarbons (PAHs), such as benzo[a]pyrene, benzo[b]fluoranthene, fluoranthene, and benzo[g,h,i]perylene. BaP is a known immunosuppressant. It can also alter cell cycle progression, induce inflammation, and impair DNA repair and apoptotic processes leading to aberrant cellular functioning. This study investigates the effect of toxicity of cooking oil fumes (COFs) in primary ICR mice' fetal lung type II-like epithelium cells (AEC II). The cells were cultured in different concentrations (0, 12.5, 25, 50, 100, and 200μg/ml) of COFs for different time periods. The results showed that cell viability decreased in a dose- and time- dependent manner, which is accompanied by increased malondialdehyde (MDA) level and decreased superoxide dismutase (SOD) and glutathione (GSH) activities. Moreover, comet assay suggested DNA damage, as well as increased production of DNA adducts induced by PAHs. The present study also shows that COFs may disturb cell cycles even at a very low dose. In summary, the present study indicates that COFs may lead to toxicity in AEC II cells. Copyright © 2013 Elsevier B.V. All rights reserved.

  1. Early renal failure after domino liver transplantation using organs from donors with primary hyperoxaluria type 1.

    PubMed

    Saner, Fuat H; Treckmann, Juergen; Pratschke, Johann; Arbogast, Helmut; Rahmel, Axel; Vester, Udo; Paul, Andreas

    2010-10-15

    Organ shortage is responsible for high mortality rates of patients awaiting liver transplantation (LT). Domino transplantation has had reported success in patients with metabolic disorders. Primary hyperoxaluria type 1 (PH1) is a rare metabolic disorder. There are a few case reports that suggest that PH1 livers originating from donors that have undergone combined liver-kidney transplantation can be successfully used for domino transplantation. In the last decade, five patients received a domino liver transplant from patients with PH1 in the EUROTRANSPLANT region. In this study, we report the clinical course and outcome of these five patients who were received a domino graft transplant. All patients, with the exception of one, suffered from multifocal hepatocellular carcinoma and underwent domino LT from patients undergoing combined liver-kidney transplantation for PH1. Within the first 4 weeks, all the domino recipients developed dialysis-dependent kidney failure despite good liver function. Four of the five patients died. The only survivor underwent retransplantation due to hepatic artery thrombosis. Twenty months after transplantation, this patient is doing well and has had no recurrence of hepatocellular carcinoma. Domino LT using donors with PH1 results in early renal failure and cannot be recommended for transplantation unless preventive strategies have been identified.

  2. Bridging the Gap of Standardized Animals Models for Blast Neurotrauma: Methodology for Appropriate Experimental Testing.

    PubMed

    VandeVord, Pamela J; Leonardi, Alessandra Dal Cengio; Ritzel, David

    2016-01-01

    Recent military combat has heightened awareness to the complexity of blast-related traumatic brain injuries (bTBI). Experiments using animal, cadaver, or biofidelic physical models remain the primary measures to investigate injury biomechanics as well as validate computational simulations, medical diagnostics and therapies, or protection technologies. However, blast injury research has seen a range of irregular and inconsistent experimental methods for simulating blast insults generating results which may be misleading, cannot be cross-correlated between laboratories, or referenced to any standard for exposure. Both the US Army Medical Research and Materiel Command and the National Institutes of Health have noted that there is a lack of standardized preclinical models of TBI. It is recommended that the blast injury research community converge on a consistent set of experimental procedures and reporting of blast test conditions. This chapter describes the blast conditions which can be recreated within a laboratory setting and methodology for testing in vivo models within the appropriate environment.

  3. An immunohistochemical and serum ELISA study of type I and III procollagen aminopropeptides in primary biliary cirrhosis.

    PubMed Central

    Davis, B. H.; Madri, J. A.

    1987-01-01

    By means of ELISA methodology, the aminopropeptides of Type I and Type III procollagen were measured in the serum of a group of patients with primary biliary cirrhosis. The corresponding liver biopsies were graded blindly for degrees of fibrosis and inflammation. When available, paraffin-embedded liver specimens underwent immunoperoxidase staining for mature Type I and III collagen as well as the aminopropeptides of Type I and III procollagen. Regardless of the degree of fibrosis or inflammation, serum levels of the aminopropeptide of Type I remained within normal limits. In contrast, serum levels of the aminopropeptide of Type III procollagen were elevated uniformly. Immunohistochemistry demonstrated that the aminopropeptide of Type III procollagen persists extracellularly. This finding may explain the previously reported relationship between levels of inflammation and serum levels of the Type III aminopropeptide. Images Figure 7 Figure 8 PMID:3303951

  4. Neuron Types in the Presumptive Primary Somatosensory Cortex of the Florida Manatee (Trichechus manatus latirostris).

    PubMed

    Reyes, Laura D; Stimpson, Cheryl D; Gupta, Kanika; Raghanti, Mary Ann; Hof, Patrick R; Reep, Roger L; Sherwood, Chet C

    2015-01-01

    Within afrotherians, sirenians are unusual due to their aquatic lifestyle, large body size and relatively large lissencephalic brain. However, little is known about the neuron type distributions of the cerebral cortex in sirenians within the context of other afrotherians and aquatic mammals. The present study investigated two cortical regions, dorsolateral cortex area 1 (DL1) and cluster cortex area 2 (CL2), in the presumptive primary somatosensory cortex (S1) in Florida manatees (Trichechus manatus latirostris) to characterize cyto- and chemoarchitecture. The mean neuron density for both cortical regions was 35,617 neurons/mm(3) and fell within the 95% prediction intervals relative to brain mass based on a reference group of afrotherians and xenarthrans. Densities of inhibitory interneuron subtypes labeled against calcium-binding proteins and neuropeptide Y were relatively low compared to afrotherians and xenarthrans and also formed a small percentage of the overall population of inhibitory interneurons as revealed by GAD67 immunoreactivity. Nonphosphorylated neurofilament protein-immunoreactive (NPNFP-ir) neurons comprised a mean of 60% of neurons in layer V across DL1 and CL2. DL1 contained a higher percentage of NPNFP-ir neurons than CL2, although CL2 had a higher variety of morphological types. The mean percentage of NPNFP-ir neurons in the two regions of the presumptive S1 were low compared to other afrotherians and xenarthrans but were within the 95% prediction intervals relative to brain mass, and their morphologies were comparable to those found in other afrotherians and xenarthrans. Although this specific pattern of neuron types and densities sets the manatee apart from other afrotherians and xenarthrans, the manatee isocortex does not appear to be explicitly adapted for an aquatic habitat. Many of the features that are shared between manatees and cetaceans are also shared with a diverse array of terrestrial mammals and likely represent highly conserved

  5. Compressive strength after blast of sandwich composite materials

    PubMed Central

    Arora, H.; Kelly, M.; Worley, A.; Del Linz, P.; Fergusson, A.; Hooper, P. A.; Dear, J. P.

    2014-01-01

    Composite sandwich materials have yet to be widely adopted in the construction of naval vessels despite their excellent strength-to-weight ratio and low radar return. One barrier to their wider use is our limited understanding of their performance when subjected to air blast. This paper focuses on this problem and specifically the strength remaining after damage caused during an explosion. Carbon-fibre-reinforced polymer (CFRP) composite skins on a styrene–acrylonitrile (SAN) polymer closed-cell foam core are the primary composite system evaluated. Glass-fibre-reinforced polymer (GFRP) composite skins were also included for comparison in a comparable sandwich configuration. Full-scale blast experiments were conducted, where 1.6×1.3 m sized panels were subjected to blast of a Hopkinson–Cranz scaled distance of 3.02 m kg−1/3, 100 kg TNT equivalent at a stand-off distance of 14 m. This explosive blast represents a surface blast threat, where the shockwave propagates in air towards the naval vessel. Hopkinson was the first to investigate the characteristics of this explosive air-blast pulse (Hopkinson 1948 Proc. R. Soc. Lond. A 89, 411–413 (doi:10.1098/rspa.1914.0008)). Further analysis is provided on the performance of the CFRP sandwich panel relative to the GFRP sandwich panel when subjected to blast loading through use of high-speed speckle strain mapping. After the blast events, the residual compressive load-bearing capacity is investigated experimentally, using appropriate loading conditions that an in-service vessel may have to sustain. Residual strength testing is well established for post-impact ballistic assessment, but there has been less research performed on the residual strength of sandwich composites after blast. PMID:24711494

  6. Compressive strength after blast of sandwich composite materials.

    PubMed

    Arora, H; Kelly, M; Worley, A; Del Linz, P; Fergusson, A; Hooper, P A; Dear, J P

    2014-05-13

    Composite sandwich materials have yet to be widely adopted in the construction of naval vessels despite their excellent strength-to-weight ratio and low radar return. One barrier to their wider use is our limited understanding of their performance when subjected to air blast. This paper focuses on this problem and specifically the strength remaining after damage caused during an explosion. Carbon-fibre-reinforced polymer (CFRP) composite skins on a styrene-acrylonitrile (SAN) polymer closed-cell foam core are the primary composite system evaluated. Glass-fibre-reinforced polymer (GFRP) composite skins were also included for comparison in a comparable sandwich configuration. Full-scale blast experiments were conducted, where 1.6×1.3 m sized panels were subjected to blast of a Hopkinson-Cranz scaled distance of 3.02 m kg(-1/3), 100 kg TNT equivalent at a stand-off distance of 14 m. This explosive blast represents a surface blast threat, where the shockwave propagates in air towards the naval vessel. Hopkinson was the first to investigate the characteristics of this explosive air-blast pulse (Hopkinson 1948 Proc. R. Soc. Lond. A 89, 411-413 (doi:10.1098/rspa.1914.0008)). Further analysis is provided on the performance of the CFRP sandwich panel relative to the GFRP sandwich panel when subjected to blast loading through use of high-speed speckle strain mapping. After the blast events, the residual compressive load-bearing capacity is investigated experimentally, using appropriate loading conditions that an in-service vessel may have to sustain. Residual strength testing is well established for post-impact ballistic assessment, but there has been less research performed on the residual strength of sandwich composites after blast.

  7. Blast overpressure after tire explosion: a fatal case.

    PubMed

    Pomara, Cristoforo; D'Errico, Stefano; Riezzo, Irene; Perilli, Gabriela; Volpe, Umberto; Fineschi, Vittorio

    2013-12-01

    Fatal blast injuries are generally reported in literature as a consequence of the detonation of explosives in war settings. The pattern of lesion depends on the position of the victim in relation to the explosion, on whether the blast tracks through air or water, and whether it happens in the open air or within an enclosed space and the distance from the explosion. Tire explosion-related injuries are rarely reported in literature. This study presents a fatal case of blast overpressure due to the accidental explosion of a truck tire occurring in a tire repair shop. A multidisciplinary approach to the fatality involving forensic pathologists and engineers revealed that the accidental explosion, which caused a series of primary and tertiary blast wave injuries, was due to tire deterioration.

  8. Divergence in Forest-Type Response to Climate and Weather: Evidence for Regional Links Between Forest-Type Evenness and Net Primary Productivity

    USGS Publications Warehouse

    Bradford, J.B.

    2011-01-01

    Climate change is altering long-term climatic conditions and increasing the magnitude of weather fluctuations. Assessing the consequences of these changes for terrestrial ecosystems requires understanding how different vegetation types respond to climate and weather. This study examined 20 years of regional-scale remotely sensed net primary productivity (NPP) in forests of the northern Lake States to identify how the relationship between NPP and climate or weather differ among forest types, and if NPP patterns are influenced by landscape-scale evenness of forest-type abundance. These results underscore the positive relationship between temperature and NPP. Importantly, these results indicate significant differences among broadly defined forest types in response to both climate and weather. Essentially all weather variables that were strongly related to annual NPP displayed significant differences among forest types, suggesting complementarity in response to environmental fluctuations. In addition, this study found that forest-type evenness (within 8 ?? 8 km2 areas) is positively related to long-term NPP mean and negatively related to NPP variability, suggesting that NPP in pixels with greater forest-type evenness is both higher and more stable through time. This is landscape- to subcontinental-scale evidence of a relationship between primary productivity and one measure of biological diversity. These results imply that anthropogenic or natural processes that influence the proportional abundance of forest types within landscapes may influence long-term productivity patterns. ?? 2011 Springer Science+Business Media, LLC (outside the USA).

  9. Blast Overpressure Waves Induce Transient Anxiety and Regional Changes in Cerebral Glucose Metabolism and Delayed Hyperarousal in Rats

    PubMed Central

    Awwad, Hibah O.; Gonzalez, Larry P.; Tompkins, Paul; Lerner, Megan; Brackett, Daniel J.; Awasthi, Vibhudutta; Standifer, Kelly M.

    2015-01-01

    Physiological alterations, anxiety, and cognitive disorders are strongly associated with blast-induced traumatic brain injury (blast TBI), and are common symptoms in service personnel exposed to blasts. Since 2006, 25,000–30,000 new TBI cases are diagnosed annually in U.S. Service members; increasing evidence confirms that primary blast exposure causes diffuse axonal injury and is often accompanied by altered behavioral outcomes. Behavioral and acute metabolic effects resulting from blast to the head in the absence of thoracic contributions from the periphery were examined, following a single blast wave directed to the head of male Sprague-Dawley rats protected by a lead shield over the torso. An 80 psi head blast produced cognitive deficits that were detected in working memory. Blast TBI rats displayed increased anxiety as determined by elevated plus maze at day 9 post-blast compared to sham rats; blast TBI rats spent significantly more time than the sham controls in the closed arms (p < 0.05; n = 8–11). Interestingly, anxiety symptoms were absent at days 22 and 48 post-blast. Instead, blast TBI rats displayed increased rearing behavior at day 48 post-blast compared to sham rats. Blast TBI rats also exhibited suppressed acoustic startle responses, but similar pre-pulse inhibition at day 15 post-blast compared to sham rats. Acute physiological alterations in cerebral glucose metabolism were determined by positron emission tomography 1 and 9 days post-blast using 18F-fluorodeoxyglucose (18F-FDG). Global glucose uptake in blast TBI rat brains increased at day 1 post-blast (p < 0.05; n = 4–6) and returned to sham levels by day 9. Our results indicate a transient increase in cerebral metabolism following a blast injury. Markers for reactive astrogliosis and neuronal damage were noted by immunoblotting motor cortex tissue from day 10 post-blast in blast TBI rats compared to sham controls (p < 0.05; n = 5–6). PMID:26136722

  10. Blast Overpressure Waves Induce Transient Anxiety and Regional Changes in Cerebral Glucose Metabolism and Delayed Hyperarousal in Rats.

    PubMed

    Awwad, Hibah O; Gonzalez, Larry P; Tompkins, Paul; Lerner, Megan; Brackett, Daniel J; Awasthi, Vibhudutta; Standifer, Kelly M

    2015-01-01

    Physiological alterations, anxiety, and cognitive disorders are strongly associated with blast-induced traumatic brain injury (blast TBI), and are common symptoms in service personnel exposed to blasts. Since 2006, 25,000-30,000 new TBI cases are diagnosed annually in U.S. Service members; increasing evidence confirms that primary blast exposure causes diffuse axonal injury and is often accompanied by altered behavioral outcomes. Behavioral and acute metabolic effects resulting from blast to the head in the absence of thoracic contributions from the periphery were examined, following a single blast wave directed to the head of male Sprague-Dawley rats protected by a lead shield over the torso. An 80 psi head blast produced cognitive deficits that were detected in working memory. Blast TBI rats displayed increased anxiety as determined by elevated plus maze at day 9 post-blast compared to sham rats; blast TBI rats spent significantly more time than the sham controls in the closed arms (p < 0.05; n = 8-11). Interestingly, anxiety symptoms were absent at days 22 and 48 post-blast. Instead, blast TBI rats displayed increased rearing behavior at day 48 post-blast compared to sham rats. Blast TBI rats also exhibited suppressed acoustic startle responses, but similar pre-pulse inhibition at day 15 post-blast compared to sham rats. Acute physiological alterations in cerebral glucose metabolism were determined by positron emission tomography 1 and 9 days post-blast using (18)F-fluorodeoxyglucose ((18)F-FDG). Global glucose uptake in blast TBI rat brains increased at day 1 post-blast (p < 0.05; n = 4-6) and returned to sham levels by day 9. Our results indicate a transient increase in cerebral metabolism following a blast injury. Markers for reactive astrogliosis and neuronal damage were noted by immunoblotting motor cortex tissue from day 10 post-blast in blast TBI rats compared to sham controls (p < 0.05; n = 5-6).

  11. Novel multiple endocrine neoplasia type 1 variations in patients with sporadic primary hyperparathyroidism

    PubMed Central

    Birla, S; Malik, E; Jyotsna, VP; Sharma, A

    2016-01-01

    Background and Objectives: Primary hyperparathyroidism (PHPT) can occur either as a sporadic case or in association with syndromes such as multiple endocrine neoplasia. Multiple endocrine neoplasia type 1 (MEN1) is a rare autosomal-dominant disease resulting from mutations in MEN1 gene encoding a 621 amino acid long tumor suppressor protein “menin.” We report here the results of MEN1 screening in 31 patients diagnosed with sporadic PHPT. Materials and Methods: Diagnosis of sporadic PHPT was made when blood urea and serum creatinine were normal, serum parathyroid hormone was high, and parathyroid enlargement could be localized on ultrasound and/or parathyroid scan. A total of 31 patients and 50 healthy volunteers were recruited for molecular analysis after taking informed consent. Results: Major symptoms at presentation were bone pain, fatigue, muscle weakness, and renal stones. Molecular genetic analysis revealed the presence of two novel intronic variations, c. 913-79T>A and c. 784-129T>A which by human splicing finder are predicted to cause potential alteration of splicing by either activating an intronic cryptic acceptor site or converting a conserved exonic splicing silencer sequence to an exonic splicing enhancer site. Apart from these, two reported polymorphisms rs144677807 and rs669976 were seen only in patients and none of the controls. Other reported polymorphisms rs2071313 and rs654440 were identified both in controls and patients. Conclusions: This is the first study of MEN1 gene screening in sporadic PHPT in India reporting on the clinical and genetic findings, wherein two novel intronic variations c. 913-79T>A and c. 784-129T>A were identified showing their possible role in disease causation. PMID:27366707

  12. Clinical and Genetic Analysis of Multiple Endocrine Neoplasia Type 1-Related Primary Hyperparathyroidism in Chinese

    PubMed Central

    Kong, Jing; Nie, Min; Shi, Jie; Hu, Yingying; Jiang, Yan; Li, Mei; Xia, Weibo; Meng, Xunwu

    2016-01-01

    Objective Multiple endocrine neoplasia type 1-related primary hyperparathyroidism (MHPT) differs in many aspects from sporadic PHPT (SHPT). The aims of this study were to summarize the clinical features and genetic background of Chinese MHPT patients and compare the severity of the disease with those of SHPT. Design and Methods A total of 40 MHPT (27 sporadic, 7 families) and 169 SHPT cases of Chinese descent were retrospectively analyzed. X-rays and ultrasound were used to assess the bone and urinary system. Dual energy x-ray absorptiometry (DXA) were performed to measure bone mineral density (BMD). Besides direct sequencing of the MEN1 and CDKN1B genes, multiplex ligation-dependent probe amplification (MLPA) was used to screen gross deletion for the MEN1 gene. Results Compared with SHPT patients, MHPT patients showed lower prevalence of typical X-ray changes related to PHPT (26.3% vs. 55.7%, P = 0.001) but higher prevalence of urolithiasis/renal calcification (40.2% vs. 60.0%, P = 0.024). MHPT patients showed higher phosphate level (0.84 vs. 0.73mmol/L, P<0.05) but lower ALP (103.0 vs. 174.0U/L, P<0.001) and PTH (4.0 vs. 9.8×upper limit, P<0.001) levels than SHPT patients. There were no significant differences in BMD Z-scores at the lumbar spine and femoral neck between the two groups. Mutations in the MEN1 gene were detected in 27 MHPT cases. Among the nine novel mutations were novel, one of them involved the deletion of exon 5 and 6. Conclusions MHPT patients experienced more common kidney complications but less skeletal issues, and a milder biochemical manifestation compared with SHPT patients. MEN1 mutation detection rate was 79.4% and 9 of the identified mutations were novel. PMID:27846313

  13. Significant head accelerations can influence immediate neurological impairments in a murine model of blast-induced traumatic brain injury.

    PubMed

    Gullotti, David M; Beamer, Matthew; Panzer, Matthew B; Chen, Yung Chia; Patel, Tapan P; Yu, Allen; Jaumard, Nicolas; Winkelstein, Beth; Bass, Cameron R; Morrison, Barclay; Meaney, David F

    2014-09-01

    Although blast-induced traumatic brain injury (bTBI) is well recognized for its significance in the military population, the unique mechanisms of primary bTBI remain undefined. Animate models of primary bTBI are critical for determining these potentially unique mechanisms, but the biomechanical characteristics of many bTBI models are poorly understood. In this study, we examine some common shock tube configurations used to study blast-induced brain injury in the laboratory and define the optimal configuration to minimize the effect of torso overpressure and blast-induced head accelerations. Pressure transducers indicated that a customized animal holder successfully reduced peak torso overpressures to safe levels across all tested configurations. However, high speed video imaging acquired during the blast showed significant head accelerations occurred when animals were oriented perpendicular to the shock tube axis. These findings of complex head motions during blast are similar to previous reports [Goldstein et al., 2012, "Chronic Traumatic Encephalopathy in Blast-Exposed Military Veterans and a Blast Neurotrauma Mouse Model," Sci. Transl. Med., 4(134), 134ra160; Sundaramurthy et al., 2012, "Blast-Induced Biomechanical Loading of the Rat: An Experimental and Anatomically Accurate Computational Blast Injury Model," J. Neurotrauma, 29(13), pp. 2352-2364; Svetlov et al., 2010, "Morphologic and Biochemical Characterization of Brain Injury in a Model of Controlled Blast Overpressure Exposure," J. Trauma, 69(4), pp. 795-804]. Under the same blast input conditions, minimizing head acceleration led to a corresponding elimination of righting time deficits. However, we could still achieve righting time deficits under minimal acceleration conditions by significantly increasing the peak blast overpressure. Together, these data show the importance of characterizing the effect of blast overpressure on head kinematics, with the goal of producing models focused on understanding the

  14. Primary cilium - antenna-like structure on the surface of most mammalian cell types

    NASA Astrophysics Data System (ADS)

    Dvorak, J.; Sitorova, V.; Hadzi Nikolov, D.; Mokry, J.; Richter, I.; Kasaova, L.; Filip, S.; Ryska, A.; Petera, J.

    2011-12-01

    The primary cilium is a sensory solitary non-motile microtubule-based organelle protruding in the quiescent phase of the cell cycle from the surface of the majority of human cells, including embryonic cells, stem cells and stromal cells of malignant tumors. The presence of a primary cilium on the surface of a cell is transient, limited to the quiescent G1(G0) phase and the beginning of the S phase of the cell cycle. The primary cilium is formed from the mother centriole. Primary cilia are key coordinators of signaling pathways during development and tissue homeostasis and, when deffective, they are a major cause of human diseases and developmental disorders, now commonly referred to as ciliopathies. Most cancer cells do not possess a primary cilium. The loss of the primary cilium is a regular feature of neoplastic transformation in the majority of solid tumors. The primary cilium could serve as a tumor suppressor organelle. The aim of this paper was to provide a review of the current knowledge of the primary cilium.

  15. Computer cast blast modelling

    SciTech Connect

    Chung, S.; McGill, M.; Preece, D.S.

    1994-07-01

    Cast blasting can be designed to utilize explosive energy effectively and economically for coal mining operations to remove overburden material. The more overburden removed by explosives, the less blasted material there is left to be transported with mechanical equipment, such as draglines and trucks. In order to optimize the percentage of rock that is cast, a higher powder factor than normal is required plus an initiation technique designed to produce a much greater degree of horizontal muck movement. This paper compares two blast models known as DMC (Distinct Motion Code) and SABREX (Scientific Approach to Breaking Rock with Explosives). DMC, applies discrete spherical elements interacted with the flow of explosive gases and the explicit time integration to track particle motion resulting from a blast. The input to this model includes multi-layer rock properties, and both loading geometry and explosives equation-of-state parameters. It enables the user to have a wide range of control over drill pattern and explosive loading design parameters. SABREX assumes that heave process is controlled by the explosive gases which determines the velocity and time of initial movement of blocks within the burden, and then tracks the motion of the blocks until they come to a rest. In order to reduce computing time, the in-flight collisions of blocks are not considered and the motion of the first row is made to limit the motion of subsequent rows. Although modelling a blast is a complex task, the DMC can perform a blast simulation in 0.5 hours on the SUN SPARCstation 10--41 while the new SABREX 3.5 produces results of a cast blast in ten seconds on a 486-PC computer. Predicted percentage of cast and face velocities from both computer codes compare well with the measured results from a full scale cast blast.

  16. Comparison of the microhardness of primary and permanent teeth after immersion in two types of carbonated beverages.

    PubMed

    Haghgou, Hamid R; Haghgoo, Roza; Asdollah, Fatemah Molla

    2016-01-01

    The consumption of carbonated beverages is one of the etiological factors that cause dental erosion. The purpose of this research was to compare changes in the microhardness of permanent and primary teeth after immersion in two types of carbonated beverages. This investigation was done on 30 healthy permanent molars and 30 healthy primary canines. Each group of primary and permanent teeth was subdivided into three groups of 10 teeth. The teeth was immersed in 40 ml of each of the three beverages for 5 min. One subgroup was immersed in water (as a control). The next was immersed in Lemon Delster and the last subgroup was immersed in Coca-Cola. The microhardness of enamel was measured using the Vickers method before and after immersion. Finally, the data was analyzed by paired t-test, one-way analysis of variance, and t-test. Microhardness reduction in the primary teeth was significant in both the Lemon Delster and Coca-Cola groups (P < 0.05). This reduction was also statistically significant in the permanent teeth (P < 0.05). A comparison of the enamel changes in the primary teeth with permanent teeth after immersion in both beverages showed a greater microhardness reduction in the primary teeth in both the experimental groups. Coca-Cola and Lemon Delster caused a significant reduction of microhardness in tooth enamel. This reduction was greater in primary teeth than in permanent teeth, and was also greater after immersion in Coca-Cola than after immersion in Lemon Delster.

  17. Calreticulin mutations in Chinese with primary myelofibrosis

    PubMed Central

    Li, Bing; Xu, Junqing; Wang, Jingya; Gale, Robert Peter; Xu, Zefeng; Cui, Yajuan; Yang, Lin; Xing, Ruixian; Ai, Xiaofei; Qin, Tiejun; Zhang, Yue; Zhang, Peihong; Xiao, Zhijian

    2014-01-01

    We tested 357 Chinese with primary myelofibrosis for mutations in CALR, JAK2 and MPL. CALR mutations were detected in 76 subjects (21%). There were 24 (32%) type-1 (L367fs*46) and 49 (64%) type-2 (K385fs*47) mutations. Seventy-two of 168 subjects (43%) without a JAK2 or MPL mutation had a CALR mutation. Subjects with a type-2 CALR mutation had lower hemoglobin concentrations (P=0.001), lower WBC counts (P<0.001), a higher percentage of blood blasts (P=0.009), and higher conventional (P<0.001) and Chinese-adjusted Dynamic International Prognostic Scoring System (P<0.001) scores compared with subjects with JAK2 mutations. Subjects with a type-2 CALR mutation were also likely to have abnormal platelet levels (<100 × 109/L, P=0.01 or >450 × 109/L, P=0.042) and no splenomegaly (P=0.004). Type-2 CALR mutation or no detectable mutation was an independent high-risk factor for survival in multivariate analyses. These data suggest the ratio between type-1 and type-2 mutations is reversed in Chinese with primary myelofibrosis compared with populations of subjects with primary myelofibrosis of predominately European descent. The unfavorable prognostic impact of CALR mutations in Chinese with primary myelofibrosis is only seen in those with type-2 mutations. These data underscore the need to evaluate the prognostic impact of genetic mutations in different populations. PMID:24997152

  18. Feasibility and effectiveness of the implementation of a primary prevention programme for type 2 diabetes in routine primary care practice: a phase IV cluster randomised clinical trial.

    PubMed

    Sanchez, Alvaro; Silvestre, Carmen; Sauto, Regina; Martínez, Catalina; Grandes, Gonzalo

    2012-11-16

    The objective of this study is to perform an independent evaluation of the feasibility and effectiveness of an educational programme for the primary prevention of type 2 diabetes (DM2) in high risk populations in primary care settings, implanted within the Basque Health Service - Osakidetza. This is a prospective phase IV cluster clinical trial conducted under routine conditions in 14 primary health care centres of Osakidetza, randomly assigned to an intervention or control group. We will recruit a total sample of 1089 individuals, aged between 45 and 70 years old, without diabetes but at high risk of developing the condition (Finnish Diabetes Risk Score, FINDRISC ≥ 14) and follow them up for 2 years. Primary health care nursing teams of the intervention centres will implement DE-PLAN, a structured educational intervention program focused on changing healthy lifestyles (diet and physical activity); while the patients in the control centres will receive the usual care for the prevention and treatment of DM2 currently provided in Osakidetza. The effectiveness attributable to the programme will be assessed by comparing the changes observed in patients exposed to the intervention and those in the control group, with respect to the risk of developing DM2 and lifestyle habits. In terms of feasibility, we will assess indicators of population coverage and programme implementation. The aim of this study is to provide the scientific basis for disseminate the programme to the remaining primary health centres in Osakidetza, as a novel way of addressing prevention of DM2. The study design will enable us to gather information on the effectiveness of the intervention as well as the feasibility of implementing it in routine practice.

  19. Feasibility and effectiveness of the implementation of a primary prevention programme for type 2 diabetes in routine primary care practice: a phase IV cluster randomised clinical trial

    PubMed Central

    2012-01-01

    Background The objective of this study is to perform an independent evaluation of the feasibility and effectiveness of an educational programme for the primary prevention of type 2 diabetes (DM2) in high risk populations in primary care settings, implanted within the Basque Health Service - Osakidetza. Methods/design This is a prospective phase IV cluster clinical trial conducted under routine conditions in 14 primary health care centres of Osakidetza, randomly assigned to an intervention or control group. We will recruit a total sample of 1089 individuals, aged between 45 and 70 years old, without diabetes but at high risk of developing the condition (Finnish Diabetes Risk Score, FINDRISC ≥ 14) and follow them up for 2 years. Primary health care nursing teams of the intervention centres will implement DE-PLAN, a structured educational intervention program focused on changing healthy lifestyles (diet and physical activity); while the patients in the control centres will receive the usual care for the prevention and treatment of DM2 currently provided in Osakidetza. The effectiveness attributable to the programme will be assessed by comparing the changes observed in patients exposed to the intervention and those in the control group, with respect to the risk of developing DM2 and lifestyle habits. In terms of feasibility, we will assess indicators of population coverage and programme implementation. Discussion The aim of this study is to provide the scientific basis for disseminate the programme to the remaining primary health centres in Osakidetza, as a novel way of addressing prevention of DM2. The study design will enable us to gather information on the effectiveness of the intervention as well as the feasibility of implementing it in routine practice. Trial registration ClinicalTrials.gov NCT01365013 PMID:23158830

  20. Reconstruction of improvised explosive device blast loading to personnel in the open

    NASA Astrophysics Data System (ADS)

    Wiri, Suthee; Needham, Charles

    2016-05-01

    Significant advances in reconstructing attacks by improvised explosive devices (IEDs) and other blast events are reported. A high-fidelity three-dimensional computational fluid dynamics tool, called Second-order Hydrodynamic Automatic Mesh Refinement Code, was used for the analysis. Computer-aided design models for subjects or vehicles in the scene accurately represent geometries of objects in the blast field. A wide range of scenario types and blast exposure levels were reconstructed including free field blast, enclosed space of vehicle cabin, IED attack on a vehicle, buried charges, recoilless rifle operation, rocket-propelled grenade attack and missile attack with single subject or multiple subject exposure to pressure levels from ˜ 27.6 kPa (˜ 4 psi) to greater than 690 kPa (>100 psi). To create a full 3D pressure time-resolved reconstruction of a blast event for injury and blast exposure analysis, a combination of intelligence data and Blast Gauge data can be used to reconstruct an actual in-theatre blast event. The methodology to reconstruct an event and the "lessons learned" from multiple reconstructions in open space are presented. The analysis uses records of blast pressure at discrete points, and the output is a spatial and temporal blast load distribution for all personnel involved.

  1. Monte Carlo simulation as a tool to predict blasting fragmentation based on the Kuz Ram model

    NASA Astrophysics Data System (ADS)

    Morin, Mario A.; Ficarazzo, Francesco

    2006-04-01

    Rock fragmentation is considered the most important aspect of production blasting because of its direct effects on the costs of drilling and blasting and on the economics of the subsequent operations of loading, hauling and crushing. Over the past three decades, significant progress has been made in the development of new technologies for blasting applications. These technologies include increasingly sophisticated computer models for blast design and blast performance prediction. Rock fragmentation depends on many variables such as rock mass properties, site geology, in situ fracturing and blasting parameters and as such has no complete theoretical solution for its prediction. However, empirical models for the estimation of size distribution of rock fragments have been developed. In this study, a blast fragmentation Monte Carlo-based simulator, based on the Kuz-Ram fragmentation model, has been developed to predict the entire fragmentation size distribution, taking into account intact and joints rock properties, the type and properties of explosives and the drilling pattern. Results produced by this simulator were quite favorable when compared with real fragmentation data obtained from a blast quarry. It is anticipated that the use of Monte Carlo simulation will increase our understanding of the effects of rock mass and explosive properties on the rock fragmentation by blasting, as well as increase our confidence in these empirical models. This understanding will translate into improvements in blasting operations, its corresponding costs and the overall economics of open pit mines and rock quarries.

  2. Prognostic relevance of HER2/neu in acute lymphoblastic leukemia and induction of NK cell reactivity against primary ALL blasts by trastuzumab

    PubMed Central

    Schmied, Bastian J.; Dang, Truong-Minh; Mirza, Nora; Möhle, Robert; Kanz, Lothar; Vogel, Wichard; Salih, Helmut R.

    2016-01-01

    The epidermal growth factor receptor HER2/neu is expressed on various cancers and represents a negative prognostic marker, but is also a target for the therapeutic monoclonal antibody Trastuzumab. In about 30% of cases, HER2/neu is expressed on acute lymphoblastic leukemia (ALL) cells and was proposed to be associated with a deleterious prognosis. Here we evaluated clinical data from 65 ALL patients (HER2/neu+, n = 17; HER2/neu−, n = 48) with a median follow-up of 19.4 months (range 0.6-176.5 months) and observed no association of HER2/neu expression with response to chemotherapy, disease free or overall survival. In vitro, treatment of primary ALL cells (CD20+HER2/neu+, CD20+HER2/neu− and CD20−HER2/neu−) with Rituximab and Trastuzumab led to activation of NK cells in strict dependence of the expression of the respective antigen. NK reactivity was more pronounced with Rituximab as compared to Trastuzumab, and combined application could lead to additive effects in cases where both antigens were expressed. Besides providing evidence that HER2/neu expression is no risk factor in ALL patients, our data demonstrates that HER2/neu can be a promising target for Trastuzumab therapy in the subset of ALL patients with the potential to improve disease outcome. PMID:26887048

  3. Silver nanowire interactions with primary human alveolar type-II epithelial cell secretions: contrasting bioreactivity with human alveolar type-I and type-II epithelial cells

    PubMed Central

    Sweeney, Sinbad; Theodorou, Ioannis G.; Zambianchi, Martina; Chen, Shu; Gow, Andrew; Schwander, Stephan; Zhang, Junfeng (Jim); Chung, Kian Fan; Shaffer, Milo S.; Ryan, Mary P.; Porter, Alexandra E.; Tetley, Teresa D.

    2015-01-01

    Inhaled nanoparticles have a high deposition rate in the alveolar units of the deep lung. The alveolar epithelium is composed of type-I and type-II epithelial cells (ATI and ATII respectively) and is bathed in pulmonary surfactant. The effect of native human ATII cell secretions on nanoparticle toxicity is not known. We investigated the cellular uptake and toxicity of silver nanowires (AgNWs; 70 nm diameter, 1.5 μm length) with human ATI-like cells (TT1), in the absence or presence of Curosurf® (a natural porcine pulmonary surfactant with a low amount of protein) or harvested primary human ATII cell secretions (HAS; containing both the complete lipid as well as the full protein complement of human pulmonary surfactant i.e. SP-A, SP-B, SP-C and SP-D). We hypothesised that Curosurf® or HAS would confer improved protection for TT1 cells, limiting the toxicity of AgNWs. In agreement with our hypothesis, HAS reduced the inflammatory and reactive oxygen species (ROS)-generating potential of AgNWs with exposed TT1 cells. For example, IL-8 release and ROS generation was reduced by 38% and 29%, respectively, resulting in similar levels to that of the non-treated controls. However in contrast to our hypothesis, Curosurf® had no effect. We found a significant reduction in AgNW uptake by TT1 cells in the presence of HAS but not Curosurf. Furthermore, we show that the SP-A and SP-D are likely to be involved in this process as they were found to be specifically bound to the AgNWs. While ATI cells appear to be protected by HAS, evidence suggested that ATII cells, despite no uptake, were vulnerable to AgNW exposure (indicated by increased IL-8 release and ROS generation and decreased intracellular SP-A levels one day post-exposure). This study provides unique findings that may be important for the study of lung epithelial-endothelial translocation of nanoparticles in general and associated toxicity within the alveolar unit. PMID:25996248

  4. Modelling and Testing of Blast Effect On the Structures

    NASA Astrophysics Data System (ADS)

    Figuli, Lucia; Jangl, Štefan; Papán, Daniel

    2016-10-01

    As a blasting agent in the blasting and mining engineering, has been using one of so called new generation of explosives which offer greater flexibility in their range and application, and such explosive is ANFO. It is type of explosive consists of an oxidiser and a fuel (ammonium nitrate and fuel oil). One of such ANFO explosives which are industrially made in Slovakia is POLONIT. The explosive is a mixture of ammonium nitrate, methyl esters of higher fatty acids, vegetable oil and red dye. The paper deals with the analysis of structure subjected to the blast load created by the explosion of POLONIT charge. First part of paper is describing behaviour and characteristic of blast wave generated from the blast (detonation characteristics, physical characteristics, time-history diagram etc.) and the second part presents the behaviour of such loaded structures, because of the analysis of such dynamical loaded structure is required knowing the parameters of blast wave, its effect on structure and the tools for the solution of dynamic analysis. The real field tests of three different weight of charges and two different structures were done. The explosive POLONIT was used together with 25 g of ignition explosive PLNp10. Analytical and numerical model of blast loaded structure is compared with the results obtained from the field tests (is compared with the corresponding experimental accelerations). For the modelling structures were approximated as a one-degree system of freedom (SDOF), where the blast wave was estimated with linear decay and exponential decay using positive and negative phase of blast wave. Numerical solution of the steel beam dynamic response was performed via FEM (Finite Element Method) using standard software Visual FEA.

  5. Cerebrovascular Injury in Blast Loading

    DTIC Science & Technology

    2010-01-01

    TITLE: Cerebrovascular injury in blast loading PRINCIPAL INVESTIGATOR: Kenneth L. Monson, PhD...SUBTITLE Cerebrovascular injury in blast loading 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-08-1-0295 5c. PROGRAM ELEMENT NUMBER 6...and pH control. 15. SUBJECT TERMS Blast brain injury; cerebrovascular injury and dysfunction; shock tube 16. SECURITY CLASSIFICATION OF: 17

  6. Clinical inertia in the treatment of hyperglycemia in type 2 diabetes patients in primary care.

    PubMed

    Mata-Cases, Manel; Benito-Badorrey, Belén; Roura-Olmeda, Pilar; Franch-Nadal, Josep; Pepió-Vilaubí, Josep Maria; Saez, Marc; Coll-de-Tuero, Gabriel

    2013-11-01

    To assess clinical inertia, defined as failure to intensify antidiabetic treatment of patients who have not achieved the HbA1c therapeutic goal (≤7%). Multicenter cross-sectional study. Clinical inertia was assessed in a random sample of type 2 diabetes mellitus (T2DM) patients seen in primary care centers. A total of 2783 patients (51.3% males; mean age: 68 [±11.5] years; diabetes duration: 7.1 [±5.6] years; mean HbA1c: 6.8 [±1.5]) were analyzed. Of those, 997 (35.8%) had HbA1c >7%. Treatment was intensified in 66.8% and consisted of: dose increase (40.5%); addition of oral antidiabetic (45.8%); or insulin treatment initiation (3.7%). Mean HbA1c values in patients for whom treatment was intensified vs. non-intensified were 8.4% (±1.2) vs. 8.2% (±1.2), p < 0.05. Clinical inertia was detected in 33.2% of patients and diminished along with treatment complexity: lifestyle changes only (38.8%), oral monotherapy (40.3%), combined oral antidiabetics (34.5%), insulin monotherapy (26.1%) and combination of insulin and oral antidiabetics (21.4%). Clinical inertia decreased as HbA1c increased: 37.3% for HbA1c values ranging between 7.1%-8%; 29.4% for the 8.1%-9% HbA1c range and 27.1% for HbA1c ≥9%. Multivariate analysis confirmed that diabetes duration, step of treatment and HbA1c were related to inertia. For each unit of HbA1c increase clinical inertia decreased 47% (OR: 0.53). The retrospective design of the study precluded an accurate investigation about reasons for lack of intensification that could actually be justified by some patient conditions, especially patients' lack of adherence. Clinical inertia affected one third of T2DM patients with poor glycemic control and was greater in patients treated with only lifestyle changes or oral monotherapy. Treatment changes were performed when mean HbA1c values were 1.4 points above therapeutic goals.

  7. Prevalence and control of type 2 diabetes mellitus among primary care physicians in Spain. PRISMA Study.

    PubMed

    Franch-Nadal, Josep; Mediavilla-Bravo, Javier; Mata-Cases, Manuel; Mauricio, Didac; Asensio, David; Sarroca, Jordi

    2017-05-01

    To describe the prevalence of known and ignored type 2 diabetes mellitus (T2DM) among primary care physicians (PCP), as well as the treatment used and the degree of metabolic control reached. Descriptive cross-sectional study on national level. The participants were randomly selected PCPs, members of the redGDPS Foundation. A total of 495 PCP were enrolled. Capillary HbA1c measurement was done with a A1CNow+(®) device and a diabetes-related survey specifically designed for the study was administered to the participants. The total prevalence of T2DM was 11.1% (95% CI 8.33-13.9) (known disease 8,1% and ignored disease 3.0%). The prevalence of prediabetes was 16.2% (95% CI 13.0-19.4). A total of 62.5% of PCPs with known T2DM reached HbA1c<7% and 15% had HbA1c>8.5%. Control of blood pressure (BP<140/90mmHg) was reached in 87.5% and control of LDL cholesterol<130mg/dl with no history of cardiovascular disease was reached in 88.6% of cases of known T2DM. In the PCPs with a history of macrovascular disease, good control of LDL was reached in 42.9% of the cases. A total of 12.5% were active smokers. A total of 71.4% of PCPs with known T2DM self-treated their own disease, usually with 2 or more drugs (51.4%). The most commonly used drug was metformin (74.3%) followed by iDPP4 (48.6%). PCPs with T2DM have better metabolic control than the general population. It is necessary to study whether PCPs with T2DM may have greater adherence to treatment and do they achieve a better metabolic control. Copyright © 2017 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. Silver nanowire interactions with primary human alveolar type-II epithelial cell secretions: contrasting bioreactivity with human alveolar type-I and type-II epithelial cells

    NASA Astrophysics Data System (ADS)

    Sweeney, Sinbad; Theodorou, Ioannis G.; Zambianchi, Marta; Chen, Shu; Gow, Andrew; Schwander, Stephan; Zhang, Junfeng (Jim); Chung, Kian Fan; Shaffer, Milo S. P.; Ryan, Mary P.; Porter, Alexandra E.; Tetley, Teresa D.

    2015-06-01

    Inhaled nanoparticles have a high deposition rate in the alveolar units of the deep lung. The alveolar epithelium is composed of type-I and type-II epithelial cells (ATI and ATII respectively) and is bathed in pulmonary surfactant. The effect of native human ATII cell secretions on nanoparticle toxicity is not known. We investigated the cellular uptake and toxicity of silver nanowires (AgNWs; 70 nm diameter, 1.5 μm length) with human ATI-like cells (TT1), in the absence or presence of Curosurf® (a natural porcine pulmonary surfactant with a low amount of protein) or harvested primary human ATII cell secretions (HAS; containing both the complete lipid as well as the full protein complement of human pulmonary surfactant i.e. SP-A, SP-B, SP-C and SP-D). We hypothesised that Curosurf® or HAS would confer improved protection for TT1 cells, limiting the toxicity of AgNWs. In agreement with our hypothesis, HAS reduced the inflammatory and reactive oxygen species (ROS)-generating potential of AgNWs with exposed TT1 cells. For example, IL-8 release and ROS generation was reduced by 38% and 29%, respectively, resulting in similar levels to that of the non-treated controls. However in contrast to our hypothesis, Curosurf® had no effect. We found a significant reduction in AgNW uptake by TT1 cells in the presence of HAS but not Curosurf. Furthermore, we show that the SP-A and SP-D are likely to be involved in this process as they were found to be specifically bound to the AgNWs. While ATI cells appear to be protected by HAS, evidence suggested that ATII cells, despite no uptake, were vulnerable to AgNW exposure (indicated by increased IL-8 release and ROS generation and decreased intracellular SP-A levels one day post-exposure). This study provides unique findings that may be important for the study of lung epithelial-endothelial translocation of nanoparticles in general and associated toxicity within the alveolar unit.Inhaled nanoparticles have a high deposition rate in

  9. Assessment of oral hygiene and periodontal health around posterior primary molars after their restoration with various crown types.

    PubMed

    Beldüz Kara, Nihal; Yilmaz, Yucel

    2014-07-01

    To compare the time-dependent changes in oral hygiene and periodontal health after restoring primary posterior molars with a traditional stainless steel crown (SSC) or an aesthetic crown using various measures of periodontal health and oral hygiene. This investigation was a randomized, non-blinded prospective controlled clinical trial in which 264 crowns of different types were fitted onto the first and/or second primary molars of 76 children. The oral hygiene and the gingival health of the restored teeth and the antagonistic teeth were evaluated clinically and radiographically at 3- and 6-month intervals for 18 months after fitting the crowns. The periodontal health of the control teeth was better than that of the remaining 215 restored teeth. The oral hygiene, as measured by the simplified oral hygiene index, and gingival health, as measured by the gingival index and the volume of gingival crevicular fluid, of the restored teeth, irrespective of crown type, progressively increased during the 18-month study period. Oral hygiene and gingival health around a restored primary tooth deteriorate with time. Our results suggest that SSC, an open-faced SSC, or a NuSmile(®) pediatric crown should be the preferred crown type for restoring posterior primary teeth. © 2013 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. Effect of Adding Pharmacists to Primary Care Teams on Blood Pressure Control in Patients With Type 2 Diabetes

    PubMed Central

    Simpson, Scot H.; Majumdar, Sumit R.; Tsuyuki, Ross T.; Lewanczuk, Richard Z.; Spooner, Richard; Johnson, Jeffrey A.

    2011-01-01

    OBJECTIVE To evaluate the effect of adding pharmacists to primary care teams on the management of hypertension and other cardiovascular risk factors in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS We conducted a randomized controlled trial with blinded ascertainment of outcomes within primary care clinics in Edmonton, Canada. Pharmacists performed medication assessments and limited history and physical examinations and provided guideline-concordant recommendations to optimize medication management. Follow-up contact was completed as necessary. Control patients received usual care. The primary outcome was a ≥10% decrease in systolic blood pressure at 1 year. RESULTS A total of 260 patients were enrolled, 57% were women, the mean age was 59 years, diabetes duration was 6 years, and blood pressure was 129/74 mmHg. Forty-eight of 131 (37%) intervention patients and 30 of 129 (23%) control patients achieved the primary outcome (odds ratio 1.9 [95% CI 1.1–3.3]; P = 0.02). Among 153 patients with inadequately controlled hypertension at baseline, intervention patients (n = 82) were significantly more likely than control patients (n = 71) to achieve the primary outcome (41 [50%] vs. 20 [28%]; 2.6 [1.3–5.0]; P = 0.007) and recommended blood pressure targets (44 [54%] vs. 21 [30%]; 2.8 [1.4–5.4]; P = 0.003). The 10-year risk of cardiovascular disease, based on changes to the UK Prospective Diabetes Study Risk Engine, were predicted to decrease by 3% for intervention patients and 1% for control patients (P = 0.005). CONCLUSIONS Significantly more patients with type 2 diabetes achieved better blood pressure control when pharmacists were added to primary care teams, which suggests that pharmacists can make important contributions to the primary care of these patients. PMID:20929988

  11. Primary cutaneous diffuse large B-cell lymphoma (PCDLBCL), leg-type and other: an update on morphology and treatment.

    PubMed

    Paulli, M; Lucioni, M; Maffi, A; Croci, G A; Nicola, M; Berti, E

    2012-12-01

    Primary cutaneous B-cell lymphoma (PCBCL) is an heterogeneous group of lymphoproliferative disorders, which account for 25-30% of all primary cutaneous lymphoma and include three main histotypes: 1) primary cutaneous marginal zone B-cell lymphoma (PCMZL); 2) primary cutaneous follicular center cell lymphoma (PCFCL); 3) primary cutaneous diffuse large B-cell lymphoma (DLBCL), leg type (PCDLBCL-LT). PCMZL and PCFCL are indolent lymphomas, with an excellent prognosis despite an high rate of cutaneous recurrences; in contrast, PCDLBCL-LT is clinically more aggressive and usually requires to be treated with multi-agent chemotherapy and anti-CD20 monoclonal antibodies. PCDLBCL-LT histologically consists of large round cells (centroblasts and immunoblasts), is characterized by strong bcl-2 expression, in the absence of t(14;18) translocation, and resembles the activated B-cell type of nodal DLBCL. Recently, the term primary cutaneous DLBCL-other (PCDLBCL-O) has been proposed to include diffuse lymphomas composed of large transformed B-cells that lack the typical features of PCDLBCL-LT and do not conform to the definition of PCFCL. Some clinical studies suggested that such cases have an indolent clinical course and may be treated in a conservative manner; however, data regarding the actual prognosis and clinical behaviour of these peculiar cases are still too limited. The spectrum of primary cutaneous DLBCL also encompasses some rare morphological variants, such as anaplastic or plasmablastic subtypes and T-cell rich B-cell lymphoma, and some recently described, exceedingly rare DLBCL subtypes, such as intravascular large B-cell lymphoma and EBV-associated large B-cell lymphoma of the elderly, which often present in the skin.

  12. A mobile screening programme for the cardiovascular and microvascular complications of Type 2 diabetes in primary care.

    PubMed

    Sampson, M J; Barrie, P; Dozio, N; Flatman, M; Hadley-Brown, M; Harvey, I; Heyburn, P J; Jones, C; Mann, R; Temple, R C; Greenwood, R H

    2005-03-01

    The Diabetes National Service framework (NSF), and the quality payments in the new contract for UK General Practitioners, promote regular screening for diabetes complications. The new contract also includes immediate incentives to meet screening and quality targets, but it will be difficult to meet these targets in primary care. We have developed a mobile 'annual review' programme for patients with Type 2 diabetes managed solely in primary care, that screens for cardiovascular disease, hypertension, retinopathy and neuropathy at the patient's general practice, and gives written foot care, dietary advice and level 1 smoking cessation advice to all patients.

  13. Triggering factors of primary care costs in the years following type 2 diabetes diagnosis in Mexico.

    PubMed

    Castro-Ríos, Angélica; Nevárez-Sida, Armando; Tiro-Sánchez, María Teresa; Wacher-Rodarte, Niels

    2014-07-01

    Diabetes represents a high epidemiological and economic burden worldwide. The cost of diabetes care increases slowly during early years, but it accelerates once chronic complications set in. There is evidence that adequate control may delay the onset of complications. Management of diabetes falls almost exclusively into primary care services until chronic complications appear. Therefore, primary care is strategic for reducing the expedited growth of costs. The objective of this study was to identify predictors of primary care costs in patients without complications in the years following diabetes diagnosis. Direct medical costs for primary care were determined from the perspective of public health services provider. Information was obtained from medical records of 764 patients. Microcosting and average cost techniques were combined. A generalized linear regression model was developed including characteristics of patients and facilities. Primary health care costs for different patient profiles were estimated. The mean annual primary care cost was USD$465.1. Gender was the most important predictor followed by weight status, insulin use, respiratoty infections, glycemic control and dyslipidemia. A gap in costs was observed between genders; women make greater use of resources (42.1% on average). Such differences are reduced with obesity (18.1%), overweight (22.8%), respiratory infection (20.8%) and age >80 years (26.8%). Improving glycemic control shows increasing costs but at decreasing rates. Modifiable factors (glycemic control, weight status and comorbidities) drive primary care costs the first 10 years. Those factors had a larger effect in costs for males than in for females. Copyright © 2014 IMSS. Published by Elsevier Inc. All rights reserved.

  14. Rural-to-Urban Migrants' Experiences with Primary Care under Different Types of Medical Institutions in Guangzhou, China

    PubMed Central

    Zeng, Jiazhi; Shi, Leiyu; Zou, Xia; Chen, Wen; Ling, Li

    2015-01-01

    Objectives China is facing the unprecedented challenge of rapidly increasing rural-to-urban migration. Migrants are in a vulnerable state when they attempt to access to primary care services. This study was designed to explore rural-to-urban migrants’ experiences in primary care, comparing their quality of primary care experiences under different types of medical institutions in Guangzhou, China. Methods The study employed a cross-sectional survey of 736 rural-to-urban migrants in Guangzhou, China in 2014. A validated Chinese version of Primary Care Assessment Tool—Adult Short Version (PCAT-AS), representing 10 primary care domains was used to collect information on migrants’ quality of primary care experiences. These domains include first contact (utilization), first contact (accessibility), ongoing care, coordination (referrals), coordination (information systems), comprehensiveness (services available), comprehensiveness (services provided), family-centeredness, community orientation and culturally competent. These measures were used to assess the quality of primary care performance as reported from patients’ perspective. Analysis of covariance was conducted for comparison on PCAT scores among migrants accessing primary care in tertiary hospitals, municipal hospitals, community health centers/community health stations, and township health centers/rural health stations. Multiple linear regression models were used to explore factors associated with PCAT total scores. Results After adjustments were made, migrants accessing primary care in tertiary hospitals (25.49) reported the highest PCAT total scores, followed by municipal hospitals (25.02), community health centers/community health stations (24.24), and township health centers/rural health stations (24.18). Tertiary hospital users reported significantly better performance in first contact (utilization), first contact (accessibility), coordination (information system), comprehensiveness (service

  15. Pulverized coal injection operation on CSC No. 3 blast furnace

    SciTech Connect

    Chan, C.M.; Hsu, C.H.

    1996-12-31

    The pulverized coal injection system was introduced for the first time in No. 1 and No. 2 blast furnace at China Steel Corporation (CSC) in 1988. Currently the coal injection rate for both blast furnaces has steadily risen to 70--89 kg/thm (designed value). No 3 blast furnace (with an inner volume of 3400 m3) was also equipped with a PCI system of Armco type and started coal injection on November 17, 1993. During the early period, some problems such as injection lance blocking, lance-tip melting down, flexible hose wear, grind mill tripping occasionally interrupted the stable operation of blast furnace. After a series of efforts offered on equipment improvement and operation adjustment, the PC rate currently reaches to 90--110 kg/thm and furnace stable operation is still being maintained with productivity more than 2.20.

  16. Blast TBI Models, Neuropathology, and Implications for Seizure Risk

    PubMed Central

    Kovacs, S. Krisztian; Leonessa, Fabio; Ling, Geoffrey S. F.

    2014-01-01

    Traumatic brain injury (TBI) due to explosive blast exposure is a leading combat casualty. It is also implicated as a key contributor to war related mental health diseases. A clinically important consequence of all types of TBI is a high risk for development of seizures and epilepsy. Seizures have been reported in patients who have suffered blast injuries in the Global War on Terror but the exact prevalence is unknown. The occurrence of seizures supports the contention that explosive blast leads to both cellular and structural brain pathology. Unfortunately, the exact mechanism by which explosions cause brain injury is unclear, which complicates development of meaningful therapies and mitigation strategies. To help improve understanding, detailed neuropathological analysis is needed. For this, histopathological techniques are extremely valuable and indispensable. In the following we will review the pathological results, including those from immunohistochemical and special staining approaches, from recent preclinical explosive blast studies. PMID:24782820

  17. Primary enteric-type mucinous adenocarcinoma of the urethra in a patient with ulcerative colitis.

    PubMed

    Dimitroulis, Dimitrios; Patsouras, Dimitrios; Katsargyris, Athanasios; Charalampoudis, Petros; Anastasiou, Ioannis; Kouraklis, Gregory

    2014-01-01

    Primary carcinoma of the male urethra accounts for less than 1% of malignancies in men. Mucinous adenocarcinoma of the urethra is extremely rare, and its biologic behavior is poorly understood. We present herein a rare case of mucinous urethral adenocarcinoma in a male patient with longstanding ulcerative colitis and multiple sclerosis. The patient presented with a voluminous pelvic mass; core biopsy of the lesion demonstrated a mucus-producing adenocarcinoma. Given the patient's history of subtotal colectomy, preoperative diagnosis was oriented towards a rectal stump adenocarcinoma. The patient underwent a pelvic exenteration: surprisingly, histology marked the prostatic urethra as the primary lesion site.

  18. Investigation on the primary creep of a nickel based alloy. [Nimonic 75 type alloy

    SciTech Connect

    Kong, Q.P.; Wang, X. )

    1993-07-01

    It is widely accepted that dislocation climb is involved in the steady state (i.e. secondary) creep at high temperatures, which is characterized by the formation and evolution of substructures. In current theories of steady state creep, dislocation climb is regarded as the rate controlling process. However, the role of dislocation climb in the primary (i.e. transient) creep at high temperatures is not clear. The present paper is to report the observations by transmission electron microscopy (TEM) on high temperature creep of a nickel based alloy. It will be shown that dislocation climb plays an important role not only in the steady state creep, but also in the primary creep.

  19. Vaginal type-II mucosa is an inductive site for primary CD8+ T-cell mucosal immunity

    PubMed Central

    Wang, Yichuan; Sui, Yongjun; Kato, Shingo; Hogg, Alison E.; Steel, Jason C.; Morris, John C.; Berzofsky, Jay A.

    2014-01-01

    The structured lymphoid tissues are considered the only inductive sites where primary T cell immune responses occur. The naïve T cells in structured lymphoid tissues, once being primed by antigen -bearing dendritic cells, differentiate into memory T cells and traffic back to the mucosal sites through the bloodstream. Contrary to this belief, here we show that the vaginal type-II mucosa itself, despite lack of structured lymphoid tissues, can act as an inductive site during primary CD8+ T cell immune responses. We provide evidence that the vaginal mucosa supports both the local immune priming of naïve CD8+ T cells and the local expansion of antigen-specific CD8+ T cells, thereby demonstrating a different paradigm for primary mucosal T cell immune induction. PMID:25600442

  20. Facial skin-mucosal biodynamic blast injuries and management.

    PubMed

    Shuker, Sabri T

    2010-08-01

    The blast biodynamic presents maxillofacial injuries of a different type. The analysis of facial skin lacerations and intense flash burns will add new clinical findings that will assist in the early diagnosis of life-threatening airway compromise due to the inhalation of hot gases and toxic fumes. Improvised explosive devices most likely result in blast injuries and severe incendiary situations. Consequently, we require a better understanding of blast pathophysiologic effects, as well as the diagnosis and emergency management of facial soft tissue injuries, which create and provoke new challenges in lifesaving techniques and procedures. This article reviews the physics and biophysics of blast facial skin shredding, extensive contusions, lacerations, multiple puncture wounds, partial scalping, flash and thermal burns, thermal inhalation, and toxic fume injuries, as well as detailing the management of blast and thermal wound injuries. In addition, the initial and immediate care of related airway compromise resulting in life-threatening conditions is reviewed. A new type of conflict-related blast injury is described and evaluated. These explosion wounds result in facial soft tissue injuries, edema of the mucosa of the upper respiratory region, and lung trauma. The understanding of the blast biodynamic injuries associated with thermal burns and inhalation of hot toxic fumes that cause serious respiratory injuries requiring special management should be shared globally with our colleagues. Recently, many victims of improvised explosive devices have shown varying degrees of facial injuries in different patterns with or without flash burns. In addition, patients have had intense thermal inhalation that leads to oral-nasal-pharyngeal edema and toxic fume inhalation that may require the management of life-threatening airway compromise. This report will contribute to the lexicon of maxillofacial surgery diagnosis and procedures, including lifesaving airway management, by the

  1. Comparison of rice lines derived through anther culture and the pedigree method in relation to blast (Pyricularia grisea Sacc.) resistance.

    PubMed

    Martínez, C P; Victoria, F C; Amézquita, M C; Tulande, E; Lema, G; Zeigler, R S

    1996-04-01

    Crosses were made between Fanny (highly susceptible to blast) and 11 cultivars differing in blast resistance. Using the pedigree method (PM) segregating generations were evaluated and selected for blast resistance. Via anther culture (AC), doubled-haploids were obtained from F1 plants and from F2 blast-susceptible plants. Pedigree and anther culture-derived lines were planted together and evaluated for blast resistance under rainfed conditions at the Santa Rosa Experiment Station, Villavicencio, Colombia. The principal objective was to compare PM and AC in terms of their efficiency in producing rice lines resistant to blast. Results of a stratified analysis showed an association between method and blast resistance. Results of the logit-model analysis showed that AC produced a significantly (P=0.0001) higher proportion of lines with initial blast resistance (leaf- and neck-blast reaction ≤4) than did PM across all cross types. Stable blast resistance was assessed based on field performance over 3 years. AC was superior to PM in generating stable resistance for only some cross types. Consequently, with a few exceptions, AC can be used as effectively as PM to develop rice cultivars resistant to blast, with savings in time and labor. Additionally, blast-resistant lines were obtained either by the pedigree method or by anther culture from crosses between blast-susceptible cultivars (Fanny/CICA4 and Fanny/Colombial). This excludes somaclonal variation as a possible mechanism responsible for this resistance and suggests that a recombination of minor genes could have occurred and was fixed through either method. However, the stability of the resistance was greater in pedigree-derived lines. The implications of these findings for rice blast-resistance breeding are discussed.

  2. 14 CFR 21.24 - Issuance of type certificate: primary category aircraft.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... aircraft in the primary category if— (1) The aircraft— (i) Is unpowered; is an airplane powered by a single... complies with the airworthiness standards and noise requirements established for the aircraft under § 21.17... category aircraft. 21.24 Section 21.24 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT...

  3. 14 CFR 21.24 - Issuance of type certificate: primary category aircraft.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... aircraft in the primary category if— (1) The aircraft— (i) Is unpowered; is an airplane powered by a single... complies with the airworthiness standards and noise requirements established for the aircraft under § 21.17... category aircraft. 21.24 Section 21.24 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT...

  4. 14 CFR 21.24 - Issuance of type certificate: primary category aircraft.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... aircraft in the primary category if— (1) The aircraft— (i) Is unpowered; is an airplane powered by a single... complies with the airworthiness standards and noise requirements established for the aircraft under § 21.17... category aircraft. 21.24 Section 21.24 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT...

  5. Ischemic stroke as the presenting symptom of primary hyperparathyroidism due to multiple endocrine neoplasia type 1.

    PubMed

    Mitre, Naim; Mack, Kenneth; Babovic-Vuksanovic, Dusica; Thompson, Geoffrey; Kumar, Seema

    2008-10-01

    We report a 14-year-old boy whose initial presentation of primary hyperparathyroidism was ischemic stroke in the absence of hypertension. We propose measurement of serum calcium and parathyroid hormone in all children with stroke symptoms or unexplained cranial infarcts.

  6. Topographic maps of brain electrical activity in primary degenerative dementia of the Alzheimer type and multiinfarct dementia.

    PubMed

    Martin-Loeches, M; Gil, P; Jimenez, F; Exposito, F J; Miguel, F; Cacabelos, R; Rubia, F J

    1991-02-01

    The topography of the electroencephalographic (EEG) pattern of ten patients with primary degenerative dementia of the Alzheimer type, ten multiinfarct dementia patients, and ten age-matched controls was compared during three different behavioral conditions: resting condition with eyes open (EO), memorizing a list of words (M), and recalling the same list of words (R). Results indicate that the alpha frequency band does not show significant changes. On the other hand, the theta band could be considered an important factor in the differential diagnosis of the primary degenerative dementia of the Alzheimer type, showing a higher power over right posterior regions in this group of patients compared with the multiinfarct dementia patients under different behavioral conditions.

  7. Primary vaginal adenocarcinoma of intestinal type arising from an adenoma: case report and review of the literature.

    PubMed

    Mudhar, H S; Smith, J H; Tidy, J

    2001-04-01

    A 1 cm polypoid lesion was encountered on the posterior vaginal wall in a 56-year-old woman with no history of diethylstilbestrol exposure that on microscopic examination was a moderately differentiated adenocarcinoma of intestinal type. The tumor was cytokeratin 20 and carcinoembryonic antigen positive and negative for cytokeratin 7. Mucin histochemistry demonstrated the presence of o-acetylated sialomucin, a specific marker of large intestinal differentiation. The initial interpretation favored a metastasis from a colonic adenocarcinoma, but clinical investigations showed no evidence of a primary gastrointestinal lesion. The morphology, histochemical, and differential cytokeratin profile led to the lesion being reinterpreted as a primary intestinal-type adenocarcinoma of the vagina arising from a tubular adenoma. Although a very rare tumor, awareness of this lesion is important as it must be distinguished from metastatic adenocarcinomas from other sites.

  8. Cryopreservation and in vitro culture of primary cell types from lung tissue of a stranded pygmy sperm whale (Kogia breviceps).

    PubMed

    Annalaura Mancia; Spyropoulos, Demetri D; McFee, Wayne E; Newton, Danforth A; Baatz, John E

    2012-01-01

    Current models for in vitro studies of tissue function and physiology, including responses to hypoxia or environmental toxins, are limited and rely heavily on standard 2-dimensional (2-D) cultures with immortalized murine or human cell lines. To develop a new more powerful model system, we have pursued methods to establish and expand cultures of primary lung cell types and reconstituted tissues from marine mammals. What little is known about the physiology of the deep-sea diving pygmy sperm whale (PSW), Kogia breviceps, comes primarily from stranding events that occur along the coast of the southeastern United States. Thus, development of a method for preserving live tissues and retrieving live cells from deceased stranded individuals was initiated. This report documents successful cryopreservation of PSW lung tissue. We established in vitro cultures of primary lung cell types from tissue fragments that had been cryopreserved several months earlier at the stranding event. Dissociation of cryopreserved lung tissues readily provides a variety of primary cell types that, to varying degrees, can be expanded and further studied/manipulated in cell culture. In addition, PSW-specific molecular markers have been developed that permitted the monitoring of fibroblast, alveolar type II, and vascular endothelial cell types. Reconstitution of 3-D cultures of lung tissues with these cell types is now underway. This novel system may facilitate the development of rare or disease-specific lung tissue models (e.g., to test causes of PSW stranding events and lead to improved treatments for pulmonary hypertension or reperfusion injury in humans). Also, the establishment of a "living" tissue bank biorepository for rare/endangered species could serve multiple purposes as surrogates for freshly isolated samples. Copyright © 2011 Elsevier Inc. All rights reserved.

  9. 30 CFR 817.68 - Use of explosives: Records of blasting operations.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ..., direction, and distance, in feet, from the nearest blast hole to the nearest dwelling, public building...-millisecond period. (l) Initiation system. (m) Type and length of stemming. (n) Mats or other protections used... and the date, time, and distance from the blast; (3) Name of the person and firm taking the reading...

  10. 30 CFR 816.68 - Use of explosives: Records of blasting operations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., direction, and distance, in feet, from the nearest blast hole to the nearest dwelling, public building...-millisecond period. (l) Initiation system. (m) Type and length of stemming. (n) Mats or other protections used... and the date, time, and distance from the blast; (3) Name of the person and firm taking the reading...

  11. 30 CFR 817.68 - Use of explosives: Records of blasting operations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., direction, and distance, in feet, from the nearest blast hole to the nearest dwelling, public building...-millisecond period. (l) Initiation system. (m) Type and length of stemming. (n) Mats or other protections used... and the date, time, and distance from the blast; (3) Name of the person and firm taking the reading...

  12. 30 CFR 816.68 - Use of explosives: Records of blasting operations.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ..., direction, and distance, in feet, from the nearest blast hole to the nearest dwelling, public building...-millisecond period. (l) Initiation system. (m) Type and length of stemming. (n) Mats or other protections used... and the date, time, and distance from the blast; (3) Name of the person and firm taking the reading...

  13. Blasting-induced damage in coal

    SciTech Connect

    Kabongo, K.K.

    1995-12-31

    The paper is drawn from a project intended to explore a technique of prediction, control and optimization of fracture in coal induced by blasting. It evaluates the fines generated in coal submitted to dynamic loading stresses in an impact stamp mortar. The aim is to analyze a complex phenomenon of coal response to blast-generated stresses from a series of discrete simulations of shock and gas actions in controllable processes. It is learned that despite the nucleation of primary crushing and fractures to originate from the point of impact energy in coal, a secondary crushing appears to depart from within the burden progressing towards the free boundaries. The extension of the secondary crushing zone appears to be influenced by the magnitude of the breaking stresses generated and the coal burden distance. A strong dependence of fines on the coal`s innate discontinuities (strength) and the energy input is highlighted.

  14. Management of Type 2 Diabetes in the Primary Care Setting: A Practice-Based Research Network Study

    PubMed Central

    Spann, Stephen J.; Nutting, Paul A.; Galliher, James M.; Peterson, Kevin A.; Pavlik, Valory N.; Dickinson, L. Miriam; Volk, Robert J.

    2006-01-01

    PURPOSE We wanted to describe how primary care clinicians care for patients with type 2 diabetes. METHODS We undertook a cross-sectional study of 95 primary care clinicians and 822 of their established patients with type 2 diabetes from 4 practice-based, primary care research networks in the United States. Clinicians were surveyed about their training and practice. Patients completed a self-administered questionnaire about their care, and medical records were reviewed for complications, treatment, and diabetes-control indicators. RESULTS Participating clinicians (average age, 45.7 years) saw an average of 32.6 adult patients with diabetes per month. Patients (average age, 59.7 years) reported a mean duration of diabetes of 9.1 years, with 34.3% having had the disease more than 10 years. Nearly one half (47.5%) of the patients had at least 1 diabetes-related complication, and 60.8% reported a body mass index greater than 30. Mean glycosylated hemoglobin (HbA1c) level was 7.6% (SD 1.73), and 40.5% of patients had values <7%. Only 35.3% of patients had adequate blood pressure control (<130/85 mm Hg), and only 43.7% had low-density lipoprotein cholesterol (LDL-C) levels <100 mg/dL. Only 7.0% of patients met all 3 control targets. Multilevel models showed that patient ethnicity, practice type, involvement of midlevel clinicians, and treatment were associated with HbA1c level; patient age, education level, and practice type were associated with blood pressure control; and patient ethnicity was associated with LDL-C control. CONCLUSIONS Only modest numbers of patients achieve established targets of diabetes control. Reengineering primary care practice may be necessary to substantially improve care. PMID:16449393

  15. [Role of radiotherapy in the treatment of NK/T-cell nasal type and primary cerebral lymphomas].

    PubMed

    Boros, A; Michot, J-M; Hoang-Xuan, K; Mazeron, R

    2016-10-01

    The head and neck are common sites for extranodal non-Hodgkin lymphomas. Radiotherapy plays an important role in the treatment of low-grade lymphomas, with curative or palliative intent. In the case of high-grade lymphomas, its combination with chemotherapy is debated. Its role is however undeniable in two specific entities: NK/T-cell lymphoma NK/T nasal type, and primary central nervous system lymphomas, which are the subject of this review.

  16. Quantitative analysis of four types of primary glomeropathy by application of a decision forest to ultrasonic and laboratory characteristics.

    PubMed

    Zhao, Tian-Chong; Wu, Jin-Yu; Li, Rui-Nan; Li, Xia

    2014-09-01

    The aim of this study was to apply a decision forest to analysis of the ultrasound characteristics and laboratory test indices of four types of primary glomerulopathy, and quantitative analysis of the four pathologic types using a combination of these two methods. The decision trees were derived from 41 clinical indices and 5 characteristic sonographic indices obtained for the left kidney. Fifty-six patients who had undergone ultrasound-guided renal biopsy were reviewed retrospectively, and on pathologic examination, the patients were diagnosed with primary glomerulopathy, which includes mesangial proliferative glomerulonephritis, membranous nephropathy, immunoglobulin A nephropathy and minimal change disease. In this study, eight characteristic indicators were correlated with pathologic type in the 56 cases of primary glomerulopathy. The order calculated by decision forests, from high to low, is proteinuria, length of kidney, serum creatinine, plasma albumin, area of kidney, total protein, thickness of renal parenchyma, 24-h urine protein. The glomerulopathy with the highest ++++ proteinuria is membranous nephropathy, which accounts for 39.2% (22/56) of the total sample; this was followed by minimal change disease, mesangial proliferative glomerulonephritis and immunoglobulin A nephropathy. On the basis of our analysis of 41 clinical indices, the key indices for quantitative analysis of primary glomerulonephritis are laboratory tests, and these include urine protein, serum creatinine, plasma albumin, total serum protein and 24-h urine protein. The three key sonographic features are measurement indices: renal length, renal area and renal parenchymal thickness. From the eight characteristic indicators, we observed that with respect to severity (from most severe to least severe), the four types of glomerulopathy are membranous nephropathy, minimal change disease, mesangial proliferative glomerulonephritis and immunoglobulin A nephropathy. Copyright © 2014 World

  17. RZ Cassiopeiae: Evidence for Spots on the Surface of the Primary Star in an Algol-type Eclipsing Binary System

    NASA Astrophysics Data System (ADS)

    Davis, S. M.; Balonek, T. J.

    1996-12-01

    The bright Algol-type eclipsing binary system RZ Cassiopeiae is known to exhibit irregular period changes as well as changes in the shape of the primary minimum light curve. Deviations from a simple partial eclipse light curve have been reported by other investigators in some, though not all, eclipses. We report CCD observations of five primary minima in 1996 obtained with the Colgate University Foggy Bottom Observatory 16-inch telescope. From these observations we construct an average "template" light curve in V for the primary eclipse and show that individual eclipses may differ significantly in shape from this template. Consecutive minima often have distinctly different shapes. The residuals between an individual light curve and the template show quasi-periodic oscillations with a "period" of about 25 minutes (corresponding to 0.013 in phase) and amplitude +/- 0.04 magnitude. The residuals of consectutive minima appear similar in structure, though displaced in time by about 15 minutes from each other. We interpret the oscillations in the light curves as evidence for hot and cool spots on the surface of the main sequence primary star resulting from mass exchange from the cooler subgiant secondary. The changes in the light curve shape indicate a non-synchronous rotation of the primary star.

  18. Comparison of the microhardness of primary and permanent teeth after immersion in two types of carbonated beverages

    PubMed Central

    Haghgou, Hamid R.; Haghgoo, Roza; Asdollah, Fatemah Molla

    2016-01-01

    Objectives: The consumption of carbonated beverages is one of the etiological factors that cause dental erosion. The purpose of this research was to compare changes in the microhardness of permanent and primary teeth after immersion in two types of carbonated beverages. Materials and Methods: This investigation was done on 30 healthy permanent molars and 30 healthy primary canines. Each group of primary and permanent teeth was subdivided into three groups of 10 teeth. The teeth was immersed in 40 ml of each of the three beverages for 5 min. One subgroup was immersed in water (as a control). The next was immersed in Lemon Delster and the last subgroup was immersed in Coca-Cola. The microhardness of enamel was measured using the Vickers method before and after immersion. Finally, the data was analyzed by paired t-test, one-way analysis of variance, and t-test. Results: Microhardness reduction in the primary teeth was significant in both the Lemon Delster and Coca-Cola groups (P < 0.05). This reduction was also statistically significant in the permanent teeth (P < 0.05). A comparison of the enamel changes in the primary teeth with permanent teeth after immersion in both beverages showed a greater microhardness reduction in the primary teeth in both the experimental groups. Conclusions: Coca-Cola and Lemon Delster caused a significant reduction of microhardness in tooth enamel. This reduction was greater in primary teeth than in permanent teeth, and was also greater after immersion in Coca-Cola than after immersion in Lemon Delster. PMID:27583223

  19. FLO11 is the primary factor in flor formation caused by cell surface hydrophobicity in wild-type flor yeast.

    PubMed

    Ishigami, Mari; Nakagawa, Youji; Hayakawa, Masayuki; Iimura, Yuzuru

    2006-03-01

    Some strains of Saccharomyces cerevisiae form a biofilm called a "flor" on the surface of wine after ethanolic fermentation, but the molecular mechanism of flor formation by the wild-type flor strain involved in wine making is not clear. Previously, we found that expression of the C-terminally truncated form of NRG1 (NRG1(1-470)) on a multicopy plasmid increases the hydrophobicity of the cell surface, conferring flor formation on the non-flor laboratory strain. Here we show that in Ar5-H12, a wild-type flor haploid strain, flor formation is regulated by NRG1(1-470). Moreover, the disruptant of the wild-type flor diploid strain (Deltaflo11/Deltaflo11) show a weak ability to form the flor. The expression of FLO11 is always high in the wild-type flor strain, regardless of carbon source. Thus FLO11 is primary factor for wild-type flor strains. Furthermore, the disruptant (Deltaflo11) shows lower hydrophobicity of cell surface than the wild type. However, the hydrophobicity of the wild-type flor strains grown in ethanol medium was much higher than those grown in glucose medium. These results indicate that cell surface hydrophobicity is closely related to flor formation in wild-type flor yeasts.

  20. Low-dose aspirin for primary prevention of atherosclerotic events in patients with type 2 diabetes: a randomized controlled trial.

    PubMed

    Ogawa, Hisao; Nakayama, Masafumi; Morimoto, Takeshi; Uemura, Shiro; Kanauchi, Masao; Doi, Naofumi; Jinnouchi, Hideaki; Sugiyama, Seigo; Saito, Yoshihiko

    2008-11-12

    Previous trials have investigated the effects of low-dose aspirin on primary prevention of cardiovascular events, but not in patients with type 2 diabetes. To examine the efficacy of low-dose aspirin for the primary prevention of atherosclerotic events in patients with type 2 diabetes. Multicenter, prospective, randomized, open-label, blinded, end-point trial conducted from December 2002 through April 2008 at 163 institutions throughout Japan, which enrolled 2539 patients with type 2 diabetes without a history of atherosclerotic disease and had a median follow-up of 4.37 years. Patients were assigned to the low-dose aspirin group (81 or 100 mg per day) or the nonaspirin group. Primary end points were atherosclerotic events, including fatal or nonfatal ischemic heart disease, fatal or nonfatal stroke, and peripheral arterial disease. Secondary end points included each primary end point and combinations of primary end points as well as death from any cause. A total of 154 atherosclerotic events occurred: 68 in the aspirin group (13.6 per 1000 person-years) and 86 in the nonaspirin group (17.0 per 1000 person-years) (hazard ratio [HR], 0.80; 95% confidence interval [CI], 0.58-1.10; log-rank test, P = .16). The combined end point of fatal coronary events and fatal cerebrovascular events occurred in 1 patient (stroke) in the aspirin group and 10 patients (5 fatal myocardial infarctions and 5 fatal strokes) in the nonaspirin group (HR, 0.10; 95% CI, 0.01-0.79; P = .0037). A total of 34 patients in the aspirin group and 38 patients in the nonaspirin group died from any cause (HR, 0.90; 95% CI, 0.57-1.14; log-rank test, P = .67). The composite of hemorrhagic stroke and significant gastrointestinal bleeding was not significantly different between the aspirin and nonaspirin groups. In this study of patients with type 2 diabetes, low-dose aspirin as primary prevention did not reduce the risk of cardiovascular events. clinicaltrials.gov Identifier: NCT00110448.

  1. A Scary Onset of a Rare and Aggressive Type of Primary Breast Sarcoma: A Case Report

    PubMed Central

    Ramalho, Inês; Campos, Sara; Rebelo, Teresa; Figueiredo Dias, Margarida

    2016-01-01

    Primary breast sarcoma, arising from connective tissue within the breast, is extremely rare, accounting for less than 1% of all primary breast malignancies and no more than 5% of all sarcomas. The rarity of this pathology limits most studies to case reports and small retrospective studies, which has led to a lack of consensus on the clinical management. We report a clinical case of a 52-year-old woman, perimenopausal, previously healthy, with regular breast surveillance, who presented with a large (>20 cm) and rapidly expanding hypervascularized tumor of the left breast developed over 10 days, with a very thin preulcerative skin over the last 4 days. There was no systemic dissemination. The patient was submitted to total mastectomy and excision of axillary adenopathy. The tumor was diagnosed histologically as malignant phyllodes tumor associated with areas of high-grade sarcoma. Due to rapid growth and aggressive histological characteristics, adjuvant chemotherapy and radiotherapy were performed. There is a lot of evidence that tumors larger than 5 cm are associated with a poor prognosis. Despite the poor prognosis associated with this aggressive entity, the patient had no recurrence during 5 years of follow-up. We review the relevant literature about primary breast sarcomas. PMID:28101028

  2. Single-Particle Tracking of Human Immunodeficiency Virus Type 1 Productive Entry into Human Primary Macrophages.

    PubMed

    Li, Qin; Li, Wei; Yin, Wen; Guo, Jia; Zhang, Zhi-Ping; Zeng, Dejun; Zhang, Xiaowei; Wu, Yuntao; Zhang, Xian-En; Cui, Zongqiang

    2017-04-25

    Macrophages are one of the major targets of human immunodeficiency virus (HIV-1), but the viral entry pathway remains poorly understood in these cells. Noninvasive virus labeling and single-virus tracking are effective tools for studying virus entry. Here, we constructed a quantum dot (QD)-encapsulated infectious HIV-1 particle to track viral entry at a single-particle level in live human primary macrophages. QDs were encapsulated in HIV-1 virions by incorporating viral accessory protein Vpr-conjugated QDs during virus assembly. With the HIV-1 particles encapsulating QDs, we monitored the early phase of viral infection in real time and observed that, during infection, HIV-1 was endocytosed in a clathrin-mediated manner; the particles were translocated into Rab5A-positive endosomes, and the core was released into the cytoplasm by viral envelope-mediated endosomal fusion. Drug inhibition assays verified that endosome fusion contributes to HIV-1 productive infection in primary macrophages. Additionally, we observed that a dynamic actin cytoskeleton is critical for HIV-1 entry and intracellular migration in primary macrophages. HIV-1 dynamics and infection could be blocked by multiple different actin inhibitors. Our study revealed a productive entry pathway in macrophages that requires both endosomal function and actin dynamics, which may assist in the development of inhibitors to block the HIV entry in macrophages.

  3. Primary anti-D immunization by weak D type 2 RBCs.

    PubMed

    Flegel, W A; Khull, S R; Wagner, F F

    2000-04-01

    D is the most immunogenic blood group antigen. In about 0.4 percent of whites, D is expressed on RBCs in a weak form. Recently, it was found that the weak D phenotypes are caused by a large number of distinct RHD alleles generally encoding altered D proteins. No particular molecular weak D type has yet been shown to induce anti-D. The threshold of D antigen density required for anti-D immunization is not known. A 72-year-old D- white man received apparently D- RBCs. Nineteen days later, he developed a positive DAT, and anti-D was found in his serum and an eluate from his RBCs. One donor was found to be D+ with a weak D type. The weak D type was determined by RHD exon 9-specific nucleotide sequencing from genomic DNA. The transfusion recipient showed alloanti-D. Ten months later, anti-D but no other antibody was detectable; the DAT was negative and the eluate was nonreactive. The donor of the incriminated unit was D+ (ccDEe) with weak D due to the weak D type 2 allele, expressing about 450 D antigens per RBC. This case provides formal proof that RBCs of weak D type 2 phenotype may cause alloanti-D immunization. Among the more prevalent weak D types in whites, weak D type 2 has the lowest D antigen density. Thus, units of blood from donors of the weak D type 2 phenotype should be labeled D+; the weak D type 2 phenotype may be useful for quality assurance.

  4. Application of AI techniques to blast furnace operations

    SciTech Connect

    Iida, Osamu; Ushijima, Yuichi; Sawada, Toshiro

    1995-10-01

    It was during the first stages of application of artificial intelligence (AI) to industrial fields, that the ironmaking division of Mizushima works at Kawasaki Steel recognized its potential. Since that time, the division has sought applications for these techniques to solve various problems. AI techniques applied to control the No. 3 blast furnace operations at the Mizushima works include: Blast furnace control by a diagnostic type of expert system that gives guidance to the actions required for blast furnace operation as well as control of furnace heat by automatically setting blast temperature; Hot stove combustion control by a combination of fuzzy inference and a physical model to insure good thermal efficiency of the stove; and blast furnace burden control using neural networks makes it possible to connect the pattern of gas flow distribution with the condition of the furnace. Experience of AI to control the blast furnace and other ironmaking operations has proved its capability for achieving automation and increased operating efficiency. The benefits are very high. For these reasons, the applications of AI techniques will be extended in the future and new techniques studied to further improve the power of AI.

  5. BOND STRENGTH OF RESIN MODIFIED GLASS IONOMER CEMENT TO PRIMARY DENTIN AFTER CUTTING WITH DIFFERENT BUR TYPES AND DENTIN CONDITIONING

    PubMed Central

    Nicoló, Rebeca Di; Shintome, Luciana Keiko; Myaki, Silvio Issáo; Nagayassu, Marcos Paulo

    2007-01-01

    The aim of this in vitro study was to evaluate the effect of different bur types and acid etching protocols on the shear bond strength (SBS) of a resin modified glass ionomer cement (RM-GIC) to primary dentin. Forty-eight clinically sound human primary molars were selected and randomly assigned to four groups (n=12). In G1, the lingual surface of the teeth was cut with a carbide bur until a 2.0-mm-diameter dentin area was exposed, followed by the application of RM-GIC (Vitremer – 3M/ESPE) prepared according to the manufacturer’s instructions. The specimens of G2, received the same treatment of G1, however the dentin was conditioned with phosphoric acid. In groups G3 and G4 the same procedures of G1 and G2 were conducted respectively, nevertheless dentin cutting was made with a diamond bur. The specimens were stored in distilled water at 37°C for 24h, and then tested in a universal testing machine. SBS. data were submitted to 2-way ANOVA (= 5%) and indicated that SBS values of RM-GIC bonded to primary dentin cut with different burs were not statistically different, but the specimens that were conditioned with phosphoric acid presented SBS values significantly higher that those without conditioning. To observe micromorphologic characteristics of the effects of dentin surface cut by diamond or carbide rotary instruments and conditioners treatment, some specimens were examined by scanning electron microscopy. Smear layer was present in all specimens regardless of the type of rotary instrument used for dentin cutting, and specimens etched with phosphoric acid presented more effective removal of smear layer. It was concluded that SBS of a RM-GIC to primary dentin was affected by the acid conditioning but the bur type had no influence. PMID:19089179

  6. Comparison of microleakage of different margin types around Class V resin restorations in primary teeth.

    PubMed

    Lopes Coutinho, T C; Almeida Tostes, M

    2013-09-01

    This in vitro study compared the effect of a concave with a straight-bevelled cavity margin on the microleakage of Class V composite resin restorations in primary teeth. Standardised Class V cavity preparations were made in vitro on the buccal (all margins placed in enamel) and on the lingual (margins placed in enamel and cementum) surfaces of 20 sound primary molars. The teeth were randomly assigned to two groups of 10 each: in Group 1, a concave bevel was made with a high-speed No. 04 tungsten carbide bur and in Group 2, a straight bevel was made with a high-speed No. 556 tungsten carbide bur. The teeth were restored incrementally with Adper Single Bond 2 (3M) adhesive and Filtek Z 350 (3M) composite resin. All specimens were subsequently thermocycled and immersed in 50% silver nitrate solution. Microleakage of the restorations was then assessed by silver penetration. A grading scale of 0 to 4 was used as the scoring criterion. At the enamel margins no statistically significant differences were observed between the two groups (p>0.05). Occlusal walls in enamel, in both groups, exhibited less leakage than the cervical walls in cementum (p<0.01) and Group 1 showed better results than Group 2 in decreasing microleakage at the cementum margins (p <0.05). Based on the results, it was concluded that concave-beveled cavity preparations may reduce but did not totally eliminate microleakage at the cementum margins of Class V composite resin restorations in primary teeth.

  7. Impaired primary mouse myotube formation on crosslinked type I collagen films is enhanced by laminin and entactin.

    PubMed

    Grefte, S; Adjobo-Hermans, M J W; Versteeg, E M M; Koopman, W J H; Daamen, W F

    2016-01-01

    In skeletal muscle, the stem cell niche is important for controlling the quiescent, proliferation and differentiation states of satellite cells, which are key for skeletal muscle regeneration after wounding. It has been shown that type I collagen, often used as 3D-scaffolds for regenerative medicine purposes, impairs myoblast differentiation. This is most likely due to the absence of specific extracellular matrix proteins providing attachment sites for myoblasts and/or myotubes. In this study we investigated the differentiation capacity of primary murine myoblasts on type I collagen films either untreated or modified with elastin, laminin, type IV collagen, laminin/entactin complex, combinations thereof, and Matrigel as a positive control. Additionally, increased reactive oxygen species (ROS) and ROCK signaling might also be involved. To measure ROS levels with live-cell microscopy, fibronectin-coated glass coverslips were additionally coated with type I collagen and Matrigel onto which myoblasts were differentiated. On type I collagen-coated coverslips, myotube formation was impaired while ROS levels were increased. However, anti-oxidant treatment did not enhance myotube formation. ROCK inhibition, which generally improve cellular attachment to uncoated surfaces or type I collagen, enhanced myoblast attachment to type I collagen-coated coverslips and -films, but slightly enhanced myotube formation. Only modification of type I collagen films by Matrigel and a combination of laminin/entactin significantly improved myotube formation. Our results indicate that type I collagen scaffolds can be modified by satellite cell niche factors of which specifically laminin and entactin enhanced myotube formation. This offers a promising approach for regenerative medicine purposes to heal skeletal muscle wounds. In this manuscript we show for the first time that impaired myotube formation on type I collagen scaffolds can be completely restored by modification with laminin and

  8. Brief cognitive behavioral therapy in primary care: a hybrid type 2 patient-randomized effectiveness-implementation design

    PubMed Central

    2012-01-01

    Background Despite the availability of evidence-based psychotherapies for depression and anxiety, they are underused in non-mental health specialty settings such as primary care. Hybrid effectiveness-implementation designs have the potential to evaluate clinical and implementation outcomes of evidence-based psychotherapies to improve their translation into routine clinical care practices. Methods This protocol article discusses the study methodology and implementation strategies employed in an ongoing, hybrid, type 2 randomized controlled trial with two primary aims: (1) to determine whether a brief, manualized cognitive behavioral therapy administered by Veterans Affairs Primary Care Mental Health Integration program clinicians is effective in treating depression and anxiety in a sample of medically ill (chronic cardiopulmonary diseases) primary care patients and (2) to examine the acceptability, feasibility, and preliminary outcomes of a focused implementation strategy on improving adoption and fidelity of brief cognitive behavioral therapy at two Primary Care-Mental Health Integration clinics. The study uses a hybrid type 2 effectiveness/implementation design to simultaneously test clinical effectiveness and to collect pilot data on a multifaceted implementation strategy that includes an online training program, audit and feedback of session content, and internal and external facilitation. Additionally, the study engages the participation of an advisory council consisting of stakeholders from Primary Care-Mental Health Integration, as well as regional and national mental health leaders within the Veterans Administration. It targets recruitment of 320 participants randomized to brief cognitive behavioral therapy (n = 200) or usual care (n = 120). Both effectiveness and implementation outcomes are being assessed using mixed methods, including quantitative evaluation (e.g., intent-to-treat analyses across multiple time points) and qualitative methods (e

  9. Brief cognitive behavioral therapy in primary care: a hybrid type 2 patient-randomized effectiveness-implementation design.

    PubMed

    Cully, Jeffrey A; Armento, Maria E A; Mott, Juliette; Nadorff, Michael R; Naik, Aanand D; Stanley, Melinda A; Sorocco, Kristen H; Kunik, Mark E; Petersen, Nancy J; Kauth, Michael R

    2012-07-11

    Despite the availability of evidence-based psychotherapies for depression and anxiety, they are underused in non-mental health specialty settings such as primary care. Hybrid effectiveness-implementation designs have the potential to evaluate clinical and implementation outcomes of evidence-based psychotherapies to improve their translation into routine clinical care practices. This protocol article discusses the study methodology and implementation strategies employed in an ongoing, hybrid, type 2 randomized controlled trial with two primary aims: (1) to determine whether a brief, manualized cognitive behavioral therapy administered by Veterans Affairs Primary Care Mental Health Integration program clinicians is effective in treating depression and anxiety in a sample of medically ill (chronic cardiopulmonary diseases) primary care patients and (2) to examine the acceptability, feasibility, and preliminary outcomes of a focused implementation strategy on improving adoption and fidelity of brief cognitive behavioral therapy at two Primary Care-Mental Health Integration clinics. The study uses a hybrid type 2 effectiveness/implementation design to simultaneously test clinical effectiveness and to collect pilot data on a multifaceted implementation strategy that includes an online training program, audit and feedback of session content, and internal and external facilitation. Additionally, the study engages the participation of an advisory council consisting of stakeholders from Primary Care-Mental Health Integration, as well as regional and national mental health leaders within the Veterans Administration. It targets recruitment of 320 participants randomized to brief cognitive behavioral therapy (n = 200) or usual care (n = 120). Both effectiveness and implementation outcomes are being assessed using mixed methods, including quantitative evaluation (e.g., intent-to-treat analyses across multiple time points) and qualitative methods (e.g., focus interviews

  10. Records and Distribution of New World Phlebotomine Sand Flies (Psychodidae, Diptera), With Special Emphasis on Primary Types and Species Diversity.

    PubMed

    Rueda, Leopoldo M; Foley, Desmond H; Pecor, David; Wolkoff, Matthew

    2015-01-01

    This article includes the records and distribution of Phlebotomine sand flies (Psychodidae, Diptera) in the New World based on the specimen collections housed in 2 repositories, the US National Museum of Natural History and the Museum of Entomology, Florida State Collection of Arthropods. Approximately 128 species have primary types housed in the 2 repositories, including holotypes (47 species, 3 subspecies), "types" (7 species), allotypes (52 species, 6 subspecies), lectotypes (4 species), paratypes (93 species, 10 subspecies), and neoallotype (1 species), mounted on slides, with a total of 1,107 type slides. For species diversity, collection data from 24 countries in the sand fly database were analyzed according to the number of species present, specimen records, decade of collections, and countries where collections were conducted.

  11. Transformation of primary hamster embryo fibroblasts by type 2 simplex virus: evidence for a "hit and run" mechanism.

    PubMed Central

    Skinner, G. R.

    1976-01-01

    The phenomenon of cell transformation by type 2 herpes simplex virus has been investigated. Primary hamster embryo fibroblasts were exposed to type 2 herpes virus under conditions which would restrict or inhibit the lytic events of virus-cell interaction. Cell lines were established by single-cell cloning. There was evidence of altered cell morphology with altered biological activity in terms of longevity and oncogenicity; there was, however, no evidence of virus specific antigen or incorporation of viral nucleic acid into the host cell genome. Virus specific antigen was only detected in the early passages of an uncloned transformed cell line. We are thus unable to confirm previous studies (vide supra) and are obliged to propose a "hit and run" model for in vitro cell transformation by type 2 herpes simplex virus. Images Fig. 1 Fig. 2 Fig. 3 PMID:183803

  12. Transformation of primary hamster embryo fibroblasts by type 2 simplex virus: evidence for a "hit and run" mechanism.

    PubMed

    Skinner, G R

    1976-08-01

    The phenomenon of cell transformation by type 2 herpes simplex virus has been investigated. Primary hamster embryo fibroblasts were exposed to type 2 herpes virus under conditions which would restrict or inhibit the lytic events of virus-cell interaction. Cell lines were established by single-cell cloning. There was evidence of altered cell morphology with altered biological activity in terms of longevity and oncogenicity; there was, however, no evidence of virus specific antigen or incorporation of viral nucleic acid into the host cell genome. Virus specific antigen was only detected in the early passages of an uncloned transformed cell line. We are thus unable to confirm previous studies (vide supra) and are obliged to propose a "hit and run" model for in vitro cell transformation by type 2 herpes simplex virus.

  13. Impact of antiretroviral pressure on selection of primary human immunodeficiency virus type 1 envelope sequences in vitro

    PubMed Central

    Harada, Shigeyoshi; Yamaguchi, Aki; Boonchawalit, Samatchaya; Yusa, Keisuke; Matsushita, Shuzo

    2013-01-01

    The initiation of drug therapy results in a reduction in the human immunodeficiency virus type 1 (HIV-1) population, which represents a potential genetic bottleneck. The effect of this drug-induced genetic bottleneck on the population dynamics of the envelope (Env) regions has been addressed in several in vivo studies. However, it is difficult to investigate the effect on the env gene of the genetic bottleneck induced not only by entry inhibitors but also by non-entry inhibitors, particularly in vivo. Therefore, this study used an in vitro selection system using unique bulk primary isolates established in the laboratory to observe the effects of the antiretroviral drug-induced bottleneck on the integrase and env genes. Env diversity was decreased significantly in one primary isolate [KP-1, harbouring both CXCR4 (X4)- and CCR5 (R5)-tropic variants] when passaged in the presence or absence of raltegravir (RAL) during in vitro selection. Furthermore, the RAL-selected KP-1 variant had a completely different Env sequence from that in the passage control (particularly evident in the gp120, V1/V2 and V4-loop regions), and a different number of potential N-glycosylation sites. A similar pattern was also observed in other primary isolates when using different classes of drugs. This is the first study to explore the influence of anti-HIV drugs on bottlenecks in bulk primary HIV isolates with highly diverse Env sequences using in vitro selection. PMID:23288425

  14. Processes and Outcomes of Congestive Heart Failure Care by Different Types of Primary Care Models.

    PubMed

    Kuo, Yong-Fang; Adhikari, Deepak; Eke, Chiemeziem G; Goodwin, James S; Raji, Mukaila A

    2017-09-01

    Having nurse practitioners (NPs) as primary care providers for patients with congestive heart failure (CHF) is one way to address the growing shortage of primary care physicians (PCPs). We used inverse probability of treatment weighted with propensity score to examine the processes and outcomes of care for patients under three care models. Approximately 72.9%, 0.8%, and 26.3% of CHF patients received care under the PCP model, the NP model, and the shared care model, respectively. Patients under the NP or shared care models were more likely than those under the PCP model to be referred to cardiologists (OR=1.35, 95%CI:1.32-1.37 and OR=1.32, 95%CI:1.30-1.35) and to get guideline-recommended medications. NPs and PCPs had similar rates of ER visits and Medicare spending after adjusting for processes of care. Patients under the shared care model had a higher burden of comorbidity and experienced a higher rate of ER visits and hospitalizations than those under the PCP model. The delivery of CHF care mirrors the severity of comorbidity in these patients. The high rate of hospitalization and ER visits in the shared care model underscores the need to design and implement more effective chronic disease management and integrated care programs. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. [Endosonography -- an additional diagnostic possibility in the differentiation between the two common types of primary hyperaldosteronism].

    PubMed

    Roggenland, Daniela; Schneider, Stephan; Klein, Harald H; Kann, Peter H

    2006-01-15

    Primary aldosteronism is an important and one of the few potentially curable forms of secondary hypertension. The distinction between aldosterone-producing adenoma (APA) and idiopathic adrenal hyperplasia (IHA) may be difficult, but establishing the correct diagnosis is essential because surgery is only effective in patients with adrenal adenoma. The case of a 65-year-old man with long-term hypertension due to an APA is reported. The routine laboratory tests displayed an elevated plasma aldosterone/renin quotient as well as an elevated 24-h urinary excretion of aldosterone and its metabolites. The serum aldosterone concentration did not decrease normally in the saline suppression test. The posture testing demonstrated an increase in aldosterone. These facts might lead to the conclusion of an IHA. Magnetic resonance imaging (MRI) of the adrenal glands revealed no abnormalities. Because of the unusual combination of laboratory findings and radiologic results an endosonographic examination of the adrenal glands was performed which yielded a unilateral adrenal adenoma. With establishing this diagnosis, curative surgery became possible. This case demonstrates that in the differential diagnosis of primary aldosteronism, endosonography is more important than previously discussed. It may be helpful in the differentiation of an unusual constellation of laboratory and radiologic findings.

  16. Frequency and the Type of Chromosomal Abnormalities in Patients with Primary Amenorrhea in Northeast of Iran

    PubMed Central

    Mohajertehran, Farnaz; Ghodsi, Kazem; Hafizi, Leili; Rezaee, Ameneh

    2013-01-01

    Objective(s): Primary and secondary amenorrhea are different from each other in that the former refers to a physiological failure in the onset of spontaneous menarche during the time when it is expected. whereas the latter involves the cessation of normal menstruation any time prior to menopause. In this study we aimed to investigate chromosomal abnormalities in patients with Primary Amenorrhea in Northeast of Iran by employing GTG banding. Materials and Methods: Chromosomal analysis was carried out on 180 cases that were referred from different clinics in eastern cities of Iran to our laboratory from 2004 to 2009. We implemented the suggested protocol regarding peripheral blood lymphocyte culture for metaphase chromosome preparation as well as conventional analysis for G-banded chromosome. Results: The karyotype results revealed that 75.55% (n=136) had normal chromosome composition and 24.45% (n=44) showed chromosomal abnormalities. Among the patients with abnormal chromosome constituents 86.36% exhibit numerical aberration and 13.63% showed structural abnormalities. The most frequent abnormality detected was X chromosome monosomy, homogeneous (21 cases –11.66%) or mosaic (8 cases – 4.44%). The other 6 cases (3.33%) had X chromosome structural imbalanced abnormalities (homogeneous or in mosaic). Discussion: As expected, this study confirmed previously reported cytogentic abnormalities in patients with amenorrhea. Although there are percentage differences between these studies and also verities in chromosomal abnormalities, they have still demonstrated the importance of cytogenetic investigations in the etiological diagnosis of amenorrhea. PMID:24250941

  17. Frequency and the Type of Chromosomal Abnormalities in Patients with Primary Amenorrhea in Northeast of Iran

    PubMed Central

    Mohajertehran, Farnaz; Ghodsi, Kazem; Hafizi, Leili; Rezaee, Ameneh

    2013-01-01

    Objective(s): Primary and secondary amenorrhea are different from each other in that the former refers to a physiological failure in the onset of spontaneous menarche during the time when it is expected. whereas the latter involves the cessation of normal menstruation any time prior to menopause. In this study we aimed to investigate chromosomal abnormalities in patients with Primary Amenorrhea in Northeast of Iran by employing GTG banding. Materials and Methods: Chromosomal analysis was carried out on 180 cases that were referred from different clinics in eastern cities of Iran to our laboratory from 2004 to 2009. We implemented the suggested protocol regarding peripheral blood lymphocyte culture for metaphase chromosome preparation as well as conventional analysis for G-banded chromosome. Results: The karyotype results revealed that 75.55% (n=136) had normal chromosome composition and 24.45% (n=44) showed chromosomal abnormalities. Among the patients with abnormal chromosome constituents 86.36% exhibit numerical aberration and 13.63% showed structural abnormalities. The most frequent abnormality detected was X chromosome monosomy, homogeneous (21 cases –11.66%) or mosaic (8 cases – 4.44%). The other 6 cases (3.33%) had X chromosome structural imbalanced abnormalities (homogeneous or in mosaic). Discussion: As expected, this study confirmed previously reported cytogentic abnormalities in patients with amenorrhea. Although there are percentage differences between these studies and also verities in chromosomal abnormalities, they have still demonstrated the importance of cytogenetic investigations in the etiological diagnosis of amenorrhea. PMID:24250944

  18. Effect of primary culture medium type for culture of canine fibroblasts on production of cloned dogs.

    PubMed

    Kim, Geon A; Oh, Hyun Ju; Kim, Min Jung; Jo, Young Kwang; Choi, Jin; Kim, Jin Wook; Lee, Tae Hee; Lee, Byeong Chun

    2015-09-01

    Fibroblasts are common source of donor cells for SCNT. It is suggested that donor cells' microenvironment, including the primary culture, affects development of reconstructed embryos. To prove this, canine embryos were cloned with fibroblasts that were cultured in two different primary media (RCMEp vs. Dulbecco's modified Eagle's medium [DMEM]) and in vivo developments were compared with relative amount of stemness, reprogramming, apoptosis gene transcripts, and telomerase activity. Donor cells cultured in RCMEp contained a significantly higher amount of SOX2, NANOG, DPPA2, REXO1, HDAC, DNMT1, MECP2 and telomerase activity than those cultured in DMEM (P < 0.05). In vivo developmental potential of cloned embryos with donor cells cultured in RCMEp had a higher birth rate than that of embryos derived from DMEM (P < 0.05). The culture medium can induce changes in gene expression of donor cells and telomerase activity, and these alterations can also affect in vivo developmental competence of the cloned embryos.

  19. Type 2 diabetes mellitus with hypertension at primary healthcare level in Malaysia: are they managed according to guidelines?

    PubMed

    Chan, G C

    2005-03-01

    A study was conducted at primary healthcare level in the Melaka Tengah district of Malaysia to determine whether hypertension in patients with type 2 diabetes mellitus were managed according to guidelines. A cross-sectional study involving 517 patients with diabetes mellitus from August to October 2003 was performed. All the subjects had type 2 diabetes mellitus. 350 (67.7 percent) patients had hypertension and about 25.7 percent of them were associated with microalbuminuria. The Malay ethnic group form the majority (54.6 percent), followed by Chinese (37.7 percent) and Indian (7.4 percent). Only 11 (3.1 percent) patients with type 2 diabetes mellitus and hypertension achieved the target blood pressure of less than 130/80 mmHg. For those who had not achieved the target goal, 39.5 percent of them were not on any antihypertensive drugs. 38.6 percent were on monotherapy and only 21.8 percent were on two or more antihypertensive drugs. Metoprolol was the most commonly used antihypertensive drug (22.4 percent), followed by Nifedipine (16.2 percent) and Prazosin (13.5 percent). Only 18.3 percent of patients with type 2 diabetes mellitus and hypertension were prescribed with angiotensin converting enzyme (ACE) inhibitors and 0.3 percent with angiotensin receptor blockers. For patients with type 2 diabetes mellitus, hypertension and microalbuminuria, only 14.1 percent of them were prescribed with ACE inhibitors. A significant proportion of patients with type 2 diabetes mellitus had associated hypertension but they were not managed optimally according to guidelines. More intensive management of hypertension among patients with diabetes is essential to reduce the morbidity and mortality at primary healthcare level.

  20. Switch from type II to I Fas/CD95 death signaling upon in vitro culturing of primary hepatocytes

    PubMed Central

    Walter, Dorothée; Schmich, Kathrin; Vogel, Sandra; Pick, Robert; Kaufmann, Thomas; Hochmuth, Florian Christoph; Haber, Angelika; Neubert, Karin; McNelly, Sabine; von Weizsäcker, Fritz; Merfort, Irmgard; Maurer, Ulrich; Strasser, Andreas; Borner, Christoph

    2010-01-01

    Fas/CD95-induced apoptosis of hepatocytes in vivo proceeds through the so-called type II pathway, requiring the pro-apoptotic BH3-only Bcl-2 family member Bid for mitochondrial death signaling. Consequently, Bid-deficient mice are protected from anti-Fas antibody injection induced fatal hepatitis. Here we report the unexpected finding that freshly isolated mouse hepatocytes, cultured on collagen or Matrigel™, become independent of Bid for Fas-induced apoptosis, thereby switching death signaling from type II to type I. In such in vitro cultures, FasL activates caspase-3 without Bid cleavage, Bax/Bak activation or cytochrome c release, and neither Bid ablation nor Bcl-2 overexpression is protective. The type II to type I switch depends on extracellular matrix adhesion, as primary hepatocytes in suspension die in a Bid-dependent manner. Moreover, the switch is specific for FasL-induced apoptosis as collagen-plated Bid-deficient hepatocytes are protected from TNFα/ActD-induced apoptosis. Conclusion Our data suggest a selective crosstalk between extracellular matrix and Fas-mediated signaling which favours mitochondria-independent type I apoptosis induction. PMID:19003879

  1. 2016 SUMMER BLAST PICNIC

    NASA Image and Video Library

    2016-06-09

    MARSHALL SPACE FLIGHT CENTER DIRECTOR TODD MAY CASTS HIS BALLOT IN THE HOMEMADE ICE CREAM CONTEST DURING THE GREAT EXCHANGE SUMMER BLAST SOCIAL, PRESENTED JUNE 9 BY THE MARSHALL EXCHANGE. THE EXCHANGE IS A NON-APPROPRIATED-FUND ACTIVITY THAT AIMS TO CONTRIBUTE TO THE WELFARE, EFFICIENCY AND MORALE OF MARSHALL TEAM MEMBERS, OTHER GOVERNMENT PERSONNEL, RETIRED NASA EMPLOYEES AND THEIR FAMILIES.

  2. Muzzle Blast Amplification

    DTIC Science & Technology

    1976-11-01

    Report) 1». SUPPLEMENTARY NOTES 19. KEY WORDS (Contlnua on reverse » Ida if nacaaeary and Identity by block number) Muzzle Blast...Range NM 88002 Commander US Army Research Office ATTN: CRD -AA-EH P. 0. Box 12211 Research Triangle Park NC 27709 Director US Army BMD Advanced

  3. Effects of blast overpressure on the ear: case reports.

    PubMed

    Chandler, D W; Edmond, C V

    1997-04-01

    The case histories of five patients who experienced blast overpressure in excess of 200-dB peak pressure level are presented. Despite the significance of the sound pressure levels received in a military training accident and the severe injuries that resulted from the blast, these individuals experienced substantial improvement of hearing 1 year later. Undoubtedly, successful surgical intervention and medical management were the primary contributors to the restoration of hearing. Audiometric data are presented documenting hearing status within 2 to 3 weeks postinjury and following final surgical remediation of the resulting middle ear damage. A review of these cases offers insight into the possible prognosis of patients with similar injuries.

  4. Hot Topics in Primary Care: Individualizing Dual Therapy for Type 2 Diabetes Mellitus.

    PubMed

    Skolnik, Neil S; Jaffa, Florence; Kiriakov, Yan

    2017-04-01

    While many advances in the management of patients with type 2 diabetes mellitus (T2DM) have occurred over the past decade, nearly half of patients with diabetes still have a glycated hemoglobin (HbA1c) above the target of 7.0%.

  5. Temporal association of cellular immune responses with the initial control of viremia in primary human immunodeficiency virus type 1 syndrome.

    PubMed Central

    Koup, R A; Safrit, J T; Cao, Y; Andrews, C A; McLeod, G; Borkowsky, W; Farthing, C; Ho, D D

    1994-01-01

    Virologic and immunologic studies were performed on five patients presenting with primary human immunodeficiency virus type 1 (HIV-1) infection. CD8+ cytotoxic T lymphocyte (CTL) precursors specific for cells expressing antigens of HIV-1 Gag, Pol, and Env were detected at or within 3 weeks of presentation in four of the five patients and were detected in all five patients by 3 to 6 months after presentation. The one patient with an absent initial CTL response had prolonged symptoms, persistent viremia, and low CD4+ T-cell count. Neutralizing antibody activity was absent at the time of presentation in all five patients. These findings suggest that cellular immunity is involved in the initial control of virus replication in primary HIV-1 infection and indicate a role for CTL in protective immunity to HIV-1 in vivo. PMID:8207839

  6. Lessons Learned from the HEALTHY Primary Prevention Trial of Risk Factors for Type 2 Diabetes in Middle-School Youth

    PubMed Central

    Marcus, Marsha D.; Kaufman, Francine; Foster, Gary D.; Baranowski, Tom

    2012-01-01

    The HEALTHY trial was designed to take a primary prevention approach to risk factors for type 2 diabetes in youth, primarily obesity. The study involved over 6000 students at 42 middle schools across the US. Half received an integrated intervention program of components addressing the school food environment, physical education, lifestyle behaviors, and promotional messaging. The intervention was designed to be more comprehensive than previous efforts and the research was amply funded. Though the primary objective of reducing percent overweight and obese in schools that received the intervention program compared to control schools was not obtained, key secondary outcomes indicated an intervention effect. In retrospect, senior investigators involved in the study’s design, conduct, and analysis discuss weaknesses and strengths, and offer recommendations for future research efforts that address prevention of childhood obesity from a public health perspective. PMID:23065367

  7. Patient perspectives on discharge from specialist type 2 diabetes care back to primary care: a qualitative study.

    PubMed

    Dutton, Heidi; Rowan, Margo S; Liddy, Clare; Maranger, Julie; Ooi, Teik Chye; Malcolm, Janine; Keely, Erin

    2014-06-01

    Timely access to specialist care remains a barrier for both patients with type 2 diabetes and their primary care physicians. To improve access to specialists for new patients, an efficient and appropriate discharge process is required. Consideration of patient perspectives is central to developing a smooth care transition, and currently, research in this area is limited. The aim of this study was to explore patients' expectations and experiences surrounding discharge from a specialized diabetes centre back to primary care. A qualitative approach was used involving data from one-to-one semistructured interviews. Participants were 12 patients with type 2 diabetes who had been discharged from the Tertiary Care Diabetes Referral Centre in Ottawa, Canada. Participants were uncertain in their initial expectations of specialist care duration. Patients expressed that an explicit discussion of the discharge process had not occurred, and many were unclear about the reason for discharge and plans for appropriate primary care physician follow up. Patients' psychological preparedness for discharge existed on a spectrum from low to high readiness. Many articulated a desire for improved communication surrounding the discharge plan, and some wished to have input into the discharge decision. Although most described their primary care physician positively, some expressed concern over cessation of specialist care. It is important to prepare patients for discharge from care, and to recognize that individual patients have varying needs and preferences. Further research is warranted to develop effective interventions for improving the discharge process for patients. Copyright © 2014 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

  8. Cinacalcet therapy in patients affected by primary hyperparathyroidism associated to Multiple Endocrine Neoplasia Syndrome type 1 (MEN1).

    PubMed

    Giusti, Francesca; Cianferotti, Luisella; Gronchi, Giorgio; Cioppi, Federica; Masi, Laura; Faggiano, Antongiulio; Colao, Annamaria; Ferolla, Piero; Brandi, Maria Luisa

    2016-06-01

    Primary hyperparathyroidism is the main endocrinopathy associated with Multiple Endocrine Neoplasia type 1 syndrome. Cinacalcet is a calcimimetic agent licensed for the treatment of secondary hyperparathyroidism in patients with end-stage renal disease, and for the reduction of marked hypercalcemia in patients with parathyroid carcinoma and sporadic hyperparathyroidism requiring surgery but for whom parathyroidectomy is contraindicated. It may provide a medical alternative for the management of primary hyperparathyroidism in subjects affected by Multiple Endocrine Neoplasia type 1. In this longitudinal, intervention study, 33 MEN1 patients had been enrolled, 10 males and 23 females with a mean age of 40 ± 11.9 years, range 20-63. Primary hyperparathyroidism was the first clinical manifestation in 12 patients. All subjects commenced with Cinacalcet 30 mg/day, 22 patients starting therapy with calcimimetics as an alternative to surgery, and 11 patients opting for the medication after the onset of persistent post-surgical primary hyperparathyroidism. Duration of follow-up was 12 months. The results of this study show significant reductions in serum calcium. The changes in hormonal secretions of pituitary and gastroenteropancreatic glands were not significant, demonstrating the overall safety of this drug in this disease. Cinacalcet has been well tolerated by 28 patients, whereas five individuals complained of heartburn and grade 1 nausea, which did not prevent the completion of the study. In conclusion, Cinacalcet has resulted to be well tolerated and safe in patients with MEN1 syndrome and the calcium homeostasis was stabilized.

  9. Pueraria mirifica extract and puerarin enhance proliferation and expression of alkaline phosphatase and type I collagen in primary baboon osteoblasts.

    PubMed

    Tiyasatkulkovit, Wacharaporn; Malaivijitnond, Suchinda; Charoenphandhu, Narattaphol; Havill, Lorena M; Ford, Allen L; VandeBerg, John L

    2014-10-15

    Phytoestrogen-rich Pueraria mirifica (PM) tuberous extract is a promising candidate for the development of anti-osteoporosis drugs for postmenopausal women, but its action has never been validated in humans or in non-human primates, which are more closely related to humans than rodents. In vitro study of non-human primate osteoblasts is thus fundamental to prepare for in vivo studies of phytoestrogen effects on primate bone. This study aimed to establish a culture system of baboon primary osteoblasts and to investigate the effects of PM extract and its phytoestrogens on these cells. Primary osteoblasts from adult baboon fibulae exhibited osteoblast characteristics in regard to proliferation, differentiation, mineralization, and estrogen receptor expression. They responded to 17β-estradiol by increased proliferation rate and mRNA levels of alkaline phosphatase (ALP), type I collagen, and osteocalcin. After being exposed for 48 h to 100 μg/ml PM extract, 1000 nM genistein, or 1000 nM puerarin, primary baboon osteoblasts markedly increased the rate of proliferation and mRNA levels of ALP and type I collagen without changes in Runx2, osterix, or osteocalcin expression. PM extract, genistein, and puerarin also decreased the RANKL/OPG ratio, suggesting that they could decrease osteoclast-mediated bone resorption. However, neither PM extract nor its phytoestrogens altered calcium deposition in osteoblast culture. In conclusion, we have established baboon primary osteoblast culture, which is a new tool for bone research and drug discovery. Furthermore, the present results provide substantial support for the potential of PM extract and its phytoestrogens to be developed as therapeutic agents against bone fragility.

  10. Cervical spine injury biomechanics: Applications for under body blast loadings in military environments.

    PubMed

    Yoganandan, Narayan; Stemper, Brian D; Pintar, Frank A; Maiman, Dennis J; McEntire, B Joseph; Chancey, Valeta Carol

    2013-07-01

    While cervical spine injury biomechanics reviews in motor vehicle and sports environments are available, there is a paucity of studies in military loadings. This article presents an analysis on the biomechanics and applications of cervical spine injury research with an emphasis on human tolerance for underbody blast loadings in the military. Following a brief review of published military studies on the occurrence and identification of field trauma, postmortem human subject investigations are described using whole body, intact head-neck complex, osteo-ligamentous cervical spine with head, subaxial cervical column, and isolated segments subjected to differing types of dynamic loadings (electrohydraulic and pendulum impact devices, free-fall drops). Spine injuries have shown an increasing trend over the years, explosive devices are one of the primary causal agents and trauma is attributed to vertical loads. Injuries, mechanisms and tolerances are discussed under these loads. Probability-based injury risk curves are included based on loading rate, direction and age. A unique advantage of human cadaver tests is the ability to obtain fundamental data to delineate injury biomechanics and establish human tolerance and injury criteria. Definitions of tolerances of the spine under vertical loads based on injuries have implications in clinical and biomechanical applications. Primary outputs such as forces and moments can be used to derive secondary variables such as the neck injury criterion. Implications are discussed for designing anthropomorphic test devices that may be used to predict injuries in underbody blast environments and improve the safety of military personnel. Published by Elsevier Ltd.

  11. Obstacles encountered in VMIS retort blasting

    SciTech Connect

    Dick, R.D.; Fourney, W.L.; Young, C.

    1986-01-01

    During 1981 and 1982, an extensive oil shale fragmentation research program was conducted at the Anvil Points Mine near Rifle, Colorado. The primary goals were to investigate factors involved for adequate fragmentation of oil shale and to evaluate the feasibility of using the vertical modified in situ (VMIS) retort method for recovery of oil from oil shale. The field test program included single-deck, single-borehole experiments to obtain basic fragmentation data; multiple-deck, multiple-borehole experiments to evaluate some practical aspects for developing an in situ retort; and the development of a variety of instrumentation techniques to diagnose the blast event. This paper discusses some explosive engineering problems encountered, such as electric cap performance in complex blasting patterns, explosive and stem performance in a variety of configurations from the simple to the complex, and the difficulties experienced when reversing the direction of throw of the oil shale in a subscale retort configuration. These problems need solutions before an adequate VMIS retort can be created in a single-blast event and even before a experimental mini-retort can be formed.

  12. Seasonal Shifts in Primary Water Source Type: A Comparison of Largely Pastoral Communities in Uganda and Tanzania.

    PubMed

    Pearson, Amber L; Zwickle, Adam; Namanya, Judith; Rzotkiewicz, Amanda; Mwita, Emiliana

    2016-01-27

    Many water-related illnesses show an increase during the wet season. This is often due to fecal contamination from runoff, yet, it is unknown whether seasonal changes in water availability may also play a role in increased illness via changes in the type of primary water source used by households. Very little is known about the dynamic aspects of access to water and changes in source type across seasons, particularly in semi-arid regions with annual water scarcity. The research questions in this study were: (1) To what degree do households in Uganda (UG) and Tanzania (TZ) change primary water source type between wet and dry seasons?; and (2) How might seasonal changes relate to water quality and health? Using spatial survey data from 92 households each in UG and TZ this study found that, from wet to dry season, 26% (UG) and 9% (TZ) of households switched from a source with higher risk of contamination to a source with lower risk. By comparison, only 20% (UG) and 0% (TZ) of households switched from a source with lower risk of contamination to a source with higher risk of contamination. This research suggests that one pathway through which water-related disease prevalence may differ across seasons is the use of water sources with higher risk contamination, and that households with access to sources with lower risks of contamination sometimes choose to use more contaminated sources.

  13. Seasonal Shifts in Primary Water Source Type: A Comparison of Largely Pastoral Communities in Uganda and Tanzania

    PubMed Central

    Pearson, Amber L.; Zwickle, Adam; Namanya, Judith; Rzotkiewicz, Amanda; Mwita, Emiliana

    2016-01-01

    Many water-related illnesses show an increase during the wet season. This is often due to fecal contamination from runoff, yet, it is unknown whether seasonal changes in water availability may also play a role in increased illness via changes in the type of primary water source used by households. Very little is known about the dynamic aspects of access to water and changes in source type across seasons, particularly in semi-arid regions with annual water scarcity. The research questions in this study were: (1) To what degree do households in Uganda (UG) and Tanzania (TZ) change primary water source type between wet and dry seasons?; and (2) How might seasonal changes relate to water quality and health? Using spatial survey data from 92 households each in UG and TZ this study found that, from wet to dry season, 26% (UG) and 9% (TZ) of households switched from a source with higher risk of contamination to a source with lower risk. By comparison, only 20% (UG) and 0% (TZ) of households switched from a source with lower risk of contamination to a source with higher risk of contamination. This research suggests that one pathway through which water-related disease prevalence may differ across seasons is the use of water sources with higher risk contamination, and that households with access to sources with lower risks of contamination sometimes choose to use more contaminated sources. PMID:26828507

  14. Common glycoproteins expressing polylactosamine-type glycans on matched patient primary and metastatic melanoma cells show different glycan profiles.

    PubMed

    Kinoshita, Mitsuhiro; Mitsui, Yosuke; Kakoi, Naotaka; Yamada, Keita; Hayakawa, Takao; Kakehi, Kazuaki

    2014-02-07

    Recently, we reported comparative analysis of glycoproteins which express cancer-specific N-glycans on various cancer cells and identified 24 glycoproteins having polylactosamine (polyLacNAc)-type N-glycans that are abundantly present in malignant cells [ Mitsui et al., J. Pharm. Biomed. Anal. 2012 , 70 , 718 - 726 ]. In the present study, we applied the technique to comparative studies on common glycoproteins present in the matched patient primary and metastatic melanoma cell lines. Metastatic melanoma cells (WM266-4) contained a large amount of polyLacNAc-type N-glycans in comparison with primary melanoma cells (WM115). To identify the glycoproteins expressing these N-glycans, glycopeptides having polyLacNAc-type N-glycans were captured by a Datura stramonium agglutinin (DSA)-immobilized agarose column. The captured glycopeptides were analyzed by LC/MS after removing N-glycans, and some glycoproteins such as basigin, lysosome-associated membrane protein-1 (LAMP-1), and chondroitin sulfate proteoglycan 4 (CSPG4) were identified in both WM115 and WM266-4 cells. The expression level of polyLacNAc of CSPG4 in WM266-4 cells was significantly higher than that in WM115 cells. In addition, sulfation patterns of chondroitin sulfate (CS) chains in CSPG4 showed dramatic changes between these cell lines. These data show that characteristic glycans attached to common proteins observed in different stages of cancer cells will be useful markers for determining degree of malignancies of tumor cells.

  15. Primary and secondary battery consumption trends in Sweden 1996-2013: method development and detailed accounting by battery type.

    PubMed

    Patrício, João; Kalmykova, Yuliya; Berg, Per E O; Rosado, Leonardo; Åberg, Helena

    2015-05-01

    In this article, a new method based on Material Flow Accounting is proposed to study detailed material flows in battery consumption that can be replicated for other countries. The method uses regularly available statistics on import, industrial production and export of batteries and battery-containing electric and electronic equipment (EEE). To promote method use by other scholars with no access to such data, several empirically results and their trends over time, for different types of batteries occurrence among the EEE types are provided. The information provided by the method can be used to: identify drivers of battery consumption; study the dynamic behavior of battery flows - due to technology development, policies, consumers behavior and infrastructures. The method is exemplified by the study of battery flows in Sweden for years 1996-2013. The batteries were accounted, both in units and weight, as primary and secondary batteries; loose and integrated; by electrochemical composition and share of battery use between different types of EEE. Results show that, despite a fivefold increase in the consumption of rechargeable batteries, they account for only about 14% of total use of portable batteries. Recent increase in digital convergence has resulted in a sharp decline in the consumption of primary batteries, which has now stabilized at a fairly low level. Conversely, the consumption of integrated batteries has increased sharply. In 2013, 61% of the total weight of batteries sold in Sweden was collected, and for the particular case of alkaline manganese dioxide batteries, the value achieved 74%.

  16. BLAST: THE REDSHIFT SURVEY

    SciTech Connect

    Eales, Stephen; Dye, Simon; Mauskopf, Philip; Moncelsi, Lorenzo; Pascale, Enzo; Raymond, Gwenifer; Chapin, Edward L.; Halpern, Mark; Marsden, Gaelen; Scott, Douglas; Devlin, Mark J.; Rex, Marie; Semisch, Christopher; Truch, Matthew D. P.; Hughes, David H.; Netterfield, Calvin B.; Viero, Marco P.; Patanchon, Guillaume; Siana, Brian

    2009-12-20

    The Balloon-borne Large Aperture Submillimeter Telescope (BLAST) has recently surveyed approx =8.7 deg{sup 2} centered on Great Observatories Origins Deep Survey-South at 250, 350, and 500 mum. In Dye et al., we presented the catalog of sources detected at 5sigma in at least one band in this field and the probable counterparts to these sources in other wavebands. In this paper, we present the results of a redshift survey in which we succeeded in measuring redshifts for 82 of these counterparts. The spectra show that the BLAST counterparts are mostly star-forming galaxies but not extreme ones when compared to those found in the Sloan Digital Sky Survey. Roughly one quarter of the BLAST counterparts contain an active nucleus. We have used the spectroscopic redshifts to carry out a test of the ability of photometric redshift methods to estimate the redshifts of dusty galaxies, showing that the standard methods work well even when a galaxy contains a large amount of dust. We have also investigated the cases where there are two possible counterparts to the BLAST source, finding that in at least half of these there is evidence that the two galaxies are physically associated, either because they are interacting or because they are in the same large-scale structure. Finally, we have made the first direct measurements of the luminosity function in the three BLAST bands. We find strong evolution out to z = 1, in the sense that there is a large increase in the space density of the most luminous galaxies. We have also investigated the evolution of the dust-mass function, finding similar strong evolution in the space density of the galaxies with the largest dust masses, showing that the luminosity evolution seen in many wavebands is associated with an increase in the reservoir of interstellar matter in galaxies.

  17. [Primary retroperitoneal carcinoid tumor associated with multiple endcrine neoplasia (men) type 1: a case report].

    PubMed

    Chiba, Syuji; Numakura, Kazuyuki; Satoyoshi, Kiyofumi; Saito, Mitsuru; Horikawa, Yohei; Takayama, Koichiro; Nara, Taketoshi; Kanda, Sohei; Miura, Yoshiko; Maita, Shinya; Tsuruta, Hiroshi; Obara, Takashi; Kumazawa, Teruaki; Narita, Shintaro; Tsuchiya, Norihiko; Satoh, Shigeru; Habuchi, Tomonori

    2011-11-01

    We report an extremely rare case of a 69-year-old man having a retroperitoneal carcinoid tumor associated with multiple endocrine neoplasia (MEN) type 1. The patient whose son and daughter were previously diagnosed with MEN type 1 was admitted to the Department of Endocrinology at our hospital for evaluation of this disorder. Computed tomography (CT) and ultrasonography revealed a parathyroid and retroperitoneal tumor (43 mm x 34 mm). The patient did not consent to surgical management of the tumor; however three years later, a follow-up CT revealed tumor enlargement (55 mm x 50 mm). We were unable to rule out a malignancy, and subsequently resected the tumor. A pathological diagnosis of retroperitoneal carcinoid was made. No local recurrence or metastasis have been observed for 21 months.

  18. Mucopolysaccharidosis type IVA: evidence of primary and secondary central nervous system involvement.

    PubMed

    Borlot, Felippe; Arantes, Paula Ricci; Quaio, Caio Robledo; Franco, José Francisco da Silva; Lourenço, Charles Marques; Gomy, Israel; Bertola, Debora Romeo; Kim, Chong Ae

    2014-05-01

    Mucopolysaccharidosis type IVA is a rare lysosomal storage disease caused by a deficiency of N-acetylgalactosamine 6-sulfatase. Studies usually focus on skeletal abnormalities and their consequences. This study explores the neurological manifestations in a cohort of mucopolysaccharidosis type IVA patients, with a detailed focus on brain and spinal magnetic resonance imaging (MRI) findings. We performed a cross-sectional study involving nine patients with a biochemical confirmation of mucopolysaccharidosis type IVA. The protocol consists of a comprehensive clinical examination and brain and spinal cord MRI analysis for all subjects. The mean age was 16.4 years (±5.7) and the mean onset of symptoms was 11.5 months (±6.3). Overall, cognition was spared in all but one patient and motor weakness was a constant finding in all patients. Deep sensation impairment was found in six patients. The brain MRIs showed non-specific white matter changes in two patients. Other abnormalities such as clival hypoplasia, basilar invagination, and arachnoid cists appeared in seven of the nine patients. Eight patients presented spinal cord compression, and in three of them, two spinal levels were compromised. Odontoid hypoplasia and degenerative features in the neuroaxis were present in all patients. Our experience with mucopolysaccharidosis type IVA patients supports the evidence of central nervous system involvement. We emphasize the importance of regular clinical assessments with complete MRI studies, as an attempt to detect the early signs of spinal cord compression. This evaluation may be especially important before surgical interventions, as occult lesions may become symptomatic and promote postoperative unfavorable outcomes. © 2014 Wiley Periodicals, Inc.

  19. Cost-effectiveness of statins for primary prevention in patients newly diagnosed with type 2 diabetes in the Netherlands.

    PubMed

    de Vries, Folgerdiena M; Denig, Petra; Visser, Sipke T; Hak, Eelko; Postma, Maarten J

    2014-03-01

    Statins are lipid-lowering drugs that reduce the risk of cardiovascular events in patients with diabetes. The objective of this study was to determine whether statin treatment for primary prevention in newly diagnosed type 2 diabetes is cost-effective, taking nonadherence, baseline risk, and age into account. A cost-effectiveness analysis was performed by using a Markov model with a time horizon of 10 years. The baseline 10-year cardiovascular risk was estimated in a Dutch population of primary prevention patients with newly diagnosed diabetes from the Groningen Initiative to Analyse Type 2 Diabetes Treatment (GIANTT) database, using the United Kingdom Prospective Diabetes Study risk engine. Statin adherence was measured as pill days covered in the IADB.nl pharmacy research database. Cost-effectiveness was measured in costs per quality-adjusted life-year (QALY) from the health care payers' perspective. For an average patient aged 60 years, the base case, statin treatment was highly cost-effective at €2245 per QALY. Favorable cost-effectiveness was robust in sensitivity analysis. Differences in age and 10-year cardiovascular risk showed large differences in cost-effectiveness from almost €100,000 per QALY to almost being cost saving. Treating all patients younger than 45 years at diabetes diagnosis was not cost-effective (weighted cost-effectiveness of almost €60,000 per QALY). Despite the nonadherence levels observed in actual practice, statin treatment is cost-effective for primary prevention in patients newly diagnosed with type 2 diabetes. Because of large differences in cost-effectiveness according to different risk and age groups, the efficiency of the treatment could be increased by targeting patients with relatively higher cardiovascular risk and higher ages. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  20. Primary and secondary battery consumption trends in Sweden 1996–2013: Method development and detailed accounting by battery type

    SciTech Connect

    Patrício, João; Kalmykova, Yuliya; Berg, Per E.O.; Rosado, Leonardo; Åberg, Helena

    2015-05-15

    Highlights: • Developed MFA method was validated by the national statistics. • Exponential increase of EEE sales leads to increase in integrated battery consumption. • Digital convergence is likely to be a cause for primary batteries consumption decline. • Factors for estimation of integrated batteries in EE are provided. • Sweden reached the collection rates defined by European Union. - Abstract: In this article, a new method based on Material Flow Accounting is proposed to study detailed material flows in battery consumption that can be replicated for other countries. The method uses regularly available statistics on import, industrial production and export of batteries and battery-containing electric and electronic equipment (EEE). To promote method use by other scholars with no access to such data, several empirically results and their trends over time, for different types of batteries occurrence among the EEE types are provided. The information provided by the method can be used to: identify drivers of battery consumption; study the dynamic behavior of battery flows – due to technology development, policies, consumers behavior and infrastructures. The method is exemplified by the study of battery flows in Sweden for years 1996–2013. The batteries were accounted, both in units and weight, as primary and secondary batteries; loose and integrated; by electrochemical composition and share of battery use between different types of EEE. Results show that, despite a fivefold increase in the consumption of rechargeable batteries, they account for only about 14% of total use of portable batteries. Recent increase in digital convergence has resulted in a sharp decline in the consumption of primary batteries, which has now stabilized at a fairly low level. Conversely, the consumption of integrated batteries has increased sharply. In 2013, 61% of the total weight of batteries sold in Sweden was collected, and for the particular case of alkaline manganese

  1. Single Pass Streaming BLAST on FPGAs*†

    PubMed Central

    Herbordt, Martin C.; Model, Josh; Sukhwani, Bharat; Gu, Yongfeng; VanCourt, Tom

    2008-01-01

    Approximate string matching is fundamental to bioinformatics and has been the subject of numerous FPGA acceleration studies. We address issues with respect to FPGA implementations of both BLAST- and dynamic-programming- (DP) based methods. Our primary contribution is a new algorithm for emulating the seeding and extension phases of BLAST. This operates in a single pass through a database at streaming rate, and with no preprocessing other than loading the query string. Moreover, it emulates parameters turned to maximum possible sensitivity with no slowdown. While current DP-based methods also operate at streaming rate, generating results can be cumbersome. We address this with a new structure for data extraction. We present results from several implementations showing order of magnitude acceleration over serial reference code. A simple extension assures compatibility with NCBI BLAST. PMID:19081828

  2. Depressive symptoms are associated with physical inactivity in patients with type 2 diabetes. The DIAZOB Primary Care Diabetes study.

    PubMed

    Koopmans, Berber; Pouwer, François; de Bie, Robert A; van Rooij, Elisabeth S; Leusink, Geraline L; Pop, Victor J

    2009-06-01

    Depression is a common complication of type 2 diabetes, associated with poor disease outcomes such as impaired glycaemic control, cardiovascular disease and increased mortality. The mechanisms behind these associations are unclear. Depression might contribute to poor disease outcomes through decreased physical activity. To test whether type 2 diabetes patients with elevated depression scores are more often physically inactive. Demographic features, clinical factors, level of physical inactivity and depressive symptoms were assessed in 2646 primary care patients with type 2 diabetes. Sequential multiple logistic regression analyses [odds ratio, 95% confidence interval (CI)] were performed to test the association between depressive symptoms and physical inactivity. About 48% of the respondents were physically inactive. Elevated depressive symptoms were found in 14% of the respondents. After adjustment for potential confounders, the odds for being physically inactive were almost doubled in depressed patients with type 2 diabetes 1.74 (95% CI 1.32-2.31). Presence of depressive symptoms almost doubles the likelihood of physical inactivity in patients with type 2 diabetes. Longitudinal studies are needed to investigate whether physical inactivity forms the link between depression and poor disease outcomes.

  3. Co-blasting of titanium surfaces with an abrasive and hydroxyapatite to produce bioactive coatings: substrate and coating characterisation.

    PubMed

    Dunne, Conor F; Twomey, Barry; O'Neill, Liam; Stanton, Kenneth T

    2014-01-01

    The aim of this work is to assess the influence of two blast media on the deposition of hydroxyapatite onto a titanium substrate using a novel ambient temperature coating technique named CoBlast. CoBlast was developed to address the problems with high temperature coating techniques. The blasting media used in this study were Al2O3 and a sintered apatite powder. The prepared and coated surfaces were compared to plasma sprayed hydroxyapatite on the same substrates using the same hydroxyapatite feedstock powder. X-ray diffraction analysis revealed the coating crystallinity was the same as the original hydroxyapatite feedstock powder for the CoBlast samples while evidence of amorphous hydroxyapatite phases and β-TCP was observed in the plasma sprayed samples. The blast media type significantly influences the adhesive strength of the coating, surface roughness of both the substrate and coating and the microstructure of the substrate. The coating adhesion increased for the CoBlasted samples from 50 MPa to 60 MPa for sintered apatite powder and alumina, respectively, while plasma spray samples were significantly lower (5 MPa) when tested using a modified pull-test. In conclusion, the choice of blast medium is shown to be a key parameter in the CoBlast process. This study indicates that sintered apatite powder is the most suitable candidate for use as a blast medium in the coating of medical devices.

  4. BeoBLAST: distributed BLAST and PSI-BLAST on a Beowulf cluster.

    PubMed

    Grant, J D; Dunbrack, R L; Manion, F J; Ochs, M F

    2002-05-01

    BeoBLAST is an integrated software package that handles user requests and distributes BLAST and PSI-BLAST searches to nodes of a Beowulf cluster, thus providing a simple way to implement a scalable BLAST system on top of relatively inexpensive computer clusters. Additionally, BeoBLAST offers a number of novel search features through its web interface, including the ability to perform simultaneous searches of multiple databases with multiple queries, and the ability to start a search using the PSSM generated from a previous PSI-BLAST search on a different database. The underlying system can also handle automated querying for high throughput work. Source code is available under the GNU public license at http://bioinformatics.fccc.edu/

  5. BLAST: The Balloon-Borne Large Aperture Submillimeter Telescope

    NASA Technical Reports Server (NTRS)

    Devlin, Mark; Ade, Peter; Bock, Jamie; Dicker, Simon; Griffin, Matt; Gunderson, Josh; Halpern, Mark; Hargrave, Peter; Hughes, David; Klein, Jeff

    2004-01-01

    BLAST is the Balloon-borne Large-Aperture Sub-millimeter Telescope. It will fly from a Long Duration Balloon (LDB) platform from Antarctica. The telescope design incorporates a 2 m primary mirror with large-format bolometer arrays operating at 250, 350 and 500 microns. By providing the first sensitive large-area (10 sq. deg.) sub-mm surveys at these wavelengths, BLAST will address some of the most important galactic and cosmological questions regarding the formation and evolution of stars, galaxies and clusters. Galactic and extragalactic BLAST surveys will: (1) identify large numbers of high-redshift galaxies; (2) measure photometric redshifts, rest-frame FIR luminosities and star formation rates thereby constraining the evolutionary history of the galaxies that produce the FIR and sub-mm background; (3) measure cold pre-stellar sources associated with the earliest stages of star and planet formation; (4) make high-resolution maps of diffuse galactic emission over a wide range of galactic latitudes. In addition to achieving the above scientific goals, the exciting legacy of the BLAST LDB experiment will be a catalogue of 3000-5000 extragalactic sub-mm sources and a 100 sq. deg. sub-mm galactic plane survey. Multi-frequency follow-up observations from SIRTF, ASTRO-F, and Herschel, together with spectroscopic observations and sub-arcsecond imaging from ALMA are essential to understand the physical nature of the BLAST sources.

  6. Absence of primary integrase resistance mutations in HIV type 1-infected patients in Venezuela.

    PubMed

    Rangel, Héctor R; Garzaro, Domingo; Fabbro, Rona; Martinez, Nahir; Ossenkop, John; Torres, Jaime R; Gutiérrez, Cristina R; Pujol, Flor H

    2010-08-01

    The preexistence of mutations to integrase inhibitors in HIV-1-infected Venezuelan patients was evaluated. The integrase region of the HIV-1 genome was amplified by nested-PCR and sequenced in 57 isolates from both naive (n = 24) and treated patients who received protease and/or reverse transcriptase inhibitors (PI and RTI, n = 33), but were never exposed to integrase inhibitors. Only one primary integrase resistance mutation, not conferring drug resistance by itself, was found among these patients, although several minor viral mutations, equally distributed among naive and PI- and RTI-treated patients, were also found. In the limited number of samples, no relation was found among the presence of resistance mutations to PI or RTI and the presence of minor mutations to integrase. The absence of resistance to integrase inhibitors may be related to the recent introduction of these drugs in our country. The availability of in-house assays allows for a more comprehensive surveillance of drug resistance to integrase inhibitors in Venezuela.

  7. Primary hepatic extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue type

    PubMed Central

    Dong, Shuilin; Chen, Lin; Chen, Yifa; Chen, Xiaoping

    2017-01-01

    Abstract Rationale: Primary hepatic mucosa-associated lymphoid tissue (MALT) lymphoma is an extremely rare disease. To the best of our knowledge, only 67 cases had been reported in 39 English literatures to date. The aim of this study was to add a new case of this disease to the literature and to review the current literature. Patient concerns: A 50-year-old man was incidentally identified with a solitary mass of 5 cm in diameter in the left lobe of the liver. Diagnoses: Based on the results of imaging studies, intrahepatic cholangiocellular carcinoma was suspected, and then surgery was performed. Microscopic findings showed that the tumor was a hepatic MALT lymphoma, and immunohistochemical analysis revealed that the lymphoma cells were CD20+, CD79a+, BCL-2+, CD3−, and CD5−. Interventions: The patient received rituximab after surgery. Outcomes: He was free of disease for 13 months at the time of this report. Lessons: Since previously published case reports and our case described nonspecific clinical features of this rare disease, it was usually misdiagnosed before histological confirmation and surgery resection may be a good choice for both diagnosis and local therapy. PMID:28353562

  8. Characterization of primary human keratinocytes transformed by human papillomavirus type 18

    SciTech Connect

    Kaur, P.; McDougall, J.K. )

    1988-06-01

    Primary human epithelial cells were cotransfected with pHPV-18 and pSV2neo, and cell strains were generated by selecting in G418. Southern blot analysis revealed the presence of at least one intact, integrated viral genome in these cells. FE-A cells showed altered growth properties, characterized by a change in morphology, and clonal density. Differentiation markers analyzed by Western blotting (immunoblotting), such as cytokeratins and involucrin, indicated that the cells resembled a partially differentiated epithelial population. Increased expression of the 40-kilodalton cytokeratin was observed in FE-A cells, similar to that observed in simian virus 40-immortalized human keratinocytes. Calcium and 12-O-tetradecanoyl-phorbol-13-acetate treatment induced normal epithelial cells to differentiate, whereas the human papillomavirus 18 (HPV-18)-containing keratinocytes were resistant to these signals, indicating their partially transformed nature. These cells were not able to induce tumors in nude mice over a period of up to 8 months. A second cell strain, FE-H18L, also generated by transfecting HPV-18, also exhibited an extended life span and similar alterations in morphology. Viral RNA transcribed from the early region of HPV-18 was detected in both cell strains by Northern (RNA) blot analysis. These cell strains should provide a useful model for determining the role of HPV in carcinogenesis.

  9. Effects of implant neck design on primary stability and overload in a type IV mandibular bone.

    PubMed

    Chou, I-Chiang; Lee, Shyh-Yuan; Jiang, Cho-Pei

    2014-11-01

    This study investigates the effect of implant neck design on primary stability and overload using 3D finite element analysis. Four commercial dental implants and mandibular segments are created. Various parameters including the osseointegration condition (non-osseointegration and full osseointegration), force direction (vertical and horizontal), and cortical bone thickness (Tc = 0.3, 0.5, and 1 mm) are considered. The vertical and horizontal forces, 500 N and 250 N, are statically applied at the top of the platform, respectively. Micromotion and von Mises stress are employed to evaluate the risk of osseointegration and bone fatigue before osseointegration condition. After osseointegration, the principal stress is used to analyze the bone overload. Maximal von Mises stress and micromotion of the peri-implant bone decreased as cortical bone thickness increased. Horizontal force induces stress concentration in the bone around the implant neck easier than that of vertical force, and it may result in crestal bone loss. Thinner cortical bone should avoid dental implantation because it causes a noteworthy larger micromotion and stress concentration in cortical bone in particular Tc less than 0.3 mm. Copyright © 2014 John Wiley & Sons, Ltd.

  10. Genetic and Functional Diversity of Human Immunodeficiency Virus Type 1 Subtype B Nef Primary Isolates

    PubMed Central

    Foster, John L.; Molina, Rene P.; Luo, Tianci; Arora, Vivek K.; Huang, Yaoxing; Ho, David D.; Garcia, J. Victor

    2001-01-01

    We have characterized the functional integrity of seven primary Nef isolates: five from a long-term nonprogressing human immunodeficiency virus (HIV)-infected individual and one each from two patients with AIDS. One of the seven Nefs was defective for CD4 downregulation, two others were defective for PAK-2 activation, and one Nef was defective for PAK-2 activation and major histocompatibility complex (MHC) class I downregulation. Five of the Nefs were tested and found to be functional for the enhancement of virus particle infectivity. The structural basis for each of the functional defects has been analyzed by constructing a consensus nef, followed by mutational analysis of the variant amino acid residues. Mutations A29V and F193I were deleterious to CD4 downregulation and PAK-2 activation, respectively, while S189R rendered Nef defective for both MHC class I downregulation and PAK-2 activation. A search of the literature identified HIVs from five patients with Nefs predominantly mutated at F193 and from one patient with Nefs predominantly mutated at A29. A29 is highly conserved in all HIV subtypes except for subtype E. F193 is conserved in subtype B (and possibly in the closely related subtype D), but none of the other HIV group M subtypes. Our results suggest that functional distinctions may exist between HIV subtypes. PMID:11160665

  11. Hypertension management algorithm for type 2 diabetic patients applied in primary care

    PubMed Central

    2013-01-01

    Background Hypertension frequently coexists with type 2 diabetes (DM), and increases the risk of cardiovascular outcomes. The aim of the study was to obtain/maintain blood pressure (BP) goals (ADA/JNC 7) according to a stepwise algorithm using the medication supplied by the Brazilian government. Methods A one-year, single-arm interventional study conducted with type 2 diabetes patients. Intervention consisted of intensification of lifestyle changes and sequential prescription of drugs: diuretic; ACE inhibitors; β-adrenergic blocking agent and calcium channel blocking agent if BP >130/80 mmHg. Results Seventy-eight patients completed the trial. During intervention, the number of antihypertensive tablets rose (3.6 ± 3.5 vs. 5.9 ± 3.5 pills/patient; p <0.001), as the number of antihypertensive classes increased (1.8 ± 1.0 vs. 2.70 ± 1.2; p < 0.01) and the overall drop of BP was 11 mmHg for SBP (145.0 ± 22.8 vs. 133.7 ± 20.9 mmHg; p < 0.01) and 5 mmHg for DBP (78.7 ± 11.5 vs. 73.7 ± 10.5 mmHg; p = 0.001). Although the number of patients with BP in target almost doubled [14 (18.7%) vs. 30 (38.5%) p = 0.008], less than 40% of the patients achieved the proposed goals. Conclusions A BP algorithm applied to type 2 diabetic and hypertensive patients is able to lower BP, however more than half of the patients did not achieve the ADA/JNC 7 targets demonstrating the complexity of BP control in this population. Trial registration ClinicalTrials.gov: NCT06260 PMID:24028306

  12. Solid-type primary intraosseous squamous-cell carcinoma in the mandible: Report of a rare case.

    PubMed

    Alotaibi, Ohoud; Al-Zaher, Nabil; Alotaibi, Faiza; Khoja, Hatim; Qannam, Ahmed

    2016-09-01

    Primary intraosseous squamous cell carcinoma (PIOSCC) is a rare malignant neoplasm that has an exquisitely exclusive affection to the jawbone. It is defined as squamous cell carcinoma arising within the jaw and developing from residual odontogenic epithelium or from a preexisting odontogenic cyst or tumor. The solid-type of this tumor is a central jaw carcinoma arising de novo and has no initial connection with the oral mucosa. Herein, we report a case of solid-type PIOSCC involving the mandible in a 37-year-old male patient elucidating its histopathological and imaging findings. The patient underwent surgical resection followed by post-operative adjuvant radiotherapy. The close 2-year follow up of the patient revealed neither locoregional nor distant metastasis.

  13. Evaluating Spatial-Temporal Dynamics of Net Primary Productivity of Different Forest Types in Northeastern China Based on Improved FORCCHN

    PubMed Central

    Zhao, Junfang; Yan, Xiaodong; Guo, Jianping; Jia, Gensuo

    2012-01-01

    An improved individual-based forest ecosystem carbon budget model for China (FORCCHN) was applied to investigate the spatial-temporal dynamics of net primary productivity of different forest types in northeastern China. In this study, the forests of northeastern China were categorized into four ecological types according to their habitats and generic characteristics (evergreen broadleaf forest, deciduous broadleaf forest, evergreen needleleaf forest and deciduous needleleaf forest). The results showed that distribution and change of forest NPP in northeastern China were related to the different forest types. From 1981 to 2002, among the forest types in northeastern China, per unit area NPP and total NPP of deciduous broadleaf forest were the highest, with the values of 729.4 gC/(m2•yr) and 106.0 TgC/yr, respectively, followed by mixed broadleaf- needleleaf forest, deciduous needleleaf forest and evergreen needleleaf forest. From 1981 to 2002, per unit area NPP and total NPP of different forest types in northeastern China exhibited significant trends of interannual increase, and rapid increase was found between the 1980s and 1990s. The contribution of the different forest type’s NPP to total NPP in northeastern China was clearly different. The greatest was deciduous broadleaf forest, followed by mixed broadleaf- needleleaf forest and deciduous needleleaf forest. The smallest was evergreen needleleaf forest. Spatial difference in NPP between different forest types was remarkable. High NPP values of deciduous needleleaf forest, mixed broadleaf- needleleaf forest and deciduous broadleaf forest were found in the Daxing’anling region, the southeastern of Xiaoxing’anling and Jilin province, and the Changbai Mountain, respectively. However, no regional differences were found for evergreen needleleaf NPP. This study provided not only an estimation NPP of different forest types in northeastern China but also a useful methodology for estimating forest carbon storage

  14. Blast impact behaviour of concrete with different fibre reinforcement

    NASA Astrophysics Data System (ADS)

    Drdlová, Martina; Čechmánek, René; Řídký, Radek

    2015-09-01

    The paper summarizes the results of the development of special concrete intended for the explosion resistance applications, with the emphasis on minimal secondary fragments formation at the explosion. The fine-grained concrete matrix has been reinforced by various types of short dispersed fibers (metallic, mineral and polymer) of different sizes and by their combination and the effect of the fibre reinforcement on the physico-mechanical properties and blast resistance was observed. The concrete prism specimens have been subjected to the determination of mechanical parameters (compressive and flexural strength at quasi-static load). The blast tests were conducted on the slab specimens prepared from selected mixtures. The material characteristics and explosion test data have been used for numerical investigation, which defined the optimal wall composition and dimensions of the concrete element which should resist the explosion defined by type, size, weight and placement of the blast. In the next step the test elements resistance was verified by real explosion test.

  15. Factors influencing insulin usage among type 2 diabetes mellitus patients: A study in Turkish primary care.

    PubMed

    Yilmaz, Ahmet; Ak, Muharrem; Cim, Abdullah; Palanci, Yilmaz; Kilinc, Faruk

    2016-12-01

    DM (diabetes mellitus) patients with poorly regulated blood glucose levels are at risk of increased morbidity and mortality. There are different factors that cause resistance to the initiation of insulin therapy such as beliefs and perceptions concerning diabetes and its treatment and the nature and consequences of insulin therapy. We aimed to explore the reasons for this reluctance and how these obstacles could be overcome so that DM patients who require insulin could initiate therapy. This was a cross-sectional, descriptive study of diabetic patients with glycated haemoglobin A1c (HbA1C) levels above 7.0%, who were followed-up at a primary care and endocrinology outpatient clinic. Ninety-four patients (57.4% females, 42.6% males) were recruited for this study. Most patients (57.4%) considered that insulin was a drug of last resort. Among all patients, 34.1% thought that insulin lowered blood glucose levels to an extreme degree and 14.9% disagreed. The patients thought that self-injection was hard (27.6%), required someone else to administer the injection (27.6%), insulin injection was painful (33.0%). 59.6% of all patients believed that their religion did not restrict the use of insulin, 52.1% stated that their family physicians had sufficiently informed them. Our most significant finding is that a lack of adequate information relating to insulin appears to be the major factor behind DM patients' refusal of insulin treatment. The fact that patients consider insulin treatment as a final solution to DM could be related to resistance to the initiation of insulin therapy. [Box: see text].

  16. 30 CFR 75.1323 - Blasting circuits.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Blasting circuits. 75.1323 Section 75.1323... MANDATORY SAFETY STANDARDS-UNDERGROUND COAL MINES Explosives and Blasting § 75.1323 Blasting circuits. (a) Blasting circuits shall be protected from sources of stray electric current. (b) Detonators made by...

  17. 30 CFR 75.1323 - Blasting circuits.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Blasting circuits. 75.1323 Section 75.1323... MANDATORY SAFETY STANDARDS-UNDERGROUND COAL MINES Explosives and Blasting § 75.1323 Blasting circuits. (a) Blasting circuits shall be protected from sources of stray electric current. (b) Detonators made by...

  18. 30 CFR 75.1323 - Blasting circuits.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Blasting circuits. 75.1323 Section 75.1323... MANDATORY SAFETY STANDARDS-UNDERGROUND COAL MINES Explosives and Blasting § 75.1323 Blasting circuits. (a) Blasting circuits shall be protected from sources of stray electric current. (b) Detonators made by...

  19. 30 CFR 75.1323 - Blasting circuits.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Blasting circuits. 75.1323 Section 75.1323... MANDATORY SAFETY STANDARDS-UNDERGROUND COAL MINES Explosives and Blasting § 75.1323 Blasting circuits. (a) Blasting circuits shall be protected from sources of stray electric current. (b) Detonators made by...

  20. 30 CFR 75.1323 - Blasting circuits.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Blasting circuits. 75.1323 Section 75.1323... MANDATORY SAFETY STANDARDS-UNDERGROUND COAL MINES Explosives and Blasting § 75.1323 Blasting circuits. (a) Blasting circuits shall be protected from sources of stray electric current. (b) Detonators made by...

  1. 29 CFR 1926.912 - Underwater blasting.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 8 2011-07-01 2011-07-01 false Underwater blasting. 1926.912 Section 1926.912 Labor... Underwater blasting. (a) A blaster shall conduct all blasting operations, and no shot shall be fired without... swimming or diving operations are in progress in the vicinity of the blasting area. If such operations are...

  2. 29 CFR 1926.912 - Underwater blasting.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 8 2010-07-01 2010-07-01 false Underwater blasting. 1926.912 Section 1926.912 Labor... Underwater blasting. (a) A blaster shall conduct all blasting operations, and no shot shall be fired without... swimming or diving operations are in progress in the vicinity of the blasting area. If such operations are...

  3. 29 CFR 1926.912 - Underwater blasting.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... nonsparking metal loading tube when tube is necessary. (d) No blast shall be fired while any vessel under way... within 1,500 feet shall be notified before a blast is fired. (e) No blast shall be fired while any... in progress, signals and arrangements shall be agreed upon to assure that no blast shall be...

  4. 29 CFR 1926.912 - Underwater blasting.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... nonsparking metal loading tube when tube is necessary. (d) No blast shall be fired while any vessel under way... within 1,500 feet shall be notified before a blast is fired. (e) No blast shall be fired while any... in progress, signals and arrangements shall be agreed upon to assure that no blast shall be...

  5. 29 CFR 1926.912 - Underwater blasting.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... nonsparking metal loading tube when tube is necessary. (d) No blast shall be fired while any vessel under way... within 1,500 feet shall be notified before a blast is fired. (e) No blast shall be fired while any... in progress, signals and arrangements shall be agreed upon to assure that no blast shall be...

  6. Domain enhanced lookup time accelerated BLAST.

    PubMed

    Boratyn, Grzegorz M; Schäffer, Alejandro A; Agarwala, Richa; Altschul, Stephen F; Lipman, David J; Madden, Thomas L

    2012-04-17

    BLAST is a commonly-used software package for comparing a query sequence to a database of known sequences; in this study, we focus on protein sequences. Position-specific-iterated BLAST (PSI-BLAST) iteratively searches a protein sequence database, using the matches in round i to construct a position-specific score matrix (PSSM) for searching the database in round i + 1. Biegert and Söding developed Context-sensitive BLAST (CS-BLAST), which combines information from searching the sequence database with information derived from a library of short protein profiles to achieve better homology detection than PSI-BLAST, which builds its PSSMs from scratch. We describe a new method, called domain enhanced lookup time accelerated BLAST (DELTA-BLAST), which searches a database of pre-constructed PSSMs before searching a protein-sequence database, to yield better homology detection. For its PSSMs, DELTA-BLAST employs a subset of NCBI's Conserved Domain Database (CDD). On a test set derived from ASTRAL, with one round of searching, DELTA-BLAST achieves a ROC5000 of 0.270 vs. 0.116 for CS-BLAST. The performance advantage diminishes in iterated searches, but DELTA-BLAST continues to achieve better ROC scores than CS-BLAST. DELTA-BLAST is a useful program for the detection of remote protein homologs. It is available under the "Protein BLAST" link at http://blast.ncbi.nlm.nih.gov.

  7. [Implications in primary health care of medical genetics and genomic in type 2 diabetes mellitus].

    PubMed

    Ramirez-Garcia, Sergio Alberto; Cabrera-Pivaral, Carlos E; Huacuja-Ruiz, Luis; Flores-Alvarado, Luis Javier; Pérez-García, Guillermo; González-Rico, José Luis; López-Velázquez, Alma; Topete-González, Luz Rosalba; Rosales-Góme, Roberto Carlos; Candelario-Mejía, Gerardo; Villa-Ruano, Nemesio

    2013-01-01

    Type 2 diabetes mellitus is a complex disease and a global health problem. Therefore, the first level of health care should handle the approaches of medical genetics and genomics to reduce its incidence. The aim is to present perspectives analyzed by our group in two areas of genetics and its clinical application. Emphasis is placed on the coexistence of several genetic forms clinically detectable in patients with diabetes, missing heritability associated with low penetrance, and epigenomics mechanism. It is discussed the effect of genetic variation associated with resistance to insulin, beta-cell dysfunction, shaft incretin, and other points of interest, such as thrifty genotype hypothesis, conformational disease, genetically unknown foods, phenocopies as clinically silent hypercortisolism, molecular phytopharmacology in the clinical management. Finally, the result was displayed in the Mexican population from genetic studies and new findings of clinical importance, such as involvement of melatonin and effect of variations in the number of copies in a genomic region.

  8. Primary prevention of Type 2 diabetes in South Asians--challenges and the way forward.

    PubMed

    Ramachandran, A; Ambady, R; Snehalatha, C; Samith Shetty, A; Nanditha, A

    2013-01-01

    Preventing diabetes is of enormous value, particularly for the South Asian countries, which have a huge healthcare burden from the onslaught of the disease. Type 2 diabetes has been proved to be preventable using lifestyle changes, even in South Asians despite their heightened risk profile. Strategies to improve awareness about diabetes and translation of preventive measures by innovative, culturally specific programmes have to be implemented at national levels. Integrated involvement of the government, community, media, healthcare and education services, and financial support from national and international organizations, are required. South Asian countries have initiated national programmes for diabetes prevention and management. It is also encouraging to note that joint ventures between developed countries such as the USA, UK and other European countries and centres of excellence in South Asia have been initiated to develop large-scale, community-oriented, pragmatic intervention strategies. © 2012 The Authors. Diabetic Medicine © 2012 Diabetes UK.

  9. [Nutritional practices in type II diabetic patients in primary care. Mexican Social Security Institute

    PubMed

    Cabrera Pivaral CE; Martínez Ramírez A; Vega López MG; González Pérez G; Muñoz De La Torre A

    1996-10-01

    Nutritional practices of diabetics reflect both human behavior and the health culture of such patients. They also represent how the diabetic deals with the health/illness issue. The purpose of this survey was to identify and relate nutritional practices with metabolic control, age, sex, years of schooling, and time since diagnosis of illness. The sample was taken from 114 cases selected through systematic random sampling in five family practice units in Guadalajara. Using thirteen structured, coded, and quantified questions of the Likert type, the study evaluated nutritional practice with a range of 0-65. Results showed that 21% of the diabetics had appropriate nutritional practices (>31 points), and when related with years of schooling and time since diagnosis of illness, they showed statistically significant differences (p=0.05). Simple regression showed that 9% of metabolic control can be explained by nutritional practices.

  10. Relationship between provider type and the attainment of treatment goals in primary care.

    PubMed

    Federman, Daniel G; Krishnamurthy, Raj; Kancir, Sue; Goulet, Joseph; Justice, Amy

    2005-09-01

    To determine the relationship between provider type (eg, resident, mid-level practitioner, attending physician) and attainment of clinical goals with respect to the treatment of dyslipidemia, diabetes mellitus, and hypertension. Using electronic medical records, we identified all patients seen in the Veterans Affairs Connecticut Health Care System in a 6-month period with an International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code corresponding to a diagnosis of coronary artery disease, diabetes mellitus, or hypertension. We recorded the most recent low-density lipoprotein cholesterol level for patients with diabetes or coronary artery disease, glycosylated hemoglobin level for patients with diabetes, and blood pressure for patients with hypertension. We then examined the relationship between these measures and provider type. After controlling for patient age and practice site, no significant differences were noted between attending physicians and residents in attaining treatment goals for dyslipidemia (odds ratio [OR] 1.15, 95% confidence interval [CI] 0.96-1.38) or diabetes (OR 1.05, 95% CI 0.82-1.33). However, attending physicians were significantly more likely to attain blood pressure goals than were residents (59% vs 54%, P = .002; OR 1.23, 95% CI 1.08-1.39). Controlling for additional patient characteristics did not alter the findings. Internal medicine residents may quickly develop expertise in managing dyslipidemia and diabetes mellitus. Residents in our sample, however, were less likely than attending physicians to reach goal blood pressure for patients with hypertension. Educational efforts aimed at house staff to improve the treatment of hypertension are warranted.

  11. Doctors' and nurses' views on patient care for type 2 diabetes: an interview study in primary health care in Oman.

    PubMed

    Noor Abdulhadi, Nadia M; Al-Shafaee, Mohammed Ali; Wahlström, Rolf; Hjelm, Katarina

    2013-07-01

    This study aimed at exploring the experiences of primary health-care providers of their encounters with patients with type 2 diabetes, and their preferences and suggestions for future improvement of diabetes care. Barriers to good diabetes care could be related to problems from health-care providers' side, patients' side or the health-care system of the country. Treatment of patients with type 2 diabetes has become a huge challenge in Oman, where the prevalence has increased to high levels. Semi-structured interviews were conducted with 26 health-care professionals, 19 doctors and seven nurses, who worked in primary health care in Oman. Qualitative content analysis was applied. Findings Organizational barriers and barriers related to patients and health-care providers were identified. These included workload and lack of teamwork approach. Poor patients' management adherence and influence of culture on their attitudes towards illness were identified. From the providers' side, language barriers, providers' frustration and aggressive attitudes towards the patients were reflected. Decreasing the workload, availability of competent teams with diabetes specialist nurses and continuity of care were suggested. Furthermore, changing professional behaviours towards a more patient-centred approach and need for health education to the patients, especially on self-management, were addressed. Appropriate training for health-care providers in communication skills with emphasis on self-care education and individualization of care according to each patient's needs are important for improvement of diabetes care in Oman.

  12. Quality of life and satisfaction with treatment in subjects with type 2 diabetes: results from primary health care in Turkey.

    PubMed

    Ozder, Aclan; Sekeroglu, Mesut; Eker, Hasan Huseyin

    2014-01-01

    The aim of this study was to assess the quality of life and degree of satisfaction with the treatment of patients with type 2 diabetes mellitus (T2DM) in primary health care in Turkey. A total of 180 adults with type 2 diabetes mellitus from the Family Medicine out-patient clinic were included in the study. Participants were asked to fill out a self-report survey to collect data via two well validated scales, including the Turkish version of the Audit of Diabetes Dependent Quality of Life (ADDQoL) instrument and the Diabetes Treatment Satisfaction Questionnaire (DTSQ). Overall average weighted impact score for the study group was -2.73 ± 2.56. Diabetes mellitus has the largest impact on enjoyment of food (mean ± SD impact rating: -1.63 ± 1.50). The mean score of the DTSQ was 21.02 ± 8.07 (range from better to worse: 36 to 0) for the entire group. Presence of diabetes-related complication was significantly related with lower treatment satisfaction scores (mean ± SD = 23.08 ± 7.32 without complications; mean ± SD = 18.48 ± 8.36 with complications, P = 0.003). Physicians working in primary care should be equipped with more recent knowledge of diabetes treatment in order to tailor more appropriate treatment strategies from current guidelines.

  13. Identification of blast resistance genes for managing rice blast disease

    USDA-ARS?s Scientific Manuscript database

    Rice blast, caused by the fungal pathogen Magnaporthe oryzae, is one of the most devastating diseases worldwide. In the present study, an international set of monogenic differentials carrying 24 major blast resistance (R) genes (Pia, Pib, Pii, Pik, Pik-h, Pik-m, Pik-p, Pik-s, Pish, Pit, Pita, Pita2,...

  14. Implementation of a lifestyle intervention for type 2 diabetes prevention in Dutch primary care: opportunities for intervention delivery

    PubMed Central

    2012-01-01

    Background As in clinical practice resources may be limited compared to experimental settings, translation of evidence-based lifestyle interventions into daily life settings is challenging. In this study we therefore evaluated the implementation of the APHRODITE lifestyle intervention for the prevention of type 2 diabetes in Dutch primary care. Based on this evaluation we discuss opportunities for refining intervention delivery. Methods A 2.5-year intervention was performed in 14 general practices in the Netherlands among individuals at high risk for type 2 diabetes (FINDRISC-score ≥ 13) (n = 479) and was compared to usual care (n = 446). Intervention consisted of individual lifestyle counselling by nurse practitioners (n = 24) and GPs (n = 48) and group-consultations. Drop-out and attendance were registered during the programme. After the intervention, satisfaction with the programme and perceived implementation barriers were assessed with questionnaires. Results Drop-out was modest (intervention: 14.6 %; usual care: 13.2 %) and attendance at individual consultations was high (intervention: 80-97 %; usual care: 86-94 %). Providers were confident about diabetes prevention by lifestyle intervention in primary care. Participants were more satisfied with counselling from nurse practitioners than from GPs. A major part of the GPs reported low self-efficacy regarding dietary guidance. Lack of counselling time (60 %), participant motivation (12 %), and financial reimbursement (11 %) were regarded by providers as important barriers for intervention implementation. Conclusions High participant compliance and a positive attitude of providers make primary care a suitable setting for diabetes prevention by lifestyle counselling. Results support a role for the nurse practitioner as the key player in guiding lifestyle modification. Further research is needed on strategies that could increase cost-effectiveness, such as more stringent criteria

  15. Implementation of a lifestyle intervention for type 2 diabetes prevention in Dutch primary care: opportunities for intervention delivery.

    PubMed

    Vermunt, Paulina W A; Milder, Ivon E J; Wielaard, Frits; Baan, Caroline A; Schelfhout, Jos D M; Westert, Gert P; van Oers, Hans A M

    2012-08-08

    As in clinical practice resources may be limited compared to experimental settings, translation of evidence-based lifestyle interventions into daily life settings is challenging. In this study we therefore evaluated the implementation of the APHRODITE lifestyle intervention for the prevention of type 2 diabetes in Dutch primary care. Based on this evaluation we discuss opportunities for refining intervention delivery. A 2.5-year intervention was performed in 14 general practices in the Netherlands among individuals at high risk for type 2 diabetes (FINDRISC-score ≥ 13) (n = 479) and was compared to usual care (n = 446). Intervention consisted of individual lifestyle counselling by nurse practitioners (n = 24) and GPs (n = 48) and group-consultations. Drop-out and attendance were registered during the programme. After the intervention, satisfaction with the programme and perceived implementation barriers were assessed with questionnaires. Drop-out was modest (intervention: 14.6 %; usual care: 13.2 %) and attendance at individual consultations was high (intervention: 80-97 %; usual care: 86-94 %). Providers were confident about diabetes prevention by lifestyle intervention in primary care. Participants were more satisfied with counselling from nurse practitioners than from GPs. A major part of the GPs reported low self-efficacy regarding dietary guidance. Lack of counselling time (60 %), participant motivation (12 %), and financial reimbursement (11 %) were regarded by providers as important barriers for intervention implementation. High participant compliance and a positive attitude of providers make primary care a suitable setting for diabetes prevention by lifestyle counselling. Results support a role for the nurse practitioner as the key player in guiding lifestyle modification. Further research is needed on strategies that could increase cost-effectiveness, such as more stringent criteria for participant inclusion, group

  16. Numerical Investigation of Thermal Stratification in the Primary Circuit of VVER-440 Type Reactors

    SciTech Connect

    Boros, Ildiko; Aszodi, Attila; Legradi, Gabor

    2006-07-01

    Thermal stratification in the primary loops and in the connected pipes can limit the lifetime of the piping, or lead to penetrating cracks due to the stresses caused by the temperature differences and the cyclic temperature changes. Therefore it is essential to determine the thermal hydraulic parameters of the stratified flow. The determination of the affected pipes can be based on the international operational experience and on engineering consideration. The most affected pipes in PWRs are the pressurizer surge line, the injection pipe of the emergency core cooling systems and the feedwater injection pipe of the steam generators. CFD codes can provide an appropriate tool for the examination of the development and the breaking up of the stratification and the determination of the temperature distribution. However, the challenge of the uncertainty of the boundary conditions has to be faced because of the unknown flow circumstances. According to an extensive evaluation, performed in 1998 by the VEIKI, in the VVER-440/213 units of Paks NPP the most affected pipe is the pressurizer surge line [1]. To find out the possible thermal stratification in the surge line, a temperature monitoring system was installed on the YP20 leg of the surge line of the Unit 1 of the Paks NPP in 2000. The measurements showed that during the heat-up period there is a thermal stratification almost all time in the surge line [2]. The maximum temperature differences reach 140 K (140 deg. C). The surge line has been modeled with the CFD code CFX-5.7. The performed transient simulations confirmed the existence of a thermal stratification in the surge line, but showed permanent recirculation of colder coolant in the lower layer, caused by the asymmetric arrangement of the surge line legs and the asymmetric connection of the two legs to the main loop. In this paper, the surge line model and the results of the transient simulations are presented. The CFD model of the injection pipe of the high

  17. Galveston Brain Injury Conference 2010: clinical and experimental aspects of blast injury.

    PubMed

    Masel, Brent E; Bell, Randy S; Brossart, Shawn; Grill, Raymond J; Hayes, Ronald L; Levin, Harvey S; Rasband, Matthew N; Ritzel, David V; Wade, Charles E; DeWitt, Douglas S

    2012-08-10

    Blast injury is the most prevalent source of mortality and morbidity among combatants in Operations Iraqi and Enduring Freedom. Blast-induced neurotrauma (BINT) is a common cause of mortality, and even mild BINT may be associated with chronic cognitive and emotional deficits. In addition to military personnel, the increasing use of explosives by terrorists has resulted in growing numbers of blast injuries in civilian populations. Since the medical and rehabilitative communities are likely to be faced with increasing numbers of patients suffering from blast injury, the 2010 Galveston Brain Injury Conference focused on topics related to the diagnosis, treatment, and mechanisms of BINT. Although past military actions have resulted in large numbers of blast casualties, BINT is considered the signature injury of the conflicts in Iraq and Afghanistan. The attention focused on BINT has led to increased financial support for research on blast effects, contributing to the development of better experimental models of blast injury and a clearer understanding of the mechanisms of BINT. This more thorough understanding of blast injury mechanisms will result in novel and more effective therapeutic and rehabilitative strategies designed to reduce injury and facilitate recovery, thereby improving long-term outcomes in patients suffering from the devastating and often lasting effects of BINT. The following is a summary of the 2010 Galveston Brain Injury Conference, that included presentations related to the diagnosis and treatment of acute BINT, the evaluation of the long-term neuropsychological effects of BINT, summaries of current experimental models of BINT, and a debate about the relative importance of primary blast effects on the acute and long-term consequences of blast exposure.

  18. Computer assisted blast design and assessment tools

    SciTech Connect

    Cameron, A.R.; Kleine, T.H.; Forsyth, W.W.

    1995-12-31

    In general the software required by a blast designer includes tools that graphically present blast designs (surface and underground), can analyze a design or predict its result, and can assess blasting results. As computers develop and computer literacy continues to rise the development of and use of such tools will spread. An example of the tools that are becoming available includes: Automatic blast pattern generation and underground ring design; blast design evaluation in terms of explosive distribution and detonation simulation; fragmentation prediction; blast vibration prediction and minimization; blast monitoring for assessment of dynamic performance; vibration measurement, display and signal processing; evaluation of blast results in terms of fragmentation; and risk and reliability based blast assessment. The authors have identified a set of criteria that are essential in choosing appropriate software blasting tools.

  19. Relationship between Orientation to a Blast and Pressure Wave Propagation Inside the Rat Brian

    DTIC Science & Technology

    2011-01-01

    generated during an explosion may result in brain damage anll related neuro- logical impairments. Several mechanisms by which the primary blast wave can...CSF). to the central nervous system. To address a basic question related to the mechanisms of blast brain injury. pressure was measured inside the...can damage the bra in have been pro- posed, includi ng: ( 1) mechanical displacement of brain resulting in contusions and hemorrhages and direct

  20. Primary structure of a Kunitz-type trypsin inhibitor from Enterolobium contortisiliquum seeds.

    PubMed

    Batista, I F; Oliva, M L; Araujo, M S; Sampaio, M U; Richardson, M; Fritz, H; Sampaio, C A

    1996-03-01

    A trypsin inhibitor was isolated from Enterolobium contortisiliquum seeds. Starting with a saline extract, ECTI (E. contortisiliquum trypsin inhibitor) was purified as a homogeneous protein by acetone precipitation, ion-exchange chromatography (DEAE-Sephadex A-50), gel filtration (Sephadex G-75 and Superose 12) and reversed phase HPLC (mu-Bondapak C-18). The amino acid sequence was determined by automatic degradation and by DABITC/PITC microsequence analysis of the reduced and carboxymethylated protein and also of purified peptides derived from the protein by cleavage with iodosobenzoic acid and by enzymic digestion with trypsin, chymotrypsin and Staphylococcus aureus V8 protease. ECTI contains 174 amino acid residues in two polypeptide chains, an alpha-chain consisting of 134 residues and a beta-chain made up of 40 residues. The inhibitor displays a high degree of sequence identity with other Kunitz-type proteinase inhibitors isolated from the Mimosoideae subfamily. The reactive site was identified (by homology) as the arginine-isoleucine peptide bond at position 64-65. ECTI inhibits trypsin and chymotrypsin in the stoichiometric ratio of 1:1 and also Factor XIIa, plasma kallikrein and plasmin, but not thrombin and Factor Xa.

  1. Global epigenomic analysis of primary human pancreatic islets provides insights into type 2 diabetes susceptibility loci

    PubMed Central

    Stitzel, Michael L.; Sethupathy, Praveen; Pearson, Daniel S.; Chines, Peter S.; Song, Lingyun; Erdos, Michael R.; Welch, Ryan; Parker, Stephen C. J.; Boyle, Alan P.; Scott, Laura J.; Margulies, Elliott H.; Boehnke, Michael; Furey, Terrence S.; Crawford, Gregory E.; Collins, Francis S.

    2010-01-01

    Summary Identifying cis-regulatory elements is important to understand how human pancreatic islets modulate gene expression in physiologic or pathophysiologic (e.g., diabetic) conditions. We conducted genome-wide analysis of DNase I hypersensitive sites, histone H3 lysine methylation modifications (K4me1, K4me3, K79me2), and CCCTC factor (CTCF) binding in human islets. This identified ~18,000 putative promoters (several hundred unannotated and islet-active). Surprisingly, active promoter modifications were absent at genes encoding islet-specific hormones, suggesting a distinct regulatory mechanism. Of 34,039 distal (non-promoter) regulatory elements, 47% are islet-unique and 22% are CTCF-bound. In the 18 type 2 diabetes (T2D)-associated loci, we identified 118 putative regulatory elements and confirmed enhancer activity for 12/33 tested. Among 6 regulatory elements harboring T2D-associated variants, 2 exhibit significant allele-specific differences in activity. These findings present a global snapshot of the human islet epigenome and should provide functional context for non-coding variants emerging from genetic studies of T2D and other islet disorders. PMID:21035756

  2. Failure of isolated kidney transplantation in a pediatric patient with primary hyperoxaluria type 2.

    PubMed

    Naderi, GholamHossein; Latif, AmirHossein; Tabassomi, Firouzeh; Esfahani, Seyed Taher

    2014-05-01

    PH type 2 is caused by decreased activity of GRHPR enzyme that eventually leads to ESRD and systemic oxalosis. Here, we describe an Iranian pediatric patient with PH2 and early ESRD development who received recommended treatment by undergoing isolated kidney transplantation. Diagnosis criteria included a history of reoccurring calcium oxalate renal stones and elevated oxalate levels combined with liver biopsy and decreased enzymatic activity at age five. ESRD prompted transplantation and was performed at age nine. On Day 12 post-op, his serum creatinine level increased. A graft biopsy showed calcium oxalate crystal deposits in renal tubes with no evidence of acute rejection, which resolved with intensive hydration and administration of a potassium citrate solution. Subsequent biopsies confirmed results found in first biopsy. Despite the immunosuppressive therapy, his serum creatinine level increased again after 11 months. Renal tubular obstruction then led to graft nephrectomy. Pathological analysis of tissue confirmed findings of past biopsies. This was a very rare case of early ESRD in PH2 resulting in a failed isolated kidney transplant. As the GRHPR enzyme is predominantly expressed in liver, we suggest a combined liver-kidney transplant may be beneficial in patients with PH2.

  3. Is autoimmunity or insulin resistance the primary driver of type 1 diabetes?

    PubMed

    Wilkin, Terence J

    2013-10-01

    Diabetes is usually classified as autoimmune or metabolic but, as difficulties have arisen with the taxonomy of diabetes, it may help to forego the conventional classification for a more inclusive model. Thus, all diabetes can be ascribed to beta cell insufficiency-hyperglycemia occurs only when the insulin supply fails to meet demand. Humans enter the world with a reserve of beta cells, which is eroded variably by apoptosis over the course of a lifetime. For most, the loss is slow and inconsequential but, for others fast enough to be critical within a lifetime. The challenge now is to define the factors that vary the tempo of beta cell loss, because tempo, not type, seems likely to determine whether diabetes occurs at all, in adulthood or in childhood. Insulin resistance is generally believed to underpin T2D, but has been a feature of insulin-dependent diabetes as well for nearly 80 years, though largely ignored until immunotherapy trials to test the autoimmunity hypothesis persistently failed to bring patient benefit. It seems possible that insulin resistance accelerates beta cell loss generally, its impact modulated by an immune response (autoimmunity) to the beta-cell stress whose intensity varies with immunogenotype. If so, the target for prevention of T1D might more logically lie with insulin sensitivity than with immunoregulation.

  4. [Disease knowledge among type 2 diabetes mellitus patients attending primary care].

    PubMed

    Avilés, Alberto González-Pedraza; Alvara-Solís, Estela Patricia; Martínez-Vázquez, Ricardo; Ponce-Rosas, Raúl Efrén

    2007-01-01

    assess disease knowledge among a patient population. Cross-sectional study in two health care centers belonging to the National Institute of Social Security (ISSSTE). A general knowledge questionnaire was applied to 141 patients with type 2 diabetes mellitus. Chi-square tests to compare demographic variables with knowledge level were used. Alpha was set at p < 0.05. 29.2% of participants scored correct answers and only 12.3% were fully knowledgeable. The highest percentage (42.4%) of correct knowledge was related to levels of blood glucose. There was no association between appropriate metabolical control among patients and disease knowledge. Being younger, having higher education and less than 10 years with the disease generated higher levels of knowledge. Knowledge levels among the studied population are low and similar to the results from the literature. Demographic characteristics such as age and education are associated with changes in degree of knowledge. Patient educational programs are a fundamental component of a comprehensive approach to diabetes prevention.

  5. Life expectancy in a large cohort of type 2 diabetes patients treated in primary care (ZODIAC-10).

    PubMed

    Lutgers, Helen L; Gerrits, Esther G; Sluiter, Wim J; Ubink-Veltmaat, Lielith J; Landman, Gijs W D; Links, Thera P; Gans, Reinold O B; Smit, Andries J; Bilo, Henk J G

    2009-08-28

    Most longitudinal studies showed increased relative mortality in individuals with type 2 diabetes mellitus until now. As a result of major changes in treatment regimes over the past years, with more stringent goals for metabolic control and cardiovascular risk management, improvement of life expectancy should be expected. In our study, we aimed to assess present-day life expectancy of type 2 diabetes patients in an ongoing cohort study. We included 973 primary care type 2 diabetes patients in a prospective cohort study, who were all participating in a shared care project in The Netherlands. Vital status was assessed from May 2001 till May 2007. Main outcome measurement was life expectancy assessed by transforming actual survival time to standardised survival time allowing adjustment for the baseline mortality rate of the general population. At baseline, mean age was 66 years, mean HbA(1c) 7.0%. During a median follow-up of 5.4 years, 165 patients died (78 from cardiovascular causes), and 17 patients were lost to follow-up. There were no differences in life expectancy in subjects with type 2 diabetes compared to life expectancy in the general population. In multivariate Cox regression analyses, concentrating on the endpoints 'all-cause' and cardiovascular mortality, a history of cardiovascular disease: hazard ratio (HR) 1.71 (95% confidence interval (CI) 1.23-2.37), and HR 2.59 (95% CI 1.56-4.28); and albuminuria: HR 1.72 (95% CI 1.26-2.35), and HR 1.83 (95% CI 1.17-2.89), respectively, were significant predictors, whereas smoking, HbA(1c), systolic blood pressure and diabetes duration were not. This study shows a normal life expectancy in a cohort of subjects with type 2 diabetes patients in primary care when compared to the general population. A history of cardiovascular disease and albuminuria, however, increased the risk of a reduction of life expectancy. These results show that, in a shared care environment, a normal life expectancy is achievable in type 2

  6. Life Expectancy in a Large Cohort of Type 2 Diabetes Patients Treated in Primary Care (ZODIAC-10)

    PubMed Central

    Sluiter, Wim J.; Ubink-Veltmaat, Lielith J.; Landman, Gijs W. D.; Links, Thera P.; Gans, Reinold O. B.; Smit, Andries J.; Bilo, Henk J. G.

    2009-01-01

    Background Most longitudinal studies showed increased relative mortality in individuals with type 2 diabetes mellitus until now. As a result of major changes in treatment regimes over the past years, with more stringent goals for metabolic control and cardiovascular risk management, improvement of life expectancy should be expected. In our study, we aimed to assess present-day life expectancy of type 2 diabetes patients in an ongoing cohort study. Methodology and Principal Findings We included 973 primary care type 2 diabetes patients in a prospective cohort study, who were all participating in a shared care project in The Netherlands. Vital status was assessed from May 2001 till May 2007. Main outcome measurement was life expectancy assessed by transforming actual survival time to standardised survival time allowing adjustment for the baseline mortality rate of the general population. At baseline, mean age was 66 years, mean HbA1c 7.0%. During a median follow-up of 5.4 years, 165 patients died (78 from cardiovascular causes), and 17 patients were lost to follow-up. There were no differences in life expectancy in subjects with type 2 diabetes compared to life expectancy in the general population. In multivariate Cox regression analyses, concentrating on the endpoints ‘all-cause’ and cardiovascular mortality, a history of cardiovascular disease: hazard ratio (HR) 1.71 (95% confidence interval (CI) 1.23–2.37), and HR 2.59 (95% CI 1.56–4.28); and albuminuria: HR 1.72 (95% CI 1.26–2.35), and HR 1.83 (95% CI 1.17–2.89), respectively, were significant predictors, whereas smoking, HbA1c, systolic blood pressure and diabetes duration were not. Conclusions This study shows a normal life expectancy in a cohort of subjects with type 2 diabetes patients in primary care when compared to the general population. A history of cardiovascular disease and albuminuria, however, increased the risk of a reduction of life expectancy. These results show that, in a shared care

  7. Evaluation of trauma patterns in blast injuries using multiple correspondence analysis.

    PubMed

    Dussault, Marie Christine; Smith, Martin; Hanson, Ian

    2016-10-01

    Anthropology features little in published literature about blast injuries. Contributions through case studies and experimental research are beginning to expand our understanding of the effect these injuries have on the human skeleton. This study examines blast injury and gunshot related fractures through multiple correspondence analysis (MCA) with the aim of establishing injury patterns between the two types of trauma. Using a sample of 491 individuals from Bosnia, MCA is employed to identify which body regions differentiate between blast or gunshot related fractures. Cranial fractures were more closely associated with gunshot related cases. Post-cranial fractures were associated with blast-related cases. A differentiation in post-cranial and cranial fractures between gunshot and blast related cases was revealed in the samples. The high prevalence of extremity trauma in blast is similar to previous work, but the smaller amount of cranial blast-related fractures differs from previous studies and from what is found in gunshot-related cases. Differentiation of blast and gunshot wound injuries can be made on the human skeleton and can be used to possibly interpret injury mechanism in large skeletal assemblages as well as single cases.

  8. MAGAZINE E30. VIEW FROM BETWEEN 1ST AND 2ND BLAST WALL ...

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

    MAGAZINE E-30. VIEW FROM BETWEEN 1ST AND 2ND BLAST WALL LOOKING TO THE REAR OF THE MAGAZINE. - Naval Magazine Lualualei, Waikele Branch, Tunnel Magazine Type, Waikakalaua & Kipapa Gulches, Pearl City, Honolulu County, HI

  9. MAGAZINE E3. ENTRY WITH DOORS OPEN SHOWING FIRST BLAST WALL ...

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

    MAGAZINE E-3-. ENTRY WITH DOORS OPEN SHOWING FIRST BLAST WALL WITH RANGE POLE. - Naval Magazine Lualualei, Waikele Branch, Tunnel Magazine Type, Waikakalaua & Kipapa Gulches, Pearl City, Honolulu County, HI

  10. Theta blast cell

    SciTech Connect

    Mc Carthy, W.W.

    1987-04-28

    An underground nuclear blast shelter is described comprising: cell means below ground level containing living space for one or more occupants of the shelter; underground command station means separated vertically and horizontally from the cell means having a dome at ground surface for providing access to the shelter, the dome being the only visible portion of the shelter; means for providing communication between the command station means and the cell means including a vertical hollow shaft extending down from the command station means and a horizontal hollow shaft connecting the vertical shaft to the cell means; the command station means including hatch means in the dome to provide the access and means for discharging waste products from the shelter; and flexing means in the vertical shaft to absorb a downward blast force on the dome.

  11. Alumina grit blasting parameters for surface preparation in the plasma spraying operation

    NASA Astrophysics Data System (ADS)

    Mellali, M.; Grimaud, A.; Leger, A. C.; Fauchais, P.; Lu, J.

    1997-06-01

    This paper examines how the grit blasting process influences the surface roughness of different sub-strates, the grit residue, and the grit erosion. The influence of grit blasting conditions on induced sub-strate residual stresses is also discussed. Aluminum alloy, cast iron, and hard steel were blasted with white alumina grits of 0.5,1, and 1.4 mm mean diameters. Grit blasting was performed using either a suction-type or a pressure-type machine equipped with straight nozzles made of B4C. The influence of the follow-ing parameters was studied: grit blasting distance (56 to 200 mm), blasting time (3 to 30 s), angle between nozzle and blasted surface (30°, 60°, 90°), and blasting pressure (0.2 to 0.7 MPa). The roughness of the substrate was characterized either by using a perthometer or by image analysis. The grit residue remain-ing at the blasted surface was evaluated after cleaning by image analysis. The residual stresses induced by grit blasting were determined by using the incremental hole drilling method and by measuring the de-flection of grit-blasted beams. Grit size was determined to be the most important influence on roughness. The average values of Ra and Rt and the percentage of grit residue increased with grit size as well as the depth of the plastic zone under the substrate. An increase of the pressure slightly increased the values of Äa and Rt but also promoted grit breakdown and grit residue. A blasting time of 3 to 6 s was sufficient to obtain the highest roughness and limit the grit breakdown. The residual stresses generated under the blasted surface were compressive, and the depth of the affected zone depended on the grit diameter, the blasting pressure, and the Young’s modulus of the substrate. More-over, the maximum residual stress was reached at the limit of the plastic zone (i.e., several tenths of a mil-limeter below the substrate surface).

  12. NCBI BLAST: a better web interface.

    PubMed

    Johnson, Mark; Zaretskaya, Irena; Raytselis, Yan; Merezhuk, Yuri; McGinnis, Scott; Madden, Thomas L

    2008-07-01

    Basic Local Alignment Search Tool (BLAST) is a sequence similarity search program. The public interface of BLAST, http://www.ncbi.nlm.nih.gov/blast, at the NCBI website has recently been reengineered to improve usability and performance. Key new features include simplified search forms, improved navigation, a list of recent BLAST results, saved search strategies and a documentation directory. Here, we describe the BLAST web application's new features, explain design decisions and outline plans for future improvement.

  13. Prevalence of chronic kidney disease in type 2 diabetes in primary health care unit of Udon Thani province, Thailand.

    PubMed

    Narenpitak, Surapong; Narenpitak, Aphaphan

    2008-10-01

    To determine the prevalence of chronic kidney disease (CKD) in Type 2 diabetes and risk factors of decreased kidney function in Type 2 diabetes at primary health care unit of Udon Thani province. A descriptive cross-sectional study, cluster random sampling method was conducted from April to August 2007. Seven hundred and sixteen patients were enrolled. Medical histories, physical examinations, and blood tests for glucose, creatinine, total cholesterol, and triglyceride after 9-12 hours fasting were collected. The definition and classification of CKD are classified according to K/DOQI guideline 2002. The mean age of the diabetic patients was 58.70 +/- 9.83 years ranged from 30 to 92 years old. The mean duration of diabetes was 5.53 +/- 4.62 years, the majority (82.41%) had diabetes less than 10 years. More than half (51.82%) were obese (BMI > or = 25 kg/m2). Most of them (89.39%) had universal coverage health assurance. According to the ADA guideline 2006, the target systolic blood pressure, diastolic blood pressure, fasting plasma glucose, total cholesterol, and triglyceride level could be achieved 55.45, 52.93, 36.31, 33.66, and 45.65% respectively. The prevalence of CKD stage 3 to 5 were 27.09 and 25.28% by using C-G and MDRD formulae respectively. The duration of diabetes, diabetes with history of hypertension, triglyceride level, and diabetic retinopathy were significant independent risk factors of the presence of decreased kidney function processed by logistic regression analysis. The present study demonstrated the clinical characteristic and the prevalence of decreased kidney function in type 2 diabetes in a primary health care setting. Intensive and optimal treatment of diabetes to slow the progression of long-term complications should be effectively managed by a disciplinary team.

  14. Kerboull-type plate in a direct anterior approach for severe bone defects at primary total hip arthroplasty: technical note

    PubMed Central

    Matsumoto, Mikio; Baba, Tomonori; Ochi, Hironori; Ozaki, Yu; Watari, Taiji; Homma, Yasuhiro; Kaneko, Kazuo

    2017-01-01

    Introduction: For cases with extensive acetabular bone defects, we perform surgery combining the Kerboull-type (KT) plate and bone graft through direct anterior approach (DAA) in primary total hip arthroplasty (THA) requiring acetabular reconstruction as minimally invasive surgery. This paper provides the details of the surgical procedure. Methods: The basic structure of the Kerboull-type plate is a cruciform plate. Since the hook of the Kerboull-type plate has to be applied to the tear drop, a space for it was exposed. The tear drop is located in the anterior lower region in surgery through DAA in supine position. It was also confirmed by fluoroscopy as needed. The bone grafting was performed using an auto- or allogeneic femoral head for bone defects in the weight-bearing region of the hip joint. Results: Of 563 patients who underwent primary THA between 2012 and 2014, THA using the KT plate through DAA was performed in 21 patients (3.7%). The mean duration of postoperative follow-up was 31.8 months. The mean operative time was 188.4 min, and the mean blood loss was 770 g. The patients became able to walk independently after 2.4 days on average (1–4 days). On clinical evaluation, the modified Harris Hip Score was 45.6 ± 12.4 before surgery, and it was significantly improved to 85.3 ± 8.97 on the final follow-up. Discussion: DAA is a true intermuscular approach capable of conserving soft tissue. Since it is applied in a supine position, fluoroscopy can be readily used, and it was very useful to accurately place the plate. PMID:28287388

  15. Cellular Mechanisms and Behavioral Outcomes in Blast-Induced Neurotrauma: Comparing Experimental Setups.

    PubMed

    Bailey, Zachary S; Hubbard, W Brad; VandeVord, Pamela J

    2016-01-01

    Blast-induced neurotrauma (BINT) has increased in incidence over the past decades and can result in cognitive issues that have debilitating consequences. The exact primary and secondary mechanisms of injury have not been elucidated and appearance of cellular injury can vary based on many factors, such as blast overpressure magnitude and duration. Many methodologies to study blast neurotrauma have been employed, ranging from open-field explosives to experimental shock tubes for producing free-field blast waves. While there are benefits to the various methods, certain specifications need to be accounted for in order to properly examine BINT. Primary cell injury mechanisms, occurring as a direct result of the blast wave, have been identified in several studies and include cerebral vascular damage, blood-brain barrier disruption, axonal injury, and cytoskeletal damage. Secondary cell injury mechanisms, triggered subsequent to the initial insult, result in the activation of several molecular cascades and can include, but are not limited to, neuroinflammation and oxidative stress. The collective result of these secondary injuries can lead to functional deficits. Behavioral measures examining motor function, anxiety traits, and cognition/memory problems have been utilized to determine the level of injury severity. While cellular injury mechanisms have been identified following blast exposure, the various experimental models present both concurrent and conflicting results. Furthermore, the temporal response and progression of pathology after blast exposure have yet to be detailed and remain unclear due to limited resemblance of methodologies. This chapter summarizes the current state of blast neuropathology and emphasizes the need for a standardized preclinical model of blast neurotrauma.

  16. Does religious affiliation influence glycaemic control in primary care patients with type 2 diabetes mellitus?

    PubMed Central

    2011-01-01

    Background To determine the relationships between religiosity, religions and glycaemic control of type 2 diabetes mellitus (T2D). Methods This is a cross-sectional study conducted at an urban, university-based, teaching outpatient clinic. Religiosity was assessed with the Beliefs and Values Scale (BV), which contains 20 items each with a Likert scale of five possible responses. The range of scores is 0 to 80, with a higher score indicating stronger religious belief. Glycaemic control was taken as the mean value of the latest three fasting plasma glucose (FPG) levels and HbA1c readings documented in each patient's case records. Results A total of 212 patients participated (a response rate of 79%). Two-thirds were female, mean age was 62.7 (SD 10.8) years and mean duration of T2D was 11.7 (SD 6.7) years. The mean BV score was 57.4 (SD 10.97, CI 55.9, 59.0). Religiosity had a negative correlation with lower FPG (r = −0.15, p = 0.041) but no such correlation was found with HbA1c. Moslem religiosity had a significant negative correlation with HbA1c (r = −0.34, p = 0.007, n = 61) even after controlling for covariates. Christians and non-religious group had significantly lower mean rank HbA1c than other religions (p = 0.042). Conclusions Those with higher religiosity amongst the Moslem population had significantly better glycaemic control. Patients who had church-going religions had better glycaemic control compared with those of other religions. PMID:22479289

  17. Costs Associated With the Primary Prevention of Type 2 Diabetes Mellitus in the Diabetes Prevention Program

    PubMed Central

    2005-01-01

    OBJECTIVE To describe the costs of the Diabetes Prevention Program (DPP) interventions to prevent or delay type 2 diabetes. RESEARCH DESIGN AND METHODS We describe the direct medical costs, direct nonmedical costs, and indirect costs of the placebo, metformin, and intensive lifestyle interventions over the 3-year study period of the DPP. Resource use and cost are summarized from the perspective of a large health system and society. Research costs are excluded. RESULTS The direct medical cost of laboratory tests to identify one subject with impaired glucose tolerance (IGT) was $139. Over 3 years, the direct medical costs of the interventions were $79 per participant in the placebo group, $2,542 in the metformin group, and $2,780 in the lifestyle group. The direct medical costs of care outside the DPP were $272 less per participant in the metformin group and $432 less in the lifestyle group compared with the placebo group. Direct nonmedical costs were $9 less per participant in the metformin group and $1,445 greater in the lifestyle group compared with the placebo group. Indirect costs were $230 greater per participant in the metformin group and $174 less in the lifestyle group compared with the placebo group. From the perspective of a health system, the cost of the metformin intervention relative to the placebo intervention was $2,191 per participant and the cost of the lifestyle intervention was $2,269 per participant over 3 years. From the perspective of society, the cost of the metformin intervention relative to the placebo intervention was $2,412 per participant and the cost of the lifestyle intervention was $3,540 per participant over 3 years. CONCLUSIONS The metformin and lifestyle interventions are associated with modest incremental costs compared with the placebo intervention. The evaluation of costs relative to health benefits will determine the value of these interventions to health systems and society. PMID:12502656

  18. Rapid dissemination of human T-lymphotropic virus type 1 during primary infection in transplant recipients.

    PubMed

    Cook, Lucy B M; Melamed, Anat; Demontis, Maria Antonietta; Laydon, Daniel J; Fox, James M; Tosswill, Jennifer H C; de Freitas, Declan; Price, Ashley D; Medcalf, James F; Martin, Fabiola; Neuberger, James M; Bangham, Charles R M; Taylor, Graham P

    2016-01-08

    Human T-lymphotropic virus type 1 (HTLV-1) infects an estimated 10 million persons globally with transmission resulting in lifelong infection. Disease, linked to high proviral load, occurs in a minority. In established infection HTLV-1 replicates through infectious spread and clonal expansion of infected lymphocytes. Little is known about acute HTLV-1 infection. The kinetics of early HTLV-1 infection, following transplantation-acquired infection in three recipients from one HTLV-1 infected donor, is reported. The recipients were treated with two HTLV-1 enzyme inhibitors 3 weeks post exposure following the detection of HTLV-1 provirus at low level in each recipient. HTLV-1 infection was serially monitored by serology, quantification of proviral load and HTLV-1 2LTR DNA circles and by HTLV-1 unique integration site analysis. HTLV-1 antibodies were first detected 16-39 days post-transplantation. HTLV-1 provirus was detected by PCR on day 16-23 and increased by 2-3 log by day 38-45 with a peak proviral doubling time of 1.4 days, after which steady state was reached. The rapid proviral load expansion was associated with high frequency of HTLV-1 2LTR DNA circles. The number of HTLV-1 unique integration sites was high compared with established HTLV-1 infection. Clonal expansion of infected cells was detected as early as day 37 with high initial oligoclonality index, consistent with early mitotic proliferation. In recipients infected through organ transplantation HTLV-1 disseminated rapidly despite early anti-HTLV-1 treatment. Proviral load set point was reached within 6 weeks. Seroconversion was not delayed. Unique integration site analysis and HTLV-1 2LTR DNA circles indicated early clonal expansion and high rate of infectious spread.

  19. Blast furnace injection symposium: Proceedings

    SciTech Connect

    1996-12-31

    These proceedings contain 14 papers related to blast furnace injection issues. Topics include coal quality, coal grinding, natural gas injection, stable operation of the blast furnace, oxygen enrichment, coal conveying, and performance at several steel companies. All papers have been processed separately for inclusion on the data base.

  20. HIGH PRODUCTIVITY VACUUM BLASTING SYSTEM

    SciTech Connect

    Dr. M.A. Ebadian

    2000-01-13

    The purpose of the project is to increase the productivity and economics of existing vacuum blasting technology. This technology is used to remove radioactive contamination, PCB's and lead-base paint and provides worker and environmental protection by continuously recycling the blast media and the full containment of the dust generated in the process.

  1. Performance of blasting caps

    NASA Technical Reports Server (NTRS)

    Bement, Laurence J. (Inventor); Schimmel, Morry L. (Inventor); Perry, Ronnie B. (Inventor)

    1993-01-01

    Common blasting caps are made from an aluminum shell in the form of a tube which is closed at both ends. One end, which is called the output end, terminates in a principal side or face, and contains a detonating agent which communicates with a means for igniting the detonating agent. The improvement of the present invention is a flat, steel foil bonded to the face in a position which is aligned perpendicularly to the longitudinal axis of the tube.

  2. Primary one-stage reconstruction of cheek defect after a shotgun blast to the face: use of the latissimus dorsi musculocutaneous free flap for soft-tissue repair and facial reanimation.

    PubMed

    Safak, T; Akyürek, M

    2001-10-01

    The authors describe a case of a shotgun blast injury to the face in which early definitive repair of both facial soft tissues and facial reanimation was accomplished in one stage using a free flap. The trauma occurred 2 days before presentation via a hunting rifle fired at a short range. On examination, a 8 x 5-cm cheek defect was evident, involving the full thickness of the perioral facial mimetic muscles as well. A free latissimus dorsi musculocutaneous flap was transferred to the defect, with the thoracodorsal nerve coapted to an ipsilateral, severed buccal branch of the facial nerve. Postoperatively, the flap survived completely, with its skin paddle excised subsequently in two stages. Good muscle movement was obtained, providing resting symmetry and a pleasant smile. Other than soft-tissue and bony defects resulting from shotgun injuries, ablation of the facial nerve or facial mimetic muscles may be an important component of the defect that needs further consideration. The authors conclude that the current technique of one-stage, early definitive repair of soft tissues and facial reanimation in such cases of facial shotgun blast injury offers the advantages of achieving both goals with one flap and accomplishing the procedure primarily in one stage.

  3. Disability evaluation in acoustic blast trauma

    PubMed Central

    Raju, Ganesan

    2015-01-01

    Introduction: Acoustic blast trauma is different from Noise induced hearing loss. Blast trauma can damage the tympanic membrane, ossicles and cochlea singly or in combination. It produces immediate severe hearing loss and may be associated with tinnitus and vestibular symptoms. Hearing loss recovers spontaneously in many cases but may be permanent in 30-55% cases. Thirteen patients working in an explosive manufacturing unit in Andhra Pradesh were exposed to blast trauma at work place. All these workers complained of immediate hearing loss and were subjected to audiological investigations. Methods: Initial evaluation showed a severe sensorineural type of hearing loss 10 of the 13 cases (77%). They were referred to our Medical board for disability evaluation after 2-3 years of initial injury. Pure tone audiometry indicated severe hearing loss in 12 of 13 cases (92%) that was not correlating clinically. Re-evaluation with Acoustic reflex and ABR (BERA) tests were done and permanent disability was evaluated with the results of these investigations. Observations: No significant hearing loss was found in most patients and these patients had minimal disability. Conclusion: Objective hearing tests should be carried out after one year or more before evaluation of permanent disability. PMID:26957811

  4. Blast-related fracture patterns: a forensic biomechanical approach

    PubMed Central

    Ramasamy, Arul; Hill, Adam M.; Masouros, Spyros; Gibb, Iain; Bull, Anthony M. J.; Clasper, Jon C.

    2011-01-01

    Improved protective measures and medical care has increased the survivability from battlefield injuries. In an attempt to reduce the debilitating consequences of blast injury, understanding and mitigating the effects of explosion on the extremities is key. In this study, forensic biomechanical analyses have been applied to determine mechanisms of injury after the traumatic event. The aims of this study were (i) to determine which effects of the explosion are responsible for combat casualty extremity bone injury in two distinct environments, namely open, free-field (open group), and in vehicle or in cover (enclosed group), and (ii) to determine whether patterns of combat casualty bone injury differed between environments. Medical records of casualties admitted to a military hospital in Afghanistan were reviewed over a six-month period. Explosive injuries have been sub-divided traditionally into primary, secondary and tertiary effects. All radiographs were independently reviewed by a military radiologist, a team of military orthopaedic surgeons and a team of academic biomechanists, in order to determine ‘zones of injury’ (ZoIs), and their related mechanisms. Sixty-two combat casualties with 115 ZoIs were identified. Thirty-four casualties in the open group sustained 56 ZoIs; 28 casualties in the enclosed group sustained 59 ZoIs. There was no statistical difference in mean ZoIs per casualty between groups (p = 0.54). There was a higher proportion of lower limb injuries in the enclosed group compared with the open group (p < 0.05). Of the casualties in the open group, 1 ZoI was owing to the primary effects of blast, 10 owing to a combination of primary and secondary blast effects, 23 owing to secondary blast effects and 24 owing to tertiary blast effects. In contrast, tertiary blast effects predominated in the enclosed group, accounting for 96 per cent of ZoIs. These data clearly demonstrate two distinct injury groups based upon the casualties' environment. The

  5. Circulation in blast driven instabilities

    NASA Astrophysics Data System (ADS)

    Henry de Frahan, Marc; Johnsen, Eric

    2016-11-01

    Mixing in many natural phenomena (e.g. supernova collapse) and engineering applications (e.g. inertial confinement fusion) is often initiated through hydrodynamic instabilities. Explosions in these systems give rise to blast waves which can interact with perturbations at interfaces between different fluids. Blast waves are formed by a shock followed by a rarefaction. This wave profile leads to complex time histories of interface acceleration. In addition to the instabilities induced by the acceleration field, the rarefaction from the blast wave decompresses the material at the interface, further increasing the perturbation growth. After the passage of the wave, circulation circulation generated by the blast wave through baroclinic vorticity continues to act upon the interface. In this talk, we provide scaling laws for the circulation and amplitude growth induced by the blast wave. Numerical simulations of the multifluid Euler equations solved using a high-order accurate Discontinuous Galerkin method are used to validate the theoretical results.

  6. NCBI BLAST+ integrated into Galaxy.

    PubMed

    Cock, Peter J A; Chilton, John M; Grüning, Björn; Johnson, James E; Soranzo, Nicola

    2015-01-01

    The NCBI BLAST suite has become ubiquitous in modern molecular biology and is used for small tasks such as checking capillary sequencing results of single PCR products, genome annotation or even larger scale pan-genome analyses. For early adopters of the Galaxy web-based biomedical data analysis platform, integrating BLAST into Galaxy was a natural step for sequence comparison workflows. The command line NCBI BLAST+ tool suite was wrapped for use within Galaxy. Appropriate datatypes were defined as needed. The integration of the BLAST+ tool suite into Galaxy has the goal of making common