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Sample records for proctalgia fugax mid-term

  1. Proctalgia fugax.

    PubMed

    Potter, M A; Bartolo, D C

    2001-11-01

    Proctalgia fugax is a benign, self-limiting pain experienced in the perineum. It is common, but most sufferers do not seek medical advice. The aetiology is unclear, but a variation of irritable bowel syndrome, pelvic floor myalgia, and internal anal sphincter spasm have all been suggested. A careful history can elicit the characteristic history, and simple reassurance is often all that is necessary. For persistent symptoms, therapies that induce internal anal sphincter relaxation are of value.

  2. Amaurosis fugax associated with congenital vascular defect

    PubMed Central

    Giltner, John W; Thomas, Edward R; Rundell, William K

    2016-01-01

    A 68-year-old female with no significant past medical history presented with loss of vision in the lower half of her left eye that lasted <5 minutes. No abnormalities were found on ocular or physical exam. Computed tomography angiography and carotid ultrasound were performed, which confirmed the diagnosis as amaurosis fugax with two abnormalities leading to the transient retinal vessel occlusion. First, it was found that the patient has a congenital vascular anomaly, which consisted most notably of a right-sided aortic arch. This vascular anomaly also consisted of abnormal branching of the left subclavian and common carotid arteries, predisposing the patient to turbulent blood flow and increased risk of the formation of an atherosclerotic plaque at the origin of the common carotid artery. This is an abnormal location for a plaque leading to amaurosis fugax compared to the most common location at the carotid bifurcation. Endarterectomy was not performed because of the difficult location of the plaque and tortuosity of the vessel. Rather, medical intervention with antiplatelet and lipid-lowering therapy was initiated to lower the risk of future retinal or cerebral thromboembolic events. PMID:27445507

  3. Amaurosis fugax: some aspects of management.

    PubMed Central

    Parkin, P J; Kendall, B E; Marshall, J; McDonald, W I

    1982-01-01

    Fifty-one patients with amaurosis fugax were followed for a mean of 4.9 years from their first attack. Females predominated under the age of 50 years in contrast to men who presented in the older age group. Minor permanent visual sequelae occurred in only three patients, but cerebral vascular symptoms were present at some time in just under half the group. A range of abnormalities was identified on cerebral angiography and some of these correlated with certain clinical findings. Twenty patients were treated by surgery and permanent relief of significant improvement in symptoms occurred in 14. A group of patients who were at greater risk of cerebral vascular complications following angiography and surgery was identified. It is concluded that careful patient selection is necessary before surgery is recommended but that in a significant number of cases with relatively focal atheroma confined to one proximal internal carotid artery an excellent long term result following surgery may be expected. Images PMID:7062065

  4. LYRA Mid-Term Periodicities

    NASA Astrophysics Data System (ADS)

    Wauters, L.; Dominique, M.; Dammasch, I. E.

    2016-08-01

    The spectra of the PROBA2/LYRA data, similarly to every other solar time series, show predominant periodicities that can be of solar or instrumental origin. In this article, we compare the main periodicities characterizing the LYRA spectrum to those found in the sunspot number, in the 10.7 cm flux, in an X-ray flare index, and in the sunspot area evolution. We focused on the 2010 to 2014 time range, for which the LYRA data are available, although we also briefly address the evolution of the main periodicities in the longer range. The mid-term periodicities at {˜} 28, {˜} 44, {˜} 54, {˜} 59, {˜} 100, {˜} 110, and {˜} 150 days appear as highly significant in several analyzed datasets. The consistency of distinct periodicities between datasets provides characteristics for the global Sun. This consistency also strengthens the reliability of LYRA data.

  5. Mid term results of Pemberton pericapsular osteotomy

    PubMed Central

    Balioğlu, Mehmet Bülent; Öner, Ali; Aykut, Ümit Selçuk; Kaygusuz, Mehmet Akif

    2015-01-01

    Background: Treatment for developmental dysplasia of the hip (DDH) varies according to the age of the patient. For children under 3 months, the preferred treatment is Pavlik bandaging and/or dynamic hip orthosis;for children of 3–18 months (with/without arthrography), closed and open reductions (ORs) are most common; and for children 18 months and older, pelvic osteotomies are used. Radiological and functional outcomes of patients between 16 months and 7 years of age who underwent Pemberton pericapsular osteotomy (PPO) were evaluated. Materials and Methods: Twelve patients with developmental dysplasia of the hip (DDH) received treatment on 14 hips between 2001 and 2006. All patients with DDH had PPO as pelvic osteotomy. PPO was done solely in 3 hips, PPO and open reduction (OR) in and OR + PPO + femoral shortening in 6. The average age was 39.85 months (range 16–83 months). All had 1-stage surgery. Acetabular index (AI) and the grade of displacement were determined according to Tönnis’. Center-edge (CE) angle was evaluated. Clinical evaluations were made as described by McKay, radiological assessments by Severin's criteria and femoral head avascular necrosis measurements by Kalamchi–MacEwen's criteria. Average followup periods were 83.35 months (range 48–115 months). Results: Preoperative and postoperative average AI levels were 41.92° (range 30–50°) and 19,5° (range 5–34°), respectively (P < 0.001). According to Severin's classification, 11 (78.57%) patients were Ia, 1 (7.14%) was Ib, 1 (7.14%) was II and 1 (7.14%) was III. According to Kalamchi–McEven criteria, 12 (85.71%) patients were type I, 2 (14.28%) patients were type II. CE postoperatively was measured as 24.24° (range 12–41°). Clinically (McKay), the functional results in 13 (92.85%) patients were very good (I) and in 1 (7.14%) was good (II). Conclusions: Functional and radiological mid term outcomes were found to be comparable in most of the patients with DDH undergoing PPO

  6. Chronic proctalgia and chronic pelvic pain syndromes: New etiologic insights and treatment options

    PubMed Central

    Chiarioni, Giuseppe; Asteria, Corrado; Whitehead, William E

    2011-01-01

    This systematic review addresses the pathophysiology, diagnostic evaluation, and treatment of several chronic pain syndromes affecting the pelvic organs: chronic proctalgia, coccygodynia, pudendal neuralgia, and chronic pelvic pain. Chronic or recurrent pain in the anal canal, rectum, or other pelvic organs occurs in 7% to 24% of the population and is associated with impaired quality of life and high health care costs. However, these pain syndromes are poorly understood, with little research evidence available to guide their diagnosis and treatment. This situation appears to be changing: A recently published large randomized, controlled trial by our group comparing biofeedback, electrogalvanic stimulation, and massage for the treatment of chronic proctalgia has shown success rates of 85% for biofeedback when patients are selected based on physical examination evidence of tenderness in response to traction on the levator ani muscle-a physical sign suggestive of striated muscle tension. Excessive tension (spasm) in the striated muscles of the pelvic floor appears to be common to most of the pelvic pain syndromes. This suggests the possibility that similar approaches to diagnostic assessment and treatment may improve outcomes in other pelvic pain disorders. PMID:22110274

  7. Chronic proctalgia and chronic pelvic pain syndromes: new etiologic insights and treatment options.

    PubMed

    Chiarioni, Giuseppe; Asteria, Corrado; Whitehead, William E

    2011-10-28

    This systematic review addresses the pathophysiology, diagnostic evaluation, and treatment of several chronic pain syndromes affecting the pelvic organs: chronic proctalgia, coccygodynia, pudendal neuralgia, and chronic pelvic pain. Chronic or recurrent pain in the anal canal, rectum, or other pelvic organs occurs in 7% to 24% of the population and is associated with impaired quality of life and high health care costs. However, these pain syndromes are poorly understood, with little research evidence available to guide their diagnosis and treatment. This situation appears to be changing: a recently published large randomized, controlled trial by our group comparing biofeedback, electrogalvanic stimulation, and massage for the treatment of chronic proctalgia has shown success rates of 85% for biofeedback when patients are selected based on physical examination evidence of tenderness in response to traction on the levator ani muscle--a physical sign suggestive of striated muscle tension. Excessive tension (spasm) in the striated muscles of the pelvic floor appears to be common to most of the pelvic pain syndromes. This suggests the possibility that similar approaches to diagnostic assessment and treatment may improve outcomes in other pelvic pain disorders.

  8. A traveling "spot sign" in recurrent amaurosis fugax and central retinal artery occlusion.

    PubMed

    Nedelmann, Max; Tanislav, Christian; Kaps, Manfred

    2014-10-01

    Sudden monocular blindness is frequently caused by central retinal artery occlusion (CRAO) from embolic sources. Treatment options are insufficient, and spontaneous prognosis toward visual recovery is poor. In addition to ophthalmologic evaluation, transorbital sonographic assessment of the central retinal artery may help establish early diagnosis by Doppler sonographic proof of occlusion and, in some cases, by B-mode detection of an intra-arterial "spot sign". We report the case of a patient with recurrent amaurosis fugax and subsequent CRAO. Ultrasound examination after 2 incidences of amaurosis fugax demonstrated a patent but stenotic central retinal artery, with stenosis caused by an embolus visualized as a "spot sign". The following day, persisting amaurosis suddenly developed. Sonographic re-evaluation revealed downstream dislodgment of the "spot sign" and complete arterial occlusion. Thrombolytic treatment did not result in clinical improvement. In conclusion, this case report describes a single case of repeated amaurosis fugax and deterioration to CRAO via embolization into the central retinal artery and consecutive downstream dislodgment. It emphasizes that ultrasound may render valuable diagnostic information in patients with acute central retinal artery embolization toward its embolic etiology and its risk of subsequent deterioration. PMID:24957310

  9. Mid-term results of tibial plateau fractures.

    PubMed

    Yong, C K; Choon, David S K

    2005-07-01

    We studied the factors influencing the mid-term outcomes of tibial plateau fractures treated conservatively (n=21) and surgically (n=27) from December 1994 to December 1997. Joint stability was an important prognostic determinant. In the surgical group, the most important factor was good anatomical reduction. Functional outcomes were comparable between the conservative and surgical groups. We concluded that conservative treatment is a valid option for fractures with minimal displacement and surgical treatment is justified for severely displaced or depressed fractures. Attention must be paid to the recognition and restoration of joint stability and articular surface congruency for a satisfactory outcome.

  10. A financial indicator for mid-term tendencies

    NASA Astrophysics Data System (ADS)

    Leonel Caetano, Marco Antonio; Yoneyama, Takashi

    2007-11-01

    This work proposes an heuristic indicator for mid-term tendencies of stock prices based on non-linear dynamic equations combined with a graphical method inspired on cell morphology analysis. The model consists of ordinary differential equations with parameters that are fitted by means of the actual data history of stock prices using Extended Kalman Filter. The model structures are to be chosen so as to adequately represent the specific microeconomic condition, such as oligopoly with leader and follower, economic clusters, firms producing complementary products and others. The equations are solved numerically and the trajectories in the phase plane are associated with cell membranes. In an analogy with the increase in the cell volume when its internal pressure rises, the new financial indicator expresses the increase of the stress in a stock market by means of expanding phase portraits.

  11. Amaurosis fugax

    MedlinePlus

    ... patients describe the loss of vision as a gray or black shade coming down over their eye. If the blockage continues, vision loss may be followed by more serious nervous system symptoms. These symptoms can be similar to those ...

  12. Mid-Term Probabilistic Forecast of Oil Spill Trajectories

    NASA Astrophysics Data System (ADS)

    Castanedo, S.; Abascal, A. J.; Cardenas, M.; Medina, R.; Guanche, Y.; Mendez, F. J.; Camus, P.

    2012-12-01

    There is increasing concern about the threat posed by oil spills to the coastal environment. This is reflected in the promulgation of various national and international standards among which are those that require companies whose activities involves oil spill risk, to have oil pollution emergency plans or similar arrangements for responding promptly and effectively to oil pollution incidents. Operational oceanography systems (OOS) that provide decision makers with oil spill trajectory forecasting, have demonstrated their usefulness in recent accidents (Castanedo et al., 2006). In recent years, many national and regional OOS have been setup focusing on short-term oil spill forecast (up to 5 days). However, recent accidental marine oil spills (Prestige in Spain, Deep Horizon in Gulf of Mexico) have revealed the importance of having larger prediction horizons (up to 15 days) in regional-scale areas. In this work, we have developed a methodology to provide probabilistic oil spill forecast based on numerical modelling and statistical methods. The main components of this approach are: (1) Use of high resolution long-term (1948-2009) historical hourly data bases of wind, wind-induced currents and astronomical tide currents obtained using state-of-the-art numerical models; (2) classification of representative wind field patterns (n=100) using clustering techniques based on PCA and K-means algorithms (Camus et al., 2011); (3) determination of the cluster occurrence probability and the stochastic matrix (matrix of transition of probability or Markov matrix), p_ij, (probability of moving from a cluster "i" to a cluster "j" in one time step); (4) Initial state for mid-term simulations is obtained from available wind forecast using nearest-neighbors analog method; (5) 15-days Stochastic Markov Chain simulations (m=1000) are launched; (6) Corresponding oil spill trajectories are carried out by TESEO Lagrangian transport model (Abascal et al., 2009); (7) probability maps are

  13. Teaching about the 2010 Mid-Term Election Using the Internet

    ERIC Educational Resources Information Center

    Risinger, C. Frederick

    2010-01-01

    Mid-term elections, particularly in a president's first term, can be as significant as presidential elections. They can determine whether or not a president and his party can fulfill promises and achieve goals that they set for the nation when elected. In this article, the author recommends websites that can help guide students in understanding…

  14. Nextgen Technologies for Mid-Term and Far-Term Air Traffic Control Operations

    NASA Technical Reports Server (NTRS)

    Prevot, Thomas

    2009-01-01

    This paper describes technologies for mid-term and far-term air traffic control operations in the Next Generation Air Transportation System (NextGen). The technologies were developed and evaluated with human-in-the-loop simulations in the Airspace Operations Laboratory (AOL) at the NASA Ames Research Center. The simulations were funded by several research focus areas within NASA's Airspace Systems program and some were co-funded by the FAA's Air Traffic Organization for Planning, Research and Technology.

  15. Mid-term outcome after surgical repair of congenital supravalvular aortic stenosis by extended aortoplasty

    PubMed Central

    Bakhtiary, Farhad; Amer, Mohammed; Etz, Christian D.; Dähnert, Ingo; Wilhelm Mohr, Friedrich; Bellinghausen, Wilfried; Kostelka, Martin

    2013-01-01

    OBJECTIVES Congenital supravalvular aortic stenosis (SVAS) is a rare arteriopathy associated with the Williams–Beuren syndrome (WBS) and other elastin gene deletions. Our objective was to review the mid-term outcomes of SVAS repair with extended aortoplasty. METHODS Congenital SVAS repairs from 2001 to 2010 were retrospectively reviewed. The follow-up records, reintervention and reoperation data and most recent echocardiograms were obtained. RESULTS From 2001 to 2010, 21 patients (15 males) underwent surgical repair of SVAS by extended aortoplasty with autologous pretreated pericardium, which is a modification of the Doty technique. The mean age was 3.1 ± 4.2 years. WBS was diagnosed in 14 of the patients. There was no early mortality, but one late death was observed. At the latest follow-up (mean follow-up, 4.3 ± 2.9 years; range, 1–108 months), echocardiograms revealed a peak Doppler gradient across the aortic outflow tract of 15 ± 8 mmHg. The majority of the patients had minimal to mild aortic insufficiency. No reoperation or reintervention was required. CONCLUSIONS Extended aortoplasty provides excellent mid-term relief of SVAS and, in addition, reshapes the aortic root geometry to a much more favourable anatomical configuration. It can be performed without any increase in operative risks. The mid-term results are excellent. PMID:23793710

  16. Effects of treadmill running on mid-term memory and swim speed in the rat with Morris water maze test.

    PubMed

    Alaei, HojjatAllah; Moloudi, Rohallah; Sarkaki, Ali Reza

    2008-01-01

    Previous studies involving exercise and memory showed that learning and memory were improved by exercise. This study was performed to find the effect of treadmill running on memory. Mid-term memory and swim speed were measured within 8 days. Twenty rats were divided into two groups, a control and a test group. Mid-term memory and swim speed were measured in the Morris water maze apparatus. Our results showed that treadmill running produced a significant enhancement on mid-term memory and swim speed in the test group, which may be mediated by specific molecular pathways.

  17. Short- and Mid-term Effects of Irreversible Electroporation on Normal Renal Tissue: An Animal Model

    SciTech Connect

    Wendler, J. J. Porsch, M.; Huehne, S.; Baumunk, D.; Buhtz, P.; Fischbach, F.; Pech, M.; Mahnkopf, D.; Kropf, S.; Roessner, A.; Ricke, J.; Schostak, M.; Liehr, U.-B.

    2013-04-15

    Irreversible electroporation (IRE) is a novel nonthermal tissue ablation technique by high current application leading to apoptosis without affecting extracellular matrix. Previous results of renal IRE shall be supplemented by functional MRI and differentiated histological analysis of renal parenchyma in a chronic treatment setting. Three swine were treated with two to three multifocal percutaneous IRE of the right kidney. MRI was performed before, 30 min (immediate-term), 7 days (short-term), and 28 days (mid-term) after IRE. A statistical analysis of the lesion surrounded renal parenchyma intensities was made to analyze functional differences depending on renal part, side and posttreatment time. Histological follow-up of cortex and medulla was performed after 28 days. A total of eight ablations were created. MRI showed no collateral damage of surrounded tissue. The highest visual contrast between lesions and normal parenchyma was obtained by T2-HR-SPIR-TSE-w sequence of DCE-MRI. Ablation zones showed inhomogeneous necroses with small perifocal edema in the short-term and sharp delimitable scars in the mid-term. MRI showed no significant differences between adjoined renal parenchyma around ablations and parenchyma of untreated kidney. Histological analysis demonstrated complete destruction of cortical glomeruli and tubules, while collecting ducts, renal calyxes, and pelvis of medulla were preserved. Adjoined kidney parenchyma around IRE lesions showed no qualitative differences to normal parenchyma of untreated kidney. This porcine IRE study reveals a multifocal renal ablation, while protecting surrounded renal parenchyma and collecting system over a mid-term period. That offers prevention of renal function ablating centrally located or multifocal renal masses.

  18. Mid term results of Furlong LOL uncemented hip hemiarthroplasty for fractures of the femoral neck.

    PubMed

    Chandran, Prakash; Azzabi, Mohammed; Burton, Dave J C; Andrews, Mark; Bradley, John G

    2006-08-01

    We report the mid-term results of hemiarthroplasty with the Furlong hydroxyapatite coated bipolar prosthesis for displaced (Garden type III and IV) intracapsular hip fracture in 480 patients operated between 1989 and 2000. Three hundred sixty eight (77%) patients were lost to follow-up due to death, dementia or movement away from the area. In the patients followed up there was an 8% reoperation rate for infection, aseptic loosening, periprosthetic fracture and acetabular erosion. One hundred and twelve patients with a mean follow-up of 4 years (3-14) were studied. Eighty eight percent had no or slight pain, 77% could mobilise outdoors and 89% needed either no aid or a single walking stick to mobilise. Radiographic assessment revealed a stable implant with visible osseointegration in 91%. We conclude that hemiarthroplasty with the hydroxyapatite coated bipolar Furlong LOL prosthesis for displaced intracapsular fracture of the neck of the femur gives good mid term results in elderly patients for return to mobility, use of mobility aids and freedom from pain. It avoids the need for cement and provides satisfactory incorporation into the host bone. The use of a modular head makes revision to total hip replacement easier.

  19. BLEED-Myocardial Infarction Score: Predicting mid-term post-discharge bleeding events

    PubMed Central

    Barra, Sérgio; Providência, Rui; Caetano, Francisca; Almeida, Inês; Paiva, Luís; Dinis, Paulo; Leitão Marques, António

    2013-01-01

    AIM: To derive and validate a score for the prediction of mid-term bleeding events following discharge for myocardial infarction (MI). METHODS: One thousand and fifty patients admitted for MI and followed for 19.9 ± 6.7 mo were assigned to a derivation cohort. A new risk model, called BLEED-MI, was developed for predicting clinically significant bleeding events during follow-up (primary endpoint) and a composite endpoint of significant hemorrhage plus all-cause mortality (secondary endpoint), incorporating the following variables: age, diabetes mellitus, arterial hypertension, smoking habits, blood urea nitrogen, glomerular filtration rate and hemoglobin at admission, history of stroke, bleeding during hospitalization or previous major bleeding, heart failure during hospitalization and anti-thrombotic therapies prescribed at discharge. The BLEED-MI model was tested for calibration, accuracy and discrimination in the derivation sample and in a new, independent, validation cohort comprising 852 patients admitted at a later date. RESULTS: The BLEED-MI score showed good calibration in both derivation and validation samples (Hosmer-Lemeshow test P value 0.371 and 0.444, respectively) and high accuracy within each individual patient (Brier score 0.061 and 0.067, respectively). Its discriminative performance in predicting the primary outcome was relatively high (c-statistic of 0.753 ± 0.032 in the derivation cohort and 0.718 ± 0.033 in the validation sample). Incidence of primary/secondary endpoints increased progressively with increasing BLEED-MI scores. In the validation sample, a BLEED-MI score below 2 had a negative predictive value of 98.7% (152/154) for the occurrence of a clinically significant hemorrhagic episode during follow-up and for the composite endpoint of post-discharge hemorrhage plus all-cause mortality. An accurate prediction of bleeding events was shown independently of mortality, as BLEED-MI predicted bleeding with similar efficacy in patients who

  20. A mid-term analysis of progress toward international biodiversity targets.

    PubMed

    Tittensor, Derek P; Walpole, Matt; Hill, Samantha L L; Boyce, Daniel G; Britten, Gregory L; Burgess, Neil D; Butchart, Stuart H M; Leadley, Paul W; Regan, Eugenie C; Alkemade, Rob; Baumung, Roswitha; Bellard, Céline; Bouwman, Lex; Bowles-Newark, Nadine J; Chenery, Anna M; Cheung, William W L; Christensen, Villy; Cooper, H David; Crowther, Annabel R; Dixon, Matthew J R; Galli, Alessandro; Gaveau, Valérie; Gregory, Richard D; Gutierrez, Nicolas L; Hirsch, Tim L; Höft, Robert; Januchowski-Hartley, Stephanie R; Karmann, Marion; Krug, Cornelia B; Leverington, Fiona J; Loh, Jonathan; Lojenga, Rik Kutsch; Malsch, Kelly; Marques, Alexandra; Morgan, David H W; Mumby, Peter J; Newbold, Tim; Noonan-Mooney, Kieran; Pagad, Shyama N; Parks, Bradley C; Pereira, Henrique M; Robertson, Tim; Rondinini, Carlo; Santini, Luca; Scharlemann, Jörn P W; Schindler, Stefan; Sumaila, U Rashid; Teh, Louise S L; van Kolck, Jennifer; Visconti, Piero; Ye, Yimin

    2014-10-10

    In 2010, the international community, under the auspices of the Convention on Biological Diversity, agreed on 20 biodiversity-related "Aichi Targets" to be achieved within a decade. We provide a comprehensive mid-term assessment of progress toward these global targets using 55 indicator data sets. We projected indicator trends to 2020 using an adaptive statistical framework that incorporated the specific properties of individual time series. On current trajectories, results suggest that despite accelerating policy and management responses to the biodiversity crisis, the impacts of these efforts are unlikely to be reflected in improved trends in the state of biodiversity by 2020. We highlight areas of societal endeavor requiring additional efforts to achieve the Aichi Targets, and provide a baseline against which to assess future progress.

  1. Mid-term Stability of Novel Mica-based Compressive Seals for Solid Oxide Fuel Cells

    SciTech Connect

    Chou, Y S.; Stevenson, Jeffry W.

    2003-04-10

    A novel mica-based hybrid compressive seal was examined the stability at elevated temperatures under the compressive stress. The hybrid mica compressive seals were composed of the Muscovite mica and two compliant inter-layers and were reported earlier to have ultra-low leak rates at 800 C. In this paper, we examined the mid-term ({approx}350-700 hours) stability of the mica-based compressive seals with three different inter-layers: a low melting borosilicate glass, a glass ceramics, and a metallic material. The 800 C leak test results showed excellent stability for the three different inter-layers in air at a compressive stress of 100 psi that the leak rates remained almost unchanged during the test. Microstructure characterization of the interface showed very limited interfacial reaction or glass penetration at the 8YSZ substrate interface. The results clearly demonstrate the applicability of the mica-based compressive seals for solid oxide fuel cells.

  2. Mid-term biochemical recurrence-free outcomes following robotic versus laparoscopic radical prostatectomy.

    PubMed

    Rochat, Charles-Henry; Sauvain, Jean; Dubernard, Pierre; Hebert, April E; Kreaden, Usha

    2011-12-01

    We compared 5-year biochemical recurrence (BCR)-free rates for robotic-assisted laparoscopic prostatectomy (RALP) and laparoscopic radical prostatectomy (LRP). Three hundred and twelve consecutive patients who underwent RALP from 2003 to 2008 were compared to 97 consecutive LRP patients from 1999 to 2004. All laparoscopic surgeries were performed by one surgeon and robotic surgeries were performed by this surgeon or a laparoscopically naïve surgeon. Both groups were evaluated for perioperative outcome, pathologic status, and mid-term oncologic outcomes (5-year BCR-free rates at prostate-specific antigen [PSA] cutoffs of <0.4, <0.2, or <0.1 ng/ml). Baseline characteristics were equivalent except for age (61.9 years vs. 65.1 years, P < 0.0001). RALP operating time was shorter (215.5 min vs. 305.3, P < 0.0001), and resulted in fewer complications (3.8% vs. 10.3%, P = 0.0214) and blood transfusions (2.9% vs. 13.4%, P = 0.0003). Positive surgical margins were equivalent (pT2 20.9% vs. 28.8%, P = 0.1818). Overall 5-year BCR-free rates were comparable for RALP (97.6, 93.4, and 85.1%) and LRP (97.7, 89.7, and 79.7%) at PSA cutoff levels of <0.4, <0.2, and <0.1 ng/ml, respectively. There was a significant difference in BCR-free rates between the RALP and LRP groups for patients with organ-confined (pT2) disease at 0.2 ng/ml (96.4% vs. 88.7%, P = 0.0373) and 0.1 ng/ml (91.0% vs. 83.0%, P = 0.0470). We report lower morbidity, comparable pathologic outcome and improved mid-term oncologic results in patients with organ-confined disease after RALP in comparison to LRP. PMID:27628114

  3. Mid-term results of an uncemented femoral stem with modular neck options.

    PubMed

    Benazzo, Francesco; Rossi, Stefano M P; Cecconi, Davide; Piovani, Lucio; Ravasi, Flavio

    2010-01-01

    We prospectively assessed the results of 239 primary total hip replacements performed using a conical stem combined with modular necks of different lengths and inclinations (Modulus System, Lima Corporate San Daniele Del Friuli, Udine, Italia) in 222 patients (50 men, 172 women), undergoing surgery between October 2001 and December 2006 and presenting with anatomical deformities of the proximal femur and/or acetabulum, including developmental dysplasia (DDH), ankylosis, and sequelae of osteotomies or fractures. Such conditions can make hip replacement problematic. The mean age at the time of surgery was 57.6 years (22 ÷ 83). No patients were lost to follow-up. 3 femoral components underwent revision. At a mean of 5 years follow-up the Harris Hip Score showed a significant improvement, increasing from 35 preoperatively to a mean of 96.6. Using Kaplan-Meier analysis the survival rate at 5 years was 98.28%. The Modulus stem showed good mid-term results in terms of survival, as well as clinical and radiographic outcome.

  4. Mid-term Results of Revision Total Hip Arthroplasty Using Modular Cementless Femoral Stems

    PubMed Central

    Jang, Hyung-Gyu; Min, Byung-Woo; Ye, Hee-Uk; Lim, Kyung-Hwan

    2015-01-01

    Purpose The purpose of this study was to evaluate the clinical and radiological results of revision total hip arthroplasty using modular distal fixation stems for proximal femoral deficiency. Materials and Methods Forty-five patients (47 hips) were analyzed more than 24 months after revision total hip arthroplasty that used modular distal fixation stems and was performed between 2006 and 2012. There were proximal femoral defects in all cases. Preoperative femoral defect classification revealed Paprosky type II in 31 cases, type IIIA in 7, and type IIIB in 9. The mean duration of follow-up was 53.4 (25-100) months. We evaluated the Harris hip score (HHS), walking ability according to Koval as clinical parameters, stem stability, and stem position change as radiographic parameters. Kaplan-Meier survival analysis was performed. Results The average HHS improved form 39.5 points to 91.3 points and walking ability also improved in most cases; all patients had stable fixation of the femoral stem. Postoperative complications included 5 cases of infection and 2 cases of dislocation. The survival rate with the end point of re-revision surgery due to infection or dislocation was 86% after 8-year follow-up. Conclusion Cementless revision total hip arthroplasty using modular femoral stems is useful because the stems can be stably fixed on the diaphyseal portion of the femur, which has relatively good bone quality at mid-term follow-up. PMID:27536616

  5. Image-guided percutaneous microwave ablation of small renal tumours: short- and mid-term outcomes

    PubMed Central

    Genson, Pierre-Yves; Mourey, Eric; Moulin, Morgan; Favelier, Sylvain; Di Marco, Lucy; Chevallier, Olivier; Cercueil, Jean-Pierre; Krausé, Denis; Cormier, Luc

    2015-01-01

    Background The purpose is to assess the short- and mid-term outcomes of microwave ablation (MWA) of small renal tumours in selected patients. Methods From August 2012 to February 2015, 29 renal tumours in 23 patients (17 male, 6 female, mean age 75 years) were treated by percutaneous MWA under imaging guidance. The tumours were 1-4.7 cm in diameter (mean size, 2.7 cm). Therapeutic effects were assessed at follow-up with magnetic resonance imaging (MRI). All patients were followed up for 2-25 months (mean, 12.2 months) to observe the therapeutic effects and complications. Changes in renal function at day 1 after treatment were statistically analyzed using the Student paired t-test or the paired Wilcoxon test. Results Technical success was achieved in all cases. One severe bleeding complication post-procedure occurred leading to death. No other unexpected side effects were observed after the MWA procedures. Clinical effectiveness was 100%. None of the patients showed recurrence on MRI imaging follow-up. No significant changes in renal function were noted after treatment (P=0.57). Conclusions Our preliminary study demonstrates that the use of MWA for the treatment of small renal tumours can be applied as safely and efficiently as other ablative techniques in selected patients not eligible for surgery. PMID:26682134

  6. The Avon Patellofemoral Joint Replacement: Mid-Term Prospective Results from an Independent Centre

    PubMed Central

    Akhbari, Pouya; Malak, Tamer; East, Debra; Miles, Kim; Butler-Manuel, P. Adrian

    2015-01-01

    Background Approximately 10% of patients with osteoarthritis (OA) of the knee have unicompartmental OA confined to the patellofemoral joint (PFJ). The main surgical options are total knee replacement (TKR) and PFJ replacement (PFJR). PFJR has a number of advantages over TKR, including being less invasive, preserving the unaffected parts of the knee, allowing faster recovery and better range of motion and function. We report our prospective mid-term results of the Avon PFJR for established isolated PFJ arthritis in 61 consecutive procedures. Methods Sixty-one Avon PFJRs were performed in 57 patients. The outcome measures were the new Oxford knee score (OKS), Hungerford and Kenna score (HKS), and Crosby Insall knee scores. Only patients with severe isolated PFJ OA were included. The diagnosis was based on a combination of clinical, radiological and, where available, arthroscopic findings. Results Mean follow-up was 5.09 years (range, 12 to 124 years). There were 2 revisions in the first 5 years. The median HKS score was 80 (interquartile range, 70 to 95) and the mean OKS was 31.8 (± standard deviation, 8.7) at 5 years. These were significantly better (p < 0.001) than the preoperative scores. Conclusions The Avon prosthesis gives good functional outcomes in the medium term and survives well. Our data support other studies in the literature and is the largest independent prospective study to date. PMID:26217462

  7. Mid-term stability of novel mica-based compressive seals for solid oxide fuel cells

    NASA Astrophysics Data System (ADS)

    Chou, Yeong-Shyung; Stevenson, Jeffry W.

    A novel mica-based compressive seal concept was examined at elevated temperatures under compressive stress to evaluate its stability. The "hybrid" mica compressive seals, composed of cleaved Muscovite mica and two compliant inter-layers, were reported earlier to have very low leak rates at 800 °C. In the present study, we examined the mid-term (˜350-700 h) stability of the mica-based compressive seals with three different inter-layers: a low melting borosilicate glass, a glass ceramic material, and a metallic material. The 800 °C leak test results showed excellent stability for the three different inter-layers in air at a compressive stress of 100 psi as the leak rates remained almost unchanged during the test. Microstructural characterization of the interfaces showed very limited interfacial reaction or glass penetration at the glass/8YSZ substrate interface. The results clearly demonstrate the applicability of the mica-based compressive seals for solid oxide fuel cells.

  8. Early and mid-term results of minimally invasive coronary artery bypass grafting

    PubMed Central

    Pande, Shantanu; Agarwal, Surendra K.; Gupta, Devendra; Mohanty, Satayapriya; Kapoor, Aditya; Tewari, Satyendra; Bansal, Anubhav; Ambesh, Sushil P.

    2014-01-01

    Introduction Minimally invasive coronary artery bypass grafting (MICABG) is a less invasive method of performing surgical revascularization. This technique coupled with use of off pump technique of surgical revascularization makes it truly less invasive. This method is highly effective even in high-risk patients. Results of this procedure are comparable to standard off pump technique and are better than percutaneous coronary intervention utilizing drug-eluting stent. We present an early and mid-term result of the use of this technique. Method We enrolled 33 patients for analysis operated between 2008 and 2012. Operation was performed utilizing off-pump technique of coronary artery bypass grafting through a minimal invasive incision. Left internal mammary artery graft was done for single vessel disease and radial artery was utilized for other grafts if required. Median follow up of 2.5 years (6 months–4 years) is available. Results Median age was 58.5 years (41–77) and all were male. Single vessel disease was present in 7, double vessel in 14 and triple vessel disease in 12 patients. All the patients had normal left ventricular size and function. There was no operative and 30-day mortality. Conversion to median sternotomy to complete the operation was done in 6.6% (2 out of 33 patients). One patient had acute myocardial infarction and there were no deaths during follow up. Conclusion MICABG is a safe and effective method of revascularization in low risk candidates for coronary artery bypass grafting. PMID:24814114

  9. Mid-Term Results of Dual-Chamber Pacing in Children with Hypertrophic Obstructive Cardiomyopathy.

    PubMed

    Alday, Luis E.; Bruno, Eva; Moreyra, Eduardo; Amuchastegui, Luis M.; Juaneda, Ernesto; Maisuls, Hector

    1998-04-01

    BACKGROUND: Permanent dual-chambered pacing (DDD) is an alternative to surgical treatment in patients with severe hypertrophic obstructive cardiomyopathy (HOCM) who do not have a satisfactory response to medical treatment. METHODS: Five children with severe HOCM still symptomatic despite medical treatment underwent permanent DDD pacing and were followed for 21 +/- 9.7 months. RESULTS: All patients improved their functional class. Doppler echocardiographic studies showed an early reduction of the left ventricular outflow tract gradient from 66 +/- 40 to 40 +/- 20 mmHg (P < 0.05) and to 30 +/- 11 mmHg (P < 0.05 and NS for comparison with the baseline and the early post-DDD pacing gradients, respectively) at mid-term follow-up. There was no evidence of left ventricular systolic dysfunction, and the results of left ventricular filling studies ruled out deleterious effects on diastolic function. Doppler echocardiography played a key role in the initial and subsequent assessment of these patients. CONCLUSIONS: Permanent DDD pacing is a reasonable alternative to surgery in children with HOCM who are still symptomatic despite medical therapy.

  10. Progress and Achievements at the Mid Term Stage of the Dragon 3 Programme

    NASA Astrophysics Data System (ADS)

    Desnos, Yves-Louis; Li, Zengyuan; Zmuda, Andy; Gao, Zhihai

    2014-11-01

    The Dragon Programme is a joint undertaking between ESA and the Ministry of Science and Technology (MOST) of China and the National Remote Sensing Center of China (NRSCC). Its purpose is to encourage increased exploitation of ESA and Chinese space resources within China as well as stimulate increased scientific cooperation in the field of Earth Observation (EO) science and applications between China and Europe. Since 2004, this pioneering programme has become a model for scientific and technological cooperation between China and Europe. By successfully encouraging joint research using ESA, Third Party Missions and Chinese EO data across a range of thematic areas, Dragon continues to deliver outstanding scientific results. The programme has successfully completed two phases, Dragon 1 from 2004 to 2008, Dragon 2 from 2008 to 2012. The third phase of Dragon was started in 2012 and will be completed in 2016. The Dragon 3 project teams are led by leading EO scientists and young scientists are also engaged on the projects. Advanced training in land, ocean and atmospheric applications is a feature of the programme and a course on land and one course on ocean applications have been successfully held in 2012 and 2013 in China. Here-in provided is an overview of the results, reporting and training activities at the mid-term stage of the programme.

  11. Short and mid-term effects of different biochar additions on soil GHG fluxes

    NASA Astrophysics Data System (ADS)

    Maier, Regine; Soja, Gerhard; Friesl-Hanl, Wolfgang; Dunst, Gerald; Kitzler, Barbara

    2015-04-01

    The application of biochar (BC) to soils may have a positive influence on physico-chemical soil properties and the mitigation of greenhouse gas (GHG) emissions. Furthermore, biochar contributes to a long-term soil carbon sequestration. The aim of this study is to explore short and mid-term effects (one day up to six months) of different BC-compost applications on soil GHG emissions, particularly CO2, CH4, N2O and NOx. In addition, compounds of the nitrogen cycle like NH4+, NO3- and the microbial biomass nitrogen (Nmic) were measured. For this purpose a field experiment in Kaindorf (Styria/Austria, gleyic Cambisol, loamy, 376 m.a.s.l.) with 16 plots and four different treatments was conducted. K = no BC-compost mixture but fertilized (NH4SO4) corresponding to T3 in 2013; T1 = 1 % BC-compost mixture, no addition of N in 2013 and 2014; T2 = 0.5 % BC-compost mixture, + 175 kg N ha-1 in 2013 and 2014; T3 = 1% BC-compost mixture, + 350 kg N ha-1 in 2013. Nitrogen was added as (NH4)2SO4 directly to the freshly produced biochar before mixing it with compost. Greenhouse gas fluxes (CO2, CH4, N2O) were measured monthly from closed chambers in the field over a period of six months, starting 30 days before BC application and ended shortly before harvesting in September. For the analysis of nitric oxide (NO) fluxes intact soil cylinders were taken from each plot and incubated at the laboratory at ambient air temperature. Mineral N contents were measured by the extraction with KCl-solution and the microbial biomass with chloroform-fumigation extraction (CFE). Biochar application to our agricultural soil showed no reduction potential of NO emissions, but N2O fluxes were significantly lower at T1 and T3 compared to treatment K. Gaseous N fluxes of the pure BC-compost mixture and the additional N fertilization with (NH4)2SO4 led to enormous gaseous N losses in form of N2O and NO. However, after application to the soil, fluxes were only higher for a short time period. We suggest

  12. Short- and Mid-Term Effects of Violent Victimization on Delinquency: A Multilevel Growth-Curve Modeling Approach.

    PubMed

    Kim, Young S; Lo, Celia C

    2016-10-01

    The present study investigates how adolescents' experiences of violent victimization exert short- and mid-term effects on their involvement in delinquency. The study compares and contrasts delinquency trajectories of youths whose experiences of violent victimization differ. A multilevel growth-curve modeling approach is applied to analyze data from five waves of the National Youth Survey. The results show that, although delinquency involvement increases as youths experience violent victimization, delinquency trajectories differ with the type of violent victimization, specifically, parental versus non-parental victimization. Violent victimization by parents produced a sharp initial decline in delinquency (short-term effect) followed by a rapid acceleration (mid-term effect). In turn, non-parental violence showed a stable trend over time. The findings have important implications for prevention and treatment services.

  13. Three metal-on-metal hip replacement devices from the same manufacturer--a short- to mid-term survival.

    PubMed

    Kostensalo, Inari; Junnila, Mika; Mokka, Jari; Virolainen, Petri; Vahlberg, Tero; Mäkelä, Keijo T

    2014-06-01

    The aim of this retrospective study was to evaluate short- to mid-term results of three different metal-on-metal hip devices from the same manufacturer. A total of 329 hip operations were performed in a single academic unit between 2004 and 2010 using either Birmingham hip resurfacing or Synergy--Birmingham and Synergy--R3 total hip arthroplasty. The overall survival rate at the end of the follow-up time for Birmingham hip resurfacing was 88%, for Synergy--Birmingham total hip arthroplasty 95%, and for Synergy--R3 total hip arthroplasty 81% (p = 0.036). Five revision operations were performed due to adverse reaction to metal debris. Head sizes > 50 mm had lower revision rates compared to smaller ones. Synergy--R3 had a poor survival already at short-term. The mid-term survival of Birmingham hip resurfacing arthroplasty was inferior compared to previous studies.

  14. Short- and Mid-Term Effects of Violent Victimization on Delinquency: A Multilevel Growth-Curve Modeling Approach.

    PubMed

    Kim, Young S; Lo, Celia C

    2016-10-01

    The present study investigates how adolescents' experiences of violent victimization exert short- and mid-term effects on their involvement in delinquency. The study compares and contrasts delinquency trajectories of youths whose experiences of violent victimization differ. A multilevel growth-curve modeling approach is applied to analyze data from five waves of the National Youth Survey. The results show that, although delinquency involvement increases as youths experience violent victimization, delinquency trajectories differ with the type of violent victimization, specifically, parental versus non-parental victimization. Violent victimization by parents produced a sharp initial decline in delinquency (short-term effect) followed by a rapid acceleration (mid-term effect). In turn, non-parental violence showed a stable trend over time. The findings have important implications for prevention and treatment services. PMID:25888502

  15. Mid-term evaluation of the NRECA (National Rural Electric Cooperative Association) Central America Rural Electrification Support Program (CARES)

    SciTech Connect

    Perlack, R.D. ); Jones, H.G. ); Garcia, A. III . Dept. of Agricultural Engineering); Flores, E. , Guatemala City )

    1990-09-01

    Oak Ridge National Laboratory was requested by the Regional Office for Central America and Panama to conduct a mid-term evaluation of the Cares Project, which is being implemented by the National Rural Electric Cooperative Association. This evaluation was conducted over a three week period by a four person team. Overall, the project has had numerous successes and is highly valued by local counterpart utilities and USAID Missions. Notwithstanding the significant results of the project, changes can be made in certain operating procedures and in the direction of some programmatic activities that can lead to an even more effective project.

  16. Percutaneous Transluminal Angioplasty of Hepatic Artery Stenosis in Patients After Orthotopic Liver Transplantation: Mid-term Results

    SciTech Connect

    Jarmila, Lastovickova Jan, Peregrin

    2011-12-15

    Purpose: This study was designed to present our experience with percutaneous treatment of hepatic artery stenosis in orthotopic liver transplant patients and to evaluate the efficacy, technical outcomes, and mid-term clinical results of the procedure. Methods: Twenty-two percutaneous transluminal angioplasties (PTAs) were performed in 19 liver transplant recipients at our institution between 1998 and 2010. Stents were placed into the hepatic/celiac artery in 16 PTAs, but balloon dilatation alone was performed in 6 because of the anatomical condition of the vessel. PTA/stenting was indicated in 17 patients because of elevated liver enzymes; 2 patients were asymptomatic. The objective of treating stenosis was prevention of long-term complications, including thrombosis. Results: Technical success was achieved in all patients. There was only one complication: dissection of the treated artery without any subsequent adverse effects. In all patients, elevated liver enzyme levels improved after treatment. No restenosis was observed in any patient during a mean follow-up of 2.6 years (1 month to 5.5 years). Conclusions: Percutaneous angioplasty/stent placement is a safe method for the treatment of hepatic artery stenosis after orthotopic liver transplantation, with a high technical success rate and promising mid-term results.

  17. Prolonged high-pressure balloon angioplasty of femoropopliteal lesions: Impact on stent implantation rate and mid-term outcome

    PubMed Central

    Rigatelli, Gianluca; Palena, Mariano; Cardaioli, Paolo; dell'Avvocata, Fabio; Giordan, Massimo; Vassilev, Dobrin; Manzi, Marco

    2014-01-01

    Objectives To assess the impact on stent implantation rate and mid-term outcomes of prolonged high pressure angioplasty of femoropopliteal lesions. Methods We retrospectively enrolled 620 consecutive patients from January 2011 to December 2011 (75.6 ± 12.3 years, 355 males, 76.5% in Rutherford class 5–6), referred for critical limb ischemia and submitted to prolonged high-pressure angioplasty of femoropopliteal lesions. The definition of prolonged high-pressure angioplasty includes dilation to at least 18 atm for at least 120 s. Procedural data, and clinical and instrumental follow-up were analyzed to assess stent implantation rate and mid-term outcomes. Results The preferred approach was ipsilateral femoral antegrade in 433/620 patients (69.7%) and contralateral cross-over in 164/620 (26.4%) and popliteal retrograde + femoral antegrade in 23/620 (3.7%). Techniques included subintimal angioplasty in 427/620 patients (68.8%) and endoluminal angioplasty in 193/620 patients (31.2%). The prolonged high pressure balloon angioplasty procedure was successful in 86.2% (minor intra-procedural complications rate 15.7 %), stent implantation was performed in 74 patients (11.9%), with a significant improvement of ankle-brachial index (0.29 ± 0.6 vs. 0.88 ± 0.3, P < 00.1) and Rutherford class (5.3 ± 0.8 vs. 0.7 ± 1.9, P < 0.01), a primary patency rate of 86.7%, restenosis of 18.6 % on Doppler ultrasound and a target lesion revascularization of 14.8% at a mean follow-up of 18.1 ± 6.4 months (range 1–24 months). Secondary patency rate was 87.7%. Conclusions Prolonged high pressure angioplasty of femoropopliteal lesions appears to be safe and effective allowing for an acceptable patency and restenosis rates on mid-term. PMID:25009562

  18. Prognostic factors of mid-term clinical outcome in congestive heart failure patients discharged after acute decompensation

    PubMed Central

    Lombardo, Enrico; Testa, Marzia; Avogadri, Enrico; Piccolo, Salvatore; Vado, Antonello

    2012-01-01

    Introduction Risk stratification in congestive heart failure (CHF) patients is based on a variety of clinical and laboratory variables. We analysed renal function, BNP, water composition, echocardiographic and functional determinations in predicting mid-term outcome in CHF patients discharged after decompensation. Material and methods All subjects with NYHA class II-IV were enrolled at hospital discharge. NYHA class, BNP, water body composition, non-invasive cardiac output and echocardiogram were analysed. Death, cardiac transplantation and hospital readmission for CHF were scheduled. Results Two-hundred and thirty-seven (64.5% males, age 71.1±10.1) patients were discharged after obtaining normal hydration; left ventricular ejection fraction (LVEF) was 43.2±16.2%, cardiac output was 3.8±1.1 l/min and BNP at discharge resulted 401.3±501.7 pg/ml. During the 14-month follow-up 15 patients (6.3%) died, 1 (0.4%) underwent cardiac transplantation and 18 (7.6%) were readmitted for CHF (event group); in 203 (85.6%) no events were observed (no-event group). Higher NYHA class (2.1±0.7 vs. 1.9±0.4, p=0.01), BNP at discharge (750.2±527.3 pg/ml vs. 340.7±474.3 pg/ml, p=0.002) and impaired LVEF (33.7±15.7% vs. 44.5±15.8%, p=0.0001) and creatinine (1.7±0.6 vs. 1.2±0.8 mg/dl, p=0.004) were noticed in the event group. At multivariate Cox analysis LVEF (p=0.0009), plasma creatinine (p=0.006) and BNP at discharge (p=0.001) were associated with adverse mid-term outcome. Kaplan-Meier survival curves demonstrated that adding cut-off points for creatinine 1.5 mg/dl and discharged BNP of 250 pg/ml discriminated significantly prognosis (p=0.0001; log rank 21.09). Conclusions In predicting mid-term clinical prognosis in CHF patients discharged after acute decompensation, BNP at discharge ≥ 250 pg/ml added with plasma creatinine > 1.5 mg/dl are strong adverse predictors. PMID:22852001

  19. [Mid-term outcomes and survival rates in patients with radical retropubic prostatectomy (RRP) under current Czech healthcare system].

    PubMed

    Safarík, L; Bílek, R; Vísek, J A; Novák, K; Tuíková, J; Pesl, M; Stolz, J; Dvorácek, J

    2009-01-01

    The mid-term results (5 yr) after radical retropubic prostatectomy (RRP) are outlined and compared with pre- and postoperative parameters of patients. While 5 years survival could be expected in as many as 92.4%, relatively higher age (majority over 65) brings a higher risk of complications with it, though fully comparable with international standards. No perioperative mortality was recorded (0%), obstructive symptoms post-operatively developed in 13.4% patients, who were subsequently managed successfully endoscopically. Continence with maximum one pad per 24 hours was recorded in 77.2%, the severe incontinence was only in 3.3%. Spontaneous erection was reported in 4.3%, but except for higher age, the other objective factors were involved.

  20. Mid-term survivorship and clinical outcomes of cobalt-chrome and oxidized zirconium on highly crosslinked polyethylene

    PubMed Central

    Petis, Stephen M.; Vasarhelyi, Edward M.; Lanting, Brent A.; Howard, James L.; Naudie, Douglas D.R.; Somerville, Lyndsay E.; McCalden, Richard W.

    2016-01-01

    Background The choice of bearing articulation for total hip arthroplasty in younger patients is amenable to debate. We compared mid-term patient-reported outcomes and survivorship across 2 different bearing articulations in a young patient cohort. Methods We reviewed patients with cobalt-chrome or oxidized zirconium on highly crosslinked polyethylene who were followed prospectively between 2004 and 2012. Kaplan–Meier analysis was used to determine predicted cumulative survivorship at 5 years with all-cause and aseptic revisions as the outcome. We compared patient-reported outcomes, including the Harris hip score (HHS), Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and Short-form 12 (SF-12) scores. Results A total of 622 patients were followed during the study period. Mean follow-up was 8.2 (range 2.0–10.6) years for cobalt-chrome and 7.8 (range 2.1–10.7) years for oxidized zirconium. Mean age was 54.9 ± 10.6 years for cobalt-chrome and 54.8 ± 10.7 years for oxidized zirconium. Implant survivorship was 96.0% (95% confidence interval [CI] 94.9%–97.1%) for cobalt-chrome and 98.7% (95% CI 98.0%–99.4%) for oxidized zirconium on highly crosslinked polyethylene for all-cause revisions, and 97.2% (95% CI 96.2%–98.2%) for cobalt-chrome and 99.0% (95% CI 98.4%–99.6%) for oxidized zirconium for aseptic revisions. An age-, sex- and diagnosis-matched comparison of the HHS, WOMAC and SF-12 scores demonstrated no significant changes in clinical outcomes across the groups. Conclusion Both bearing surface couples demonstrated excellent mid-term survivorship and outcomes in young patient cohorts. Future analyses on wear and costs are warranted to elicit differences between the groups at long-term follow-up. PMID:26812409

  1. CT-Guided Radiofrequency Ablation of T1a Renal Cell Carcinoma in Korea: Mid-Term Outcomes

    PubMed Central

    Kim, Hae Jin; Park, Jung Jae; Kim, Chan Kyo

    2016-01-01

    Objective To evaluate the mid-term outcomes of percutaneous radiofrequency ablation (RFA) treatment in patients with small (< 4 cm) renal cell carcinoma (RCC) in Korea. Materials and Methods Between 2010 and 2015, 51 patients (40 men and 11 women; median age, 57 years) with biopsyproven 51 RCC were treated using CT-guided RFA. All patients were clinically staged T1aN0M0 prior to RFA. The median tumor size and follow-up period were 2.1 cm (range, 1.0–3.9 cm) and 26 months (4–60 months), respectively. Local tumor progression, distant metastasis, primary and secondary effectiveness rates, and major complication rates were recorded. Estimated glomerular filtration rates (GFRs) between pre-RFA and last follow-up were compared using paired t tests. The 2-year recurrence-free survival rate was calculated using Kaplan-Meier survival analysis. Results Of the 51 patients, 2 (3.9%) experienced local tumor progression, and 1 (2.0%) had lymph node metastasis after the first RFA session. Primary and secondary effectiveness rates were 96.1% (49/51) and 100% (1/1), respectively. Only 1 patient experienced a major complication (uretero-pelvic stricture) after the second RFA session for treating a local tumor progression, and the major complication rate was 1.9% (1/52). The median pre-RFA and last follow-up GFRs were 87.1 mL/ min/1.73 m2 (14.2–142.7 mL/min/1.73 m2) and 72.0 mL/min/1.73 m2 (7.2–112.6 mL/min/1.73 m2), respectively (p < 0.0001). The 2-year recurrence-free survival rate was 96.0%. Conclusion CT-guided RFA is a safe and effective treatment in Korean patients with T1a RCC because of excellent mid-term outcomes. PMID:27587966

  2. Mid-Term Report.

    ERIC Educational Resources Information Center

    Coplan, Carol

    1987-01-01

    Offers a midterm report on United States Supreme Court Cases. The cases dealt with voting rights, affirmative action, jury bias, the handicapped status of AIDS victims, religious holidays for teachers, and political spending of nonprofit corporations. (JDH)

  3. Mid-term Clinical Results and Patient Satisfaction After Uterine Artery Embolization in Women with Symptomatic Uterine Fibroids

    SciTech Connect

    Smeets, Albert J.; Lohle, Paul N. M. Vervest, Harry A. M.; Boekkooi, P. Focco; Lampmann, Leo E.H.

    2006-04-15

    Purpose. To evaluate the mid-term clinical results and patient satisfaction following uterine artery embolization (UAE) in women with symptomatic fibroids. Methods. Between August 1998 and December 2002, 135 patients had UAE for symptomatic uterine fibroids. All patients were asked to fill in a questionnaire. Questions were aimed at changes in bleeding, pain, and bulk-related symptoms. Symptoms after UAE were scored as disappeared, improved, unchanged or worsened. Adverse events were noted, such as vaginal dryness and discharge, menopausal complaints or fibroid expulsion. Patient satisfaction after UAE was assessed. Patient satisfaction of women embolized with polyvinyl alcohol (PVA) particles was compared with satisfaction of women embolized with calibrated microspheres. Results. The questionnaire was returned by 110 of 135 women (81%) at a median time interval of 14 months following UAE. In 10 women additional embolization or hysterectomy had been performed. Of the 110 responders, 86 (78%) were satisfied with the result of UAE. The proportion of satisfied women was higher in the group embolized with calibrated microspheres than in women embolized with PVA, although this difference was not statistically significant (p = 0.053). Conclusion. UAE in women with symptomatic uterine fibroids leads to improvement of symptoms and patient satisfaction is good in the vast majority after a median follow-up period of 14 months.

  4. Early- and mid-term outcomes after transcatheter aortic valve implantation. Data from a single-center registry

    PubMed Central

    Bagienski, Maciej; Dziewierz, Artur; Rzeszutko, Lukasz; Sorysz, Danuta; Trebacz, Jaroslaw; Sobczynski, Robert; Tomala, Marek; Stapor, Maciej; Gackowski, Andrzej; Dudek, Dariusz

    2016-01-01

    Introduction Transcatheter aortic valve implantation (TAVI) is a less invasive treatment option for elderly, high-risk patients with symptomatic severe aortic stenosis (AS) than aortic valve replacement. More importantly, TAVI improves survival and quality of life as compared to medical treatment in inoperable patients. Aim To assess early- and mid-term clinical outcomes after TAVI. Material and methods All consecutive high-risk patients with severe symptomatic AS undergoing TAVI from November 2008 to August 2014 were enrolled. The clinical and procedural characteristics, as well as clinical outcomes including mortality during 12-month follow-up, were assessed. Results A total of 101 consecutive patients underwent TAVI for native aortic valve stenosis (100%). Patients were elderly, with a median age of 81.0 (76.0–84.0) years, 60.4% were female and 83.2% presented with NYHA III/IV. Median baseline EuroSCORE I and STS scores were 14.0 (10.0–22.5)% and 12.0 (5.0–24.0)%, respectively. The main periprocedural and in-hospital complications were minor vascular complications, bleeding requiring blood transfusions, and the need for a permanent pacemaker. In-hospital, 30-day, 6-month and 12-month mortality rates were 6.9%, 10.9%, 15.8% and 17.8%, respectively. Conclusions A mortality rate of < 20% after 12 months seems acceptable given the high-risk population enrolled. PMID:27279871

  5. Preparedness actions towards seismic risk mitigation for the general public in Martinique, French Lesser Antilles: a mid-term appraisal

    NASA Astrophysics Data System (ADS)

    Audru, J. C.; Vernier, J. L.; Capdeville, B.; Salindre, J. J.; Mouly, É.

    2013-08-01

    Martinique is a French island in the Lesser Antilles, with a high seismic hazard. In 2006, Martinican stakeholders involved in seismic safety formed the "Réplik" working group ("Aftershock" in French), the first of its kind in this region. This paper addresses a mid-term appraisal of the first seismic awareness campaign organised by Réplik from 2006 to 2011, and how it has modified, or not, local earthquake and tsunami preparedness. Despite efforts from Réplik to assess its efficiency through surveys, a growing gap is noted between the observed awareness and the actual preparedness of the public. As usual, gender, age, educational level, then boredom and saturation contribute to this discrepancy; strong cultural items may also influence the perception of actions. To remain efficient and respond to the public's expectations, Réplik must redirect its actions towards a cultural congruence of information: consideration of religion and local beliefs, comprehensive messages on TV and radio, use of the Creole language, participatory experiences and drills, and a little science. With this, the Réplik stakeholders can hope to increase Martinicans' involvement into the preparedness process, to cope quickly with a strong earthquake and this know-how can be shared with other seismically active islands in the Caribbean.

  6. Ankle arthroplasty in a patient with bleeding diathesis and the mid-term clinical outcome of the case

    PubMed Central

    Yilmaz, Barış; Kömür, Baran; Özdemir, Güzelali; Heybeli, Nurettin

    2015-01-01

    Purpose The purpose of this report was to present the case of a patient with bleeding diathesis on whom we performed ankle arthroplasty for the first time. Materials and methods A 29-year old male patient with bleeding diathesis, who had been treated and followed up over a long period, underwent ankle arthroplasty because of osteoarthritis of the ankle. The patient was prepared for surgery by the haematology department in accordance with the guidelines for surgical preparation, diagnosis and management of haemophilia. After ankle arthroplasty was performed, the preoperative and two-year postoperative clinical outcomes were evaluated using a subjective foot score and Maryland foot score. Results Preoperative factor VIII levels were raised to the target level of haemostasis prior to the surgical procedure. The factor VIII levels were maintained within the normal range up to postoperative day 14. The subjective foot score of the patient was 40 preoperatively and 85 postoperatively, whereas their Maryland foot scores were 33 preoperatively and 90 postoperatively. Both scoring systems indicate an excellent clinical outcome. Conclusion As observed, the early and mid-term functional outcomes are promising for patients with bleeding diathesis who undergo ankle arthroplasty. PMID:26635956

  7. A Review of Literature on Formative Evaluation of Teachers through Mid-Term Student Feedback and How the Reiser and Dick Instructional Planning Model Can Enhance This Feedback.

    ERIC Educational Resources Information Center

    Hampton, Scott E.

    Research has shown that student mid-term feedback has significantly increased subsequent ratings of teacher effectiveness, student achievement, and student attitudes when the feedback results were accompanied by expert consultation. A gap in the literature is an instrument intended to provide specific feedback on systematic planning and delivery…

  8. Short to Mid-Term Term Surgical Outcome Study with Posterior Only Approach on Tuberculous Spondylodiscitis in an Elderly Population

    PubMed Central

    Kothari, Manish; Tikoo, Agnivesh; Nene, Abhay

    2016-01-01

    Study Design Retrospective study. Purpose To study short to mid-term outcome of surgically managed elderly patients of tuberculous spondylodiscitis with posterior only approach in terms of decision making and challenges in treatment, choice of implants and outcomes. Overview of Literature Tuberculous spondylodiscitis in the elderly is increasing due to longer survival rates. It presents with varied clinical manifestations needing surgical management. Management in tuberculous spondylodiscitis has been scarcely reported in the elderly, with a paucity of data on the choice of implants and approach. Methods Sixteen patients (five males, 11 females) older than 70-years-of-age culture and/or histopathology proven tuberculous spondylodiscitis were included in the study. All patients were operated using a single posterior approach. Pedicle screw with rods (PS/rods) or spinal loop with sublaminar wires (SL/SLW) were used for fixation. Clinical and surgical details were recorded. Sagittal correction achieved postoperatively and loss of correction at follow-up were noted. Results The mean age was 73.6 years (range, 70 to 80 years). The mean follow up was 44.5 months (range, 24 to 84 months). The mean immediate postoperative correction of sagittal deformity was 11.3 degrees; this correction was lost by a mean of 3.1 degrees at last follow-up. All 10 patients with deficit showed neurological recovery and all but one of the seven non-walkers were capable of independent ambulation at follow-up. Patients with SL/SLW and PS/rods had similar radiological outcome at final follow up. Conclusions Operative management gives satisfactory results in elderly patients with tuberculous spondylodiscitis. The posterior approach provides adequate exposure for decompression and rigid fixation, providing satisfactory clinical and radiological outcomes. SSL/SLW and pedicle screw rod construct both give similar radiological results if used appropriately in patients. PMID:27114766

  9. Mid-term Follow-up of the Transcatheter Closure of Perimembranous Ventricular Septal Defects in Children Using the Amplatzer

    PubMed Central

    Ghaderian, Mehdi; Merajie, Mahmood; Mortezaeian, Hodjjat; Aarabi Moghadam, Mohammad Yoosef; Shah Mohammadi, Akbar

    2015-01-01

    Background: The ventricular septal defect (VSD) is the most common form of congenital heart defects. The purpose of this study was to evaluate the results of the early complications and mid-term follow-up of the transcatheter closure of the VSD using the Amplatzer VSD Occluder. Methods: Between April 2012 and October 2013, 110 patients underwent the percutaneous closure of the perimembranous VSD. During the procedure, the size and type of the VSD were obtained via ventriculography. A device at least 2 mm larger than the VSD diameter measured via ventriculography was deployed. The size of the VSD, size of the Amplatzer, and device-size to VSD-size ratio were calculated. After the confirmation of the suitable position of the device via echocardiography and left ventriculography, the device was released. Follow-up evaluations were done at discharge as well as at 1, 6, and 12 months and yearly thereafter for the VSD occlusion and complete heart block. Results: The study population comprised 62 females and 48 males. The mean age and weight of the patients at procedure were 4.3 ± 5.6 years (range: 2 to 14) and 14.9 ± 10.8 kg (range: 10 to 43). The average device size was 7.0 ± 2.5 mm (range: 4 to 14). The VSD occlusion rate was 72.8% at the completion of the procedure and rose up to 99.0% during the follow-up. The most serious significant complication was complete atrioventricular block, which was seen in 2 patients. The mean follow-up duration was 10.9 ± 3.6 months. Conclusion: The transcatheter closure of the perimembranous VSD was a safe and effective treatment with excellent closure rates in our study population. This procedure had neither mortality nor serious complications. PMID:26985206

  10. Mid-term results of Ponseti management for an idiopathic congenital clubfoot at a single center in Vietnam.

    PubMed

    Vo, Nam Q D; Huynh, Nhi M

    2016-05-01

    Despite the increasing popularity of the Ponseti method for the treatment of idiopathic congenital clubfeet, the relapse rate and sequela after the initial correction of manipulating and casting remain high. This study presents a scale to evaluate the relapse and identify the factors correlated with the relapse and latest follow-up mid-term results. A total of 101 children (newborn to 12 months), 142 idiopathic congenital clubfeet, were recruited for this study following treatment with the Ponseti method at the Hospital for Traumatology and Orthopaedics (Ho Chi Minh City, Vietnam) with a follow-up period of a minimum of 2 years. The clubfeet were then classified and evaluated during casting, for initial correction, and for relapse according to Diméglio's score. Next, the latest follow-up results were evaluated according to Richards' classification. The initial correction was successful in 95.8% (perfect: 74.0%, acceptable: 21.8%); 6.6% developed relapses and relapse-related factors were the initial correction and bracing program. The latest follow-up results are good in 74.7%, fair in 22.5%, and poor in 2.8%, and correlated with the age of presentation and the follow-up period in both univariate and multivariate analysis. On the basis of a precise evaluation of the relapse, this study indicates that the initial correction classified by the author on the basis of Diméglio's score and bracing compliance affect relapse. In addition, early treatment after birth and continuous long-term follow-up to appropriately manage the sequelae are essential to obtain the latest follow-up results as expected.

  11. Devising an indicator to detect mid-term abortions in dairy cattle: a first step towards syndromic surveillance of abortive diseases.

    PubMed

    Bronner, Anne; Morignat, Eric; Hénaux, Viviane; Madouasse, Aurélien; Gay, Emilie; Calavas, Didier

    2015-01-01

    Bovine abortion surveillance is essential for human and animal health because it plays an important role in the early warning of several diseases. Due to the limited sensitivity of traditional surveillance systems, there is a growing interest for the development of syndromic surveillance. Our objective was to assess whether, routinely collected, artificial insemination (AI) data could be used, as part of a syndromic surveillance system, to devise an indicator of mid-term abortions in dairy cattle herds in France. A mid-term abortion incidence rate (MAIR) was computed as the ratio of the number of mid-term abortions to the number of female-weeks at risk. A mid-term abortion was defined as a return-to-service (i.e., a new AI) taking place 90 to 180 days after the previous AI. Weekly variations in the MAIR in heifers and parous cows were modeled with a time-dependent Poisson model at the département level (French administrative division) during the period of 2004 to 2010. The usefulness of monitoring this indicator to detect a disease-related increase in mid-term abortions was evaluated using data from the 2007-2008 episode of bluetongue serotype 8 (BT8) in France. An increase in the MAIR was identified in heifers and parous cows in 47% (n = 24) and 71% (n = 39) of the departements. On average, the weekly MAIR among heifers increased by 3.8% (min-max: 0.02-57.9%) when the mean number of BT8 cases that occurred in the previous 8 to 13 weeks increased by one. The weekly MAIR among parous cows increased by 1.4% (0.01-8.5%) when the mean number of BT8 cases occurring in the previous 6 to 12 weeks increased by one. These results underline the potential of the MAIR to identify an increase in mid-term abortions and suggest that it is a good candidate for the implementation of a syndromic surveillance system for bovine abortions. PMID:25746469

  12. Devising an indicator to detect mid-term abortions in dairy cattle: a first step towards syndromic surveillance of abortive diseases.

    PubMed

    Bronner, Anne; Morignat, Eric; Hénaux, Viviane; Madouasse, Aurélien; Gay, Emilie; Calavas, Didier

    2015-01-01

    Bovine abortion surveillance is essential for human and animal health because it plays an important role in the early warning of several diseases. Due to the limited sensitivity of traditional surveillance systems, there is a growing interest for the development of syndromic surveillance. Our objective was to assess whether, routinely collected, artificial insemination (AI) data could be used, as part of a syndromic surveillance system, to devise an indicator of mid-term abortions in dairy cattle herds in France. A mid-term abortion incidence rate (MAIR) was computed as the ratio of the number of mid-term abortions to the number of female-weeks at risk. A mid-term abortion was defined as a return-to-service (i.e., a new AI) taking place 90 to 180 days after the previous AI. Weekly variations in the MAIR in heifers and parous cows were modeled with a time-dependent Poisson model at the département level (French administrative division) during the period of 2004 to 2010. The usefulness of monitoring this indicator to detect a disease-related increase in mid-term abortions was evaluated using data from the 2007-2008 episode of bluetongue serotype 8 (BT8) in France. An increase in the MAIR was identified in heifers and parous cows in 47% (n = 24) and 71% (n = 39) of the departements. On average, the weekly MAIR among heifers increased by 3.8% (min-max: 0.02-57.9%) when the mean number of BT8 cases that occurred in the previous 8 to 13 weeks increased by one. The weekly MAIR among parous cows increased by 1.4% (0.01-8.5%) when the mean number of BT8 cases occurring in the previous 6 to 12 weeks increased by one. These results underline the potential of the MAIR to identify an increase in mid-term abortions and suggest that it is a good candidate for the implementation of a syndromic surveillance system for bovine abortions.

  13. Devising an Indicator to Detect Mid-Term Abortions in Dairy Cattle: A First Step Towards Syndromic Surveillance of Abortive Diseases

    PubMed Central

    Bronner, Anne; Morignat, Eric; Hénaux, Viviane; Madouasse, Aurélien; Gay, Emilie; Calavas, Didier

    2015-01-01

    Bovine abortion surveillance is essential for human and animal health because it plays an important role in the early warning of several diseases. Due to the limited sensitivity of traditional surveillance systems, there is a growing interest for the development of syndromic surveillance. Our objective was to assess whether, routinely collected, artificial insemination (AI) data could be used, as part of a syndromic surveillance system, to devise an indicator of mid-term abortions in dairy cattle herds in France. A mid-term abortion incidence rate (MAIR) was computed as the ratio of the number of mid-term abortions to the number of female-weeks at risk. A mid-term abortion was defined as a return-to-service (i.e. a new AI) taking place 90 to 180 days after the previous AI. Weekly variations in the MAIR in heifers and parous cows were modeled with a time-dependent Poisson model at the département level (French administrative division) during the period of 2004 to 2010. The usefulness of monitoring this indicator to detect a disease-related increase in mid-term abortions was evaluated using data from the 2007–2008 episode of bluetongue serotype 8 (BT8) in France. An increase in the MAIR was identified in heifers and parous cows in 47% (n = 24) and 71% (n = 39) of the départements. On average, the weekly MAIR among heifers increased by 3.8% (min-max: 0.02–57.9%) when the mean number of BT8 cases that occurred in the previous 8 to 13 weeks increased by one. The weekly MAIR among parous cows increased by 1.4% (0.01–8.5%) when the mean number of BT8 cases occurring in the previous 6 to 12 weeks increased by one. These results underline the potential of the MAIR to identify an increase in mid-term abortions and suggest that it is a good candidate for the implementation of a syndromic surveillance system for bovine abortions. PMID:25746469

  14. COST Action TU1208 "Civil Engineering Applications of Ground Penetrating Radar:" ongoing research activities and mid-term results

    NASA Astrophysics Data System (ADS)

    Pajewski, Lara; Benedetto, Andrea; Loizos, Andreas; Slob, Evert; Tosti, Fabio

    2015-04-01

    This work aims at presenting the ongoing activities and mid-term results of the COST (European COoperation in Science and Technology) Action TU1208 'Civil Engineering Applications of Ground Penetrating Radar.' Almost three hundreds experts are participating to the Action, from 28 COST Countries (Austria, Belgium, Croatia, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Ireland, Italy, Latvia, Malta, Macedonia, The Netherlands, Norway, Poland, Portugal, Romania, Serbia, Slovakia, Slovenia, Spain, Sweden, Switzerland, Turkey, United Kingdom), and from Albania, Armenia, Australia, Egypt, Hong Kong, Jordan, Israel, Philippines, Russia, Rwanda, Ukraine, and United States of America. In September 2014, TU1208 has been praised among the running Actions as 'COST Success Story' ('The Cities of Tomorrow: The Challenges of Horizon 2020,' September 17-19, 2014, Torino, IT - A COST strategic workshop on the development and needs of the European cities). The principal goal of the COST Action TU1208 is to exchange and increase scientific-technical knowledge and experience of GPR techniques in civil engineering, whilst simultaneously promoting throughout Europe the effective use of this safe and non-destructive technique in the monitoring of infrastructures and structures. Moreover, the Action is oriented to the following specific objectives and expected deliverables: (i) coordinating European scientists to highlight problems, merits and limits of current GPR systems; (ii) developing innovative protocols and guidelines, which will be published in a handbook and constitute a basis for European standards, for an effective GPR application in civil- engineering tasks; safety, economic and financial criteria will be integrated within the protocols; (iii) integrating competences for the improvement and merging of electromagnetic scattering techniques and of data- processing techniques; this will lead to a novel freeware tool for the localization of buried objects

  15. Mid term monitoring of heavy metals content in soils of Mediterranean coastal wetlands. La Albufera de Valencia Natural Park, Spain

    NASA Astrophysics Data System (ADS)

    Pascual-Aguilar, Juan Antonio; Andreu, Vicente; Gimeno-García, Eugenia

    2014-05-01

    Coastal wetlands, in general, and Mediterranean ones, in particular, suffer from differente anthropogenic pressures that may affect their intrinsic environmental and ecological functions. Most, if not all, Mediterranean wetlands are not natural spaces were preservation of habitat and wildlife is the only management policy achieved, bur rather their terriroty is a combination of land units with different activities and influences, such as farming, environmental protection and connectivities with urban and industrial areas. Therefore, the need of periodical monitoring is required whenever pressures and environmental health of wetlands is assessed, particularly of those processes that affect the interconnection of environmental compartiments involving water, soils and biota. In agro-ecological protected wetlands soils play and important role because they are potential sources of pollutants due to farming practices. In this case, presence of heavy metals in soils is and indicator of both environmental health and anthtopogenic direct (farming activities) and indirect (neighbour urban areas) pressures. In this work a mid term (17 year) monitoring of seven heavy metals (Cd, Co, Cr, Cu, Pb, Ni and Zn) in soils of coastal Mediterranean wetlands (La Albufera Natural Park, Spain) are analyzed. Two monitoring campaings were achieved in 1991 and 2008. In both cases the same 20 points were visited which were distributed in the natural park according two four different sectors of potential anthropogenic pressure and land use. At each point two soil samples were collected at differente depths (0 to 20 cm and 20 to 40 cm). The selected metals were analyzed to determine its total and extractable fractions by treatment with EDTA. Atomic Absorption Spectrometry, using graphite furnace when necessary, was used for the determination of metals. In general, there is a reduction of metal contents in the study area in both dates. The trend of metals according to average concentration (mg

  16. Initial Weight Loss after Restrictive Bariatric Procedures May Predict Mid-Term Weight Maintenance: Results From a 12-Month Pilot Trial

    PubMed Central

    Nikolić, Marko; Kirigin, Lora; Mirošević, Gorana; Ljubičić, Neven; Nikolić, Borka Pezo; Bekavac-Bešlin, Miroslav; Budimir, Ivan; Vrkljan, Milan

    2015-01-01

    Background: Bariatric procedures are effective options for weight loss (WL) in the morbidly obese. However, some patients fail to lose any weight after bariatric surgery, and mid-term weight maintenance is variable. The aim of this study was to investigate whether initial WL could predict mid-term weight maintenance. Methods: Eighty patients were enrolled, of whom 44 were treated with the BioEnterics Intragastric Balloon (BIB), 21 with laparoscopic adjustable gastric lap-banding (LAGB), and 15 with laparoscopic sleeve gastrectomy (LSG). Percentage of body WL and percentage of excess weight loss (EWL) were calculated at baseline and after 1, 3, 6, and 12 months. Successful WL was defined as EWL >20% for patients treated with BIB and >50% for patients treated with LAGB and SG. Results: Success in the 6th and 12th month was achieved in 80% and 58% of patients in the BIB group, 33% and 40% in the LAGB group, and 60% and 73% in the LSG group. In the BIB group, WL in the 1st month correlated positively with WL at the 6th and 12th month, and an initial WL >6.5% best predicted success (sensitivity 50%, specificity 80%). A similar association was observed in the LAGB group at the 6th and 12th month and an initial WL >9.4% best predicted success (sensitivity 90.0%, specificity 81.2%). In patients treated with LSG, WL in the 3rd month correlated positively with EWL at the 6th and 12th month, with a cutoff value of 17% (sensitivity 66.7%, specificity 100%). Conclusions: WL in the 1st month in patients treated with BIB and LAGB and WL in the 3rd month in patients treated with LSG could be used as a prognostic factor to predict mid-term weight maintenance. PMID:26594600

  17. The assessment of treated wastewater quality and the effects of mid-term irrigation on soil physical and chemical properties (case study: Bandargaz-treated wastewater)

    NASA Astrophysics Data System (ADS)

    Kaboosi, Kami

    2016-05-01

    This study was conducted to investigate the characteristics of inflow and outflow wastewater of the Bandargaz wastewater treatment plant on the basis of the data collection of operation period and the samples taken during the study. Also the effects of mid-term use of the wastewater for irrigation (from 2005 to 2013) on soil physical and chemical characteristics were studied. For this purpose, 4 samples were taken from the inflow and outflow wastewater and 25 quality parameters were measured. Also, the four soil samples from a depth of 0-30 cm of two rice field irrigated with wastewater in the beginning and middle of the planting season and two samples from one adjacent rice field irrigated with fresh water were collected and their chemical and physical characteristics were determined. Average of electrical conductivity, total dissolved solids, sodium adsorption ratio, chemical oxygen demand and 5 days biochemical oxygen demand in treated wastewater were 1.35 dS/m, 707 ppm, 0.93, 80 ppm and 40 ppm, respectively. Results showed that although some restrictions exist about chlorine and bicarbonate, the treated wastewater is suitable for irrigation based on national and international standards and criteria. In comparison with fresh water, the mid-term use of wastewater caused a little increase of soil salinity. However, it did not lead to increase of soil salinity beyond rice salinity threshold. Also, there were no restrictions on soil in the aspect of salinity and sodium hazard on the basis of many irrigated soil classifications. In comparison with fresh water, the mid-term use of wastewater caused the increase of total N, absorbable P and absorbable K in soil due to high concentration of those elements in treated wastewater.

  18. COST Action TU1208 "Civil Engineering Applications of Ground Penetrating Radar:" ongoing research activities and mid-term results

    NASA Astrophysics Data System (ADS)

    Pajewski, Lara; Benedetto, Andrea; Loizos, Andreas; Slob, Evert; Tosti, Fabio

    2015-04-01

    This work aims at presenting the ongoing activities and mid-term results of the COST (European COoperation in Science and Technology) Action TU1208 'Civil Engineering Applications of Ground Penetrating Radar.' Almost three hundreds experts are participating to the Action, from 28 COST Countries (Austria, Belgium, Croatia, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Ireland, Italy, Latvia, Malta, Macedonia, The Netherlands, Norway, Poland, Portugal, Romania, Serbia, Slovakia, Slovenia, Spain, Sweden, Switzerland, Turkey, United Kingdom), and from Albania, Armenia, Australia, Egypt, Hong Kong, Jordan, Israel, Philippines, Russia, Rwanda, Ukraine, and United States of America. In September 2014, TU1208 has been praised among the running Actions as 'COST Success Story' ('The Cities of Tomorrow: The Challenges of Horizon 2020,' September 17-19, 2014, Torino, IT - A COST strategic workshop on the development and needs of the European cities). The principal goal of the COST Action TU1208 is to exchange and increase scientific-technical knowledge and experience of GPR techniques in civil engineering, whilst simultaneously promoting throughout Europe the effective use of this safe and non-destructive technique in the monitoring of infrastructures and structures. Moreover, the Action is oriented to the following specific objectives and expected deliverables: (i) coordinating European scientists to highlight problems, merits and limits of current GPR systems; (ii) developing innovative protocols and guidelines, which will be published in a handbook and constitute a basis for European standards, for an effective GPR application in civil- engineering tasks; safety, economic and financial criteria will be integrated within the protocols; (iii) integrating competences for the improvement and merging of electromagnetic scattering techniques and of data- processing techniques; this will lead to a novel freeware tool for the localization of buried objects

  19. Prospective sur les besoins « défense » en détecteurs infrarougeMid-term defence needs for infrared detectors

    NASA Astrophysics Data System (ADS)

    Peyrard, Jean-Christophe

    2003-12-01

    In this paper, we propose to present the prospects for mid-term needs for infrared detectors. These needs are derived from expected evolutions in imaging techniques as well as from operational requirements. The main trends that shall allow the direct development in infrared detection are as much the pursuit of greater range, a better discrimination of targets, as the efforts to minimize cost, volume, weigh and consumption. These trends will lead to an examination of the specific needs for some kind of 'smart' infrared detector. Among these applications, we will investigate more deeply the technological requirements for flash and 3D imaging, hyperspectral and uncooled imaging. To cite this article: J.-C. Peyrard, C. R. Physique 4 (2003).

  20. Mid-term results of 17-mm St. Jude Medical Regent prosthetic valves in elder patients with small aortic annuli: comparison with 19-mm bioprosthetic valves.

    PubMed

    Teshima, Hideki; Ikebuchi, Masahiko; Sano, Toshikazu; Tai, Ryuta; Horio, Naohiro; Irie, Hiroyuki

    2014-09-01

    This study was designed to compare the mid-term outcomes after aortic valve replacement (AVR) between 17-mm mechanical heart valves (MV) and 19-mm bioprosthetic valves (BV) in elderly patients with small aortic annuli. Between 2000 and 2011, 127 consecutive patients (mean age 79 years; 87 % female) underwent AVR for aortic valve stenosis with a small aortic annulus. 19-mm BV (n = 67) was implanted. When the 19-mm BV did not fit the annulus, 17-mm St. Jude Medical Regent prosthetic mechanical valve (n = 60) was used instead of an aortic root-enlargement procedure. The follow-up rate was 94.0 % in the BV group, and 98.5 % in the MV group. No significant differences in survival rate and valve-related complications were found between the 2 groups. In-hospital mortality rates were 1.5 % (n = 1) in the BV group and 5.0 % (n = 3) in the MV group. Late mortality rates were 3.9 % per patient-years (p-y; n = 8) in the BV group, and 6.0 % per p-y (n = 10) in the MV group. Five-year Kaplan-Meier survival rates were 62 % in the BV group, and 72 % in the MV group (log-rank P = 0.280). Freedom from major adverse valve-related stroke and cerebral bleeding events was 92.5 and 98.5 % in the BV group, and 94.7 and 100 % in the MV group. AVR using 17-mm MV in elder patients with small aortic annuli provided equivalent mid-term clinical results to that with 19-mm BV. PMID:24878870

  1. Anterior Cervical Discectomy and Fusion with Stand-Alone Trabecular Metal Cages as a Surgical Treatment for Cervical Radiculopathy: Mid-Term Outcomes

    PubMed Central

    ElAbed, Khaldoun; Shawky, Ahmad; Ainscow, Donald

    2016-01-01

    Study Design Retrospective case cohort study done between 2002 and 2012. Purpose To assess the mid-term clinical and radiological outcomes of 1-level and 2-level anterior cervical discectomy and fusion (ACDF) with stand-alone trabecular metal cages. Overview of Literature ACDF is the gold standard surgical treatment for cervical degenerative disease. The usual surgical practice is to use an anteriorly placed fusion plate with or without interdiscal cages. Methods Patients between 36 and 64 years of age diagnosed with cervical radiculopathy who underwent ACDF using stand-alone trabecular metal cages with at least 3 years follow-up were included in this study. Recorded clinical outcomes included residual axial neck pain, radicular arm pain, upper extremity weakness, and upper extremity altered sensation. Visual Analogue scores were also recorded. Fusion was assessed by lateral radiographs looking for bone breaching and radiolucent lines around the device at the latest follow-up. Results Ninety patients were included in the study. Fifty-one patients underwent 2-level surgery and 39 patients underwent 1-level surgery. Mean age was 44±10.4 years and mean follow-up time was 4.5±2.6 years. Patients reported excellent or good outcomes (90%), as well as improvements in axial neck pain (80%), radicular arm pain (95%), upper extremity weakness (85%), and upper extremity altered sensation (90%). Most patients (90%) progressed to fusion at the 1-year follow-up. The reoperation rate was 3.6%. There was no reported persistent dysphagia, voice complaints, dural tear, or tracheal or oesophageal perforation in any of the patients. One patient developed a deep methicillin-resistant Staphylococcus aureus infectious infarction of the spinal cord, which was treated with antibiotics. Recovery was complete at the 1-year follow up. Conclusions Mid-term results show that surgical treatment with ACDF with trabecular metal cages is a safe and effective treatment of single and 2-level

  2. Mid-term results using a cementless hip prosthesis in young Chinese patients: a five- to seven-year follow-up study

    PubMed Central

    Qiu, XueYong; Yang, Jing; Shen, Bin; Zhou, ZongKe; Zhang, Hui

    2008-01-01

    A retrospective study was undertaken to evaluate the clinical and radiographic outcomes of 74 cementless total hip arthroplasties (THA) in 69 young Chinese patients. The Asian size and MMA AML stems with smoothly tapered tip were used, and the patients were followed up for at least five years. The mean Harris hip score was 45.4 preoperatively and 95.3 at the last follow-up. The incidence of thigh pain was 5.4%, and was related to the short stature of the patient (<160 cm) (P = 0.030). Six patients (6 hips, 8.1%) had acetabular osteolysis in zone 2; reoperation was performed in one patient because of osteolysis and wear of the polyethylene liner. The survival rate of the metal acetabular and femoral components was 100% (95% confidence interval, 0.95–1.0). Primary THA with this AML prosthesis had an acceptable mid-term result in young Chinese patients. PMID:19050881

  3. MedTech Mag-Lev, single-use, extracorporeal magnetically levitated centrifugal blood pump for mid-term circulatory support.

    PubMed

    Nagaoka, Eiki; Fujiwara, Tatsuki; Kitao, Takashi; Sakota, Daisuke; Shinshi, Tadahiko; Arai, Hirokuni; Takatani, Setsuo

    2013-01-01

    Short- to mid-term extracorporeal ventricular assist devices (VADs) are recommended for critical cardiogenic shock patients. We have designed a preclinical, single-use MedTech Mag-Lev VAD for one-month extracorporeal use. The impeller-rotor of the pump was suspended by a two degree-of-freedom active magnetic bearing in a 300 μm fluid gap, where the computational fluid dynamics analysis predicted a secondary flow of about 400-500 ml/min at a pump speed of 1800-2200 rpm. Three eddy current sensors were employed to implement noise- and drift-free magnetic levitation. The pump components were injection molded using polycarbonate for smooth surfaces as well as improved reproducibility, followed by coating with a biocompatible 2-methacryloyl-oxyethyl phosphorylcholine polymer. Chronic animal experiments were performed in nine calves. Three of the nine calves were excluded from analysis for problems with the circuit. Five of the six (83.3%) completed the 60 day duration of the study, while one prematurely died of massive bleeding due to inflow port detachment. The pump did not stop due to magnetic-levitation malfunction. Neither pump thrombosis nor major organ infarction was observed at autopsy. In comparison to machined surfaces, the injection-molded pump surfaces were thrombus-free after 60 day implantation. This study demonstrates the feasibility of MedTech Mag-Lev VAD for 60 day circulatory support. PMID:23644611

  4. MedTech Mag-Lev, single-use, extracorporeal magnetically levitated centrifugal blood pump for mid-term circulatory support.

    PubMed

    Nagaoka, Eiki; Fujiwara, Tatsuki; Kitao, Takashi; Sakota, Daisuke; Shinshi, Tadahiko; Arai, Hirokuni; Takatani, Setsuo

    2013-01-01

    Short- to mid-term extracorporeal ventricular assist devices (VADs) are recommended for critical cardiogenic shock patients. We have designed a preclinical, single-use MedTech Mag-Lev VAD for one-month extracorporeal use. The impeller-rotor of the pump was suspended by a two degree-of-freedom active magnetic bearing in a 300 μm fluid gap, where the computational fluid dynamics analysis predicted a secondary flow of about 400-500 ml/min at a pump speed of 1800-2200 rpm. Three eddy current sensors were employed to implement noise- and drift-free magnetic levitation. The pump components were injection molded using polycarbonate for smooth surfaces as well as improved reproducibility, followed by coating with a biocompatible 2-methacryloyl-oxyethyl phosphorylcholine polymer. Chronic animal experiments were performed in nine calves. Three of the nine calves were excluded from analysis for problems with the circuit. Five of the six (83.3%) completed the 60 day duration of the study, while one prematurely died of massive bleeding due to inflow port detachment. The pump did not stop due to magnetic-levitation malfunction. Neither pump thrombosis nor major organ infarction was observed at autopsy. In comparison to machined surfaces, the injection-molded pump surfaces were thrombus-free after 60 day implantation. This study demonstrates the feasibility of MedTech Mag-Lev VAD for 60 day circulatory support.

  5. Effects of arthroscopic-assisted surgery on irreducible developmental dislocation of hip by mid-term follow-up: An observational study.

    PubMed

    Xu, Hui-Fa; Yan, Ya-Bo; Xu, Chao; Li, Tian-Qing; Zhao, Tian-Feng; Liu, Ning; Huang, Lu-Yu; Zhang, Chun-Li; Lei, Wei

    2016-08-01

    The purpose of this study was to investigate the indications, surgical technique, and the clinical effects of arthroscopic-assisted treatment of irreducible developmental dislocation of the hip by mid-term follow-up. Arthroscopic-assisted surgeries were performed on 40 children (52 hips) between January 2005 and December 2009. Anterior and antero-superior greater trochanter portals were used in these treatments. Spica cast and abduction splint were applied for 3 months postoperatively. The follow-up was conducted on every 3 months postoperatively. During 12-month follow-up, a secondary treatment such as acetabuloplasty and/or femoral osteotomy (shortening, varus, and derotation) was applied if the acetabular angle was greater than 25°. The pelvic acetabular angle, Mckay and Severin score were evaluated every 6 months in all children. With 36 to 96 months (average 71 months) follow-up, 35 children (44 hips) were successfully followed up with complete case data while 5 children unsuccessfully. According to Tönnis classification, there were 5 grade 1 hips, 14 grade 2 hips, 14 grade 3 hips, 11 grade 4 hips, in which 3 children (4 hips) were failed in arthroscopic reduction and femoral head avascular necrosis occurred in 2 children (4 hips). According to Mckay standard, the good rate is 100%. According to Severin standard, the good rate is 84.1%. Arthroscopic assisted treatment is an effective way of reduction of the irreducible hip. Compared with the open reduction, arthroscopic treatment combined with acetabuloplasty and/or femoral osteotomy has advantages of less trauma and better function preservation. PMID:27537595

  6. Development of the deep flexor tendons and lumbricalis muscle in the hand and foot: a histological study using human mid-term foetuses.

    PubMed

    Cho, K H; Kim, J H; Ha, Y S; Murakami, G; Cho, B H; Abe, S

    2012-08-01

    To revisit foetal development of the deep flexor tendons of the hand and foot, we examined the paraffin-embedded histology of 20 mid-term foetuses at 8-15 weeks of estimated gestational age (35-118 mm crown-rump length or CRL). At 8-9 weeks, in front of the metacarpal bones, the flexor pollicis longus and flexor digitorum profundus (FDP) muscles provided a plate-like, common tendon from which the lumbricalis muscles originated. However, in the foot, we had no evidence of such a common tendon. The flexor pollicis tendon was separated from the common tendon at 9-10 weeks possibly due to mechanical stress from the laterally growing thumb. Notably, at the lumbricalis muscle origins at 10-12 weeks, the FDP and flexor digitorum longus tendons remained undifferentiated and the primitive tenocytes were dispersed from them. The dispersed cells seemed to develop into an interface tissue between the lumbricalis muscle fibre and the deep tendon. In 3 of 5 specimens at 15 weeks, we found an excess number of the FDP tendons (5-7) in the proximal side of the lumbricalis muscle origin. However, the excess tendons dispersed in the lumbricalis muscle origin. The development of the lumbricalis muscle origin might follow the tendon splitting for four fingers. However, conversely, we hypothesised that the developing lumbricalis muscles re-arranged the deep flexor tendons to provide a configuration of one deep tendon per one finger (or toe). The quadrates plantae muscle seemed not to contribute on the re-arrangement.

  7. Seismic hazard models for the central Apennines constrained by GPS and InSAR: mid-term review results of the ESA Pathfinder project CHARMING

    NASA Astrophysics Data System (ADS)

    Merryman Boncori, John Peter; Pezzo, Giuseppe; Visini, Francesco; Carafa, Michele; Devoti, Roberto; Atzori, Simone; Kastelic, Vanja; Berardino, Paolo; Fornaro, Gianfranco; Riguzzi, Federica; Pietrantonio, Grazia; d'Amico, Vera; Meletti, Carlo; Salvi, Stefano

    2015-04-01

    The contribution of space geodetic techniques to earthquake rate estimation, and thus seismic hazard modelling, has been recognized since two decades and made possible in more recent years by the increased availability and accuracy of geodetic measurements. We present the mid-term review results of a feasibility study named "Constraining Seismic Hazard Models with InSAR and GPS (CHARMING)", funded by the European Space Agency's (ESA) Support to Science Element (STSE) Pathfinders 2013 project. The area of interest considered at this stage of the project comprises a 200 km x 200 km area, covering the Abruzzi region (central Italy). In a later stage this area shall be extended to comprise a large portion of central and southern Italy, including most of the highest strain regions identified by recent studies. We present the interseismic velocities derived by ~60 permanent GPS stations and measurements derived from coast-to-coast strips of Synthetic Aperture Radar imagery from the ERS-1/2 AMI, ENVISAT ASAR and ALOS PALSAR sensors. The latter are processed with the Intermittent Small Baseline Subset (ISBAS) techniques, which greatly improves the measurement coverage compared to previous studies. Corrections are applied concerning tropospheric propagation errors, using ENVISAT MERIS precipitable water vapour maps and ERA-Interim numerical weather model parameters, as well as for the recently discovered oscillator drift of the ENVISAT ASAR sensor. Finally, measurements from individual SAR tracks are calibrated using GPS to ensure a common reference frame. For a set of composite seismogenic sources extracted from the DISS v.3.1.1 catalogue (Database of Italian Seismogenic Sources), we use the kinematic finite element NeoKinema model to derive long term average velocity fields and slip rates. We then derive earthquake rates, i.e. the number of earthquakes in a given time period above an established magnitude threshold, following the Seismic Hazard Inferred From Tectonics

  8. Use of a New Hybrid Heparin-Bonded Nitinol Ring Stent in the Popliteal Artery: Procedural and Mid-term Clinical and Anatomical Outcomes

    SciTech Connect

    Parthipun, Aneeta; Diamantopoulos, Athanasios; Kitrou, Panagiotis; Padayachee, Soundrie; Karunanithy, Narayan; Ahmed, Irfan; Zayed, Hany; Katsanos, Konstantinos E-mail: katsanos@med.upatras.gr

    2015-08-15

    PurposeTo report the immediate and mid-term clinical and anatomical outcomes of a novel, hybrid, heparin-bonded, nitinol ring stent (TIGRIS; Gore Medical) when used for the treatment of lesions located in the popliteal artery.Materials and MethodsThis was a prospective single-centre registry. Patients eligible for inclusion were individuals suffering from symptomatic popliteal arterial occlusive disease (Rutherford–Becker stage 3–6; P1–P3 segments) and treated with placement of the TIGRIS stent(s). Patients were prospectively scheduled for clinical review and duplex ultrasound follow-up after 6 and 12 months. Outcome measures included immediate technical success, primary vessel patency, in-stent binary restenosis (evaluable by Duplex at 50 % threshold; PSVR > 2.0), freedom from target lesion revascularization (TLR) and amputation-free survival (AFS) estimated by Kaplan–Meier (K–M) survival analysis. Cox proportional-hazards regression analysis was also performed to adjust for confounders and search for independent predictors of outcomes.ResultsFrom August 2012 to March 2014, a total of 54 popliteal TIGRIS stents were implanted in 50 limbs of 48 patients (27 men and 21 women; mean age 76.0 ± 1.7 years). Median Rutherford–Becker stage was five at baseline and 37/50 (74.0 %) were chronic total occlusions. Technical success was achieved in all cases (100 %). Stented lesion length was 114.2 ± 36.9 mm (range 6–20 cm). Median follow-up was 11.8 ± 0.8 months. After 12 months, primary patency of the TIGRIS stent was 69.5 ± 10.2 % with an 86.1 ± 5.9 % freedom from TLR and 87 ± 5.0 % AFS (K–M estimates).ConclusionThe TIGRIS hybrid heparin-bonded nitinol ring stent is a safe and effective endovascular option for complex occlusive disease of the popliteal artery.

  9. Common Anorectal Disorders

    PubMed Central

    Foxx-Orenstein, Amy E.; Umar, Sarah B.; Crowell, Michael D.

    2014-01-01

    Anorectal disorders result in many visits to healthcare specialists. These disorders include benign conditions such as hemorrhoids to more serious conditions such as malignancy; thus, it is important for the clinician to be familiar with these disorders as well as know how to conduct an appropriate history and physical examination. This article reviews the most common anorectal disorders, including hemorrhoids, anal fissures, fecal incontinence, proctalgia fugax, excessive perineal descent, and pruritus ani, and provides guidelines on comprehensive evaluation and management. PMID:24987313

  10. Poor mid-term survival of the low-carbide metal-on-metal Zweymüller-plus total hip arthroplasty system: a concise follow-up, at a minimum of ten years, of a previous report*.

    PubMed

    Repantis, Thomas; Vitsas, Vasilis; Korovessis, Panagiotis

    2013-03-20

    Between 1994 and 1999, 217 metal-on-metal total hip arthroplasties with a low-carbide bearing surface were performed with use of the cementless Zweymüller SL-Plus stem and the Bicon-Plus threaded cup in 194 consecutive patients. After a minimum follow-up of ten years, 181 living patients (203 hips) were available for evaluation. The revision rate after an average of twelve years was 18% (thirty-six hips in thirty-six patients were revised). The main reason for revision was aseptic loosening of one or both components. The probability of survival of the stem at fifteen years was 77% (95% confidence interval [CI], 65% to 86%). The probability of survival of the cup was 80% (95% CI, 62% to 90%). These high failure rates at mid-term follow-up led us to abandon the use of low-carbide metal-on-metal total hip arthroplasty components. PMID:23515994

  11. The Present, Mid-Term, and Long-Term Supply Curves for Tellurium; and Updates in the Results from NREL's CdTe PV Module Manufacturing Cost Model (Presentation)

    SciTech Connect

    Woodhouse, M.; Goodrich, A.; Redlinger, M.; Lokanc, M.; Eggert, R.

    2013-09-01

    For those PV technologies that rely upon Te, In, and Ga, first-order observations and calculations hint that there may be resource constraints that could inhibit their successful deployment at a SunShot level. These are only first-order approximations, however, and the possibility for an expansion in global Te, In, and Ga supplies needs to be considered in the event that there are upward revisions in their demand and prices.In this study, we examine the current, mid-term, and long-term prospects of Tellurium (Te) for use in PV. We find that the current global supply base of Te would support <10 GW of annual traditional CdTe PV manufacturing production. But as for the possibility that the supply base for Te might be expanded, after compiling several preliminary cumulative availability curves we find that there may be significant upside potential in the supply base for this element - principally vis a vis increasing demand and higher prices. Primarily by reducing the Tellurium intensity in manufacturing and by increasing the recovery efficiency of Te in Cu refining processes, we calculate that it may prove affordable to PV manufacturers to expand the supply base for Te such that 100 GW, or greater, of annual CdTe PV production is possible in the 2030 - 2050 timeframe.

  12. Multiscale Mathematical Modeling in Dental Tissue Engineering: Toward Computer-Aided Design of a Regenerative System Based on Hydroxyapatite Granules, Focussing on Early and Mid-Term Stiffness Recovery

    PubMed Central

    Scheiner, Stefan; Komlev, Vladimir S.; Gurin, Alexey N.; Hellmich, Christian

    2016-01-01

    We here explore for the very first time how an advanced multiscale mathematical modeling approach may support the design of a provenly successful tissue engineering concept for mandibular bone. The latter employs double-porous, potentially cracked, single millimeter-sized granules packed into an overall conglomerate-type scaffold material, which is then gradually penetrated and partially replaced by newly grown bone tissue. During this process, the newly developing scaffold-bone compound needs to attain the stiffness of mandibular bone under normal physiological conditions. In this context, the question arises how the compound stiffness is driven by the key design parameters of the tissue engineering system: macroporosity, crack density, as well as scaffold resorption/bone formation rates. We here tackle this question by combining the latest state-of-the-art mathematical modeling techniques in the field of multiscale micromechanics, into an unprecedented suite of highly efficient, semi-analytically defined computation steps resolving several levels of hierarchical organization, from the millimeter- down to the nanometer-scale. This includes several types of homogenization schemes, namely such for porous polycrystals with elongated solid elements, for cracked matrix-inclusion composites, as well as for assemblies of coated spherical compounds. Together with the experimentally known stiffnesses of hydroxyapatite crystals and mandibular bone tissue, the new mathematical model suggests that early stiffness recovery (i.e., within several weeks) requires total avoidance of microcracks in the hydroxyapatite scaffolds, while mid-term stiffness recovery (i.e., within several months) is additionally promoted by provision of small granule sizes, in combination with high bone formation and low scaffold resorption rates. PMID:27708584

  13. Mid-Term Quasi-Periodicities and Solar Cycle Variation of the White-Light Corona from 18.5 Years (1996.0 - 2014.5) of LASCO Observations

    NASA Astrophysics Data System (ADS)

    Barlyaeva, T.; Lamy, P.; Llebaria, A.

    2015-07-01

    We report on the analysis of the temporal evolution of the solar corona based on 18.5 years (1996.0 - 2014.5) of white-light observations with the SOHO/LASCO-C2 coronagraph. This evolution is quantified by generating spatially integrated values of the K-corona radiance, first globally, then in latitudinal sectors. The analysis considers time series of monthly values and 13-month running means of the radiance as well as several indices and proxies of solar activity. We study correlation, wavelet time-frequency spectra, and cross-coherence and phase spectra between these quantities. Our results give a detailed insight on how the corona responds to solar activity over timescales ranging from mid-term quasi-periodicities (also known as quasi-biennial oscillations or QBOs) to the long-term 11 year solar cycle. The amplitude of the variation between successive solar maxima and minima (modulation factor) very much depends upon the strength of the cycle and upon the heliographic latitude. An asymmetry is observed during the ascending phase of Solar Cycle 24, prominently in the royal and polar sectors, with north leading. Most prominent QBOs are a quasi-annual period during the maximum phase of Solar Cycle 23 and a shorter period, seven to eight months, in the ascending and maximum phases of Solar Cycle 24. They share the same properties as the solar QBOs: variable periodicity, intermittency, asymmetric development in the northern and southern solar hemispheres, and largest amplitudes during the maximum phase of solar cycles. The strongest correlation of the temporal variations of the coronal radiance - and consequently the coronal electron density - is found with the total magnetic flux. Considering that the morphology of the solar corona is also directly controlled by the topology of the magnetic field, this correlation reinforces the view that they are intimately connected, including their variability at all timescales.

  14. Chronic perineal pain: current pathophysiological aspects, diagnostic approaches and treatment.

    PubMed

    Andromanakos, Nikolaos P; Kouraklis, Grigorios; Alkiviadis, Kostakis

    2011-01-01

    Chronic perineal pain is the anorectal and perineal pain without underlying organic disease, anorectal or endopelvic, which has been excluded by careful physical examination, radiological and endoscopic investigations. A variety of neuromuscular disorders of the pelvic floor lead to the different pathological conditions such as anorectal incontinence, urinary incontinence and constipation of obstructed defecation, sexual dysfunction and pain syndromes. The most common functional disorders of the pelvic floor muscles, accompanied by perineal pain are levator ani syndrome, proctalgia fugax, myofascial syndrome and coccygodynia. In the diagnosis of these syndromes, contributing to a thorough history, physical examination, selected specialized investigations and the exclusion of organic disease with proctalgia is carried out. Accurate diagnosis of the syndromes helps in choosing an appropriate treatment and in avoiding unnecessary and ineffective surgical procedures, which often are performed in an attempt to alleviate the patient's symptoms.

  15. Provenance of alluvial fan deposits to constrain the mid-term offsets along a strike-slip active fault: the Elsinore fault in the Coyote Mountains, Imperial Valley, California.

    NASA Astrophysics Data System (ADS)

    Masana, Eulalia; Stepancikova, Petra; Rockwell, Thomas

    2013-04-01

    The lateral variation in rates along a fault and its constancy along time is a matter of discussion. To give light to this discussion, short, mid and long term offset distribution along a fault is needed. Many studies analyze the short-term offset distribution along a strike-slip fault that can be obtained by the analysis of offset features imprinted in the morphology of the near-fault area. We present an example on how to obtain the mid- to long-term offset values based on the composition of alluvial fans that are offset by the fault. The study area is on the southern tip of the Elsinore fault, which controls the mountain front of the Coyote Mountains (California). The Elsinore-Laguna Salada fault is part of the San Andreas fault (SAF) system, extending 250 km from the Los Angeles Basin southeastward into the Gulf of California, in Mexico. The slip-rate on the southern Elsinore fault is believed to be moderate based on recent InSAR observations, although a recent study near Fossil Canyon (southern Coyote Mountains) suggests a rate in the range of 1-2 mm/yr. For this study we processed the airborne LiDAR dataset (EarthScope Southern & Eastern California, SoCal) to map short to mid-term alluvial offsets. We reprocessed the point clouds to produce DEMs with 0.5m and 0.25m grids and we varied the insolation angles to illuminate the various fault strands and the offset features. We identified numerous offset features, such as rills, channel bars, channel walls, alluvial fans, beheaded channels and small erosional basins that varied in displacement from 1 to 350 m. For the mid- to long-term offsets of the alluvial fans we benefited from the diverse petrological composition of their sources. Moreover, we recognized that older alluvium, which is offset by greater amounts, is in some cases buried beneath younger alluvial fan deposits and separated by buried soils. To determine the source canyon of various alluvial elements, we quantified the clast assemblage of each source

  16. Mid-term experience with valved bovine jugular vein conduits.

    PubMed

    Pawelec-Wojtalik, Malgorzata; Mrówczyński, Wojciech; Wodziński, Andrzej; Wojtalik, Michal; Henschke, Jacek; Sharma, Girish K

    2005-12-01

    From June 1999 to January 2004, 43 children underwent implantation of a valved bovine jugular vein conduit and correction of complex congenital heart defects. Median age was 1.98 years (range, 11 days - 13.3 years). There were 7 early deaths (16.3%) unrelated to conduit failure or thrombosis. Median follow-up of 36 survivors was 24 months (range, 1-48 months, quartile range, 12-48 months), total follow-up was 78 patient-years. There were 3 late deaths (8.3%) due to infection, pulmonary thromboembolism, and sudden cardiac arrest after re-operation to repair a right ventricular outflow tract aneurysm. There were 2 conduit explantations due to dysfunction and suspected endocarditis. Three patients underwent balloon dilatation of distal stenoses. The mean peak gradient through the pulmonary anastomosis was 15 mm Hg (range, 3-42 mm Hg) among patients free from re-intervention. No severe valve regurgitation was observed. Freedom from re-intervention was 72% at 48 months. This conduit remains a good alternative to homografts. Causes of distal stenosis must be clarified, guidelines for prophylactic anticoagulation must be created, and the role of percutaneous balloon dilatation established. PMID:16304226

  17. Texasgulf solar cogeneration program. Mid-term topical report

    SciTech Connect

    Not Available

    1981-02-01

    The status of technical activities of the Texasgulf Solar Cogeneration Program at the Comanche Creek Sulfur Mine is described. The program efforts reported focus on preparation of a system specification, selection of a site-specific configuration, conceptual design, and facility performance. Trade-off studies performed to select the site-specific cogeneration facility configuration that would be the basis for the conceptual design efforts are described. Study areas included solar system size, thermal energy storage, and field piping. The conceptual design status is described for the various subsystems of the Comanche Creek cogeneration facility. The subsystems include the collector, receiver, master control, fossil energy, energy storage, superheat boiler, electric power generation, and process heat subsystems. Computer models for insolation and performance are also briefly discussed. Appended is the system specification. (LEW)

  18. MotherCare praised in mid-term review.

    PubMed

    1993-02-01

    The MotherCare Project, a USAID-funded program, is aimed at preventing maternal and perinatal mortality and morbidity. As part of its activities, the project engages in a series of applied research initiatives in different countries and offers short-term technical and training support. Five long-term demonstration projects which form the basic building blocks for program strategies have been developed in five countries. In each of these national demonstration projects, MotherCare aims to fill the gaps which exist in maternity care. In Uganda and Nigeria, training midwives in life-saving skills for dealing with complications has been selected as a priority. The demonstration projects in Bolivia, Guatemala, and Indonesia take a community-oriented approach and are designed to encourage behavior change which boosts maternal and newborn health. In Bolivia, there are plans for hospital staff to discuss MotherCare research findings which show why women are often reluctant to use health services and develop strategies to overcome such barriers. Communities seem to be responding to the stimulus provided by the projects. MotherCare intends to define the essential components of success within each demonstration project for the benefit of planners, policymakers, and researchers involved in safe motherhood. Guidelines for safe motherhood based on the experiences have been developed and these will provide the basis for "A guide to the minimum maternity service package required to detect, treat and prevent maternal and neonatal mortality. PMID:12344823

  19. Predicting Mid-Term Grades for Science Students at Perkinston.

    ERIC Educational Resources Information Center

    Mann, Noel R.

    In order to reduce the 35-40% dropout/failure rate in chemistry classes at the Perkinston Campus of Mississippi Gulf Coast Junior College, this study sought predictors which would provide early identification of students in need of special or additional help. Using regression analysis, data accumulated from the achievement records of students over…

  20. The formal Darwinism project: a mid-term report.

    PubMed

    Grafen, A

    2007-07-01

    For 8 years I have been pursuing in print an ambitious and at times highly technical programme of work, the 'Formal Darwinism Project', whose essence is to underpin and formalize the fitness optimization ideas used by behavioural ecologists, using a new kind of argument linking the mathematics of motion and the mathematics of optimization. The value of the project is to give stronger support to current practices, and at the same time sharpening theoretical ideas and suggesting principled resolutions of some untidy areas, for example, how to define fitness. The aim is also to unify existing free-standing theoretical structures, such as inclusive fitness theory, Evolutionary Stable Strategy (ESS) theory and bet-hedging theory. The 40-year-old misunderstanding over the meaning of fitness optimization between mathematicians and biologists is explained. Most of the elements required for a general theory have now been implemented, but not together in the same framework, and 'general time' remains to be developed and integrated with the other elements to produce a final unified theory of neo-Darwinian natural selection.

  1. On Mid-Term Periodicities in Cosmic Rays

    NASA Astrophysics Data System (ADS)

    Kudela, Karel; Mavromichalaki, Helen; Papaioannou, Athanasios; Gerontidou, Maria

    2010-09-01

    The contributions of quasi-periodic variations of cosmic rays for T>27 days at the primary energies to which neutron monitors are sensitive have a rather complicated character. They were reported in several papers ( e.g. Valdés-Galicia, Perez-Enriquez, and Otaola, 1996; Mavromichalaki et al., 2003; Kudela et al., 2002; Caballero and Valdés-Galicia, 2001) from individual stations and for various time intervals covered. The data archive of several neutron monitor stations developed within the NMDB project ( www.nmdb.eu ) now involves long time series of measurements at neutron monitors situated at different geomagnetic cut-off rigidity positions and at different altitudes. It is updated continuously. Using the daily averages of cosmic-ray intensity at three selected stations within NMDB: i) the temporal evolution of the selected quasi-periodicities, especially those of approximately 1.7 yr, 150 days and 26 - 32 days respectively, until 2008 are reviewed, ii) the similarities of the spectra are checked and iii) the occurrence of quasi-periodicities with those observed in solar, interplanetary and geomagnetic activities (Moussas et al., 2005; Richardson and Cane, 2005) as well as in energetic particles below the atmospheric threshold are discussed (Laurenza et al., 2009).

  2. [Amaurosis fugax in inferior wall myocardial infarction with ST segment elevation].

    PubMed

    Hrycek, Eugeniusz; Bońkowski, Michał; Nowakowski, Przemysław; Żurakowski, Aleksander; Buszman, Paweł

    2016-01-01

    The patient, a fifty nine year old male, was admitted to the ward with symptoms of inferior wall myocardial infarction with ST segment elevation combined with intermittent right side sight loss. Despite typical resting stenocardial chest pain, ST segment elevation in ECG, transient symptoms of acute heart failure and slightly elevated myocardial necrosis biomarkers, coronarography did not reveal obvious source of myocardial ischemia. Moreover, echocardiography did not confirm decreased ejection fraction. However further research confirmed critical stenosis of the left internal carotid artery and chronic occlusion of the right internal carotid artery. Several questions were raised during diagnostic process including: the cause of cardiac ischemia and the cause of cerebral ischemia. Clinical data analysis and available literature allowed authors to exclude cerebral ischemia as a source of ECG ischemic changes and to establish transient myocardial ischemia causing circulatory decompensation amplified by carotid arteries atherosclerosis as the source of neurological symptoms. PMID:27487548

  3. Global Immunization Vision and Strategy (GIVS): a mid-term analysis of progress in 50 countries.

    PubMed

    Kamara, Lidija; Lydon, Patrick; Bilous, Julian; Vandelaer, Jos; Eggers, Rudi; Gacic-Dobo, Marta; Meaney, William; Okwo-Bele, Jean-Marie

    2013-01-01

    Within the overall framework set out in the Global Immunization Vision and Strategy (GIVS) for the period 2006-2015, over 70 countries had developed comprehensive Multi-Year Plans (cMYPs) by 2008, outlining their plans for implementing the GIVS strategies and for attaining the GIVS Goals at the midpoint in 2010 or earlier. These goals are to: (1) reach ≥90% and ≥80% vaccination coverage at national and district level, respectively; and (2) reduce measles-related mortality by 90% compared with the 2000 level. Fifty cMYPs were analysed along the four strategic areas of the GIVS: (1) protecting more people in a changing world; (2) introducing new vaccines and technologies; (3) integrating immunization, other health interventions and surveillance in the health system context; and (4) immunizing in the context of global interdependence. By 2010, all 50 countries planned to have introduced hepatitis B (HepB) vaccine, 48 the Haemophilus influenzae type B (Hib) vaccine and only a few countries had firm plans to introduce pneumococcal or rotavirus vaccines. Countries seem to be inadequately prepared in terms of cold-chain requirements to deal with the expected increases in storage that will be required for vaccines, and in making provisions to establish a corresponding surveillance system for planned new vaccine introductions. Immunization contacts are used to deliver other health interventions, especially in the countries in the World Health Organization (WHO) Africa Region. The cost for the planned immunization activities will double to U$27 per infant, of which U$5 per infant is the expected shortfall. Global Alliance for Vaccines and Immunization (GAVI) funding is becoming the largest contributor to immunization programmes. PMID:22411879

  4. [Use of the anatomical cemented femoral stem SAS I: mid-term results].

    PubMed

    Mikláš, M; Pink, M; Valoušek, T

    2015-01-01

    PURPOSE OF THE STUDY In view of increasing interest in a relationship between the surface of an implant and its behaviour and longevity in total hip arthroplasty (THA), the aim of this study is to present the clinical and radiographic results, as well as complications, of hip replacement surgery using the cemented femoral stem SAS I. MATERIAL AND METHODS A total of 298 cemented femoral stems SAS I were implanted in 275 patients at our department between 1996 and 2005. The patient average age was 72.1 years, with the range from 64 to 92 years. The pre-operative diagnoses were as follows: primary osteoarthritis in 179 (30.1%); post-dysplastic osteoarthritis in 41 (13.7%); femoral neck fracture in 44 (14.8%); avascular necrosis of the femoral head in 23 (7.7%); rheumatoid arthritis in nine (3%) and other causes in two (0.7%) patients. Of the 275 patients who had the surgery, 186 (204 THAs) underwent clinical and X-ray examination at an average follow-up of 11.5 years (range, 8 to 17 years). The clinical results were used to calculate the Harris hip score and radiographic evaluation was based on antero-posterior views. RESULTS The group of 186 assessed patients (204 THAs) comprised 106 women and 80 men, who were on average 85.4 years old on evaluation (range, 72 to 92 years). Of the remaining patients, 62 patients (64 THAs) died from causes unrelated to the surgery and 27 patients (30 THAs) were lost to follow-up. The functional outcome of surgery assessed by the Harris hip score was excellent in 61 (32.8%), good in 94 (50.5%), satisfactory in 26 (14%) and poor in five (2.7%) patients. The 93.1% SAS I stem longevity was recorded in relation to aseptic loosening; reimplantation for this indication was performed in 14 THAs. No revision surgery for failure due to valgus/varus deviations of the stem was carried out. Of the 204 hips, 188 had femoral stems aligned in neutral, 12 (5.9%) in valgus and four (2%) in varus positions. DISCUSSION The anatomical femoral stem SAS I is an implant made to fit the proximal femur anatomy. Its highly polished surface allows for optimal fitting with the supporting bone and for even distribution of weight bearing. This results in a low rate of THA failure. In accordance with the relevant literature, the acetabular components is considered to be the weakest element in total hip replacement in terms of aseptic loosening and implant failure. At present, the SAS I stem has no Morse Eurocone taper and this is the chief obstacle hindering its more frequent use in endoprosthetics. CONCLUSIONS The results of our study are in agreement with those of other successfully implanted polished cemented femoral components. Key words: anatomical cemented femoral component, surface adjustment of the femoral stem, complications.

  5. U.S. Natural Gas Markets: Mid-Term Prospects for Natural Gas Supply

    EIA Publications

    2001-01-01

    This service report describes the recent behavior of natural gas markets with respect to natural gas prices, their potential future behavior, the potential future supply contribution of liquefied natural gas and increased access to federally restricted resources, and the need for improved natural gas data.

  6. Comparison of Mid-Term Clinical Outcomes of Different Surgical Approaches in Symptomatic Diaphragmatic Eventration

    PubMed Central

    Tezel, Cagatay; Vayvada, Mustafa; Kanbur, Serda; Urek, Senol; Baysungur, Volkan; Yalçınkaya, Irfan

    2016-01-01

    Purpose: There is no data comparing different surgical techniques for diaphragmatic re-positioning for hemi-diaphragmatic eventration in adults. Our aim was to verify the potential pros and cons of two major surgical techniques in symptomatic eventration patients. Methods: Patients undergoing thoracotomy for diaphragmatic elevation repair either by un-opened (accordion placation) or by opened (double-breasted placation) diaphragmatic technique between January 2007 and August 2013 were analyzed retrospectively, and compared in terms of operative outcomes on 12th and 24th months. Results: Forty-two patients underwent accordion (n = 23) or double-breasted (n = 19) plication. Postoperative drainage was significantly increased (215 ± 66 ml vs. 114 ± 48 ml; P = 0.0082) in double-breasted group. Although the corrected diaphragm was radiologically better preserved in this group, this divergence showed no additional effect on postoperative pulmonary functions or the dyspnea score on 12th or 24th months. No complication particularly related to both techniques or recurrence was noted during follow-up of 28 ± 12 months. Conclusions: Radiological prospect of corrected diaphragm is better preserved with double-breasted plication, but the significant and permanent improvement of respiratory functions was similar. Since the clinical outcome is equivalent, incision of the diaphragm is not essential. PMID:27076066

  7. Early and Mid-Term Outcome of Pediatric Congenital Mitral Valve Surgery

    PubMed Central

    Baghaei, Ramin; Tabib, Avisa; Jalili, Farshad; Totonchi, Ziae; Mahdavi, Mohammad; Ghadrdoost, Behshid

    2015-01-01

    Background: Congenital lesions of the mitral valve are relatively rare and are associated with a wide spectrum of cardiac malformations. The surgical management of congenital mitral valve malformations has been a great challenge. Objectives: The aim of this study was to evaluate the early and intermediate-term outcome of congenital mitral valve (MV) surgery in children and to identify the predictors for poor postoperative outcomes and death. Patients and Methods: In this retrospective study, 100 consecutive patients with congenital MV disease undergoing mitral valve surgery were reviewed in 60-month follow-up (mean, 42.4 ± 16.4 months) during 2008 - 2013. Twenty-six patients (26%) were under one-year old. The mean age and weight of the patients were 41.63 ± 38.18 months and 11.92 ± 6.12 kg, respectively. The predominant lesion of the mitral valve was MV stenosis (MS group) seen in 21% and MR (MR group) seen in 79% of the patients. All patients underwent preoperative two-dimensional echocardiography and then every six months after surgery Results: Significant improvement in degree of MR was noted in all patients with MR during postoperative and follow-up period in both patients with or without atrioventricular septal defect (AVSD) (P = 0.045 in patients with AVSD and P = 0.008 in patients without AVSD). Decreasing trend of mean gradient (MG) in MS group was statistically significant (P = 0.005). In patients with MR, the mean pulmonary artery pressure (PAP) had improved postoperatively (P < 0.001). Although PAP in patients with MV stenosis was reduced, this reduction was not statistically significant (P = 0.17). In-hospital mortality was 7%. Multivariate analysis demonstrated that age (P < 0.001), weight (P < 0.001), and pulmonary stenosis (P = 0.03) are strong predictors for mortality. Based on the echocardiography report at the day of discharge from hospital, surgical results were optimal (up to moderate degree for MR group and up to mild degree for MS group) in 85.7% of patients with MS and in 76.6% of patients with MR. Age (P = 0.002) and weight (P = 0.003) of patients are strong predictors for surgical success in multivariate analysis. Conclusions: Surgical repair of the congenital MV disease yields acceptable early and intermediate-term satisfactory valve function and good survival at intermediate-term follow-up. Strong predictors for poor surgical outcome and death were age smaller than 1 year, weight smaller or equal than 6 kg, and associated cardiac anomalies such as pulmonary stenosis. PMID:26446282

  8. Space station needs, attributes and architectural options study. Briefing material, mid-term review

    NASA Technical Reports Server (NTRS)

    1982-01-01

    User mission requirements and their relationship to the current space transportation system are examined as a means of assuring the infusion of corporate ideas and knowledge in the space station program. Specific tasks include developing strategies to develop user consistency; determine DOD implication and requirements; and foster industry involvement in the space station. Mission alternatives; accrued benefits; program options; system attributes and characteristics; and a recommended plan for space station evolution are covered.

  9. Coronary artery bypass surgery without cardiopulmonary bypass: short- and mid-term results.

    PubMed

    Mishra, Y; Mehta, Y; Kohli, V M; Kohli, V; Mairal, M; Mishra, A; Bapna, R K; Trehan, N

    1997-01-01

    From March 1994 to April 1997, 433 patients had undergone coronary artery bypass grafting without cardiopulmonary bypass in our institute. Sixty-eight patients had various organ dysfunctions and/or aortic atheroma or calcification and were regarded as high risk for cardiopulmonary bypass. In 277 patients surgery was performed through midline sternotomy, while in 156 minithoracotomy approach was used. In 361 patients single coronary artery bypass grafting was done, and in 72 two-coronary arteries were bypassed. In 63 patients who had graftable vessels in anterior wall and diffusely diseased ungraftable vessels in posterolateral and/or inferior wall, transmyocardial laser revascularisation was also done along with coronary artery bypass grafting to achieve complete myocardial revascularisation. Nine patients in this series were also subjected to simultaneous carotid endarterectomy along with myocardial revascularisation. In two patients complementary percutaneous transluminal coronary angioplasty of left circumflex coronary artery was done five days after minithoracotomy and left internal mammary artery to left anterior descending coronary artery bypass grafting. Forty-two cases were extubated in operating room. Average blood loss was 260 ml. Six patients were reexplored for postoperative bleeding. Seven patients had perioperative myocardial infarction. One developed neurological complication. Hospital mortality was 2.3 percent (10/433 cases) and four deaths were due to malignant ventricular arrhythmias. Nine patients developed chest wound complications. Average hospital stay after operation was six days, 423 patients were discharged from hospital and all of them were asymptomatic. During three years follow-up (range 3 to 38 months) there were three known cardiac deaths. Ninety percent (391) patients reported to the follow-up clinic and 91 percent of them were angina-free. In patients who were subjected to transmyocardial laser revascularisation along with coronary artery bypass grafting, myocardial perfusion scan showed a step-wise improvement in reversible ischemia. The perfusion index increased from 52 percent at three months to 90 percent at 12 months. We conclude that coronary artery bypass grafting without cardiopulmonary bypass can be done with relatively low mortality, more so in a group of patients in whom cardiopulmonary bypass poses a high risk. Transmyocardial laser revascularisation is a suitable means to provide complete myocardial revascularisation along with coronary artery bypass surgery in patients who have graftable vessels in anterior wall and ungraftable vessels in posterolateral and inferior walls. PMID:9505019

  10. Mid-term financial impact of animal welfare improvements in Dutch broiler production.

    PubMed

    Gocsik, E; Lansink, A G J M Oude; Saatkamp, H W

    2013-12-01

    This study used a stochastic bioeconomic simulation model to simulate the business and financial risk of different broiler production systems over a 5-yr period. Simulation analysis was conducted using the @Risk add-in in MS Excel. To compare the impact of different production systems on economic feasibility, 2 cases were considered. The first case focused on the economic feasibility of a completely new system, whereas the second examined economic feasibilities when a farm switches from a conventional to an animal welfare-improving production system. A sensitivity analysis was conducted to assess the key drivers of economic feasibility and to reveal systematic differences across production systems. The study shows that economic feasibility of systems with improved animal welfare predominantly depends on the price that farmers receive. Moreover, the study demonstrates the importance of the level and variation of the price premium for improved welfare, particularly in the first 5 yr after conversion. The economic feasibility of the production system increases with the level of welfare improvements for a sufficiently high price level for broiler meat and low volatility in producer prices. If this is not the case, however, risk attitudes of farmers become important as well as the use of potential risk management instruments.

  11. Return to sporting activity after Birmingham hip resurfacing arthroplasty: Mid term results

    PubMed Central

    Sandiford, Nemandra; Muirhead-Allwood, SK; Skinner, JA

    2015-01-01

    Background: Hip resurfacing arthroplasty (HRA) is primarily indicated for young, active patients with disabling coxarthrosis who wish to remain active and return to sports after surgery. Relatively few prospective studies have assessed return to sporting activity and impact of gender and age on this. Materials and Methods: Seventy-nine consecutive patients treated with HRA were included. Patients were reviewed clinically and radiologically. Function was assessed using the modified University of California Los Angeles (UCLA) activity score. The Oxford, Harris and WOMAC hip scores were calculated. Results: Average age at the time of surgery was 54.9 years (range 34.5–73.6 years). Average preoperative and postoperative UCLA scores were 4 and 7.6 respectively. Patients were involved in 2 (0–4) sporting activities preoperatively and 2 (0–5) postoperatively. Preoperative and postoperative Oxford Hip Scores, Harris Hip Score and WOMAC scores were 40, 46 and 51 and 16, 94 and 3 respectively (P < 0.0001). Patients returned to sports at an average of 3 months postoperatively. Conclusion: Patients were able to return to sports by 3 months and perform the same number of activities at preoperative intensity. Activity levels are maintained up to the medium term with few complications. PMID:26806965

  12. [Use of the anatomical cemented femoral stem SAS I: mid-term results].

    PubMed

    Mikláš, M; Pink, M; Valoušek, T

    2015-01-01

    PURPOSE OF THE STUDY In view of increasing interest in a relationship between the surface of an implant and its behaviour and longevity in total hip arthroplasty (THA), the aim of this study is to present the clinical and radiographic results, as well as complications, of hip replacement surgery using the cemented femoral stem SAS I. MATERIAL AND METHODS A total of 298 cemented femoral stems SAS I were implanted in 275 patients at our department between 1996 and 2005. The patient average age was 72.1 years, with the range from 64 to 92 years. The pre-operative diagnoses were as follows: primary osteoarthritis in 179 (30.1%); post-dysplastic osteoarthritis in 41 (13.7%); femoral neck fracture in 44 (14.8%); avascular necrosis of the femoral head in 23 (7.7%); rheumatoid arthritis in nine (3%) and other causes in two (0.7%) patients. Of the 275 patients who had the surgery, 186 (204 THAs) underwent clinical and X-ray examination at an average follow-up of 11.5 years (range, 8 to 17 years). The clinical results were used to calculate the Harris hip score and radiographic evaluation was based on antero-posterior views. RESULTS The group of 186 assessed patients (204 THAs) comprised 106 women and 80 men, who were on average 85.4 years old on evaluation (range, 72 to 92 years). Of the remaining patients, 62 patients (64 THAs) died from causes unrelated to the surgery and 27 patients (30 THAs) were lost to follow-up. The functional outcome of surgery assessed by the Harris hip score was excellent in 61 (32.8%), good in 94 (50.5%), satisfactory in 26 (14%) and poor in five (2.7%) patients. The 93.1% SAS I stem longevity was recorded in relation to aseptic loosening; reimplantation for this indication was performed in 14 THAs. No revision surgery for failure due to valgus/varus deviations of the stem was carried out. Of the 204 hips, 188 had femoral stems aligned in neutral, 12 (5.9%) in valgus and four (2%) in varus positions. DISCUSSION The anatomical femoral stem SAS I is an implant made to fit the proximal femur anatomy. Its highly polished surface allows for optimal fitting with the supporting bone and for even distribution of weight bearing. This results in a low rate of THA failure. In accordance with the relevant literature, the acetabular components is considered to be the weakest element in total hip replacement in terms of aseptic loosening and implant failure. At present, the SAS I stem has no Morse Eurocone taper and this is the chief obstacle hindering its more frequent use in endoprosthetics. CONCLUSIONS The results of our study are in agreement with those of other successfully implanted polished cemented femoral components. Key words: anatomical cemented femoral component, surface adjustment of the femoral stem, complications. PMID:26317186

  13. Phase 3 study of selected tether applications in space, mid-term review

    NASA Technical Reports Server (NTRS)

    1986-01-01

    Topics addressed include: guidelines for the Space Transportation System (STS) payload deployer design; mini-orbital maneuvering vehicle (MOMV) design: shuttle tether deployer systems (STEDS); cost modeling; tethered platform analysis; fuel savings analysis; and STEDS control simulation.

  14. Immediate and mid-term effects of pyrimethanil toxicity on microalgae by simulating an episodic contamination.

    PubMed

    Shinn, Cândida; Delello-Schneider, Danieli; Mendes, Lucas B; Sanchez, André L; Müller, Ruth; Espíndola, Evaldo L G; Araújo, Cristiano V M

    2015-02-01

    Since pesticides can represent a threat for non-target aquatic communities, including microalgae, we looked at the effects of the fungicide pyrimethanil on the growth of the freshwater green microalgae Selenastrum capricornutum. Additionally, attenuation of the toxicity of pyrimethanil due to its dissipation in the water was assessed. Pyrimethanil-contaminated samples were taken from outdoor mesocosms one (1.4 mg L(-1) of pyrimethanil) and ten (0.78 mg L(-1) of pyrimethanil) days after pyrimethanil application. Different dilutions were prepared using both nutrient-rich culture medium (LC Oligo) and non-contaminated mesocosm samples, and cell growth inhibition was assessed. Reference mesocosm samples were also diluted with LC Oligo in order to verify how the nutrient concentration in the LC Oligo could improve cell growth. Comparing cell growth of population exposed to pyrimethanil-treated sample taken at day 1 with cells growing in reference sample and LC Oligo, the growth inhibition was 80% (± 6.5) and 95% (± 2.0), respectively. The toxicity of samples taken from contaminated mesocosms at day 10 was attenuated to 34% (± 15) (when compared with reference sample) and 88% (± 3.0) (when compared with LC Oligo), as pyrimethanil concentrations in the mesocosms decreased. In conclusion, (i) pyrimethanil can be an environmental disturber for the microalgae; (ii) the toxicity of pyrimethanil in water was reduced almost 2.4 times (when compared with the reference sample) at as short a period as 10d if assuming that pesticide entrance is not continuous; (iii) toxicity of an environmental sample could be underestimated if the sample/medium used in dilution presents different nutrient levels. PMID:25216469

  15. Immediate and mid-term effects of pyrimethanil toxicity on microalgae by simulating an episodic contamination.

    PubMed

    Shinn, Cândida; Delello-Schneider, Danieli; Mendes, Lucas B; Sanchez, André L; Müller, Ruth; Espíndola, Evaldo L G; Araújo, Cristiano V M

    2015-02-01

    Since pesticides can represent a threat for non-target aquatic communities, including microalgae, we looked at the effects of the fungicide pyrimethanil on the growth of the freshwater green microalgae Selenastrum capricornutum. Additionally, attenuation of the toxicity of pyrimethanil due to its dissipation in the water was assessed. Pyrimethanil-contaminated samples were taken from outdoor mesocosms one (1.4 mg L(-1) of pyrimethanil) and ten (0.78 mg L(-1) of pyrimethanil) days after pyrimethanil application. Different dilutions were prepared using both nutrient-rich culture medium (LC Oligo) and non-contaminated mesocosm samples, and cell growth inhibition was assessed. Reference mesocosm samples were also diluted with LC Oligo in order to verify how the nutrient concentration in the LC Oligo could improve cell growth. Comparing cell growth of population exposed to pyrimethanil-treated sample taken at day 1 with cells growing in reference sample and LC Oligo, the growth inhibition was 80% (± 6.5) and 95% (± 2.0), respectively. The toxicity of samples taken from contaminated mesocosms at day 10 was attenuated to 34% (± 15) (when compared with reference sample) and 88% (± 3.0) (when compared with LC Oligo), as pyrimethanil concentrations in the mesocosms decreased. In conclusion, (i) pyrimethanil can be an environmental disturber for the microalgae; (ii) the toxicity of pyrimethanil in water was reduced almost 2.4 times (when compared with the reference sample) at as short a period as 10d if assuming that pesticide entrance is not continuous; (iii) toxicity of an environmental sample could be underestimated if the sample/medium used in dilution presents different nutrient levels.

  16. What can we expect from near to mid-term direct imaging programs?

    NASA Astrophysics Data System (ADS)

    Boccaletti, A.

    2015-10-01

    Direct imaging for exoplanets has made enormous progress in the last decades owing to the advent of new technologies, efficient algorithms for postprocessing and dedicated observing strategies. A few young giant exoplanets were detected with the previous generation of instruments (beta Pic b, HS3799bcde, HR95086b ...). While SPHERE and GPI were conceived with this very purpose, we are thus expecting many more discoveries in the next years. SPHERE comes with a series of facilities to characterize the atmosphere of these planets, from the visible to the near IR, with broad band, narrow band filters, and low to medium resolution spectroscopy as well. It is also a fabulous instrument to study circumstellar disks both intensity and polarimetry in order to establish the link between planets and their environments. A large survey of 600 targets on a 5 years baseline has been started. The next space telescope, JWST equipped with MIRI and NIRCAM will extend the ability to characterize young giants in the mid IR. NO doubt we will learn more about their atmospheres. Finally, by the next decade, very large apertures will become available on the ground. Extremely Large Telescope will have general first light instruments (MICADO, HARMONI), but some programs to image and characterize young giant planets around very distant stars (>100pc) will be feasible. For much ambitious goal, detecting telluric planets and studying their atmosphere, two paths are now considered either from space (WFIRST AFTA-C is good candidate) and from the Ground with SPHERE-like instruments on ELTs. A review of achievments and perspectives in the context of direct imaging will be presented.

  17. Mid-Term Outcomes Following Endovascular Re-Intervention for Iliac Artery In-Stent Restenosis

    PubMed Central

    Javed, Usman; Balwanz, Christopher R.; Armstrong, Ehrin J.; Yeo, Khung-Keong; Singh, Gagan D.; Singh, Satinder; Anderson, David; Westin, Gregory G.; Pevec, William C.; Laird, John R.

    2013-01-01

    Objectives We sought to evaluate the procedural characteristics and clinical outcomes of endovascular repair for iliac artery (IA) in-stent restenosis (ISR). Background An increasing percentage of patients with complex IA occlusive disease are treated with an endovascular approach, but the outcomes of IA-ISR have not been well described. Methods We analyzed all endovascular procedures for treatment of IA-ISR performed at our institution between July 2006–December 2010. The primary outcome was primary patency, defined as <50% stenosis as assessed by clinical examination and duplex ultrasonography (DUS). Results Forty-one lesions in 24 patients who underwent repeated endovascular intervention for treatment of IA-ISR. Most lesions were unilateral and involved the common IA (66%). The mean length of ISR was 30.1 ± 14.1 mm with type I (focal) and II (diffuse) ISR occurring with the greatest frequency (34% and 39%, respectively). All patients underwent balloon angioplasty; adjunctive stenting zwas performed in 27 (66%) of the lesions. Type II ISR lesions more frequently required stenting (13/16 lesions, P = 0.02 compared with other patterns of ISR). Procedural success was 100% with a mean gain of 0.13 in the ankle-brachial index (P = 0.001). The 6-and 12-month primary patency rates were 96% and 82%, respectively. The 12-month primary-assisted patency rate was 90% with clinically driven target lesion revascularization (TLR) in three patients. Conclusions Endovascular treatment of IA-ISR using an approach of balloon angioplasty followed by selective stenting is associated with high-patency rates and low rates of TLR at 1 year. PMID:23613343

  18. Mid-term effects of mine soil reclamation by use of aided phytostabilization

    NASA Astrophysics Data System (ADS)

    Zornoza, Raúl; Faz, Ángel; Martínez-Martínez, Silvia; Acosta, Jose Alberto; Gómez, María Dolores; Yanardag, Ibrahim

    2014-05-01

    Abandoned tailing ponds show environmental and human health hazards by the transfer of heavy metals through erosion or leaching. To reduce these hazards, a reclamation strategy has been developed on a tailing pond based on aided phytostabilization. In 2011 marble mud and pig slurry were applied on the tailing pond surface. In spring 2012 thirteen native vegetal species were introduced. During two years (2012-2013) the evolution of different soil properties and the bioavailable fraction of the heavy metals Cd, Pb and Zn has been monitored. Results showed that pH, aggregates stability, organic carbon, nitrogen and cation exchange capacity increased with the application of the amendments and the development of vegetation, while the bioavailable fraction of the heavy metals drastically decreased (90-99%). Thus, the strategy followed resulted positive to reduce the availability of heavy metals, improving soil quality and fertility. These results are promising in areas with extractive activity of carbonated materials, since the generated wastes can be used for reclamation of soils affected with heavy metals, turning a waste into a by-product. Key words: amendments, geochemistry, heavy metals, mining, tailing pond. Acknowledgements: This work has been funded by the European Union LIFE+ project MIPOLARE (LIFE09 ENV/ES/000439).

  19. Global Immunization Vision and Strategy (GIVS): a mid-term analysis of progress in 50 countries.

    PubMed

    Kamara, Lidija; Lydon, Patrick; Bilous, Julian; Vandelaer, Jos; Eggers, Rudi; Gacic-Dobo, Marta; Meaney, William; Okwo-Bele, Jean-Marie

    2013-01-01

    Within the overall framework set out in the Global Immunization Vision and Strategy (GIVS) for the period 2006-2015, over 70 countries had developed comprehensive Multi-Year Plans (cMYPs) by 2008, outlining their plans for implementing the GIVS strategies and for attaining the GIVS Goals at the midpoint in 2010 or earlier. These goals are to: (1) reach ≥90% and ≥80% vaccination coverage at national and district level, respectively; and (2) reduce measles-related mortality by 90% compared with the 2000 level. Fifty cMYPs were analysed along the four strategic areas of the GIVS: (1) protecting more people in a changing world; (2) introducing new vaccines and technologies; (3) integrating immunization, other health interventions and surveillance in the health system context; and (4) immunizing in the context of global interdependence. By 2010, all 50 countries planned to have introduced hepatitis B (HepB) vaccine, 48 the Haemophilus influenzae type B (Hib) vaccine and only a few countries had firm plans to introduce pneumococcal or rotavirus vaccines. Countries seem to be inadequately prepared in terms of cold-chain requirements to deal with the expected increases in storage that will be required for vaccines, and in making provisions to establish a corresponding surveillance system for planned new vaccine introductions. Immunization contacts are used to deliver other health interventions, especially in the countries in the World Health Organization (WHO) Africa Region. The cost for the planned immunization activities will double to U$27 per infant, of which U$5 per infant is the expected shortfall. Global Alliance for Vaccines and Immunization (GAVI) funding is becoming the largest contributor to immunization programmes.

  20. Mid-Term Report On 'SMOS CAL/VAL In China'

    NASA Astrophysics Data System (ADS)

    Zhang, Weiguo; Wu, Ji; Liu, Heguang; Liu, Hao; Li, Zengyuan; Kerr, Yann; Desnos, Y.-L.; Hahne, A.; Mecklenburg, S.

    2010-10-01

    Within framework of Dragon-2 programme, collaboration on SMOS Cal/Val is on the track. This paper reviewed SMOS behavior and status which follows the latest progress in the field. By analyzing historical low frequency microwave radiometric observation and ground truth data, it is shown the Taklamakan desert is well suited for calibration of spaceborne microwave sensors such as SMOS MIRAS. The pioneer experiment confirms the assumption in the simulation and defines requirements for further works. Sampling tools for the specified environment as well as an L band ground based radiometer were designed and constructed. Data analysis shows many areas in China are affected by RFI problem. It will be necessary to investigate the problem further in depth both technically and tactically.

  1. Anococcygeal Raphe Revisited: A Histological Study Using Mid-Term Human Fetuses and Elderly Cadavers

    PubMed Central

    Arakawa, Takashi; Abe, Hiroshi; Abe, Shinichi; Cho, Baik Hwan; Murakami, Gen; Sugihara, Kenichi

    2012-01-01

    Purpose We recently demonstrated the morphology of the anococcygeal ligament. As the anococcygeal ligament and raphe are often confused, the concept of the anococcygeal raphe needs to be re-examined from the perspective of fetal development, as well as in terms of adult morphology. Materials and Methods We examined the horizontal sections of 15 fetuses as well as adult histology. From cadavers, we obtained an almost cubic tissue mass containing the dorsal wall of the anorectum, the coccyx and the covering skin. Most sections were stained with hematoxylin and eosin or Masson-trichrome solution. Results The adult ligament contained both smooth and striated muscle fibers. A similar band-like structure was seen in fetuses, containing: 1) smooth muscle fibers originating from the longitudinal muscle coat of the anal canal and 2) striated muscle fibers from the external anal sphincter (EAS). However, in fetuses, the levator ani muscle did not attach to either the band or the coccyx. Along and around the anococcygeal ligament, we did not find any aponeurotic tissue with transversely oriented fibers connecting bilateral levator ani slings. Instead, in adults, a fibrous tissue mass was located at a gap between bilateral levator ani slings; this site corresponded to the dorsal side of the ligament and the EAS in the immediately deep side of the natal skin cleft. Conclusion We hypothesize that a classically described raphe corresponds to the specific subcutaneous tissue on the superficial or dorsal side of the anococcygeal ligament. PMID:22665356

  2. Mid-Term Outcomes in Patients Implanted with Cardiac Resynchronization Therapy

    PubMed Central

    Lee, Sung Ho; Park, Seung-Jung; Kim, June Soo; Shin, Dae-Hee; Cho, Dae Kyoung

    2014-01-01

    We applied cardiac resynchronization therapy (CRT) for desynchronized heart failure patients. We evaluated clinical outcomes including morbidity, mortality, and echocardiographic parameters in 47 patients with implanted CRT in Korea from October 2005 to May 2013. The combined outcomes of hospitalization from heart failure, heart transplantation and death were the primary end point. Median follow-up period was 17.5 months. The primary outcomes listed above occurred in 10 (21.3%) patients. Two patients (4.3%) died after CRT and 8 (17%) patients were hospitalized for recurrent heart failure. Among patients hospitalized for heart failure, 2 (4.3%) patients underwent heart transplantation. The overall free rate of heart failure requiring hospitalization was 90.1% (95% CI, 0.81-0.99) over one year and 69.4% (95% CI, 0.47-0.91) over 3 yr. We observed improvement of the New York Heart Association classification (3.1±0.5 to 1.7±0.4), decreases in QRS duration (169.1 to 146.9 ms), decreases in left ventricular (LV) end-diastolic (255.0 to 220.1 mL) and end-systolic (194.4 to 159.4 mL) volume and increases in LV ejection fraction (22.5% to 31.1%) at 6 months after CRT. CRT improved symptoms and echocardiographic parameters in a relatively short period, resulting in low mortality and a decrease in hospitalization due to heart failure. PMID:25469065

  3. Mid-term NEAT review: analysing the improvements in hospital ED performance.

    PubMed

    Khanna, Sankalp; Boyle, Justin; Good, Norm; Lind, James

    2014-01-01

    Introduced with a promise to reduce overcrowding in the Emergency Department (ED) and the associated morbidity and mortality linked to bed access difficulties, the National Emergency Access Target (NEAT) is now over halfway through transitionary arrangements towards a target of 90% of patients that visit a hospital ED being admitted or discharged within 4 hours. Facilitation and reward funding has ensured hospitals around the country are remodelling workflows to ensure compliance. Recent reports however show that the majority of hospitals are still far from being able to meet this target. We investigate the NEAT journey of 30 Queensland hospitals over the past two years and compare this performance to a previous study that investigated the 4 hour ED discharge performance of these hospitals at various times of day and under varying occupancy conditions. Our findings reveal that, while most hospitals have made significant improvements to their 4 hour discharge performance in 2013, the underlying flow patterns and periods of poor NEAT compliance remain largely unchanged. The work identifies areas for targeted improvement to inform system redesign and workflow planning.

  4. Lost Opportunities: The Civil Rights Record of the Bush Administration Mid-Term.

    ERIC Educational Resources Information Center

    Liss, Susan M., Ed.; Taylor, William L., Ed.

    This study of the civil rights policies and practices of the Bush Administration reviews the first 2 years of that administration's actions, presents recommendations for the future, and offers a series of working papers prepared by experts in the civil rights field. Part 1 of two major parts presents the actual report of the Citizen's Commission…

  5. [The painful hip joint in the child: differential diagnosis and therapy of coxitis fugax, Perthes disease and septic coxitis].

    PubMed

    Parsch, K

    1992-01-01

    The differential diagnosis of a painful hip joint in children is important. Transient synovitis is frequently seen in children from 3 to 7 years of age with a short history of limping. The joint effusion is visualized by ultrasound. Radiograms and laboratory data are negative. Therapy consists of short term bed rest supported by an oral antiphlogistic drug. Children with Legg-Calve-Perthes disease complain about knee or hip pain in an early stage. X-ray documentation in the a.p and axial view are mandatory as well as ultrasound visualization of the accompanying effusion. Healing of the capital femural epiphysis is aided by weight relief and improved head containment. This may need from one to three years according to the age of the child and the amount of head involvement. More than half of the children's hips with Perthes disease surgical help to achieve a satisfactory result. Hip pain is overwhelming in cases of septic arthritis of the hip joint. This is the most important help to differentiate septic coxitis from transient synovitis or Perthes disease. Rapidly rising values of red cell sedimentation and c-reactive protein are important for early diagnosis. Septic effusions are visualized by ultrasound. X-ray changes are absent in the beginning and are seen only in delayed cases. Early arthrotomy with scrupulous rinsing of the joint, followed by parenteral antibiotic treatment, is the treatment of choice.

  6. Tension myalgia of the pelvic floor.

    PubMed

    Sinaki, M; Merritt, J L; Stillwell, G K

    1977-11-01

    The clinical picture in and efficacy of physical treatment for pelvic floor myalgia were reviewed. The medical records of patients having a diagnosis of pyriformis syndrome, coccygodynia, levator ani spasm syndrome, proctalgia fugax, or rectal pain who had been seen at the Mayo Clinic and treated in the Department of Physical Medicine and Rehabilitation from 1970 through 1975 were retrieved. Adequate information and follow-up were available for 94 patients. Seventy-eight patients were women and 16 were men, whose ages ranged from 26 to 72 years. All patients had tenderness of the pelvic floor muscles on rectal examination. The most common associated findings were poor posture, deconditioned abdominal muscles, and generalized muscle attachment tenderness. The most effective therapeutic regimen was a combination of rectal diathermy, Thiele's massage, and relaxation exercises. Of the 94 patients, 30 had complete resolution of their symptoms, 19 had marked improvement, 17 had moderate improvement, and 14 had mild improvement. Only 14 patients had no change and 1 patient was worse after treatment.

  7. Mid-term clinical results of total hip arthroplasty using a Wagner standard cup for dysplastic hip

    PubMed Central

    Maezawa, Katsuhiko; Nozawa, Masahiko; Yuasa, Takahito; Aritomi, Kentaro; Ogawa, Seiki; Maruyama, Yuichiro; Kaneko, Kazuo

    2014-01-01

    Background The outcome of cementless total hip arthroplasty depends on many factors. We must not forget fundamental things those are design of outer surface of the component, that leads bone ingrowth into the prosthesis, better initial stability, and better insertional techniques. The purpose of this study was to review our experience with metal-on-metal total hip arthroplasty with a Wagner standard cup for patients who had acetabular dysplasia. Patients and methods Fifty-four patients with 55 hips underwent primary metal-on-metal total hip arthroplasty (Metasul prosthesis) with a Wagner standard cup (44–48 mm in outer diameter) and were followed for a minimum of 10 years. All patients received the same type of cementless femoral component (Natural hip stem) and femoral head (28 mm in diameter). Results Seventeen of the 55 Wagner standard cups (30.9%) showed aseptic loosening over a mean period of 3.6 years after surgery, and there were no bone anchors on the outer surface of the 16 retrieved cups. Conclusion From our experience, the small Wagner standard cup does not achieve sufficient osteointegration and we do not recommend the use of this cup, especially for patients with acetabular dysplasia and/or those with a small stature. PMID:25561751

  8. Mid-term evaluation of USAID (US Agency for International Development) Sudan Energy Planning and Management Project (650-0059)

    SciTech Connect

    Jones, D.W.; Stovall, J.P.; Raby, J.G.; Younger, D.R.; Pryor, C.A.

    1988-06-01

    In 1984, the United States Agency for International Development's mission in Sudan implemented the Energy Planning and Management Project to strengthen several key institutions in the energy sector of Sudan. One component of the project focused on improving management, billing and collection, pricing, purchasing and stores, and vehicle operation and maintenance in the National Electricity Corporation. The other major component was devoted to strengthening the capability of the National Energy Administration to conduct national energy planning studies, including the analysis of energy issues and policies and the recommendation of policies. Originally the planned date for the midterm evaluation of this project was early 1986, but because political turmoil and other events impeded implementation of the project, that evaluation was only conducted in January and February 1987. ORNL, at the request of the Sudan Mission and the office of Energy of AID, fielded a team in January 1987 to evaluate the progress of the project to that date and make recommendations for the remainder of the project's implementation. This study reports the findings and recommendations of the evaluation team regarding the Sudan Energy Management and Planning Project. 84 refs., 2 figs., 6 tabs.

  9. THE POTENTIAL MID-TERM ROLE OF NUCLEAR POWER IN THE UNITED STATES: A SCENARIO ANALYSIS USING MARKAL

    EPA Science Inventory

    With all nations facing enormous challenges related to energy security, sustainability and environmental quality, nuclear power is likely to play an increasingly important role in the future. In particular, the life-cycle emissions of criteria pollutants and greenhouse gases (GHG...

  10. Morphologic and Clinical Outcome of Intracranial Aneurysms after Treatment Using Flow Diverter Devices: Mid-Term Follow-Up

    PubMed Central

    Breu, Anna-Katharina; Hauser, Till-Karsten; Ebner, Florian H.; Bischof, Felix; Ernemann, Ulrike; Seeger, Achim

    2016-01-01

    Flow diverters (FDs) are designed for the endovascular treatment of complex intracranial aneurysm configurations. From February 2009 to March 2013 28 patients (22 females, 6 males) were treated with FD; mean age was 57 years. Data, including aneurysm features, clinical presentation, history of previous bleeding, treatment, and follow-up results, are presented. Early postinterventional neurological deficits (transient: n = 3/enduring: n = 1) appeared in 4/28 patients (14%), and early improvement of neurological symptoms was observed in 7 patients with previous restriction of cranial nerve function. The overall occlusion rate was 20/26 (77%; 59% after 3 months). 77% achieved best results according to O'Kelly-Marotta score grade D with no contrast material filling (70% of those after 3 months). In 4/6 patients who did not achieve grade D, proximal and/or distal stent overlapping ≥5 mm was not guaranteed sufficiently. During follow-up we did not detect any aneurysm recurrence or haemorrhage. In-stent stenosis emerged as the most frequent complication (4/27; 15%) followed by 2 cases of vascular obliteration (AICA/VA). In conclusion endovascular reconstruction using a FD represents a modern and effective treatment in those aneurysms that are not suitable for conventional interventional or surgical treatment. The appearance of severe complications was rare. PMID:27006830

  11. Narrowing the treatment gap with equitable access: mid-term outcomes of a community case management program in Cameroon.

    PubMed

    Littrell, Megan; Moukam, Laure Vartan; Libite, Roger; Youmba, Jean Christian; Baugh, Gunther

    2013-10-01

    Coverage of case management interventions remains low and inadequate to achieve millennium development goal (MDG) target reductions in child mortality. Children living in the poorest households are particularly disadvantaged. Community case management (CCM) uses trained and supervised community health workers to improve access to, quality of and demand for effective case management. Evidence that CCM programs can achieve equitable improvements in coverage is limited. This cross-sectional study uses a quasi-experimental design with intervention and comparison areas. Outcomes of a CCM program for malaria and diarrhoea operating in two districts of Cameroon were measured after 1 year of implementation. A household census (N = 16 954) provided measurement of treatment-seeking behaviour for recent episodes of fever and diarrhoea. Results were compared between areas using chi-square tests. Intervention-area children with fever or diarrhoea were nearly nine times more likely to receive treatment with artemisinin combination therapy or oral rehydration salts, respectively, vs neighbouring comparison-area children. High levels of effective treatment were equitable across socioeconomic status in intervention areas, whereas disparities were observed in neighbouring comparison areas. CCM can achieve rapid and equitable improvements in coverage of case management for malaria and diarrhoea, and is a promising strategy for achieving MDG 4. Improved access to treatment, quality of care and caregiver demand were achieved in two districts of Cameroon. CCM must be scaled up to demonstrate outcomes and impact at scale.

  12. Mid-term results of Autologous Matrix-Induced Chondrogenesis for treatment of focal cartilage defects in the knee.

    PubMed

    Gille, J; Schuseil, E; Wimmer, J; Gellissen, J; Schulz, A P; Behrens, P

    2010-11-01

    Articular cartilage defects heal poorly. Autologous Matrix-Induced Chondrogenesis (AMIC) is an innovative treatment for localized full-thickness cartilage defects combining the well-known microfracturing with collagen scaffold and fibrin glue. The purpose of this prospective study was to evaluate the medium-term results of this enhanced microfracture technique for the treatment of chondral lesions of the knee. Thirty-two chondral lesions in 27 patients were treated with AMIC. Within the context of clinical follow-up, these patients were evaluated for up to 5 years after the intervention. Five different scores (Meyer score, Tegner score, Lysholm score, ICRS score, Cincinnati score) as well as radiographs were used for outcome analysis. Articular resurfacing was assessed by magnetic resonance imaging (MRI). The average age of patients (11 females, 16 males; mean body mass index 26, range 20-32) was 37 years (range 16-50 years). The mean defect size of the chondral lesions was 4.2 cm(2) (range 1.3-8.8 cm(2)). All defects were classified as grade IV according to the Outerbridge classification. The follow-up period was between 24 and 62 months with a mean of 37 months. Twenty out of 23 individuals (87%) questioned were subjectively highly satisfied with the results after surgery. Significant improvement (P < 0.05) of all scores was observed as early as 12 months after AMIC, and further increased values were notable up to 24 months postoperatively. MRI analysis showed moderate to complete filling with a normal to incidentally hyperintense signal in most cases. Results did not show a clinical impact of patient's age at the time of operation, body mass index and number of previous operations (n.s.). In contrast, males showed significant higher values in the ICRS score compared to their female counterparts. AMIC is an effective and safe method of treating symptomatic full-thickness chondral defects of the knee in appropriately selected cases. However, further studies with long-term follow-up are needed to determine whether the grafted area will maintain structural and functional integrity over time.

  13. Does Previous Hip Surgery Effect the Outcome of Tönnis Triple Periacetabular Osteotomy? Mid-Term Results

    PubMed Central

    Konya, Mehmet Nuri; Aydın, Bahattin Kerem; Yıldırım, Timur; Sofu, Hakan; Gürsu, Sarper

    2016-01-01

    Abstract Hip dysplasia (HD) is 1 of the major reasons of coxarthrosis. The goal of the treatment of HD by Tönnis triple pelvic osteotomy (TPAO) is to improve the function of hip joint while relieving pain, delaying and possibly preventing end-stage arthritis. The aim of this study is to compare the clinical and radiological results of TPAO to determine if previous surgery has a negative effect on TPAO. Patients operated with TPAO between 2005 and 2010, included in this study. Patients divided into 2 groups: primary acetabular dysplasia (PAD) and residual acetabular dysplasia (RAD). Prepostoperatively, hip range of motion, Harris hip score (HHS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) hip score, visual analog scores (VAS), impingement tests, and also the presence of Trendelenburg sign (TS) were investigated for clinical evaluation. For radiological analysis pre–postoperative, anterior–posterior (AP) pelvis and faux profile radiographs were used. Acetabular index, lateral center edge (LCE) angle, and Sharp angles were measured by AP pelvis; anterior center edge (ACE) angle were measured by faux profile radiography. All the clinical and radiological data of the groups were analyzed separately for the pre–postoperative scores also the amount of improvement in all parameters were analyzed. SPSS20 (SPSS Inc., Chicago, IL) was used for statistical analysis. Wilcoxon test, McNemar test, paired t tests, and Mann–Whitney U tests were used to compare the groups. P < 0.05 were defined as statistically significant. Study included 27 patients: 17 patients were in PAD and 10 patients were in RAD. The mean follow-up period was 6.2 years (5.2–10.3 years). In all patients, the radiological and the clinical outcomes were better after TPAO except the flexion of the hip parameter. When the patient groups were evaluated as pre–postoperatively, more statistically significant parameters were found in the PAD group when compared with RAD group. Extension, impingement, TS, VAS, HHS, WOMAC score parameters in clinical outcome and LCE, ACE, Sharp angle, coverage ratio in radiological results were significantly better in PAD group postoperatively but in RAD group; only extension, VAS, HHS, and WOMAC parameters were clinically and LCE and Coverage ratio were significantly different compared with the preoperative measurements. The change of the parameters that used for the evaluation of clinical and radiological results did not show a significant difference between groups. Our data suggest that TPAO can be performed on patients with HD for both groups. Although there were fewer parameters which changed significantly after TPAO in RAD patients; the improvement of radiological and clinical results was similar for groups. Further long-term follow-up studies with large number of patients are needed to determine the proper results of TPAO. PMID:26962829

  14. Information Requirements for Supervisory Air Traffic Controllers in Support of a Mid-Term Wake Vortex Departure System

    NASA Technical Reports Server (NTRS)

    Lohr, Gary W.; Williams, Daniel M.; Trujillo, Anna C.; Johnson, Edward J.; Domino, David A.

    2008-01-01

    A concept focusing on wind dependent departure operations has been developed the current version of this concept is called the Wake Turbulence Mitigation for Departures (WTMD). This concept takes advantage the fact that cross winds of sufficient velocity blow wakes generated by "heavy" and B757 category aircraft on the downwind runway away from the upwind runway. Supervisory Air Traffic Controllers would be responsible for authorization of the Procedure. An investigation of the information requirements necessary to for Supervisors to approve monitor and terminate the Procedure was conducted. Results clearly indicated that the requisite information is currently available in air traffic control towers and that additional information was not required.

  15. Treating Epiphora in Adults With the Wilhelm Plastic Nasolacrimal Stent: Mid-Term Results of a Prospective Study

    SciTech Connect

    Ciampi, Juan J. Lanciego, Carlos; Navarro, Sofia; Cuena, Rafael; Velasco, Javier; Perea, Miguel; Garcia-Garcia, Lorenzo

    2011-02-15

    The objective of the present study was to evaluate, in a prospective, single-center study, the effectiveness of the Wilhelm-type stent used in interventional radiology for the management of epiphora. Patients (n = 104; mean age 64 [range 25-88]; 33 male and 71 female) with severe epiphora had the stents inserted (135 stents in 115 eyes) to treat obstruction of the nasolacrimal system. The etiology of the obstruction was idiopathic in 83 cases, chronic dacryocystitis in 31, cases and postsurgical status in 1 case. The overall technical success rate of stent placement was near 94%. Resolution of epiphora was complete in 105 cases and partial in 3 cases. During a mean 13-month follow-up (range 1 week to 28 months), the median duration of primary patency was 11 months, and the percentage of patency at 6 months was 60.8%, at 1 year was 39.6%, and at 2 years was 25%. Stents malfunctioned in 54 cases, and all were easily withdrawn except in 1 case. Of these 27 cases, patency recovered spontaneously in 9 and by way of a second stent in 18. Secondary patency was 50%. Factors presdisposing to lower primary patency are inflammatory etiology and location of the obstruction. The benefit of stent deployment is clear with respect to the resolution of epiphora in candidate patients for percutaneous treatment. Technical and/or design improvements would be welcomed.

  16. Mid-Term Results After Endovascular Stent-Grafting of Descending Aortic Aneurysms in High-Risk Patients

    SciTech Connect

    Brandt, Michael Walluscheck, Knut P.; Jahnke, Thomas; Attmann, Tim; Heller, Martin; Cremer, Jochen; Mueller-Huelsbeck, Stefan

    2006-10-15

    Purpose. To analyze our experience with endovascular stent-grafting of descending aortic aneurysms in high-risk patients. Methods. Nineteen patients underwent endovascular stent-graft repair of descending aortic aneurysms using the Talent Stent Graft System (Medtronic). All patients were considered high-risk for open surgical repair due to their age, requirement for emergency surgery, and comorbidities. Computed tomography and/or MR tomography were performed at 3, 6 and 12 months postoperatively and thereafter every 12 months. Results. Secondary technical success was 100%. Thirty-day mortality was 5%. Incidence of postoperative stroke and paraplegia were 5% each. One patient required a second stent-graft due to a type I endoleak during the same hospital stay (primary technical success 95%). All patients have been followed for a median of 20 months. No migration, wire fractures or endoleak appeared during follow-up. Conclusion. Endovascular stent-grafting had a low 30-day mortality and morbidity in high-risk patients. One patient developed an aortoesophageal fistula 40 days after stent implantation. Stent-graft repair is a valuable supplement to surgical therapy in high-risk patients.

  17. Endovascular Repair of Abdominal Aortic Aneurysms: Analysis of Aneurysm Volumetric Changes at Mid-Term Follow-Up

    SciTech Connect

    Bargellini, Irene Cioni, Roberto; Petruzzi, Pasquale; Pratali, Alessandro; Napoli, Vinicio; Vignali, Claudio; Ferrari, Mauro; Bartolozzi, Carlo

    2005-05-15

    Purpose. To evaluate the volumetric changes in abdominal aortic aneurysms (AAA) after endovascular AAA repair (EVAR) in 24 months of follow-up. Methods. We evaluated the volume modifications in 63 consecutive patients after EVAR. All patients underwent strict duplex ultrasound and computed tomography angiography (CTA) follow-up; when complications were suspected, digital subtraction angiography was also performed. CTA datasets at 1, 6, 12, and 24 months were post-processed through semiautomatic segmentation, to isolate the aneurysmal sac and calculate its volume. Maximum transverse diameters (Dmax) were also obtained in the true axial plane, Presence and type of endoleak (EL) were recorded. A statistical analysis was performed to assess the degree of volume change, correlation with diameter modifications, and significance of the volume increase with respect to ELs. Results. Mean reconstruction time was 7 min. Mean volume reduction rates were 6.5%, 8%, and 9.6% at 6, 12, and 24 months follow-up, respectively. Mean Dmax reduction rates were 4.2%, 6.7%, and 12%; correlation with volumes was poor (r = 0.73-0.81). ELs were found in 19 patients and were more frequent (p = 0.04) in patients with higher preprocedural Dmax, The accuracies of volume changes in predicting ELs ranged between 74.6% and 84.1% and were higher than those of Dmax modifications. The strongest independent predictor of EL was a volume change at 6 months {<=}0.3% (p = 0.005), although 6 of 19 (32%) patients with EL showed no significant AAA enlargement, whereas in 6 of 44 (14%) patients without EL the aneurysm enlarged. Conclusion. The lack of volume decrease in the aneurysm of at least 0.3% at 6 months follow-up indicates the need for closer surveillance, and has a higher predictive accuracy for an endoleak than Dmax.

  18. Is the tantalum Strecker stent suitable for TIPS creation? short- and mid-term results in 20 consecutive patients

    SciTech Connect

    Ugolotti, Ugo; Larini, Pietro; Marcato, Carla; Saccani, Andrea; Puccianti, Franca; Pedretti, Giovanni

    1997-01-15

    Purpose. To assess the suitability of tantalum Strecker stents for transjugular intrahepatic portosystemic shunt (TIPS) creation. Methods. TIPS was performed with Strecker balloon-expandable stents in the first 20 patients of our series. A total of 26 prostheses were utilized (average 1.3 per patient). Results. Immediate technical success was achieved in all 20 cases. Nine patients (45%) died during follow-up. The overall average follow-up period was 18.9 months; the 11 survivors were followed for a mean period of 29.8 months. In 4 patients (20%) the stent dislodged towards the hepatic vein during withdrawal of the balloon catheter, and difficulties in recatheterizing the shunt for routine control portal phlebography were frequently encountered. Rebleeding occurred in 5 cases and aggravation of pre-existing encephalopathy occurred in 2 cases. Shunt occlusions or stenosis required further intervention in 4 and 9 patients, respectively. Conclusion. In our opinion the tantalum Strecker stent is not particularly suitable for TIPS. Although it has evident advantages, such as high radiopacity and minimal shortening after deployment, the tendency of the device to dislodge and the difficulty in recatheterization during portal phlebography were important drawbacks. Furthermore, the atraumatic ends of the device did not seem to reduce shunt-related complications, which were comparable to those occurring with other types of stent.

  19. Mid-term quasi-periodicities in the CaII-K plage index of the Sun and their implications

    NASA Astrophysics Data System (ADS)

    Chowdhury, Partha; Gokhale, M. H.; Singh, Jagdev; Moon, Y.-J.

    2016-02-01

    We present results of the fast Fourier transform (FFT), the MEM analysis, and the wavelet analysis (WA), of the temporal variation of the monthly disk integrated "CaII-K plage-area and enhanced network (EN) area" hereafter called `plage index' derived by Tlatov et al. (2009), from spectro-heliograms taken in Ca II K line at Kodaikanal Observatory, from February 1907 to April, 1998, In the range {>}3 months and < decade, the Fourier transform power spectra reveal solar cycle periodicity {˜}122 months, its sub-harmonic ˜61 months, two short quasi-periodicities ({>}2 and <4 months), and nine `intermediate-range' quasi-periodicities (≳ 4 mo and <11 yr), in the variation of the plage index. The quasi-periodicities include Rieger, Rieger type and quasi-biennial. The presence of quasi-periodicities and the mean values of the periods are confirmed by the maximum entropy method (MEM). The temporal spans of the quasi-periodicities during different solar cycles are determined from the complex Morlet-wavelet analyses. The Rieger quasi-periodicity (150-160 days) appeared during cycle 21 and cycle 22. Each of the quasi-periodicities in the studied range lies close to one or more planetary periodicities (orbital, or spring tidal, or heliocentric conjunction frequency). We discuss possible interpretations of our results, and those of similar results obtained earlier by other authors, towards understanding the mechanisms of excitation of various quasi-periodicities detected in solar variability parameters.

  20. The mid-term outcome of total ankle arthroplasty and ankle fusion in rheumatoid arthritis: a systematic review

    PubMed Central

    2013-01-01

    Background While arthrodesis is the standard treatment of a severely arthritic ankle joint, total ankle arthroplasty has become a popular alternative. This review provides clinical outcomes and complications of both interventions in patients with rheumatoid arthritis. Methods Studies were obtained from Pubmed, Embase and Web of Science (January 1980 – June 2011) and additional manual search. Inclusion criteria: original clinical study, > 5 rheumatoid arthritis (population), internal fixation arthrodesis or three-component mobile bearing prosthesis (intervention), ankle scoring system (outcome). The clinical outcome score, complication- and failure rates were extracted and the methodological quality of the studies was analysed. Results 17 observational studies of 868 citations were included. The effect size concerning total ankle arthroplasty ranged between 1.9 and 6.0, for arthrodesis the effect sizes were 4.0 and 4.7. Reoperation due to implant failure or reoperation due to non-union, was 11% and 12% for respectively total ankle arthroplasty and arthrodesis. The methodological quality of the studies was low (mean 6.4 out of a maximum of 14 points) and was lower for arthrodesis (mean 4.8) as compared to arthroplasty (mean 7.8) (p = 0.04). Conclusions 17 observational and no (randomized) controlled clinical trials are published on the effectiveness of arthroplasty or arthrodesis of the ankle in rheumatoid arthritis. Regardless of the methodological limitations it can be concluded that both interventions show clinical improvement and in line with current literature neither procedure is superior to the other. PMID:24161014

  1. Fixation of 3- and 4-part proximal humerus fractures using the PHILOS plate: mid-term results.

    PubMed

    Gaheer, Rajinder Singh; Hawkins, Amanda

    2010-09-07

    Treatment of unstable, displaced, and comminuted fractures of the proximal humerus remains challenging, and optimal treatment continues to be controversial. Fifty-six patients with displaced 3- and 4-part fractures of the proximal humerus had open reduction and internal fixation using the proximal humeral internal locking system (PHILOS) plate (Synthes, Stratec Medical Ltd, Mezzovico, Switzerland). Data were collected retrospectively, and clinical and radiological outcomes were assessed. Mean follow-up was 40 months (range, 18-62 months). The study shows that the PHILOS plate gives good results in the treatment of displaced 3- and 4-part fractures of the proximal humerus. Good fracture stability can be achieved early, allowing early mobilization without compromising fracture union. Most importantly, it requires minimal soft tissue dissection, does not need contouring, and gives good stability. No differences were observed in the functional outcomes of patients younger and older than 65 years. Few complications were associated with the plate, and the number of ≥2 surgeries was minimal. The complications noted were 1 case each of superficial wound infection, failure of the plate, and persistent stiffness. One patient had screw perforation of the humeral head articular surface, and 1 had subacromial impingement. Of the 32 patients who had been in active employment before the injury, 28 returned to their previous occupation.

  2. Covered Stent Implantation for the Treatment of Direct Carotid-Cavernous Fistula and Its Mid-Term Follow-up

    PubMed Central

    Briganti, F.; Tortora, F.; Marseglia, M.; Napoli, M.; Cirillo, L.

    2009-01-01

    Summary Carotid-cavernous fistulas are abnormal arteriovenous communications either directly between the internal carotid artery and the cavernous sinus or between the dural branches of the internal and external carotid arteries. These fistulas predominantly present with ocular manifestations and they are treated mainly by endovascular techniques in most cases. A detailed review of the literature allowed us to make a complete analysis of the information available on the topic. We describe a case of a direct carotid-cavernous fistula occluded by endovascular implantation of a covered stent, showing the persistence of results after three years. PMID:20465897

  3. Proctalgia and colorectal stricture as the result of a 2-year transit of a retained rectal chicken bone: a case presentation and review of the literature.

    PubMed

    Elmoghrabi, Adel; Mohamed, Mohamed; Wong, Kristoffer; McCann, Michael

    2016-01-01

    We report a case of a 70-year-old woman who presented with progressively increasing intensity of lower abdominal, pelvic and rectal pain of 3-day duration. She had similar symptoms intermittently over the preceding 2 years. CT of the abdomen and pelvis revealed the presence of a 3.8×0.4 cm linear foreign body in the colorectal region. History obtained from relatives recalled inadvertent ingestion of a chicken bone 2 years prior to presentation. Trials of foreign body retrieval, both manually and via rigid and flexible sigmoidoscopy, however, were unsuccessful due to the presence of obstruction by a circumferential rectal stricture. Consequently, an exploratory laparotomy was performed, with segmental resection of 17 cm of rectum and distal sigmoid. Dissection of the strictured segment revealed the presence of a chicken bone. The patient had an uneventful postoperative course, was discharged and is to continue following up on an outpatient basis. PMID:27325671

  4. Mid-term results of small-sized St. Jude Medical Regent prosthetic valves (21 mm or less) for small aortic annulus.

    PubMed

    Mizoguchi, Hiroki; Sakaki, Masayuki; Inoue, Kazushige; Iwata, Takashi; Tei, Keikou; Miura, Takuya

    2013-11-01

    Prosthesis-patient mismatch (PPM) is always of concern when performing aortic valve replacement (AVR) in patients with a small aortic annulus. Although bioprosthetic AVR is preferred in patients older than 65 years, we have experienced cases in elderly patients with a small aortic annulus whereby we could not implant small-sized bioprosthetic valves. We have implanted St. Jude Medical Regent (SJMR) mechanical valves (St. Jude Medical, St. Paul, MN, USA) as necessary, even in elderly patients with no aortic annulus enlargement. We investigated our experiences of AVR with SJMR mechanical valves of 21 mm or less in size. Between January 2006 and December 2009, 40 patients underwent AVR with SJMR mechanical valves ≤21 mm in size: 9 patients received 21-mm valves, 19 received 19-mm valves, and 12 received 17-mm valves. The mean age was 65.9 ± 9.5 years, and 25 patients (62.5 %) were 65 years or older. We evaluated the clinical outcome and the echocardiographic data for each valve size. There was no operative or hospital mortality. The mean duration of clinical follow-up was 31.2 ± 17.6 months. During follow-up, there were no hospitalizations due to heart failure. The cumulative valve-related event-free survival was 93 % at 33 months, and the cumulative hemorrhagic event-free survival was 93 % at 33 months and 84 % at 43 months, using the Kaplan-Meier method. At follow-up, the mean values of the measured effective orifice area (EOA) for the 21-, 19-, and 17-mm prostheses were 2.00 ± 0.22, 1.74 ± 0.37, and 1.25 ± 0.26 cm(2), and the mean measured EOA index (EOAI) were 1.17 ± 0.12, 1.11 ± 0.21 and 0.90 ± 0.22 cm(2)/m(2), respectively. A PPM (EOAI ≤0.85) was documented in 5 patients, all of whom had received a 17-mm SJMR valve. AVR with SJMR valves of 21 mm or less in size appears to show satisfactory clinical and hemodynamic results.

  5. Class III Mid-Term Project, "Increasing Heavy Oil Reserves in the Wilmington Oil Field Through Advanced Reservoir Characterization and Thermal Production Technologies"

    SciTech Connect

    Scott Hara

    2007-03-31

    The overall objective of this project was to increase heavy oil reserves in slope and basin clastic (SBC) reservoirs through the application of advanced reservoir characterization and thermal production technologies. The project involved improving thermal recovery techniques in the Tar Zone of Fault Blocks II-A and V (Tar II-A and Tar V) of the Wilmington Field in Los Angeles County, near Long Beach, California. A primary objective has been to transfer technology that can be applied in other heavy oil formations of the Wilmington Field and other SBC reservoirs, including those under waterflood. The first budget period addressed several producibility problems in the Tar II-A and Tar V thermal recovery operations that are common in SBC reservoirs. A few of the advanced technologies developed include a three-dimensional (3-D) deterministic geologic model, a 3-D deterministic thermal reservoir simulation model to aid in reservoir management and subsequent post-steamflood development work, and a detailed study on the geochemical interactions between the steam and the formation rocks and fluids. State of the art operational work included drilling and performing a pilot steam injection and production project via four new horizontal wells (2 producers and 2 injectors), implementing a hot water alternating steam (WAS) drive pilot in the existing steamflood area to improve thermal efficiency, installing a 2400-foot insulated, subsurface harbor channel crossing to supply steam to an island location, testing a novel alkaline steam completion technique to control well sanding problems, and starting on an advanced reservoir management system through computer-aided access to production and geologic data to integrate reservoir characterization, engineering, monitoring, and evaluation. The second budget period phase (BP2) continued to implement state-of-the-art operational work to optimize thermal recovery processes, improve well drilling and completion practices, and evaluate the geomechanical characteristics of the producing formations. The objectives were to further improve reservoir characterization of the heterogeneous turbidite sands, test the proficiency of the three-dimensional geologic and thermal reservoir simulation models, identify the high permeability thief zones to reduce water breakthrough and cycling, and analyze the nonuniform distribution of the remaining oil in place. This work resulted in the redevelopment of the Tar II-A and Tar V post-steamflood projects by drilling several new wells and converting idle wells to improve injection sweep efficiency and more effectively drain the remaining oil reserves. Reservoir management work included reducing water cuts, maintaining or increasing oil production, and evaluating and minimizing further thermal-related formation compaction. The BP2 project utilized all the tools and knowledge gained throughout the DOE project to maximize recovery of the oil in place.

  6. Monitoring and evaluation of the PAHO/WHO cooperation project, the Mais Médicos (More Doctors) Program: a mid-term assessment.

    PubMed

    Molina, Joaquín; Tasca, Renato; Suárez, Julio

    2016-09-01

    Working relations between the Pan- American Health Organization/World Health Organization (PAHO/WHO) and Brazilian health institutions accumulated a long history of cooperation with mutual benefits, which in many cases were shared with other nations under various cooperation frameworks among countries for health development. A milestone in this relationship is the technical cooperation provided by PAHO/WHO to the More Doctors Program (Programa Mais Médicos - PMM). This cooperation has added both strategic value in reducing gaps in health equality and has capitalized on the unique nature of the Cuba-Brazil South-South cooperation experience, triangulated through PAHO/WHO. This paper discusses PAHO/WHO's role in the evaluation of its technical cooperation within PMM. A Monitoring and Evaluation (M&E) Framework has been developed in order to progressively identify the advances in coverage and quality of primary health care provided by the Unified Health System (Sistema Único de Saúde - SUS) through the PMM. Special attention was given to identify best practices in health services, to analyze results and impacts of the PMM, and to manage and share knowledge that has been produced by its implementation, through a web-based knowledge platform. Some relevant results of PMM are briefly presented and discussed. PMID:27653078

  7. An emerging view of the crust and mantle of tectonic North America from EMScope: a mid- term progress review of Earthscope's magnetotelluric program

    NASA Astrophysics Data System (ADS)

    Schultz, A.; Bedrosian, P.; Evans, R.; Egbert, G.; Kelbert, A.; Mickus, K.; Livelybrooks, D.; Park, S.; Patro, P.; Peery, T.; Wannamaker, P.; Unsworth, M.; Weiss, C.; Woodward, B.

    2008-12-01

    EMScope, the MT component of the Earthscope project has completed its final year of infrastructure construction, and its third annual campaign of regional magnetotelluric array operations in the western USA. Seven semi-permanent "backbone" MT observatories have been installed in California, Oregon, Montana, New Mexico, Minnesota, Missouri and Virginia, designed through installation in 2 m deep, insulated underground vaults and with long, buried electric dipole detectors using stable electrodes, to provide extremely long-period magnetotelluric data meant to provide a set of regional, deep structural "anchor points" penetrating into the mid-mantle, in which a series of denser and more uniform regional, transportable MT networks can be tied. A total of 160 "transportable array" MT stations have been occupied in Oregon, Washington, Idaho, northernmost-California, and Montana. These were located on a 70 km quasi-regular grid, with coverage of Cascadia, parts of the Basin and Range, the Rockies and the Snake River Plain, the zone above a putative mantle plume that is hypothesized to serve as the magma source for both the Yellowstone supervolcano and a chain of volcanic features extending westward into Oregon. It is anticipated that in 2009 the transportable array will sweep eastward through the Yellowstone region, following which a set of regional transects at sites of special geodynamic interest will be staged. The transportable array stations are typically occupied for three weeks, providing MT response functions extending from 2-10,000 s or in cases as great as 20,000 s period. These stations are anchored at longer periods (extending as close to 100,000 s periods as possible) by the network of 7 backbone stations, to be operated continuously for up to five years. We present an initial set of 3-d inverse models from the EMScope data sets There is substantial coherence between the resulting 3-d conductivity model and the known boundaries of major physiographic provinces, as well as seismically delineated mid-to-lower crustal and upper mantle features. A combination of telemetry from backbone stations and frequent batch transmission of data from the transportable array field sites, followed by rapid data quality control procedures and generation of MT response functions provides a data set of use to all interested researchers. All EMScope data are made available freely through the IRIS Data Management Center or via the EMScope data portal. For transportable array sites these data are available typically within two weeks of acquisition.

  8. Project 5322 Mid-Term Report: Key Eco-Hydrological Parameters Retrieval And Land Data Assimilation System Development In A Typical Inland River Basin Of Chinas Arid Region

    NASA Astrophysics Data System (ADS)

    Faivre, R.; Colin, J.; Menenti, M.; Lindenbergh, R.; Van Den Bergh, L.; Yu, H.; Jia, L.; Xin, L.

    2010-10-01

    Improving the understanding and the monitoring of high elevation regions hydrology is of major relevance from both societal and environmental points of view for many Asian countries, in particular in terms of flood and drought, but also in terms of food security in a chang- ing environment. Satellite and airborne remote sensing technologies are of utmost for such a challenge. Exist- ing imaging spectro-radiometers, radars, microwave ra- diometers and backscatter LIDAR provide a very com- prehensive suite of measurements over a wide rage of wavelengths, time frequencies and spatial resolu- tions. It is however needed to devise new algorithms to convert these radiometric measurements into useful eco-hydrological quantitative parameters for hydrologi- cal modeling and water management. The DRAGON II project entitled Key Eco-Hydrological Parameters Re- trieval and Land Data Assimilation System Development in a Typical Inland River Basin of Chinas Arid Region (ID 5322) aims at improving the monitoring, understand- ing, and predictability of hydrological and ecological pro- cesses at catchment scale, and promote the applicability of quantitative remote sensing in watershed science. Ex- isting Earth Observation platforms provided by the Euro- pean Space Agency as well as prototype airborne systems developed in China - ENVISAT/AATSR, ALOS/PRISM and PALSAR, Airborne LIDAR - are used and combined to retrieve advanced land surface physical properties over high elevation arid regions of China. The existing syn- ergies between this project, the CEOP-AEGIS project (FP7) and the WATER project (CAS) provide incentives for innovative studies. The investigations presented in the following report focus on the development of advanced and innovative methodologies and algorithms to monitor both the state and the trend of key eco-hydrological vari- ables: 3D vegetation properties, land surface evaporation, glacier mass balance and drought indicators.

  9. New Challenges: The Civil Rights Record of the Clinton Administration Mid-Term. Report of the Citizens' Commission on Civil Rights.

    ERIC Educational Resources Information Center

    Yu, Corrine M., Ed.; Taylor, William L., Ed.

    This report is the work of the Citizens' Commission on Civil Rights, a bipartisan group of former federal officials with responsibility for equal opportunity. Part 1 contains three chapters: (1) "Introduction"; (2) "Executive Summary and Review"; and (3) "Recommendations of the Commission." Part 2 contains the following working papers: (4)…

  10. Clinical and Radiographic Mid-Term Outcomes After Total Shoulder Replacement: A Retrospective Study Protocol Including 400 Anatomical and Reverse Prosthetic Implants

    PubMed Central

    Merolla, Giovanni; Tartarone, Antonio; Porcellini, Giuseppe

    2016-01-01

    Objectives: To obtain outcomes data on anatomical and reverse total shoulder arthroplasty by analysis of clinical scores and standard radiographs. Subject selection and enrollment: 400 consecutive series of patients replaced with anatomical and reverse total shoulder arthroplasty (minimum 3 years follow-up). Study Design: retrospective monocenter. Preoperative assessment: Demographics, clinical scores (Constant-Murley) as available, shoulder X-ray (AP, outlet and axillary views) . Last follow-up: Postoperative radiographhs and clinical scores. Adverse events and complications to be reported as occurred since implantation. Statistical analysis: Data collected will be summarized and analyzed for statistical significance. PMID:27326389

  11. Prevalence of autism spectrum disorders among children (1-10 years of age) – Findings of a mid-term report from Northwest India

    PubMed Central

    Raina, SK; Kashyap, V; Bhardwaj, AK; Kumar, D; Chander, V

    2015-01-01

    Background: India is the second most populous country of the world. A large portion of the population of this country is below 20 years of age but still there is a paucity of information about the prevalence and incidence of many developmental disorders. This study was planned to estimate the prevalence of autism spectrum disorders (ASDs) in the selected areas (tribal, rural, and urban) of a northern state of India, Himachal Pradesh. Methods: A cross-sectional two-phase study was conducted covering all the children in the range of 1-10 years of age. Phase one included screening of all the children in the age group of 1-10 years, with the help of an indigenous assessment tool for autism. The sociodemographic profile of the participants was also recorded during phase one. Phase two involved the clinical evaluation of individuals who were suspected of autism on screening. Results: The results show a prevalence rate of 0.9/1000. The highest prevalence rate was observed in the rural area. Conclusions: Socioeconomic status (SES) may be one of the fundamental indicators for ASDs in India. PMID:26440394

  12. Osteochondritis dissecans of the elbow: excellent mid-term follow-up results in teenage athletes treated by arthroscopic debridement and microfracture

    PubMed Central

    Bojanić, Ivan; Smoljanović, Tomislav; Dokuzović, Stjepan

    2012-01-01

    Aim To extend the microfracture procedure, which has been proven successful on osteochondritis dissecans (OCD) lesions in the knee and ankle, to OCD lesions in the elbow. Methods Nine young patients were treated by arthroscopic debridement and microfracture by a single surgeon. The average age at operation was 15.0 years (median 15; range 12-19). The average length of the follow-up was 5.3 years (median 5; range 2-9). The follow-up included physical examination and patient interview with elbow function scoring. Success of treatment was determined according to pre-operative and follow-up Mayo Elbow Performance Index scores and the patients’ return to sports. Results Eight patients scored excellent results on the follow-up and 1 scored a good result. Four out of 9 patients were able to increase their training intensity, 2 returned to the same level of activity, 2 changed sports (due to reasons unrelated to the health of their elbow), and 1 left professional sports and started training only recreationally. No patients stopped participating in sports altogether. Conclusions We advocate arthroscopic microfracturing, followed by a strict rehabilitation regime, as a highly effective treatment for OCD of the humeral capitellum. PMID:22351577

  13. Total Hip Arthroplasty Using Modular Trabecular Metal Acetabular Components for Failed Treatment of Acetabular Fractures: A Mid-term Follow-up Study

    PubMed Central

    Huang, De-Yong; Zhang, Liang; Zhou, Yi-Xin; Zhang, Chun-Yu; Xu, Hui; Huang, Yong

    2016-01-01

    Background: Porous-coated cups have been widely used in acetabular reconstruction after failed treatment of acetabular fractures, and good results have been reported with the use of these cups; however, the durability and functionality of modular trabecular metal (TM) acetabular components in acetabular reconstruction after failed treatment of acetabular fractures remain unclear. This study aimed to examine the radiographic and clinical outcomes associated with the use of modular TM acetabular components for failed treatment of acetabular fractures to assess the durability and functionality of these components in acetabular reconstruction after failed treatment of acetabular fractures. Methods: A total of 41 patients (41 hips) underwent total hip arthroplasty (THA) using modular TM acetabular components for failed treatment of acetabular fractures at our hospital between January 2007 and December 2012. Among these patients, two were lost to follow-up. Therefore, 39 patients (39 hips) were finally included in this study. The Harris hip score before and after the surgery, satisfaction level of the patients, and radiographic results were assessed. Results: The mean Harris hip score increased from 34 (range, 8–52) before surgery to 91 (range, 22–100) at the latest follow-up examination (P < 0.001). The results were excellent for 28 hips, good for six, fair for three, and poor for two. Among the 39 patients, 25 (64%) and 10 (26%) were very satisfied and somewhat satisfied, respectively. All cups were found to be fully incorporated, and no evidence of cup migration or periacetabular osteolysis was noted. Conclusions: Despite the technically demanding nature of the procedure, THA using modular TM acetabular components showed good durability and functionality and may be an effective reconstruction option for failed treatment of acetabular fractures. PMID:27064033

  14. Uncemented total hip arthroplasty in osteoarthritis of hip secondary to low and high dislocated hips: A mid-term follow-up study

    PubMed Central

    Munigangaiah, Sudarshan; O’Dwyer, Sinead; Masterson, Eric

    2016-01-01

    Background: Performing successful total hip replacement (THR) in dysplastic, subluxed, and dislocated hip is a challenging task. Here, we assessed midterm clinical and radiological outcomes of uncemented total hip arthroplasty in osteoarthritis (OA) of hip secondary to Hartofilakidis low and high-dislocated hips with a mean follow-up of 8.8 years. Materials and Methods: A retrospective study of prospectively collected data was designed involving all consecutive patients who underwent uncemented THR for OA of hip secondary to developmental dysplasia of the hip and Grade II or Grade III Hartofilakidis classification. Results: Thirty-two patients underwent 45 THR, with 23 Grade II (low dislocation) and 22 Grade III (high-dislocation) of Hartofilakidis classification. Thirteen patients had bilateral hip replacements, 19 patients had unilateral THR. There was highly statistically significant difference between preoperative and postoperative HHS and SF-36v2™ at each follow-up. Survivorship of original implant was 98.88% at a mean follow-up of 8.8 years. The mean improvement in leg length in this series was 3.6 cm (1.8-4.5, 95% confidence interval). No sciatic nerve or femoral nerve palsies were observed. Conclusions: Uncemented THR provides better function and quality of life. However, longer follow-up studies are needed to assess survivorship of uncemented THR in Hartofilakidis low and high-dislocations. PMID:27433063

  15. A deeper look at the response of oxygenated and non oxygenated VOC to mid-term drought over the seasonal cycle: the case study of a drought-resistant species

    NASA Astrophysics Data System (ADS)

    Saunier, Amelie; Ormeño Lafuente, Elena; Wortham, Henri; Temime-Roussel, Brice; Fernandez, Catherine

    2015-04-01

    At the end of this century, climatic models plan an intensification of summer drought in the Mediterranean area due to a 30% rain reduction and a temperature rise of 3.4 °C. Plants respond to drought by modifying their primary (growth) and their secondary metabolism, the later being partly represented by volatile organic compound (VOC) emissions, such as terpenes. With drought, oxygenated and non oxygenated terpene emissions have been observed to increase, decrease or remain unchanged according to drought severity and vegetal model. By contrast, the response of non-terpenic oxygenated compounds to drought has been poorly studied. The aim of this study is to determine the potential impact of a two-year drought period on the full screen of VOC released by Q. pubescens, with a focus on both isoprene and methanol, issued from plant anabolism , and the numerous highly volatile oxygenated VOC, issued from plant catabolism (i.e. issued from oxidation of isoprene or methanol). A 70 years-old Downy oak forest (Quercus pubescens), highly resistant to drought stress, was selected as model ecosystem since it is well widespread in Southern France occupying 321 000 ha. Downy oak also represents the major source of isoprene emissions in the Mediterranean area and, unlike the other major Quercus sp. of the region (i.e. Quercus ilex, a monoterpene emitter) the impact of watering withholding over years has never been tackled. The study was performed at the experimental platform of O3HP (Oak Observatory at Observatoire de Haute Provence) in Southern France which is equipped with both a rain exclusion (by 30 %) and a rain addition structure (simulating the rainiest years of the region), allowing for comparison with naturally watered trees. Using dynamic enclosure chambers at the branch level and PTR-MS-Q-ToF, we screened the anabolic VOC (isoprene, methanol) and the catabolic VOC (e.g. methacrolein, methyl vinyl ketone, C6 aldehydes and carboxylic acids) of trees located under the three watering treatments during the three seasons of the vegetation period (spring, summer and autumn). Concomitantly, water stress was characterized by monitoring the ecophysiological plant parameters such as predawn leaf water potential, photosynthesis, stomatal conductance as well as VOCanabolic/VOCCcatabolic ratios indicators of oxidation within the cell. Differences among the three watering treatments were slight or absent depending on the season and the compound. This response was attributed to Downy Oak resistance to rain exclusion as reflected by the maintenance of the photosynthetic machinery activity and leaf water levels.

  16. School restrictions on outdoor activities and weight status in adolescent children after Japan’s 2011 Fukushima Nuclear Power Plant disaster: a mid-term to long-term retrospective analysis

    PubMed Central

    Nomura, Shuhei; Blangiardo, Marta; Hodgson, Susan

    2016-01-01

    Objective Radiation fears following Japan's 2011 Fukushima nuclear disaster affected levels of physical activity in local children. We assessed the postdisaster versus predisaster weight status in school children and evaluated to what extent school restrictions on outdoor activities that were intended to reduce radiation exposure risk affected child weight. Participants We considered children aged 13–15 years from 4 of the 5 secondary schools in Soma City (n=1030, 99.1% of all children in the city), located in 35–50 km from the Fukushima nuclear plant, postdisaster (2012 and 2015) and predisaster (2010). Methods Weight status, in terms of body mass index (BMI), percentage of overweight (POW) and incidence of obesity and underweight (defined as a POW ≥20% and ≤−20%, respectively) were examined and compared predisaster and postdisaster using regression models. We also constructed models to assess the impact of school restrictions on outdoor activity on weight status. Results After adjustment for covariates, a slight decrease in mean BMI and POW was detected in females in 2012 (−0.37, 95% CI −0.68 to −0.06; and −1.97, 95% CI −3.57 to −0.36, respectively). For male children, obesity incidence increased in 2012 (OR for obesity: 1.45, 95% CI 1.02 to 2.08). Compared with predisaster weight status, no significant weight change was identified in 2015 in either males or females. School restrictions on outdoor activities were not significantly associated with weight status. Conclusions 4 years following the disaster, weight status has recovered to the predisaster levels for males and females; however, a slight decrease in weight in females and a slight increase in risk of obesity were observed in males 1 year following the disaster. Our findings could be used to guide actions taken during the early phase of a radiological disaster to manage the postdisaster health risks in adolescent children. PMID:27683520

  17. Pseudotumour incidence, cobalt levels and clinical outcome after large head metal-on-metal and conventional metal-on-polyethylene total hip arthroplasty: mid-term results of a randomised controlled trial.

    PubMed

    van der Veen, H C; Reininga, I H F; Zijlstra, W P; Boomsma, M F; Bulstra, S K; van Raay, J J A M

    2015-11-01

    We compared the incidence of pseudotumours after large head metal-on-metal (MoM) total hip arthroplasty (THA) with that after conventional metal-on-polyethylene (MoP) THA and assessed the predisposing factors to pseudotumour formation. From a previous randomised controlled trial which compared large head (38 mm to 60 mm) cementless MoM THA with conventional head (28 mm) cementless MoP THA, 93 patients (96 THAs: 41 MoM (21 males, 20 females, mean age of 64 years, standard deviation (sd) 4) and 55 MoP (25 males, 30 females, mean age of 65 years, sd 5) were recruited after a mean follow-up of 50 months (36 to 64). The incidence of pseudotumours, measured using a standardised CT protocol was 22 (53.7%) after MoM THA and 12 (21.8%) after MoP THA. Women with a MoM THA were more likely to develop a pseudotumour than those with a MoP THA (15 vs 7, odds ratio (OR) = 13.4, p < 0.001). There was a similar incidence of pseudotumours in men with MoM THAs and those with MoP THAs (7 vs 5, OR = 2.1, p = 0.30). Elevated cobalt levels (≥ 5 microgram/L) were only associated with pseudotumours in women with a MoM THA. There was no difference in mean Oxford and Harris hip scores between patients with a pseudotumour and those without. Contrary to popular belief, pseudotumours occur frequently around MoP THAs. Women with a MoM THA and an elevated cobalt level are at greatest risk. In this study, pseudotumours had no effect on the functional outcome after either large head MoM or conventional MoP THA.

  18. Cost-effectiveness of initial stress cardiovascular MR, stress SPECT or stress echocardiography as a gate-keeper test, compared with upfront invasive coronary angiography in the investigation and management of patients with stable chest pain: mid-term outcomes from the CECaT randomised controlled trial

    PubMed Central

    Thom, Howard; West, Nicholas E J; Hughes, Vikki; Dyer, Matthew; Buxton, Martin; Sharples, Linda D; Jackson, Christopher H; Crean, Andrew M

    2014-01-01

    Objectives To compare outcomes and cost-effectiveness of various initial imaging strategies in the management of stable chest pain in a long-term prospective randomised trial. Setting Regional cardiothoracic referral centre in the east of England. Participants 898 patients (69% man) entered the study with 869 alive at 2 years of follow-up. Patients were included if they presented for assessment of stable chest pain with a positive exercise test and no prior history of ischaemic heart disease. Exclusion criteria were recent infarction, unstable symptoms or any contraindication to stress MRI. Primary outcome measures The primary outcomes of this follow-up study were survival up to a minimum of 2 years post-treatment, quality-adjusted survival and cost-utility of each strategy. Results 898 patients were randomised. Compared with angiography, mortality was marginally higher in the groups randomised to cardiac MR (HR 2.6, 95% CI 1.1 to 6.2), but similar in the single photon emission CT-methoxyisobutylisonitrile (SPECT-MIBI; HR 1.0, 95% CI 0.4 to 2.9) and ECHO groups (HR 1.6, 95% CI 0.6 to 4.0). Although SPECT-MIBI was marginally superior to other non-invasive tests there were no other significant differences between the groups in mortality, quality-adjusted survival or costs. Conclusions Non-invasive cardiac imaging can be used safely as the initial diagnostic test to diagnose coronary artery disease without adverse effects on patient outcomes or increased costs, relative to angiography. These results should be interpreted in the context of recent advances in imaging technology. Trial registration ISRCTN 47108462, UKCRN 3696. PMID:24508847

  19. 76 FR 52034 - Self-Regulatory Organizations; NYSE Arca, Inc.; Order Granting Approval of Proposed Rule Change...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-19

    ... COMMISSION Self-Regulatory Organizations; NYSE Arca, Inc.; Order Granting Approval of Proposed Rule Change To List and Trade Shares of ProShares Short VIX Short-Term Futures ETF, ProShares Short VIX Mid-Term Futures ETF, ProShares Ultra VIX Short-Term Futures ETF, ProShares Ultra VIX Mid-Term Futures ETF,...

  20. White Paper on School-Lunch Nutrition.

    ERIC Educational Resources Information Center

    Center for Science in the Public Interest, Washington, DC.

    Recommendations are made on how school lunch programs can provide better nutrition and promote healthier eating habits. Recommendations consist of goals with both short-term and mid-term objectives. The short-term objectives should be implemented over the next 2 to 4 years; the mid-term objectives should be implemented by the year 2000 or sooner…

  1. 'Crescendo' transient ischemic attacks: clinical and angiographic correlations.

    PubMed

    Rothrock, J F; Lyden, P D; Yee, J; Wiederholt, W C

    1988-02-01

    Forty-seven consecutive patients presenting acutely with repetitive symptoms indicative of anterior circulation ischemia ("crescendo" transient ischemic attacks) were evaluated to identify clinical features that might reliably predict the presence of significant stenosis, ulceration, or both in the presumably symptomatic internal carotid artery. Angiographic or intraoperative correlation was obtained in all patients, and 26 (55%) were found to have anatomically significant disease. Of 20 patients with signs or symptoms suggestive of cortical ischemia, amaurosis fugax, or both, 17 (85%) had "positive" angiograms; of 18 with numbness/weakness only, 9 (50%) had positive angiograms; of 9 whose symptoms suggested lacunar ischemia, none had positive angiograms.

  2. Visual impairment.

    PubMed

    Ellenberger, Carl

    2016-01-01

    This chapter can guide the use of imaging in the evaluation of common visual syndromes: transient visual disturbance, including migraine and amaurosis fugax; acute optic neuropathy complicating multiple sclerosis, neuromyelitis optica spectrum disorder, Leber hereditary optic neuropathy, and Susac syndrome; papilledema and pseudotumor cerebri syndrome; cerebral disturbances of vision, including posterior cerebral arterial occlusion, posterior reversible encephalopathy, hemianopia after anterior temporal lobe resection, posterior cortical atrophy, and conversion blindness. Finally, practical efforts in visual rehabilitation by sensory substitution for blind patients can improve their lives and disclose new information about the brain. PMID:27430448

  3. Acute, painless vision loss.

    PubMed

    Beran, David I; Murphy-Lavoie, Heather

    2009-01-01

    This article provides a review of various conditions causing sudden, painless vision loss. The conditions of amaurosis fugax, central retinal artery occlusion (CRAO), central retinal vein occlusion (CRVO), vitreous hemorrhage, ischemic optic neuropathies (ION), posterior cerebrovascular accidents, and retinal detachment (RD) are discussed. The history, physical, pathophysiology, and treatment of each disease state are discussed along with possible preventative measures for each. An emphasis is made on early ophthalmologic involvement for potential vision restoration and the importance of a thorough history and physical for all patients with ocular complaints. PMID:19785313

  4. Leucosiid crabs (Crustacea: Decapoda: Brachyura) from Taiwan, with three new records.

    PubMed

    Shih, Yi-Jia; Ho, Ping-Ho; Chan, Tin-Yam

    2015-12-01

    Four leucosiid species from Taiwan are presented. Ebalia nudipes Sakai, 1963, with its male first gonopod figured for the first time. Galilia petricola Komai & Tsuchida, 2014, is recorded on the basis of a larger specimen, and distinguishing features with its only congener, G. narusei Ng & Richer de Forges, 2007, reappraised. Nursia rhomboidalis (Miers, 1879), previously known only from Japan, Korea, and mainland China, is also recorded from Taiwan. Myra fugax (Fabricius, 1798) is now formally recorded from Taiwan, and female characters identified to help separate the three known Taiwanese species of Myra.

  5. Comparison of selected species of Bipolaris, Drechslera and Exserohilum by random amplification of polymorphic DNA.

    PubMed

    Bakonyi, J; Pomázi, A; Fischl, G; Hornok, L

    1995-01-01

    Forty-six strains representing 15 species of Drechslera, five of Bipolaris and four of Exserohilum, as well as two formae of Drechslera teres were compared by RAPD analysis. Drechslera formed a large, heterologous group, while species of Bipolaris and Exserohilum were more closely related. Strong pair-wise affinities were observed between D. graminea and D. teres, D. tritici-repentis and D. bromi, D. siccans and D. biseptata, D. fugax and D. poae, B. sorghicola and B. zeicola, as well as between E. rostratum and E. turcicum.

  6. Advanced batteries for electric vehicle applications: Nontechnical summary

    NASA Astrophysics Data System (ADS)

    Henriksen, G. L.

    This paper provides an overview of the performance characteristics of the most prominent batteries under development for electric vehicles (EV's) and compares these characteristics to the USABC Mid-Term and Long-Term criteria, as well as to typical vehicle-related battery requirements. Most of the battery performance information was obtained from independent tests, conducted using simulated driving power profiles, for DOE and EPRI at Argonne National Laboratory. The EV batteries are categorized as near-term, mid-term, and long-term technologies based on their relative development status, as well as our estimate of their potential availability as commercial EV batteries. Also, the performance capabilities generally increase in going from the near-term to the mid-term and on to the long-term technologies. To date, the USABC has chosen to fund a few selected mid-term and long-term battery technologies.

  7. Cutting Balloon Angioplasty of Bilateral Renal Artery Stenosis Due to Takayasu Arteritis in a 5-Year-Old Child with Midterm Follow-Up

    SciTech Connect

    Gumus, Burcak Cevik, Halime; Vuran, Can; Omay, Oguz; Kocyigit, Ozgen Ilgaz; Turkoz, Riza

    2010-04-15

    The aim of this report is to demonstrate the successful endovascular treatment of bilateral renal artery stenosis due to Takayasu arteritis by cutting balloon angioplasty in a 5-year-old child with mid-term follow-up.

  8. Advanced Aero-Propulsive Mid-Lift-to-Drag Ratio Entry Vehicle for Future Exploration Missions

    NASA Astrophysics Data System (ADS)

    Campbell, C. H.; Sostaric, R. R.; Cerimele, C. J.; Wong, K. A.; Valle, G. D.; Garcia, J. A.; Melton, J. E.; Munk, M. M.; Blades, E.; Kuruvila, G.; Picetti, D. J.; Hassan, B.; Kniskern, M. W.

    2012-06-01

    Advanced mid-L/D entry vehicles can provide performance advantages significant to mid-term robotic and human missions. Preliminary simulations with new paradigms show transonic Mach vehicle staging possible for retro-propulsion, descent and landing.

  9. 29 CFR 1425.2 - Notice to the Service of agreement negotiations.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... implementation bargaining (I&I) and/or mid-term bargaining and provide a brief listing of issues, e.g. Smoking... for grievance mediation. (See item 9.) In item #9. Please give the title of the official, phone...

  10. [Ocular complications of giant cell arteritis].

    PubMed

    Liozon, E; Ly, K-H; Robert, P-Y

    2013-07-01

    Permanent visual loss (PVL) is the most dreaded complication of giant cell arteritis (GCA). It results from anterior ischemic optic neuropathy or, less commonly, retinal artery occlusion. This complication still occurs in 14 to 20% of patients and is typically devastating and permanent, although it is highly preventable by an early diagnosis of giant cell arteritis and appropriate glucocorticoid treatment. Transient ischemic symptoms such as amaurosis fugax, episodes of blurred vision or diplopia may occur, either heralding visual loss or remaining isolated. In studies, the main predictors of PVL are jaw claudication, amaurosis fugax, lack of systemic "B" symptoms, a modestly increased ESR and a higher haemoglobin level. The evaluation of a GCA patient with PVL includes emergency fundoscopy completed by fluorescein angiography, immediate erythrocyte sedimentation rate, C-reactive protein, and complete blood count. Treatment is extremely urgent mainly because, if left untreated, GCA is associated with visual loss in the fellow eye within days in up to 50% of individuals. Treatment may begin with high-dose intravenous methylprednisolone, followed by oral prednisone administered at 1 mg/kg per day. Daily adjunctive aspirin orally may be added since it has been shown, in retrospective studies, to protect against stroke and visual loss. Although treatment duration of complicated GCA is not codified, an initial PVL deserves close monitoring of patient's systemic symptoms, ESR and CRP to avoid relapses due to a significant risk of late recurrence of visual loss during steroid tapering. PMID:23523078

  11. The requirements for batteries for electric vehicles

    NASA Technical Reports Server (NTRS)

    Schwartz, H. J.

    1976-01-01

    Analysis of automobile use patterns shows that the battery requirements for an urban car can be met by mid-term battery technology. The far-term technology potentially offers greater range but does not proportionately increase the usefulness of the vehicle. This suggests that emphasis should be shifted toward more modest energy density goals, if such a shift would ease technical problems and allow the use of lower cost materials and construction methods. A technology diffusion model indicates that the impact of the mid-term batteries by the year 2000 would be greater than that of the far-term batteries because of their earlier introduction and nearly equal market potential. From the standpoint of maximizing both the cumulative impact and the benefits derived in the year 2000, however, a strategy of early introduction of near-term and mid-term cars followed by the far-term vehicle would produce the optimum results.

  12. Taxonomic revision of Phygopoda Thomson, 1864 and Pseudophygopoda Tavakilian & Peñaherrera-Leiva, 2007 (Insecta: Coleoptera: Cerambycidae: Cerambycinae).

    PubMed

    Carelli, Allan; Monné, Marcela L

    2015-01-01

    A taxonomic revision based on the study of the external morphology and the terminalia of Phygopoda Thomson, 1864 and Pseudophygopoda Tavakilian & Peñaherrera-Leiva, 2007 is presented. The genera and their species are redescribed. Five synonymies are proposed: Panamapoda Clarke, 2014 and Paraphygopoda Clarke, 2014 = Pseudophygopoda Tavakilian & Peñaherrera-Leiva, 2007; Paraphygopoda viridimicans (Fisher, 1952); Paraphygopoda nappae Clarke, 2014; and Paraphygopoda longipennis (Zajciw, 1963) = Pseudophygopoda albitarsis (Klug, 1825). The genus Phygopoda is composed of five species: Phygopoda fugax Thomson, 1864; Phygopoda fulvitarsis Gounelle, 1911; Phygopoda ingae Peñaherrera-Leiva & Tavakilian, 2004; Phygopoda jacobi Fuchs, 1961; and Phygopoda nigritarsis Gounelle, 1911. Pseudophygopoda is now composed of three species: Pseudophygopoda subvestita (White, 1855), Pseudophygopoda panamensis (Giesbert, 1996) comb. nov., and Pseudophygopoda albitarsis (Klug, 1825) comb. nov. New geographical records are reported for six species. A key to the species of Phygopoda and Pseudophygopoda, photographs, plates of drawings, and maps of the geographical distribution of the species are provided.

  13. An important clue in the sonographic diagnosis of internal carotid artery agenesis: ipsilateral common carotid artery hypoplasia.

    PubMed

    Kaya, Omer; Yilmaz, Cengiz; Gulek, Bozkurt; Soker, Gokhan; Cikman, Gokalp; Inan, Ibrahim; Demirduzen, Selahaddin

    2014-01-01

    A 42-year-old female patient, who had been diagnosed with an occlusion of her left internal carotid artery (ICA) following Doppler ultrasonographic (US) and digitally-subtracted angiographic (DSA) examinations performed in an outer healthcare center in order to eliminate the underlying cause of her complaint of amorosis fugax, later applied to our hospital with the same complaint. At Doppler US performed in our hospital's radiology department, her right common carotid artery (CCA) was normal, but her left CCA was hypoplastic. The right internal artery (ICA) was validated as normal. At the left side, however, the ICA was apparent only as a stump and it did not demonstrate a continuity. The diagnosis of ICA agenesis was confirmed by the utilization of Doppler US, CT, and DSA imaging, and it was concluded also that ipsilateral CCA hypoplasia could be evaluated as an important clue to the diagnosis of ICA agenesis. PMID:25097789

  14. Embolic and nonembolic transient monocular visual field loss: a clinicopathologic review.

    PubMed

    Petzold, Axel; Islam, Niaz; Hu, Han-Hwa; Plant, Gordon T

    2013-01-01

    Transient monocular blindness and amaurosis fugax are umbrella terms describing a range of patterns of transient monocular visual field loss (TMVL). The incidence rises from ≈1.5/100,000 in the third decade of life to ≈32/100,000 in the seventh decade of life. We review the vascular supply of the retina that provides an anatomical basis for the types of TMVL and discuss the importance of collaterals between the external and internal carotid artery territories and related blood flow phenomena. Next, we address the semiology of TMVL, focusing on onset, pattern, trigger factors, duration, recovery, frequency-associated features such as headaches, and on tests that help with the important differential between embolic and non-embolic etiologies.

  15. Embolic and nonembolic transient monocular visual field loss: a clinicopathologic review.

    PubMed

    Petzold, Axel; Islam, Niaz; Hu, Han-Hwa; Plant, Gordon T

    2013-01-01

    Transient monocular blindness and amaurosis fugax are umbrella terms describing a range of patterns of transient monocular visual field loss (TMVL). The incidence rises from ≈1.5/100,000 in the third decade of life to ≈32/100,000 in the seventh decade of life. We review the vascular supply of the retina that provides an anatomical basis for the types of TMVL and discuss the importance of collaterals between the external and internal carotid artery territories and related blood flow phenomena. Next, we address the semiology of TMVL, focusing on onset, pattern, trigger factors, duration, recovery, frequency-associated features such as headaches, and on tests that help with the important differential between embolic and non-embolic etiologies. PMID:23217587

  16. [Ophthalmological manifestations of cerebrovascular disease].

    PubMed

    Gallego Culleré, J; Herrera, M; Navarro, Mc

    2008-01-01

    Transient or persistent loss of vision in one eye is a common and distinctive manifestation of occlusive vascular disease. Occasionally, both eyes are involved together or sequentially, with temporary or even permanent blindness. The internal carotid arteries supply blood to the organ of vision; therefore pathologies of those arteries caused by arteriosclerosis may have a direct influence on its functioning. The most common syndromes are temporary (amaurosis fugax) or constant reduction of visual acuity. In fundus examination central retinal artery occlusion and branch retinal artery occlusion are the most common diagnosis, while retinal vein occlusion, anterior ischemic optic neuropathy, ocular ischemic syndrome are less common. There are many clinical ophtlamological manifestations due to vascular brain damage. Proper recognition and diagnosis of the disease may protect the patient against serious life-threatening complications such as stroke. PMID:19169299

  17. [Ophthalmological complications associated with clinically significant carotid stenosis].

    PubMed

    Rozegnał-Madej, Agnieszka; Bielecka, Emilia; Swiech-Zubilewicz, Anna; Zarnowski, Tomasz; Karakuła, Wacław; Zubilewicz, Tomasz

    2012-01-01

    The aim of the study was to show ocular manifestations in carotid artery occlusive disease, with pathogenesis, diagnostic and therapeutic abilities of this changes. Carotid arteries are the main route by which the blood is supplied to the cerebrum and eyes. Clinical significant carotid artery stenosis is mainly caused by atherosclerosis. Most frequent neurological symptoms are transient ischemic attacks (TIA) and temporary visual loss (amaurosos fugax) are most common ocular symptoms. Other ocular pathologies in fundus examination are retinal embolies, retinal vein occlusion, anterior ischemic optic neuropathy, ocular ischemic syndrome or glaucoma. Most dangerous complications are stroke, blindness, or even patients death. Besides clinical examination the diagnosis is usually confirmed by carotid artery color Doppler ultrasound, magnetic resonance angiography and retinal fluorescein angiography. It is important to refer a patient with suspected or confirmed significant carotid artery stenosis for appropriate evaluation and treatment to a endovascular surgeon. PMID:22783748

  18. Hyperbaric oxygen in the treatment of radiation-induced optic neuropathy

    SciTech Connect

    Guy, J.; Schatz, N.J.

    1986-08-01

    Four patients with radiation-induced optic neuropathies were treated with hyperbaric oxygen. They had received radiation therapy for treatment of pituitary tumors, reticulum cell sarcoma, and meningioma. Two presented with amaurosis fugax before the onset of unilateral visual loss and began hyperbaria within 72 hours after development of unilateral optic neuropathy. Both had return of visual function to baseline levels. The others initiated treatment two to six weeks after visual loss occurred in the second eye and had no significant improvement of vision. Treatment consisted of daily administration of 100% oxygen under 2.8 atmospheres of pressure for 14-28 days. There were no medical complications of hyperbaria. While hyperbaric oxygen is effective in the treatment of radiation-induced optic neuropathy, it must be instituted within several days of deterioration in vision for restoration of baseline function.

  19. Results of sleeves in revision total knee arthroplasty: an editorial comment on recently published in the Journal of Arthroplasty

    PubMed Central

    Jiang, Chao

    2015-01-01

    The paper entitled “Direct, cementless, metaphyseal fixation in knee revision arthroplasty with sleeves-short-term results” published in the Journal of Arthroplasty to analyze the short- and mid-term results in revision total knee arthroplasty (TKA) in a largest series so far. This article shown that cementless metaphyseal fixation with sleeves is a promising option for revision TKA implant fixation. The clinical outcomes regarding the range of motion and the KSS are also promising. Based on this article and related literatures about sleeves, we assess the short to mid-term outcomes and the clinical perspectives in revision TKAs. PMID:26697477

  20. 26 CFR 25.7520-1 - Valuation of annuities, unitrust interests, interests for life or terms of years, and remainder...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... remainder unitrust. (b) Components of valuation—(1) Interest rate component—(i) Section 7520 Interest rate. The section 7520 interest rate is the rate of return, rounded to the nearest two-tenths of one percent, that is equal to 120 percent of the applicable Federal mid-term rate, compounded annually, for...

  1. 26 CFR 1.7520-1 - Valuation of annuities, unitrust interests, interests for life or terms of years, and remainder...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... a charitable remainder unitrust. (b) Components of valuation—(1) Interest rate component—(i) Section 7520 Interest rate. The section 7520 interest rate is the rate of return, rounded to the nearest two-tenths of one percent, that is equal to 120 percent of the applicable Federal mid-term rate,...

  2. 26 CFR 20.7520-1 - Valuation of annuities, unitrust interests, interests for life or terms of years, and remainder...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... transferred to a charitable remainder unitrust. (b) Components of valuation—(1) Interest rate component—(i) Section 7520 Interest rate. The section 7520 interest rate is the rate of return, rounded to the nearest two-tenths of one percent, that is equal to 120 percent of the applicable Federal mid-term...

  3. 26 CFR 25.7520-1 - Valuation of annuities, unitrust interests, interests for life or terms of years, and remainder...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... remainder unitrust. (b) Components of valuation—(1) Interest rate component—(i) Section 7520 Interest rate. The section 7520 interest rate is the rate of return, rounded to the nearest two-tenths of one percent, that is equal to 120 percent of the applicable Federal mid-term rate, compounded annually, for...

  4. 26 CFR 20.7520-1 - Valuation of annuities, unitrust interests, interests for life or terms of years, and remainder...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... transferred to a charitable remainder unitrust. (b) Components of valuation—(1) Interest rate component—(i) Section 7520 Interest rate. The section 7520 interest rate is the rate of return, rounded to the nearest two-tenths of one percent, that is equal to 120 percent of the applicable Federal mid-term...

  5. Atomic clock using coherent population trapping in a cesium cell: frequency stability and limitations

    NASA Astrophysics Data System (ADS)

    Mejri, Sinda; Tricot, Francois; Danet, Jean-Marie; Yun, Peter; De Clercq, Emeric; Guerandel, Stephane

    2016-06-01

    Toward the next generation of compact devices, atomic clocks based on coherent population trapping (CPT) offer a very interesting alternative. We present a review of our studies on the short and mid term stability of a compact high performance atomic clock based on CPT in view of portable applications.

  6. Energy Frontier Research Center, Center for Materials Science of Nuclear Fuels

    SciTech Connect

    Todd R. Allen

    2011-12-01

    This is a document required by Basic Energy Sciences as part of a mid-term review, in the third year of the five-year award period and is intended to provide a critical assessment of the Center for Materials Science of Nuclear Fuels (strategic vision, scientific plans and progress, and technical accomplishments).

  7. Do Those Who Benefit the Most Need it the Least? A Four-Year Experiment in Enquiry-Based Feedback

    ERIC Educational Resources Information Center

    Adcroft, Andy; Willis, Robert

    2013-01-01

    The aim of this paper is to report on an ongoing experiment in an enquiry-based approach to feedback. Over the course of four years, almost 1800 students have studied a final-year undergraduate module involving a mid-term assignment and end of module examination. Feedback on the assignment is delivered through a process which involves the…

  8. Predicting Pre-Service Classroom Teachers' Civil Servant Recruitment Examination's Educational Sciences Test Scores Using Artificial Neural Networks

    ERIC Educational Resources Information Center

    Demir, Metin

    2015-01-01

    This study predicts the number of correct answers given by pre-service classroom teachers in Civil Servant Recruitment Examination's (CSRE) educational sciences test based on their high school grade point averages, university entrance scores, and grades (mid-term and final exams) from their undergraduate educational courses. This study was…

  9. Top Tips for Buying Telecommunication Services.

    ERIC Educational Resources Information Center

    Linder, Jeff

    2001-01-01

    Examines top regulatory issues and other unique issues resulting from this regulatory overlay when negotiating for corporate telecom services. Issues cover such topics as tariffs, rate negotiation, exclusivity provisions, revenue commitments, mid-term negotiations, service-level agreements, and dispute resolution. (GR)

  10. FY 1979 Unit Cost Analysis for the Public Community Colleges of Illinois.

    ERIC Educational Resources Information Center

    Illinois Community Coll. Board, Springfield.

    A unit cost analysis for fiscal year (FY) 1979 was conducted by the Illinois Community College Board using mid-term enrollment data and uniform accounting information from each of the state's 51 community colleges. Unit costs for instructional areas were determined at three incremental levels: (1) net instructional cost (NIC), which includes…

  11. Altering Test Environments for Reducing Test Anxiety and for Improving Academic Performance.

    ERIC Educational Resources Information Center

    Bushnell, Don D.

    To test the effects of altering situational variables in stressful examinations on high test anxious and low test anxious undergraduates, mid-terms and final examinations were administered in two environmental settings: large lecture halls and small language laboratories. Mean test scores for high test anxious students in the language labs were…

  12. Standing Still or Moving Up? Evidence from Wisconsin on the Long-Term Employment and Earnings of TANF Participants

    ERIC Educational Resources Information Center

    Wu, Chi-Fang; Cancian, Maria; Meyer, Daniel R.

    2008-01-01

    This study identified the employment and earnings trajectories of welfare recipients over six years for a sample of 14,150 women who entered the Temporary Assistance for Needy Families program (TANF) in Wisconsin in its first year. Wisconsin longitudinal administrative data were used to examine differential patterns of mid-term (three years) and…

  13. 76 FR 199 - Self-Regulatory Organizations; NYSE Arca, Inc.; Order Granting Approval of Proposed Rule Change...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-03

    ... COMMISSION Self-Regulatory Organizations; NYSE Arca, Inc.; Order Granting Approval of Proposed Rule Change Relating to the Listing and Trading of the ProShares VIX Short-Term Futures ETF and the ProShares VIX Mid-Term Futures ETF December 27, 2010. I. Introduction On November 5, 2010, NYSE Arca, Inc....

  14. New Technology Trends in Education: Seven Years of Forecasts and Convergence

    ERIC Educational Resources Information Center

    Martin, Sergio; Diaz, Gabriel; Sancristobal, Elio; Gil, Rosario; Castro, Manuel; Peire, Juan

    2011-01-01

    Each year since 2004, a new Horizon Report has been released. Each edition attempts to forecast the most promising technologies likely to impact on education along three horizons: the short term (the year of the report), the mid-term (the next 2 years) and the long term (the next 4 years). This paper analyzes the evolution of technology trends…

  15. English Teaching in South Africa: Languages, Literacies and Politics.

    ERIC Educational Resources Information Center

    Farrell, Lesley; Homer, David; Patterson, Annette

    1998-01-01

    Uses three addresses given at a mid-term International Federation for the Teaching of English at the University of Witwatersrand to outline workplace realities for South African teachers. Summarizes the addresses which deal with (1) the role of intellectuals in Africa; (2) the problems of school and social reconstruction; and (3) the political…

  16. National Electric Sector Cybersecurity Organization Resource (NESCOR)

    SciTech Connect

    None, None

    2014-06-30

    The goal of the National Electric Sector Cybersecurity Organization Resource (NESCOR) project was to address cyber security issues for the electric sector, particularly in the near and mid-term. The following table identifies the strategies from the DOE Roadmap to Achieve Energy Delivery Systems Cybersecurity published in September 2011 that are applicable to the NESCOR project.

  17. Evolutionary Theories of Detection

    SciTech Connect

    Fitch, J P

    2005-04-29

    Current, mid-term and long range technologies for detection of pathogens and toxins are briefly described in the context of performance metrics and operational scenarios. Predictive (evolutionary) and speculative (revolutionary) assessments are given with trade-offs identified, where possible, among competing performance goals.

  18. Extracorporeal shock wave lithotripsy in infants less than 12-month old.

    PubMed

    Turna, Burak; Tekin, Ali; Yağmur, İsmail; Nazlı, Oktay

    2016-10-01

    There is a lack of literature on children compared to adults regarding the long-term effects of extracorporeal shock wave lithotripsy (SWL), specifically in infants. The aim of the present study was to analyze the efficacy and safety of SWL in infants and also evaluate its potential adverse effects in the mid-term. Between May 1999 and December 2013, 36 infants with 39 renal units underwent SWL treatment for kidney stones with an electrohydraulic lithotripter (Dornier MPL 9000/ELMED Multimed Classic). All children were less than 12-month old. The mid-term effects of SWL were examined at the last follow-up by measuring arterial blood pressure, random blood glucose level and ipsilateral kidney size. Evaluation of treatment and its consequences was based on clinical examination, blood tests and conventional imaging (plain abdominal radiography and ultrasound). Overall stone-free rate was 84.6 % after 3-month follow-up without any major complications. Mid-term follow-up was available in 20 of 36 children with a mean follow-up of 3.2 ± 2.8 years (range 0.5-15.3). None of the infants were found to develop new onset of hypertension or diabetes. All treated infant kidneys' sizes were in the normal percentile range. SWL for management of infant kidney stones is effective and safe in the mid-term.

  19. 29 CFR 4022.81 - General rules.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... date will be included. (3) Credit for interest on net underpayments. If at the end of a month there is a positive account balance (a net underpayment), the PBGC will add to the account balance interest thereon for that month using— (i) For months after May 1998, the applicable federal mid-term rate...

  20. Community Analysis for the Pitkin County Library.

    ERIC Educational Resources Information Center

    Kirwin, Florence M.

    This document analyzes the social and demographic characteristics of Pitkin County, Colorado (population 12,000) and the Pitkin County Library located in Aspen (24,000 volumes). The report contains statistics gathered from the 1978 Mid-Term U.S. Bureau Census of Pitkin County, as well as other statistics from local, state, and federal sources; the…

  1. Woven TPS — An Enabling Technology for Mars Sample Return, In-Situ Science and Human Exploration Missions

    NASA Astrophysics Data System (ADS)

    Venkatapathy, E.; Stackpoole, M.; Feldman, J.; Kowal, J.; Munk, M.

    2012-06-01

    Woven TPS, an innovative new concept, an exploratory effort funded by OCT under game changing technology, has the potential to enable MSR (longer term) and in-situ Science missions to Venus, Outer Planets and high-speed sample return (near/mid term).

  2. Resilience and Learning: A Conspectus for Environmental Education

    ERIC Educational Resources Information Center

    Lundholm, Cecilia; Plummer, Ryan

    2010-01-01

    There has been an increasing interest in how environmental education contributes to sustainability dating from the 1977 UNESCO conference in Tbilisi to the current Decade of Education for Sustainable Development, which in 2009, reached mid term. There is also a growing interest and concern in the complexity, uncertainty and changing nature of…

  3. Cyclic Nucleotide-Gated Channels, Calmodulin, Adenylyl Cyclase, and Calcium/Calmodulin-Dependent Protein Kinase II Are Required for Late, but Not Early, Long-Term Memory Formation in the Honeybee

    ERIC Educational Resources Information Center

    Matsumoto, Yukihisa; Sandoz, Jean-Christophe; Devaud, Jean-Marc; Lormant, Flore; Mizunami, Makoto; Giurfa, Martin

    2014-01-01

    Memory is a dynamic process that allows encoding, storage, and retrieval of information acquired through individual experience. In the honeybee "Apis mellifera," olfactory conditioning of the proboscis extension response (PER) has shown that besides short-term memory (STM) and mid-term memory (MTM), two phases of long-term memory (LTM)…

  4. Course Syllabus: Minds and Robots.

    ERIC Educational Resources Information Center

    Goldman, Steven L.

    1985-01-01

    Describes and outlines the general syllabus of a philosophy course entitled, "Minds and Robots." Lists the assigned readings and explains the issues addressed in the 14-week course. Essay questions that are used for the mid-term and final exams are also included. (ML)

  5. A United Nations Decade of Education for Sustainable Development (2005-14): What Difference Will It Make?

    ERIC Educational Resources Information Center

    Mula, Ingrid; Tilbury, Daniella

    2009-01-01

    The launch of the United Nations Decade of Education for Sustainable Development (DESD) (2005-2014) was accompanied by a series of high-profile events and celebratory activities across the globe, which raised awareness about the Decade's objectives. Now, as the DESD approaches its mid-term, many stakeholders are asking these questions: What will…

  6. Evaluating Knowledge, Attitudinal, and Behavioral Change Effects from a Multinational HIV/AIDS Education Program for Youth

    ERIC Educational Resources Information Center

    Hardre, Patricia L.; Garcia, Fe; Apamo, Peter; Mutheu, Lucy; Ndege, Monica; Bois, Iderle

    2010-01-01

    This project tracked the mid-term evaluation processes, practices, and products of a multinational program to reduce at-risk behaviors for HIV/AIDS among children in Kenya, Tanzania, and Haiti. It focused on participant and community perceptions; program effectiveness in promoting abstinence and monogamy decisions; and factors supporting ongoing…

  7. Metacognitive Monitoring in University Classes: Anticipating a Graded vs. a Pass-Fail Test Affects Monitoring Accuracy

    ERIC Educational Resources Information Center

    Barenberg, Jonathan; Dutke, Stephan

    2013-01-01

    Three field studies tested the hypothesis that anticipating a graded test as opposed to a pass-fail test enhances metacognitive monitoring. Participants were teacher candidates who completed a mid-term and a final test in psychology courses. Each participant chose whether the result of the final test should be evaluated with one of five grades or…

  8. Maintenance Crisis vs Solutions.

    ERIC Educational Resources Information Center

    Haggard, Susie

    Industrial maintenance in Northeast Georgia is facing an acute crisis. Contributing factors are economic development that is depleting the work force, aging of the population, downsizing of the military, and lack of technical school graduates. Solutions to the crisis fall into three categories: short-term, mid-term, and long-term. For short-term…

  9. Left ventricular assist device support with a centrifugal pump for 2 months in a 5-kg child.

    PubMed

    Inoue, Takafumi; Nishimura, Takashi; Murakami, Arata; Itatani, Keiichi; Takaoka, Tetsuhiro; Kitahori, Kazuo; Umeki, Akihide; Takezoe, Toshiko; Kashiwa, Koichi; Kyo, Shunei; Ono, Minoru

    2011-09-01

    The mid-term and long-term results of left ventricular assist device (LVAD) implantation for small children are still unsatisfactory. There have been few reports of LVAD implantation for more than a month in children weighing under 5 kg. We report the case of a 4-month-old female infant who survived for 2 months after being diagnosed with dilated cardiomyopathy (DCM) with extracorporeal centrifugal pump support. In recent years, although pumps designed for small children have been introduced and are used as a bridge to transplantation or recovery, mid-term or long-term mechanical support for small children with heart failure is still difficult. We managed to successfully provide support for a low-body-weight child with a centrifugal pump over a mid-term period. We achieved acceptable control of thrombosis, but eventually the infant died of sepsis. Autopsy revealed no prominent thrombosis in the perfusion cannula, drainage cannula, the pump, or the left ventricle. This is the first case report of LVAD support with the centrifugal pump, ROTAFLOW(®) (Maquet, Rastatt, Germany), for 2 months in a child weighing under 5 kg. Our method may potentially save severe heart failure children who need mid-term LVAD support.

  10. 29 CFR 1425.2 - Notice to the Service of agreement negotiations.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Form. In item #2. If other assistance in bargaining is requested please specify: e.g.; impact and... filed within 30 days after commencing negotiations. (b) Parties engaging in mid-term or impact and/or... general in nature e.g., smoking policies, or Alternative Work Schedules (AWS). (c) Parties...

  11. Coping with historic drought in California rangelands

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The current drought in California is of historic proportion, both in its intensity and its effect on agriculture. Although storms of the 2015-16 winter rainfall season have provided modest drought relief, their effects on alleviating the multi-year drought are unknown. Short- and mid-term forecasts...

  12. EFA Mid-Decade Assessment Meeting Report. Annual EFA Coordinators Meeting/EFA Mid-Decade Assessment Planning Meeting (7th, Bangkok, Thailand, October 24-29, 2005)

    ERIC Educational Resources Information Center

    Tung, Ko-Chih

    2006-01-01

    Six Education For All (EFA) goals were agreed to in the World Education Forum in Dakar, Senegal in 2000. Since then, UNESCO Bangkok, UNICEF and the Regional Thematic Working Group on EFA have been jointly assisting countries in conducting assessment of progress and gaps towards the EFA goals and mid-term review of policies and reforms. In October…

  13. Development of PCK for Novice and Experienced University Physics Instructors: A Case Study

    ERIC Educational Resources Information Center

    Jang, Syh-Jong; Tsai, Meng-Fang; Chen, Ho-Yuan

    2013-01-01

    The current study assessed and compared university students' perceptions' of a novice and an experienced physics instructor's Pedagogical Content Knowledge (PCK). Two college physics instructors and 116 students voluntarily participated in this study. The research model comprised three workshops, mid-term and final evaluations and…

  14. The Effect of Context and Input Conditions on Oral and Written Development: A Study Abroad Perspective

    ERIC Educational Resources Information Center

    Perez-Vidal, Carmen; Juan-Garau, Maria

    2011-01-01

    This article aims at describing and explaining the effects of a period of Study Abroad spent in the target language country (SA) on foreign language development. Such effects are analysed in the short- and mid-term and in contrast with the impact of a period of formal instruction (FI) previously spent in the home country (AH). It is hypothesised…

  15. Incorporating Multiple-Choice Questions into an AACSB Assurance of Learning Process: A Course-Embedded Assessment Application to an Introductory Finance Course

    ERIC Educational Resources Information Center

    Santos, Michael R.; Hu, Aidong; Jordan, Douglas

    2014-01-01

    The authors offer a classification technique to make a quantitative skills rubric more operational, with the groupings of multiple-choice questions to match the student learning levels in knowledge, calculation, quantitative reasoning, and analysis. The authors applied this classification technique to the mid-term exams of an introductory finance…

  16. Identifying Functional Requirements for Flexible Airspace Management Concept Using Human-In-The-Loop Simulations

    NASA Technical Reports Server (NTRS)

    Lee, Paul U.; Bender, Kim; Pagan, Danielle

    2011-01-01

    Flexible Airspace Management (FAM) is a mid- term Next Generation Air Transportation System (NextGen) concept that allows dynamic changes to airspace configurations to meet the changes in the traffic demand. A series of human-in-the-loop (HITL) studies have identified procedures and decision support requirements needed to implement FAM. This paper outlines a suggested FAM procedure and associated decision support functionality based on these HITL studies. A description of both the tools used to support the HITLs and the planned NextGen technologies available in the mid-term are presented and compared. The mid-term implementation of several NextGen capabilities, specifically, upgrades to the Traffic Management Unit (TMU), the initial release of an en route automation system, the deployment of a digital data communication system, a more flexible voice communications network, and the introduction of a tool envisioned to manage and coordinate networked ground systems can support the implementation of the FAM concept. Because of the variability in the overall deployment schedule of the mid-term NextGen capabilities, the dependency of the individual NextGen capabilities are examined to determine their impact on a mid-term implementation of FAM. A cursory review of the different technologies suggests that new functionality slated for the new en route automation system is a critical enabling technology for FAM, as well as the functionality to manage and coordinate networked ground systems. Upgrades to the TMU are less critical but important nonetheless for FAM to be fully realized. Flexible voice communications network and digital data communication system could allow more flexible FAM operations but they are not as essential.

  17. Bevacizumab, Capecitabine, Amifostine, and Preoperative Hypofractionated Accelerated Radiotherapy (HypoArc) for Rectal Cancer: A Phase II Study

    SciTech Connect

    Koukourakis, Michael I.; Tsoutsou, Pelagia; Chloropoulou, Pelagia A.; Manolas, Kostantinos; Sivridis, Efthimios

    2011-06-01

    Purpose: Bevacizumab has established therapeutic activity in patients with metastatic colorectal cancer, and anti-vascular endothelial growth factor therapy enhances the activity of radiotherapy in experimental models. We assessed the feasibility and efficacy of preoperative radiochemotherapy combined with bevacizumab in patients with rectal cancer. Methods and Materials: Nineteen patients with radiologic T3 and/or N+ rectal carcinoma were treated with preoperative conformal hypofractionated accelerated radiotherapy (3.4 Gy in 10 consecutive fractions) supported with amifostine (500-1,000 mg daily), capecitabine (600 mg/m{sup 2} twice daily, 5 days per week), and bevacizumab (5 mg/kg every 2 weeks for 2 cycles). Surgery followed 6 weeks after the end of radiotherapy. A cohort of 14 sequential patients treated with the same regimen without bevacizumab was available for comparison. Results: Grade 2 or 3 diarrhea was noted in 7 of 19 patients (36.8%), which was statistically worse than patients receiving the same regimen without bevacizumab (p = 0.01). A higher incidence of Grade 2 or 3 proctalgia was also noted (21.1%) (p = 0.03). Bladder and skin toxicity was negligible. All toxicities regressed completely within 2 weeks after the end of therapy. Pathologic complete and partial response was noted in 7 of 19 cases (36.8%) and 8 of 19 cases (42.1%). Within a median follow-up of 21 months, none of the patients has had late complications develop and only 1 of 18 evaluable cases (5.5%) has had locoregional relapse. Conclusions: Bevacizumab can be safely combined with hypofractionated radiotherapy and capecitabine as a preoperative radiochemotherapy regimen for patients with rectal cancer. The high pathologic complete response rates urges the testing of bevacizumab in randomized studies.

  18. Techno-economic analysis of corn stover fungal fermentation to ethanol

    SciTech Connect

    Meyer, Pimphan; Tews, Iva J.; Magnuson, Jon K.; Karagiosis, Sue A.; Jones, Susanne B.

    2013-11-01

    This techno-economic analysis assesses the process economics of ethanol production from lignocellulosic feedstock by fungi in order to identify promising opportunities and the research needed to achieve them. Based on literature derived data, four different ethanologen strains are considered in this study: native and recombinant Saccharomyces cerevisiae, the natural pentose-fermenting yeast, Pichia stipitis and the filamentous fungus Fusarium oxysporum. Organism performance and technology readiness are split into three groups: near-term (<5 years), mid-term (5-10 years) and long-term (>10 years) process deployment. Processes classified as near-term could reasonably be developed in this shorter time frame, as suggested by recent literature. Mid-term technology process models are based on lab-scale experimental data, and yields near the theoretical limit are used to estimate long-term technology goals. Further research and economic evaluation on the integrated production of chemicals and fuels in biorefineries are recommended.

  19. The requirements for batteries for electric vehicles

    NASA Technical Reports Server (NTRS)

    Schwartz, H. J.

    1976-01-01

    The paper reassesses the role of electric vehicles in the modern transportation system and their potential impact on oil consumption. Three major factors determining the size of this impact are discussed: the market potential, the date of introduction, and the rate of consumer acceptance. The strategy of selecting the battery type for an urban car to introduce in coming years is analyzed. The results of the analysis suggest that the research and development emphasis should be placed on near- and mid-term battery technology. From the standpoint of maximizing both the cumulative impact and the benefits derived in the year 2000, however, a strategy of early introduction of near-term and mid-term cars followed by the far-term vehicles seems to produce the optimum result.

  20. Support of a pathway to a hydrogen future

    SciTech Connect

    Hoffman, A.R.

    1997-12-31

    This paper consists of viewgraphs which outline the content of the presentation. Subjects addressed include: hydrogen research program vision; electricity industry restructuring -- opportunities and challenges for hydrogen; transportation sector -- opportunities for hydrogen; near-term and mid-term opportunities for hydrogen; and hydrogen production technologies from water. It is concluded that the global climate change challenge is the potential driver for the development of hydrogen systems.

  1. Climate observing system studies: An element of the NASA Climate Research Program: Workshop report

    NASA Technical Reports Server (NTRS)

    1980-01-01

    Plans for NASA's efforts in climatology were discussed. Targets for a comprehensive observing system for the early 1990's were considered. A program to provide useful data in the near and mid-term, and a program to provide for a feasibility assessment of instruments and methods for the development of a long-term system were discussed. Climate parameters that cannot be measured from space were identified. Long-term calibration, intercomparison, standards, and ground truth were discussed.

  2. How to Awaken an Appreciation for the Value of Practicing Learning Skills in an Environment of Poverty, Theft, Destruction and Violent Behavior

    ERIC Educational Resources Information Center

    Fish, James C.

    2011-01-01

    A first-year teacher thrust mid-term into a mixed-grade geometry class in a tough high school struggles to sort out what works and does not work to engage the 120 students in meaningful learning. The students are largely from low-income urban families and demonstrate a broad range of abilities and motivation. The purpose of this study is to…

  3. Frequency stability of maser oscillators operated with cavity Q. [hydrogen and rubidium masers

    NASA Technical Reports Server (NTRS)

    Tetu, M.; Tremblay, P.; Lesage, P.; Petit, P.; Audoin, C.

    1982-01-01

    The short term frequency stability of masers equipped with an external feedback loop to increase the cavity quality factor was studied. The frequency stability of a hydrogen and a rubidium maser were measured and compared with theoretical evaluation. It is shown that the frequency stability passes through an optimum when the cavity Q is varied. Long term fluctuations are discussed and the optimum mid term frequency stability achievably by small size active and passive H-masers is considered.

  4. Classroom Life

    ERIC Educational Resources Information Center

    Miller, Karl

    2014-01-01

    In this reflective piece, Karl Miller looks down the lens at an ancient world, once his own. He does so with the help of a memoir, "Rebecca's Vest," which he published much later, in the mid-1990s: a mid-term report in which he describes how he became a reader and about what he read. With the end of the term approaching, he offers a…

  5. Multiple left ventricular aneurysms in a young female.

    PubMed

    Raval, Abhishek P; Shukla, Anand; Garg, Rajiv; Rana, Yashpal; Shah, Komal

    2016-02-01

    Multiple left ventricular aneurysms (LVAs) are rare, especially in a young female. A 29-year-old woman presented vague symptoms. Multiple LVAs were revealed and confirmed on different imaging modalities, including chest radiography, echocardiography, contrast ventriculography and cardiac magnetic resonance imaging. Detailed work-up for probable etiologies including ischemic, infectious, inflammatory and autoimmune causes was negative. In the absence of angina, decompensated congestive heart failure, arrhythmias and embolism, the patient was managed conservatively, with excellent mid-term outcome.

  6. Impact of Transapical Aortic Cannulation for Acute Type A Aortic Dissection

    PubMed Central

    Sato, Manabu; Fumoto, Hideyuki; Hiromitsu Kawasaki; Koga MD, Syugo

    2015-01-01

    Objective: Early and mid-term result of transapical aortic (TAA) cannulation technique was evaluated compared with femoral artery (FA) cannulation in Acute Type A Aortic Dissection(AAAD). Methods: From January 2000 to October 2013, 80 consecutive patients with AAAD were underwent the ascending aortic replacement at Nagasaki Kouseikai Hospital. These patients were divided into two groups according to the cannulation site, FA cannulation (n = 34) and TAA cannulation (n = 46). Early and mid-term outcomes were compared between two groups. Result: Preoperative patient characteristics were almost comparable between groups. The time from skin incision to starting cardiopulmonary bypass (CPB) was significantly shorter in the TAA group (45 ± 16 vs 23 ± 5.1 min; P <0.001). There were no significant differences in post-operative cerebral infarction in two groups (17% versus 11%; P = NS). The operative mortality rate was 8.8% in FA group and 4.3% in TAA group (P = NS). During follow up (mean, 6.8 years), survival at 3 years and 5 years was 77.4% and 71.9% in TAA group and 76.3% and 73.8% in FA group, respectively. Conclusion: The postoperative morbidity and mortality between the two groups were almost the same. TAA cannulation for acute Type A aortic dissection is faster, easy and safe with acceptable early and mid-term outcome. PMID:25740452

  7. Adverse Cardiovascular Outcomes associated with Coronary Artery Bypass Surgery and Percutaneous Coronary Intervention with Everolimus Eluting Stents: A Meta-Analysis

    PubMed Central

    Bundhun, Pravesh Kumar; Pursun, Manish; Teeluck, Abhishek Rishikesh; Bhurtu, Akash; Soogund, Mohammad Zafooruddin Sani; Huang, Wei-Qiang

    2016-01-01

    This study aimed to compare the mid-term adverse cardiovascular outcomes associated with Coronary Artery Bypass Surgery (CABG) and Percutaneous Coronary Intervention (PCI) with Everolimus Eluting Stents (EES). Electronic databases were searched for studies comparing the mid-term (>1 year) adverse cardiovascular outcomes between CABG and PCI with EES. Odd Ratios (OR) with 95% Confidence Intervals (CIs) were calculated and the pooled analyses were performed with RevMan 5.3 software. A total number of 5207 patients were involved in this analysis. No significant difference was observed in mortality between CABG and EES with OR: 0.90, 95% CI: 0.73–1.10; P = 0.30. Moreover, CABG was associated with a high stroke rate, with OR: 0.73, 95% CI: 0.45–1.17; P = 0.19, without any statistical significant. CABG was associated with significantly lower Major Adverse Cardiac Events and Myocardial Infarction with OR: 1.46, 95% CI: 1.05–2.04; P = 0.03 and OR: 1.46, 95% CI: 1.01–2.12; P = 0.05 respectively whereas PCI was associated with a significantly higher repeated revascularization with OR: 2.21; 95% CI: 1.76–2.77; P = 0.00001. In conclusion, significant differences were noted in several subgroups analyzing the mid-term cardiovascular outcomes between CABG and EES. PMID:27775055

  8. Fourier-Transform Raman and Fourier-Transform Infrared Spectroscopy (An Investigation of Five Higher Plant Cell Walls and Their Components).

    PubMed Central

    Sene, CFB.; McCann, M. C.; Wilson, R. H.; Grinter, R.

    1994-01-01

    Infrared and Raman spectra of sequentially extracted primary cell walls and their pectic polymers were obtained from five angiosperm plants. Fourier-transform Raman spectrometry was shown to be a powerful tool for the investigation of primary cell-wall architecture at a molecular level, providing complementary information to that obtained by Fourier-transform infrared microspectroscopy. The use of an extraction procedure using imidazole instead of cyclohexane trans-1,2-N,N,N[prime],N[prime]-diaminotetraacetate allows the extension of the infrared spectral window for data interpretation from 1300 to 800 cm-1, to 2000 to 800 cm-1, and allows us to obtain Raman spectra from extracted cell-wall material. Wall constituents such as pectins, proteins, aromatic phenolics, cellulose, and hemicellulose have characteristic spectral features that can be used to identify and/or fingerprint these polymers without, in most cases, the need for any physical separation. The Gramineae (rice [Oryza sativa], polypogon [Polypogon fugax steud], and sweet corn [Zea mays]) are spectroscopically very different from the nongraminaceous monocotyledon (onion [Allium cepa]) and the dicotyledon (carrot [Daucus carota]); this reflects differences in chemical composition and cross-linking of the walls. The possibility of a taxonomic classification of plant cell walls based on infrared and Raman spectroscopies and the use of spectral fingerprinting for authentication and detection of adulteration of products rich in cell-wall materials are discussed. PMID:12232436

  9. Variogram methods for texture classification of atherosclerotic plaque ultrasound images

    NASA Astrophysics Data System (ADS)

    Jeromin, Oliver M.; Pattichis, Marios S.; Pattichis, Constantinos; Kyriacou, Efthyvoulos; Nicolaides, Andrew

    2006-03-01

    Stroke is the third leading cause of death in the western world and the major cause of disability in adults. The type and stenosis of extracranial carotid artery disease is often responsible for ischemic strokes, transient ischemic attacks (TIAs) or amaurosis fugax (AF). The identification and grading of stenosis can be done using gray scale ultrasound scans. The appearance of B-scan pictures containing various granular structures makes the use of texture analysis techniques suitable for computer assisted tissue characterization purposes. The objective of this study is to investigate the usefulness of variogram analysis in the assessment of ultrasound plague morphology. The variogram estimates the variance of random fields, from arbitrary samples in space. We explore stationary random field models based on the variogram, which can be applied in ultrasound plaque imaging leading to a Computer Aided Diagnosis (CAD) system for the early detection of symptomatic atherosclerotic plaques. Non-parametric tests on the variogram coefficients show that the cofficients coming from symptomatic versus asymptomatic plaques come from distinct distributions. Furthermore, we show significant improvement in class separation, when a log point-transformation is applied to the images, prior to variogram estimation. Model fitting using least squares is explored for anisotropic variograms along specific directions. Comparative classification results, show that variogram coefficients can be used for the early detection of symptomatic cases, and also exhibit the largest class distances between symptomatic and asymptomatic plaque images, as compared to over 60 other texture features, used in the literature.

  10. [Hypercoagulable workup in ophthalmology. When and what].

    PubMed

    Muñoz-Negrete, F J; Casas-Lleras, P; Pérez-López, M; Rebolleda, G

    2009-07-01

    Most ophthalmologic disorders secondary to hypercoagulabe state are due to the confluence of congenital and adquired factors. A systematic workup is mandatory. Most of congenital coagulation disorders cause venous trombosis and are inherited autosomal dominantly. In order of frequency these are factor V Leiden mutation (activated protein C resistance), G20210A mutation of the prothrombin gen and protein C, protein S, and antithrombin III deficiencies. Sickle cell anemia can determine arerial and venous thrombosis. In relation with arterial occlusion, the markers most frequently involved are homcysteine fasting levels and the markers of antiphospholipid antibody syndrome. Both of them can also determine venous thrombosis. Several acquired factors can lead to hypoercoagulable state, especially hyperhomocysteinemia, antiphospholipid antibody syndrome, hepatic disease, alcohol and tobacco intake, oral contraceptives, immobilization, surgeries and malignancies. In central venous occlusion is only necessary to rule out hyperhomocysteinemia and antiphospholipid antibody syndrome in young patients without known risk factors. In central artery occlusion, hypercoagulable workup is only recommended for patients less than 50 years-old with unknown emboli source. In this cases protein C, protein S, and antithrombin III deficiencies, homocystein, sickle cell disease and antiphospholipid antibody syndrome will ruled out. In non arteritic ischemic optic neuropathy hypercoagulable work up is not necessary. In amaurosis fugax without known emboli source, it is recommended to rule out etiologies of arterial occlusion, especially antithrombin III deficiencies, homocystein, sickle cell disease and antiphospholipid antibody syndrome. PMID:19658050

  11. Digital cameras with designs inspired by the arthropod eye.

    PubMed

    Song, Young Min; Xie, Yizhu; Malyarchuk, Viktor; Xiao, Jianliang; Jung, Inhwa; Choi, Ki-Joong; Liu, Zhuangjian; Park, Hyunsung; Lu, Chaofeng; Kim, Rak-Hwan; Li, Rui; Crozier, Kenneth B; Huang, Yonggang; Rogers, John A

    2013-05-01

    In arthropods, evolution has created a remarkably sophisticated class of imaging systems, with a wide-angle field of view, low aberrations, high acuity to motion and an infinite depth of field. A challenge in building digital cameras with the hemispherical, compound apposition layouts of arthropod eyes is that essential design requirements cannot be met with existing planar sensor technologies or conventional optics. Here we present materials, mechanics and integration schemes that afford scalable pathways to working, arthropod-inspired cameras with nearly full hemispherical shapes (about 160 degrees). Their surfaces are densely populated by imaging elements (artificial ommatidia), which are comparable in number (180) to those of the eyes of fire ants (Solenopsis fugax) and bark beetles (Hylastes nigrinus). The devices combine elastomeric compound optical elements with deformable arrays of thin silicon photodetectors into integrated sheets that can be elastically transformed from the planar geometries in which they are fabricated to hemispherical shapes for integration into apposition cameras. Our imaging results and quantitative ray-tracing-based simulations illustrate key features of operation. These general strategies seem to be applicable to other compound eye devices, such as those inspired by moths and lacewings (refracting superposition eyes), lobster and shrimp (reflecting superposition eyes), and houseflies (neural superposition eyes). PMID:23636401

  12. Venous Thromboembolism and Cerebrovascular Events in Patients with Giant Cell Arteritis: A Population-Based Retrospective Cohort Study

    PubMed Central

    Crowson, Cynthia S.; Makol, Ashima; Ytterberg, Steven R.; Saitta, Antonino; Salvarani, Carlo; Matteson, Eric L.; Warrington, Kenneth J.

    2016-01-01

    Objective To investigate the incidence of venous thromboembolism (VTE) and cerebrovascular events in a community-based incidence cohort of patients with giant cell arteritis (GCA) compared to the general population. Methods A population-based inception cohort of patients with incident GCA between January 1, 1950 and December 31, 2009 in Olmsted County, Minnesota and a cohort of non-GCA subjects from the same population were assembled and followed until December 31, 2013. Confirmed VTE and cerebrovascular events were identified through direct medical record review. Results The study population included 244 patients with GCA with a mean ± SD age at diagnosis of 76.2 ± 8.2 years (79% women) and an average length of follow-up of 10.2 ± 6.8 years. Compared to non-GCA subjects of similar age and sex, patients diagnosed with GCA had a higher incidence (%) of amaurosis fugax (cumulative incidence ± SE: 2.1 ± 0.9 versus 0, respectively; p = 0.014) but similar rates of stroke, transient ischemic attack (TIA), and VTE. Among patients with GCA, neither baseline characteristics nor laboratory parameters at diagnosis reliably predicted risk of VTE or cerebrovascular events. Conclusion In this population-based study, the incidence of VTE, stroke and TIA was similar in patients with GCA compared to non-GCA subjects. PMID:26901431

  13. Cytospora species from Populus and Salix in China with C. davidiana sp. nov.

    PubMed

    Wang, Yan-Li; Lu, Quan; Decock, Cony; Li, Yong-Xia; Zhang, Xing-Yao

    2015-05-01

    Poplar and willow plantations have become widespread in China, in order to meet national economic and environmental needs. The emergence of several pathogens is enhanced by climatic change and associated human factors. Species of Cytospora are well-known pathogens on poplar and willow, and cause stem cankers and diebacks. In the present study, we conducted a survey of Cytospora species occurring on Populus spp. and Salix spp. in China. We used morphological examination and phylogenetic inferences, based on the DNA sequence data from the internal transcribed spacer regions (ITS1, 5.8S rDNA, and ITS2) and partial β-tubulin gene, to identify six Cytospora species occurring on poplar and willow. Five of these species belonged to known taxa, viz. Cytospora chrysosperma (asexual state of Valsa sordida), Cytospora translucens (asexual state of Leucostoma translucens), Cytospora fugax (asexual state of Valsa salicina), Cytospora atrocirrhata, and Cytospora kantschavelii. Our study yielded a new species, Cytospora davidiana sp. nov., on poplar. The new species is characterized by typical torsellioid conidiomata. An additional Cytospora sp. 1, which formed a distinct clade in the phylogenetic inferences, remains unnamed; the paucity of available materials prevented phenotypical characterization.

  14. [Changes introduced into the recent International Classification of Headache Disorders: ICHD-III beta classification].

    PubMed

    Belvis, Robert; Mas, Natàlia; Roig, Carles

    2015-01-16

    Introduccion. La Sociedad Internacional de Cefaleas (IHS) ha publicado la tercera edicion de la Clasificacion Internacional de las Cefaleas (ICHD-III beta), la guia diagnostica de las cefaleas mas utilizada en el mundo. Objetivo. Revisar las recientes aportaciones de la guia, explicando las nuevas entidades que en ella aparecen y comparando las entidades que han matizado sus criterios con sus criterios de la edicion precedente. Desarrollo. Hemos registrado multitud de matices en los criterios de practicamente todas las cefaleas y neuralgias de la clasificacion, pero las entidades que han experimentado mas matizaciones trascendentales son la migraña cronica, la cefalea asociada exclusivamente a la actividad sexual, las cefaleas neuralgiformes unilaterales de breve duracion, la cefalea diaria persistente de novo, la cefalea por abuso de medicacion sintomatica, el sindrome de cefalea y deficits neurologicos transitorios con pleocitosis linfocitaria. Las entidades nuevas mas destacables que se han incorporado son las cefaleas por presion externa, las cefaleas por crioestimulo, la cefalea numular, la cefalea atribuida a vuelos de avion y la cefalea atribuida a disreflexia autonomica. Tambien cabe destacar las nuevas cefaleas, aun no consideradas como entidades, que se incorporan al apendice, entre las que destacan la epicranea fugax, la migraña vestibular y los colicos infantiles. Conclusiones. La IHS recomienda utilizar ya la nueva clasificacion (ICHD-III beta), prescindiendo de la anterior clasificacion, en la asistencia, la docencia y la investigacion, asi como hacer la maxima difusion de esta nueva guia.

  15. ACUTE RETINAL ARTERIAL OCCLUSIVE DISORDERS

    PubMed Central

    Hayreh, Sohan Singh

    2011-01-01

    The initial section deals with basic sciences; among the various topics briefly discussed are the anatomical features of ophthalmic, central retinal and cilioretinal arteries which may play a role in acute retinal arterial ischemic disorders. Crucial information required in the management of central retinal artery occlusion (CRAO) is the length of time the retina can survive following that. An experimental study shows that CRAO for 97 minutes produces no detectable permanent retinal damage but there is a progressive ischemic damage thereafter, and by 4 hours the retina has suffered irreversible damage. In the clinical section, I discuss at length various controversies on acute retinal arterial ischemic disorders. Classification of acute retinal arterial ischemic disorders These are of 4 types: CRAO, branch retinal artery occlusion (BRAO), cotton wools spots and amaurosis fugax. Both CRAO and BRAO further comprise multiple clinical entities. Contrary to the universal belief, pathogenetically, clinically and for management, CRAO is not one clinical entity but 4 distinct clinical entities – non-arteritic CRAO, non-arteritic CRAO with cilioretinal artery sparing, arteritic CRAO associated with giant cell arteritis (GCA) and transient non-arteritic CRAO. Similarly, BRAO comprises permanent BRAO, transient BRAO and cilioretinal artery occlusion (CLRAO), and the latter further consists of 3 distinct clinical entities - non-arteritic CLRAO alone, non-arteritic CLRAO associated with central retinal vein occlusion and arteritic CLRAO associated with GCA. Understanding these classifications is essential to comprehend fully various aspects of these disorders. Central retinal artery occlusion The pathogeneses, clinical features and management of the various types of CRAO are discussed in detail. Contrary to the prevalent belief, spontaneous improvement in both visual acuity and visual fields does occur, mainly during the first 7 days. The incidence of spontaneous visual

  16. Hybrid Endovascular Repair in Aortic Arch Pathologies: A Retrospective Study

    PubMed Central

    Ma, Xiaohui; Guo, Wei; Liu, Xiaoping; Yin, Tai; Jia, Xin; Xiong, Jiang; Zhang, Hongpeng; Wang, Lijun

    2010-01-01

    The aortic arch presents specific challenges to endovascular repair. Hybrid repair is increasingly evolving as an alternative option for selected patients, and promising initial results have been reported. The aim of this study was to introduce our experiences and evaluate mid-term results of supra aortic transpositions for extended endovascular repair of aortic arch pathologies. From December 2002 to January 2008, 25 patients with thoracic aortic aneurysms and dissections involving the aortic arch were treated with hybrid endovascular treatment in our center. Of the 25 cases, 14 were atherosclerotic thoracic aortic aneurysms and 11 were thoracic aortic dissection. The hybrid repair method included total-arch transpositions (15 cases) or hemi-arch transpositions (10 cases), and endovascular procedures. All hybrid endovascular procedures were completed successfully. Three early residual type-I endoleaks and one type-II endoleak were observed. Stroke occurred in three patients (8%) during the in-hospital stage. The perioperative mortality rate was 4%; one patients died post-operatively from catheter related complications. The average follow-up period was 15 ± 5.8 months (range, 1–41 months). The overall crude survival rate at 15 months was 92% (23/25). During follow-up, new late endoleaks and stent-raft related complications were not observed. One case (4%) developed a unilateral lower limb deficit at 17 days and was readmitted to hospital. In conclusion, the results are encouraging for endovascular aortic arch repair in combination with supra-aortic transposition in high risk cases. Aortic endografting offers good mid-term results. Mid-term results of the hybrid approach in elderly patients with aortic arch pathologies are satisfying. PMID:21151464

  17. Final report for next generation multi-scale quantum simulation software for strongly correlated materials

    SciTech Connect

    Jarrell, Mark

    2014-11-18

    The goal of this project was to develop a new formalism for the correlated electron problem, which we call, the Multi Scale Many Body formalism. This report will focus on the work done at the Louisiana State University (LSU) since the mid term report. The LSU group moved from the University of Cincinnati (UC) to LSU in the summer of 2008. In the last full year at UC, only half of the funds were received and it took nearly two years for the funds to be transferred from UC to LSU . This effectively shut down the research at LSU until the transfer was completed in 2011, there were also two no-cost extensions of the grant until August of this year. The grant ended for the other SciDAC partners at Davis and ORNL in 2011. Since the mid term report, the LSU group has published 19 papers [P1-P19] acknowledging this SciDAC, which are listed below. In addition, numerous invited talked acknowledged the SciDAC. Below, we will summarize the work at LSU since the mid-term report and mainly since funding resumed. The projects include the further development of multi-scale methods for correlated systems (1), the study of quantum criticality at finite doping in the Hubbard model (2), the description of a promising new method to study Anderson localization with a million-fold reduction of computational complexity!, the description of other projects (4), and (5) a workshop to close out the project that brought together exascale program developers (Stellar, MPI, OpenMP,...) with applications developers.

  18. Nature and nurture: a case of transcending haematological pre-malignancies in a pair of monozygotic twins adding possible clues on the pathogenesis of B-cell proliferations.

    PubMed

    Hansen, Marcus C; Nyvold, Charlotte G; Roug, Anne S; Kjeldsen, Eigil; Villesen, Palle; Nederby, Line; Hokland, Peter

    2015-05-01

    We describe a comprehensive molecular analysis of a pair of monozygotic twins, who came to our attention when one experienced amaurosis fugax and was diagnosed with JAK2+ polycythaemia vera. He (Twin A) was also found to have an asymptomatic B-cell chronic lymphocytic leukaemia (B-CLL). Although JAK2-, Twin B was subsequently shown to have a benign monoclonal B-cell lymphocytosis (MBL). Flow cytometric and molecular analyses of the B-cell compartments revealed different immunoglobulin light and heavy chain usage in each twin. We hypothesized that whole exome sequencing could help delineating the pattern of germline B-cell disorder susceptibility and reveal somatic mutations potentially contributing to the differential patterns of pre-malignancy. Comparing bone marrow cells and T cells and employing in-house engineered integrative analysis, we found aberrations in Twin A consistent with a myeloid neoplasm, i.e. in TET2, RUNX1, PLCB1 and ELF4. Employing the method for detecting high-ranking variants by extensive annotation and relevance scoring, we also identified shared germline variants in genes of proteins interacting with B-cell receptor signalling mediators and the WNT-pathway, including IRF8, PTPRO, BCL9L, SIT1 and SIRPB1, all with possible implications in B-cell proliferation. Similar patterns of IGHV-gene usage to those demonstrated here have been observed in inherited acute lymphoblastic leukaemia. Collectively, these findings may help in facilitating identification of putative master gene(s) involved in B-cell proliferations in general and MBL and B-CLL in particular. PMID:25752595

  19. Diagnostic ramifications of ocular vascular occlusion as a first thrombotic event associated with factor V Leiden and prothrombin gene heterozygosity

    PubMed Central

    Schockman, Samantha; Glueck, Charles J; Hutchins, Robert K; Patel, Jaykumar; Shah, Parth; Wang, Ping

    2015-01-01

    Aim This study aimed to assess the diagnostic ramifications of vascular occlusion of the ocular vein and artery as a first thrombotic event associated with factor V Leiden (FVL) and/or prothrombin gene (PTG) heterozygosity. Methods Patients with ocular vein (n=191) and artery (n=74) occlusion, free of cardioembolic etiologies, were sequentially referred from vitreoretinal specialists for measurement of thrombophilia-hypofibrinolysis and compared to 110 healthy normal controls. Results Of the 265 patients, 29 (11%; 17 women, 12 men) of all referred ocular vascular occlusion (OVO) cases were found to be heterozygous for FVL and/or PTG, including 16 with FVL, 12 with PTG, and 1 with both. Of the 29 cases, 16 had central retinal vein occlusion (CRVO), 2 branch retinal vein occlusion (BRVO), 5 nonarteritic anterior ischemic optic neuropathy (NA-AION), 3 retinal artery occlusion (RAO), 2 amaurosis fugax (AF), and 1 had both CRVO and RAO. Of the 16 FVL cases, 15 (94%) had OVO as a first thrombotic event without prior deep venous thrombosis (DVT) or pulmonary embolism (PE); 6 (38%) also had other thrombotic events, including recurrent miscarriage, osteonecrosis, ischemic stroke, and/or ischemic colitis; and 5 (31%) had immediate family members with previous venous thromboembolism (VTE). Of the 12 PTG cases, 9 (75%) had OVO as a first thrombotic event, 5 (42%) experienced VTE other than DVT or PE, and 6 (50%) had immediate family members with VTE. In one patient with both FVL and PTG, DVT occurred before BRVO. Of the 17 women with FVL and/or PTG mutations, 7 (41%) experienced ≥1 miscarriage, 6 (35%) were on estrogen therapy, and 1 (6%) was on clomiphene. Conclusion Of the 265 patients with OVO, 29 (11%) had FVL and/or PTG, and 83% of these 29 cases presented with OVO as their first thrombotic event. By diagnosing thrombophilia as an etiology for OVO, the ophthalmologist opens a window to family screening and preventive therapy. PMID:25897198

  20. Nature and nurture: a case of transcending haematological pre-malignancies in a pair of monozygotic twins adding possible clues on the pathogenesis of B-cell proliferations.

    PubMed

    Hansen, Marcus C; Nyvold, Charlotte G; Roug, Anne S; Kjeldsen, Eigil; Villesen, Palle; Nederby, Line; Hokland, Peter

    2015-05-01

    We describe a comprehensive molecular analysis of a pair of monozygotic twins, who came to our attention when one experienced amaurosis fugax and was diagnosed with JAK2+ polycythaemia vera. He (Twin A) was also found to have an asymptomatic B-cell chronic lymphocytic leukaemia (B-CLL). Although JAK2-, Twin B was subsequently shown to have a benign monoclonal B-cell lymphocytosis (MBL). Flow cytometric and molecular analyses of the B-cell compartments revealed different immunoglobulin light and heavy chain usage in each twin. We hypothesized that whole exome sequencing could help delineating the pattern of germline B-cell disorder susceptibility and reveal somatic mutations potentially contributing to the differential patterns of pre-malignancy. Comparing bone marrow cells and T cells and employing in-house engineered integrative analysis, we found aberrations in Twin A consistent with a myeloid neoplasm, i.e. in TET2, RUNX1, PLCB1 and ELF4. Employing the method for detecting high-ranking variants by extensive annotation and relevance scoring, we also identified shared germline variants in genes of proteins interacting with B-cell receptor signalling mediators and the WNT-pathway, including IRF8, PTPRO, BCL9L, SIT1 and SIRPB1, all with possible implications in B-cell proliferation. Similar patterns of IGHV-gene usage to those demonstrated here have been observed in inherited acute lymphoblastic leukaemia. Collectively, these findings may help in facilitating identification of putative master gene(s) involved in B-cell proliferations in general and MBL and B-CLL in particular.

  1. Hemodynamic and metabolic effects of cerebral revascularization.

    PubMed

    Leblanc, R; Tyler, J L; Mohr, G; Meyer, E; Diksic, M; Yamamoto, L; Taylor, L; Gauthier, S; Hakim, A

    1987-04-01

    Pre- and postoperative positron emission tomography (PET) was performed in six patients undergoing extracranial to intracranial bypass procedures for the treatment of symptomatic extracranial carotid occlusion. The six patients were all men, aged 52 to 68 years. Their symptoms included transient ischemic attacks (five cases), amaurosis fugax (two cases), and completed stroke with good recovery (one case). Positron emission tomography was performed within 4 weeks prior to surgery and between 3 to 6 months postoperatively, using oxygen-15-labeled CO, O2, and CO2 and fluorine-18-labeled fluorodeoxyglucose. Cerebral blood flow (CBF), cerebral blood volume (CBV), cerebral metabolic rates for oxygen and glucose (CMRO2 and CMRGlu), and the oxygen extraction fraction (OEF) were measured in both hemispheres. Preoperatively, compared to five elderly control subjects, patients had increased CBV, a decreased CBF/CBV ratio, and decreased CMRO2, indicating reduced cerebral perfusion pressure and depressed oxygen metabolism. The CBF was decreased in only one patient who had bilateral carotid occlusions; the OEF, CMRGlu, and CMRO2/CMRGlu and CMRGlu/CBF ratios were not significantly different from control measurements. All bypasses were patent and all patients were asymptomatic following surgery. Postoperative PET revealed decreased CBV and an increased CBF/CBV ratio, indicating improved hemodynamic function and oxygen hypometabolism. This was associated with increased CMRO2 in two patients in whom the postoperative OEF was also increased. The CMRGlu and CMRGlu/CBF ratio were increased in five patients. Changes in CBF and the CMRO2/CMRGlu ratio were variable. One patient with preoperative progressive mental deterioration, documented by serial neuropsychological testing and decreasing CBF and CMRO2, had improved postoperative CBF and CMRO2 concomitant with improved neuropsychological functioning. It is concluded that symptomatic carotid occlusion is associated with altered

  2. Energy data collection as a necessary activity for developing countries

    SciTech Connect

    Loebl, A. S.; Cagle, J. D.

    1980-01-01

    This paper examines the reasons for energy data collection by developing countries and includes an examination of the special requirements of Costa Rica for energy data collection. A primary reason for national data collection is to support the planning function, and this is particularly significant where energy planning and economic development are concerned. Energy data are necessary to support all phases of planning: short-term; mid-term; and long-range and/or strategic planning. These different planning requirements are discussed. Energy data are also necessary to support national management, as well as the economic-development functions. These latter requirements are also discussed briefly.

  3. Advanced batteries for electric vehicle applications

    SciTech Connect

    Henriksen, G.L.

    1993-08-01

    A technology assessment is given for electric batteries with potential for use in electric powered vehicles. Parameters considered include: specific energy, specific power, energy density, power density, cycle life, service life, recharge time, and selling price. Near term batteries include: nickel/cadmium and lead-acid batteries. Mid term batteries include: sodium/sulfur, sodium/nickel chloride, nickel/metal hydride, zinc/air, zinc/bromine, and nickel/iron systems. Long term batteries include: lithium/iron disulfide and lithium- polymer systems. Performance and life testing data for these systems are discussed. (GHH)

  4. Technology Development Plan for the Baseline Detector System of the X-Ray Microcalorimeter Spectrometer (XMS) of the International X-Ray Observatory (IXO)

    NASA Technical Reports Server (NTRS)

    Kilbourne, C. A.; Boriese, W. B.

    2010-01-01

    The primary purpose of this document is to present the technology development plan for the XMS detector system. It covers the current status (including assessment of the Technology Readiness Level, TRL, and a justification of the level assigned), the roadmap to progress to a level between TRL 5 and TRL 6 by the middle of 2012, and an assessment of the associated cost. A secondary purpose of this document is to address the Action Items raised at the XMS Phase-A Study Mid-Term Review that pertain to the detector system (AI #4, #8, and #9).

  5. Emerging Community Noise Reduction Approaches

    NASA Technical Reports Server (NTRS)

    Envia, Edmane

    2012-01-01

    An overview of the current NASA research portfolio in the area of aircraft noise reduction is presented. The emphasis of the research described herein is on meeting the aggressive near- and mid-term national goals for reducing aircraft noise emissions, which NASA internal studies have shown to be feasible using noise reduction technologies currently being developed in-house or in partnership with NASA s industry and academic partners. While NASA has an active research effort in airframe noise reduction, this overview focuses on propulsion noise reduction only.

  6. Moderate Patient-Prosthesis Mismatch Has No Negative Effect on Patients’ Functional Status After Aortic Valve Replacement With CarboMedics Prosthesis

    PubMed Central

    Alizadeh-Ghavidel, Alireza; Azarfarin, Rasoul; Alizadehasl, Azin; Sadeghpour-Tabaei, Ali; Totonchi, Ziae

    2016-01-01

    Background: Patient-prosthesis mismatch (PPM) after aortic valve replacement (AVR) is the subject of continuing debate in the cardiac surgery field. Objectives: The aim of this study was to evaluate the frequency and severity of patient-prosthesis mismatch (PPM) and the functional status of patients undergoing aortic valve replacement (AVR) using a CarboMedics prosthesis in the mid-term follow up. Patients and Methods: We retrospectively studied 66 consecutive patients who were referred to AVR with a CarboMedics prosthesis at the Rajaie cardiovascular medical and research center, a university referral hospital in Tehran, Iran. The severity of PPM as well as clinical and echocardiographic parameters and the patients’ New York heat association (NYHA) functional classification status, operative data and postoperative complications, and mortality in a mid-term (4 - 5 months) follow up period was assessed. Severe PPM was defined as the effective orifice area (EOA) indexed to the patient’s body surface area (BSA) < 0.65 cm2/m2 and moderate PPM was defined as the indexed effective orifice area (IEOA) between 0.65 and 0.85 cm2/m2. Results: Of the 66 studied patients, 39 were male and 27 were female. The mean age of the patients was 43 ± 17 with a range of 6 - 76 years. Implanted sizes of the CarboMedics AV prosthesis in 22 patients were 19 and 21 mm, and in 44 patients were 23 and 25 mm. Eleven patients had moderate PPM (IEOA < 0.85 cm2/m2) and 55 of them did not have PPM (IEOA ≥ 0.85 cm2/m2). There were no statistically significant differences between the two groups in the echocardiographic trans-aortic pressure gradients (35.6 ± 19 vs. 23.2 ± 16 mmHg; P = 0.061) and the mean NYHA functional classification (1.10 ± 0.3 vs. 1.01 ± 0.10; P = 0.074) after AVR in the mid-term follow up. Conclusions: Moderate PPM has no negative effect on echocardiographic trans-aortic pressure gradients or the patients’ NYHA functional status after AVR with a Carbo

  7. In-Space Propulsion Solar Electric Propulsion Program Overview of 2006

    NASA Technical Reports Server (NTRS)

    Baggett, Randy M.; Hulgan, Wendy W.; Dankanich, John W.; Bechtel, Robert T.

    2006-01-01

    The primary source of electric propulsion development throughout NASA is implemented by the In-Space Propulsion Technology Project at the NASA MSFC under the management of the Science Mission Directorate. The Solar Electric Propulsion technology area's objective is to develop near and mid-term SEP technology to enhance or enable mission capture while minimizing risk and cost to the end user. Major activities include developing NASA s Evolutionary Xenon Thruster (NEXT), implementing a Standard Architecture, and developing a long life High Voltage Hall Accelerator (HiVHAC). Lower level investments include advanced feed system development, advanced cathode testing and xenon recovery testing. Progress on current investments and future plans are discussed.

  8. Isolation and characterization of an abortifacient protein, momorcochin, from root tubers of Momordica cochinchinensis (family cucurbitaceae).

    PubMed

    Yeung, H W; Ng, T B; Wong, N S; Li, W W

    1987-07-01

    A glycoprotein with a molecular weight of 32,000 as estimated by SDS-polyacrylamide gel electrophoresis, and characterized by an abundance of Asp and Glu residues and an absence of Cys residues in its amino acid analysis, was isolated from fresh root tubers of Momordica cochinchinensis using a procedure that involved acetone precipitation, ammonium sulfate precipitation, ion exchange chromatography on DEAE Sepharose CL-6B and gel filtration on Sephadex G-75. The protein was capable of inducing mid-term abortion in mice. The characteristics of this protein were compared and contrasted with those of the abortifacient proteins isolated from other plants of the Cucurbitaceae family. PMID:3667075

  9. Activities of the Oil Implementation Task Force, December 1990--February 1991; Contracts for field projects and supporting research on enhanced oil recovery, April--June 1990

    SciTech Connect

    Tiedemann, H.A. )

    1991-03-01

    The Oil Implementation Task Force was appointed to implement the US DOE's new oil research program directed toward increasing domestic oil production by expanded research on near- or mid-term enhanced oil recovery methods. An added priority is to preserve access to reservoirs that have the largest potential for oil recovery, but that are threatened by the large number of wells abandoned each year. This report describes the progress of research activities in the following areas: chemical flooding; gas displacement; thermal recovery; resource assessment; microbial technology; geoscience technology; and environmental technology. (CK)

  10. Upper stage alternatives for the shuttle era

    NASA Technical Reports Server (NTRS)

    1981-01-01

    The status and general characteristics of Space Shuttle upper stages now in use or in development, as well as new vehicle possibilities are examined. Upper stage requirements for both civil and Department of Defense missions, categorized generally into near-term (early and mid-1980's), mid-term (late 1980's to mid-1990's), and far-term (late 1990's and beyond) are discussed. Finally, the technical, schedule and cost impact of alternative ways in which these requirements could be met are examined, and a number of conclusions and recommendations are reached.

  11. Blood pressure variability and cardiovascular disease: systematic review and meta-analysis

    PubMed Central

    Wood, Sally; Koshiaris, Constantinos; Law, Kathryn; Glasziou, Paul; McManus, Richard J

    2016-01-01

    Objective To systematically review studies quantifying the associations of long term (clinic), mid-term (home), and short term (ambulatory) variability in blood pressure, independent of mean blood pressure, with cardiovascular disease events and mortality. Data sources Medline, Embase, Cinahl, and Web of Science, searched to 15 February 2016 for full text articles in English. Eligibility criteria for study selection Prospective cohort studies or clinical trials in adults, except those in patients receiving haemodialysis, where the condition may directly impact blood pressure variability. Standardised hazard ratios were extracted and, if there was little risk of confounding, combined using random effects meta-analysis in main analyses. Outcomes included all cause and cardiovascular disease mortality and cardiovascular disease events. Measures of variability included standard deviation, coefficient of variation, variation independent of mean, and average real variability, but not night dipping or day-night variation. Results 41 papers representing 19 observational cohort studies and 17 clinical trial cohorts, comprising 46 separate analyses were identified. Long term variability in blood pressure was studied in 24 papers, mid-term in four, and short-term in 15 (two studied both long term and short term variability). Results from 23 analyses were excluded from main analyses owing to high risks of confounding. Increased long term variability in systolic blood pressure was associated with risk of all cause mortality (hazard ratio 1.15, 95% confidence interval 1.09 to 1.22), cardiovascular disease mortality (1.18, 1.09 to 1.28), cardiovascular disease events (1.18, 1.07 to 1.30), coronary heart disease (1.10, 1.04 to 1.16), and stroke (1.15, 1.04 to 1.27). Increased mid-term and short term variability in daytime systolic blood pressure were also associated with all cause mortality (1.15, 1.06 to 1.26 and 1.10, 1.04 to 1.16, respectively). Conclusions Long term

  12. Electrolysis: Information and Opportunities for Electric Power Utilities

    SciTech Connect

    Kroposki, B.; Levene, J.; Harrison, K.; Sen, P.K.; Novachek, F.

    2006-09-01

    Recent advancements in hydrogen technologies and renewable energy applications show promise for economical near- to mid-term conversion to a hydrogen-based economy. As the use of hydrogen for the electric utility and transportation sectors of the U.S. economy unfolds, electric power utilities need to understand the potential benefits and impacts. This report provides a historical perspective of hydrogen, discusses the process of electrolysis for hydrogen production (especially from solar and wind technologies), and describes the opportunities for electric power utilities.

  13. IRIS - Progressing Toward a Worldwide Deployment

    SciTech Connect

    Carelli, Mario D.; Petrovic, Bojan

    2006-07-01

    The International Reactor Innovative and Secure (IRIS) is an advanced, integral, light-water cooled, pressurized reactor of smaller generating capacity (1000 MWt, or about 335 MWe). It is being developed through a strong international partnership for near term deployment (within the next decade) to offer a simple nuclear plant with outstanding safety, attractive economics and enhanced proliferation resistance characteristics. IRIS provides a viable bridge to Generation IV reactors and has excellent capability to satisfy in the near/mid-term time frame the Global Nuclear Energy Partnership (GNEP) requirements for small-scale reactors. This paper provides a top-level overview of the project status. (authors)

  14. In-Space Propulsion Solar Electric Propulsion Technology Overview

    NASA Astrophysics Data System (ADS)

    Dankanich, John W.

    2006-12-01

    NASA’s In-space Propulsion Technology Project is developing new propulsion technologies that can enable or enhance near and mid-term NASA science missions. The solar electric propulsion technology area has been investing in NASA’s Evolutionary Xenon Thruster (NEXT), the High Voltage Hall Accelerator (HiVHAC), lightweight reliable feed systems, wear testing and thruster modeling. These investments are specifically targeted to increase planetary science payload capability, expand the envelope of planetary science destinations, and significantly reduce the travel times, risk and cost of NASA planetary science missions. Current status and expected capabilities of the solar electric propulsion technologies will be discussed.

  15. Isolation and characterization of an abortifacient protein, momorcochin, from root tubers of Momordica cochinchinensis (family cucurbitaceae).

    PubMed

    Yeung, H W; Ng, T B; Wong, N S; Li, W W

    1987-07-01

    A glycoprotein with a molecular weight of 32,000 as estimated by SDS-polyacrylamide gel electrophoresis, and characterized by an abundance of Asp and Glu residues and an absence of Cys residues in its amino acid analysis, was isolated from fresh root tubers of Momordica cochinchinensis using a procedure that involved acetone precipitation, ammonium sulfate precipitation, ion exchange chromatography on DEAE Sepharose CL-6B and gel filtration on Sephadex G-75. The protein was capable of inducing mid-term abortion in mice. The characteristics of this protein were compared and contrasted with those of the abortifacient proteins isolated from other plants of the Cucurbitaceae family.

  16. “DK Crush” Technique for a Tightly Stenosed Conjoined SVG Lesion in a Patient with Acute Coronary Syndrome and Cardiogenic Shock

    PubMed Central

    Chen, Kuan-Ju; Lee, Wen-Lieng; Liu, Tsun-Jui; Chang, Wei-Chun; Wang, Kuo-Yang; Su, Chieh-Shou

    2015-01-01

    Coronary artery bifurcation disease of saphenous venous graft (SVG) is extremely rare. SVG disease remains a challenging lesion to treat because of increased morbidity and mortality with repeated coronary artery bypass graft surgery (CABG), high rates of periprocedural complications, and in-stent restenosis or occlusion requiring repeat revascularization with percutaneous coronary intervention. Herein, we present the first reported case of using the “DK crush” technique to treat an inverted Y-shaped SVG bifurcation disease in a patient with a prior CABG and new-onset acute coronary syndrome. Arising from our treatment, favorable immediate and mid-term angiographic and clinical outcomes were obtained. PMID:27122880

  17. [Femicide Across Europe COST Action, a transnational cooperation network for the study of and approach to femicide in Europe].

    PubMed

    Sanz-Barbero, Belén; Otero-García, Laura; Boira, Santiago; Marcuello, Chaime; Vives Cases, Carmen

    2016-01-01

    Femicide or the murder of women because of their gender is a recognised public health problem as well as a serious violation of human rights. Its magnitude worldwide is still unknown, given the methodological difficulties to differentiate these murders from other female homicides. The European Union programme entitled «European Cooperation in Science and Technology» (COST) launched the «Femicide across Europe» COST Action in 2013, establishing an optimal European framework for transnational cooperation among experts addressing great social and public health challenges such as femicide. This field note describes the main objectives, the participating groups of experts and the mid-term results of this experience.

  18. The Role of Carbon Capture, Sequestration and Emissions Trading in Achieving Short-Term Carbon Emissions Reductions

    SciTech Connect

    Dooley, James J. ); Kim, Son H. ); Runci, Paul J. ); D. Williams

    2001-08-10

    The near- to mid-term deployment of carbon capture and sequestration technologies can accelerate the process of significantly reducing emissions of carbon dioxide under a wide range of policy scenarios and reduce significantly the costs of complying with a climate change mitigation protocol -- by as much as$1 trillion over the period 2005-2050. These carbon capture and sequestration technologies also allow the continued use of fossil fuels, while reducing their carbon emissions and keeping the cost of electricity generated from fossil fuels competitive with other generation technologies.

  19. Outcomes of total cavopulmonary connection for single ventricle palliation

    PubMed Central

    Zou, Minghui; Wang, Yanfei; Cui, Hujun; Ma, Li; Yang, Shengchun; Xia, Yuansheng; Chen, Weidan

    2016-01-01

    Background The aim of this study was to review the early and mid-term outcomes of the total cavopulmonary connection (TCPC) procedure and evaluate risk factors for prolonged pleural effusions. Methods The clinical records of 82 consecutive patients, who underwent a TCPC operation between January 2008 and December 2013, were reviewed for incidence of prolonged pleural effusions, duration of ventilation time and pleural drainage, length of intensive care unit (ICU) stay, and early and mid-term morbidity and mortality. Results The median age at surgery was 3.0 years. The main single ventricle diagnoses included 18 cases of a double-inlet single ventricle, 17 cases of heterotaxy, 16 cases of tricuspid atresia, 4 cases of mitral atresia, 12 cases of unbalanced complete atrioventricular canal (CAVC), 5 cases of double-outlet right ventricle (DORV) combined with ventricular septal defect (VSD) and pulmonary stenosis (PS), 4 cases of transposition of the great arteries (TGA) combined with VSD and PS, 4 cases of corrected transposition of great arteries (cTGA) combined VSD and PS, and 2 cases of criss-cross heart. Preoperative mean pulmonary artery pressure (mPAP) was 13.66±2.21 mmHg with 23.2% (n=19) higher than 15 mmHg. A total of 61 (74.4%) patients underwent a fenestration. The perioperative mortality was 4.9%. The median duration of pleural effusion was 10 days (range, 3−80 days), and prolonged pleural effusions occurred in 16 (19.5%) patients. Multivariable analysis revealed that mPAP >15 mmHg was independently associated with prolonged pleural effusions (OR, 8.33; 95% CI, 2.33−29.74; P=0.001), and creation of a fenestration was associated with decreased odds of effusion (OR, 0.21; 95% CI, 0.06−0.74; P=0.015). Five-year estimated Kaplan-Meier survival of two-stage TCPC was significantly higher than that of one-stage group(96.7% vs. 79.7%, P=0.023). Patients with heterotaxy or obstructed totally anomalous pulmonary venous connection (TAPVC) had significantly

  20. An Overview of the VHITAL Program: A Two-Stage Bismuth Fed Very High Specific Impulse Thruster with Anode Layer

    NASA Technical Reports Server (NTRS)

    Sengupta, Anita; Marrese-Reading, Colleen; Capelli, Mark; Scharfe, David; Tverdokhlebov, Sergey; Semenkin, Sasha; Tverdokhlebov, Oleg; Boyd, Ian; Keidar, Michael; Yalin, Azer; Markusic, Tom; Polzin, Kurt

    2005-01-01

    The Very High Isp Thruster with Anode Layer (VHITAL) is a two stage Hall thruster program that is a part of NASA's Prometheus Program in NASA's New Exploration Systems Mission Directorate (ESMD). It is a potentially viable low-cost alternative to ion engines for near-term NEP applications with the growth potential to support mid-term and far-term NEP missions... This paper will present an overview of the thruster fabrication, pre-existing TAL 160 demonstration, feed system development, lifetime assessment, contamination assessment, and mission study activities performed to date.

  1. NEMS industrial module documentation report

    SciTech Connect

    Not Available

    1994-01-01

    The NEMS Industrial Demand Model is a dynamic accounting model, bringing together the disparate industries and uses of energy in those industries, and putting them together in an understandable and cohesive framework. The Industrial Model generates mid-term (up to the year 2010) forecasts of industrial sector energy demand as a component of the NEMS integrated forecasting system. From the NEMS system, the Industrial Model receives fuel prices, employment data, and the value of output of industrial activity. Based on the values of these variables, the Industrial Model passes back to the NEMS system estimates of consumption by fuel types.

  2. Time to look beyond one-year mortality in critically ill hematological patients?

    PubMed

    Moors, Ine; Benoit, Dominique D

    2014-01-01

    The spectacular improvement in long-term prognosis of patients with hematological malignancies since the 1980s, coupled with the subsequent improvement over the past decade in short- and mid-term survival in cases of critical illness, resulted in an increasing referral of such patients to the ICU. A remaining question, however, is how these patients perform in the long term with regard to survival and quality of life. Here we discuss the present multicenter study on survival beyond 1 year in critically ill patients with hematological malignancies. We conclude with suggestions on how we can further improve the long-term outcome of these patients. PMID:24517551

  3. Endovascular treatment of the nutcracker syndrome: report of two cases.

    PubMed

    Baldi, Sebastián; Rabellino, Martín; Zander, Tobias; González, Gabriela; Maynar, Manuel

    2011-12-01

    The nutcracker syndrome (NS) is a rare condition characterized by the entrapment of the left renal vein (LRV) between the superior mesenteric artery (SMA) and the aorta. Clinically, it presents with flank pain, hematuria, and symptoms of pelvic venous congestion. Several surgical techniques have been described including left renal vein (LRV) transposition, autotransplantation, LRV bypass, superior mesenteric artery (SMA) transposition, gonadocaval bypass and nephrectomy. More recently, endovascular stenting of the renal vein has been proposed. We present two patients with NS who were successfully managed endovascularly, providing satisfactory mid-term clinical and imaging results.

  4. Interventional Treatment of Pulmonary Valve Stenosis: A Single Center Experience

    PubMed Central

    Idrizi, Shpend; Milev, Ivan; Zafirovska, Planinka; Tosheski, Goce; Zimbakov, Zan; Ampova-Sokolov, Vilma; Angjuseva, Tanja; Mitrev, Zan

    2015-01-01

    BACKGROUND: Percutaneous pulmonary valvuloplasty is well established treatment of choice in pulmonary valve stenosis. AIM: The aim of our study was to present our experience with the interventional technique, its immediate and mid-term effectiveness as well as its complication rate. MATERIAL AND METHODS: The study included 43 patients, where 33 (74%) of them were children between the age of 1 month and 15 years. RESULTS: The procedure was successful in 38 patients or 90%. Mean peak to peak transvalvular gradient was reduced from 91.2 mmHg (55-150 mmHg) to 39.1 mmHg (20-80 mmHg). Follow- up of patients was between 2 and 13 years and included echocardiographic evaluation of pulmonary valve gradient, right heart dimensions and function as well as assessment of pulmonary regurgitation. We experienced one major complication pericardial effusion in a 5 months old child that required pericardiocenthesis. Six patients (13.9%) required a second intervention. During the follow up period there was significant improvement of right heart function and echocardiography parameters. Mild pulmonary regurgitation was noted in 24 (55%) patients, and four (9%) patients developed moderate regurgitation, without affecting the function of the right ventricle. CONCLUSIONS: Percutaneous pulmonary valvuloplasty is an effective procedure in treatment of pulmonary stenosis with good short and mid-term results. PMID:27275259

  5. Degradation of Kidney and Psoas Muscle Proteins as Indicators of Post-Mortem Interval in a Rat Model, with Use of Lateral Flow Technology.

    PubMed

    Lee, Dong-Gi; Yang, Kyeong Eun; Hwang, Jeong Won; Kang, Hwan-Soo; Lee, Seung-Yeul; Choi, Seoyeon; Shin, Joonchul; Jang, Ik-Soon; An, Hyun Joo; Chung, Heesun; Jung, Hyo-Il; Choi, Jong-Soon

    2016-01-01

    We investigated potential protein markers of post-mortem interval (PMI) using rat kidney and psoas muscle. Tissue samples were taken at 12 h intervals for up to 96 h after death by suffocation. Expression levels of eight soluble proteins were analyzed by Western blotting. Degradation patterns of selected proteins were clearly divided into three groups: short-term, mid-term, and long-term PMI markers based on the half maximum intensity of intact protein expression. In kidney, glycogen synthase (GS) and glycogen synthase kinase-3β were degraded completely within 48 h making them short-term PMI markers. AMP-activated protein kinase α, caspase 3 and GS were short-term PMI markers in psoas muscle. Glyceraldehyde 3-phosphate dehydrogenase (GAPDH) was a mid-term PMI marker in both tissues. Expression levels of the typical long-term PMI markers, p53 and β-catenin, were constant for at least 96 h post-mortem in both tissues. The degradation patterns of GS and caspase-3 were verified by immunohistochemistry in both tissues. GAPDH was chosen as a test PMI protein to perform a lateral flow assay (LFA). The presence of recombinant GAPDH was clearly detected in LFA and quantified in a concentration-dependent manner. These results suggest that LFA might be used to estimate PMI at a crime scene. PMID:27552165

  6. Urgent carotid endarterectomy in patients with acute neurological ischemic events within six hours after symptoms onset.

    PubMed

    Gajin, P; Radak, Dj; Tanaskovic, S; Babic, S; Nenezic, D

    2014-06-01

    To analyze the outcome of urgent carotid endarterectomy (CEA) performed within less than six hours in patients with crescendo transient ischemic attack (TIA) and stroke in progression. From January 1998 to December 2008, 58 urgent CEAs were done for acute neurological ischemic events--46 patients with crescendo TIA and 12 patients with stroke in progression. Brain computed tomography (CT) was done prior and after the surgery. Disability level was assessed prior to and after urgent CEA using modified Rankin scale. Median follow-up was 42.1 ± 16.6 months. In the early postoperative period stroke rate was 0% for the patients in crescendo TIA group while in patients with stroke in progression group 3 patients (25%) had positive postoperative brain CT, yet neurological status significantly improved. Mid-term stroke rate was 2.2% in crescendo TIA group and 8.3% in stroke in progression group. In the early postoperative period there were no lethal outcomes, mid-term mortality was 8.3% in stroke in progression while in crescendo TIA group lethal outcomes were not observed. In conclusion, based on our results urgent CEA is a safe and effective treatment option for patients with crescendo TIA and stroke in progression with acceptable rate of postoperative complications.

  7. Implication of Paris Agreement in the context of long-term climate mitigation goals.

    PubMed

    Fujimori, Shinichiro; Su, Xuanming; Liu, Jing-Yu; Hasegawa, Tomoko; Takahashi, Kiyoshi; Masui, Toshihiko; Takimi, Maho

    2016-01-01

    The Paris Agreement confirmed the global aim to achieve a long-term climate goal, in which the global increase in mean temperature is kept below 2 °C compared to the preindustrial level. We investigated the implications of the near-term emissions targets (for around the year 2030) in the context of the long-term climate mitigation goal using the Asia-Pacific Integrated Model framework. To achieve the 2 °C goal, a large greenhouse gas emissions reduction is required, either in the early or latter half of this century. In the mid-term (from 2030 to 2050), it may be necessary to consider rapid changes to the existing energy or socioeconomic systems, while long-term measures (after 2050) will rely on the substantial use of biomass combined with carbon capture and storage technology or afforestation, which will eventually realize so-called negative CO2 emissions. With respect to the policy context, two suggestions are provided here. The first is the review and revision of the nationally determined contributions (NDCs) in 2020, with an additional reduction target to the current NDCs being one workable alternative. The second suggestion is a concrete and numerical mid-term emissions reduction target, for example to be met by 2040 or 2050, which could also help to achieve the long-term climate goal.

  8. Outcomes of Surgery for Total Anomalous Pulmonary Venous Return without Total Circulatory Arrest

    PubMed Central

    Lee, Youngok; Cho, Joon Yong; Kwon, O Young; Jang, Woo Sung

    2016-01-01

    Background Recent developments in surgical techniques and hospital care have led to improved outcomes following total anomalous pulmonary venous return (TAPVR) repair. However, the surgical repair of TAPVR remains associated with a high risk of mortality and need for reoperation. We conducted this retrospective study to evaluate mid-term outcomes following in situ TAPVR repair without total circulatory arrest (TCA), and to identify the risk factors associated with surgical outcomes. Methods We retrospectively reviewed 29 cases of surgical intervention for TAPVR conducted between April 2000 and July 2015. All patients were newborns or infants who underwent in situ TAPVR repair without TCA. Results Four anatomic subtypes of TAPVR were included in this study: supracardiac (20 cases, 69.0%), cardiac (4 cases, 13.8%), infracardiac (4 cases, 13.8%), and mixed (1 case, 3.4%). The median follow-up period for all patients was 42.9 months. Two (6.9%) early mortalities occurred, as well as 2 (6.9%) cases of postoperative pulmonary venous obstruction (PVO). Preoperative ventilator care (p=0.027) and preoperative PVO (p=0.002) were found to be independent risk factors for mortality. Conclusion In situ repair of TAPVR without TCA was associated with encouraging mid-term outcomes. Preoperative ventilator care and preoperative PVO were found to be independent risk factors for mortality associated with TAPVR repair. PMID:27733992

  9. Modified team-based learning strategy to improve human anatomy learning: A pilot study at the Universidad del Norte in Barranquilla, Colombia.

    PubMed

    Martínez, Emilio G; Tuesca, Rafael

    2014-01-01

    As part of an institutional program sponsored by the Centre for Teaching Excellence at the Universidad del Norte, Barranquilla, Colombia, we developed an educational research study on two sessions of human anatomy in which we combined team-based learning (TBL) and the use of iPads. Study data included the TBL, assessments applied during the course, student's grades on mid-term examinations and students' perceptions of their experiences. Students reported a positive attitude toward the use of the TBL sessions, and the results showed a significant improvement in their learning between the first and second sessions. Significantly positive correlations (P < 0.05) were obtained between (a) the individual students' readiness test performance 1 and mid-term examination 1, (b) the individual readiness test performances from Session 1 to Session 2, and (c) the group readiness test performances from the first and second sessions. These results point to positive learning experiences for these students. Analyses of the students' reflections on their activities also pointed toward future challenges.

  10. Degradation of Kidney and Psoas Muscle Proteins as Indicators of Post-Mortem Interval in a Rat Model, with Use of Lateral Flow Technology

    PubMed Central

    Lee, Dong-Gi; Yang, Kyeong Eun; Hwang, Jeong Won; Kang, Hwan-Soo; Lee, Seung-Yeul; Choi, Seoyeon; Shin, Joonchul; Jang, Ik-Soon; An, Hyun Joo; Chung, Heesun; Jung, Hyo-Il; Choi, Jong-Soon

    2016-01-01

    We investigated potential protein markers of post-mortem interval (PMI) using rat kidney and psoas muscle. Tissue samples were taken at 12 h intervals for up to 96 h after death by suffocation. Expression levels of eight soluble proteins were analyzed by Western blotting. Degradation patterns of selected proteins were clearly divided into three groups: short-term, mid-term, and long-term PMI markers based on the half maximum intensity of intact protein expression. In kidney, glycogen synthase (GS) and glycogen synthase kinase-3β were degraded completely within 48 h making them short-term PMI markers. AMP-activated protein kinase α, caspase 3 and GS were short-term PMI markers in psoas muscle. Glyceraldehyde 3-phosphate dehydrogenase (GAPDH) was a mid-term PMI marker in both tissues. Expression levels of the typical long-term PMI markers, p53 and β-catenin, were constant for at least 96 h post-mortem in both tissues. The degradation patterns of GS and caspase-3 were verified by immunohistochemistry in both tissues. GAPDH was chosen as a test PMI protein to perform a lateral flow assay (LFA). The presence of recombinant GAPDH was clearly detected in LFA and quantified in a concentration-dependent manner. These results suggest that LFA might be used to estimate PMI at a crime scene. PMID:27552165

  11. Changes in cannabinoid receptors, aquaporin 4 and vimentin expression after traumatic brain injury in adolescent male mice. Association with edema and neurological deficit.

    PubMed

    Lopez-Rodriguez, Ana Belen; Acaz-Fonseca, Estefania; Viveros, Maria-Paz; Garcia-Segura, Luis M

    2015-01-01

    Traumatic brain injury (TBI) incidence rises during adolescence because during this critical neurodevelopmental period some risky behaviors increase. The purpose of this study was to assess the contribution of cannabinoid receptors (CB1 and CB2), blood brain barrier proteins (AQP4) and astrogliosis markers (vimentin) to neurological deficit and brain edema formation in a TBI weight drop model in adolescent male mice. These molecules were selected since they are known to change shortly after lesion. Here we extended their study in three different timepoints after TBI, including short (24h), early mid-term (72h) and late mid-term (two weeks). Our results showed that TBI induced an increase in brain edema up to 72 h after lesion that was directly associated with neurological deficit. Neurological deficit appeared 24 h after TBI and was completely recovered two weeks after trauma. CB1 receptor expression decreased after TBI and was negatively correlated with edema formation and behavioral impairments. CB2 receptor increased after injury and was associated with high neurological deficit whereas no correlation with edema was found. AQP4 increased after TBI and was positively correlated with edema and neurological impairments as occurred with vimentin expression in the same manner. The results suggest that CB1 and CB2 differ in the mechanisms to resolve TBI and also that some of their neuroprotective effects related to the control of reactive astrogliosis may be due to the regulation of AQP4 expression on the end-feet of astrocytes.

  12. Changes in Cannabinoid Receptors, Aquaporin 4 and Vimentin Expression after Traumatic Brain Injury in Adolescent Male Mice. Association with Edema and Neurological Deficit

    PubMed Central

    Lopez-Rodriguez, Ana Belen; Acaz-Fonseca, Estefania; Viveros, Maria-Paz; Garcia-Segura, Luis M.

    2015-01-01

    Traumatic brain injury (TBI) incidence rises during adolescence because during this critical neurodevelopmental period some risky behaviors increase. The purpose of this study was to assess the contribution of cannabinoid receptors (CB1 and CB2), blood brain barrier proteins (AQP4) and astrogliosis markers (vimentin) to neurological deficit and brain edema formation in a TBI weight drop model in adolescent male mice. These molecules were selected since they are known to change shortly after lesion. Here we extended their study in three different timepoints after TBI, including short (24h), early mid-term (72h) and late mid-term (two weeks). Our results showed that TBI induced an increase in brain edema up to 72 h after lesion that was directly associated with neurological deficit. Neurological deficit appeared 24 h after TBI and was completely recovered two weeks after trauma. CB1 receptor expression decreased after TBI and was negatively correlated with edema formation and behavioral impairments. CB2 receptor increased after injury and was associated with high neurological deficit whereas no correlation with edema was found. AQP4 increased after TBI and was positively correlated with edema and neurological impairments as occurred with vimentin expression in the same manner. The results suggest that CB1 and CB2 differ in the mechanisms to resolve TBI and also that some of their neuroprotective effects related to the control of reactive astrogliosis may be due to the regulation of AQP4 expression on the end-feet of astrocytes. PMID:26039099

  13. Transcatheter Embolisation of Proximal Type 1 Endoleaks Following Endovascular Aneurysm Sealing (EVAS) Using the Nellix Device: Technique and Outcomes

    SciTech Connect

    Ameli-Renani, S. Morgan, R. A.

    2015-10-15

    AimTo evaluate the technical success and mid-term outcomes following transcatheter embolisation of type 1a endoleak after Nellix endovascular aneurysm sealing (EVAS).Materials and MethodsSeven patients (5 men; mean age 83; range 79–90) underwent transcatheter embolisation between July 2013 and August 2014. The average time from EVAS to embolisation was 136 days (range 6–301) and from endoleak diagnosis to embolisation was 20 days (range 2–50). Embolisation was performed with coils and Onyx in six cases and Onyx only in one case. Technical success, imaging and clinical outcomes of embolisation were reviewed. Technical success was defined as elimination of the endoleak on completion angiography and first imaging follow-up. Clinical success was defined as unchanged or decreased aneurysm sac size on subsequent follow-up (average 8 months; range 103–471 days).ResultsAll cases were technically successful. One patient required a second endovascular procedure following Onyx reflux into the Nellix endograft and another patient required surgical closure of a brachial puncture site. All patients are endoleak free with stable sac size on the latest available follow-up imaging.ConclusionIf a type 1 endoleak occurs after EVAS, embolisation using Onyx with or without coils is feasible and effective with high technical success and freedom from endoleak recurrence at mid-term follow-up.

  14. The effect of permafrost on soil erosion using meteoric 10Be, 137Cs and 239+240Pu in the Eastern Swiss Alps

    NASA Astrophysics Data System (ADS)

    Pichler, Barbara; Brandovà, Dagmar; Alewell, Christine; Ivy-Ochs, Susan; Kubik, Peter W.; Kneisel, Christof; Meusburger, Katrin; Ketterer, Michael; Egli, Markus

    2013-04-01

    Permafrost ecosystems are highly sensitive to climate warming. The expected changes in the thermal and hydrological soil regime might have crucial consequences on soil erosion processes. Therefore, the determination of erosional activities on the long- (since the beginning of soil formation) and mid-term (last 50-60 yr) using cosmogenic and anthropogenic radionuclides can provide important information on past and ongoing processes. Permafrost soils in the Alps and their behaviour with climate change are only rarely studied. The expected new insights will lead to a better understanding of the processes of high mountain soils and are a further step towards improving climate-related modelling of fast warming scenarios and increasing system disequilibria. Our aim is to quantify soil erosion processes in permafrost soils and nearby unfrozen soils in the Alpine (sites at 2700 m asl) and the sub-Alpine (sites 1800 m asl) range of the Swiss Alps (Upper Engadine). We hypothesise that permafrost soils differ distinctly in their long- and mid-term soil erosion rates due to different water retention capacities. Long-term soil erosion was assessed using meteoric 10Be. Meteoric 10Be in a soil profile was estimated assuming that it is has been deposited as a function of precipitation and adsorbed in the fine earth fraction (

  15. Stability analysis of large electric power systems

    SciTech Connect

    Elwood, D.M.

    1993-01-01

    Modern electric power systems are large and complicated, and, in many regions of the world, the generation and transmission systems are operating near their limits. Ensuring the reliable operation of the power system requires engineers to study the response of the system to various disturbances. The responses to large disturbances are examined by numerically solving the nonlinear differential-algebraic equations describing the power system. The response to small disturbances is typically studied via eigenanalysis. The Electric Power Research Institute (EPRI) recently developed the Extended Transient/Mid-term Stability Program (ETMSP) to study large disturbance stability and the Small Signal Stability Program Package (SSSP) to study small signal stability. The primary objectives of the work described in this report were to (1) explore ways of speeding up ETMSP, especially on mid-term voltage stability problems, (2) explore ways of speeding up the Multi-Area Small-Signal Stability program (MASS), one of the codes in SSSP, and (3) explore ways of increasing the size of problem that can be solved by the Cray version of MASS.

  16. Peripheral Applications of Drug-Coated Balloons: Past, Present and Future

    SciTech Connect

    Krokidis, Miltiadis Spiliopoulos, Stavros Katsanos, Konstantinos Sabharwal, Tarun

    2013-04-15

    Drug-coated balloon (DCB) technologies represent the latest and hottest development in the field of endovascular treatment of peripheral arterial disease. Initial experience with paclitaxel-coated balloon use in the femoral artery has demonstrated lower mid-term restenosis and superior mid-term clinical outcomes in terms of improved wound healing and reduced repeat angioplasty rates compared with standard balloon angioplasty. Many companies are presently developing and/or improving DCB catheters and therefore ongoing, technical improvements of the already existing platforms, new drugs, and innovative carriers are expected. The ongoing basic research studies and various multicenter randomized, controlled trials that are currently in progress will offer valuable scientific insights regarding the long-term effectiveness and other crucial issues, such as efficacy in various vascular beds, optimal balloon dosage, and post angioplasty antiplatelet therapy. Future applications of these devices also could include in-stent restenosis, anastomotic stenosis of surgical bypass, and benign stenoses of the central venous system. The authors envision that DCB angioplasty will evolve to a major paradigm shift in the endovascular treatment of occlusive vascular diseases.

  17. Novel Approaches to the Management of Advanced Peripheral Artery Disease: Perspectives on Drug-Coated Balloons, Drug-Eluting Stents, and Bioresorbable Scaffolds.

    PubMed

    Zeller, Thomas; Rastan, Aljoscha; Macharzina, Roland; Beschorner, Ulrich; Noory, Elias

    2015-09-01

    Introducing anti-restenotic drug-based treatment modalities in femoropopliteal interventions is the potential revolutionizing reperfusion treatment of peripheral artery disease. Durability of recanalization procedures using drug-coated balloons (DCB) and drug-eluting stents (DES) yields in excellent mid-term and long-term technical and clinical outcomes and may be cost saving on the long term as compared to traditional treatment modalities such as plain old balloon angioplasty (POBA) and bare metal nitinol stent implantation. Drug-eluting bioresorbable scaffolds are another drug-based promising treatment option but are still investigational. In particular, DCB provide a novel method to locally deliver paclitaxel into the arterial wall without the need of a chronically implanted delivery system or even if those devices will be indicated, they can be delivered focally. Following the first positive pilot studies, two large pivotal trials have confirmed superiority of DCB over plain old balloon angioplasty (POBA) in the treatment of TASC II A and B femoropopliteal lesions. Even for more complex femoropopliteal lesions such as long lesions and instent restenosis, single center studies and small randomized studies have shown promising mid-term technical and clinical results. For DES, follow-up data for the only commercially available device are now presented up to 5 years with excellent clinical outcome regarding freedom from target lesion revascularization and improvement of walking capacity. This review article summarizes the current knowledge and perspectives of drug-based endovascular treatment modalities in femoropopliteal interventions and discusses still unresolved needs.

  18. Phlogopite mica-based compressive seals for solid oxide fuel cells: effect of mica thickness

    NASA Astrophysics Data System (ADS)

    Chou, Yeong-Shyung; Stevenson, Jeffry W.

    Commercially available Phlogopite mica papers of varying thickness, ˜0.1, ˜0.2, and ˜0.5 mm, were evaluated as potential solid oxide fuel cell (SPFC) seal materials. The micas were tested in two forms: plain and hybrid. The hybrid form involved the addition of glass interlayers between the mica and the adjacent components. For each sample, about 30 thermal cycles were conducted and the 800 °C leak rates were determined. The results showed an excellent thermal cycle stability of the Phlogopite micas in the hybrid design in that the leak rates remained almost constant after ˜10 cycles. In addition, the leak rate appeared to increase with increasing mica thickness in the hybrid design, but showed no thickness dependence for mica in the plain design. The Phlogopite micas also showed good mid-term (˜500 h) stability in both air and reducing environments. Microstructure characterization showed no distinct degradation such as fragmentation and particle formation after thermal cycle and the mid-term stability tests.

  19. Tightly Coupled Inertial Navigation System/Global Positioning System (TCMIG)

    NASA Technical Reports Server (NTRS)

    Watson, Michael D.; Jackson, Kurt (Technical Monitor)

    2002-01-01

    Many NASA applications planned for execution later this decade are seeking high performance, miniaturized, low power Inertial Management Units (IMU). Much research has gone into Micro-Electro-Mechanical System (MEMS) over the past decade as a solution to these needs. While MEMS devices have proven to provide high accuracy acceleration measurements, they have not yet proven to have the accuracy required by many NASA missions in rotational measurements. Therefore, a new solution has been formulated integrating the best of all IMU technologies to address these mid-term needs in the form of a Tightly Coupled Micro Inertial Navigation System (INS)/Global Positioning System (GPS) (TCMIG). The TCMIG consists of an INS and a GPS tightly coupled by a Kalman filter executing on an embedded Field Programmable Gate Array (FPGA) processor. The INS consists of a highly integrated Interferometric Fiber Optic Gyroscope (IFOG) and a MEMS accelerometer. The IFOG utilizes a tightly wound fiber coil to reduce volume and the high level of integration and advanced optical components to reduce power. The MEMS accelerometer utilizes a newly developed deep etch process to increase the proof mass and yield a highly accurate accelerometer. The GPS receiver consists of a low power miniaturized version of the Blackjack receiver. Such an IMU configuration is ideal to meet the mid-term needs of the NASA Science Enterprises and the new launch vehicles being developed for the Space Launch Initiative (SLI).

  20. Endovascular Treatment of Descending Thoracic Aortic Aneurysms with the EndoFit Stent-Graft

    SciTech Connect

    Saratzis, N.; Saratzis, Athanasios Melas, N.; Ginis, G.; Lioupis, A.; Lykopoulos, D.; Lazaridis, J.; Kiskinis, Dimitrios

    2007-04-15

    Objective. To evaluate the mid-term feasibility, efficacy, and durability of descending thoracic aortic aneurysm (DTAA) exclusion using the EndoFit device (LeMaitre Vascular). Methods. Twenty-three (23) men (mean age 66 years) with a DTAA were admitted to our department for endovascular repair (21 were ASA III+ and 2 refused open repair) from January 2003 to July 2005. Results. Complete aneurysm exclusion was feasible in all subjects (100% technical success). The median follow-up was 18 months (range 8-40 months). A single stent-graft was used in 6 cases. The deployment of a second stent-graft was required in the remaining 17 patients. All endografts were attached proximally, beyond the left subclavian artery, leaving the aortic arch branches intact. No procedure-related deaths have occurred. A distal type I endoleak was detected in 2 cases on the 1 month follow-up CT scan, and was repaired with reintervention and deployment of an extension graft. A nonfatal acute myocardial infarction occurred in 1 patient in the sixth postoperative month. Graft migration, graft infection, paraplegia, cerebral or distal embolization, renal impairment or any other major complications were not observed. Conclusion. The treatment of DTAAs using the EndoFit stent-graft is technically feasible. Mid-term results in this series are promising.

  1. Uterine Fibroid Embolization for Symptomatic Fibroids: Study at a Teaching Hospital in Kenya

    PubMed Central

    Mutai, John Kiprop; Vinayak, Sudhir; Stones, William; Hacking, Nigel; Mariara, Charles

    2015-01-01

    Objective: Characterization of magnetic (MRI) features in women undergoing uterine fibroid embolization (UFE) and identification of clinical correlates in an African population. Materials and Methods: Patients with symptomatic fibroids who are selected to undergo UFE at the hospital formed the study population. The baseline MRI features, baseline symptom score, short-term imaging outcome, and mid-term symptom scores were analyzed for interval changes. Assessment of potential associations between short-term imaging features and mid-term symptom scores was also done. Results: UFE resulted in statistically significant reduction (P < 0.001) of dominant fibroid, uterine volumes, and reduction of symptom severity scores, which were 43.7%, 40.1%, and 37.8%, respectively. Also, 59% of respondents had more than 10 fibroids. The predominant location of the dominant fibroid was intramural. No statistically significant association was found between clinical and radiological outcome. Conclusion: The response of uterine fibroids to embolization in the African population is not different from the findings reported in other studies from the west. The presence of multiple and large fibroids in this study is consistent with the case mix described in other studies of African-American populations. Patient counseling should emphasize the independence of volume reduction and symptom improvement. Though volume changes are of relevance for the radiologist in understanding the evolution of the condition and identifying potential technical treatment failures, it should not be the main basis of evaluation of treatment success. PMID:25883858

  2. A Systems Approach to Developing an Affordable Space Ground Transportation Architecture using a Commonality Approach

    NASA Technical Reports Server (NTRS)

    Garcia, Jerry L.; McCleskey, Carey M.; Bollo, Timothy R.; Rhodes, Russel E.; Robinson, John W.

    2012-01-01

    This paper presents a structured approach for achieving a compatible Ground System (GS) and Flight System (FS) architecture that is affordable, productive and sustainable. This paper is an extension of the paper titled "Approach to an Affordable and Productive Space Transportation System" by McCleskey et al. This paper integrates systems engineering concepts and operationally efficient propulsion system concepts into a structured framework for achieving GS and FS compatibility in the mid-term and long-term time frames. It also presents a functional and quantitative relationship for assessing system compatibility called the Architecture Complexity Index (ACI). This paper: (1) focuses on systems engineering fundamentals as it applies to improving GS and FS compatibility; (2) establishes mid-term and long-term spaceport goals; (3) presents an overview of transitioning a spaceport to an airport model; (4) establishes a framework for defining a ground system architecture; (5) presents the ACI concept; (6) demonstrates the approach by presenting a comparison of different GS architectures; and (7) presents a discussion on the benefits of using this approach with a focus on commonality.

  3. Phlogopite Mica-based Compressive Seals for Solid Oxide Fuel Cells: Effect of Mica Thickness

    SciTech Connect

    Chou, Y S.; Stevenson, Jeffry W.

    2003-11-24

    Commercially available Phlogopite mica papers of varying thickness, {approx} 0.1 mm, {approx} 0.2 mm, and {approx} 0.5 mm, were evaluated as potential solid oxide fuel cell seal materials. The micas were tested in two forms: plain and hybrid. The hybrid form involved the addition of glass interlayers between the mica and the adjacent components. For each sample, about 30 thermal cycles were conducted and the 800 C leak rates were determined. The results showed an excellent thermal cycle stability of the Phlogopite micas in the hybrid design in that the leak rates remained almost constant after {approx}10 cycles. In addition, the leak rate appeared to increase with increasing mica thickness in the hybrid design, but showed no thickness dependence for mica in the plain design. The Phlogopite micas also showed good mid-term ({approx}500 hrs) stability in both air and reducing environments. Microstructure characterization showed no distinct degradation such as fragmentation and particle formation after thermal cycle and the mid-term stability tests.

  4. Implication of Paris Agreement in the context of long-term climate mitigation goals.

    PubMed

    Fujimori, Shinichiro; Su, Xuanming; Liu, Jing-Yu; Hasegawa, Tomoko; Takahashi, Kiyoshi; Masui, Toshihiko; Takimi, Maho

    2016-01-01

    The Paris Agreement confirmed the global aim to achieve a long-term climate goal, in which the global increase in mean temperature is kept below 2 °C compared to the preindustrial level. We investigated the implications of the near-term emissions targets (for around the year 2030) in the context of the long-term climate mitigation goal using the Asia-Pacific Integrated Model framework. To achieve the 2 °C goal, a large greenhouse gas emissions reduction is required, either in the early or latter half of this century. In the mid-term (from 2030 to 2050), it may be necessary to consider rapid changes to the existing energy or socioeconomic systems, while long-term measures (after 2050) will rely on the substantial use of biomass combined with carbon capture and storage technology or afforestation, which will eventually realize so-called negative CO2 emissions. With respect to the policy context, two suggestions are provided here. The first is the review and revision of the nationally determined contributions (NDCs) in 2020, with an additional reduction target to the current NDCs being one workable alternative. The second suggestion is a concrete and numerical mid-term emissions reduction target, for example to be met by 2040 or 2050, which could also help to achieve the long-term climate goal. PMID:27652193

  5. Role of galectin-3 and plasma B type-natriuretic peptide in predicting prognosis in discharged chronic heart failure patients

    PubMed Central

    Feola, Mauro; Testa, Marzia; Leto, Laura; Cardone, Marco; Sola, Mario; Rosso, Gian Luca

    2016-01-01

    Abstract Galectin-3 demonstrated to be a robust independent marker of cardiovascular mid-term (18-month) outcome in heart failure (HF) patients. The objective of this study was to analyze the value of a predischarged determination of plasma galectin-3 alone and with plasma brain natriuretic peptide (BNP) in predicting mid-term outcome in frequent-flyers (FF) HF (≥2 hospitalization for HF/year)/dead patients discharged after an acute decompensated HF (ADHF) episode. All FF chronic HF subjects discharged alive after an ADHF were enrolled. All patients underwent a determination of BNP and galectin-3, a 6-minute walk test, and an echocardiogram within 48 hours upon hospital discharge. Death by any cause, cardiac transplantation, and worsening HF requiring readmission to hospital were considered cardiovascular events. Eighty-three patients (67 males, age 73.2 ± 8.6 years old) were analyzed (mean follow-up 11.6 ± 5.2 months; range 4–22 months). During the follow-up 38 events (45.7%) were scheduled: (13 cardiac deaths, 35 rehospitalizations for ADHF). According to medical history, in 33 patients (39.8%) a definition of FF HF patients was performed (range 2–4 hospitalization/year). HF patients who suffered an event (FF or death) demonstrated more impaired ventricular function (P = 0.037), higher plasma BNP (P = 0.005), and Gal-3 at predischarge evaluation (P = 0.027). Choosing adequate cut-off points (BNP ≥ 500 pg/mL and Gal-3 ≥ 17.6 ng/mL), the Kaplan–Meier curves depicted the powerful stratification using BNP + Gal-3 in predicting clinical course at mid-term follow-up (log rank 5.65; P = 0.017). Adding Gal-3 to BNP, a single predischarge strategy testing seemed to obtain a satisfactorily predictive value in alive HF patients discharged after an ADHF episode. PMID:27368017

  6. Can Platforms Affect the Safety and Efficacy of Drug-Eluting Stents in the Era of Biodegradable Polymers?: A Meta-Analysis of 34,850 Randomized Individuals

    PubMed Central

    Zhang, Ming-Duo; Li, Xin-He; Nie, Mao-Xiao; Feng, Ting-Ting; Zhao, Xin; Wang, Lu-Ya; Zhao, Quan-Ming

    2016-01-01

    Objective In the era of bare metal stents (BMSs), alloys have been considered to be better materials for stent design than stainless steel. In the era of biodegradable polymer drug-eluting stents (BP-DESs), the safety and efficacy of BP-DESs with different metal platforms (stainless steel or alloys) have not yet been reported, although their polymers are eventually absorbed, and only the metal platforms remain in the body. This study sought to determine the clinical safety and efficacy of BP-DESs with different platforms compared with other stents (other DESs and BMSs). Methods PubMed, Embase and Clinical Trials.gov were searched for randomized controlled trials (RCTs) that compared BP-DESs with other stents. After performing pooled analysis of BP-DESs and other stents, we performed a subgroup analysis using two classification methods: stent platform and follow-up time. The study characteristics, patient characteristics and clinical outcomes were abstracted. Results Forty RCTs (49 studies) comprising 34,850 patients were included. Biodegradable polymer stainless drug-eluting stents (BP-stainless DESs) were superior to the other stents [mainly stainless drug-eluting stents (DESs)] in terms of pooled definite/probable stent thrombosis (ST) (OR [95% CI] = 0.76[0.61–0.95], p = 0.02), long-term definite/probable ST (OR [95% CI] = 0.73[0.57–0.94], p = 0.01), very late definite/probable ST (OR [95% CI] = 0.56[0.33–0.93], p = 0.03) and long-term definite ST. BP-stainless DESs had lower rates of pooled, mid-term and long-term target vessel revascularization (TVR) and target lesion revascularization (TLR) than the other stainless DESs and BMSs. Furthermore, BP-stainless DESs were associated with lower rates of long-term death than other stainless DESs and lower rates of mid-term myocardial infarction than BMSs. However, only the mid-term and long-term TVR rates were superior in BP-alloy DESs compared with the other stents. Conclusion Our results indirectly suggest that

  7. Recommended names for pleomorphic genera in Dothideomycetes.

    PubMed

    Rossman, Amy Y; Crous, Pedro W; Hyde, Kevin D; Hawksworth, David L; Aptroot, André; Bezerra, Jose L; Bhat, Jayarama D; Boehm, Eric; Braun, Uwe; Boonmee, Saranyaphat; Camporesi, Erio; Chomnunti, Putarak; Dai, Dong-Qin; D'souza, Melvina J; Dissanayake, Asha; Gareth Jones, E B; Groenewald, Johannes Z; Hernández-Restrepo, Margarita; Hongsanan, Sinang; Jaklitsch, Walter M; Jayawardena, Ruvishika; Jing, Li Wen; Kirk, Paul M; Lawrey, James D; Mapook, Ausana; McKenzie, Eric H C; Monkai, Jutamart; Phillips, Alan J L; Phookamsak, Rungtiwa; Raja, Huzefa A; Seifert, Keith A; Senanayake, Indunil; Slippers, Bernard; Suetrong, Satinee; Taylor, Joanne E; Thambugala, Kasun M; Tian, Qing; Tibpromma, Saowaluck; Wanasinghe, Dhanushka N; Wijayawardene, Nalin N; Wikee, Saowanee; Woudenberg, Joyce H C; Wu, Hai-Xia; Yan, Jiye; Yang, Tao; Zhang, Ying

    2015-12-01

    This paper provides recommendations of one name for use among pleomorphic genera in Dothideomycetes by the Working Group on Dothideomycetes established under the auspices of the International Commission on the Taxonomy of Fungi (ICTF). A number of these generic names are proposed for protection because they do not have priority and/or the generic name selected for use is asexually typified. These include: Acrogenospora over Farlowiella; Alternaria over Allewia, Lewia, and Crivellia; Botryosphaeria over Fusicoccum; Camarosporula over Anthracostroma; Capnodium over Polychaeton; Cladosporium over Davidiella; Corynespora over Corynesporasca; Curvularia over Pseudocochliobolus; Elsinoë over Sphaceloma; Excipulariopsis over Kentingia; Exosporiella over Anomalemma; Exserohilum over Setosphaeria; Gemmamyces over Megaloseptoria; Kellermania over Planistromella; Kirschsteiniothelia over Dendryphiopsis; Lecanosticta over Eruptio; Paranectriella over Araneomyces; Phaeosphaeria over Phaeoseptoria; Phyllosticta over Guignardia; Podonectria over Tetracrium; Polythrincium over Cymadothea; Prosthemium over Pleomassaria; Ramularia over Mycosphaerella; Sphaerellopsis over Eudarluca; Sphaeropsis over Phaeobotryosphaeria; Stemphylium over Pleospora; Teratosphaeria over Kirramyces and Colletogloeopsis; Tetraploa over Tetraplosphaeria; Venturia over Fusicladium and Pollaccia; and Zeloasperisporium over Neomicrothyrium. Twenty new combinations are made: Acrogenospora carmichaeliana (Berk.) Rossman & Crous, Alternaria scrophulariae (Desm.) Rossman & Crous, Pyrenophora catenaria (Drechsler) Rossman & K.D. Hyde, P. dematioidea (Bubák & Wróbl.) Rossman & K.D. Hyde, P. fugax (Wallr.) Rossman & K.D. Hyde, P. nobleae (McKenzie & D. Matthews) Rossman & K.D. Hyde, P. triseptata (Drechsler) Rossman & K.D. Hyde, Schizothyrium cryptogamum (Batzer & Crous) Crous & Batzer, S. cylindricum (G.Y. Sun et al.) Crous & Batzer, S. emperorae (G.Y. Sun & L. Gao) Crous & Batzer, S. inaequale (G.Y. Sun & L

  8. Linear headache: a recurrent unilateral head pain circumscribed in a line-shaped area

    PubMed Central

    2014-01-01

    Background A headache circumscribed in a line-shaped area but not confined to the territory of one particular nerve had ever been described in Epicrania Fugax (EF) of which the head pain is moving and ultrashort. In a 25-month period from Feb 2012 to Mar 2014, we encountered 12 patients with a paroxysmal motionless head pain restricted in a linear trajectory. The head pain trajectory was similar to that of EF, but its all other features obviously different from those of EF. We named this distinctive but undescribed type of headache linear headache (LH). Methods A detailed clinical feature of the headache was obtained in all cases to differentiate with EF, trigeminal autonomic cephalalgias (TACs) and cranial neuralgia. Similarities and differences in clinical features were compared between LH and migraine. Results The twelve LH patients (mean age 43.9 ± 12.2) complained of a recurrent, moderate to severe, distending (n = 9), pressure-like (n = 3) or pulsating (n = 3) pain within a strictly unilateral line-shaped area. The painful line is distributed from occipital or occipitocervical region to the ipsilateral eye (n = 5), forehead (n = 6) or parietal region (n = 1). The pain line has a trajecory similar to that of EF but no characteristics of moving. The headache duration would be ranged from five minutes to three days, but usually from half day to one day in most cases (n = 8). Six patients had the accompaniment of nausea with or without vomiting, and two patients had the accompaniment of ipsilateral dizziness. The attacks could be either spontaneous (n = 10) or triggered by noise, depression and resting after physical activity (n = 1), or by stress and staying up late (n = 1). The frequency of attacks was variable. The patients had well response to flunarizine, sodium valproate and amitriptyline but not to carbamazepine or oxcarbazepine. LH is different from EF, trigeminal autonomic cephalalgias (TACs) and cranial neuralgia, but it had couple of features similar

  9. Restenosis after carotid artery stenting and endarterectomy: a secondary analysis of CREST, a randomised controlled trial

    PubMed Central

    Lal, Brajesh K.; Beach, Kirk W.; Roubin, Gary S.; Lutsep, Helmi L.; Moore, Wesley S.; Malas, Mahmoud B.; Chiu, David; Gonzales, Nicole R.; Burke, J. Lee; Rinaldi, Michael; Elmore, James R.; Weaver, Fred A.; Narins, Craig R.; Foster, Malcolm; Hodgson, Kim J.; Shepard, Alexander D.; Meschia, James F.; Bergelin, Robert O.; Voeks, Jenifer H.; Howard, George; Brott, Thomas G.

    2012-01-01

    Background In the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST), the composite primary endpoint of stroke, myocardial infarction, or death during the periprocedural period or ipsilateral stroke thereafter did not differ between carotid artery stenting and carotid endarterectomy for symptomatic or asymptomatic carotid stenosis. A secondary aim of this randomised trial was to compare the composite endpoint of restenosis or occlusion. Methods Patients with stenosis of the carotid artery who were asymptomatic or had had a transient ischaemic attack, amaurosis fugax, or a minor stroke were eligible for CREST and were enrolled at 117 clinical centres in the USA and Canada between Dec 21, 2000, and July 18, 2008. In this secondary analysis, the main endpoint was a composite of restenosis or occlusion at 2 years. Restenosis and occlusion were assessed by duplex ultrasonography at 1, 6, 12, 24, and 48 months and were defined as a reduction in diameter of the target artery of at least 70%, diagnosed by a peak systolic velocity of at least 3·0 m/s. Studies were done in CREST-certified laboratories and interpreted at the Ultrasound Core Laboratory (University of Washington). The frequency of restenosis was calculated by Kaplan-Meier survival estimates and was compared during a 2-year follow-up period. We used proportional hazards models to assess the association between baseline characteristics and risk of restenosis. Analyses were per protocol. CREST is registered with ClinicalTrials.gov, number NCT00004732. Findings 2191 patients received their assigned treatment within 30 days of randomisation and had eligible ultrasonography (1086 who had carotid artery stenting, 1105 who had carotid endarterectomy). In 2 years, 58 patients who underwent carotid artery stenting (Kaplan-Meier rate 6·0%) and 62 who had carotid endarterectomy (6·3%) had restenosis or occlusion (hazard ratio [HR] 0·90, 95% CI 0·63–1·29; p=0·58). Female sex (1·79, 1·25–2

  10. Opportunities for Drell-Yan Physics at RHIC

    SciTech Connect

    Aschenauer, E.; Bland, L.; Crawford, H.; Goto, Y.; Eyser, O.; Kang, Z.; Vossen, A.

    2011-05-24

    Drell-Yan (DY) physics gives the unique opportunity to study the parton structure of nucleons in an experimentally and theoretically clean way. With the availability of polarized proton-proton collisions and asymmetric d+Au collisions at the Relativistic Heavy Ion Collider (RHIC), we have the basic (and unique in the world) tools to address several fundamental questions in QCD, including the expected gluon saturation at low partonic momenta and the universality of transverse momentum dependent parton distribution functions. A Drell-Yan program at RHIC is tied closely to the core physics questions of a possible future electron-ion collider, eRHIC. The more than 80 participants of this workshop focused on recent progress in these areas by both theory and experiment, trying to address imminent questions for the near and mid-term future.

  11. Dismantle or Improve ObamaCare? Nurses Must Take Action.

    PubMed

    Gardner, Deborah B

    2014-01-01

    Following the 2014 mid-term elections, what will the next 2 years of Republican leadership do to change the structures still being put into place to meet the goals of the Affordable Care Act (ACA)? Nurses need to be visible by creating partnerships with their new state and federal representatives and by demonstrating collaboration through identified shared values. Nurses must hold all congressional leaders accountable for continuing to improve access to quality and affordable health care, while containing costs and strengthening incentives to provide a client-centered approach to care delivery. As health care reform legislation is a highly charged political battleground, nurses must support legislative changes in the ACA that will strengthen our health care system, not weaken it. PMID:26267964

  12. Bretton Woods Institution Narratives about Inequality and Economic Vulnerability on the Eve of South African Austerity.

    PubMed

    Bond, Patrick

    2015-01-01

    In South Africa, at a time when National Health Insurance should be generously funded (7 years after its approval as public policy by the ruling party), state fiscal austerity appears certain to nip the initiative in the bud. The World Bank and the International Monetary Fund issued separate reports about South Africa in late 2014, following a new finance minister's mid-term budget speech. In justifying austerity, they revealed 2 important conceptual blockages regarding inequality and international financial relations. The resulting political bias in the macroeconomic debate has, in turn, given neoliberal policy advocates intellectual weaponry to impose deeper austerity. In contrast, the rise of a "united front" of labor, community-based, and social movement activists, along with a vigorous left opposition party in Parliament, ensure that one of the world's most visible class struggles ratchets up in intensity in the years ahead. PMID:26077853

  13. Treatment of chronic low back pain in patients with spinal deformities using a sagittal re-alignment brace

    PubMed Central

    Weiss, Hans-Rudolf; Werkmann, Mario

    2009-01-01

    Background For adult scoliosis patients with chronic low back pain bracing is initially indicated before spinal surgery is considered. Until recently there has been a lack of research into the effect upon pain reductions in the mid and long-term. Promising results have been documented in short-term studies for the application of a sagittal re-alignment brace in patients with spinal deformities and along with pain; however mid-term and long-term results are not yet available. The purpose of this study is to investigate the mid-term effects of this brace with respect to pain control. Materials and methods 67 patients (58 females and 9 males) with chronic low back pain (> 24 months) and the diagnosis of scoliosis or hyperkyphosis were treated with a sagittal re-alignment brace (physio-logic brace™) between January 2006 and July 2007. The indication for this kind of brace treatment was derived from a positive sagittal re-alignment test (SRT) and the exclusion of successful conservative treatment during the last 24 months. The aim of this type of conservative intervention was to avoid surgery for chronic low back pain. Results The average pain intensity was measured on the Roland and Morris VRS (5 steps) before treatment. This was 3.3 (t1), at the time of brace adjustment it was 2.7 (t2) and after at an average observation time of 18 months it was 2.0 (t3). The differences were highly significant in the Wilcoxon test. Discussion Short-term measurements showed that a significant pain reduction is possible in chronic postural low back pain using a sagittal re-alignment brace inducing lumbar re-lordosation. In a preliminary report at adjustment (t2), highly significant improvements of pain intensity have also been demonstrated. At 6 months of treatment however, no improvement was measured. The improvement of the mid-term effects (18 months) found in this study compared to the preliminary report may be due to the changed approach to compliance: whilst the bracing standard

  14. Techno-economic analysis of corn stover fungal fermentation to ethanol

    SciTech Connect

    Meyer, Pimphan A.; Tews, Iva J.; Magnuson, Jon K.; Karagiosis, Sue A.; Jones, Susanne B.

    2013-11-01

    This techno-economic analysis assesses the process economics of ethanol production from lignocellulosic feedstock by fungi to identify promising opportunities, and the research needed to achieve them. Based on literature derived data, four different ethanologen strains are considered in this study: native and recombinant Saccharomyces cerevisiae, the natural pentose-fermenting yeast, Pichia stipitis and the filamentous fungus Fusarium oxysporum. In addition, filamentous fungi are applied in multi-organism and consolidated process configurations. Organism performance and technology readiness are categorized as near-term (<5 years), mid-term (5-10 years), and long-term (>10 years) process deployment. The results of the analysis suggest that the opportunity for fungal fermentation exists for lignocellulosic ethanol production.

  15. ECASTAR: Energy Conservation; an Assessment of Systems, Technologies and Requirements

    NASA Technical Reports Server (NTRS)

    1975-01-01

    A methodology for a systems approach display and assessment of the potential for energy conservation actions and the impacts of those actions was presented. The U.S. economy is divided into four sectors: energy industry, industry, residential/commercial and transportation. Each sector is assessed with respect to energy conservation actions and impacts. The four sectors are combined and three strategies for energy conservation actions for the combined sectors are assessed. The three strategies (national energy conservation, electrification and diversification) represent energy conservation actions for the near term (now to 1985), the mid term (1985 to 2000) and the far term (2000 and beyond). The assessment procedure includes input/output analysis to bridge the flows between the sectors, and net economics and net energetics as performance criteria for the conservation actions. Targets of opportunity for large net energy net energy savings and the application of technology to achieve these savings are discussed.

  16. Mycotic aortic arch aneurysm coexistent with constrictive pericarditis: is surgery a dangerous resort?

    PubMed Central

    Yu, Peter S. Y.; Yu, Simon C. H.; Chu, Cheuk-Man; Kwok, Micky W. T.; Lam, Yuk-Hoi; Underwood, Malcolm J.

    2016-01-01

    An elderly man presented with fever and evidence of Salmonella infection, and was diagnosed to have coexisting constrictive pericarditis and mycotic aneurysm of the aortic arch. Pericardiectomy was performed under cardiopulmonary bypass with good result. To avoid deep hypothermic circulatory arrest, an aorto-brachiocephalic bypass, instead of total arch replacement, was performed. This was followed by a staged carotid-carotid bypass, thoracic endovascular stent graft placement. He was subsequently treated with prolonged antibiotics, and inflammatory marker normalized afterwards. He was last seen well 2 years after the operation. Follow-up computer tomography (CT) scan at 18 months post-op showed no evidence of endoleak or fistulation. Our case demonstrated that a hybrid treatment of open pericardiectomy and aortic debranching followed by thoracic endovascular stent graft placement is feasible and associated with satisfactory mid-term outcome. PMID:27621905

  17. Rat full term amniotic fluid harbors highly potent stem cells.

    PubMed

    Mun-Fun, Hoo; Ferdaos, Nurfarhana; Hamzah, Siti Nurusaadah; Ridzuan, Noridzzaida; Hisham, Nurul Afiqah; Abdullah, Syahril; Ramasamy, Rajesh; Cheah, Pike See; Thilakavathy, Karrupiah; Yazid, Mohd Nazri; Nordin, Norshariza

    2015-10-01

    Amniotic fluid stem cells (AFSCs) are commonly isolated from mid-term amniotic fluid (AF) of animals and human collected via an invasive technique, amniocentesis. Alternatively, AFSCs could be collected at full-term. However, it is unclear whether AFSCs are present in the AF at full term. Here, we aimed to isolate and characterize stem cells isolated from AF of full term pregnant rats. Three stem cell lines have been established following immuno-selection against the stem cell marker, c-kit. Two of the new lines expressed multiple markers of pluripotency until more than passage 90. Further, they spontaneously differentiated into derivatives of the three primary germ layers through the formation of good quality embryoid bodies (EBs), and can be directly differentiated into neural lineage. Their strong stemness and potent neurogenic properties highlight the presence of highly potent stem cells in AF of full-term pregnancies, which could serve as a potential source of stem cells for regenerative medicine.

  18. Supporting analyses and assessments

    SciTech Connect

    Ohi, J.

    1995-09-01

    Supporting analysis and assessments can provide a sound analytic foundation and focus for program planning, evaluation, and coordination, particularly if issues of hydrogen production, distribution, storage, safety, and infrastructure can be analyzed in a comprehensive and systematic manner. The overall purpose of this activity is to coordinate all key analytic tasks-such as technology and market status, opportunities, and trends; environmental costs and benefits; and regulatory constraints and opportunities-within a long-term and systematic analytic foundation for program planning and evaluation. Within this context, the purpose of the project is to help develop and evaluate programmatic pathway options that incorporate near and mid-term strategies to achieve the long-term goals of the Hydrogen Program. In FY 95, NREL will develop a comprehensive effort with industry, state and local agencies, and other federal agencies to identify and evaluate programmatic pathway options to achieve the long-term goals of the Program. Activity to date is reported.

  19. [New concepts in local burn wound therapy].

    PubMed

    Behr, B; Megerle, K O; Germann, G; Kloeters, O

    2008-12-01

    Local burn wound care represents an integral part in the treatment of burn victims. A primary treatment goal is to prevent superficial infections, which can lead to life-threatening bacteraemia and sepsis. Secondary goals include improvement of functional and aesthetic outcome of the regenerating skin or scar tissue. Within the last few years numerous innovations have been evolved and some have already been incorporated into the clinical routine. In line with this, the first mid-term studies can be found in the literature. For instance, a hydrosurgical system can now be used for debridement and novel skin substitutes like Suprathel and Matriderm are commercially available. This review article summarises the most recent innovations in local burn wound care and puts them into a scientific perspective.

  20. The quality of life and mortality risk of elderly people in rural China: the role of family support.

    PubMed

    Liu, Huijun; Xiao, Qunying; Cai, Yanzhi; Li, Shuzhuo

    2015-03-01

    The number of elderly in China's population is projected to grow well beyond the capacity of the nation's social security system. Meanwhile, family care is being challenged by a decline in fertility and an increase in migration from rural to urban areas. This article examines the short-term, mid-term, and long-term effects of family support on elderly well-being in rural China, using 4-wave panel data on 1456 persons aged 60 and older in the Chaohu region of China. Findings showed that compared with living alone, being coresident with others lowered the mortality risk of several chronic diseases, but being coresident with adult children increased the mortality risk of cardiovascular diseases, though it was associated with a higher quality of life in the short and middle terms. Children's educational attainment and financial support increased the quality of life except for an increased risk of new incidence of cardiovascular disease in the middle term.

  1. Application and future of solid foams

    NASA Astrophysics Data System (ADS)

    Bienvenu, Yves

    2014-10-01

    To conclude this series of chapters on solid foam materials, a review of industrial current applications and of mid-term market perspectives centred on manmade foams is given, making reference to natural cellular materials. Although the polymeric foam industrial development overwhelms the rest and finds applications on many market segments, more attention will be paid to the emerging market of inorganic-especially metallic-foams (and cellular materials) and their applications, present or upcoming. It is shown that the final applications of solid foams are primarily linked to transport and the present-day development of the different classes of solid foams is contrasted between functional applications and structural applications. xml:lang="fr"

  2. The in vitro immunoregulatory properties of cultured murine trophoblast are not unique to this tissue.

    PubMed Central

    Drake, B L; Rodger, J C

    1985-01-01

    Primary cultures of murine trophoblast (ectoplacental cone and mid-term placenta) and their supernatants were found to inhibit in vitro lymphocyte proliferative responses to concanavalin A (77-87%) and allo-antigen (52-84%). However, cultures and cell-conditioned media from non-trophoblastic tissues (embryonic sac, adult lung and liver, and B16 melanoma line) produced similar results. In all cases, the inhibitory effects were not due to reduced cell viability. Addition of anti-progesterone serum to the ectoplacental cone-lymphocyte co-cultures, at a concentration known to bind the available trophoblast-derived progesterone, did not overcome the observed suppression. The results clearly demonstrate that a range of cultured cell types, and their conditioned media, will suppress immune responses in vitro. We conclude that cultured trophoblast is not an appropriate model for studies of placental immunoregulation. PMID:3159651

  3. Observations on the effects of vibration and noise on plasma ACTH and zinc levels, pregnancy and respiration rate in the guineapig.

    PubMed

    Bailey, K J; Stephens, D B; Delaney, C E

    1986-04-01

    The responses of female guineapigs to vibration and noise were examined with the use of an apparatus designed to simulate transport. Peak levels of plasma ACTH and zinc concentrations were attained after 4 min of exposure to vibration and 80-90 dB of noise. The respiration rate, normally around 90/min, was increased to 103/min when the animals were moved (while still in their cages) to the experimental area; it rose to 129/min when the apparatus was switched on to expose the animals to vibration and noise. Those left adjacent to the apparatus and exposed to noise alone elevated their respiration rates to 115/min. Respiration rates returned to normal within 2.5 h. There was no apparent effect on the maintenance of pregnancy, gestation length, litter size or post-partum growth of the young born to guineapigs exposed to this vibration and noise for a period of 1 h at mid-term.

  4. Neurosciences research in space - Future directions

    NASA Technical Reports Server (NTRS)

    Sulzman, Frank M.; Wolfe, James W.

    1991-01-01

    In order to gain a better understanding of the effects of long-duration space missions on the central nervous system, near-term research, to take place from 1990-1995, will be directed at investigating the acute effects of microgravity and the 'space adaptation syndrome'. These include experiments scheduled for the Spacelab Life Sciences 1 which is designed to evaluate changes in the visual, vestibular, and proprioceptive systems. An extensive series of experiments, collectively termed Microgravity Vestibular Investigations (MVI), is also planned for the IML-1 mission to be flown in 1992. The IML-2 mission will emphasize behavior and performance, biological rhythms, and further vestibular studies. Mid-term goals, projected to be achieved from 1995-2000, include the use of new technology such as magnetic recording techniques. Long-term goals are also discussed including studies dealing with neuronal plasticity and sensory substitution, augmentation, and robotic telepresence.

  5. Photovoltaics at the Tipping Point: Taking Us from the Evolutionary to the Revolutionary

    SciTech Connect

    Kazmerski, L. L.

    2007-01-01

    We examine the current situation and future technology opportunities for solar photovoltaics (PV), emphasizing the importance of both policy and technology investments for the future markets and competitiveness of this solar approach. We review some examples of policy significantly impacting world markets and discuss the targets of the new U.S. Solar America Initiative. On the technology side, we present insights to technical and other investments needed to tip PV to its next level of contribution as a significant clean-energy partner in the world energy portfolio. The need to venture into disruptive and revolutionary technology pathways is argued for our needs in the mid term (the next 10-15 years) and the long term (beyond the first quarter of this century).

  6. A CPT-based Cs vapor cell atomic clock with a short-term fractional frequency stability of 3 x 10-13 τ-1/2

    NASA Astrophysics Data System (ADS)

    Abdel Hafiz, Moustafa; Liu, Xiaochi; Guérandel, Stéphane; De Clercq, Emeric; Boudot, Rodolphe

    2016-06-01

    This article reports on the development and short-term fractional frequency stability of a continuous-regime (CW) Cs vapor cell atomic clock based on coherent population trapping (CPT). The push-pull optical pumping technique is used to increase the number of atoms that participate to the clock transition, yielding a typical CPT resonance contrast of 25% for a CPT linewidth of about 450 Hz. The clock short-term fractional frequency stability is measured to be 3 x 10-13 τ-1/2 up to 100 seconds averaging time, in correct agreement with the signal-to-noise ratio limit. The mid-term frequency stability results are currently mainly limited by laser power effects. The detection of high-contrast narrow Raman-Ramsey fringes is demonstrated with this setup by making the atoms interact with a light pulse sequence.

  7. Toward water-gas shift enhancement and carbon capture in gasification environments

    SciTech Connect

    Morreale, B.D.; Howard, B.; Taylor, C.; Osemwengie, I.; Enick, R.M.; Miller, J.B.; Sholl, D.S.; Alfonso, D.R.; Ciocco, M.V.

    2007-08-01

    The United States Department of Energy's National Energy Technology Laboratory (NETL) is aggressively pursuing research and development directed towards mitigating apprehensions over fuel independence, energy availability and reliability and environmental issues, especially as related to global warming. The production of “synthesis gas” (syngas) from indigenous carbonaceous feedstocks has the potential to address some of these energy and environmental concerns. The abundance of coal in the US in conjunction with the flexibility of syngas, which can be converted to electricity, hydrogen and/or liquid fuels, is considered a promising near- to mid-term component in the transition to a renewable energy society. Hydrogen membranes, implemented as a means of separation or integrated as a water-gas shift membrane reactor (WGSMR), have been identified as a promising means of maximizing the production of pure hydrogen while simultaneously yielding a high-pressure, concentrated CO2-containing stream ready for sequestration.

  8. Isolation of a ribosome-inactivating and abortifacient protein from seeds of Luffa acutangula.

    PubMed

    Yeung, H W; Li, W W; Ng, T B

    1991-07-01

    A glycoprotein with a molecular weight of 28,000 as estimated by SDS-polyacrylamide gel electrophoresis was isolated from seeds of Luffa acutangula using a procedure that involved acetone precipitation, ion exchange chromatography on CM Sepharose CL-6B and gel filtration on Sephadex G-50. In immunodiffusion studies it was found to be immunologically distinct from abortifacient proteins isolated from other members of the Cucurbitaceae family including Momordica charantia, Momordica cochinchinensis, Trichosanthes kirilowii and Trichosanthes cucumeroides. There were some differences in amino acid composition among the proteins although there was a gross similarity. The protein from L. acutangula was capable of inducing mid-term abortion in mice and inhibiting protein synthesis in a cell-free system. PMID:1938101

  9. Psychology in the public service.

    PubMed

    Zimbardo, Philip G

    2002-01-01

    Philip G. Zimbardo outlines the challenges and opportunities he faces as the American Psychological Association's (APA's) 110th president. This article expands on remarks made in his introduction to Patrick H. DeLeon's presidential address at the APA's 2001 annual convention in San Francisco, California. Appearing now, mid-term in his presidency, that vision is a working blueprint of his activities and what he hopes to accomplish in his remaining tenure: enhancing psychologists' pride in psychology; developing more productive relationships with all media as gatekeepers to the public; publishing the standard high school psychology textbook; developing a compendium of all psychological research that illustrates how psychologists have made a significant difference in improving various aspects of the quality of life of individuals, groups, communities, and the United States; and encouraging greater unity of purpose and respect among psychologists across their many diverse domains and specialties.

  10. Seven to twelve year results with Versys ET cementless stem. A retrospective study of 225 cases.

    PubMed

    D'Angelo, Fabio; Murena, Luigi; Vulcano, Ettore; Zatti, Giovanni; Cherubino, Paolo

    2010-01-01

    A retrospective review was conducted to evaluate the mid-term results (8.5 years follow-up) of the Versys ET stem (Zimmer, Warsaw, Indiana, USA). From 1995 to 2000, 225 total hip arthroplasties (THA) were performed using this device. All patients were evaluated clinically by the Harris Hip Score, and radiographically. The Hip Score increased from 54 preoperatively to 97 points postoperatively. The stem displayed a varus alignment between 5 degrees and 10 degrees in 17 cases without any clinical consequences (HHS 96.8). We recorded one case of septic loosening and one case of aseptic loosening. The stability of the stem was radiographically evaluated according to Engh's criteria, confirming bone ongrowth in all other cases.

  11. The Etiology and Arthroscopic Surgical Management of Cam Lesions.

    PubMed

    Werner, Brian C; Gaudiani, Michael A; Ranawat, Anil S

    2016-07-01

    Cam-type deformity of the proximal femur is a relative increase in the discrepancy of the femoral head-neck offset. The etiology is unknown; several conditions have been implicated in the development of abnormal proximal femoral anatomy. Recent evidence suggests that high-impact sports place stress on the immature physis during growth and may play an important role. Imaging is essential in the initial diagnostic workup, characterization of pathology, preoperative planning, and intraoperative decision making. Short-term and mid-term outcomes for arthroscopic osteoplasty of cam lesions for both isolated cam-type deformity and mixed cam-pincer femoroacetabular impingement have been well-described and are favorable. PMID:27343392

  12. Periodicity of the solar radius revisited by using empirical mode decomposition and the Lomb-Scargle method

    NASA Astrophysics Data System (ADS)

    Qu, Zhi-Ning; Feng, Wen; Liang, Hong-Fei

    2015-06-01

    Using the Hilbert-Huang transform and the Lomb-Scargle method, we investigate periodicities in the daily solar radius data during the time interval from February 1978 to October 1999 derived from Calern Observatory. The following prominent periods are found: (1) the rotation cycle signal; (2) several mid-term periods including 122, 162.9 and 225 days, annual-variation periodicities (319 and 359 days), quasi-triennial oscillations (3.46 and 3.94 years); (3) the 11-year Schwabe cycle, which is in anti-phase with solar activity. This result indicates that the strong magnetic field associated with the Sun has a greater inhibitive effect on the radius variation. Supported by the National Natural Science Foundation of China.

  13. Mycotic aortic arch aneurysm coexistent with constrictive pericarditis: is surgery a dangerous resort?

    PubMed Central

    Yu, Peter S. Y.; Yu, Simon C. H.; Chu, Cheuk-Man; Kwok, Micky W. T.; Lam, Yuk-Hoi; Underwood, Malcolm J.

    2016-01-01

    An elderly man presented with fever and evidence of Salmonella infection, and was diagnosed to have coexisting constrictive pericarditis and mycotic aneurysm of the aortic arch. Pericardiectomy was performed under cardiopulmonary bypass with good result. To avoid deep hypothermic circulatory arrest, an aorto-brachiocephalic bypass, instead of total arch replacement, was performed. This was followed by a staged carotid-carotid bypass, thoracic endovascular stent graft placement. He was subsequently treated with prolonged antibiotics, and inflammatory marker normalized afterwards. He was last seen well 2 years after the operation. Follow-up computer tomography (CT) scan at 18 months post-op showed no evidence of endoleak or fistulation. Our case demonstrated that a hybrid treatment of open pericardiectomy and aortic debranching followed by thoracic endovascular stent graft placement is feasible and associated with satisfactory mid-term outcome.

  14. International spotlight: developing a gerontological social policy agenda for Turkey.

    PubMed

    Arun, Özgür

    2013-12-01

    From 1960 to 2013, the population of Turkey increased almost threefold, with older adults aged 65 and older increasing almost sevenfold. In light of the demographic revolution in the age composition of world populations, we investigated the following research questions from the perspective of Turkish gerontologists: What are the conditions of older people based on sociological factors such as gender, partnership status, income, education, health, religion, and ethnicity? What should Turkey's gerontological agenda contain for the short term, mid-term, and long term, particularly in view of the rapidly changing nature of political, social, and economic life in the country? By 2025, adults (aged 40-65) will make up the largest population group in Turkey's history. It is time for Turkey to embrace this demographic gift and identify its own gerontological agenda to pave the way for social justice and social citizenship.

  15. Seven to twelve year results with Versys ET cementless stem. A retrospective study of 225 cases.

    PubMed

    D'Angelo, Fabio; Murena, Luigi; Vulcano, Ettore; Zatti, Giovanni; Cherubino, Paolo

    2010-01-01

    A retrospective review was conducted to evaluate the mid-term results (8.5 years follow-up) of the Versys ET stem (Zimmer, Warsaw, Indiana, USA). From 1995 to 2000, 225 total hip arthroplasties (THA) were performed using this device. All patients were evaluated clinically by the Harris Hip Score, and radiographically. The Hip Score increased from 54 preoperatively to 97 points postoperatively. The stem displayed a varus alignment between 5 degrees and 10 degrees in 17 cases without any clinical consequences (HHS 96.8). We recorded one case of septic loosening and one case of aseptic loosening. The stability of the stem was radiographically evaluated according to Engh's criteria, confirming bone ongrowth in all other cases. PMID:20235069

  16. Mortality after percutaneous edge-to-edge mitral valve repair: a contemporary review

    PubMed Central

    de Beenhouwer, Thomas; Swaans, Martin J.; Post, Marco C.; van der Heyden, Jan A. S.; Eefting, Frank D.; Rensing, Benno J. W. M.

    2016-01-01

    Percutaneous edge-to-edge mitral valve (MV) repair is a relatively new treatment option for mitral regurgitation (MR). After the feasibility and safety having been proved in low-surgical-risk patients, the use of this procedure has shifted more to the treatment of high-risk patients. With the absence of randomized controlled trials (RCT) for this particular subgroup, observational studies try to add evidence to the safety aspect of this procedure. These also provide short- and mid-term mortality figures. Several mortality predictors have been identified, which may help the optimal selection of patients who will benefit most from this technique. In this article we provide an overview of the literature about mortality and its predictors in patients treated with the percutaneous edge-to-edge device. PMID:27054105

  17. World Energy Projection System Plus (WEPS ): Global Activity Module

    EIA Publications

    2016-01-01

    The World Energy Projection System Plus (WEPS ) is a comprehensive, mid?term energy forecasting and policy analysis tool used by EIA. WEPS projects energy supply, demand, and prices by country or region, given assumptions about the state of various economies, international energy markets, and energy policies. The Global Activity Module (GLAM) provides projections of economic driver variables for use by the supply, demand, and conversion modules of WEPS . GLAM’s baseline economic projection contains the economic assumptions used in WEPS to help determine energy demand and supply. GLAM can also provide WEPS with alternative economic assumptions representing a range of uncertainty about economic growth. The resulting economic impacts of such assumptions are inputs to the remaining supply and demand modules of WEPS .

  18. Bretton Woods Institution Narratives about Inequality and Economic Vulnerability on the Eve of South African Austerity.

    PubMed

    Bond, Patrick

    2015-01-01

    In South Africa, at a time when National Health Insurance should be generously funded (7 years after its approval as public policy by the ruling party), state fiscal austerity appears certain to nip the initiative in the bud. The World Bank and the International Monetary Fund issued separate reports about South Africa in late 2014, following a new finance minister's mid-term budget speech. In justifying austerity, they revealed 2 important conceptual blockages regarding inequality and international financial relations. The resulting political bias in the macroeconomic debate has, in turn, given neoliberal policy advocates intellectual weaponry to impose deeper austerity. In contrast, the rise of a "united front" of labor, community-based, and social movement activists, along with a vigorous left opposition party in Parliament, ensure that one of the world's most visible class struggles ratchets up in intensity in the years ahead.

  19. Trabecular Metal Augments for the Management of Paprosky Type III Defects Without Pelvic Discontinuity.

    PubMed

    Grappiolo, Guido; Loppini, Mattia; Longo, Umile Giuseppe; Traverso, Francesco; Mazziotta, Giuseppe; Denaro, Vincenzo

    2015-06-01

    Fifty-five hips undergoing acetabular reconstruction with trabecular metal (TM)-coated cup and TM augments were reviewed at an average follow up of 53.7 months (36-91). Bony defects were Paprosky type IIIA in 42 and type IIIB without pelvic discontinuity in 13 hips. The average HHS increased from 40 (27-52) preoperatively to 90.5 (61-100) postoperatively (P<0.0001). Four (7.3%) of 55 hips underwent acetabular components revision: three cases of loosening (5.4%), and one of recurrent instability (1.8%) were reported. Survival rate at 2 and 5 years was 96.4% and 92.8%. In conclusion, the use of TM-coated cups and augments could be considered an effective management of Paprosky type III defects without pelvic discontinuity providing good clinical and radiographic outcomes in the mid term.

  20. A critical friend: monitoring and evaluation systems, development cooperation and local government. The case of Tuscany.

    PubMed

    Rossignoli, Serena; Coticchia, Fabrizio; Mezzasalma, Annarosa

    2015-06-01

    The role of monitoring and evaluation (M&E) systems in the field of development cooperation has globally increased in last decades. International and regional organizations, as well as states, local governments and NGOs have largely adopted the tools provided by M&E in order to enhance transparency, effectiveness and efficiency. The paper aims at verifying how and to what extent the implementation of M&E systems has affected the overall quality of international cooperation projects financed by a local government. After a literature review on M&E in development cooperation, the research analyzes the wide range of activities (evaluation ex-ante, mid-term, final, monitoring, consultancy) carried out by the Evaluation Team of the XY in the last eight years in behalf of an Italian local government: the Region of Tuscany. The paper reveals the strategic significance of adopting M&E systems in the medium-long term.

  1. Fenestrated and Chimney Technique for Juxtarenal Aortic Aneurysm: A Systematic Review and Pooled Data Analysis

    PubMed Central

    Li, Yue; Hu, Zhongzhou; Bai, Chujie; Liu, Jie; Zhang, Tao; Ge, Yangyang; Luan, Shaoliang; Guo, Wei

    2016-01-01

    Juxtarenal aortic aneurysms (JAA) account for approximately 15% of abdominal aortic aneurysms. Fenestrated endovascular aneurysm repair (FEVAR) and chimney endovascular aneurysm repair (CH-EVAR) are both effective methods to treat JAAs, but the comparative effectiveness of these treatment modalities is unclear. We searched the PubMed, Medline, Embase, and Cochrane databases to identify English language articles published between January 2005 and September 2013 on management of JAA with fenestrated and chimney techniques to conduct a systematic review to compare outcomes of patients with juxtarenal aortic aneurysm (JAA) treated with the two techniques. We compared nine F-EVAR cohort studies including 542 JAA patients and 8 CH-EVAR cohorts with 158 JAA patients regarding techniques success rates, 30-day mortality, late mortality, endoleak events and secondary intervention rates. The results of this systematic review indicate that both fenestrated and chimney techniques are attractive options for JAAs treatment with encouraging early and mid-term outcomes. PMID:26869488

  2. Model documentation report: Residential sector demand module of the national energy modeling system

    SciTech Connect

    1998-01-01

    This report documents the objectives, analytical approach, and development of the National Energy Modeling System (NEMS) Residential Sector Demand Module. The report catalogues and describes the model assumptions, computational methodology, parameter estimation techniques, and FORTRAN source code. This reference document provides a detailed description for energy analysts, other users, and the public. The NEMS Residential Sector Demand Module is currently used for mid-term forecasting purposes and energy policy analysis over the forecast horizon of 1993 through 2020. The model generates forecasts of energy demand for the residential sector by service, fuel, and Census Division. Policy impacts resulting from new technologies, market incentives, and regulatory changes can be estimated using the module. 26 refs., 6 figs., 5 tabs.

  3. Overview of the Thermal Energy Storage (TES) Program

    NASA Astrophysics Data System (ADS)

    Gurevich, M.

    1981-03-01

    The program promotes energy savings and fuel substitution by developing and helping to commercialize technologies for storing heat or cold, with shot investment payback periods as a cost goal. The sources of energy include industrial and utility waste heat as well as primary sources such as solar, geothermal, nuclear and fossil fuels. The primary source of "cold" for seasonal storage is winter chilled air. The program emphasizes near-term (1980's) approaches to energy conservation and displacement of natural gas and oil. It also provides for development of technologies which will allow use of renewable resources such as solar-thermal energy during the mid-term (1990's) and advanced energy storage and transport techniques for the far-term (beyond 2000).

  4. [Femicide Across Europe COST Action, a transnational cooperation network for the study of and approach to femicide in Europe].

    PubMed

    Sanz-Barbero, Belén; Otero-García, Laura; Boira, Santiago; Marcuello, Chaime; Vives Cases, Carmen

    2016-01-01

    Femicide or the murder of women because of their gender is a recognised public health problem as well as a serious violation of human rights. Its magnitude worldwide is still unknown, given the methodological difficulties to differentiate these murders from other female homicides. The European Union programme entitled «European Cooperation in Science and Technology» (COST) launched the «Femicide across Europe» COST Action in 2013, establishing an optimal European framework for transnational cooperation among experts addressing great social and public health challenges such as femicide. This field note describes the main objectives, the participating groups of experts and the mid-term results of this experience. PMID:27321371

  5. Workplan for Catalyzing Collaboration with Amazonian Universities in the Large Scale Biosphere-Atmosphere Experiment in Amazonia (LBA)

    NASA Technical Reports Server (NTRS)

    Brown, I. Foster; Moreira, Adriana

    1997-01-01

    Success of the Large-Scale Biosphere-Atmospheric Experiment in Amazonia (LBA) program depends on several critical factors, the most important being the effective participation of Amazonian researchers and institutions. Without host-county counterparts, particularly in Amazonia, many important studies cannot he undertaken due either to lack of qualified persons or to legal constraints. No less important, the acceptance of the LBA program in Amazonia is also dependent on what LBA can do for improving the scientific expertise in Amazonia. Gaining the active investment of Amazonian scientists in a comprehensive research program is not a trivial task. Potential collaborators are few, particularly where much of the research was to be originally focused - the southern arc of Brazilian Amazonia. The mid-term goals of the LBA Committee on Training and Education are to increase the number of collaborators and to demonstrate that LBA will be of benefit to the region.

  6. High tibial osteotomy in varus knees: indications and limits

    PubMed Central

    LOIA, MARCO CORGIAT; VANNI, STEFANIA; ROSSO, FEDERICA; BONASIA, DAVIDE EDOARDO; BRUZZONE, MATTEO; DETTONI, FEDERICO; ROSSI, ROBERTO

    2016-01-01

    Opening wedge high tibial osteotomy (OWHTO) is a surgical procedure that aims to correct the weight-bearing axis of the knee, moving the loads laterally from the medial compartment. Conventional indications for OWHTO are medial compartment osteoarthritis and varus malalignment of the knee; recently OWHTO has been used successfully in the treatment of double and triple varus. OWHTO, in contrast to closing wedge high tibial osteotomy, does not require fibular osteotomy or peroneal nerve dissection, or lead to disruption of the proximal tibiofibular joint and bone stock loss. For these reasons, interest in this procedure has grown in recent years. The aim of this study is to review the literature on OWHTO, considering indications and prognostic factors (body mass index, grade of osteoarthritis, instability, range of movement and age), outcomes at mid-term follow-up, and limits of the procedure (slope modifications, patellar height changes and difficulties in conversion to a total knee arthroplasty). PMID:27602350

  7. High tibial osteotomy in varus knees: indications and limits

    PubMed Central

    LOIA, MARCO CORGIAT; VANNI, STEFANIA; ROSSO, FEDERICA; BONASIA, DAVIDE EDOARDO; BRUZZONE, MATTEO; DETTONI, FEDERICO; ROSSI, ROBERTO

    2016-01-01

    Opening wedge high tibial osteotomy (OWHTO) is a surgical procedure that aims to correct the weight-bearing axis of the knee, moving the loads laterally from the medial compartment. Conventional indications for OWHTO are medial compartment osteoarthritis and varus malalignment of the knee; recently OWHTO has been used successfully in the treatment of double and triple varus. OWHTO, in contrast to closing wedge high tibial osteotomy, does not require fibular osteotomy or peroneal nerve dissection, or lead to disruption of the proximal tibiofibular joint and bone stock loss. For these reasons, interest in this procedure has grown in recent years. The aim of this study is to review the literature on OWHTO, considering indications and prognostic factors (body mass index, grade of osteoarthritis, instability, range of movement and age), outcomes at mid-term follow-up, and limits of the procedure (slope modifications, patellar height changes and difficulties in conversion to a total knee arthroplasty).

  8. [Recommendations issued by the Spanish Society of Pediatric Infectious Diseases for the follow-up of the child exposed to the human immunodeficiency virus and to antiretroviral drugs during pregnancy and the neonatal period].

    PubMed

    Noguera Julian, A; De José, M I

    2012-06-01

    Human immunodeficiency virus vertical transmission in developed countries has dramatically decreased to less than 2% over the last 15 years due to the consecutive implementation of different prophylactic measures, including the use of antiretrovirals, elective cesarean section and refraining from breastfeeding. The follow-up of these otherwise healthy children is, by far, the most common situation related to HIV infection that general pediatricians currently face in routine clinical care in Spain. These recommendations issued by the Spanish Society of Pediatric Infectious Diseases attempt to summarize the main aspects of this follow-up, including birth management, type of feeding, neonatal antiretroviral prophylaxis, HIV infection diagnosis, common early comorbidities, short- and mid-term toxicities, vaccination and other prophylactic measures and long-term follow-up.

  9. [Endovascular repair for an acute traumatic aortic transection: a case report].

    PubMed

    Sanioğlu, Soner; Sahin, Sinan; Aydoğan, Hakki; Barutça, Hakan; Eren, Ergin

    2012-03-01

    A thirty-eight-year-old male patient who suffered from 10th and 11th thoracal vertebrae fractures, paraplegia and acute traumatic aortic transection because of accidental fall was referred to our hospital. Open surgical repair carried a very high risk due to severe coexisting injuries. Transection was treated with 30x100 mm Valiant thoracic endograft, which was deployed just distal to the ostium of the left carotid artery. The patient was transferred to the neurosurgery clinic for treatment of paraplegia after an uneventful recovery. Endovascular repair of acute transection confers substantial advantages in mortality and morbidity compared to surgical repair. However, the long-term durability of thoracic endografts remains unknown. If the long-term results are as satisfactory as the promising mid-term results, this technique may become the gold standard approach for the treatment of acute transection. PMID:22792827

  10. Survivorship and Complications of Revision Total Hip Arthroplasty with a Mid-Modular Femoral Stem.

    PubMed

    Riesgo, Aldo M; Hochfelder, Jason P; Adler, Edward M; Slover, James D; Specht, Lawrence M; Iorio, Richard

    2015-12-01

    We retrospectively reviewed 161 revision THAs with diaphyseal fitting, mid-modular femoral components performed by ten surgeons at two academic medical centers. The average follow-up was 6.1 years. At final follow-up, 4 patients required re-revision for failure of the femoral component; 3 (2%) for aseptic loosening and 1 for mechanical failure of stem in setting of periprosthetic fracture. There were a total of 24 (14.9%) revisions for any reason, with the most common reason being septic failure (10 of 24). To our knowledge, this is the largest reported series of mid-term survivorship and complications of revision THA with mid-modular femoral components. Our results show that these stems have a low rate of aseptic loosening, subsidence, and mechanical failure.

  11. Mechanically-Deployed Hypersonic Decelerator and Conformal Ablator Technologies for Mars Missions

    NASA Technical Reports Server (NTRS)

    Venkatapathy, Ethiraj; Wercinski, Paul F.; Beck, Robin A. S.; Hamm, Kenneth R.; Yount, Bryan C.; Makino, A.; Smith, B.; Gage, P.; Prabhu, D.

    2012-01-01

    The concept of a mechanically deployable hypersonic decelerator, developed initially for high mass (40 MT) human Mars missions, is currently funded by OCT for technology maturation. The ADEPT (Adaptive, Deployable Entry and Placement Technology) project has broad, game-changing applicability to in situ science missions to Venus, Mars, and the Outer Planets. Combined with maturation of conformal ablator technology (another current OCT investment), the two technologies provide unique low mass mission enabling capabilities otherwise not achievable by current rigid aeroshell or by inflatables. If this abstract is accepted, we will present results that illustrate the mission enabling capabilities of the mechanically deployable architecture for: (1) robotic Mars (Discovery or New Frontiers class) in the near term; (2) alternate approaches to landing MSL-class payloads, without the need for supersonic parachute or lifting entry, in the mid-term; and (3) Heavy mass and human missions to Mars in the long term.

  12. Use of learning styles to enhance graduate education.

    PubMed

    Murray, Cindy

    2011-01-01

    This study was carried out to help occupational therapy students utilize learning strategies necessary to be successful at the graduate level. Students completed The Kolb Learning Style Inventory and Motivation Strategies for Learning Questionnaire to identify their personal learning preferences. These preferences were used as the basis for a remediation program carried out during the second semester of the curriculum following less than adequate performance during the first semester in basic science content. At mid-term, all but one student was satisfied with her performance in neuroanatomy. Following a closer scrutiny of the dissatisfied student's approach to learning, the student and program developer devised a more comprehensive plan. By the end of the semester, all students successfully passed neuroanatomy while adequately balancing other courses within the semester. Given the initial positive results, the utilization of attention to learning styles as a means to direct student learning may be a promising model for struggling students in graduate education.

  13. 2nd Generation RLV Risk Definition Program

    NASA Technical Reports Server (NTRS)

    Davis, Robert M.; Stucker, Mark (Technical Monitor)

    2000-01-01

    The 2nd Generation RLV Risk Reduction Mid-Term Report summarizes the status of Kelly Space & Technology's activities during the first two and one half months of the program. This report was presented to the cognoscente Contracting Officer's Technical Representative (COTR) and selected Marshall Space Flight Center staff members on 26 September 2000. The report has been approved and is distributed on CD-ROM (as a PowerPoint file) in accordance with the terms of the subject contract, and contains information and data addressing the following: (1) Launch services demand and requirements; (2) Architecture, alternatives, and requirements; (3) Costs, pricing, and business cases analysis; (4) Commercial financing requirements, plans, and strategy; (5) System engineering processes and derived requirements; and (6) RLV system trade studies and design analysis.

  14. Mycotic aortic arch aneurysm coexistent with constrictive pericarditis: is surgery a dangerous resort?

    PubMed

    Yu, Peter S Y; Yu, Simon C H; Chu, Cheuk-Man; Kwok, Micky W T; Lam, Yuk-Hoi; Underwood, Malcolm J; Wong, Randolph H L

    2016-08-01

    An elderly man presented with fever and evidence of Salmonella infection, and was diagnosed to have coexisting constrictive pericarditis and mycotic aneurysm of the aortic arch. Pericardiectomy was performed under cardiopulmonary bypass with good result. To avoid deep hypothermic circulatory arrest, an aorto-brachiocephalic bypass, instead of total arch replacement, was performed. This was followed by a staged carotid-carotid bypass, thoracic endovascular stent graft placement. He was subsequently treated with prolonged antibiotics, and inflammatory marker normalized afterwards. He was last seen well 2 years after the operation. Follow-up computer tomography (CT) scan at 18 months post-op showed no evidence of endoleak or fistulation. Our case demonstrated that a hybrid treatment of open pericardiectomy and aortic debranching followed by thoracic endovascular stent graft placement is feasible and associated with satisfactory mid-term outcome. PMID:27621905

  15. [Tissue engineering and construction of human skin in vitro].

    PubMed

    Arvelo, Francisco

    2007-09-01

    Tissue engineering is the new science that has come to make possible the growth of new organ tissue from small fragments of healthy tissue, thus partially or totally restoring the lost functions of ill tissues or organs, as shown by the achievements made with the culture of skin, cornea or cartilage. Thus far, this new science is able to ensure the recovery of lost functions and, doubtlessly, in a near future will be capable of developing tissues and organs not unlike natural ones. In our laboratory we have began the development of tissue engineering techniques for the successful construction of in vitro skin with the aim at mid term of producing cornea and cartilage. In a first clinical trial, these techniques were applied in the treatment of chronic skin lesions and the advantages and reach of these new tools were demonstrated for the effective solution of problems with would otherwise not be easily solved through the use of conventional treatments.

  16. Emergency endovascular treatment of popliteal aneurysms.

    PubMed

    Saratzis, Athanasios; Melas, Nikolaos; Dixon, Hannah; Saratzis, Nikolaos

    2010-12-01

    Popliteal artery aneurysm (PAA), despite being rare, is the most common peripheral aneurysm. It can present as acute thrombosis and occlusion of the aneurysmal segment, and distal embolization, causing either chronic or acute limb ischemia. It has traditionally been treated with open surgical reconstruction. Endovascular repair of PAAs has recently been applied electively with a favourable early and mid-term outcome; however there is a lack of reports on the endovascular treatment of PAAs presenting with acute complications. This report describes the treatment of a thrombosed PAA in a 58 year old male using an endovascular stent-graft and also provides a systematic review of the literature on the emergency endovascular treatment of PAAs.

  17. Endovascular Treatment of Venous Occlusive Disease

    PubMed Central

    2008-01-01

    Endovascular treatment of acute and chronic iliac vein occlusions has proven to be safe and effective. Recanalization of chronic occlusions with balloon angioplasty and stenting can re-establish normal venous flow in the iliac veins and the IVC and relieve symptoms in the majority of treated patients. CDT with recanalization and stenting of underlying chronically obstructed iliofemoral segments is becoming the treatment of choice for patients with acute iliofemoral thrombosis, as anticoagulation and compression therapy alone are not satisfactory in preventing PTS. The new treatment modalities offer stimulating options for a patient group that is not adequately treated, neither by medical nor open surgical therapy. The substantial effort and additional costs of endovascular treatment appear to be justified by the encouraging mid-term results both for patients with acute and chronic occlusive iliofemoral disease. However, multi-center randomized prospective studies are required to further validate the role of these techniques. PMID:23555345

  18. Isolation of a ribosome-inactivating and abortifacient protein from seeds of Luffa acutangula.

    PubMed

    Yeung, H W; Li, W W; Ng, T B

    1991-07-01

    A glycoprotein with a molecular weight of 28,000 as estimated by SDS-polyacrylamide gel electrophoresis was isolated from seeds of Luffa acutangula using a procedure that involved acetone precipitation, ion exchange chromatography on CM Sepharose CL-6B and gel filtration on Sephadex G-50. In immunodiffusion studies it was found to be immunologically distinct from abortifacient proteins isolated from other members of the Cucurbitaceae family including Momordica charantia, Momordica cochinchinensis, Trichosanthes kirilowii and Trichosanthes cucumeroides. There were some differences in amino acid composition among the proteins although there was a gross similarity. The protein from L. acutangula was capable of inducing mid-term abortion in mice and inhibiting protein synthesis in a cell-free system.

  19. [Indicators, variables and obstacles to the life cycle of scientific and technical information in health. Experiences of the Centro Nacional de Información y Documentación en Salud in Mexico].

    PubMed

    Macías-Chapula, C A

    1987-01-01

    Indicators, variables and barriers to scientific and technical health information have been detected and described by CENIDS in Mexico within the life cycle of the information production model, covering the phases of: a) generation; b) institutionalization; c) maintenance/development; and d) distribution/dissemination. Emphasis is placed on the important role that play social, economic, demographic, and political factors of each developing country to conform their ideal information life cycle. After an analysis of the existing Mexican situation, and a short description of CENIDS' structure, organization, functions and services, CENIDS' short-term and mid-term projects, and suggestions for further research lines to improve the current situation in Mexico are also given.

  20. [Spanish National Plan for Scientific Research, Development and Innovation 2008-2011: an opportunity for healthcare research].

    PubMed

    Catalá-López, Ferrán; Contreras, Mónica

    2008-01-01

    Research in health sciences is a core element for success in any strategy aiming to improve health in today's society. The search for a safe, effective and efficient healthcare, that guarantees citizens equitable access to health services, has placed evidence-based clinical practice and research in healthcare in the front line. In this context, the Spanish National Plan for Scientific Research, Development and Innovation (R&D&I) 2008-2011 is the programming tool through which objectives and priorities of the national research policy are set in the mid-term. The present document is an approach to the current Spanish National Plan for R&D&I 2008-2011, which also describes current opportunities for developing research in health care within the Spanish National Health System. PMID:18579065

  1. NextGen Far-Term Concept Exploration for Integrated Gate-to-Gate Trajectory-Based Operations

    NASA Technical Reports Server (NTRS)

    Johnson, Sally C.; Barmore, Bryan E.

    2016-01-01

    NASA is currently conducting concept exploration studies toward the definition of a far-term, gate-to-gate concept for Trajectory-Based Operations. This paper presents a basic architectural framework for the far-term concept and discusses some observations about implementation of trajectory-based operations in the National Airspace System. Within the concept, operators and service providers collaboratively negotiate aircraft trajectories, providing agile, optimized, aircraft-specific routing to meet service provider gate-to-gate flow-management constraints and increasing capacity by smoothly and effectively combining flight-deck-based and ground-based metering, merging, and spacing in a mixed-equipage environment. The far-term TBO concept is intended to influence the direction of mid-term TBO research and to inform the definition of stable requirements and standards for TBO communications infrastructure and user equipage.

  2. Recurrent Dislocation of the Patella

    PubMed Central

    Benítez, Gustavo

    2015-01-01

    Purpose: To evaluate results of medial patellofemoral ligament (MPFL) reconstruction associated with lateral release and advancement of vastus medialis in recurrent dislocation of the patella. Methods: We retrospectively evaluated 11 patients with a mean follow-up of 19 months. Mean age was 23, mainly women. We did MPFL reconstruction with semitendinosus or gracilis tendon depending on BMI, associated with advancement of vastus medialis and lateral release. Results: Mean Kujala score improved from 46,54 pts. preoperative to 88,36 postoperative. Our main complication was 1 patient with rigid knee, who required movilization under anesthesia and arthroscopic arthrolisis to improve her outcome. Conclusion: The combination of this techniques are a good alternative to treat patients with recurrent patella disclocation, with good short and mid-term results. Biomechanic intra and postop complications of MPFL reconstruction are related to patellar fixation, anatomic positioning of femoral tunnel and knee position of the graft fixation.

  3. [Tissue engineering and construction of human skin in vitro].

    PubMed

    Arvelo, Francisco

    2007-09-01

    Tissue engineering is the new science that has come to make possible the growth of new organ tissue from small fragments of healthy tissue, thus partially or totally restoring the lost functions of ill tissues or organs, as shown by the achievements made with the culture of skin, cornea or cartilage. Thus far, this new science is able to ensure the recovery of lost functions and, doubtlessly, in a near future will be capable of developing tissues and organs not unlike natural ones. In our laboratory we have began the development of tissue engineering techniques for the successful construction of in vitro skin with the aim at mid term of producing cornea and cartilage. In a first clinical trial, these techniques were applied in the treatment of chronic skin lesions and the advantages and reach of these new tools were demonstrated for the effective solution of problems with would otherwise not be easily solved through the use of conventional treatments. PMID:17853796

  4. Three strategies for conservation

    NASA Technical Reports Server (NTRS)

    1975-01-01

    The three strategies considered as energy conservation oriented were given: national energy conservation, electrification, and diversification. The first one applies to the near term period (now-1985), the second one to the mid term (1985-2000), and the third one to the far term (2000- ). The rest of this section was focussed on the near term period. The following proposed actions were considered: (1) roll back the price of newly discovered oil, (2) force conversion of many power plants from gas and oil to coal, (3) freeze gasoline production for three years at 1972 levels, (4) mandate automobile mileage requirements, (5) require industry to improve energy efficiency, and (6) require manufacture of household appliances with greater efficiency. Each of these six actions was described and discussed in more detail.

  5. KTP laser stapedotomy with a self-crimping, thermal shape memory Nitinol piston: follow-up study reporting intermediate-term hearing.

    PubMed

    Gerlinger, Imre; Bakó, Péter; Piski, Zalán; Révész, Péter; Ráth, Gábor; Karosi, Tamás; Lujber, László

    2014-12-01

    The aim of this study was an evaluation of the mid-term hearing results after the implantation of a self-crimping heat memory Nitinol piston in stapes surgery. The 12-month postoperative results were compared with those at a minimum of 3 years (maximum 6.7, average 4.4 years). The medical records of all 44 patients who underwent surgery with a Nitinol piston for stapes fixation between November 2005 and January 2007 were evaluated retrospectively. The prostheses used in all cases measured either 4.5 or 4.75 × 0.6 mm. We hypothesized that the 12-month postoperative hearing results would be permanent after an average follow-up of 4.4 years. Thirty-two of the 44 consecutive patients were females and 12 were males. Their mean age was 40.4 years (range 27-69). All underwent a 12-month postoperative audiometric evaluation. 38 (30 females, 8 males, average age 45, range 28-77 years) of the 44 were available for mid-term 4.4-year (minimum 3 years, maximum 6.7 years) postoperative audiometric evaluation. The mean air-bone gap (ABG) for the frequencies 0.5, 1, 2 and 3 kHz at the 12-month postoperative follow-up was 11 dB (SD 4.1) and that after an average 4.4-year postoperative evaluation was 6.4 dB (SD 3.6). The mean decrease in ABG after 12 months was 19.5 dB, and that after the average 4.4 years was 21.3 dB. ABG closure within 10 dB was achieved in 77.2 % after 12 months and in 89.5 % after the average 4.4 years. No patient with an ABG > 20 dB was recorded after the average 4.4 years. The mean air conduction threshold at 4 kHz was examined pre and postoperatively so as to indicate any possible inner ear damage. At the 12-month follow-up, the difference between the pre and postoperative values was -2.5 dB, whereas after the average 4.4 years the difference was surprisingly +13 dB. The individual AC improvements were also demonstrated with the use of Amsterdam Hearing Evaluation Plots (AHEPs). The Nitinol prosthesis allowed excellent intraoperative handling and no

  6. High tibial osteotomy in varus knees: indications and limits.

    PubMed

    Loia, Marco Corgiat; Vanni, Stefania; Rosso, Federica; Bonasia, Davide Edoardo; Bruzzone, Matteo; Dettoni, Federico; Rossi, Roberto

    2016-01-01

    Opening wedge high tibial osteotomy (OWHTO) is a surgical procedure that aims to correct the weight-bearing axis of the knee, moving the loads laterally from the medial compartment. Conventional indications for OWHTO are medial compartment osteoarthritis and varus malalignment of the knee; recently OWHTO has been used successfully in the treatment of double and triple varus. OWHTO, in contrast to closing wedge high tibial osteotomy, does not require fibular osteotomy or peroneal nerve dissection, or lead to disruption of the proximal tibiofibular joint and bone stock loss. For these reasons, interest in this procedure has grown in recent years. The aim of this study is to review the literature on OWHTO, considering indications and prognostic factors (body mass index, grade of osteoarthritis, instability, range of movement and age), outcomes at mid-term follow-up, and limits of the procedure (slope modifications, patellar height changes and difficulties in conversion to a total knee arthroplasty). PMID:27602350

  7. Silicon CVD on powders in fluidized bed: Experimental and multifluid Eulerian modelling study

    SciTech Connect

    Cadoret, L.; Reuge, N; Pannala, Sreekanth; Syamlal, M; Coufort, C; Caussat, B

    2007-01-01

    The Computational Fluid Dynamics code MFIX was used for transient simulations of silicon Fluidized Bed Chemical Vapor Deposition (FBCVD) from silane (SiH4) on coarse alumina powders. FBCVD experiments were first performed to obtain a reference database for modelling. Experimental thermal profiles existing along the bed were considered in the model. 3D simulations provide better results than 2D ones and predict silane conversion rate with a mean deviation of 9% compared to experimental values. The model can predict the temporal and spatial evolutions of local void fractions, gas and particle velocities, species gas fractions and silicon deposition rate. We aim at mid term to model FBCVD treatments of submicronic powders in a vibrated reactor since we have performed experiments proving the efficacy of the process to treat submicronic particles.

  8. Silicon CVD on powders in fluidized bed: Experimental and multifluid Eulerian modelling study

    SciTech Connect

    Cadoret, L.; Reuge, N.; Pannala, S.; Syamlal, M.; Coufort, C.; Caussat, B.

    2007-09-25

    The Computational Fluid Dynamics code MFIX was used for transient simulations of silicon Fluidized Bed Chemical Vapor Deposition (FBCVD) from silane (SiH4) on coarse alumina powders. FBCVD experiments were first performed to obtain a reference database for modelling. Experimental thermal profiles existing along the bed were considered in the model. 3D simulations provide better results than 2D ones and predict silane conversion rate with a mean deviation of 9% compared to experimental values. The model can predict the temporal and spatial evolutions of local void fractions, gas and particle velocities, species gas fractions and silicon deposition rate. We aim at mid term to model FBCVD treatments of submicronic powders in a vibrated reactor since we have performed experiments proving the efficacy of the process to treat submicronic particles.

  9. Chapter 1.03: Solar Photovoltaics Technology: No Longer an Outlier

    SciTech Connect

    Kazmerski, L. L.

    2012-01-01

    The status and future technology, market, and industry opportunities for solar photovoltaics are examined and discussed. The co-importance of both policy and technology investments for the future markets and competitiveness of this solar approach is emphasized. This paper underscores the technology side, with a comprehensive overview and insights to technical, policy, market, industry and other investments needed to tip photovoltaics to its next level of contribution as a significant clean-energy partner in the world energy economy. The requirement to venture from near-term and evolutionary approaches into disruptive and revolutionary technology pathways is argued for our needs in the mid-term (the next 10-15 years) and the long-term (beyond the first quarter of this century).

  10. [Diuretics in heart failure and Karl Popper's turkey].

    PubMed

    Cice, Gennaro

    2015-12-01

    Heart failure and renal failure often coexist in the same patient. This condition is commonly referred to as cardiorenal syndrome. When this occurs, patient survival worsens significantly with increasing degree of renal dysfunction. Management of this complex patient poses treatment challenges because of unstable hemodynamics (the problem is to reduce congestion without affecting organ perfusion) and very high mid-term in-hospital mortality. Congestion is a typical feature of this syndrome, and use of diuretics is mandatory. Loop diuretics should be administered first. However, poor attention to pharmacodynamic and pharmacokinetic properties of loop diuretics may contribute to the development of diuretic resistance leading to iatrogenic hyponatremia. Accordingly, emphasis is given to the importance of sequential nephron blockade to reduce the number of non-responder patients to diuretics and to recognize a possible role for acquaretics.

  11. The management of bone loss in revision total knee arthroplasty: rebuild, reinforce, and augment.

    PubMed

    Sculco, P K; Abdel, M P; Hanssen, A D; Lewallen, D G

    2016-01-01

    The treatment of bone loss in revision total knee arthroplasty has evolved over the past decade. While the management of small to moderate sized defects has demonstrated good results with a variety of traditional techniques (cement and screws, small metal augments, impaction bone grafting or modular stems), the treatment of severe defects continues to be problematic. The use of a structural allograft has declined in recent years due to an increased failure rate with long-term follow-up and with the introduction of highly porous metal augments that emphasise biological metaphyseal fixation. Recently published mid-term results on the use of tantalum cones in patients with severe bone loss has reaffirmed the success of this treatment strategy. PMID:26733657

  12. Peak load demand forecasting using two-level discrete wavelet decomposition and neural network algorithm

    NASA Astrophysics Data System (ADS)

    Bunnoon, Pituk; Chalermyanont, Kusumal; Limsakul, Chusak

    2010-02-01

    This paper proposed the discrete transform and neural network algorithms to obtain the monthly peak load demand in mid term load forecasting. The mother wavelet daubechies2 (db2) is employed to decomposed, high pass filter and low pass filter signals from the original signal before using feed forward back propagation neural network to determine the forecasting results. The historical data records in 1997-2007 of Electricity Generating Authority of Thailand (EGAT) is used as reference. In this study, historical information of peak load demand(MW), mean temperature(Tmean), consumer price index (CPI), and industrial index (economic:IDI) are used as feature inputs of the network. The experimental results show that the Mean Absolute Percentage Error (MAPE) is approximately 4.32%. This forecasting results can be used for fuel planning and unit commitment of the power system in the future.

  13. Climate indices over the last three decades in Tunisia using Weather Research and Forecasting Model:WRF

    NASA Astrophysics Data System (ADS)

    Deli, Meriem; Mkhinini, Nadia; Sadok Guellouz, Mohamed; Benjabrallah, Sadok

    2016-04-01

    Tunisia is a country situated in the south of the mediterannen basin. This region undergoes direct and indirect effects of climate change. Actually, we notice that summer temperatures have risen during the last decades. Nevertheless research on the tunisian climate are not well developed and are mainly based on observations; short and mid term forecast are not available for the tunisian case. In this context we have studied the climate properties of Tunisia over the last 30 years using Weather Research and Forecasting model WRF. Afterwards we compared our results to the observations that we have obteined on behalf of the National Institute of Meteorology. Results were then used to calculate different climate indices related to the air temperature such as extreme values during a specific period exceeding specific limits (Percentile), warm and cold spell duration and growing season length. We admit that we have created a reliable database for the Tunisian climate.

  14. Dumb and Lazy? A Comparison of Color Learning and Memory Retrieval in Drones and Workers of the Buff-Tailed Bumblebee, Bombus terrestris, by Means of PER Conditioning.

    PubMed

    Lichtenstein, Leonie; Sommerlandt, Frank M J; Spaethe, Johannes

    2015-01-01

    More than 100 years ago, Karl von Frisch showed that honeybee workers learn and discriminate colors. Since then, many studies confirmed the color learning capabilities of females from various hymenopteran species. Yet, little is known about visual learning and memory in males despite the fact that in most bee species males must take care of their own needs and must find rewarding flowers to obtain food. Here we used the proboscis extension response (PER) paradigm to study the color learning capacities of workers and drones of the bumblebee, Bombus terrestris. Light stimuli were paired with sucrose reward delivered to the insects' antennae and inducing a reflexive extension of the proboscis. We evaluated color learning (i.e. conditioned PER to color stimuli) in absolute and differential conditioning protocols and mid-term memory retention was measured two hours after conditioning. Different monochromatic light stimuli in combination with neutral density filters were used to ensure that the bumblebees could only use chromatic and not achromatic (e.g. brightness) information. Furthermore, we tested if bees were able to transfer the learned information from the PER conditioning to a novel discrimination task in a Y-maze. Both workers and drones were capable of learning and discriminating between monochromatic light stimuli and retrieved the learned stimulus after two hours. Drones performed as well as workers during conditioning and in the memory test, but failed in the transfer test in contrast to workers. Our data clearly show that bumblebees can learn to associate a color stimulus with a sugar reward in PER conditioning and that both workers and drones reach similar acquisition and mid-term retention performances. Additionally, we provide evidence that only workers transfer the learned information from a Pavlovian to an operant situation.

  15. Effect of forced exercise and exercise withdrawal on memory, serum and hippocampal corticosterone levels in rats.

    PubMed

    Radahmadi, Maryam; Alaei, Hojjatallah; Sharifi, Mohammad Reza; Hosseini, Nasrin

    2015-10-01

    Evidence suggests that there are positive effects of exercise on learning and memory. Moreover, some studies have demonstrated that forced exercise plays the role of a stressor. This study was aimed at investigating the effects of different timing of exercise and exercise withdrawal on memory, and serum and hippocampal corticosterone (CORT) levels. Wistar rats were randomly divided into five groups: control, sham, exercise-rest (exercise withdrawal), rest-exercise (exercised group), and exercise-exercise (continuous exercise). Rats were forced to run on a treadmill for 1 h/day at a speed 20-21-m/min. Memory function was evaluated by the passive avoidance test in different intervals (1, 7 and 21 days) after foot shock. Findings showed that after the exercise withdrawal, short-term and mid-term memories, had significant enhancement compared to the control group, while the long-term memory did not present this result. In addition, the serum and hippocampal CORT levels were at the basal levels after the rest period in the exercise-rest group. In the rest-exercise group, exercise improved mid- and long-term memories, whereas continuous exercise improved all types short-, mid- and long-term memories, particularly the mid-term memory. Twenty-one and forty-two days of exercise significantly decreased the serum and hippocampal CORT levels. It seems that exercise for at least 21 days with no rest could affect biochemical factors in the brain. Also, regular continuous exercise plays an important role in memory function. Hence, the duration and withdraw of exercise are important factors for the neurobiological aspects of the memory responses.

  16. Outcomes of Thoracic Endovascular Aortic Repair and Subclavian Revascularization Techniques

    PubMed Central

    Zamor, Kimberly C; Eskandari, Mark K; Rodriguez, Heron E; Ho, Karen J; Morasch, Mark D; Hoel, Andrew W

    2015-01-01

    Background Practice guidelines regarding management of the left subclavian artery (LSA) during thoracic endovascular aortic repair (TEVAR) are based on low quality evidence and there is limited literature that addresses optimal revascularization techniques. The purpose of this study is to compare outcomes of LSA coverage during TEVAR and revascularization techniques. Study Design We performed a single-center retrospective cohort study from 2001–2013. Patients were categorized by LSA revascularization and by revascularization technique, carotid-subclavian bypass (CSB) or subclavian-carotid transposition (SCT). Thirty-day and mid-term stroke, spinal cord ischemia, vocal cord paralysis, upper extremity ischemia, primary patency of revascularization, and mortality were compared. Results Eighty patients underwent TEVAR with LSA coverage, 25% (n=20) were unrevascularized and the remaining patients underwent CSB (n=22, 27.5%) or SCT (n=38, 47.5%). Mean follow-up time was 24.9 months. Comparisons between unrevascularized and revascularized patients were significant for a higher rate of 30-day stroke (25% vs. 2%, p=0.003) and upper extremity ischemia (15% vs. 0%, p=0.014). However, there was no difference in 30-day or mid-term rates of spinal cord ischemia, vocal cord paralysis, or mortality. There were no statistically significant differences in 30-day or midterm outcomes for CSB vs. SCT. Primary patency of revascularizations was 100%. Survival analysis comparing unrevascularized vs. revascularized LSA, was statistically significant for freedom from stroke and upper extremity ischemia, p=0.02 and p=0.003, respectively. After adjustment for advanced age, urgency and coronary artery disease, LSA revascularization was associated with lower rates of peri-operative adverse events (OR 0.23, p=0.034). Conclusions During TEVAR, LSA coverage without revascularization is associated with an increased risk of stroke and upper extremity ischemia. When LSA coverage is required during

  17. Three-Year Follow-up of Conservative Treatments of Shoulder Osteoarthritis in Older Patients.

    PubMed

    Guo, Jiong Jiong; Wu, Kailun; Guan, Huaqing; Zhang, Lei; Ji, Cheng; Yang, Huilin; Tang, Tiansi

    2016-07-01

    Little is known about the mid-term results of nonsurgical treatment for shoulder osteoarthritis (OA), especially in a Chinese population. This study sought to determine the efficacy of nonsurgical management in older patients with shoulder OA. A total of 129 conservatively treated unilateral shoulder OA patients who were older than 65 years were evaluated prospectively at the initial office visit and then subsequently at 3, 6, 12, 18, 24, and 36 months later. During the 36-month follow-up period, all patients could receive conventional therapy, such as nonsteroidal anti-inflammatory medication, corticosteroid injection, sodium hyaluronate, and education, at the discretion of treating physicians. Some patients received physiotherapy, rehabilitation training, and a shoulder strap to improve the range of motion and muscular strength training from a physical therapist. Parameters measured included comparative effectiveness of each therapeutic method, visual analog scale (VAS), Simple Shoulder Test (SST), and Short Form (36) Health Survey (SF-36) scores. At 3-year follow-up, most patients had a significant increase from their pretreatment values in pain, self-assessed shoulder function, mental health, and 5 of 8 SF-36 domains. The study showed a decline in SST and VAS at 6 and 12 months after an initial ascent at 3 months, and then it was rescued and continued at 3-year follow-up. Combined therapy could improve symptoms significantly. This study suggests that a conservative approach may be more appropriate and can produce satisfactory mid-term outcomes in selected cases. The findings of this study suggest that conservative treatments should be extended for longer than 12 months before the decision regarding shoulder arthroplasty is made. [Orthopedics. 2016; 39(4):e634-e641.]. PMID:27286050

  18. Vascular Plug Assisted Retrograde Transvenous Obliteration (PARTO) for Gastric Varix Bleeding Patients in the Emergent Clinical Setting

    PubMed Central

    Yang, Heechul; Lee, Chun Kyon; Kim, Gun Bea

    2016-01-01

    Purpose To evaluate the technical feasibility and safety of vascular plug assisted retrograde transvenous obliteration (PARTO) for bleeding gastric varix performed in the emergent clinical setting and describe the mid-term clinical results. Materials and Methods From April 2012 to January 2015, emergent PARTO was tried in total 9 patients presented with active gastric varix bleeding. After initial insufficient or failure of endoscopic approach, they underwent PARTO in the emergent clinical setting. Gelatin sponge embolization of both gastrorenal (GR) shunt and gastric varix was performed after retrograde transvenous placement of a vascular plug in GR shunt. Coil assisted RTO (CARTO) was performed in one patient who had challenging GR shunt anatomy for vascular plug placement. Additional embolic materials, such as microcoils and NBCA glue-lipiodol mixture, were required in three patients to enhance complete occlusion of GR shunt or obliteration of competitive collateral vessels. Clinical success was defined as no variceal rebleeding and disappearance of gastric varix. Results All technical and clinical success–i.e., complete GR shunt occlusion and offending gastric varix embolization with immediate bleeding control–was achieved in all 9 patients. There was no procedure-related complication. All cases showed successful clinical outcome during mean follow up of 17 months (12–32 months), evidenced by imaging studies, endoscopy and clinical data. In 4 patients, mild worsening of esophageal varices or transient ascites was noted as portal hypertensive related change. Conclusion Emergent PARTO is technically feasible and safe, with acceptable mid-term clinical results, in treating active gastric varix bleeding. PMID:27189294

  19. Neurosciences research in space Future directions

    NASA Astrophysics Data System (ADS)

    Sulzman, Frank M.; Wolfe, James W.

    Future research in the neurosciences can best be understood in the context of NASA's life sciences goals in the near term (1990-1995), mid term (1995-2000), and long term (2000 and beyond). Since NASA is planning short-duration Spacelab and International Microgravity Laboratory (IML) flights for many years to come, the acute effects of exposure to microgravity will continue to be of experimental and operational interest in the near term. To this end, major new areas of research will be devoted to ground-based studies of preflight adaptation trainers and their efficacy in preventing or reducing the incidence of space motion sickness. In addition, an extensive series of studies of the vestibular system will be conducted inflight on the IML-1 mission The IML-2 mission will emphasize behavior and performance, biological rhythms, and further vestibular studies. In the mid-term period, Spacelab missions will employ new technology such as magnetic recording techniques in order to evaluate changes in the processing of sensory and motor inputs at the brainstem and cortical level during exposure to microgravity. Two Space Life Sciences (SLS) missions planned for the mid to late 1990's, SLS-4 and SLS-5, will utilize an onboard centrifuge facility that will enable investigators to study the effects of partial gravity on sensory and motor function. In the long term (2000 and beyond), Space Station Freedom and long-duration missions will provide opportunities to explore new options in the neurosciences, such as sensory substitution and augmentation, through the use of physical sensors to provide three-dimensional tactile-visual, tactile-auditory and tactile-somatosensory inputs. The use of this technology will be extremely important in the area of robotic telepresence. Finally, Space Station Freedom and proposed LifeSat missions will provide neuroscientists the opportunity to study the effects of partial gravity and microgravity on neuronal plasticity.

  20. Three-Year Follow-up of Conservative Treatments of Shoulder Osteoarthritis in Older Patients.

    PubMed

    Guo, Jiong Jiong; Wu, Kailun; Guan, Huaqing; Zhang, Lei; Ji, Cheng; Yang, Huilin; Tang, Tiansi

    2016-07-01

    Little is known about the mid-term results of nonsurgical treatment for shoulder osteoarthritis (OA), especially in a Chinese population. This study sought to determine the efficacy of nonsurgical management in older patients with shoulder OA. A total of 129 conservatively treated unilateral shoulder OA patients who were older than 65 years were evaluated prospectively at the initial office visit and then subsequently at 3, 6, 12, 18, 24, and 36 months later. During the 36-month follow-up period, all patients could receive conventional therapy, such as nonsteroidal anti-inflammatory medication, corticosteroid injection, sodium hyaluronate, and education, at the discretion of treating physicians. Some patients received physiotherapy, rehabilitation training, and a shoulder strap to improve the range of motion and muscular strength training from a physical therapist. Parameters measured included comparative effectiveness of each therapeutic method, visual analog scale (VAS), Simple Shoulder Test (SST), and Short Form (36) Health Survey (SF-36) scores. At 3-year follow-up, most patients had a significant increase from their pretreatment values in pain, self-assessed shoulder function, mental health, and 5 of 8 SF-36 domains. The study showed a decline in SST and VAS at 6 and 12 months after an initial ascent at 3 months, and then it was rescued and continued at 3-year follow-up. Combined therapy could improve symptoms significantly. This study suggests that a conservative approach may be more appropriate and can produce satisfactory mid-term outcomes in selected cases. The findings of this study suggest that conservative treatments should be extended for longer than 12 months before the decision regarding shoulder arthroplasty is made. [Orthopedics. 2016; 39(4):e634-e641.].

  1. Single-Bundle Anterior Cruciate Ligament Reconstruction with Semitendinosus Tendon Using the PINN-ACL CrossPin System: Minimum 4-Year Follow-up

    PubMed Central

    Baek, Seung-Gil; Lee, Byoung-Joo; Lee, Chang-Hwa

    2015-01-01

    Purpose This study evaluated mid-term results of anterior cruciate ligament (ACL) reconstruction using the PINN-ACL CrossPin system that allowed for short graft fixation. Materials and Methods Forty-three patients underwent single-bundle ACL reconstruction with a 4-strand semitendinosus tendon graft using the PINN-ACL CrossPin system. Femoral fixation was done using the PINN-ACL CrossPin system, and the tibial side was fixed with post-tie and a bioabsorbable interference screw. The mean follow-up period was 50 months. Evaluation was done using the Lachman test, pivot-shift test, International Knee Documentation Committee (IKDC) score and grade. Anterior displacement was assessed. Results There was improvement in the Lachman test and pivot-shift test at final follow-up, form grade II (n=40) or III (n=3) to grade I (n=3) or 0 (n=40) and from grade I (n=20) or II (n=10) to grade I (n=8) or 0 (n=22), respectively. The mean IKDC score was 88.7, and grade A and B were 93.0% at final follow-up. Side-to-side difference was improved from 6.7 mm to 2.1 mm at final follow-up. Complications occurred in 3 patients, a re-ruptured due to trauma at 2 years after surgery and a deep infection and a superficial infection. Conclusions The mid-term follow-up results of ACL reconstruction with the PINN-ACL CrossPin system were satisfactory. The PINN-ACL CrossPin can be considered as a useful instrument for short graft fixation. PMID:25750893

  2. Prognostic value of the ratio between prosthesis area and indexed annulus area measured by MultiSlice-CT for transcatheter aortic valve implantation procedures

    PubMed Central

    Debry, Nicolas; Sudre, Arnaud; Elquodeimat, Ibrahim; Delhaye, Cédric; Schurtz, Guillaume; Bical, Antoine; Koussa, Mohamad; Fattouch, Khalil; Modine, Thomas

    2016-01-01

    Background Postprocedural aortic regurgitations following transcatheter aortic valve implantation (TAVI) procedures remain an issue. Benefit of oversizing strategies to prevent them isn't well established. We compared different level of oversizing in our cohort of consecutive patients to address if severe oversizing compared to normal sizing had an impact on post-procedural outcomes. Methods From January 2010 to August 2013, consecutive patients were referred for TAVI with preoperative Multislice-CT (MSCT) and the procedures were achieved using Edwards Sapien® or Corevalve devices®. Retrospectively, according to pre-procedural MSCT and the valve size, patients were classified into three groups: normal, moderate and severe oversizing; depending on the ratio between the prosthesis area and the annulus area indexed and measured on MSCT. Main endpoint was mid-term mortality and secondary endpoints were the Valve Academic Research Consortium (VARC-2) endpoints. Results Two hundred and sixty eight patients had a MSCT and underwent TAVI procedure, with mainly Corevalve®. While all-cause and cardiovascular mortality rates were similar in all groups, post-procedural new pacemaker (PM) implantation rate was significantly higher in the severe oversizing group (P = 0.03), while we observed more in-hospital congestive heart-failure (P = 0.02) in the normal sizing group. There was a trend toward more moderate to severe aortic regurgitation (AR) in the normal sizing group (P = 0.07). Conclusions Despite a higher rate of PM implantation, oversizing based on this ratio reduces aortic leak with lower rates of post-procedural complications and a similar mid-term survival. PMID:27582762

  3. Using Ensemble Streamflows for Power Marketing at Bonneville Power Administration

    NASA Astrophysics Data System (ADS)

    Barton, S. B.; Koski, P.

    2014-12-01

    Bonneville Power Administration (BPA) is a federal non-profit agency within the Pacific Northwest responsible for marketing the power generated from 31 federal hydro projects throughout the Columbia River Basin. The basin encompasses parts of five states and portions of British Columbia, Canada. BPA works with provincial entities, federal and state agencies, and tribal members to manage the water resources for a variety of purposes including flood risk management, power generation, fisheries, irrigation, recreation, and navigation. This basin is subject to significant hydrologic variability in terms of seasonal volume and runoff shape from year to year which presents new water management challenges each year. The power generation planning group at BPA includes a team of meteorologists and hydrologists responsible for preparing both short-term (up to three weeks) and mid-term (up to 18 months) weather and streamflow forecasts including ensemble streamflow data. Analysts within the mid-term planning group are responsible for running several different hydrologic models used for planning studies. These models rely on these streamflow ensembles as a primary input. The planning studies are run bi-weekly to help determine the amount of energy available, or energy inventory, for forward marketing (selling or purchasing energy up to a year in advance). These studies are run with the objective of meeting the numerous multi-purpose objectives of the basin under the various streamflow conditions within the ensemble set. In addition to ensemble streamflows, an ensemble of seasonal volume forecasts is also provided for the various water conditions in order to set numerous constraints on the system. After meeting all the various requirements of the system, a probabilistic energy inventory is calculated and used for marketing purposes.

  4. Dumb and Lazy? A Comparison of Color Learning and Memory Retrieval in Drones and Workers of the Buff-Tailed Bumblebee, Bombus terrestris, by Means of PER Conditioning

    PubMed Central

    Lichtenstein, Leonie; Sommerlandt, Frank M. J.; Spaethe, Johannes

    2015-01-01

    More than 100 years ago, Karl von Frisch showed that honeybee workers learn and discriminate colors. Since then, many studies confirmed the color learning capabilities of females from various hymenopteran species. Yet, little is known about visual learning and memory in males despite the fact that in most bee species males must take care of their own needs and must find rewarding flowers to obtain food. Here we used the proboscis extension response (PER) paradigm to study the color learning capacities of workers and drones of the bumblebee, Bombus terrestris. Light stimuli were paired with sucrose reward delivered to the insects’ antennae and inducing a reflexive extension of the proboscis. We evaluated color learning (i.e. conditioned PER to color stimuli) in absolute and differential conditioning protocols and mid-term memory retention was measured two hours after conditioning. Different monochromatic light stimuli in combination with neutral density filters were used to ensure that the bumblebees could only use chromatic and not achromatic (e.g. brightness) information. Furthermore, we tested if bees were able to transfer the learned information from the PER conditioning to a novel discrimination task in a Y-maze. Both workers and drones were capable of learning and discriminating between monochromatic light stimuli and retrieved the learned stimulus after two hours. Drones performed as well as workers during conditioning and in the memory test, but failed in the transfer test in contrast to workers. Our data clearly show that bumblebees can learn to associate a color stimulus with a sugar reward in PER conditioning and that both workers and drones reach similar acquisition and mid-term retention performances. Additionally, we provide evidence that only workers transfer the learned information from a Pavlovian to an operant situation. PMID:26230643

  5. The Use of the 'Preclosure' Technique for Antegrade Aspiration Thrombectomy with Large Catheters in Acute Limb Ischemia

    SciTech Connect

    Funke, C. Pfiffner, R.; Husmann, M.; Pfammatter, T.

    2013-04-15

    This study was designed to assess retrospectively short- and mid-term outcomes of the use of a suture-mediated closure device to close the antegrade access in patients undergoing percutaneous aspiration thrombectomy with large catheters for acute leg ischemia. Between November 2005 and February 2010, a suture-mediated active closure system (ProGlide{sup Registered-Sign} 6F, Abbott) was placed before arterial sheath (mean 9 F, range 6-12 F) introduction in 101 patients (74 men, 73 %, mean age 70.1 {+-} 12.6 years standard deviation). Data regarding mortality, complications, and factors contributing to vascular complications at the access site was collected for 6 month after the intervention to detect device-related problems. As a coincidence, 77 patients had follow-up visits for a duplex ultrasound. There were a total of 19 vascular complications (19 %) at the puncture site, all of which were of hemorrhagic nature and none of which consisted of vessel occlusion. Two major outcome complications (2 %) occurred. A retroperitoneal hematoma and a serious inguinal bleeding required additive treatment and did not result in permanent sequelae. Nine cases involved death of which eight were not attributable to the closure and one remained unclear. Successful closure was achieved in 95 patients (94 %); additional manual compression was sufficient in the majority of the remaining patients. Numerous factors contributing to vascular complications were encountered. With acceptable short- and mid-term outcomes, the 'preclose' technique can be a reliable option for the closure of a large antegrade femoral access even for patients at a high risk of vascular complications, such as those undergoing aspiration thrombectomy.

  6. Effect of traditional Chinese exercise on the quality of life and depression for chronic diseases: a meta-analysis of randomised trials

    PubMed Central

    Wang, Xueqiang; Pi, Yanling; Chen, Binglin; Chen, Peijie; Liu, Yu; Wang, Ru; Li, Xin; Zhu, Yi; Yang, Yujie; Niu, Zhanbin

    2015-01-01

    Traditional Chinese exercise (TCE) has many uses in the prevention and treatment of chronic diseases. However, there is no consensus regarding the benefit of TCE for chronic diseases. Our objective is to examine the effect of TCE on the quality of life and depression for chronic diseases by performing a meta-analysis of randomized controlled trials (RCTs). We only cover published RCTs. The outcome measures included quality of life and depression. Sixty articles with a total of 4311 patients were included. The pooling revealed that TCE could improve the SF-36 physical function subscale in the short term [SMD (95% CI) = 0.35 (0.13, 0.56), P = 0.002] and mid-term [SMD (95% CI) = 0.49 (0.12, 0.85), P = 0.009], GHQ [SMD (95% CI) = −0.68 (−1.26, −0.09), P = 0.02], the Center for Epidemiologic Studies depression scale in the short term [SMD (95% CI) = −0.86 (−1.42, −0.31), P = 0.002] and mid-term [SMD (95% CI) = −0.41 (−0.64, −0.18), P < 0.001]. The meta-analysis of RCT demonstrates that TCE can significantly improve the quality of life and depression of patients with chronic diseases. These findings provide useful information for patients with chronic diseases as well as for medical staff. PMID:26525282

  7. Dumb and Lazy? A Comparison of Color Learning and Memory Retrieval in Drones and Workers of the Buff-Tailed Bumblebee, Bombus terrestris, by Means of PER Conditioning.

    PubMed

    Lichtenstein, Leonie; Sommerlandt, Frank M J; Spaethe, Johannes

    2015-01-01

    More than 100 years ago, Karl von Frisch showed that honeybee workers learn and discriminate colors. Since then, many studies confirmed the color learning capabilities of females from various hymenopteran species. Yet, little is known about visual learning and memory in males despite the fact that in most bee species males must take care of their own needs and must find rewarding flowers to obtain food. Here we used the proboscis extension response (PER) paradigm to study the color learning capacities of workers and drones of the bumblebee, Bombus terrestris. Light stimuli were paired with sucrose reward delivered to the insects' antennae and inducing a reflexive extension of the proboscis. We evaluated color learning (i.e. conditioned PER to color stimuli) in absolute and differential conditioning protocols and mid-term memory retention was measured two hours after conditioning. Different monochromatic light stimuli in combination with neutral density filters were used to ensure that the bumblebees could only use chromatic and not achromatic (e.g. brightness) information. Furthermore, we tested if bees were able to transfer the learned information from the PER conditioning to a novel discrimination task in a Y-maze. Both workers and drones were capable of learning and discriminating between monochromatic light stimuli and retrieved the learned stimulus after two hours. Drones performed as well as workers during conditioning and in the memory test, but failed in the transfer test in contrast to workers. Our data clearly show that bumblebees can learn to associate a color stimulus with a sugar reward in PER conditioning and that both workers and drones reach similar acquisition and mid-term retention performances. Additionally, we provide evidence that only workers transfer the learned information from a Pavlovian to an operant situation. PMID:26230643

  8. Does a period of detraining cause a decrease in serum brain-derived neurotrophic factor?

    PubMed

    Goekint, Maaike; Roelands, Bart; De Pauw, Kevin; Knaepen, Kristel; Bos, Inge; Meeusen, Romain

    2010-12-17

    Brain-derived neurotrophic factor (BDNF) is one of the neurotrophins promoting cognitive function and contributing to neurogenesis and neuroprotection. Available evidence suggests that exercise influences serum BDNF concentrations, but that the effect is transient. The purpose of this study is to determine whether a period of aerobic training, followed by a period of detraining, can influence basal serum BDNF levels in humans. Sixteen young, sedentary subjects were assigned to an experimental group (n=9) and a control group (n=7). The experimental group performed an aerobic training program during 8 weeks, followed by 8 weeks of detraining, during which subjects returned to their previous, sedentary activity level. The control group remained physically inactive during 16 weeks. In both groups, performance on short-term (Digit Span test) and mid-term memory (Recall of Images) was assessed. Aerobic training significantly increased the VO(2) peak in the experimental group, and these values returned to baseline after 8 weeks of detraining. Basal serum BDNF was not influenced by 8 weeks of aerobic training and detraining did not seem to have an effect on basal peripheral BDNF concentrations. Both training and detraining did not clearly influence short-term memory performance on the Digit Span test and no differences were present between the experimental and control group on the mid-term memory test. Future studies should focus on patient groups and elderly to further investigate the effect of training and detraining on neurotrophic factors and cognitive function, and on the effects of training and detraining on the BDNF response to acute exercise.

  9. Strength training does not influence serum brain-derived neurotrophic factor.

    PubMed

    Goekint, Maaike; De Pauw, Kevin; Roelands, Bart; Njemini, Rose; Bautmans, Ivan; Mets, Tony; Meeusen, Romain

    2010-09-01

    The purpose of the study was to examine the acute effect of a strength training session on brain-derived neurotrophic factor and insulin-like growth factor 1. Furthermore, the influence of a 10-week strength training program on brain-derived neurotrophic factor (BDNF) and insulin-like growth factor-1 (IGF-1) resting levels and memory performance was studied. Fifteen untrained subjects followed a strength training program for 10 weeks. Eight control subjects remained physically inactive. To study the influence of an acute strength training session, blood samples were taken before and after the sixth and 30th sessions. Training effects were evaluated by taking blood samples at rest before and following the training program. Short- and mid-term memories were assessed using the digit span and a recall of images test. BDNF, IGF-1 and its binding protein (IGFBP-3) were measured in serum samples. Data were analyzed (p < 0.05) using a mixed design ANOVA model, Duncan's multiple range post hoc tests, and Pearson's correlation. A single strength training session did not influence BDNF and IGF-1 concentrations. No effect of the strength training period on BDNF, IGF-1, and IGFBP-3 was found. No correlation was found between peripheral BDNF and IGF-1. Short-term memory improved in both the experimental and control groups, but no difference between groups was present. Mid-term memory did not improve following the 10 weeks of training. A period of strength training in sedentary subjects does not significantly change the growth factors or memory function compared to a control group. Also, BDNF and IGF-1 are not acutely influenced by a training session. Further research should focus on the beneficial role of physical exercise in neurodegenerative diseases.

  10. Effect of collaborative testing on learning and retention of course content in nursing students

    PubMed Central

    RIVAZ, MOZHGAN; MOMENNASAB, MARZIEH; SHOKROLLAHI, PAYMANEH

    2015-01-01

    Introduction Collaborative testing is a learning strategy that provides students with the opportunity to learn and practice collaboration. This study aimed to determine the effect of collaborative testing on test performance and retention of course content in nursing students of Shiraz University of Medical Sciences, Shiraz, Iran. Methods This quasi-experimental study was carried out on 84 students enrolled in the course of Medical-Surgical 2 in Spring 2013 and Fall 2013 semesters. The control group consisting of 39 students participated in the first mid-term exam in an individual format. The intervention group, on the other hand, consisted of 45 students who took the test in a two-stage process. The first stage included an individual testing, while the second stage was a collaborative one given in groups of five individuals chosen randomly. Four weeks later, in order to investigate retention of the course content, both groups took part in the second mid-term exam held individually. Results The study findings showed significant difference between the mean scores in the intervention group in the Fall 2013 semester (p=0.001). Besides, a statistically significant difference was found between the two groups regarding the tests mean scores (p=0.001). Moreover, retention of course content improved in the collaborative group (p=0.001). Conclusion The results indicated an increase in test performance and a long-term learning enhancement in collaborative testing compared with the traditional method. Collaborative testing, as an active learning technique and a valuable assessment method, can help nursing instructors provide the alumni with strong problem-solving and critical thinking abilities at healthcare environments. PMID:26457315

  11. Neurosciences research in space: future directions.

    PubMed

    Sulzman, F M; Wolfe, J W

    1991-01-01

    Future research in the neurosciences can best be understood in the context of NASA's life sciences goals in the near term (1990-95), mid term (1995-2000), and long term (2000 and beyond). Since NASA is planning short-duration Spacelab and International Microgravity Laboratory (IML) flights for many years to come, the acute effects of exposure to microgravity will continue to be of experimental and operational interest in the near term. To this end, major new areas of research will be devoted to ground-based studies of preflight adaptation trainers and their efficacy in preventing or reducing the incidence of space motion sickness. In addition, an extensive series of studies of the vestibular system will be conducted inflight on the IML-1 mission The IML-2 mission will emphasize behavior and performance, biological rhythms, and further vestibular studies. In the mid-term period, Spacelab missions will employ new technology such as magnetic recording techniques in order to evaluate changes in the processing of sensory and motor inputs at the brainstem and cortical level during exposure to microgravity. Two Space Life Sciences (SLS) missions planned for the mid to late 1990's, SLS-4 and SLS-5, will utilize an onboard centrifuge facility that will enable investigators to study the effects of partial gravity on sensory and motor function. In the long term (2000 and beyond), Space Station Freedom and long-duration missions will provide opportunities to explore new options in the neurosciences, such as sensory substitution and augmentation, through the use of physical sensors to provide three-dimensional tactile-visual, tactile-auditory and tactile-somatosensory inputs. The use of this technology will be extremely important in the area of robotic telepresence. Finally, Space Station Freedom and proposed LifeSat missions will provide neuroscientists the opportunity to study the effects of partial gravity and microgravity on neuronal plasticity.

  12. Faecal retention: a common cause in functional bowel disorders, appendicitis and haemorrhoids--with medical and surgical therapy.

    PubMed

    Raahave, Dennis

    2015-03-01

    The present studies explored whether faecal retention in the colon is a causative factor in functional bowel disease, appendicitis, and haemorrhoids. Faecal retention was characterized by colon transit time (CTT) after radio-opaque marker ingestion and estimation of faecal loading on abdominal radiographs at 48 h and 96 h. Specific hypotheses were tested in patients (n = 251 plus 281) and in healthy random controls (n = 44). A questionnaire was completed for each patient, covering abdominal and anorectal symptoms and without a priori grouping. Patients with functional bowel disorders, predominantly women, had a significantly increased CTT and faecal load compared to controls. The CTT was significantly and positively correlated with segmental and total faecal loading. The faecal load was equal at 48 h and 96 h, mirroring the presence of permanent faecal reservoirs. In these first clinical studies to correlate bowel symptoms with CTT and colon faecal loading, abdominal bloating was significantly correlated with faecal loading in the right colon, total faecal load, and CTT. Abdominal pain was significantly and positively correlated to distal faecal loading and significantly associated with bloating. A new phenomenon with a high faecal load and a normal CTT was observed in a subset of patients (n = 90), proving faecal retention as hidden constipation. The CTT and faecal load were significantly higher in the right-side compared to the left and distal segments. Within the control group of healthy persons, the right-sided faecal load was significantly greater than the left and distal load. The CTT and faecal load significantly positively correlated with a palpable mass in the left iliac fossa and meteorism. Cluster analysis revealed that CTT and faecal load positively correlated with a symptom factor consisting of bloating, proctalgia and infrequent defecation of solid faeces. On the other hand, CTT and faecal load negatively correlated with a symptom factor comprising

  13. Faecal retention: a common cause in functional bowel disorders, appendicitis and haemorrhoids--with medical and surgical therapy.

    PubMed

    Raahave, Dennis

    2015-03-01

    The present studies explored whether faecal retention in the colon is a causative factor in functional bowel disease, appendicitis, and haemorrhoids. Faecal retention was characterized by colon transit time (CTT) after radio-opaque marker ingestion and estimation of faecal loading on abdominal radiographs at 48 h and 96 h. Specific hypotheses were tested in patients (n = 251 plus 281) and in healthy random controls (n = 44). A questionnaire was completed for each patient, covering abdominal and anorectal symptoms and without a priori grouping. Patients with functional bowel disorders, predominantly women, had a significantly increased CTT and faecal load compared to controls. The CTT was significantly and positively correlated with segmental and total faecal loading. The faecal load was equal at 48 h and 96 h, mirroring the presence of permanent faecal reservoirs. In these first clinical studies to correlate bowel symptoms with CTT and colon faecal loading, abdominal bloating was significantly correlated with faecal loading in the right colon, total faecal load, and CTT. Abdominal pain was significantly and positively correlated to distal faecal loading and significantly associated with bloating. A new phenomenon with a high faecal load and a normal CTT was observed in a subset of patients (n = 90), proving faecal retention as hidden constipation. The CTT and faecal load were significantly higher in the right-side compared to the left and distal segments. Within the control group of healthy persons, the right-sided faecal load was significantly greater than the left and distal load. The CTT and faecal load significantly positively correlated with a palpable mass in the left iliac fossa and meteorism. Cluster analysis revealed that CTT and faecal load positively correlated with a symptom factor consisting of bloating, proctalgia and infrequent defecation of solid faeces. On the other hand, CTT and faecal load negatively correlated with a symptom factor comprising

  14. Stroke risk in the early period after carotid related symptoms: a systematic review.

    PubMed

    Tsantilas, P; Kühnl, A; Kallmayer, M; Knappich, C; Schmid, S; Kuetchou, A; Zimmermann, A; Eckstein, H H

    2015-12-01

    Current guidelines recommend performing carotid endarterectomy in patients with symptomatic carotid disease as soon as possible after the neurological index event. However, early stroke risk has not been well documented for this patient group. We therefore conducted a systematic analysis of the current literature on the recurrent risk of ischemic events in patients with symptomatic carotid stenosis. Systematic review was performed by searching the MEDLINE® database from 1950 until June 8, 2015 (key words: cerebral ischemia, transient ischemic attack, amaurosis fugax, stroke, symptomatic carotid stenosis, recurrent risk, outcome, prognosis, follow-up, cohort and natural history). All studies reporting stroke risks in patients with symptomatic carotid stenosis after neurologic index events within a period of 7 days were included. Cumulative stroke risks with 95% confidence intervals after a neurologic index event were recalculated at 2-3, 7, 14 and 30 days and a meta-analysis including an analysis of heterogeneity were performed using the statistical package R and Excel for Mac 2003. Ten studies with a total number of 2634 patients were included. Results of an overall stroke risk were as follows: 2.0-17.2% at 2-3 days, 0-22.1% at 7 days, 0-29.6% at 14 days and 0-11.1% at 30 days in patients with a symptomatic extracranial carotid stenosis. The pooled stroke risk in the six studies with active follow-up was 6.0% (95% CI 2.4-14.4) at 2-3 days, 10.9% (6.1-18.7) at 7 days and 17.6% (9.7-29.9) at 14 days. Pooled stroke risk in the three studies with uncensored populations was even higher with 6.4% (1.5-23.8%) at 2-3 days, 19.5% (12.7-28.7) at 7 days and 26.1% (20.6-32.5%) at 14 days. Significant heterogeneity (P<0.001) could be explained by the different inclusion criteria and the study's design. Retrospective studies with passive follow-up had the lowest stroke risk whereas prospective studies with active follow-up and without bias through early intervention by carotid

  15. Impact of set-aside management on soil mesofauna

    NASA Astrophysics Data System (ADS)

    Landi, Silvia; d'Errico, Giada; Mazza, Giuseppe; Mocali, Stefano; Bazzoffi, Paolo; Roversi, Pio Federico

    2014-05-01

    (MI) resulted significantly higher in set-aside managements than in conventional crops in Fagna and Metaponto sites. In contrast, Caorle was characterized by a significant soil degradation (prevalence of extreme colonizers) and any increase of MI values in the set-aside have been not detected. About microarthropods, the taxa richness was significantly higher in set-aside managements than conventional crops in all the sites sampled. QBS index showed the same trend, but the differences were not significant. Caorle site was characterized by a lack of balance in the relative abundance among soil microarthropods taxa. In particular, set-aside managements showed a strong prevalence of an aggressive ants Solenopsis fugax (Hymenoptera: Formicidae). In conclusion, the best results were observed in Fagna and Metaponto sites, where MI and QBS values increased under set-aside management as compared to the conventional. Further analyses will be carried out over a long period to better understand the possible correlation between the enhancement of the organic matter observed in the soils less degraded and the biological quality improvement.

  16. Impacts of Climate change on the watershed of the hydropower reservoir Gigerwaldsee using hydrological modeling

    NASA Astrophysics Data System (ADS)

    Etter, Simon; Seibert, Jan; Vis, Marc; Addor, Nans; Huss, Matthias; Finger, David

    2015-04-01

    Increasing temperatures and changing precipitation patterns will diminish snow cover and force glaciers to shrink in mountain environments. The runoff in Alpine catchments such as the watershed of the Gigerwaldsee, providing water resources for hydro power production in the Swiss Alps, will be affected by those changes. Using an updated version of the conceptual hydrological model HBV-light future hydro-climatic changes in the catchment where simulated. The hydrological model was driven by seven GCM-RCM combinations from the ENSEMBLES project under the emission scenario A1B. The climate projections were bias-corrected using quantile mapping. Besides a baseline scenario (1992-2021), a mid-term future scenario (2036-2065) and a long term scenario (2069-2098) were calculated. For calibration, the model was driven with a gridded dataset from MeteoSwiss and glacier extents from 1990. The calibration was performed using three datasets: i) discharge data, derived from a volume-lake level relationship of the Gigerwaldsee, ii) the fraction of the snow covered area in the catchment, retrieved from MODIS snowcover images and iii) extrapolated glacier mass balances. The parameters were determined using Pareto selection from 10'000 Monte Carlo simulation runs according to their performance over five objective functions. Two objective functions were used to evaluate the discharge simulation and two for snow cover, whereof one rated the simulation over the whole year and one only during summer. A fifth objective function was used for glacier mass balance simulations. An evaluation of different selections of parameter sets showed that relying on discharge, snowcover and glacier mass balance data led to a higher model consistency. The contribution of the climate scenarios, model parameters and glacier scenarios to the total uncertainty of the simulated future discharge was assessed using analysis of variance (ANOVA). The results indicate a decrease in runoff during the high flow

  17. Effectiveness of a 'Global Postural Reeducation' program for persistent Low Back Pain: a non-randomized controlled trial

    PubMed Central

    2010-01-01

    Background The aim of this non-randomized controlled trial was to evaluate the effectiveness of a Global Postural Reeducation (GPR) program as compared to a Stabilization Exercise (SE) program in subjects with persistent low back pain (LBP) at short- and mid-term follow-up (ie. 3 and 6 months). Methods According to inclusion and exclusion criteria, 100 patients with a primary complaint of persistent LBP were enrolled in the study: 50 were allocated to the GPR group and 50 to the SE group. Primary outcome measures were Roland and Morris Disability Questionnaire (RMDQ) and Oswestry Disability Index (ODI). Secondary outcome measures were lumbar Visual Analogue Scale (VAS) and Fingertip-to-floor test (FFT). Data were collected at baseline and at 3/6 months by health care professionals unaware of the study. An intention to treat approach was used to analyze participants according to the group to which they were originally assigned. Results Of the 100 patients initially included in the study, 78 patients completed the study: 42 in the GPR group and 36 in the SE group. At baseline, the two groups did not differ significantly with respect to gender, age, BMI and outcome measures. Comparing the differences between groups at short- and mid-term follow-up, the GPR group revealed a significant reduction (from baseline) in all outcome measures with respect to the SE group. The ordered logistic regression model showed an increased likelihood of definitive improvement (reduction from baseline of at least 30% in RMDQ and VAS scores) for the GPR group compared to the SE group (OR 3.9, 95% CI 2.7 to 5.7). Conclusions Our findings suggest that a GPR intervention in subjects with persistent LBP induces a greater improvement on pain and disability as compared to a SE program. These results must be confirmed by further studies with higher methodological standards, including randomization, larger sample size, longer follow-up and subgrouping of the LBP subjects. Trial registration NCT

  18. Lysosomal and tissue-level biomarkers in mussels cross-transplanted among four estuaries with different pollution levels.

    PubMed

    Lekube, Xabier; Izagirre, Urtzi; Soto, Manu; Marigómez, Ionan

    2014-02-15

    A 3-4 wk cross-transplantation experiment was carried out in order to investigate the sensitivity, rapidity, durability and reversibility of lysosomal and tissue-level biomarkers in the digestive gland of mussels. Four localities in the Basque coast with different levels of chemical pollution and environmental stress were selected. Lysosomal membrane stability (LP) and lysosomal structural changes (VvL; S/VL; NvL) and changes in cell-type composition in digestive gland epithelium (VvBAS) were investigated to determine short (2d) and mid-term (3-4 wk) responses after cross-transplantation. Mussels from Txatxarramendi presented VvBAS<0.1 μm(3)/μm(3) (unstressed) whilst VvBAS>0.12 μm(3)/μm(3) was recorded in mussels from Plentzia (moderate stress) and VvBAS>0.2 μm(3)/μm(3) in Arriluze and Muskiz (high stress). Accordingly, LP<10 min (high stress) was recorded in mussels from Muskiz and Arriluze and LP~15 min (low-to-moderate stress) in those from Plentzia and Txatxarramendi. According to the VvL, S/VL and NvL data, a certain lysosomal enlargement was envisaged in mussels from Arriluze in comparison with those from Txatxarramendi and Plentzia. Mussels from Muskiz exhibited a peculiar endo-lysosomal system made of abundant tiny lysosomes (low VvL and high S/VL and NvL values). Lysosomal and tissue-level biomarkers were responsive after 2d cross-transplantation between the reference and the polluted localities, which indicated that these biomarkers were quickly induced and, to a large extent, reversible. Moreover, the tissue-level biomarker values were maintained during the entire period (3-4 wk) of cross-transplantation, which evidenced the durability of the responsiveness. In contrast, comparisons in the mid-term were unfeasible for lysosomal biomarkers as these exhibited a seasonal winter attenuation resulting from low food availability and low temperatures. In conclusion, lysosomal enlargement and membrane stability and changes in cell-type composition were

  19. Mid- and long-term clinical results of surgical therapy in unicameral bone cysts

    PubMed Central

    2011-01-01

    Background Unicameral (or simple) bone cysts (UBC) are benign tumours most often located in long bones of children and adolescents. Pathological fractures are common, and due to high recurrence rates, these lesions remain a challenge to treat. Numerous surgical procedures have been proposed, but there is no general consensus of the ideal treatment. The aim of this investigation therefore was to study the long-term outcome after surgical treatment in UBC. Methods A retrospective analysis of 46 patients surgically treated for UBC was performed for short and mid-term outcome. Clinical and radiological outcome parameters were studied according to a modified Neer classification system. Long-term clinical information was retrieved via a questionnaire at a minimum follow-up of 10 years after surgery. Results Forty-six patients (17 female, 29 male) with a mean age of 10.0 ± 4.8 years and with histopathologically confirmed diagnosis of UBC were included. Pathological fractures were observed in 21 cases (46%). All patients underwent surgery for UBC (35 patients underwent curettage and bone grafting as a primary therapy, 4 curettage alone, 3 received corticoid instillation and 4 decompression by cannulated screws). Overall recurrence rate after the first surgical treatment was 39% (18/46), second (17.4% of all patients) and third recurrence (4.3%) were frequently observed and were addressed by revision surgery. Recurrence was significantly higher in young and in male patients as well as in active cysts. After a mean of 52 months, 40 out of 46 cysts were considered healed. Prognosis was significantly better when recurrence was observed later than 30 months after therapy. After a mean follow-up of 15.5 ± 6.2 years, 40 patients acknowledged clinically excellent results, while five reported mild and casual pain. Only one patient reported a mild limitation of range of motion. Conclusions Our results suggest satisfactory overall long-term outcome for the surgical treatment of UBC

  20. Experience With Fenestrated Endovascular Repair of Juxtarenal Abdominal Aortic Aneurysms at a Single Center

    PubMed Central

    Hu, Zhongzhou; Li, Yue; Peng, Ran; Liu, Jie; Zhang, Tao; Guo, Wei

    2016-01-01

    Abstract To present the early and mid-term results of fenestrated endovascular aneurysm repair (FEVAR) using the Zenith fenestrated device for juxtarenal abdominal aortic aneurysms (JAAAs) at our center in China. Design: Retrospective study. The study included 15 male patients with JAAAs, who underwent FEVAR using the Zenith fenestrated device at our center between February 2011 and June 2015. All custom-made Zenith fenestrated devices were designed according to computed tomography angiography (CTA) images obtained preoperatively. The patients with renal insufficiency underwent duplex ultrasonography, while the patients with normal renal function underwent 3 CT data acquisitions including nonenhanced CT, arterial phase, and venous phase. These examinations and blood examinations were completed at 3, 6, and 12 months after discharge, and annually thereafter. The mean age of the patients was 73.13 ± 9.06 years (range, 57–86 years), and the median follow-up period was 30 months (8–52 months). Small fenestrations were used in 27 renal arteries, scallops were used in 7 superior mesenteric arteries (SMAs) and 2 renal arteries, and large fenestrations were used in 2 SMAs. Conversion to an open procedure was not required in any of the patients, and the technical success rate was 100%. The mean length of hospital stay was 11.33 ± 2.02 days (7–15 days). No patient died within the 1st 30 days after the operation. One patient had a type Ia endoleak, which disappeared at 6 months after the operation, 1 patient had a type Ib endoleak, which was detected at 17 months after the operation, and 2 patients had type II endoleaks. One patient died at 17 months and another patient died at 30 months after the operation. Therefore, the all-cause mortality rate was 13.33% (2/15). The target vessel patency rate was 100% without occlusion. The early and mid-term results of FEVAR using the Zenith fenestrated device were good, demonstrating that this procedure is effective for

  1. Laparoscopic gastric bypass vs sleeve gastrectomy in obese Korean patients

    PubMed Central

    Park, Ji Yeon; Kim, Yong Jin

    2015-01-01

    AIM: To compare the mid-term outcomes of laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) in obese Korean patients. METHODS: All consecutive patients who underwent either LSG or LRYGB with primary to treat morbid obesity between January 2011 and December 2012 were retrospectively reviewed. Patients with a body mass index (BMI) ≥ 30 kg/m2 with inadequately controlled obesity-related comorbidities (e.g., diabetes, obstructive sleep apnea, hypertension, or obesity-related arthropathy) or BMI ≥ 35 kg/m2 were considered for bariatric surgery according to the International Federation for the Surgery of Obesity-Asia Pacific Chapter Consensus statements in 2011. The decision regarding the procedure type was made on an individual basis following extensive discussion with the patient about the specific risks associated with each procedure. All operative procedures were performed laparoscopically by a single surgeon experienced in upper gastrointestinal surgeries. Baseline demographics, perioperative surgical outcomes, and postoperative anthropometric data from a prospectively established database were thoroughly reviewed and compared between the two surgical approaches. RESULTS: One hundred four patients underwent LSG, and 236 underwent LRYGB. Preoperative BMI in the LSG group was significantly higher than that of the LRYGB group (38.6 kg/m2 vs 37.2 kg/m2, P = 0.024). Patients with diabetes were more prevalent in the LRYGB group (18.3% vs 35.6%, P = 0.001). Operating time and hospital stay were significantly shorter in the LSG group compared with the LRYGB group (100 min vs 130 min, P < 0.001; 1 d vs 2 d, P = 0.003), but the incidence of perioperative complications was similar between the groups (P = 0.351). The mean percentage of excess weight loss (%EWL) was 71.2% for LRYGB, while it was 63.5% for LSG, at mean follow-up periods of 18.0 and 21.0 mo, respectively (P = 0.073). The %EWL at 1, 3, 6, 12, 18, 24, and 36 mo was equivalent

  2. Management of Complicated Aortic Aneurysms Using Multiple Overlapping Uncovered Stents

    PubMed Central

    Zhang, Yongxue; Teng, Zhongzhao; Lu, Qingsheng; Zhao, Zhiqing; Bao, Junmin; Feng, Xiang; Feng, Rui; Chen, Zengsheng; Huang, Yuan; Sadat, Umar; Gillard, Jonathan H; Jing, Zaiping

    2014-01-01

    Abstract This study sought to report the mid-term outcome of a modified flow-diverting strategy in the treatment of complicated aortic aneurysms of different morphology. Historical data suggested aortic aneurysm expansion and rupture after endovascular treatment with current commercial flow-diverters, indicating the essentiality of further investigation of this technique prior to its large-scale clinical application. An alternative flow-diverting strategy using layer-by-layer assembled multiple overlapping uncovered stents was employed in this study. The treatment outcome in aneurysms of different morphology (saccular, fusiform, and dissecting) was assessed during a mid-term follow-up period. Of 42 patients enrolled in this study (30 male, mean age: 63.3 years), technical success was achieved in 40 cases. During an average follow-up period of 20.9 months, mean aneurysm diameter shrunk from 53.4 ± 13.6 mm to 48.8 ± 13.9 mm (P < 0.001), while stent-induced sac thrombosis ratio increased significantly (18.1 ± 14.9% to 93.6 ± 9.5%, P < 0.001). The majority of side branches (74/76 major visceral branches, 237/244 minor segmental arteries), covered by 3.3 stents on average, maintained their patency after stenting. Saccular aneurysms manifested the highest thrombus deposition speed (18/20 were totally thrombosed within 12 months) and most significant shrinkage (51.4 ± 13.3 mm pre-operatively vs 43.5 ± 10.2 mm during follow-up, P < 0.001) compared with fusiform and dissecting aneurysms. This modified flow-diverting strategy could be a feasible alternative in the management of complicated aortic aneurysms where vital branches need to be preserved. The treatment outcome may depend on the aneurysm type. Further studies with larger patient cohort and longer follow-up are required to substantiate these results. PMID:25501077

  3. Ventricular Assist Devices and Increased Blood Product Utilization for Cardiac Transplantation

    PubMed Central

    Stone, Matthew L.; LaPar, Damien J.; Benrashid, Ehsan; Scalzo, David C.; Ailawadi, Gorav; Kron, Irving L.; Bergin, James D.; Blank, Randal S.; Kern, John A.

    2016-01-01

    Background and Aim of Study The purpose of this study was to examine whether blood product utilization, one-year cell-mediated rejection rates, and mid-term survival significantly differ for ventricular assist device (VAD patients compared to non-VAD (NVAD) patients following cardiac transplantation. Methods From July 2004 to August 2011, 79 patients underwent cardiac transplantation at a single institution. Following exclusion of patients bridged to transplantation with VADs other than the HeartMate II® LVAD (n = 10), patients were stratified by VAD presence at transplantation: VAD patients (n = 35, age: 54.0 [48.0–59.0] years) vs. NVAD patients (n = 34, age: 52.5 [42.8–59.3] years). The primary outcomes of interest were blood product transfusion requirements, one-year cell-mediated rejection rates, and mid-term survival post-transplantation. Results Preoperative patient characteristics were similar for VAD and NVAD patients. NVAD patients presented with higher median preoperative creatinine levels compared to VAD patients (1.3 [1.1–1.6] vs. 1.1 [0.9–1.4], p = 0.004). VAD patients accrued higher intraoperative transfusion of all blood products (all p ≤ 0.001) compared to NVAD patients. The incidence of clinically significant cell-mediated rejection within the first posttransplant year was higher in VAD compared to NVAD patients (66.7% vs. 33.3%, p = 0.02). During a median follow-up period of 3.2 (2.0, 6.3) years, VAD patients demonstrated an increased postoperative mortality that did not reach statistical significance (20.0% vs. 8.8%, p = 0.20). Conclusions During the initial era as a bridge to transplantation, the HeartMate II® LVAD significantly increased blood product utilization and one-year cell-mediated rejection rates for cardiac transplantation. Further study is warranted to optimize anticoagulation strategies and to define causal relationships between these factors for the current era of cardiac transplantation. PMID:25529999

  4. Long-Term Results after Proximal Thoracic Aortic Redo Surgery

    PubMed Central

    Czerny, Martin; Barchichat, Ilan; Meszaros, Katharina; Sodeck, Gottfried H.; Weber, Alberto; Reineke, David; Englberger, Lars; Schönhoff, Florian; Kadner, Alexander; Jenni, Hansjörg; Schmidli, Jürg; Carrel, Thierry P.

    2013-01-01

    Objective To evaluate early and mid-term results in patients undergoing proximal thoracic aortic redo surgery. Methods We analyzed 60 patients (median age 60 years, median logistic EuroSCORE 40) who underwent proximal thoracic aortic redo surgery between January 2005 and April 2012. Outcome and risk factors were analyzed. Results In hospital mortality was 13%, perioperative neurologic injury was 7%. Fifty percent of patients underwent redo surgery in an urgent or emergency setting. In 65%, partial or total arch replacement with or without conventional or frozen elephant trunk extension was performed. The preoperative logistic EuroSCORE I confirmed to be a reliable predictor of adverse outcome- (ROC 0.786, 95%CI 0.64–0.93) as did the new EuroSCORE II model: ROC 0.882 95%CI 0.78–0.98. Extensive individual logistic EuroSCORE I levels more than 67 showed an OR of 7.01, 95%CI 1.43–34.27. A EuroSCORE II larger than 28 showed an OR of 4.44 (95%CI 1.4–14.06). Multivariate logistic regression analysis identified a critical preoperative state (OR 7.96, 95%CI 1.51–38.79) but not advanced age (OR 2.46, 95%CI 0.48–12.66) as the strongest independent predictor of in-hospital mortality. Median follow-up was 23 months (1–52 months). One year and five year actuarial survival rates were 83% and 69% respectively. Freedom from reoperation during follow-up was 100%. Conclusions Despite a substantial early attrition rate in patients presenting with a critical preoperative state, proximal thoracic aortic redo surgery provides excellent early and mid-term results. Higher EuroSCORE I and II levels and a critical preoperative state but not advanced age are independent predictors of in-hospital mortality. As a consequence, age alone should no longer be regarded as a contraindication for surgical treatment in this particular group of patients. PMID:23469220

  5. a Stochastic Approach to Multiobjective Optimization of Large-Scale Water Reservoir Networks

    NASA Astrophysics Data System (ADS)

    Bottacin-Busolin, A.; Worman, A. L.

    2013-12-01

    A main challenge for the planning and management of water resources is the development of multiobjective strategies for operation of large-scale water reservoir networks. The optimal sequence of water releases from multiple reservoirs depends on the stochastic variability of correlated hydrologic inflows and on various processes that affect water demand and energy prices. Although several methods have been suggested, large-scale optimization problems arising in water resources management are still plagued by the high dimensional state space and by the stochastic nature of the hydrologic inflows. In this work, the optimization of reservoir operation is approached using approximate dynamic programming (ADP) with policy iteration and function approximators. The method is based on an off-line learning process in which operating policies are evaluated for a number of stochastic inflow scenarios, and the resulting value functions are used to design new, improved policies until convergence is attained. A case study is presented of a multi-reservoir system in the Dalälven River, Sweden, which includes 13 interconnected reservoirs and 36 power stations. Depending on the late spring and summer peak discharges, the lowlands adjacent to Dalälven can often be flooded during the summer period, and the presence of stagnating floodwater during the hottest months of the year is the cause of a large proliferation of mosquitos, which is a major problem for the people living in the surroundings. Chemical pesticides are currently being used as a preventive countermeasure, which do not provide an effective solution to the problem and have adverse environmental impacts. In this study, ADP was used to analyze the feasibility of alternative operating policies for reducing the flood risk at a reasonable economic cost for the hydropower companies. To this end, mid-term operating policies were derived by combining flood risk reduction with hydropower production objectives. The performance

  6. Angioplasty and Stenting of Symptomatic Vertebral Artery Stenosis

    PubMed Central

    Mohammadian, R.; Sharifipour, E.; Mansourizadeh, R.; Sohrabi, B.; Nayebi, A.R; Haririan, S.; Farhoudi, M.; Charsouei, S.; Najmi, S.

    2013-01-01

    Summary Percutaneous transluminal angioplasty (PTA) has recently become a noteworthy treatment option for significant stenosis involving the vertebral artery (VA) in selected patients. We conducted a prospective study to evaluate the efficacy, safety and mid-term follow up results of 206 cases received PTA with or without stent implant to treat their symptomatic atherosclerotic VA stenosis in all segments (V1-V4). In a prospective mono-arm trial from October 2008 to July 2012 in a single center, 239 lesions affecting the intra or extracranial VA (171 in V1, 17 in V2, 14 in V3, 21 in V4 and 16 in combined segments) were treated by PTA with or without stent implant. Non-disabling stroke patients who had failed conservative medical treatment and had angiographic evidence of >50% stenosis in the dominant VA with clinical signs and symptoms of VB stenosis were included in this study. They were mean followed for 13.15±5.24 months after treatment. Overall, 206 patients underwent the procedure. A stent was implemented in 199 patients (96.6%). The periprocedural complication rate was 7.2%. The procedural (technical) success rate was 97.6%. Of the total 239 lesions, 223 were treated with stent implant. Clinical success was achieved in all 206 symptomatic patients after the procedure. Restenosis occurred in 15.9% after a mean 10.8 (6-24) months. Of those, 63.1% and 34.2% had mild and moderate stenosis that was treated medically, whereas one case (2.6%) with severe restenosis underwent balloon angioplasty. No deaths occurred during the follow-up period. The follow-up complication rate was 6.3%. TIA occurred in 4.4%, a minor stroke in 1.4% and a major stroke in one patient. The overall patient event-free survival was 92.4%. These results demonstrate the safety and feasibility of PTA with or without stent implant, with a high technical success rate, a low complication rate, a low restenosis rate and durable clinical success in patients with symptomatic VA stenosis. This

  7. Efficient production of multi-modified pigs for xenotransplantation by 'combineering', gene stacking and gene editing.

    PubMed

    Fischer, Konrad; Kraner-Scheiber, Simone; Petersen, Björn; Rieblinger, Beate; Buermann, Anna; Flisikowska, Tatiana; Flisikowski, Krzysztof; Christan, Susanne; Edlinger, Marlene; Baars, Wiebke; Kurome, Mayuko; Zakhartchenko, Valeri; Kessler, Barbara; Plotzki, Elena; Szczerbal, Izabela; Switonski, Marek; Denner, Joachim; Wolf, Eckhard; Schwinzer, Reinhard; Niemann, Heiner; Kind, Alexander; Schnieke, Angelika

    2016-01-01

    Xenotransplantation from pigs could alleviate the shortage of human tissues and organs for transplantation. Means have been identified to overcome hyperacute rejection and acute vascular rejection mechanisms mounted by the recipient. The challenge is to combine multiple genetic modifications to enable normal animal breeding and meet the demand for transplants. We used two methods to colocate xenoprotective transgenes at one locus, sequential targeted transgene placement - 'gene stacking', and cointegration of multiple engineered large vectors - 'combineering', to generate pigs carrying modifications considered necessary to inhibit short to mid-term xenograft rejection. Pigs were generated by serial nuclear transfer and analysed at intermediate stages. Human complement inhibitors CD46, CD55 and CD59 were abundantly expressed in all tissues examined, human HO1 and human A20 were widely expressed. ZFN or CRISPR/Cas9 mediated homozygous GGTA1 and CMAH knockout abolished α-Gal and Neu5Gc epitopes. Cells from multi-transgenic piglets showed complete protection against human complement-mediated lysis, even before GGTA1 knockout. Blockade of endothelial activation reduced TNFα-induced E-selectin expression, IFNγ-induced MHC class-II upregulation and TNFα/cycloheximide caspase induction. Microbial analysis found no PERV-C, PCMV or 13 other infectious agents. These animals are a major advance towards clinical porcine xenotransplantation and demonstrate that livestock engineering has come of age. PMID:27353424

  8. Lunate Osteochondral Fracture Treated by Excision: A Case Report and Literature Review

    PubMed Central

    Saberi, Sadegh; Arabzadeh, Aidin; Farhoud, Amir Reza

    2016-01-01

    Introduction Lunate fracture is a rare injury. Most reports are associated with other wrist injuries such as perilunate dislocation and distal radius fracture. Isolated lunate fracture has been reported even more rarely. The choice of treatment and outcomes are consequently undetermined. Case Presentation In this case report we will describe a lunate avulsion fracture as an isolated injury after a fall from nine meters treated operatively by excision of the comminuted avulsed fragment. After 33 months of follow-up radiographs showed no sign of degenerative joint disorder on simple X-ray, but slight Volar Intercalated Segment Instability (VISI) by a capitolunate angle of 26 degrees was noted. Clinically, the patient was pain free near full wrist and forearm range of motion and could perform his previous vocational and recreational tasks without any limitations. Conclusions Despite apparently good short and mid-term clinical outcome, slight volar intercalated segment instability after 33 months of follow-up revealed that lunotriquetral ligament function was probably lost, which led to static instability. This ligament injury may be missed primarily. Excision of the avulsed osteochondral fragment should be the last option of treatment and most attempts should be tried to fix and/or restore the normal anatomy of ligamentous structure. PMID:27626007

  9. Posterior ankle impingement syndrome: A systematic four-stage approach

    PubMed Central

    Yasui, Youichi; Hannon, Charles P; Hurley, Eoghan; Kennedy, John G

    2016-01-01

    Posterior ankle impingement syndrome (PAIS) is a common injury in athletes engaging in repetitive plantarflexion, particularly ballet dancers and soccer players. Despite the increase in popularity of the posterior two-portal hindfoot approach, concerns with the technique remain, including; the technical difficulty, relatively steep learning curve, and difficulty performing simultaneous anterior ankle arthroscopy. The purpose of the current literature review is to provide comprehensive knowledge about PAIS, and to describe a systematic four-stage approach of the posterior two-portal arthroscopy. The etiology, clinical presentation, diagnostic strategies are first introduced followed by options in conservative and surgical management. A detailed systematic approach to posterior hindfoot arthroscopy is then described. This technique allows for systematic review of the anatomic structures and treatment of the bony and/or soft tissue lesions in four regions of interest in the hindfoot (superolateral, superomedial, inferomedial, and inferolateral). The review then discusses biological adjuncts and postoperative rehabilitation and ends with a discussion on the most recent clinical outcomes after posterior hindfoot arthroscopy for PAIS. Although clinical evidence suggests high success rates following posterior hindfoot arthroscopy in the short- and mid-term it may be limited in the pathology that can be addressed due to the technical skills required, but the systematic four-stage approach of the posterior two-portal arthroscopy may improve upon this problem. PMID:27795947

  10. Solar Weather Event Modelling and Prediction

    NASA Astrophysics Data System (ADS)

    Messerotti, Mauro; Zuccarello, Francesca; Guglielmino, Salvatore L.; Bothmer, Volker; Lilensten, Jean; Noci, Giancarlo; Storini, Marisa; Lundstedt, Henrik

    2009-11-01

    Key drivers of solar weather and mid-term solar weather are reviewed by considering a selection of relevant physics- and statistics-based scientific models as well as a selection of related prediction models, in order to provide an updated operational scenario for space weather applications. The characteristics and outcomes of the considered scientific and prediction models indicate that they only partially cope with the complex nature of solar activity for the lack of a detailed knowledge of the underlying physics. This is indicated by the fact that, on one hand, scientific models based on chaos theory and non-linear dynamics reproduce better the observed features, and, on the other hand, that prediction models based on statistics and artificial neural networks perform better. To date, the solar weather prediction success at most time and spatial scales is far from being satisfactory, but the forthcoming ground- and space-based high-resolution observations can add fundamental tiles to the modelling and predicting frameworks as well as the application of advanced mathematical approaches in the analysis of diachronic solar observations, that are a must to provide comprehensive and homogeneous data sets.

  11. CaO-based CO2 sorbents: from fundamentals to the development of new, highly effective materials.

    PubMed

    Kierzkowska, Agnieszka M; Pacciani, Roberta; Müller, Christoph R

    2013-07-01

    The enormous anthropogenic emission of the greenhouse gas CO2 is most likely the main reason for climate change. Considering the continuing and indeed growing utilisation of fossil fuels for electricity generation and transportation purposes, development and implementation of processes that avoid the associated emissions of CO2 are urgently needed. CO2 capture and storage, commonly termed CCS, would be a possible mid-term solution to reduce the emissions of CO2 into the atmosphere. However, the costs associated with the currently available CO2 capture technology, that is, amine scrubbing, are prohibitively high, thus making the development of new CO2 sorbents a highly important research challenge. Indeed, CaO, readily obtained through the calcination of naturally occurring limestone, has been proposed as an alternative CO2 sorbent that could substantially reduce the costs of CO2 capture. However, one of the major drawbacks of using CaO derived from natural sources is its rapidly decreasing CO2 uptake capacity with repeated carbonation-calcination reactions. Here, we review the current understanding of fundamental aspects of the cyclic carbonation-calcination reactions of CaO such as its reversibility and kinetics. Subsequently, recent attempts to develop synthetic, CaO-based sorbents that possess high and cyclically stable CO2 uptakes are presented. PMID:23821467

  12. The NASA In-Space Propulsion Technology Project, Products, and Mission Applicability

    NASA Technical Reports Server (NTRS)

    Anderson, David J.; Pencil, Eric; Liou, Larry; Dankanich, John; Munk, Michelle M.; Kremic, Tibor

    2009-01-01

    The In-Space Propulsion Technology (ISPT) Project, funded by NASA s Science Mission Directorate (SMD), is continuing to invest in propulsion technologies that will enable or enhance NASA robotic science missions. This overview provides development status, near-term mission benefits, applicability, and availability of in-space propulsion technologies in the areas of aerocapture, electric propulsion, advanced chemical thrusters, and systems analysis tools. Aerocapture investments improved: guidance, navigation, and control models of blunt-body rigid aeroshells; atmospheric models for Earth, Titan, Mars, and Venus; and models for aerothermal effects. Investments in electric propulsion technologies focused on completing NASA s Evolutionary Xenon Thruster (NEXT) ion propulsion system, a 0.6 to 7 kW throttle-able gridded ion system. The project is also concluding its High Voltage Hall Accelerator (HiVHAC) mid-term product specifically designed for a low-cost electric propulsion option. The primary chemical propulsion investment is on the high-temperature Advanced Material Bipropellant Rocket (AMBR) engine providing higher performance for lower cost. The project is also delivering products to assist technology infusion and quantify mission applicability and benefits through mission analysis and tools. In-space propulsion technologies are applicable, and potentially enabling for flagship destinations currently under evaluation, as well as having broad applicability to future Discovery and New Frontiers mission solicitations.

  13. Quality of trace element contaminated soils amended with compost under fast growing tree Paulownia fortunei plantation.

    PubMed

    Madejón, P; Xiong, J; Cabrera, F; Madejón, E

    2014-11-01

    The use of fast growing trees could be an alternative in trace element contaminated soils to stabilize these elements and improve soil quality. In this study we investigate the effect of Paulownia fortunei growth on trace element contaminated soils amended with two organic composts under semi-field conditions for a period of 18 months. The experiment was carried out in containers filled with tree different soils, two contaminated soils (neutral AZ and acid V) and a non contaminated soil, NC. Three treatments per soil were established: two organic amendments (alperujo compost, AC, and biosolid compost, BC) and a control without amendment addition. We study parameters related with fertility and contamination in soils and plants. Paulownia growth and amendments increased pH in acid soils whereas no effect of these factors was observed in neutral soils. The plant and the amendments also increased organic matter and consequently, soil fertility. Positive results were also found in soils that were only affected by plant growth (without amendment). A general improvement of "soil biochemical quality" was detected over time and treatments, confirming the positive effect of amendments plus paulownia. Even in contaminated soils, except for Cu and Zn, trace element concentrations in leaves were in the normal range for plants. Results of this mid-term study showed that Paulownia fortunei is a promising species for phytoremediation of trace element polluted soils. PMID:24950211

  14. Development Progress of the Neutron Imaging Station in CPHS

    NASA Astrophysics Data System (ADS)

    Xiao, Yongshun; Chen, Zhiqiang; Yang, Yigang; Wang, Xuewu

    The neutron imaging station based on the proton-linac-driven neutron source at CPHS, is presently under construction at Tsinghua University. Itis driven by a high-intensity proton linac (ECR proton source, LEBT, RFQ, DTL and HEBT) with a 13-MeV proton beam and a beryllium target station for neutron production. The facility has achieved its mid-term objective to deliver a 3 MeV proton beam directly from the RFQ output to the neutron target station by the HEBT, with a peak current of 22 mA and a pulse length of 100 μs.In addition the neutron imaging station of the first stage to provide neutron radiography is installed. In this paper, the instrument design and engineering construction status of the neutron imaging station of CPHS is presented, including the preliminary neutron imaging experiments and the results. The beam energy of the CPHS will be enhanced to 13 MeV after the DTL is ready in 2015.

  15. A comprehensive dairy valorization model.

    PubMed

    Banaszewska, A; Cruijssen, F; van der Vorst, J G A J; Claassen, G D H; Kampman, J L

    2013-02-01

    Dairy processors face numerous challenges resulting from both unsteady dairy markets and some specific characteristics of dairy supply chains. To maintain a competitive position on the market, companies must look beyond standard solutions currently used in practice. This paper presents a comprehensive dairy valorization model that serves as a decision support tool for mid-term allocation of raw milk to end products and production planning. The developed model was used to identify the optimal product portfolio composition. The model allocates raw milk to the most profitable dairy products while accounting for important constraints (i.e., recipes, composition variations, dairy production interdependencies, seasonality, demand, supply, capacities, and transportation flows). The inclusion of all relevant constraints and the ease of understanding dairy production dynamics make the model comprehensive. The developed model was tested at the international dairy processor FrieslandCampina (Amersfoort, the Netherlands). The structure of the model and its output were discussed in multiple sessions with and approved by relevant FrieslandCampina employees. The elements included in the model were considered necessary to optimally valorize raw milk. To illustrate the comprehensiveness and functionality of the model, we analyzed the effect of seasonality on milk valorization. A large difference in profit and a shift in the allocation of milk showed that seasonality has a considerable impact on the valorization of raw milk. PMID:23200469

  16. Managing maritime automobile terminals: an approach toward decision-support model for higher productivity

    NASA Astrophysics Data System (ADS)

    Beškovnik, Bojan; Twrdy, Elen

    2011-12-01

    The article describes actions and strategies to obtain higher productivity on maritime automobile terminals. The main focus is on elaboration of efficient and effective organizational structure to model and implement short-term, mid-term and long-term strategies. In addition, with an empiric approach we combined the analyses of current findings in important scientific papers and our acknowledgments in practical research of north Adriatic maritime automobile terminals. The main goal is to propose actions towards increasing system's productivity. Based on our research of the north Adriatic maritime automobile terminals and with Lambert's model an in-deep analysis of limiting factors, user's expectations and possibilities for productivity increase has been performed. Moreover, with our acknowledgments a three-level decision-support model is presented. With an adequate model implementation it is possible to efficiently develop and implement different strategies of productivity measurement and productivity increase, especially in the fields of internal transport productivity, entrance/exit truck gates operations and wagon manipulations. According to our observation a significant increase might be achieved in all three fields.

  17. Is it ever possible to treat left ventricular free wall rupture conservatively?

    PubMed

    Nasir, Abdul; Gouda, Mohammad; Khan, Amir; Bose, Amal

    2014-09-01

    A best evidence topic was written according to a structured protocol. The question addressed was whether conservative or surgical management would result in better outcomes in patients presenting with left ventricular free wall rupture (LVFWR) following acute myocardial infarction. Surgical techniques involved were infarctectomy + patch repair, suturing of an overlay patch to the defect, patch-and-glue repair and so on, on or off cardiopulmonary bypass. A total of 210 papers were found using the reported searches, of which 10 represented the best evidence to answer the clinical question. The authors, date, journal, study type, population, main outcome measures and results were tabulated. The studies found analysed the outcome related to conservative and surgical approaches plus the effects of cardiopulmonary bypass circuit and systemic heparinization on bleeding around the peri-infarct myocardial tissue in the surgical group. Most of the data available were either case reports or retrospective analysis of the cohort using the 2 techniques and showed that ruptures present in different sites and sizes. Patients with a milder form of LVFWR can be managed conservatively, but the irony is that it is difficult to identify these patients, because a small oozing-type rupture can increase in size and lead to large defect with sudden arrest of the patient and most probably death. More recently with patch-and-glue techniques, avoiding cardiopulmonary bypass, short- and mid-term survival rates have improved to 60-80% in studies of consecutive patients' series, which illustrates real-life experiences.

  18. Sclerosing polidocanol injections of small vessels to treat the chronic painful tendon.

    PubMed

    Alfredson, H; Lorentzon, R

    2007-04-01

    The chronic painful tendon (tendinopathy, tendinosis) is generally considered difficult to treat, not seldom causing long-term disability and sometimes ending the sports or work carreér. Most common sites for tendinopathy are the Achilles-, patellar-, extensor carpi radialis brevis (ERCB)-, and supraspinatus tendons. The origin of pain has for many years been unknown, but recently, by using ultrasound (US) + colour Doppler (CD), immunohistochemical analyses of tendon biopsies, and diagnostic injections of local anaestesia, we found a close relationship between areas with vasculo-neural ingrowth and tendon pain. Sensory nerves (Substance-P-SP and Calcitonin Gene Related Peptide-CGRP) were found inside and outside the vascular wall. In following clinical studies we have demonstrated good short-and mid-term clinical results using treatment with US+CD-guided sclerosing polidocanol injections, targeting the area with neovessels outside the tendon. Two-year follow ups have showed remaining good clinical results, and sonographically signs of remodelling with a significantly thinner tendon with a more normal structure. Whether the effects of polidocanol are mediated through destruction of neovessels, activity on nerves or a combination, is under evaluation. PMID:17430133

  19. Should Endovascular Therapy Be Considered for Patients With Connective Tissue Disorder?

    PubMed

    Gagné-Loranger, Maude; Voisine, Pierre; Dagenais, François

    2016-01-01

    Because of early diagnosis, strict imaging follow-up, and advances in medical and surgical management, life expectancy of Marfan patients has dramatically improved since the 1970s. Although disease of the root and ascending aorta are more frequent in patients with connective tissue disorders, a subset of patients present with diffuse disease that might involve any portion of the thoracoabdominal aorta. Thoracic endovascular aortic repair (TEVAR) has gained widespread acceptance for the treatment of different pathologies of the descending aorta. In contrast, TEVAR in patients with connective tissue disorders is associated with a high risk of early and mid-term complications and reinterventions. Currently, a consensus of experts recommend that an open approach should be reserved for use in acceptable risk candidates with connective tissue disorders. TEVAR should be considered solely in patients in a complex repeat surgical setting or in patients judged to have prohibitive open surgical risk. Finally, as a bridge to a definite open repair, TEVAR might be life-saving in patients with connective tissue disorders who present with exsanguination or severe malperfusion. Future developments in stent-graft technology might decrease stent-graft-related complications in patients with connective tissue disorders, although securing a device with radial force in a fragile aorta in the long-term will be challenging.

  20. Functionality and Safety of an Ultra-Congruent Rotating Platform Knee Prosthesis at 5.6 Years: More than 5- Year Follow-Up of the e.motion® UC-TKA

    PubMed Central

    Chavoix, Jean-Baptiste

    2013-01-01

    Background: Mobile bearing TKA prostheses were designed to minimize polyethylene wear by increasing implant conformity and reducing stresses between the articulating prosthesis components. It is the purpose of this study to assess the mid-term functionality and clinical outcome associated with a highly congruent mobile platform design, the e.motion® UC total knee prosthesis. Material and Methods: Functional and clinical outcomes were assessed after an average of 5.6 years (5.1 – 6.0 years) after total knee arthroplasty in 28 patients (24 women), aged 77.8±7.5 years. The Knee injury and Osteoarthritis Outcome Score (KOOS) was assessed. Secondary outcomes included the Knee Society Score (KSS), radiological evaluation of radiolucent lines and recording of adverse events. Results: The average KOOS subscore for the activities of daily life was 77.8 points after 5.6 years. Both the clinical and functional KSS improved at 2.4 and 5.6 years. Two patients showed radiolucent lines at 5.6 years. Adverse events over 5.6 years included 3 subluxations, 1 tilting and 1 misalignment of the patella. None of the prostheses were revised. Conclusion: This pilot study shows promising outcomes for the e.motion® UC prosthesis. In the small sample, the implant performed comparably to the LCS prosthesis (the gold standard). There were no loosenings or revisions observed at 5.6 years. PMID:23730378

  1. System level traffic shaping in disk servers with heterogeneous protocols

    NASA Astrophysics Data System (ADS)

    Cano, Eric; Kruse, Daniele Francesco

    2014-06-01

    Disk access and tape migrations compete for network bandwidth in CASTORs disk servers, over various protocols: RFIO, Xroot, root and GridFTP. As there are a limited number of tape drives, it is important to keep them busy all the time, at their nominal speed. With potentially 100s of user read streams per server, the bandwidth for the tape migrations has to be guaranteed to a controlled level, and not the fair share the system gives by default. Xroot provides a prioritization mechanism, but using it implies moving exclusively to the Xroot protocol, which is not possible in short to mid-term time frame, as users are equally using all protocols. The greatest commonality of all those protocols is not more than the usage of TCP/IP. We investigated the Linux kernel traffic shaper to control TCP/ IP bandwidth. The performance and limitations of the traffic shaper have been understood in test environment, and satisfactory working point has been found for production. Notably, TCP offload engines' negative impact on traffic shaping, and the limitations of the length of the traffic shaping rules were discovered and measured. A suitable working point has been found and the traffic shaping is now successfully deployed in the CASTOR production systems at CERN. This system level approach could be transposed easily to other environments.

  2. Prenatal dexamethasone exposure induces changes in nonhuman primate offspring cardiometabolic and hypothalamic-pituitary-adrenal axis function

    PubMed Central

    de Vries, Annick; Holmes, Megan C.; Heijnis, Areke; Seier, Jürgen V.; Heerden, Joritha; Louw, Johan; Wolfe-Coote, Sonia; Meaney, Michael J.; Levitt, Naomi S.; Seckl, Jonathan R.

    2007-01-01

    Prenatal stress or glucocorticoid administration has persisting “programming” effects on offspring in rodents and other model species. Multiple doses of glucocorticoids are in widespread use in obstetric practice. To examine the clinical relevance of glucocorticoid programming, we gave 50, 120, or 200 μg/kg/d of dexamethasone (dex50, dex120, or dex200) orally from mid-term to a singleton-bearing nonhuman primate, Chlorocebus aethiops (African vervet). Dexamethasone dose-dependently reduced maternal cortisol levels without effecting maternal blood pressure, glucose, electrolytes, or weight gain. Birth weight was unaffected by any dexamethasone dose, although postnatal growth was attenuated after dex120 and dex200. At 8 months of age, dex120 and dex200 offspring showed impaired glucose tolerance and hyperinsulinemia, with reduced (approximately 25%) pancreatic β cell number at 12 months. Dex120 and dex200 offspring had increased systolic and diastolic blood pressures at 12 months. Mild stress produced an exaggerated cortisol response in dex200 offspring, implying hypothalamic-pituitary-adrenal axis programming. The data are compatible with the extrapolation of the glucocorticoid programming hypothesis to primates and indicate that repeated glucocorticoid therapy and perhaps chronic stress in humans may have long-term effects. PMID:17380204

  3. Regenerative treatments to enhance orthopedic surgical outcome.

    PubMed

    Murrell, William D; Anz, Adam W; Badsha, Humeira; Bennett, William F; Boykin, Robert E; Caplan, Arnold I

    2015-04-01

    In orthopedic surgery there has been a never-ending quest to improve surgical outcome and the patient's experience. Progression has been marked by the refinement of surgical techniques and instruments and later by enhanced diagnostic imaging capability, specifically magnetic resonance. Over time implant optimization was achieved, along with the development of innovative minimally invasive arthroscopic technical skills to leverage new versions of classic procedures and implants to improve short-term patient morbidity and initial, mid-term, and long-term patient outcomes. The use of regenerative and/or biological adjuncts to aid the healing process has followed in the drive for continual improvement, and major breakthroughs in basic science have significantly unraveled the mechanisms of key healing and regenerative pathways. A wide spectrum of primary and complementary regenerative treatments is becoming increasingly available, including blood-derived preparations, growth factors, bone marrow preparations, and stem cells. This is a new era in the application of biologically active material, and it is transforming clinical practice by providing effective supportive treatments either at the time of the index procedure or during the postoperative period. Regenerative treatments are currently in active use to enhance many areas of orthopedic surgery in an attempt to improve success and outcome. In this review we provide a comprehensive overview of the peer-reviewed evidence-based literature, highlighting the clinical outcomes in humans both with preclinical data and human clinical trials involving regenerative preparations within the areas of rotator cuff, meniscus, ligament, and articular cartilage surgical repair.

  4. Contegra conduit: current outcomes and concerns.

    PubMed

    Raja, Shahzad G

    2006-09-01

    A variety of congenital cardiac anomalies with severe right ventricular outflow tract (RVOT) obstruction or RVOT interruption require surgical reconstruction from the infundibulum up to the pulmonary artery bifurcation or even into the branches of the pulmonary arteries. Ideally, the conduit or valve required for such reconstruction has to be formed of autologous tissue that grows, resists infection, lasts for the life span of the patient and is readily available in all sizes. Such conduits, however, are not available and although several alternatives have been used, none of which are without potential drawbacks. Contegra valved bovine internal jugular vein conduit (Medtronic Inc., MN, USA) has recently emerged as a promising option for pediatric RVOT reconstruction and has been advocated for its 'off-the-shelf' availability in sizes ranging from 12 to 22 mm, surgical pliability and encouraging short- and mid-term success in experimental animal, as well as clinical studies. This review focuses on the current outcomes of Contegra conduit and highlights some of the major concerns related to the use of this conduit and strategies to tackle these concerns. PMID:17081094

  5. Design, construction and tests of a 3 GHz proton linac booster (LIBO) for cancer therapy

    NASA Astrophysics Data System (ADS)

    Berra, Paolo

    2007-12-01

    In the last ten years the use of proton beams in radiation therapy has become a clinical tool for treatment of deep-seated tumours. LIBO is a RF compact and low cost proton linear accelerator (SCL type) for hadrontherapy. It is conceived by TERA Foundation as a 3 GHz Linac Booster, to be mounted downstream of an existing cyclotron in order to boost the energy of the proton beam up to 200 MeV, needed for deep treatment (~25 cm) in the human body. With this solution it is possible to transform a low energy commercial cyclotron, normally used for eye melanoma therapy, isotope production and nuclear physics research, into an accelerator for deep-seated tumours. A prototype module of LIBO has been built and successfully tested with full RF power at CERN and with proton beam at INFN Laboratori Nazionali del Sud (LNS) in Catania, within an international collaboration between TERA Foundation, CERN, the Universities and INFN groups of Milan and Naples. The mid-term aim of the project is the technology transfer of the accumulated know-how to a consortium of companies and to bring this novel medical tool to hospitals. The design, construction and tests of the LIBO prototype are described in detail.

  6. Graphene spintronics: the European Flagship perspective

    NASA Astrophysics Data System (ADS)

    Roche, Stephan; Åkerman, Johan; Beschoten, Bernd; Charlier, Jean-Christophe; Chshiev, Mairbek; Prasad Dash, Saroj; Dlubak, Bruno; Fabian, Jaroslav; Fert, Albert; Guimarães, Marcos; Guinea, Francisco; Grigorieva, Irina; Schönenberger, Christian; Seneor, Pierre; Stampfer, Christoph; Valenzuela, Sergio O.; Waintal, Xavier; van Wees, Bart

    2015-09-01

    We review current challenges and perspectives in graphene spintronics, which is one of the most promising directions of innovation, given its room-temperature long-spin lifetimes and the ability of graphene to be easily interfaced with other classes of materials (ferromagnets, magnetic insulators, semiconductors, oxides, etc), allowing proximity effects to be harvested. The general context of spintronics is first discussed together with open issues and recent advances achieved by the Graphene Spintronics Work Package consortium within the Graphene Flagship project. Based on such progress, which establishes the state of the art, several novel opportunities for spin manipulation such as the generation of pure spin current (through spin Hall effect) and the control of magnetization through the spin torque phenomena appear on the horizon. Practical applications are within reach, but will require the demonstration of wafer-scale graphene device integration, and the realization of functional prototypes employed for determined applications such as magnetic sensors or nano-oscillators. This is a specially commissioned editorial from the Graphene Flagship Work Package on Spintronics. This editorial is part of the 2D Materials focus collection on ‘Progress on the science and applications of two-dimensional materials,’ published in association with the Graphene Flagship. It provides an overview of key recent advances of the spintronics work package as well as the mid-term objectives of the consortium.

  7. Treatment and Prevention of (Early) Osteoarthritis Using Articular Cartilage Repair—Fact or Fiction? A Systematic Review

    PubMed Central

    de Windt, Tommy S.; Vonk, Lucienne A.; Brittberg, Mats

    2013-01-01

    Early osteoarthritis (OA) is increasingly being recognized in patients who wish to remain active while not accepting the limitations of conservative treatment or joint replacement. The aim of this systematic review was to evaluate the existing evidence for treatment of patients with early OA using articular cartilage repair techniques. A systematic search was performed in EMBASE, MEDLINE, and the Cochrane collaboration. Articles were screened for relevance and appraised for quality. Nine articles of generally low methodological quality (mean Coleman score 58) including a total of 502 patients (mean age range = 36-57 years) could be included. In the reports, both radiological and clinical criteria for early OA were applied. Of all patients included in this review, 75% were treated with autologous chondrocyte implantation. Good short-term clinical outcome up to 9 years was shown. Failure rates varied from 8% to 27.3%. The conversion to total knee arthroplasty rate was 2.5% to 6.5%. Although a (randomized controlled) trial in this patient category with long-term follow-up is needed, the literature suggests autologous chondrocyte implantation could provide good short- to mid-term clinical outcome and delay the need for total knee arthroplasty. The use of standardized criteria for early OA and implementation of (randomized) trials with long-term follow-up may allow for further expansion of the research field in articular cartilage repair to the challenging population with (early) OA. PMID:26069664

  8. Long-term results of the threaded Weill cup in primary total hip arthroplasty

    PubMed Central

    Clarius, Michael; Jung, Alexander W.; Raiss, Patric; Streit, Marcus R.; Merle, Christian

    2009-01-01

    Uncemented, threaded acetabular components with smooth surface treatment were widely used in continental Europe in the 1970s and 1980s for primary total hip arthroplasty (THA). Previously published studies showed high failure rates in the mid-term. In a consecutive series of 116 patients, 127 threaded cups with smooth surface treatment (Weill cup; Zimmer, Winterthur, Switzerland) were implanted in combination with one type of uncemented stem. Patients were followed up clinically and radiographically. Mean time of follow-up was 17 years (range 15–20). At the time of follow-up, the acetabular component had been revised or was awaiting revision in 30 hips (24%). Two hips were revised for infection and 23 for aseptic loosening. Four polyethylene liners were exchanged because of excessive wear. One hip was awaiting revision. The survival rate for all acetabular revisions including one hip awaiting revision was 75% (95%CI: 65–85%) at 17 years. These results support the view that smooth, threaded acetabular components do not provide satisfactory long-term fixation and should be abandoned. It is important to closely monitor patients with these components as the failure rate remains high in the long-term. PMID:19629480

  9. Long-term results of the threaded Mecron cup in primary total hip arthroplasty

    PubMed Central

    Clarius, Michael; Jung, Alexander W.; Streit, Marcus R.; Merle, Christian; Raiss, Patric

    2009-01-01

    In the 1970s, high failure rates of cemented acetabular components, especially in young patients, in the middle- and long-term prompted a search for alternatives. The Mecring was one of the most popular first generation uncemented, threaded cups widely used in the 1980s for arthroplasty of the hip. First generation threaded cups commonly had smooth surface treatment and showed unacceptably high failure rates in the mid-term. In a consecutive series of 209 patients, 221 threaded uncemented acetabular cups with smooth surface treatment (Mecring) had been implanted in combination with one type of uncemented stem. Patients were followed up clinically and radiographically. The mean time of follow-up was 17 (range 15–20) years. In 91 (41%) hips the acetabular component had been revised or was awaiting revision: two hips for infection and 84 (38%) for aseptic loosening. Five hips were awaiting revision. The survival rate for all revisions including hips awaiting revision was 49% (95% CI: 41–57%) at 17 years. These results support the view that smooth, threaded acetabular components do not provide satisfactory long-term fixation and should be abandoned. Patients with these components must be closely monitored as the failure rate remains high in the long-term. PMID:19629481

  10. Aseptic stem loosening in primary THA: migration analysis of cemented and cementless fixation

    PubMed Central

    Kroell, Artur; Beaulé, Paul; Krismer, Martin; Behensky, Hannes; Stoeckl, Bernd

    2008-01-01

    Early migration has reportedly been predictive for later implant failure. Using four different migration patterns, this study aimed to analyse migration behaviour of the two types of implant fixation—cemented and cementless—throughout the process of loosening. Migrational behaviour of 69 revised stems (49 cemented, 20 uncemented) was analysed retrospectively with EBRA-FCA (Einzel-Bild-Röntgen-Analyse, Femoral Component Analysis). Uncemented stems failed after early and late onset migration alike, while late migration was the predominant pattern in cemented stems. Mean prosthetic failure after early migration occurred 5.8 (±4.4) years postoperatively due to insufficient primary stability. Initially stable stems with late onset migration were revised after 12.4 (±4.5) years. Measurement of early migration was found to be a valuable tool to screen short-term and mid-term failure. In the long run the method’s sensitivity decreased. Late onset migration, however, preceded long-term failure by a mean of three years. PMID:19066889

  11. Integrated geological-engineering model of Patrick Draw field and examples of similarities and differences among various shoreline barrier systems

    SciTech Connect

    Schatzinger, R.A.; Szpakiewicz, M.J.; Jackson, S.R.; Chang, M.M.; Sharma, B.; Tham, M.K.; Cheng, A.M.

    1992-04-01

    The Reservoir Assessment and Characterization Research Program at NIPER employs an interdisciplinary approach that focuses on the high priority reservoir class of shoreline barrier deposits to: (1) determine the problems specific to this class of reservoirs by identifying the reservoir heterogeneities that influence the movement and trapping of fluids; and (2) develop methods to characterize effectively this class of reservoirs to predict residual oil saturation (ROS) on interwell scales and improve prediction of the flow patterns of injected and produced fluids. Accurate descriptions of the spatial distribution of critical reservoir parameters (e.g., permeability, porosity, pore geometry, mineralogy, and oil saturation) are essential for designing and implementing processes to improve sweep efficiency and thereby increase oil recovery. The methodologies and models developed in this program will, in the near- to mid-term, assist producers in the implementation of effective reservoir management strategies such as location of infill wells and selection of optimum enhanced oil recovery methods to maximize oil production from their reservoirs.

  12. Toward models of surgical procedures: analyzing a database of neurosurgical cases

    NASA Astrophysics Data System (ADS)

    Raimbault, Melanie; Morandi, Xavier; Jannin, Pierre

    2005-04-01

    Image-guided surgery systems can be improved by the knowledge of surgical expertise. The more the surgeon and the system know about the surgical procedure to perform beforehand, the easier it will be to plan and perform. The main objective of this paper is to introduce an approach for predicting surgical performance according to input variables related to the patient. This prediction is a first step towards the inclusion of surgical expertise in the image guided surgery systems. We previously proposed a generic model for describing surgical procedures in the specific context of multimodal neuronavigation. In this paper, we present the preliminary results of the analysis of a neurosurgical cases database built in accordance with the generic model and including 159 surgical cases concerning right-handed patients. We defined two queries on this surgical cases database to illustrate how it could be used to extract relevant and conclusive information about the surgical procedures: How does the anatomical localization of the target influence patient positioning? How does the anatomical localization of the target influence progress of the steps involved in the surgical procedure? The mid-term goal of our research is to semi automatically extract information, a priori models or scenarios of specific surgical procedures that can make easier the decision making process both for planning and surgery.

  13. Bacterial Diversity Analysis during the Fermentation Processing of Traditional Chinese Yellow Rice Wine Revealed by 16S rDNA 454 Pyrosequencing.

    PubMed

    Fang, Ruo-si; Dong, Ya-chen; Chen, Feng; Chen, Qi-he

    2015-10-01

    Rice wine is a traditional Chinese fermented alcohol drink. Spontaneous fermentation with the use of the Chinese starter and wheat Qu lead to the growth of various microorganisms during the complete brewing process. It's of great importance to fully understand the composition of bacteria diversity in rice wine in order to improve the quality and solve safety problems. In this study, a more comprehensive bacterial description was shown with the use of bacteria diversity analysis, which enabled us to have a better understanding. Rarefaction, rank abundance, alpha Diversity, beta diversity and principal coordinates analysis simplified their complex bacteria components and provide us theoretical foundation for further investigation. It has been found bacteria diversity is more abundant at mid-term and later stage of brewing process. Bacteria community analysis reveals there is a potential safety hazard existing in the fermentation, since most of the sequence reads are assigned to Enterobacter (7900 at most) and Pantoea (7336 at most), followed by Staphylococcus (2796 at most) and Pseudomonas (1681 at most). Lactic acid bacteria are rare throughout the fermentation process which is not in accordance with other reports. This work may offer us an opportunity to investigate micro ecological fermentation system in food industry.

  14. Scoliosis bracing and exercise for pain management in adults—a case report

    PubMed Central

    Weiss, Hans-Rudolf; Moramarco, Kathryn; Moramarco, Marc

    2016-01-01

    [Purpose] For adult patients with late-onset idiopathic scoliosis, cosmetic concerns and pain are the main reasons for seeking treatment at a physician’s office. The purpose of this paper was to describe the mid-term effect of physical rehabilitation and part-time bracing on an adult scoliosis patient who had been suffering from chronic low back pain for fourteen years. [Subject and Methods] Case description: A 37-year-old female patient with late-onset idiopathic scoliosis presented in the office of the first author in January 2014. She reported having chronic pain (low back pain) since the age of 23 and reported daily pain at a level of 5–7 on average on a Visual Analogue Scale of 0 to 10. She received a short scoliosis-specific Schroth exercise program and was also fitted with a Gensingen brace for part-time wear. [Results] At a 16 month follow-up, the patient no longer suffered from daily low back pain (with heavy lifting only) and was fully active. Additionally, her lumbar Cobb angle and angle of trunk rotation improved. [Conclusion] Patients with late-onset idiopathic scoliosis and pain may benefit from a pattern-specific conservative treatment approach. In this population, surgical intervention should be regarded as the last resort, since there are many long-term unknowns with surgery. PMID:27630444

  15. Augmented Fish Health Monitoring, 1989 Annual Report.

    SciTech Connect

    Michak, Patty

    1990-05-01

    Since 1986 Washington Department of Fisheries (WDF) has participated in the Columbia Basin Augmented Fish Health Monitoring Project, funded by Bonneville Power Administration (BPA). This interagency project was developed to provide a standardized level of fish health information from all Agencies rearing fish in the Columbia Basin. Agencies involved in the project are: WDF, Washington Department of Wildlife, Oregon Fish and Wildlife, Idaho Fish and Game, and the US Fish and Wildlife Service. WDF has actively participated in this project, and completed its third year of fish health monitoring, data collection and pathogen inspection during 1989. This report will present data collected from January 1, 1989 to December 31, 1989 and will compare sampling results from screening at spawning for viral pathogens and bacterial kidney disease (BKD), and evaluation of causes of pre-spawning loss. The juvenile analysis will include pre-release examination results, mid-term rearing exam results and evaluation of the Organosomatic Analysis completed on stocks. 2 refs., 4 figs., 15 tabs.

  16. Now To Harness The Sun!

    NASA Astrophysics Data System (ADS)

    Solar Energy Research Institute, E. L.

    1980-09-01

    Recognition of the necessity to fully develop alternative energy resources has resulted in renewed interest in capturing energy from the sun. The daily average amount of energy delivered to the earth by this essentially eternal source is a staggering 14,170 quads (1 quad = 101b Btu), compared to an annual world energy consumption of approximately 225 quads. The United States alone accounts for 35 percent, i.e., 79 quads, of the world's annual energy consumption. The incentives to harness the sun's energy are clear solar energy is free, clean, and abundant. However, the task of harvesting the energy and directing or controlling the manner in which it is used is an arduous one that encompasses diverse technologies, including direct and indirect conversion mechanisms. The solar technologies are photovoltaics, biomass conversion, solar thermal (including passive design), wind, ocean systems, and hydropower. Near-and mid-term energy contributions from solar passive design and active heating and cooling systems, wind energy conversion systems, and elements of biomass conversion such as alcohol production are expected. Later year contributions from photovoltaics, ocean systems, large solar thermal installations, and other biomass conversion processes are very promising. The impact of government policies, energy conservation, and the availability of other energy resources on the development of the solar options is significant and may influence the energy contribution that is achieved.

  17. The Third Pacific Basin Biofuels Workshop: Proceedings

    NASA Astrophysics Data System (ADS)

    Among the many compelling reasons for the development of biofuels on remote Pacific islands, several of the most important include: (1) a lack of indigenous fossil fuels necessitates their import at great economic loss to local island economics, (2) ideal conditions for plant growth exist on many Pacific islands to produce yields of biomass feedstocks, (3) gaseous and liquid fuels such as methane, methanol and ethanol manufactured locally from biomass feedstocks are the most viable alternatives to gasoline and diesel fuels for transportation, and (4) the combustion of biofuels is cleaner than burning petroleum products and contributes no net atmospheric CO2 to aggravate the greenhouse effect and the subsequent threat of sea level rise to low islands. Dr. Vic Phillips, HNEI Program Manager of the Hawaii Integrated Biofuels Research Program welcomed 60 participants to the Third Pacific Basin Biofuels Workshop at the Sheraton Makaha Hotel, Waianae, Oahu, on March 27 and 28, 1989. The objectives of the workshop were to update progress since the Second Pacific Basin Biofuels Workshop in April 1987 and to develop a plan for action for biofuels R and D, technology transfer, and commercialization now (immediate attention), in the near-term (less than two years), in the mid-term (three to five years), and in the long-term (more than six years). An emerging theme of the workshop was how the production, conversion, and utilization of biofuels can help increase environmental and economic security locally and globally. Individual papers are processed separately for the data base.

  18. An assessment of advanced technology for industrial cogeneration

    NASA Technical Reports Server (NTRS)

    Moore, N.

    1983-01-01

    The potential of advanced fuel utilization and energy conversion technologies to enhance the outlook for the increased use of industrial cogeneration was assessed. The attributes of advanced cogeneration systems that served as the basis for the assessment included their fuel flexibility and potential for low emissions, efficiency of fuel or energy utilization, capital equipment and operating costs, and state of technological development. Over thirty advanced cogeneration systems were evaluated. These cogeneration system options were based on Rankine cycle, gas turbine engine, reciprocating engine, Stirling engine, and fuel cell energy conversion systems. The alternatives for fuel utilization included atmospheric and pressurized fluidized bed combustors, gasifiers, conventional combustion systems, alternative energy sources, and waste heat recovery. Two advanced cogeneration systems with mid-term (3 to 5 year) potential were found to offer low emissions, multi-fuel capability, and a low cost of producing electricity. Both advanced cogeneration systems are based on conventional gas turbine engine/exhaust heat recovery technology; however, they incorporate advanced fuel utilization systems.

  19. Splenic flexure colon cancers: minimally invasive treatment.

    PubMed

    Fiscon, Valentino; Portale, Giuseppe; Migliorini, Giovanni; Frigo, Flavio

    2015-03-01

    Optimal treatment of splenic flexure (SF) colon cancer-less than 10% of all colorectal cancers is a matter of debate, in particular with regard to the optimal extent of radical surgery, according to the oncological principles of curative resection. Aims of this study were to assess the clinicopathological characteristics and report operative data and survival of patients with SF colon cancers. Short- and mid-term outcome of patients undergoing laparoscopic curative resection for SF colon cancer between June 2005 and September 2011 was assessed. The analysis considered 16 patients: 10 underwent segmental resection, 4 left hemicolectomy and 2 subtotal colectomy. There were no intraoperative deaths or major morbidity. The median operative time was 185 min. The median number of lymph nodes harvested was 17. Disease-free survival rate at 30-month follow-up was 75%. Laparoscopic resection of SF cancer is feasible and safe. Oncological principles of disease-free margins and minimum node harvest can be respected even with segmental resection.

  20. High Performance Healthcare Buildings: A Roadmap to Improved Energy Efficiency

    SciTech Connect

    Singer, Brett C.; Tschudi, William F.

    2009-09-08

    This document presents a road map for improving the energy efficiency of hospitals and other healthcare facilities. The report compiles input from a broad array of experts in healthcare facility design and operations. The initial section lists challenges and barriers to efficiency improvements in healthcare. Opportunities are organized around the following ten themes: understanding and benchmarking energy use; best practices and training; codes and standards; improved utilization of existing HVAC designs and technology; innovation in HVAC design and technology; electrical system design; lighting; medical equipment and process loads; economic and organizational issues; and the design of next generation sustainable hospitals. Achieving energy efficiency will require a broad set of activities including research, development, deployment, demonstration, training, etc., organized around 48 specific objectives. Specific activities are prioritized in consideration of potential impact, likelihood of near- or mid-term feasibility and anticipated cost-effectiveness. This document is intended to be broad in consideration though not exhaustive. Opportunities and needs are identified and described with the goal of focusing efforts and resources.

  1. Cruciate retaining and cruciate substituting ultra-congruent insert

    PubMed Central

    Deledda, Davide; Rosso, Federica; Ratto, Nicola; Bruzzone, Matteo; Bonasia, Davide Edoardo; Rossi, Roberto

    2016-01-01

    The posterior cruciate ligament (PCL) conservation and the polyethylene insert constraint in total knee arthroplasty (TKA) are still debated. The PCL is one of the primary stabilizers of the joint, but cruciate retaining (CR) implants have the disadvantage of a difficult balancing of the PCL. Postero-stabilized (PS) implants were introduced to reduce this problem. However, also the PS implants have some disadvantages, due to the cam-mechanism, such as high risk of cam-mechanism polyethylene wear. To minimize the polyethylene wear of the cam-mechanism and the bone sacrifice due to the intercondylar box, different types of inserts were developed, trying to increase the implant conformity and to reduce stresses on the bone-implant interface. In this scenario ultra-congruent (UC) inserts were developed. Those inserts are characterized by a high anterior wall and a deep-dished plate. This conformation should guarantee a good stability without the posterior cam. Few studies on both kinematic and clinical outcomes of UC inserts are available. Clinical and radiological outcomes, as well as kinematic data are similar between UC mobile bearing (MB) and standard PS MB inserts at short to mid-term follow-up. In this manuscript biomechanics and clinical outcomes of UC inserts will be described, and they will be compared to standard PS or CR inserts. PMID:26855938

  2. The Impact of Near-term Climate Policy Choices on Technology and Emissions Transition Pathways

    SciTech Connect

    Eom, Jiyong; Edmonds, James A.; Krey, Volker; Johnson, Nils; Longden, Thomas; Luderer, Gunnar; Riahi, Keywan; Van Vuuren, Detlef

    2015-01-01

    This paper explores the implications of delays associated with currently formulated climate policies (compared to optimal policies) for long-term transition pathways to limit climate forcing to 450ppm CO2e on the basis of the AMPERE Work Package 2 model comparison study. The paper highlights the critical importance of the 2030-2050 period for ambitious mitigation strategies. In this period, the most rapid shift to non-greenhouse gas emitting technology occurs. In the delayed response emissions mitigation scenarios, an even faster transition rate in this period is required to compensate for the additional emissions before 2030. Our physical deployment measures indicate that, without CCS, technology deployment rates in the 2030-2050 period would become considerably high. Yet the presence of CCS greatly alleviates the challenges to the transition particularly after the delayed climate policies. The results also highlight the critical role that bioenergy and CO2 capture and storage (BECCS) could play. If this technology is available, transition pathways exceed the emissions budget in the mid-term, removing the excess with BECCS in the long term. Excluding either BE or CCS from the technology portfolio implies that emission reductions need to take place much earlier.

  3. Geomagnetic Activity Forecasting Model based on SW-M-I coupling

    NASA Astrophysics Data System (ADS)

    Nagatsuma, Tsutomu; Kunitake, Manabu

    Prediction of geomagnetic activity is one of the fundamental issues of space weather forecast. We are developing geomagnetic activity forecasting model based on the solar wind -magneto-sphere -ionosphere (SW-M-I) coupling. The key point of our forecasting model is ionosphereic conductivity dependence of the coupling function. We have found that the efficiency of SW-M-I coupling is not constant but has a dependence of ionospheric conductivity within the polar cap. Therefore, operational forecasting model of geomagnetic activity should take into account these variations and dependence. Our model can explain the diurnal and semiannual and solar cycle variations of geomagnetic activity from solar wind parameter and F10.7 index. We also examine the possibility of using inner heliospheric solar wind data such as STEREO data for a few days advance of geomagnetic activity forecast. Based on the comparison between ACE and STEREO data, we have found that the solar wind velocity can be predicted from the STEREO data well, but the Bz component of interplanetary magnetic field (IMF) is difficult to predict rather than the magnitude of IMF. This suggests that the probabilistic approach is needed for the mid-term geomagnetic forecast. We will introduce the future direction of our geomagnetic activity forecasting model in our talk.

  4. [Reasearch progress in health economic evaluation of colorectal cancer screening in China].

    PubMed

    Huang, Huiyao; Shi, Jufang; Dai, Min

    2015-08-01

    Burden of colorectal cancer is rising in China. More attention and financial input have been paid to it by central government that colorectal cancer screening program has been carried out recently in many areas in China. Diversity of screening strategies and limited health resources render selecting the best strategy in a population-wide program a challenging task that economy was also required to be considered except safety and efficacy. To provide a reference for the subsequent further economic evaluation, here we reviewed the evidence available on the economic evaluation of colorectal cancer screening in China. Meanwhile, information related to screening strategies, participation and mid-term efficacy of screening, information and results on economic evaluation were extracted and summarized. Three of the four studies finally included evaluated strategies combining immunochemical fecel occult blood test (iFOBT) with high-risk factor questionnaire as initial screening, colonoscopy as diagnostic screening. There was a consensus regarding the efficacy and effectiveness of screening compared to no screening. Whereas the lack and poor comparability between studies, multi-perspective and multi-phase economic evaluation of colorectal cancer screening is needed, relying on current population-based screening program to conduct a comprehensive cost accounting. PMID:26733038

  5. Flexible Airspace Management (FAM) Research 2010 Human-in-the-Loop Simulation

    NASA Technical Reports Server (NTRS)

    Lee, Paul U.; Brasil, Connie; Homola, Jeffrey; Kessell, Angela; Prevot, Thomas; Smith, Nancy

    2011-01-01

    A human-in-the-Ioop (HITL) simulation was conducted to assess potential user and system benefits of Flexible Airspace Management (FAM) concept, as well as designing role definitions, procedures, and tools to support the FAM operations in the mid-term High Altitude Airspace (HAA) environment. The study evaluated the benefits and feasibility of flexible airspace reconfiguration in response to traffic overload caused by weather deviations, and compared them to those in a baseline condition without the airspace reconfiguration. The test airspace consisted of either four sectors in one Area of Specialization or seven sectors across two Areas. The test airspace was assumed to be at or above FL340 and fully equipped Vvith data communications (Data Comm). Other assumptions were consistent with those of the HAA concept. Overall, results showed that FAM operations with multiple Traffic Management Coordinators, Area Supervisors, and controllers worked remarkably well. The results showed both user and system benefits, some of which include the increased throughput, decreased flight distance, more manageable sector loads, and better utilized airspace. Also, the roles, procedures, airspace designs, and tools were all very well received. Airspace configuration options that resulted from a combination of algorithm-generated airspace configurations with manual modifications were well acceptec and posed little difficuIty and/or workload during airspace reconfiguration process. The results suggest a positive impact of FAM operations in HAA. Further investigation would be needed to evaluate if the benefits and feasibility would extend in either non-HAA or mixed equipage environment.

  6. Safety and feasibility of radiofrequency ablation for treatment of Bosniak IV renal cysts

    PubMed Central

    de Menezes, Marcos Roberto; Viana, Publio Cesar Cavalcante; Yamanari, Tássia Regina; Reis, Leonardo Oliveira; Nahas, William

    2016-01-01

    ABSTRACT Purpose To describe our initial experience with radiofrequency ablation (RFA) of Bosniak IV renal cysts. Materials and Methods From 2010 to 2014, 154 renal tumor cases were treated with percutaneous thermal ablation, of which 10 cases (6.4%) from nine patients were complex renal cysts and were treated with radiofrequency ablation. Results All complex cysts were classified as Bosniak IV (four women and five men; mean age: 63.6 yrs, range: 33–83 years). One patient had a single kidney. Lesion size ranged from 1.5 to 4.1cm (mean: 2.5cm) and biopsy was performed on four cysts immediately before the procedure, all of which were malignant (two clear cell and two papillary carcinoma). Mean volume reduction of complex cysts was 25% (range: 10–40%). No patients required retreatment with RFA and no immediate or late complications were observed. The follow-up of Bosniak IV cysts had a median of 27 months (interquartile range [IQR], 23 to 38) and no recurrence or significant loss of renal function were observed. Conclusions Mid-term follow-up of the cases in our database suggests that image-guided percutaneous RFA can treat Bosniak IV cysts with very low complication rates and satisfactorily maintain renal function. PMID:27286107

  7. Effects of Platelet-Rich Plasma (PRP) on a Model of Renal Ischemia-Reperfusion in Rats.

    PubMed

    Martín-Solé, Oriol; Rodó, Joan; García-Aparicio, Lluís; Blanch, Josep; Cusí, Victoria; Albert, Asteria

    2016-01-01

    Renal ischemia-reperfusion injury is a major cause of acute renal failure, causing renal cell death, a permanent decrease of renal blood flow, organ dysfunction and chronic kidney disease. Platelet-rich plasma (PRP) is an autologous product rich in growth factors, and therefore able to promote tissue regeneration and angiogenesis. This product has proven its efficacy in multiple studies, but has not yet been tested on kidney tissue. The aim of this work is to evaluate whether the application of PRP to rat kidneys undergoing ischemia-reperfusion reduces mid-term kidney damage. A total of 30 monorrenal Sprague-Dawley male rats underwent renal ischemia-reperfusion for 45 minutes. During ischemia, PRP (PRP Group, n = 15) or saline solution (SALINE Group, n = 15) was administered by subcapsular renal injection. Control kidneys were the contralateral organs removed immediately before the start of ischemia in the remaining kidneys. Survival, body weight, renal blood flow on Doppler ultrasound, kidney weight, kidney volume, blood biochemistry and histopathology were determined for all subjects and kidneys, as applicable. Correlations between these variables were searched for. The PRP Group showed significantly worse kidney blood flow (p = 0.045) and more histopathological damage (p<0.0001). Correlations were found between body weight, kidney volume, kidney weight, renal blood flow, histology, and serum levels of creatinine and urea. Our study provides the first evidence that treatment with PRP results in the deterioration of the kidney's response to ischemia-reperfusion injury. PMID:27551718

  8. Bioresorbable vascular scaffolds—time to vanish?

    PubMed Central

    Arroyo, Diego; Cook, Stéphane

    2016-01-01

    The fully bioabsorbable vascular scaffold (BVS) has been developed to reduce late adverse events after coronary stenting such as device thrombosis. The device consists of polylactic acid, which is gradually absorbed within the first few years after its implantation. The initial experience with the device in low-risk patients presenting with simple lesions was satisfying and generated optimism among interventional cardiologists by promising better patient outcomes. However, the unrestricted use of the device in patients presenting with a higher baseline risk and more complex lesions came at the cost of alarmingly high rates of early device thrombosis. The performance of the device largely depends on an optimal implantation technique, which differs from that employed with metallic drug-eluting stents due to the device’s distinct physical propensity. Mid-term outcomes in large-scale randomized clinical trial were disappointing. Although its non-inferiority compared to metallic everolimus-eluting stents was formally met, there was a clear trend towards an increased occurrence of myocardial infarction and device thrombosis during the first year after device implantation. However, the BVS’s putative advantages are expected to manifest themselves at long-term, that is 3 to 5 years after the device has been implanted. Evidence pertaining to these long-term outcomes is eagerly awaited. PMID:27293872

  9. Solar Electric Propulsion

    NASA Technical Reports Server (NTRS)

    LaPointe, Michael

    2006-01-01

    The Solar Electric Propulsion (SEP) technology area is tasked to develop near and mid-term SEP technology to improve or enable science mission capture while minimizing risk and cost to the end user. The solar electric propulsion investments are primarily driven by SMD cost-capped mission needs. The technology needs are determined partially through systems analysis tasks including the recent "Re-focus Studies" and "Standard Architecture Study." These systems analysis tasks transitioned the technology development to address the near term propulsion needs suitable for cost-capped open solicited missions such as Discovery and New Frontiers Class missions. Major SEP activities include NASA's Evolutionary Xenon Thruster (NEXT), implementing a Standard Architecture for NSTAR and NEXT EP systems, and developing a long life High Voltage Hall Accelerator (HiVHAC). Lower level investments include advanced feed system development and xenon recovery testing. Future plans include completion of ongoing ISP development activities and evaluating potential use of commercial electric propulsion systems for SMD applications. Examples of enhanced mission capability and technology readiness dates shall be discussed.

  10. In-Space Propulsion Technology Program Solar Electric Propulsion Technologies

    NASA Technical Reports Server (NTRS)

    Dankanich, John W.

    2006-01-01

    NASA's In-space Propulsion (ISP) Technology Project is developing new propulsion technologies that can enable or enhance near and mid-term NASA science missions. The Solar Electric Propulsion (SEP) technology area has been investing in NASA s Evolutionary Xenon Thruster (NEXT), the High Voltage Hall Accelerator (HiVHAC), lightweight reliable feed systems, wear testing, and thruster modeling. These investments are specifically targeted to increase planetary science payload capability, expand the envelope of planetary science destinations, and significantly reduce the travel times, risk, and cost of NASA planetary science missions. Status and expected capabilities of the SEP technologies are reviewed in this presentation. The SEP technology area supports numerous mission studies and architecture analyses to determine which investments will give the greatest benefit to science missions. Both the NEXT and HiVHAC thrusters have modified their nominal throttle tables to better utilize diminished solar array power on outbound missions. A new life extension mechanism has been implemented on HiVHAC to increase the throughput capability on low-power systems to meet the needs of cost-capped missions. Lower complexity, more reliable feed system components common to all electric propulsion (EP) systems are being developed. ISP has also leveraged commercial investments to further validate new ion and hall thruster technologies and to potentially lower EP mission costs.

  11. Electrochemical energy — progress towards a cleaner future: lead/acid batteries and the competition

    NASA Astrophysics Data System (ADS)

    Appleby, A. J.

    Electric vehicles (EVs) with conventional architecture may be capable of a range of 72-80 km (45-50 miles) with a 35 Wh kg -1 lead/acid battery with a weight equal to 25% of that of the vehicle. An improved vehicle (such as the GM Impact) with lower energy utilization and architecture that allows greater battery weight may attain 160 km (100 miles). A battery corresponding to the mid-term goal of the US Advanced Battery Consortium in an Impact-type vehicle could allow 480 km (300 miles) range. It remains to be seen if this will be technically and economically attained. The EV is more likely to be made practical with the development of a satisfactory polymer-exchange-membrane (PEM) fuel cell, which will involve the same recharging logistics as those of a gasoline vehicle, with much improved energy efficiency. Considerable progress is still required, but one major problem, the amount of platinum catalyst required per vehicle, appears to have been overcome. A loading of 0.15 g/kW now appears to be feasible, so major production of such vehicles will allow platinum producers to keep pace. The advent of the PEM-fuel-cell/battery hybrid vehicle wiil open up a larger market for rechargeable bateries than that for vehicles which use traction batteries alone. Economics seem to point to the fact that such vehicles will use lead/acid batteries for the hybrid peak power and regenerative braking element.

  12. Laparoscopic resection of splenic flexure tumors.

    PubMed

    Carlini, Massimo; Spoletini, Domenico; Castaldi, Fabio; Giovannini, Cristiano; Passaro, Umberto

    2016-03-01

    In this paper a single institution experience in laparoscopic treatment of splenic flexure tumors (SFT) is reported. Low incidence of these tumors and complexity of the procedure make the laparoscopic resection not diffuse and not well standardized. Since 2004, in a specific database, we prospectively record clinicopathological features and outcome of all patients submitted to laparoscopic colorectal resection. From January 2004 to October 2015, out of 567 cases of minimally invasive colorectal procedures, we performed 20 laparoscopic resection of SFT, 11 with extracorporeal anastomosis and 9 totally laparoscopic. Twelve patients had an advanced disease. Conversion rate was null. The mean operative time was 105' (range 70'-135'). Comparing extracorporeal and intracorporeal anastomoses, we did not find any significant difference in mean duration of surgery. Mean distal margin was 9.4 ± 3.1 cm (mean ± DS), mean proximal margin 8.9 ± 2.7 cm. The mean number of harvested lymph nodes was 17.8 ± 5.6. Evaluating surgical short-term and oncological mid-term outcomes, laparoscopic resection of splenic flexure for tumors, even if challenging, resulted technically feasible and oncologically safe and it seems to be advisable.

  13. Analysis and clustering of natural gas consumption data for thermal energy use forecasting

    NASA Astrophysics Data System (ADS)

    Franco, Alessandro; Fantozzi, Fabio

    2015-11-01

    In this paper, after a brief analysis of the connections between the uses of natural gas and thermal energy use, the natural gas consumption data related to Italian market are analyzed and opportunely clustered in order to compute the typical consumption profile in different days of the week in different seasons and for the different class of users: residential, tertiary and industrial. The analysis of the data shows that natural gas consumption profile is mainly related to seasonality pattern and to the weather conditions (outside temperature, humidity and wind chiller). There is also an important daily pattern related to industrial and civil sector that, at a lower degree than the previous one, does affect the consumption profile and have to be taken into account for defining an effective short and mid term thermal energy forecasting method. A possible mathematical structure of the natural gas consumption profile is provided. Due to the strong link between thermal energy use and natural gas consumption, this analysis could be considered the first step for the development of a model for thermal energy forecasting.

  14. Acquiring experience in pathology predominantly from what you see, not from what you read: the HIPON e-learning platform.

    PubMed

    Riccioni, Olga; Vrasidas, Charalambos; Brcic, Luka; Armenski, Goce; Seiwerth, Sven; Smeets, Annemieke; van Krieken, J Han Jm; Lazaris, Andreas C

    2015-01-01

    It is indisputable that nowadays one of the hardest and most important tasks in medicine and especially in medical education, is the conversion of the extensive amount of available data, into medical experience, after a proper analysis. A project under the title "ICT (Information and Communication Technology) eModules on HistoPathology: a useful online tool for students, researchers and professionals - HIPON", co-financed by the Lifelong Learning Program of the Education, Audiovisual and Culture Executive Agency (EACEA), The Commission of the European Union, has been launched at the beginning of 2013. HIPON's purpose is not to provide just another pathology website atlas, but to convey professional experience and thinking in pathology. HIPON has resulted in a well-structured and user-friendly, open resource, multi-language, e-learning platform which, taking advantage of modern image technology, offers medical students, researchers, and professionals a valuable teaching instrument so that they can acquire professional experience in pathology. The mid-term report of HIPON has been favorably evaluated by the EACEA experts who appreciated the potential of our teaching tool in providing the opportunity and the means to acquire medical experience. Through the use of virtual slides, educative videos and microscopic, high resolution, marked images accompanied by relevant questions and answers, HIPON project aims to make end-users able to think as experienced pathologists and become highly efficient in correlating pathologic data with other clinical-laboratory information. PMID:26089711

  15. From Streams to Lumps: Transforming Long-Term Incentives into Up-Front Financing for New Nuclear Construction

    SciTech Connect

    George, Glenn R.

    2006-07-01

    The Energy Policy Act of 2005 is an important development in the financing of new nuclear capacity in the near- to mid-term in the U.S.A. Key features of the Act, including production tax credits, loan guarantees, funding support, and 'standby support', are intended to provide significant incentives for new nuclear development, construction, and operation. There is a mismatch, however, between the nature and extent of incentives being offered and what is needed to spur nuclear plant deployment in light of power market uncertainty, utility investor wariness, and the need to raise significant capital before a nuclear construction project can be launched. In this paper, the author addresses these issues through the lens of financial tools and techniques. The paper considers various ways in which long-term streams of subsidies can be transformed into up-front financing for new nuclear capacity. Securing and related financial structures are among the mechanisms considered for potentially bridging the temporal gap between flows of financial benefits conferred legislatively and lumps of capital required by developers and investors in advance of a construction program. (authors)

  16. Controlled programmed trial of Ocimum sanctum leaf on generalized anxiety disorders.

    PubMed

    Bhattacharyya, D; Sur, T K; Jana, U; Debnath, P K

    2008-09-01

    Ocimumn sanctum, an Indian medicinal plant, has been on trial for its role in generalized anxiety disorder (GAD) in hospital based clinical set-up. Hamilton's brief psychiatric rating scale (BPRS) and thorough clinical investigations were used to screen the subjects. Thirty-five subjects (21 male and 14 female; average age 38.4 years) were medicated with the plant extract in a fixed dose regime (500 mg/capsule, twice daily, p.o. after meal). They were thoroughly investigated clinically and using standard questionnaires based on different psychological rating scale at baseline (day 0), mid-term (day 30) and final (day 60). The observations exhibited that, O. sanctum significantly (p<0.001) attenuated generalized anxiety disorders and also attenuated its correlated stress and depression. It further significantly (p<0.001) improved the willingness to adjustment and attention in human. Therefore, it may be concluded that O. sanctum may be useful in the treatment of GAD in human and may be a promising anxiolytic agent in near future. PMID:19253862

  17. Laparoscopic resection of splenic flexure tumors.

    PubMed

    Carlini, Massimo; Spoletini, Domenico; Castaldi, Fabio; Giovannini, Cristiano; Passaro, Umberto

    2016-03-01

    In this paper a single institution experience in laparoscopic treatment of splenic flexure tumors (SFT) is reported. Low incidence of these tumors and complexity of the procedure make the laparoscopic resection not diffuse and not well standardized. Since 2004, in a specific database, we prospectively record clinicopathological features and outcome of all patients submitted to laparoscopic colorectal resection. From January 2004 to October 2015, out of 567 cases of minimally invasive colorectal procedures, we performed 20 laparoscopic resection of SFT, 11 with extracorporeal anastomosis and 9 totally laparoscopic. Twelve patients had an advanced disease. Conversion rate was null. The mean operative time was 105' (range 70'-135'). Comparing extracorporeal and intracorporeal anastomoses, we did not find any significant difference in mean duration of surgery. Mean distal margin was 9.4 ± 3.1 cm (mean ± DS), mean proximal margin 8.9 ± 2.7 cm. The mean number of harvested lymph nodes was 17.8 ± 5.6. Evaluating surgical short-term and oncological mid-term outcomes, laparoscopic resection of splenic flexure for tumors, even if challenging, resulted technically feasible and oncologically safe and it seems to be advisable. PMID:27040272

  18. Bioresorbable vascular scaffolds-time to vanish?

    PubMed

    Arroyo, Diego; Cook, Stéphane; Puricel, Serban

    2016-06-01

    The fully bioabsorbable vascular scaffold (BVS) has been developed to reduce late adverse events after coronary stenting such as device thrombosis. The device consists of polylactic acid, which is gradually absorbed within the first few years after its implantation. The initial experience with the device in low-risk patients presenting with simple lesions was satisfying and generated optimism among interventional cardiologists by promising better patient outcomes. However, the unrestricted use of the device in patients presenting with a higher baseline risk and more complex lesions came at the cost of alarmingly high rates of early device thrombosis. The performance of the device largely depends on an optimal implantation technique, which differs from that employed with metallic drug-eluting stents due to the device's distinct physical propensity. Mid-term outcomes in large-scale randomized clinical trial were disappointing. Although its non-inferiority compared to metallic everolimus-eluting stents was formally met, there was a clear trend towards an increased occurrence of myocardial infarction and device thrombosis during the first year after device implantation. However, the BVS's putative advantages are expected to manifest themselves at long-term, that is 3 to 5 years after the device has been implanted. Evidence pertaining to these long-term outcomes is eagerly awaited. PMID:27293872

  19. Solar Central Receiver Hybrid Power Systems sodium-cooled receiver concept. Final report. Volume III. Appendices

    SciTech Connect

    1980-01-01

    The overall, long term objective of the Solar Central Receiver Hybrid Power System is to identify, characterize, and ultimately demonstrate the viability and cost effectiveness of solar/fossil, steam Rankine cycle, hybrid power systems that: (1) consist of a combined solar central receiver energy source and a nonsolar energy source at a single, common site, (2) may operate in the base, intermediate, and peaking capacity modes, (3) produce the rated output independent of variations in solar insolation, (4) provide a significant savings (50% or more) in fuel consumpton, and (5) produce power at the minimum possible cost in mills/kWh. It is essential that these hybrid concepts be technically feasible and economically competitive with other systems in the near to mid-term time period (1985-1990) on a commercial scale. The program objective for Phase I is to identify and conceptually characterize solar/fossil steam Rankine cycle, commercial-scale, power plant systems that are economically viable and technically feasible. This volume contains appendices to the conceptual design and systems analysis studies gien in Volume II, Books 1 and 2. (WHK)

  20. The influence of clearance on friction, lubrication and squeaking in large diameter metal-on-metal hip replacements.

    PubMed

    Brockett, Claire L; Harper, Phil; Williams, Sophie; Isaac, Graham H; Dwyer-Joyce, Rob S; Jin, Zhongmin; Fisher, John

    2008-04-01

    Large diameter metal-on-metal bearings (MOM) are becoming increasingly popular, addressing the needs of young and more active patients. Clinical data has shown excellent short-to-mid-term results, though incidences of transient squeaking have been noted between implantation and up to 2 years post-operative. Geometric design features, such as clearance, have been significant in influencing the performance of the bearings. Sets of MOM bearings with different clearances were investigated in this study using a hip friction simulator to examine the influence of clearance on friction, lubrication and squeaking. The friction factor was found to be highest in the largest clearance bearings under all test conditions. The incidence of squeaking was also highest in the large clearance bearings, with all bearings in this group squeaking throughout the study. A very low incidence of squeaking was observed in the other two clearance groups. The measured lubricating film was found to be lowest in the large clearance bearings. This study suggests that increasing the bearing clearance results in reduced lubricant film thickness, increased friction and an increased incidence of squeaking.

  1. Improvement of tuberculosis laboratory capacity on Pemba Island, Zanzibar: a health cooperation project.

    PubMed

    Paglia, Maria G; Bevilacqua, Nazario; Haji, Haji Said; Vairo, Francesco; Girardi, Enrico; Nicastri, Emanuele; Muhsin, Juma; Racalbuto, Vincenzo; Jiddawi, Mohammed S; Ippolito, Giuseppe

    2012-01-01

    Low-income countries with high Tuberculosis burden have few reference laboratories able to perform TB culture. In 2006, the Zanzibar National TB Control Programme planned to decentralize TB diagnostics. The Italian Cooperation Agency with the scientific support of the "L. Spallanzani" National Institute for Infectious Diseases sustained the project through the implementation of a TB reference laboratory in a low-income country with a high prevalence of TB. The implementation steps were: 1) TB laboratory design according to the WHO standards; 2) laboratory equipment and reagent supplies for microscopy, cultures, and identification; 3) on-the-job training of the local staff; 4) web- and telemedicine-based supervision. From April 2007 to December 2010, 921 sputum samples were received from 40 peripheral laboratories: 120 TB cases were diagnosed. Of all the smear-positive cases, 74.2% were culture-positive. During the year 2010, the smear positive to culture positive rate increased up to 100%. In March 20, 2010 the Ministry of Health and Social Welfare of Zanzibar officially recognized the Public Health Laboratory- Ivo de Carneri as the National TB Reference Laboratory for the Zanzibar Archipelago. An advanced TB laboratory can represent a low cost solution to strengthen the TB diagnosis, to provide capacity building and mid-term sustainability.

  2. A model to forecast data centre infrastructure costs.

    NASA Astrophysics Data System (ADS)

    Vernet, R.

    2015-12-01

    The computing needs in the HEP community are increasing steadily, but the current funding situation in many countries is tight. As a consequence experiments, data centres, and funding agencies have to rationalize resource usage and expenditures. CC-IN2P3 (Lyon, France) provides computing resources to many experiments including LHC, and is a major partner for astroparticle projects like LSST, CTA or Euclid. The financial cost to accommodate all these experiments is substantial and has to be planned well in advance for funding and strategic reasons. In that perspective, leveraging infrastructure expenses, electric power cost and hardware performance observed in our site over the last years, we have built a model that integrates these data and provides estimates of the investments that would be required to cater to the experiments for the mid-term future. We present how our model is built and the expenditure forecast it produces, taking into account the experiment roadmaps. We also examine the resource growth predicted by our model over the next years assuming a flat-budget scenario.

  3. Quaternary downcutting rates from cave-deposited river sediment and Holocene erosion rates from river sand in the Central Pyrenees

    NASA Astrophysics Data System (ADS)

    Vernant, Philippe; Genti, Manon; Chéry, Jean; Cazes, Gaël; Braucher, Régis

    2016-04-01

    We use 26Al and 10Be to infer the time of cave-deposited river sediment emplacement in the Central Pyrenees and the Cevennes. Using these ages, we derive mid-term downcutting rates (1-4.106 a). We also use the cosmogenic radionuclides 10Be concentration in quartz extracted from river sand to estimate short-term (102-105 a) erosion rates. Along the N-S profile across the central Pyrenees, we do not see any significant change in erosion rates during the Quaternary. On the other hand, the erosion rates are highly correlated with the local elevation. They vary roughly from 50 m/Myr in the foreland up to 800 m/Myr in the axial part of the mountain range. The mechanisms responsible for the Pyrenees moderate, but frequent, seismicity have yet to be determined. Based on numerical modeling and our erosion rates, we propose that this seismicity could be explained by the isostatic rebound associated to the erosion of the range. To evaluate the likeliness of this hypothesis, we aim at comparing the Pyrenees and the Cevennes to check if the rates are significantly different between these mountain ranges with very different seismic behavior.

  4. Cyclic nucleotide–gated channels, calmodulin, adenylyl cyclase, and calcium/calmodulin-dependent protein kinase II are required for late, but not early, long-term memory formation in the honeybee

    PubMed Central

    Matsumoto, Yukihisa; Sandoz, Jean-Christophe; Devaud, Jean-Marc; Lormant, Flore; Mizunami, Makoto; Giurfa, Martin

    2014-01-01

    Memory is a dynamic process that allows encoding, storage, and retrieval of information acquired through individual experience. In the honeybee Apis mellifera, olfactory conditioning of the proboscis extension response (PER) has shown that besides short-term memory (STM) and mid-term memory (MTM), two phases of long-term memory (LTM) are formed upon multiple-trial conditioning: an early phase (e-LTM) which depends on translation from already available mRNA, and a late phase (l-LTM) which requires de novo transcription and translation. Here we combined olfactory PER conditioning and neuropharmacological inhibition and studied the involvement of the NO–cGMP pathway, and of specific molecules, such as cyclic nucleotide-gated channels (CNG), calmodulin (CaM), adenylyl cyclase (AC), and Ca2+/calmodulin-dependent protein kinase (CaMKII), in the formation of olfactory LTM in bees. We show that in addition to NO–cGMP and cAMP–PKA, CNG channels, CaM, AC, and CaMKII also participate in the formation of a l-LTM (72-h post-conditioning) that is specific for the learned odor. Importantly, the same molecules are dispensable for olfactory learning and for the formation of both MTM (in the minute and hour range) and e-LTM (24-h post-conditioning), thus suggesting that the signaling pathways leading to l-LTM or e-LTM involve different molecular actors. PMID:24741108

  5. Post-experimental analysis of a solid oxide fuel cell stack using hybrid seals

    NASA Astrophysics Data System (ADS)

    Thomann, O.; Rautanen, M.; Himanen, O.; Tallgren, J.; Kiviaho, J.

    2015-01-01

    A post-experimental analysis of a SOFC stack is presented. The stack was operated for 1800 h at 700 °C with air and hydrogen and contained hybrid glass-Thermiculite 866 seals. The goal of this work was to investigate the sealing microstructure and possible corrosion during mid-term operation. It was found that hybrid seals could effectively compensate for manufacturing tolerances of cells and other components due to the compliance of the glass layer. Additionally, different interfaces were investigated for corrosion. Corrosion was not observed at two-phase interfaces such as Crofer 22 APU/glass, glass/electrolyte and glass/Thermiculite 866. The three-phase interface between Crofer 22 APU/glass/hydrogen exhibited no corrosion. Some evidence of non-systematic corrosion was found at the Crofer 22 APU/glass/air interface. The possible reasons for the corrosion are discussed. Lastly, dual exposure to humid hydrogen and air of the 0.2 mm Crofer 22 APU interconnect had no detrimental effect on the corrosion compared to air exposure. Overall the hybrid seals used in combination with the thin interconnects were found to be a promising solution due to the low leak rate and limited material interactions.

  6. Simulated Performance of the Orbiting Wide-angle Light Collectors (OWL) Experiment

    NASA Technical Reports Server (NTRS)

    Krizmanic, J. F.; Whitaker, Ann F. (Technical Monitor)

    2001-01-01

    The Orbiting Wide-angle Light collectors (OWL) experiment is in NASA's mid-term strategic plan and will stereoscopically image, from equatorial orbit, the air fluorescence signal generated by airshowers induced by the ultrahigh energy (E greater than few x 10(exp 19) eV) component of the cosmic radiation. The use of a space-based platform enables an extremely large event acceptance aperture and thus will allow a high statistics measurement of these rare events. Detailed Monte Carlo simulations are required to quantify the physics potential of the mission as well as optimize the instrumental parameters. This paper reports on the results of the GSFC Monte Carlo simulation for two different, OWL instrument baseline designs. These results indicate that, assuming a continuation of the cosmic ray spectrum (theta approximately E(exp -2.75), OWL could have an event rate of 4000 events/year with E greater than or equal to 10(exp 20) eV. Preliminary results, based upon these Monte Carlo simulations, indicate that events can be accurately reconstructed in the detector focal plane arrays for the OWL instrument baseline designs under consideration.

  7. Monitoring progress of the role of integration of environmental health education with water and sanitation services in changing community behaviours.

    PubMed

    Metwally, Ammal M; Saad, Amal; Ibrahim, Nihad A; Emam, Hanaa M; El-Etreby, Lobna A

    2007-02-01

    The health benefits of clean water, improved sanitation and better hygiene are now more recognized than ever before. The objective of the present study focused on monitoring the progress of behavioural changes towards appropriate behaviours related to water, environment and sanitation (WES). This was achieved through assessing the baseline community behaviours towards WES, exploring to what extent community hygienic behaviours had changed towards desirable and sustainable behaviours, through monitoring progress. The expected behavioural changes are results of an integrated package; safe water supply, sanitation, and hygiene education interventions produced by governmental and non-governmental organizations. The monitoring progress consisted of three household surveys that were administered over three years in four Egyptian districts within three Governorates; Fayoum, Beni Suef, and El-Menia. Behavioural changes were detected through special observation checklist indicators. These indicators were 7, 6, and 9 indicators each for personal hygienic behaviours, proper handling of drinking water, and proper use and maintenance of simple constructed sanitary latrines. The results from the baseline to mid-term and final surveys suggested improvement in the majority of the household behaviours towards the desirable behaviours. The proportions of the householders who practiced desirable behaviours were not to the same levels in the four districts. The results provide support to the concept that integrated interventions can produce a significant sustainable improvement in health promotion. PMID:17365081

  8. Targeted technology applications for infield reserve growth: A synopsis of the Secondary Natural Gas Recovery project, Gulf Coast Basin. Topical report, September 1988--April 1993

    SciTech Connect

    Levey, R.A.; Finley, R.J.; Hardage, B.A.

    1994-06-01

    The Secondary Natural Gas Recovery (SGR): Targeted Technology Applications for Infield Reserve Growth is a joint venture research project sponsored by the Gas Research Institute (GRI), the US Department of Energy (DOE), the State of Texas through the Bureau of Economic Geology at The University of Texas at Austin, with the cofunding and cooperation of the natural gas industry. The SGR project is a field-based program using an integrated multidisciplinary approach that integrates geology, geophysics, engineering, and petrophysics. A major objective of this research project is to develop, test, and verify those technologies and methodologies that have near- to mid-term potential for maximizing recovery of gas from conventional reservoirs in known fields. Natural gas reservoirs in the Gulf Coast Basin are targeted as data-rich, field-based models for evaluating infield development. The SGR research program focuses on sandstone-dominated reservoirs in fluvial-deltaic plays within the onshore Gulf Coast Basin of Texas. The primary project research objectives are: To establish how depositional and diagenetic heterogeneities cause, even in reservoirs of conventional permeability, reservoir compartmentalization and hence incomplete recovery of natural gas. To document examples of reserve growth occurrence and potential from fluvial and deltaic sandstones of the Texas Gulf Coast Basin as a natural laboratory for developing concepts and testing applications. To demonstrate how the integration of geology, reservoir engineering, geophysics, and well log analysis/petrophysics leads to strategic recompletion and well placement opportunities for reserve growth in mature fields.

  9. Trends in pesticide concentrations and use for major rivers of the United States.

    PubMed

    Ryberg, Karen R; Gilliom, Robert J

    2015-12-15

    Trends in pesticide concentrations in 38 major rivers of the United States were evaluated in relation to use trends for 11 commonly occurring pesticide compounds. Pesticides monitored in water were analyzed for trends in concentration in three overlapping periods, 1992-2001, 1997-2006, and 2001-2010 to facilitate comparisons among sites with variable sample distributions over time and among pesticides with changes in use during different periods and durations. Concentration trends were analyzed using the SEAWAVE-Q model, which incorporates intra-annual variability in concentration and measures of long-term, mid-term, and short-term streamflow variability. Trends in agricultural use within each of the river basins were determined using interval-censored regression with high and low estimates of use. Pesticides strongly dominated by agricultural use (cyanazine, alachlor, atrazine and its degradate deethylatrazine, metolachlor, and carbofuran) had widespread agreement between concentration trends and use trends. Pesticides with substantial use in both agricultural and nonagricultural applications (simazine, chlorpyrifos, malathion, diazinon, and carbaryl) had concentration trends that were mostly explained by a combination of agricultural-use trends, regulatory changes, and urban use changes inferred from concentration trends in urban streams. When there were differences, concentration trends usually were greater than use trends (increased more or decreased less). These differences may occur because of such factors as unaccounted pesticide uses, delayed transport to the river through groundwater, greater uncertainty in the use data, or unquantified land use and management practice changes.

  10. Overview of Research Transition Products

    NASA Technical Reports Server (NTRS)

    Robinson, John

    2014-01-01

    Demonstrate increased, more consistent use of Performance- Based Navigation (PBN). Accelerate transfer of NASA scheduling and spacing technologies for inclusion in late mid-term NAS. During high-fidelity human-in-the-loop simulations of Terminal Sequencing and Spacing, air traffic controllers have significantly improved their use of PBN procedures during busy traffic periods without increased workload. Executed an aggressive, short timeframe development schedule. Developed TSS prototype based upon FAA operational systems. Conducted multiple joint FAA/NASA human-in-the-loop simulations. Performed repeated incremental deliveries of tech transfer material to non-traditional RTT stakeholders. Will continue to participate in later phases of FAA acquisition process. ATD-1 transferred Terminal Sequencing and Spacing (TSS) technologies to the FAA. TSS enables routine use of underutilized advanced avionics and PBN procedures. Potential benefits to airlines operating at initial TSS sites estimated to be $300-400M/year. FAA is planning for an initial capability in the NAS in 2018.

  11. Potential of Securitization in Solar PV Finance

    SciTech Connect

    Lowder, T.; Mendelsohn, M.

    2013-12-01

    This report aims to demonstrate, hypothetically and at a high level, what volumes of solar deployment could be supported given solar industry access to the capital markets in the form of security issuance. Securitization is not anticipated to replace tax equity in the near- to mid-term, but it could provide an additional source of funds that would be comparatively inexpensive and could reduce the weighted average cost of capital for a given solar project or portfolio. Thus, the potential to securitize solar assets and seek financing in the capital markets could help to sustain the solar industry when the investment tax credit (ITC) -- one of the federal incentives that has leveraged billions of dollars of private capital in the solar industry -- drops from 30% to 10% at the close of 2016. The report offers analysis on the size of the U.S. third-party financed solar market, as well as on the volumes (in MW) of solar asset origination possible through a $100 million securitization fund (assuming no overcollateralization). It also provides data on the size of the relevant securities markets and how the solar asset class may fit into these markets.

  12. Closure of the middle ear with special reference to the development of the tegmen tympani of the temporal bone

    PubMed Central

    Rodríguez-Vázquez, José Francisco; Murakami, Gen; Verdugo-López, Samuel; Abe, Shin-ichi; Fujimiya, Mineko

    2011-01-01

    Closure of the middle ear is believed to be closely related to the evolutionary development of the mammalian jaw. However, few comprehensive descriptions are available on fetal development. We examined paraffin-embedded specimens of 20 mid-term human fetuses at 8–25 weeks of ovulation age (crown-rump length or CRL, 38–220 mm). After 9 weeks, the tympanic bone and the squamous part of the temporal bone, each of which was cranial or caudal to Meckel's cartilage, grew to close the lateral part of the tympanosquamosal fissure. At the same time, the cartilaginous tegmen tympani appeared independently of the petrous part of the temporal bone and resulted in the petrosquamosal fissure. Subsequently, the medial part of the tympanosquamosal fissure was closed by the descent of a cartilaginous inferior process of the tegmen tympani. When Meckel's cartilage changed into the sphenomandibular ligament and the anterior ligament of the malleus, the inferior process of the tegmen tympani interposed between the tympanic bone and the squamous part of the temporal bone, forming the petrotympanic fissure for the chorda tympani nerve and the discomalleolar ligament. Therefore, we hypothesize that, in accordance with the regression of Meckel's cartilage, the rapidly growing temporomandibular joint provided mechanical stress that accelerated the growth and descent of the inferior process of the tegmen tympani via the discomalleolar ligament. The usual diagram showing bony fissures around the tegmen tympani may overestimate the role of the tympanic bone in the fetal middle-ear closure. PMID:21477146

  13. Space Weather Models - What They Can and Cannot Do.

    NASA Astrophysics Data System (ADS)

    MacNeice, P. J.

    2014-12-01

    For more than 10 years, the CCMC has been hosting and testing almost all of the models currently used for space weather forecasting, and those in the pipeline for future use. This puts us in a unique position to review their capabilities, identify strengths and weaknesses, and project the arrival in the operational forecasting theatre of new, more accurate and more comprehensive forecasting tools. In this talk we will review the current status of forecasting models, focussing on those for the solar corona and inner heliosphere, including their impact on the Earth's magnetosphere. We will identify their capabilities and weaknesses. We will discuss how these weaknesses may be addressed in the near and mid-term, with new models, model updates and new supporting tools. We will assess the expected use of time dependent assimilative models of photospheric magnetic field and of time dependent high resolution and high cadence vector magnetograms on near term heliophysical model development. We will also discuss a web based semi-automated model validation project which the modeling community has been developing.

  14. NASA's In-Space Propulsion Technology Program: A Step Toward Interstellar Exploration

    NASA Astrophysics Data System (ADS)

    Johnson, L.; James, B.; Baggett, R.; Montgomery, E. E., IV

    NASA's In-Space Propulsion Technology Program is investing in technologies that have the potential to revolutionize the robotic exploration of deep space. For robotic exploration and science missions, increased efficiencies of future propulsion systems are critical to reduce overall life-cycle costs and, in some cases, enable missions previously considered impossible. Continued reliance on conventional chemical propulsion alone will not enable the robust exploration of deep space. The maximum theoretical efficiencies have almost been reached and are insufficient to meet needs for many ambitious science missions currently being considered. By developing the capability to support mid-term robotic mission needs, the program is laying the technological foundation for travel to nearby interstellar space. The In-Space Propulsion Technology Program's technology portfolio includes many advanced propulsion systems. From the next-generation ion propulsion systems operating in the 5-10 kW range, to solar sail propulsion, substantial advances in spacecraft propulsion performance are anticipated. Some of the most promising technologies for achieving these goals use the environment of space itself for energy and propulsion and are generically called “propellantless” because they do not require onboard fuel to achieve thrust. Propellantless propulsion technologies include scientific innovations such as solar sails and aerocapture. This paper will provide an overview of those propellantless and propellant-based advanced propulsion technologies that will most significantly advance our exploration of deep space.

  15. Development of On-Orbit Servicing Concepts, Technology Option and Roadmap (Part I) - Commercial Aspects

    NASA Astrophysics Data System (ADS)

    Grover, D.; Jacobs, S.; Abbasi, V.; Cree, D.; Daae, M.; Hay, J.; He, W.; Huang, X.; Jun, Z.; Kearney, S.; Kuwahara, T.; Lenzi, F.; Mirahmetoglu, H.; Morley, S.; Otani, M.; Pastena, M.; Pinni, M.; Schwartz, J.; Shala, K.; Shi, J.-F.; Singh Khorai, J.; Steinkellner, M.; Treat, D.; Ulrich, S.; Verheyden, P.; Wang, X. Y.; Weeden, C.

    On-Orbit Servicing has the potential to completely reshape the satellite industry, but for the technology to become common- place, the commercial benefits must be apparent. This paper first examines the economics of servicing missions, demonstrat- ing the potential financial gains possible through viable de-orbiter and life extension concepts, as well as a component exchange service in Geostationary Orbit. The system trades and the resulting architecture are presented, and an economically viable mission concept is discussed. The analysis uses current commercial satellite revenue generation and capital expenditure statistics, and for the analysis of the exchange service, assumes a landscape 20 years in the future where satellite design incorporates some levels of standardization. The system design costs and pricing points necessary to make the exchange mission economically viable are calculated. The findings of this paper are that On-Orbit Servicing missions, including life extension missions in the near future and component exchange services in the mid-term are economically viable possibilities and could be pursued by satellite operators or private companies.

  16. Outcomes of Varus Valgus Constrained Versus Rotating-Hinge Implants in Total Knee Arthroplasty.

    PubMed

    Malcolm, Tennison L; Bederman, S Samuel; Schwarzkopf, Ran

    2016-01-01

    The stability of a total knee arthroplasty is determined by the ability of the prosthesis components in concert with supportive bone and soft tissue structures to sufficiently resist deforming forces transmitted across the knee joint. Constrained prostheses are used in unstable knees due to their ability to resist varus and valgus transformative forces across the knee. Constraint requires inherent rigidity, which can facilitate early implant failure. The purpose of this study was to describe the comparative indications for surgery and postoperative outcomes of varus valgus constrained knee (VVK) and rotating-hinge knee (RHK) total knee arthroplasty prostheses. Seven retrospective observational studies describing 544 VVK and 254 RHK patients with an average follow-up of 66 months (range, 7-197 months) were evaluated. Patients in both groups experienced similar failure rates (P=.74), ranges of motion (P=.81), and Knee Society function scores (P=.29). Average Knee Society knee scores were 4.2 points higher in VVK patients compared with RHK patients, indicating minimal mid-term clinical differences may exist (P<.0001). Absent collateral ligament support is an almost universal indication for RHK implantation vs VVK. Constrained device implantation is routinely guided by inherent stability of the knee, and, when performed, similar postoperative outcomes can be achieved with VVK and RHK prostheses.

  17. The Vision and Challenges of Hokkaido Pharmaceutical University's Affiliated Pharmacy.

    PubMed

    Norose, Takahiko; Manabe, Tomohiro; Furuta, Seiichi; Watanabe, Kazuhiro

    2016-01-01

    Hokkaido Pharmaceutical University (HPU), according to its educational mission, seeks to "develop medical professionals who contribute to community medicine", and it has produced more than 6300 graduates since 1974. With recent medical advancements and a progressively aging society, the role of the pharmacist in community medicine has diversified and is increasing in importance. Therefore, in April 2012, the Hokkaido Pharmaceutical University Affiliated Pharmacy was established as a for-profit business of the Educational Foundation of the Hokkaido University of Science, the parent body of HPU. The pharmacy is located near the Sapporo station; it is operated by six pharmacists and four clerks, and supported by three faculty members who are engaged in providing HPU student education such as on-site clinical training, in addition to their pharmacy duties such as home care pharmaceutics. For the first two years it was open, the pharmacy focused on the establishment of pharmacy administration and fiscal consolidation. In April 2015, the Pharmacy Management Committee set the pharmacy's future vision, as well as its mid-term strategy, which consists of the four main components of pharmacy practices, education, research, and social contribution, in order for the pharmacy to serve as a model of community pharmacy.

  18. Coal: Energy for the future

    SciTech Connect

    1995-05-01

    This report was prepared in response to a request by the US Department of energy (DOE). The principal objectives of the study were to assess the current DOE coal program vis-a-vis the provisions of the Energy Policy Act of 1992 (EPACT), and to recommend the emphasis and priorities that DOE should consider in updating its strategic plan for coal. A strategic plan for research, development, demonstration, and commercialization (RDD and C) activities for coal should be based on assumptions regarding the future supply and price of competing energy sources, the demand for products manufactured from these sources, technological opportunities, and the need to control the environmental impact of waste streams. These factors change with time. Accordingly, the committee generated strategic planning scenarios for three time periods: near-term, 1995--2005; mid-term, 2006--2020; and, long-term, 2021--2040. The report is divided into the following chapters: executive summary; introduction and scope of the study; overview of US DOE programs and planning; trends and issues for future coal use; the strategic planning framework; coal preparation, coal liquid mixtures, and coal bed methane recovery; clean fuels and specialty products from coal; electric power generation; technology demonstration and commercialization; advanced research programs; conclusions and recommendations; appendices; and glossary. 174 refs.

  19. Genetic Diversity and Ecological Niche Modelling of Wild Barley: Refugia, Large-Scale Post-LGM Range Expansion and Limited Mid-Future Climate Threats?

    PubMed Central

    Russell, Joanne; van Zonneveld, Maarten; Dawson, Ian K.; Booth, Allan; Waugh, Robbie; Steffenson, Brian

    2014-01-01

    Describing genetic diversity in wild barley (Hordeum vulgare ssp. spontaneum) in geographic and environmental space in the context of current, past and potential future climates is important for conservation and for breeding the domesticated crop (Hordeum vulgare ssp. vulgare). Spatial genetic diversity in wild barley was revealed by both nuclear- (2,505 SNP, 24 nSSR) and chloroplast-derived (5 cpSSR) markers in 256 widely-sampled geo-referenced accessions. Results were compared with MaxEnt-modelled geographic distributions under current, past (Last Glacial Maximum, LGM) and mid-term future (anthropogenic scenario A2, the 2080s) climates. Comparisons suggest large-scale post-LGM range expansion in Central Asia and relatively small, but statistically significant, reductions in range-wide genetic diversity under future climate. Our analyses support the utility of ecological niche modelling for locating genetic diversity hotspots and determine priority geographic areas for wild barley conservation under anthropogenic climate change. Similar research on other cereal crop progenitors could play an important role in tailoring conservation and crop improvement strategies to support future human food security. PMID:24505252

  20. Effect of different sterilization processing methods on the mechanical properties of human cancellous bone allografts.

    PubMed

    Vastel, L; Meunier, A; Siney, H; Sedel, L; Courpied, J-P

    2004-05-01

    Use of new sterilization methods applied to human bone is likely to affect both the mechanical and biological properties of human cancellous grafts. The mechanical properties of the transplanted bone inevitably determine the short- and mid-term results of the orthopedic procedure performed. The aim of this study was to compare, under similar conditions, the mechanical effects of gamma irradiation, lipid extraction, and treatment with 6M urea on trabecular bone samples, through conventional mechanical tests and measurement of the ultrasound wave propagation rate. Deteriorations measured for gamma irradiation and lipid extraction were low: 2.4% and 2.5%, respectively, for ultrasound propagation wave measurements. They were clearly significant for protocol including 6M urea, corresponding to a loss of 30% in values measured in the control sample for the stress to failure, inciting prudence when grafted bone is used for support in orthopedic assembly. High consistency in the results obtained between travel time of the ultrasound wave, easily done, and measurement of stress to failure through conventional tests, favor the use of ultrasound protocol, described as a quality test performed on bone grafts in the tissue bank before distribution and implantation. PMID:14741625

  1. Lymphocyte subpopulations in the liver, spleen, intestines, and mesenteric nodes: an immunohistochemical study using human fetuses at 15-16 weeks.

    PubMed

    Hwang, Si Eun; Kim, Ji Hyun; Yu, Hee Chul; Murakami, Gen; Cho, Baik Hwan

    2014-08-01

    The roles of the liver and intestines in lymphocyte differentiation in human fetuses were assessed by immunohistochemical analysis of the thymus, bone marrow, liver, spleen, intestines, and lymph nodes of 15-16 week human fetuses using primary antibodies against IgM, CD3, CD7, CD8, CD10, CD20, CD45RO, HLA-DR, and CD68. The density of immunoreactive lymphocytes was high in the thymus and lymph nodes, but much lower in the bones, liver, spleen, and intestines. The medulla of the thymus contained IgM-positive mature B lymphocytes as well as CD20-positve B lymphocytes. In contrast, CD10-positive immature B lymphocytes were restricted in the cortex. There were no site-dependent differences among axillary, mediastinal, mesenteric, and pelvic lymph nodes. CD68-positive cells were observed at all sites examined. Many HLA-DR-positive round cells were present in the thymus, with fewer in the liver and spleen. The absolute number of lymphocytes was estimated to be ≥10-fold higher in lymph nodes than in liver. Although limited by analysis of only one fetal stage, these findings suggest that mesenteric nodes are likely to be more important than the liver, spleen, and intestines for lymphocyte proliferation and differentiation in human mid-term fetuses.

  2. Single injection of platelet-rich plasma as a novel treatment of carpal tunnel syndrome.

    PubMed

    Malahias, Michael Alexander; Johnson, Elizabeth O; Babis, George C; Nikolaou, Vasileios S

    2015-11-01

    Both in vitro and in vivo experiments have confirmed that platelet-rich plasma has therapeutic effects on many neuropathies, but its effects on carpal tunnel syndrome remain poorly understood. We aimed to investigate whether single injection of platelet-rich plasma can improve the clinical symptoms of carpal tunnel syndrome. Fourteen patients presenting with median nerve injury who had suffered from mild carpal tunnel syndrome for over 3 months were included in this study. Under ultrasound guidance, 1-2 mL of platelet-rich plasma was injected into the region around the median nerve at the proximal edge of the carpal tunnel. At 1 month after single injection of platelet-rich plasma, Visual Analogue Scale results showed that pain almost disappeared in eight patients and it was obviously alleviated in three patients. Simultaneously, the disabilities of the arm, shoulder and hand questionnaire showed that upper limb function was obviously improved. In addition, no ultrasonographic manifestation of the carpal tunnel syndrome was found in five patients during ultrasonographic measurement of the width of the median nerve. During 3-month follow-up, the pain was not greatly alleviated in three patients. These findings show very encouraging mid-term outcomes regarding use of platelet-rich plasma for the treatment of carpal tunnel syndrome.

  3. Control of VTEC in Dutch livestock and meat production.

    PubMed

    Reinders, R D; Weber, M F; Lipman, L J; Verhoeff, J; Bijker, P G

    2001-05-21

    The Dutch government and the meat industry, recognising VTEC as having important public health, meat quality and economic implications, have taken a number of initiatives within the last 5 years to control VTEC in livestock and meat. These initiatives, brought together last year in a 'Masterplan VTEC', include short-, middle- and long-term priorities. Short-term priorities include advice on interventions in the cases of an outbreak of VTEC associated with a cattle herd, the implementation of handbooks for Good Manufacturing Practice (GMP) in slaughterhouses and deboning plants, and the execution of an action programme on zero-tolerance to faecal contamination of carcasses. Mid-term activities include surveillance of the occurrence of VTEC and other enteropathogens in livestock and meat, and the investigations of VTEC population dynamics in dairy farms, transportation and farm hygiene. In the longer term, this programme aims to produce a system of Integrated Quality Assurance, consolidating effective measures to control VTEC in Dutch livestock and meat, and integrating emerging means for control and prevention. PMID:11407551

  4. Stenting of the Cystic Duct in Benign Disease: A Definitive Treatment for the Elderly and Unwell

    SciTech Connect

    Hersey, N.; Goode, S. D.; Peck, R. J. Lee, F.

    2015-08-15

    PurposeThere have been few case reports describing cystic duct stent insertion in the management of acute cholecystitis secondary to benign disease with no case series published to date. We present our series demonstrating the role of cystic duct stents in managing benign gallbladder disease in those patients unfit for surgery.Materials and MethodsThirty three patients unfit for surgery in our institution underwent cystic duct stent insertion for the management of acute cholecystitis in the period June 2008 to June 2013. Patients underwent a mixture of transperitoneal and transhepatic gallbladder puncture. The cystic duct was cannulated with a hydrophilic guidewire which was subsequently passed through the common bile duct and into the duodenum. An 8Fr 12-cm double-pigtail stent was placed with the distal end lying within the duodenum and the proximal end within the gallbladder.ResultsTen patients presented with gallbladder perforation, 21 patients with acute cholecystitis, 1 with acute cholangitis and 1 with necrotising pancreatitis. The technical success rate was 91 %. We experienced a 13 % complication rate with 3 % mortality rate at 30 days.ConclusionCystic duct stent insertion can be successfully used to manage acute cholecystitis, gallbladder empyema or gallbladder perforations in those unfit for surgery and should be considered alongside external gallbladder drainage as a definitive mid-term treatment option.

  5. DC State of Mind; A Congressional update

    NASA Astrophysics Data System (ADS)

    Larsen, Kristopher

    2010-10-01

    Every day the headlines are dominated by news of a slow economic recovery, high unemployment, and a Congress focused on the next election. Deficit hawks, Tea Partiers, partisanship, and mid-term elections are all topics typically outside the ken of physics but are critically important to our ability to continue to pursue cutting edge innovative research. For example, during the last six months Congress has, among other things, worked on passing the 2011 federal budget and reauthorization of America COMPETES. Both of these major pieces of legislation are fundamental to how our country will fund physics research for the next few years. For the past two years, science has done very well thanks to the support of Congress and the administration. The coming years are going to be far more difficult and every physicist needs to commit themselves to defending the gains we have made. This poster will provide an overview of what has happened on Capitol Hill in the past few months and what, to the best of our knowledge, the physics community can expect for the coming years. The legislative successes of the last few months couldn't of happened without the aid of physicists who got involved. Around the country, physicists wrote opinion pieces for their local papers, wrote letters-to-the-editor, called their representatives, made their voices heard and helped shape policy.

  6. DC State of Mind; A Congressional update

    NASA Astrophysics Data System (ADS)

    Larsen, Kristopher

    2010-10-01

    Every day the headlines are dominated by news of a slow economic recovery, high unemployment, and a Congress focused on the next election. Deficit hawks, Tea Partiers, partisanship, and mid-term elections are all topics typically outside the ken of physics but are critically important to our ability to continue to pursue cutting edge innovative research. For example, during the last six months Congress has, among other things, worked on passing the 2011 federal budget and reauthorization of America COMPETES. Both of these major pieces of legislation are fundamental to how our country will fund physics research for the next few years. For the past two years, science has done very well thanks to the support of Congress and the administration. The coming years are going to be far more difficult and every physicist needs to commit themselves to defending the gains we have made. This talk will provide an overview of what has happened on Capitol Hill in the past few months and what, to the best of our knowledge, the physics community can expect for the coming years. The legislative successes of the last few months were, in part, made possibly with the aid of physicists who got involved. Around the country, physicists wrote opinion pieces for their local papers, wrote letters-to-the-editor, called their representatives, made their voices heard and helped shape policy.

  7. DC State of Mind: A Congressional update

    NASA Astrophysics Data System (ADS)

    Larsen, Kristopher

    2010-10-01

    Every day the headlines are dominated by news of a slow economic recovery, high unemployment, and a Congress focused on the next election. Deficit hawks, Tea Partiers, partisanship, and mid-term elections are all topics typically outside the ken of physics but are critically important to our ability to continue to pursue cutting edge innovative research. For example, during the last six months Congress has, among other things, worked on passing the 2011 federal budget and reauthorization of America COMPETES. Both of these major pieces of legislation are fundamental to how our country will fund physics research for the next few years. For the past two years, science has done very well thanks to the support of Congress and the administration. The coming years are going to be far more difficult and every physicist needs to commit themselves to defending the gains we have made. This talk will provide an overview of what has happened on Capitol Hill in the past few months and what, to the best of our knowledge, the physics community can expect for the coming years. Also included will be a discussion of how physicists can get involved, educate Congress, and assure that the United States retains a strong commitment to basic research.

  8. Energy and land use

    SciTech Connect

    Not Available

    1981-12-01

    This report addresses the land use impacts of past and future energy development and summarizes the major federal and state legislation which influences the potential land use impacts of energy facilities and can thus influence the locations and timing of energy development. In addition, this report describes and presents the data which are used to measure, and in some cases, predict the potential conflicts between energy development and alternative uses of the nation's land resources. The topics section of this report is divided into three parts. The first part describes the myriad of federal, state and local legislation which have a direct or indirect impact upon the use of land for energy development. The second part addresses the potential land use impacts associated with the extraction, conversion and combustion of energy resources, as well as the disposal of wastes generated by these processes. The third part discusses the conflicts that might arise between agriculture and energy development as projected under a number of DOE mid-term (1990) energy supply and demand scenarios.

  9. Trajectory Assessment and Modification Tools for Next Generation Air Traffic Management Operations

    NASA Technical Reports Server (NTRS)

    Brasil, Connie; Lee, Paul; Mainini, Matthew; Lee, Homola; Lee, Hwasoo; Prevot, Thomas; Smith, Nancy

    2011-01-01

    This paper reviews three Next Generation Air Transportation System (NextGen) based high fidelity air traffic control human-in-the-loop (HITL) simulations, with a focus on the expected requirement of enhanced automated trajectory assessment and modification tools to support future air traffic flow management (ATFM) planning positions. The simulations were conducted at the National Aeronautics and Space Administration (NASA) Ames Research Centers Airspace Operations Laboratory (AOL) in 2009 and 2010. The test airspace for all three simulations assumed the mid-term NextGenEn-Route high altitude environment utilizing high altitude sectors from the Kansas City and Memphis Air Route Traffic Control Centers. Trajectory assessment, modification and coordination decision support tools were developed at the AOL in order to perform future ATFM tasks. Overall tool usage results and user acceptability ratings were collected across three areas of NextGen operatoins to evaluate the tools. In addition to the usefulness and usability feedback, feasibility issues, benefits, and future requirements were also addressed. Overall, the tool sets were rated very useful and usable, and many elements of the tools received high scores and were used frequently and successfully. Tool utilization results in all three HITLs showed both user and system benefits including better airspace throughput, reduced controller workload, and highly effective communication protocols in both full Data Comm and mixed-equipage environments.

  10. Portable Diagnostics Technology Assessment for Space Missions. Part 1; General Technology Capabilities for NASA Exploration Missions

    NASA Technical Reports Server (NTRS)

    Nelson, Emily S.; Chait, Arnon

    2010-01-01

    The changes in the scope of NASA s mission in the coming decade are profound and demand nimble, yet insightful, responses. On-board clinical and environmental diagnostics must be available for both mid-term lunar and long-term Mars exploration missions in an environment marked by scarce resources. Miniaturization has become an obvious focus. Despite solid achievements in lab-based devices, broad-based, robust tools for application in the field are not yet on the market. The confluence of rapid, wide-ranging technology evolution and internal planning needs are the impetus behind this work. This report presents an analytical tool for the ongoing evaluation of promising technology platforms based on mission- and application-specific attributes. It is not meant to assess specific devices, but rather to provide objective guidelines for a rational down-select of general categories of technology platforms. In this study, we have employed our expertise in the microgravity operation of fluidic devices, laboratory diagnostics for space applications, and terrestrial research in biochip development. A rating of the current state of technology development is presented using the present tool. Two mission scenarios are also investigated: a 30-day lunar mission using proven, tested technology in 5 years; and a 2- to 3-year mission to Mars in 10 to 15 years.

  11. Superfund flop, new Congress fail to faze environmental execs

    SciTech Connect

    Bishop, J.

    1995-01-01

    Congressional failure to pass a Superfund reauthorization bill this fall disappointed environmental consulting and engineering companies, environmentalists and parties liable for site cleanups. The Clinton administration's reform bill was introduced in the House Feb. 3, six months overdue, only seven months before Congress' annual summer break and less than a year before mid-term elections. The House bill was revised in August, but reauthorization was declared a lost cause in October, when supporters faced the harsh political fact that Republicans would hold the line against passing a new law until after the November elections. Of the three major environmental laws overdue for reauthorization--the Resource Conservation and Recovery Act, Clean Water Act and Superfund (officially, the Comprehensive Environmental Response, Compensation and Liability Act)--the Superfund law appears to have the best chance of making it through the 104 Congress successfully. The latest version of the administration-sponsored bill received wide-spread support from environmentalists, industry and environmental business groups as being more reasonable and fair than the existing law.

  12. Technical assessment of cryo-compressed hydrogen storage tank systems for automotive applications.

    SciTech Connect

    Ahluwalia, R.; Hua, T.; Peng, J.-K.; Lasher, S.; McKenney, K.; Sinha, J.; Gardiner, M.; Nuclear Engineering Division; TIAX LLC; U.S. DOE

    2010-05-01

    On-board and off-board performance and cost of cryo-compressed hydrogen storage are assessed and compared to the targets for automotive applications. The on-board performance of the system and high-volume manufacturing cost were determined for liquid hydrogen refueling with a single-flow nozzle and a pump that delivers liquid H{sub 2} to the insulated cryogenic tank capable of being pressurized to 272 atm. The off-board performance and cost of delivering liquid hydrogen were determined for two scenarios in which hydrogen is produced by central steam methane reforming (SMR) or by central electrolysis. The main conclusions are that the cryo-compressed storage system has the potential of meeting the ultimate target for system gravimetric capacity, mid-term target for system volumetric capacity, and the target for hydrogen loss during dormancy under certain conditions of minimum daily driving. However, the high-volume manufacturing cost and the fuel cost for the SMR hydrogen production scenario are, respectively, 2-4 and 1.6-2.4 times the current targets, and the well-to-tank efficiency is well short of the 60% target specified for off-board regenerable materials.

  13. Silicon sensor prototypes for the Phase II upgrade of the CMS tracker

    NASA Astrophysics Data System (ADS)

    Bergauer, Thomas

    2016-09-01

    The High-Luminosity LHC (HL-LHC) has been identified as the highest priority program in High Energy Physics in the mid-term future. It will provide the experiments an additional integrated luminosity of about 2500 fb-1 over 10 years of operation, starting in 2025. In order to meet the experimental challenges of unprecedented p-p luminosity, especially in terms of radiation levels and occupancy, the CMS collaboration will need to replace its entire strip tracker by a new one. In this paper the baseline layout option for this new Phase-II tracker is shown, together with two variants using a tilted barrel geometry or larger modules from 8-inch silicon wafers. Moreover, the two module concepts are discussed, which consist either of two strip sensors (2S) or of one strip and one pixel sensor (PS). These two designs allow pT discrimination at module level enabling the tracker to contribute to the L1 trigger decision. The paper presents testing results of the macro-pixel-light sensor for the PS module and shows the first electrical characterization of unirradiated, full-scale strip sensor prototypes for the 2S module concept, both on 6- and 8-inch wafers.

  14. Efficacy of kinesio tape application on pain and muscle strength in patients with myofascial pain syndrome: a placebo-controlled trial.

    PubMed

    Öztürk, Gülcan; Külcü, Duygu Geler; Mesci, Nilgün; Şilte, Ayşe Duygu; Aydog, Ece

    2016-04-01

    [Purpose] The purpose of this study was to determine the short- and mid-term effects of Kinesio taping on the trapezius muscle in individuals with myofascial pain syndrome. [Subjects and Methods] Thirty-seven patients with active upper trapezius myofascial trigger points were randomly divided to 2 groups: group 1 received Kinesio taping for the upper trapezius muscle, and group 2 received a sham Kinesio taping application. Neck pain (Visual Analog Scale and pressure algometry) and trapezius muscle strength data were collected at baseline, immediately after Kinesio taping application, and at one month follow-up. [Results] The mean changes in Visual Analog Scale scores were significantly different between groups at T2 and T1, with less pain in group 1. The mean changes in algometry scores were significantly different between groups at T3 compared with T2 in favor of group 1. The mean changes in trapezius muscle strength were significantly different between the groups at T2 compared with T1 in favor of group 1. [Conclusion] Patients with myofascial pain syndrome receiving an application of Kinesio taping exhibited statistically significant improvements in pain and upper trapezius muscle strength.

  15. Haemocyanin is essential for embryonic development and survival in the migratory locust.

    PubMed

    Chen, B; Ma, R; Ma, G; Guo, X; Tong, X; Tang, G; Kang, L

    2015-10-01

    Haemocyanins are commonly known as copper-containing oxygen carriers within the haemolymph of arthropods, and have been found in many orders of insects. However, it remains unresolved why haemocyanins persist in insects that possess elaborate tracheal systems for oxygen diffusion to cells. Here we identified haemocyanins in the migratory locust Locusta migratoria that consists of two distinct subunits, Hc1 and Hc2. Genomic sequence analysis indicated that Hc1 and Hc2 have four and three gene copies, respectively, which may have evolved via gene duplication followed by divergent evolution of introns. The two subunits exhibit abundant and embryonic-specific expression at the mRNA and protein level; their expression peaks in the mid-term embryo and is not detectable in the late nymphal and adult stages. A larger proportion of the haemocyanins is present in the yolk compared with that in the embryo. Immunostaining shows that haemocyanins in the embryo are mainly expressed in the epidermis. Knockdown of Hc1 and Hc2 results in significant embryonic developmental delay and abnormality as well as reduced egg hatchability, ie the proportion of hatched eggs. These results reveal a previously unappreciated and fundamental role for haemocyanins in embryonic development and survival in insects, probably involving the exchange of molecules (eg O2 ) between the embryo and its environment. PMID:26010377

  16. Nanomedicine for the reduction of the thrombogenicity of stent coatings

    PubMed Central

    Karagkiozaki, Varvara C; Logothetidis, Stergios D; Kassavetis, Spyridon N; Giannoglou, George D

    2010-01-01

    The treatment of patients with drug-eluting stents (DES) continues to evolve with the current emergence of DES technology that offers a combination of pharmacological and mechanical approaches to prevent arterial restenosis. However, despite the promising short-term and mid-term outcomes of DES, there are valid concerns about adverse clinical effects of late stent thrombosis. In this study, we present an example of how nanomedicine can offer solutions for improving stent coating manufacturing, by producing nanomaterials with tailored and controllable properties. The study is based on the exploitation of human platelets response towards carbon-based nanocoatings via atomic force microscope (AFM). AFM can facilitate the comprehensive analysis of platelets behavior onto stent nanocoatings and enable the study of thrombogenicity. Platelet-rich plasma from healthy donors was used for the real-time study of biointerfacial interactions. The carbon nanomaterials were developed by rf magnetron sputtering technique under controllable deposition conditions to provide favorable surface nanotopography. It was shown that by altering the surface topography of nanocoatings, the activation of platelets can be affected, while the carbon nanocoatings having higher surface roughness were found to be less thrombogenic in terms of platelets adhesion. This is an actual solution for improving the stent coating fabrication. PMID:20463940

  17. Treadmill exercise reduces self-administration of morphine in male rats.

    PubMed

    Hosseini, Mahmoud; Alaei, Hojjat Allah; Naderi, Asieh; Sharifi, Mohammad Reza; Zahed, Reza

    2009-06-01

    Exercise can activate the same pathways as morphine. The aim of the present study was to clarify the effect of short-term and mid-term exercises on the self-administration of morphine in rats. Male Wistar rats were initially trained to receive small pellets of food by pressing the active lever in self-administration apparatus. Rats were divided into 4 groups: Saline, Morphine, Exercise 1 (11 days) and Exercise 2 (30 days). Their jugular vein was cannulated. The animals were placed in self-administration apparatus and allowed to self-administer morphine (0.5mg per infusion all test groups) or saline (Saline group) during consecutive days, for 2h/sessions. In the group 1 the rats were running before each session of self-administration and of group Exercise 2, 30 days before surgery as well as before each session. The pressing numbers of active and passive levers in each group and among different groups were compared. The number of active lever pressing of Morphine group was significantly higher than Saline group (p<0.001). In Exercise 1 and Exercise 2 groups, the number of active lever pressing was significantly lower than Morphine group (p<0.001). As exercise can activate many neurotransmitter systems involved in the addiction process and increase the release of endorphins, it is likely that could decrease the morphine self-administration in this experimental setup. PMID:19131225

  18. Methanol-driven enhanced biological phosphorus removal with a syntrophic consortium.

    PubMed

    Tayà, Carlota; Guerrero, Javier; Vanneste, Gianni; Guisasola, Albert; Baeza, Juan A

    2013-02-01

    The presence of suitable carbon sources for enhanced biological phosphorus removal (EBPR) plays a key role in phosphorus removal from wastewater in urban WWTP. For wastewaters with low volatile fatty acids (VFAs) content, an external carbon addition is necessary. As methanol is the most commonly external carbon source used for denitrification it could be a priori a promising alternative, but previous attempts to use it for EBPR have failed. This study is the first successful report of methanol utilization as external carbon source for EBPR. Since a direct replacement strategy (i.e., supply of methanol as a sole carbon source to a propionic-fed PAO-enriched sludge) failed, a novel process was designed and implemented successfully: development of a consortium with anaerobic biomass and polyphosphate accumulating organisms (PAOs). Methanol-degrading acetogens were (i) selected against other anaerobic methanol degraders from an anaerobic sludge; (ii) subjected to conventional EBPR conditions (anaerobic + aerobic); and (iii) bioaugmented with PAOs. EBPR with methanol as a sole carbon source was sustained in a mid-term basis with this procedure.

  19. Noninferiority of Shanghai Cingular biotech’s bovine pericardial valve preclinical study in juvenile ovine model

    PubMed Central

    Chen, Jin-Miao; Ding, Yu; Lu, Shu-Yang; Pan, Sun; Abudupataer, Mieradilijiang

    2016-01-01

    Background This study introduces a newly Chinese domestic-designed/manufactured bovine pericardial valve, the SCBC valve (Shanghai Cingular Biotech Corporation, Shanghai, China), and evaluates its hemodynamic performance and calcification potential compared with the Carpentier-Edwards (CE) PerimountTM valve (Edwards Lifesciences, Irvine, CA, USA) in juvenile sheep for preclinical study. Methods Five SCBC valves in study group and three CE PerimountTM valves (6900P with TFX) in control group were implanted in the mitral position of juvenile sheep and followed up for five months. Transthoracic echocardiography (TTE) for hemodynamic measurement was performed ten days, three months and five months postoperatively. Valve calcification was assessed by X-ray after euthanasia. Other collected data included macroscopic examination, blood analysis, microorganism culture and histological assessment. Results All sheep in two groups lived to sacrifice without evidence of valvular dysfunction. The SCBC valve had similar hemodynamic performance and susceptibility of calcification compared with the CE PerimountTM valve in juvenile ovine model. In all other parameters, the SCBC valve also exhibited no significant difference compared with the CE PerimountTM valve. Conclusions Our study demonstrated that the SCBC valve can exhibit similar mid-term satisfactory safety and efficacy compared with the CE PerimountTM valve in the mitral position of juvenile sheep model. PMID:27293835

  20. Human and Robotic Space Mission Use Cases for High-Performance Spaceflight Computing

    NASA Technical Reports Server (NTRS)

    Some, Raphael; Doyle, Richard; Bergman, Larry; Whitaker, William; Powell, Wesley; Johnson, Michael; Goforth, Montgomery; Lowry, Michael

    2013-01-01

    Spaceflight computing is a key resource in NASA space missions and a core determining factor of spacecraft capability, with ripple effects throughout the spacecraft, end-to-end system, and mission. Onboard computing can be aptly viewed as a "technology multiplier" in that advances provide direct dramatic improvements in flight functions and capabilities across the NASA mission classes, and enable new flight capabilities and mission scenarios, increasing science and exploration return. Space-qualified computing technology, however, has not advanced significantly in well over ten years and the current state of the practice fails to meet the near- to mid-term needs of NASA missions. Recognizing this gap, the NASA Game Changing Development Program (GCDP), under the auspices of the NASA Space Technology Mission Directorate, commissioned a study on space-based computing needs, looking out 15-20 years. The study resulted in a recommendation to pursue high-performance spaceflight computing (HPSC) for next-generation missions, and a decision to partner with the Air Force Research Lab (AFRL) in this development.

  1. Maximum in the Middle: Nonlinear Response of Microbial Plankton to Ultraviolet Radiation and Phosphorus

    PubMed Central

    Medina-Sánchez, Juan Manuel; Delgado-Molina, José Antonio; Bratbak, Gunnar; Bullejos, Francisco José; Villar-Argaiz, Manuel; Carrillo, Presentación

    2013-01-01

    The responses of heterotrophic microbial food webs (HMFW) to the joint action of abiotic stressors related to global change have been studied in an oligotrophic high-mountain lake. A 2×5 factorial design field experiment performed with large mesocosms for >2 months was used to quantify the dynamics of the entire HMFW (bacteria, heterotrophic nanoflagellates, ciliates, and viruses) after an experimental P-enrichment gradient which approximated or surpassed current atmospheric P pulses in the presence vs. absence of ultraviolet radiation. HMFW underwent a mid-term (<20 days) acute development following a noticeable unimodal response to P enrichment, which peaked at intermediate P-enrichment levels and, unexpectedly, was more accentuated under ultraviolet radiation. However, after depletion of dissolved inorganic P, the HMFW collapsed and was outcompeted by a low-diversity autotrophic compartment, which constrained the development of HMFW and caused a significant loss of functional biodiversity. The dynamics and relationships among variables, and the response patterns found, suggest the importance of biotic interactions (predation/parasitism and competition) in restricting HMFW development, in contrast to the role of abiotic factors as main drivers of autotrophic compartment. The response of HMFW may contribute to ecosystem resilience by favoring the maintenance of the peculiar paths of energy and nutrient-mobilization in these pristine ecosystems, which are vulnerable to threats by the joint action of abiotic stressors related to global change. PMID:23593178

  2. Saharan dust inputs and high UVR levels jointly alter the metabolic balance of marine oligotrophic ecosystems

    PubMed Central

    Cabrerizo, Marco J.; Medina-Sánchez, Juan Manuel; González-Olalla, Juan Manuel; Villar-Argaiz, Manuel; Carrillo, Presentación

    2016-01-01

    The metabolic balance of the most extensive bioma on the Earth is a controversial topic of the global-change research. High ultraviolet radiation (UVR) levels by the shoaling of upper mixed layers and increasing atmospheric dust deposition from arid regions may unpredictably alter the metabolic state of marine oligotrophic ecosystems. We performed an observational study across the south-western (SW) Mediterranean Sea to assess the planktonic metabolic balance and a microcosm experiment in two contrasting areas, heterotrophic nearshore and autotrophic open sea, to test whether a combined UVR × dust impact could alter their metabolic balance at mid-term scales. We show that the metabolic state of oligotrophic areas geographically varies and that the joint impact of UVR and dust inputs prompted a strong change towards autotrophic metabolism. We propose that this metabolic response could be accentuated with the global change as remote-sensing evidence shows increasing intensities, frequencies and number of dust events together with variations in the surface UVR fluxes on SW Mediterranean Sea. Overall, these findings suggest that the enhancement of the net carbon budget under a combined UVR and dust inputs impact could contribute to boost the biological pump, reinforcing the role of the oligotrophic marine ecosystems as CO2 sinks. PMID:27775100

  3. Aircraft Loss of Control Causal Factors and Mitigation Challenges

    NASA Technical Reports Server (NTRS)

    Jacobson, Steven R.

    2010-01-01

    Loss of control is the leading cause of jet fatalities worldwide. Aside from their frequency of occurrence, accidents resulting from loss of aircraft control seize the public s attention by yielding a large number of fatalities in a single event. In response to the rising threat to aviation safety, the NASA Aviation Safety Program has conducted a study of the loss of control problem. This study gathered four types of information pertaining to loss of control accidents: (1) statistical data; (2) individual accident reports that cite loss of control as a contributing factor; (3) previous meta-analyses of loss of control accidents; and (4) inputs solicited from aircraft manufacturers, air carriers, researchers, and other industry stakeholders. Using these information resources, the study team identified the causal factors that were cited in the greatest number of loss of control accidents, and which were emphasized most by industry stakeholders. This report describes the study approach, the key causal factors for aircraft loss of control, and recommended mitigation strategies to make near-term impacts, mid-term impacts, and Next Generation Air Transportation System impacts on the loss of control accident statistics

  4. Energy from biological processes

    SciTech Connect

    Not Available

    1980-07-01

    This assessment responds to a request by the Senate Committee on Commerce, Science, and Transportation for an evaluation of the energy potential of various sources of plant and animal matter (biomass). This report complements an earlier OTA report on the Application of Solar Technology to Today's Energy Needs in evaluating the major solar energy resources available to the United States. The findings also will serve as part of the material to be used in an upcoming OTA assessment of synthetic fuels for transportation. This volume presents analyses of prominent biomass issues, summaries of four biomass fuel cycles, a description of biomass' place in two plausible energy futures, and discussions of policy options for promoting energy from biomass. The four fuel cycles - wood, alcohol fuels, grasses and crop residues, and animal wastes - were chosen because of their near- to mid-term energy potential and because of the public interest in them. A second volume presents technical analyses of the resource base, conversion technologies, and end uses that provide a basis for the discussion in this volume. Also included in Volume II are various unconventional approaches to bioenergy production as well as the use of biomass to produce chemicals.

  5. Sea-level Rise Increases the Frequency of Nuisance Flooding in Coastal Regions

    NASA Astrophysics Data System (ADS)

    Moftakhari Rostamkhani, H.; Aghakouchak, A.; Sanders, B. F.; Feldman, D.; Sweet, W.; Matthew, R.; Luke, A.

    2015-12-01

    The global warming-drivensea-level rise (SLR) posesa serious threat for population and assets in flood-prone coastal zones over the next century. The rate of SLR is accelerated in recent decades and is expected to increase based on current trajectories of anthropogenic activities and greenhouse gas emissions. Over the 20th century, an increase in the frequency of nuisance (minor) flooding has been reported due to the reduced gap between tidal datum and flood stage. Nuisance flooding (NF), however non-destructive, causes public inconvenience, business interruption, and substantial economic losses due to impacts such as road closures and degradation of infrastructure. It also portends an increased risk in severe floods. Here we report substantial increases in NF along the coasts of United States due to SLR over the past decades. We then take the projected SLR under the least and the most extreme representative concentration pathways (e.gRCP2.6 and RCP 8.5) to estimate the increase in NF in the near- (2030) and mid-term (2050) future. The results suggest that projected SLR will cause up to two-fold more frequent NF by 2050, compared with the 20th century. The projected increase in NF will have significant socio-economic impacts and pose public health risks especially in rapidly urbanized coastal regions.

  6. Solar Central Receiver Hybrid Power Systems sodium-cooled receiver concept. Final report. Volume II, Book 2. Conceptual design, Sections 5 and 6

    SciTech Connect

    1980-01-01

    The overall, long-term objective of the Solar Central Receiver Hybrid Power System program is to identify, characterize, and ultimately demonstrate the viability and cost effectiveness of solar/fossil, steam Rankine cycle, hybrid power systems that: (1) consist of a combined solar central receiver energy source and a nonsolar energy source at a single, common site, (2) may operate in the base, intermediate, and peaking capacity modes, (3) produce the rated output independent of variations in solar insolation, (4) provide a significant savings (50% or more) in fuel consumption, and (5) produce power at the minimum possible cost in mills/kWh. It is essential that these hybrid concepts be technically feasible and economically competitive with other systems in the near to mid-term time period (1985-1990) on a commercial scale. The program objective for Phase I is to identify and conceptually characterize solar/fossil steam Rankine cycle, commercial-scale, power plant systems that are economically viable and technically feasible. This volume contains the detailed conceptual design and cost/performance estimates and an assessment of the commercial scale solar central receiver hybrid power system. (WHK)

  7. Operative Management of Lumbar Degenerative Disc Disease

    PubMed Central

    Lee, Yu Chao; Osti, Orso Lorenzo

    2016-01-01

    Lumbar degenerative disc disease is extremely common. Current evidence supports surgery in carefully selected patients who have failed non-operative treatment and do not exhibit any substantial psychosocial overlay. Fusion surgery employing the correct grafting and stabilization techniques has long-term results demonstrating successful clinical outcomes. However, the best approach for fusion remains debatable. There is some evidence supporting the more complex, technically demanding and higher risk interbody fusion techniques for the younger, active patients or patients with a higher risk of non-union. Lumbar disc arthroplasty and hybrid techniques are still relatively novel procedures despite promising short-term and mid-term outcomes. Long-term studies demonstrating superiority over fusion are required before these techniques may be recommended to replace fusion as the gold standard. Novel stem cell approaches combined with tissue engineering therapies continue to be developed in expectation of improving clinical outcomes. Results with appropriate follow-up are not yet available to indicate if such techniques are safe, cost-effective and reliable in the long-term. PMID:27559465

  8. Sobering news from the real world. Clinton on population, Part 1.

    PubMed

    Grant, L

    1995-02-01

    Mid-term, the Clinton administration has done well on international population assistance measured against the Reagan-Bush years, but not so well with regard to the needs of developing countries. With regard to US population growth, the administration has done virtually nothing and may not realize that a problem exists. A serious domestic population problem does, however, exist. The US population grew from 76 million in 1900 to 262 million in 1995, with 43% of that growth due to post-1900 immigrants and their descendants. A conservative projection with some decline in immigrants' fertility leads to a population of 397 million in 2050 and 492 million in 2100, 91% of that growth due to post-2000 immigrants and their descendants. The US is already suffering environmental pressures generated by population growth. In this context, the author argues that US population growth and immigration should be central issues in government policy making. Possibilities for the rest of Clinton's term must now be judged in the context of Republican victories in November 1994 and the adjustments Democrats will make as they work to regain lost ground. PMID:12178982

  9. Near-term Horizontal Launch for Flexible Operations: Results of the DARPA/NASA Horizontal Launch Study

    NASA Technical Reports Server (NTRS)

    Bartolotta, Paul A.; Wilhite, Alan W.; Schaffer, Mark G.; Huebner, Lawrence D.; Voland, Randall T.; Voracek, David F.

    2012-01-01

    Horizontal launch has been investigated for 60 years by over 130 different studies. During this time only one concept, Pegasus, has ever been in operation. The attractiveness of horizontal launch is the capability to provide a "mobile launch pad" that can use existing aircraft runways, cruise above weather, loiter for mission instructions, and provide precise placement for orbital intercept, rendezvous, or reconnaissance. A jointly sponsored study by DARPA and NASA, completed in 2011, explored the trade space of horizontal launch system concepts which included an exhaustive literature review of the past 70 years. The Horizontal Launch Study identified potential near- and mid-term concepts capable of delivering 15,000 lb payloads to a 28.5 due East inclination, 100 nautical-mile low-Earth orbit. Results are presented for a range of near-term system concepts selected for their availability and relatively low design, development, test, and evaluation (DDT&E) costs. This study identified a viable low-cost development path forward to make a robust and resilient horizontal launch capability a reality.

  10. Estimation of desmosponge (Porifera, Demospongiae) larval settlement rates from short-term recruitment rates: Preliminary experiments

    NASA Astrophysics Data System (ADS)

    Zea, Sven

    1992-09-01

    During a study of the spatial and temporal patterns of desmosponge (Porifera, Demospongiae) recruitment on rocky and coral reef habitats of Santa Marta, Colombian Caribbean Sea, preliminary attempts were made to estimate actual settlement rates from short-term (1 to a few days) recruitment censuses. Short-term recruitment rates on black, acrylic plastic plates attached to open, non-cryptic substratum by anchor screws were low and variable (0 5 recruits/plate in 1 2 days, sets of n=5 10 plates), but reflected the depth and seasonal trends found using mid-term (1 to a few months) censusing intervals. Moreover, mortality of recruits during 1 2 day intervals was low (0 12%). Thus, short-term censusing intervals can be used to estimate actual settlement rates. To be able to make statistical comparisons, however, it is necessary to increase the number of recruits per census by pooling data of n plates per set, and to have more than one set per site or treatment.

  11. Management of failed rotator cuff repair: a systematic review

    PubMed Central

    Lädermann, Alexandre; Denard, Patrick J; Burkhart, Stephen S

    2016-01-01

    Importance Recurrent tear after rotator cuff repair (RCR) is common. Conservative, and open and arthroscopic revisions, have been advocated to treat these failures. Aim or objective The purpose of this systematic review was to evaluate the different options for managing recurrent rotator cuff tears. Evidence review A search was conducted of level I through 4 studies from January 2000 to October 2015, to identify studies reporting on failed RCR. 10 articles were identified. The overall quality of evidence was very low. Findings Mid-term to long-term follow-up of patients treated conservatively revealed acceptable results; a persistent defect is a well-tolerated condition that only occasionally requires subsequent surgery. Conservative treatment might be indicated in most patients, particularly in case of posterosuperior involvement and poor preoperative range of motion. Revision surgery might be indicated in a young patient with a repairable lesion, a 3 tendon tear, and in those with involvement of the subscapularis. Conclusions and relevance The current review indicates that arthroscopic revision RCR can lead to improvement in functional outcome despite a high retear rate. Further studies are needed to develop specific rehabilitation in the case of primary rotator cuff failure, to better understand the place of each treatment option, and, in case of repair, to optimise tendon healing. PMID:27134759

  12. Development of a computer-based instructional system in pharmacokinetics: efficacy in clinical pharmacology teaching for senior medical students.

    PubMed

    Feldman, R D; Schoenwald, R; Kane, J

    1989-02-01

    The teaching of pharmacokinetics is acknowledged to be a key aspect of the core curriculum in clinical pharmacology and therapeutics, but is also widely acknowledged to be a very difficult part of the curriculum to teach. In order to assess the potential efficacy of interactive computer instruction in clinical pharmacokinetics we have developed a prototype computer-based instructional package. The courseware contains a comprehensive learning system including tutorial, simulation, and problem solving components. To determine the efficacy of this approach we randomly assigned senior medical student volunteers enrolled in the fourth year clinical pharmacology and therapeutics course to receive conventional teaching in clinical pharmacokinetics and/or adjuctive teaching using the computer-based instructional system. There was a high degree of acceptance of the program and over the short term of the trial those students using the computer program scored significantly higher [35%, P less than 0.05] on the mid-term pharmacokinetics quiz. The data suggests that a computerized instructional system in pharmacokinetics may significantly improve the teaching of clinical pharmacokinetics to medical students. PMID:2654201

  13. Augmented Fish Monitoring, 1988 Annual Report.

    SciTech Connect

    Michak, Patty

    1989-05-01

    Since 1986 Washington department of Fisheries (WDF) has participated in the Columbia Basin Augmented Fish Health Monitoring Project. This project provides a standardized level of fish health information from all Agencies rearing fish in the Columbia Basin. WDF has actively participated in this project, and completed its second year of fish health monitoring, data collection and pathogen inspection during 1988. This report will present data collected from January 1, 1988 to December 31, 1988 and will compare sampling results from 1987 and 1988. The analysis will be divided in two sections: adult analysis and juvenile analysis. The adult analysis will include results from screening at spawning for viral pathogens and bacterial kidney disease (BKD), and evaluation of causes of pre-spawning loss. The juvenile analysis will include pre-release examination results, mid-term rearing exam results and evaluation of the Organosomatic Analysis completed on index stocks. Additionally, highlights from monthly monitoring exams will identify any significant and unusual findings from the routine exams completed in 1988. 6 refs., 8 figs., 14 tabs.

  14. Efficient production of multi-modified pigs for xenotransplantation by ‘combineering’, gene stacking and gene editing

    PubMed Central

    Fischer, Konrad; Kraner-Scheiber, Simone; Petersen, Björn; Rieblinger, Beate; Buermann, Anna; Flisikowska, Tatiana; Flisikowski, Krzysztof; Christan, Susanne; Edlinger, Marlene; Baars, Wiebke; Kurome, Mayuko; Zakhartchenko, Valeri; Kessler, Barbara; Plotzki, Elena; Szczerbal, Izabela; Switonski, Marek; Denner, Joachim; Wolf, Eckhard; Schwinzer, Reinhard; Niemann, Heiner; Kind, Alexander; Schnieke, Angelika

    2016-01-01

    Xenotransplantation from pigs could alleviate the shortage of human tissues and organs for transplantation. Means have been identified to overcome hyperacute rejection and acute vascular rejection mechanisms mounted by the recipient. The challenge is to combine multiple genetic modifications to enable normal animal breeding and meet the demand for transplants. We used two methods to colocate xenoprotective transgenes at one locus, sequential targeted transgene placement - ‘gene stacking’, and cointegration of multiple engineered large vectors - ‘combineering’, to generate pigs carrying modifications considered necessary to inhibit short to mid-term xenograft rejection. Pigs were generated by serial nuclear transfer and analysed at intermediate stages. Human complement inhibitors CD46, CD55 and CD59 were abundantly expressed in all tissues examined, human HO1 and human A20 were widely expressed. ZFN or CRISPR/Cas9 mediated homozygous GGTA1 and CMAH knockout abolished α-Gal and Neu5Gc epitopes. Cells from multi-transgenic piglets showed complete protection against human complement-mediated lysis, even before GGTA1 knockout. Blockade of endothelial activation reduced TNFα-induced E-selectin expression, IFNγ-induced MHC class-II upregulation and TNFα/cycloheximide caspase induction. Microbial analysis found no PERV-C, PCMV or 13 other infectious agents. These animals are a major advance towards clinical porcine xenotransplantation and demonstrate that livestock engineering has come of age. PMID:27353424

  15. Feasibility study for producing a carrot/potato matrix reference material for 11 selected pesticides at EU MRL level: material processing, homogeneity and stability assessment.

    PubMed

    Saldanha, Helena; Sejerøe-Olsen, Berit; Ulberth, Franz; Emons, Hendrik; Zeleny, Reinhard

    2012-05-01

    The feasibility for producing a matrix reference material for selected pesticides in a carrot/potato matrix was investigated. A commercially available baby food (carrot/potato-based mash) was spiked with 11 pesticides at the respective EU maximum residue limits (MRLs), and further processed by either freezing or freeze-drying. Batches of some 150 units were produced per material type. First, the materials were assessed for the relative amount of pesticide recovered after processing (ratio of pesticide concentration in the processed material to the initially spiked pesticide concentration). In addition, the materials' homogeneity (bottle-to-bottle variation), and the short-term (1 month) and mid-term (5 months) stability at different temperatures were assessed. For this, an in-house validated GC-EI-MS method operated in the SIM mode with a sample preparation procedure based on the QuEChERS ("quick, easy, cheap, effective, rugged, and safe") principle was applied. Measurements on the frozen material provided the most promising results (smallest analyte losses during production), and also freeze-drying proved to be a suitable alternative processing technique for most of the investigated pesticides. Both the frozen and the freeze-dried material showed to be sufficiently homogeneous for the intended use, and storage at -20°C for 5 months did not reveal any detectable material degradation. The results constitute an important step towards the development of a pesticide matrix reference material. PMID:26434333

  16. Ceilometer Aerosol Profiling versus Raman Lidar in the Frame of Interact Campaign of Actris

    NASA Astrophysics Data System (ADS)

    Madonna, F.; Amato, F.; Rosoldi, M.; Vande Hey, J.; Pappalardo, G.

    2016-06-01

    In this paper, multi-wavelength Raman lidar measurements are used to investigate the capability of ceilometers to provide reliable information about atmospheric aerosol properties through the INTERACT (INTERcomparison of Aerosol and Cloud Tracking) campaign carried out at the CNR-IMAA Atmospheric Observatory (760 m a.s.l., 40.60 N, 15.72 E), in the framework of ACTRIS (Aerosol Clouds Trace gases Research InfraStructure) FP7 project. This work is the first time that three different commercial ceilometers with an advanced Raman lidar are compared over a period of six month. The comparison of the attenuated backscatter coefficient profiles from a multi-wavelength Raman lidar and three ceilometers (CHM15k, CS135s, CT25K) reveals differences due to the expected discrepancy in the SNR but also due to effect of changes in the ambient temperature on the stability of ceilometer calibration over short and mid-term. Technological improvements of ceilometers towards their operational use in the monitoring of the atmospheric aerosol in the low and free troposphere are likely needed.

  17. Multiperiod planning tool for multisite pig production systems.

    PubMed

    Nadal-Roig, E; Plà, L M

    2014-09-01

    This paper presents a multiperiod planning tool for multisite pig production systems based on Linear Programming (LP). The aim of the model is to help pig managers of multisite systems in making short-term decisions (mainly related to pig transfers between farms and batch management in fattening units) and mid-term or long-term decisions (according to company targets and expansion strategy). The model skeleton follows the structure of a three-site system that can be adapted to any multisite system present in the modern pig industry. There are three basic phases, namely, piglet production, rearing pigs, and fattening. Each phase involves a different set of farms; therefore, transportation between farms and delivering of pigs to the abattoir are under consideration. The model maximizes the total gross margin calculated from the income of sales to the abattoir and the production costs over the time horizon considered. Production cost depends on each type of farm involved in the process. Parameters like number of farms per phase and distance, farm capacity, reproduction management policies, feeding and veterinary expenses, and transportation costs are taken into account. The model also provides a schedule of transfers between farms in terms of animals to be transported and number of trucks involved. The use of the model is illustrated with a case study based on a real instance of a company located in Catalonia (Spain).

  18. Plant-centered biosystems in space environments: technological concepts for developing a plant genetic assessment and control system.

    PubMed

    Lomax, Terri L; Findlay, Kirk A; White, T J; Winner, William E

    2003-06-01

    Plants will play an essential role in providing life support for any long-term space exploration or habitation. We are evaluating the feasibility of an adaptable system for measuring the response of plants to any unique space condition and optimizing plant performance under those conditions. The proposed system is based on a unique combination of systems including the rapid advances in the field of plant genomics, microarray technology for measuring gene expression, bioinformatics, gene pathways and networks, physiological measurements in controlled environments, and advances in automation and robotics. The resulting flexible module for monitoring and optimizing plant responses will be able to be inserted as a cassette into a variety of platforms and missions for either experimental or life support purposes. The results from future plant functional genomics projects have great potential to be applied to those plant species most likely to be used in space environments. Eventually, it will be possible to use the plant genetic assessment and control system to optimize the performance of any plant in any space environment. In addition to allowing the effective control of environmental parameters for enhanced plant productivity and other life support functions, the proposed module will also allow the selection or engineering of plants to thrive in specific space environments. The proposed project will advance human exploration of space in the near- and mid-term future on the International Space Station and free-flying satellites and in the far-term for longer duration missions and eventual space habitation.

  19. Open screw fixation of large anterior glenoid rim fractures: mid- and long-term results in 29 patients.

    PubMed

    Raiss, Patric; Baumann, Florian; Akbar, Michael; Rickert, Markus; Loew, Markus

    2009-02-01

    The aim of this retrospective study was to analyse the clinical, functional and radiographic outcomes of patients sustaining traumatic anterior dislocations of the shoulder in combination with large anterior glenoid rim fractures, treated by open reduction and internal screw fixation (ORIF). Twenty-nine patients with a mean follow-up of 6.5 years (2.5-12 years) were evaluated clinically using the Constant and DASH scores, radiographs in two planes and isokinetic muscle strength measurement (Biodex 3 PRO). Mean age was 41.6 years (17-68 years). There was no case of postoperative re-dislocation. Eight out of 29 patients (27.5%) underwent revision surgery to remove the screws. The mean age- and gender-adjusted Constant score was 93.3% (range 64-102%), and the mean DASH score was 10.1 points (range 0-71 points). On radiological examination, 6 patients had signs of osteoarthritis: Samilson type I (n = 3) and II (n = 3). Significant differences for maximal strength in external rotation and muscular endurance compared to the unaffected side were found (P < 0.035). Twenty-seven patients (93%) were satisfied or very satisfied with the result after surgery. ORIF seems to be a good treatment option in cases of large glenoid rim fractures to avoid re-dislocation in the mid-term. Prospective randomised studies are necessary to compare these findings with those after non-operative or arthroscopic treatment of these injuries. PMID:19039575

  20. Prognostic factors for disease-free survival in patients with T-4 or N+ rectal cancer treated with preoperative chemoradiation therapy, surgery, and intraoperative irradiation

    SciTech Connect

    Diaz-Gonzalez, Juan A.; Calvo, Felipe A.; Cortes, Javier; Garcia-Sabrido, Jose L.; Gomez-Espi, Marina; Valle, Emilio del; Munoz-Jimenez, Fernando; Alvarez, Emilio

    2006-03-15

    Purpose: Fluoropyrimidine-radiosensitizing agents in conjunction with preoperative radiotherapy have proven to induce tumor and nodal downstaging effects, sphincter preservation promotion, and mid-term favorable survival rates. Intraoperative electron beam radiation therapy may improve pelvic control in patients with locally advanced rectal cancer stages. Potential predictive factors for response and disease-free survival, with intense local multidisciplinary approach, are analyzed. Methods and Materials: One hundred fifteen patients with rectal cancer were treated with oral 5-fluorouracil or Tegafur with preoperative radiotherapy, surgery, and intraoperative electron beam radiation therapy to identify potential pre- and on-treatment characteristics that might be of prognostic value for disease outcome. Univariate and multivariate analyses were performed. Results: Older patients and those treated with Tegafur were more likely to achieve a major histologic response, categorized as persistence of minimal residual microscopic disease foci in the surgical specimen ('mic' response). Factors unfavorably associated with disease-free survival in the multivariate model were male gender and persistence of macroscopic disease in the rectal wall ('mac' response). Accordingly, 3-year disease-free survival rates in the groups of patients with 0, 1, or 2 of these risk factors were 100%, 81%, and 53%, respectively (p < 0.001). Conclusions: Females with an intense pathologic response (pT{sub mic} residue) to preoperative chemoradiotherapy have an excellent 3-year disease-free survival. This information might be of interest for stratification of patients in the development of adjuvant treatment trials.

  1. [Reasearch progress in health economic evaluation of colorectal cancer screening in China].

    PubMed

    Huang, Huiyao; Shi, Jufang; Dai, Min

    2015-08-01

    Burden of colorectal cancer is rising in China. More attention and financial input have been paid to it by central government that colorectal cancer screening program has been carried out recently in many areas in China. Diversity of screening strategies and limited health resources render selecting the best strategy in a population-wide program a challenging task that economy was also required to be considered except safety and efficacy. To provide a reference for the subsequent further economic evaluation, here we reviewed the evidence available on the economic evaluation of colorectal cancer screening in China. Meanwhile, information related to screening strategies, participation and mid-term efficacy of screening, information and results on economic evaluation were extracted and summarized. Three of the four studies finally included evaluated strategies combining immunochemical fecel occult blood test (iFOBT) with high-risk factor questionnaire as initial screening, colonoscopy as diagnostic screening. There was a consensus regarding the efficacy and effectiveness of screening compared to no screening. Whereas the lack and poor comparability between studies, multi-perspective and multi-phase economic evaluation of colorectal cancer screening is needed, relying on current population-based screening program to conduct a comprehensive cost accounting.

  2. Coupled ocean-atmosphere modeling on horizontally icosahedral and vertically hybrid-isentropic/isopycnic grids.

    NASA Astrophysics Data System (ADS)

    Bleck, Rainer; Sun, Shan; Li, Haiqin; Benjamin, Stan

    2016-04-01

    Current efforts to close the gap between weather prediction and climate models have led to the construction of a coupled ocean-atmosphere system consisting of two high-resolution component models, operating on matching icosahedral grids and utilizing adaptive, near-isentropic/isopycnic vertical coordinates. The two components models, FIM and HYCOM (the latter converted to an icosahedral mesh for this purpose), have been tested extensively in twice-daily global medium-range weather prediction (http://fim.noaa.gov) and in real-time ocean data assimilation (http://hycom.org), respectively. The use of matching horizontal grids, currently at resolutions of 15km, 30km and 60km, avoids coastline ambiguities and interpolation errors at the air-sea interface. The intended purpose of the coupled model being subseasonal-to-seasonal prediction, our focus is on mid-term precipitation biases and the statistical steadiness of the atmospheric circulation (blocking frequency, Rossby wave breaking, meridional heat transport, etc.), as well as on possible causes of ocean model drift. An attempt is made to isolate the weather model's role in modifying water mass properties and ocean circulations (including meridional overturning) by comparing coupled model results to ocean-only experiments forced by observed atmospheric boundary conditions. A multi-decadal run at 60km resolution is used to illustrate ENSO variability in the coupled system.

  3. Controlled programmed trial of Ocimum sanctum leaf on generalized anxiety disorders.

    PubMed

    Bhattacharyya, D; Sur, T K; Jana, U; Debnath, P K

    2008-09-01

    Ocimumn sanctum, an Indian medicinal plant, has been on trial for its role in generalized anxiety disorder (GAD) in hospital based clinical set-up. Hamilton's brief psychiatric rating scale (BPRS) and thorough clinical investigations were used to screen the subjects. Thirty-five subjects (21 male and 14 female; average age 38.4 years) were medicated with the plant extract in a fixed dose regime (500 mg/capsule, twice daily, p.o. after meal). They were thoroughly investigated clinically and using standard questionnaires based on different psychological rating scale at baseline (day 0), mid-term (day 30) and final (day 60). The observations exhibited that, O. sanctum significantly (p<0.001) attenuated generalized anxiety disorders and also attenuated its correlated stress and depression. It further significantly (p<0.001) improved the willingness to adjustment and attention in human. Therefore, it may be concluded that O. sanctum may be useful in the treatment of GAD in human and may be a promising anxiolytic agent in near future.

  4. Neuroprotective role of estrogens: relationship with insulin/IGF-1 signaling.

    PubMed

    Alonso, Ana; Gonzalez, Celestino

    2012-01-01

    Postmenopausal women have an elevated risk of developing a neurodegenerative disease. These clinical observation supported by basic research, suggest that estrogens are neuroprotective. Insulin resistance represents an independent factor in the etiology of age-associated disease and metabolic syndrome should be considered as a contributing factor to the higher post-menopausal vulnerability to neurological disorders. Elucidating the relationship between insulin resistance associated with aging in females, and the cross-talk between estradiol, insulin, and insulin-like growth factor (IGF-1) signaling pathways, will lead to a more complete understanding of the mechanism underlying estradiol-mediated neuroprotection. In past decades, estrogen replacement therapy (ERT) was commonly used as a palliative therapy during menopause, but the mid-term and long-term effects of estrogen as possible promoters of breast cancer and the increased risk of coronary illness or stroke, has limited current usage. A deeper understanding of the molecular mechanisms common to all forms of neurodegenerative diseases may hasten the development of protective strategies against chronic age-related deterioration and acute illness, ultimately providing a better quality of life for the elderly. PMID:22201898

  5. Model documentation: Renewable Fuels Module of the National Energy Modeling System

    SciTech Connect

    Not Available

    1994-04-01

    This report documents the objectives, analytical approach, and design of the National Energy Modeling System (NEMS) Renewable Fuels Module (RFM) as it related to the production of the 1994 Annual Energy Outlook (AEO94) forecasts. The report catalogues and describes modeling assumptions, computational methodologies, data inputs, and parameter estimation techniques. A number of offline analyses used in lieu of RFM modeling components are also described. This documentation report serves two purposes. First, it is a reference document for model analysts, model users, and the public interested in the construction and application of the RFM. Second, it meets the legal requirement of the Energy Information Administration (EIA) to provide adequate documentation in support of its models. The RFM consists of six analytical submodules that represent each of the major renewable energy resources -- wood, municipal solid waste (MSW), solar energy, wind energy, geothermal energy, and alcohol fuels. Of these six, four are documented in the following chapters: municipal solid waste, wind, solar and biofuels. Geothermal and wood are not currently working components of NEMS. The purpose of the RFM is to define the technological and cost characteristics of renewable energy technologies, and to pass these characteristics to other NEMS modules for the determination of mid-term forecasted renewable energy demand.

  6. Open Stented Grafts for Frozen Elephant Trunk Technique: Technical Aspects and Current Outcomes

    PubMed Central

    Ma, Wei-Guo; Zheng, Jun; Sun, Li-Zhong; Elefteriades, John A.

    2015-01-01

    With growing experience in patients with aneurysms and dissections in the arch and proximal descending aorta, the frozen elephant trunk (FET) technique has been shown to be safe and effective, and has achieved favorable short to mid-term outcomes. As the FET technique is gaining wider acceptance, there is a growing need for versatile, technically simple, and highly durable open stented grafts involving less complicated deployment mechanisms enabling use in various indications. This paper gives a brief review on the technical aspects and clinical outcomes of currently available open stented grafts used in the FET technique, including the E-vita Open Plus, Thoraflex Hybrid, Cronus, and J Graft. While none of these grafts can claim to be an ideal device, technology continues to improve towards this goal. As newer devices and systems are developed, more widespread use of the FET technique can be expected; such progress promises to improve the clinical outcomes and quality of life for patients with complex aortic diseases. PMID:27069943

  7. Potential of the TCE-degrading endophyte Pseudomonas putida W619-TCE to improve plant growth and reduce TCE phytotoxicity and evapotranspiration in poplar cuttings

    SciTech Connect

    Weyens, N.; van der Lelie, D.; Truyens, S.; Dupae, J.; Newman, L.; Taghavi, S.; Carleer, R.; Vangronsveld, J.

    2010-09-01

    The TCE-degrading poplar endophyte Pseudomonas putida W619-TCE was inoculated in poplar cuttings, exposed to 0, 200 and 400 mg l{sup -1} TCE, that were grown in two different experimental setups. During a short-term experiment, plants were grown hydroponically in half strength Hoagland nutrient solution and exposed to TCE for 3 days. Inoculation with P. putida W619-TCE promoted plant growth, reduced TCE phytotoxicity and reduced the amount of TCE present in the leaves. During a mid-term experiment, plants were grown in potting soil and exposed to TCE for 3 weeks. Here, inoculation with P. putida W619-TCE had a less pronounced positive effect on plant growth and TCE phytotoxicity, but resulted in strongly reduced amounts of TCE in leaves and roots of plants exposed to 400 mg l{sup -1} TCE, accompanied by a lowered evapotranspiration of TCE. Dichloroacetic acid (DCAA) and trichloroacetic acid (TCAA), which are known intermediates of TCE degradation, were not detected. The endophyte P. putida W619-TCE degrades TCE during its transport through the xylem, leading to reduced TCE concentrations in poplar, and decreased TCE evapotranspiration.

  8. Hip resurfacing: a large, US single-surgeon series.

    PubMed

    Brooks, P J

    2016-01-01

    Hip resurfacing has been proposed as an alternative to traditional total hip arthroplasty in young, active patients. Much has been learned following the introduction of metal-on-metal resurfacing devices in the 1990s. The triad of a well-designed device, implanted accurately, in the correct patient has never been more critical than with these implants. Following Food and Drug Administration approval in 2006, we studied the safety and effectiveness of one hip resurfacing device (Birmingham Hip Resurfacing) at our hospital in a large, single-surgeon series. We report our early to mid-term results in 1333 cases followed for a mean of 4.3 years (2 to 5.7) using a prospective, observational registry. The mean patient age was 53.1 years (12 to 84); 70% were male and 91% had osteoarthritis. Complications were few, including no dislocations, no femoral component loosening, two femoral neck fractures (0.15%), one socket loosening (0.08%), three deep infections (0.23%), and three cases of metallosis (0.23%). There were no destructive pseudotumours. Overall survivorship at up to 5.7 years was 99.2%. Aseptic survivorship in males under the age of 50 was 100%. We believe this is the largest United States series of a single surgeon using a single resurfacing system. PMID:26733633

  9. Comparative analysis of selected fuel cell vehicles

    SciTech Connect

    1993-05-07

    Vehicles powered by fuel cells operate more efficiently, more quietly, and more cleanly than internal combustion engines (ICEs). Furthermore, methanol-fueled fuel cell vehicles (FCVs) can utilize major elements of the existing fueling infrastructure of present-day liquid-fueled ICE vehicles (ICEVs). DOE has maintained an active program to stimulate the development and demonstration o fuel cell technologies in conjunction with rechargeable batteries in road vehicles. The purpose of this study is to identify and assess the availability of data on FCVs, and to develop a vehicle subsystem structure that can be used to compare both FCVs and ICEV, from a number of perspectives--environmental impacts, energy utilization, materials usage, and life cycle costs. This report focuses on methanol-fueled FCVs fueled by gasoline, methanol, and diesel fuel that are likely to be demonstratable by the year 2000. The comparative analysis presented covers four vehicles--two passenger vehicles and two urban transit buses. The passenger vehicles include an ICEV using either gasoline or methanol and an FCV using methanol. The FCV uses a Proton Exchange Membrane (PEM) fuel cell, an on-board methanol reformer, mid-term batteries, and an AC motor. The transit bus ICEV was evaluated for both diesel and methanol fuels. The transit bus FCV runs on methanol and uses a Phosphoric Acid Fuel Cell (PAFC) fuel cell, near-term batteries, a DC motor, and an on-board methanol reformer. 75 refs.

  10. Optical engineering capstone design projects with industry sponsors

    NASA Astrophysics Data System (ADS)

    Bunch, Robert M.; Leisher, Paul O.; Granieri, Sergio C.

    2014-09-01

    Capstone senior design is the culmination of a student's undergraduate engineering education that prepares them for engineering practice. In fact, any engineering degree program that pursues accreditation by the Engineering Accreditation Commission of ABET must contain "a major design experience based on the knowledge and skills acquired in earlier course work and incorporating appropriate engineering standards and multiple realistic constraints." At Rose-Hulman, we offer an interdisciplinary Optical Engineering / Engineering Physics senior design curriculum that meets this requirement. Part of this curriculum is a two-course sequence where students work in teams on a design project leading to a functional prototype. The students begin work on their capstone project during the first week of their senior year. The courses are deliverable-driven and the students are held accountable for regular technical progress through weekly updates with their faculty advisor and mid-term design reviews. We have found that client-sponsored projects offer students an enriched engineering design experience as it ensures consideration of constraints and standards requirements similar to those that they will encounter as working engineers. Further, client-sponsored projects provide teams with an opportunity for regular customer interactions which help shape the product design. The process that we follow in both soliciting and helping to scope appropriate industry-related design projects will be described. In addition, an outline of the capstone course structure as well as methods used to hold teams accountable for technical milestones will be discussed. Illustrative examples of past projects will be provided.

  11. NASA's In-Space Propulsion Technology Project Overview, Near-term Products and Mission Applicability

    NASA Technical Reports Server (NTRS)

    Dankanich, John; Anderson, David J.

    2008-01-01

    The In-Space Propulsion Technology (ISPT) Project, funded by NASA's Science Mission Directorate (SMD), is continuing to invest in propulsion technologies that will enable or enhance NASA robotic science missions. This overview provides development status, near-term mission benefits, applicability, and availability of in-space propulsion technologies in the areas of aerocapture, electric propulsion, advanced chemical thrusters, and systems analysis tools. Aerocapture investments improved (1) guidance, navigation, and control models of blunt-body rigid aeroshells, 2) atmospheric models for Earth, Titan, Mars and Venus, and 3) models for aerothermal effects. Investments in electric propulsion technologies focused on completing NASA s Evolutionary Xenon Thruster (NEXT) ion propulsion system, a 0.6-7 kW throttle-able gridded ion system. The project is also concluding its High Voltage Hall Accelerator (HiVHAC) mid-term product specifically designed for a low-cost electric propulsion option. The primary chemical propulsion investment is on the high-temperature Advanced Material Bipropellant Rocket (AMBR) engine providing higher performance for lower cost. The project is also delivering products to assist technology infusion and quantify mission applicability and benefits through mission analysis and tools. In-space propulsion technologies are applicable, and potentially enabling for flagship destinations currently under evaluation, as well as having broad applicability to future Discovery and New Frontiers mission solicitations.

  12. Transvaginal Cervical Length and Tobacco Use in Appalachian Women: Association with Increased Risk for Spontaneous Preterm Birth

    PubMed Central

    Findley, Joseph; Seybold, Dara J.; Broce, Mike; Yadav, Dolly; Calhoun, Byron C.

    2015-01-01

    Currently ACOG recommends that a mid-term screening strategy may be considered to identify short cervix in low risk populations in an effort to prevent preterm birth. Vaginal progesterone is recommended for women with a cervical length ≤20 mm. Cerclage is recommended for women with prior spontaneous preterm birth who are already receiving progesterone supplementation and CL is <25 mm. This study examined risk factors for spontaneous preterm birth (SPB) <35 weeks among a general obstetrical population prior to these ACOG recommendations. However, cervical cerclage was a possible intervention. Study population included 1,074 patients from 1 Jan 2007-30 Jun 2008 receiving mid-trimester transvaginal ultrasounds during prenatal care at a tertiary medical center clinic. Receiver operator characteristic (ROC) curve cutoff optimal value was ≤34 mm, (n=224), corresponding to 8.9% SPB with shortened cervices compared to 1.4% in patients with normal cervices (>34 mm; n=850; p<0.001 (Area Under the Curve (AUC) 76.6, p<0.001). Cervical lengths <30 mm had 12 times the risk of SPB (p<0.001) while 30-34 mm had 5 times (p=0.005). Tobacco use (≥10 cigarettes per day), p=0.030, and low BMI, p=0.034, had additive effect. Shortened cervical length during routine screening independently predicted SPB while heavy smoking with shortened cervix during pregnancy doubled risk compared to shortened cervix alone. PMID:26050294

  13. Preventive and therapeutic effect of treadmill running on chronic stress-induced memory deficit in rats.

    PubMed

    Radahmadi, Maryam; Alaei, Hojjatallah; Sharifi, Mohammad Reza; Hosseini, Nasrin

    2015-04-01

    Previous results indicated that stress impairs learning and memory. In this research, the effects of preventive, therapeutic and regular continually running activity on chronic stress-induced memory deficit in rats were investigated. 70 male rats were randomly divided into seven groups as follows: Control, Sham, Stress-Rest, Rest-Stress, Stress-Exercise, Exercise-Stress and Exercise-Stress & Exercise groups. Chronic restraint stress was applied 6 h/day for 21days and treadmill running 1 h/day. Memory function was evaluated by the passive avoidance test. The results revealed that running activities had therapeutic effect on mid and long-term memory deficit and preventive effects on short and mid-term memory deficit in stressed rats. Regular continually running activity improved mid and long-term memory compared to Exercise-Stress group. The beneficial effects of exercise were time-dependent in stress conditions. Finally, data corresponded to the possibility that treadmill running had a more important role on treatment rather than on prevention on memory impairment induced by stress.

  14. Generic Airspace Concepts and Research

    NASA Technical Reports Server (NTRS)

    Mogford, Richard H.

    2010-01-01

    The purpose of this study was to evaluate methods for reducing the training and memorization required to manage air traffic in mid-term, Next Generation Air Transportation System (NextGen) airspace. We contrasted the performance of controllers using a sector information display and NextGen automation tools while working with familiar and unfamiliar sectors. The airspace included five sectors from Oakland and Salt Lake City Centers configured as a "generic center" called "West High Center." The Controller Information Tool was used to present essential information for managing these sectors. The Multi Aircraft Control System air traffic control simulator provided data link and conflict detection and resolution. There were five experienced air traffic controller participants. Each was familiar with one or two of the five sectors, but not the others. The participants rotated through all five sectors during the ten data collection runs. The results addressing workload, traffic management, and safety, as well as controller and observer comments, supported the generic sector concept. The unfamiliar sectors were comparable to the familiar sectors on all relevant measures.

  15. Design rules for successful governmental payments for ecosystem services: Taking agri-environmental measures in Germany as an example.

    PubMed

    Meyer, Claas; Reutter, Michaela; Matzdorf, Bettina; Sattler, Claudia; Schomers, Sarah

    2015-07-01

    In recent years, increasing attention has been paid to financial environmental policy instruments that have played important roles in solving agri-environmental problems throughout the world, particularly in the European Union and the United States. The ample and increasing literature on Payments for Ecosystem Services (PES) and agri-environmental measures (AEMs), generally understood as governmental PES, shows that certain single design rules may have an impact on the success of a particular measure. Based on this research, we focused on the interplay of several design rules and conducted a comparative analysis of AEMs' institutional arrangements by examining 49 German cases. We analyzed the effects of the design rules and certain rule combinations on the success of AEMs. Compliance and noncompliance with the hypothesized design rules and the success of the AEMs were surveyed by questioning the responsible agricultural administration and the AEMs' mid-term evaluators. The different rules were evaluated in regard to their necessity and sufficiency for success using Qualitative Comparative Analysis (QCA). Our results show that combinations of certain design rules such as environmental goal targeting and area targeting conditioned the success of the AEMs. Hence, we generalize design principles for AEMs and discuss implications for the general advancement of ecosystem services and the PES approach in agri-environmental policies. Moreover, we highlight the relevance of the results for governmental PES program research and design worldwide.

  16. Quality of trace element contaminated soils amended with compost under fast growing tree Paulownia fortunei plantation.

    PubMed

    Madejón, P; Xiong, J; Cabrera, F; Madejón, E

    2014-11-01

    The use of fast growing trees could be an alternative in trace element contaminated soils to stabilize these elements and improve soil quality. In this study we investigate the effect of Paulownia fortunei growth on trace element contaminated soils amended with two organic composts under semi-field conditions for a period of 18 months. The experiment was carried out in containers filled with tree different soils, two contaminated soils (neutral AZ and acid V) and a non contaminated soil, NC. Three treatments per soil were established: two organic amendments (alperujo compost, AC, and biosolid compost, BC) and a control without amendment addition. We study parameters related with fertility and contamination in soils and plants. Paulownia growth and amendments increased pH in acid soils whereas no effect of these factors was observed in neutral soils. The plant and the amendments also increased organic matter and consequently, soil fertility. Positive results were also found in soils that were only affected by plant growth (without amendment). A general improvement of "soil biochemical quality" was detected over time and treatments, confirming the positive effect of amendments plus paulownia. Even in contaminated soils, except for Cu and Zn, trace element concentrations in leaves were in the normal range for plants. Results of this mid-term study showed that Paulownia fortunei is a promising species for phytoremediation of trace element polluted soils.

  17. Why students still can't solve physics problems after solving over 2000 problems

    NASA Astrophysics Data System (ADS)

    Byun, Taejin; Lee, Gyoungho

    2014-09-01

    This study investigates the belief that solving a large number of physics problems helps students better learn physics. We investigated the number of problems solved, student confidence in solving these problems, academic achievement, and the level of conceptual understanding of 49 science high school students enrolled in upper-level physics classes from Spring 2010 to Summer 2011. The participants solved an average of 2200 physics problems before entering high school. Despite having solved so many problems, no statistically significant correlation was found between the number of problems solved and academic achievement on either a mid-term or physics competition examination. In addition, no significant correlation was found between the number of physics problems solved and performance on the Force Concept Inventory (FCI). Lastly, four students were selected from the 49 participants with varying levels of experience and FCI scores for a case study. We determined that their problem solving and learning strategies was more influential in their success than the number of problems they had solved.

  18. Multi-sensory rooms: comparing effects of the Snoezelen and the Stimulus Preference environment on the behavior of adults with profound mental retardation.

    PubMed

    Fava, Leonardo; Strauss, Kristin

    2010-01-01

    The present study examined whether Snoezelen and Stimulus Preference environments have differential effects on disruptive and pro-social behaviors in adults with profound mental retardation and autism. In N=27 adults these target behaviors were recorded for a total of 20 sessions using both multi-sensory rooms. Three comparison groups were created by diagnosis and motor respective linguistic abilities. Each client was exposed to only one multi-sensory room. Results showed that Snoezelen intervention decreased disruptive behaviors only in individuals with autism, while Stimulus Preference increased pro-social behaviors only in participants with profound mental retardation with co-occurring poor motor and linguistic abilities. Furthermore, several trend analyses of the improved behaviors were conducted throughout all sessions toward short and mid term effects of the multi-sensory room applications. These findings support both the prudence of using the Snoezelen room in individuals with developmental disabilities and the importance of using a Stimulus Preference assessment in multi-sensory environments in clients with profound mental retardation.

  19. Resolved Abdominal Aortic Aneurysms Following Stent Graft Treatment: A Report of Five Cases

    SciTech Connect

    Rimon, Uri; Garniek, Alexander; Golan, Gil; Bensaid, Paul; Galili, Yair; Schneiderman, Jacob; Morag, Benyamina

    2004-03-15

    Complete aneurysm resolution is the hallmark of successful endoluminal stent-graft treatment. We describe 5 patients in whom an abdominal aortic aneurysm (AAA) disappeared completely at mid-term follow-up after endovascular stent-graft placement. We reviewed 45 patients (43 men and 2 women) who underwent AAA repair using an endovascular technique, from April 1997 to December 2001. Mean AAA diameter was 58.3 mm. On 48-month follow-up, 12 aneurysms had not changed in size, 4 had grown, 16 had shrunk, and 5 had resolved completely. We describe these 5 patients in detail. The 5 patients were all men, mean age 68 years; their mean aneurysmal sac diameter was 54 mm. The only common finding in all of them was patency of lumbar and inferior mesenteric arteries at pre-procedure evaluation as well as at follow-up. Mean time to complete resolution was 18 months. No major complications were encountered. AAA may resolve completely after endovascular stent-graft implantation. Patent side branches may perhaps contribute to AAA disappearance by antegrade flow. A larger patient population should be reviewed, however, before any statistical conclusion can be drawn.

  20. Stent-Grafts for Unruptured Abdominal Aortic Aneurysms: Current Status

    SciTech Connect

    Rose, John

    2006-06-15

    Aortic stent-grafts were introduced at the beginning of the 1990s as a less invasive method of dealing with aortic aneurysms in patients with poor cardiovascular reserve. The numbers of procedures performed worldwide has increased exponentially despite the current lack of any substantial evidence for long-term efficacy in comparison with the gold standard of open surgical grafting. This review summarizes the evolution of the abdominal aortic stent-graft, the techniques used for assessment and deployment, and the effect of the procedure on both the patient and the device. The recent publication of two national multicenter trials has confirmed that the endovascular technique confers a 2.5-fold reduction in 30-day mortality in comparison with open surgery. However, over 4 years of follow-up, there is a 3-fold increase in the risk of reintervention and the overall costs are 30% greater with endovascular repair. Although the improvement in aneurysm-related mortality persists in the mid-term, because of the initial reduction in perioperative mortality, the all-cause mortality rate at 4 years is actually no better than for open surgery. Longer-term data from the randomized trials are awaited as well as results from the latest trials utilizing state-of-the-art devices. Whilst the overall management of abdominal aortic aneurysms has undoubtedly benefited from the introduction of stent-grafts, open repair currently remains the gold standard treatment.