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Sample records for proctalgia fugax mid-term

  1. Hereditary proctalgia fugax and constipation: report of a second family.

    PubMed Central

    Celik, A F; Katsinelos, P; Read, N W; Khan, M I; Donnelly, T C

    1995-01-01

    A second family with hereditary proctalgia fugax and internal anal sphincter hypertrophy associated with constipation is described. Anorectal ultrasonography, manometry, and sensory tests were conducted in two symptomatic and one asymptomatic subjects within the same family and further clinical information was obtained from other family members. The inheritance would correspond to an autosomal dominant condition with incomplete penetration, presenting after the second decade of life. Physiological studies showed deep, ultraslow waves and an absence of internal anal sphincter relaxation on rectal distension in the two most severely affected family members, suggesting the possibility of a neuropathic origin. Both of these patients had an abnormally high blood pressure. After treatment with a sustained release formulation of the calcium antagonist, nifedipine, their blood pressure returned to normal, anal tone was reduced, and the frequency and intensity of anal pain was suppressed. These together improved the quality of the patients' sleep, which had previously been very troubled because of night time attacks of anal pain. PMID:7737568

  2. Epicrania Fugax.

    PubMed

    Cuadrado, María Luz; Guerrero, Angel L; Pareja, Juan A

    2016-04-01

    Epicrania fugax (EF) is a primary headache of recent description. EF essentially consists of brief paroxysms of pain describing a linear or zigzag trajectory across the surface of one hemicranium, commencing and terminating in the territories of different nerves. The pain of forward EF originates in a particular area of the occipital, parietal or temporal regions and moves anteriorly, whereas the pain of backward EF originates in the frontal area, the eye or the nose and moves posteriorly. Some patients have ocular or nasal autonomic accompaniments, and some have triggers. Between attacks, many patients have continuous or intermittent pain and/or tenderness at the stemming area. Pain frequency is extremely variable and some patients have spontaneous remissions. Preventive therapy is required when the paroxysms are frequent and non-remitting. Neuromodulators, indomethacin, amitryptiline, nerve anesthetic blockades, and trochlear steroid injections have been used in different cases, with partial or complete response.

  3. Linear interictal pain in Epicrania Fugax.

    PubMed

    Pareja, Juan A; Bandrés, Pablo

    2015-01-01

    Epicrania Fugax is a paroxysmal, short-lasting, head pain moving across one hemicranium, describing a linear or zag trajectory, starting and ending in territories of different nerves. Between attacks, patients are usually free of symptoms. We describe an Epicrania Fugax patient complaining of interictal pain. The interictal pain was line-shaped and extended across the usual starting and ending points of the typical Epicrania Fugax paroxysms. Although rarely encountered, persistent linear pain may be a feature of Epicrania Fugax.

  4. Ocean Commission mid-term report

    NASA Astrophysics Data System (ADS)

    Showstack, Randy

    In its mid-term report issued on 24 September, the U.S. Commission on Ocean Policy paints a bleak picture of the oceans and marine resources. Among the concerns are dramatic increases in population and pollution along shorelines, which indicate that the management of U.S. coastal areas is inadequate. Other problems outlined include outdated and under-utilized ocean and coastal observing and prediction systems, jurisdictional and legal confusion and ambiguity about coastal laws, and a lack of public awareness about threats to oceans.

  5. Electrification: Mid-term (1985 - 2000)

    NASA Technical Reports Server (NTRS)

    1975-01-01

    Electrification, intended to provide a basis for the mid term period of the energy conservation program, was defined as a set of actions and/or policies that leads to an increasing proportion of total energy used in the form of electricity. The important actions within electrification are those with the greatest impacts (coal and nuclear), the greatest technological requirements (peak shaving and transmission) and the greatest response from the decision makers (economic health and growth of utilities in an era of increasing energy costs). The following areas were discussed: increased power generation from coal action, increased use of nuclear power action, improved operation of public utilities action, actions to be taken in industry, transportation and residential/commercial areas. The various ways in which electrification leads to energy conservation were clarified, and a number of specific recommendations relative to electrification were suggested.

  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. Amaurosis fugax: risk factors and prevalence of significant carotid stenosis

    PubMed Central

    Kvickström, Pia; Lindblom, Bertil; Bergström, Göran; Zetterberg, Madeleine

    2016-01-01

    Purpose The purpose of this study was to describe clinical characteristics and prevalence of carotid stenosis in patients with amaurosis fugax (AF). Method Patients diagnosed with AF and subjected to carotid ultrasound in 2004–2010 in Sahlgrenska University Hospital, Gothenburg (n=302), were included, and data were retrospectively collected from medical records. Results The prevalence of significant carotid stenosis was 18.9%, and 14.2% of the subjects were subjected to carotid endarterectomy. Significant associations with risk of having ≥70% stenosis were male sex (adjusted odds ratio [aOR]: 2.62; 95% confidence interval [CI]: 1.26–5.46), current smoking (aOR: 6.26; 95% CI: 2.62–14.93), diabetes (aOR: 3.68; 95% CI: 1.37–9.90) and previous vasculitis (aOR: 10.78; 95% CI: 1.36–85.5). A majority of the patients (81.4%) was seen by an ophthalmologist prior to the first ultrasound. Only 1.7% of the patients exhibited retinal artery emboli at examination. Conclusion The prevalence of carotid stenosis among patients with AF is higher than has previously been demonstrated in stroke patients. An association with previously reported vascular risk factors and with vasculitis is seen in this patient group. Ocular findings are scarce. PMID:27826182

  8. Resistance to ACCase-inhibiting herbicides in an Asia minor bluegrass (Polypogon fugax) population in China.

    PubMed

    Tang, Wei; Zhou, Fengyan; Chen, Jie; Zhou, Xiaogang

    2014-01-01

    Asia minor bluegrass (Polypogon fugax) is a common annual grass weed of winter crops distributed across China. We conducted a study on the resistance level and the mechanism of resistance to ACCase-inhibiting herbicides in a P. fugax population from China. Whole-plant dose-response experiments in greenhouse showed that the resistant P. fugax population was 1991, 364, 269, 157, and 8-fold resistant to clodinafop-propargyl, fluazifop-p-butyl, haloxyfop-R-methyl, quizalofop-p-ethyl and fenoxaprop-p-ethyl relative to the reference susceptible population, which was susceptible to all the five AOPP herbicides. Much lower R/S values of 3.5, 2.4 and 3.5, respectively, were detected for clethodim, sethoxydim and pinoxaden. Molecular analysis of resistance confirmed that the Ile2041 to Asn mutation in the resistant population conferred resistance to AOPP herbicides, but not to CHD and DEN herbicides. This is the first report of a target site mutation that corresponded to resistance to AOPP herbicides in P. fugax. Proper resistance management practices are necessary to prevent ACCase-inhibiting herbicides from becoming ineffective over wide areas.

  9. Amaurosis fugax

    MedlinePlus

    ... pressure. If you have diabetes, heart disease, or hardening of the arteries, your LDL "bad" cholesterol should ... Saunders; 2014:chap 9.26. Read More Diabetes Hardening of the arteries High blood cholesterol levels High ...

  10. 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

  11. 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…

  12. Mid-Term Outcomes of Anterior Cruciate Ligament Reconstruction with Far Anteromedial Portal Technique

    PubMed Central

    Jeon, Yoon Sang; Choi, Sung Wook; Park, Ju Hyun; Yoon, Jae Sik; Shin, Jung Sub; Kim, Myung Ku

    2017-01-01

    Purpose The purpose of this study was to evaluate the mid-term outcomes of anatomic anterior cruciate ligament (ACL) reconstruction using two anteromedial (AM) portals by comparing with short-term follow-up results. Materials and Methods Fifty patients who were treated by ACL reconstruction using a two AM portal technique were evaluated retrospectively. The follow-up period was at least 5 years. The mean follow-up period was 68.5±13.9 months. The mid-term clinical outcomes were compared with short-term (≥12 months) results. For the assessment of knee stability, anterior tibial translation was evaluated using the Lachman test and the KT-2000. Rotational stability was evaluated using pivot shift test. For clinical assessment, the Lysholm and International Knee Documentation Committee scores were used. Results The average anterior translation was 2.1±1.4 mm at the short-term follow-up and 2.8±1.8 mm at the mid-term follow-up. Stability and midterm clinical outcomes were not significantly improved compared to the short-term follow-up results. At the mid-term follow-up, anteroposterior (AP) instability assessed by the KT-2000 was slightly increased, but still acceptable. On the other clinical physical evaluation, there was no statistically significant difference. Conclusions The short-term and mid-term outcomes of ACL reconstruction using the two AM portal technique were not significantly different except for AP stability although the value was less than 3 mm at both follow-ups. Therefore, this operative technique could be considered a satisfactory alternative for ACL reconstruction. PMID:28231644

  13. 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.

  14. 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

  15. Mid-Term Results of Computer-Assisted Cervical Pedicle Screw Fixation

    PubMed Central

    Uehara, Masashi; Mukaiyama, Keijiro; Kuraishi, Shugo; Shimizu, Masayuki; Ikegami, Shota; Futatsugi, Toshimasa; Ogihara, Nobuhide; Hashidate, Hiroyuki; Hirabayashi, Hiroki; Kato, Hiroyuki

    2014-01-01

    Study Design A retrospective study. Purpose The present study aimed to evaluate mid-term results of cervical pedicle screw (CPS) fixation for cervical instability. Overview of Literature CPS fixation has widely used in the treatment of cervical spinal instability from various causes; however, there are few reports on mid-term surgical results of CPS fixation. Methods Record of 19 patients who underwent cervical and/or upper thoracic (C2-T1) pedicle screw fixation for cervical instability was reviewed. The mean observation period was 90.2 months. Evaluated items included Japanese Orthopaedic Association (JOA) score and C2-7 lordotic angle before surgery and at 5 years after surgery. Postoperative computerized tomography was used to determine the accuracy of screw placement. Visual analog scale (VAS) for neck pain and radiological evidence of adjacent segment degeneration (ASD) at the 5-year follow-up were also evaluated. Results Mean JOA score was significantly improved from 9.0 points before surgery to 12.8 at 5 years after surgery (p=0.001). The C2-7 lordotic angle of the neutral position improved from 6.4° to 7.8° at 5 years after surgery, but this was not significant. The major perforation rate was 5.0%. There were no clinically significant complications such as vertebral artery injury, spinal cord injury, or nerve root injury caused by any screw perforation. Mean VAS for neck pain was 49.4 at 5 years after surgery. The rate of ASD was 21.1%. Conclusions Our mid-term results showed that CPS fixation was useful for treating cervical instability. Severe complications were prevented with the assistance of a computed tomography-based navigation system. PMID:25558318

  16. 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.

  17. (Mid-term evaluation of the Central America Rural Electrification Support program)

    SciTech Connect

    Perlack, R.D.

    1990-03-30

    Oak Ridge National Laboratory (ORNL) was requested by Regional Office for Central America and Panama (ROCAP) to conduct a mid-term evaluation of the CARES project. Numerous meetings were held with National Rural Electric Cooperative Association (NRECA) staff, ROCAP staff, and local officials in Guatemala, Honduras, and Belize. In general, the CARES project has been quite successful in a number of key areas as well as in soliciting support from utilities and US Agency for International Development (USAID) Missions. Changes were recommended in the area of report writing and some management activities. It was also recommended that any new activities be considered in the light of the availability of local personnel.

  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. Indications and early to mid-term results of ulnar head replacement

    PubMed Central

    Shyamalan, G; Balabanidou, E

    2013-01-01

    Introduction The aim of this study was to explore the indications and show the early to mid-term results of ulnar head replacement for the treatment of pathological conditions of the distal radioulnar joint. Methods Our study group comprised 52 patients with a mean age of 64 years who had 56 ulnar head replacements. Seven were implanted to salvage an unstable deletive procedure; the rest were for primary treatment of osteoarthritis, rheumatoid arthritis and trauma. Concomitant procedures along with the ulnar head replacement included wrist arthrodesis, joint replacement and tendon transfers. Results The follow-up duration ranged from 1 year to 11 years (mean: 60 months, median: 60 months). In almost all of the patients, pain improved with a median visual analogue scale score of 2 (mean: 2.2, range: 0–8) and a median DASH (Disabilities of the Arm, Shoulder and Hand) score of 12.5 (mean: 17.9, range: 0–56). Of the 52 patients, 47 reported they would have the same procedure again. Conclusions Ulnar head replacement appears to be a reliable and effective procedure solving several pathological problems of the distal radioulnar joint. We present a large patient group with a short to medium-term follow-up duration. PMID:24025293

  20. Hip resurfacing arthroplasty: mid-term results in 486 cases and current indication in our institution.

    PubMed

    Ribas, Manuel; Cardenas, Carlomagno; Astarita, Emanuele; Moya, Esther; Bellotti, Vittorio

    2014-10-02

    In the previous decade, metal-on-metal hip resurfacing has been considered an attractive option and theoretically advantageous over conventional total hip arthroplasty, especially in young active patients. Different authors have reported favourable mid-term clinical and functional results with acceptable survival rates. Proper indication and planning, as accurate technical execution have been advocated to be crucial elements for success.Concerns regarding serum metal ion levels and possible clinical implications have led in the last years to a decline in the use of metal-on-metal hip resurfacing and metal-on-metal bearings in general.The aim of this study is to present the results of our first 486 cases of hybrid hip resurfacing arthroplasties with a second generation cementing technique, and to describe our current restricted indication of this type of prosthesis, in the light of recent findings in the literature about the possible complications related to metallosis or improper patient selection. Global survivorship of our series was 97.9% at a mean follow-up of 7.2 years.In the second season of our experience the indication is restrictive. The candidate for a resurfacing hip replacement is a young and active male patient, with good bone quality, that has been made aware of the risks and benefits of this type of prosthesis.

  1. The Bologna-Oxford total ankle replacement: a mid-term follow-up study.

    PubMed

    Bianchi, A; Martinelli, N; Sartorelli, E; Malerba, F

    2012-06-01

    The Bologna-Oxford (BOX) total ankle replacement (TAR) was developed with the aim of achieving satisfactory pain-free movement of the ankle. To date, only one single multicentre study has reported its clinical results. The aim of this study was to conduct an independent review of its mid-term results. We retrospectively reviewed a total of 60 prospectively followed patients in whom 62 BOX TARs had been implanted between 2004 and 2008. We used the American Orthopedic Foot and Ankle Society (AOFAS) score to assess the clinical results. Standardised radiographs taken at the time of final follow-up were analysed by two observers. The overall survival was 91.9% at a mean follow-up of 42.5 months (24 to 71). The mean AOFAS score had improved from 35.1 points (sd 16.6; 4 to 73) pre-operatively to 78.0 (sd 10.7; 57 to 100) at final follow-up (p < 0.01). Tibial radiolucencies < 2 mm in width were seen around 16 TARs. Talar radiolucencies < 2 mm were seen around four TARs. A total of 47 patients (78.3%) were very satisfied or satisfied with the outcome. Five patients required revision for functional limitation or continuing pain.

  2. Nonoperatively treated type A spinal fractures: mid-term versus long-term functional outcome.

    PubMed

    Post, R B; van der Sluis, C K; Leferink, V J M; Dijkstra, P U; ten Duis, H J

    2009-08-01

    This study focuses on the mid-term (four years) and long-term (ten years) functional outcome of patients treated nonoperatively for a type A spinal fracture without primary neurological deficit. Functional outcome was measured using the visual analogue scale spine score (VAS) and the Roland-Morris disability questionnaire (RMDQ). The 50 patients included were on average 41.2 years old at the time of injury. Four years post injury, a mean VAS score of 74.5 and a mean RMDQ score of 4.9 were found. Ten years after the accident, the mean VAS and RMDQ scores were 72.6 and 4.7, respectively (NS). No significant relationships were found between the difference scores of the VAS and RMDQ compared with age, gender, fracture sub-classification, and time between measurements. Three (6%) patients had a poor long-term outcome. None of the patients required surgery for late onset pain or progressive neurological deficit. Functional outcome after a nonoperatively treated type A spinal fracture is good, both four and ten years post injury. For the group as a whole, four years after the fracture a steady state exists in functional outcome, which does not change for ten years at least after the fracture.

  3. Mid-Term Assessment of English 10 Students: A Comparison of Methods of Entry into the Course.

    ERIC Educational Resources Information Center

    Isonio, Steven

    In spring 1992, a mid-term assessment of English 10 students was conducted at Golden West College, in California, in order to compare four course placement methods. English 10, "Writing Essentials," is a nontransferrable course which focuses on paragraph writing and grammar review in order to prepare students for entry into English 100.…

  4. Mid-Term Vascular Safety of Renal Denervation Assessed by Follow-up MR Imaging

    SciTech Connect

    Schmid, Axel Schmieder, Raphael; Lell, Michael; Janka, Rolf; Veelken, Roland; Schmieder, Roland E.; Uder, Michael; Ott, Christian

    2016-03-15

    Background/AimsRenal denervation (RDN) emerged as a treatment option for reducing blood pressure (BP) in patients with treatment-resistant hypertension (TRH). However, concerns have been raised regarding the incidence of late renal artery stenosis or thromboembolism after RDN. The goal of the current study was, therefore, to conduct a prospective clinical trial on the mid-term vascular integrity of the renal arteries and the perfusion of the renal parenchyma assessed by magnetic resonance imaging (MRI) in the follow-up after catheter-based RDN.MethodsIn our single-centre investigator initiated study, 51 patients with true TRH underwent catheter-based RDN using the Symplicity Flex{sup TM} catheter (Medtronic Inc., Palo Alto, CA). Follow-up MRI was performed at a median of 11 months (interquartile range 6–18 months) after RDN on a 1.5T MR unit. High-resolution MR angiography (MRA) and MRI results were compared to the baseline digital angiography of renal arteries obtained at time of RDN. In case of uncertainties (N = 2) catheter angiography was repeated.ResultsBoth office and 24-h ambulatory BP were significantly reduced 6 and 12 months after RDN. Renal function remained unchanged 6 and 12 months after RDN. In all patients, MRA excluded new or progression of pre-existing low grade renal artery stenosis as well as focal aneurysms at the sites of radiofrequency ablation. In none of the patients new segmental perfusion deficits in either kidney were detected on MRI.ConclusionsNo vascular or parenchymal complications after radiofrequency-based RDN were detected in 51 patients followed up by MRI.

  5. On Mid-Term Periodicities in Sunspot Groups and Flare Index

    NASA Astrophysics Data System (ADS)

    Mendoza, Blanca; Velasco-Herrera, Víctor Manuel

    2011-07-01

    In this work we study the mid-term periodicities (MTPs), between 1 and 2 years, of the sunspot groups and the flare index (FI), by separating the data into hemispheres and spectral bands (SBs) according to the most significant periodicities presented by these phenomena. We found that the MTP of sunspot groups has a diminished power during the Modern Minimum and an increased power during the Modern Maximum, with the exception of cycle 20. For flares, the MTP has a diminished power during the low activity cycle 20, and an increased power during cycles 21 and 22. Therefore, for both sunspot groups and FI, cycle 20 shows a very diminished power followed by the active and higher-power cycles 21 and 22; cycle 23 shows a weaker power than cycles 21 and 22. It is uncertain whether MTP can be a precursor of a long-term minimum of solar activity or not, as has been previously suggested. Also, there is no one-to-one correlation between the cycle intensity and the importance of MTP. Concerning the quasi-biennial periodicities and the theory of two kinds of dynamos, we notice the tendency that higher-power cycles mean weaker coupling in the model. Concerning the hemispheric north-south asymmetry, for sunspot groups the southern hemisphere dominates in most of the SBs, while for FI the northern hemisphere dominates for all the SBs. Additionally, the time lag found between the two hemispheres indicates that the degrees of coupling in the photosphere for sunspot groups and in the corona for flares are between moderate and strong. Finally, the modulation shown by the MTP time series suggests that these periodicities are the product of chaotic quasi-periodic processes and not of stochastic processes.

  6. 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

  7. 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.

  8. HeartWare third-generation implantable continuous flow pump as biventricular support: mid-term follow-up.

    PubMed

    Loforte, Antonio; Monica, Paola Lilla Della; Montalto, Andrea; Musumeci, Francesco

    2011-03-01

    A long-term mechanical biventricular support by HeartWare HVAS third-generation continuous flow pump (HeartWare, Inc, Miramar, FL, USA) was implanted in a Korean patient with a small chest size for treatment of a refractory end-stage heart failure due to an idiopathic dilative cardiomyopathy. We report our experience with a single patient and the early mid-term follow-up results with such a mechanical ventricular support.

  9. 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.

  10. Evaluation of myocardial deformation in patients with Kawasaki disease using speckle-tracking echocardiography during mid-term follow-up.

    PubMed

    Dedeoglu, Reyhan; Barut, Kenan; Oztunc, Funda; Atik, Sezen; Adrovic, Amra; Sahin, Sezgin; Cengiz, Dicle; Kasapcopur, Ozgur

    2017-04-05

    Speckle-tracking echocardiography is a recently developed technique for the evaluation of myocardial deformation or strain. Our objective was to examine strain through a mid-term follow-up of patients with Kawasaki disease.

  11. Early intra-aortic balloon pumping following perioperative myocardial injury improves hospital and mid-term prognosis.

    PubMed

    Rubino, Antonino S; Onorati, Francesco; Santarpino, Giuseppe; Abdalla, Karim; Caroleo, Santo; Santangelo, Ermenigildo; Renzulli, Attilio

    2009-03-01

    We evaluated the impact of immediate intra-aortic balloon pumping (IABP) on hospital and mid-term outcome of coronary artery bypass graft (CABG) whenever perioperative acute complications developed. We compared clinical, biochemical, echocardiographic in-hospital results and two-year follow-up outcome of 30 low-risk (EuroSCORE<5) CABG (group A) who immediately received perioperative IABP when acute complications were suspected, to a contemporary, uncomplicated case-matched group (30 patients; Group B). Two in-hospital deaths were recorded in group A with no deaths in controls (P=0.492). Group A showed significantly higher lactate only at ICU arrival (P=0.001). Troponin I was always higher, but never reached values diagnostic for myocardial infarction (P<0.001). Worse left ventricular ejection fraction (P<0.001) and wall motion score index (P=0.008) were recorded at ICU arrival in group A, although an almost complete recovery was registered at discharge. Two-year actuarial survival was similar between the two groups (P=0.598). No differences were observed in freedom from acute myocardial infarction (P=0.503) and from overall cardiac complications (P=0.410). Early IABP should be established whenever cardiac complications are suspected, because of its beneficial impact on enzymatic leakage, myocardial recovery at echocardiography, hospital outcome, mid-term follow-up survival and freedom from cardiovascular events.

  12. 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.

  13. 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

  14. Short- and mid-term results of plica excision in patients with mediopatellar plica and associated cartilage degeneration.

    PubMed

    Guney, Ahmet; Bilal, Okkes; Oner, Mithat; Halici, Mehmet; Turk, Yildirim; Tuncel, Mehmet

    2010-11-01

    This study aimed to evaluate the short- and mid-term results of plica excision in patients with mediopatellar plica and associated cartilage degeneration. Seventy-six surgically treated patients with mediopatellar plica and associated cartilage degeneration at medial femoral condyle (MFC) and/or medial pole of patella were included. Patients were evaluated at baseline, at 6 weeks and 6 months after the operation for their clinical outcomes and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores. The frequency of all signs and symptoms, including all pain parameters, and WOMAC scores were significantly improved compared to baseline, at 6 weeks and 6 months after the operation (P < 0.017). Based on mean WOMAC scores, results of most patients were rated as excellent both at 6 weeks (88%) and at 6 months (94%). Surgical excision of mediopatellar plica associated with cartilage degeneration appears to result in substantial clinical improvement, thus it represents an effective treatment modality.

  15. Mid-term evaluation of Sorin Soprano bioprostheses in patients with a small aortic annulus

    PubMed

    Vohra, Hunaid A; Whistance, Robert N; Bolgeri, Marco; Velissaris, Theodore; Tsang, Geoffrey M K; Barlow, Clifford W; Ohri, Sunil K

    2010-03-01

    We set to examine the mid-term outcome after aortic valve replacement (AVR) with Soprano pericardial stented bioprosthesis measuring mid-term outcome. Continued follow-up is required to determine the long-term efficacy of the prosthesis.

  16. 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

  17. 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

  18. 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

  19. The Mid-Term Results of Patients who Underwent Radiofrequency Atrial Fibrillation Ablation Together with Mitral Valve Surgery

    PubMed Central

    Çolak, Abdurrahim; Kaya, Ugur; Ceviz, Munacettin; Becit, Necip; Kocak, Hikmet

    2016-01-01

    Objetive Saline-irrigated radiofrequency ablation, which has been widely used for surgical treatment of atrial fibrillation in recent years, is 80-90% successful in achieving sinus rhythm. In our study, our surgical experience and mid-term results in patients who underwent mitral valve surgery and left atrial radiofrequency ablation were analyzed. Methods Forty patients (15 males, 25 females; mean age 52.05±9.9 years; range 32-74) underwent surgery for atrial fibrillation associated with mitral valvular disease. All patients manifested atrial fibrillation, which started at least six months before the surgical intervention. The majority of patients (36 patients, 90%) were in NYHA class III; 34 (85%) patients had rheumatic heart disease. In addition to mitral valve surgery and radiofrequency ablation, coronary artery bypass, DeVega tricuspid annuloplasty, left ventricular aneurysm repair, and left atrial thrombus excision were performed. Following discharge from the hospital, patients' follow-up was performed as outpatient clinic examinations and the average follow-up period of patients was 18±3 months. Results While the incidence of sinus rhythm was 85.3% on the first postoperative day, it was 80% during discharge and 71% in the 1st year follow-up examination. Conclusion Radiofrequency ablation is an effective method when it is performed by appropriate surgical technique. Its rate for returning to sinus rhythm is as high as the rate of conventional surgical procedure. PMID:27849303

  20. 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.

  1. Comparable mid-term survival in patients undergoing elective fenestrated endovascular aneurysm repair and endovascular aneurysm repair for abdominal aortic aneurysm

    PubMed Central

    Gottsäter, Anders; Acosta, Stefan

    2014-01-01

    Objective: To evaluate mid-term survival in patients undergoing elective fenestrated endovascular aneurysm repair and standard endovascular aneurysm repair for abdominal aortic aneurysm. Methods: Consecutive patients treated from 2007 to 2011 with elective fenestrated endovascular aneurysm repair (n = 81) and endovascular aneurysm repair (n = 201) were evaluated concerning age, cardiovascular medication, comorbidities, and mid-term mortality. Results: Patients in the elective fenestrated endovascular aneurysm repair group were younger than the endovascular aneurysm repair group (p = 0.006). In comparison with the endovascular aneurysm repair group, a lower proportion of patients in the elective fenestrated endovascular aneurysm repair group had diabetes (p = 0.013) and anemia (p = 0.003), and a higher proportion had arterial hypertension (p = 0.009). When entering age, endovascular aneurysm repair or fenestrated endovascular aneurysm repair operation, diabetes, anemia, and hypertension in a Cox regression model, only age (hazard ratio: 1.07; 95% confidence interval: 1.03–1.11; p < 0.001) was a risk factor for mid-term mortality. Conclusion: Careful patient selection and medical optimization resulted in comparable mid-term survival in patients undergoing elective fenestrated endovascular aneurysm repair and endovascular aneurysm repair. PMID:26770700

  2. 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…

  3. 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

  4. Combined baseline strain dyssynchrony index and its acute reduction predicts mid-term left ventricular reverse remodeling and long-term outcome after cardiac resynchronization therapy.

    PubMed

    Tatsumi, Kazuhiro; Tanaka, Hidekazu; Matsumoto, Kensuke; Miyoshi, Tatsuya; Hiraishi, Mana; Tsuji, Takayuki; Kaneko, Akihiro; Ryo, Keiko; Fukuda, Yuko; Norisada, Kazuko; Onishi, Tetsuari; Yoshida, Akihiro; Kawai, Hiroya; Hirata, Ken-ichi

    2014-04-01

    The objective of this study was to test the hypothesis that combining assessment of baseline radial strain dyssynchrony index (SDI), that expressed both left ventricular (LV) dyssynchrony and residual myocardial contractility, and of acute changes in this index can yield more accurate prediction of mid-term responders and long-term outcome after cardiac resynchronization therapy (CRT). Radial SDI for 75 CRT patients was calculated as the average difference between peak and end-systolic speckle tracking strain from 6 segments of the mid-LV short-axis view before and 8 ± 2 days after CRT. Mid-term responder was defined as ≥ 15% decrease in LV end-systolic volume 6 ± 2 months after CRT. Long-term outcome was tracked over 5 years. Baseline radial SDI ≥ 6.5% is considered predictive of responder and favorable outcome, as previously reported. Acute reduction in radial SDI ≥ 1.5% was found to be the best predictor of mid-term responders with CRT. Furthermore, patients with acute reductions in radial SDI ≥1.5% were associated with a significantly more favorable long-term outcome after CRT than those with radial SDI <1.5% (log rank P < 0.001). An important findings were that baseline radial SDI ≥6.5% and acute reductions in radial SDI ≥ 1.5% in 42 patients were associated with the highest event-free survival rate of 92%, whereas, 21 patients corresponding values of <6.5% and <1.5% were associated with low event-free survival rate of 46% (log rank P < 0.001). Combined assessment of baseline radial SDI and its acute reduction after CRT may have clinical implications for predicting responders and thus patients' care.

  5. Mid-term survival after transcatheter aortic valve implantation: Results with respect to the anesthetic management and to the access route (transfemoral versus transapical)

    PubMed Central

    Gauthier, Caroline; Astarci, Parla; Baele, Philippe; Matta, Amine; Kahn, David; Kefer, Joëlle; Momeni, Mona

    2015-01-01

    Context: Several studies have analyzed the long-term survival after transcatheter aortic valve implantation (TAVI). However, no previous studies have looked at survival beyond 1-year with respect to the type of anesthesia. Aims: The aim was to evaluate the mid-term survival after TAVI with respect to the type of anesthesia (general anesthesia [GA] vs. local anesthesia ± sedation [LASedation]) or the type of procedure (transfemoral [transfem] vs. transapical TAVI) performed. Settings and Design: Retrospective cohort study. Subjects and Methods: This retrospective study included TAVI's between January 2009 and June 2013. Patients were divided into three groups: transfem TAVI under GA, transfem TAVI under LASedation and transapical TAVI. A total of 176 patients were eligible. The following clinical outcomes were evaluated: (1) Mortality, (2) Major cardiovascular complications, (3) Conduction abnormalities and arrhythmias, (4) Acute kidney injury, (5) Aortic regurgitation, (6) Neurologic events, (7) Vascular complications, (8) Pulmonary complications, (9) Bleeding, (10) Infectious complications, (11) Delirium. Statistical Analysis Used: A Kruskal–Wallis test was performed to test significance between the three groups for quantitative variables. Categorical variables were compared using a Chi-square test. Survival was estimated using Kaplan–Meier method. Results: There was no statistically significant difference between the survival of both transfem TAVI's (P = 0.46). The short-term outcome of the transfem TAVI groups was better than the transapical arm, but their mid-term survival did not show any significant difference (P = 0.69 transapical vs. transfem GA; P = 0.07 transapical vs. transfem LASedation). Conclusions: Our results demonstrate that the type of anesthesia and the access route do not influence mid-term survival after TAVI. PMID:26139739

  6. 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.

  7. 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

  8. Prolene hernia system compared with mesh plug technique: a prospective study of short- to mid-term outcomes in primary groin hernia repair.

    PubMed

    Huang, C S; Huang, C C; Lien, H H

    2005-05-01

    Two types of anterior tension-free hernioplasty, prolene hernia system (PHS) repair and mesh plug technique (MPT), were introduced to Taiwan in 2001. This study compared the short- to mid-term outcomes following primary groin hernia repair with PHS and MPT. From January 2001 to December 2003, 393 patients with 426 primary groin hernias were operated on by a single surgeon using MPT (n=192) and PHS (n=234). Baseline perioperative details and follow-up information were compared. Demographic characteristics of both groups were similar. The laterality, types of anesthesia, postoperative stay, postoperative wound pain scores, wound complications and days to return to activities of daily life were equally distributed between the two groups. However, the distribution of Gilbert types in the PHS group was shifted a little to the right compared with that of the MPT group. PHS repair had longer operative time (34+/-17 vs 25+/-9 minutes, p<0.01). No recurrence was noted in both groups during the follow-up from 5 to 41 months. Chronic non-disabling groin pains were noted in 2.8% (6/218) of patients in the PHS group and 8.9% (14/175) in the MPT group (p=0.01). Our results show that both PHS and MPT repairs can be performed with short operation time, minor wound pain and quick return to activities of daily life without short- to mid-term recurrences, but postoperatively the MPT group had higher incidence of chronic non-disabling groin pain. Although the MPT is less invasive, the additional protective patch in the preperitoneal space of the PHS may provide a further safeguard against recurrences, especially for those patients with attenuated inguinal floor. Long-term follow-up is needed.

  9. 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

  10. Short- and mid-term oscillations of solar, geomagnetic activity and cosmic-ray intensity during the last two solar magnetic cycles

    NASA Astrophysics Data System (ADS)

    Singh, Y. P.; Badruddin

    2017-04-01

    Short-and mid-term oscillations of the solar activity (sunspot number and 10.7 cm solar flux), geomagnetic activity (Ap index) and cosmic-ray intensity (neutron monitor count rate) are analysed during the past two solar-magnetic cycles (1968-1989 and 1989-2014). We have implemented the wavelet analysis on the daily time resolution data of sunspot number (SSN), 10.7 cm solar flux, geomagnetic Ap index and Oulu neutron monitor count rate. Results suggest that few quasi and intermittent oscillations are observed with remarkable power density in addition to fundamental periods, like 27 day (synodic period), 154 day (Rieger period), semi-annual, annual, 1.3 year, and 1.7 year. We have consistently observed first (27 day), second (13.5 day) and third (9.0 day) solar-rotation harmonics in the geomagnetic Ap-index during both the magnetic cycles. Rieger period is more pronounced in SSN and solar flux during 1980-82 and 1990-92. Semi-annual variation of Ap-index is consistently observed during both the magnetic cycles. The annual and 1.85 year variation are also observed in all the considered parameters with good signatures in CRI.

  11. Mid-term results of joint-preserving procedures by a modified Mann method for big toe deformities in rheumatoid patients undergoing forefoot surgeries.

    PubMed

    Takakubo, Yuya; Takagi, Michiaki; Tamaki, Yasunobu; Sasaki, Akiko; Nakano, Haruki; Orui, Hiroshi; Ogino, Toshihiko

    2010-04-01

    This study aimed to evaluate joint-preserving procedures by a modified Mann method for rheumatoid forefoot deformities and their functional outcomes in the mid-term. Eleven feet in seven patients underwent forefoot surgery using a modified Mann method for the big toe, combined with offset osteotomy or resection arthroplasty of the lesser toes. The mean follow-up period was 3.6 years. The mean score on the Japanese Society for Surgery of the Foot scale for rheumatoid arthritis foot and ankle joints improved from 44.0 to 72.0. The mean hallux valgus angle improved from 39.4 degrees to 20.5 degrees and the mean M1M5 angle improved from 31.1 degrees to 25.8 degrees . However, deformities involving a hallux valgus angle of more than 25.0 degrees recurred in three feet at the latest follow-up, although the patients did not complain of any symptoms from the recurrence. Improvement in the Sharp score for joint space narrowing was observed in the big toe, indicating better congruity of the metatarsophalangeal joint. For restraint of rheumatoid forefoot deformities, a modified Mann method, combined with offset osteotomy or resection arthroplasty, was satisfactory for not only improving the foot function, but also preserving the metatarsophalangeal joint mobility.

  12. 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.

  13. Mid-Term Outcomes of a Modification of Extended Aortic Arch Anastomosis with Pulmonary Artery Banding in Single Ventricle Neonates with Hypoplastic Transverse Arch

    PubMed Central

    Thang, Bui Quoc; Furugaki, Tatsuya; Osaka, Motoo; Watanabe, Yutaka; Kanemoto, Shinya; Suetsugu, Fuminaga

    2016-01-01

    Purpose: There is less certainty regarding the best strategy for treating neonates with functional single ventricle (SV) and hypoplastic aortic arch. We have applied a modified extended aortic arch anastomosis (EAAA) and main pulmonary artery banding (PAB) as an initial palliation in neonates with transverse arch hypoplasia and assessed the mid-term outcomes. Methods: In total, 10 neonates with functional SV and extensive hypoplasia or interruption of the arch underwent a modified EAAA (extended arch anastomosis with a subclavian flap) concomitant with main PAB through a thoracotomy without cardiopulmonary bypass. Patient age and weight ranged from 4 to 14 days and 2.3 to 3.8 kg, respectively. Results: There were no hospital deaths although there were two late deaths. Gradients across the arch were 0 to 7 mmHg at postoperative day 1 and no arch reoperations were required. Two patients required balloon aortoplasty. Nine underwent bidirectional cavopulmonary shunt and two of them needed concomitant Damus–Kaye–Stansel (DKS) anastomosis. Six have completed Fontan. Conclusion: Our modification of EAAA with main PAB for SV neonates may benefit a certain population with transverse arch hypoplasia as an option to be considered. Patients with the potential for developing outflow obstruction may be best managed with an initial DKS-type palliation. PMID:27725352

  14. Mid-term efficacy and safety of cervical disc arthroplasty versus fusion in cervical spondylosis: A systematic review and meta-analysis.

    PubMed

    Zhao, Guo-Sheng; Zhang, Qiao; Quan, Zheng-Xue

    2017-02-01

    Anterior cervical discectomy and fusion (ACDF) and cervical disc arthroplasty (CDA) are the most commonly used procedures in cervical spondylosis. However, only a few published studies exist in the literature comparing these two operation types, particularly its mid-term efficacy and safety. Furthermore, in those studies, even large sample trials, when compared, have elicited controversial results, making it inconvenient for clinicians to refer to them. The aim of the present study was to clarify the advantages and shortcomings of the two procedures. Articles indexed in the PubMed, Web of Science, Cochrane Library, EMBASE, China Biological Medicine and China National Knowledge Infrastructure (CNKI) databases, as of March 2016, that met our criteria were searched. A total of 18 trials involving 3,040 patients were included in our final analysis. The most important results drawn from the present analysis were as follows: Insignificant differences were identified in the blood loss [weighted mean difference (WMD)=6.23; 95% confidence intervals (CI), -0.85 to 13.32; P=0.08], surgical time [standardized mean difference (SMD)=0.40; 95% CI, -0.01 to 0.82; P=0.06], the time of hospital stay (SMD=0.05; 95% CI, -0.28 to 0.37; P=0.77) and the total complications rate [odds ratio (OR)=0.86; 95% CI, 0.66 to 1.131; P=0.28] on a comparison of the two operation methods. By contrast, comparing CDA with ACDF, the CDA had higher Short Form survey (SF-36) scores (WMD=1.65; 95% CI, 0.61 to 2.69; P=0.002), a larger range of motion in the operation level (SMD=6.53; 95% CI, 3.89 to 9.17; P<0.0001), a higher rate of neurological improvement following the operation (OR=1.80; 95% CI, 1.29 to 2.52; P=0.0006), a lower Visual Analog Scale (VAS) score of neck pain (WMD= 0.16; 95% CI, -0.28 to 0.05; P=0.006) and arm pain (WMD= 0.12; 95% CI, -0.24 to -0.01; P=0.04). In addition, in the mid-term following the surgery, CDA had a lower Neck Disability Index (NDI; SMD=0.18; 95% CI, -0.28 to -0.07; P=0

  15. Mid-term efficacy and safety of cervical disc arthroplasty versus fusion in cervical spondylosis: A systematic review and meta-analysis

    PubMed Central

    Zhao, Guo-Sheng; Zhang, Qiao; Quan, Zheng-Xue

    2017-01-01

    Anterior cervical discectomy and fusion (ACDF) and cervical disc arthroplasty (CDA) are the most commonly used procedures in cervical spondylosis. However, only a few published studies exist in the literature comparing these two operation types, particularly its mid-term efficacy and safety. Furthermore, in those studies, even large sample trials, when compared, have elicited controversial results, making it inconvenient for clinicians to refer to them. The aim of the present study was to clarify the advantages and shortcomings of the two procedures. Articles indexed in the PubMed, Web of Science, Cochrane Library, EMBASE, China Biological Medicine and China National Knowledge Infrastructure (CNKI) databases, as of March 2016, that met our criteria were searched. A total of 18 trials involving 3,040 patients were included in our final analysis. The most important results drawn from the present analysis were as follows: Insignificant differences were identified in the blood loss [weighted mean difference (WMD)=6.23; 95% confidence intervals (CI), −0.85 to 13.32; P=0.08], surgical time [standardized mean difference (SMD)=0.40; 95% CI, −0.01 to 0.82; P=0.06], the time of hospital stay (SMD=0.05; 95% CI, −0.28 to 0.37; P=0.77) and the total complications rate [odds ratio (OR)=0.86; 95% CI, 0.66 to 1.131; P=0.28] on a comparison of the two operation methods. By contrast, comparing CDA with ACDF, the CDA had higher Short Form survey (SF-36) scores (WMD=1.65; 95% CI, 0.61 to 2.69; P=0.002), a larger range of motion in the operation level (SMD=6.53; 95% CI, 3.89 to 9.17; P<0.0001), a higher rate of neurological improvement following the operation (OR=1.80; 95% CI, 1.29 to 2.52; P=0.0006), a lower Visual Analog Scale (VAS) score of neck pain (WMD= 0.16; 95% CI, −0.28 to 0.05; P=0.006) and arm pain (WMD= 0.12; 95% CI, −0.24 to −0.01; P=0.04). In addition, in the mid-term following the surgery, CDA had a lower Neck Disability Index (NDI; SMD=0.18; 95% CI, −0

  16. Impact of thermodilution-derived coronary blood flow patterns after percutaneous coronary intervention on mid-term left ventricular remodeling in patients with ST elevation myocardial infarction.

    PubMed

    Sumiyoshi, Akinori; Fujii, Kenichi; Fukunaga, Masashi; Shibuya, Masahiko; Imanaka, Takahiro; Kawai, Kenji; Miki, Kojiro; Tamaru, Hiroto; Horimatsu, Tetsuo; Saita, Ten; Nishimura, Machiko; Masuyama, Tohru; Ishihara, Masaharu

    2017-01-01

    We recently reported the coronary thermodilution curve can be evaluated by analyzing the thermodilution curve obtained from a pressure sensor/thermistor-tipped guidewire, and presence of a bimodal-shaped thermodilution curve following primary percutaneous coronary intervention (pPCI) in ST-segment elevation myocardial infarction (STEMI) patients was associated with worse outcomes. This study evaluated whether the bimodal-shaped thermodilution curve predicts left ventricular (LV) remodeling after STEMI. The coronary thermodilution curve patterns were evaluated for 75 patients treated by pPCI for their first STEMI using a pressure sensor/thermistor-tipped guidewire, and classified into the three groups according to the thermodilution curve shape: narrow unimodal (n = 39), wide unimodal (n = 26), and bimodal pattern (n = 10). Echocardiography was performed at baseline and 6 months after STEMI. LV remodeling was defined as a >20 % increase in LV end-diastolic volumes (LVEDV). LVEDV at 6-month follow-up was greater in the bimodal group than in the other groups (p < 0.001). The prevalence of LV remodeling was highest in the bimodal group than in the narrow and wide unimodal groups (60, 12, and 15 %, respectively; p = 0.003). Multivariate analysis revealed a bimodal-shaped thermodilution curve as an independent predictor of the prevalence of LV remodeling. A bimodal-shaped thermodilution curve is associated with LV remodeling after STEMI. This easily assessable coronary thermodilution curve pattern is useful to predict mid-term LV remodeling for STEMI patients at the catheterization laboratory.

  17. 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.

  18. 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

  19. Incidence, Predictors, and Mid-Term Outcomes of Percutaneous Closure Failure After Transfemoral Aortic Valve Implantation Using an Expandable Sheath (from the Optimized Transcatheter Valvular Intervention [OCEAN-TAVI] Registry).

    PubMed

    Nara, Yugo; Watanabe, Yusuke; Kozuma, Ken; Kataoka, Akihisa; Nakashima, Makoto; Hioki, Hirofumi; Kawashima, Hideyuki; Nagura, Fukuko; Shirai, Shinichi; Tada, Norio; Araki, Motoharu; Naganuma, Toru; Yamanaka, Futoshi; Yamamoto, Masanori; Hayashida, Kentaro

    2017-02-15

    The aim of this study was to evaluate the incidence, predictors, and outcomes of percutaneous closure device (PCD) failure during transfemoral transcatheter aortic valve implantation (TAVI) with an Edwards Sapien-XT prosthesis using an expandable sheath (eSheath). From October 2013 to April 2016, 1,215 patients who underwent TAVI were prospectively enrolled in the Optimized Transcatheter Valvular Intervention (OCEAN-TAVI) registry. Of these, 478 patients underwent transfemoral TAVI with Sapien-XT prosthesis using an eSheath and percutaneous closure with a Perclose ProGlide system. We evaluated the predictors of PCD failure and whether it affected the clinical outcomes. Patients were aged 85 years (interquartile range 82 to 88 years). PCD failure occurred in 36 patients (8%). Sheath-to-femoral artery ratio (SFAR) (per 1 increase) (odds ratio 5.40, 95% confidence interval 1.28 to 22.92, p = 0.022) predicted PCD failure in a multivariate model. The sensitivity-specificity curves identified an SFAR threshold of 1.03; the area under the curve for SFAR as a predictor of PCD failure was 0.629. The PCD failure group did not have a higher rate of 30-day mortality (0% vs 1%, p = 0.52) or mid-term (365-day) mortality (log-rank test p = 0.85) compared with the PCD success group in the Kaplan-Meier analysis. In conclusion, PCD failures occurred in 8% of the patients and were not associated with 30-day or mid-term mortality rates after percutaneous transfemoral TAVI. The SFAR threshold of 1.03 was useful for predicting PCD failures.

  20. 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.

  1. 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

  2. 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

  3. National Security Reform 2010: A Mid-Term Assessment

    DTIC Science & Technology

    2011-08-01

    Administration’s Ballistic Mis- sile Defense Program: Treading Water in Shark -Infested Seas,” Heritage Foundation Backgrounder No. 2396, April 8, 2010, avail...able from http://www.heritage.org/Research/Reports/2010/04/The- Obama-Administrations-Ballistic-Missile-Defense-Program-Treading- Water-in- Shark ...and the White House provided happy hunt - ing grounds for the media. This dysfunctional system claimed Haig 18 months later amid the storms of the

  4. 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.

  5. One-step bone marrow-derived cell transplantation in talarosteochondral lesions: mid-term results

    PubMed Central

    BUDA, ROBERTO; VANNINI, FRANCESCA; CAVALLO, MARCO; BALDASSARRI, MATTEO; NATALI, SIMONE; CASTAGNINI, FRANCESCO; GIANNINI, SANDRO

    2013-01-01

    Purpose to verify the capability of scaffold-supported bone marrow-derived cells to be used in the repair of osteochondral lesions of the talus. Methods using a device to concentrate bone marrow-derived cells, a scaffold (collagen powder or hyaluronic acid membrane) for cell support and platelet gel, a one-step arthroscopic technique was developed for cartilage repair. In a prospective clinical study, we investigated the ability of this technique to repair talar osteochondral lesions in 64 patients. The mean follow-up was 53 months. Clinical results were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) scale score. We also considered the influence of scaffold type, lesion area, previous surgery, and lesion depth. Results the mean preoperative AOFAS scale score was 65.2 ± 13.9. The clinical results peaked at 24 months, before declining gradually to settle at a score of around 80 at the maximum follow-up of 72 months. Conclusions the use of bone marrow-derived cells supported by scaffolds to repair osteochondral lesions of the talus resulted in significant clinical improvement, which was maintained over time. Level of Evidence level IV, therapeutic case series. PMID:25606518

  6. Mid-Term Progress Report on the Development of Army Closed Cycle Circulator (CCC) System.

    DTIC Science & Technology

    1979-09-20

    installation of the rotor assembly. The compressor shaft is sealed with a Crane Type 28 Kinetic Wedge gas seal for positive static sealing. A unitized...Pressure ratio 1.91 Horsepower 134 R (Molecular weight 18.67) 82.76 The compressor is fitted with a Crane Packing Company Type 28 gas seal. This seal...simply reading a digital voltmeter which is hooked up to the anemometer. The only preparation that the anemometer requires is that the operating

  7. 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).

  8. Mid-term evaluation of USAID 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.

    1987-07-01

    The Energy Planning and Management (EPM) Project was designed to increase reliability of the Blue Nile Grid and to bolster the management and operation of the National Electricity Corporation (NEC) and the General Petroleum Corporation (GPC), and to help develop the National Energy Administration (NEA) as a national energy planning institution. Two major successes are already in evidence at NEC at mid-project. The Blue Nile Grid reliability has improved from a low of 74% in 1983 to 94% currently; although the EPM project has not been the only influence, its maintenance activities have been partly responsible for this improvement. Accomplishments of NEA and NEC are described.

  9. Mid-term clinical outcome of radial shortening for kienbock disease

    PubMed Central

    Ebrahimzadeh, Mohammad H; Moradi, Ali; Vahedi, Ehsan; Kachooei, Amir Reza

    2015-01-01

    Background: To evaluate the intermediate-term outcomes of radius shortening as a treatment for Kienbock's disease. Materials and Methods: In a historical cohort, 16 skeletally mature patients (9 men and 7 women) with Kienbock disease, who were treated with radial shortening osteotomy between 2002 and 2012, were reviewed in our study. The mean age of our patients was 30 (range 18-43) years old. According to Litchman staging, there were 7 wrists at stage II and 9 wrists at stage III (6 at stage IIIA and 3 at stage IIIB). The data of grip strength, pain (visual analog scale (VAS) score), wrist range of motion (ROM), ulnar variance (according to Palmer method), and the Lichtman stage were gathered before and after surgery. We evaluated overall wrist function using the Mayo Wrist score and disabilities of the arm shoulder and hand (DASH) score before surgery and at the last follow-up. Results: The average of follow-up was 7 years (range from 5 to 9 years). Preoperative ulnar variance was −1.3 mm (range from 2.5 to 1) preoperatively. The mean postoperative ulnar variance was 1 mm positive (range from 0.5 to 1.5). The VAS pain score, the mean arc of wrist flexion and extension, and grip strength improved significantly preoperatively compared to after recovery from surgery. The Lichtman stage was unchanged in nine patients, one grade worse in six patients, and one grade better in one patient. The mean DASH and Mayo scores improved significantly postoperatively compare with preoperation. Comparing preoperative positive, neuter, and negative ulnar variance, there was no significant difference in terms of VAS, DASH, and Mayo scores as well as ROM and grip strength. Conclusion: Our study shows that radius shortening surgery improves pain and disability regardless of ulnar variance. PMID:25983766

  10. 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.

  11. The Education for All Global Monitoring Report: A Mid-Term Assessment

    ERIC Educational Resources Information Center

    Packer, Steve

    2008-01-01

    The Education for All (EFA) Global Monitoring Report is six years old and seven reports have been produced (UNESCO, 2000-2008). It is a product of the outcomes of the World Education Forum in Dakar held in 2000. It is designed to track progress towards the realization of the six EFA goals and to hold governments and the international community to…

  12. 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.

  13. [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.

  14. Pretransplant and protocol biopsies may help in defining short and mid-term kidney transplant outcome.

    PubMed

    Esposito, C; Migotto, C; Torreggiani, M; Maggi, N; Manini, A; Castoldi, F; Grosjean, F; Mangione, F; Abelli, M; Scaramuzzi, M L; Catucci, D; Dal Canton, A

    2012-09-01

    Although many variables may affect long-term graft survival no biomarker is available to identify donor kidney with poor quality and with inadequate short and long-term outcome. While in marginal donors pre-transplant renal biopsies are commonly performed to establish if donor kidneys are suitable for transplantation they are not performed in standard donors. In this study we assessed the relevance of pre-transplant morphological features on post-transplant renal function and evaluated the association between perioperative parameters with posttransplant histological and clinical findings. Kidney transplant recipients undergone pre-transplant and post transplant protocol biopsies at 1, 6, and 12 months were enrolled in the study. Perioperative and posttransplant clinical and biochemical parameters were recorded. Semiquantitative analysis of PAS stained kidney sections was used to determine the degree of lesions. Glomerular volume was measured by computed morphometry. A strong inverse correlation was found between donor age and renal graft function at 1, 6, and 12 months after transplantation. A prompt functional recovery was associated with a better renal function at 6 months and one year. Kidneys with higher glomerular volume demonstrated a lower serum creatinine at 1 month. Higher tubulo-interstitial grading at protocol biopsies was associated with a poor renal function at 1 month. Our findings confirm the importance of donor age in kidney transplant long-term outcome and demonstrate that pretransplant and protocol biopsies are valid options to determine graft outcome and to define therapeutic strategies and tailor immunosuppressive regimen for each patient.

  15. 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…

  16. Maternal and Fetal Death following Group A Streptococcal Meningitis in Mid-Term Pregnancy

    PubMed Central

    Kamaledeen, Abderahman; Law, Penelope

    2014-01-01

    Background. Group A streptococcal (GAS) meningitis is rarely seen in the antenatal period, but it is associated with significant mortality. We present a case of a mid-trimester woman who developed fulminant meningitis following a rapid onset atypical presentation of infection with this organism. Case. A multiparous 23+5-week woman presented with a 10-day history of a non-productive cough associated with pyrexia. Within minutes of her admission she collapsed and lost consciousness; sepsis was suspected and cross-specialty care was initiated. She was managed empirically in extremis with broad-spectrum antibiotics and mannitol with 3% hypertonic saline for suspected infection and raised intracranial pressure, respectively. Despite intensivist management, a CT head revealed diffuse oedema with coning of the cerebellar tonsils. Brainstem death was certified within 19 hours of admission and fetal death ensued. Postmortem bacteriology confirmed GAS meningitis. Conclusion. Through raising awareness of this patient and her disease course, we hope that future policy decisions, primary care, and hospital level management will be informed accordingly for treatment of pregnant women with suspected GAS infection. PMID:24883215

  17. Mid Term Progress Report: Desertification Assessment and Monitoring in China Based on Remote Sensing

    NASA Astrophysics Data System (ADS)

    Gao, Zhihai; del Barrio, Gabriel; Li, Xiaosong; Wang, Wengyu; Puigdefabregas, Juan; Sanjuan, Maria E.; Bai, Lina; Wu, Junjun; Sun, Bin; Li, Changlong

    2014-11-01

    The objective of Dragon 3 Project 10367 is the development of techniques research for desertification assessment and monitoring in China using remote sensing data in combination with climate and environmental-related data. The main achievements acquired since 2012 could be summarized as follows:(1) Photosynthetic vegetation (PV) and non-photosynthetic vegetation (NPV) fraction were retrieved separately through utilizing Auto Monte Carlo Unmixing technique (AutoMCU), based on BJ-1 data and field measured spectral library.(2) The accuracy of sandy land classification was as high as 81.52% when the object-oriented method and Support Vector Machine (SVM) classifiers were used.(3) A new Monthly net primary productivity (NPP) dataset from 2002 to 2010 for the whole China were established with Envisat-MERIS fraction of absorbed photosynthetically active radiation (FPAR) data.(4) The 2dRUE proved to be a good indicator for land degradation, based on which, land degradation status in the general potential extent of desertification in China (PEDC) was assessed preliminarily.

  18. Mid Term Progress Report: Desertification Assessment and Monitoring in China Based on Remote Sensing

    NASA Astrophysics Data System (ADS)

    Gao, Zhihai; del Barrio, Gabriel; Li, Xiaosong; Wang, Bengyu; Puigdefabregas, Juan; Sanjuan, Maria E.; Bai, Lina; Wu, Junjun; Sun, Bin; Li, Changlong

    2014-11-01

    The objective of Dragon 3 Project 10367 is the development of techniques research for desertification assessment and monitoring in China using remote sensing data in combination with climate and environmental-related data. The main achievements acquired since2012could be summarized as follows: (1)Photosynthetic vegetation(PV)and non-photosynthetic vegetation(NPV)fraction were retrieved separately through utilizing Auto Monte Carlo Unmixing technique (AutoMCU), based on BJ-1 data and field measured spectral library. (2) The accuracy of sandy land classification was as high as81.52%when the object-oriented method and Support Vector Machine (SVM) classifiers were used. (3) A new Monthly net primary productivity (NPP)dataset from 2002 to 2010 for the whole China were established with Envisat-MERIS fraction of absorbed photosynthetically active radiation (FPAR) data. (4) The 2dRUE proved to be a good indicator for land degradation, based on which, land degradation status in the general potential extent of desertification in China(PEDC) was assessed preliminarily.

  19. Apophis: No impact risks for the mid-term, but after?

    NASA Astrophysics Data System (ADS)

    Prado, J.-Y.; Bancelin, D.; Colas, F.; Hestroffer, D.; Thuillot, W.

    2011-05-01

    Apophis will come back very close to the Earth on April 13, 2029. Its heliocentric orbit will gain energy from the gravitational pull from the Earth and, depending on its actual pass geometry, it will be placed on a new nominal orbit of period around 422 days. Even if impact possibilities are excluded for the years 2036 (corresponding to a new period for Apophis of 426.15 days) and 2037 (period of 417.23 days), the actual value of the post 2029 period can be in resonance with the orbit period of the Earth and leads to a new close encounter in the next decades. Apophis should be visible from ground-based observatories at some time intervals between 2011 and 2013, with a reasonable expectation that radar measurements from Arecibo can be performed in 2013. Furthermore, space astrometry by Gaia mission will also give accurate measurements in the 2013-2017 period. Then it will be possible to characterize the nongravitational forces, starting with the Yarkovsky effect and propagate the orbit solutions up to April 2029 in order to refine the further impact risk probabilities. It will be possible to check the correctness of the 2029 pass in 2021 when again Apophis can be observed from the Earth. Finally, on April 13, 2029, Apophis will be tracked at least by ground-based observatories and it can be expected that the determination of its orbit relative to the Earth will be accurate to the meter level. Then, it will be known with a high confidence if the key holes that would lead to a collision of Apophis with the Earth have been missed or not. Each of these observations periods (2013, 2021, 2029) will be highly scrutinized by astronomers who will have to report to the public opinion and the decision makers on the observation and ephemeris activities, and impact risk at least for the decades to come. It is of prime interest for the NEO community to show them that the observation campaigns of Apophis will provide an incremental improvement of the threat assessment.

  20. Application of Classification Methods for Forecasting Mid-Term Power Load Patterns

    NASA Astrophysics Data System (ADS)

    Piao, Minghao; Lee, Heon Gyu; Park, Jin Hyoung; Ryu, Keun Ho

    Currently an automated methodology based on data mining techniques is presented for the prediction of customer load patterns in long duration load profiles. The proposed approach in this paper consists of three stages: (i) data preprocessing: noise or outlier is removed and the continuous attribute-valued features are transformed to discrete values, (ii) cluster analysis: k-means clustering is used to create load pattern classes and the representative load profiles for each class and (iii) classification: we evaluated several supervised learning methods in order to select a suitable prediction method. According to the proposed methodology, power load measured from AMR (automatic meter reading) system, as well as customer indexes, were used as inputs for clustering. The output of clustering was the classification of representative load profiles (or classes). In order to evaluate the result of forecasting load patterns, the several classification methods were applied on a set of high voltage customers of the Korea power system and derived class labels from clustering and other features are used as input to produce classifiers. Lastly, the result of our experiments was presented.

  1. 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.

  2. Mid-term functional outcome after the internal fixation of distal radius fractures

    PubMed Central

    2012-01-01

    Background Distal radius fracture is a common injury with a variety of operative and non-operative management options. There remains debate as to the optimal treatment for a given patient and fracture. Despite the popularity of volar locking plate fixation, there are few large cohort or long term follow up studies to justify this modality. Our aim was to report the functional outcome of a large number of patients at a significant follow up time after fixation of their distal radius with a volar locking plate. Methods 180 patients with 183 fractures and a mean age of 62.4 years were followed up retrospectively at a mean of 30 months (Standard deviation = 10.4). Functional assessment was performed using the Disabilities of the Arm, Shoulder and Hand (DASH) and modified MAYO wrist scores. Statistical analysis was performed to identify possible variables affecting outcome and radiographs were assessed to determine time to fracture union. Results The median DASH score was 2.3 and median MAYO score was 90 for the whole group. Overall, 133 patients (74%) had a good or excellent DASH and MAYO score. Statistical analysis showed that no specific variable including gender, age, fracture type, post-operative immobilisation or surgeon grade significantly affected outcome. Complications occurred in 27 patients (15%) and in 11 patients were major (6%). Conclusion This single centre large population series demonstrates good to excellent results in the majority of patients after volar locking plate fixation of the distal radius, with complication rates comparable to other non-operative and operative treatment modalities. On this basis we recommend this mode of fixation for distal radius fractures requiting operative intervention. PMID:22280557

  3. Tri-component, mobile bearing, total ankle replacement: mid-term functional outcome and survival.

    PubMed

    Dhawan, Rohit; Turner, Jake; Sharma, Vikas; Nayak, Ramesh K

    2012-01-01

    Tri-component, mobile bearing, uncemented, total ankle replacements were introduced after the high failure rates of cemented, highly constrained, first-generation, total ankle replacement implants. A total of 30 primary total ankle replacements in 29 patients (20 males and 9 females) were followed up in the present retrospective study for up to 13 (mean 5.1 ± 4) years. The postoperative functional and radiographic outcomes were measured. Failure was defined as revision of either of the components for any reason or conversion of the total ankle replacement to arthrodesis because of debilitating pain that did not resolve after surgery. Of the 29 patients, 2 underwent revision and 1 underwent arthrodesis. All 3 patients had the malpositioned talar implant revised. The mean American Orthopaedic Foot and Ankle Society score was 81 at 1 year postoperatively. Revision of the tibial or talar component for any reason or conversion of the ankle replacement to arthrodesis was considered failure for the survival analysis. Kaplan-Meier analysis showed a 5-year survival rate of 87.6%. The last failure occurred 23.3 months after surgery.

  4. 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.

  5. 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

  6. 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

  7. The Generation of Situational Awareness within Autonomous Systems - A Near to Mid term Study - Analysis

    DTIC Science & Technology

    2006-07-01

    Programmability. The bottleneck issue centres on the capacity to communicate with the robot once deployed, and thus change its behaviour . This issue...robotic systems. This appendix formally presents this framework, and the way that it can be applied to generate insights. The discussion is organised ...capacity to communicate with the robot once deployed, and thus change its behaviour . This issue weighs into the balance of autonomy solutions against

  8. Mid-Term Results of Terrain Measurements in the Dragon-3 Program

    NASA Astrophysics Data System (ADS)

    Liao, Mingsheng; Zhang, Lu; Balz, Timo; Li, Deren

    2014-11-01

    In the project 10569 under the theme “Terrain Measurement” within the ESA-MOST Dragon-3 program, our research focused on topographic mapping and deformation measurements with SAR data acquired by ESA missions as well as third party missions. SAR data was used to map topography in mountainous area using interferometry and stereoscopy. Deformations due to slow landslide movements and urban ground subsidence were measured by PSI and offset tracking techniques. In this paper an overview of the studies undertaken is given and the achievements are summarized.

  9. Mid-Term Results of Terrain Measurements in the Dragon-3 Program

    NASA Astrophysics Data System (ADS)

    Liao, Mingsheng; Zhang, Lu; Balz, Timo; Li, Deren

    2014-11-01

    In the project 10569 under the theme “Terrain Measurement" within the ESA-MOST Dragon-3 program, our research focused on topographic mapping and deformation measurements with SAR data acquired by ESA missions as well as third party missions. SAR data was used to map topography in mountainous area using interferometry and stereoscopy. Deformations due to slow landslide movements and urban ground subsidence were measured by PSI and offset tracking techniques. In this paper an overview of the studies undertaken is given and the achievements are summarized.

  10. Presacral abscess as a rare complication of sacral nerve stimulator implantation.

    PubMed

    Gumber, A; Ayyar, S; Varia, H; Pettit, S

    2017-03-01

    A 50-year-old man with intractable anal pain attributed to proctalgia fugax underwent insertion of a sacral nerve stimulator via the right S3 vertebral foramen for pain control with good symptomatic relief. Thirteen months later, he presented with signs of sepsis. Computed tomography (CT) and magnetic resonance imaging (MRI) showed a large presacral abscess. MRI demonstrated increased enhancement along the pathway of the stimulator electrode, indicating that the abscess was caused by infection introduced at the time of sacral nerve stimulator placement. The patient was treated with broad spectrum antibiotics, and the sacral nerve stimulator and electrode were removed. Attempts were made to drain the abscess transrectally using minimally invasive techniques but these were unsuccessful and CT guided transperineal drainage was then performed. Despite this, the presacral abscess progressed, developing enlarging gas locules and extending to the pelvic brim to involve the aortic bifurcation, causing hydronephrosis and radiological signs of impending sacral osteomyelitis. MRI showed communication between the rectum and abscess resulting from transrectal drainage. In view of the progressive presacral sepsis, a laparotomy was performed with drainage of the abscess, closure of the upper rectum and formation of a defunctioning end sigmoid colostomy. Following this, the presacral infection resolved. Presacral abscess formation secondary to an infected sacral nerve stimulator electrode has not been reported previously. Our experience suggests that in a similar situation, the optimal management is to perform laparotomy with drainage of the presacral abscess together with simultaneous removal of the sacral nerve stimulator and electrode.

  11. Diurnal and twenty-four hour patterning of human diseases: acute and chronic common and uncommon medical conditions.

    PubMed

    Smolensky, Michael H; Portaluppi, Francesco; Manfredini, Roberto; Hermida, Ramon C; Tiseo, Ruana; Sackett-Lundeen, Linda L; Haus, Erhard L

    2015-06-01

    The symptom intensity and mortality of human diseases, conditions, and syndromes exhibit diurnal or 24 h patterning, e.g., skin: atopic dermatitis, urticaria, psoriasis, and palmar hyperhidrosis; gastrointestinal: esophageal reflux, peptic ulcer (including perforation and hemorrhage), cyclic vomiting syndrome, biliary colic, hepatic variceal hemorrhage, and proctalgia fugax; infection: susceptibility, fever, and mortality; neural: frontal, parietal, temporal, and occipital lobe seizures, Parkinson's and Alzheimer's disease, hereditary progressive dystonia, and pain (cancer, post-surgical, diabetic neuropathic and foot ulcer, tooth caries, burning mouth and temporomandibular syndromes, fibromyalgia, sciatica, intervertebral vacuum phenomenon, multiple sclerosis muscle spasm, and migraine, tension, cluster, hypnic, and paroxysmal hemicranial headache); renal: colic and nocturnal enuresis and polyuria; ocular: bulbar conjunctival redness, keratoconjunctivitis sicca, intraocular pressure and anterior ischemic optic neuropathy, and recurrent corneal erosion syndrome; psychiatric/behavioral: major and seasonal affective depressive disorders, bipolar disorder, parasuicide and suicide, dementia-associated agitation, and addictive alcohol, tobacco, and heroin cravings and withdrawal phenomena; plus autoimmune and musculoskeletal: rheumatoid arthritis, osteoarthritis, axial spondylarthritis, gout, Sjögren's syndrome, and systemic lupus erythematosus. Knowledge of these and other 24 h patterns of human pathophysiology informs research of their underlying circadian and other endogenous mechanisms, external temporal triggers, and more effective patient care entailing clinical chronopreventive and chronotherapeutic strategies.

  12. 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.

  13. 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...

  14. 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.

  15. Outcome of Kienbök’s disease in twelve cases: a mid-term follow-up study

    PubMed Central

    Gupta, Ravi; Pruthi, Manish; Kumar, Amit; Garg, Sudhir

    2014-01-01

    INTRODUCTION No single study has established the superiority of one treatment of Kienböck’s disease over the other. Pooled outcome data is presently considered the best way to add to the knowledge and understanding of Kienböck’s disease. METHODS A total of 12 patients (9 male and 3 female) with Kienböck’s disease were included in the present case series. The mean age of the 12 patients was 28 years. One patient presented in Lichtman stage I, five in Lichtman stage II, five in Lichtman stage IIIa, and one in Lichtman stage IV. Univariate and multivariate analyses of the obtained data were performed to identify any correlations. RESULTS The mean follow-up time was 62 months, and the mean modified Mayo wrist score improved from the preoperative value of 29.5 to the final value of 89.6. Lichtman stage at presentation showed moderate positive correlation with the duration of symptoms (r = 0.56), and a strong negative correlation with the preoperative and final modified Mayo scores (r = –0.89 and r = –0.77, respectively). The final modified Mayo score showed moderate negative correlation with the duration of the symptoms (r = –0.55). There was a significant difference in the preoperative modified Mayo scores of patients who presented in stage II and those of patients who presented in stage IIIa (p = 0.03). However, the difference in the final modified Mayo scores of the patients in these stages was not significant (p = 0.14). CONCLUSION Lichtman’s stage is moderately related to the duration of symptoms, suggesting natural progression of the disease. The final outcomes of stages II and IIIa were the same irrespective of the surgical treatment (radial shortening and/or vascularised bone grafting). PMID:25631969

  16. A thorough analysis of the short- and mid-term activity-related variations in the solar acoustic frequencies

    NASA Astrophysics Data System (ADS)

    Santos, A. R. G.; Cunha, M. S.; Avelino, P. P.; Chaplin, W. J.; Campante, T. L.

    2017-02-01

    The frequencies of the solar acoustic oscillations vary over the activity cycle. The variations in other activity proxies are found to be well correlated with the variations in the acoustic frequencies. However, each proxy has a slightly different time behaviour. Our goal is to characterize the differences between the time behaviour of the frequency shifts and of two other activity proxies, namely the area covered by sunspots and the 10.7-cm flux. We define a new observable that is particularly sensitive to the short-term frequency variations. We then compare the observable when computed from model frequency shifts and from observed frequency shifts obtained with the Global Oscillation Network Group (GONG) for cycle 23. Our analysis shows that on the shortest time-scales, the variations in the frequency shifts seen in the GONG observations are strongly correlated with the variations in the area covered by sunspots. However, a significant loss of correlation is still found. We verify that the times when the frequency shifts and the sunspot area do not vary in a similar way tend to coincide with the times of the maxima of the quasi-biennial variations seen in the solar seismic data. A similar analysis of the relation between the 10.7-cm flux and the frequency shifts reveals that the short-time variations in the frequency shifts follow even more closely those of the 10.7-cm flux than those of the sunspot area. However, a loss of correlation between frequency shifts and 10.7-cm flux variations is still found around the same times.

  17. Mid-term coral-algal dynamics and conservation status of a Gorgona Island (Tropical Eastern Pacific) coral reef.

    PubMed

    Zapata, Fernando A; Rodríguez-Ramírez, Alberto; Caro-Zambrano, Carlos; Garzón-Ferreira, Jaime

    2010-05-01

    Colombian coral reefs, as other reefs worldwide, have deteriorated significantly during the last few decades due to both natural and anthropogenic disturbances. The National Monitoring System for Coral Reefs in Colombia (SIMAC) was established in 1998 to provide long-term data bases to assess the changes of Colombian coral reefs against perturbations and to identify the factors responsible for their decline or recovery. On the Pacific coast, data on coral and algal cover have been collected yearly during seven consecutive years (1998-2004) from 20 permanent transects in two sites at La Azufrada reef, Gorgona Island. Overall, coral cover was high (55.1%-65.7%) and algal cover low (28.8%-37.5%) and both exhibited significant changes among years, most notably on shallow areas. Differences between sites in both coral and algal cover were present since the study began and may be explained by differences in sedimentation stress derived from soil runoff. Differences between depths most likely stem from the effects of low tidal sub-aerial exposures. Particularly intense sub-aerial exposures occurred repeatedly during January-March, 2001 and accounted for a decrease in coral and an increase in algal cover on shallow depths observed later that year. Additionally, the shallow area on the Northern site seems to be negatively affected by the combined effect of sedimentation and low tidal exposure. However, a decrease in coral cover and an increase of algal cover since 2001 on deep areas at both sites remain unexplained. Comparisons with previous studies suggest that the reef at La Azufrada has been more resilient than other reefs in the Tropical Eastern Pacific (TEP), recovering pre-disturbance (1979) levels of coral cover within a 10 year period after the 1982-83 El Niño, which caused 85% mortality. Furthermore, the effects of the 1997-98 El Niño, indicated by the difference in overall live coral cover between 1998 and 1999, were minor (< 6% reduction). Despite recurrent natural disturbances, live coral cover in 2004 was as high as that existing before 1982 at La Azufrada, and one of the highest observed on healthy coral reefs in the TEP region.

  18. Meta-analysis of short- and mid-term efficacy of ketamine in unipolar and bipolar depression.

    PubMed

    Romeo, Bruno; Choucha, Walid; Fossati, Philippe; Rotge, Jean-Yves

    2015-12-15

    Among treatments currently assessed in major depression, ketamine, has been proposed of great interest, especially because of its very rapid action. However, the time-course of the antidepressive action of ketamine remained unclear. In the present meta-analysis, we provided a clear and objective view regarding the putative antidepressive effect of ketamine and its time-course. We searched the MEDLINE and PsycINFO databases through December 2013, without limits on year of publication, using the key words ketamine and synonyms for mood disorder or episode. Six randomized, double-blind and placebo-controlled trials of ketamine in major depression (n=103 patients) were thus identified. Authors were contacted and they all provided original data necessary for this meta-analysis. Standardized mean differences (SMD) were calculated between the depression scores in ketamine and placebo groups at days 1, 2, 3-4, 7 and 14. Ketamine showed an overall antidepressive efficacy from day 1 to day 7. However, the maintenance of its efficacy over time failed to reach significance in bipolar depression after day 3-4. Significant SMDs were not explained by demographic or clinical characteristics of included samples. The present meta-analysis provides a high level of evidence that ketamine has a rapid antidepressive action during one week, especially in unipolar disorder.

  19. Mid-term and scaling effects of forest residue mulching on post-fire runoff and soil erosion.

    PubMed

    Prats, Sergio Alegre; Wagenbrenner, Joseph W; Martins, Martinho António Santos; Malvar, Maruxa Cortizo; Keizer, Jan Jacob

    2016-12-15

    Mulching is an effective post-fire soil erosion mitigation treatment. Experiments with forest residue mulch have demonstrated that it increased ground cover to 70% and reduced runoff and soil loss at small spatial scales and for short post-fire periods. However, no studies have systematically assessed the joint effects of scale, time since burning, and mulching on runoff, soil loss, and organic matter loss. The objective of this study was to evaluate the effects of scale and forest residue mulch using 0.25m(2) micro-plots and 100m(2) slope-scale plots in a burnt eucalypt plantation in central Portugal. We assessed the underlying processes involved in the post-fire hydrologic and erosive responses, particularly the effects of soil moisture and soil water repellency. Runoff amount in the micro-plots was more than ten-fold the runoff in the larger slope-scale plots in the first year and decreased to eight-fold in the third post-fire year. Soil losses in the micro-plots were initially about twice the values in the slope-scale plots and this ratio increased over time. The mulch greatly reduced the cumulative soil loss measured in the untreated slope-scale plots (616gm(-2)) by 91% during the five post-fire years. The implications are that applying forest residue mulch immediately after a wildfire can reduce soil losses at spatial scales of interest to land managers throughout the expected post-fire window of disturbance, and that mulching resulted in a substantial relative gain in soil organic matter.

  20. 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

  1. [A mid-term review of the Millennium Development Goals: where are we with the goals on health?].

    PubMed

    Kaddar, Miloud

    2009-01-01

    The eight Millennium Development Goals (MDGs) are the expressed commitment by world leaders to combat the most obvious forms of social inequality in the world: poverty, illiteracy and disease. The MDGs set health priorities and serve as markers of the most fundamental problems to solve: the maternal and child health high mortality, and the fight against major endemic diseases. Thus, health appears in three of the eight goals, and plays a decisive role in achieving the other MDGs such as the eradication of poverty and hunger, promotion of education and gender equality. While progress has been made in various domains and in numerous countries, enormous gaps and lack of funding remain. This is the case for infant mortality and HIV/AIDS, and even more so in the area of maternal mortality reduction especially in sub-Saharan Africa and Southeast Asia. The recent proliferation of forums and international partnerships for health have put at the forefront the targeted health-related MDG, increased financial resources for the benefit of poor countries but have made the architecture of global health even more fragmented and complex. Attempts to align on country priorities, needs and national health plans, and also to harmonize donors and partners' actions and funding according to the 2005 Paris Declaration principles, were difficult to actually materialize. The revitalization of primary health care and the strengthening of health systems are now back on the international and national health agenda.

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

    PubMed

    Konya, Mehmet Nuri; Aydn, Bahattin Kerem; Yldrm, Timur; Sofu, Hakan; Gürsu, Sarper

    2016-03-01

    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.

  3. Looking Forward with LIFE: Literacy Initiative for Empowerment. Global LIFE Mid-Term Evaluation Report 2006-2011

    ERIC Educational Resources Information Center

    Hanemann, Ulrike

    2012-01-01

    The United Nations Educational, Scientific and Cultural Organization (UNESCO) launched the Literacy Initiative for Empowerment (2006-2015)--LIFE--to tackle the literacy challenge. This is a collaborative effort to accelerate literacy efforts in thirty five of the world's most challenged countries and thereby to unlock progress to reach all of the…

  4. 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.

  5. 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.

  6. Probabilistic seismic hazard at Mt. Etna (Italy): The contribution of local fault activity in mid-term assessment

    NASA Astrophysics Data System (ADS)

    Azzaro, R.; D'Amico, S.; Peruzza, L.; Tuvè, T.

    2013-02-01

    In this work, we tackle the problem of seismic hazard at Etna deriving from the recurrent seismogenic activity of local faults, by adopting two independent methods based on probabilistic approaches. We assess the hazard in terms of macroseismic intensity and represent the occurrence probability calculated for different exposure times both on maps and at fault scale. Seismic hazard maps obtained by applying the "site approach" through the SASHA code and a new probabilistic attenuation model, indicate the eastern flank of the volcano as the most hazardous, with expected intensity (Iexp) in 50 years (i.e. the standard exposure time adopted in the seismic regulations) ranging from degrees IX to X EMS. In shorter exposure periods (20, 10, 5 years), values of Iexp up to IX are also reached in the same area, but they are clearly determined by the earthquakes generated by the Timpe fault system. In order to quantify the contribution of local seismogenic sources to the hazard of the region, we reconstruct the seismic history of each fault and calculate with SASHA the probability that earthquakes of a given intensity may be generated in different exposure times. Results confirm the high level of hazard due to the S. Tecla, Moscarello and Fiandaca faults especially for earthquakes of moderate intensity, i.e. VI ≤ I0 ≤ VII, with probabilities respectively exceeding 50% and 20% in 10 years, and 30% and 10% in 5 years. Occurrence probability of major events (I0 ≥ VIII) at the fault scale has also been investigated by statistics on intertimes. Under stationary assumptions we obtain a probability of 6.8% in 5 years for each structure; by introducing the time-dependency (time elapsed since the last event occurred on each fault) through a BPT model, we identify the Moscarello and S. Tecla faults as the most probable sources to be activated in the next 5 years (2013-2017). This result may represent a useful indication to establish priority criteria for actions aimed at reducing seismic risk at a local scale.

  7. 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.

  8. 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.

  9. Mid-Term Outcomes of Endovascular Treatment for TASC-II D Femoropopliteal Occlusive Disease with Critical Limb Ischemia

    SciTech Connect

    Torres-Blanco, Álvaro Edo-Fleta, Gemma; Gómez-Palonés, Francisco; Molina-Nácher, Vicente; Ortiz-Monzón, Eduardo

    2016-03-15

    PurposeThe purpose of the study was to assess the safety and midterm effectiveness of endovascular treatment in Trans-Atlantic Inter-Society Consensus II (TASC-II) D femoropopliteal occlusions in patients with critical limb ischemia (CLI).MethodsPatients with CLI who underwent endovascular treatment for TASC-D de novo femoropopliteal occlusive disease between September 2008 and December 2013 were selected. Data included anatomic features, pre- and postprocedure ankle-brachial index, duplex ultrasound, and periprocedural complications. Sustained clinical improvement, limb salvage rate, freedom from target lesion revascularization (TLR), and freedom from target extremity revascularization (TER) were assessed by Kaplan–Meier estimation and predictors of restenosis/occlusion with Cox analysis.ResultsThirty-two patients underwent treatment of 35 TASC-D occlusions. Mean age was 76 ± 9. Mean lesion length was 23 ± 5 cm. Twenty-eight limbs (80 %) presented tissue loss. Seventeen limbs underwent treatment by stent, 13 by stent-graft, and 5 by angioplasty. Mean follow-up was 29 ± 20 months. Seven patients required major amputation and six patients died during follow-up. Eighteen endovascular and three surgical TLR procedures were performed due to restenosis or occlusion. Estimated freedom from TLR and TER rates at 2 years were 41 and 76 %, whereas estimated primary and secondary patency rates were 41 and 79 %, respectively.ConclusionsEndovascular treatment for TASC II D lesions is safe and offers satisfying outcomes. This patient subset would benefit from a minimally invasive approach. Follow-up is advisable due to a high rate of restenosis. Further follow-up is necessary to know the long-term efficacy of these procedures.

  10. The results of arthroscopic versus mini-open repair for rotator cuff tears at mid-term follow-up

    PubMed Central

    Pearsall, Albert W; Ibrahim, Khalid A; Madanagopal, Sudhakar G

    2007-01-01

    Background To prospectively evaluate patients who underwent a "mini-open" repair versus a completely arthroscopic technique for small to large size rotator cuff tears. Methods Fifty-two patients underwent "mini-open" or all arthroscopic repair of a full thickness tear of the rotator cuff. Patients who complained of shoulder pain and/or weakness and who had failed a minimum of 6 weeks of physical therapy and had at least one sub-acromial injection were surgical candidates. Pre and post-operative clinical evaluations included the following: 1) demographics; 2) Simple Shoulder Test (SST); 3) University of California, Los Angeles (UCLA) rating scale; 4) visual analog pain assessment (VAS); and 5) pre-op SF12 assessment. Descriptive analysis was performed for patient demographics and for all variables. Pre and post outcome scores, range of motion and pain scale were compared using paired t-tests. Analysis of variance (ANOVA) was used to evaluate any effect between dependent and independent variables. Significance was set at p is less than or equal to 0.05. Results There were 31 females and 21 males. The average follow-up was 50.6 months (27 – 84 months). The average age was similar between the two groups [arthroscopic x = 55 years/mini-open x = 58 years, p = 0.7]. Twenty-seven patients underwent arthroscopic repair and 25 underwent repair with a mini-open incision. The average rotator cuff tear size was 3.1 cm (range: 1–5 centimeters). There was no significant difference in tear size between the two groups (arthroscopic group = 2.9 cm/mini-open group = 3.2 cm, p = 0.3). Overall, there was a significant improvement from pre-operative status in shoulder pain, shoulder function as measured on the Simple Shoulder test and UCLA Shoulder Form. Visual analog pain improved, on average, 4.4 points and the most recent Short Shoulder Form and UCLA scores were 8 and 26 respectively. Both active and passive glenohumeral joint range of motion improved significantly from pre-operatively. Conclusion Based upon the number available, we found no statistical difference in outcome between the two groups, indicating that either procedure is efficacious in the treatment of small and medium size rotator cuff tears. Level of Evidence Type III PMID:18053153

  11. Prospective Developments in Western Europe and in the Northwest Indian-Ocean Region. A Study of Selected Mid-Term Problems in U.S. Foreign Policy,

    DTIC Science & Technology

    1975-02-01

    that can sufficiently harmonize particularistic interests and provide the discipline of transpersonal motivatior to a large enough number of people..- It...ethic of social obligations covering a!l groups in the society, its centuries-old ideal of transpersonal public service by the educated elites, and tl.a...relations of authority and subordination, and the transpersonal motivation and discipline Inherent in traditional Chinese society and culture. Nor is it

  12. Mid-term and long-term follow-up of intracranial aneurysms treated by the p64 Flow Modulation Device: a multicenter experience

    PubMed Central

    Briganti, Francesco; Leone, Giuseppe; Ugga, Lorenzo; Marseglia, Mariano; Macera, Antonio; Manto, Andrea; Delehaye, Luigi; Resta, Maurizio; Resta, Mariachiara; Burdi, Nicola; Nuzzi, Nunzio Paolo; Divenuto, Ignazio; Caranci, Ferdinando; Muto, Mario; Solari, Domenico; Cappabianca, Paolo; Maiuri, Francesco

    2017-01-01

    Background Experience with the endovascular treatment of cerebral aneurysms using the p64 Flow Modulation Device is still limited. This study discusses the results and complications of this new flow diverter device. Methods 40 patients (30 women, 10 men) with 50 cerebral aneurysms treated in six Italian neurointerventional centers with the p64 Flow Modulation Device between April 2013 and September 2015 were retrospectively reviewed. Results Complete occlusion was obtained in 44/50 aneurysms (88%) and partial occlusion in 3 (6%). In the other three aneurysms (6%), two cases of asymptomatic in-stent thrombosis and one intraprocedural occlusion of the parent vessel occurred. Technical complications were observed in eight procedures (16%). Permanent morbidity due to acute in-stent thrombosis and consequent ischemic stroke occurred in one patient (2.5%). No delayed aneurysm rupture, subarachnoid or intraparenchymal hemorrhage, or ischemic complications occurred and there were no deaths. Conclusions Endovascular treatment with the p64 Flow Modulation Device is a safe treatment for unruptured cerebral aneurysms, resulting in a high rate of occlusion. As with other flow diverter devices, we recommend this treatment mainly for large-necked aneurysms of the internal carotid artery siphon. However, endovascular treatment with the p64 device should also be encouraged in difficult cases such as aneurysms of the posterior circulation and beyond the circle of Willis. PMID:27439887

  13. MID TERM RESULTS AFTER OPEN HEART SURGERY IN HEMODIALYSIS PATIENTS AWAITING KIDNEY TRANSPLANT: DOES CARDIOVASCULAR SURGICAL INTERVENTION PRIOR TO TRANSPLANTATION PROLONG SURVIVAL?

    PubMed

    Ozbek, C; Sever, K; Demirhan, O; Mansuroglu, D; Kurtoglu, N; Ugurlucan, M; Sevmis, S; Karakayali, H

    2015-12-01

    The aim of this study was to compare the mid and long term postoperative outcomes between the hemodialysis-dependent patients awaiting kidney transplantat who underwent open heart surgery in our department during the last five years, and those who did not receive a renal transplant, to determine the predictors of mortality, and assess the possible contribution of post heart surgery kidney transplantation to survival. The patients were separated into two groups: those who underwent a transplantation after open heart surgery were included in the Tp+ group, and those who did not in the Tp- group Between June 2008 and December 2012, 127 dialysis dependent patients awaiting kidney transplant and who underwent open heart surgery were separated into two groups. Those who underwent transplantation after open heart surgery were determined as Tp+ (n=33), and those who did not as Tp- (n=94). Both groups were compared with respect to preoperative paramaters including age, sex, diabetes mellitus (DM), hypertension (HT), hyperlipidemia (HL), obesity, smoking, chronic obstructive pulmonary disease (COPD), peripheral vascular disease (PVD), left ventricle ejection fraction (EF), Euroscore; operative parameters including cross clamp time, perfusion time, number of grafts, use of internal mammary artery (IMA); postoperative parameters including revision, blood transfusion, ventilation time, use of inotropic agents, length of stay in the intensive care unit and hospital, and follow up findings. Problems encountered during follow up were recorded. Predictors of mortality were determined and the survival was calculated. Among the preoperative parameters, when compared with the Tp- group, the Tp+ group had significantly lower values in mean age, presence of DM, obesity, PVD, and Euroscore levels, and higher EF values. Assessment of postoperative values showed that blood transfusion requirement and length of hospital stay were significantly lower in the Tp+ group compared to the Tp- group, whereas the length of follow up was significantly higher in the Tp+ group. The use of inotropic agents was significantly higher in the Tp- group. A logistic regression analysis was made to determine the factors affecting mortality. Revision (p=0.013), blood transfusion (p=0.017), ventilation time (p=0.019), and length of stay in the intensive care unit (p=0.009) were found as predictors of mortality. Survival rates at years 1, 2 and 3 were 86.1%, 81%, 77.5% in the Tp- group, and 96.0%, 96.3%, 90.4% in the Tp+ group. Median survival rate was 41.35±2.02 in the Tp- group, and 49.64±1.59 in the Tp+ group which was significantly higher compared to the Tp- group (p=0.048). Chronic renal failure is among the perioperative risk factors for patients undergoing open heart surgery. Transplantation is still an important health issue due to insufficiency of available transplant organs. Patients with chronic renal failure are well known to have higher risks for coronary artery disease. A radical solution of the cardiovascular system problems prior to kidney transplantation seems to have a significant contribution to the post transplant survival.

  14. 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.

  15. Arthroscopic release of iliopsoas tendon in patients with femoro-acetabular impingement: clinical results at mid-term follow-up

    PubMed Central

    Mardones, Rodrigo; Via, Alessio Giai; Tomic, Alexander; Rodriguez, Claudio; Salineros, Matias; Somarriva, Marcelo

    2016-01-01

    Summary Background The iliopsoas tendon is a recognized cause of extra-articular hip pain, and tenotomy has been described as an effective treatment in patients who do not respond to conservative treatments. Endoscopic release showed higher success rate, lower recurrence, fewer complications compared to open surgery. The aim of the study is to report the results at a mean of 4 years follow-up of a series of patients affected by femoroacetabular impingement (FAI) and an associated iliopsoas tendinopathy, treated with hip arthroscopy and transcapsular tendon release. Methods Fifteen patients were retrospectively reviewed. Assessment of radiographic signs of FAI was performed, the alpha angle, the femoral head-neck offset and the lateral center edge angle (LCEA) were collected. Osteoarthritis was assessed from the AP pelvic and graded according to the Tönnis classification. Modified Harris Hip Score (mHHS), VAIL score and VAS score were administered to all patients before surgery, at follow-up at 1 year (T1) and final follow-up (T2). Results We found a statistical significant improvement in functional scores (mHHS and VAIL score) from the baseline to T2. According to VAS score, a statistical significant improvement was also found from T0 to T2, from a median of 5.5 (range 3–7) to 0 (range 0–5) (P<0.001). Two patients referred a recurrence of pain one year after surgery who were treated conservatively. No other complications have been reported. Conclusion Iliopsoas tendinopathy can be associated to FAI in some patients, and failure in diagnosing and treating may be the reason of poor results and a revision surgery. Arthroscopic iliopsoas tendon release seems to produce good clinical outcome, reducing pain and the rate of a revision surgeries. Level of evidence: IV case series. PMID:28066744

  16. Cutting Balloon Angioplasty Versus Standard Balloon Angioplasty for Failing Infra-inguinal Vein Grafts: Comparative Study of Short- and Mid-Term Primary Patency Rates

    SciTech Connect

    Vikram, Raghunandan; Ross, Rose A.; Bhat, Rajesh; Griffiths, Gareth D.; Stonebridge, Peter A.; Houston, J. Graeme; Chakraverty, S.

    2007-07-15

    Purpose. To evaluate the results of a recent change in practice in our institution using cutting balloon angioplasty instead of standard balloon angioplasty as the primary treatment for failing infra-inguinal vein bypass grafts. Methods. In this nonrandomized cohort study with a historical control, failing infra-inguinal vein grafts were identified at duplex surveillance or clinical examination. Patients had confirmatory arteriography and balloon angioplasty at the same attendance. Interventions proximal or distal to the graft itself and prosthetic grafts were not included. Patients were entered into a duplex graft surveillance program. Initial assessment of technical success was duplex or improvement 4-6 weeks after the primary angioplasty. Results. Twenty-seven consecutive patients were treated with standard balloon angioplasty, then 11 consecutive patients were treated with cutting balloon angioplasty. Initial technical success was 74% for the standard balloon versus 82% for the cutting balloon. The primary patency rate at 6 months was 16/26 (62%) for standard balloon angioplasty and 8/10 (80%) for cutting balloon angioplasty (p = 0.44). The primary patency rate at 12 months was 9/25 (36%) for standard balloon angioplasty and 5/10 (50%) for cutting balloon angioplasty (p = 0.47). Conclusion. The use of cutting balloons for primary angioplasty of infra-inguinal vein grafts offers no definite advantage over standard balloon angioplasty in this institution or compared with patency rates after standard balloon angioplasty reported elsewhere. Larger multicenter studies would be required to demonstrate whether there was any real difference between the two techniques.

  17. Mid-Term Outcomes and Complications with Cementless Distal Locking Hip Revision Stem with Hydroxyapatite Coating for Proximal Bone Defects and Fractures.

    PubMed

    Carrera, Lluis; Haddad, Sleiman; Minguell, Joan; Amat, Carles; Corona, Pablo S

    2015-06-01

    We revised the first 100 revision total hip arthroplasties using a cementless distal locking revision stem conducted in our referral centre. Average follow-up was 9.2 years (range: 5.5-12 years). Harris Hip Score improved from 42.5 to 81.6, and none had thigh pain at last follow-up. No significant stress shielding, osteolysis, or radiologic loosening was found. All patients showed radiological evidence of secondary implant osseointegration. Overall survival was 97% with three patients being revised: two stem ruptures and one subsidence. We could trace these complications to technical errors. These findings suggest that a diaphyseal fixation of the revision stem with distal locking can provide the needed primary axial and rotational stability of the prosthesis. This would allow further bony ingrowth, enhanced by the hydroxyapatite coating.

  18. 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

  19. 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.

  20. Mid-term results in otherwise treatment refractory primary or secondary liver confined tumours treated with selective internal radiation therapy (SIRT) using (90)Yttrium resin-microspheres.

    PubMed

    Jakobs, Tobias F; Hoffmann, Ralf-T; Poepperl, Gabriele; Schmitz, Anna; Lutz, Jürgen; Koch, Walter; Tatsch, Klaus; Lubiensky, Andreas; Reiser, Maximilian F; Helmberger, Thomas

    2007-05-01

    The purpose was to determine the response and survival and to analyse the feasibility of single-session, whole-liver SIRT in patients with non-resectable, otherwise non-responding liver cancer. Thirty-nine patients qualified for SIRT. Eighteen patients suffered from colorectal-cancer metastases (CRC), breast-cancer metastases (MBC, 7), HCC (5) and other tumours (9). Response was assessed by tumour-markers and CT-imaging. At 2-4, 5-7 and 8-9 months follow-up in 3/17, 5/15 and 5/10 of CRC-patients CEA-levels were higher than before. In the MBC group 1-3 and 4-6 months after SIRT tumour-marker-levels were higher in 2/6 and 3/3 patients, respectively. In all HCC-patients AFP-levels dropped 1-3 months after SIRT. Using RECIST, in the CRC-group progressive liver disease (PD) was found in 4/17, 2/12, 2/10 and 2/5 patients at 2-4, 5-8, 9-10 and 12-14 months follow-up. Concerning MBC, after 3 months 7/7 patients presented with stable-disease (SD) or partial-response (PR). At 5-6 months, 1/5 patients showed PD. All HCC-patients showed SD/PR at 2-3 months with no PD at 5-8 months. In the mixed-group 5/6 patients presented with SD/PR at 3-4 months and with SD in 2/3 patients at 5-6 months. The median time-to-PD was 6.5, 8.5 and 8 months for the CRC-, MBC- and mixed-group, respectively. SIRT is a promising, liver-targeted approach for patients with otherwise treatment-refractory liver tumours.

  1. 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.

  2. 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…

  3. 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

  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. Treatment with acetylsalicylic acid prevents short to mid-term radiographic progression of nontraumatic osteonecrosis of the femoral head: a pilot study

    PubMed Central

    Albers, Anthony; Carli, Alberto; Routy, Bertrand; Harvey, Edward J.; Séguin, Chantal

    2015-01-01

    Background Nontraumatic osteonecrosis of the femoral head (ONFH) is a progressive disease in young adults producing substantial morbidity and frequently resulting in total hip arthroplasty. Although hip-preserving surgical procedures represent the current mainstay of treatment for early disease, medical therapies targeting specific pathways in the ONFH pathogenesis could help prevent disease progression while producing less morbidity. Acetylsalicylic acid (ASA) is a promising alternative to other therapies for ONFH owing to its anti-inflammatory and antithrombotic mechanisms of action and its relatively benign side effect profile. Methods We followed a prospective cohort of 10 patients (12 hips) with precollapse ONFH who were given ASA to prevent disease progression. Their outcomes were compared with those of a historic control group taken from the literature. Results Progression occurred in 1 of 12 (8%) patients taking ASA compared with 30 of 45 (66.6%) controls (p = 0.002) at a mean follow-up of 3.7 years. Patients taking ASA also tended to exhibit decreased femoral head involvement at the end of therapy. Conclusion This hypothesis-generating study leads us to believe that ASA may be a simple and effective treatment option for delaying disease progression in patients with early-stage ONFH. PMID:26011853

  6. Mid-term variation of vertical distribution of acid volatile sulphide and simultaneously extracted metals in sediment cores from Lake Albufera (Valencia, Spain).

    PubMed

    Hernández-Crespo, Carmen; Martín, Miguel

    2013-11-01

    Lake Albufera is one of the most eutrophic bodies of water in Spain due to point and diffuse pollution over past decades, and its sediments are likely to be anoxic because of high organic matter flux. Hence, sulphides can play an important role in limiting the mobility of heavy metals. This study aimed to study the vertical variation of acid volatile sulphide (AVS) and simultaneously extracted metals (SEM) in sediment cores collected from Lake Albufera; other sediment characteristics, such as organic matter, biochemical oxygen, demand or total metals, were also studied. Three sites were selected, and four sampling campaigns were performed to study spatial and temporal variation as well as to obtain information regarding historical variation in the composition of sediments. AVS and SEM were analysed by the purge-and-trap method. The vertical distribution of AVS and SEM varied depending on the sampling site-concentrations of AVS and SEM were higher at sites close to mouths of inflowing channels. A decreasing trend of AVS has been found at these sites over time: In the two first samplings, AVS increased with depth reaching maximum concentrations of 40 and 21 μmol g(-1), but from then on AVS were lower and decreased with depth. SEM decreased with depth from 3 μmol g(-1) in surface layers to approximately 1 μmol g(-1) at deeper segments at these sites. However, the central site was more uniform with respect to depth as well as with time; it presented lower values of SEM and AVS (mean 0.9 and 2.0 μmol g(-1) respectively), and the maximum value of AVS (7 μmol g(-1)) was found at the top layer (0-3 cm). According to the (SEM-AVS)/fOC approach, every site, and throughout the cores, can be classified as containing nontoxic metals because the values were <130 μmol g(-1).

  7. Mid-term Clinical Outcomes of Stand-alone Posterior Interbody Fusion with Rectangular Cages: A 4-year-minimum Follow-up

    PubMed Central

    Cho, Kyung Rae; Lee, Sun-Ho; Kim, Eun Sang

    2013-01-01

    Objective We sought to determine minimum 4 years of clinical outcomes including fusion rate, revision rate and complications of patients who underwent placement of rectangular stand-alone cages. Methods Thirty-three cases of degenerative spine that had been followed for at least 4-years were reviewed retrospectively. Cages were inserted at L4-L5 level or L5-S1 in 27 or in 6 cases respectively. Visual analogue scale (VAS), Odom's criteria, fusion rate, intervertebral disc height and lumbar lordosis were determined pre- and post-operatively on standing x-rays. Amount of intra- and postoperative blood loss, total volume transfused, duration of surgery and perioperative complications were also evaluated. Results The mean VAS score of back pain and sciatica were improved from 8.0 and 7.0 points to 3.4 and 2.4 during 1 years follow-up visit and the scores was raised gradually. Also, during the follow-up, 94% of patients showed excellent or good outcomes by the Odom's criteria. Intervertebral disc height was increased from 8.2±1.4mm to 9.2±1.9mm at the first year of follow-up, however, found to be decreased and stabilized to 8.3±1.8mm after 2 years. The fusion rate was approximately 91% after 4 year postoperative. The segmental angle of lordosis was increased significantly by two years but it was not maintained after four years. A statistically insignificant change in total lumbar lordosis was also observed. Three patients (9%) had experienced perioperative complications. Conclusion The use of rectangular stand-alone cages for posterior lumbar interbody fusion (PLIF) resulted in a various degree of subsidence and demonstrate very low complication rate, high functional stability and improved clinical outcomes in patients with degenerative lumbar disc disease. PMID:24757473

  8. 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

  9. A mid-term follow-up of Koutsogiannis’ osteotomy in adult-acquired flatfoot stage II and “early stage III”

    PubMed Central

    Arvinius, Camilla; Manrique, Elena; Urda, Antonio; Cardoso, Zulema; Galeote, Jose Enrique; Marco, Fernando

    2017-01-01

    Introduction: Koutsogiannis’ osteotomy has been widely described to treat adult-acquired flatfoot. However, few articles describe its midterm follow-up. Our aim was to study clinical and radiological outcomes at least one year after surgery and to analyze whether a combined procedure on the medial soft tissue affected these outcomes. Methods: We performed a retrospective study of 30 feet of patients who underwent a Koutsogiannis’ osteotomy due to adult-acquired flatfoot stage II and “early stage III”: a stage III acquired flatfoot without any important structural deformities. The parameters studied were additional medial soft tissue procedures, clinical outcome through the American Orthopaedic Foot and Ankle Society (AOFAS) ankle and midfoot score as well as complications and radiological measurements. Results: Sixteen cases were “early stage III” and 14 stage II. Thirteen patients underwent an associated posterior tibial tendon (PTT) revision: in three cases an end-to-end suture was possible, seven cases needed a FDL transposition, and three underwent synovectomy. Statistically significant improvement was found in the AOFAS score although no significant changes were seen radiologically. No additional benefit was found with the revision of the posterior tibial tendon. As to clinical and radiological results, no differences were found between stage II and “early stage III”. Five cases presented a mild dysesthesia but only one patient needed neurolysis. Conclusions: We consider the Koutsogiannis’ osteotomy to be a safe and effective procedure to reduce pain in patients with stage II and “early stage III” adult-acquired flatfoot. PMID:28304274

  10. Mid-term outcomes of floating platform mobile-bearing total knee arthroplasty under navigational guidance with a minimum 4-year follow-up.

    PubMed

    Lee, Dae-Hee; Lee, Dong-Ki; Shin, Young-Soo; Han, Seung-Beom

    2013-12-01

    We evaluated 106 knees that underwent primary total knee arthroplasty (TKA) with the navigation-assisted gap balancing technique using an e.-motion cruciate retaining floating platform (FP) mobile-bearing prosthesis to prospectively assess the survival of the e.-motion FP system after a minimum follow-up of 4 years. There was no evidence of any complications, including dissociation or breakage of the polyethylene liner or component loosening at last follow up (5.1 ± 0.6 years). Four knees, however, required re-operation, three for distal femoral fracture, and one for infection. The estimated 5-year prosthesis survival rates without revision for any reason and for prosthesis-associated problems were 96.2% and 100%, respectively. The e.-motion floating platform, with a cruciate retaining design under navigation guidance, demonstrated excellent clinical results and 5-year survival rate.

  11. 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

  12. EU-FP7-iMARS: analysis of Mars multi-resolution images using auto-coregistration, data mining and crowd source techniques: A Mid-term Report

    NASA Astrophysics Data System (ADS)

    Muller, J.-P.; Yershov, V.; Sidiropoulos, P.; Gwinner, K.; Willner, K.; Fanara, L.; Waelisch, M.; van Gasselt, S.; Walter, S.; Ivanov, A.; Cantini, F.; Morley, J. G.; Sprinks, J.; Giordano, M.; Wardlaw, J.; Kim, J.-R.; Chen, W.-T.; Houghton, R.; Bamford, S.

    2015-10-01

    Understanding the role of different solid surface formation processes within our Solar System is one of the fundamental goals of planetary science research. There has been a revolution in planetary surface observations over the last 8 years, especially in 3D imaging of surface shape (down to resolutions of 10s of cms) and subsequent terrain correction of imagery from orbiting spacecraft. This has led to the potential to be able to overlay different epochs back to the mid-1970s. Within iMars, a processing system has been developed to generate 3D Digital Terrain Models (DTMs) and corresponding OrthoRectified Images (ORIs) fully automatically from NASA MRO HiRISE and CTX stereo-pairs which are coregistered to corresponding HRSC ORI/DTMs. In parallel, iMars has developed a fully automated processing chain for co-registering level-1 (EDR) images from all previous NASA orbital missions to these HRSC ORIs and in the case of HiRISE these are further co-registered to previously co-registered CTX-to-HRSC ORIs. Examples will be shown of these multi-resolution ORIs and the application of different data mining algorithms to change detection using these co-registered images. iMars has recently launched a citizen science experiment to evaluate best practices for future citizen scientist validation of such data mining processed results. An example of the iMars website will be shown along with an embedded Version 0 prototype of a webGIS based on OGC standards.

  13. 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.

  14. 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.

  15. Comparison of minimally invasive surgery with standard open surgery for vertebral thoracic metastases causing acute myelopathy in patients with short- or mid-term life expectancy: surgical technique and early clinical results.

    PubMed

    Miscusi, Massimo; Polli, Filippo Maria; Forcato, Stefano; Ricciardi, Luca; Frati, Alessandro; Cimatti, Marco; De Martino, Luca; Ramieri, Alessandro; Raco, Antonino

    2015-05-01

    OBJECT Spinal metastasis is common in patients with cancer. About 70% of symptomatic lesions are found in the thoracic region of the spine, and cord compression presents as the initial symptom in 5%-10% of patients. Minimally invasive spine surgery (MISS) has recently been advocated as a useful approach for spinal metastases, with the aim of decreasing the morbidity associated with more traditional open spine surgery; furthermore, the recovery time is reduced after MISS, such that postoperative chemotherapy and radiotherapy can begin sooner. METHODS Two series of oncological patients, who presented with acute myelopathy due to vertebral thoracic metastases, were compared in this study. Patients with complete paraplegia for more than 24 hours and with a modified Bauer score greater than 2 were excluded from the study. The first group (n = 23) comprised patients who were prospectively enrolled from May 2010 to September 2013, and who were treated with minimally invasive laminotomy/laminectomy and percutaneous stabilization. The second group (n = 19) comprised patients from whom data were retrospectively collected before May 2010, and who had been treated with laminectomy and stabilization with traditional open surgery. Patient groups were similar regarding general characteristics and neurological impairment. Results were analyzed in terms of neurological recovery (American Spinal Injury Association grade), complications, pain relief (visual analog scale), and quality of life (European Organisation for Research and Treatment of Cancer [EORTC] QLQ-C30 and EORTC QLQ-BM22 scales) at the 30-day follow-up. Operation time, postoperative duration of bed rest, duration of hospitalization, intraoperative blood loss, and the need and length of postoperative opioid administration were also evaluated. RESULTS There were no significant differences between the 2 groups in terms of neurological recovery and complications. Nevertheless, the MISS group showed a clear and significant improvement in terms of blood loss, operation time, and bed rest length, which is associated with a more rapid functional recovery and discharge from the hospital. Postoperative pain and the need for opioid administration were also significantly less pronounced in the MISS group. Results from the EORTC QLQ-C30 and QLQ-BM22 scales showed a more pronounced improvement in quality of life at follow-up in the MISS group. CONCLUSIONS In the authors' opinion, MISS techniques should be considered the first choice for the treatment for patients with spinal metastasis and myelopathy. MISS is as safe and effective for spinal cord decompression and spine fixation as traditional surgery, and it also reduces the impact of surgery in critical patients. However, further studies are needed to confirm these findings.

  16. 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

  17. Microaggregates: Experimental and Clinical Aspects - Symposium on Microaggregates, Held at Letterman Army Institute of Research on 20-21 June 1977,

    DTIC Science & Technology

    1980-06-01

    pain thershold and ECG changes associated with angina pectoris (57). It has also been found not to reduce the frequency of diminished pulses following...1972. 57. Frishman, W.H., Christodoulou, J., Seksler, B. et al.: Aspirin therapy in angina pectoris : Effects on platelet aggregation, exercise...infarction 4. Stable angina 5. Amaurosis fugax 6. Nephrotic syndrome 7. Diabetes mellitus 8. Hyperbetalipoproteinemia 9. Acute arterial insufficiency 10

  18. 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…

  19. Horsfield's hawk-cuckoo nestlings simulate multiple gapes for begging.

    PubMed

    Tanaka, Keita D; Ueda, Keisuke

    2005-04-29

    Nestlings of some brood parasitic birds evict hosts' eggs and young soon after hatching, thereby avoiding discrimination by hosts while monopolizing parental care. Eviction carries a cost, however, because lone parasitic nestlings attract a reduced provisioning rate. Here we describe a form of visual signaling used by the evicting Horsfield's hawk-cuckoo (Cuculus fugax) to obtain sufficient food. The chick displays a gape-colored patch on the wing to the host parents as they deliver food, simulating the gaping display of more than one nestling.

  20. Rheumatoid vasculitis: early presentation of rheumatoid arthritis.

    PubMed

    Abdulqader, Yasir; Al-Ani, Muhsen; Parperis, Konstantinos

    2016-11-08

    Rheumatoid vasculitis is a rare and late complication of rheumatoid arthritis and may affect small-to-medium-sized vessels. Here, we report a case of a 49-year-old man who presented with amaurosis fugax in the left eye, symmetric polyarthritis, Raynaud's symptoms and paraesthesia in both lower extremities. The patient subsequently experienced right foot drop, nail fold infracts and gangrene of his right second toe. He was found to have a high titre of rheumatoid factor and treatment with rituximab and high dose of corticosteroids led to significant improvement of his symptoms. This is rare case describing the early onset of rheumatoid vasculitis in a patient with rheumatoid arthritis.

  1. Goals for limited strategic defenses

    SciTech Connect

    Canavan, G.H.

    1989-05-01

    This report reviews the nature of near and mid-term accidental, third-country, and limited threats, discusses the technologies available to defend against them, and examines the development programs required. 22 refs.

  2. 40 CFR Table 4 to Subpart Ttttt of... - Continuous Compliance With Emission Limits

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... CATEGORIES (CONTINUED) National Emissions Standards for Hazardous Air Pollutants for Primary Magnesium... least twice during each term of your title V operating permit (at mid-term and renewal). 2....

  3. 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.

  4. 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.

  5. Right ventricular relative wall thickness as a predictor of outcomes and of right ventricular reverse remodeling for patients with pulmonary hypertension.

    PubMed

    Sano, Hiroyuki; Tanaka, Hidekazu; Motoji, Yoshiki; Fukuda, Yuko; Mochizuki, Yasuhide; Hatani, Yutaka; Matsuzoe, Hiroki; Hatazawa, Keiko; Shimoura, Hiroyuki; Ooka, Junichi; Ryo-Koriyama, Keiko; Nakayama, Kazuhiko; Matsumoto, Kensuke; Emoto, Noriaki; Hirata, Ken-Ichi

    2017-03-01

    Mid-term right ventricular (RV) reverse remodeling after treatment in patients with pulmonary hypertension (PH) is associated with long-term outcome as well as baseline RV remodeling. However, baseline factors influencing mid-term RV reverse remodeling after treatment and its prognostic capability remain unclear. We studied 54 PH patients. Mid-term RV remodeling was assessed in terms of the RV area, which was traced planimetrically at the end-systole (RVESA). RV reverse remodeling was defined as a relative decrease in the RVESA of at least 15% at 10.2 ± 9.4 months after treatment. Long-term follow-up was 5 years. Adverse events occurred in ten patients (19%) and mid-term RV reverse remodeling after treatment was observed in 37 (69%). Patients with mid-term RV reverse remodeling had more favorable long-term outcomes than those without (log-rank: p = 0.01). Multivariate logistic regression analysis showed that RV relative wall thickness (RV-RWT), as calculated as RV free-wall thickness/RV basal linear dimension at end-diastole, was an independent predictor of mid-term RV reverse remodeling (OR 1.334; 95% CI, 1.039-1.713; p = 0.03). Moreover, patients with RV-RWT ≥0.21 showed better long-term outcomes than did those without (log-rank p = 0.03), while those with RV-RWT ≥0.21 and mid-term RV reverse remodeling had the best long-term outcomes. Patients with RV-RWT <0.21 and without mid-term RV reverse remodeling, on the other hand, had worse long-term outcomes than other sub-groups. In conclusions, RV-RWT could predict mid-term RV reverse remodeling after treatment in PH patients, and was associated with long-term outcomes. Our finding may have clinical implications for better management of PH patients.

  6. 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.

  7. Visual claudicatio: diagnosis with 64-slice computed tomography.

    PubMed

    Cademartiri, Filippo; Maffei, Erica; Palumbo, Alessandro; Mollet, Nico R; van der Lugt, Aad; Crisi, Girolamo

    2007-06-01

    We present a case of a 78-year-old male referred presented to our institution with amaurosis fugax after walking 20 steps ("visual claudicatio"). Duplex ultrasound was not able to visualize the carotid arteries. Multislice computed tomography (Sensation 64 Cardiac, Siemens, Germany) of the cerebro-vascular circulation was performed from its origin at the level of the aortic arch to the circle of Willis. The investigation demonstrated a complete occlusion of both common carotid arteries at their origin and a severe origo stenosis of both vertebral arteries. An important collateral circulation of the vertebral arteries through the minor vessels of the neck was also displayed. Both comunicans posterior arteries were small but patent. The intra-cranial arteries were patent. Multislice CT of the cerebro-vascular circulation is an optimal tool for a comprehensive evaluation when duplex ultrasound fails.

  8. Obstetrical management of patients with extra-anatomic vascular bypass grafts due to Takayasu arteritis.

    PubMed

    Miyasaka, Naoyuki; Egawa, Makiko; Isobe, Mitsuaki; Inoue, Yoshinori; Kubota, Toshiro

    2016-12-01

    Little is known about the obstetrical management of patients with Takayasu arteritis (TA) who have undergone extra-anatomic vascular bypass (EAVB). We describe two cases of EAVB. Case 1 underwent EAVB due to renovascular hypertension associated with stenosis of the abdominal aorta, and Case 2 due to amaurosis fugax episodes associated with stenosis of the brachiocephalic and left common carotid arteries. Pregnancy outcomes were favorable for both cases, though the original symptoms recurred during the third trimester in each case, possibly due to increased blood flow to the pregnant uterus. Neither bypass occlusion nor anastomotic aneurysm formation was observed. Pregnancy outcomes of patients with EAVB due to TA are favorable, although pregnancies of patients with TA who have cardiovascular complications are associated with an increased risk of maternal and fetal morbidity. The obstetrical management of these patients, however, should include monitoring for complications related to the EAVB.

  9. 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.

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

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... implementation bargaining (I&I) and/or mid-term bargaining and provide a brief listing of issues, e.g. Smoking... general in nature e.g., smoking policies, or Alternative Work Schedules (AWS). (c) Parties requesting... for grievance mediation. (See item 9.) In item #9. Please give the title of the official, phone...

  11. 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…

  12. 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…

  13. 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)

  14. 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.

  15. Medial pivot knee in primary total knee arthroplasty.

    PubMed

    Atzori, Francesco; Salama, Wael; Sabatini, Luigi; Mousa, Shazly; Khalefa, Abdelrahman

    2016-01-01

    Total knee arthroplasty (TKA) with a medial pivot design was developed in order to mimic normal knee kinematics; the highly congruent medial compartment implant should improve clinical results and decrease contact stresses. Clinical and radiographic mid-term outcomes are satisfactory, but we need other studies to evaluate long-term results and indications for unusual cases.

  16. Plant community composition after 75 years of sustained grazing intensity treatments in shortgrass steppe

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Plant community responses to livestock grazing lack conformity across studies, even those conducted within similar ecosystems. Variability in outcomes is often related to the strong influences of short-term weather patterns, mid-term climatic cycles, differences in the timing and intensity of grazin...

  17. 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…

  18. 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 instructor…

  19. 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…

  20. 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…

  1. 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…

  2. 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…

  3. 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.

  4. Enhancing Student Performance through Cooperative Learning in Physical Sciences

    ERIC Educational Resources Information Center

    Gupta, Madan L.

    2004-01-01

    Students in a physical sciences course were introduced to cooperative learning at the University of Queensland, Gatton Campus. Groups of four to five students worked together in tutorial and practical sessions. Mid-term and practical examinations were abolished and 40% of total marks were allocated to the cooperative learning activities. A peer-…

  5. 31 CFR 50.74 - Collecting the Surcharge.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Collecting the Surcharge. 50.74 Section 50.74 Money and Finance: Treasury Office of the Secretary of the Treasury TERRORISM RISK INSURANCE..., mid-term, and audit premiums for a policy term are subject to the Surcharge in effect on the...

  6. 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.

  7. 76 FR 48758 - 2017-2025 Model Year Light-Duty Vehicle GHG Emissions and CAFE Standards: Supplemental Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-09

    ... vehicles and plug-in hybrid electric vehicles. B. Mid-Term Review Given the long time frame at issue in... hybrid electric vehicles and fuel cell vehicles, and hybrid electric large pickups. In addition, the... Vehicles, Plug-in Hybrid Electric Vehicles, and Fuel Cell Vehicles To facilitate market penetration of...

  8. Economic analysis of the unified heliostat array

    SciTech Connect

    Not Available

    1980-06-13

    Viewgraphs for the mid-term review outline the contract objectives and project details, give optical performance assumptions and constraints, and diagram the methodologies for the performance determination. The method of calculating performance is outlined. The flux distribution over the heliostat field is computed and graphed. (LEW)

  9. 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…

  10. 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…

  11. 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)…

  12. 26 CFR 1.460-6 - Look-back method.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... contract. The discount rate for this purpose is the Federal mid-term rate under section 1274(d) in effect... alternative minimum tax liability) with the actual tax liability for that year. The effect of taking these... applicable regular tax rate is the highest rate of tax in effect for the redetermination year under section...

  13. 26 CFR 1.460-6 - Look-back method.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... contract. The discount rate for this purpose is the Federal mid-term rate under section 1274(d) in effect... alternative minimum tax liability) with the actual tax liability for that year. The effect of taking these... applicable regular tax rate is the highest rate of tax in effect for the redetermination year under section...

  14. 26 CFR 1.460-6 - Look-back method.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... contract. The discount rate for this purpose is the Federal mid-term rate under section 1274(d) in effect... alternative minimum tax liability) with the actual tax liability for that year. The effect of taking these... applicable regular tax rate is the highest rate of tax in effect for the redetermination year under section...

  15. 26 CFR 1.460-6 - Look-back method.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... contract. The discount rate for this purpose is the Federal mid-term rate under section 1274(d) in effect... alternative minimum tax liability) with the actual tax liability for that year. The effect of taking these... applicable regular tax rate is the highest rate of tax in effect for the redetermination year under section...

  16. 26 CFR 1.460-6 - Look-back method.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Federal mid-term rate under section 1274(d) in effect at the time the amount is properly taken into... liability for that year. The effect of taking these items into account in applying the look-back method is... impact method, the applicable regular tax rate is the highest rate of tax in effect for...

  17. Students' Confusions with Reciprocal and Inverse Functions

    ERIC Educational Resources Information Center

    Kontorovich, Igor'

    2017-01-01

    These classroom notes are focused on undergraduate students' understanding of the polysemous symbol of superscript (-1), which can be interpreted as a reciprocal or an inverse function. Examination of 240 scripts in a mid-term test identified that some first-year students struggle with choosing the contextually correct interpretation and there are…

  18. Development of an Academic Alert and Advisement System Using a Participational Governance Structure.

    ERIC Educational Resources Information Center

    Mackin, Sara Lee

    Due to the implementation of new standards for academic progress in Fall 1978 and the resultant suspension of or imposition of credit limitations upon students not meeting these standards, Miami-Dade Community College developed and tested an academic alert program in which computer-generated letters were sent to students at mid-term to provide an…

  19. 29 CFR 4022.81 - General rules.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... thereon for that month using— (i) For months after May 1998, the applicable federal mid-term rate (as... (or, where the rate for a month is not available at the time the PBGC calculates the amount to be recouped or reimbursed, the most recent month for which the rate is available) based on monthly...

  20. 29 CFR 4022.81 - General rules.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... after May 1998, the applicable federal mid-term rate (as determined by the Secretary of the Treasury pursuant to section 1274(d)(1)(C)(ii) of the Code) for that month (or, where the rate for a month is not... which the rate is available) based on monthly compounding; and (ii) For May 1998 and earlier months,...

  1. 29 CFR 4022.81 - General rules.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... after May 1998, the applicable federal mid-term rate (as determined by the Secretary of the Treasury pursuant to section 1274(d)(1)(C)(ii) of the Code) for that month (or, where the rate for a month is not... which the rate is available) based on monthly compounding; and (ii) For May 1998 and earlier months,...

  2. 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…

  3. 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…

  4. 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).

  5. 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...

  6. 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.

  7. GIS Pedagogy, Web-Based Learning and Student Achievement

    ERIC Educational Resources Information Center

    Clark, Andrew M.; Monk, Janice; Yool, Stephen R.

    2007-01-01

    The authors evaluate impacts of web-based learning (WBL) for a geographic information system (GIS) course in which self-paced interactive learning modules replaced lectures to prepare students for GIS laboratory activities. They compare student laboratory, mid-term, final exam and overall scores before and after introduction of WBL, analyzing for…

  8. 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…

  9. Cuisenaire Daily Calendar of a Primary One Teacher. How-I-Did-It.

    ERIC Educational Resources Information Center

    Loomis, Challie

    A teacher's daily record of activities and strategies for teaching arithmetic to a class of first grade students exclusively through the use of Cuisenaire rods is described. Worksheets and the mid-term test are included. A short evaluation of the results of the instructional method concludes the paper. (DT)

  10. 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.

  11. Pudendal nerve decompression in perineology : a case series

    PubMed Central

    Beco, Jacques; Climov, Daniela; Bex, Michèle

    2004-01-01

    Background Perineodynia (vulvodynia, perineal pain, proctalgia), anal and urinary incontinence are the main symptoms of the pudendal canal syndrome (PCS) or entrapment of the pudendal nerve. The first aim of this study was to evaluate the effect of bilateral pudendal nerve decompression (PND) on the symptoms of the PCS, on three clinical signs (abnormal sensibility, painful Alcock's canal, painful "skin rolling test") and on two neurophysiological tests: electromyography (EMG) and pudendal nerve terminal motor latencies (PNTML). The second aim was to study the clinical value of the aforementioned clinical signs in the diagnosis of PCS. Methods In this retrospective analysis, the studied sample comprised 74 female patients who underwent a bilateral PND between 1995 and 2002. To accomplish the first aim, the patients sample was compared before and at least one year after surgery by means of descriptive statistics and hypothesis testing. The second aim was achieved by means of a statistical comparison between the patient's group before the operation and a control group of 82 women without any of the following signs: prolapse, anal incontinence, perineodynia, dyschesia and history of pelvi-perineal surgery. Results When bilateral PND was the only procedure done to treat the symptoms, the cure rates of perineodynia, anal incontinence and urinary incontinence were 8/14, 4/5 and 3/5, respectively. The frequency of the three clinical signs was significantly reduced. There was a significant reduction of anal and perineal PNTML and a significant increase of anal richness on EMG. The Odd Ratio of the three clinical signs in the diagnosis of PCS was 16,97 (95% CI = 4,68 – 61,51). Conclusion This study suggests that bilateral PND can treat perineodynia, anal and urinary incontinence. The three clinical signs of PCS seem to be efficient to suspect this diagnosis. There is a need for further studies to confirm these preliminary results. PMID:15516268

  12. 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.

  13. Platelet-rich plasma versus open surgical release in chronic tennis elbow: A retrospective comparative study

    PubMed Central

    Karaduman, Mert; Okkaoglu, Mustafa Caner; Sesen, Hakan; Taskesen, Anil; Ozdemir, Mahmut; Altay, Murat

    2016-01-01

    Purpose To compare short and mid-term results in the treatment of chronic elbow tendinosis with platelet-rich plasma (PRP) or Nirschl surgical technique. Method A retrospective study was conducted on patients with chronic lateral epicondylitis, treated by Nirschl surgical technique (50 elbows) or PRP (60 elbows). Outcome was evaluated with Visual Analog Score (VAS), Mayo Elbow Scores and grip strength measurements. Results VAS and Mayo Elbow Scores of the PRP group had improved as a mean of 83% (p = 0.0001), 74% (p = 0.0001) over baseline and 34.2 pounds gain of grip strength. Conclusion The PRP seems to be better for pain relief and functionality in the short and mid-term periods. PMID:26955228

  14. Acute Iliac Artery Rupture: Endovascular Treatment

    SciTech Connect

    Chatziioannou, A.; Mourikis, D.; Katsimilis, J.; Skiadas, V. Koutoulidis, V.; Katsenis, K.; Vlahos, L.

    2007-04-15

    The authors present 7 patients who suffered iliac artery rupture over a 2 year period. In 5 patients, the rupture was iatrogenic: 4 cases were secondary to balloon angioplasty for iliac artery stenosis and 1 occurred during coronary angioplasty. In the last 2 patients, the rupture was secondary to iliac artery mycotic aneurysm. Direct placement of a stent-graft was performed in all cases, which was dilated until extravasation was controlled. Placement of the stent-graft was successful in all the cases, without any complications. The techniques used, results, and mid-term follow-up are presented. In conclusion, endovascular placement of a stent-graft is a quick, minimally invasive, efficient, and safe method for emergency treatment of acute iliac artery rupture, with satisfactory short- and mid-term results.

  15. 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.

  16. The U.S. Army Energy and Water Campaign Plan for Installations. Fiscal Year 2008 - Fiscal Year 2013

    DTIC Science & Technology

    2006-08-01

    Campaign Plan defines the actions, the short-term, mid-term, and long-term approaches, and the tools, technologies and projects required to ensure the Army... define location and staffing of the installation energy office FY 2007 Develop standardized job descriptions FY 2007 Develop Army-specific energy...that have established an active energy management accountability network as demonstrated by conducting quarterly energy committee meetings. b. The

  17. Mammalian Toxicity of Munition Compounds. Phase III. Effects of Lifetime Exposure. Part I. 2,4-Dinitrotoluene

    DTIC Science & Technology

    1979-11-01

    these mice had a toxic nephropathy , excessive pigmentation, liver dysplasia, and (in the males) renal tumors not seen in the control mice. The middle dose...control) for 10 or 13 weeks, as specified below. Each male was then mated to two virgin females of the same strain. At mid-term of pregnancy , the females...treatment for longer periods; they will be discussed later. Senile nephropathy was seen earlier in che high dose rats, but this is a normal lesion in

  18. National Test Bed Security and Communications Architecture Working Group Report

    DTIC Science & Technology

    1992-04-01

    PtKMITS NETWOItK CONSOl II )A I ION • IMPROVES SIIRVIVAHIIITY lirOIICLS MANAGEMENT OVERHEAD NOW MID-TERM FUTURE CFE SDNS OVERLAY NETWORK SECURITY...Architecture 2. This approach employs the Government-developed BLACKER Front End (BFE) or CANEWARE Front End ( CFE ) devices as the interface between single-level...LANs (or hosts) and a packet switched network. BFE and CFE systems provide Type 1 encryption as well as computer security features.. (3

  19. 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.

  20. JPDO Portfolio Analysis of NextGen

    DTIC Science & Technology

    2009-09-01

    various phases of maturity and implementation, the EA will continually be refined. Refinements include iterative enhancements to critical OIs and...It is consistent with the FAA’s plans through the mid-term period (approximately 2015-2018). This alternative still requires enhanced avionics, but...Surveillance Radars and Navigation Backup E- LORAN Backup Conventional Surveillance Radars and Navigation Backup Full Weather Information

  1. Misogyny in heart disease?

    PubMed

    Silva, Rafael C; Lemos, Pedro A

    2015-04-01

    Overall, mid-term outcomes of edge-to-edge mitral valve repair with the MitraClip system do not seem to be markedly affected by gender. Nevertheless, there seems to be subtle differences in the results of men and women treated with MitraClip, which might affect patient selection and therapeutic strategy. Further studies with larger sample sizes are required to fully assess the potential differences in specific subsets.

  2. 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…

  3. Report on activities of the Sub-Working Group 1 "Precession/Nutation" of the IAU/IAG Joint Working Group on Theory of Earth Rotation.

    NASA Astrophysics Data System (ADS)

    Getino, J.; Escapa, A.

    2015-08-01

    This is the mid-term report of the Sub-WG1 of the IAU/IAG Joint Working Group on Theory of Earth Rotation (JWG ThER). The main objectives are (1) to provide some feasible enhancements of current precession/nutation model; (2) to give a list of potential future improvements of that model provided by the contributors of the subgroup, and (3) to raise out some open questions which should be discussed within the JWG ThER.

  4. Russia and the European Union: The Sources and Limits of "Special Relationships"

    DTIC Science & Technology

    2007-02-01

    Russia, 2002, 2003, 2005. 43. EBRD Transition Reports; and Cynthia Roberts and Thomas Sherlock , “Bringing the Russian State Back In,” Comparative...April 2006, pp. 69-82, at p. 69. 104 146. Chris Holmes , “Atlantic Basin, Mideast Adequate to Supply Europe, US in Mid-Term,” Oil and Gas Journal’s...Limits of Partial Integration.” Aktualnye problemy Evropy (Urgent Problems of Europe). Vol. 4, 2004, pp. 87-113. _______ and Thomas Sherlock

  5. Brain Structure-Function Couplings: Year 2 Accomplishments and Programmatic Plans

    DTIC Science & Technology

    2013-06-01

    performance through individual-specific neurotechnologies and enhance Soldier protection technologies to minimize neural injury. The long-term vision of this...envision pathways that enable our basic science accomplishments to foster development of revolutionary Soldier neurotechnologies and Soldier protection...improve Soldier-system performance with Soldier-specific neurotechnologies . We expect mid-term impact with models linking structure and function that can

  6. A Crude Reality; Exploring the Interdependencies of Energy (Oil), the Macro-Economy, and National Security

    DTIC Science & Technology

    2012-04-11

    imported oil rather than on the more stable and available domestic energy resources such as coal, natural gas, hydroelectric , nuclear, and renewable...This is difficult to determine with certainty. Wide variations are reported, and politicians from all persuasions use statistics and terms to suit...attractive, have the potential to speed along the transformation. Like it or not, our economy is tied to oil for the near- and mid-term future. The

  7. Rare associations of tetralogy of Fallot with anomalous left coronary artery from pulmonary artery and totally anomalous pulmonary venous connection.

    PubMed

    Sen, Supratim; Rao, Suresh G; Kulkarni, Snehal

    2016-06-01

    We describe the cases of two patients with tetralogy of Fallot, aged 4 years and 8 months, who were incidentally detected to have concomitant anomalous left coronary artery from pulmonary artery and total anomalous pulmonary venous connection, respectively, on preoperative imaging. They underwent surgical correction with good mid-term outcomes. In this study, we discuss the embryological basis, physiological effects, and review the literature of these two unusual associations. Awareness of these rare associations will avoid missed diagnoses and consequent surgical surprises.

  8. 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…

  9. 2011 Army Strategic Planning Guidance

    DTIC Science & Technology

    2011-03-25

    TESI ) of 22,000 Soldiers, the Army’s total force by the end of the mid-term period is programmed to be 520K (AC). We will achieve a more...dwell ratios, extending TESI authority to adequately man deploying units and sustain the All-Volunteer Force, right-sizing the generating force, and... TESI Temporary End-Strength Increase WMD Weapons of Mass Destruction 2011 ARMY STRATEGIC PLANNING GUIDANCE Page 19 2011

  10. [Evaluation of aortic valve replacement involving small severely calcified aortic annulus in elderly patients].

    PubMed

    Iwahashi, M; Nishimura, Y; Hiramatsu, K; Komori, S; Shibata, M; Yuzaki, M; Okamura, Y

    2006-04-01

    We performed aortic valve replacement in 24 patients aged over 70 with small calcified valves. The surgical management of such patients remains controversial as the extensive calcification compromises implantation. Hence, we used an ultrasonic debridement instrument to remove calcium and selected a small prosthesis with the largest possible orifice without enlargement of the aortic annulus. Echocardiography showed significant reductions in left ventricular mass index compared with preoperative values. Early and mid-term prognosis has been relatively good.

  11. An Effect of Unstructured Evaluation on Academic Integrity.

    ERIC Educational Resources Information Center

    Marsh, Robert

    An attempt was made to determine whether student honesty is affected by a take-home test, referred to as an unstructured evaluation. A group of 27 students in a history class at a university was given a teacher-made take-home test as a mid-term examination. A second group of 27 students was given the same examination in class. Unknown to the…

  12. International Intelligence Forum 2005, Africa: Perspectives on Multinational Intelligence Cooperation in Africa

    DTIC Science & Technology

    2005-06-01

    AT THE FIELD LEVEL Intelligence in the field filters through the Joint Operations Centre (JOC) and the Joint Mission Analysis Cell ( JMAC ), a newly...established concept in peacekeeping. While the JOC is providing the watch and emergency response capacity in military terms, the JMAC provides for the...and diplomatic sources. As a mission tool, the JMAC should be capable of providing in-depth current and mid-term analysis on issues affecting the

  13. Evaluation, Analysis, and Documentation Support for the 10kW Signature Suppressed Lightweight Electric Energy Plant (SLEEP)

    DTIC Science & Technology

    1988-03-14

    Energy Plant,ý ~{ ~ LF &E Mobile Electric Power,’ Engine Generators,’ Free PPiston Stirling Engine," Kinematic Stirling Engine;(Continued) k19. ABTAT...Kinematic Stirling technologies are projected to be excellent candidates for development. Stirling is a mid-term technologyI that is projected to meet all...for the Signature Suppressed, Lightweight Electric Energy Plant (SLEEP). The SLEEP requirement identifies a family of lightweight, compact, mobile

  14. 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.

  15. 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.

  16. WE Are the Interagency: Exercising a Comprehensive Approach to Crisis Action and Conflict Termination and Stabilization.

    DTIC Science & Technology

    2010-12-01

    CapabilitiesRequired: Water/sanitation, shelter, food , health, security, access, logistics, communication • Risk: JTF medical assets becomefocus for medical...supplyat the expense of HN infrastructure • Duration: Major combat ops or follow-on security ops Mid-TermEffort: • Lead: HN ( MOH , Ministryof Refugees...Internally DisplacedPersons) • Supporting Effort: Donors, NGOs, IGOs, JTF • CapabilitiesRequired: Water/sanitation, shelter, food , health, security

  17. [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.

  18. [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.

  19. Testosterone therapy, thrombosis, thrombophilia, cardiovascular events.

    PubMed

    Glueck, Charles J; Wang, Ping

    2014-08-01

    There are similar time intervals between starting testosterone therapy (TT) and development of thrombotic (~4.5 months) or cardiovascular (CVD) events (~3 months) which may, speculatively, reflect a shared pathophysiology. We have described thrombotic events 5 months (median) after starting TT in 38 men and 4 women, including 27 with deep venous thrombosis-pulmonary embolism, 12 with osteonecrosis, 1 with central retinal vein thrombosis, 1 with amaurosis fugax, and 1 with spinal cord infarction. In 8 men whose TT was continued, second thrombotic events occurred despite adequate anticoagulation with Coumadin in 8 men, 3 of whom had a third thrombotic event. Of these 42 cases, 40 had measures of thrombophilia-hypofibrinolysis, and 39 were found to have previously undiagnosed thrombophilia-hypofibrinolysis. Before beginning TT, especially in men with previous history of thrombotic events, we suggest that, at a minimum, measurements be made for the Factor V Leiden and Prothrombin mutations, Factors VIII and XI, and homocysteine, to identify men who should not receive TT. We need prospective data focused on whether there should be pre-TT screening based on history of previous venous thromboembolism or for all subjects for major gene thrombophilias. To better resolve questions about TT and all cause and cardiovascular morbidity and mortality and thrombosis, a long term, prospective, randomized, blinded study following the example of the Women's Health Initiative is needed. While we wait for prospective placebo-controlled TT outcome data, TT should be restricted to men with well-defined androgen deficiency syndromes.

  20. Clinical results of carotid artery stenting versus carotid endarterectomy

    PubMed Central

    Akinci, Tuba; Derle, Eda; Kibaroğlu, Seda; Harman, Ali; Kural, Feride; Cınar, Pınar; Kilinc, Munire; Akay, Hakki T.; Can, Ufuk; Benli, Ulku S.

    2016-01-01

    Objective: To review our results of carotid artery stenting (CAS) and carotid endarterectomy (CEA). Methods: We evaluated the medical records of patients undergoing carotid artery revascularization procedure, between 2001 and 2013 in Baskent University Hospital, Ankara, Turkey. Carotid artery stenting or CEA procedures were performed in patients with asymptomatic carotid stenosis (≥70%) or symptomatic stenosis (≥50%). Demographic data, procedural details, and clinical outcomes were recorded. Primary outcome measures were in 30-day stroke/transient ischemic attacks (TIA)/amaurosis fugax or death. Secondary outcome measures were nerve injury, bleeding complications, length of stay in hospital, stroke, restenosis (ICA patency), and all-cause death during long-term follow-up. Results: One hundred ninety-four CEA and 115 CAS procedures were performed for symptomatic and/or asymptomatic carotid artery stenosis. There is no significant differences 30-day mortality and neurologic morbidity between CAS (13%) and CEA procedures (7.7%). Length of stay in hospital were significantly longer in CEA group (p=0.001). In the post-procedural follow up, only in symptomatic patients, restenosis rate was higher in the CEA group (p=.045). The other endpoints did not differ significantly. Conclusions: Endovascular stent treatment of carotid artery atherosclerotic disease is an alternative for vascular surgery, especially for patients that are high risk for standard CEA. The increasing experience, development of cerebral protection systems and new treatment protocols increases CAS feasibility. PMID:27744460

  1. Antiphospholipid syndrome in Latin American patients: clinical and immunologic characteristics and comparison with European patients.

    PubMed

    García-Carrasco, M; Galarza, C; Gómez-Ponce, M; Cervera, R; Rojas-Rodríguez, J; Espinosa, G; Bucciarelli, S; Gómez-Puerta, J A; Bové, A; Escárcega, R O; Font, J

    2007-01-01

    The objective of this study was to analyse the prevalence and characteristics of the main clinical and immunological manifestations at the onset and during the evolution of the disease in a cohort of patients from Latin America (mainly of mestizo origin) and to compare the Latin American with the European patients. Clinical and serological characteristics of 100 APS patients from Mexico and Ecuador were collected in a protocol form that was identical to that used to study the ;Euro-Phospholipid' cohort. The cohort consisted of 93 female patients (93.0%) and seven (7.0%) male patients. There were 91 mestizos (91.0%), seven whites (7.0%) and two Amerindians (2.0%). The most common manifestations were livedo reticularis (40.0%), migraine (35.0%), inferior extremity deep vein thrombosis (32.0%), thrombocytopenia (28.0%) and hemolytic anemia (20.0%). Several clinical manifestations were more prevalent in Latin American than in European patients and they included mainly neurological (migraine, transient global amnesia, acute ischemic encephalopathy, amaurosis fugax) and cutaneous (livedo reticularis, skin ulcerations, superficial cutaneous necrosis, multiple subungual splinter hemorrhages) manifestations as well as hemolytic anemia. The APS has a wide variety of clinical and immunological manifestations at the onset and during the evolution of the disease and the ethnic origin in addition to environmental and socioeconomic factors can modify the disease expression.

  2. 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

  3. The CHAT classification of stroke.

    PubMed

    Bernstein, E F; Browse, N L

    1989-02-01

    Current terminology for clinical episodes relating to stroke is inconsistent and unclear, does not permit inclusion of data regarding the location and magnitude of extracranial and intracerebral arterial disease, does not coincide with existing classifications in Europe, and characterizes a hemispheric entity only, as opposed to a global description including prior symptoms in both hemispheres. A new classification system (CHAT) has been designed to deal with these problems, including the current clinical presentation, historical clinical episodes, the site and pathologic type of arterial disease, and information regarding abnormalities of the brain. Using this system, a retrospective review of 480 consecutive carotid endarterectomies is presented, demonstrating the advantages of the CHAT classification. Data include a significant difference in the probability of survival after carotid endarterectomy for asymptomatic stenosis in patients with prior symptoms on the opposite side, as well as a significant difference in the probability of stroke-free survival between patients with amaurosis fugax and those with prior carotid cortical symptoms (TIAs) as the presenting clinical condition. The CHAT classification is suggested as a significant advance in the reporting of all surgical cerebrovascular disease experience, and has particular implications for the current randomized trials between medical and surgical therapy for carotid artery disease.

  4. 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

    2013-05-02

    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).

  5. Computer-based programmes for the prevention and management of illicit recreational drug use: a systematic review.

    PubMed

    Wood, Sara K; Eckley, Lindsay; Hughes, Karen; Hardcastle, Katherine A; Bellis, Mark A; Schrooten, Jochen; Demetrovics, Zsolt; Voorham, Lotte

    2014-01-01

    The last few decades have seen increasing use of computer-based programmes to address illicit recreational drug use but knowledge about their effectiveness is limited. We conducted a systematic review to examine evidence on these programmes. Eight electronic databases were searched to identify primary research studies evaluating computer-based programmes to prevent or reduce use of illicit recreational drugs. From an initial 3413 extracted studies, 10 were identified for inclusion, covering a range of intervention types, target groups and settings. Universal drug prevention programmes were effective in reducing the frequency of recreational drug use in the mid-term (<12 months), but not immediately post intervention. Programmes targeting recreational drug users showed more inconsistent results but were generally effective in reducing use of drugs both immediately and in the mid-term. Computer-based programmes have the potential for use in addressing recreational drug use when targeted both universally and at illicit drug users, at least in the mid-term. However, longer term evaluations are needed to better understand the duration of effects. Given the benefits that computer-based programmes can have over traditional delivery methods, research is needed to better understand the value of human contact in health interventions and help inform whether, and how much, professional contact should be involved in computer-based programmes.

  6. Highly potent stem cells from full-term amniotic fluid: A realistic perspective.

    PubMed

    Hamid, Adila A; Joharry, Muhammad Khair; Mun-Fun, Hoo; Hamzah, Siti Nurusaadah; Rejali, Zulida; Yazid, Mohd Nazri; Karuppiah, Thilakavathy; Nordin, Norshariza

    2017-03-01

    Amniotic fluid (AF) is now known to harbor highly potent stem cells, making it an excellent source for cell therapy. However, most of the stem cells isolated are from AF of mid-term pregnancies in which the collection procedure involves an invasive technique termed amniocentesis. This has limited the access in getting the fluid as the technique imposes certain level of risks to the mother as well as to the fetus. Alternatively, getting AF from full-term pregnancies or during deliveries would be a better resolution. Unfortunately, very few studies have isolated stem cells from AF at this stage of gestation, the fluid that is merely discarded. The question remains whether full-term AF harbors stem cells of similar potency as of the stem cells of mid-term AF. Here, we aim to review the prospect of having this type of stem cells by first looking at the origin and contents of AF particularly during different gestation period. We will then discuss the possibility that the AF, at full term, contains a population of highly potent stem cells. These stem cells are distinct from, and probably more potent than the AF mesenchymal stem cells (AF-MSCs) isolated from full-term AF. By comparing the studies on stem cells isolated from mid-term versus full-term AF from various species, we intend to address the prospect of having highly potent amniotic fluid stem cells from AF of full-term pregnancies in human and animals.

  7. Comparison of real-world clinical outcomes between Cypher- and Taxus-eluting stents: the GARA-GARA study.

    PubMed

    Fukumoto, Atsushi; Otsuji, Satoru; Takiuchi, Shin; Ikushima, Masashi; Asano, Katsuaki; Terasoma, Kunihiko; Hasegawa, Katsuyuki; Yabuki, Masanori; Higashino, Yorihiko

    2011-09-01

    To evaluate real-world outcomes of PCI in unselected individuals using sirolimus-eluting (SESs) or paclitaxel-eluting stents (PESs) in a single-center randomized trial. Eight hundred consecutive patients (919 lesions) with coronary artery disease were randomized to receive SES or PES implantation. In-hospital, mid-term, and 1-year clinical and angiographical outcomes in both groups were compared. MACEs were defined as cardiac death, myocardial infarction, CABG and target vessel revascularization (TLR). Follow-up angiography was performed in 80.7% of patients. The baseline clinical characteristics were similar in both groups. Pre- and postprocedural reference vessel diameter, minimum length diameter, and diameter stenosis (%DS) were similar in both groups, as was incidence of in-hospital and mid-term MACEs. SESs significantly reduced the risk of TLR, compared with PESs (SES = 5.5%, PES = 10.5%). The superiority of SESs for TLR was also demonstrated with regard to small vessel lesions (stent diameter <2.5 mm) (SES = 6.0%, PES = 15.9%), whereas larger vessel (stent diameter >2.5 mm) lesions did not differ between groups (SES = 5.3%, PES = 8.4%). The safety and efficacy of both DESs were nearly equivalent. SESs, however, were superior to PESs in reducing mid-term TLR, particularly in the small vessel lesion subsets.

  8. 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

  9. 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.

  10. Primary subtalar arthrodesis for the treatment of comminuted intra-articular calcaneal fractures.

    PubMed

    Potenza, V; Caterini, R; Farsetti, P; Bisicchia, S; Ippolito, E

    2010-07-01

    We report the short- and mid-term results in six patients (seven feet) affected by markedly comminuted intra-articular calcaneal fractures (Sanders type IV), treated by primary subtalar arthrodesis. The average age at surgery was 40 years. In all patients, arthrodesis of the subtalar joint was performed using a limited lateral approach to the calcaneus; it was stabilised with two or three cannulated screws. No patient had a preliminary reduction and internal fixation of the fracture. The time from injury to surgery averaged 20 days because all of the patients had associated visceral and/or other skeletal injuries. All of the patients were followed up clinically and radiographically 2 times, at an average of 12 months and 53 months after surgery. At the short-term follow-up, the mean AOFAS score was 70 points; the X-rays showed a complete fusion of the subtalar joint in all seven feet, without any sign of osteoarthritis of the calcaneo-cuboid and the talo-navicular joints. In all cases, an altered shape of the calcaneus was present. At the mid-term follow-up, the mean AOFAS score increased to 85 points; in one patient, radiographic signs of osteoarthritis of the calcaneo-cuboid and the talo-navicular joints were present and, in another patient, only talo-navicular joint was present, although both patients were free from pain. The difference between the two AOFAS scores was statistically significant. We believe that primary subtalar arthrodesis performed for markedly comminuted Sanders type IV calcaneal fractures yielded good mid-term results, and it is especially indicated when surgical treatment is delayed for whatever reason. A preliminary open reduction and internal fixation to restore the normal height of the calcaneus before performing the subtalar arthrodesis, as suggested by several authors, does not seem indispensable to obtain good clinical results.

  11. Titanium-nitride-oxide-coated coronary stents: insights from the available evidence.

    PubMed

    Karjalainen, Pasi P; Nammas, Wail

    2016-11-12

    Coating of stent surface with a biocompatible material is suggested to improve stent safety profile. A proprietary process was developed to coat titanium-nitride-oxide on the stent surface, based on plasma technology that uses the nano-synthesis of gas and metal. Preclinical in vitro and in vivo investigation confirmed blood compatibility of titanium (nitride-) oxide films. Titanium-nitride-oxide-coated stents demonstrated a better angiographic outcome, compared with bare-metal stents at mid-term follow-up; however, they failed to achieve non-inferiority for angiographic outcome versus second-generation drug-eluting stents. Observational studies showed adequate clinical outcome at mid-term follow-up. Non-randomized studies showed an outcome of titanium-nitride-oxide-coated stents comparable to - or better than - first-generation drug-eluting stents at long-term follow-up. Two randomized controlled trials demonstrated comparable efficacy outcome, and a better safety outcome of titanium-nitride-oxide-coated stents versus drug-eluting stents at long-term follow-up. Evaluation by optical coherence tomography at mid-term follow-up revealed better neointimal strut coverage associated with titanium-nitride-oxide-coated stents versus drug-eluting stents; yet, neointimal hyperplasia thickness was greater. Key messages Stents coated with titanium-nitride-oxide demonstrated biocompatibility in preclinical studies: they inhibit platelet and fibrin deposition, and reduce neointimal growth. In observational and non-randomized studies, titanium-nitride-oxide-coated stents were associated with adequate safety and efficacy outcome. In randomized trials of patients with acute coronary syndrome, titanium-nitride-oxide-coated stents were associated with a better safety outcome, compared with drug-eluting stents; efficacy outcome was comparable.

  12. 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.

  13. Drug-Coated Balloons: Current Outcomes and Future Directions.

    PubMed

    Kondapalli, Ananya; Danek, Barbara A; Khalili, Houman; Jeon-Slaughter, Haekyung; Banerjee, Subhash

    2017-04-01

    Paclitaxel-coated drug-coated balloons have significantly improved short-term and mid-term clinical outcomes in patients with symptomatic femoropopliteal peripheral artery disease. However, long-term results are awaited. Furthermore, the clinical success of drug-coated balloons in the infrapopliteal peripheral arteries has been more modest and overall similar to traditional balloon angioplasty, and remains an area of unmet clinical need. This article provides an overview of the clinical evidence for paclitaxel-coated balloons in the femoropopliteal and infrapopliteal peripheral artery distributions and future directions in this area.

  14. Monitoring the Heavens, Today, and Tomorrow

    NASA Technical Reports Server (NTRS)

    Johnson, Nicholas L.

    2006-01-01

    The current Earth satellite population in LEO for all sizes is relatively well-established by a combination of deterministic and statistical means. At higher altitudes, the population of satellites with diameters of less than 1 m is not well defined. Although a few new sensors might become operational in the near- to mid-term, no major improvement in environment characterization is anticipated during this period. With the increasing deployment of micro- and pico-satellites and with the continued growth of the small debris population, a need exists for better space surveillance to support spacecraft design and operations.

  15. 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)

  16. Business aspects and sustainability for healthgrids - an expert survey.

    PubMed

    Scholz, Stefan; Semler, Sebastian C; Breitner, Michael H

    2009-01-01

    Grid computing initiatives in medicine and life sciences are under pressure to prove their sustainability. While some first business model frameworks were outlined, few practical experiences were considered. This gap has been narrowed by an international survey of 33 grid computing experts with biomedical and non-biomedical background on business aspects. The experts surveyed were cautiously optimistic about a sustainable implementation of grid computing within a mid term timeline. They identified marketable application areas, stated the underlying value proposition, outlined trends and specify critical success factors. From a general perspective of their answers, they provided a stable basis for a road map of sustainable grid computing solutions for medicine and life sciences.

  17. Multi-Team and Multi-Organization Systems

    DTIC Science & Technology

    2009-11-01

    par- tenariat, la structure de contrôle et de cooperation et la dynamique de l’adhésion. Les coûts et les avantages de chaque type de système...et de coopération, et la dynamique de l’adhésion. Les coûts et les avantages de chaque type de système multi-organisationnel sont discutés...formation responds to precise organizational objectives, which are short or mid-term operational goals, group creation is more vaguely based on a

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. [Control situation and primary task of key parasitic diseases in China].

    PubMed

    Lei, Zheng-long; Wang, Li-ying

    2012-02-29

    In the "11th Five-year Plan" period, China unveiled a mid-term planning on the control of the key parasitic diseases, including schistosomiasis, malaria, echinococcosis (hydatid disease), as well as some other parasitic diseases. It clarifies the goals on the control of the major parasitic diseases in the national control program during the "12th Five-year' Plan" period (2011-2015) , formulates current main tasks based on analyzing the progress of the national control program on key parasitic diseases, in order to meet the challenges appearing in the future implementation.

  3. Mammalian Toxicity of Munitions Compounds Phase III: Effects of Life-Time Exposure Part II: Trinitroglycerin

    DTIC Science & Technology

    1978-11-01

    below. Each male was then mated to two virgin females of the same strain. At mid-term of pregnancy , the femalesr : were killed and the following data...i.. Kidney Chronic senile nephropathy 1 4 1 3 3 4 1 2 I 4 4 4 3 Hydronephrousl 1 1 I Tubular nephrosi’ 1 fyrl.njphrit...Intest’ne 0 r Kidnov Chrounlo waoLle nephropathy 2 4 1 1 3 1 Foci of monocuclear cells 1 1 1 UrinarX !ledder

  4. 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.

  5. The `advanced DIR-MCFC development' project, an overview

    NASA Astrophysics Data System (ADS)

    Kortbeek, P. J.; Ottervanger, R.

    An overview is given of the approach and mid-term status of the joint European `Advanced DIR-MCFC Development' project, in which BCN, BG plc, GDF, ECN, Stork, Schelde and Sydkraft co-operate. Hospitals are identified as an attractive initial market for cogeneration direct internal reforming-molten carbonate fuel cell (DIR-MCFC) systems in the size of 400 kWe. Innovative system and stack design concepts are being developed for this application. The `SMARTER' system, based on DIR stacks, combines high electric efficiency and a wide operational window with optimal system simplicity and low cost.

  6. 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.

  7. U.S. Leadership Perceptions of the Soviet Problem Since 1945.

    DTIC Science & Technology

    1982-03-01

    Harry S . Truman, Memoirs: Year of Decisions, Vol. 1, Doubleday and Company, Inc., Garden City, N.Y., 1955, pp. 555-556. I 20 Balanced Force Reductions...in literature.8 NSC 68’ s stress on the inherently defective nature of the Soviet Union has since become characteristic of most hard management...18lInterview in G. R. Urban, Detente (Temple, Smith, London, 1976), quoted in Coral Bell , "Virtue Unrewarded: Carter’s Foreign Policy at Mid-Term

  8. Development of Ductile Cr-Re Alloys for High Temperature Application in Aggresive Atmosphere

    DTIC Science & Technology

    2007-11-02

    to 1600°C) – Joining and welding – Resistance to propellant – Thermomechanical fatigue The demonstration alloys Cr-35ReCr-18Re Manufacturing method... Heating kinetics of 500 K/s (700 cycles) Materials history 1960 Cobalt base 800 °C 1970 Nickel base 1000 °C 1990 Platinum base 1700 °C Investigated...Powder Metallurgy VS Ingot Metallugy – Short to mid term: Ingot Metallurgy · Prototype alloys by Arc Melting · Production by Induction Melting and

  9. [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.

  10. Advanced Cryo-Tanks Structural Design Investigated in CHATT

    NASA Astrophysics Data System (ADS)

    Sippel, Martin; Kopp, Alexander; Mattsson, David; Koussios, Sotiris

    2014-06-01

    An EU-funded study called CHATT (Cryogenic Hypersonic Advanced Tank Technologies) has been initiated early 2012 and recently passed its mid-term milestone. The project CHATT is part of the European Commission's Seventh Framework Programme and run on behalf of the Commission by DLR-SART in a multinational collaboration. One of the core objectives is to investigate Carbon Fiber Reinforced Plastic (CFRP) cryogenic pressure tanks. Four different subscale CFRP-tanks are planned to be designed, manufactured, and tested.The paper outlines the study logic of CHATT, gives a presentation of the technology development tasks, and summarizes available research results on the liner testing and CFRP-tank manufacturing.

  11. Involvement of Lipid Metabolism in the Action of Phospholipase A2 Neurotoxins

    DTIC Science & Technology

    1993-12-03

    into synaptosomes a) the time course of choline uptake b) the effects of temperature on choline uptake c) the kinetics ( K ., V.) of choline uptake d) the...yielding a single high affinity choline uptake process with a K . of 4/1M (37"C, 4 min; see Figure 2 in Mid-Term Report). The viability of the choline...reflect the normally released pools of ACh. Therefore, in collaboration with Dr. Robert Storella (Hahnemann University, PA), we have examined the

  12. Grammont inverted prosthesis for the treatment of cuff tear arthropathy: a 6-year follow-up study.

    PubMed

    de Cupis, Vincenzo; Chillemi, Claudio; Marinelli, Mario

    2008-05-01

    This study evaluated mid-term functional results of the Grammont inverted prosthesis for the treatment of shoulder osteoarthritis associated with massive cuff rupture. Twenty-eight patients with a minimum of 6 years of follow-up were evaluated. Clinical evaluation was performed on all patients preoperatively and at follow-up using the Constant score. Radiologic assessment included radiographs and magnetic resonance imaging preoperatively and radiographs at follow-up. Constant score improved from 27.4 preoperatively to 64.6 postoperatively. The inverted prosthesis is attractive and remains one of the options for treating cuff tear arthropathy. However, glenoid loosening remains a serious problem.

  13. 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)

  14. 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).

  15. [Implantation of an automatic cardioverter-defibrillator in small children--two case reports].

    PubMed

    Przybylski, Andrzej; Kucińska, Beata; Grabowski, Krzysztof; Sterliński, Maciej; Wróblewska-Kałuzewska, Maria; Szwed, Hanna

    2004-07-01

    Implantation of an automatic cardioverter-defibrillator (ICD) in children may be challenging due to the increased risk of periprocedural and long-term complications. ICD was implanted in two boys with hypertrophic cardiomyopathy, aged 6 and 9 years, with of a body weight of 20 and 25 kg, respectively. In one patient an ICD was implanted due to a history of ventricular fibrillation whereas the second patient underwent prophylactic ICD implantation due to a family history of sudden cardiac death. No short- or mid-term complications were recorded. Difficulties and risks of ICD implantation in children are discussed.

  16. 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.

  17. 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

  18. 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).

  19. 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.

  20. 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

  1. Features and impacts of five multidisciplinary community-university research partnerships.

    PubMed

    King, Gillian; Servais, Michelle; Forchuk, Cheryl; Chalmers, Heather; Currie, Melissa; Law, Mary; Specht, Jacqueline; Rosenbaum, Peter; Willoughby, Teena; Kertoy, Marilyn

    2010-01-01

    Despite the increasing number of multidisciplinary community-university research partnerships designed to address real-world issues, little is known about their nature. This article describes the features and impacts of five research partnerships addressing health or social service issues, which constituted a convenience sample from the province of Ontario, Canada. The article describes their characteristics, ways of operating, outputs, types of requests received from community members and mid-term impacts. Requests directed to partnerships were tracked over a 10-month period in 2003 to 2004, using a research contact checklist, and 174 community members later completed an impact questionnaire capturing perceptions of the impacts of the partnerships on personal knowledge and research skill development, organisational/group access to and use of information, and community and organisational development. The data indicated that partnerships had similar priorities and magnitudes of mid-term impacts, yet differed in the scope of their partnering, realm of intended influence and the number of mechanisms used to engage and communicate with target audiences. The partnerships produced different types of outputs and received different types of requests from community members. The findings inform researchers about partnership diversity and help to establish more realistic expectations about the magnitude of partnerships' impacts.

  2. FY 90 annual research plan

    SciTech Connect

    Not Available

    1990-01-01

    The National Institute for Petroleum and Energy Research (NIPER) was established by the DOE to perform contract research for government and industrial clients. The emphasis of the DOE program is immediate near- and mid-term concerns of domestic oil and gas producibility. Its primary purpose is to improve the fundamental understanding of domestic oil and gas resources and the chemical, physical, and biological phenomena that govern the occurrence and recovery of these resources in addition to their associated environmental issues. The near-term objective of the DOE program is to maintain access to resources presently being produced in domestic oil and gas fields, and to decrease the rate of decline of domestic production. NIPER projects in chemical flooding, gas injection, steam injection, and microbial EOR address near-term concerns of domestic oil production. Further, problems associated with the utilization of heavier fossil feedstocks are being addressed. The mid-term objective of the DOE program is to maximize the recovery efficiency of discovered oil and gas through improved understanding of the resource and to develop advanced extraction and instrumentation techniques. The objective also emphasizes an expanded understanding of the environment. NIPER projects dealing with the quantification of reservoir heterogeneities, pore structure analysis, and fluid flow in porous media are designed to improve extraction technologies. 3 figs., 3 tabs.

  3. 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

  4. 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.

  5. Intramyocardial Delivery of Mesenchymal Stem Cell-Seeded Hydrogel Preserves Cardiac Function and Attenuates Ventricular Remodeling after Myocardial Infarction

    PubMed Central

    Mathieu, Eva; Lamirault, Guillaume; Toquet, Claire; Lhommet, Pierre; Rederstorff, Emilie; Sourice, Sophie; Biteau, Kevin; Hulin, Philippe; Forest, Virginie; Weiss, Pierre

    2012-01-01

    Background To improve the efficacy of bone marrow-derived mesenchymal stem cell (MSC) therapy targeted to infarcted myocardium, we investigated whether a self-setting silanized hydroxypropyl methylcellulose (Si-HPMC) hydrogel seeded with MSC (MSC+hydrogel) could preserve cardiac function and attenuate left ventricular (LV) remodeling during an 8-week follow-up study in a rat model of myocardial infarction (MI). Methodology/Principal Finding Si-HPMC hydrogel alone, MSC alone or MSC+hydrogel were injected into the myocardium immediately after coronary artery ligation in female Lewis rats. Animals in the MSC+hydrogel group showed an increase in cardiac function up to 28 days after MI and a mid-term prevention of cardiac function alteration at day 56. Histological analyses indicated that the injection of MSC+hydrogel induced a decrease in MI size and an increase in scar thickness and ultimately limited the transmural extent of MI. These findings show that intramyocardial injection of MSC+hydrogel induced short-term recovery of ventricular function and mid-term attenuation of remodeling after MI. Conclusion/Significance These beneficial effects may be related to the specific scaffolding properties of the Si-HPMC hydrogel that may provide the ability to support MSC injection and engraftment within myocardium. PMID:23284842

  6. 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.

  7. Cardiac myxoma: preoperative diagnosis using a multimodal imaging approach and surgical outcome in a large contemporary series.

    PubMed

    Rahmanian, Parwis B; Castillo, Javier G; Sanz, Javier; Adams, David H; Filsoufi, Farzan

    2007-08-01

    Diagnosis of cardiac myxoma is typically suggested in the presence of symptoms and echocardiographic findings of an intracardiac mass and confirmed histologically. Coronary angiography (CA) and cardiac magnetic-resonance-imaging (MRI) may provide specific additional information which could lead to a precise preoperative diagnosis. Herein we report a series of 28 patients who underwent excision of myxoma between 1998 and 2005. Data analysis included patient demographics, clinical presentation, imaging modalities, and operative outcome. Echocardiography revealed an intra-atrial mass in all patients but did not differentiate between myxoma and other formations such as thrombi. CA showed neovascularization suggestive of cardiac tumor in 12 (53%) patients. MRI demonstrated specific characteristics of myxomatous tissue in all cases. Surgical removal was performed with no hospital mortality or major complications. Mid-term survival was similar to that of the general population. In patients with a cardiac mass, echocardiography remains the first diagnostic imaging modality but does not allow definite discrimination between cardiac tumors and thrombi. CA shows neovascularization in 50% and has, therefore, a low sensitivity and specificity in distinguishing the nature of the mass. MRI shows specific tissue characteristics facilitating the diagnosis of myxoma preoperatively. Surgery should be performed promptly and this can provide excellent early and mid-term results.

  8. 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.

  9. 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.

  10. 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.

  11. An interplanetary mission to Neptune System I: Analysis of trajectories to Neptune using gravity assists

    NASA Astrophysics Data System (ADS)

    Solórzano, C.; Sukhanov, A.; Prado, A.

    At the present time the search for the knowledge of our Solar System continues effective So in July 1st 2004 the international Cassini-Huygens Mission spacecraft entered into orbit around the planet Saturn and in January 2005 send data from the Huygens probe which is studing Saturn s largest moon Titan On January 19 2006 occurred the launch of the New Horizons spacecraft to Pluto and Charon NASA s Solar System Exploration theme listed a Neptune mission as one of its top priorities for the mid-term 2008-2013 The gravity assist is a proven technique in interplanetary exploration as exemplified by the missions Voyager Galileo Cassini etc Here a mission to Neptune for the mid-term 2008-2020 is proposed with the goal of studiyng several schemes for the mission A direct transfer to Neptune is considered and also Venus Earth Jupiter and Saturn gravity assists are used for the transfer to Neptune which represent new contributions for a possible real mission We show several schemes with and without braking near Neptune in order to find a good compromise between the Delta V and time of flight to Neptune Besides taking advantage of asteroid flyby opportunities when the spacecraft passes through the asteroid belt To incorporta as asteroid flyby we first need to optimize a trajectory to Neptune with planetary flybys and then search for asteroids that pass close to this trajectory to finally reoptimize the trajectory including one or more asteroid flybys

  12. Perventricular device closure of isolated muscular ventricular septal defect in infants: A single centre experience☆

    PubMed Central

    Thakkar, Bhavesh; Patel, Nehal; Shah, Shaunak; Poptani, Vishal; Madan, Tarun; Shah, Chirag; Shukla, Anand; Prajapati, Vaishali

    2012-01-01

    Objectives To evaluate prospective single centre experience of mid-term safety and efficacy of perventricular device closure of isolated large muscular ventricular septal defect (mVSD) in high-risk infants. Background Surgical closures of large mVSD in infants represent a challenge with significant morbidity. Methods Between August 2008–2010, perventricular closure was attempted in 24 infants of 6.01 ± 2.37 months age and 4.27 ± 0.56 kg weight under TEE guidance. Results The device was successfully deployed in 21/24 infants. Size of mVSD was 8.42 ± 1.46 mm (6.1–12 mm). Mean procedure time was 28.8 ± 11.7 min. The closure rate was 84% immediately and 100% at 6 months. Four patients suffered major complications: 2-died, 1-esophageal perforation, 1-persistent CHB. At 26.23 ± 6.63 months follow-up two patients were symptomatic: 1-required device retrieval, 1-died of severe gastroenteritis. Conclusion Perventricular device closure of isolated mVSD appears feasible option at mid-term follow-up and may either substitute or complement the conventional surgical technique in selected cases depending on institutional paediatric cardiac surgery performance. PMID:23253407

  13. Formative assessment and academic achievement in pre-graduate students of health sciences.

    PubMed

    Carrillo-de-la-Peña, María T; Baillès, Eva; Caseras, Xavier; Martínez, Alvar; Ortet, Generós; Pérez, Jorge

    2009-03-01

    Although educational experts recommend the use of formative assessment, there is a dearth of empirical studies on its impact on academic achievement. In this research the authors analyse to what extent participation and performance in formative assessment are associated with positive academic outcomes of pre-graduate students of health sciences. A total of 548 students from three health science degrees (Medicine, Psychology and Biology) from four Spanish universities were involved in this study. The students who carried out mid-term formative assessment got better marks and had higher success rates in final summative assessment that the students who did not participate. In addition, success in formative assessment tests was associated with better summative marks. Interestingly, participation in formative assessment was a better predictor of final outcome than success in formative assessment, a result that supports the key role of feedback in formative assessment. Students who took the mid-term examination, irrespective of their success, obtained feedback about their achievement and probably this determined their greater involvement in the learning process. Although causal relationships between formative and summative assessment cannot be established from this research, the generalized benefits of formative assessments found here encourage the practice of them in health sciences education.

  14. Variations of Leaf Cuticular Waxes Among C3 and C4 Gramineae Herbs.

    PubMed

    He, Yuji; Gao, Jianhua; Guo, Na; Guo, Yanjun

    2016-11-01

    Modern C4 plants are commonly distributed in hot and dry environments whereas C3 plants predominate in cool and shade areas. At the outmost of plant surface, the deposition and chemical composition of cuticular waxes vary under different environmental conditions. However, whether such variation of cuticular wax is related to the distribution of C3 and C4 under different environmental conditions is still not clear. In this study, leaves of six C3 Gramineae herbs distributed in spring, Roegneria kamoji, Polypogon fugax, Poa annua, Avena fatua, Alopecurus aequalis, and Oplismenus undulatifolius, and four C4 and one C3 Gramineae herbs distributed in summer, Digitaria sanguinalis, Eleusine indica, Setaria viridis, S. plicata, and O. undulatifolius, were sampled and analyzed for cuticular wax. Plates were the main epicuticular wax morphology in both C3 and C4 plants except S. plicata. The plates melted in C4 plants but not in C3 plants. The total cuticular wax amounts in C4 plants were significantly lower than those in C3 plants, except for O. undulatifolius. Primary alcohols were the most abundant compounds in C3 plants, whereas n-alkanes were relatively the most abundant compounds in C4 plants. C29 was the most abundant n-alkane in C3 plants except for O. undulatifolius, whereas the most abundant n-alkane was C31 or C33 in C4 plants. The average chain length (ACL) of n-alkanes was higher in C4 than in C3 plants, whereas the ACL of n-alkanoic acids was higher in C3 than C4 plants. The cluster analysis based on the distribution of n-alkanes clearly distinguished C3 and C4 plants into two groups, except for O. undulatifolius which was grouped with C4 plants. These results suggest that the variations of cuticular waxes among C3 and C4 Gramineae herbs are related to the distribution of C3 and C4 plants under different environmental conditions.

  15. 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

  16. Clinical and angiographic predictors of stroke and death from carotid endarterectomy: systematic review.

    PubMed Central

    Rothwell, P. M.; Slattery, J.; Warlow, C. P.

    1997-01-01

    OBJECTIVE: To identify risk factors for operative stroke and death from carotid endarterectomy. DESIGN: Systematic review of all studies published since 1980 which related risk of stroke and death to various preoperative clinical and angiographic characteristics, including unpublished data on 1729 patients from the European carotid surgery trial. MAIN OUTCOME MEASURE: Operative risk of stroke and death. RESULTS: Thirty six published studies fulfilled our criteria. The effect of 14 potential risk factors was examined. The odds of stroke and death were decreased in patients with ocular ischaemia alone (amaurosis fugax or retinal artery occlusion) compared with those with cerebral transient ischaemic attack or stroke (seven studies; odds ratio 0.49; 95% confidence interval 0.37 to 0.66; P < 0.00001). The odds were increased in women (seven studies; 1.44; 1.14 to 1.83; P < 0.005), subjects aged > or = 75 years (10 studies: 1.36; 1.09 to 1.71; P < 0.01), and with systolic blood pressure > 180 mm Hg (four studies; 1.82; 1.37 to 2.41; P < 0.0001), peripheral vascular disease (one study; 2.19; 1.40 to 3.60; P < 0.0005), occlusion of the contralateral internal carotid artery (14 studies; 1.91; 1.35 to 2.69; P < 0.0001), stenosis of the ipsilateral internal carotid siphon (five studies; 1.56; 1.03 to 2.36; P = 0.02), and stenosis of the ipsilateral external carotid artery (one study; 1.61; 1.05 to 2.47; P = 0.03). Operative risk was not significantly related to presentation with cerebral transient ischaemic attack versus stroke, diabetes, angina, recent myocardial infarction, current cigarette smoking, or plaque surface irregularity at angiography. Multiple regression analysis of data from the European carotid surgery trial identified cerebral versus ocular events at presentation, female sex, systolic hypertension, and peripheral vascular disease as independent risk factors. CONCLUSIONS: The risk of stroke and death from carotid endarterectomy is related to several clinical

  17. 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

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

    PubMed

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

    2016-06-01

    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.

  19. Plutonium Multiple Recycling In PWRs

    SciTech Connect

    Nigon, Jean-Louis; Lenain, Richard; Zaetta, Alain

    2002-07-01

    Reprocessing and recycling open the road to a sustainable management of nuclear materials and an environment friendly management of nuclear waste. However, long or very long term recycling implies fast neutron reactors. High burn-ups of irradiated standard UO{sub 2} fuel as well as recycling of plutonium fuel in thermal reactors lead to a 'degradation' of plutonium that means a low fissile content, which is hardly compatible with recycling in LWRs. Thus the question of plutonium management has been raised; although there are some limitations, a truly large variety of options do exist; no one of the presently selected ways of plutonium management is a dead end road. Among these various options, some are fully compatible with the existing reactors and may be considered for the mid term future; they offer a competitive management of plutonium during the transition from thermal to fast reactors. (authors)

  20. 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"

  1. STARSEM—A reliable and affordable space transportation system

    NASA Astrophysics Data System (ADS)

    Luciani, Bernard

    2000-03-01

    The launch services industry is facing a tremendous evolution caused by the changes brought to the design of the satellites. The launch industry must cope with the ≪≪ smaller, faster, better ≫> era. This context is the main reason for the creation of the European-Russian joint venture STARSEM promoting the exclusive marketing of the SOYUZ launch services. As a matter of fact, the characteristics of the SOYUZ launch vehicle fit the customers' specific requirements and STARSEM is able to provide all the range of services needed to perform launches complying with requests from satellites operators. For this purpose, STARSEM relies on a completely operational infrastructure in both Samara and Baikonur, from launch vehicles manufacturing up to launch campaigns. This is why leaders in space activities have already chosen STARSEM. Indeed, prospects look promising as short and mid-term challenges are to be taken up by the company.

  2. Evaluation of the program to eliminate lymphatic filariasis in Vanuatu following two years of mass drug administration implementation: results and methodologic approach.

    PubMed

    Fraser, Margaret; Taleo, George; Taleo, Fasihah; Yaviong, James; Amos, Morris; Babu, Mark; Kalkoa, Morris

    2005-10-01

    This report presents the results of the Vanuatu mid-term evaluation of the lymphatic filariasis elimination program being implemented countrywide. Vanuatu is one of the first countries to initiate this program as part of the Global Program for Elimination of Lymphatic Filariasis, based on a five-year annual mass drug administration (MDA) of albendazole and diethylcarbamazine and complemented in Vanuatu by extensive coverage with bed nets. This paper reports results of 561 persons tested at eight sentinel sites following two years of MDA. Coverage was 72% and bed net use was more than 70%. Antigen prevalence was reduced by 63% (from 22% to 8%) and prevalence of microfilaremia prevalence was reduced by 93% (from 12% to 0.8%). Results of surveys of health workers and the community are also reported, and the methodology used for this evaluation is discussed.

  3. 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.

  4. 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 .

  5. 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.

  6. GVPM Energy Storage Overview

    DTIC Science & Technology

    2011-08-10

    12V 6T Battery 50-60Wh/kg 400-450W/kg >$2000/kWhr Energy Content Trends Advanced Battery Technologies Price Targets... Battery Technology Near-Term Mid-Term Production Long-Term High Volume Lead Acid ( 12V ) $400/kWh $350/kWh $250/kWh Ni-Zn ( 12V ) $500/kWh $350/kWh $200/kWh Li-ion ( 12V or 28V) $5,000/kWh $1,000/kWh $500/kWh ...NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) U.S. Army TARDEC ,6501 E.11 Mile

  7. 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.

  8. 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.

  9. Toothpick inside the Common Bile Duct: A Case Report and Literature Review

    PubMed Central

    Brunaldi, M. O.; Masagao, R.; Silva, C.; Masuda, H.; Brunaldi, J. E.

    2017-01-01

    The incidence and prevalence of foreign body (FB) ingestion are difficult to estimate. Unlike other foreign bodies, the ingestion of a toothpick is very uncommon and carries high morbidity and mortality rates. We report a case of a 73-year-old female patient presenting mid-term epigastric pain. Abdominal ultrasound revealed a slightly dilated common bile duct (CBD) and magnetic resonance showed an irregular filling failure in distal CBD and gallstones. Endoscopic Retrograde Cholangiopancreatography revealed major papilla on the edge of a diverticulum and confirmed the distal filling failure. After sphincterotomy, a partially intact toothpick was extracted from the CBD. Neither fistulas nor perforation signs were found. Literature related to foreign bodies and toothpick ingestion was reviewed and some hypotheses to explain the reported case were created. To our knowledge, this is the first report of a toothpick lodged inside the biliary tract. PMID:28356912

  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. 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.

  12. In Vivo Performance of Moderately Crosslinked, Thermally Treated Polyethylene in a Prospective Randomized Controlled Primary Total Knee Arthroplasty Trial.

    PubMed

    Kindsfater, Kirk A; Pomeroy, Donald; Clark, Charles R; Gruen, Thomas A; Murphy, Jeff; Himden, Sam

    2015-08-01

    Cross-linked bearings have been developed for use in total knee arthroplasty that exhibit improved wear properties, but at the expense of a decrease in mechanical strength of the cross-linked material. Adoption has been slow due to fears of mechanical failure secondary to this alteration in mechanical properties. This prospective, randomized study compared mid-term survivorship, clinical and radiographic results of a conventional polyethylene (GVF) to a cross-linked polyethylene (XLK) in total knee prostheses of the same design. At minimum 5-year follow-up there was no difference in survivorship, clinical performance or radiographic findings between the groups. There were no revisions for polyethylene wear, osteolysis or tibial insert dissociation. Most importantly, there were no revisions for mechanical failure or fracture of the polyethylene bearing in either group.

  13. Development of Capacitors for Power Electronics in Hybrid Vehicles

    SciTech Connect

    Balachandran, U.

    2016-02-16

    The purpose of this CRADA is to develop a fabrication process to reduce the manufacturing cost for a very compact, high temperature, film-on-foil high energy-density PLZT (Pb-La-Zr- Ti-O) capacitor. Motivation for this CRADA is derived from the DOE’s Office of Vehicle Technologies (OVT) program, which seeks to advance technologies to improve vehicle fuel efficiency in the mid-term and facilitate the transition to electric drive vehicles over the longterm. The objective of Argonne’s work is to develop and characterize high-performance capacitors on base-metal foils. The PLZT film-on-foil prepared using a spin-coating technique

  14. Immunological responses to semen in the female genital tract.

    PubMed

    Schuberth, H J; Taylor, U; Zerbe, H; Waberski, D; Hunter, R; Rath, D

    2008-11-01

    When spermatozoa, seminal plasma and semen extender reach the uterus and interact with local leukocytes and endometrial cells, several immune mechanisms are initiated which have immediate, mid-term and long-term effects on ovulation, sperm cell selection, fertilization and pregnancy success by assuring the acceptance of fetal tissues. This report gives an overview on relevant key immune mechanisms following roughly the time axis after insemination. Detailed knowledge regarding these mechanisms will aid maximizing reproductive efficiency in livestock production. In the future, the many species involved will require a more comparative approach, since evidence is growing that endometrial physiology and the response to varying amounts and compositions of seminal plasma, various semen extenders, and variable numbers of spermatozoa also provoke different immune responses.

  15. Science Operations For Esa's Smart-1 Mission To The Moon

    NASA Astrophysics Data System (ADS)

    Almeida, M.; Foing, B.; Heather, D.; Marini, A.; Lumb, R.; Racca, G.

    The primary objective of the European Space Agency's SMART-1 mission to the Moon is to test and validate a new electric propulsion engine for potential use on other larger ESA Cornerstone missions. However, the SMART-1 spacecraft will also carry a number of scientific instruments and experiments for use en-route to and in orbit about the Moon. SMART-1's major operational constraint is that it will be only contacted twice per week. As a result, there will be a stronger emphasis on mid-term planning, and the spacecraft will be operated using a large list of telecommands sent during the communication windows. This approach leads to a higher probability of there being resource and/or instruments conflicts. To eliminate these, two software tools were developed: the Experiment Planning System (EPS), and the Project Test Bed (PTB). These tools will also allow us to predict the lunar coverage of the scien- tific instruments, and to simulate target selections.

  16. Bilateral trans-humeral arm transplantation: result at 2 years.

    PubMed

    Cavadas, P C; Ibáñez, J; Thione, A; Alfaro, L

    2011-05-01

    Unilateral and bilateral hand transplantations have been performed worldwide with good mid-term functional results. An above-elbow bilateral transplantation was performed in a 29-year-old male patient from a fully HLA-mismatched donor. Alemtuzumab induction and steroid-free maintenance immunosuppression with tacrolimus and mycophenolate was used. Due to acute rejection, steroids were introduced at 6 months. Three acute rejection episodes occurred, one treated with alemtuzumab. New-onset diabetes after transplant, dyslipemia and worsening of previous high blood pressure required treatment. At 26 months post-transplantation, the patient has excellent elbow active movement, active flexion and extension of the thumb and fingers, useful sensation and a gainful job. Based on the functional results of the case reported, bilateral trans-humeral transplantation could be a viable treatment for selected bilateral above-elbow amputees.

  17. 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.

  18. Lidar

    NASA Astrophysics Data System (ADS)

    Sage, J.-P.; Aubry, Y.

    1981-09-01

    It is noted that a photodetector at the telescope focal plane of a lidar produces a signal which is processed, giving information on the concentration of the species being monitored. The delay between the emitted and return signals indicates the distance to the interacting volume. Because of the poor efficiency of the interaction processes, the main difficulty in developing a good lidar has to do with the availability of sufficiently efficient lasers. Certain laser characteristics are discussed, and a CNES program for the development of lasers for lidar techniques is presented, future space applications being considered as mid-term objectives. The various components of the laser system developed by CNES are described. These are a dual frequency tunable oscillator, the amplifier chain, the beam control unit and wavelength servo-system, and the harmonic conversion subsystem.

  19. 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.

  20. 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

  1. Role of robotic surgery in colorectal resections for cancer.

    PubMed

    Bertani, E; Chiappa, A; Ubiali, P; Fiore, B; Corbellini, C; Cossu, M L; Minicozzi, A; Andreoni, B

    2012-09-01

    In recent years, robotic surgery is becoming a valid alternative in colorectal diseases treatment to laparoscopic and traditional open surgery. The most relevant reported technical advantages of the robotic surgery are 3D-view, tremor-filtering, seven degree-free motion and a higher comfortable setting for the surgeon. Both case series and comparative studies available in Literature report only short and mid-term outcomes. These studies are able to demonstrate that robotic surgery is as safe and feasible as laparoscopic surgery regarding perioperative outcomes. Trials with long term follow up are needed to establish the real safety and effectiveness of the robotic surgery especially concerning resections for cancer. The robotic surgery could be considered a promising surgical field. The high costs represent one of the most relevant drawbacks.

  2. 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

  3. 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.

  4. 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.

  5. 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.

  6. 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

  7. Application of Cross Wavelet Transform and Wavelet coherence to sunspot area and sunspot number during the ascending phase of solar cycle 24

    NASA Astrophysics Data System (ADS)

    Kasde, Satish Kumar; Gwal, Ashok Kumar; Sondhiya, Deepak Kumar

    Abstract: To understand better the variation of solar activity indicators originated at different layers of the solar atmosphere with respect to sunspot cycles, we carried out a study of phase relationship between sunspot number and Sunspot area using cross-correlation analysis. Extended wavelet based approaches such as continuous wavelet transform (CWT), cross wavelet transform (XWT), and wavelet coherence (WTC). It gives better understanding in the physical processes responsible for the solar activity and the solar cycle phenomenon. In this study we found: short term variability for current solar cycle 24 (Jan2008 - May2013). We have observed the mid-term quasi periodicities for this solar cycle and we also investigate the correlation between both parameters and identify the unusual conditions in space weather. Key words: Wavelet analysis, Sunspot Cycle, Solar Activity.

  8. Thin-film rechargeable lithium batteries

    SciTech Connect

    Dudney, N.J.; Bates, J.B.; Lubben, D.

    1994-11-01

    Small thin-film rechargeable cells have been fabricated with a lithium phosphorus oxyniuide electrolyte, Li metal anode, and Li{sub 1-x}Mn{sub 2}O{sub 4} as the cathode film. The cathode films were fabricated by several different techniques resulting in both crystalline and amorphous films. These were compared by observing the cell discharge behavior. Estimates have been made for the scale-up of such a thin-film battery to meet the specifications for the electric vehicle application. The specific energy, energy density, and cycle life are expected to meet the USABC mid-term criteria. However, the areas of the thin-films needed to fabricate such a cell are very large. The required areas could be greatly reduced by operating the battery at temperatures near 100{degrees}C or by enhancing the lithium ion transport rate in the cathode material.

  9. 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.

  10. [Elbow reconstruction with massive total osteoarticular allograft: early failure due to instability].

    PubMed

    Delloye, C; Cornu, O; Dubuc, J-E; Vincent, A; Barbier, O

    2004-06-01

    Total elbow allografts were implanted for the treatment of trauma-induced bone defects in three patients between 1986 and 1990. Six allografts were implanted and finally explanted. The longest follow-up for an implanted allograft was five years. Allografts had to be removed because of nonunion in one patient and gross instability in the others. A constrained elbow prosthesis was implanted in all three patients. This short series illustrates mid-term failure to be expected with total elbow allografts, mainly due to instability. Accordingly, we no longer recommend the use of total elbow allografts alone as a salvage procedure for bony defects. If an allograft is needed, it should be implanted with a prosthesis.

  11. Monitoring atmospheric gravity waves in the middle atmosphere as an innovative approach to estimate the differential energy content of a strong cyclone

    NASA Astrophysics Data System (ADS)

    Wüst, Sabine; Bittner, Michael

    It is well-known that atmospheric gravity waves are generated not only by orographic forcing but also by strong convective areas like storms. It is proposed that monitoring of the cyclone induced atmospheric wave activity by remote sensing and in situ techniques allows helping quantifying the change of the underlying cyclones angular momentum and energy content. This effect might be used to allow a better mid-term storm forecast. Based on meteorological rocket measurements ("falling spheres") above Wallops Island (37° N, 75° W) a case study is presented revealing the presence of gravity wave signatures in 50km to 70km height. Evidence is given that these waves are connected to an underlying low pressure system.

  12. Reverse shoulder arthroplasty.

    PubMed

    Smithers, Christopher J; Young, Allan A; Walch, Gilles

    2011-12-01

    The reverse shoulder arthroplasty emerged as a potential solution for those patients who could not be managed effectively with a conventional total shoulder arthroplasty. Grammont revolutionized the design by medializing and distalizing the center of rotation and utilizing a large convex glenoid surface and concave humeral component with a neck-shaft angle of 155°. This design has been highly successful in cuff deficient shoulders, and indications continue to broaden. Many mid-term studies have improved upon the early encouraging results. Long-term studies are starting to emerge, demonstrating good survivorship, but progressive functional and radiographic deterioration continue to be concerning. Careful patient selection and attention to appropriate technique are required to reduce the current high rate of complications. New prosthesis designs are continuing to develop to address some of these limitations.

  13. Midterm results of a femoral stem with a modular neck design: clinical outcomes and metal ion analysis.

    PubMed

    Silverton, Craig D; Jacobs, Joshua J; Devitt, Jeffrey W; Cooper, H John

    2014-09-01

    Modular neck femoral stems have a higher-than-anticipated rate of failure in registry results, but large single-center cohort studies are lacking. This is a retrospective cohort of 152 hips implanted with a single titanium stem with a modular titanium neck, presenting clinical, radiographic, and metal ion results at a mean 4.5-year follow-up. Five hips were revised during the study period, for an overall Kaplan-Meier survival of 0.894 at 8 years. There was one modular neck fracture (0.66%), but others demonstrated corrosion or adverse tissue reaction. Serum metal levels demonstrated wide variability. Despite good clinical results in the majority of patients, we confirmed an increased rate of femoral revision at mid-term follow-up, and therefore urge caution in the use of this particular stem design.

  14. Sauvé-Kapandji and reverse Sauvé-Kapandji procedures for treating chronic longitudinal radioulnar dissociation with capitellum fracture.

    PubMed

    Hernández-Cortés, Pedro; Gómez-Sánchez, Rafael; Pajares-López, Miguel; O'Valle-Ravassa, Francisco

    2014-01-01

    Almost all reported cases of longitudinal radioulnar dissociation have involved fracture of the radial head, rupture of the interosseous membrane, and disruption of the distal radioulnar joint, although unusual patterns of Essex-Lopresti injury have also been described. To our knowledge, this is the first report of a chronic Essex-Lopresti variant including fracture of the capitellum. A displaced capitellum fracture must alert to the possibility of longitudinal radioulnar dissociation, even without concomitant radial head fracture or symptoms at the forearm and ulnar wrist. Successful mid-term results can be achieved by treating malunion of humeral condyle and proximal migration of the radius with simultaneous Sauvé-Kapandji procedure at the wrist and reverse Sauvé-Kapandji at the elbow.

  15. The Clinical Frailty Scale: Upgrade Your Eyeball Test.

    PubMed

    Afilalo, Jonathan

    2017-03-16

    With the emergence of transcatheter aortic valve replacement (TAVR) as a therapeutic option to treat high-risk older adults suffering from aortic stenosis, the geriatric concept of frailty has assumed mainstream relevance for cardiovascular practitioners. We have eagerly adopted tools to objectify the definition of frailty and accordingly discern good and bad candidates among a pool of complex octogenarians with multiple chronic conditions - a daunting yet mission-critical task. Initial studies published during the first half of this decade revealed that frailty status was one of the top predictors of mid-term mortality and incident disability after TAVR1, leading to its integration in clinical care pathways and predictive risk models. The encouraging findings from small single-center studies are now being validated in larger multi-center registries and trials, affirming the strengths and uncovering the limitations of various frailty assessment tools.

  16. [Segmental posterior spinal osteosynthesis using the Luque-Dove technic].

    PubMed

    Kerboul, B; Courtois, B

    1989-03-01

    The Hartshill frame is method for segmental osteosynthesis of the spine. It is attached at each vertebral level by sub-laminal metal wires. This frame therefore ensures immediate stability and avoids the need for a post-operative corset. It enables correction of frontal deformities (scoliosis) whilst retaining sagittal physiological curves (lumbar lordosis--dorsal kyphosis). It ensures the fixation of posterior spinal instability (destruction of posterior ligaments and bone tissue, spondylolisthesis, etc.). The Hartshill frame can thus be seen to be a posterior brace. It has been used in 92 patients, (53 lumbar disorders, 10 cases of scoliosis, 4 of kyphosis, 19 tumors, 6 fractures). Results are generally entirely satisfactory in the mid term apart from fractures (recurrence of initial displacement). Specific complications are of a neurological nature (cases of cutaneous hyperesthesia, one severe motor deficit) long-term problems with device and material are uncommon; rupture of sub-laminar wire 8 cases; secondary incurving of frame 1 case.

  17. Safety and efficacy of carbon dioxide and intravascular ultrasound-guided stenting for renal artery stenosis in patients with chronic renal insufficiency.

    PubMed

    Kawasaki, Daizo; Fujii, Kenichi; Fukunaga, Masashi; Fukuda, Nobuhisa; Masuyama, Tohru; Ohkubo, Nobukazu; Kato, Masaaki

    2015-03-01

    We evaluated the feasibility, safety, and mid-term outcomes of renal artery stenting using carbon dioxide (CO₂) digital subtraction angiography and intravascular ultrasound (IVUS) for patients with renal insufficiency and significant atherosclerotic renal artery stenosis (RAS). Eighteen consecutive patients with chronic renal insufficiency underwent renal artery stenting under the guidance of CO₂ angiography and IVUS without contrast media. Renal function and blood pressure were assessed pre- and postintervention. A total of 27 de novo RAS in 18 patients (15 males; mean age: 72 ± 9 years) with renal insufficiency were treated by renal artery stenting with the combined use of the CO₂ angiography and IVUS without any procedural complications. Although the mean serum creatinine concentration preprocedure and 6 months after treatment did not change (2.7 ± 1.0-2.4 ± 1.1 mg/dL), blood pressure significantly decreased 6 months after stenting (158 ± 10-147 ± 11 mm Hg, P < .01).

  18. 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

  19. [Non fusion techniques in spinal surgery].

    PubMed

    Schizas, C; Duff, J M; Tessitore, E; Faundez, A

    2009-12-16

    In order to prevent adjacent segment degeneration following spinal fusion new techniques are being used. Lumbar disc arthroplasty yields mid term results equivalent to those of spinal fusion. Cervical disc arthroplasty is indicated in the treatment of cervicobrachialgia with encouraging initial results. The ability of arthroplasty to prevent adjacent segment degeneration has yet to be proven. Although dynamic stabilization had not been proven effective in treating chronic low back pain, it might be useful following decompression of lumbar spinal stenosis in degenerative spondylolisthesis. Interspinal devices are useful in mild lumbar spinal stenosis but their efficacy in treating low back pain is yet to be proven. Confronted with a growing number of new technologies clinicians should remain critical while awaiting long term results.

  20. 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.

  1. 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.

  2. 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.

  3. [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.

  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. 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.

  6. 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.

  7. The application of interferometry to optical astronomical imaging.

    PubMed

    Baldwin, John E; Haniff, Christopher A

    2002-05-15

    In the first part of this review we survey the role optical/infrared interferometry now plays in ground-based astronomy. We discuss in turn the origins of astronomical interferometry, the motivation for its development, the techniques of its implementation, examples of its astronomical significance, and the limitations of the current generation of interferometric arrays. The second part focuses on the prospects for ground-based astronomical imaging interferometry over the near to mid-term (i.e. 10 years) at optical and near-infrared wavelengths. An assessment is made of the astronomical and technical factors which determine the optimal designs for imaging arrays. An analysis based on scientific capability, technical feasibility and cost argues for an array of large numbers of moderate-sized (2 m class) telescopes rather than one comprising a small number of much larger collectors.

  8. When good evidence goes bad: the weak evidence effect in judgment and decision-making.

    PubMed

    Fernbach, Philip M; Darlow, Adam; Sloman, Steven A

    2011-06-01

    An indispensable principle of rational thought is that positive evidence should increase belief. In this paper, we demonstrate that people routinely violate this principle when predicting an outcome from a weak cause. In Experiment 1 participants given weak positive evidence judged outcomes of public policy initiatives to be less likely than participants given no evidence, even though the evidence was separately judged to be supportive. Experiment 2 ruled out a pragmatic explanation of the result, that the weak evidence implies the absence of stronger evidence. In Experiment 3, weak positive evidence made people less likely to gamble on the outcome of the 2010 United States mid-term Congressional election. Experiments 4 and 5 replicated these findings with everyday causal scenarios. We argue that this "weak evidence effect" arises because people focus disproportionately on the mentioned weak cause and fail to think about alternative causes.

  9. 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.

  10. Capacity planning and appointment scheduling for new patient oncology consults.

    PubMed

    Ma, Xiang; Sauré, Antoine; Puterman, Martin L; Taylor, Marianne; Tyldesley, Scott

    2016-12-01

    To ensure that patients receive timely access to care, it has become increasingly important to use existing care provider capacity as efficiently as possible and to make informed capacity planning decisions. To support this decision-making process at a regional cancer center in British Columbia (Canada), we undertook a simulation and optimization based study that investigated the simultaneous impact of the available number of new patient consultation slots, appointment scheduling policies and oncologist specialization configurations on the timeliness of patient access to care and physician workload. The key contribution of this paper is the methodological framework it provides to decision makers who manage specialty clinics to ensure that they are using their resources efficiently and making informed strategic short- and mid-term capacity planning decisions for new patient demand.

  11. 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.].

  12. Long-term olfactory memories are stabilised via protein synthesis in Camponotus fellah ants.

    PubMed

    Guerrieri, Fernando J; d'Ettorre, Patrizia; Devaud, Jean-Marc; Giurfa, Martin

    2011-10-01

    Ants exhibit impressive olfactory learning abilities. Operant protocols in which ants freely choose between rewarded and non-rewarded odours have been used to characterise associative olfactory learning and memory. Yet, this approach precludes the use of invasive methods allowing the dissection of molecular bases of learning and memory. An open question is whether the memories formed upon olfactory learning that are retrievable several days after training are indeed based on de novo protein synthesis. Here, we addressed this question in the ant Camponotus fellah using a conditioning protocol in which individually harnessed ants learn an association between odour and reward. When the antennae of an ant are stimulated with sucrose solution, the insect extends its maxilla-labium to absorb the solution (maxilla-labium extension response). We differentially conditioned ants to discriminate between two long-chain hydrocarbons, one paired with sucrose and the other with quinine solution. Differential conditioning leads to the formation of a long-term memory retrievable at least 72 h after training. Long-term memory consolidation was impaired by the ingestion of cycloheximide, a protein synthesis blocker, prior to conditioning. Cycloheximide did not impair acquisition of either short-term memory (10 min) or early and late mid-term memories (1 or 12 h). These results show that, upon olfactory learning, ants form different memories with variable molecular bases. While short- and mid-term memories do not require protein synthesis, long-term memories are stabilised via protein synthesis. Our behavioural protocol opens interesting research avenues to explore the cellular and molecular bases of olfactory learning and memory in ants.

  13. Minimum 5-year Follow-up Results of Minimally Invasive Total Knee Arthroplasty Using Mini-Keel Modular Tibial Implant

    PubMed Central

    Yoo, Ju-Hyung; Park, Byoung-Kyu; Han, Chang-Dong; Oh, Hyun-Cheol

    2014-01-01

    Purpose To evaluate the minimum 5-year mid-term clinical and radiological results of minimally invasive surgery total knee arthroplasty (MIS-TKA) using a mini-keel modular tibia component. Materials and Methods We retrospectively evaluated 254 patients (361 cases) who underwent MIS-TKA between 2005 and 2006. The latest clinical and radiological assessments were done in 168 cases that had been followed on an outpatient basis for more than 5 postoperative years. Clinical results were assessed using the Hospital for Special Surgery (HSS) score and Knee Society score. Radiological evaluation included measurements of knee alignment. Results The average postoperative knee range of motion and HSS score were 134.3°±12.4° and 92.7°±7.0°, respectively. The average postoperative femorotibial angle and tibial component alignment angle were 5.2°±1.7° valgus and 90.2°±1.6°, respectively. The average tibial component posterior inclination was 4.8°±2.1°. The percentage of cases with tibial component alignment angle of 90°±3° was 96.1%, and that with the femorotibial angle of 6°±3° valgus was 94.0%. Radiolucent lines were observed in 20 cases (12.0%): around the femur, tibia, and patella in 14 cases, 10 cases, and 1 case, respectively. However, they were less than 2 mm and non-progressive in all cases. The survival rate was 99.4% and there was no implant-related revision. Conclusions MIS-TKA using a mini-keel modular tibial plate showed satisfactory results, a high survival rate, and excellent clinical and radiological results in the mid-term follow-up. PMID:25229044

  14. Comparison of outcomes of tricuspid annuloplasty with 3D-rigid versus flexible prosthetic ring for functional tricuspid regurgitation secondary to rheumatic mitral valve disease

    PubMed Central

    Wang, Haiping; Wang, Xin; Lv, Zhenqian; Liu, Xiaojun

    2016-01-01

    Background Annuloplasty bands and rings are widely used for repairing functional tricuspid regurgitation (FTR). However, the question regarding which is the ideal annuloplasty device remains unclear. The aim of this study was to compare the efficacy and mid-term durability of tricuspid ring annuloplasty for FTR secondary to rheumatic mitral valve disease using flexible Cosgrove-Edwards band and the rigid Edwards MC3 ring (Edwards Lifesciences, LLC, Irvine, CA, USA). Methods We retrospectively collected the clinical data of those who underwent mitral valve replacement (MVR) in concomitant with tricuspid ring annuloplasty from 2009 to 2013. The flexible band was used in 46 patients (flexible group), and the 3D rigid ring was used in 60 patients (rigid group). Echocardiographic evaluation of tricuspid function was performed preoperatively and postoperatively. Results The grade of TR was significantly improved compared to preoperative values in two groups. There was no significant difference regarding postoperative TR grade between the two groups at 1 week and 2–3 months but there was statistical significant difference at postoperative 6–12 months, and 2–3 years. During the follow up period, 25 of 46 patients (54.3%) in flexible group and 22 of 60 patients (30.3%) in rigid group developed recurrent TR. Freedom from recurrent TR in flexible group is significant lower than rigid group in each postoperative follow up period. Conclusions These findings suggest that 3D rigid ring annuloplasty might be more effective for tricuspid ring annuloplasty in FTR in mid-term postoperative periods when compared to flexible band. PMID:28066587

  15. 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.

  16. 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.

  17. Effect of renal function on prognosis in chronic heart failure.

    PubMed

    Löffler, Adrián Ignacio; Cappola, Thomas P; Fang, James; Hetzel, Scott J; Kadlec, Andrew; Astor, Brad; Sweitzer, Nancy K

    2015-01-01

    Renal dysfunction (RD) is associated with increased mortality in heart failure (HF). The aim of this study was to identify whether worsened or improved renal function during mid-term follow-up is associated with worsened outcomes in patients with chronic HF. A total of 892 participants from a multicenter cohort study of chronic HF were followed over 3.1 ± 1.9 years of enrollment. Worsened and improved renal functions were tested with multivariate models as independent predictors of HF hospitalization and mortality. Although 12% of subjects experienced a ≥25% decrease in estimated glomerular filtration rate (eGFR), 17% experienced a ≥25% increase in eGFR, and there was stability of kidney function observed in the cohort as a whole. The quartile with the worst RD at any point in time had increased risk of HF hospitalization and mortality. Worsened eGFR was associated with HF outcomes in the unadjusted (hazard ratio = 1.71, 95% confidence interval 1.04 to 2.81, p = 0.035), but not the adjusted analysis. Improvement in eGFR was not associated with outcome (p = 0.453). In chronic HF, the severity of RD predicts risk of poor outcome better than changes in renal function during mid-term follow-up. This suggests that in patients with appropriately treated chronic HF, worsening renal function in itself does not yield useful prognostic information and may not reflect poor outcome.

  18. Effects of oxidative stress reaction for the Eisenia fetida with exposure in Cd(2).

    PubMed

    Dongxing, Zhou; Yucui, Ning; Jiabin, Liu; Jie, Deng; Guohua, Rong; Bilige, Siqin; Yijun, Liu

    2016-11-01

    Earthworms are widely used in all kinds of pollutants as sensitive bio-indicator organisms because of their immediately oxidative stress response under the stress of heavy metal. However, there are a large number of indexes associated with the oxidative stress response. Finding out the key monitoring indexes in the stress process becomes a practical demand of the pollution monitoring and warning process. We studied two groups, the short-term test and the long-term test. The former one is for 10 days, taking out an earthworm every day. The latter test lasted 30 days, taking out an earthworm every 10 days. The Cd(2+) concentration was set at 50, 100, 125, 250, and 500 mg kg(-1). Post-clitellum segments of earthworms were chosen to determine superoxide enzyme (SOD), peroxidase (POD), glutathione peroxidase (GSH-Px), glutathione-S transferase (GST), catalase (CAT), vitamin E (VE), malondialdehyde (MDA), and acetylcholinesterase (AChE). The results showed that the main bio-indicators associating with oxidative stress reaction in short-term group were CAT, SOD, and POD. MDA could be used as a bio-indicator in the early and mid-term. VE was only the bio-indicator in the mid-term stress. While with the long-term test, the main bio-indicators associated with oxidative stress reaction were GSH-Px and MDA. The AChE activity was only suitable for oxidative stress response caused by heavy metal stress more than 30 days.

  19. 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.

  20. Effectiveness of weekly supplementation of iron to control anaemia among adolescent girls of Nashik, Maharashtra, India.

    PubMed

    Deshmukh, P R; Garg, B S; Bharambe, M S

    2008-03-01

    A national nutritional anaemia-control programme in India, focusing on supplementation of iron to pregnant women after the first trimester of pregnancy, failed to make an impact. It is prudent to recommend the correction of iron stores before the woman becomes pregnant. 'Efficacy' of weekly supplementation of iron has been proved to improve iron stores in adolescence in many studies abroad and in India. The objective was to study the 'effectiveness' of a weekly iron-supplementation regimen among urban-slum, rural, and tribal girls of Nashik district, Maharashtra, India. A baseline and the mid-term assessments were done using the cluster-sampling techniques. In each stratum, 30 clusters were identified. Twelve and 10 adolescent girls from each cluster were identified in the baseline and mid-term surveys respectively. The haemoglobin estimation was done using the HemoCue system. Data were analyzed using the Epi Info software (version 6.04). The overall prevalence of anaemia came down significantly to 54.3% from 65.3%. The decline was statistically significant (p<0.001) in tribal girls (48.6% from 68.9%) and among rural girls (51.6% from 62.8%). But the decline was not statistically significant among urban slum girls. Similarly, a significant rise in the mean haemoglobin levels was seen among tribal and rural girls. However, it did not increase significantly among urban slum girls. The programme had performed poorly in urban-slum areas, as the mean number of tablets consumed in urban-slum areas was only 5.6+/-3.3, as against 6.7+/-2.6 tablets in tribal girls and 7.2+/-2.2 tablets in rural girls. Considering the biological and operational feasibility and the effectiveness of the intervention, weekly supplementation of iron to adolescent girls should be universally started to correct the iron stores of a woman before she becomes pregnant.

  1. 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.

  2. 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

  3. Transcatheter Closure of Patent Foramen Ovale: A Single Center Experience

    PubMed Central

    Milev, Ivan; Zafirovska, Planinka; Zimbakov, Zan; Idrizi, Shpend; Ampova-Sokolov, Vilma; Gorgieva, Emilija; Ilievska, Liljana; Tosheski, Goce; Hristov, Nikola; Georgievska-Ismail, Ljubica; Anguseva, Tanja; Mitrev, Zan

    2016-01-01

    BACKGROUND: Percutaneous transcatheter closure (PTC) of patent foramen ovale (PFO) is implicated in cryptogenic stroke, transitional ischemic attack (TIA) and treatment of a migraine. AIM: Our goal was to present our experience in the interventional treatment of PFO, as well as to evaluate the short and mid-term results in patients with closed PFO. MATERIAL AND METHODS: Transcatheter closure of PFO was performed in 52 patients (67.3% women, mean age 40.7 ± 11.7 years). Patients were interviewed for subjective grading of the intensity of headaches before and after the PFO closure. RESULTS: During 2 years of follow-up, there was no incidence of new stroke, TIA and/or syncope. Follow-up TCD performed in 35 patients showed complete PFO closure in 20 patients (57.1%). Out of 35 patients, 22 (62.9%) reported having a migraine before the procedure with an intensity of headaches at 8.1 ± 1.9 on a scale from 1 to 10. During 2 years of follow-up, symptoms of a migraine disappeared in 4 (18.2%) and the remaining 18 patients reported the significant decrease in intensity 4.8 ± 2.04 (p = 0.0001). In addition, following PFO closure the incidence of the headaches decreased significantly (p = 0.0001). CONCLUSIONS: Percutaneous transcatheter closure of PFO is a safe and effective procedure showing mid-term relief of neurological symptoms in patients as well as significant reduction of migraine symptoms. PMID:28028400

  4. 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

  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. Decompression without Fusion for Low-Grade Degenerative Spondylolisthesis

    PubMed Central

    Cheung, Jason Pui Yin; Cheung, Prudence Wing Hang; Cheung, Kenneth Man Chee

    2016-01-01

    Study Design Retrospective series. Purpose Assess results of decompression-only surgery for low-grade degenerative spondylolisthesis with consideration of instability. Overview of Literature There is no consensus on whether fusion or decompression-only surgery leads to better outcomes for patients with low-grade degenerative spondylolisthesis. Current trends support fusion but many studies are flawed due to over-generalization without consideration of radiological instability and their variable presentations and natural history. Methods Patients with surgically treated degenerative spondylolisthesis from 1990–2013 were included. Clinical and radiological instability measures were included. Any residual or recurrence of symptoms, revision surgery performed and functional outcome scores including the numerical global rate of change scale, visual analogue scale, and modified Barthel index were measured. Follow-up periods for patients were divided into short-term (<5 years), mid-term (5–10 years) and long-term (>10 years). Results A total of 64 patients were recruited. Mechanical low back pain was noted in 48 patients and most (85.4%) had relief of back pain postoperatively. Radiological instability was noted in 4 subjects by flexion-extension radiographs and 12 subjects with prone traction radiographs by increased disc height and reduction of olisthesis and slip angle. From the results of the short-term, mid-term and long-term follow-up, reoperation only occurred within the first 5-year follow-up period. All functional scores improved from preoperative to postoperative 1-year follow-up. Conclusions Decompression-only for low-grade degenerative spondylolisthesis has good long-term results despite instability. Further higher-level studies should be performed on this patient group with radiological instability to suggest the superior surgical option. PMID:26949462

  7. Hepatectomy combined with microwave ablation of the spleen for treatment of hepatocellular carcinoma complicated with splenomegaly: A retrospective study

    PubMed Central

    Han, Jian-Bo; Kong, Feng-Wei; Ding, Hai; Zhang, Yu-Feng; Liu, Jun-Mao; Wei, Qiang; Hu, Liang; Zhao, Liang; Xu, Chuan-Jun; Yi, Yong-Xiang

    2017-01-01

    The present retrospective study aimed to investigate the mid-term safety and efficacy of hepatectomy combined with microwave ablation of the partial spleen for treatment of liver cancer complicated with hypersplenism. A retrospective analysis was performed on 23 patients who underwent hepatectomy combined with microwave ablation of the partial spleen for liver cancer, complicated with hypersplenism that was secondary to cirrhosis. The splenic and ablated volumes were calculated according to a contrast-enhanced computed tomography scan prior to and 2 weeks after the operation. Complete blood count and liver function tests were examined prior to and following the surgery, and complications and changes in the blood tests were monitored for 6 months. Over this period of investigation, the splenic volume was reduced by a mean value of 34.0%. The levels of serum alanine aminotransferase and aspartate aminotransferase were increased on the first day after the operation (P<0.05), although they recovered to the normal level within 1 week (P<0.05). The total level of bilirubin increased slightly, along with moderately decreased levels of albumin and cholinesterase on the first day, although these changes were not significant compared with the baseline (P>0.05). The white blood cell count was persistently significantly higher compared with the baseline over the course of the 6 months (P>0.05). The platelet count did not increase significantly for the first week after the operation (P>0.05); however, it was revealed to be significantly increased 1 month after the surgery (P<0.05). No significant complications were occurred during the follow-up period. In conclusion, hepatectomy combined with microwave ablation of the spleen was demonstrated to be a safe and effective procedure for patients with liver cancer and hypersplenism in the mid-term.

  8. Effect of traditional Chinese exercise on the quality of life and depression for chronic diseases: a meta-analysis of randomised trials.

    PubMed

    Wang, Xueqiang; Pi, Yanling; Chen, Binglin; Chen, Peijie; Liu, Yu; Wang, Ru; Li, Xin; Zhu, Yi; Yang, Yujie; Niu, Zhanbin

    2015-11-03

    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.

  9. Rotational Atherectomy and Stent Implantation for Calcified Left Main Lesions

    PubMed Central

    Schwartz, Bryan G.; Mayeda, Guy S.; Economides, Christina; Kloner, Robert A.; Shavelle, David M.; Burstein, Steven

    2011-01-01

    Background Left main coronary artery (LMCA) bifurcation and heavily calcified lesions are common and challenging to treat percutaneously. Rotational atherectomy (RA) may be beneficial in this setting to facilitate stent placement though direct supporting evidence is lacking. This study sought to analyze patients who underwent RA of the LMCA. Methods Consecutive cases involving RA of the LMCA between 1/1/2004 and 12/31/2009 at a private, tertiary referral hospital were reviewed retrospectively. Medical records, angiograms and clinically driven follow-up were reviewed. Results Thirty-one cases were identified (20 protected, 11 unprotected), including 23 with stent implantation (21 drug-eluting, 2 bare metal). All 31 lesions had moderate to severe calcification, 84% involved the distal segment. Mean burr-to-vessel ratio was 0.43. Overall angiographic success was 90% (28/31) and was higher with a drug-eluting stent versus no stent (100% vs. 62%; P = 0.0153). In-hospital major adverse cardiovascular events (MACE) occurred in 1 patient (3%). Mid-term MACE occurred in 6 patients (26%) and tended to occur less frequently in patients with protected LMCAs (P = 0.0697). At final follow-up, patients were more likely to be alive and free from angina with a protected LMCA (94% vs. 57% unprotected; P = 0.0564) and with a drug-eluting stent (89% vs. 50% with no stent; P = 0.0281). Conclusions RA of the LMCA to facilitate stent implantation appears to be safe and effective with favorable mid-term outcomes. In the setting of severe calcification and distal LMCA involvement RA and drug-eluting stent implantation should be considered.

  10. 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

  11. 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

  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. 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.

  14. Strategic Planning for Drought Mitigation Under Climate Change

    NASA Astrophysics Data System (ADS)

    Cai, X.; Zeng, R.; Valocchi, A. J.; Song, J.

    2012-12-01

    Droughts continue to be a major natural hazard and mounting evidence of global warming confronts society with a pressing question: Will climate change aggravate the risk of drought at local scale? It is important to explore what additional risk will be imposed by climate change and what level of strategic measures should be undertaken now to avoid vulnerable situations in the future, given that tactical measures may not avoid large damage. This study addresses the following key questions on strategic planning for drought mitigation under climate change: What combination of strategic and tactical measures will move the societal system response from a vulnerable situation to a resilient one with minimum cost? Are current infrastructures and their operation enough to mitigate the damage of future drought, or do we need in-advance infrastructure expansion for future drought preparedness? To address these questions, this study presents a decision support framework based on a coupled simulation and optimization model. A quasi-physically based watershed model is established for the Frenchman Creek Basin (FCB), part of the Republic River Basin, where groundwater based irrigation plays a significant role in agriculture production and local hydrological cycle. The physical model is used to train a statistical surrogate model, which predicts the watershed responses under future climate conditions. The statistical model replaces the complex physical model in the simulation-optimization framework, which makes the models computationally tractable. Decisions for drought preparedness include traditional short-term tactical measures (e.g. facility operation) and long-term or in-advance strategic measures, which require capital investment. A scenario based three-stage stochastic optimization model assesses the roles of strategic measures and tactical measures in drought preparedness and mitigation. Two benchmark climate prediction horizons, 2040s and 2090s, represent mid-term and

  15. Minimally Circulatory-Assisted On-Pump Beating Coronary Artery Bypass Grafting for Patients With Complex Conditions for Off-Pump Surgery.

    PubMed

    Mizuno, Tomohiro; Egi, Koso; Sakai, Kenji; Oi, Keiji; Hachimaru, Tsuyoshi; Makita, Tohru; Oishi, Kiyotoshi; Arai, Hirokuni

    2017-03-01

    Off-pump coronary artery bypass grafting (OPCAB) in patients with acute myocardial infarction (AMI) is difficult because of circulatory deterioration during displacement of the heart. At our institution, we performed minimally circulatory-assisted on-pump beating coronary artery bypass grafting (MICAB) in these patients. During MICAB, support flow was controlled at a minimal level to maintain a systemic blood pressure of approximately 100 mm Hg and a pulmonary arterial systolic pressure of <30 mm Hg, providing optimal pulsatile circulation for end-organ perfusion and prevention of heart congestion. From September 2006 to March 2012, MICAB was performed in 37 patients. Either emergent or urgent MICAB was performed in 27 patients following AMI because of hemodynamic instability during reconstruction. Elective MICAB was performed in the remaining 10 patients because of dilated left ventricle (LV) or small target coronary arteries. The details of bypass grafts, perioperative renal function, and early and mid-term morbidity and mortality were compared between the patients who received MICAB and the 37 consecutive patients who underwent OPCAB during the study period at our hospital. The assist flow indices (actual support flow/body surface area) during anastomosis to the left anterior descending artery, left circumflex artery, and right coronary artery were 0.95 ± 0.48 L/min/m(2) , 1.32 ± 0.53 L/min/m(2) , and 1.15 ± 0.47 L/min/m(2) , respectively, in the emergent and urgent patients following AMI, and 0.44 ± 0.39 L/min/m(2) , 1.25 ± 0.39 L/min/m(2) , and 1.14 ± 0.43 L/min/m(2) , respectively, in the elective patients with either dilated LVs or small target vessels. The lowest mixed venous oxygen saturation during pump support in the MICAB group was significantly higher than that in the OPCAB group (83.8 ± 10.8%, 71.6 ± 7.5%, P < 0.001). Comparing MICAB and OPCAB, the median number of distal bypass grafts for both groups was

  16. 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

  17. 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

  18. Dragon in Support Harmonizing European and Chinese Marine Monitoring for Environment and Security

    NASA Astrophysics Data System (ADS)

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

    2008-04-01

    ESA has been cooperating with National Remote Sensing Center of China (NRSCC), Ministry Of Science and Technology of China (MOST) in the development of Earth Observation (EO) applications for the last 15 years. In 2004, this cooperation was reinforced with the creation of a dedicated three-year EO science and exploitation programme called "Dragon". The programme brings together joint Sino-European teams to address 16 identified priority themes investigating land, ocean and atmospheric applications using data from ESA's ERS and Envisat missions. Detailed coordination of all requested acquisitions over China has been performed since the programme started. Consequently a large amount of data has now been delivered.The results of the joint teams' research have been presented at annual Symposia and regular progress meeting with Chinese scientists in Beijing. The mid term results of the programme have been published as a joint ESA and NRSCC publication entitled "Proceedings of Dragon Programme Mid Term Results (SP-611)". Since then, notable results have been achieved in all the thematic areas under investigation exploiting both archive ERS and Envisat instrument data, for example: • Forest cover and forest biomass maps of NE China using ERS SAR tandem data from the 1990s and change detection using up-to-date forest maps based on ASAR AP data• Flood monitoring and mapping and NRT information provision to local and national authorities• Ship cruises for collection of validation data in support of ocean colour studies • Exploitation of the ASAR, RA, MERIS and AA TSR sensors for bio-physical parameter retrieval for China seas• Quantification and modelling of NO2, CO and CH4 levels and their increasing trend since the 1990s •Mixing and modelling and changes in NO2 distribution and concentration in the middle atmospheric layers • Rice mapping and methane modelling exploiting Envisat's optical, SAR and atmospheric sensors• Impact of the Olympic games on the

  19. Trabecular metal cup without augments for acetabular revision in case of extensive bone loss and low bone-prosthesis contact.

    PubMed

    Pierannunzii, L; Mambretti, A; D'Imporzano, M

    2011-01-01

    Current evidences in revision hip arthroplasty suggest to treat severe acetabular bone loss with dedicated implants, such as anti-protrusio cages, stemmed cups, modular systems supplied with iliac flanges and obturatory hook. However recent literature is reporting satisfactory outcomes with simple elliptical Trabecular Metal cups. Purpose of the study was to evaluate mid-term results of such a surgical procedure. All hip revisions performed from 2008 to 2009 with implantation of a TMT multi-hole acetabular cup without augmentations were retrospectively reviewed. The cases with low-degree acetabular bone loss (stage I and II according to GIR classification), with surgical report poorly describing the bone defect, with inadequate pre- and post-operative x-rays were ruled out. Twenty-five cases were identified, but four were lost to follow-up. The twenty-one patients were 71 year-old on average (from 60 to 82), with stage IV bone loss in 6 cases and stage III bone loss in 15 cases. Mean interval from surgery to evaluation was 20.9 months (from 13 to 30). The evaluation included bone-prosthesis contact estimation, component position, survivorship, complications, final Harris Hip Score, presence of periprosthetic radiolucencies. Host bone-prosthesis contact was estimated to be about 35%. Only three implant were subsequently reoperated (for infection, early migration, recurrent dislocation). The HHS among non-reoperated 18 patients was 81.96 on average (from 63.44 to 95.82). Six cases showed thin radiolucencies in one of the three Charnley zones, while three cases showed radiolucencies in two. None of these images was evolutive, thus they were not considered signs of loosening. The mid-term results of this series confirm the hypothesis that a porous tantalum acetabular cup is an effective option to deal with difficult acetabular revisions. Although no extra-acetabular fixation device is available, the very high surface friction guaranteed by the material and the

  20. An Adaptation Strategy to Address Sea Level Rise Along Coastal Developments

    NASA Astrophysics Data System (ADS)

    Trivedi, D. R.

    2010-12-01

    understanding of acceptable levels of risks, a strategy encompassing the near-term, mid-term, and long term was developed for the projects. Immovable structures such as buildings and vital infrastructure will be raised to above the conservative levels of identified sea level rise. Perimeter improvements would be built to mid-term values with adaptation strategies incorporated into the project documents.

  1. Robotic cardiac surgery in Brazil

    PubMed Central

    Toschi, Alisson P.; Pope, Renato B.; Montanhesi, Paola K.; Santos, Ricardo S.; Teruya, Alexandre; Hatanaka, Dina M.; Rusca, Gabriel F.; Fischer, Claudio H.; Vieira, Marcelo C.; Makdisse, Marcia R.

    2017-01-01

    Background Brazil, the largest country and economy in South America, is a major driving force behind the development of new medical technologies in the region. Robotic cardiac surgery (RCS) has been evolving rapidly since 2010, when the first surgery using the DaVinci® robotic system was performed in Latin America. The aim of this article is to evaluate short and mid-term results in patients undergoing robotic cardiac surgery in Brazil. Methods From March 2010 to December 2015, 39 consecutive patients underwent robotic cardiac surgery. Twenty-seven patients were male (69.2%), with the mean age of 51.3±17.9 years. Participants had a mean ejection fraction of 62±5%. The procedures included in this study were mitral valve surgery, surgical treatment of atrial fibrillation, atrial septal defect closure, resection of intra-cardiac tumors, totally endoscopic coronary artery bypass and pericardiectomy. Results The mean time spent on cardiopulmonary bypass (CPB) during RCS was 154.9±94.2 minutes and the mean aortic cross-clamp time was 114.48±75.66 minutes. Thirty-two patients (82%) were extubated in the operating room immediately after surgery. The median intensive care unit (ICU) length of stay was 1 day (ranging from 0 to 25) and the median hospital length of stay was 5 days (ranging from 3 to 25). For each type of procedure, endpoints were individually reported. There were no conversions to sternotomy and no intra-operative complications. Patient follow-up was complete in 100% of the participants, with two early deaths unrelated to the procedures and no re-operations at mid-term. Conclusions Despite the heterogeneity of this series, RCS appears to be feasible, safe and effective when used for the correction of various intra- and extra-cardiac pathologies. Adopting the robotic system has been a challenge in Brazil, where its limited clinical application may be related to the lack of specific training and the high cost of technology. PMID:28203537

  2. Hybrid procedures for peripheral obstructive disease.

    PubMed

    Schrijver, A M; Moll, F L; De Vries, J P Pm

    2010-12-01

    The incidence and prevalence of high-risk patients suffering from critical limb ischemia due to multilevel arterial obstructive disease is growing rapidly. Invasive surgical procedures to restore inflow to the crural and pedal circulation in case of TransAtlantic InterSociety Consensus C and D (TASC) lesions of the iliacofemoral arteries are related with substantial morbidity and mortality. The mid-term and long-term outcomes of sole percutaneous revascularization procedures are disappointing for TASC C and D lesions. Hybrid endovascular and open surgical revascularization procedures might be of benefit because of its less invasive character, no need for extensive venous graft material, and the ability to overcome long-segment arterial obstructions. The common femoral artery (CFA) plays a central role in most of the hybrid procedures. CFA desobstruction, in combination with open iliac angioplasty or open superficial femoral artery (SFA) angioplasty, and CFA desobstruction with remote endarterectomy of the superficial femoral artery, are commonplace. Another valuable hybrid technique is open angioplasty of the SFA and one-staged distal origin bypass grafting. Hybrid techniques can safely be performed in the vascular operating room providing that the inventory is equipped for endovascular interventions. Vascular surgeons with thorough experience in open transluminal angioplasty, whether or not in cooperation with interventional radiologists or angiologists, will have the lead in the preoperative and perioperative planning. No randomized controlled trials have been published comparing hybrid techniques and open surgical reconstructions, or sole endvascular methods for multilevel peripheral arterial disease. During the last decade, multiple prospective and retrospective series have been reported concerning hybrid techniques, all with good initial technical success (up to 95%) and acceptable 30-day morbidity and mortality rates. Mid-term and long-term patency rates are

  3. Evaluation of regional climate model simulations versus gridded observed and regional reanalysis products using a combined weighting scheme

    NASA Astrophysics Data System (ADS)

    Eum, Hyung-Il; Gachon, Philippe; Laprise, René; Ouarda, Taha

    2012-04-01

    This study presents a combined weighting scheme which contains five attributes that reflect accuracy of climate data, i.e. short-term (daily), mid-term (annual), and long-term (decadal) timescales, as well as spatial pattern, and extreme values, as simulated from Regional Climate Models (RCMs) with respect to observed and regional reanalysis products. Southern areas of Quebec and Ontario provinces in Canada are used for the study area. Three series of simulation from two different versions of the Canadian RCM (CRCM4.1.1, and CRCM4.2.3) are employed over 23 years from 1979 to 2001, driven by both NCEP and ERA40 global reanalysis products. One series of regional reanalysis dataset (i.e. NARR) over North America is also used as reference for comparison and validation purpose, as well as gridded historical observed daily data of precipitation and temperatures, both series have been beforehand interpolated on the CRCM 45-km grid resolution. Monthly weighting factors are calculated and then combined into four seasons to reflect seasonal variability of climate data accuracy. In addition, this study generates weight averaged references (WARs) with different weighting factors and ensemble size as new reference climate data set. The simulation results indicate that the NARR is in general superior to the CRCM simulated precipitation values, but the CRCM4.1.1 provides the highest weighting factors during the winter season. For minimum and maximum temperature, both the CRCM4.1.1 and the NARR products provide the highest weighting factors, respectively. The NARR provides more accurate short- and mid-term climate data, but the two versions of the CRCM provide more precise long-term data, spatial pattern and extreme events. Or study confirms also that the global reanalysis data (i.e. NCEP vs. ERA40) used as boundary conditions in the CRCM runs has non-negligible effects on the accuracy of CRCM simulated precipitation and temperature values. In addition, this study demonstrates

  4. In vivo evaluation of micro-rough and bioactive titanium dental implants using histometry and pull-out tests.

    PubMed

    Aparicio, Conrado; Padrós, Alejandro; Gil, Francisco-Javier

    2011-11-01

    We report on the in vivo histological and mechanical performance of titanium dental implants with a new surface treatment (2Step) consisting of an initial grit-blasting process to produce a micro-rough surface, followed by a combined chemical and thermal treatment that produces a potentially bioactive surface, i.e., that can form an apatitic layer when exposed to biomimetic conditions in vitro. Our aim was to assess the short- and mid-term bone regenerative potential and mechanical retention of 2Step implants in mandible and maxilla of minipigs and compare them with micro-rough grit-blasted, micro-rough acid-etched, and smooth as-machined titanium implants. The percent of bone-to-implant contact after 2, 4, 6, and 10 weeks of implantation as well as the mechanical retention after 4, and 6 weeks of implantation were evaluated with histometric and pull-out tests, respectively, as a measure of the osseointegration of the implants. We also aimed to assess the bioactive nature of 2Step surfaces in vivo. Our results demonstrated that the 2Step treatment produced micro-rough and bioactive implants that accelerated bone tissue regeneration and increased mechanical retention in the bone bed at short periods of implantation in comparison with all other implants tested. This was mostly attributed to the ability of 2Step implants to form in vivo a layer of apatitic mineral that coated the implant and could rapidly stimulate (a) bone nucleation directly on the implant surface, and (b) bone growing from the implant surface. We also proved that roughness values of Ra≈4.5 μm favoured osseointegration of dental implants at short- and mid-term healing periods, as grit-blasted implants and 2Step implants had higher retention values than as machined and acid-etched implants. The surface quality resulting from the 2Step treatment applied on cpTi provided dental implants with a unique combination of rapid bone regeneration and high mechanical retention.

  5. 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

  6. 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

  7. Application de methodes de programmation dynamique stochastique au probleme de planification de la production d'hydroelectricite

    NASA Astrophysics Data System (ADS)

    Faik, Mouad

    The hydro-power generation planning is a complex problem implicating different fields of applied mathematics. Optimal or almost-optimal decisions are taken after optimization. This optimization is sometimes deterministic with integer variables (short-term planning), sometimes it is stochastic and continuous (mid or long-term planning). In order to master the randomness of parameters such as inflows or spot prices one must use and develop statistical and probabilistic models. Hydro-plants' power generation functions are modeled using nonlinear optimization, numerical calculating methods. etc. This thesis focuses on two main subjects: concavation methods of hydro-plants' power generation functions and stochastic optimization methods applied to a mid-term hydro-power generation planning problem under uncertainty that lies on natural inflows. Hydro-plants' power generation functions depend on the turbined outflow and water head, they are consequently not linear nor concave. These functions must be approximated by concave, piecewise linear functions, so they can fit into a linear mathematical programming model. There are two methods to do so: approximation of the objective function by a concave hull and approximation by a concave piecewise linear function. The second approach has two variants: fitting hyperplanes construction with the least squares criterion or the criterion of minimizing the maximal error to the real generation function. We conclude that these two methods are almost equivalent according to their root-mean square error, but the second method has less impact on planning algorithms' running time. There are many methods that can be used to solve the mid-term hydro-power generation planning under uncertainty. Stochastic dynamic programming-based methods are still the most rigorous with respect to their formulation, the solution algorithms used and the way in which uncertainty is represented. Two of these methods are compared in this thesis: Stochastic Dual

  8. 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.

  9. Evidence for effectiveness of Extracorporal Shock-Wave Therapy (ESWT) to treat calcific and non-calcific rotator cuff tendinosis--a systematic review.

    PubMed

    Huisstede, Bionka M A; Gebremariam, Lukas; van der Sande, Renske; Hay, Elaine M; Koes, Bart W

    2011-10-01

    Extracorporeal shock-wave therapy (ESWT) is suggested as a treatment alternative for calcific and non-calcific rotator cuff tendinosis (RC-tendinosis), which may decrease the need for surgery. In this study we assessed the evidence for effectiveness of ESWT for these disorders. The Cochrane Library, PubMed, Embase, Pedro, and Cinahl were searched for relevant systematic reviews and RCTs. Two reviewers independently extracted data and assessed the methodological quality. Seventeen RCTs (11 calcific, 6 non-calcific) were included. For calcific RC-tendinosis, strong evidence was found for effectiveness in favour of high-ESWT versus low-ESWT in short-term. Moderate evidence was found in favour of high-ESWT versus placebo in short-, mid- and long-term and versus low-ESWT in mid- and long-term. Moreover, high-ESWT was more effective (moderate evidence) with focus on calcific deposit versus focus on tuberculum major in short- and long-term. RSWT was more effective (moderate evidence) than placebo in mid-term. For non-calcific RC-tendinosis, no strong or moderate evidence was found in favour of low-, mid- or high-ESWT versus placebo, each other, or other treatments. This review shows that only high-ESWT is effective for treating calcific RC-tendinosis. No evidence was found for the effectiveness of ESWT to treat non-calcific RC-tendinosis.

  10. Activity of Science and Operational Research of NICT Space Weather

    NASA Astrophysics Data System (ADS)

    Ishii, Mamoru; Nagatsuma, Tsutomu; Watari, Shinichi; Shinagawa, Hiroyuki; Tsugawa, Takuya; Kubo, Yuki

    Operational space weather forecast is for contribution to social infrastructure than for academic interests. These user need will determine the target of research, e.g., the precision level, spatial and temporal resolution and/or required lead time. We, NICT, aim two target in the present mid-term strategic plan, which are (1) forecast of ionospheric disturbance influencing to satellite positioning, and (2) forecast of disturbance in radiation belt influencing to satellite operation. We have our own observation network and develop empirical and numerical models for achieving each target. However in actual situation, it is much difficult to know the user needs quantitatively. Most of space weather phenomena makes the performance of social infrastructure poor, for example disconnect of HF communication, increase of GNSS error. Most of organizations related to these operation are negative to open these information. We have personal interviews to solve this issue. In this interview, we try to collect incident information related to space weather in each field, and to retrieve which space weather information is necessary for users. In this presentation we will introduce our research and corresponding new service, in addition to our recent scientific results.

  11. Enhancement of hemocompatibility of the MERA monopivot centrifugal pump: toward medium-term use.

    PubMed

    Yamane, Takashi; Kosaka, Ryo; Nishida, Masahiro; Maruyama, Osamu; Yamamoto, Yoshihiro; Kuwana, Katsuyuki; Kawamura, Hiroshi; Shiraishi, Yasuyuki; Yambe, Tomoyuki; Sankai, Yoshiyuki; Tsutsui, Tatsuo

    2013-02-01

    The MERA monopivot centrifugal pump has been developed for use in open-heart surgery, circulatory support, and bridge-to-decision for up to 4 weeks. The pump has a closed-type, 50-mm diameter impeller with four straight paths. The impeller is supported by a monopivot bearing and is driven by a radial-flux magnet-coupling motor. Because flow visualization experiments have clarified sufficient pivot wash and stagnation at the sharp corner of the pivot support was suggested, sharp corners were removed in the design stage. The index of hemolysis of the pump operating at more than 200 mm Hg was found to be lower than that of a commercial pump. Four-week animal tests were then conducted two times; improvement of thrombus formation was seen in the female pivot through modification of female pivot geometry. Overall antithrombogenicity was also recorded. Finally, to assure mid-term use, an additional 4-week durability test revealed that the rate of the axial pivot wear was as small as 1.1 µm/day. The present in vitro and in vivo studies revealed that the MERA monopivot centrifugal pump has sufficient hemocompatibility and durability for up to 4 weeks.

  12. 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.

  13. 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.

  14. Angiographic and Clinical Result of Endovascular Treatment in Paraclinoid Aneurysms

    PubMed Central

    Kwon, Wi Hyun; Kim, Sung Tae; Seo, Jung Hwa

    2014-01-01

    Purpose The purpose of this study was to analyze the results of an immediate and mid-term angiographic and clinical follow-up of endovascular treatment for paraclinoid aneurysms. Materials and Methods From January 2002 to December 2012, a total of 113 consecutive patients (mean age: 56.2 years) with 116 paraclinoid saccular aneurysms (ruptured or unruptured) were treated with endovascular coiling procedures. Clinical and angiographic outcomes were retrospectively evaluated. Results Ninety-three patients (82.3%) were female. The mean size of the aneurysm was 5.5 mm, and 101 aneurysms (87.1%) had a wide neck. Immediate catheter angiography showed complete occlusion in 40 aneurysms (34.5%), remnant sac in 51 (43.9%), and remnant neck in 25 (21.6%). Follow-up angiographic studies were performed on 80 aneurysms (69%) at a mean period of 20.4 months. Compared with immediate angiographic results, follow-up angiograms showed no change in 38 aneurysms, improvement in 37 (Fig. 2), and recanalization in 5. There were 6 procedure-related complications (5.2%), with permanent morbidity in one patient. Conclusion Out study suggests that properly selected patients with paraclinoid aneurysms can be successfully treated by endovascular means. PMID:25426303

  15. Engaging with Policy Makers

    NASA Astrophysics Data System (ADS)

    Massey, R.; Miller, S.; Heward, A.

    2011-10-01

    The need to engage with Europe's policy makers is more crucial now than ever. MEPs' understanding of the contribution and importance of planetary science to European research, industry, culture, education and job-creation may have major implications for both the direction of research and future funding for Europe's planetary science community. The mid-term review of the European Commission's Seventh Framework Programme is currently in progress and these discussions will feed into the drafting of Framework Eight. With space-going nations around the world redefining priorities, Europe may have an opportunity to take a lead in planetology on a global scale. This should be taken into account when considering planetology within the frameworks of the European Space Policy. This panel discussion, hosted by Dr Robert Massey, Deputy Executive of the Royal Astronomical Session, will look at engaging with policy makers from the point of view of those working in the European Parliament, European Commission, industry, as well as the planetary community.

  16. 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.

  17. Fetal anatomy of the human carotid sheath and structures in and around it.

    PubMed

    Miyake, Naritomo; Hayashi, Shogo; Kawase, Tetsuaki; Cho, Baik Hwan; Murakami, Gen; Fujimiya, Mineko; Kitano, Hiroya

    2010-03-01

    The aim of this study was to find basic rules governing the morphological development of the typical neurovascular sheath. We carried out histological examination of 15 paraffin-embedded mid-term fetuses at 9-25 weeks of gestation (three fetuses each at 9, 12, 15, 20, and 25 weeks). As the result, the vagus nerve showed a high propensity to change its topographical relationship with the common carotid artery (CCA) during 9-20 weeks of gestation: that is, from a primitive ventral course to a final dorsal course. The adventitia of the great arteries, which was distinct from other fascial structures, became evident by 15 weeks. The carotid sheath appeared at and after 20 weeks: it was clearly separated from the prevertebral lamina of the deep cervical fasciae, but fused with the pretracheal lamina covering the strap muscles. Thus the carotid sheath, as well as the topographical relationships of structures within it, seems to become established much later than the prevertebral and pretracheal laminae of the deep cervical fasciae. However, the adventitia of the cervical great arteries consistently becomes evident much earlier than the sheath, and it seems to be regarded as one of the basic components of the fetal deep cervical fasciae.

  18. Fetal anatomy of the lower cervical and upper thoracic fasciae with special reference to the prevertebral fascial structures including the suprapleural membrane.

    PubMed

    Miyake, Naritomo; Takeuchi, Hiromi; Cho, Baik Hwan; Murakami, Gen; Fujimiya, Mineko; Kitano, Hiroya

    2011-07-01

    The aim of this study was to find basic rules governing the fetal anatomy of the deep cervical fasciae and their connections to the mediastinal fasciae. We examined the histology of paraffin-embedded preparations of 18 mid-term fetuses (5 between 9 and 12 weeks of gestation, 3 between 15 and 18 weeks, and 10 between 20 and 25 weeks). The prevertebral lamina of the deep cervical fasciae (PLDCF) developed as an intermediate aponeurosis for the bilateral bellies of the longus colli muscles. In contrast, the alar fascia developed as a connecting band between the bilateral adventitiae of the common carotid artery. The retropharyngeal fascia became evident much later than the latter two fasciae. The fascia covering the thymus was thicker than the fascia for the strap muscles (the pretracheal lamina of the cervical fascia). The primitive suprapleural membrane, or Sibson's fascia, contained veins and fatty tissues, and was composed of the alar fascia rather than the PLDCF, tranversalis fascia, or endothoracic fascia. The prevertebral two-laminar configuration was rather evident in the early stages of development because, in the later stages, the fasciae together provided a multilaminar structure, especially in the lateral area in front of the longus colli, which suspended the cupula pleurae. To consider a continuation from the base of the neck to the upper mediastinum, the alar fascia seems to be a key structure for connecting the vascular sheath to the parietal pleura.

  19. Lifestyle behaviors associated with exposures to endocrine disruptors

    PubMed Central

    Martina, Camille A.; Weiss, Bernard; Swan, Shanna H.

    2013-01-01

    Identifying and characterizing sources of exposure to phthalates and bisphenol A (BPA) have proved challenging due to the presence of multiple co-exposures resulting from a wide variety of home environments and lifestyles. We hypothesized that the consistent lifestyle of an Old Order Mennonite (OOM) community would provide an ideal setting in which to characterize sources of exposure to BPA and phthalates. We obtained urine samples from ten mid-term pregnant OOM women (ages-21–39) to determine concentrations of 9 phthalate metabolites and BPA and collected a self-reported survey of participants' household environment, product use, and lifestyle within a 48-h period prior to urine collection. We compared their metabolite concentrations to pregnant women included in the National Health and Nutrition Examination Survey (NHANES 2007–2008). Although OOM participants reported some use of plastic and fragranced household products, concentrations of metabolites were lower and significantly less for BPA (p = 0.002) and phthalate metabolites MEHP (p = 0.0215), MiBP (p = 0.0020) and MEP (p = 0.021), when compared to NHANES pregnant women. Levels of other phthalate metabolites were also lower in this population. Our data suggest three practices that may contribute to these lower levels: (1) consuming mostly homegrown produce (ingestion), (2) no cosmetics and limited use of personal care products, and (3) transportation primarily by sources other than automobiles. PMID:22739065

  20. Life cycle assessment of switchgrass- and corn stover-derived ethanol-fueled automobiles.

    PubMed

    Spatari, Sabrina; Zhang, Yimin; MacLean, Heather L

    2005-12-15

    Utilizing domestically produced cellulose-derived ethanol for the light-duty vehicle fleet can potentially improve the environmental performance and sustainability of the transport and energy sectors of the economy. A life cycle assessment model was developed to examine environmental implications of the production and use of ethanol in automobiles in Ontario, Canada. The results were compared to those of low-sulfur reformulated gasoline (RFG) in a functionally equivalent automobile. Two time frames were evaluated, one near-term (2010), which examines converting a dedicated energy crop (switchgrass) and an agricultural residue (corn stover) to ethanol; and one midterm (2020), which assumes technological improvements in the switchgrass-derived ethanol life cycle. Near-term results show that, compared to a RFG automobile, life cycle greenhouse gas (GHG) emissions are 57% lower for an E85-fueled automobile derived from switchgrass and 65% lower for ethanol from corn stover, on a grams of CO2 equivalent per kilometer basis. Corn stover ethanol exhibits slightly lower life cycle GHG emissions, primarily due to sharing emissions with grain production. Through projected improvements in crop and ethanol yields, results for the mid-term scenario show that GHG emissions could be 25-35% lower than those in 2010 and that, even with anticipated improvements in RFG automobiles, E85 automobiles could still achieve up to 70% lower GHG emissions across the life cycle.

  1. Solar Central Receiver Hybrid Power Systems sodium-cooled receiver concept. Final report. Volume II, Book 1. Conceptual design, Sections 1 through 4

    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 presents in detail the market analysis, parametric analysis, and the selection process for the preferred system. (WHK)

  2. 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

  3. Sustainable funding of health initiatives in Wonju, Republic of Korea via a tobacco consumption tax.

    PubMed

    Nam, Eun Woo; De Leeuw, Evelyne; Moon, Ji Young; Ikeda, Nayu; Dorjsuren, Bayarsaikhan; Park, Myung Bae

    2011-12-01

    Wonju is the first municipality in the Republic of Korea to fund the Healthy City project through municipal revenues from the local tobacco consumption tax. We investigated the process of the local tobacco consumption tax being approved as the main source of financing for the local Healthy City project. We also examined the sustainability and sufficiency of the funding by looking at the pricing policies instituted for cigarettes, smoking prevalence, cigarette consumption and revenues from local tobacco consumption as well as the budgetary allocations among programs in the city. The strong initiative of the mayor of Wonju was one of the factors that enabled the earmarking of the local tobacco consumption tax for the Healthy City Wonju project. He consulted academic counselors and persuaded the municipal government and the City Council to approve the bill. Despite the increasing price of cigarettes in Korea, adequate funding can be sustained to cover the short-term and mid-term programs in Wonju for at least 5 years of the mayor's term, because the smoking rate is persistently high. Analyzing the effects of strong leadership on the part of local authorities and the balance between revenues from the tobacco tax and the prevalence of smoking in the face of anti-smoking policies would be helpful for other countries and communities interested in developing sustainable Healthy Cities projects.

  4. 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.

  5. South Africa's universal health coverage reforms in the post-apartheid period.

    PubMed

    van den Heever, Alexander Marius

    2016-12-01

    In 2011, the South African government published a Green Paper outlining proposals for a single-payer National Health Insurance arrangement as a means to achieve universal health coverage (UHC), followed by a White Paper in 2015. This follows over two decades of health reform proposals and reforms aimed at deepening UHC. The most recent reform departure aims to address pooling and purchasing weaknesses in the health system by internalising both functions within a single scheme. This contrasts with the post-apartheid period from 1994 to 2008 where pooling weaknesses were to be addressed using pooling schemes, in the form of government subsidies and risk-equalisation arrangements, external to the public and private purchasers. This article reviews both reform paths and attempts to reconcile what may appear to be very different approaches. The scale of the more recent set of proposals requires a very long reform path because in the mid-term (the next 25 years) no single scheme will be able to raise sufficient revenue to provide a universal package for the entire population. In the interim, reforms that maintain and improve existing forms of coverage are required. The earlier reform framework (1994-2008) largely addressed this concern while leaving open the final form of the system. Both reform approaches are therefore compatible: the earlier reforms addressed medium- to long-term coverage concerns, while the more recent define the long-term institutional goal.

  6. Integrated optics in the mid-infrared: application to nulling interferometry for the detection of earth-like planets

    NASA Astrophysics Data System (ADS)

    Labadie, L.

    Nulling interferometry, a coronographic technique used in astronomy, is the core of the ESA Darwin mission dedicated to the direct detection of extrasolar earth-like planets. This technique requires a very stable optical system for the combination of multiple beams. Moreover, the scientific objectives require the use of modal filtering of the incoming beams. This thesis focuses on the development of mid-infrared integrated optics (IO) that can perform both combination and modal filtering functions. The initial context is thus the extension of single-mode IO from the near-infrared to the mid-infrared range, which corresponds to an important spectral domain for planet searches. After a description of nulling interferometry requirements, I present the fundamental guided-optics notions used to study the dielectric waveguides and the hollow metallic waveguides solutions. Moreover, I discuss the issue of coupling light into the waveguide. The lab characterization work at 10 microns has involved the implementation of dedicated methods and breadboards in the mid-infrared, which permitted me to demonstrate the waveguide and the single-mode behavior of the first manufactured structures. The preliminary measurements of the signal extinction have also shown the importance of pursuing this technological research for purposes of modal filtering. Mid-infrared integrated optics has now reached a new and important step and will contribute, on a mid-term basis, to the implemetation of nulling interferometry.

  7. 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.

  8. Multiscale asymmetric orthogonal wavelet kernel for linear programming support vector learning and nonlinear dynamic systems identification.

    PubMed

    Lu, Zhao; Sun, Jing; Butts, Kenneth

    2014-05-01

    Support vector regression for approximating nonlinear dynamic systems is more delicate than the approximation of indicator functions in support vector classification, particularly for systems that involve multitudes of time scales in their sampled data. The kernel used for support vector learning determines the class of functions from which a support vector machine can draw its solution, and the choice of kernel significantly influences the performance of a support vector machine. In this paper, to bridge the gap between wavelet multiresolution analysis and kernel learning, the closed-form orthogonal wavelet is exploited to construct new multiscale asymmetric orthogonal wavelet kernels for linear programming support vector learning. The closed-form multiscale orthogonal wavelet kernel provides a systematic framework to implement multiscale kernel learning via dyadic dilations and also enables us to represent complex nonlinear dynamics effectively. To demonstrate the superiority of the proposed multiscale wavelet kernel in identifying complex nonlinear dynamic systems, two case studies are presented that aim at building parallel models on benchmark datasets. The development of parallel models that address the long-term/mid-term prediction issue is more intricate and challenging than the identification of series-parallel models where only one-step ahead prediction is required. Simulation results illustrate the effectiveness of the proposed multiscale kernel learning.

  9. 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.

  10. 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.

  11. 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)

  12. 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.

  13. Paranal Instrumentation Programme: 2013-2020 Development Plan

    NASA Astrophysics Data System (ADS)

    Pasquini, L.; Casali, M.; Russell, A.

    2013-12-01

    The development plan for instrumentation at the Paranal Observatory was presented to the ESO Scientific Technical Committee (STC) in April 2013. Its overall goal is to keep Paranal at the forefront of ground-based astronomy. In addition to the completion of the current second generation instruments, the installation of the Adaptive Optics Facility with the imager and spectrometer ERIS, and execution of the Very Large Telescope Interferometer (VLT/I) mid-term implementation plan, it will allow one new instrument, or instrument upgrade, to be initiated per year (provided current projects are completed). The plan is divided into two phases. Over 2013-2017, instruments are selected and developed with the criteria of filling the VLT capabilities and maintaining the balance between dedicated and general purpose facilities. Beyond 2018, the instruments will be deployed in the era of maturity of the European Extremely Large Telescope (E-ELT). The strategy for the second phase derives from analysis of VLT science in the E-ELT era, to be fully shaped in the coming five years. One new instrument is also proposed for the New Technology Telescope at La Silla, fully funded by the community.

  14. Lower recurrence rates after mesh-reinforced versus simple hiatal hernia repair: a meta-analysis of randomized trials.

    PubMed

    Antoniou, Stavros A; Antoniou, George A; Koch, Oliver O; Pointner, Rudolph; Granderath, Frank A

    2012-12-01

    Mesh hiatoplasty has been postulated to reduce recurrence rates, it is however prone to esophageal stricture, and early-term and mid-term dysphagia. The present meta-analysis was designed to compare the outcome between mesh-reinforced and primary hiatal hernia repair. The databases of Medline, EMBASE, and the Cochrane Library were searched; only randomized controlled trials entered the meta-analytical model. Anatomic recurrence documented by barium oesophagography was defined as the primary outcome endpoint. Three randomized controlled trials reporting the outcomes of 267 patients were identified. The follow-up period ranged between 6 and 12 months. The weighted mean recurrence rates after primary and mesh-reinforced hiatoplasty were 24.3% and 5.8%, respectively. Pooled analysis demonstrated increased risk of recurrence in primary hiatal closure (odds ratio, 4.2; 95% confidence interval, 1.8-9.5; P=0.001). Mesh-reinforced hiatal hernia repair is associated with an approximately 4-fold decreased risk of recurrence in comparison with simple repair. The long-term results of mesh-augmented hiatal closure remain to be investigated.

  15. Surgery for infants with a hypoplastic systemic ventricle and severe outflow obstruction: early results with a modified Norwood procedure.

    PubMed Central

    Bu'Lock, F. A.; Stümper, O.; Jagtap, R.; Silove, E. D.; De Giovanni, J. V.; Wright, J. G.; Sethia, B.; Brawn, W. J.

    1995-01-01

    OBJECTIVE--Prospective audit of the first year of implementation of a modified approach to palliation for infants with hypoplastic systemic ventricle and severe systemic outflow obstruction. SETTING--Tertiary referral centre for neonatal and infant cardiac surgery. PATIENTS AND METHODS--17 of 19 infants (aged < 35 days) presenting to Birmingham Children's Hospital in 1993 with hypoplastic systemic ventricle and severe outflow obstruction underwent surgery. This was performed using a new modification of the Norwood-type arch repair, without the use of exogenous material, and a 3.5 mm Gore-tex shunt between the innominate and right pulmonary arteries. The Gore-tex shunt was replaced by a cavopulmonary shunt between 3 and 5 months later. Clinical, morphological, and functional determinants of outcome were examined. RESULTS--10 (59%) infants survived initial surgery. All proceeded to cavopulmonary shunt without further loss. Significant atrioventricular valve regurgitation seemed to be the main risk factor for poor outcome. If this was excluded, the morphology of the dominant ventricle seemed to have little effect on the outcome of initial surgery. CONCLUSIONS--Early survival was achieved in 59% of patients in the first year of implementation of a protocol for surgery in infants with hypoplastic systemic ventricle and severe outflow obstruction. The construction of a neoaorta without the use of exogenous material may allow improved later growth of the neoaorta. Early cavopulmonary shunt can be performed safely and should reduce mid-term complications from cyanosis and systemic ventricular volume loading. PMID:7540406

  16. Potential of the TCE-degrading endophyte Pseudomonas putida W619-TCE to improve plant growth and reduce TCE phytotoxicity and evapotranspiration in poplar cuttings.

    PubMed

    Weyens, Nele; Truyens, Sascha; Dupae, Joke; Newman, Lee; Taghavi, Safiyh; van der Lelie, Daniel; Carleer, Robert; Vangronsveld, Jaco

    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(-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(-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.

  17. 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.

  18. 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.

  19. 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.

  20. Transcatheter Mitral Valve Repair in Surgical High-Risk Patients: Gender-Specific Acute and Long-Term Outcomes

    PubMed Central

    Tigges, Eike; Kalbacher, Daniel; Thomas, Christina; Appelbaum, Sebastian; Deuschl, Florian; Schofer, Niklas; Schlüter, Michael; Conradi, Lenard; Schirmer, Johannes; Treede, Hendrik; Reichenspurner, Hermann; Blankenberg, Stefan; Schäfer, Ulrich; Lubos, Edith

    2016-01-01

    Background. Analyses emphasizing gender-related differences in acute and long-term outcomes following MitraClip therapy for significant mitral regurgitation (MR) are rare. Methods. 592 consecutive patients (75 ± 8.7 years, 362 men, 230 women) underwent clinical and echocardiographic follow-up for a median of 2.13 (0.99–4.02) years. Results. Significantly higher prevalence of cardiovascular comorbidities, renal failure, and adverse echocardiographic parameters in men resulted in longer device time (p = 0.007) and higher numbers of implanted clips (p = 0.0075), with equal procedural success (p = 1.0). Rehospitalization for heart failure did not differ (p[logrank] = 0.288) while survival was higher in women (p[logrank] = 0.0317). Logarithmic increase of NT-proBNP was a common independent predictor of death. Hypercholesterolemia and peripheral artery disease were predictors of death only in men while ischemic and dilative cardiomyopathy (CM) and age were predictors in women. Independent predictors of rehospitalization for heart failure were severely reduced ejection fraction and success in men while both ischemic and dilative CM, logistic EuroSCORE, and MR severity were predictive in women. Conclusions. Higher numbers of implanted clips and longer device time are likely related to more comorbidities in men. Procedural success and acute and mid-term clinical outcomes were equal. Superior survival for women in long-term analysis is presumably attributable to a comparatively better preprocedural health. PMID:27042662

  1. 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.

  2. Efficacy of kinesio tape application on pain and muscle strength in patients with myofascial pain syndrome: a placebo-controlled trial

    PubMed Central

    Öztürk, Gülcan; Külcü, Duygu Geler; Mesci, Nilgün; Şilte, Ayşe Duygu; Aydog, Ece

    2016-01-01

    [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. PMID:27190430

  3. 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.

  4. Functional outcome after perineal stapled prolapse resection for external rectal prolapse

    PubMed Central

    2010-01-01

    Background A new surgical technique, the Perineal Stapled Prolapse resection (PSP) for external rectal prolapse was introduced in a feasibility study in 2008. This study now presents the first results of a larger patient group with functional outcome in a mid-term follow-up. Methods From December 2007 to April 2009 PSP was performed by the same surgeon team on patients with external rectal prolapse. The prolapse was completely pulled out and then axially cut open with a linear stapler at three and nine o'clock in lithotomy position. Finally, the prolapse was resected stepwise with the curved Contour® Transtar™ stapler at the prolapse's uptake. Perioperative morbidity and functional outcome were prospectively measured by appropriate scores. Results 32 patients participated in the study; median age was 80 years (range 26-93). No intraoperative complications and 6.3% minor postoperative complications occurred. Median operation time was 30 minutes (15-65), hospital stay 5 days (2-19). Functional outcome data were available in 31 of the patients after a median follow-up of 6 months (4-22). Preoperative severe faecal incontinence disappeared postoperatively in 90% of patients with a reduction of the median Wexner score from 16 (4-20) to 1 (0-14) (P < 0.0001). No new incidence of constipation was reported. Conclusions The PSP is an elegant, fast and safe procedure, with good functional results. Trial registration ISRCTN68491191 PMID:20205956

  5. 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

  6. 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.

  7. NASA's In-Space Propulsion Technology Program: A Step Toward Interstellar Exploration

    NASA Technical Reports Server (NTRS)

    Johnson, Les; James, Bonnie; Baggett, Randy; Montgomery, Sandy

    2005-01-01

    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, electrodynamic and momentum transfer tethers, 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.

  8. Proceedings of the natural gas research and development contractors review meeting

    SciTech Connect

    Malone, R.D.; Shoemaker, H.D.; Byrer, C.W.

    1990-11-01

    The purpose of this meeting was to present results of the research in the DOE-sponsored Natural Gas Program, and simultaneously to provide a forum for real-time technology transfer, to the active research community, to the interested public, and to the natural gas industry, who are the primary users of this technology. The current research focus is to expand the base of near-term and mid-term economic gas resources through research activities in Eastern Tight Gas, Western Tight Gas, Secondary Gas Recovery (increased recovery of gas from mature fields); to enhance utilization, particularly of remote gas resources through research in Natural Gas to Liquids Conversion; and to develop additional, long term, potential gas resources through research in Gas Hydrates and Deep Gas. With the increased national emphasis on the use of natural gas, this forum has been expanded to include summaries of DOE-sponsored research in energy-related programs and perspectives on the importance of gas to future world energy. Thirty-two papers and fourteen poster presentations were given in seven formal, and one informal, sessions: Three general sessions (4 papers); Western Tight Gas (6 papers); Eastern Tight Gas (8 papers); Conventional/Speculative Resources (8 papers); and Gas to Liquids (6 papers). Individual reports are processed separately on the data bases.

  9. 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.

  10. 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.

  11. 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.

  12. Technology development goals for automotive fuel cell power systems. Final report

    SciTech Connect

    James, B.D.; Baum, G.N.; Kuhn, I.F. Jr.

    1994-08-01

    This report determines cost and performance requirements for Proton Exchange Membrane (PEM) fuel cell vehicles carrying pure H{sub 2} fuel, to achieve parity with internal combustion engine (ICE) vehicles. A conceptual design of a near term FCEV (fuel cell electric vehicle) is presented. Complete power system weight and cost breakdowns are presented for baseline design. Near term FCEV power system weight is 6% higher than ICE system, mid-term FCEV projected weights are 29% lower than ICE`s. There are no inherently high-cost components in FCE, and at automotive production volumes, near term FCEV cost viability is closer at hand than at first thought. PEM current vs voltage performance is presented for leading PEM manufacturers and researchers. 5 current and proposed onboard hydrogen storage techniques are critically compared: pressurized gas, cryogenic liquid, combined pressurized/cryogenic, rechargeable hydride, adsorption. Battery, capacitor, and motor/controller performance is summarized. Fuel cell power system component weight and cost densities (threshold and goal) are tabulated.

  13. 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.

  14. 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.

  15. 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.

  16. Physical therapy intervention studies on idiopathic scoliosis-review with the focus on inclusion criteria1

    PubMed Central

    2012-01-01

    Background Studies investigating the outcome of conservative scoliosis treatment differ widely with respect to the inclusion criteria used. This study has been performed to investigate the possibility to find useful inclusion criteria for future prospective studies on physiotherapy (PT). Materials and methods A PubMed search for outcome papers on PT was performed in order to detect study designs and inclusion criteria used. Results Real outcome papers (start of treatment in immature samples/end results after the end of growth; controlled studies in adults with scoliosis with a follow-up of more than 5 years) have not been found. Some papers investigated mid-term effects of exercises, most were retrospective, few prospective and many included patient samples with questionable treatment indications. Conclusion There is no outcome paper on PT in scoliosis with a patient sample at risk for being progressive in adults or in adolescents followed from premenarchial status until skeletal maturity. However, papers on bracing are more frequently found and bracing can be regarded as evidence-based in the conservative management and rehabilitation of idiopathic scoliosis in adolescents. PMID:22277541

  17. In-Space Propulsion Program Overview and Status

    NASA Technical Reports Server (NTRS)

    Wercinski, Paul F.; Johnson, Les; Baggett, Randy M.

    2003-01-01

    NASA's In-Space Propulsion (ISP) Program is designed to develop advanced propulsion technologies that can enable or greatly enhance near and mid-term NASA science missions by significantly reducing cost, mass, and/or travel times. These technologies include: Solar Electric Propulsion, Aerocapture, Solar Sails, Momentum Exchange Tethers, Plasma Sails and other technologies such as Advanced Chemical Propulsion. The ISP Program intends to develop cost-effective propulsion technologies that will provide a broad spectrum of mission possibilities, enabling NASA to send vehicles on longer, more useful voyages and in many cases to destinations that were previously unreachable using conventional means. The ISP approach to identifying and prioritizing these most promising technologies is to use mission and system analysis and subsequent peer review. The ISP program seeks to develop technologies under consideration to Technology Readiness Level (TRL) -6 for incorporation into mission planning within 3-5 years of initiation. The NASA TRL 6 represents a level where a technology is ready for system level demonstration in a relevant environment, usually a space environment. In addition, maximum use of open competition is encouraged to seek optimum solutions under ISP. Several NASA Research Announcements (NRA's) have been released asking industry, academia and other organizations to propose propulsion technologies designed to improve our ability to conduct scientific study of the outer planets and beyond. The ISP Program is managed by NASA Headquarters Office of Space Science and implemented by the Marshall Space Flight Center in Huntsville, Alabama.

  18. 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.

  19. 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.

  20. 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

  1. An experience of liver transplantation in Latin America: a medical center in Colombia

    PubMed Central

    Londoño, Mauricio; Marín, Juan; Muñoz, Octavio; Mena, Álvaro; Guzmán, Carlos; Hoyos, Sergio; Restrepo, Juan; Arbeláez, María; Correa, Gonzalo

    2015-01-01

    Objectives: Liver transplantation is the treatment of choice for acute and chronic liver failure, for selected cases of tumors, and for conditions resulting from errors in metabolism. This paper reports the experience of a medical center in Latin America. Methods: Were conducted 305 orthotopic liver transplantations on 284 patients between 2004 and 2010. Of these patients, 241 were adults undergoing their first transplantation. Results: The average age of patients was 52 years old, and 62% of the individuals were male. The most common indication was alcoholic cirrhosis. The rate of patient survival after 1 and 5 years was 82 and 72% respectively. The rate of liver graft survival after 1 and 5 years was 78 and 68% respectively. The main cause of death was sepsis. Complications in the hepatic artery were documented for 5% of the patients. Additionally, 14.5% of the patients had complications in the biliary tract. Infections were found in 41% of the individuals. Acute rejection was observed in 30% of the subjects, and chronic rejection in 3%. Conclusion: In conclusion, liver transplantation at our medical center in Colombia offers good mid-term results, with a complication rate similar to that reported by other centers around the world. PMID:26019379

  2. Antarctica Search for Transiting Extrasolar Planets

    NASA Astrophysics Data System (ADS)

    Fressin, F.; Guillot, T.; Bouchy, F.; Erikson, A.; Gay, J.; Léger, A.; Pont, F.; Rauer, H.; Rivet, J.-P.; Valbousquet, F.

    We present “A STEP”, a project dedicated to the search for planetary transits from Antartica. The project consists of a fully automatic 40 cm telescope equipped with an 11-million-pixel CCD installed at Dome C. The site offers crucial assets for a ground-based exoplanet transit search: uninterrupted phase coverage and excellent seeing. This system would be able to detect hot Jupiters transiting in front of stars as faint as magnitude sixteen and could also detect smaller planets in close-in period around brighter stars. Our estimations, based on results of previous surveys are an average of 6 detections per 60 days survey. Compared to existing surveys, this excellent yield is due to the nearly-continuous phase coverage and excellent seiing. This short term project is meant to be a photometric qualifyer for the site and the first stage of a massive detection campaign. A mid-term objective of 1000 detections for 2012 could be achieved either with many small telescopes or with a large Schmidt telescope with a large field of view. The project is relatively simple and cost-effective, and has the double purpose of qualifying the site and obtaining first-class scientific results. Our team is already familiar with transit detection with an automated telescope (BEST) and cold temperature qualification.

  3. A Step: Towards a Successor to CoRoT on Dome C, Antarctica

    NASA Astrophysics Data System (ADS)

    Fressin, F.; Guillot, T.; Schmider, F. X.; Agabi, Karim; Moutou, Claire; Bouchy, Francois; Boer, Michel; Pont, Frédéric; Erikson, Anders; Rauer, Heike; Astep Team

    2006-11-01

    We present ASTEP”(Antarctica Search for Transiting Extrasolar Planets), a project dedicated to the search for planetary transits from Antartica. The project consists of a semi-automatic 40 cm telescope equipped with an 4-million-pixel CCD installed at Dome C. The site offers crucial assets for a groundbased exoplanet transit search : uninterrupted phase coverage, excellent weather, low air-mass variations and reduced scintillation. This system would be able to detect Pegasids transiting in front of stars as faint as magnitude sixteen and could also detect smaller planets in close-in period around brighter stars. This short term project is meant to be a photometric qualifyer for the site and the first stage of a massive detection campaign. A mid-term objective of 1000 detections for 2012 could be achieved either with many small telescopes or with a large Schmidt telescope with a large field of view. The project is relatively simple and cost-effective, and has the double purpose of qualifying the site and obtaining first-class scientific results. Our team is already familiar with transit detection with an automated telescope and cold temperature qualification.

  4. A STEP: Towards a Large Photometric Survey for Exoplanets at Dome C

    NASA Astrophysics Data System (ADS)

    Fressin, F.; Guillot, T.; Schmider, F.-X.; Agabi, A.; Moutou, C.; Aigrain, S.; Bouchy, F.; Boer, M.; Pont, F.; Erikson, A.; Rauer, H.; A Step Team

    We present “A STEP” (Antarctica Search for Transiting Extrasolar Planets), a project dedicated to the search for planetary transits from Antartica. The project consists of a semi-automatic ~40 cm telescope equipped with a 16-million-pixel CCD installed at Dome C. The site offers crucial assets for a ground-based exoplanet transit search: uninterrupted phase coverage, excellent weather, low air-mass variations and reduced scintillation. This system would be able to detect Pegasids transiting in front of stars as faint as magnitude sixteen and could also detect smaller planets in close-in period around brighter stars. This short term project is meant to be a photometric qualifyer for the site and the first stage of a massive detection campaign. A mid-term objective of 1000 detections for 2012 could be achieved either with many small telescopes or with a large Schmidt telescope with a large field of view. The project is relatively simple and cost-effective, and has the double purpose of qualifying the site and obtaining first-class scientific results. Our team is already familiar with transit detection with an automated telescope and cold temperature qualification.

  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. Expression of hyaluronan (hyaluronic acid) in the developing laminar architecture of the human fetal brain.

    PubMed

    Shibata, Shunichi; Cho, Kwang Ho; Kim, Ji Hyun; Abe, Hiroshi; Murakami, Gen; Cho, Baik Hwan

    2013-10-01

    Hyaluronan (also called hyaluronic acid or HA) plays a key role in the morphogenesis of the brain, but little is known about its expression in the human fetal neocortex. Using immunohistochemical methods, we assayed the expression of HA, glial fibrillary acidic protein, vimentin, nestin, and proliferating cell nuclear antigen in paraffin-embedded histologic sections of 8 mid-term fetuses (estimated gestational age, 12-16 weeks; crown-rump length, 75-120mm). At 12-13 weeks, HA was expressed strongly along the membranes of many cells in the cortical plate and the layer 1 or marginal zone, but showed weak, spotty expression in a fiber-rich layer adjacent to the cortical plate, called the cortical stratified transitional field-1 (STF-1 or a primitive form of the subplate). At 15-16 weeks, HA was expressed in the layer 1 and in the early subplate or presubplate, but less strongly in cells of the possible STF-5 near the subventricular zone. However, the positive observation in STF-5 was probably a result of individual difference in development. The developing cortical plate seemed to produce HA in the presubplate to harbor axonal plexus of various afferent systems, while Cajal-Retzius cells were likely to accumulate HA in the layer 1. The HA-rich zones, those sandwiched the cortical plate, might avoid further migration of cortical cells.

  7. Earthquake-Induced Building Damage Assessment Based on SAR Correlation and Texture

    NASA Astrophysics Data System (ADS)

    Gong, Lixia; Li, Qiang; Zhang, Jingfa

    2016-08-01

    Comparing with optical Remote Sensing, the Synthetic Aperture Radar (SAR) has unique advantages as applied to seismic hazard monitoring and evaluation. SAR can be helpful in the whole process of after an earthquake, which can be divided into three stages. On the first stage, pre-disaster imagery provides history information of the attacked area. On the mid-term stage, up-to-date thematic maps are provided for disaster relief. On the later stage, information is provided to assist secondary disaster monitoring, post- disaster assessment and reconstruction second stage. In recent years, SAR has become an important data source of earthquake damage analysis and evaluation.Correlation between pre- and post-event SAR images is considered to be related with building damage. There will be a correlation decrease when the building collapsed in a shock. Whereas correlation decrease does not definitely indicate building changes. Correlation is also affected by perpendicular baseline, the ground coverage type, atmospheric change and other natural conditions, data processing and other factors. Building samples in the earthquake are used to discriminate the relation between damage degree and SAR correlation.

  8. Proceedings: Eleventh forecasting symposium. Forecasting in a competitive electricity market

    SciTech Connect

    Vogt, T.; Ignelzi, P.

    1998-10-01

    EPRI`s Eleventh Forecasting Symposium: ``Forecasting in a Competitive Electricity Market`` was held in Arlington, Virginia, in November 1997. This proceedings documents the symposium`s wide variety of topics, ranging from very-short-term operations issues to mid-term market planning issues. Speakers described the forecasting practices of other industries, predicted forecasting directions in the electric power industry; related their experiences with new forecasting approaches; and suggested further enhancements to forecasting methods, tools, and data. The objectives of the symposium were to explore the expanding roles of forecasting in a competitive market, to exchange information about forecasting techniques under development, and to discuss the forecasting techniques currently used by the electric power industry in and outside the US and in other industries. The 30 papers are arranged under the following topical sections: restructuring and regulatory issues--implications for forecasting; forecasting experiences in other industries; operations-related forecasting; data warehousing and database marketing; forecasting and risk management; understanding and predicting market prices; forecasting methods for the new environment; predicting customer response; and symposium wrap-up.

  9. Alpine Skiing With total knee ArthroPlasty (ASWAP): clinical and radiographic outcomes.

    PubMed

    Hofstaedter, T; Fink, C; Dorn, U; Pötzelsberger, B; Hepperger, C; Gordon, K; Müller, E

    2015-08-01

    The aim of the study was to assess the effect of a recreational alpine skiing intervention on implant-related factors, such as loosening and wear, in patients with total knee arthoplasty (TKA). A group of 16 TKA patients were examined 2.3 ± 0.1 years after skiing about 80 days over three seasons inclusive of a ski intervention of 2-3 times per week (25.5 days) over a 12-week period. Mean follow-up period was 5.1 ± 1 years after surgery. All patients had excellent clinical and radiological outcomes. The average flexion was 120-130°, the average Oxford Knee Score increased from 15 points pre-operatively to 47.4 points post-operatively. An average Tegner activity level of 5.5 was assessed, indicating a very high post-operative activity level. No radiolucencies or osteolyses were observed in any of the radiographs. One patient sustained a meniscal tear in the contralateral knee. Recreational alpine skiing on intermediate terrain at moderate speed can be recommended after TKA. Analysis of mid-term follow-up has not shown any negative effect on the implant loosening or additional polyethylene wear.

  10. Multidimensional associative factors for improvement in pain, function, and working capacity after rehabilitation of whiplash associated disorder: a prognostic, prospective outcome study

    PubMed Central

    2014-01-01

    Background Whiplash associated disorders (WAD) have dramatic consequences for individual and public health. Risk factors for better and worse outcomes are important to optimize management. This study aimed to determine short- and mid-term associative co-factors of neck pain relief, improved physical functioning, and improved working capacity (dependent variables) in patients suffering from whiplash associated disorder who participated in a standardized, inpatient pain management program. Methods Naturalistic, observational, prospective cohort study. Outcome was measured by standardized assessment instruments. Co-factors covered sociodemographics, comorbidities, social participation, affective health, and coping abilities. Stepwise, multivariate linear regression analysis was performed at discharge and at the 6-month follow-up. Results All regression models explained high proportions of variance (53.3% – 72.1%). The corresponding baseline level was significantly associated with a change in every dependent variable (explained variances: 11.4%-56.7%). Pain relief significantly depended on improved function and vice-versa (3.4%-14.8%). Improved ability to decrease pain was associated with pain relief at discharge (9.6%). Functional improvement was associated with decreased catastrophizing (19.4%) at discharge and decreased depression (20.5%) at the 6 month follow-up. Conclusions Pain relief, improved physical function and working capacity were associated with each other. Improved coping (catastrophizing and ability to decrease pain) and reduced depression may act as important predictors for pain relief and improved function. These findings offer toe-holds for optimized therapy of chronic WAD. PMID:24739588

  11. 3D bioprint me: a socioethical view of bioprinting human organs and tissues.

    PubMed

    Vermeulen, Niki; Haddow, Gill; Seymour, Tirion; Faulkner-Jones, Alan; Shu, Wenmiao

    2017-03-20

    In this article, we review the extant social science and ethical literature on three-dimensional (3D) bioprinting. 3D bioprinting has the potential to be a 'game-changer', printing human organs on demand, no longer necessitating the need for living or deceased human donation or animal transplantation. Although the technology is not yet at the level required to bioprint an entire organ, 3D bioprinting may have a variety of other mid-term and short-term benefits that also have positive ethical consequences, for example, creating alternatives to animal testing, filling a therapeutic need for minors and avoiding species boundary crossing. Despite a lack of current socioethical engagement with the consequences of the technology, we outline what we see as some preliminary practical, ethical and regulatory issues that need tackling. These relate to managing public expectations and the continuing reliance on technoscientific solutions to diseases that affect high-income countries. Avoiding prescribing a course of action for the way forward in terms of research agendas, we do briefly outline one possible ethical framework 'Responsible Research Innovation' as an oversight model should 3D bioprinting promises are ever realised. 3D bioprinting has a lot to offer in the course of time should it move beyond a conceptual therapy, but is an area that requires ethical oversight and regulation and debate, in the here and now. The purpose of this article is to begin that discussion.

  12. The Geological Grading Scale: Every million Points Counts!

    NASA Astrophysics Data System (ADS)

    Stegman, D. R.; Cooper, C. M.

    2006-12-01

    The concept of geological time, ranging from thousands to billions of years, is naturally quite difficult for students to grasp initially, as it is much longer than the timescales over which they experience everyday life. Moreover, universities operate on a few key timescales (hourly lectures, weekly assignments, mid-term examinations) to which students' maximum attention is focused, largely driven by graded assessment. The geological grading scale exploits the overwhelming interest students have in grades as an opportunity to instill familiarity with geological time. With the geological grading scale, the number of possible points/marks/grades available in the course is scaled to 4.5 billion points --- collapsing the entirety of Earth history into one semester. Alternatively, geological time can be compressed into each assignment, with scores for weekly homeworks not worth 100 points each, but 4.5 billion! Homeworks left incomplete with questions unanswered lose 100's of millions of points - equivalent to missing the Paleozoic era. The expected quality of presentation for problem sets can be established with great impact in the first week by docking assignments an insignificant amount points for handing in messy work; though likely more points than they've lost in their entire schooling history combined. Use this grading scale and your students will gradually begin to appreciate exactly how much time represents a geological blink of the eye.

  13. A Generic Framework for Tsunami Evacuation Planning

    NASA Astrophysics Data System (ADS)

    Scheer, Stefan; Eftichidis, George; Guillande, Richard

    2010-05-01

    Coastal communities are vulnerable with regard to the devastating impacts tsunami waves may generate to life, lifelines, assets and economy. The risk is quantified by rather rare occurrence on one hand, and by high damage to be expected on the other hand. Hence a pure numerical calculation could easily become meaningless. Yet over-dramatizing the threat could become counter-productive taking into account social behaviour and human perception of potential risk of tsunami waves. Local communities would therefore rather act in a "silent" way by gradually improving the level of preparedness. The goal should be to create a concept of an emergency and evacuation plan that could easily be invoked if necessary. Obviously such concepts are based on a huge variety of parameters which can be set in an individual way considering local particularities, scopes and questions of applicability. Nevertheless guidance through all these parameters and their calculations is difficult to find. This abstract proposes a generic framework that summarizes the application of various steps to be taken, the interdependencies of these steps and the three phases of repetition due to generation, mid-term maintenance and long-term revision of such emergency and evacuation plans. The abstract represents the outcome of research work done as part of the EU-funded SCHEMA (scenarios for hazard-induced emergencies management) project.

  14. 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.

  15. 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.

  16. Pulmonary Arteriovenous Malformation Causing Systemic Hypoxemia in Early Infancy

    PubMed Central

    Khan, D. M.; Rhodes, J. F.

    2017-01-01

    Pulmonary arteriovenous malformation (AVM) is not routinely appreciated during the standard echocardiogram to assess for structural abnormalities or pulmonary hypertension. The distal pulmonary AVM is suspected only if an injection of agitated saline is performed and late entry of particles is appreciated in the left heart structures. A large or complex pulmonary AVM can result in significant right-to-left shunting and consequential systemic hypoxemia in the presence or absence of pulmonary hypertension. For direct visualization of the pulmonary AVM, computerized tomography (CT) scan is the procedure of choice. Here, we present two young infants with systemic hypoxemia who underwent standard medical management including mechanical ventilation and one patient was placed on extracorporeal membrane oxygenation (ECMO) before the diagnosis of pulmonary AVM was established. Subsequently, both patients have done well into mid-term follow-up after being treated successfully using transcatheter occlusion techniques in the cardiac catheterization laboratory during early infancy. We aim to emphasize the importance of a high index of suspicion for pulmonary AVM in infants with refractory systemic hypoxemia of unclear etiology. PMID:28373920

  17. Reverse Shoulder Arthroplasty for the Treatment of 3 and 4- Part Fractures of the Humeral Head in the Elderly

    PubMed Central

    Gigis, Ioannis; Nenopoulos, Alexandros; Giannekas, Dimitrios; Heikenfeld, Roderich; Beslikas, Theodoros; Hatzokos, Ippokratis

    2017-01-01

    Background: Proximal humeral fractures in elderly patients present with severe comminution and osteoporotic bone quality. Reverse shoulder arthroplasty has lately been proven beneficial in treating patients with complex proximal humeral fractures. The above technique is recommended and has better results in elderly than in younger individuals. Methods: We performed a literature search in the databases Pubmed, Medline, EMBASE and Cochrane Library for published articles between 1970 and 2016 using the terms: proximal humerus fractures and reverse shoulder arthroplasty. Results: Significant benefits with the use of reverse prosthesis, especially in patients older than 70 years with a proximal humeral fracture, include reduced rehabilitation time as well as conservation of a fixed fulcrum for deltoid action in case of rotator cuff failure. Compared with hemiarthroplasty and internal fixation, reverse prosthesis may be particularly useful and give superior outcomes in older patients, due to comminuted fractures in osteopenic bones. However, significant disadvantages of this technique are potential complications and a demanding learning curve.Therefore, trained surgeons should follow specific indications when applying the particular treatment of proximal humeral fractures and be familiar with the surgical technique. Conclusion: Although long-term results and randomized studies for reverse prosthesis are lacking, short and mid- term outcomes have given promising results encouraging more shoulder surgeons to use this type of prosthesis in proximal humeral fractures.

  18. 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

  19. Inorganic carbon acquisition in algal communities: are the laboratory data relevant to the natural ecosystems?

    PubMed

    Mercado, Jesús M; Gordillo, F J L

    2011-09-01

    Most of the experimental work on the effects of ocean acidification on the photosynthesis of algae has been performed in the laboratory using monospecific cultures. It is frequently assumed that the information obtained from these cultures can be used to predict the acclimation response in the natural environment. CO(2) concentration is known to regulate the expression and functioning of the CCMs in the natural communities; however, ambient CO(2) can become quite variable in the marine ecosystems even in the short- to mid-term. We propose that the degree of saturation of the photosynthesis for a given algal community should be defined in relation to the particular characteristics of its habitat, and not only in relation to its taxonomic composition. The convenience of high CO(2) experiments to infer the degree of photosynthesis saturation by CO(2) in the natural algal communities under the present ocean conditions, as well as its trend in a coming future is discussed taking into account other factors such as the availability of light and nutrients, and seasonality.

  20. Laparoscopic sleeve gastrectomy versus Roux-en-Y gastric bypass for morbid obesity: a 1:1 matched cohort study in a Chinese population

    PubMed Central

    Zhou, Hong-xu; Li, Xue; Zhang, Xiao-juan; Zhou, Zong-guang; Cheng, Zhong

    2016-01-01

    Objectives This 1:1 matched cohort study with 3-year follow-up aimed to compare the safety and efficacy of LSG with LRYGB for morbid obesity patients. Methods From 2009 to 2013, patients undergoing LRYGB (n = 63) were matched with LSG (n = 63) by gender, age, and body mass index (BMI). Major complications, BMI, percentage of excess weight loss (%EWL), and obesity-related comorbidities after 6, 12, 24, and 36 months were compared. Results Hospital stay and major complication rates were comparable, but operative time in LSG was significantly shorter (83.2 ± 23.7 vs. 108.3 ± 21.3 min). No significant differences in mean %EWL and BMI were observed at 6, 12, 24 months. At 3-year follow-up, mean %EWL in the LRYGB group was significantly higher than in the LSG group (76.5 ± 9.2% vs. 65.7 ± 10.3%) and, consequently, mean BMI was significantly lower in LRYGB (28.2 ± 1.5 vs. 30.9 ± 2.4 kg/m2). No significant differences in remission of comorbidities were observed at 1- or 3-year follow-up. Conclusions Both LRYGB and LSG were safe and effective bariatric procedures in this Chinese population, but LRYGB seemed to be superior to LSG in terms of mid-term weight loss. PMID:27729621

  1. Rapid automatized naming and immediate memory functions in Chinese children who read English as a second language.

    PubMed

    Ding, Yi; Guo, Jian-Peng; Yang, Ling-Yan; Zhang, Dake; Ning, Huan; Richman, Lynn C

    2013-01-01

    This study examined reading performance of 102 Chinese Mandarin-speaking 4th graders in their second language (L2, English) as a function of performance in their first language (L1, Chinese). The results revealed that for Rapid Automatized Naming (RAN) and Rapid Alternating Stimulus (RAS) measures, the mean naming time decreased monotonically in high-achieving, average, and low-achieving readers. RAN and RAS differentiated poor readers from good and average readers but failed to differentiate between good and average readers. RAN deficits occurred in poor readers in both languages. Comparison of memory profiles revealed that patterns varied depending on the mode of stimulus presentation or response. Low-achieving readers performed poorly on a subtest involving visual components only and did relatively better on a subtest involving verbal components only. Poor readers in Chinese also encountered difficulties in learning English as a L2. RAN-character accounted for unique variance in two Chinese reading measures. RAN-letter explained unique variance in English mid-term reading grade. The unique variance captured by the Color Span Subtest 1 (visual-visual) was found in Chinese reading comprehension but not in English reading comprehension. Reading performance in L1 was predictive of reading performance in L2 and vice versa.

  2. 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.

  3. Is the Role of Physicians Really Evolving Due to Non-physician Clinicians Predominance in Staff Makeup in Sub-Saharan African Health Systems? Comment on "Non-physician Clinicians in Sub-Saharan Africa and the Evolving Role of Physicians".

    PubMed

    Sidat, Mohsin M

    2016-07-02

    Health workforce shortages in Sub-Saharan Africa are widely recognized, particularly of physicians, leading the training and deployment of Non-physician clinicians (NPCs). The paper by Eyal et al provides interesting and legitimate viewpoints on evolving role of physicians in context of decisive increase of NPCss in Sub-Saharan Africa. Certainly, in short or mid-term, NPCs will continue to be a proxy solution and a valuable alternative to overcome physicians' shortages in sub-Saharan Africa. Indeed, NPCs have an important role at primary healthcare (PHC) level. Physicians at PHC level can certainly have all different roles that were suggested by Eyal et al, including those not directly related to healthcare provision. However, at secondary and higher levels of healthcare, physicians would assume other roles that are mainly related to patient clinical care. Thus, attempting to generalize the role of physicians without taking into account the context where they will work would be not entirely appropriate. It is true that often physicians start the professional carriers at PHC level and progress to other levels of healthcare particularly after clinical post-graduation training. Nevertheless, the training programs offered by medical institutions in sub-Saharan Africa need to be periodically reviewed and take into account professional and occupational roles physicians would take in context of evolving health systems in sub-Saharan Africa.

  4. [Registries of myocardial infarction in Germany. Consequences for drug therapy of patients with acute ST elevation myocardial infarction].

    PubMed

    Zeymer, U; Zahn, R; Senges, J; Gitt, A

    2010-10-01

    Current national and international guidelines for patients with ST elevation myocardial infarction (STEMI) are mainly based on the results of randomised clinical trials. However, it is well perceived that patients in such trials often represent a low risk population. Therefore the results of randomised clinical trials are not necessarily applicable to patients in clinical practice. This gap can be filled by prospective registries. Since the early nineties a number of prospective large registries in patients with STEMI have been performed in Germany. It could be shown that guideline adherent acute therapies and secondary prevention therapies were associated with an improvement in inhospital and mid-term outcomes. The benefit of guideline adherent therapy observed was especially high in patients with higher baseline risk. Registries are not able to replace randomised clinical trials, but can help to test if the results of these trials are comprehensible in clinical practice. Therefore prospective STEMI registries are an important part of clinical research to optimize therapies and improve outcome in patients with STEMI.

  5. Reasons of Revision for First-Generation Highly Crosslinked Polyethylenes

    PubMed Central

    Kurtz, Steven M.; Medel, Francisco; MacDonald, Daniel; Parvizi, Javad; Kraay, Matthew; Rimnac, Clare

    2010-01-01

    Over a ten-year period, we prospectively evaluated the reasons for revision for contemporary and highly crosslinked polyethylene formulations in a multicenter retrieval program. 212 consecutive retrievals were classified as conventional gamma-inert sterilized liners (n=37), annealed (Crossfire™, n=72), or remelted (Longevity™, XLPE, Durasul; n=93). The most frequent reasons for revision were loosening (35%), instability (28%) and infection (21%) and were not related to polyethylene formulation (p = 0.17). Annealed and remelted liners had comparable linear penetration rates (0.03 and 0.04 mm/y, respectively, on average) and were significantly lower than conventional retrievals (0.11 mm/y; p ≤ 0.0005). This retrieval study including first-generation highly crosslinked liners demonstrated lower wear than conventional polyethylene. While loosening remained the most prevalent reason for revision, we could not demonstrate a relationship between wear and loosening. The long-term clinical performance of first-generation highly crosslinked remains promising, based on the mid-term outcomes of the components documented in this study. PMID:20541895

  6. 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.

  7. Lattisimus Dorsi Transfer assisted by arthroscopy for the treatment of irreparable posterolateral Rotator Cuff Tears

    PubMed Central

    Muiño, José María Silberberg; Gimenez, Martín Alejandro; Salvucci, Mauro Gabriel Maroa; Ferro, Diego; Rullan, Ramón Muiña

    2017-01-01

    Objective: To evaluate subjective and functional mid term results of patients treated by a lattisimus dorsi tendón transfer arthroscopically assisted for massive irreparable posterolateral injuries of the Rotator Cuff. Methods: Between 2009 and 2012, 17 Lattisimus Dorsi transfers (Paribelli technique) for irreparable posterolateral rotator cuff tears were performed. Distribution by sex: 12 men and 5 women with a mean age of 53 years old (range, 40-63). Thirteen right shoulders and 4 left shoulders. Average duration of symptoms prior to surgery was 8 months (range, 6-13 months). Mean follow-up was 28 months (range, 18-44). Patients were evaluated by the VAS, satisfaction rate, the Constant Modified Scale, postoperative range of motion and strength. Postoperative radiological studies included simple AP radiographs and MRI in order to measure AC distance and asses the integrity of the plasty. Results: Postoperative Constant Modified score averaged 63.54 points. (average increase of 13 points compared to preoperative score. (P ..05)). Active Mobility: a) Mean elevation: 142° postop vs. 119° preop (p <.001). b) Mean abduction: 138.24º postop vs. 112.35º preop (p <.001). c) Mean external rotation 40° postop vs. 20.29º preop (p <.004). Insert text. Conclusion: Lattisimus Dorsi transfer in patients with posterolateral massive irreparable injuries of the RC, is a highly demanding and palliative procedure for those cases with loss of active mobility, especially lifting and shoulder abduction.

  8. 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

  9. Nature of the Warm Excess in eps Eri: Asteroid belt or Dragged-in Grains

    NASA Astrophysics Data System (ADS)

    Su, Kate Y. L.; Rieke, George; Marengo, Massimo; Stapelfeldt, Karl R.

    2016-01-01

    Eps Eri and its debris disk provide a unique opportunity to probe the outer zones of a planetary system due to its young age (roughly 1 Gyr) and proximity (3.22 pc, the closest prominent debris disk by more than a factor of two). It is the Rosetta Stone for more distant exoplanetary debris systems and thus critical to understanding the mid-term evolution of our Solar System. From resolved images in the far-infrared and submillimeter along with spectra from 10-35 and 55-95 microns, the eps Eri disk was suggested to have a complex structure, with multiple zones in both warm (asteroid-like) and cold (KBO-like) components. Alternatively, the warm excess can also originate from small grains in the cold disk, which are transported inward by the combination of Poynting-Robertson and stellar wind drags. Here we present a SOFIA/FORCAST 35 micron image of the system, and provide additional constraints on the nature of the warm excess inferred fromprevious Spitzer and Herschel observations.

  10. Mitral valve repair: is there still a place for suture annuloplasty?

    PubMed

    Fundarò, Pino; Tartara, Paolo M; Villa, Emmanuel; Fratto, Pasquale; Campisi, Salvatore; Vitali, Ettore O

    2007-08-01

    Prosthetic ring annuloplasty is considered the gold standard technique for mitral valve repair, but it has been associated with some drawbacks. Suture annuloplasty is less expensive and may have some physiopathologic advantages. We reviewed the literature to assess clinical results of mitral suture annuloplasty. Thirteen series, each reporting more than 50 patients and published in the last 10 years, were included in the analysis. They comprised 1,648 patients with cumulative follow-up of 5,607 patient-years. Our review suggests that suture annuloplasty is a safe procedure, but a trend toward recurrence of annular dilatation with time was reported. In selected cases, suture annuloplasty is effective, and its mid-term clinical results are encouraging and compare well with those of prosthetic ring repair series. The quality of the results varies according to the particular annuloplasty technique used and to the mitral valve pathology treated. Recent technical modifications have been found to decrease the incidence of repair failure and promise to improve the reproducibility of the procedure. Further investigations are warranted to better assess the long-term results of suture annuloplasty, and to determine whether its theoretical functional advantages translate into a real clinical benefit.

  11. A Spectral Evaluation of Models Performances in Mediterranean Oak Woodlands

    NASA Astrophysics Data System (ADS)

    Vargas, R.; Baldocchi, D. D.; Abramowitz, G.; Carrara, A.; Correia, A.; Kobayashi, H.; Papale, D.; Pearson, D.; Pereira, J.; Piao, S.; Rambal, S.; Sonnentag, O.

    2009-12-01

    Ecosystem processes are influenced by climatic trends at multiple temporal scales including diel patterns and other mid-term climatic modes, such as interannual and seasonal variability. Because interactions between biophysical components of ecosystem processes are complex, it is important to test how models perform in frequency (e.g. hours, days, weeks, months, years) and time (i.e. day of the year) domains in addition to traditional tests of annual or monthly sums. Here we present a spectral evaluation using wavelet time series analysis of model performance in seven Mediterranean Oak Woodlands that encompass three deciduous and four evergreen sites. We tested the performance of five models (CABLE, ORCHIDEE, BEPS, Biome-BGC, and JULES) on measured variables of gross primary production (GPP) and evapotranspiration (ET). In general, model performance fails at intermediate periods (e.g. weeks to months) likely because these models do not represent the water pulse dynamics that influence GPP and ET at these Mediterranean systems. To improve the performance of a model it is critical to identify first where and when the model fails. Only by identifying where a model fails we can improve the model performance and use them as prognostic tools and to generate further hypotheses that can be tested by new experiments and measurements.

  12. 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.

  13. Left heart bypass support with the Rotaflow Centrifugal Pump® as a bridge to decision and recovery in an adult.

    PubMed

    Kashiwa, Koichi; Nishimura, Takashi; Saito, Aya; Kubo, Hitoshi; Fukaya, Aoi; Tamai, Hisayoshi; Yambe, Tomoyuki; Kyo, Shunei; Ono, Minoru

    2012-06-01

    Since left heart bypass or biventricular circulatory assist with an extracorporeal centrifugal pump as a bridge to decision or recovery sometimes requires long-time support, the long-term durability of extracorporeal centrifugal pumps is crucial. The Rotaflow Centrifugal Pump(®) (MAQUET Cardiopulmonary AG, Hirrlingen, Germany) is one of the centrifugal pumps available for long-term use in Japan. However, there have been few reports of left heart bypass or biventricular circulatory support over the mid-term. This is a case report of left heart bypass support with the Rotaflow Centrifugal Pump(®) as a bridge to decision and recovery for an adult patient who could not be weaned from cardiopulmonary bypass and percutaneous cardiopulmonary support after cardiac surgery. We could confirm that the patient's consciousness level was normal; however, the patient could not be weaned from the left heart bypass support lasting 1 month. Therefore, the circulatory assist device was switched to the extracorporeal Nipro ventricular assist device (VAD). This time, left heart bypass support could be maintained for 30 days using a single Rotaflow Centrifugal Pump(®). There were no signs of hemolysis during left heart bypass support. The Rotaflow Centrifugal Pump(®) itself may be used as a device for a bridge to decision or recovery before using a VAD in cardiogenic shock patients.

  14. Total Hip Arthroplasty Using S-ROM Prosthesis for Dysplastic Hip

    PubMed Central

    Moon, Kyoung Ho; Kim, Ryuh Sup; Park, Seung Rim; Lee, Jung Sun; Shin, Sang Hyun

    2011-01-01

    Purpose The purpose of this study was to evaluate the clinical and radiological results of total hip arthroplasty using a proximal modular femoral stem in patients who had secondary coxarthrosis associated with a dysplastic hip. Materials and Methods Forty-two patients (45 hips) with secondary coxarthrosis were evaluated after undergoing primary total hip arthroplasty using an S-ROM proximal modular femoral stem. The average follow-up was 80 months (range: 60 to 96 months). Clinical and radiological assessments were performed based on the Harris hip score and the radiological changes around the prosthesis. Results The average Harris hip score improved from 52.2 points to 88.5 points. All femoral stems showed stable fixation; there were 37 cases by bony ingrowth and 8 cases by stable fibrous ingrowth. Neither osteolysis nor progressive radiolucent lines around the femoral stem were found at the last follow-up. Forty-one hips (91.9%) revealed excellent or good clinical results at the most recent follow-up. Conclusion For advanced secondary coxarthrosis, total hip arthroplasty with the use of the proximal modular femoral stem yielded good mid-term results with respect to the clinical and radiological criteria. PMID:21623609

  15. 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.

  16. Model documentation report: Industrial sector demand module of the National Energy Modeling System

    SciTech Connect

    1997-01-01

    This report documents the objectives, analytical approach, and development of the National Energy Modeling System (NEMS) Industrial Demand Model. The report catalogues and describes model assumptions, computational methodology, parameter estimation techniques, and model source code. This document serves three purposes. First, it is a reference document providing a detailed description of the NEMS Industrial Model for model analysts, users, and the public. Second, this report meets the legal requirement of the Energy Information Administration (EIA) to provide adequate documentation in support of its models. Third, it facilitates continuity in model development by providing documentation from which energy analysts can undertake model enhancements, data updates, and parameter refinements as future projects. 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 2015) 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 industrial output. Based on the values of these variables, the Industrial Model passes back to the NEMS system estimates of consumption by fuel types.

  17. [Optimal indication for surgical ventricular restoration for dilated cardiomyopathy].

    PubMed

    Wakasa, Satoru; Shingu, Yasushige; Kubota, Suguru; Minamida, Taro; Iijima, Makoto; Naito, Yuji; Ooka, Tomonori; Tachibana, Tsuyoshi; Matsui, Yoshiro

    2013-01-01

    In this study, we assessed mid-term results of surgical ventricular restoration (SVR) for dilated cardiomyopathy. The study subjects were 107 patients who underwent SVR for both ischemic (ischemic cardiomyopathy:ICM, n=57) and non-ischemic (dilated cardiomyopathy:DCM, n=50) dilated cardiomyopathy. In 49(86%)patients ICM was associated with New York heart Association(NYHA) class III or more. Preoperative left ventricular ejection fraction (LVEF) and left ventricular end-diastolic dimension(LVDd)were 22±6% and 67±9 mm, respectively. Hospital mortality was 14% and 5-year mortality was 40%. In contrast, 46( 92%) of the DCM patients presented with NYHA class III or more. Preoperative LVEF and LVDd were 20±6% and 74±9 mm, respectively. Hospital mortality was 28% and 5-year mortality was 63%. For NYHA class III or less, however, 5-year mortality rates were 23% and 39% in those with ICM and DCM, respectively. For those with NYHA functional class III or less, SVR was associated with a satisfactory survival rate and is recommended. For those with severe heart failure, however, ventricular assist devices or heart transplantation may have to be indicated.

  18. 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.

  19. Addressing the slow uptake of HIV testing in Malawi: the role of stigma, self-efficacy, and knowledge in the Malawi BRIDGE Project.

    PubMed

    Berendes, Sima; Rimal, Rajiv N

    2011-01-01

    This study was carried out to test the hypothesis that HIV-related stigma would function as a barrier to uptake of HIV testing and that knowledge and self-efficacy would serve as facilitators. We also hypothesized that exposure to a behavior-change campaign would be associated with lower levels of stigma and higher levels of knowledge and self-efficacy. We conducted two separate cross-sectional surveys as part of the Malawi BRIDGE Project, including one at baseline in eight districts (n = 891), and another at mid-term in four districts in Malawi (n = 881). HIV-related knowledge, self-efficacy, and lack of stigma were positively associated with HIV testing. A positive association was also found between program exposure, on one hand, and knowledge, self-efficacy, and lack of stigma, on the other. These findings suggest that important psychosocial variables are linked with people's likelihood of HIV testing, and that these variables may be influenced by behavior-change programs.

  20. 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.

  1. Wearable technology and ECG processing for fall risk assessment, prevention and detection.

    PubMed

    Melillo, Paolo; Castaldo, Rossana; Sannino, Giovanna; Orrico, Ada; de Pietro, Giuseppe; Pecchia, Leandro

    2015-01-01

    Falls represent one of the most common causes of injury-related morbidity and mortality in later life. Subjects with cardiovascular disorders (e.g., related to autonomic dysfunctions and postural hypotension) are at higher risk of falling. Autonomic dysfunctions increasing the risk of falling in the short and mid-term could be assessed by Heart Rate Variability (HRV) extracted by electrocardiograph (ECG). We developed three trials for assessing the usefulness of ECG monitoring using wearable devices for: risk assessment of falling in the next few weeks; prevention of imminent falls due to standing hypotension; and fall detection. Statistical and data-mining methods are adopted to develop classification and regression models, validated with the cross-validation approach. The first classifier based on HRV features enabled to identify future fallers among hypertensive patients with an accuracy of 72% (sensitivity: 51.1%, specificity: 80.2%). The regression model to predict falls due to orthostatic dropdown from HRV recorded before standing achieved an overall accuracy of 80% (sensitivity: 92%, specificity: 90%). Finally, the classifier to detect simulated falls using ECG achieved an accuracy of 77.3% (sensitivity: 81.8%, specificity: 72.7%). The evidence from these three studies showed that ECG monitoring and processing could achieve satisfactory performances compared to other system for risk assessment, fall prevention and detection. This is interesting as differently from other technologies actually employed to prevent falls, ECG is recommended for many other pathologies of later life and is more accepted by senior citizens.

  2. Is the Role of Physicians Really Evolving Due to Non-physician Clinicians Predominance in Staff Makeup in Sub-Saharan African Health Systems?

    PubMed Central

    Sidat, Mohsin M.

    2016-01-01

    Health workforce shortages in Sub-Saharan Africa are widely recognized, particularly of physicians, leading the training and deployment of Non-physician clinicians (NPCs). The paper by Eyal et al provides interesting and legitimate viewpoints on evolving role of physicians in context of decisive increase of NPCss in Sub-Saharan Africa. Certainly, in short or mid-term, NPCs will continue to be a proxy solution and a valuable alternative to overcome physicians’ shortages in sub-Saharan Africa. Indeed, NPCs have an important role at primary healthcare (PHC) level. Physicians at PHC level can certainly have all different roles that were suggested by Eyal et al, including those not directly related to healthcare provision. However, at secondary and higher levels of healthcare, physicians would assume other roles that are mainly related to patient clinical care. Thus, attempting to generalize the role of physicians without taking into account the context where they will work would be not entirely appropriate. It is true that often physicians start the professional carriers at PHC level and progress to other levels of healthcare particularly after clinical post-graduation training. Nevertheless, the training programs offered by medical institutions in sub-Saharan Africa need to be periodically reviewed and take into account professional and occupational roles physicians would take in context of evolving health systems in sub-Saharan Africa. PMID:28005553

  3. One Year Experience of Iliac Bifurcated Device for Aortoiliac Aneurysm in a Korean Single Center

    PubMed Central

    Kim, Moon Hwan; Park, Keun-Myoung; Jeon, Yong Sun; Cho, Soon Gu; Hong, Kee Chun; Shin, Woo Young; Choe, Yun-Mee; Shin, Seok-Hwan; Kim, Kyung Rae

    2015-01-01

    One of the predominant methods for preserving the internal iliac artery (IIA) in aortoiliac aneurysms is to use an iliac bifurcated device (IBD). However, there are a few limitations to the use of IBD in Korea. Our study aims to present the technical aspects of these devices, and to provide a mid-term analysis of IBD. Since 2013, 4 IBDs were used in 4 patients, with a mean follow-up of 14 months (range, 6–22 months). A 100% technical success rate was achieved without mortality and morbidity in our cases. The mean procedural time was 176 min (range, 145–240 min), and the mean contrast dose used was 184 mL (range, 135–220 mL). Type I or III endoleaks and postoperative expansion of the aneurysms weren't observed. Our cases demonstrates that IBD is a relatively safe repair method of aortoiliac aneurysms with preservation of the IIAs. However, a longer follow-up is needed to review the midterm results. PMID:26719840

  4. Woodward Effect Experimental Verifications

    NASA Astrophysics Data System (ADS)

    March, Paul

    2004-02-01

    The work of J. F. Woodward (1990 1996a; 1996b; 1998; 2002a; 2002b; 2004) on the existence of ``mass fluctuations'' and their use in exotic propulsion schemes was examined for possible application in improving space flight propulsion and power generation. Woodward examined Einstein's General Relativity Theory (GRT) and assumed that if the strong Machian interpretation of GRT as well as gravitational / inertia like Wheeler-Feynman radiation reaction forces hold, then when an elementary particle is accelerated through a potential gradient, its rest mass should fluctuate around its mean value during its acceleration. Woodward also used GRT to clarify the precise experimental conditions necessary for observing and exploiting these mass fluctuations or ``Woodward effect'' (W-E). Later, in collaboration with his ex-graduate student T. Mahood, they also pushed the experimental verification boundaries of these proposals. If these purported mass fluctuations occur as Woodward claims, and his assumption that gravity and inertia are both byproducts of the same GRT based phenomenon per Mach's Principle is correct, then many innovative applications such as propellantless propulsion and gravitational exotic matter generators may be feasible. This paper examines the reality of mass fluctuations and the feasibility of using the W-E to design propellantless propulsion devices in the near to mid-term future. The latest experimental results, utilizing MHD-like force rectification systems, will also be presented.

  5. 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.

  6. 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.

  7. Acquiring experience in pathology predominantly from what you see, not from what you read: the HIPON e-learning platform

    PubMed Central

    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

  8. CO{sub 2} Huff-n-Puff process in a light oil shallow shelf carbonate reservoir. Quarterly technical progress report, Fourth quarter 1995

    SciTech Connect

    Wehner, S.; Prieditis, J.

    1996-02-05

    The principle objective of the Central Vacuum Unit (CVU) CO{sub 2} Huff-n-Puff (H-n-P) project is to determine the feasibility and practicality of the technology in a waterflooded shallow shelf carbonate environment. The results of parametric simulation of the CO{sub 2} H-n-P process, coupled with the CVU reservoir characterization components will determine if this process is technically and economically feasible for field implementation. The technology transfer objective of the project is to disseminate the knowledge gained through an innovative plan in support of the Department of Energy`s objective of increasing domestic oil production and deferring the abandonment of shallow shelf carbonate (SSC) reservoirs. Texaco Exploration and Production Inc`s. (TEPI) mid-term plans are to implement a full-scale miscible CO{sub 2} project in the CVU. TEPI has concluded all of the Tasks associated with the First Budget Period. The DOE approved the TEPI continuation application. Budget Period No. 2 is now in progress. Initial injection of CO{sub 2} began in November, and after a short shut-in period for the soak, the well was returned to production in late December, 1995.

  9. Cartilage viability after trochleoplasty.

    PubMed

    Schöttle, Philip B; Schell, Hanna; Duda, Georg; Weiler, Andreas

    2007-02-01

    Trochleoplasty is an established and accepted technique for the treatment of patellar instability because of a missing trochlear groove. In this technique, a flap of cartilage over the trochlea is carefully removed and a new trochlear groove is created in the underlying bone before the cartilaginous flap is reattached with sutures. The mid-term clinical and radiological results of this operation are promising but no information about the viability of the reattached cartilage has been reported. To evaluate cartilage viability and quality after trochleoplasty and to verify the healing process, two osteochondral biopsies were harvested from three patients 6, 8, and 9 months after trochleoplasty. One cylinder was evaluated histologically to assess cartilage, calcified cartilage (cc), and subchondral bone quality, while the other one was examined by confocal microscopy to evaluate cell viability. The histological examination showed a normal matrix and cell distribution of the cartilage, while the cc showed lacunae ingrowing from the underlying bone. The subchondral bone showed normal lamellae and histology, and the healing of the flap. Confocal microscopy showed almost exclusively viable chondrocytes. This demonstration of non-injured cartilage at short-term follow-up together with promising clinical and radiological 2- and 5-year follow-up results indicate a potential promising outlook for the long term, as further chondral damage is not expected. So trochleoplasty can be seen as a primary intervention for patellar instability because of trochlear dysplasia as the risk for cartilage damage is low.

  10. 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.

  11. 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.

  12. Spare Ion Engine Being Checked

    NASA Technical Reports Server (NTRS)

    2003-01-01

    July 21, 2003

    An ion thruster is removed from a vacuum chamber at NASA's Jet Propulsion Laboratory, Pasadena, Calif., its job done following almost five years of testing. Engineers John Anderson and Keith Goodfellow, from left, are part of JPL's Advanced Propulsion Technology Group. The thruster, a spare engine from NASA's Deep Space 1 mission, ran for a record 30,352 hours, giving researchers the ability to observe its performance and wear at different power levels throughout the test. This information will be vital to future missions that use ion propulsion.

    Ion propulsion systems can be very lightweight, running on just a few grams of xenon gas a day. This fuel efficiency can lower launch vehicle costs. Xenon is the same gas that is found in photo flash bulbs. The very successful Deep Space 1 mission featured the first use of an ion engine as the primary means of propulsion on a NASA spacecraft.

    NASA's next-generation ion propulsion efforts are led by the In-Space Propulsion Program, managed by the Office of Space Science at NASA Headquarters, Washington, D.C., and implemented by the Marshall Space Flight Center, Huntsville, Ala.. The program seeks to develop advanced propulsion technologies that will help near and mid-term NASA science missions by significantly reducing cost, mass or travel times. JPL is managed by the California Institute of Technology, Pasadena, Calif., for NASA.

  13. Growth in Boys with 45,X/46,XY Mosaicism: Effect of Growth Hormone Treatment on Statural Growth.

    PubMed

    Bertelloni, Silvano; Baroncelli, Giampiero I; Massart, Francesco; Toschi, Benedetta

    2015-01-01

    45,X/46,XY mosaicism is a rare sex chromosome disorder of sex development. Short stature is a main feature of boys with this condition. Different causes likely contribute to growth impairment. Growth hormone (GH) has been administered to treat short stature in boys with 45,X/46,XY mosaicism, but conflicting data are available. Here, spontaneous growth patterns as well as short- and long-term follow-up studies during GH therapy in these patients are reviewed. Short- and mid-term data showed an improvement of the growth pattern in GH-treated boys, mainly when hormonal therapy was started early, while long-term follow-up demonstrated similar adult heights in GH-treated and untreated patients. Individual biological factors (e.g. different chromosome constitution, different mosaicism among various tissues, impaired pubertal growth spurt), non-homogeneous GH doses and different ages at start of therapy may contribute to the variable results. Thus, early GH therapy at pharmacological doses may improve the growth pattern of short boys with 45,X/46,XY mosaicism, but data on adult height are disappointing. Evaluation of larger patient samples treated by homogeneous doses and long-term follow-up studies assessing adult height and safety are needed to reach definitive conclusions on GH therapy in boys with 45,X/46,XY mosaicism.

  14. Saharan dust inputs and high UVR levels jointly alter the metabolic balance of marine oligotrophic ecosystems

    NASA Astrophysics Data System (ADS)

    Cabrerizo, Marco J.; Medina-Sánchez, Juan Manuel; González-Olalla, Juan Manuel; Villar-Argaiz, Manuel; Carrillo, Presentación

    2016-10-01

    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.

  15. 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.

  16. Seasonal dynamics of Schistosoma japonicum infection in buffaloes in the Poyang Lake region and suggestions on local treatment schemes.

    PubMed

    Liu, Jin-Ming; Yu, Hua; Shi, Yao-Jun; Li, Hao; He, Liang; Li, Jian-Xi; Dong, Chang-Hua; Xie, Qiao; Jin, Ya-Mei; Lu, Ke; Lin, Jiao-Jiao

    2013-11-15

    Schistosomiasis japonica remains a major public health problem and the Poyang Lake region in Jiangxi province is one of the worst affected endemic areas. Buffaloes play a major role in the transmission of Schistosoma japonicum to humans. The aim of the present study was to increase understanding of the epidemic characteristics of schistosomiasis japonica in water buffaloes in the Poyang Lake region, after achieving the national mid-term goal, and to provide a basis for further interventions. The baseline prevalence in two villages in the Poyang Lake region in May 2010 was compared with respect to usage, sex and age in the total study population. Seasonal dynamics from May 2010 to May 2011 were observed in a natural village in the studied area. The baseline prevalence of infection in both villages (Caohui and Gaozhou) was 4.94% in May 2010. The prevalence in buffalo younger than 12 months was 12.82% in Caohui and 15.11% in Gaozhou, which was significantly higher than that found in those aged 13-24 months and older than 24 months. Of the 28 infected buffaloes, 82.14% (23) were younger than 12 months. The flow of seasonal dynamics showed that S. japonicum infection buffaloes were found from May to July and from November to January of the following year. This survey suggested that it is necessary to conduct two mass treatments (especially for young animals) in late March or early April and November, with an additional treatment of positive animals in July or June.

  17. Identification of latent faults using a radon test

    NASA Astrophysics Data System (ADS)

    González-Díez, A.; Soto, J.; Gómez-Arozamena, J.; Bonachea, J.; Martínez-Díaz, J. J.; Cuesta, J. A.; Olague, I.; Remondo, J.; Fernández Maroto, G.; Díaz de Terán, J. R.

    2009-09-01

    This paper discusses the use of 222Rn concentrations in water of natural springs as a geomorphological method to identify latent faults in low-mid term activity areas. The identification of this type of active fault may be crucial in hazard analysis, structural geomorphology and in landscape evolution analysis. The test used to identify these faults is based on the measuring of 222Rn concentrations in water of springs linked to faults, and comparison with those obtained from springs which, although exactly the same lithological context, are not linked with faults (reference values). If the difference between the measured value and the reference value is positive then an anomaly is identified and that measurement indicates a spring linked to a latent fault. The test was applied and validated in springs linked to faults with a latent behaviour in Cantabria, Northern Spain. These faults have shown an intermittent movement over the last 50,000 years, and have contributed towards landslide processes playing a significant role in landscape evolution of the area.

  18. Impacts, Perceptions and Management of Climate-Related Risks to Cage Aquaculture in the Reservoirs of Northern Thailand.

    PubMed

    Lebel, Louis; Lebel, Phimphakan; Lebel, Boripat

    2016-12-01

    Weather is suspected to influence fish growth and survival, and be a factor in mass mortality events in cage aquaculture in reservoirs. The purpose of this study was to identify the important climate-related risks faced by cage aquaculture farms; evaluate how these risks were currently being managed; and explore how farmers might adapt to the effects of climate change. Fish farmers were interviewed across the northern region of Thailand to get information on impacts, perceptions and practices. Drought or low water levels, heat waves, cold spells and periods with dense cloud cover, each caused significant financial losses. Perceptions of climate-related risks were consistent with experienced impacts. Risks are primarily managed in the short-term with techniques like aeration and reducing feed. In the mid-term farmers adjust stocking calendars, take financial measures and seek new information. Farmers also emphasize the importance of maintaining good relations with other stakeholders and reservoir management. Larger farms placed greater importance on risk management than small farms, even though types and levels of risk perceived were very similar. Most fish farms were managed by men alone, or men and women working together. Gender differences in risk perception were not detected, but women judged a few risk management practices as more important than men. Fish farmers perceived that climate is changing, but their perceptions were not strongly associated with recently having suffered impacts from extreme weather. The findings of this study provide important inputs to improving risk management under current and future climate.

  19. Systems analysis of hydrogen supplementation in natural gas pipelines

    SciTech Connect

    Hermelee, A.; Beller, M.; D'Acierno, J.

    1981-11-01

    The potential for hydrogen supplementation in natural gas pipelines is analyzed for a specific site from both mid-term (1985) and long-term perspectives. The concept of supplementing natural gas with the addition of hydrogen in the existing gas pipeline system serves to provide a transport and storage medium for hydrogen while eliminating the high investment costs associated with constructing separate hydrogen pipelines. This paper examines incentives and barriers to the implementation of this concept. The analysis is performed with the assumption that current developmental programs will achieve a process for cost-effectively separating pure hydrogen from natural gas/hydrogen mixtures to produce a separable and versatile chemical and fuel commodity. The energy systems formulation used to evaluate the role of hydrogen in the energy infrastructure is the Reference Energy System (RES). The RES is a network diagram that provides an analytic framework for incorporating all resources, technologies, and uses of energy in a uniform manner. A major aspect of the study is to perform a market analysis of traditional uses of resources in the various consuming sectors and the potential for hydrogen substitution in these sectors. The market analysis will focus on areas of industry where hydrogen is used as a feedstock rather than for its fuel-use opportunities to replace oil and natural gas. The sectors of industry where hydrogen is currently used and where its use can be expanded or substituted for other resources include petroleum refining, chemicals, iron and steel, and other minor uses.

  20. 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.

  1. In-Space Propulsion Program Overview and Status

    NASA Technical Reports Server (NTRS)

    Carroll, Carol; Johnson, Les; Baggett, Randy

    2002-01-01

    NASA's In-Space Propulsion (ISP) Program is designed to develop advanced propulsion technologies that can enable or greatly enhance near and mid-term NASA science missions by significantly reducing cost, mass, and/or travel times. These technologies include: Electric Propulsion (Solar and Nuclear Electric) [note: The Nuclear Electric Propulsion work will be transferred to the NSI program in FY03]; Propellantless Propulsion (aerocapture, solar sails, plasma sails, and momentum exchange tethers); Advanced Chemical Propulsion. The ISP approach to identifying and prioritizing these most promising technologies is to use mission analysis and subsequent peer review. These technologies under consideration are mid-Technology Readiness Level (TRL) up to TRL-6 for incorporation into mission planning within three - five years of initiation. In addition, maximum use of open competition is encouraged to seek optimum solutions under ISP. Several NASA Research Announcements (NRAs) have been released asking industry, academia and other organizations to propose propulsion technologies designed to improve our ability to conduct scientific study of the outer planets and beyond. The ISP Program is managed by NASA HQ (Headquarters) and implemented by the Marshall Space Flight Center in Huntsville, Alabama.

  2. 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.

  3. Osteoarticular and Total Elbow Allograft Reconstruction With Severe Bone Loss

    PubMed Central

    Busfield, Benjamin T.; Khorshad, Daniel S.; Hornicek, Francis J.; Mankin, Henry J.

    2008-01-01

    Osteoarticular allograft reconstruction is an option in patients with massive periarticular elbow bone loss secondary to tumor surgery or trauma. Our consecutive series consisted of 18 patients with tumors and one patient with trauma. Reconstruction consisted of 16 hemiarticular allografts and three total elbow osteoarticular allografts; patients had a minimum followup of 2 years (mean, 9.9 years; range, 2–12 years). For patients who had hemiarticular allografts, 14 of 16 were able to return to their preoperative level of occupational function, with one patient experiencing failure of the allograft from infection. For the three patients who had total elbow allograft reconstructions, all had degenerative changes develop after surgery and two of the allografts failed. Complications occurred in six of 19 patients. Hemiarticular elbow allograft reconstruction is useful for limb salvage with massive bone loss. Total elbow allograft reconstructions have a high failure rate in the mid-term. Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence. PMID:18196394

  4. Lifestyle behaviors associated with exposures to endocrine disruptors.

    PubMed

    Martina, Camille A; Weiss, Bernard; Swan, Shanna H

    2012-12-01

    Identifying and characterizing sources of exposure to phthalates and bisphenol A (BPA) have proved challenging due to the presence of multiple co-exposures resulting from a wide variety of home environments and lifestyles. We hypothesized that the consistent lifestyle of an Old Order Mennonite (OOM) community would provide an ideal setting in which to characterize sources of exposure to BPA and phthalates. We obtained urine samples from ten mid-term pregnant OOM women (ages-21-39) to determine concentrations of 9 phthalate metabolites and BPA and collected a self-reported survey of participants' household environment, product use, and lifestyle within a 48-h period prior to urine collection. We compared their metabolite concentrations to pregnant women included in the National Health and Nutrition Examination Survey (NHANES 2007-2008). Although OOM participants reported some use of plastic and fragranced household products, concentrations of metabolites were lower and significantly less for BPA (p=0.002) and phthalate metabolites MEHP (p=0.0215), MiBP (p=0.0020) and MEP (p=0.021), when compared to NHANES pregnant women. Levels of other phthalate metabolites were also lower in this population. Our data suggest three practices that may contribute to these lower levels: (1) consuming mostly homegrown produce (ingestion), (2) no cosmetics and limited use of personal care products, and (3) transportation primarily by sources other than automobiles.

  5. Beamed Energy Propulsion: Research Status And Needs--Part 1

    SciTech Connect

    Birkan, Mitat

    2008-04-28

    One promising solution to the operationally responsive space is the application of remote electromagnetic energy to propel a launch vehicle into orbit. With beamed energy propulsion, one can leave the power source stationary on the ground or space, and direct heat propellant on the spacecraft with a beam from a fixed station. This permits the spacecraft to leave its power source at home, saving significant amounts of mass, greatly improving performance. This concept, which removes the mass penalty of carrying the propulsion energy source on board the vehicle, was first proposed by Arthur Kantrowitz in 1972; he invoked an extremely powerful ground based laser. The same year Michael Minovich suggested a conceptually similar 'in-space' laser rocket system utilizing a remote laser power station. In the late 1980's, Air Force Office of Scientific Research (AFOSR) funded continuous, double pulse laser and microwave propulsion while Strategic Defense Initiative Office (SDIO) funded ablative laser rocket propulsion. Currently AFOSR has been funding the concept initiated by Leik Myrabo, repetitively pulsed laser propulsion, which has been universally perceived, arguably, to be the closest for mid-term applications. This 2-part paper examines the investment strategies in beamed energy propulsion and technical challenges to be overcome. Part 1 presents a world-wide review of beamed energy propulsion research, including both laser and microwave arenas.

  6. Beamed Energy Propulsion: Research Status And Needs--Part 2

    SciTech Connect

    Birkan, Mitat

    2008-04-28

    One promising solution to the operationally responsive space is the application of remote electromagnetic energy to propel a launch vehicle into orbit. With beamed energy propulsion, one can leave the power source stationary on the ground or space, and direct heat propellant on the spacecraft with a beam from a fixed station. This permits the spacecraft to leave its power source at home, saving significant amounts of mass, greatly improving performance. This concept, which removes the mass penalty of carrying the propulsion energy source on board the vehicle, was first proposed by Arthur Kantrowitz in 1972; he invoked an extremely powerful ground based laser. The same year Michael Minovich suggested a conceptually similar 'in-space' laser rocket system utilizing a remote laser power station. In the late 1980's, Air Force Office of Scientific Research (AFOSR) funded continuous, double pulse laser and microwave propulsion while Strategic Defense Initiative Office (SDIO) funded ablative laser rocket propulsion. Currently AFOSR has been funding the concept initiated by Leik Myrabo, repetitively pulsed laser propulsion, which has been universally perceived, arguably, to be the closest for mid-term applications. This 2-part paper examines the investment strategies in beamed energy propulsion and technical challenges to be covers Part 2 covers the present research status and needs.

  7. The role of papillary muscle approximation in mitral valve repair for the treatment of secondary mitral regurgitation.

    PubMed

    Mihos, Christos G; Yucel, Evin; Santana, Orlando

    2016-12-30

    SummarySecondary mitral regurgitation (MR) is present in up to half of patients with dilated cardiomyopathy, and is associated with a poor prognosis. It primarily results from progressive left ventricular remodelling, papillary muscle displacement and tethering of the mitral valve leaflets. Mitral valve repair with an undersized ring annuloplasty is the reparative procedure of choice in the treatment of secondary MR. However, this technique is associated with a 30-60% incidence of recurrent moderate or greater MR at mid-term follow-up, which results in progressive deterioration of left ventricular function and increased morbidity. Combined mitral valve repair and papillary muscle approximation has been applied in order to address both the annular and subvalvular dysfunction that coexist in secondary MR, which include graft and suture-based techniques. Herein, we provide a systematic review of the published literature regarding the technical aspects, clinical application, and outcomes of mitral valve repair with combined ring annuloplasty and papillary muscle approximation for the treatment of secondary MR.

  8. 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.

  9. 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.

  10. Future Physics Capabilities of RHIC

    NASA Astrophysics Data System (ADS)

    Johnson, B. M.

    2007-05-01

    The Relativistic Heavy Ion Collider (RHIC) at Brookhaven National Laboratory is a versatile facility for both heavy-ion and polarized-proton collision physics. The initial heavy-ion runs (Au+Au, Cu+Cu, and d+Au) have led to the unexpected discoveries at RHIC that (1) the new state of matter produced is a "nearly-perfect" fluid, (2) fast quarks (jets) lose large amounts of energy, when traversing the medium, (3) the quarks themselves are observed to flow, and (4) forward particle production is lower than expected. The polarized proton (p+p) program has discovered that gluons do not make a maximal contribution to the spin of the proton. Substantial upgrades to the accelerator and experimental detectors are ushering in an exciting transition from discovery to understanding. RHIC is poised to address these fundamental questions of broad significance: (a) What are the phases of QCD matter? (b) What is the wave function of the proton? (c) What is the wave function of a heavy nucleus? (d) What is the nature of non-equilibrium processes in a fundamental theory? After a brief introduction this talk and paper give an abbreviated overview of what has been learned so far, the plan for the mid-term (2006-2011), and the long-range plan (2012 and beyond).

  11. 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.

  12. Scapholunate ligament reconstruction using the palmaris longus tendon and suture anchor fixation in chronic scapholunate instability

    PubMed Central

    Gandhi, Maulik Jagdish; Knight, Timothy Paul; Ratcliffe, Peter John

    2016-01-01

    Background: Multiple reconstruction techniques have been described in the management of chronic scapholunate (SL) instability, either based on the capsulodesis or tenodesis principle. It is uncertain which surgical method produces the best patient outcomes. We describe results of a technique using palmaris longus (PL) tendon for surgical reconstruction of the SL ligament and provide functional outcomes scores. Materials and Methods: We surgically reconstructed the SL ligament using a PL tendon graft secured with Mitek® bone anchors. Surgical technique with photographs is provided in the main text. Functional outcomes were measured using the disabilities of the arm, shoulder, and hand and Mayo wrist scores. Patient satisfaction was assessed using a simple measure. Results: Eleven patients attended mid-term followup (mean 45.8 months post-surgery) and had functional outcomes and satisfaction of this procedure that compared favorably to case series that used tenodesis for chronic SL ligament injuries. Almost all patients (n = 10) were able to return to regular employment. The majority of patients (n = 10) were satisfied with their primary reconstruction procedure. Conclusion: This technique avoids the use of drill holes to weave tendon through bone, uses an easy to access graft, and exploits the superior pullout strength of anchors while offering satisfactory functional outcomes that are comparable to alternative tenodesis techniques. PMID:27904216

  13. Effects of allyl sulfide, germanium and NaCl on the development of glutathion S-transferase P-positive rat hepatic foci initiated by diethylnitrosamine.

    PubMed

    Jang, J J; Cho, K J; Kim, S H

    1989-01-01

    The modification potentials of allyl sulfide, germanium and NaCl on the development of preneoplastic hepatic enzyme altered foci were examined in an in vivo mid-term assay system. Rats were initially given a single dose (200 mg/kg), intraperitoneal injection of diethylnitrosamine (DEN) and, starting 2 weeks later, were treated with allyl sulfide, germanium and NaCl at a concentration of 0.5%, 0.05% and 5%, respectively, in the diet for 6 weeks and then killed. All rats were subjected to two-thirds partial hepatectomy at week 3. The modifying potential was scored by comparing the number and area per cm2 of induced glutathione S-transferase placental form-positive (GST-P+) foci in the liver with those of the corresponding control group given DEN alone. Allyl sulfide exerted an obvious inhibition of the development of GST-P+ foci as regards both number and area. On the contrary, germanium showed a significant increase in the number of GST-P+ foci, although the data for area were not altered. NaCl had no modifying effect on their development.

  14. Mission Assessment of the Faraday Accelerator with Radio-frequency Assisted Discharge (FARAD)

    NASA Technical Reports Server (NTRS)

    Dankanich, John W.; Polzin, Kurt A.

    2008-01-01

    Pulsed inductive thrusters have typically been considered for future, high-power, missions requiring nuclear electric propulsion. These high-power systems, while promising equivalent or improved performance over state-of-the-art propulsion systems, presently have no planned missions for which they are well suited. The ability to efficiently operate an inductive thruster at lower energy and power levels may provide inductive thrusters near term applicability and mission pull. The Faraday Accelerator with Radio-frequency Assisted Discharge concept demonstrated potential for a high-efficiency, low-energy pulsed inductive thruster. The added benefits of energy recapture and/or pulse compression are shown to enhance the performance of the pulsed inductive propulsion system, yielding a system that con compete with and potentially outperform current state-of-the-art electric propulsion technologies. These enhancements lead to mission-level benefits associated with the use of a pulsed inductive thruster. Analyses of low-power near to mid-term missions and higher power far-term missions are undertaken to compare the performance of pulsed inductive thrusters with that delivered by state-of-the-art and development-level electric propulsion systems.

  15. 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.

  16. 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.

  17. 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.

  18. Impacts, Perceptions and Management of Climate-Related Risks to Cage Aquaculture in the Reservoirs of Northern Thailand

    NASA Astrophysics Data System (ADS)

    Lebel, Louis; Lebel, Phimphakan; Lebel, Boripat

    2016-12-01

    Weather is suspected to influence fish growth and survival, and be a factor in mass mortality events in cage aquaculture in reservoirs. The purpose of this study was to identify the important climate-related risks faced by cage aquaculture farms; evaluate how these risks were currently being managed; and explore how farmers might adapt to the effects of climate change. Fish farmers were interviewed across the northern region of Thailand to get information on impacts, perceptions and practices. Drought or low water levels, heat waves, cold spells and periods with dense cloud cover, each caused significant financial losses. Perceptions of climate-related risks were consistent with experienced impacts. Risks are primarily managed in the short-term with techniques like aeration and reducing feed. In the mid-term farmers adjust stocking calendars, take financial measures and seek new information. Farmers also emphasize the importance of maintaining good relations with other stakeholders and reservoir management. Larger farms placed greater importance on risk management than small farms, even though types and levels of risk perceived were very similar. Most fish farms were managed by men alone, or men and women working together. Gender differences in risk perception were not detected, but women judged a few risk management practices as more important than men. Fish farmers perceived that climate is changing, but their perceptions were not strongly associated with recently having suffered impacts from extreme weather. The findings of this study provide important inputs to improving risk management under current and future climate.

  19. 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.

  20. Transcriptomic analysis on the formation of the viable putative non-culturable state of beer-spoilage Lactobacillus acetotolerans

    PubMed Central

    Liu, Junyan; Deng, Yang; Peters, Brian M.; Li, Lin; Li, Bing; Chen, Lequn; Xu, Zhenbo; Shirtliff, Mark E.

    2016-01-01

    Lactic acid bacteria (LAB) are the most common beer-spoilage bacteria regardless of beer type, and thus pose significant problems for the brewery industry. The aim of this study was to investigate the genetic mechanisms involved in the ability of the hard-to-culture beer-spoilage bacterium Lactobacillus acetotolerans to enter into the viable putative non-culturable (VPNC) state. A genome-wide transcriptional analysis of beer-spoilage L. acetotolerans strains BM-LA14526, BM-LA14527, and BM-LA14528 under normal, mid-term and VPNC states were performed using RNA-sequencing (RNA-seq) and further bioinformatics analyses. GO function, COG category, and KEGG pathway enrichment analysis were conducted to investigate functional and related metabolic pathways of the differentially expressed genes. Functional and pathway enrichment analysis indicated that heightened stress response and reduction in genes associated with transport, metabolic process, and enzyme activity might play important roles in the formation of the VPNC state. This is the first transcriptomic analysis on the formation of the VPNC state of beer spoilage L. acetotolerans. PMID:27819317