Full-wave receiver architecture for the homodyne motion sensor

DOEpatents

Haugen, Peter C; Dallum, Gregory E; Welsh, Patrick A; Romero, Carlos E

2013-11-19

A homodyne motion sensor or detector based on ultra-wideband radar utilizes the entire received waveform through implementation of a voltage boosting receiver. The receiver includes a receiver input and a receiver output. A first diode is connected to the receiver output. A first charge storage capacitor is connected from between the first diode and the receiver output to ground. A second charge storage capacitor is connected between the receiver input and the first diode. A second diode is connected from between the second charge storage capacitor and the first diode to ground. The dual diode receiver performs voltage boosting of a RF signal received at the receiver input, thereby enhancing receiver sensitivity.

Effects of 8-week sensory electrical stimulation combined with motor training on EEG-EMG coherence and motor function in individuals with stroke.

PubMed

Pan, Li-Ling Hope; Yang, Wen-Wen; Kao, Chung-Lan; Tsai, Mei-Wun; Wei, Shun-Hwa; Fregni, Felipe; Chen, Vincent Chiun-Fan; Chou, Li-Wei

2018-06-15

The peripheral sensory system is critical to regulating motor plasticity and motor recovery. Peripheral electrical stimulation (ES) can generate constant and adequate sensory input to influence the excitability of the motor cortex. The aim of this proof of concept study was to assess whether ES prior to each hand function training session for eight weeks can better improve neuromuscular control and hand function in chronic stroke individuals and change electroencephalography-electromyography (EEG-EMG) coherence, as compared to the control (sham ES). We recruited twelve subjects and randomly assigned them into ES and control groups. Both groups received 20-minute hand function training twice a week, and the ES group received 40-minute ES on the median nerve of the affected side before each training session. The control group received sham ES. EEG, EMG and Fugl-Meyer Assessment (FMA) were collected at four different time points. The corticomuscular coherence (CMC) in the ES group at fourth weeks was significantly higher (p = 0.004) as compared to the control group. The notable increment of FMA at eight weeks and follow-up was found only in the ES group. The eight-week rehabilitation program that implemented peripheral ES sessions prior to function training has a potential to improve neuromuscular control and hand function in chronic stroke individuals.

Apparatus and method for combining light from two or more fibers into a single fiber

DOEpatents

Klingsporn, Paul Edward

2007-02-20

An apparatus and method for combining light signals carried on a plurality of input fibers onto a single receiving fiber with a high degree of efficiency. The apparatus broadly comprises the receiving fiber and a plurality of input fiber-lens assemblies, with each fiber lens assembly including an input fiber; a collimating lens interposed between the input fiber and the receiving fiber and adapted to collimate the light signal; and a focusing lens interposed between the collimating lens and the receiving fiber and adapted to focus the collimated light signal onto the face of the receiving fiber. The components of each fiber-lens assembly are oriented along an optic axis that is inclined relative to the receiving fiber, with the inclination angle depending at least in part on the input fiber's numerical aperture and the focal lengths and diameters of the collimating and focusing lenses.

Apparatus and method for combining light from two or more fibers into a single fiber

DOEpatents

Klingsporn, Paul Edward

2006-03-14

An apparatus and method for combining light signals carried on a plurality of input fibers onto a single receiving fiber with a high degree of efficiency. The apparatus broadly comprises the receiving fiber and a plurality of input fiber-lens assemblies, with each fiber lens assembly including an input fiber; a collimating lens interposed between the input fiber and the receiving fiber and adapted to collimate the light signal; and a focusing lens interposed between the collimating lens and the receiving fiber and adapted to focus the collimated light signal onto the face of the receiving fiber. The components of each fiber-lens assembly are oriented along an optic axis that is inclined relative to the receiving fiber, with the inclination angle depending at least in part on the input fiber's numerical aperture and the focal lengths and diameters of the collimating and focusing lenses.

Performance measurement for people with multiple chronic conditions: conceptual model.

PubMed

Giovannetti, Erin R; Dy, Sydney; Leff, Bruce; Weston, Christine; Adams, Karen; Valuck, Tom B; Pittman, Aisha T; Blaum, Caroline S; McCann, Barbara A; Boyd, Cynthia M

2013-10-01

Improving quality of care for people with multiple chronic conditions (MCCs) requires performance measures reflecting the heterogeneity and scope of their care. Since most existing measures are disease specific, performance measures must be refined and new measures must be developed to address the complexity of care for those with MCCs. To describe development of the Performance Measurement for People with Multiple Chronic Conditions (PM-MCC) conceptual model. Framework development and a national stakeholder panel. We used reviews of existing conceptual frameworks of performance measurement, review of the literature on MCCs, input from experts in the multistakeholder Steering Committee, and public comment. The resulting model centers on the patient and family goals and preferences for care in the context of multiple care sites and providers, the type of care they are receiving, and the national priority domains for healthcare quality measurement. This model organizes measures into a comprehensive framework and identifies areas where measures are lacking. In this context, performance measures can be prioritized and implemented at different levels, in the context of patients' overall healthcare needs.

Cell-type specific circuit connectivity of hippocampal CA1 revealed through Cre-dependent rabies tracing

PubMed Central

Sun, Yanjun; Nguyen, Amanda; Nguyen, Joseph; Le, Luc; Saur, Dieter; Choi, Jiwon; Callaway, Edward M.; Xu, Xiangmin

2014-01-01

Summary We applied a new Cre-dependent, genetically modified rabies-based tracing system to map direct synaptic connections to CA1 excitatory and inhibitory neuron types in mouse hippocampus. We found common inputs to excitatory and inhibitory CA1 neurons from CA3, CA2, entorhinal cortex and the medial septum (MS), and unexpectedly also from the subiculum. Excitatory CA1 neurons receive inputs from both cholinergic and GABAergic MS neurons while inhibitory CA1 neurons receive a great majority of input from GABAergic MS neurons; both cell types also receive weaker input from glutamatergic MS neurons. Comparisons of inputs to CA1 PV+ interneurons versus SOM+ interneurons showed similar strengths of input from the subiculum, but PV+ interneurons receive much stronger input than SOM+ neurons from CA3, entorhinal cortex and MS. Differential input from CA3 to specific CA1 cell types was also demonstrated functionally using laser scanning photostimulation and whole cell recordings. PMID:24656815

Control and optimization system

DOEpatents

Xinsheng, Lou

2013-02-12

A system for optimizing a power plant includes a chemical loop having an input for receiving an input parameter (270) and an output for outputting an output parameter (280), a control system operably connected to the chemical loop and having a multiple controller part (230) comprising a model-free controller. The control system receives the output parameter (280), optimizes the input parameter (270) based on the received output parameter (280), and outputs an optimized input parameter (270) to the input of the chemical loop to control a process of the chemical loop in an optimized manner.

Attenuated frontal and sensory inputs to the basal ganglia in cannabis users.

PubMed

Blanco-Hinojo, Laura; Pujol, Jesus; Harrison, Ben J; Macià, Dídac; Batalla, Albert; Nogué, Santiago; Torrens, Marta; Farré, Magí; Deus, Joan; Martín-Santos, Rocío

2017-07-01

Heavy cannabis use is associated with reduced motivation. The basal ganglia, central in the motivation system, have the brain's highest cannabinoid receptor density. The frontal lobe is functionally coupled to the basal ganglia via segregated frontal-subcortical circuits conveying information from internal, self-generated activity. The basal ganglia, however, receive additional influence from the sensory system to further modulate purposeful behaviors according to the context. We postulated that cannabis use would impact functional connectivity between the basal ganglia and both internal (frontal cortex) and external (sensory cortices) sources of influence. Resting-state functional connectivity was measured in 28 chronic cannabis users and 29 controls. Selected behavioral tests included reaction time, verbal fluency and exposition to affective pictures. Assessments were repeated after one month of abstinence. Cannabis exposure was associated with (1) attenuation of the positive correlation between the striatum and areas pertaining to the 'limbic' frontal-basal ganglia circuit, and (2) attenuation of the negative correlation between the striatum and the fusiform gyrus, which is critical in recognizing significant visual features. Connectivity alterations were associated with lower arousal in response to affective pictures. Functional connectivity changes had a tendency to normalize after abstinence. The results overall indicate that frontal and sensory inputs to the basal ganglia are attenuated after chronic exposure to cannabis. This effect is consistent with the common behavioral consequences of chronic cannabis use concerning diminished responsiveness to both internal and external motivation signals. Such an impairment of the fine-tuning in the motivation system notably reverts after abstinence. © 2016 Society for the Study of Addiction.

A 25-Gbps high-sensitivity optical receiver with 10-Gbps photodiode using inductive input coupling for optical interconnects

NASA Astrophysics Data System (ADS)

Oku, Hideki; Narita, Kiyomi; Shiraishi, Takashi; Ide, Satoshi; Tanaka, Kazuhiro

2012-01-01

A 25-Gbps high-sensitivity optical receiver with a 10-Gbps photodiode (PD) using inductive input coupling has been demonstrated for optical interconnects. We introduced the inductive input coupling technique to achieve the 25-Gbps optical receiver using a 10-Gbps PD. We implemented an input inductor (Lin) between the PD and trans-impedance amplifier (TIA), and optimized inductance to enhance the bandwidth and reduce the input referred noise current through simulation with the RF PD-model. Near the resonance frequency of the tank circuit formed by PD capacitance, Lin, and TIA input capacitance, the PD photo-current through Lin into the TIA is enhanced. This resonance has the effects of enhancing the bandwidth at TIA input and reducing the input equivalent value of the noise current from TIA. We fabricated the 25-Gbps optical receiver with the 10-Gbps PD using an inductive input coupling technique. Due to the application of an inductor, the receiver bandwidth is enhanced from 10 GHz to 14.2 GHz. Thanks to this wide-band and low-noise performance, we were able to improve the sensitivity at an error rate of 1E-12 from non-error-free to -6.5 dBm. These results indicate that our technique is promising for cost-effective optical interconnects.

CDC Guideline for Prescribing Opioids for Chronic Pain - United States, 2016.

PubMed

Dowell, Deborah; Haegerich, Tamara M; Chou, Roger

2016-03-18

This guideline provides recommendations for primary care clinicians who are prescribing opioids for chronic pain outside of active cancer treatment, palliative care, and end-of-life care. The guideline addresses 1) when to initiate or continue opioids for chronic pain; 2) opioid selection, dosage, duration, follow-up, and discontinuation; and 3) assessing risk and addressing harms of opioid use. CDC developed the guideline using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework, and recommendations are made on the basis of a systematic review of the scientific evidence while considering benefits and harms, values and preferences, and resource allocation. CDC obtained input from experts, stakeholders, the public, peer reviewers, and a federally chartered advisory committee. It is important that patients receive appropriate pain treatment with careful consideration of the benefits and risks of treatment options. This guideline is intended to improve communication between clinicians and patients about the risks and benefits of opioid therapy for chronic pain, improve the safety and effectiveness of pain treatment, and reduce the risks associated with long-term opioid therapy, including opioid use disorder, overdose, and death. CDC has provided a checklist for prescribing opioids for chronic pain (http://stacks.cdc.gov/view/cdc/38025) as well as a website (http://www.cdc.gov/drugoverdose/prescribingresources.html) with additional tools to guide clinicians in implementing the recommendations.

Is Chronic Otitis Media Associated with Differences in Parental Input at 12 Months of Age? An Analysis of Joint Attention and Directives.

ERIC Educational Resources Information Center

Yont, Kristine M.; Snow, Catherine E.; Vernon-Feagans, Lynne

2003-01-01

Argues that parental input is an important factor often neglected in research that may mediate language outcomes. Investigated how parents interact with their 12-month-old children, who suffer from otitis media status. Results indicate that parents of chronically affected children direct attention more often and engage in fewer joint attentional…

Fuzzy logic control and optimization system

DOEpatents

Lou, Xinsheng [West Hartford, CT

2012-04-17

A control system (300) for optimizing a power plant includes a chemical loop having an input for receiving an input signal (369) and an output for outputting an output signal (367), and a hierarchical fuzzy control system (400) operably connected to the chemical loop. The hierarchical fuzzy control system (400) includes a plurality of fuzzy controllers (330). The hierarchical fuzzy control system (400) receives the output signal (367), optimizes the input signal (369) based on the received output signal (367), and outputs an optimized input signal (369) to the input of the chemical loop to control a process of the chemical loop in an optimized manner.

The Comparative Effects of Comprehensible Input, Output and Corrective Feedback on the Receptive Acquisition of L2 Vocabulary Items

ERIC Educational Resources Information Center

Nowbakht, Mohammad; Shahnazari, Mohammadtaghi

2015-01-01

In the present study, the comparative effects of comprehensible input, output and corrective feedback on the receptive acquisition of L2 vocabulary items were investigated. Two groups of beginning EFL learners participated in the study. The control group received comprehensible input only, while the experimental group received input and was…

Transcutaneous electrical nerve stimulation combined with task-related training improves lower limb functions in subjects with chronic stroke.

PubMed

Ng, Shamay S M; Hui-Chan, Christina W Y

2007-11-01

Previous studies have shown that repeated sensory inputs could enhance brain plasticity and cortical motor output. The purpose of this study was to investigate whether combining electrically induced sensory inputs through transcutaneous electrical nerve stimulation (TENS) with task-related training (TRT) in a home-based program would augment voluntary motor output in chronic stroke survivors better than either treatment alone or no treatment. Eighty-eight patients with stroke were assigned randomly to receive a home-based program of (1) TENS, (2) TENS+TRT, (3) placebo TENS+TRT, or (4) no treatment (control) 5 days a week for 4 weeks. Outcome measurements included Composite Spasticity Scale, peak torques generated during maximum isometric voluntary contraction of ankle dorsiflexors and plantarflexors, and gait velocity recorded at baseline, after 2 and 4 weeks of treatment, and 4 weeks after treatment ended. When compared with TENS, the combined TENS+TRT group showed significantly greater improvement in ankle dorsiflexion torque at follow-up and in ankle plantarflexion torque at week 2 and follow-up (P<0.01). When compared with placebo+TRT, the TENS+TRT group produced earlier and greater reduction of plantarflexor spasticity and improvement in ankle dorsiflexion torque at week 2 (P<0.01). When compared with all 3 groups, the TENS+TRT group showed significantly greater improvement in gait velocity (P<0.01). In patients with chronic stroke, 20 sessions of a combined TENS+TRT home-based program decreased plantarflexor spasticity, improved dorsiflexor and plantarflexor strength, and increased gait velocity significantly more than TENS alone, placebo+TRT, or no treatment. Such improvements can even be maintained 4 weeks after treatment ended.

Stress Increases the Negative Effects of Chronic Pain on Hippocampal Neurogenesis.

PubMed

Romero-Grimaldi, Carmen; Berrocoso, Esther; Alba-Delgado, Cristina; Madrigal, Jose Luis M; Perez-Nievas, Beatriz G; Leza, Juan Carlos; Mico, Juan Antonio

2015-10-01

Patients with chronic pain often suffer from affective disorders and cognitive decline, which significantly impairs their quality of life. In addition, many of these patients also experience stress unrelated to their illness, which can aggravate their symptoms. These nociceptive inputs are received by the hippocampus, in which maladaptive neuroplastic changes may occur in the conditions of chronic pain. The hippocampus is a structure involved in emotionality, learning, and memory, and the proliferating cells in the granular layer of the hippocampal dentate gyrus respond to chronic pain by slowing their turnover. However, whether the maturation, survival, and integration of newborn cells in the hippocampus are affected by chronic pain remains unclear. In addition, it is unknown whether an added stress may increase this effect. We have evaluated the proliferation, differentiation, and survival of newborn hippocampal cells in a rat model of neuropathic pain (chronic constriction injury), with or without stress (chronic immobilization), by assessing the incorporation of bromodeoxyuridine into proliferating cells and immunostaining. The data obtained indicated that there was a decrease in the number of proliferating cells 8 days after nerve injury in animals subjected to neuropathic pain, an effect that was exacerbated by stress. Moreover, 4 weeks after nerve injury, neuropathic pain was associated with a loss of neuroblasts and the reduced survival of new mature neurons in the hippocampal granular layer, phenomena that also were increased by stress. By contrast, the rate of differentiation was not affected in this paradigm. Neuropathic pain negatively influences hippocampal neurogenesis (proliferation and survival), and this effect is exacerbated by stress. These neuroplastic changes may account for the affective and cognitive impairment seen in patients with chronic pain.

Presynaptic Partners of Dorsal Raphe Serotonergic and GABAergic Neurons

PubMed Central

Weissbourd, Brandon; Ren, Jing; DeLoach, Katherine E.; Guenthner, Casey J.; Miyamichi, Kazunari; Luo, Liqun

2016-01-01

SUMMARY The serotonin system powerfully modulates physiology and behavior in health and disease, yet the circuit mechanisms underlying serotonin neuron activity are poorly understood. The major source of forebrain serotonergic innervation is from the dorsal raphe nucleus (DR), which contains both serotonin and GABA neurons. Using viral tracing combined with electrophysiology, we found that GABA and serotonin neurons in the DR receive excitatory, inhibitory, and peptidergic inputs from the same specific brain regions. Embedded in this overall similarity are important differences. Serotonin neurons are more likely to receive synaptic inputs from anterior neocortex while GABA neurons receive disproportionally higher input from the central amygdala. Local input mapping revealed extensive serotonin-serotonin as well as GABA-serotonin connectivity with a distinct spatial organization. Covariance analysis suggests heterogeneity of both serotonin and GABA neurons with respect to the inputs they receive. These analyses provide a foundation for further functional dissection of the serotonin system. PMID:25102560

Ka-Band Waveguide 2-Way Hybrid Combiner for MMIC Amplifiers with Unequal and Arbitrary Power Output Ratio

NASA Technical Reports Server (NTRS)

Simons, Rainee N (Inventor); Chevalier, Christine T (Inventor); Wintucky, Edwin G (Inventor); Freeman, Jon C (Inventor)

2016-01-01

One or more embodiments of the present invention describe an apparatus and method to combine unequal powers. The apparatus includes a first input port, a second input port, and a combiner. The first input port is operably connected to a first power amplifier and is configured to receive a first power from the first power amplifier. The second input port is operably connected to a second power amplifier and is configured to receive a second power from the second power amplifier. The combiner is configured to simultaneously receive the first power from the first input port and the second power from the second input port. The combiner is also configured to combine the first power and second power to produce a maximized power. The first power and second power are unequal.

Altered Excitability and Local Connectivity of mPFC-PAG Neurons in a Mouse Model of Neuropathic Pain.

PubMed

Cheriyan, John; Sheets, Patrick L

2018-05-16

The medial prefrontal cortex (mPFC) plays a major role in both sensory and affective aspects of pain. There is extensive evidence that chronic pain produces functional changes within the mPFC. However, our understanding of local circuit changes to defined subpopulations of mPFC neurons in chronic pain models remains unclear. A major subpopulation of mPFC neurons project to the periaqueductal gray (PAG), which is a key midbrain structure involved in endogenous pain suppression and facilitation. Here, we used laser scanning photostimulation of caged glutamate to map cortical circuits of retrogradely labeled cortico-PAG (CP) neurons in layer 5 (L5) of mPFC in brain slices prepared from male mice having undergone chronic constriction injury (CCI) of the sciatic nerve. Whole-cell recordings revealed a significant reduction in excitability for L5 CP neurons contralateral to CCI in the prelimbic (PL), but not infralimbic (IL), region of mPFC. Circuit mapping showed that excitatory inputs to L5 CP neurons in both PL and IL arose primarily from layer 2/3 (L2/3) and were significantly reduced in CCI mice. Glutamate stimulation of L2/3 and L5 elicited inhibitory inputs to CP neurons in both PL and IL, but only L2/3 input was significantly reduced in CP neurons of CCI mice. We also observed significant reduction in excitability and L2/3 inhibitory input to CP neurons ipsilateral to CCI. These results demonstrating region and laminar specific changes to mPFC-PAG neurons suggest that a unilateral CCI bilaterally alters cortical circuits upstream of the endogenous analgesic network, which may contribute to persistence of chronic pain. SIGNIFICANCE STATEMENT Chronic pain is a significant unresolved medical problem that is refractory to traditional analgesics and can negatively affect emotional health. The role of central circuits in mediating the persistent nature of chronic pain remains unclear. Local circuits within the medial prefrontal cortex (mPFC) process ascending pain inputs and can modulate endogenous analgesia via direct projections to the periaqueductal gray (PAG). However, the mechanisms by which chronic pain alters intracortical circuitry of mPFC-PAG neurons are unknown. Here, we report specific changes to local circuits of mPFC-PAG neurons in mice displaying chronic pain behavior after nerve injury. These findings provide evidence for a neural mechanism by which chronic pain disrupts the descending analgesic system via functional changes to cortical circuits. Copyright © 2018 the authors 0270-6474/18/384829-11$15.00/0.

The human motor neuron pools receive a dominant slow‐varying common synaptic input

PubMed Central

Negro, Francesco; Yavuz, Utku Şükrü

2016-01-01

Key points Motor neurons in a pool receive both common and independent synaptic inputs, although the proportion and role of their common synaptic input is debated.Classic correlation techniques between motor unit spike trains do not measure the absolute proportion of common input and have limitations as a result of the non‐linearity of motor neurons.We propose a method that for the first time allows an accurate quantification of the absolute proportion of low frequency common synaptic input (<5 Hz) to motor neurons in humans.We applied the proposed method to three human muscles and determined experimentally that they receive a similar large amount (>60%) of common input, irrespective of their different functional and control properties.These results increase our knowledge about the role of common and independent input to motor neurons in force control. Abstract Motor neurons receive both common and independent synaptic inputs. This observation is classically based on the presence of a significant correlation between pairs of motor unit spike trains. The functional significance of different relative proportions of common input across muscles, individuals and conditions is still debated. One of the limitations in our understanding of correlated input to motor neurons is that it has not been possible so far to quantify the absolute proportion of common input with respect to the total synaptic input received by the motor neurons. Indeed, correlation measures of pairs of output spike trains only allow for relative comparisons. In the present study, we report for the first time an approach for measuring the proportion of common input in the low frequency bandwidth (<5 Hz) to a motor neuron pool in humans. This estimate is based on a phenomenological model and the theoretical fitting of the experimental values of coherence between the permutations of groups of motor unit spike trains. We demonstrate the validity of this theoretical estimate with several simulations. Moreover, we applied this method to three human muscles: the abductor digiti minimi, tibialis anterior and vastus medialis. Despite these muscles having different functional roles and control properties, as confirmed by the results of the present study, we estimate that their motor pools receive a similar and large (>60%) proportion of common low frequency oscillations with respect to their total synaptic input. These results suggest that the central nervous system provides a large amount of common input to motor neuron pools, in a similar way to that for muscles with different functional and control properties. PMID:27151459

Apparatus and Method for Effecting Data Transfer Between Data Systems

NASA Technical Reports Server (NTRS)

Kirkpatrick, Joey V. (Inventor); Grosz, Francis B., Jr. (Inventor); Lannes, Kenny (Inventor); Maniscalco, David G. (Inventor)

2001-01-01

An apparatus for effecting data transfer between data systems comprising a first transceiver and a second transceiver. The first transceiver has an input for receiving digital data from one of the data systems, an output for serially outputting digital data to one of the data systems, at least one transmitter for converting digital data received at the input into optical signals, and at least one receiver for receiving optical signals and serially converting the received optical signals to digital data for output to the data output. The second transceiver has an input for receiving digital data from another one of the data systems, an output for serially outputting digital data to the another one of the data systems, at least one transmitter for serially converting digital data received at the input of the second transceiver into optical signals, and at least one receiver for receiving optical signals and serially converting the received optical signals to digital data for output to the output of the second transceiver. The apparatus further comprises an optical link connecting the first and second transceivers. The optical link comprising a pair of optical fibers. One of the optical fibers optically links the transmitter of the first transceiver to the receiver of the second transceiver. The other optical fiber optically links the receiver of the first transceiver to the transmitter of the second transceiver.

Patterns of innervation of neurones in the inferior mesenteric ganglion of the cat.

PubMed Central

Julé, Y; Krier, J; Szurszewski, J H

1983-01-01

The patterns of peripheral and central synaptic input to non-spontaneous, irregular discharging and regular discharging neurones in the inferior mesenteric ganglion of the cat were studied in vitro using intracellular recording techniques. All three types of neurones in rostral and caudal lobes received central synaptic input primarily from L3 and L4 spinal cord segments. Since irregular discharging neurones received synaptic input from intraganglionic regular discharging neurones, some of the central input to irregular discharging neurones may have been relayed through the regular discharging neurones. In the rostral lobes of the ganglion, more than 70% of the non-spontaneous and irregular discharging neurones tested received peripheral synaptic input from the lumbar colonic, intermesenteric and left and right hypogastric nerves. Most of the regular discharging neurones tested received synaptic input from the intermesenteric and lumbar colonic nerves; none of the regular discharging neurones received synaptic input from the hypogastric nerves. Some of the peripheral synaptic input from the lumbar colonic and intermesenteric nerves to irregular discharging neurones may have been relayed through the regular discharging neurones. Axons of non-spontaneous and irregular discharging neurones located in the rostral lobes travelled to the periphery exclusively in the lumbar colonic nerves. Antidromic responses were not observed in regular discharging neurones during stimulation of any of the major peripheral nerve trunks. This suggests these neurones were intraganglionic. In the caudal lobes, irregular discharging neurones received a similar pattern of peripheral synaptic input as did irregular discharging neurones located in the rostral lobes. The majority of irregular discharging neurones in the caudal lobes projected their axons to the periphery through the lumbar colonic nerves. Non-spontaneous neurones in the caudal lobes, in contrast to those located in the rostral lobes, received peripheral synaptic input primarily from the hypogastric nerves. Axons of the majority of non-spontaneous neurones located in the caudal lobes travelled to the periphery through hypogastric nerves. The results suggest that non-spontaneous neurones and irregular discharging neurones in the rostral lobes and the majority of irregular discharging neurones in the caudal lobes transact and integrate neural commands destined for abdominal viscera supplied by the lumbar colonic nerves. Non-spontaneous neurones in the caudal lobes transact and integrate neural commands destined for pelvic viscera supplied by the hypogastric nerves. PMID:6655582

Patterns of innervation of neurones in the inferior mesenteric ganglion of the cat.

PubMed

Julé, Y; Krier, J; Szurszewski, J H

1983-11-01

The patterns of peripheral and central synaptic input to non-spontaneous, irregular discharging and regular discharging neurones in the inferior mesenteric ganglion of the cat were studied in vitro using intracellular recording techniques. All three types of neurones in rostral and caudal lobes received central synaptic input primarily from L3 and L4 spinal cord segments. Since irregular discharging neurones received synaptic input from intraganglionic regular discharging neurones, some of the central input to irregular discharging neurones may have been relayed through the regular discharging neurones. In the rostral lobes of the ganglion, more than 70% of the non-spontaneous and irregular discharging neurones tested received peripheral synaptic input from the lumbar colonic, intermesenteric and left and right hypogastric nerves. Most of the regular discharging neurones tested received synaptic input from the intermesenteric and lumbar colonic nerves; none of the regular discharging neurones received synaptic input from the hypogastric nerves. Some of the peripheral synaptic input from the lumbar colonic and intermesenteric nerves to irregular discharging neurones may have been relayed through the regular discharging neurones. Axons of non-spontaneous and irregular discharging neurones located in the rostral lobes travelled to the periphery exclusively in the lumbar colonic nerves. Antidromic responses were not observed in regular discharging neurones during stimulation of any of the major peripheral nerve trunks. This suggests these neurones were intraganglionic. In the caudal lobes, irregular discharging neurones received a similar pattern of peripheral synaptic input as did irregular discharging neurones located in the rostral lobes. The majority of irregular discharging neurones in the caudal lobes projected their axons to the periphery through the lumbar colonic nerves. Non-spontaneous neurones in the caudal lobes, in contrast to those located in the rostral lobes, received peripheral synaptic input primarily from the hypogastric nerves. Axons of the majority of non-spontaneous neurones located in the caudal lobes travelled to the periphery through hypogastric nerves. The results suggest that non-spontaneous neurones and irregular discharging neurones in the rostral lobes and the majority of irregular discharging neurones in the caudal lobes transact and integrate neural commands destined for abdominal viscera supplied by the lumbar colonic nerves. Non-spontaneous neurones in the caudal lobes transact and integrate neural commands destined for pelvic viscera supplied by the hypogastric nerves.

A 100-Channel Hermetically Sealed Implantable Device for Chronic Wireless Neurosensing Applications

PubMed Central

Yin, Ming; Borton, David A.; Aceros, Juan; Patterson, William R.; Nurmikko, Arto V.

2014-01-01

A 100-channel fully implantable wireless broadband neural recording system was developed. It features 100 parallel broadband (0.1 Hz–7.8 kHz) neural recording channels, a medical grade 200 mAh Li-ion battery recharged inductively at 150 kHz, and data telemetry using 3.2 GHz to 3.8 GHz FSK modulated wireless link for 48 Mbps Manchester encoded data. All active electronics are hermetically sealed in a titanium enclosure with a sapphire window for electromagnetic transparency. A custom, high-density configuration of 100 individual hermetic feedthrough pins enable connection to an intracortical neural recording microelectrode array. A 100 MHz bandwidth custom receiver was built to remotely receive the FSK signal and achieved −77.7 dBm sensitivity with 10−8 BER at 48 Mbps data rate. ESD testing on all the electronic inputs and outputs has proven that the implantable device satisfies the HBM Class-1B ESD Standard. In addition, the evaluation of the worst-case charge density delivered to the tissue from each I/O pin verifies the patient safety of the device in the event of failure. Finally, the functionality and reliability of the complete device has been tested on-bench and further validated chronically in ongoing freely moving swine and monkey animal trials for more than one year to date. PMID:23853294

Analysis and Simulation of Disadvantaged Receivers for Multiple-Input Multiple-Output Communications Systems

DTIC Science & Technology

2010-09-01

SIMULATION OF DISADVANTAGED RECEIVERS FOR MULTIPLE-INPUT MULTIPLE- OUTPUT COMMUNICATIONS SYSTEMS by Tracy A. Martin September 2010 Thesis...DATE September 2010 3. REPORT TYPE AND DATES COVERED Master’s Thesis 4. TITLE AND SUBTITLE Analysis and Simulation of Disadvantaged Receivers...Channel State Information at the Transmitter (CSIT). A disadvantaged receiver is subsequently introduced to the system lacking the optimization enjoyed

Which Patients First? Setting Priorities for Antiretroviral Therapy Where Resources Are Limited

PubMed Central

McGough, Laura J.; Reynolds, Steven J.; Quinn, Thomas C.; Zenilman, Jonathan M.

2005-01-01

The availability of limited funds from international agencies for the purchase of antiretroviral (ARV) treatment in developing countries presents challenges, especially in prioritizing who should receive therapy. Public input and the protection of human rights are crucial in making treatment programs equitable and accountable. By examining historical precedents of resource allocation, we aim to provoke and inform debate about current ARV programs. Through a critical review of the published literature, we evaluate 4 precedents for key lessons: the discovery of insulin for diabetes in 1922, the release of penicillin for civilian use in 1943, the development of chronic hemodialysis programs in 1961, and current allocation of liver transplants. We then describe current rationing mechanisms for ARVs. PMID:15983271

Multiple-frequency acoustic wave devices for chemical sensing and materials characterization in both gas and liquid phase

DOEpatents

Martin, S.J.; Ricco, A.J.

1993-08-10

A chemical or intrinsic physical property sensor is described comprising: (a) a substrate; (b) an interaction region of said substrate where the presence of a chemical or physical stimulus causes a detectable change in the velocity and/or an attenuation of an acoustic wave traversing said region; and (c) a plurality of paired input and output interdigitated electrodes patterned on the surface of said substrate where each of said paired electrodes has a distinct periodicity, where each of said paired electrodes is comprised of an input and an output electrode; (d) an input signal generation means for transmitting an input signal having a distinct frequency to a specified input interdigitated electrode of said plurality so that each input electrode receives a unique input signal, whereby said electrode responds to said input signal by generating an acoustic wave of a specified frequency, thus, said plurality responds by generating a plurality of acoustic waves of different frequencies; (e) an output signal receiving means for determining an acoustic wave velocity and an amplitude of said acoustic waves at several frequencies after said waves transverses said interaction region and comparing these values to an input acoustic wave velocity and an input acoustic wave amplitude to produce values for perturbations in acoustic wave velocities and for acoustic wave attenuation as a function of frequency, where said output receiving means is individually coupled to each of said output interdigitated electrode; (f) a computer means for analyzing a data stream comprising information from said output receiving means and from said input signal generation means to differentiate a specified response due to a perturbation from a subsequent specified response due to a subsequent perturbation to determine the chemical or intrinsic physical properties desired.

A Secure and Reliable High-Performance Field Programmable Gate Array for Information Processing

DTIC Science & Technology

2012-03-01

receives a data token from its control input (shown as a horizontal arrow above). The value of this data token is used to select an input port. The input...dual of a merge. It receives a data token from its control input (shown as a horizontal arrow above). The value of this data token is used to select...Transactions on Computer-Aided Design of Intergrated Circuits and Systems, Vol. 26, No. 2, February 2007. [12] Cadence Design Systems, “Clock Domain

Ultra-wideband receiver

DOEpatents

McEwan, Thomas E.

1994-01-01

An ultra-wideband (UWB) receiver utilizes a strobed input line with a sampler connected to an amplifier. In a differential configuration, .+-.UWB inputs are connected to separate antennas or to two halves of a dipole antenna. The two input lines include samplers which are commonly strobed by a gating pulse with a very low duty cycle. In a single ended configuration, only a single strobed input line and sampler is utilized. The samplers integrate, or average, up to 10,000 pulses to achieve high sensitivity and good rejection of uncorrelated signals.

Ultra-wideband receiver

DOEpatents

McEwan, Thomas E.

1996-01-01

An ultra-wideband (UWB) receiver utilizes a strobed input line with a sampler connected to an amplifier. In a differential configuration, .+-.UWB inputs are connected to separate antennas or to two halves of a dipole antenna. The two input lines include samplers which are commonly strobed by a gating pulse with a very low duty cycle. In a single ended configuration, only a single strobed input line and sampler is utilized. The samplers integrate, or average, up to 10,000 pulses to achieve high sensitivity and good rejection of uncorrelated signals.

[Severity classification of chronic obstructive pulmonary disease based on deep learning].

PubMed

Ying, Jun; Yang, Ceyuan; Li, Quanzheng; Xue, Wanguo; Li, Tanshi; Cao, Wenzhe

2017-12-01

In this paper, a deep learning method has been raised to build an automatic classification algorithm of severity of chronic obstructive pulmonary disease. Large sample clinical data as input feature were analyzed for their weights in classification. Through feature selection, model training, parameter optimization and model testing, a classification prediction model based on deep belief network was built to predict severity classification criteria raised by the Global Initiative for Chronic Obstructive Lung Disease (GOLD). We get accuracy over 90% in prediction for two different standardized versions of severity criteria raised in 2007 and 2011 respectively. Moreover, we also got the contribution ranking of different input features through analyzing the model coefficient matrix and confirmed that there was a certain degree of agreement between the more contributive input features and the clinical diagnostic knowledge. The validity of the deep belief network model was proved by this result. This study provides an effective solution for the application of deep learning method in automatic diagnostic decision making.

Differential Acute and Chronic Effects of Leptin on Hypothalamic Astrocyte Morphology and Synaptic Protein Levels

PubMed Central

García-Cáceres, Cristina; Fuente-Martín, Esther; Burgos-Ramos, Emma; Granado, Miriam; Frago, Laura M.; Barrios, Vicente; Horvath, Tamas

2011-01-01

Astrocytes participate in neuroendocrine functions partially through modulation of synaptic input density in the hypothalamus. Indeed, glial ensheathing of neurons is modified by specific hormones, thus determining the availability of neuronal membrane space for synaptic inputs, with the loss of this plasticity possibly being involved in pathological processes. Leptin modulates synaptic inputs in the hypothalamus, but whether astrocytes participate in this action is unknown. Here we report that astrocyte structural proteins, such as glial fibrillary acidic protein (GFAP) and vimentin, are induced and astrocyte morphology modified by chronic leptin administration (intracerebroventricular, 2 wk), with these changes being inversely related to modifications in synaptic protein densities. Similar changes in glial structural proteins were observed in adult male rats that had increased body weight and circulating leptin levels due to neonatal overnutrition (overnutrition: four pups/litter vs. control: 12 pups/litter). However, acute leptin treatment reduced hypothalamic GFAP levels and induced synaptic protein levels 1 h after administration, with no effect on vimentin. In primary hypothalamic astrocyte cultures leptin also reduced GFAP levels at 1 h, with an induction at 24 h, indicating a possible direct effect of leptin. Hence, one mechanism by which leptin may affect metabolism is by modifying hypothalamic astrocyte morphology, which in turn could alter synaptic inputs to hypothalamic neurons. Furthermore, the responses to acute and chronic leptin exposure are inverse, raising the possibility that increased glial activation in response to chronic leptin exposure could be involved in central leptin resistance. PMID:21343257

Bone architecture adaptations after spinal cord injury: impact of long-term vibration of a constrained lower limb.

PubMed

Dudley-Javoroski, S; Petrie, M A; McHenry, C L; Amelon, R E; Saha, P K; Shields, R K

2016-03-01

This study examined the effect of a controlled dose of vibration upon bone density and architecture in people with spinal cord injury (who eventually develop severe osteoporosis). Very sensitive computed tomography (CT) imaging revealed no effect of vibration after 12 months, but other doses of vibration may still be useful to test. The purposes of this report were to determine the effect of a controlled dose of vibratory mechanical input upon individual trabecular bone regions in people with chronic spinal cord injury (SCI) and to examine the longitudinal bone architecture changes in both the acute and chronic state of SCI. Participants with SCI received unilateral vibration of the constrained lower limb segment while sitting in a wheelchair (0.6g, 30 Hz, 20 min, three times weekly). The opposite limb served as a control. Bone mineral density (BMD) and trabecular micro-architecture were measured with high-resolution multi-detector CT. For comparison, one participant was studied from the acute (0.14 year) to the chronic state (2.7 years). Twelve months of vibration training did not yield adaptations of BMD or trabecular micro-architecture for the distal tibia or the distal femur. BMD and trabecular network length continued to decline at several distal femur sub-regions, contrary to previous reports suggesting a "steady state" of bone in chronic SCI. In the participant followed from acute to chronic SCI, BMD and architecture decline varied systematically across different anatomical segments of the tibia and femur. This study supports that vibration training, using this study's dose parameters, is not an effective anti-osteoporosis intervention for people with chronic SCI. Using a high-spatial-resolution CT methodology and segmental analysis, we illustrate novel longitudinal changes in bone that occur after spinal cord injury.

Local and Long-Range Circuit Connections to Hilar Mossy Cells in the Dentate Gyrus

PubMed Central

Sun, Yanjun; Grieco, Steven F.; Holmes, Todd C.

2017-01-01

Abstract Hilar mossy cells are the prominent glutamatergic cell type in the dentate hilus of the dentate gyrus (DG); they have been proposed to have critical roles in the DG network. To better understand how mossy cells contribute to DG function, we have applied new viral genetic and functional circuit mapping approaches to quantitatively map and compare local and long-range circuit connections of mossy cells and dentate granule cells in the mouse. The great majority of inputs to mossy cells consist of two parallel inputs from within the DG: an excitatory input pathway from dentate granule cells and an inhibitory input pathway from local DG inhibitory neurons. Mossy cells also receive a moderate degree of excitatory and inhibitory CA3 input from proximal CA3 subfields. Long range inputs to mossy cells are numerically sparse, and they are only identified readily from the medial septum and the septofimbrial nucleus. In comparison, dentate granule cells receive most of their inputs from the entorhinal cortex. The granule cells receive significant synaptic inputs from the hilus and the medial septum, and they also receive direct inputs from both distal and proximal CA3 subfields, which has been underdescribed in the existing literature. Our slice-based physiological mapping studies further supported the identified circuit connections of mossy cells and granule cells. Together, our data suggest that hilar mossy cells are major local circuit integrators and they exert modulation of the activity of dentate granule cells as well as the CA3 region through “back-projection” pathways. PMID:28451637

Thalamic connections of the core auditory cortex and rostral supratemporal plane in the macaque monkey.

PubMed

Scott, Brian H; Saleem, Kadharbatcha S; Kikuchi, Yukiko; Fukushima, Makoto; Mishkin, Mortimer; Saunders, Richard C

2017-11-01

In the primate auditory cortex, information flows serially in the mediolateral dimension from core, to belt, to parabelt. In the caudorostral dimension, stepwise serial projections convey information through the primary, rostral, and rostrotemporal (AI, R, and RT) core areas on the supratemporal plane, continuing to the rostrotemporal polar area (RTp) and adjacent auditory-related areas of the rostral superior temporal gyrus (STGr) and temporal pole. In addition to this cascade of corticocortical connections, the auditory cortex receives parallel thalamocortical projections from the medial geniculate nucleus (MGN). Previous studies have examined the projections from MGN to auditory cortex, but most have focused on the caudal core areas AI and R. In this study, we investigated the full extent of connections between MGN and AI, R, RT, RTp, and STGr using retrograde and anterograde anatomical tracers. Both AI and R received nearly 90% of their thalamic inputs from the ventral subdivision of the MGN (MGv; the primary/lemniscal auditory pathway). By contrast, RT received only ∼45% from MGv, and an equal share from the dorsal subdivision (MGd). Area RTp received ∼25% of its inputs from MGv, but received additional inputs from multisensory areas outside the MGN (30% in RTp vs. 1-5% in core areas). The MGN input to RTp distinguished this rostral extension of auditory cortex from the adjacent auditory-related cortex of the STGr, which received 80% of its thalamic input from multisensory nuclei (primarily medial pulvinar). Anterograde tracers identified complementary descending connections by which highly processed auditory information may modulate thalamocortical inputs. © 2017 Wiley Periodicals, Inc.

Hope or hype in the treatment of schizophrenia - what's the role of the physician?

PubMed

Bressan, Rodrigo A; Grohs, Geder E M; Matos, Gabriela; Shergill, Sukhi

2018-01-01

According to the experience of people with schizophrenia, their psychiatrists' attitude towards the outcome of their illness is lacking in hope, which directly affects mutual faith in treatment. Here we discuss the scientific basis of hope and show its instrumental role in optimising the best treatment strategies for schizophrenia. Declaration of interest R.A.B has received honoraria for educational input and non-financial support from Ache; honoraria for educational input from Lundbeck; grants, honoraria for educational input and non-financial support from Janssen; all outside the submitted work. G.E.M.G. has received honoraria for educational input and non-financial support from Janssen outside the submitted work. G.M. reports support from Janssen-Cilag, outside the submitted work, and is an employee at Janssen-Cilag. S.S. has received grants and honoraria for educational input from EnVivo Pharmaceuticals, Takeda, AbbVie and Janssen Pharmaceuticals, outside the submitted work.

Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014

PubMed Central

Kim, Scott Y H; De Vries, Raymond; Peteet, John R

2017-01-01

Importance Euthanasia and/or physician assisted suicide of psychiatric patients is increasing in some jurisdictions such as Belgium and the Netherlands. However, little is known about the practice and it remains very controversial. Objective To describe the characteristics of patients receiving euthanasia/assisted suicide for psychiatric conditions and how the practice is regulated in the Netherlands. Design and Setting A review of psychiatric euthanasia/assisted suicide case summaries made available online by the Dutch Regional Euthanasia Review Committees, as of 1 June 2015. Two senior psychiatrists used directed content analysis to review and code the reports. 66 cases from 2011–14 were reviewed. Main Outcomes Clinical and social characteristics of patients, physician review process of the patients’ requests, and the Review Committees’ assessments of the physicians’ actions. Results 70% (46 of 66) of patients were women, 32% were over 70 years-old, 44% were between 50–70, and 24% were 30–50. Most had chronic, severe conditions, with histories of attempted suicides and psychiatric hospitalizations. A majority had personality disorders and were described as socially isolated or lonely. Depressive disorders were the primary issue in 55% of cases. Other conditions represented were psychotic, PTSD/anxiety, somatoform, neurocognitive, and eating disorders, as well as prolonged grief and autism. Co-morbidities with functional impairments were common. A minority (41%) of physicians performing euthanasia/assisted suicide were psychiatrists. 18 (27%) patients received the procedure from physicians new to them, 15 (23%) of whom were physicians from the End-of-Life Clinic, a mobile euthanasia clinic. Consultation with other physicians was extensive, but 11% of cases had no independent psychiatric input and 24% of cases involved disagreement among consultants. The Review Committee found one case to have failed to meet legal due care criteria. Conclusions and Relevance Persons receiving EAS for psychiatric disorders in the Netherlands are mostly women, of diverse ages, with complex and chronic psychiatric, medical, and psychosocial histories. The granting of their EAS requests appears to involve considerable physician judgment, usually involving multiple physicians who do not always agree (and sometimes without independent psychiatric input) but the Review Committees generally defer to the physicians performing the EAS. PMID:26864709

Euthanasia and Assisted Suicide of Patients With Psychiatric Disorders in the Netherlands 2011 to 2014.

PubMed

Kim, Scott Y H; De Vries, Raymond G; Peteet, John R

2016-04-01

Euthanasia or assisted suicide (EAS) of psychiatric patients is increasing in some jurisdictions such as Belgium and the Netherlands. However, little is known about the practice, and it remains controversial. To describe the characteristics of patients receiving EAS for psychiatric conditions and how the practice is regulated in the Netherlands. This investigation reviewed psychiatric EAS case summaries made available online by the Dutch regional euthanasia review committees as of June 1, 2015. Two senior psychiatrists used directed content analysis to review and code the reports. In total, 66 cases from 2011 to 2014 were reviewed. Clinical and social characteristics of patients, physician review process of the patients' requests, and the euthanasia review committees' assessments of the physicians' actions. Of the 66 cases reviewed, 70% (n = 46) were women. In total, 32% (n = 21) were 70 years or older, 44% (n = 29) were 50 to 70 years old, and 24% (n = 16) were 30 to 50 years old. Most had chronic, severe conditions, with histories of attempted suicides and psychiatric hospitalizations. Most had personality disorders and were described as socially isolated or lonely. Depressive disorders were the primary psychiatric issue in 55% (n = 36) of cases. Other conditions represented were psychotic, posttraumatic stress or anxiety, somatoform, neurocognitive, and eating disorders, as well as prolonged grief and autism. Comorbidities with functional impairments were common. Forty-one percent (n = 27) of physicians performing EAS were psychiatrists. Twenty-seven percent (n = 18) of patients received the procedure from physicians new to them, 14 of whom were physicians from the End-of-Life Clinic, a mobile euthanasia clinic. Consultation with other physicians was extensive, but 11% (n = 7) of cases had no independent psychiatric input, and 24% (n = 16) of cases involved disagreement among consultants. The euthanasia review committees found that one case failed to meet legal due care criteria. Persons receiving EAS for psychiatric disorders in the Netherlands are mostly women and of diverse ages, with complex and chronic psychiatric, medical, and psychosocial histories. The granting of their EAS requests appears to involve considerable physician judgment, usually involving multiple physicians who do not always agree (sometimes without independent psychiatric input), but the euthanasia review committees generally defer to the judgments of the physicians performing the EAS.

Reduced Structural Connectivity in Frontostriatal White Matter Tracts in the Associative Loop in Schizophrenia.

PubMed

Levitt, James J; Nestor, Paul G; Levin, Laura; Pelavin, Paula; Lin, Pan; Kubicki, Marek; McCarley, Robert W; Shenton, Martha E; Rathi, Yogesh

2017-11-01

The striatum receives segregated and integrative white matter tracts from the cortex facilitating information processing in the cortico-basal ganglia network. The authors examined both types of input tracts in the striatal associative loop in chronic schizophrenia patients and healthy control subjects. Structural and diffusion MRI scans were acquired on a 3-T system from 26 chronic schizophrenia patients and 26 matched healthy control subjects. Using FreeSurfer, the associative cortex was parcellated into ventrolateral prefrontal cortex and dorsolateral prefrontal cortex subregions. The striatum was manually parcellated into its associative and sensorimotor functional subregions. Fractional anisotropy and normalized streamlines, an estimate of fiber counts, were assessed in four frontostriatal tracts (dorsolateral prefrontal cortex-associative striatum, dorsolateral prefrontal cortex-sensorimotor striatum, ventrolateral prefrontal cortex-associative striatum, and ventrolateral prefrontal cortex-sensorimotor striatum). Furthermore, these measures were correlated with a measure of cognitive control, the Trail-Making Test, Part B. Results showed reduced fractional anisotropy and fewer streamlines in chronic schizophrenia patients for all four tracts, both segregated and integrative. Post hoc t tests showed reduced fractional anisotropy in the left ventrolateral prefrontal cortex-associative striatum and left ventrolateral prefrontal cortex-sensorimotor striatum and fewer normalized streamlines in the right dorsolateral prefrontal cortex-sensorimotor striatum and in the left and right ventrolateral prefrontal cortex-sensorimotor striatum in chronic schizophrenia patients. Furthermore, normalized streamlines in the right dorsolateral prefrontal cortex-sensorimotor striatum negatively correlated with Trail-Making Test, Part B, time spent in healthy control subjects but not in chronic schizophrenia patients. These findings demonstrated that structural connectivity is reduced in both segregated and integrative tracts in the striatal associative loop in chronic schizophrenia and that reduced normalized streamlines in the right-hemisphere dorsolateral prefrontal cortex-sensorimotor striatum predicted worse cognitive control in healthy control subjects but not in chronic schizophrenia patients, suggesting a loss of a "normal" brain-behavior correlation in chronic schizophrenia.

Ultra-wideband receiver

DOEpatents

McEwan, T.E.

1994-09-06

An ultra-wideband (UWB) receiver utilizes a strobed input line with a sampler connected to an amplifier. In a differential configuration, [+-] UWB inputs are connected to separate antennas or to two halves of a dipole antenna. The two input lines include samplers which are commonly strobed by a gating pulse with a very low duty cycle. In a single ended configuration, only a single strobed input line and sampler is utilized. The samplers integrate, or average, up to 10,000 pulses to achieve high sensitivity and good rejection of uncorrelated signals. 16 figs.

Ultra-wideband receiver

DOEpatents

McEwan, T.E.

1996-06-04

An ultra-wideband (UWB) receiver utilizes a strobed input line with a sampler connected to an amplifier. In a differential configuration, {+-}UWB inputs are connected to separate antennas or to two halves of a dipole antenna. The two input lines include samplers which are commonly strobed by a gating pulse with a very low duty cycle. In a single ended configuration, only a single strobed input line and sampler is utilized. The samplers integrate, or average, up to 10,000 pulses to achieve high sensitivity and good rejection of uncorrelated signals. 21 figs.

Stimulated by Novelty? The Role of Psychological Needs and Perceived Creativity

PubMed Central

De Jonge, Kiki M. M.; Rietzschel, Eric F.; Van Yperen, Nico W.

2018-01-01

In the current research, we aimed to address the inconsistent finding in the brainstorming literature that cognitive stimulation sometimes results from novel input, yet other times from non-novel input. We expected and found, in three experiments, that the strength and valence of this relationship are moderated by people’s psychological needs for structure and autonomy. Specifically, the effect of novel input (vs. non-novel input), through perceived creativity, on cognitive stimulation was stronger for people who were either low in need for structure or high in need for autonomy. Also, when the input people received did not fit their needs, they experienced less psychological cognitive stimulation from this input (i.e., less task enjoyment and feeling more blocked) compared with when they did not receive any input. Hence, to create the ideal circumstances for people to achieve cognitive stimulation when brainstorming, input novelty should be aligned with their psychological needs. PMID:29405847

Long period pseudo random number sequence generator

NASA Technical Reports Server (NTRS)

Wang, Charles C. (Inventor)

1989-01-01

A circuit for generating a sequence of pseudo random numbers, (A sub K). There is an exponentiator in GF(2 sup m) for the normal basis representation of elements in a finite field GF(2 sup m) each represented by m binary digits and having two inputs and an output from which the sequence (A sub K). Of pseudo random numbers is taken. One of the two inputs is connected to receive the outputs (E sub K) of maximal length shift register of n stages. There is a switch having a pair of inputs and an output. The switch outputs is connected to the other of the two inputs of the exponentiator. One of the switch inputs is connected for initially receiving a primitive element (A sub O) in GF(2 sup m). Finally, there is a delay circuit having an input and an output. The delay circuit output is connected to the other of the switch inputs and the delay circuit input is connected to the output of the exponentiator. Whereby after the exponentiator initially receives the primitive element (A sub O) in GF(2 sup m) through the switch, the switch can be switched to cause the exponentiator to receive as its input a delayed output A(K-1) from the exponentiator thereby generating (A sub K) continuously at the output of the exponentiator. The exponentiator in GF(2 sup m) is novel and comprises a cyclic-shift circuit; a Massey-Omura multiplier; and, a control logic circuit all operably connected together to perform the function U(sub i) = 92(sup i) (for n(sub i) = 1 or 1 (for n(subi) = 0).

Viral-genetic tracing of the input-output organization of a central noradrenaline circuit.

PubMed

Schwarz, Lindsay A; Miyamichi, Kazunari; Gao, Xiaojing J; Beier, Kevin T; Weissbourd, Brandon; DeLoach, Katherine E; Ren, Jing; Ibanes, Sandy; Malenka, Robert C; Kremer, Eric J; Luo, Liqun

2015-08-06

Deciphering how neural circuits are anatomically organized with regard to input and output is instrumental in understanding how the brain processes information. For example, locus coeruleus noradrenaline (also known as norepinephrine) (LC-NE) neurons receive input from and send output to broad regions of the brain and spinal cord, and regulate diverse functions including arousal, attention, mood and sensory gating. However, it is unclear how LC-NE neurons divide up their brain-wide projection patterns and whether different LC-NE neurons receive differential input. Here we developed a set of viral-genetic tools to quantitatively analyse the input-output relationship of neural circuits, and applied these tools to dissect the LC-NE circuit in mice. Rabies-virus-based input mapping indicated that LC-NE neurons receive convergent synaptic input from many regions previously identified as sending axons to the locus coeruleus, as well as from newly identified presynaptic partners, including cerebellar Purkinje cells. The 'tracing the relationship between input and output' method (or TRIO method) enables trans-synaptic input tracing from specific subsets of neurons based on their projection and cell type. We found that LC-NE neurons projecting to diverse output regions receive mostly similar input. Projection-based viral labelling revealed that LC-NE neurons projecting to one output region also project to all brain regions we examined. Thus, the LC-NE circuit overall integrates information from, and broadcasts to, many brain regions, consistent with its primary role in regulating brain states. At the same time, we uncovered several levels of specificity in certain LC-NE sub-circuits. These tools for mapping output architecture and input-output relationship are applicable to other neuronal circuits and organisms. More broadly, our viral-genetic approaches provide an efficient intersectional means to target neuronal populations based on cell type and projection pattern.

Resilience to the contralateral visual field bias as a window into object representations

PubMed Central

Garcea, Frank E.; Kristensen, Stephanie; Almeida, Jorge; Mahon, Bradford Z.

2016-01-01

Viewing images of manipulable objects elicits differential blood oxygen level-dependent (BOLD) contrast across parietal and dorsal occipital areas of the human brain that support object-directed reaching, grasping, and complex object manipulation. However, it is unknown which object-selective regions of parietal cortex receive their principal inputs from the ventral object-processing pathway and which receive their inputs from the dorsal object-processing pathway. Parietal areas that receive their inputs from the ventral visual pathway, rather than from the dorsal stream, will have inputs that are already filtered through object categorization and identification processes. This predicts that parietal regions that receive inputs from the ventral visual pathway should exhibit object-selective responses that are resilient to contralateral visual field biases. To test this hypothesis, adult participants viewed images of tools and animals that were presented to the left or right visual fields during functional magnetic resonance imaging (fMRI). We found that the left inferior parietal lobule showed robust tool preferences independently of the visual field in which tool stimuli were presented. In contrast, a region in posterior parietal/dorsal occipital cortex in the right hemisphere exhibited an interaction between visual field and category: tool-preferences were strongest contralateral to the stimulus. These findings suggest that action knowledge accessed in the left inferior parietal lobule operates over inputs that are abstracted from the visual input and contingent on analysis by the ventral visual pathway, consistent with its putative role in supporting object manipulation knowledge. PMID:27160998

Monitoring chronic and acute PAH atmospheric pollution using transplants of the moss Hypnum cupressiforme and Robinia pseudacacia leaves

NASA Astrophysics Data System (ADS)

Capozzi, F.; Di Palma, A.; Adamo, P.; Spagnuolo, V.; Giordano, S.

2017-02-01

Few studies are focused on correlations between the concentrations of PAHs in mosses and other bioindicator plant species. This study was carried out to investigate the potential of the joint use of devitalized H. cupressiforme transplants and R. pseudoacacia leaves as cost effective biomonitors for the assessment of PAHs in the air. The test was performed in a land historically devoted to agriculture, where recurrent waste burnings randomly occur, especially in the season we chose for the investigation. The presence of 20 PAHs was assessed following EPA 3550 C 2007 and EPA 8270 D 2014 protocols. R. pseudoacacia was able to accumulate both LMW and HMW PAHs, while moss prevalently collected the latter. It is suggested that R. pseudoacacia combined chronic pyrogenic and petrogenic PAH inputs, while moss transplants reflected PAH depositions from recent pyrogenic events. Our approach revealed long and short-term pollution footprints, with R. pseudoacacia recording the chronic input of PAH compounds loaded along its vegetative growth, and moss bags reflecting acute pollution inputs occurred during the exposure duration.

Hybrid zero-voltage switching (ZVS) control for power inverters

DOEpatents

Amirahmadi, Ahmadreza; Hu, Haibing; Batarseh, Issa

2016-11-01

A power inverter combination includes a half-bridge power inverter including first and second semiconductor power switches receiving input power having an intermediate node therebetween providing an inductor current through an inductor. A controller includes input comparison circuitry receiving the inductor current having outputs coupled to first inputs of pulse width modulation (PWM) generation circuitry, and a predictive control block having an output coupled to second inputs of the PWM generation circuitry. The predictive control block is coupled to receive a measure of Vin and an output voltage at a grid connection point. A memory stores a current control algorithm configured for resetting a PWM period for a switching signal applied to control nodes of the first and second power switch whenever the inductor current reaches a predetermined upper limit or a predetermined lower limit.

Biased low differential input impedance current receiver/converter device and method for low noise readout from voltage-controlled detectors

DOEpatents

Degtiarenko, Pavel V [Williamsburg, VA; Popov, Vladimir E [Newport News, VA

2011-03-22

A first stage electronic system for receiving charge or current from voltage-controlled sensors or detectors that includes a low input impedance current receiver/converter device (for example, a transimpedance amplifier), which is directly coupled to the sensor output, a source of bias voltage, and the device's power supply (or supplies), which use the biased voltage point as a baseline.

Should patients with self-inflicted illness receive lower priority in access to healthcare resources? Mapping out the debate.

PubMed

Sharkey, Kerith; Gillam, Lynn

2010-11-01

The distribution of scarce healthcare resources is an increasingly important issue due to factors such as expensive 'high tech' medicine, longer life expectancies and the rising prevalence of chronic illness. Furthermore, in the current healthcare context lifestyle-related factors such as high blood pressure, tobacco use and obesity are believed to contribute significantly to the global burden of disease. As such, this paper focuses on an ongoing debate in the academic literature regarding the role of responsibility for illness in healthcare resource allocation: should patients with self-caused illness receive lower priority in access to healthcare resources? This paper critically describes the lower priority debate's 12 key arguments and maps out their relationships. This analysis reveals that most arguments have been refuted and that the debate has stalled and remains unresolved. In conclusion, we suggest progression could be achieved by inviting multidisciplinary input from a range of stakeholders for the development of evidence-based critical evaluations of existing arguments and the development of novel arguments, including the outstanding rebuttals.

Asymmetric temporal integration of layer 4 and layer 2/3 inputs in visual cortex.

PubMed

Hang, Giao B; Dan, Yang

2011-01-01

Neocortical neurons in vivo receive concurrent synaptic inputs from multiple sources, including feedforward, horizontal, and feedback pathways. Layer 2/3 of the visual cortex receives feedforward input from layer 4 and horizontal input from layer 2/3. Firing of the pyramidal neurons, which carries the output to higher cortical areas, depends critically on the interaction of these pathways. Here we examined synaptic integration of inputs from layer 4 and layer 2/3 in rat visual cortical slices. We found that the integration is sublinear and temporally asymmetric, with larger responses if layer 2/3 input preceded layer 4 input. The sublinearity depended on inhibition, and the asymmetry was largely attributable to the difference between the two inhibitory inputs. Interestingly, the asymmetric integration was specific to pyramidal neurons, and it strongly affected their spiking output. Thus via cortical inhibition, the temporal order of activation of layer 2/3 and layer 4 pathways can exert powerful control of cortical output during visual processing.

Organization of monosynaptic inputs to the serotonin and dopamine neuromodulatorysystems

PubMed Central

Ogawa, Sachie K.; Cohen, Jeremiah Y.; Hwang, Dabin; Uchida, Naoshige; Watabe-Uchida, Mitsuko

2014-01-01

SUMMARY Serotonin and dopamine are major neuromodulators. Here we used a modified rabies virus to identify monosynaptic inputs to serotonin neurons in the dorsal and median raphe (DR and MR). We found that inputs to DR and MR serotonin neurons are spatially shiftedin the forebrain, with MRserotonin neurons receiving inputs from more medial structures. We then compared these data with inputs to dopamine neurons in the ventral tegmental area (VTA) and substantianigra pars compacta (SNc). We found that DR serotonin neurons receive inputs from a remarkably similar set of areas as VTA dopamine neurons, apart from the striatum, which preferentially targets dopamine neurons. Ourresults suggest three majorinput streams: amedial stream regulates MR serotonin neurons, anintermediate stream regulatesDR serotonin and VTA dopamine neurons, and alateral stream regulatesSNc dopamine neurons. These results providefundamental organizational principlesofafferent control forserotonin and dopamine. PMID:25108805

Balance exercise in patients with chronic sensory ataxic neuropathy: a pilot study.

PubMed

Riva, Nilo; Faccendini, Simone; Lopez, Ignazio D; Fratelli, Annamaria; Velardo, Daniele; Quattrini, Angelo; Gatti, Roberto; Comi, Giancarlo; Comola, Mauro; Fazio, Raffaella

2014-06-01

Although exercise therapy is considered part of the treatment of neuropathic patients, and somatosensory input is essential for motor learning, performance and neural plasticity, rehabilitation of patients with sensory ataxia has received little attention so far. The aim of this prospective pilot study was to explore the short- and medium-term efficacy of a 3-week intensive balance and treadmill exercise program in chronic ataxic neuropathy patients; 20 consecutive patients with leg overall disability sum score (ODSS-leg) ≥2, absent/mild motor signs, clinical and therapeutic stability ≥4 months were enrolled. Evaluations were done at baseline, at the end of treatment and at 3- and 6-month follow-up. Outcome measurements included: ODSS-leg, Berg balance scale, 6-min walk distance, and the functional independence measure (FIM) scale. The short-form-36 health status scale (SF-36) was used to measure health-related quality of life (HRQoL). ODSS-leg improved significantly compared with baseline, 3 weeks, 3 months (primary outcome), and 6 months follow-up. A significant improvement in all functional secondary outcome measurements and in some SF-36 subscales was also observed. This pilot study suggests that balance exercise is safe and well tolerated and might be effective in ameliorating disability and HRQoL in patients with chronic peripheral sensory ataxia. © 2014 Peripheral Nerve Society.

Unexpected Anemia and Reticulocytopenia in an Adolescent With Sickle Cell Anemia Receiving Chronic Transfusion Therapy.

PubMed

Blauel, Emily R; Grossmann, Lily T; Vissa, Madhav; Miller, Scott T

2015-10-01

In a patient with sickle cell disease receiving chronic transfusion, exacerbation of anemia with reticulocytopenia must prompt consideration of a delayed hemolytic transfusion reaction with hyperhemolysis, as further transfusion may worsen this condition; definitive diagnosis is sometimes difficult. Anemia evolving during parvovirus B19-induced erythroid hypoplasia (transient aplastic crisis) should be attenuated in chronic transfusion patients due to superior survival of transfused over endogenous red blood cells. A 16-year-old with sickle cell disease receiving chronic transfusion of modified intensity (goal to maintain hemoglobin S<50%) who developed symptomatic anemia with reticulocytopenia was later shown to have had transient aplastic crisis.

Exhaust system for use with a turbine and method of assembling same

DOEpatents

Dalsania, Prakash Bavanjibhai; Sadhu, Antanu

2015-08-18

An exhaust system for use with a steam turbine is provided. An exhaust hood includes an input and an output, the input receiving fluid from the steam turbine. The exhaust hood includes a first side wall that extends between the input and the output. The first side wall includes an aperture. An ejector is coupled to the exhaust hood. The ejector includes inlets and an outlet. At least one of the inlets receives fluid from the exhaust hood via the aperture.

A High-Performance Reconfigurable Fabric for Cognitive Information Processing

DTIC Science & Technology

2010-12-01

receives a data token from its control input (shown as a horizontal arrow above). The value of this data token is used to select an input port. The...dual of a merge. It receives a data token from its control input (shown as a horizontal arrow above). The value of this data token is used to select...Computer-Aided Design of Intergrated Circuits and Systems, Vol. 26, No. 2, February 2007. [12] Cadence Design Systems. Clock Domain Crossing: Closing the

Light adaptation alters the source of inhibition to the mouse retinal OFF pathway

PubMed Central

Mazade, Reece E.

2013-01-01

Sensory systems must avoid saturation to encode a wide range of stimulus intensities. One way the retina accomplishes this is by using both dim-light-sensing rod and bright-light-sensing cone photoreceptor circuits. OFF cone bipolar cells are a key point in this process, as they receive both excitatory input from cones and inhibitory input from AII amacrine cells via the rod pathway. However, in addition to AII amacrine cell input, other inhibitory inputs from cone pathways also modulate OFF cone bipolar cell light signals. It is unknown how these inhibitory inputs to OFF cone bipolar cells change when switching between rod and cone pathways or whether all OFF cone bipolar cells receive rod pathway input. We found that one group of OFF cone bipolar cells (types 1, 2, and 4) receive rod-mediated inhibitory inputs that likely come from the rod-AII amacrine cell pathway, while another group of OFF cone bipolar cells (type 3) do not. In both cases, dark-adapted rod-dominant light responses showed a significant contribution of glycinergic inhibition, which decreased with light adaptation and was, surprisingly, compensated by an increase in GABAergic inhibition. As GABAergic input has distinct timing and spatial spread from glycinergic input, a shift from glycinergic to GABAergic inhibition could significantly alter OFF cone bipolar cell signaling to downstream OFF ganglion cells. Larger GABAergic input could reflect an adjustment of OFF bipolar cell spatial inhibition, which may be one mechanism that contributes to retinal spatial sensitivity in the light. PMID:23926034

Early Phonological and Lexical Development and Otitis Media: A Diary Study.

ERIC Educational Resources Information Center

Donahue, Mavis L.

1993-01-01

A child with chronic otitis media with effusion solved the problem of reduced and fluctuating auditory input with phonological selection and avoidance strategies that capitalized on prosodic cues. Findings illustrate the need to consider interactions among performance, input, and linguistic constraints to explain individual variation in language…

RATIO COMPUTER

DOEpatents

Post, R.F.

1958-11-11

An electronic computer circuit is described for producing an output voltage proportional to the product or quotient of tbe voltages of a pair of input signals. ln essence, the disclosed invention provides a computer having two channels adapted to receive separate input signals and each having amplifiers with like fixed amplification factors and like negatlve feedback amplifiers. One of the channels receives a constant signal for comparison purposes, whereby a difference signal is produced to control the amplification factors of the variable feedback amplifiers. The output of the other channel is thereby proportional to the product or quotient of input signals depending upon the relation of input to fixed signals in the first mentioned channel.

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

Hamlet, Jason R.; Mayo, Jackson R.

Embodiments of the invention describe a Boolean circuit having a voter circuit and a plurality of approximate circuits each based, at least in part, on a reference circuit. The approximate circuits are each to generate one or more output signals based on values of received input signals. The voter circuit is to receive the one or more output signals generated by each of the approximate circuits, and is to output one or more signals corresponding to a majority value of the received signals. At least some of the approximate circuits are to generate an output value different than the referencemore » circuit for one or more input signal values; however, for each possible input signal value, the majority values of the one or more output signals generated by the approximate circuits and received by the voter circuit correspond to output signal result values of the reference circuit.« less

Cocaine-Induced Structural Plasticity in Input Regions to Distinct Cell Types in Nucleus Accumbens.

PubMed

Barrientos, Cindy; Knowland, Daniel; Wu, Mingche M J; Lilascharoen, Varoth; Huang, Kee Wui; Malenka, Robert C; Lim, Byung Kook

2018-05-09

The nucleus accumbens (NAc) is a brain region implicated in pathological motivated behaviors such as drug addiction and is composed predominantly of two discrete populations of neurons, dopamine receptor-1- and dopamine receptor-2-expressing medium spiny neurons (D1-MSNs and D2-MSNs, respectively). It is unclear whether these populations receive inputs from different brain areas and whether input regions to these cell types undergo distinct structural adaptations in response to the administration of addictive drugs such as cocaine. Using a modified rabies virus-mediated tracing method, we created a comprehensive brain-wide monosynaptic input map to NAc D1- and D2-MSNs. Next, we analyzed nearly 2000 dendrites and 125,000 spines of neurons across four input regions (the prelimbic cortex, medial orbitofrontal cortex, basolateral amygdala, and ventral hippocampus) at four separate time points during cocaine administration and withdrawal to examine changes in spine density in response to repeated intraperitoneal cocaine injection in mice. D1- and D2-MSNs display overall similar input profiles, with the exception that D1-MSNs receive significantly more input from the medial orbitofrontal cortex. We found that neurons in distinct brain areas projecting to D1- and D2-MSNs display different adaptations in dendritic spine density at different stages of cocaine administration and withdrawal. While NAc D1- and D2-MSNs receive input from similar brain structures, cocaine-induced spine density changes in input regions are quite distinct and dynamic. While previous studies have focused on input-specific postsynaptic changes within NAc MSNs in response to cocaine, these findings emphasize the dramatic changes that occur in the afferent input regions as well. Published by Elsevier Inc.

Effect of task-based mirror therapy on motor recovery of the upper extremity in chronic stroke patients: a pilot study.

PubMed

Arya, Kamal Narayan; Pandian, Shanta

2013-01-01

Mirror therapy (MT) is an alternative therapeutic intervention that uses the interaction of visuomotor-proprioception inputs to enhance movement performance of the impaired limb. Despite strong evidence for task-specific training in stroke, MT has been investigated using nontask movements. The aim of this pilot study was to assess the effectiveness of task-based MT on motor recovery of the upper extremity in chronic stroke patients. In a pretest-posttest single-group design, a convenience sample of 13 chronic stroke patients at an occupational therapy department of a rehabilitation institute was assessed on a task-based MT intervention. Participants received a task-based MT program, performing various tasks by the less affected upper extremity and observing in the mirror box along with conventional management, 4 days per week for 4 weeks. Fugl-Meyer Assessment (FMA), which includes subsection upper extremity (FMA-UE) and subpart upper arm (FMA-UA) and hand (FMA-WH), was used as an outcome measure. Participants showed no significant improvement for FMA-UE and FMA-UA at postassessment. FMA-UE changed from 43% to 51%. Post FMA-UA score showed only 2% improvement. However, there was statistically significant improvement on mean scores of FMA-WH at postassessment (16.21 ± 3.06) as compared with the prescores (12.29 ± 3.1; P < .05). FMA-WH improved from 41% to 54%. The preliminary findings suggest that task-based MT is effective in improving wrist and hand motor recovery in chronic stroke patients. Further studies in the form of randomized trials are needed to validate its effectiveness.

High-order motor cortex in rats receives somatosensory inputs from the primary motor cortex via cortico-cortical pathways.

PubMed

Kunori, Nobuo; Takashima, Ichiro

2016-12-01

The motor cortex of rats contains two forelimb motor areas; the caudal forelimb area (CFA) and the rostral forelimb area (RFA). Although the RFA is thought to correspond to the premotor and/or supplementary motor cortices of primates, which are higher-order motor areas that receive somatosensory inputs, it is unknown whether the RFA of rats receives somatosensory inputs in the same manner. To investigate this issue, voltage-sensitive dye (VSD) imaging was used to assess the motor cortex in rats following a brief electrical stimulation of the forelimb. This procedure was followed by intracortical microstimulation (ICMS) mapping to identify the motor representations in the imaged cortex. The combined use of VSD imaging and ICMS revealed that both the CFA and RFA received excitatory synaptic inputs after forelimb stimulation. Further evaluation of the sensory input pathway to the RFA revealed that the forelimb-evoked RFA response was abolished either by the pharmacological inactivation of the CFA or a cortical transection between the CFA and RFA. These results suggest that forelimb-related sensory inputs would be transmitted to the RFA from the CFA via the cortico-cortical pathway. Thus, the present findings imply that sensory information processed in the RFA may be used for the generation of coordinated forelimb movements, which would be similar to the function of the higher-order motor cortex in primates. © 2016 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

Power selective optical filter devices and optical systems using same

DOEpatents

Koplow, Jeffrey P

2014-10-07

In an embodiment, a power selective optical filter device includes an input polarizer for selectively transmitting an input signal. The device includes a wave-plate structure positioned to receive the input signal, which includes at least one substantially zero-order, zero-wave plate. The zero-order, zero-wave plate is configured to alter a polarization state of the input signal passing in a manner that depends on the power of the input signal. The zero-order, zero-wave plate includes an entry and exit wave plate each having a fast axis, with the fast axes oriented substantially perpendicular to each other. Each entry wave plate is oriented relative to a transmission axis of the input polarizer at a respective angle. An output polarizer is positioned to receive a signal output from the wave-plate structure and selectively transmits the signal based on the polarization state.

System and method for motor parameter estimation

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

Luhrs, Bin; Yan, Ting

2014-03-18

A system and method for determining unknown values of certain motor parameters includes a motor input device connectable to an electric motor having associated therewith values for known motor parameters and an unknown value of at least one motor parameter. The motor input device includes a processing unit that receives a first input from the electric motor comprising values for the known motor parameters for the electric motor and receive a second input comprising motor data on a plurality of reference motors, including values for motor parameters corresponding to the known motor parameters of the electric motor and values formore » motor parameters corresponding to the at least one unknown motor parameter value of the electric motor. The processor determines the unknown value of the at least one motor parameter from the first input and the second input and determines a motor management strategy for the electric motor based thereon.« less

Through-the-earth radio

DOEpatents

Reagor, David [Los Alamos, NM; Vasquez-Dominguez, Jose [Los Alamos, NM

2006-05-09

A method and apparatus for effective through-the-earth communication involves a signal input device connected to a transmitter operating at a predetermined frequency sufficiently low to effectively penetrate useful distances through-the earth, and having an analog to digital converter receiving the signal input and passing the signal input to a data compression circuit that is connected to an encoding processor, the encoding processor output being provided to a digital to analog converter. An amplifier receives the analog output from the digital to analog converter for amplifying said analog output and outputting said analog output to an antenna. A receiver having an antenna receives the analog output passes the analog signal to a band pass filter whose output is connected to an analog to digital converter that provides a digital signal to a decoding processor whose output is connected to an data decompressor, the data decompressor providing a decompressed digital signal to a digital to analog converter. An audio output device receives the analog output form the digital to analog converter for producing audible output.

Room-temperature quantum noise limited spectrometry and methods of the same

DOEpatents

Stevens, Charles G.; Tringe, Joseph W.; Cunningham, Christopher Thomas

2014-08-26

In one embodiment, a heterodyne detection system for detecting light includes a first input aperture adapted for receiving first light from a scene input, a second input aperture adapted for receiving second light from a local oscillator input, a broadband local oscillator adapted for providing the second light to the second input aperture, a dispersive element adapted for dispersing the first light and the second light, and a final condensing lens coupled to an infrared detector. The final condensing lens is adapted for concentrating incident light from a primary condensing lens onto the infrared detector, and the infrared detector is a square-law detector capable of sensing the frequency difference between the first light and the second light. More systems and methods for detecting light are described according to other embodiments.

Room-temperature quantum noise limited spectrometry and methods of the same

DOEpatents

Stevens, Charles G; Tringe, Joseph W

2014-12-02

In one embodiment, a heterodyne detection system for detecting light includes a first input aperture adapted for receiving a first light from a scene input, a second input aperture adapted for receiving a second light from a local oscillator input, a broadband local oscillator adapted for providing the second light to the second input aperture, a dispersive element adapted for dispersing the first light and the second light, and a final condensing lens coupled to an infrared detector. The final condensing lens is adapted for concentrating incident light from a primary condensing lens onto the detector, and the detector is a square-law detector capable of sensing the frequency difference between the first light and the second light. More systems and methods for detecting light are disclosed according to more embodiments.

Room-temperature quantum noise limited spectrometry and methods of the same

DOEpatents

Stevens, Charles G.; Tringe, Joseph W.; Cunningham, Christopher T.

2016-08-02

In one embodiment, a heterodyne detection system for detecting light includes a first input aperture configured to receive first light from a scene input, a second input aperture configured to receive second light from a local oscillator input, a broadband local oscillator configured to provide the second light to the second input aperture, a dispersive element configured to disperse the first light and the second light, and a final condensing lens coupled to an infrared detector. The final condensing lens is configured to concentrate incident light from a primary condensing lens onto the infrared detector, and the infrared detector is a square-law detector capable of sensing the frequency difference between the first light and the second light. More systems and methods for detecting light are described according to other embodiments.

Approximate circuits for increased reliability

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

Hamlet, Jason R.; Mayo, Jackson R.

2015-08-18

Embodiments of the invention describe a Boolean circuit having a voter circuit and a plurality of approximate circuits each based, at least in part, on a reference circuit. The approximate circuits are each to generate one or more output signals based on values of received input signals. The voter circuit is to receive the one or more output signals generated by each of the approximate circuits, and is to output one or more signals corresponding to a majority value of the received signals. At least some of the approximate circuits are to generate an output value different than the referencemore » circuit for one or more input signal values; however, for each possible input signal value, the majority values of the one or more output signals generated by the approximate circuits and received by the voter circuit correspond to output signal result values of the reference circuit.« less

Drivers from the deep: the contribution of collicular input to thalamocortical processing.

PubMed

Wurtz, Robert H; Sommer, Marc A; Cavanaugh, James

2005-01-01

A traditional view of the thalamus is that it is a relay station which receives sensory input and conveys this information to cortex. This sensory input determines most of the properties of first order thalamic neurons, and so is said to drive, rather than modulate, these neurons. This holds as a rule for first order thalamic nuclei, but in contrast, higher order thalamic nuclei receive much of their driver input back from cerebral cortex. In addition, higher order thalamic neurons receive inputs from subcortical movement-related centers. In the terminology popularized from studies of the sensory system, can we consider these ascending motor inputs to thalamus from subcortical structures to be modulators, subtly influencing the activity of their target neurons, or drivers, dictating the activity of their target neurons? This chapter summarizes relevant evidence from neuronal recording, inactivation, and stimulation of pathways projecting from the superior colliculus through thalamus to cerebral cortex. The study concludes that many inputs to the higher order nuclei of the thalamus from subcortical oculomotor areas - from the superior colliculus and probably other midbrain and pontine regions - should be regarded as motor drivers analogous to the sensory drivers at the first order thalamic nuclei. These motor drivers at the thalamus are viewed as being at the top of a series of feedback loops that provide information on impending actions, just as sensory drivers provide information about the external environment.

System and circuitry to provide stable transconductance for biasing

NASA Technical Reports Server (NTRS)

Garverick, Steven L. (Inventor); Yu, Xinyu (Inventor)

2012-01-01

An amplifier system can include an input amplifier configured to receive an analog input signal and provide an amplified signal corresponding to the analog input signal. A tracking loop is configured to employ delta modulation for tracking the amplified signal, the tracking loop providing a corresponding output signal. A biasing circuit is configured to adjust a bias current to maintain stable transconductance over temperature variations, the biasing circuit providing at least one bias signal for biasing at least one of the input amplifier and the tracking loop, whereby the circuitry receiving the at least one bias signal exhibits stable performance over the temperature variations. In another embodiment the biasing circuit can be utilized in other applications.

Local area network with fault-checking, priorities, and redundant backup

NASA Technical Reports Server (NTRS)

Morales, Sergio (Inventor); Friedman, Gary L. (Inventor)

1989-01-01

This invention is a redundant error detecting and correcting local area networked computer system having a plurality of nodes each including a network connector board within the node for connecting to an interfacing transceiver operably attached to a network cable. There is a first network cable disposed along a path to interconnect the nodes. The first network cable includes a plurality of first interfacing transceivers attached thereto. A second network cable is disposed in parallel with the first cable and, in like manner, includes a plurality of second interfacing transceivers attached thereto. There are a plurality of three position switches each having a signal input, three outputs for individual selective connection to the input, and a control input for receiving signals designating which of the outputs is to be connected to the signal input. Each of the switches includes means for designating a response address for responding to addressed signals appearing at the control input and each of the switches further has its signal input connected to a respective one of the input/output lines from the nodes. Also, one of the three outputs is connected to a repective one of the plurality of first interfacing transceivers. There is master switch control means having an output connected to the control inputs of the plurality of three position switches and an input for receiving directive signals for outputting addressed switch position signals to the three position switches as well as monitor and control computer means having a pair of network connector boards therein connected to respective ones of one of the first interfacing transceivers and one of the second interfacing transceivers and an output connected to the input of the master switch means for monitoring the status of the networked computer system by sending messages to the nodes and receiving and verifying messages therefrom and for sending control signals to the master switch to cause the master switch to cause respective ones of the nodes to use a desired one of the first and second cables for transmitting and receiving messages and for disconnecting desired ones of the nodes from both cables.

Bone architecture adaptations after spinal cord injury: impact of long-term vibration of a constrained lower limb

PubMed Central

Dudley-Javoroski, S.; Petrie, M. A.; McHenry, C. L.; Amelon, R. E.; Saha, P. K.

2015-01-01

Summary This study examined the effect of a controlled dose of vibration upon bone density and architecture in people with spinal cord injury (who eventually develop severe osteoporosis). Very sensitive computed tomography (CT) imaging revealed no effect of vibration after 12 months, but other doses of vibration may still be useful to test. Introduction The purposes of this report were to determine the effect of a controlled dose of vibratory mechanical input upon individual trabecular bone regions in people with chronic spinal cord injury (SCI) and to examine the longitudinal bone architecture changes in both the acute and chronic state of SCI. Methods Participants with SCI received unilateral vibration of the constrained lower limb segment while sitting in a wheelchair (0.6g, 30 Hz, 20 min, three times weekly). The opposite limb served as a control. Bone mineral density (BMD) and trabecular micro-architecture were measured with high-resolution multi-detector CT. For comparison, one participant was studied from the acute (0.14 year) to the chronic state (2.7 years). Results Twelve months of vibration training did not yield adaptations of BMD or trabecular micro-architecture for the distal tibia or the distal femur. BMD and trabecular network length continued to decline at several distal femur sub-regions, contrary to previous reports suggesting a “steady state” of bone in chronic SCI. In the participant followed from acute to chronic SCI, BMD and architecture decline varied systematically across different anatomical segments of the tibia and femur. Conclusions This study supports that vibration training, using this study’s dose parameters, is not an effective antiosteoporosis intervention for people with chronic SCI. Using a high-spatial-resolution CT methodology and segmental analysis, we illustrate novel longitudinal changes in bone that occur after spinal cord injury. PMID:26395887

UWB delay and multiply receiver

DOEpatents

Dallum, Gregory E.; Pratt, Garth C.; Haugen, Peter C.; Romero, Carlos E.

2013-09-10

An ultra-wideband (UWB) delay and multiply receiver is formed of a receive antenna; a variable gain attenuator connected to the receive antenna; a signal splitter connected to the variable gain attenuator; a multiplier having one input connected to an undelayed signal from the signal splitter and another input connected to a delayed signal from the signal splitter, the delay between the splitter signals being equal to the spacing between pulses from a transmitter whose pulses are being received by the receive antenna; a peak detection circuit connected to the output of the multiplier and connected to the variable gain attenuator to control the variable gain attenuator to maintain a constant amplitude output from the multiplier; and a digital output circuit connected to the output of the multiplier.

Reimbursement of analgesics for chronic pain.

PubMed

Pedersen, Line; Hansen, Anneli Borge; Svendsen, Kristian; Skurtveit, Svetlana; Borchgrevink, Petter C; Fredheim, Olav Magnus S

2012-11-27

The prevalence of chronic non-malignant pain in Norway is between 24% and 30%. The proportion of the population using opioids for non-malignant pain on a long-term basis is around 1%. The purpose of our study was to investigate how many were prescribed analgesics on reimbursable prescription under reimbursement code -71 (chronic non-malignant pain) in 2009 and 2010, which analgesics were prescribed and whether prescribing practices were in accordance with national guidelines. We retrieved pseudonymised data from the National Prescription Database on all those who received drugs with reimbursement code -71 in 2009 and 2010. The data contain information on drug, dosage, formulation, reimbursement code and date of issue. 90,731 patients received reimbursement for drugs indicated for chronic non-malignant pain in 2010. Of these, 6,875 were given opioids, 33,242 received paracetamol, 25,865 non-steroid inflammatory drugs (NSAIDs), 20,654 amitryptiline and 16,507 gabapentin. Oxycodone was the most frequently prescribed opioid, followed by buprenorphine, tramadol and codeine/paracetamol. Of those who were prescribed opioids, 4,047 (59%) received mainly slow-release opioids, 2,631 (38%) also received benzodiazepines and 2,418 (35%) received benzodiazepine-like sleep medications. The number of patients who received analgesics and opioids on reimbursable prescriptions was low compared to the proportion of the population with chronic pain and the proportion using opioids long-term. 38% of those reimbursed for opioids also used benzodiazepines, which is contrary to official Norwegian guidelines.

Pancreatic head excavation for tissue diagnosis may reduce unnecessary pancreaticoduodenectomies in the setting of chronic pancreatitis.

PubMed

Fancellu, Alessandro; Ginesu, Giorgio C; Feo, Claudio F; Cossu, Maria L; Puledda, Marco; Pinna, Antonio; Porcu, Alberto

2017-06-01

The necessity to obtain a tissue diagnosis of cancer prior to pancreatic surgery still remains an open debate. In fact, a non-negligible percentage of patients undergoing pancreaticoduodenectomy (PD) for suspected cancer has a benign lesion at final histology. We describe an approach for patients with diagnostic uncertainty between cancer and chronic pancreatitis, with the aim of minimizing the incidence of PD for suspicious malignancy finally diagnosed as benign disease. Eighty-eight patients (85.4%) with a clinicoradiological picture highly suggestive for malignancy received formal PD (group 1). Fifteen patients (14.6%) in whom preoperative diagnosis was uncertain between pancreatic cancer and chronic pancreatitis underwent pancreatic head excavation (PHEX) for intraoperative tissue diagnosis (group 2): those diagnosed as having cancer received PD, whereas those with chronic pancreatitis received pancreaticojejunostomy (PJ). No patient received PD for benign disease. All patients in group 1 had adenocarcinoma on final histology. Eight patients of group 2 (53.3%) received PD after intraoperative diagnosis of cancer, whereas 7 (46.7%) received PJ because no malignancy was found at introperative frozen sections. No signs of cancer were encountered in patients receiving PHEX and PJ after a median follow-up of 42 months. Overall survival did not differ between patients receiving PD for cancer in the group 1 and those receiving PD for cancer after PHEX in the group 2 (P=0.509). Although the described technique has been used in a very selected group of patients, our results suggest that PHEX for tissue diagnosis may reduce rates of unnecessary PD, when the preoperative diagnosis is uncertain between cancer and chronic pancreatitis.

Human iPSC Derived GABA Ergic Precursor Cell Therapy for Chronic Epilepsy

DTIC Science & Technology

2016-10-01

chronically epileptic rats ( CERs ) would: (1) diminish the frequency and intensity of spontaneous recurrent seizures (SRS, Specific Aim 1, SA1); and (2...epileptic rats: CERs receiving hMGE-like cell grafts and cyclosporine (an immunosuppressant to promote the survival of human cell grafts in the rat brain... CERs receiving sham-grafting surgery, CERs receiving cyclosporine only and CERs receiving no treatment. The results showed that, in comparison to

Control assembly for controlling a fuel cell system during shutdown and restart

DOEpatents

Venkataraman, Ramki; Berntsen, George; Carlson, Glenn L.; Farooque, Mohammad; Beachy, Dan; Peterhans, Stefan; Bischoff, Manfred

2010-06-15

A fuel cell system and method in which the fuel cell system receives and an input oxidant gas and an input fuel gas, and in which a fuel processing assembly is provided and is adapted to at least humidify the input fuel gas which is to be supplied to the anode of the fuel cell of the system whose cathode receives the oxidant input gas via an anode oxidizing assembly which is adapted to couple the output of the anode of the fuel cell to the inlet of the cathode of the fuel cell during normal operation, shutdown and restart of the fuel cell system, and in which a control assembly is further provided and is adapted to respond to shutdown of the fuel cell system during which input fuel gas and input oxidant gas cease to be received by the fuel cell system, the control assembly being further adapted to, when the fuel cell system is shut down: control the fuel cell system so as to enable a purging gas to be able to flow through the fuel processing assembly to remove humidified fuel gas from the processing assembly and to enable a purging gas to be able to flow through the anode of the fuel cell.

Developing an automated speech-recognition telephone diabetes intervention.

PubMed

Goldman, Roberta E; Sanchez-Hernandez, Maya; Ross-Degnan, Dennis; Piette, John D; Trinacty, Connie Mah; Simon, Steven R

2008-08-01

Many patients do not receive guideline-recommended care for diabetes and other chronic conditions. Automated speech-recognition telephone outreach to supplement in-person physician-patient communication may enhance patient care for chronic illness. We conducted this study to inform the development of an automated telephone outreach intervention for improving diabetes care among members of a large, not-for-profit health plan. In-depth telephone interviews with qualitative analysis. participants Individuals with diabetes (n=36) enrolled in a large regional health plan in the USA. Main outcome measure Patients' opinions about automated speech-recognition telephone technology. Patients who were recently diagnosed with diabetes and some with diabetes for a decade or more expressed basic informational needs. While most would prefer to speak with a live person rather than a computer-recorded voice, many felt that the automated system could successfully supplement the information they receive from their physicians and could serve as an integral part of their care. Patients suggested that such a system could provide specific dietary advice, information about diabetes and its self-care, a call-in menu of information topics, reminders about laboratory test results and appointments, tracking of personal laboratory results and feedback about their self-monitoring. While some patients expressed negative attitudes toward automated speech recognition telephone systems generally, most felt that a variety of functions of such a system could be beneficial to their diabetes care. In-depth interviews resulted in substantive input from health plan members for the design of an automated telephone outreach system to supplement in-person physician-patient communication in this population.

Silicon photonics thermal phase shifter with reduced temperature range

DOEpatents

Lentine, Anthony L; Kekatpure, Rohan D; DeRose, Christopher; Davids, Paul; Watts, Michael R

2013-12-17

Optical devices, phased array systems and methods of phase-shifting an input signal are provided. An optical device includes a microresonator and a waveguide for receiving an input optical signal. The waveguide includes a segment coupled to the microresonator with a coupling coefficient such that the waveguide is overcoupled to the microresonator. The microresonator received the input optical signal via the waveguide and phase-shifts the input optical signal to form an output optical signal. The output optical signal is coupled into the waveguide via the microresonator and transmitted by the waveguide. At an operating point of the optical device, the coupling coefficient is selected to reduce a change in an amplitude of the output optical signal and to increase a change in a phase of the output optical signal, relative to the input optical signal.

Response of pontomedullary reticulospinal neurons to vestibular stimuli in vertical planes. Role in vertical vestibulospinal reflexes of the decerebrate cat

NASA Technical Reports Server (NTRS)

Bolton, P. S.; Goto, T.; Schor, R. H.; Wilson, V. J.; Yamagata, Y.; Yates, B. J.

1992-01-01

1. To investigate the neural substrate of vestibulospinal reflexes in decerebrate cats, we studied the responses of pontomedullary reticulospinal neurons to natural stimulation of the labyrinth in vertical planes. Our principal aim was to determine whether reticulospinal neurons that terminate in, or are likely to give off collaterals to, the upper cervical segments had properties similar to those of the vestibulocollic reflex (VCR). 2. Antidromic stimulation was used to determine whether the neurons projected to the neck, lower cervical, thoracic, or lumbar levels. Dynamics of the responses of spontaneously firing neurons were studied with sinusoidal stimuli delivered at 0.05-1 Hz and aligned to the plane of body rotation, that produced maximal modulation of the neuron (response vector orientation). Each neuron was assigned a vestibular input classification of otolith, vertical canal, otolith + canal, or spatial-temporal convergence (STC). 3. We found, in agreement with previous studies, that the largest fraction of pontomedullary reticulospinal neurons projected to the lumbar cord, and that only a small number ended in the neck segments. Neurons projecting to all levels of the spinal cord had similar responses to labyrinth stimulation. 4. Reticulospinal neurons that received only vertical canal inputs were rare (1 of 67 units). Most reticulospinal neurons (48%) received predominant otolith inputs, 18% received otolith + canal input, and only 9% had STC behavior. These data are in sharp contrast to the results of our previous studies of vestibulospinal neurons. A considerable portion of vestibulospinal neurons receives vertical canal input (38%), fewer receive predominantly otolith input (22%), whereas the proportion that have otolith + canal input or STC behavior is similar to our present reticulospinal data. 5. The response vector orientations of our reticulospinal neurons, particularly those with canal inputs (canal, otolith + canal, STC) were predominantly in the roll quadrants. There was no evidence of convergence of inputs from like canals across the midline (e.g., right anterior + left anterior). 6. Two characteristics of the VCR, STC behavior and bilateral input from symmetric vertical canals (in some muscles), cannot be accounted for by the reticulospinal neurons that we studied. Because these characteristics are also not seen in vestibulocollic neurons, they are likely to be the result of the appropriate convergence of vestibular signals in the spinal cord. 7. Pontomedullary reticulospinal neurons seem particularly well suited to play a role in gravity-dependent postural reflexes of neck and limbs.

Embedding global barrier and collective in torus network with each node combining input from receivers according to class map for output to senders

DOEpatents

Chen, Dong; Coteus, Paul W; Eisley, Noel A; Gara, Alan; Heidelberger, Philip; Senger, Robert M; Salapura, Valentina; Steinmacher-Burow, Burkhard; Sugawara, Yutaka; Takken, Todd E

2013-08-27

Embodiments of the invention provide a method, system and computer program product for embedding a global barrier and global interrupt network in a parallel computer system organized as a torus network. The computer system includes a multitude of nodes. In one embodiment, the method comprises taking inputs from a set of receivers of the nodes, dividing the inputs from the receivers into a plurality of classes, combining the inputs of each of the classes to obtain a result, and sending said result to a set of senders of the nodes. Embodiments of the invention provide a method, system and computer program product for embedding a collective network in a parallel computer system organized as a torus network. In one embodiment, the method comprises adding to a torus network a central collective logic to route messages among at least a group of nodes in a tree structure.

Systems and methods for reconfiguring input devices

NASA Technical Reports Server (NTRS)

Lancaster, Jeff (Inventor); De Mers, Robert E. (Inventor)

2012-01-01

A system includes an input device having first and second input members configured to be activated by a user. The input device is configured to generate activation signals associated with activation of the first and second input members, and each of the first and second input members are associated with an input function. A processor is coupled to the input device and configured to receive the activation signals. A memory coupled to the processor, and includes a reconfiguration module configured to store the input functions assigned to the first and second input members and, upon execution of the processor, to reconfigure the input functions assigned to the input members when the first input member is inoperable.

Cell Type-Specific Circuit Mapping Reveals the Presynaptic Connectivity of Developing Cortical Circuits

PubMed Central

Cocas, Laura A.; Fernandez, Gloria; Barch, Mariya; Doll, Jason; Zamora Diaz, Ivan

2016-01-01

The mammalian cerebral cortex is a dense network composed of local, subcortical, and intercortical synaptic connections. As a result, mapping cell type-specific neuronal connectivity in the cerebral cortex in vivo has long been a challenge for neurobiologists. In particular, the development of excitatory and inhibitory interneuron presynaptic input has been hard to capture. We set out to analyze the development of this connectivity in the first postnatal month using a murine model. First, we surveyed the connectivity of one of the earliest populations of neurons in the brain, the Cajal-Retzius (CR) cells in the neocortex, which are known to be critical for cortical layer formation and are hypothesized to be important in the establishment of early cortical networks. We found that CR cells receive inputs from deeper-layer excitatory neurons and inhibitory interneurons in the first postnatal week. We also found that both excitatory pyramidal neurons and inhibitory interneurons received broad inputs in the first postnatal week, including inputs from CR cells. Expanding our analysis into the more mature brain, we assessed the inputs onto inhibitory interneurons and excitatory projection neurons, labeling neuronal progenitors with Cre drivers to study discrete populations of neurons in older cortex, and found that excitatory cortical and subcortical inputs are refined by the fourth week of development, whereas local inhibitory inputs increase during this postnatal period. Cell type-specific circuit mapping is specific, reliable, and effective, and can be used on molecularly defined subtypes to determine connectivity in the cortex. SIGNIFICANCE STATEMENT Mapping cortical connectivity in the developing mammalian brain has been an intractable problem, in part because it has not been possible to analyze connectivity with cell subtype precision. Our study systematically targets the presynaptic connections of discrete neuronal subtypes in both the mature and developing cerebral cortex. We analyzed the connections that Cajal-Retzius cells make and receive, and found that these cells receive inputs from deeper-layer excitatory neurons and inhibitory interneurons in the first postnatal week. We assessed the inputs onto inhibitory interneurons and excitatory projection neurons, the major two types of neurons in the cortex, and found that excitatory inputs are refined by the fourth week of development, whereas local inhibitory inputs increase during this postnatal period. PMID:26985044

Design and simulation of a planar micro-optic free-space receiver

NASA Astrophysics Data System (ADS)

Nadler, Brett R.; Hallas, Justin M.; Karp, Jason H.; Ford, Joseph E.

2017-11-01

We propose a compact directional optical receiver for free-space communications, where a microlens array and micro-optic structures selectively couple light from a narrow incidence angle into a thin slab waveguide and then to an edge-mounted detector. A small lateral translation of the lenslet array controls the coupled input angle, enabling the receiver to select the transmitter source direction. We present the optical design and simulation of a 10mm x 10mm aperture receiver using a 30μm thick silicon waveguide able to couple up to 2.5Gbps modulated input to a 10mm x 30μm wide detector.

Wave-plate structures, power selective optical filter devices, and optical systems using same

DOEpatents

Koplow, Jeffrey P [San Ramon, CA

2012-07-03

In an embodiment, an optical filter device includes an input polarizer for selectively transmitting an input signal. The device includes a wave-plate structure positioned to receive the input signal, which includes first and second substantially zero-order, zero-wave plates arranged in series with and oriented at an angle relative to each other. The first and second zero-wave plates are configured to alter a polarization state of the input signal passing in a manner that depends on the power of the input signal. Each zero-wave plate includes an entry and exit wave plate each having a fast axis, with the fast axes oriented substantially perpendicular to each other. Each entry wave plate is oriented relative to a transmission axis of the input polarizer at a respective angle. An output polarizer is positioned to receive a signal output from the wave-plate structure and selectively transmits the signal based on the polarization state.

Impact of Iodinated Contrast on Renal Function and Hemodynamics in Rats with Chronic Hyperglycemia and Chronic Kidney Disease

PubMed Central

Fernandes, Sheila Marques; Martins, Daniel Malisani; da Fonseca, Cassiane Dezoti; Watanabe, Mirian; Vattimo, Maria de Fátima Fernandes

2016-01-01

Iodinated contrast (IC) is clinically used in diagnostic and interventional procedures, but its use can result in contrast-induced acute kidney injury (CI-AKI). Chronic kidney disease (CKD) and chronic hyperglycemia (CH) are important predisposing factors to CI-AKI. The aim of this study was to investigate the impact of iodinated contrast on the renal function and hemodynamics in rats with chronic hyperglycemia and chronic kidney disease. A total of 30 rats were divided into six groups; Sham: control of chronic renal disease; Citrate: control of chronic hyperglycemia (CH); Nx5/6: rats with 5/6 nephrectomy; Chronic Hyperglycemia: rats receiving Streptozotocin 65 mg/kg; Nx5/6 + IC: rats Nx5/6 received 6 mL/kg of IC; CH + IC: Chronic hyperglycemia rats receiving 6 mL/kg of IC. Renal function (inulin clearance; urinary neutrophil gelatinase-associated lipocalin, NGAL) and hemodynamics (arterial blood pressure; renal blood flow; renal vascular resistance) were evaluated. Iodinated contrast significantly increased urinary NGAL and reduced inulin clearance, while the hemodynamics parameters showed changes in arterial blood pressure, renal blood flow, and renal vascular resistance in both CKD and CH groups. The results suggest that the iodinated contrast in risk factors models has important impact on renal function and hemodynamics. NGAL was confirmed to play a role of highlight in diagnosis of CI-AKI. PMID:27034930

Neurons in the pontomedullary reticular formation receive converging inputs from the hindlimb and labyrinth.

PubMed

Miller, Derek M; DeMayo, William M; Bourdages, George H; Wittman, Samuel R; Yates, Bill J; McCall, Andrew A

2017-04-01

The integration of inputs from vestibular and proprioceptive sensors within the central nervous system is critical to postural regulation. We recently demonstrated in both decerebrate and conscious cats that labyrinthine and hindlimb inputs converge onto vestibular nucleus neurons. The pontomedullary reticular formation (pmRF) also plays a key role in postural control, and additionally participates in regulating locomotion. Thus, we hypothesized that like vestibular nucleus neurons, pmRF neurons integrate inputs from the limb and labyrinth. To test this hypothesis, we recorded the responses of pmRF neurons to passive ramp-and-hold movements of the hindlimb and to whole-body tilts, in both decerebrate and conscious felines. We found that pmRF neuronal activity was modulated by hindlimb movement in the rostral-caudal plane. Most neurons in both decerebrate (83% of units) and conscious (61% of units) animals encoded both flexion and extension movements of the hindlimb. In addition, hindlimb somatosensory inputs converged with vestibular inputs onto pmRF neurons in both preparations. Pontomedullary reticular formation neurons receiving convergent vestibular and limb inputs likely participate in balance control by governing reticulospinal outflow.

Neurons in the pontomedullary reticular formation receive converging inputs from the hindlimb and labyrinth

PubMed Central

Miller, Derek M.; DeMayo, William M.; Bourdages, George H.; Wittman, Samuel; Yates, Bill J.; McCall, Andrew A.

2017-01-01

The integration of inputs from vestibular and proprioceptive sensors within the central nervous system is critical to postural regulation. We recently demonstrated in both decerebrate and conscious cats that labyrinthine and hindlimb inputs converge onto vestibular nucleus neurons. The pontomedullary reticular formation (pmRF) also plays a key role in postural control, and additionally participates in regulating locomotion. Thus, we hypothesized that like vestibular nucleus neurons, pmRF neurons integrate inputs from the limb and labyrinth. To test this hypothesis, we recorded the responses of pmRF neurons to passive ramp-and-hold movements of the hindlimb and to whole-body tilts, in both decerebrate and conscious felines. We found that pmRF neuronal activity was modulated by hindlimb movement in the rostral-caudal plane. Most neurons in both decerebrate (83% of units) and conscious (61% of units) animals encoded both flexion and extension movements of the hindlimb. Additionally, hindlimb somatosensory inputs converged with vestibular inputs onto pmRF neurons in both preparations. Pontomedullary reticular formation neurons receiving convergent vestibular and limb inputs likely participate in balance control by governing reticulospinal outflow. PMID:28188328

Consumer Quality Index Chronic Skin Disease (CQI-CSD): a new instrument to measure quality of care from the patient's perspective.

PubMed

van Cranenburgh, O D; Krol, M W; Hendriks, M C P; de Rie, M A; Smets, E M A; de Korte, J; Sprangers, M A G

2015-10-01

Assessing quality of care from the patient's perspective is considered to be highly relevant. As a standardized instrument in dermatology was lacking, we developed a patient experience questionnaire regarding chronic skin disease care: the Consumer Quality Index Chronic Skin Disease (CQI-CSD). (i) To evaluate the dimensional structure of the CQI-CSD, (ii) to assess its ability to distinguish between hospitals according to patients' experiences with quality of care, (iii) to explore patients' experiences with dermatological care and priorities for quality improvement according to the patients, and (iv) to optimize the questionnaire based on psychometric results and stakeholders' input. In a cross-sectional study 5647 adult patients who received dermatological care in the past 12 months in 20 hospitals were randomly selected and invited to fill out the questionnaire. Overall 1160 of 3989 eligible respondents (29% response rate, 30-87 per hospital) were included for analysis. The CQI-CSD comprised seven scales with high internal consistency (Cronbach's α = 0·74-0·92). The instrument's discriminative power was limited. Patients were positive about the care provided by nurses and doctors, but the provision of information by healthcare providers, accessibility of care and patient involvement could be improved. We optimized the CQI-CSD, resulting in a revised questionnaire containing 65 items. In conclusion, the CQI-CSD is a useful instrument to measure patient experiences with dermatological care. © 2015 British Association of Dermatologists.

Room-temperature quantum noise limited spectrometry and methods of the same

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

Stevens, Charles G.; Tringe, Joseph W.; Cunningham, Christopher T.

According to one embodiment, a heterodyne detection system for detecting light, includes: a first input aperture configured to receive first light from a scene input; a second input aperture configured to receive second light from a local oscillator input; a broadband local oscillator configured to provide the second light to the second input aperture; a dispersive element configured to disperse the first light and the second light; and a final condensing lens coupled to a detector. The final condensing lens is configured to concentrate incident light from a primary condensing lens onto the detector. The detector is configured to sensemore » a frequency difference between the first light and the second light; and the final condensing lens comprises a plasmonic condensing lens. Methods for forming a plasmonic condensing lens to enable room temperature quantum noise limited spectrometry are also disclosed.« less

Advanced Unmanned Search System (AUSS) Surface Navigation, Underwater Tracking, and Transponder Network Calibration

DTIC Science & Technology

1992-09-01

5 ENTER PULSE REP PERIOD ................................ 900 ENTER RETURN TO TOP LEVEL C-5 26. SBS1 RECEIVER ----- HYDROPHONE ----- HYDRI ...HYDROPHONE ----- HYDRI PRECISION RETURN 1 LEVEL 29. HEADING INPUT ------ GYRO 1 ------ CONTINUE RANGE GATE OFF ----- FILTER OFF RETURN TO TOP LEVEL 30...700 ENTER RETURN TO TOP LEVEL 12. SBSI RECEIVER ------ HYDROPHONE ------ HYDRI PRECISION RETURN 1 LEVEL 13. HEADING INPUT ------ GYRO 1

Persistent Catechol-O-methyltransferase-dependent Pain Is Initiated by Peripheral β-Adrenergic Receptors.

PubMed

Ciszek, Brittney P; O'Buckley, Sandra C; Nackley, Andrea G

2016-05-01

Patients with chronic pain disorders exhibit increased levels of catecholamines alongside diminished activity of catechol-O-methyltransferase (COMT), an enzyme that metabolizes catecholamines. The authors found that acute pharmacologic inhibition of COMT in rodents produces hypersensitivity to mechanical and thermal stimuli via β-adrenergic receptor (βAR) activation. The contribution of distinct βAR populations to the development of persistent pain linked to abnormalities in catecholamine signaling requires further investigation. Here, the authors sought to determine the contribution of peripheral, spinal, and supraspinal βARs to persistent COMT-dependent pain. They implanted osmotic pumps to deliver the COMT inhibitor OR486 (Tocris, USA) for 2 weeks. Behavioral responses to mechanical and thermal stimuli were evaluated before and every other day after pump implantation. The site of action was evaluated in adrenalectomized rats receiving sustained OR486 or in intact rats receiving sustained βAR antagonists peripherally, spinally, or supraspinally alongside OR486. The authors found that male (N = 6) and female (N = 6) rats receiving sustained OR486 exhibited decreased paw withdrawal thresholds (control 5.74 ± 0.24 vs. OR486 1.54 ± 0.08, mean ± SEM) and increased paw withdrawal frequency to mechanical stimuli (control 4.80 ± 0.22 vs. OR486 8.10 ± 0.13) and decreased paw withdrawal latency to thermal heat (control 9.69 ± 0.23 vs. OR486 5.91 ± 0.11). In contrast, adrenalectomized rats (N = 12) failed to develop OR486-induced hypersensitivity. Furthermore, peripheral (N = 9), but not spinal (N = 4) or supraspinal (N = 4), administration of the nonselective βAR antagonist propranolol, the β2AR antagonist ICI-118,511, or the β3AR antagonist SR59230A blocked the development of OR486-induced hypersensitivity. Peripheral adrenergic input is necessary for the development of persistent COMT-dependent pain, and peripherally-acting βAR antagonists may benefit chronic pain patients.

Reciprocal synapses between mushroom body and dopamine neurons form a positive feedback loop required for learning.

PubMed

Cervantes-Sandoval, Isaac; Phan, Anna; Chakraborty, Molee; Davis, Ronald L

2017-05-10

Current thought envisions dopamine neurons conveying the reinforcing effect of the unconditioned stimulus during associative learning to the axons of Drosophila mushroom body Kenyon cells for normal olfactory learning. Here, we show using functional GFP reconstitution experiments that Kenyon cells and dopamine neurons from axoaxonic reciprocal synapses. The dopamine neurons receive cholinergic input via nicotinic acetylcholine receptors from the Kenyon cells; knocking down these receptors impairs olfactory learning revealing the importance of these receptors at the synapse. Blocking the synaptic output of Kenyon cells during olfactory conditioning reduces presynaptic calcium transients in dopamine neurons, a finding consistent with reciprocal communication. Moreover, silencing Kenyon cells decreases the normal chronic activity of the dopamine neurons. Our results reveal a new and critical role for positive feedback onto dopamine neurons through reciprocal connections with Kenyon cells for normal olfactory learning.

Fluoxetine induces input-specific hippocampal dendritic spine remodeling along the septotemporal axis in adulthood and middle age.

PubMed

McAvoy, Kathleen; Russo, Craig; Kim, Shannen; Rankin, Genelle; Sahay, Amar

2015-11-01

Fluoxetine, a selective serotonin-reuptake inhibitor (SSRI), is known to induce structural rearrangements and changes in synaptic transmission in hippocampal circuitry. In the adult hippocampus, structural changes include neurogenesis, dendritic, and axonal plasticity of pyramidal and dentate granule neurons, and dedifferentiation of dentate granule neurons. However, much less is known about how chronic fluoxetine affects these processes along the septotemporal axis and during the aging process. Importantly, studies documenting the effects of fluoxetine on density and distribution of spines along different dendritic segments of dentate granule neurons and CA1 pyramidal neurons along the septotemporal axis of hippocampus in adulthood and during aging are conspicuously absent. Here, we use a transgenic mouse line in which mature dentate granule neurons and CA1 pyramidal neurons are genetically labeled with green fluorescent protein (GFP) to investigate the effects of chronic fluoxetine treatment (18 mg/kg/day) on input-specific spine remodeling and mossy fiber structural plasticity in the dorsal and ventral hippocampus in adulthood and middle age. In addition, we examine levels of adult hippocampal neurogenesis, maturation state of dentate granule neurons, neuronal activity, and glutamic acid decarboxylase-67 expression in response to chronic fluoxetine in adulthood and middle age. Our studies reveal that while chronic fluoxetine fails to augment adult hippocampal neurogenesis in middle age, the middle-aged hippocampus retains high sensitivity to changes in the dentate gyrus (DG) such as dematuration, hypoactivation, and increased glutamic acid decarboxylase 67 (GAD67) expression. Interestingly, the middle-aged hippocampus shows greater sensitivity to fluoxetine-induced input-specific synaptic remodeling than the hippocampus in adulthood with the stratum-oriens of CA1 exhibiting heightened structural plasticity. The input-specific changes and circuit-level modifications in middle-age were associated with modest enhancement in contextual fear memory precision, anxiety-like behavior and antidepressant-like behavioral responses. © 2015 Wiley Periodicals, Inc.

Fluoxetine induces input-specific hippocampal dendritic spine remodeling along the septo-temporal axis in adulthood and middle age

PubMed Central

McAvoy, Kathleen; Russo, Craig; Kim, Shannen; Rankin, Genelle; Sahay, Amar

2015-01-01

Fluoxetine, a selective serotonin-reuptake inhibitor (SSRI), is known to induce structural rearrangements and changes in synaptic transmission in hippocampal circuitry. In the adult hippocampus, structural changes include neurogenesis, dendritic and axonal plasticity of pyramidal and dentate granule neurons, and dedifferentiation of dentate granule neurons. However, much less is known about how chronic fluoxetine affects these processes along the septo-temporal axis and during the aging process. Importantly, studies documenting the effects of fluoxetine on density and distribution of spines along different dendritic segments of dentate granule neurons and CA1 pyramidal neurons along the septo-temporal axis of hippocampus in adulthood and during aging are conspicuously absent. Here, we use a transgenic mouse line in which mature dentate granule neurons and CA1 pyramidal neurons are genetically labeled with green fluorescent protein (GFP) to investigate the effects of chronic fluoxetine treatment (18mg/kg/day) on input-specific spine remodeling and mossy fiber structural plasticity in the dorsal and ventral hippocampus in adulthood and middle age. In addition, we examine levels of adult hippocampal neurogenesis, maturation state of dentate granule neurons, neuronal activity and glutamic acid decarboxylase-67 expression in response to chronic fluoxetine in adulthood and middle age. Our studies reveal that while chronic fluoxetine fails to augment adult hippocampal neurogenesis in middle age, the middle-aged hippocampus retains high sensitivity to changes in the dentate gyrus (DG) such as dematuration, hypoactivation, and increased glutamic acid decarboxylase 67 (GAD67) expression. Interestingly, the middle-aged hippocampus shows greater sensitivity to fluoxetine-induced input-specific synaptic remodeling than the hippocampus in adulthood with the stratum-oriens of CA1 exhibiting heightened structural plasticity. The input-specific changes and circuit-level modifications in middle-age were associated with modest enhancement in contextual fear memory precision, anxiety-like behavior and antidepressant-like behavioral responses. PMID:25850664

Ecosystem nutrient responses to chronic nittogen inputs at Fernow Experimental Forest, West Virginia

Treesearch

Frank S. ​Gilliam; Mary Beth Adams; Bradley M. Yurish

1996-01-01

Among the current environmental concerns for forests of the eastern United States is nitrogen (N) saturation, a result of excessive inputs of N associated with acidic deposition. We studied nutrient responses on N-treated and untreated watersheds of the Fernow Experimental Forest, West Virginia, to test for evidence of N saturation on the treated watershed. The...

Regulation of spatial selectivity by crossover inhibition.

PubMed

Cafaro, Jon; Rieke, Fred

2013-04-10

Signals throughout the nervous system diverge into parallel excitatory and inhibitory pathways that later converge on downstream neurons to control their spike output. Converging excitatory and inhibitory synaptic inputs can exhibit a variety of temporal relationships. A common motif is feedforward inhibition, in which an increase (decrease) in excitatory input precedes a corresponding increase (decrease) in inhibitory input. The delay of inhibitory input relative to excitatory input originates from an extra synapse in the circuit shaping inhibitory input. Another common motif is push-pull or "crossover" inhibition, in which increases (decreases) in excitatory input occur together with decreases (increases) in inhibitory input. Primate On midget ganglion cells receive primarily feedforward inhibition and On parasol cells receive primarily crossover inhibition; this difference provides an opportunity to study how each motif shapes the light responses of cell types that play a key role in visual perception. For full-field stimuli, feedforward inhibition abbreviated and attenuated responses of On midget cells, while crossover inhibition, though plentiful, had surprisingly little impact on the responses of On parasol cells. Spatially structured stimuli, however, could cause excitatory and inhibitory inputs to On parasol cells to increase together, adopting a temporal relation very much like that for feedforward inhibition. In this case, inhibitory inputs substantially abbreviated a cell's spike output. Thus inhibitory input shapes the temporal stimulus selectivity of both midget and parasol ganglion cells, but its impact on responses of parasol cells depends strongly on the spatial structure of the light inputs.

40 CFR 60.252 - Standards for thermal dryers.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) heat input. (iii) Thermal dryers that receive all of their thermal input from a source other than coal... (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Standards of Performance for Coal Preparation.../MMBtu) heat input; or (ii) The owner or operator must not cause to be discharged into the atmosphere...

Two-Stage Variable Sample-Rate Conversion System

NASA Technical Reports Server (NTRS)

Tkacenko, Andre

2009-01-01

A two-stage variable sample-rate conversion (SRC) system has been pro posed as part of a digital signal-processing system in a digital com munication radio receiver that utilizes a variety of data rates. The proposed system would be used as an interface between (1) an analog- todigital converter used in the front end of the receiver to sample an intermediatefrequency signal at a fixed input rate and (2) digita lly implemented tracking loops in subsequent stages that operate at v arious sample rates that are generally lower than the input sample r ate. This Two-Stage System would be capable of converting from an input sample rate to a desired lower output sample rate that could be var iable and not necessarily a rational fraction of the input rate.

Dendritic integration: 60 years of progress.

PubMed

Stuart, Greg J; Spruston, Nelson

2015-12-01

Understanding how individual neurons integrate the thousands of synaptic inputs they receive is critical to understanding how the brain works. Modeling studies in silico and experimental work in vitro, dating back more than half a century, have revealed that neurons can perform a variety of different passive and active forms of synaptic integration on their inputs. But how are synaptic inputs integrated in the intact brain? With the development of new techniques, this question has recently received substantial attention, with new findings suggesting that many of the forms of synaptic integration observed in vitro also occur in vivo, including in awake animals. Here we review six decades of progress, which collectively highlights the complex ways that single neurons integrate their inputs, emphasizing the critical role of dendrites in information processing in the brain.

Chronic amphetamine enhances visual input to and suppresses visual output from the superior colliculus in withdrawal.

PubMed

Turner, Amy C; Kraev, Igor; Stewart, Michael G; Stramek, Agata; Overton, Paul G; Dommett, Eleanor J

2018-06-04

Heightened distractibility is a core symptom of Attention Deficit Hyperactivity Disorder (ADHD). Effective treatment is normally with chronic orally administered psychostimulants including amphetamine. Treatment prevents worsening of symptoms but the site of therapeutic processes, and their nature, is unknown. Mounting evidence suggests that the superior colliculus (SC) is a key substrate in distractibility and a therapeutic target, so we assessed whether therapeutically-relevant changes are induced in this structure by chronic oral amphetamine. We hypothesized that amphetamine would alter visual responses and morphological measures. Six-week old healthy male rats were treated with oral amphetamine (2, 5 or 10 mg/kg) or a vehicle for one month after which local field potential and multiunit recordings were made from the superficial layers of the SC in response to whole-field light flashes in withdrawal. Rapid Golgi staining was also used to assess dendritic spines, and synaptophysin staining was used to assess synaptic integrity. Chronic amphetamine increased local field potential responses at higher doses, and increased synaptophysin expression, suggesting enhanced visual input involving presynaptic remodelling. No comparable increases in multiunit activity were found suggesting amphetamine suppresses collicular output activity, counterbalancing the increased input. We also report, for the first time, five different dendritic spine types in the superficial layers and show these to be unaffected by amphetamine, indicating that suppression does not involve gross postsynaptic structural alterations. In conclusion, we suggest that amphetamine produces changes at the collicular level that potentially stabilise the structure and may prevent the worsening of symptoms in disorders like ADHD. Copyright © 2018. Published by Elsevier Ltd.

The effect of chronic seaweed subsidies on herbivory: plant-mediated fertilization pathway overshadows lizard-mediated predator pathways.

PubMed

Piovia-Scott, Jonah; Spiller, David A; Takimoto, Gaku; Yang, Louie H; Wright, Amber N; Schoener, Thomas W

2013-08-01

Flows of energy and materials link ecosystems worldwide and have important consequences for the structure of ecological communities. While these resource subsidies typically enter recipient food webs through multiple channels, most previous studies focussed on a single pathway of resource input. We used path analysis to evaluate multiple pathways connecting chronic marine resource inputs (in the form of seaweed deposits) and herbivory in a shoreline terrestrial ecosystem. We found statistical support for a fertilization effect (seaweed increased foliar nitrogen content, leading to greater herbivory) and a lizard numerical response effect (seaweed increased lizard densities, leading to reduced herbivory), but not for a lizard diet-shift effect (seaweed increased the proportion of marine-derived prey in lizard diets, but lizard diet was not strongly associated with herbivory). Greater seaweed abundance was associated with greater herbivory, and the fertilization effect was larger than the combined lizard effects. Thus, the bottom-up, plant-mediated effect of fertilization on herbivory overshadowed the top-down effects of lizard predators. These results, from unmanipulated shoreline plots with persistent differences in chronic seaweed deposition, differ from those of a previous experimental study of the short-term effects of a pulse of seaweed deposition: while the increase in herbivory in response to chronic seaweed deposition was due to the fertilization effect, the short-term increase in herbivory in response to a pulse of seaweed deposition was due to the lizard diet-shift effect. This contrast highlights the importance of the temporal pattern of resource inputs in determining the mechanism of community response to resource subsidies.

Multiplexer and time duration measuring circuit

DOEpatents

Gray, Jr., James

1980-01-01

A multiplexer device is provided for multiplexing data in the form of randomly developed, variable width pulses from a plurality of pulse sources to a master storage. The device includes a first multiplexer unit which includes a plurality of input circuits each coupled to one of the pulse sources, with all input circuits being disabled when one input circuit receives an input pulse so that only one input pulse is multiplexed by the multiplexer unit at any one time.

Perceived quality of chronic illness care is associated with self-management: Results of a nationwide study in the Netherlands.

PubMed

van Houtum, L; Heijmans, M; Rijken, M; Groenewegen, P

2016-04-01

Healthcare providers are increasingly expected to help chronically ill patients understand their own central role in managing their illness. The aim of this study was to determine whether experiencing high-quality chronic illness care and having a nurse involved in their care relate to chronically ill people's self-management. Survey data from 699 people diagnosed with chronic diseases who participated in a nationwide Dutch panel-study were analysed using linear regression analysis, to estimate the association between chronic illness care and various aspects of patients' self-management, while controlling for their socio-demographic and illness characteristics. Chronically ill patients reported that the care they received was of high quality to some extent. Patients who had contact with a practise nurse or specialised nurse perceived the quality of the care they received as better than patients who only had contact with a GP or medical specialist. Patients' perceptions of the quality of care were positively related to all aspects of their self-management, whereas contact with a practise nurse or specialised nurse in itself was not. Chronically ill patients who have the experience to receive high-quality chronic illness care that focusses on patient activation, decision support, goal setting, problem solving, and coordination of care are better self-managers. Having a nurse involved in their care seems to be positively valued by chronically ill patients, but does not automatically imply better self-management. Copyright © 2016. Published by Elsevier Ireland Ltd.

Probe for optically monitoring progress of in-situ vitrification of soil

DOEpatents

Timmerman, Craig L.; Oma, Kenton H.; Davis, Karl C.

1988-01-01

A detector system for sensing the progress of an ISV process along an expected path comprises multiple sensors each having an input port. The input ports are distributed along the expected path of the ISV process between a starting location and an expected ending location. Each sensor generates an electrical signal representative of the temperature in the vicinity of its input port. A signal processor is coupled to the sensors to receive an electrical signal generated by a sensor, and generate a signal which is encoded with information which identifies the sensor and whether the ISV process has reached the sensor's input port. A transmitter propagates the encoded signal. The signal processor and the transmitter are below ground at a location beyond the expected ending location of the ISV process in the direction from the starting location to the expected ending location. A signal receiver and a decoder are located above ground for receiving the encoded signal propagated by the transmitter, decoding the encoded signal and providing a human-perceptible indication of the progress of the ISV process.

Probe for optically monitoring progress of in-situ vitrification of soil

DOEpatents

Timmerman, C.L.; Oma, K.H.; Davis, K.C.

1988-08-09

A detector system for sensing the progress of an ISV process along an expected path comprises multiple sensors each having an input port. The input ports are distributed along the expected path of the ISV process between a starting location and an expected ending location. Each sensor generates an electrical signal representative of the temperature in the vicinity of its input port. A signal processor is coupled to the sensors to receive an electrical signal generated by a sensor, and generate a signal which is encoded with information which identifies the sensor and whether the ISV process has reached the sensor's input port. A transmitter propagates the encoded signal. The signal processor and the transmitter are below ground at a location beyond the expected ending location of the ISV process in the direction from the starting location to the expected ending location. A signal receiver and a decoder are located above ground for receiving the encoded signal propagated by the transmitter, decoding the encoded signal and providing a human-perceptible indication of the progress of the ISV process. 7 figs.

A pilot study on using acupuncture and transcutaneous electrical nerve stimulation to treat chronic non-specific low back pain.

PubMed

Itoh, Kazunori; Itoh, Satoko; Katsumi, Yasukazu; Kitakoji, Hiroshi

2009-02-01

The present study tests whether a combined treatment of acupuncture and transcutaneous electrical nerve stimulation (TENS) is more effective than acupuncture or TENS alone for treating chronic low back pain (LBP). Thirty-two patients with chronic LBP were randomly allocated to four groups. The acupuncture group (ACP) received only acupuncture treatment at selected acupoints for low back pain; the TENS group (TENS) received only TENS treatment at pain areas; the acupuncture and TENS group (A&T) received both acupuncture and TENS treatments; the control group (CT) received topical poultice (only when necessary). Each group received specific weekly treatment five times during the study. Outcome measures were pain intensity in terms of visual analogue scale (VAS) and QOL of low back in terms of Roland-Morris Disability Questionnaire (RDQ). The ACP, TENS and A&T groups all reported lower VAS and RDQ scores. Significant reduction in pain intensity (P<0.008) and significant improvement in QOL (P<0.008) were shown in the A&T group. Combined acupuncture and TENS treatment is effective in pain relief and QOL of low back improvement for the sampled patients suffering from chronic LBP.

A BCR-ABL Kinase Activity-Independent Signaling Pathway in Chronic Myelogenous Leukemia

DTIC Science & Technology

2008-02-01

myeloproliferative disease in mice receiving P210 bcr/abl-transduced bone marrow. Blood. 1998;92:3780-3792. 17. Zhang X, Ren R. Bcr-Abl efficiently induces a... myeloproliferative disease and production of excess interleukin-3 and granulocyte-macrophage colony-stimulating factor in mice: a novel model for chronic...Xu L, et al. Efficient and rapid induction of a chronic myelogenous leukemia-like myeloproliferative disease in mice receiving P210 bcr/abl-transduced

Gating-signal propagation by a feed-forward neural motif

NASA Astrophysics Data System (ADS)

Liang, Xiaoming; Yanchuk, Serhiy; Zhao, Liang

2013-07-01

We study the signal propagation in a feed-forward motif consisting of three bistable neurons: Two input neurons receive input signals and the third output neuron generates the output. We find that a weak input signal can be propagated from the input neurons to the output neuron without amplitude attenuation. We further reveal that the initial states of the input neurons and the coupling strength act as signal gates and determine whether the propagation is enhanced or not. We also investigate the effect of the input signal frequency on enhanced signal propagation.

Visceral Pain: The Neurophysiological Mechanism

PubMed Central

Sengupta, Jyoti N.

2011-01-01

The mechanism of visceral pain is still less understood compared with that of somatic pain. This is primarily due to the diverse nature of visceral pain compounded by multiple factors such as sexual dimorphism, psychological stress, genetic trait, and the nature of predisposed disease. Due to multiple contributing factors there is an enormous challenge to develop animal models that ideally mimic the exact disease condition. In spite of that, it is well recognized that visceral hypersensitivity can occur due to (1) sensitization of primary sensory afferents innervating the viscera, (2) hyperexcitability of spinal ascending neurons (central sensitization) receiving synaptic input from the viscera, and (3) dysregulation of descending pathways that modulate spinal nociceptive transmission. Depending on the type of stimulus condition, different neural pathways are involved in chronic pain. In early-life psychological stress such as maternal separation, chronic pain occurs later in life due to dysregulation of the hypothalamic–pituitary–adrenal axis and significant increase in corticotrophin releasing factor (CRF) secretion. In contrast, in early-life inflammatory conditions such as colitis and cystitis, there is dysregulation of the descending opioidergic system that results excessive pain perception (i.e., visceral hyperalgesia). Functional bowel disorders and chronic pelvic pain represent unexplained pain that is not associated with identifiable organic diseases. Often pain overlaps between two organs and approximately 35% of patients with chronic pelvic pain showed significant improvement when treated for functional bowel disorders. Animal studies have documented that two main components such as (1) dichotomy of primary afferent fibers innervating two pelvic organs and (2) common convergence of two afferent fibers onto a spinal dorsal horn are contributing factors for organ-to-organ pain overlap. With reports emerging about the varieties of peptide molecules involved in the pathological conditions of visceral pain, it is expected that better therapy will be achieved relatively soon to manage chronic visceral pain. PMID:19655104

Treatment of chronic back pain by sensory discrimination training. A Phase I RCT of a novel device (FairMed) vs. TENS.

PubMed

Barker, Karen L; Elliott, Christopher J; Sackley, Catherine M; Fairbank, Jeremy C T

2008-06-28

The causes of chronic low back pain (CLBP) remain obscure and effective treatment of symptoms remains elusive. A mechanism of relieving chronic pain based on the consequences of conflicting unpleasant sensory inputs to the central nervous system has been hypothesised. As a result a device was generated to deliver sensory discrimination training (FairMed), and this randomised controlled trial compared therapeutic effects with a comparable treatment modality, TENS. 60 patients with CLBP were recruited from physiotherapy referrals to a single-blinded, randomised controlled, non-inferiority trial. They were randomised to receive either FairMed or TENS and asked to use the allocated device for 30 minutes, twice a day, for 3 weeks. The primary outcome variable measured at 0 and 3 weeks was pain intensity measured using a visual analogue scale averaged over 7 days. Secondary outcome measures were Oswestry Disability Index, 3 timed physical tests, 4 questionnaires assessing different aspects of emotional coping and a global measure of patient rating of change. Data were analysed for the difference in change of scores between groups using one-way ANOVA. Baseline characteristics of the two groups were comparable. The primary outcome, change in pain intensity (VAS) at 3 weeks showed a mean difference between groups of -0.1, (non significant p = 0.82). The mean difference in change in ODI scores was 0.4; (non significant p = 0.85). Differences in change of physical functioning showed that no significant difference in change of scores for any of these test (p = 0.58 - 0.90). Changes in scores of aspects of emotional coping also demonstrated no significant difference in change scores between the groups (p = 0.14 - 0.94). FairMed was not inferior to TENS treatment. The findings have implications for further research on current chronic pain theories and treatments. Further work to explore these mechanisms is important to expand our understanding of chronic pain and the role of neuro-modulation.

Impact of nonzero boresight pointing error on ergodic capacity of MIMO FSO communication systems.

PubMed

Boluda-Ruiz, Rubén; García-Zambrana, Antonio; Castillo-Vázquez, Beatriz; Castillo-Vázquez, Carmen

2016-02-22

A thorough investigation of the impact of nonzero boresight pointing errors on the ergodic capacity of multiple-input/multiple-output (MIMO) free-space optical (FSO) systems with equal gain combining (EGC) reception under different turbulence models, which are modeled as statistically independent, but not necessarily identically distributed (i.n.i.d.) is addressed in this paper. Novel closed-form asymptotic expressions at high signal-to-noise ratio (SNR) for the ergodic capacity of MIMO FSO systems are derived when different geometric arrangements of the receive apertures at the receiver are considered in order to reduce the effect of nonzero inherent boresight displacement, which is inevitably present when more than one receive aperture is considered. As a result, the asymptotic ergodic capacity of MIMO FSO systems is evaluated over log-normal (LN), gamma-gamma (GG) and exponentiated Weibull (EW) atmospheric turbulence in order to study different turbulence conditions, different sizes of receive apertures as well as different aperture averaging conditions. It is concluded that the use of single-input/multiple-output (SIMO) and MIMO techniques can significantly increase the ergodic capacity respect to the direct path link when the inherent boresight displacement takes small values, i.e. when the spacing among receive apertures is not too big. The effect of nonzero additional boresight errors, which is due to the thermal expansion of the building, is evaluated in multiple-input/single-output (MISO) and single-input/single-output (SISO) FSO systems. Simulation results are further included to confirm the analytical results.

Defining Multiple Chronic Conditions for Quality Measurement.

PubMed

Drye, Elizabeth E; Altaf, Faseeha K; Lipska, Kasia J; Spatz, Erica S; Montague, Julia A; Bao, Haikun; Parzynski, Craig S; Ross, Joseph S; Bernheim, Susannah M; Krumholz, Harlan M; Lin, Zhenqiu

2018-02-01

Patients with multiple chronic conditions (MCCs) are a critical but undefined group for quality measurement. We present a generally applicable systematic approach to defining an MCC cohort of Medicare fee-for-service beneficiaries that we developed for a national quality measure, risk-standardized rates of unplanned admissions for Accountable Care Organizations. To define the MCC cohort we: (1) identified potential chronic conditions; (2) set criteria for cohort conditions based on MCC framework and measure concept; (3) applied the criteria informed by empirical analysis, experts, and the public; (4) described "broader" and "narrower" cohorts; and (5) selected final cohort with stakeholder input. Subjects were patients with chronic conditions. Participants included 21.8 million Medicare fee-for-service beneficiaries in 2012 aged 65 years and above with ≥1 of 27 Medicare Chronic Condition Warehouse condition(s). In total, 10 chronic conditions were identified based on our criteria; 8 of these 10 were associated with notably increased admission risk when co-occurring. A broader cohort (2+ of the 8 conditions) included 4.9 million beneficiaries (23% of total cohort) with an admission rate of 70 per 100 person-years. It captured 53% of total admissions. The narrower cohort (3+ conditions) had 2.2 million beneficiaries (10%) with 100 admissions per 100 person-years and captured 32% of admissions. Most stakeholders viewed the broader cohort as best aligned with the measure concept. By systematically narrowing chronic conditions to those most relevant to the outcome and incorporating stakeholder input, we defined an MCC admission measure cohort supported by stakeholders. This approach can be used as a model for other MCC outcome measures.

A molecular-sized optical logic circuit for digital modulation of a fluorescence signal

NASA Astrophysics Data System (ADS)

Nishimura, Takahiro; Tsuchida, Karin; Ogura, Yusuke; Tanida, Jun

2018-03-01

Fluorescence measurement allows simultaneous detection of multiple molecular species by using spectrally distinct fluorescence probes. However, due to the broad spectra of fluorescence emission, the multiplicity of fluorescence measurement is generally limited. To overcome this limitation, we propose a method to digitally modulate fluorescence output signals with a molecular-sized optical logic circuit by using optical control of fluorescence resonance energy transfer (FRET). The circuit receives a set of optical inputs represented with different light wavelengths, and then it switches high and low fluorescence intensity from a reporting molecule according to the result of the logic operation. By using combinational optical inputs in readout of fluorescence signals, the number of biomolecular species that can be identified is increased. To implement the FRET-based circuits, we designed two types of basic elements, YES and NOT switches. An YES switch produces a high-level output intensity when receiving a designated light wavelength input and a low-level intensity without the light irradiation. A NOT switch operates inversely to the YES switch. In experiments, we investigated the operation of the YES and NOT switches that receive a 532-nm light input and modulate the fluorescence intensity of Alexa Fluor 488. The experimental result demonstrates that the switches can modulate fluorescence signals according to the optical input.

Association Between Facility-Level Utilization of Non-pharmacologic Chronic Pain Treatment and Subsequent Initiation of Long-Term Opioid Therapy.

PubMed

Carey, Evan P; Nolan, Charlotte; Kerns, Robert D; Ho, P Michael; Frank, Joseph W

2018-05-01

Expert guidelines recommend non-pharmacologic treatments and non-opioid medications for chronic pain and recommend against initiating long-term opioid therapy (LTOT). We examined whether veterans with incident chronic pain receiving care at facilities with greater utilization of non-pharmacologic treatments and non-opioid medications are less likely to initiate LTOT. Retrospective cohort study PARTICIPANTS: Veterans receiving primary care from a Veterans Health Administration facility with incident chronic pain between 1/1/2010 and 12/31/2015 based on either of 2 criteria: (1) persistent moderate-to-severe patient-reported pain and (2) diagnoses "likely to represent" chronic pain. The independent variable was facility-level utilization of pain-related treatment modalities (non-pharmacologic, non-opioid medications, LTOT) in the prior calendar year. The dependent variable was patient-level initiation of LTOT (≥ 90 days within 365 days) in the subsequent year, adjusting for patient characteristics. Among 1,094,569 veterans with incident chronic pain from 2010 to 2015, there was wide facility-level variation in utilization of 10 pain-related treatment modalities, including initiation of LTOT (median, 16%; range, 5-32%). Veterans receiving care at facilities with greater utilization of non-pharmacologic treatments were less likely to initiate LTOT in the year following incident chronic pain. Conversely, veterans receiving care at facilities with greater non-opioid and opioid medication utilization were more likely to initiate LTOT; this association was strongest for past year facility-level LTOT initiation (adjusted rate ratio, 2.10; 95% confidence interval, 2.06-2.15, top vs. bottom quartile of facility-level LTOT initiation in prior calendar year). Facility-level utilization patterns of non-pharmacologic, non-opioid, and opioid treatments for chronic pain are associated with subsequent patient-level initiation of LTOT among veterans with incident chronic pain. Further studies should seek to understand facility-level variation in chronic pain care and to identify facility-level utilization patterns that are associated with improved patient outcomes.

Divide and control: split design of multi-input DNA logic gates.

PubMed

Gerasimova, Yulia V; Kolpashchikov, Dmitry M

2015-01-18

Logic gates made of DNA have received significant attention as biocompatible building blocks for molecular circuits. The majority of DNA logic gates, however, are controlled by the minimum number of inputs: one, two or three. Here we report a strategy to design a multi-input logic gate by splitting a DNA construct.

76 FR 15044 - Federal Interagency Committee on Emergency Medical Service (FICEMS) Teleconference Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-18

... stakeholder input call-in session to receive input regarding the current and future role of the Federal... for EMS. The National Security Staff Resilience Directorate has requested that FICEMS engage with stakeholders and develop an options paper by May 15, 2011. FICEMS is interested in any stakeholder input about...

Neighbourly support of people with chronic illness; is it related to neighbourhood social capital?

PubMed

Waverijn, Geeke; Heijmans, Monique; Groenewegen, Peter P

2017-01-01

The neighbourhood may provide resources for health. It is to date unknown whether people who live in neighbourhoods with more social capital have more access to practical and emotional support by neighbours, or whether this is a resource only available to those who are personally connected to people in their neighbourhood. We investigated whether support by neighbours of people with chronic illness was related to neighbourhood social capital and to individual neighbourhood connections. Furthermore, we investigated whether support received from neighbours by people with chronic illness differed according to demographic and disease characteristics. We collected data on support by neighbours and individual connections to neighbours among 2272 people with chronic illness in 2015. Data on neighbourhood social capital were collected among 69,336 people in 3425 neighbourhoods between May 2011 and September 2012. Neighbourhood social capital was estimated with ecometric measurements. We conducted multilevel regression analyses. People with chronic illness were more likely to receive practical and emotional support from neighbours if they had more individual connections to people in their neighbourhood. People with chronic illness were not more likely to receive practical and emotional support from neighbours if they lived in a neighbourhood with more social capital. People with chronic illness with moderate physical disabilities or with comorbidity, and people with chronic illness who lived together with their partner or children, were more likely to receive support from neighbours. To gain more insight into the benefits of neighbourhood social capital, it is necessary to differentiate between the resources only accessible through individual connections to people in the neighbourhood and resources provided through social capital on the neighbourhood level. Copyright © 2016 Elsevier Ltd. All rights reserved.

Social participation and psychosocial outcomes of young adults with chronic physical conditions: Comparing recipients and non-recipients of disability benefits.

PubMed

Bal, Marjolijn I; Sattoe, Jane N T; Miedema, Harald S; van Staa, AnneLoes

2018-03-01

Little is known about any differences between young people with chronic physical conditions who do and do not apply for disability benefits in young adulthood for providing insights for future policy and rehabilitation care. We aimed to identify predictors during adolescence of receiving disability benefits in young adulthood and to compare recipients and non-recipients of benefits in social participation and psychosocial outcomes in young adulthood. Follow-up study of 18 to 25 year olds with various chronic conditions who at adolescent age completed a web-based survey (n=518; T0). The outcome was receiving disability benefits (yes or no). Associations with background characteristics, social participation, and impact of the chronic condition were explored with stepwise multivariate modelling, using T0 variables. Differences between recipients and non-recipients were explored using chi-square tests and t-tests. Receiving disability benefits in young adulthood was associated with greater extent of physical disability, receiving less special education, absenteeism at school/work, and low health-related quality of life during adolescence. In young adulthood, recipients of benefits reported higher perceived impact of the chronic condition on their school/work career and lower quality of life than non-recipients. Social participation varied across domains. This study provides important insights into the characteristics of a vulnerable subgroup of young people with chronic physical conditions. Disability benefit recipients experienced more impact of their chronic condition and reported a lower health-related quality of life over time than non-recipients. Rehabilitation professionals are encouraged to use patient-reported outcomes to address the lived experiences and screen the need for psychosocial support of this vulnerable subgroup of young people with chronic physical conditions. Copyright © 2018. Published by Elsevier Masson SAS.

MEMS Based Acoustic Array

NASA Technical Reports Server (NTRS)

Sheplak, Mark (Inventor); Nishida, Toshikaza (Inventor); Humphreys, William M. (Inventor); Arnold, David P. (Inventor)

2006-01-01

Embodiments of the present invention described and shown in the specification aid drawings include a combination responsive to an acoustic wave that can be utilized as a dynamic pressure sensor. In one embodiment of the present invention, the combination has a substrate having a first surface and an opposite second surface, a microphone positioned on the first surface of the substrate and having an input and a first output and a second output, wherein the input receives a biased voltage, and the microphone generates an output signal responsive to the acoustic wave between the first output and the second output. The combination further has an amplifier positioned on the first surface of the substrate and having a first input and a second input and an output, wherein the first input of the amplifier is electrically coupled to the first output of the microphone and the second input of the amplifier is electrically coupled to the second output of the microphone for receiving the output sinual from the microphone. The amplifier is spaced from the microphone with a separation smaller than 0.5 mm.

Frequency-Agile LIDAR Receiver for Chemical and Biological Agent Sensing

DTIC Science & Technology

2010-06-01

transimpedance preamplifier architecture was optimized around the selected IR detector diode – Input-referenced noise density of 0.8 nV/ Hz0.5  A portion of...objectives: • Reduce baseline (background) photon flux on detector : Tunable Fabry-Perot etalon in optical train • Reduce input-referenced amplifier noise ...custom amplifier • Reduce detector dark current: High impedance detector  Performance Metrics: – Noise equivalent power of receiver system (NEP

Essential fatty acid supplementation in chronic hepatitis B.

PubMed

Jenkins, A P; Green, A T; Thompson, R P

1996-08-01

Dietary supplementation with essential fatty acids and polyunsaturated lecithin may improve biochemical and histological parameters in liver disease. Ten patients with serological and histological evidence of chronic hepatitis B received capsules of the polyunsaturated fatty acid-rich evening primrose oil in a dose of 4 g daily for 12 months, while a matched group received liquid paraffin capsules as a placebo. Compared to the placebo group, the patients receiving evening primrose oil showed no improvement in either biochemical or histological indices of liver damage, or in the rate of loss of circulating e antigen. Dietary, supplementation with this dose of essential fatty acids is unlikely to be of benefit in chronic hepatitis B.

System and method for controlling ammonia levels in a selective catalytic reduction catalyst using a nitrogen oxide sensor

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

None

A system according to the principles of the present disclosure includes an air/fuel ratio determination module and an emission level determination module. The air/fuel ratio determination module determines an air/fuel ratio based on input from an air/fuel ratio sensor positioned downstream from a three-way catalyst that is positioned upstream from a selective catalytic reduction (SCR) catalyst. The emission level determination module selects one of a predetermined value and an input based on the air/fuel ratio. The input is received from a nitrogen oxide sensor positioned downstream from the three-way catalyst. The emission level determination module determines an ammonia level basedmore » on the one of the predetermined value and the input received from the nitrogen oxide sensor.« less

Anthropogenic phosphorus (P) inputs to a river basin and their impacts on P fluxes along its upstream-downstream continuum

NASA Astrophysics Data System (ADS)

Zhang, Wangshou; Swaney, Dennis; Hong, Bongghi; Howarth, Robert

2017-04-01

Phosphorus (P) originating from anthropogenic sources as a pollutant of surface waters has been an environmental issue for decades because of the well-known role of P in eutrophication. Human activities, such as food production and rapid urbanization, have been linked to increased P inputs which are often accompanied by corresponding increases in riverine P export. However, uneven distributions of anthropogenic P inputs along watersheds from the headwaters to downstream reaches can result in significantly different contributions to the riverine P fluxes of a receiving water body. So far, there is still very little scientific understanding of anthropogenic P inputs and their impacts on riverine flux in river reaches along the upstream to downstream continuum. Here, we investigated P budgets in a series of nested watersheds draining into Hongze Lake of China, and developed a simple empirical function to describe the relationship between anthropogenic inputs and riverine TP fluxes. The results indicated that an average of 1.1% of anthropogenic P inputs are exported into rivers, with most of the remainder retained in the watershed landscape over the period studied. Fertilizer application was the main contributor of P loading to the lake (55% of total loads), followed by legacy P stock (30%), food and feed P inputs (12%) and non-food P inputs (4%). From 60% to 89% of the riverine TP loads generated from various locations within this basin were ultimately transported into the receiving lake of the downstream, with an average rate of 1.86 tons P km-1 retaining in the main stem of the inflowing river annually. Our results highlight that in-stream processes can significantly buffer the riverine P loading to the downstream receiving lake. An integrated P management strategy considering the influence of anthropogenic inputs and hydrological interactions is required to assess and optimize P management for protecting fresh waters.

Overdose and prescribed opioids: Associations among chronic non-cancer pain patients

PubMed Central

Dunn, Kate M; Saunders, Kathleen W; Rutter, Carolyn M; Banta-Green, Caleb J; Merrill, Joseph O; Sullivan, Mark D; Weisner, Constance M; Silverberg, Michael J; Campbell, Cynthia I; Psaty, Bruce M; Von Korff, Michael

2010-01-01

Background Chronic opioid therapy for chronic non-cancer pain (CNCP) is increasingly common in community practice. Concomitant with this practice change, rates of fatal opioid overdose have increased. It is not known to what extent overdose risks are elevated among patients receiving medically prescribed chronic opioid therapy. Objective To estimate rates of opioid overdose and their association with average prescribed daily opioid dose among patients receiving medically prescribed chronic opioid therapy. Design Cox proportional hazards models were used to estimate overdose risk as a function of average daily opioid dose (morphine equivalents) received at time of overdose. Setting Health maintenance organization. Patients Individuals (n=9940) who received 3+ opioid prescriptions within 90-days for CNCP between 1997 and 2005. Measurements Average daily opioid dose over the previous 90 days from automated pharmacy data. Primary outcomes, non-fatal and fatal overdoses, were identified through diagnostic codes from inpatient and outpatient care and death certificates and confirmed by medical record review. Results Fifty-one opioid-related overdoses were identified, including six deaths. Compared to patients receiving 1-20mg of opioids per day (0.2% annual overdose rate), patients receiving 50-99 mg had a 3.7 fold increase in overdose risk (95% C.I. 1.5, 9.5) and a 0.7% annual overdose rate. Patients receiving 100mg or more per day had an 8.9 fold increase in overdose risk (95% C.I. 4.0, 19.7) and a 1.8% annual overdose rate. Limitations Increased overdose risk among patients on higher dose regimens may be due to confounding by patient differences and by use of opioids in ways not intended by prescribing physicians. The small number of overdoses in the study cohort is also a limitation. Conclusions Patients receiving higher doses of prescribed opioids are at increased risk of opioid overdose, underscoring the need for close supervision of these patients. PMID:20083827

Bevacizumab-induced chronic interstitial pneumonia during maintenance therapy in non-small cell lung cancer.

PubMed

Sekimoto, Yasuhito; Kato, Motoyasu; Shukuya, Takehiko; Koyama, Ryo; Nagaoka, Tetsutaro; Takahashi, Kazuhisa

2016-04-01

Bevacizumab is a monoclonal antibody targeting the vascular endothelial growth factor receptor and a key drug for advanced non-small cell lung cancer. There are few reports describing bevacizumab-induced chronic interstitial pneumonia. A 62-year-old man with advanced non-small cell lung cancer was admitted to our hospital with dyspnea. He previously received four courses of carboplatin plus paclitaxel with bevacizumab combination therapy and thereafter received four courses of maintenance bevacizumab monotherapy. A chest-computed tomography scan on admission revealed diffuse ground glass opacity. He had not received any other drugs and did not have pneumonia. Thus, he was diagnosed with bevacizumab-induced chronic interstitial pneumonia and was treated with a high dose of corticosteroids. After steroid treatment, his dyspnea and radiological findings improved. This case report is the first description of bevacizumab-induced chronic interstitial pneumonia during maintenance therapy in a patient with non-small cell lung cancer.

SHORT-TERM METHODS FOR ESTIMATING THE CHRONIC TOXICITY OF EFFLUENTS AND RECEIVING WATERS TO WEST COAST MARINE AND ESTUARINE ORGANISMS

EPA Science Inventory

This manual describes six short-term (forty minutes to seven days) estuarine and marine methods for measuring the chronic toxicity of effluents and receiving waters to eight species: the topsmelt, Atherinops affinis; the mysid, Holmesimysis costata; the sea urchin, Stronglocentro...

The impact of lymphatic filariasis on labour inputs in southern India: results of a multi-site study.

PubMed

Ramaiah, K D; Radhamani, M P; John, K R; Evans, D B; Guyatt, H; Joseph, A; Datta, M; Vanamail, P

2000-06-01

A multi-site study was undertaken, in the rural areas of three districts in Tamil Nadu state, in southern India, to examine the impact of acute and chronic forms of lymphatic filariasis, caused by infection with Wuchereria bancrofti, on labour inputs. More than half of the acute episodes of adenolymphangitis (ADL) observed in the study communities caused total disability. The mean (S.D.) time that each ADL case was able to allocate to economic activity each day during these acute episodes was much less than seen in the controls matched for sex, age and occupation [0.97 (2.36) v. 4.48 (3.82) h; P < 0.01]. The acute disease also severely affected domestic activities, with female ADL cases spending only 1.54 (2.12) h/day on domestic activity, compared with 4.18 (2.61) h by controls. The subjects with chronic filariasis also spent significantly less time in economic activity than their matched controls [4.40 (3.79) v. 5.13 (3.83) h/day; P < 0.01). Although the acute episodes have a dramatic effect on the productivity of the affected individual, the labour loss caused by chronic disease is more serious, as the manifestations of chronic disease mostly affect the most productive age-groups, persist for life and are mostly irreversible. The adverse impact of acute and chronic filariasis was observed in males and females, farmers and non-farmers and during the rainy, winter and summer seasons. It is estimated that about 3.8% of the potential labour inputs of the men and 0.77% of those of the women were lost because of lymphatic filariasis. In addition to this loss, the total economic burden of the disease must include the costs of treatment and other health care and of the resources spent on control programmes. Estimates of the disease burden are likely to be useful in determining the costs and benefits of the recently launched campaign to eliminate lymphatic filariasis.

Physical dependence increases the relative reinforcing effects of caffeine versus placebo.

PubMed

Garrett, B E; Griffiths, R R

1998-10-01

Using a within-subject cross-over design, this study examined the role of physical dependence in caffeine reinforcement by experimentally manipulating physical dependence. Each subject was exposed to two chronic drug phases (300 mg/70 kg/day caffeine and placebo) for 9-12 days, with order of phases counterbalanced across subjects. On 2 separate days immediately following each of the chronic drug exposures, subjects received acute doses of either caffeine (300 mg/70 kg) or placebo in counterbalanced order. The reinforcing effects of these drugs were then determined by using a multiple-choice procedure in which subjects made a series of discrete choices between receiving varying amounts of money or receiving the drug again, and a choice between the two drugs. To ensure that subjects completed the form carefully, following exposure to both of the acute drug administrations, one of the subject's previous choices from the multiple-choice form was randomly selected and the consequence of that choice was implemented. When subjects were maintained on chronic caffeine, they were willing to forfeit significantly more money and showed significant increases in typical withdrawal symptoms (e.g. fatigue, mood disturbance) after receiving placebo as compared to the other three conditions. When subjects were maintained on chronic caffeine, they also chose to receive caffeine over placebo twice as often than when they were maintained on chronic placebo. These findings provide the strongest evidence to date indicating that caffeine physical dependence increases the relative reinforcing effects of caffeine versus placebo.

Forecasting hotspots using predictive visual analytics approach

DOEpatents

Maciejewski, Ross; Hafen, Ryan; Rudolph, Stephen; Cleveland, William; Ebert, David

2014-12-30

A method for forecasting hotspots is provided. The method may include the steps of receiving input data at an input of the computational device, generating a temporal prediction based on the input data, generating a geospatial prediction based on the input data, and generating output data based on the time series and geospatial predictions. The output data may be configured to display at least one user interface at an output of the computational device.

Compact particle accelerator

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

Elizondo-Decanini, Juan M.

2017-08-29

A compact particle accelerator having an input portion configured to receive power to produce particles for acceleration, where the input portion includes a switch, is provided. In a general embodiment, a vacuum tube receives particles produced from the input portion at a first end, and a plurality of wafer stacks are positioned serially along the vacuum tube. Each of the plurality of wafer stacks include a dielectric and metal-oxide pair, wherein each of the plurality of wafer stacks further accelerate the particles in the vacuum tube. A beam shaper coupled to a second end of the vacuum tube shapes themore » particles accelerated by the plurality of wafer stacks into a beam and an output portion outputs the beam.« less

Physical Therapy for Chronic Low Back Pain in North Carolina: Overuse, Underuse, or Misuse?

PubMed Central

Carey, Timothy S.; Holmes, George M.

2011-01-01

Background There are limited population-based studies of determinants of physical therapy use for chronic low back pain (LBP) and of the types of treatments received by individuals who see a physical therapist. Objective The purposes of this study were: (1) to identify determinants of physical therapy use for chronic LBP, (2) to describe physical therapy treatments for chronic LBP, and (3) to compare use of treatments with current best evidence on care for this condition. Design This study was a cross-sectional, population-based telephone survey of North Carolinians. Methods Five hundred eighty-eight individuals with chronic LBP who had sought care in the previous year were surveyed on their health and health care use. Bivariate and multivariable analyses were conducted to identify predisposing, enabling, and need characteristics associated with physical therapy use. Descriptive analyses were conducted to determine the use of physical treatments for individuals who saw a physical therapist. Use of treatments was compared with evidence from systematic reviews. Results Of our sample, 29.7% had seen a physical therapist in the previous year, with a mean of 15.6 visits. In multivariable analyses, receiving workers' compensation, seeing physician specialists, and higher Medical Outcomes Study 12-Item Short-Form Health Survey questionnaire (SF-12) physical component scores were positively associated with physical therapy use. Having no health insurance was negatively associated with physical therapy use. Exercise was the most frequent treatment received (75% of sample), and traction was the least frequent treatment received (7%). Some effective treatments were underutilized, whereas some ineffective treatments were overutilized. Limitations Only one state was examined, and findings were based on patient report. Conclusions Fewer than one third of individuals with chronic LBP saw a physical therapist. Health-related and non–health-related factors were associated with physical therapy use. Individuals who saw a physical therapist did not always receive evidence-based treatments. There are potential opportunities for improving access to and quality of physical therapy for chronic LBP. PMID:21330449

Using a treatment diary to improve the medication adherence in patients with chronic myeloid leukaemia.

PubMed

Santoleri, Fiorenzo; Lasala, Ruggero; Logreco, Andrea; Ranucci, Elena; Costantini, Alberto

2018-01-01

Purpose The aim of this study was to verify whether the distribution of a treatment diary by a pharmacist could influence the adherence to oral treatment with imatinib, nilotinib, and dasatinib in patients with chronic myeloid leukaemia. Methods The level of adherence was calculated using the received daily dose/prescribed daily dose ratio and compared between patients who used a diary and those who did not. Results Forty-four (35.8%) of 123 patients with chronic myeloid leukaemia completed the diary: 20 (45.4%) receiving imatinib, 17 (38.6%) receiving nilotinib, and seven (15.9%) receiving dasatinib. Treatment adherence with the diary calculated using received daily dose/prescribed daily dose method was 93.6% (imatinib 94.9%, nilotinib 91.1%, and dasatinib 95.8%). Adherence during the period without a diary was 86.5% (84.9, 87.4, and 90%). Adherence was significantly greater with than without a diary (p < 0.0001). Conclusions The findings of this study that, in the case of chronic diseases, direct pharmacist-patient contact is important in order to maintain high levels of adherence, and a treatment diary is a valid means of doing this. According to these data, it is necessary to support similar patient-oriented programmes in order to ensure high levels of adherence and optimize drug management.

[Chronic non-communicable diseases in Brazil: priorities for disease management and research].

PubMed

Duncan, Bruce Bartholow; Chor, Dóra; Aquino, Estela M L; Bensenor, Isabela M; Mill, José Geraldo; Schmidt, Maria Inês; Lotufo, Paulo Andrade; Vigo, Alvaro; Barreto, Sandhi Maria

2012-12-01

Chronic Non-Communicable Diseases are the main source of disease burden in Brazil. In 2011, the Brazilian Ministry of Health launched the Strategic Plan of Action for Management of Chronic Non-Communicable Diseases focusing on population-based interventions to manage cardiovascular diseases, diabetes, cancer, and chronic respiratory diseases mainly through fighting tobacco use, unhealthy diets, physical inactivity and the harmful use of alcohol. Although a significant number of scientific studies on chronic diseases and their risk factors have been undertaken in Brazil, few are of cohort design. In this context, the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), a cohort study of 15,105 Brazilian public servants reflects the reality of high prevalences of diabetes, hypertension and the main chronic diseases risk factors. The diversity of information that the Study will produce can provide important input to better understand the causes of chronic diseases and to support public policies for fighting them.

Optimal degrees of synaptic connectivity

PubMed Central

Litwin-Kumar, Ashok; Harris, Kameron Decker; Axel, Richard; Sompolinsky, Haim; Abbott, L. F.

2017-01-01

Summary Synaptic connectivity varies widely across neuronal types. Cerebellar granule cells receive five orders of magnitude fewer inputs than the Purkinje cells they innervate, and cerebellum-like circuits including the insect mushroom body also exhibit large divergences in connectivity. In contrast, the number of inputs per neuron in cerebral cortex is more uniform and large. We investigate how the dimension of a representation formed by a population of neurons depends on how many inputs they each receive and what this implies for learning associations. Our theory predicts that the dimensions of the cerebellar granule-cell and Drosophila Kenyon-cell representations are maximized at degrees of synaptic connectivity that match those observed anatomically, showing that sparse connectivity is sometimes superior to dense connectivity. When input synapses are subject to supervised plasticity, however, dense wiring becomes advantageous, suggesting that the type of plasticity exhibited by a set of synapses is a major determinant of connection density. PMID:28215558

A high sensitive 66 dB linear dynamic range receiver for 3-D laser radar

NASA Astrophysics Data System (ADS)

Ma, Rui; Zheng, Hao; Zhu, Zhangming

2017-08-01

This study presents a CMOS receiver chip realized in 0.18 μm standard CMOS technology and intended for high precision 3-D laser radar. The chip includes an adjustable gain transimpedance pre-amplifier, a post-amplifier and two timing comparators. An additional feedback is employed in the regulated cascode transimpedance amplifier to decrease the input impedance, and a variable gain transimpedance amplifier controlled by digital switches and analog multiplexer is utilized to realize four gain modes, extending the input dynamic range. The measurement shows that the highest transimpedance of the channel is 50 k {{Ω }}, the uncompensated walk error is 1.44 ns in a wide linear dynamic range of 66 dB (1:2000), and the input referred noise current is 2.3 pA/\\sqrt{{Hz}} (rms), resulting in a very low detectable input current of 1 μA with SNR = 5.

ADVANCE: Study to Evaluate Cinacalcet Plus Low Dose Vitamin D on Vascular Calcification in Subjects With Chronic Kidney Disease Receiving Hemodialysis

ClinicalTrials.gov

2014-07-14

Chronic Kidney Disease; End Stage Renal Disease; Coronary Artery Calcification; Vascular Calcification; Calcification; Cardiovascular Disease; Chronic Renal Failure; Hyperparathyroidism; Kidney Disease; Nephrology; Secondary Hyperparathyroidism

Specialized Community-Based Care: An Evidence-Based Analysis

PubMed Central

2012-01-01

Background Specialized community-based care (SCBC) refers to services that manage chronic illness through formalized links between primary and specialized care. Objectives The objectives of this evidence-based analysis (EBA) were as follows: to summarize the literature on SCBC, also known as intermediate care to synthesize the evidence from previous Medical Advisory Secretariat (now Health Quality Ontario) EBAs on SCBC for heart failure, diabetes, chronic obstructive pulmonary disease (COPD), and chronic wounds to examine the role of SCBC in family practice Results Part 1: Systematic Review of Intermediate Care Seven systematic reviews on intermediate care since 2008 were identified. The literature base is complex and difficult to define. There is evidence to suggest that intermediate care is effective in improving outcomes; however, the effective interventions are still uncertain. Part 2: Synthesis of Evidence in Intermediate Care Mortality • Heart failure Significant reduction in patients receiving SCBC • COPD Nonsignificant reduction in patients receiving SCBC Hospitalization • Heart failure Nonsignificant reduction in patients receiving SCBC • COPD Significant reduction in patients receiving SCBC Emergency Department Visits • Heart failure Nonsignificant reduction in patients receiving SCBC • COPD Significant reduction in patients receiving SCBC Disease-Specific Patient Outcomes • COPD Nonsignificant improvement in lung function in patients receiving SCBC • Diabetes Significant reduction in hemoglobin A1c (HbA1c) and systolic blood pressure in patients receiving SCBC • Chronic wounds Significant increase in the proportion of healed wounds in patients receiving SCBC Quality of Life • Heart failure Trend toward improvement in patients receiving SCBC • COPD Significant improvement in patients receiving SCBC Part 3: Intermediate Care in Family Practice—Evidence-Based Analysis Five randomized controlled trials were identified comparing SCBC to usual care in family practice. Inclusion criteria were 1) the presence of multiple chronic conditions, and 2) interventions that included 2 or more health care professions. The GRADE quality of the evidence was assessed as low for all outcomes due to the inconsistency and indirectness of the results. Limitations This review did not look at disease-specific studies on intermediate care in family practice. Conclusions Specialized community-based care effectively improves outcomes in patients with heart failure, COPD, and diabetes. The effectiveness of SCBC in family practice is unclear. PMID:23226812

Patient Factors Influencing Respiratory-Related Clinician Actions in Chronic Obstructive Pulmonary Disease Screening.

PubMed

Wadland, William C; Zubek, Valentina Bayer; Clerisme-Beaty, Emmanuelle M; Ríos-Bedoya, Carlos F; Yawn, Barbara P

2017-01-01

The purpose of this study was to identify patient-related factors that may explain the increased likelihood of receiving a respiratory-related clinician action in patients identified to be at risk for chronic obstructive pulmonary disease in a U.S.-based pragmatic study of chronic obstructive pulmonary disease screening. This post hoc analysis (conducted in 2014-2015) of the Screening, Evaluating and Assessing Rate Changes of Diagnosing Respiratory Conditions in Primary Care 1 (SEARCH1) study (conducted in 2010-2011), used the chronic obstructive pulmonary disease Population Screener questionnaire in 112 primary care practices. Anyone with a previous chronic obstructive pulmonary disease diagnosis was excluded. Multivariate logistic regression modeling was used to assess patient factors associated with the likelihood of receiving an respiratory-related clinician action following positive screening. Overall, 994 of 6,497 (15%) screened positive and were considered at risk for chronic obstructive pulmonary disease. However, only 187 of the 994 patients (19%) who screened positive received a respiratory-related clinician action. The chances of receiving a respiratory-related clinician action were significantly increased in patients who visited their physician with a respiratory issue (p<0.05) or had already been prescribed a respiratory medication (p<0.05). Most (81%) patients who screened positive or had a respiratory-related clinician action had one or more comorbidity, including cardiovascular disease (68%), diabetes (30%), depression/anxiety (26%), asthma (11%), and cancer (9%). Routine chronic obstructive pulmonary disease screening appears to promote respiratory-related clinician actions in patients with a high likelihood for disease who have respiratory complaints or already use prescribed respiratory medication. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Interaural Phase and Level Difference Sensitivity in Low-Frequency Neurons in the Lateral Superior Olive

PubMed Central

Tollin, Daniel J.; Yin, Tom C. T.

2006-01-01

The lateral superior olive (LSO) is believed to encode differences in sound level at the two ears, a cue for azimuthal sound location. Most high-frequency-sensitive LSO neurons are binaural, receiving inputs from both ears. An inhibitory input from the contralateral ear, via the medial nucleus of the trapezoid body (MNTB), and excitatory input from the ipsilateral ear enable level differences to be encoded. However, the classical descriptions of low-frequency-sensitive neurons report primarily monaural cells with no contralateral inhibition. Anatomical and physiological evidence, however, shows that low-frequency LSO neurons receive low-frequency inhibitory input from ipsilateral MNTB, which in turn receives excitatory input from the contralateral cochlear nucleus and low-frequency excitatory input from the ipsilateral cochlear nucleus. Therefore, these neurons would be expected to be binaural with contralateral inhibition. Here, we re-examined binaural interaction in low-frequency (less than ~3 kHz) LSO neurons and phase locking in the MNTB. Phase locking to low-frequency tones in MNTB and ipsilaterally driven LSO neurons with frequency sensitivities < 1.2 kHz was enhanced relative to the auditory nerve. Moreover, most low-frequency LSO neurons exhibited contralateral inhibition: ipsilaterally driven responses were suppressed by raising the level of the contralateral stimulus; most neurons were sensitive to interaural time delays in pure tone and noise stimuli such that inhibition was nearly maximal when the stimuli were presented to the ears in-phase. The data demonstrate that low-frequency LSO neurons of cat are not monaural and can exhibit contralateral inhibition like their high-frequency counterparts. PMID:16291937

Fine and distributed subcellular retinotopy of excitatory inputs to the dendritic tree of a collision-detecting neuron

PubMed Central

Zhu, Ying

2016-01-01

Individual neurons in several sensory systems receive synaptic inputs organized according to subcellular topographic maps, yet the fine structure of this topographic organization and its relation to dendritic morphology have not been studied in detail. Subcellular topography is expected to play a role in dendritic integration, particularly when dendrites are extended and active. The lobula giant movement detector (LGMD) neuron in the locust visual system is known to receive topographic excitatory inputs on part of its dendritic tree. The LGMD responds preferentially to objects approaching on a collision course and is thought to implement several interesting dendritic computations. To study the fine retinotopic mapping of visual inputs onto the excitatory dendrites of the LGMD, we designed a custom microscope allowing visual stimulation at the native sampling resolution of the locust compound eye while simultaneously performing two-photon calcium imaging on excitatory dendrites. We show that the LGMD receives a distributed, fine retinotopic projection from the eye facets and that adjacent facets activate overlapping portions of the same dendritic branches. We also demonstrate that adjacent retinal inputs most likely make independent synapses on the excitatory dendrites of the LGMD. Finally, we show that the fine topographic mapping can be studied using dynamic visual stimuli. Our results reveal the detailed structure of the dendritic input originating from individual facets on the eye and their relation to that of adjacent facets. The mapping of visual space onto the LGMD's dendrites is expected to have implications for dendritic computation. PMID:27009157

Vagal innervation of the aldosterone-sensitive HSD2 neurons in the NTS

PubMed Central

Shin, Jung-Won; Geerling, Joel C.; Loewy, Arthur D.

2009-01-01

The nucleus of the solitary tract (NTS) contains a unique subpopulation of aldosterone-sensitive neurons. These neurons express the enzyme 11-β-hydroxysteroid dehydrogenase type 2 (HSD2) and are activated by sodium deprivation. They are located in the caudal NTS, a region which is densely innervated by the vagus nerve, suggesting that they could receive direct viscerosensory input from the periphery. To test this possibility, we injected the highly sensitive axonal tracer biotinylated dextran amine (BDA) into the left nodose ganglion in rats. Using confocal microscopy, we observed a sparse input from the vagus to most HSD2 neurons. Roughly 80% of the ipsilateral HSD2 neurons exhibited at least one close contact with a BDA-labeled vagal bouton, although most of these cells received only a few total contacts. Most of these contacts were axo-dendritic (~80%), while ~20% were axo-somatic. In contrast, the synaptic vesicular transporters VGLUT2 or GAD7 labeled much larger populations of boutons contacting HSD2-labeled dendrites and somata, suggesting that direct input from the vagus may only account for a minority of the information integrated by these neurons. In summary, the aldosterone-sensitive HSD2 neurons in the NTS appear to receive a small amount of direct viscerosensory input from the vagus nerve. The peripheral sites of origin and functional significance of this projection remain unknown. Combined with previously-identified central sources of input to these cells, the present finding indicates that the HSD2 neurons integrate humoral information with input from a variety of neural afferents. PMID:19010311

A preliminary study comparing methadone and buprenorphine in patients with chronic pain and coexistent opioid addiction.

PubMed

Neumann, Anne M; Blondell, Richard D; Jaanimägi, Urmo; Giambrone, Amanda K; Homish, Gregory G; Lozano, Jacqueline R; Kowalik, Urszula; Azadfard, Mohammadreza

2013-01-01

Patients with opioid addiction who receive prescription opioids for treatment of nonmalignant chronic pain present a therapeutic challenge. Fifty-four participants with chronic pain and opioid addiction were randomized to receive methadone or buprenorphine/naloxone. At the 6-month follow-up examination, 26 (48.1%) participants who remained in the study noted a 12.75% reduction in pain (P = 0.043), and no participants in the methadone group compared to 5 in the buprenorphine group reported illicit opioid use (P = 0.039). Other differences between the two conditions were not found. Long-term, low-dose methadone or buprenorphine/naloxone treatment produced analgesia in participants with chronic pain and opioid addiction.

How Much Input Is Enough? Correlating Comprehension and Child Language Input in an Endangered Language

ERIC Educational Resources Information Center

Meakins, Felicity; Wigglesworth, Gillian

2013-01-01

In situations of language endangerment, the ability to understand a language tends to persevere longer than the ability to speak it. As a result, the possibility of language revival remains high even when few speakers remain. Nonetheless, this potential requires that those with high levels of comprehension received sufficient input as children for…

Input-output budgets of selected nutrients on an experimental watershed near Parsons, West Virginia

Treesearch

J. D. Helvey; Samuel H. Kunkle; Samuel H. Kunkle

1986-01-01

A control watershed at the Fernow Experimental Watershed effectively neutralizes acids received in precipitation. However, sulfate input by precipitation greatly exceeds sulfate losses as streamflow and watershed acidification is a real concern.

Maxine: A spreadsheet for estimating dose from chronic atmospheric radioactive releases

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

Jannik, Tim; Bell, Evaleigh; Dixon, Kenneth

MAXINE is an EXCEL© spreadsheet, which is used to estimate dose to individuals for routine and accidental atmospheric releases of radioactive materials. MAXINE does not contain an atmospheric dispersion model, but rather doses are estimated using air and ground concentrations as input. Minimal input is required to run the program and site specific parameters are used when possible. Complete code description, verification of models, and user’s manual have been included.

Filtering data from the collaborative initial glaucoma treatment study for improved identification of glaucoma progression.

PubMed

Schell, Greggory J; Lavieri, Mariel S; Stein, Joshua D; Musch, David C

2013-12-21

Open-angle glaucoma (OAG) is a prevalent, degenerate ocular disease which can lead to blindness without proper clinical management. The tests used to assess disease progression are susceptible to process and measurement noise. The aim of this study was to develop a methodology which accounts for the inherent noise in the data and improve significant disease progression identification. Longitudinal observations from the Collaborative Initial Glaucoma Treatment Study (CIGTS) were used to parameterize and validate a Kalman filter model and logistic regression function. The Kalman filter estimates the true value of biomarkers associated with OAG and forecasts future values of these variables. We develop two logistic regression models via generalized estimating equations (GEE) for calculating the probability of experiencing significant OAG progression: one model based on the raw measurements from CIGTS and another model based on the Kalman filter estimates of the CIGTS data. Receiver operating characteristic (ROC) curves and associated area under the ROC curve (AUC) estimates are calculated using cross-fold validation. The logistic regression model developed using Kalman filter estimates as data input achieves higher sensitivity and specificity than the model developed using raw measurements. The mean AUC for the Kalman filter-based model is 0.961 while the mean AUC for the raw measurements model is 0.889. Hence, using the probability function generated via Kalman filter estimates and GEE for logistic regression, we are able to more accurately classify patients and instances as experiencing significant OAG progression. A Kalman filter approach for estimating the true value of OAG biomarkers resulted in data input which improved the accuracy of a logistic regression classification model compared to a model using raw measurements as input. This methodology accounts for process and measurement noise to enable improved discrimination between progression and nonprogression in chronic diseases.

A Transcriptional Signature of Fatigue Derived from Patients with Primary Sjögren's Syndrome.

PubMed

James, Katherine; Al-Ali, Shereen; Tarn, Jessica; Cockell, Simon J; Gillespie, Colin S; Hindmarsh, Victoria; Locke, James; Mitchell, Sheryl; Lendrem, Dennis; Bowman, Simon; Price, Elizabeth; Pease, Colin T; Emery, Paul; Lanyon, Peter; Hunter, John A; Gupta, Monica; Bombardieri, Michele; Sutcliffe, Nurhan; Pitzalis, Costantino; McLaren, John; Cooper, Annie; Regan, Marian; Giles, Ian; Isenberg, David; Saravanan, Vadivelu; Coady, David; Dasgupta, Bhaskar; McHugh, Neil; Young-Min, Steven; Moots, Robert; Gendi, Nagui; Akil, Mohammed; Griffiths, Bridget; Wipat, Anil; Newton, Julia; Jones, David E; Isaacs, John; Hallinan, Jennifer; Ng, Wan-Fai

2015-01-01

Fatigue is a debilitating condition with a significant impact on patients' quality of life. Fatigue is frequently reported by patients suffering from primary Sjögren's Syndrome (pSS), a chronic autoimmune condition characterised by dryness of the eyes and the mouth. However, although fatigue is common in pSS, it does not manifest in all sufferers, providing an excellent model with which to explore the potential underpinning biological mechanisms. Whole blood samples from 133 fully-phenotyped pSS patients stratified for the presence of fatigue, collected by the UK primary Sjögren's Syndrome Registry, were used for whole genome microarray. The resulting data were analysed both on a gene by gene basis and using pre-defined groups of genes. Finally, gene set enrichment analysis (GSEA) was used as a feature selection technique for input into a support vector machine (SVM) classifier. Classification was assessed using area under curve (AUC) of receiver operator characteristic and standard error of Wilcoxon statistic, SE(W). Although no genes were individually found to be associated with fatigue, 19 metabolic pathways were enriched in the high fatigue patient group using GSEA. Analysis revealed that these enrichments arose from the presence of a subset of 55 genes. A radial kernel SVM classifier with this subset of genes as input displayed significantly improved performance over classifiers using all pathway genes as input. The classifiers had AUCs of 0.866 (SE(W) 0.002) and 0.525 (SE(W) 0.006), respectively. Systematic analysis of gene expression data from pSS patients discordant for fatigue identified 55 genes which are predictive of fatigue level using SVM classification. This list represents the first step in understanding the underlying pathophysiological mechanisms of fatigue in patients with pSS.

Obesity-driven synaptic remodeling affects endocannabinoid control of orexinergic neurons

PubMed Central

Cristino, Luigia; Busetto, Giuseppe; Imperatore, Roberta; Ferrandino, Ida; Palomba, Letizia; Silvestri, Cristoforo; Petrosino, Stefania; Orlando, Pierangelo; Bentivoglio, Marina; Mackie, Kenneth; Di Marzo, Vincenzo

2013-01-01

Acute or chronic alterations in energy status alter the balance between excitatory and inhibitory synaptic transmission and associated synaptic plasticity to allow for the adaptation of energy metabolism to new homeostatic requirements. The impact of such changes on endocannabinoid and cannabinoid receptor type 1 (CB1)-mediated modulation of synaptic transmission and strength is not known, despite the fact that this signaling system is an important target for the development of new drugs against obesity. We investigated whether CB1-expressing excitatory vs. inhibitory inputs to orexin-A–containing neurons in the lateral hypothalamus are altered in obesity and how this modifies endocannabinoid control of these neurons. In lean mice, these inputs are mostly excitatory. By confocal and ultrastructural microscopic analyses, we observed that in leptin-knockout (ob/ob) obese mice, and in mice with diet-induced obesity, orexinergic neurons receive predominantly inhibitory CB1-expressing inputs and overexpress the biosynthetic enzyme for the endocannabinoid 2-arachidonoylglycerol, which retrogradely inhibits synaptic transmission at CB1-expressing axon terminals. Patch-clamp recordings also showed increased CB1-sensitive inhibitory innervation of orexinergic neurons in ob/ob mice. These alterations are reversed by leptin administration, partly through activation of the mammalian target of rapamycin pathway in neuropeptide-Y-ergic neurons of the arcuate nucleus, and are accompanied by CB1-mediated enhancement of orexinergic innervation of target brain areas. We propose that enhanced inhibitory control of orexin-A neurons, and their CB1-mediated disinhibition, are a consequence of leptin signaling impairment in the arcuate nucleus. We also provide initial evidence of the participation of this phenomenon in hyperphagia and hormonal dysregulation in obesity. PMID:23630288

Background-free balanced optical cross correlator

DOEpatents

Nejadmalayeri, Amir Hossein; Kaertner, Franz X

2014-12-23

A balanced optical cross correlator includes an optical waveguide, a first photodiode including a first n-type semiconductor and a first p-type semiconductor positioned about the optical waveguide on a first side of the optical waveguide's point of symmetry, and a second photodiode including a second n-type semiconductor and a second p-type semiconductor positioned about the optical waveguide on a second side of the optical waveguide's point of symmetry. A balanced receiver including first and second inputs is configured to produce an output current or voltage that reflects a difference in currents or voltages, originating from the first and the second photodiodes of the balanced cross correlator and fed to the first input and to the second input of the balanced receiver.

[Treatment Strategy and Results of Carotid Endarterectomy in Chronic Renal Failure Patients].

PubMed

Murahashi, Takeo; Kamiyama, Kenji; Osato, Toshiaki; Watanabe, Toshiichi; Ogino, Tatsuya; Sugio, Hironori; Endo, Hideki; Takahira, Kazuki; Shindo, Koichiro; Takahashi, Shuhei; Nakamura, Hirohiko

2017-02-01

The number of patients receiving chronic dialysis treatment in Japan currently exceeds 300,000 people. Few reports have described carotid endarterectomy(CEA)for chronic renal failure patients because of the unacceptable rate of perioperative stroke and other morbidities. A strategy for and treatment results of CEA for chronic renal failure patients in our hospital are described herein. The present study included 6 patients who underwent CEA while receiving dialysis treatment between April 2011 and November 2014. Dialysis treatment was initiated due to diabetes in 4 patients and renal sclerosis in 2 patients. All the patients were men, with a mean age of 74.0 years. Two patients were symptomatic, and four were asymptomatic. In all the patients, heart vascular lesions and arteriosclerosis risk factors were present. Postoperatively, pneumonia transient cranial neuropathy, heart failure, and pneumonia in 1 case required extensive treatment. However, by the time of discharge from hospital, no cases had deteriorated compared with their pre-CEA state. The modified Rankin scale score on discharge was 0-2 for all the patients. CEA can be performed safely in patients receiving dialysis, but further operative procedures and careful postoperative management are likely to be needed for patients with CEA who are receiving dialysis.

Efficacy of Trimetazidine Dihydrochloride for Relieving Chronic Tinnitus: A Randomized Double-Blind Study

PubMed Central

Kumral, Tolgar Lütfi; Yıldırım, Güven; Berkiten, Güler; Saltürk, Ziya; Ataç, Enes; Atar, Yavuz; Uyar, Yavuz

2016-01-01

Objectives. To evaluate the efficacy of trimetazidine dihydrochloride as a treatment for chronic tinnitus. Methods. A total of 97 chronic tinnitus patients were evaluated in this randomized, prospective, double-blind, placebo-controlled trial. After assessing for eligibility, 82 patients were randomly assigned into placebo or trimetazidine groups according to the medication. The trimetazidine group received 20×3 mg/day per oral trimetazidine dihydrochloride and the placebo group received 20×3 mg/day per oral placebo for 3 months. Tinnitus handicap inventory (THI), visual analogue scale (VAS) questionnaires and audiometric results were used to determine the effectiveness of trimetazidine treatment. Results. The study group comprised 82 tinnitus subjects, 42 (51%) of whom received trimetazidine dihydrochloride and 40 (49%) who received placebo. There was no significant difference between placebo and trimetazidine groups in THI grade and VAS (both pre- and posttreatment scores) (P>0.05) and no significant improvement was observed in subjective loudness score in either group (P>0.05). Additionally there was no significant difference between groups in pre- and posttreatment pure tone hearing thresholds at all measured frequencies (P>0.05). Conclusion. Trimetazidine dihydrochloride therapy was ineffective for relieving chronic tinnitus. PMID:27230273

RF Design of a Wideband CMOS Integrated Receiver for Phased Array Applications

NASA Astrophysics Data System (ADS)

Jackson, Suzy A.

2004-06-01

New silicon CMOS processes developed primarily for the burgeoning wireless networking market offer significant promise as a vehicle for the implementation of highly integrated receivers, especially at the lower end of the frequency range proposed for the Square Kilometre Array (SKA). An RF-CMOS ‘Receiver-on-a-Chip’ is being developed as part of an Australia Telescope program looking at technologies associated with the SKA. The receiver covers the frequency range 500 1700 MHz, with instantaneous IF bandwidth of 500 MHz and, on simulation, yields an input noise temperature of < 50 K at mid-band. The receiver will contain all active circuitry (LNA, bandpass filter, quadrature mixer, anti-aliasing filter, digitiser and serialiser) on one 0.18 μm RF-CMOS integrated circuit. This paper outlines receiver front-end development work undertaken to date, including design and simulation of an LNA using noise cancelling techniques to achieve a wideband input-power-match with little noise penalty.

SymptomCare@Home: Developing an Integrated Symptom Monitoring and Management System for Outpatients Receiving Chemotherapy.

PubMed

Beck, Susan L; Eaton, Linda H; Echeverria, Christina; Mooney, Kathi H

2017-10-01

SymptomCare@Home, an integrated symptom monitoring and management system, was designed as part of randomized clinical trials to help patients with cancer who receive chemotherapy in ambulatory clinics and often experience significant symptoms at home. An iterative design process was informed by chronic disease management theory and features of assessment and clinical decision support systems used in other diseases. Key stakeholders participated in the design process: nurse scientists, clinical experts, bioinformatics experts, and computer programmers. Especially important was input from end users, patients, and nurse practitioners participating in a series of studies testing the system. The system includes both a patient and clinician interface and fully integrates two electronic subsystems: a telephone computer-linked interactive voice response system and a Web-based Decision Support-Symptom Management System. Key features include (1) daily symptom monitoring, (2) self-management coaching, (3) alerting, and (4) nurse practitioner follow-up. The nurse practitioner is distinctively positioned to provide assessment, education, support, and pharmacologic and nonpharmacologic interventions to intensify management of poorly controlled symptoms at home. SymptomCare@Home is a model for providing telehealth. The system facilitates using evidence-based guidelines as part of a comprehensive symptom management approach. The design process and system features can be applied to other diseases and conditions.

Achieving ventricular rate control using metoprolol in β-blocker-naive patients vs patients on chronic β-blocker therapy.

PubMed

Kuang, Patricia; Mah, Nathan D; Barton, Cassie A; Miura, Andrea J; Tanas, Laura R; Ran, Ran

2016-03-01

The objective of the study is to evaluate the difference in ventricular rate control using an intravenous (IV) metoprolol regimen commonly used in clinical practice in patients receiving chronic β-blocker therapy compared to patients considered β-blocker naive admitted to the emergency department (ED) for atrial fibrillation (AF) with rapid ventricular rate. A single-center retrospective cohort study of adult ED patients who were admitted with a rapid ventricular rate of 120 beats per minute (bpm) or greater and treated with IV metoprolol was performed. Rate control was defined as either a decrease in ventricular rate to less than 100 bpm or a 20% decrease in heart rate to less than 120 bpm after metoprolol administration. Patient demographics, differences in length of stay, and adverse events were recorded. A total of 398 patients were included in the study, with 79.4% (n=316) receiving chronic β-blocker therapy. Patients considered to be β-blocker naive were more likely to achieve successful rate control with IV metoprolol compared to patients on chronic β-blocker therapy (56.1% vs 42.4%; P=.03). β-Blocker-naive status was associated with a shorter length of stay in comparison to patients receiving chronic β-blocker therapy (1.79 vs 2.64 days; P<.01). Intravenous metoprolol for the treatment of atrial fibrillation with rapid ventricular rate was associated with a higher treatment response in patients considered β-blocker naive compared to patients receiving chronic β-blocker therapy. Copyright © 2015 Elsevier Inc. All rights reserved.

Multi-input and binary reproducible, high bandwidth floating point adder in a collective network

DOEpatents

Chen, Dong; Eisley, Noel A.; Heidelberger, Philip; Steinmacher-Burow, Burkhard

2016-11-15

To add floating point numbers in a parallel computing system, a collective logic device receives the floating point numbers from computing nodes. The collective logic devices converts the floating point numbers to integer numbers. The collective logic device adds the integer numbers and generating a summation of the integer numbers. The collective logic device converts the summation to a floating point number. The collective logic device performs the receiving, the converting the floating point numbers, the adding, the generating and the converting the summation in one pass. One pass indicates that the computing nodes send inputs only once to the collective logic device and receive outputs only once from the collective logic device.

High speed preamplifier circuit, detection electronics, and radiation detection systems therefrom

DOEpatents

Riedel, Richard A [Knoxville, TN; Wintenberg, Alan L [Knoxville, TN; Clonts, Lloyd G [Knoxville, TN; Cooper, Ronald G [Oak Ridge, TN

2010-09-21

A preamplifier circuit for processing a signal provided by a radiation detector includes a transimpedance amplifier coupled to receive a current signal from a detector and generate a voltage signal at its output. A second amplification stage has an input coupled to an output of the transimpedance amplifier for providing an amplified voltage signal. Detector electronics include a preamplifier circuit having a first and second transimpedance amplifier coupled to receive a current signal from a first and second location on a detector, respectively, and generate a first and second voltage signal at respective outputs. A second amplification stage has an input coupled to an output of the transimpedance amplifiers for amplifying the first and said second voltage signals to provide first and second amplified voltage signals. A differential output stage is coupled to the second amplification stage for receiving the first and second amplified voltage signals and providing a pair of outputs from each of the first and second amplified voltage signals. Read out circuitry has an input coupled to receive both of the pair of outputs, the read out circuitry having structure for processing each of the pair of outputs, and providing a single digital output having a time-stamp therefrom.

Radiation detection system

DOEpatents

Riedel, Richard A [Knoxville, TN; Wintenberg, Alan L [Knoxville, TN; Clonts, Lloyd G [Knoxville, TN; Cooper, Ronald G [Oak Ridge, TN

2012-02-14

A preamplifier circuit for processing a signal provided by a radiation detector includes a transimpedance amplifier coupled to receive a current signal from a detector and generate a voltage signal at its output. A second amplification stage has an input coupled to an output of the transimpedance amplifier for providing an amplified voltage signal. Detector electronics include a preamplifier circuit having a first and second transimpedance amplifier coupled to receive a current signal from a first and second location on a detector, respectively, and generate a first and second voltage signal at respective outputs. A second amplification stage has an input coupled to an output of the transimpedance amplifiers for amplifying the first and said second voltage signals to provide first and second amplified voltage signals. A differential output stage is coupled to the second amplification stage for receiving the first and second amplified voltage signals and providing a pair of outputs from each of the first and second amplified voltage signals. Read out circuitry has an input coupled to receive both of the pair of outputs, the read out circuitry having structure for processing each of the pair of outputs, and providing a single digital output having a time-stamp therefrom.

Ionospheric Tomography Using Faraday Rotation of Automatic Dependant Surveillance Broadcast UHF Signals

NASA Astrophysics Data System (ADS)

Cushley, A. C.

2013-12-01

The proposed launch of a satellite carrying the first space-borne ADS-B receiver by the Royal Military College of Canada (RMCC) will create a unique opportunity to study the modification of the 1090 MHz radio waves following propagation through the ionosphere from the transmitting aircraft to the passive satellite receiver(s). Experimental work successfully demonstrated that ADS-B data can be used to reconstruct two dimensional (2D) electron density maps of the ionosphere using computerized tomography (CT). The goal of this work is to evaluate the feasibility of CT reconstruction. The data is modelled using Ray-tracing techniques. This allows us to determine the characteristics of individual waves, including the wave path and the state of polarization at the satellite receiver. The modelled Faraday rotation (FR) is determined and converted to total electron content (TEC) along the ray-paths. The resulting TEC is used as input for computerized ionospheric tomography (CIT) using algebraic reconstruction technique (ART). This study concentrated on meso-scale structures 100-1000 km in horizontal extent. The primary scientific interest of this thesis was to show the feasibility of a new method to image the ionosphere and obtain a better understanding of magneto-ionic wave propagation. Multiple feature input electron density profile to ray-tracing program. Top: reconstructed relative electron density map of ray-trace input (Fig. 1) using TEC measurements and line-of-sight path. Bottom: reconstructed electron density map of ray-trace input using quiet background a priori estimate.

Effect of Fixed Versus Adjusted Transcutaneous Electrical Nerve Stimulation Amplitude on Chronic Mechanical Low Back Pain.

PubMed

Elserty, Noha; Kattabei, Omaima; Elhafez, Hytham

2016-07-01

This study aimed to investigate the effect of adjusting pulse amplitude of transcutaneous electrical nerve stimulation versus fixed pulse amplitude in treatment of chronic mechanical low back pain. Randomized clinical trial. El-sahel Teaching Hospital, Egypt. Forty-five patients with chronic low back pain assigned to three equal groups. Their ages ranged from 20 to 50 years. The three groups received the same exercise program. Group A received transcutaneous electrical nerve stimulation with fixed pulse amplitude for 40 minutes. Group B received transcutaneous electrical nerve stimulation with adjusted pulse amplitude for 40 minutes, with the pulse amplitude adjusted every 5 minutes. Group C received exercises only. Treatment sessions were applied three times per week for 4 weeks for the three groups. A visual analogue scale was used to assess pain severity, the Oswestry Disability Index was used to assess functional level, and a dual inclinometer was used to measure lumbar range of motion. Evaluations were performed before and after treatment. Visual analogue scale, Oswestry Disability Index, and back range of motion significantly differed between the two groups that received transcutaneous electrical nerve stimulation and the control group and did not significantly differ between fixed and adjusted pulse amplitude of transcutaneous electrical nerve stimulation. Adjusting pulse amplitude of transcutaneous electrical nerve stimulation does not produce a difference in the effect of transcutaneous electrical nerve stimulation used to treat chronic low back pain.

The Impact of Input Quality on Early Sign Development in Native and Non-Native Language Learners

ERIC Educational Resources Information Center

Lu, Jenny; Jones, Anna; Morgan, Gary

2016-01-01

There is debate about how input variation influences child language. Most deaf children are exposed to a sign language from their non-fluent hearing parents and experience a delay in exposure to accessible language. A small number of children receive language input from their deaf parents who are fluent signers. Thus it is possible to document the…

Wide bandgap matrix switcher, amplifier and oscillator

DOEpatents

Sampayan, Stephen

2016-08-16

An electronic device comprising an optical gate, an electrical input an electrical output and a wide bandgap material positioned between the electrical input and the electrical output to control an amount of current flowing between the electrical input and the electrical output in response to a stimulus received at the optical gate can be used in wideband telecommunication applications in transmission of multi-channel signals.

Grassland biodiversity bounces back from long-term nitrogen addition

NASA Astrophysics Data System (ADS)

Storkey, J.; MacDonald, A. J.; Poulton, P. R.; Scott, T.; Köhler, I. H.; Schnyder, H.; Goulding, K. W. T.; Crawley, M. J.

2015-12-01

The negative effect of increasing atmospheric nitrogen (N) pollution on grassland biodiversity is now incontrovertible. However, the recent introduction of cleaner technologies in the UK has led to reductions in the emissions of nitrogen oxides, with concomitant decreases in N deposition. The degree to which grassland biodiversity can be expected to ‘bounce back’ in response to these improvements in air quality is uncertain, with a suggestion that long-term chronic N addition may lead to an alternative low biodiversity state. Here we present evidence from the 160-year-old Park Grass Experiment at Rothamsted Research, UK, that shows a positive response of biodiversity to reducing N addition from either atmospheric pollution or fertilizers. The proportion of legumes, species richness and diversity increased across the experiment between 1991 and 2012 as both wet and dry N deposition declined. Plots that stopped receiving inorganic N fertilizer in 1989 recovered much of the diversity that had been lost, especially if limed. There was no evidence that chronic N addition has resulted in an alternative low biodiversity state on the Park Grass plots, except where there has been extreme acidification, although it is likely that the recovery of plant communities has been facilitated by the twice-yearly mowing and removal of biomass. This may also explain why a comparable response of plant communities to reduced N inputs has yet to be observed in the wider landscape.

Grassland biodiversity bounces back from long-term nitrogen addition.

PubMed

Storkey, J; Macdonald, A J; Poulton, P R; Scott, T; Köhler, I H; Schnyder, H; Goulding, K W T; Crawley, M J

2015-12-17

The negative effect of increasing atmospheric nitrogen (N) pollution on grassland biodiversity is now incontrovertible. However, the recent introduction of cleaner technologies in the UK has led to reductions in the emissions of nitrogen oxides, with concomitant decreases in N deposition. The degree to which grassland biodiversity can be expected to 'bounce back' in response to these improvements in air quality is uncertain, with a suggestion that long-term chronic N addition may lead to an alternative low biodiversity state. Here we present evidence from the 160-year-old Park Grass Experiment at Rothamsted Research, UK, that shows a positive response of biodiversity to reducing N addition from either atmospheric pollution or fertilizers. The proportion of legumes, species richness and diversity increased across the experiment between 1991 and 2012 as both wet and dry N deposition declined. Plots that stopped receiving inorganic N fertilizer in 1989 recovered much of the diversity that had been lost, especially if limed. There was no evidence that chronic N addition has resulted in an alternative low biodiversity state on the Park Grass plots, except where there has been extreme acidification, although it is likely that the recovery of plant communities has been facilitated by the twice-yearly mowing and removal of biomass. This may also explain why a comparable response of plant communities to reduced N inputs has yet to be observed in the wider landscape.

Improved noise-adding radiometer for microwave receivers

NASA Technical Reports Server (NTRS)

Batelaan, P. D.; Stelzried, C. T.; Goldstein, R. M.

1973-01-01

Use of input switch and noise reference standard is avoided by using noise-adding technique. Excess noise from solid state noise-diode is coupled into receiver through directional coupler and square-wave modulated at low rate. High sensitivity receivers for radioastronomy applications are utilized with greater confidence in stability of radiometer.

Data compression/error correction digital test system. Appendix 3: Maintenance. Book 2: Receiver assembly drawings

NASA Technical Reports Server (NTRS)

1972-01-01

The assembly drawings of the receiver unit are presented for the data compression/error correction digital test system. Equipment specifications are given for the various receiver parts, including the TV input buffer register, delta demodulator, TV sync generator, memory devices, and data storage devices.

Viscerosensory input drives angiotensin II type 1A receptor-expressing neurons in the solitary tract nucleus.

PubMed

Carter, D A; Guo, H; Connelly, A A; Bassi, J K; Fong, A Y; Allen, A M; McDougall, S J

2018-02-01

Homeostatic regulation of visceral organ function requires integrated processing of neural and neurohormonal sensory signals. The nucleus of the solitary tract (NTS) is the primary sensory nucleus for cranial visceral sensory afferents. Angiotensin II (ANG II) is known to modulate peripheral visceral reflexes, in part, by activating ANG II type 1A receptors (AT 1A R) in the NTS. AT 1A R-expressing NTS neurons occur throughout the NTS with a defined subnuclear distribution, and most of these neurons are depolarized by ANG II. In this study we determined whether AT 1A R-expressing NTS neurons receive direct visceral sensory input, and whether this input is modulated by ANG II. Using AT 1A R-GFP mice to make targeted whole cell recordings from AT 1A R-expressing NTS neurons, we demonstrate that two-thirds (37 of 56) of AT 1A R-expressing neurons receive direct excitatory, visceral sensory input. In half of the neurons tested (4 of 8) the excitatory visceral sensory input was significantly reduced by application of the transient receptor potential vallinoid type 1 receptor agonist, capsaicin, indicating AT 1A R-expressing neurons can receive either C- or A-fiber-mediated input. Application of ANG II to a subset of second-order AT 1A R-expressing neurons did not affect spontaneous, evoked, or asynchronous glutamate release from visceral sensory afferents. Thus it is unlikely that AT 1A R-expressing viscerosensory neurons terminate on AT 1A R-expressing NTS neurons. Our data suggest that ANG II is likely to modulate multiple visceral sensory modalities by altering the excitability of second-order AT 1A R-expressing NTS neurons.

Real Time Calibration Method for Signal Conditioning Amplifiers

NASA Technical Reports Server (NTRS)

Medelius, Pedro J. (Inventor); Mata, Carlos T. (Inventor); Eckhoff, Anthony (Inventor); Perotti, Jose (Inventor); Lucena, Angel (Inventor)

2004-01-01

A signal conditioning amplifier receives an input signal from an input such as a transducer. The signal is amplified and processed through an analog to digital converter and sent to a processor. The processor estimates the input signal provided by the transducer to the amplifier via a multiplexer. The estimated input signal is provided as a calibration voltage to the amplifier immediately following the receipt of the amplified input signal. The calibration voltage is amplified by the amplifier and provided to the processor as an amplified calibration voltage. The amplified calibration voltage is compared to the amplified input signal, and if a significant error exists, the gain and/or offset of the amplifier may be adjusted as necessary.

Comorbid condition care quality in cancer survivors: role of primary care and specialty providers and care coordination.

PubMed

Snyder, Claire F; Frick, Kevin D; Herbert, Robert J; Blackford, Amanda L; Neville, Bridget A; Lemke, Klaus W; Carducci, Michael A; Wolff, Antonio C; Earle, Craig C

2015-12-01

The purpose of this study is to investigate provider specialty, care coordination, and cancer survivors' comorbid condition care. This retrospective cross-sectional Surveillance, Epidemiology, and End Results (SEER)-Medicare study included cancer survivors diagnosed in 2004, 2-3 years post-cancer diagnosis, in fee-for-service Medicare. We examined (1) provider specialties (primary care providers (PCPs), oncology specialists, other specialists) visited post-hospitalization, (2) role of provider specialties in chronic and acute condition management, and (3) an ambulatory care coordination measure. Outcome measures covered (1) visits post-hospitalization for nine conditions, (2) chronic disease management (lipid profile, diabetic eye exam, diabetic monitoring), and (3) acute condition management (electrocardiogram (EKG) for congestive heart failure (CHF), imaging for CHF, EKG for transient ischemic attack, cholecystectomy, hip fracture repair). Among 8661 cancer survivors, patients were more likely to visit PCPs than oncologists or other specialists following hospitalizations for 8/9 conditions. Patients visiting a PCP (vs. not) were more likely to receive recommended care for 3/3 chronic and 1/5 acute condition indicators. Patients visiting a nother specialist (vs. not) were more likely to receive recommended care for 3/3 chronic and 2/5 acute condition indicators. Patients visiting an oncology specialist (vs. not) were more likely to receive recommended care on 2/3 chronic indicators and less likely to receive recommended care on 1/5 acute indicators. Patients at greatest risk for poor coordination were more likely to receive appropriate care on 4/6 indicators. PCPs are central to cancer survivors' non-cancer comorbid condition care quality. Implications for Cancer Survivors PCP involvement in cancer survivors' care should be promoted.

Method and apparatus for automatic control of a humanoid robot

NASA Technical Reports Server (NTRS)

Abdallah, Muhammad E (Inventor); Platt, Robert (Inventor); Wampler, II, Charles W. (Inventor); Sanders, Adam M (Inventor); Reiland, Matthew J (Inventor)

2013-01-01

A robotic system includes a humanoid robot having a plurality of joints adapted for force control with respect to an object acted upon by the robot, a graphical user interface (GUI) for receiving an input signal from a user, and a controller. The GUI provides the user with intuitive programming access to the controller. The controller controls the joints using an impedance-based control framework, which provides object level, end-effector level, and/or joint space-level control of the robot in response to the input signal. A method for controlling the robotic system includes receiving the input signal via the GUI, e.g., a desired force, and then processing the input signal using a host machine to control the joints via an impedance-based control framework. The framework provides object level, end-effector level, and/or joint space-level control of the robot, and allows for functional-based GUI to simplify implementation of a myriad of operating modes.

The area centralis in the chicken retina contains efferent target amacrine cells

PubMed Central

Weller, Cynthia; Lindstrom, Sarah H.; De Grip, Willem J.; Wilson, Martin

2012-01-01

The retinas of birds receive a substantial efferent, or centrifugal, input from a midbrain nucleus. The function of this input is presently unclear but previous work in the pigeon has shown that efferent input is excluded from the area centralis, suggesting that the functions of the area centralis and the efferent system are incompatible. Using an antibody specific to rods, we have identified the area centralis in another species, the chicken, and mapped the distribution of the unique amacrine cells that are the postsynaptic partners of efferent fibers. Efferent target amacrine cells are found within the chicken area centralis and their density is continuous across the border of the area centralis. In contrast to the pigeon retina then, we conclude that the chicken area centralis receives efferent input. We suggest that the difference between the 2 species is attributable to the presence of a fovea within the area centralis of the pigeon and its absence from that of the chicken. PMID:19296862

Knowledge of hypertension and its management among hypertensive patients on chronic medicines at primary health care public sector facilities in South Africa; findings and implications.

PubMed

Rampamba, Enos M; Meyer, Johanna C; Helberg, Elvera; Godman, Brian

2017-08-01

There are high growing prevalence rates of hypertension in South Africa. Consequently, there is a need to assess knowledge and management among hypertensive patients receiving chronic medication from primary health care (PHC) facilities in South Africa as a basis for improving future management. This is important as South Africa seeks to improve its management of chronic diseases. Descriptive, quantitative study amongst chronic hypertensive patients in the chronic disease programme. Patients were interviewed face-to-face by trained pharmacists using a structured questionnaire. Data analysis included descriptive and inferential statistics. Half (53.7%) of the patients had uncontrolled blood pressure (BP). Less than a third of patients (27.7%) knew what hypertension is, the meaning of recorded BP numbers (4.5%), and what normal BP should be (19.9%). All patients who knew the meaning of BP numbers had formal education (p = 0.047). Only 15.6% of the 56.0% patients, who received hypertension information, received it on antihypertensive medicines specifically. The majority of the patients lacked hypertension specific knowledge and only half had controlled BP. Interventions to improve the control of high BP should be targeted at closing knowledge gaps as part of the current chronic treatment initiatives in South Africa to ensure the benefits of increased access to care are realized.

Communication about chronic critical illness.

PubMed

Nelson, Judith E; Mercado, Alice F; Camhi, Sharon L; Tandon, Nidhi; Wallenstein, Sylvan; August, Gary I; Morrison, R Sean

2007-12-10

Despite poor outcomes, life-sustaining treatments including mechanical ventilation are continued for a large and growing population of patients with chronic critical illness. This may be owing in part to a lack of understanding resulting from inadequate communication between clinicians and patients and families. Our objective was to investigate the informational needs of patients with chronic critical illness and their families and the extent to which these needs are met. In this prospective observational study conducted at 5 adult intensive care units in a large, university-affiliated hospital in New York, New York, 100 patients with chronic critical illness (within 3-7 days of elective tracheotomy for prolonged mechanical ventilation) or surrogates for incapacitated patients were surveyed using an 18-item questionnaire addressing communication about chronic critical illness. Main outcome measures included ratings of importance and reports of whether information was received about questionnaire items. Among 125 consecutive, eligible patients, 100 (80%) were enrolled; questionnaire respondents included 2 patients and 98 surrogates. For all items, more than 78% of respondents rated the information as important for decision making (>98% for 16 of 18 items). Respondents reported receiving no information for a mean (SD) of 9.0 (3.3) of 18 items, with 95% of respondents reporting not receiving information for approximately one-quarter of the items. Of the subjects rating the item as important, 77 of 96 (80%) and 69 of 74 (93%) reported receiving no information about expected functional status at hospital discharge and prognosis for 1-year survival, respectively. Many patients and their families may lack important information for decision making about continuation of treatment in the chronic phase of critical illness. Strategies for effective communication in this clinical context should be investigated and implemented.

Pregabalin for the Treatment of Men With Chronic Prostatitis/Chronic Pelvic Pain Syndrome

PubMed Central

Pontari, Michel A.; Krieger, John N.; Litwin, Mark S.; White, Paige C.; Anderson, Rodney U.; McNaughton-Collins, Mary; Nickel, J. Curtis; Shoskes, Daniel A.; Alexander, Richard B.; O'Leary, Michael; Zeitlin, Scott; Chuai, Shannon; Landis, J. Richard; Cen, Liyi; Propert, Kathleen J.; Kusek, John W.; Nyberg, Leroy M.; Schaeffer, Anthony J.

2013-01-01

Background Evidence suggests that the urogenital pain of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) may be neuropathic. Methods This randomized, double-blind, placebo-controlled trial was conducted across 10 tertiary care centers in North America to determine whether pregabalin, which has been proved effective in other chronic pain syndromes, is effective in reducing CP/CPPS symptoms. In 2006–2007, 324 men with pelvic pain for at least 3 of the previous 6 months were enrolled in this study. Men were randomly assigned to receive pregabalin or placebo in a 2:1 ratio and were treated for 6 weeks. Pregabalin dosage was increased from 150 to 600 mg/d during the first 4 weeks. The primary outcome was a 6-point decrease in the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) total score. Multiple secondary outcomes were assessed. Results Of 218 men assigned to receive pregabalin, 103 (47.2%) reported at least a 6-point decrease in the NIHCPSI total score at 6 weeks compared with 35.8% (38 of 106 men) assigned to receive placebo (P = .07, exact Mantel-Haenszel test, adjusting for clinical sites). Compared with the placebo group, men assigned to receive pregabalin experienced reductions in the NIH-CPSI total score and sub-scores (P < .05), a higher Global Response Assessment response rate (31.2% and 18.9%; P = .02), and improvement in total McGill Pain Questionnaire score (P = .01). Results for the other outcomes did not differ between groups. Conclusion Pregabalin therapy for 6 weeks was not superior to placebo use in the rate of a 6-point decrease (improvement) in the NIH-CPSI total score in men with CP/CPPS. Trial Registration clinicaltrials.gov Identifier: NCT00371033 PMID:20876412

Communication About Chronic Critical Illness

PubMed Central

Nelson, Judith E.; Mercado, Alice F.; Camhi, Sharon L.; Tandon, Nidhi; Wallenstein, Sylvan; August, Gary I.; Morrison, R. Sean

2008-01-01

Background Despite poor outcomes, life-sustaining treatments including mechanical ventilation are continued for a large and growing population of patients with chronic critical illness. This may be owing in part to a lack of understanding resulting from inadequate communication between clinicians and patients and families. Our objective was to investigate the informational needs of patients with chronic critical illness and their families and the extent to which these needs are met. Methods In this prospective observational study conducted at 5 adult intensive care units in a large, university-affiliated hospital in New York, New York, 100 patients with chronic critical illness (within 3–7 days of elective tracheotomy for prolonged mechanical ventilation) or surrogates for incapacitated patients were surveyed using an 18-item questionnaire addressing communication about chronic critical illness. Main outcome measures included ratings of importance and reports of whether information was received about questionnaire items. Results Among 125 consecutive, eligible patients, 100 (80%) were enrolled; questionnaire respondents included 2 patients and 98 surrogates. For all items, more than 78% of respondents rated the information as important for decision making (>98% for 16 of 18 items). Respondents reported receiving no information for a mean (SD) of 9.0 (3.3) of 18 items, with 95% of respondents reporting not receiving information for approximately one-quarter of the items. Of the subjects rating the item as important, 77 of 96 (80%) and 69 of 74 (93%) reported receiving no information about expected functional status at hospital discharge and prognosis for 1-year survival, respectively. Conclusions Many patients and their families may lack important information for decision making about continuation of treatment in the chronic phase of critical illness. Strategies for effective communication in this clinical context should be investigated and implemented. PMID:18071175

PAlliative Care in chronic Kidney diSease: the PACKS study--quality of life, decision making, costs and impact on carers in people managed without dialysis.

PubMed

Noble, Helen Rose; Agus, Ashley; Brazil, Kevin; Burns, Aine; Goodfellow, Nicola A; Guiney, Mary; McCourt, Fiona; McDowell, Cliona; Normand, Charles; Roderick, Paul; Thompson, Colin; Maxwell, A P; Yaqoob, M M

2015-07-11

The number of patients with advanced chronic kidney disease opting for conservative management rather than dialysis is unknown but likely to be growing as increasingly frail patients with advanced renal disease present to renal services. Conservative kidney management includes ongoing medical input and support from a multidisciplinary team. There is limited evidence concerning patient and carer experience of this choice. This study will explore quality of life, symptoms, cognition, frailty, performance decision making, costs and impact on carers in people with advanced chronic kidney disease managed without dialysis and is funded by the National Institute of Health Research in the UK. In this prospective, multicentre, longitudinal study, patients will be recruited in the UK, by renal research nurses, once they have made the decision not to embark on dialysis. Carers will be asked to 'opt-in' with consent from patients. The approach includes longitudinal quantitative surveys of quality of life, symptoms, decision making and costs for patients and quality of life and costs for carers, with questionnaires administered quarterly over 12 months. Additionally, the decision making process will be explored via qualitative interviews with renal physicians/clinical nurse specialists. The study is designed to capture patient and carer profiles when conservative kidney management is implemented, and understand trajectories of care-receiving and care-giving with the aim of optimising palliative care for this population. It will explore the interactions that lead to clinical care decisions and the impact of these decisions on informal carers with the intention of improving clinical outcomes for patients and the experiences of care givers.

How smartphones are changing the face of mobile and participatory healthcare: an overview, with example from eCAALYX.

PubMed

Boulos, Maged N Kamel; Wheeler, Steve; Tavares, Carlos; Jones, Ray

2011-04-05

The latest generation of smartphones are increasingly viewed as handheld computers rather than as phones, due to their powerful on-board computing capability, capacious memories, large screens and open operating systems that encourage application development. This paper provides a brief state-of-the-art overview of health and healthcare smartphone apps (applications) on the market today, including emerging trends and market uptake. Platforms available today include Android, Apple iOS, RIM BlackBerry, Symbian, and Windows (Windows Mobile 6.x and the emerging Windows Phone 7 platform). The paper covers apps targeting both laypersons/patients and healthcare professionals in various scenarios, e.g., health, fitness and lifestyle education and management apps; ambient assisted living apps; continuing professional education tools; and apps for public health surveillance. Among the surveyed apps are those assisting in chronic disease management, whether as standalone apps or part of a BAN (Body Area Network) and remote server configuration. We describe in detail the development of a smartphone app within eCAALYX (Enhanced Complete Ambient Assisted Living Experiment, 2009-2012), an EU-funded project for older people with multiple chronic conditions. The eCAALYX Android smartphone app receives input from a BAN (a patient-wearable smart garment with wireless health sensors) and the GPS (Global Positioning System) location sensor in the smartphone, and communicates over the Internet with a remote server accessible by healthcare professionals who are in charge of the remote monitoring and management of the older patient with multiple chronic conditions. Finally, we briefly discuss barriers to adoption of health and healthcare smartphone apps (e.g., cost, network bandwidth and battery power efficiency, usability, privacy issues, etc.), as well as some workarounds to mitigate those barriers.

How smartphones are changing the face of mobile and participatory healthcare: an overview, with example from eCAALYX

PubMed Central

2011-01-01

The latest generation of smartphones are increasingly viewed as handheld computers rather than as phones, due to their powerful on-board computing capability, capacious memories, large screens and open operating systems that encourage application development. This paper provides a brief state-of-the-art overview of health and healthcare smartphone apps (applications) on the market today, including emerging trends and market uptake. Platforms available today include Android, Apple iOS, RIM BlackBerry, Symbian, and Windows (Windows Mobile 6.x and the emerging Windows Phone 7 platform). The paper covers apps targeting both laypersons/patients and healthcare professionals in various scenarios, e.g., health, fitness and lifestyle education and management apps; ambient assisted living apps; continuing professional education tools; and apps for public health surveillance. Among the surveyed apps are those assisting in chronic disease management, whether as standalone apps or part of a BAN (Body Area Network) and remote server configuration. We describe in detail the development of a smartphone app within eCAALYX (Enhanced Complete Ambient Assisted Living Experiment, 2009-2012), an EU-funded project for older people with multiple chronic conditions. The eCAALYX Android smartphone app receives input from a BAN (a patient-wearable smart garment with wireless health sensors) and the GPS (Global Positioning System) location sensor in the smartphone, and communicates over the Internet with a remote server accessible by healthcare professionals who are in charge of the remote monitoring and management of the older patient with multiple chronic conditions. Finally, we briefly discuss barriers to adoption of health and healthcare smartphone apps (e.g., cost, network bandwidth and battery power efficiency, usability, privacy issues, etc.), as well as some workarounds to mitigate those barriers. PMID:21466669

Multi-input and binary reproducible, high bandwidth floating point adder in a collective network

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

Chen, Dong; Eisley, Noel A; Heidelberger, Philip

To add floating point numbers in a parallel computing system, a collective logic device receives the floating point numbers from computing nodes. The collective logic devices converts the floating point numbers to integer numbers. The collective logic device adds the integer numbers and generating a summation of the integer numbers. The collective logic device converts the summation to a floating point number. The collective logic device performs the receiving, the converting the floating point numbers, the adding, the generating and the converting the summation in one pass. One pass indicates that the computing nodes send inputs only once to themore » collective logic device and receive outputs only once from the collective logic device.« less

Advanced capability RFID system

DOEpatents

Gilbert, Ronald W.; Steele, Kerry D.; Anderson, Gordon A.

2007-09-25

A radio-frequency transponder device having an antenna circuit configured to receive radio-frequency signals and to return modulated radio-frequency signals via continuous wave backscatter, a modulation circuit coupled to the antenna circuit for generating the modulated radio-frequency signals, and a microprocessor coupled to the antenna circuit and the modulation circuit and configured to receive and extract operating power from the received radio-frequency signals and to monitor inputs on at least one input pin and to generate responsive signals to the modulation circuit for modulating the radio-frequency signals. The microprocessor can be configured to generate output signals on output pins to associated devices for controlling the operation thereof. Electrical energy can be extracted and stored in an optional electrical power storage device.

Standing postural reaction to visual and proprioceptive stimulation in chronic acquired demyelinating polyneuropathy.

PubMed

Provost, Clement P; Tasseel-Ponche, Sophie; Lozeron, Pierre; Piccinini, Giulia; Quintaine, Victorine; Arnulf, Bertrand; Kubis, Nathalie; Yelnik, Alain P

2018-02-28

To investigate the weight of visual and proprioceptive inputs, measured indirectly in standing position control, in patients with chronic acquired demyelinating polyneuropathy (CADP). Prospective case study. Twenty-five patients with CADP and 25 healthy controls. Posture was recorded on a double force platform. Stimulations were optokinetic (60°/s) for visual input and vibration (50 Hz) for proprioceptive input. Visual stimulation involved 4 tests (upward, downward, rightward and leftward) and proprioceptive stimulation 2 tests (triceps surae and tibialis anterior). A composite score, previously published and slightly modified, was used for the recorded postural signals from the different stimulations. Despite their sensitivity deficits, patients with CADP were more sensitive to proprioceptive stimuli than were healthy controls (mean composite score 13.9 ((standard deviation; SD) 4.8) vs 18.4 (SD 4.8), p = 0.002). As expected, they were also more sensitive to visual stimuli (mean composite score 10.5 (SD 8.7) vs 22.9 (SD 7.5), p <0.0001). These results encourage balance rehabilitation of patients with CADP, aimed at promoting the use of proprioceptive information, thereby reducing too-early development of visual compensation while proprioception is still available.

Information encoder/decoder using chaotic systems

DOEpatents

Miller, Samuel Lee; Miller, William Michael; McWhorter, Paul Jackson

1997-01-01

The present invention discloses a chaotic system-based information encoder and decoder that operates according to a relationship defining a chaotic system. Encoder input signals modify the dynamics of the chaotic system comprising the encoder. The modifications result in chaotic, encoder output signals that contain the encoder input signals encoded within them. The encoder output signals are then capable of secure transmissions using conventional transmission techniques. A decoder receives the encoder output signals (i.e., decoder input signals) and inverts the dynamics of the encoding system to directly reconstruct the original encoder input signals.

Information encoder/decoder using chaotic systems

DOEpatents

Miller, S.L.; Miller, W.M.; McWhorter, P.J.

1997-10-21

The present invention discloses a chaotic system-based information encoder and decoder that operates according to a relationship defining a chaotic system. Encoder input signals modify the dynamics of the chaotic system comprising the encoder. The modifications result in chaotic, encoder output signals that contain the encoder input signals encoded within them. The encoder output signals are then capable of secure transmissions using conventional transmission techniques. A decoder receives the encoder output signals (i.e., decoder input signals) and inverts the dynamics of the encoding system to directly reconstruct the original encoder input signals. 32 figs.

Device and method to enhance availability of cluster-based processing systems

NASA Technical Reports Server (NTRS)

Lupia, David J. (Inventor); Ramos, Jeremy (Inventor); Samson, Jr., John R. (Inventor)

2010-01-01

An electronic computing device including at least one processing unit that implements a specific fault signal upon experiencing an associated fault, a control unit that generates a specific recovery signal upon receiving the fault signal from the at least one processing unit, and at least one input memory unit. The recovery signal initiates specific recovery processes in the at least one processing unit. The input memory buffers input data signals input to the at least one processing unit that experienced the fault during the recovery period.

Remote media vision-based computer input device

NASA Astrophysics Data System (ADS)

Arabnia, Hamid R.; Chen, Ching-Yi

1991-11-01

In this paper, we introduce a vision-based computer input device which has been built at the University of Georgia. The user of this system gives commands to the computer without touching any physical device. The system receives input through a CCD camera; it is PC- based and is built on top of the DOS operating system. The major components of the input device are: a monitor, an image capturing board, a CCD camera, and some software (developed by use). These are interfaced with a standard PC running under the DOS operating system.

Method of fuzzy inference for one class of MISO-structure systems with non-singleton inputs

NASA Astrophysics Data System (ADS)

Sinuk, V. G.; Panchenko, M. V.

2018-03-01

In fuzzy modeling, the inputs of the simulated systems can receive both crisp values and non-Singleton. Computational complexity of fuzzy inference with fuzzy non-Singleton inputs corresponds to an exponential. This paper describes a new method of inference, based on the theorem of decomposition of a multidimensional fuzzy implication and a fuzzy truth value. This method is considered for fuzzy inputs and has a polynomial complexity, which makes it possible to use it for modeling large-dimensional MISO-structure systems.

The effectiveness of Cognitive Behavioral Therapy (CBT) with general exercises versus general exercises alone in the management of chronic low back pain.

PubMed

Khan, Muhammad; Akhter, Saeed; Soomro, Rabail Rani; Ali, Syed Shahzad

2014-07-01

To evaluate the effectiveness of Cognitive Behavioural Therapy (CBT) along with General exercises and General exercises alone in chronic low back pain. Total 54 patients with chronic low back pain who fulfilled inclusion criteria were recruited from Physiotherapy, Department of Alain Poly Clinic Karachi and Institute of Physical Medicine & Rehabilitation Dow University of Health Sciences Karachi. Selected patients were equally divided and randomly assigned into two groups with simple randomisation method. The Cognitive Behavioural Therapy (CBT) and General exercises group received Operant model of CBT and General Exercises whereas General exercises group received General exercises only. Both groups received a home exercise program as well. Patients in both groups received 3 treatment sessions per week for 12 consecutive weeks. Clinical assessment was performed using Visual Analogue Scale (VAS) and Ronald Morris Disability Questionnaire at baseline and after 12 weeks. Both study groups showed statistically significant improvements in both outcomes measures p=0.000. However, mean improvements in post intervention VAS score and Ronald Morris score was better in CBT and exercises group as compared to General exercise group. In conclusion, both interventions are effective in treating chronic low back pain however; CBT & General exercises are clinically more effective than General exercises alone.

Thoracic 9 Spinal Transection-Induced Model of Muscle Spasticity in the Rat: A Systematic Electrophysiological and Histopathological Characterization

PubMed Central

Corleto, Jose A.; Bravo-Hernández, Mariana; Kamizato, Kota; Kakinohana, Osamu; Santucci, Camila; Navarro, Michael R.; Platoshyn, Oleksandr; Cizkova, Dasa; Lukacova, Nadezda; Taylor, Julian; Marsala, Martin

2015-01-01

The development of spinal hyper-reflexia as part of the spasticity syndrome represents one of the major complications associated with chronic spinal traumatic injury (SCI). The primary mechanism leading to progressive appearance of muscle spasticity is multimodal and may include loss of descending inhibitory tone, alteration of segmental interneuron-mediated inhibition and/or increased reflex activity to sensory input. Here, we characterized a chronic thoracic (Th 9) complete transection model of muscle spasticity in Sprague-Dawley (SD) rats. Isoflurane-anesthetized rats received a Th9 laminectomy and the spinal cord was transected using a scalpel blade. After the transection the presence of muscle spasticity quantified as stretch and cutaneous hyper-reflexia was identified and quantified as time-dependent changes in: i) ankle-rotation-evoked peripheral muscle resistance (PMR) and corresponding electromyography (EMG) activity, ii) Hoffmann reflex, and iii) EMG responses in gastrocnemius muscle after paw tactile stimulation for up to 8 months after injury. To validate the clinical relevance of this model, the treatment potency after systemic treatment with the clinically established anti-spastic agents baclofen (GABAB receptor agonist), tizanidine (α2-adrenergic agonist) and NGX424 (AMPA receptor antagonist) was also tested. During the first 3 months post spinal transection, a progressive increase in ankle rotation-evoked muscle resistance, Hoffmann reflex amplitude and increased EMG responses to peripherally applied tactile stimuli were consistently measured. These changes, indicative of the spasticity syndrome, then remained relatively stable for up to 8 months post injury. Systemic treatment with baclofen, tizanidine and NGX424 led to a significant but transient suppression of spinal hyper-reflexia. These data demonstrate that a chronic Th9 spinal transection model in adult SD rat represents a reliable experimental platform to be used in studying the pathophysiology of chronic spinal injury-induced spasticity. In addition a consistent anti-spastic effect measured after treatment with clinically effective anti-spastic agents indicate that this model can effectively be used in screening new anti-spasticity compounds or procedures aimed at modulating chronic spinal trauma-associated muscle spasticity. PMID:26713446

Helping Your Partner with Chronic Pain: The Importance of Helping Motivation, Received Social Support, and Its Timeliness.

PubMed

Kindt, Sara; Vansteenkiste, Maarten; Josephy, Haeike; Bernardes, Sonia F; Goubert, Liesbet

2018-02-02

Like all intentional acts, social support provision varies with respect to its underlying motives. Greater autonomous or volitional motives (e.g., enjoyment, full commitment) to help individuals with chronic pain (ICPs) are associated with greater well-being benefits for the latter, as indexed by improved satisfaction of their psychological needs for autonomy, competence, and relatedness. The present study investigates the processes explaining why partners' autonomous or volitional helping motivation yields these benefits. A total of 134 couples, where at least one partner had chronic pain, completed a 14-day diary. Partners reported on their daily helping motives, whereas ICPs reported on their daily received support, timing of help, need-based experiences, and pain. On days when partners provided help for volitional motives, ICPs indicated receiving more help, which partially accounted for the effect of autonomous helping motivation on ICP need-based experiences. Timing of help moderated the effects of daily received support on ICP need-based experiences. Findings highlight the importance of ICPs of receiving support in general and the role of timing in particular, which especially matters when there is little support being received. © 2018 American Academy of Pain Medicine. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

Responses of aortic depressor nerve-evoked neurones in rat nucleus of the solitary tract to changes in blood pressure

PubMed Central

Zhang, Jing; Mifflin, Steven W

2000-01-01

Using electrophysiological techniques, the discharge of neurones in the nucleus of the solitary tract (NTS) receiving aortic depressor nerve (ADN) inputs was examined during blood pressure changes induced by I.V. phenylephrine or nitroprusside in anaesthetized, paralysed and artificially ventilated rats. Various changes in discharge rate were observed during phenylephrine-induced blood pressure elevations: an increase (n = 38), a decrease (n = 5), an increase followed by a decrease (n = 4) and no response (n = 11). In cells receiving a monosynaptic ADN input (MSNs), the peak discharge frequency response was correlated to the rate of increase in mean arterial pressure (P < 0.01) but was not correlated to the absolute increase in blood pressure. The peak discharge frequency response of cells receiving a polysynaptic ADN input (PSNs) was correlated to neither the absolute increase in blood pressure nor the rate of increase in mean arterial pressure. Diverse changes in discharge rate were observed during nitroprusside-induced reductions in blood pressure: an increase (n = 3), a decrease (n = 10), an increase followed by a decrease (n = 3) and no response (n = 6). Reductions in pressure of 64 ± 2 mmHg produced weak reductions in spontaneous discharge of 1.3 ± 0.9 Hz and only totally abolished spontaneous discharge in one neurone. These response patterns of NTS neurones during changes in arterial pressure suggest that baroreceptor inputs are integrated differently in MSNs compared to PSNs. The sensitivity of MSNs to the rate of change of pressure provides a mechanism for the rapid regulation of cardiovascular function. The lack of sensitivity to the mean level of a pressure increase in both MSNs and PSNs suggests that steady-state changes in pressure are encoded by the number of active neurones and not graded changes in the discharge of individual neurones. Both MSNs and PSNs receive tonic excitatory inputs from the arterial baroreceptors; however, these tonic inputs appear to be insufficient to totally account for their spontaneous discharge. PMID:11101652

Polarimetric receiver in the forty gigahertz band: new instrument for the Q-U-I joint Tenerife experiment

NASA Astrophysics Data System (ADS)

Villa, Enrique; Cano, Juan L.; Aja, Beatriz; Terán, J. Vicente; de la Fuente, Luisa; Mediavilla, Ángel; Artal, Eduardo

2018-03-01

This paper describes the analysis, design and characterization of a polarimetric receiver developed for covering the 35 to 47 GHz frequency band in the new instrument aimed at completing the ground-based Q-U-I Joint Tenerife Experiment. This experiment is designed to measure polarization in the Cosmic Microwave Background. The described high frequency instrument is a HEMT-based array composed of 29 pixels. A thorough analysis of the behaviour of the proposed receiver, based on electronic phase switching, is presented for a noise-like linearly polarized input signal, obtaining simultaneously I, Q and U Stokes parameters of the input signal. Wideband subsystems are designed, assembled and characterized for the polarimeter. Their performances are described showing appropriate results within the 35-to-47 GHz frequency band. Functionality tests are performed at room and cryogenic temperatures with adequate results for both temperature conditions, which validate the receiver concept and performance.

Air Brayton Solar Receiver, phase 2

NASA Technical Reports Server (NTRS)

Deanda, L. E.

1981-01-01

An air Brayton solar receiver (ABSR) is discussed. The ABSR consists of a cylindrical, insulated, offset plate fin heat exchanger which is mounted at the focal plane of a fully tracking parabolic solar collector. The receiver transfer heat from the concentrated solar radiation (which impinges on the inside walls of the heat exchanger) to the working fluid i.e., air. The hot air would then e used to drive a small Brayton cycle heat engine. The engine in turn drives a generator which produces electrical energy. Symmetrical and asymmetrical solar power input into the ABSR are analyzed. The symmetrical cases involve the baseline incident flux and the axially shifted incident fluxes. The asymmetrical cases correspond to the solar fluxes that are obtained by reduced solar input from one half of the concentrator or by receiver offset of plus or minus 1 inch from the concentrator optical axis.

Developmental regulation of inhibitory synaptic currents in the dorsal motor nucleus of the vagus in the rat

PubMed Central

Anselmi, Laura; Travagli, R. Alberto

2016-01-01

Prior immunohistochemical studies have demonstrated that at early postnatal time points, central vagal neurons receive both glycinergic and GABAergic inhibitory inputs. Functional studies have demonstrated, however, that adult vagal efferent motoneurons receive only inhibitory GABAergic synaptic inputs, suggesting loss of glycinergic inhibitory neurotransmission during postnatal development. The purpose of the present study was to test the hypothesis that the loss of glycinergic inhibitory synapses occurs in the immediate postnatal period. Whole cell patch-clamp recordings were made from dorsal motor nucleus of the vagus (DMV) neurons from postnatal days 1–30, and the effects of the GABAA receptor antagonist bicuculline (1–10 μM) and the glycine receptor antagonist strychnine (1 μM) on miniature inhibitory postsynaptic current (mIPSC) properties were examined. While the baseline frequency of mIPSCs was not altered by maturation, perfusion with bicuculline either abolished mIPSCs altogether or decreased mIPSC frequency and decay constant in the majority of neurons at all time points. In contrast, while strychnine had no effect on mIPSC frequency, its actions to increase current decay time declined during postnatal maturation. These data suggest that in early postnatal development, DMV neurons receive both GABAergic and glycinergic synaptic inputs. Glycinergic neurotransmission appears to decline by the second postnatal week, and adult neurons receive principally GABAergic inhibitory inputs. Disruption of this developmental switch from GABA-glycine to purely GABAergic transmission in response to early life events may, therefore, lead to adverse consequences in vagal efferent control of visceral functions. PMID:27440241

Caring for the Chronically Ill: A Vital Subject for Medical Education.

ERIC Educational Resources Information Center

Cohen, Andrew J.

1998-01-01

Patients with chronic illness account for three-fourths of United States' health-care expenditures, and considerable growth in these costs is likely as the population ages. However, management of chronic illness has received little attention in either undergraduate or graduate medical education. Competencies required to develop curricula in…

Religious and Spiritual Beliefs and Practices of Persons with Chronic Pain

ERIC Educational Resources Information Center

Glover-Graf, Noreen M.; Marini, Irmo; Baker, Jeff; Buck, Tina

2007-01-01

Ninety-five persons receiving treatment for chronic pain were surveyed using the Spirituality and Chronic Pain Survey (SCPS). The survey included a pain assessment, a spiritual/religious practices assessment, and questions related to spiritual/religious beliefs and attitudes. Most participants reported experiencing constant, higher-level pain. The…

Acute and Chronic Noradrenergic Effects on Cortical Excitability in Healthy Humans

PubMed Central

Kuo, Hsiao-I; Paulus, Walter; Batsikadze, Giorgi; Jamil, Asif; Kuo, Min-Fang

2017-01-01

Abstract Background Noradrenaline is a major neuromodulator in the central nervous system, and it is involved in the pathophysiology of diverse neuropsychiatric diseases. Previous transcranial magnetic stimulation studies suggested that acute application of selective noradrenaline reuptake inhibitors enhances cortical excitability in the human brain. However, other, such like clinical effects, usually require prolonged noradrenaline reuptake inhibitor treatment, which might go along with different physiological effects. Methods The purpose of this study was to investigate the acute and chronic effects of the selective noradrenaline reuptake inhibitor reboxetine on cortical excitability in healthy humans in a double-blind, placebo-controlled, randomized crossover study. Sixteen subjects were assessed with different transcranial magnetic stimulation measurements: motor thresholds, input-output curve, short-latency intracortical inhibition and intracortical facilitation, I-wave facilitation, and short-interval afferent inhibition before and after placebo or reboxetine (8 mg) single-dose administration. Afterwards, the same subjects took reboxetine (8 mg/d) consecutively for 21 days. During this period (subjects underwent 2 experimental sessions with identical transcranial magnetic stimulation measures under placebo or reboxetine), transcranial magnetic stimulation measurements were assessed before and after drug intake. Results Both single-dose and chronic administration of reboxetine increased cortical excitability; increased the slope of the input-output curve, intracortical facilitation, and I-wave facilitation; but decreased short-latency intracortical inhibition and short-interval afferent inhibition. Moreover, chronic reboxetine showed a larger enhancement of intracortical facilitation and I-wave facilitation compared with single-dose application. Conclusions The results show physiological mechanisms of noradrenergic enhancement possibly underlying the functional effects of reboxetine regarding acute and chronic application. PMID:28430976

OnabotulinumtoxinA Injection

MedlinePlus

... older than 18 years of age with chronic migraine (severe, throbbing headaches that are sometimes accompanied by ... limb spasticity, urinary incontinence, overactive bladder, or chronic migraine, you may receive additional injections every 3 to ...

Computer held chronic disease registers in general practice: a validation study.

PubMed Central

Coulter, A; Brown, S; Daniels, A

1989-01-01

Lists of patients receiving repeat prescriptions for epilepsy, diabetes, thyroid disease and asthma were compared with chronic disease registers stored on seven practice computers. Diabetes was the most accurately recorded disease: the names of 72% of patients receiving medication for this condition appeared on the relevant disease registers. Agreement between the two data sources was 68% for thyroid disease, 58% for asthma and 49% for epilepsy. The levels of accuracy are not yet high enough for the computerised chronic disease registers to provide an accurate estimate of the prevalence of these conditions, but new system developments suggest a more optimistic outlook for the future. PMID:2592887

Development of an Air Brayton solar receiver

NASA Technical Reports Server (NTRS)

1980-01-01

Various receiver configurations and operating conditions were examined. The interface requirements between the receiver/concentrator/power module were addressed. Production cost estimates were obtained to determine the cost of the receiver during the 1980 timeframe. A conceptual design of an air Brayton solar receiver is presented based on the results. The following design goals were established: (1)peak thermal input power - 85 KWt; (2)receiver outlet air temperature - 1500 F; (3)receiver inlet air temperature - 1050 F; (4)design mass flow rate - 0.533 lb/sec; and (5)design receiver inlet pressure - 36.75 psia.

Transfer Function Control for Biometric Monitoring System

NASA Technical Reports Server (NTRS)

Chmiel, Alan J. (Inventor); Grodinsky, Carlos M. (Inventor); Humphreys, Bradley T. (Inventor)

2015-01-01

A modular apparatus for acquiring biometric data may include circuitry operative to receive an input signal indicative of a biometric condition, the circuitry being configured to process the input signal according to a transfer function thereof and to provide a corresponding processed input signal. A controller is configured to provide at least one control signal to the circuitry to programmatically modify the transfer function of the modular system to facilitate acquisition of the biometric data.

2.5 Gbit/s Optical Receiver Front-End Circuit with High Sensitivity and Wide Dynamic Range

NASA Astrophysics Data System (ADS)

Zhu, Tiezhu; Mo, Taishan; Ye, Tianchun

2017-12-01

An optical receiver front-end circuit is designed for passive optical network and fabricated in a 0.18 um CMOS technology. The whole circuit consists of a transimpedance amplifier (TIA), a single-ended to differential amplifier and an output driver. The TIA employs a cascode stage as the input stage and auxiliary amplifier to reduce the miller effect. Current injecting technique is employed to enlarge the input transistor's transconductance, optimize the noise performance and overcome the lack of voltage headroom. To achieve a wide dynamic range, an automatic gain control circuit with self-adaptive function is proposed. Experiment results show an optical sensitivity of -28 dBm for a bit error rate of 10-10 at 2.5 Gbit/s and a maxim input optical power of 2 dBm using an external photodiode. The chip occupies an area of 1×0.9 mm2 and consumes around 30 mW from single 1.8 V supply. The front-end circuit can be used in various optical receivers.

25-Gbit/s burst-mode optical receiver using high-speed avalanche photodiode for 100-Gbit/s optical packet switching.

PubMed

Nada, Masahiro; Nakamura, Makoto; Matsuzaki, Hideaki

2014-01-13

25-Gbit/s error-free operation of an optical receiver is successfully demonstrated against burst-mode optical input signals without preambles. The receiver, with a high-sensitivity avalanche photodiode and burst-mode transimpedance amplifier, exhibits sufficient receiver sensitivity and an extremely quick response suitable for burst-mode operation in 100-Gbit/s optical packet switching.

Chinese Herbal Medicine as an Adjunctive Therapy Ameliorated the Incidence of Chronic Hepatitis in Patients with Breast Cancer: A Nationwide Population-Based Cohort Study.

PubMed

Huang, Kuo-Chin; Yen, Hung-Rong; Chiang, Jen-Huai; Su, Yuan-Chih; Sun, Mao-Feng; Chang, Hen-Hong; Huang, Sheng-Teng

2017-01-01

We conducted a National Health Insurance Research Database-based Taiwanese nationwide population-based cohort study to evaluate whether Chinese herbal medicine (CHM) treatment decreased the incidence of chronic hepatitis in breast cancer patients receiving chemotherapy and/or radiotherapy. A total of 81171 patients were diagnosed with breast cancer within the defined study period. After randomly equal matching, data from 13856 patients were analyzed. Hazard ratios of incidence rate of chronic hepatitis were used to determine the influence and therapeutic potential of CHM in patients with breast cancer. The patients with breast cancer receiving CHM treatment exhibited a significantly decreased incidence rate of chronic hepatitis even across the stratification of age, CCI score, and treatments. The cumulative incidence of chronic hepatitis for a period of seven years after initial breast cancer diagnosis was also reduced in the patients receiving CHM treatment. The ten most commonly used single herbs and formulas were effective in protecting liver function in patients with breast cancer, where Hedyotis diffusa and Jia-Wei-Xiao-Yao-San were the most commonly used herbal agents. In conclusion, our study provided information that western medicine therapy combined with CHM as an adjuvant modality may have a significant impact on liver protection in patients with breast cancer.

Characterization of Synaptically Connected Nuclei in a Potential Sensorimotor Feedback Pathway in the Zebra Finch Song System

PubMed Central

Williams, Shayna M.; Nast, Alexis; Coleman, Melissa J.

2012-01-01

Birdsong is a learned behavior that is controlled by a group of identified nuclei, known collectively as the song system. The cortical nucleus HVC (used as a proper name) is a focal point of many investigations as it is necessary for song production, song learning, and receives selective auditory information. HVC receives input from several sources including the cortical area MMAN (medial magnocellular nucleus of the nidopallium). The MMAN to HVC connection is particularly interesting as it provides potential sensorimotor feedback to HVC. To begin to understand the role of this connection, we investigated the physiological relation between MMAN and HVC activity with simultaneous multiunit extracellular recordings from these two nuclei in urethane anesthetized zebra finches. As previously reported, we found similar timing in spontaneous bursts of activity in MMAN and HVC. Like HVC, MMAN responds to auditory playback of the bird's own song (BOS), but had little response to reversed BOS or conspecific song. Stimulation of MMAN resulted in evoked activity in HVC, indicating functional excitation from MMAN to HVC. However, inactivation of MMAN resulted in no consistent change in auditory responses in HVC. Taken together, these results indicate that MMAN provides functional excitatory input to HVC but does not provide significant auditory input to HVC in anesthetized animals. We hypothesize that MMAN may play a role in motor reinforcement or coordination, or may provide modulatory input to the song system about the internal state of the animal as it receives input from the hypothalamus. PMID:22384172

42 CFR 431.51 - Free choice of providers.

Code of Federal Regulations, 2010 CFR

2010-10-01

... developmental disabilities or with chronic mental illness. This limitation may only be permitted so that the... chronic mental illness are capable of ensuring that those individuals receive needed services. (d...

Chronic Pain: Symptoms, Diagnosis, & Treatment | NIH MedlinePlus the Magazine

MedlinePlus

... pain and how it can be relieved. Although technology can help health professionals form a diagnosis, the best treatment plans are tailored to the person, with input from healthcare team members, who each have different training backgrounds ...

47 CFR 11.33 - EAS Decoder.

Code of Federal Regulations, 2014 CFR

2014-10-01

...: (1) Inputs. Decoders must have the capability to receive at least two audio inputs from EAS... externally, at least two minutes of audio or text messages. A decoder manufactured without an internal means to record and store audio or text must be equipped with a means (such as an audio or digital jack...

47 CFR 11.33 - EAS Decoder.

Code of Federal Regulations, 2013 CFR

2013-10-01

...: (1) Inputs. Decoders must have the capability to receive at least two audio inputs from EAS... externally, at least two minutes of audio or text messages. A decoder manufactured without an internal means to record and store audio or text must be equipped with a means (such as an audio or digital jack...

47 CFR 11.33 - EAS Decoder.

Code of Federal Regulations, 2012 CFR

2012-10-01

...: (1) Inputs. Decoders must have the capability to receive at least two audio inputs from EAS... externally, at least two minutes of audio or text messages. A decoder manufactured without an internal means to record and store audio or text must be equipped with a means (such as an audio or digital jack...

77 FR 14031 - Public Listening Sessions To Obtain Input on the Multi-Stakeholder Group Tasked With the...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-08

... DEPARTMENT OF THE INTERIOR [Docket No. ONRR-2012-0002] Public Listening Sessions To Obtain Input... Transparency Initiative AGENCY: Office of the Secretary, Interior. ACTION: Notice. SUMMARY: The Department of the Interior (Department) announces four public listening sessions to receive comments regarding a...

Methods and systems for positioning micro elements

DOEpatents

Stalford, Harold L

2015-04-28

A micro device may comprise a substrate, a first micro structure coupled to the substrate, a second micro structure coupled to the substrate, and port configured to receive an input. The first micro structure is configured to move into engagement with the second micro structure in response to the input.

The use of Chinese herbal medicine as an adjuvant therapy to reduce incidence of chronic hepatitis in colon cancer patients: A Taiwanese population-based cohort study.

PubMed

Lin, Tsai-Hui; Yen, Hung-Rong; Chiang, Jen-Huai; Sun, Mao-Feng; Chang, Hen-Hong; Huang, Sheng-Teng

2017-04-18

There is a decided lack of in-depth studies to evaluate the effectiveness of Chinese Herbal Medicine (CHM) as an adjuvant therapy on the incidence of chronic hepatitis in patients with colon cancer. The aim of this study is to assess whether CHM treatment decreased the incidence of chronic hepatitis in colon cancer patients who received conventional Western medical treatment. A Taiwanese nationwide population-based study of colon cancer patients receiving Western medicine treatment in conjunction with CHM treatment, using data provided by the National Health Insurance (NHI) Research Database, was conducted. A total of 61676 patients were diagnosed with colon cancer in Taiwan within the defined study period, from 1997 to 2010. After randomly equal matching for age, sex, excluding patients younger than 18 years of age, chronic hepatitis before colon cancer diagnosis date, receiving acupuncture and/or moxibustion and taking CHM for less than 30 days, data from 155 patients were analyzed. Hazard ratios of incidence rate of chronic hepatitis were used to determine the influence of CHM and the therapeutic potential of herbal products in treating patients with colon cancer. CHM used for patients with colon cancer exhibited significantly decreased incidence rates of chronic hepatitis [hazard ratio (HR)=0.53; 95% confidence interval (CI):0.38-0.74], with multivariate adjustment, compared to those without CHM use. The protective effect of CHM treatment with statistical significance across the stratification of age, gender, co-morbidity and treatment modality was noted. The cumulative incidence of chronic hepatitis was also reduced in patients with colon cancer receiving CHM treatment during a five-year period. In this study, we provide the ten most used single herbs and herbal formulas that were prescribed for patients with colon cancer; moreover, we identify the eight single herbs and five formulas used in CHM treatment which significantly decreased incidence of chronic hepatitis among colon cancer patients. This nationwide retrospective cohort study determined that therapy using CHM as an adjuvant modality may have a significant impact on liver protection in patients with colon cancer. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Network interactions: non-geniculate input to V1.

PubMed

Muckli, Lars; Petro, Lucy S

2013-04-01

The strongest connections to V1 are fed back from neighbouring area V2 and from a network of higher cortical areas (e.g. V3, V5, LOC, IPS and A1), transmitting the results of cognitive operations such as prediction, attention and imagination. V1 is therefore at the receiving end of a complex cortical processing cascade and not only at the entrance stage of cortical processing of retinal input. One elegant strategy to investigate this information-rich feedback to V1 is to eliminate feedforward input, that is, exploit V1's retinotopic organisation to isolate subregions receiving no direct bottom-up stimulation. We highlight the diverse mechanisms of cortical feedback, ranging from gain control to predictive coding, and conclude that V1 is involved in rich internal communication processes. Copyright © 2013 Elsevier Ltd. All rights reserved.

Adaptive voting computer system

NASA Technical Reports Server (NTRS)

Koczela, L. J.; Wilgus, D. S. (Inventor)

1974-01-01

A computer system is reported that uses adaptive voting to tolerate failures and operates in a fail-operational, fail-safe manner. Each of four computers is individually connected to one of four external input/output (I/O) busses which interface with external subsystems. Each computer is connected to receive input data and commands from the other three computers and to furnish output data commands to the other three computers. An adaptive control apparatus including a voter-comparator-switch (VCS) is provided for each computer to receive signals from each of the computers and permits adaptive voting among the computers to permit the fail-operational, fail-safe operation.

The Chinese version of the Severe Respiratory Insufficiency questionnaire for patients with chronic hypercapnic chronic obstructive pulmonary disease receiving non-invasive positive pressure ventilation.

PubMed

Chen, Rongchang; Guan, Lili; Wu, Weiliang; Yang, Zhicong; Li, Xiaoying; Luo, Qun; Liang, Zhenyu; Wang, Fengyan; Guo, Bingpeng; Huo, Yating; Yang, Yuqiong; Zhou, Luqian

2017-08-28

The Severe Respiratory Insufficiency (SRI) questionnaire is the best assessment tool for health-related quality of life in patients with chronic obstructive pulmonary disease (COPD) receiving non-invasive positive pressure ventilation (NIPPV). This study aimed to translate the SRI Questionnaire into Chinese and to validate it. Prospective validation study. A total of 149 participants with chronic hypercapnic COPD receiving NIPPV completed the study. The SRI questionnaire was translated into Chinese using translation and back-translation. Reliability was gauged using Cronbach's α coefficient. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to assess construct validity. Content validity was confirmed by evaluating the relationship between the score of each item and the total score of the relevant subscale. Cronbach's α coefficients for each subscale and summary scale were above 0.7. Using EFA, one factor was extracted from the anxiety and summary scales and two factors were extracted from the remaining six subscales. Based on the EFA results, subsequent CFA revealed a good model fit for each subscale, but the extracted factors of each subscale were correlated. Content validity was confirmed by the good relationship between the score of each item and the total score of the relevant subscale. The Chinese version of the SRI questionnaire is valid and reliable for patients with chronic hypercapnic COPD receiving NIPPV in China. NCT02499718. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Transition Planning for Students with Chronic Health Conditions. Position Statement

ERIC Educational Resources Information Center

Baszler, Rita; Rochkes, Laura; Dolatowski, Rosemary; Mendes, Irene; Yow, Barbara; Butler, Sarah; Fekaris, Nina

2014-01-01

It is the position of the National Association of School Nurses (NASN) that all children with chronic health conditions should receive coordinated and deliberate transition planning to maximize lifelong functioning and well-being. Transition planning refers to a coordinated set of activities to assist students with chronic health conditions to…

Radiotherapy for malignancy in patients with scleroderma: The Mayo Clinic experience

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

Gold, Douglas G.; Miller, Robert C.; Petersen, Ivy A.

2007-02-01

Purpose: To determine the frequency of acute and chronic adverse effects in patients with scleroderma who receive radiotherapy for treatment of cancer. Methods and Materials: Records were reviewed of 20 patients with scleroderma who received radiotherapy. Acute and chronic toxic effects attributable to radiotherapy were analyzed, and freedom from radiation-related toxicity was calculated. Results: Of the 20 patients, 15 had acute toxic effects, with Grade 3 or higher toxicity for 3 patients. Seven patients had self-limited Grade 1 or 2 radiation dermatitis, and no patient had Grade 3 or higher radiation dermatitis. Thirteen patients had chronic toxic effects, with Grademore » 3 or higher chronic toxicity for 3 patients. The median estimated time to any grade chronic toxicity was 0.4 years, and the median estimated time to Grade 3 or higher chronic toxicity has not been reached. Conclusions: The results suggest that although some patients with scleroderma treated with radiation experience considerable toxic effects, the occurrence of Grade 3 or higher toxicity may be less than previously anticipated.« less

Ultrasonic input-output for transmitting and receiving longitudinal transducers coupled to same face of isotropic elastic plate

NASA Technical Reports Server (NTRS)

Williams, J. H., Jr.; Karagulle, H.; Lee, S. S.

1982-01-01

The quantitative understanding of ultrasonic nondestructive evaluation parameters such as the stress wave factor were studied. Ultrasonic input/output characteristics for an isotropic elastic plate with transmitting and receiving longitudinal transducers coupled to the same face were analyzed. The asymptotic normal stress is calculated for an isotropic elastic half space subjected to a uniform harmonic normal stress applied to a circular region at the surface. The radiated stress waves are traced within the plate by considering wave reflections at the top and bottom faces. The output voltage amplitude of the receiving transducer is estimated by considering only longitudinal waves. Agreement is found between the output voltage wave packet amplitudes and times of arrival due to multiple reflections of the longitudinal waves.

Imatinib mesylate in chronic myeloid leukemia: frontline treatment and long-term outcomes.

PubMed

Stagno, Fabio; Stella, Stefania; Spitaleri, Antonio; Pennisi, Maria Stella; Di Raimondo, Francesco; Vigneri, Paolo

2016-01-01

The tyrosine kinase inhibitor Imatinib Mesylate has dramatically improved the clinical outcome of chronic myeloid leukemia (CML) patients in the chronic phase of the disease, generating unprecedented rates of complete hematologic and cytogenetic responses and sustained reductions in BCR-ABL transcripts. Here, we present an overview on the efficacy and safety of Imatinib and describe the most important clinical studies employing this drug for the frontline treatment of chronic phase CML. We also discuss recent reports describing the long-term outcome of patients receiving Imatinib for their disease. The imminent availability of generic forms of Imatinib coupled with the approval of expensive second-generation tyrosine kinase inhibitors underlines an unmet need for early molecular parameters that may distinguish CML patients likely to benefit from the drug from those that should receive alternative forms of treatment.

Chronic pain induces generalized enhancement of aversion

PubMed Central

Zhang, Qiaosheng; Manders, Toby; Tong, Ai Phuong; Yang, Runtao; Garg, Arpan; Martinez, Erik; Zhou, Haocheng; Dale, Jahrane; Goyal, Abhinav; Urien, Louise; Yang, Guang; Chen, Zhe; Wang, Jing

2017-01-01

A hallmark feature of chronic pain is its ability to impact other sensory and affective experiences. It is notably associated with hypersensitivity at the site of tissue injury. It is less clear, however, if chronic pain can also induce a generalized site-nonspecific enhancement in the aversive response to nociceptive inputs. Here, we showed that chronic pain in one limb in rats increased the aversive response to acute pain stimuli in the opposite limb, as assessed by conditioned place aversion. Interestingly, neural activities in the anterior cingulate cortex (ACC) correlated with noxious intensities, and optogenetic modulation of ACC neurons showed bidirectional control of the aversive response to acute pain. Chronic pain, however, altered acute pain intensity representation in the ACC to increase the aversive response to noxious stimuli at anatomically unrelated sites. Thus, chronic pain can disrupt cortical circuitry to enhance the aversive experience in a generalized anatomically nonspecific manner. DOI: http://dx.doi.org/10.7554/eLife.25302.001 PMID:28524819

670 GHz Schottky Diode Based Subharmonic Mixer with CPW Circuits and 70 GHz IF

NASA Technical Reports Server (NTRS)

Chattopadhyay, Goutam (Inventor); Schlecht, Erich T. (Inventor); Lee, Choonsup (Inventor); Lin, Robert H. (Inventor); Gill, John J. (Inventor); Sin, Seth (Inventor); Mehdi, Imran (Inventor)

2014-01-01

A coplanar waveguide (CPW) based subharmonic mixer working at 670 GHz using GaAs Schottky diodes. One example of the mixer has a LO input, an RF input and an IF output. Another possible mixer has a LO input, and IF input and an RF output. Each input or output is connected to a coplanar waveguide with a matching network. A pair of antiparallel diodes provides a signal at twice the LO frequency, which is then mixed with a second signal to provide signals having sum and difference frequencies. The output signal of interest is received after passing through a bandpass filter tuned to the frequency range of interest.

Reimbursement policies in the Asia-Pacific for chronic hepatitis B.

PubMed

Lim, Seng Gee; Amarapurkar, Deepak N; Chan, Henry Lik-Yuen; Crawford, Darrell H; Gane, Edward J; Han, Kwang-Hyub; Ahn, Sang Hoon; Jafri, Wasim; Jia, Jidong; Kao, Jia-Horng; Lesmana, Laurentius A; Lesmana, C Rinaldi A; Mohamed, Rosmawati; Phiet, Pham Hoang; Piratvisuth, Teerha; Sarin, Shiv K; Sollarno, Jose D; Eguchi, Yuichiro; Mahtab, Mamun-Al; Lee, Keat Hong

2015-01-01

There is considerable variation in reimbursement policies in Asian countries and this is likely to have an impact on treatment practice for chronic hepatitis B (CHB). Consequently a survey of leading hepatologists was performed to evaluate such policies and their impact on management of CHB in the Asia Pacific region. A questionnaire was sent to key hepatologists in Asia Pacific for information on CHB reimbursement policy-its nature, coverage, funding source, duration, review strategy and impact on Asia Pacific Association for the Study of the Liver (APASL) CHB guidelines. The results were analysed and described. Leading hepatologists from 16 Asia Pacific countries responded. Almost all of the countries have reimbursement policies but eligibility varied from only a limited group (e.g. civil servants only) to universal access. In most instances reimbursement was from the central government (except China, Pakistan and Hong Kong). Reimbursement policies were usually created by Ministry of Health committees, who received input from medical professionals, although they may not be aware of the APASL guidelines. Policies were limited by available resources, funds and prioritization. Where there was a regular review this occurred between 1 and 5 years. The quantum of reimbursement varied from 50% in Singapore to 100% in the majority of other countries. The criteria for treatment reimbursement were based on doctor's opinion alone (Bangladesh, India, Pakistan, Philippines, Singapore and Vietnam) or specific clinical/laboratory criteria in the rest of the countries. In general, most countries offered unlimited duration for reimbursement except Taiwan, Indonesia and Pakistan. Monitoring tests for treatment response were reimbursed in all countries other than Vietnam. Viral resistance was diagnosed by viral or biochemical breakthrough, and viral resistance testing was uncommon. The main rescue therapy was adefovir. Reimbursement policies differed from country to country, the quantum and the proportion of patients who received reimbursement also varied significantly. Asia Pacific countries were able to follow APASL guidelines with variable success based on their reimbursement policies.

Unlocking the limitations: Living with chronic obstructive pulmonary disease and receiving care through telemedicine-A phenomenological study.

PubMed

Barken, Tina Lien; Thygesen, Elin; Söderhamn, Ulrika

2018-01-01

To describe the lived experiences of quality of life among a group of patients living with chronic obstructive pulmonary disease who were included in a telemedical intervention after hospitalisation for disease exacerbation. Patients with chronic obstructive pulmonary disease have high symptom burden, poor control of symptoms and a need for greater requirements in care. Telemedicine can provide benefits for patients with chronic obstructive pulmonary disease by improving self-management. Descriptive phenomenological approach. Ten in-depth interviews were conducted with chronic obstructive pulmonary disease patients participating in a telemedical intervention. The collected data were analysed using a descriptive phenomenological research method. Living with chronic obstructive pulmonary disease was experienced as creating physical and mental limitations of the diseased body and an increasing identity as a patient, which led to impaired quality of life. Being included in the telemedicine intervention increased accessibility to healthcare services and support from telemedicine nurses. Self-measurement of health data increased participants' clinical insight and created a mutual clinical language in dialogue with telemedicine nurses, which led to increased quality of life. However, receiving care through telemedicine was also experienced as a dual chore. Telemedicine can reduce the perceived limitations imposed by chronic obstructive pulmonary disease through four key elements: (i) improving accessibility to healthcare services, (ii) increasing support from health professionals, (iii) strengthening clinical insight and (iv) developing a mutual clinical language, thus increasing quality of life. The transparency facilitated through telemedicine in this healthcare context encourages open decision-making, where the participants can increase their knowledge and improve acknowledgement of and collaboration with telemedicine nurses. Telemedicine can be beneficial when rethinking care for chronic obstructive pulmonary disease by providing knowledge on how living with chronic obstructive pulmonary disease can affect the experience of receiving care through telemedicine and further determine for whom telemedicine is useful. © 2017 John Wiley & Sons Ltd.

Low rates of hepatitis A and B vaccination in patients with chronic hepatitis C at an urban methadone maintenance program.

PubMed

Felsen, Uriel R; Fishbein, Dawn A; Litwin, Alain H

2010-10-01

Patients with chronic hepatitis C virus (HCV) are at increased risk for complications of liver disease if they become infected with the hepatitis A (HAV) or hepatitis B (HBV) viruses. The authors examined the rates of testing for HAV, HBV, and HCV, as well as rates of vaccination against HAV and HBV in patients with chronic HCV in a random sample (N = 207) of medical records of patients enrolled in a methadone maintenance program. Almost all patients reviewed were tested for HAV, HBV, and HCV. Of the 111 patients with chronic HCV, 53 (48.6%) and 68 (63%) lacked immunity to HAV and HBV, respectively. Of those lacking immunity, 29 (54.7%) and 2 (2.9%) were vaccinated for HAV and HBV, respectively. Despite high rates of testing for HAV, HBV, and HCV at a methadone maintenance program, approximately half of those with chronic HCV eligible for the HAV vaccine received it, and few of those eligible for HBV vaccine received it.

Blastocystis Hominis and Chronic Abdominal Pain in Children: Is there an Association between Them?

PubMed

Toro Monjaraz, Erick Manuel; Vichido Luna, Miguel Angel; Montijo Barrios, Ericka; Cervantes Bustamante, Roberto; Zárate Mondragón, Flora; Huante Anaya, Alfonso; Cadena León, José; Mendez, Monserrat Cazares; López Ugalde, Martha; Ramirez Mayans, Jaime A

2017-08-03

Chronic abdominal pain has many etiologies, one of them being parasites. The aim of this study was to find an association between chronic abdominal pain in children and Blastocystis hominis (Bh). Clinical files of patients with Bh and functional abdominal pain were reviewed. A comparison was made between patients who showed an improvement of their symptoms and those who did not. Out of the 138 patients who had functional abdominal pain and Bh, 37 patients did not receive any treatment (26.8%), while 101 received it and were treated with different antimicrobial agents (73.2%); regarding the improvement of symptoms, a statistically significant difference (p < 0.001) was observed. Chronic abdominal pain in children has different etiologies; however, we have documented through this work that it is appropriate to provide antimicrobial treatment for patients with Bh and chronic abdominal pain. © The Author [2017]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Comparing serum levels of cardiac biomarkers in cancer patients receiving chemotherapy and subjects with chronic periodontitis

PubMed Central

2012-01-01

Background Chronic periodontitis (CP) is a chronic inflammation associated with elevations of several inflammatory and cardiac markers. Studies implicated CP as one of the etiologies in coronary heart disease (CHD). Cardiotoxicity is a major complication of anticancer drugs, including anthracyclines and 5-fluorouracil (5FU). The most severe cardiac complications are heart failure, arrhythmia and coronary heart disease (CHD). In this study, we compared the level of inflammatory factors and cardiac markers between chronic periodontitis patients and cancer patients receiving chemotherapy. Methods 108 blood samples of periodontally healthy subjects were obtained on random from Hong Kong Red Cross, and these represented the controlled population. Forty-four patients diagnosed with chronic periodontitis were recruited from the West China Hospital of Stomatology, Sichuan University. They have received scaling and root planning with mean pocket depths of 6.05 mm. Thirty breast cancer patients diagnosed with invasive ductal carcinoma from UNIMED Medical Institute, Hong Kong gave consent to participate in this study. They received 4 cycles of 500mg/m2 5-fluorouracil, 75 mg/m2 epirubicin and 500mg/m2 cyclophosphamide at a 3-week interval between each cycle. Peripheral venous blood from each group was taken for measurement of blood cells, inflammatory marker (P-selectin, high sensitvity C-reactive protein) and cardiac markers (troponin T; troponin I; N-terminal pro brain natriuretic peptide (Nt-proBNP) and Lactate dehydrogenase (LDH). Results The lymphocyte count was higher (p < 0.05) in periodontitis patients than the other two groups, and more neutrophils (p < 0.05) were seen in cancer patients receiving chemotherapy. The two test groups demonstrated higher levels (p < 0.01) of inflammatory and cardiac markers than the control group. Conclusions The elevated cardiac markers found in periodontitis patients suggested that they may carry potential risks in developing cardiac lesions. Troponin T, troponin I, pro-BNP, LDH and high sensitvity C-reactive protein may be used as markers to monitor cardiac lesions in chronic inflammatory patients. PMID:23046680

Effects of Marine Fish Oils on the Anticoagulation Status of Patients Receiving Chronic Warfarin Therapy.

PubMed

Bender; Kraynak; Chiquette; Linn; Clark; Bussey

1998-07-01

The purpose of this placebo-controlled, randomized, double-blinded, parallel study was to determine the existence and magnitude of effect of various doses of fish oil supplements on International Normalized Ratio (INR) determinations in patients receiving chronic warfarin therapy. Patients from anticoagulation clinics from both the Brady Green Community Health Center and Audie L. Murphy Veterans Administration in San Antonio, Texas were enrolled in the study. The enrolled subjects included 5 males and 11 females, all of whom were receiving chronic warfarin therapy for indications requiring oral anticoagulation. All enrolled patients underwent a 4-week placebo monitoring period in which INRs were determined on a weekly basis. If the INRs were found to be stable, patients were randomized to receive a 4-week treatment period of either placebo capsules (n = 6), 3 grams of fish oil daily (n = 5), or 6 grams of fish oil daily (n = 5). Patients were followed on a twice-weekly basis for INR determinations and adverse reactions. Five patients were discontinued from the study due to noncompliance (2) and unstable INRs (3). There was no statistically significant difference in INRs between the placebo lead-in and treatment period within each group (P = 0.82). There was also no difference in INRs found between groups (P= 0.41). One bruising episode was reported, yet no major bleeding episodes were observed during the study. Fish oil supplementation in doses of 3-6 grams per day does not seem to create a statistically significant effect on the anticoagulation status of patients receiving chronic warfarin therapy.

Concept development and needs identification for INFLO : report on stakeholder input on transformative goals, performance measures and high level user needs for INFLO.

DOT National Transportation Integrated Search

2012-04-01

The purpose of this report is to document the stakeholder input received at the February 8, 2012, stakeholder workshop at the Hall of States in Washington, D.C. on goals, performance measures, transformative performance targets, and high-level user n...

76 FR 17485 - Meeting Notice Correction-Federal Interagency Committee on Emergency Medical Services; Correction...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-29

... (FICEMS) to be held as a stakeholder input call-in session to receive input regarding the current and... options for establishing or designating a Federal lead office or agency for EMS. The National Security Staff Resilience Directorate has requested that FICEMS engage with stakeholders and develop an options...

Microwave limb sounder. [measuring trace gases in the upper atmosphere

NASA Technical Reports Server (NTRS)

Gustincic, J. J. (Inventor)

1981-01-01

Trace gases in the upper atmosphere can be measured by comparing spectral noise content of limb soundings with the spectral noise content of cold space. An offset Cassegrain antenna system and tiltable input mirror alternately look out at the limb and up at cold space at an elevation angle of about 22. The mirror can also be tilted to look at a black body calibration target. Reflection from the mirror is directed into a radiometer whose head functions as a diplexer to combine the input radiation and a local ocillator (klystron) beam. The radiometer head is comprised of a Fabry-Perot resonator consisting of two Fabry-Perot cavities spaced a number of half wavelengths apart. Incoming radiation received on one side is reflected and rotated 90 deg in polarization by the resonator so that it will be reflected by an input grid into a mixer, while the klystron beam received on the other side is also reflected and rotated 90 deg, but not without passing some energy to be reflected by the input grid into the mixer.

Multistage Force Amplification of Piezoelectric Stacks

NASA Technical Reports Server (NTRS)

Xu, Tian-Bing (Inventor); Siochi, Emilie J. (Inventor); Zuo, Lei (Inventor); Jiang, Xiaoning (Inventor); Kang, Jin Ho (Inventor)

2015-01-01

Embodiments of the disclosure include an apparatus and methods for using a piezoelectric device, that includes an outer flextensional casing, a first cell and a last cell serially coupled to each other and coupled to the outer flextensional casing such that each cell having a flextensional cell structure and each cell receives an input force and provides an output force that is amplified based on the input force. The apparatus further includes a piezoelectric stack coupled to each cell such that the piezoelectric stack of each cell provides piezoelectric energy based on the output force for each cell. Further, the last cell receives an input force that is the output force from the first cell and the last cell provides an output apparatus force In addition, the piezoelectric energy harvested is based on the output apparatus force. Moreover, the apparatus provides displacement based on the output apparatus force.

Embedding global and collective in a torus network with message class map based tree path selection

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

Chen, Dong; Coteus, Paul W.; Eisley, Noel A.

Embodiments of the invention provide a method, system and computer program product for embedding a global barrier and global interrupt network in a parallel computer system organized as a torus network. The computer system includes a multitude of nodes. In one embodiment, the method comprises taking inputs from a set of receivers of the nodes, dividing the inputs from the receivers into a plurality of classes, combining the inputs of each of the classes to obtain a result, and sending said result to a set of senders of the nodes. Embodiments of the invention provide a method, system and computermore » program product for embedding a collective network in a parallel computer system organized as a torus network. In one embodiment, the method comprises adding to a torus network a central collective logic to route messages among at least a group of nodes in a tree structure.« less

Attention Enhances Synaptic Efficacy and Signal-to-Noise in Neural Circuits

PubMed Central

Briggs, Farran; Mangun, George R.; Usrey, W. Martin

2013-01-01

Summary Attention is a critical component of perception. However, the mechanisms by which attention modulates neuronal communication to guide behavior are poorly understood. To elucidate the synaptic mechanisms of attention, we developed a sensitive assay of attentional modulation of neuronal communication. In alert monkeys performing a visual spatial attention task, we probed thalamocortical communication by electrically stimulating neurons in the lateral geniculate nucleus of the thalamus while simultaneously recording shock-evoked responses from monosynaptically connected neurons in primary visual cortex. We found that attention enhances neuronal communication by (1) increasing the efficacy of presynaptic input in driving postsynaptic responses, (2) increasing synchronous responses among ensembles of postsynaptic neurons receiving independent input, and (3) decreasing redundant signals between postsynaptic neurons receiving common input. These results demonstrate that attention finely tunes neuronal communication at the synaptic level by selectively altering synaptic weights, enabling enhanced detection of salient events in the noisy sensory milieu. PMID:23803766

Integration of cortical and pallidal inputs in the basal ganglia-recipient thalamus of singing birds

PubMed Central

Goldberg, Jesse H.; Farries, Michael A.

2012-01-01

The basal ganglia-recipient thalamus receives inhibitory inputs from the pallidum and excitatory inputs from cortex, but it is unclear how these inputs interact during behavior. We recorded simultaneously from thalamic neurons and their putative synaptically connected pallidal inputs in singing zebra finches. We find, first, that each pallidal spike produces an extremely brief (∼5 ms) pulse of inhibition that completely suppresses thalamic spiking. As a result, thalamic spikes are entrained to pallidal spikes with submillisecond precision. Second, we find that the number of thalamic spikes that discharge within a single pallidal interspike interval (ISI) depends linearly on the duration of that interval but does not depend on pallidal activity prior to the interval. In a detailed biophysical model, our results were not easily explained by the postinhibitory “rebound” mechanism previously observed in anesthetized birds and in brain slices, nor could most of our data be characterized as “gating” of excitatory transmission by inhibitory pallidal input. Instead, we propose a novel “entrainment” mechanism of pallidothalamic transmission that highlights the importance of an excitatory conductance that drives spiking, interacting with brief pulses of pallidal inhibition. Building on our recent finding that cortical inputs can drive syllable-locked rate modulations in thalamic neurons during singing, we report here that excitatory inputs affect thalamic spiking in two ways: by shortening the latency of a thalamic spike after a pallidal spike and by increasing thalamic firing rates within individual pallidal ISIs. We present a unifying biophysical model that can reproduce all known modes of pallidothalamic transmission—rebound, gating, and entrainment—depending on the amount of excitation the thalamic neuron receives. PMID:22673333

Towards full band colorless reception with coherent balanced receivers.

PubMed

Zhang, Bo; Malouin, Christian; Schmidt, Theodore J

2012-04-23

In addition to linear compensation of fiber channel impairments, coherent receivers also provide colorless selection of any desired data channel within multitude of incident wavelengths, without the need of a channel selecting filter. In this paper, we investigate the design requirements for colorless reception using a coherent balanced receiver, considering both the optical front end (OFE) and the transimpedance amplifier (TIA). We develop analytical models to predict the system performance as a function of receiver design parameters and show good agreement against numerical simulations. At low input signal power, an optimum local oscillator (LO) power is shown to exist where the thermal noise is balanced with the residual LO-RIN beat noise. At high input signal power, we show the dominant noise effect is the residual self-beat noise from the out of band (OOB) channels, which scales not only with the number of OOB channels and the common mode rejection ratio (CMRR) of the OFE, but also depends on the link residual chromatic dispersion (CD) and the orientation of the polarization tributaries relative to the receiver. This residual self-beat noise from OOB channels sets the lower bound for the LO power. We also investigate the limitations imposed by overload in the TIA, showing analytically that the DC current scales only with the number of OOB channels, while the differential AC current scales only with the link residual CD, which induces high peak-to-average power ratio (PAPR). Both DC and AC currents at the input to the TIA set the upper bounds for the LO power. Considering both the OFE noise limit and the TIA overload limit, we show that the receiver operating range is notably narrowed for dispersion unmanaged links, as compared to dispersion managed links. © 2012 Optical Society of America

Orbital-angular-momentum mode-group multiplexed transmission over a graded-index ring-core fiber based on receive diversity and maximal ratio combining

NASA Astrophysics Data System (ADS)

Zhang, Junwei; Zhu, Guoxuan; Liu, Jie; Wu, Xiong; Zhu, Jiangbo; Du, Cheng; Luo, Wenyong; Chen, Yujie; Yu, Siyuan

2018-02-01

An orbital-angular-momentum (OAM) mode-group multiplexing (MGM) scheme based on a graded-index ring-core fiber (GIRCF) is proposed, in which a single-input two-output (or receive diversity) architecture is designed for each MG channel and simple digital signal processing (DSP) is utilized to adaptively resist the mode partition noise resulting from random intra-group mode crosstalk. There is no need of complex multiple-input multiple-output (MIMO) equalization in this scheme. Furthermore, the signal-to-noise ratio (SNR) of the received signals can be improved if a simple maximal ratio combining (MRC) technique is employed on the receiver side to efficiently take advantage of the diversity gain of receiver. Intensity-modulated direct-detection (IM-DD) systems transmitting three OAM mode groups with total 100-Gb/s discrete multi-tone (DMT) signals over a 1-km GIRCF and two OAM mode groups with total 40-Gb/s DMT signals over an 18-km GIRCF are experimentally demonstrated, respectively, to confirm the feasibility of our proposed OAM-MGM scheme.

HIV-related chronic lung disease in adolescents: are we prepared for the future?

PubMed

Goussard, Pierre; Gie, Robert P

2017-12-01

Chronic lung diseases (CLD) are the most chronic disease occurring in adolescents living with human immunodeficiency virus (ALHIV). In ALHIV who received antiretroviral therapy (ART) late in childhood, bronchiectasis, bronchiolitis obliterans and interstitial pneumonitis are common. In adolescents who received ART early in life the spectrum of CLD has changed with asthma and chronic obstructive pulmonary disease being common. Areas covered: The aim of this paper was to review CLD in ALHIV. We conducted a literature review of electronic databases focusing on CLD that were common prior to the introduction of ART (1996-2004), the present situation where ART is widely available (2005 to 2016), and articles which aided us speculating on the impact of HIV-related CLD in adolescents transitioning to adult HIV-clinics. Amongst the approximately 2.1 million adolescents living with HIV, CLD commonly occurs. Awareness of the CLD amongst ALHIV needs to be raised to ensure that disease appropriate treatment is available to these vulnerable adolescents. Expert commentary: As adolescents' transition from pediatric HIV-clinics to adult HIV-clinics the evidence shows that adolescents might not receive optimal care if adult pulmonologists are not aware of the CLD that commonly occur in ALHIV.

Report on Honduras: ripples in the pond--the financial crisis and remittances to chronically ill patients in Honduras.

PubMed

Piette, John D; Mendoza-Avelares, Milton O; Chess, Laura; Milton, Evan C; Matiz Reyes, Armando; Rodriguez-Saldaña, Joel

2012-01-01

The U.S. financial crisis has affected employment opportunities for Latino immigrants, and this could affect their ability to send financial assistance, or "remittances", to chronically ill family members in their home country. In a cross-sectional survey of 624 chronically ill adults conducted in Honduras between June and August 2009, respondents reported their receipt of remittances, health service use, and cost-related access barriers. Fifty-four percent of respondents reported relatives living outside the country, and of this group, 66 percent (37% of the overall sample) received remittances. Seventy-four percent of respondents receiving remittances reported a decrease over the prior year, mostly due to job losses among their relatives abroad. Respondents reporting reductions in remittances received significantly less per month, on average, than those without a reduction (US $170 vs. $234; p = 0.01). In multivariate models, respondents experiencing a reduction in remittances used fewer health services and medications due to cost concerns. Remittance payments from relatives resident in the United States are a major source of income for chronically ill individuals in Latin America. Most recipients of remittances reported a reduction during the financial downturn that affected their access to care.

Impact of whole-body rehabilitation in patients receiving chronic mechanical ventilation.

PubMed

Martin, Ubaldo J; Hincapie, Luis; Nimchuk, Mark; Gaughan, John; Criner, Gerard J

2005-10-01

To evaluate the prevalence and magnitude of weakness in patients receiving chronic mechanical ventilation and the impact of providing aggressive whole-body rehabilitation on conventional weaning variables, muscle strength, and overall functional status. Retrospective analysis of 49 consecutive patients. Multidisciplinary ventilatory rehabilitation unit in an academic medical center. Forty-nine consecutive chronic ventilator-dependent patients referred to a tertiary care hospital ventilator rehabilitation unit. None. Patients were 58 +/- 7 yrs old with multiple etiologies for respiratory failure. On admission, all patients were bedridden and had severe weakness of upper and lower extremities measured by a 5-point muscle strength score and a 7-point Functional Independence Measurement. Postrehabilitation, patients had increases in upper and lower extremity strength (p < .05) and were able to stand and ambulate. All weaned from mechanical ventilation, but three required subsequent intermittent support. Six patients died before hospital discharge. Upper extremity strength on admission inversely correlated with time to wean from mechanical ventilation (R = .72, p < .001). : Patients receiving chronic ventilation are weak and deconditioned but respond to aggressive whole-body and respiratory muscle training with an improvement in strength, weaning outcome, and functional status. Whole-body rehabilitation should be considered a significant component of their therapy.

Chronic care model strategies in the United States and Germany deliver patient-centered, high-quality diabetes care.

PubMed

Stock, Stephanie; Pitcavage, James M; Simic, Dusan; Altin, Sibel; Graf, Christian; Feng, Wen; Graf, Thomas R

2014-09-01

Improving the quality of care for chronic diseases is an important issue for most health care systems in industrialized nations. One widely adopted approach is the Chronic Care Model (CCM), which was first developed in the late 1990s. In this article we present the results from two large surveys in the United States and Germany that report patients' experiences in different models of patient-centered diabetes care, compared to the experiences of patients who received routine diabetes care in the same systems. The study populations were enrolled in either Geisinger Health System in Pennsylvania or Barmer, a German sickness fund that provides medical insurance nationwide. Our findings suggest that patients with type 2 diabetes who were enrolled in the care models that exhibited key features of the CCM were more likely to receive care that was patient-centered, high quality, and collaborative, compared to patients who received routine care. This study demonstrates that quality improvement can be realized through the application of the Chronic Care Model, regardless of the setting or distinct characteristics of the program. Project HOPE—The People-to-People Health Foundation, Inc.

Exercise and self-management for people with chronic knee, hip or lower back pain: a cluster randomised controlled trial of clinical and cost-effectiveness. Study protocol.

PubMed

Walsh, Nicola; Cramp, Fiona; Palmer, Shea; Pollock, Jon; Hampson, Lisa; Gooberman-Hill, Rachael; Green, Colin; Jones, Louise; Phillips, Sonia; Johnson, Liz; Hurley, Mike

2013-12-01

Chronic musculoskeletal pain and osteoarthritis can significantly limit the functional independence of individuals, and given that 25% of the population experience these problems, the socioeconomic impact is immense. Exercise and self-management have proven benefits for these conditions, but most trials tailor interventions for specific joints. Epidemiological data demonstrates that many older people with degenerative joint problems experience pain and functional difficulty in other joints, seeking further healthcare input when these present. Managing multiple joint presentations simultaneously could potentially reduce the need for repeat visits to healthcare professionals as advice is frequently the same for differing site presentations. This single-blind cluster randomised controlled trial will determine the clinical and cost-effectiveness of an exercise and self-management intervention delivered to people over-50 with either hip, knee or lower back pain, compared to 'standard' GP care. A qualitative analysis will also establish the acceptability of the intervention. 352 people with chronic degenerative musculoskeletal pain of the hip, knee or lower back will be recruited from primary care. GP surgeries will be randomised to either the intervention or control arms. Participants in the intervention arm will receive a 6-week group exercise and self-management programme facilitated by a physiotherapist in primary care. Participants allocated to the control arm will continue under 'standard' GP care. The primary outcome measure is the Dysfunction Index of the Short Musculoskeletal Functional Assessment (SMFA). Individual patient responses will be modelled using a mixed effects linear regression, allowing for the clustering effects. Resource use and related intervention costs will be estimated and broader resource use data will be collected using a version of the Client Service Receipt Inventory adapted for musculoskeletal relevance. In addition, a cost-utility analysis will be undertaken to present an estimate of the incremental cost per QALY. A qualitative analysis investigating the acceptability of the intervention to participants and healthcare professionals will also be undertaken and thematically analysed. Ethical approval was received from South West 4 REC, identification number 11/SW/0053. Study findings will be disseminated via conference and journal presentation; via arthritis charitable organisations; and through local GP consortia. Copyright © 2012 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

A thalamic input to the nucleus accumbens mediates opiate dependence.

PubMed

Zhu, Yingjie; Wienecke, Carl F R; Nachtrab, Gregory; Chen, Xiaoke

2016-02-11

Chronic opiate use induces opiate dependence, which is characterized by extremely unpleasant physical and emotional feelings after drug use is terminated. Both the rewarding effects of a drug and the desire to avoid withdrawal symptoms motivate continued drug use, and the nucleus accumbens is important for orchestrating both processes. While multiple inputs to the nucleus accumbens regulate reward, little is known about the nucleus accumbens circuitry underlying withdrawal. Here we identify the paraventricular nucleus of the thalamus as a prominent input to the nucleus accumbens mediating the expression of opiate-withdrawal-induced physical signs and aversive memory. Activity in the paraventricular nucleus of the thalamus to nucleus accumbens pathway is necessary and sufficient to mediate behavioural aversion. Selectively silencing this pathway abolishes aversive symptoms in two different mouse models of opiate withdrawal. Chronic morphine exposure selectively potentiates excitatory transmission between the paraventricular nucleus of the thalamus and D2-receptor-expressing medium spiny neurons via synaptic insertion of GluA2-lacking AMPA receptors. Notably, in vivo optogenetic depotentiation restores normal transmission at these synapses and robustly suppresses morphine withdrawal symptoms. This links morphine-evoked pathway- and cell-type-specific plasticity in the paraventricular nucleus of the thalamus to nucleus accumbens circuit to opiate dependence, and suggests that reprogramming this circuit holds promise for treating opiate addiction.

Chinese Herbal Medicine as an Adjunctive Therapy Ameliorated the Incidence of Chronic Hepatitis in Patients with Breast Cancer: A Nationwide Population-Based Cohort Study

PubMed Central

Chiang, Jen-Huai; Su, Yuan-Chih; Chang, Hen-Hong

2017-01-01

We conducted a National Health Insurance Research Database-based Taiwanese nationwide population-based cohort study to evaluate whether Chinese herbal medicine (CHM) treatment decreased the incidence of chronic hepatitis in breast cancer patients receiving chemotherapy and/or radiotherapy. A total of 81171 patients were diagnosed with breast cancer within the defined study period. After randomly equal matching, data from 13856 patients were analyzed. Hazard ratios of incidence rate of chronic hepatitis were used to determine the influence and therapeutic potential of CHM in patients with breast cancer. The patients with breast cancer receiving CHM treatment exhibited a significantly decreased incidence rate of chronic hepatitis even across the stratification of age, CCI score, and treatments. The cumulative incidence of chronic hepatitis for a period of seven years after initial breast cancer diagnosis was also reduced in the patients receiving CHM treatment. The ten most commonly used single herbs and formulas were effective in protecting liver function in patients with breast cancer, where Hedyotis diffusa and Jia-Wei-Xiao-Yao-San were the most commonly used herbal agents. In conclusion, our study provided information that western medicine therapy combined with CHM as an adjuvant modality may have a significant impact on liver protection in patients with breast cancer. PMID:29234362

Cytokine ratios in chronic periodontitis and type 2 diabetes mellitus.

PubMed

Acharya, Anirudh B; Thakur, Srinath; Muddapur, M V; Kulkarni, Raghavendra D

Chronic periodontitis may influence systemic cytokines in type 2 diabetes. This study aimed to evaluate the cytokine ratios in type 2 diabetes with, and without chronic periodontitis. Gingival status, periodontal, glycemic parameters and serum cytokines were evaluated in participants grouped as healthy, chronic periodontitis, and type 2 diabetes with, and without chronic periodontitis. Cytokine ratios showed significant differences in type 2 diabetes and chronic periodontitis, were highest in participants having both type 2 diabetes and chronic periodontitis, with a statistically significant cut-off point and area under curve by receiver operating characteristic. Copyright © 2016 Diabetes India. Published by Elsevier Ltd. All rights reserved.

75 FR 32190 - Disease, Disability, and Injury Prevention and Control Special Interest Projects (SIPs...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-07

... Cognitive Impairment on Co-Occurring Chronic Conditions SIP 10-037 and Epidemiologic Follow- Up Study of... received in response to ``Examining the Impact of Cognitive Impairment on Co- Occurring Chronic Conditions...

Identifying factors associated with experiences of coronary heart disease patients receiving structured chronic care and counselling in European primary care

PubMed Central

2012-01-01

Background Primary care for chronic illness varies across European healthcare systems. In patients suffering from coronary heart disease (CHD), factors associated with patients’ experiences of receiving structured chronic care and counselling at the patient and practice level were investigated. Methods In an observational study comprising 140 general practices from five European countries (Austria, Germany, the Netherlands, Switzerland and the United Kingdom), 30 patients with Coronary Heart Disease (CHD) per practice were chosen at random to partake in this research. Patients were provided with a questionnaire and the Patient Assessment of Chronic Illness Care (PACIC-5A) - instrument. Practice characteristics were assessed through a practice questionnaire and face to face interviews. Data were aggregated to obtain two practice scores representing quality management and CHD care, respectively. A hierarchical multilevel analysis was performed to examine the impact of patient and practice characteristics on PACIC scores. Results The final sample included 1745 CHD-patients from 131 general practices with a mean age of 67.8 (SD 9.9) years. The overall PACIC score was 2.84 (95%CI: 2.79; 2.89) and the 5A score reflecting structured lifestyle counselling was 2.75 (95% CI: 2.69; 2.79). At the patient level, male gender, more frequent practice contact and fewer related or unrelated conditions were associated with higher PACIC scores. At the practice level, performance scores reflecting quality management (p = 0.013) and CHD care (p = 0.009) were associated with improved assessment of the structured chronic care and counselling received. Conclusions Patients’ perceived quality of care varies. However, good practice management and organisation of care were positively reflected in patients’ assessments of receiving structured chronic illness care. This highlights the importance of integrating patient experiences into quality measurements to provide feedback to health care professionals. PMID:22838403

Evaluation of Vasopressin for Septic Shock in Patients on Chronic Renin-Angiotensin-Aldosterone System Inhibitors.

PubMed

Erwin, Beth L; Denaburg, Michael A; Barker, Andrew B; McArdle, Philip J; Windham, Samuel T; Morgan, Charity J

2017-12-01

To compare the hemodynamic response in septic shock patients receiving vasopressin who were on chronic renin-angiotensin-aldosterone system inhibitor therapy with those who were not. Single-center, retrospective cohort study. Medical and surgical ICUs at a 1,100-bed academic medical center. Medical and surgical ICU patients with septic shock who received vasopressin infusion added to at least one concomitant vasopressor agent between January 2014 and December 2015, then divided into two cohorts: 1) patients who were on chronic renin-angiotensin-aldosterone system inhibitor therapy as outpatients and 2) patients who were not on chronic renin-angiotensin-aldosterone system inhibitor therapy as outpatients. None. Mean arterial pressure at 6 hours was 72.2 mm Hg in the renin-angiotensin-aldosterone system inhibitor group versus 69.7 mm Hg in the non-renin-angiotensin-aldosterone system inhibitor group (p = 0.298). There was no difference in mean arterial pressure at 1, 24, or 48 hours between groups. Total concomitant vasopressor requirements, based on norepinephrine equivalents excluding vasopressin, were significantly lower at 24 hours in the renin-angiotensin-aldosterone system inhibitor group versus the non-renin-angiotensin-aldosterone system inhibitor group (10.7 vs 18.1 µg/min, respectively; p = 0.007), but no significant differences were seen at the other time points assessed. There were no significant differences in ICU or hospital length of stay or mortality. There was no significant difference in the primary outcome of 6-hour mean arterial pressure in septic shock patients receiving vasopressin who were on chronic renin-angiotensin-aldosterone system inhibitor therapy versus those receiving vasopressin who were not on chronic renin-angiotensin-aldosterone system inhibitor therapy. Renin-angiotensin-aldosterone system inhibitor patients had lower total concomitant vasopressor requirements at 24 hours compared with non-renin-angiotensin-aldosterone system inhibitor patients.

Chronic postthoracotomy pain and perioperative ketamine infusion.

PubMed

Hu, Jie; Liao, Qin; Zhang, Fan; Tong, Jianbin; Ouyang, Wen

2014-06-01

The objectives of this study were to investigate whether continuous intravenous ketamine during the first 72 hours after thoracotomy could reduce the incidence and intensity of chronic postthoracotomy pain (CPTP) and to define the incidence and risk factors of CPTP. Seventy-eight patients receiving thoracotomy for lung tumor (benign or malignant) were randomly divided into two groups: ketamine group (n = 31) and control groups (n = 47). Patients in the ketamine group received intravenous ketamine 1 mg/kg before incision, followed by 2 μg/kg/minute infusion for 72 hours plus sufentanil patient-controlled intravenous analgesia after thoracotomy. Patients in the control group received intravenous a 0.9% normal saline and infusion plus sufentanil patient-controlled intravenous analgesia. The solutions patients received were blinded. The numerical rating scale (NRS) pain scores and the incidence and risk factors of CPTP were recorded during the first 6 months after surgery. Compared with control group, the incidence of chronic pain in the ketamine group did not decrease at 2 months (χ(2) = 1.599, P = .206) and 6 months (χ(2) = 0.368, P = .544) after surgery. Postoperative pain scores in the ketamine group were not significantly different from those of the control group patients at 2 months (U = 677.5, P = .593) and 6 months (U = 690.5, P = .680). The incidence of CPTP was 78.2% (61/78) at 2 months and 53.8% (42/78) at 6 months after surgery. Retractor used time (OR = 5.811, P = .002), inadequate acute pain control (NRS ≥ 5) (OR = 5.425, P = .048), and chemotherapy (OR = 3.784, P = .056) were independent risk factors for chronic postthoracotomy pain. The authors conclude that continuous intravenous ketamine (2 μg/kg/min) during the first 72 hours after thoracotomy was not beneficial to prevent chronic postthoracotomy pain. The independent risk factors for chronic postthoracotomy pain were retractor used time, inadequate acute pain control, and chemotherapy.

Apparatus and method for detecting and measuring changes in linear relationships between a number of high frequency signals

DOEpatents

Bittner, J.W.; Biscardi, R.W.

1991-03-19

An electronic measurement circuit is disclosed for high speed comparison of the relative amplitudes of a predetermined number of electrical input signals independent of variations in the magnitude of the sum of the signals. The circuit includes a high speed electronic switch that is operably connected to receive on its respective input terminals one of said electrical input signals and to have its common terminal serve as an input for a variable-gain amplifier-detector circuit that is operably connected to feed its output to a common terminal of a second high speed electronic switch. The respective terminals of the second high speed electronic switch are operably connected to a plurality of integrating sample and hold circuits, which in turn have their outputs connected to a summing logic circuit that is operable to develop first, second and third output voltages, the first output voltage being proportional to a predetermined ratio of sums and differences between the compared input signals, the second output voltage being proportional to a second summed ratio of predetermined sums and differences between said input signals, and the third output voltage being proportional to the sum of signals to the summing logic circuit. A servo system that is operably connected to receive said third output signal and compare it with a reference voltage to develop a slowly varying feedback voltage to control the variable-gain amplifier in said common amplifier-detector circuit in order to make said first and second output signals independent of variations in the magnitude of the sum of said input signals. 2 figures.

Apparatus and method for detecting and measuring changes in linear relationships between a number of high frequency signals

DOEpatents

Bittner, John W.; Biscardi, Richard W.

1991-01-01

An electronic measurement circuit for high speed comparison of the relative amplitudes of a predetermined number of electrical input signals independent of variations in the magnitude of the sum of the signals. The circuit includes a high speed electronic switch that is operably connected to receive on its respective input terminals one of said electrical input signals and to have its common terminal serve as an input for a variable-gain amplifier-detector circuit that is operably connected to feed its output to a common terminal of a second high speed electronic switch. The respective terminals of the second high speed electronic switch are operably connected to a plurality of integrating sample and hold circuits, which in turn have their outputs connected to a summing logic circuit that is operable to develop first, second and third output voltages, the first output voltage being proportional to a predetermined ratio of sums and differences between the compared input signals, the second output voltage being proportional to a second summed ratio of predetermined sums and differences between said input signals, and the third output voltage being proportional to the sum of signals to the summing logic circuit. A servo system that is operably connected to receive said third output signal and compare it with a reference voltage to develop a slowly varying feedback voltage to control the variable-gain amplifier in said common amplifier-detector circuit in order to make said first and second output signals independent of variations in the magnitude of the sum of said input signals.

Platelet-rich plasma for chronic lateral epicondylitis: is one injection sufficient?

PubMed

Glanzmann, Michael C; Audigé, Laurent

2015-12-01

Chronic lateral epicondylitis is generally treated using nonsurgical methods including physiotherapy and infiltrations of cortisone or platelet-rich plasma (PRP). The latter is known for its simple application as well as associated low risk of adverse events, which lend to its widespread use in treating various musculoskeletal conditions. There is limited evidence on the effectiveness of PRP injections to optimally treat chronic lateral epicondylitis. This study explored the effectiveness of single or repeated injections for patients with symptoms that spanned 6 months or more and were unresponsive to alternate conservative measures. Patients with chronic lateral epicondylitis received PRP injections in 4-week intervals that were complemented with standardized physical therapy. Patient-reported outcomes based on the patient-rated elbow evaluation (PREE), quick disabilities of the arm, shoulder and hand (qDASH), and EuroQol (five dimensions) 3-level version (EQ5D3L) questionnaires were documented at each visit including 6 months after the first injection. These outcomes were compared between patients receiving 1 vs. 2 or 3 PRP injections. Sixty-two patients received one (n = 36) or more (n = 26) PRP injections. The mean baseline to 6-month follow-up scores of the PREE and qDASH questionnaires improved significantly from 54.0 to 23.0 and 50.3 to 20.7, respectively. The mean baseline EQ5D3L-visual analogue scale score improved from 62.5 to 82.9 by 6 months post-injection. These outcomes did not significantly differ between the patients who received varying numbers of injections. Patients with chronic lateral epicondylitis reported significant pain relief and gain in function as well as quality of life 6 months after localized PRP treatment. A single PRP injection may be sufficient.

Depression and anxiety among chronic pain patients receiving prescription opioids and medical marijuana.

PubMed

Feingold, Daniel; Brill, Silviu; Goor-Aryeh, Itay; Delayahu, Yael; Lev-Ran, Shaul

2017-08-15

High rates of depression and anxiety have been consistently reported among patients suffering from chronic pain. Prescription opioids are one of the most common modalities for pharmacological treatment of pain, however in recent years medical marijuana(MM) has been increasingly used for pain control in the US and in several countries worldwide. The aim of this study was to compare levels of depression and anxiety among pain patients receiving prescription opioids and MM. Participants were patients suffering from chronic pain treated with prescription opioids (OP,N=474), MM (N=329) or both (OPMM,N=77). Depression and anxiety were assessed using the depression module of the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder scale (GAD-7). Prevalence of depression among patients in the OP, MM and OPMM groups was 57.1%, 22.3% and 51.4%, respectively and rates of anxiety were 48.4%, 21.5% and 38.7%, respectively. After controlling for confounders, patients in the OP group were significantly more likely to screen positive for depression (Adjusted Odds Ratio(AOR)=6.18;95%CI=4.12-9.338) and anxiety(AOR=4.12;CI=3.84-5.71)) compared to those in the MM group. Individuals in the OPMM group were more prone for depression (AOR for depression=3.34;CI=1.52-7.34)) compared to those in the MM group. Cross-sectional study, restricting inference of causality. Levels of depression and anxiety are higher among chronic pain patients receiving prescription opioids compared to those receiving MM. Findings should be taken into consideration when deciding on the most appropriate treatment modality for chronic pain, particularly among those at risk for depression and anxiety. Copyright © 2017 Elsevier B.V. All rights reserved.

Efficacy of preventive spinal manipulation for chronic low-back pain and related disabilities: a preliminary study.

PubMed

Descarreaux, Martin; Blouin, Jean-Sébastien; Drolet, Marc; Papadimitriou, Stanislas; Teasdale, Normand

2004-10-01

To document the potential role of maintenance chiropractic spinal manipulation to reduce overall pain and disability levels associated with chronic low-back conditions after an initial phase of intensive chiropractic treatments. Thirty patients with chronic nonspecific low-back pain were separated into 2 groups. The first group received 12 treatments in an intensive 1-month period but received no treatment in a subsequent 9-month period. For this group, a 4-week period preceding the initial phase of treatment was used as a control period to examine the sole effect of time on pain and disability levels. The second group received 12 treatments in an intensive 1-month period and also received maintenance spinal manipulation every 3 weeks for a 9-month follow-up period. Pain and disability levels were evaluated with a visual analog scale and a modified Oswestry questionnaire, respectively. The 1-month control period did not modify the pain and disability levels. For both groups, the pain and disability levels decreased after the intensive phase of treatments. Both groups maintained their pain scores at levels similar to the postintensive treatments throughout the follow-up period. For the disability scores, however, only the group that was given spinal manipulations during the follow-up period maintained their postintensive treatment scores. The disability scores of the other group went back to their pretreatment levels. Intensive spinal manipulation is effective for the treatment of chronic low back pain. This experiment suggests that maintenance spinal manipulations after intensive manipulative care may be beneficial to patients to maintain subjective postintensive treatment disability levels. Future studies, however, are needed to confirm the finding in a larger group of patients with chronic low-back pain.

TREATMENT OF HEAVY METALS IN STORMWATER RUNOFF USING WET POND AND WETLAND MESOCOSMS

EPA Science Inventory

Urban stormwater runoff is being recognized as a major source of pollutants to receiving waters and a number of recent investigations have evaluated stormwater runoff quality and best management practices to minimize pollutant input to receiving waters. Particle-bound contaminant...

Encrypting Digital Camera with Automatic Encryption Key Deletion

NASA Technical Reports Server (NTRS)

Oakley, Ernest C. (Inventor)

2007-01-01

A digital video camera includes an image sensor capable of producing a frame of video data representing an image viewed by the sensor, an image memory for storing video data such as previously recorded frame data in a video frame location of the image memory, a read circuit for fetching the previously recorded frame data, an encryption circuit having an encryption key input connected to receive the previously recorded frame data from the read circuit as an encryption key, an un-encrypted data input connected to receive the frame of video data from the image sensor and an encrypted data output port, and a write circuit for writing a frame of encrypted video data received from the encrypted data output port of the encryption circuit to the memory and overwriting the video frame location storing the previously recorded frame data.

Staging memory for massively parallel processor

NASA Technical Reports Server (NTRS)

Batcher, Kenneth E. (Inventor)

1988-01-01

The invention herein relates to a computer organization capable of rapidly processing extremely large volumes of data. A staging memory is provided having a main stager portion consisting of a large number of memory banks which are accessed in parallel to receive, store, and transfer data words simultaneous with each other. Substager portions interconnect with the main stager portion to match input and output data formats with the data format of the main stager portion. An address generator is coded for accessing the data banks for receiving or transferring the appropriate words. Input and output permutation networks arrange the lineal order of data into and out of the memory banks.

Grazoprevir plus elbasvir in HCV genotype-1 or -4 infected patients with stage 4/5 severe chronic kidney disease is safe and effective.

PubMed

Alric, Laurent; Ollivier-Hourmand, Isabelle; Bérard, Emilie; Hillaire, Sophie; Guillaume, Maeva; Vallet-Pichard, Anais; Bernard-Chabert, Brigitte; Loustaud-Ratti, Veronique; Bourlière, Marc; de Ledinghen, Victor; Fouchard-Hubert, Isabelle; Canva, Valerie; Minello, Anne; Nguyen-Khac, Eric; Leroy, Vincent; Saadoun, David; Trias, Dominique; Pol, Stanislas; Kamar, Nassim

2018-07-01

Patients with advanced chronic kidney disease who receive direct-acting antiviral drugs require special consideration regarding comorbid conditions. Here we assessed the efficacy and safety of grazoprevir plus elbasvir in 93 patients infected with HCV genotype 1 or 4 and with advanced chronic kidney disease in a non-randomized, multicenter, nationwide observational survey. Twenty patients with HCV genotype 1a, 51 patients with 1b, four unclassified genotype 1, 17 with genotype 4 and one with genotype 6 received grazoprevir plus elbasvir (100/50 mg) once daily. All patients had severe chronic kidney disease with 70 patients stage G5, including patients on hemodialysis (74.2%), and 23 were stage G4 chronic kidney disease. Severe liver disease (Metavir F3/F4) was found in 33 patients. A sustained virologic response 12 weeks after the end of therapy was achieved in 87 of 90 patients. Two patients had a virologic breakthrough and one had a relapse after treatment withdrawal. Most patients received many concomitant medications (mean 7.7) related to comorbid conditions. Serious adverse events occurred in six patients, including three deaths while on grazoprevir plus elbasvir, not related to this therapy. Thus, once-daily grazoprevir plus elbasvir was highly effective with a low rate of adverse events in this advanced chronic kidney disease difficult-to-treat population with an HCV genotype 1 or 4 infection. Copyright © 2018 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

Service Use Preceding Opioid-Related Fatality.

PubMed

Olfson, Mark; Wall, Melanie; Wang, Shuai; Crystal, Stephen; Blanco, Carlos

2017-11-28

This study analyzed health service patterns before opioid-related death among nonelderly individuals in the Medicaid program, focusing on decedents with and without past-year diagnoses of noncancer chronic pain. The authors identified opioid-related decedents, age ≤64 years, in the Medicaid program and characterized their clinical diagnoses, filled medication prescriptions, and nonfatal poisoning events during the 30 days and 12 months before death. The study group included 13,089 opioid-related deaths partitioned by presence or absence of chronic noncancer pain diagnoses in the last year of life. Most decedents (61.5%) had received clinical diagnoses of chronic noncancer pain conditions in the last year of life. As compared with decedents without chronic pain diagnoses, those with these diagnoses were significantly more likely to have filled prescriptions for opioids (49.0% versus 17.2%) and benzodiazepines (52.1% versus 26.6%) during the last 30 days of life, while diagnoses of opioid use disorder during this period were uncommon in both groups (4.2% versus 4.3%). The chronic pain group was also significantly more likely than the nonpain group to receive clinical diagnoses of drug use (40.8% versus 22.1%), depression (29.6% versus 13.0%) or anxiety (25.8% versus 8.4%) disorders during the last year of life. Persons dying of opioid-related causes, particularly those who were diagnosed with chronic pain conditions, commonly received services related to drug use disorders and mental disorders in the last year of life, though opioid use disorder diagnoses near the time of death were rare.

Persistent Adaptations in Afferents to Ventral Tegmental Dopamine Neurons after Opiate Withdrawal

PubMed Central

Kaufling, Jennifer

2015-01-01

Protracted opiate withdrawal is accompanied by altered responsiveness of midbrain dopaminergic (DA) neurons, including a loss of DA cell response to morphine, and by behavioral alterations, including affective disorders. GABAergic neurons in the tail of the ventral tegmental area (tVTA), also called the rostromedial tegmental nucleus, are important for behavioral responses to opiates. We investigated the tVTA–VTA circuit in rats after chronic morphine exposure to determine whether tVTA neurons participate in the loss of opiate-induced disinhibition of VTA DA neurons observed during protracted withdrawal. In vivo recording revealed that VTA DA neurons, but not tVTA GABAergic neurons, are tolerant to morphine after 2 weeks of withdrawal. Optogenetic stimulation of tVTA neurons inhibited VTA DA neurons similarly in opiate-naive and long-term withdrawn rats. However, tVTA inactivation increased VTA DA activity in opiate-naive rats, but not in withdrawn rats, resembling the opiate tolerance effect in DA cells. Thus, although inhibitory control of DA neurons by tVTA is maintained during protracted withdrawal, the capacity for disinhibitory control is impaired. In addition, morphine withdrawal reduced both tVTA neural activity and tonic glutamatergic input to VTA DA neurons. We propose that these changes in glutamate and GABA inputs underlie the apparent tolerance of VTA DA neurons to opiates after chronic exposure. These alterations in the tVTA–VTA DA circuit could be an important factor in opiate tolerance and addiction. Moreover, the capacity of the tVTA to inhibit, but not disinhibit, DA cells after chronic opiate exposure may contribute to long-term negative affective states during withdrawal. SIGNIFICANCE STATEMENT Dopaminergic (DA) cells of the ventral tegmental area (VTA) are the origin of a brain reward system and are critically involved in drug abuse. Morphine has long been known to affect VTA DA cells via GABAergic interneurons. Recently, GABAergic neurons caudal to the VTA were discovered and named the tail of VTA (tVTA). Here, we show that tVTA GABA neurons lose their capacity to disinhibit, but not to inhibit, VTA DA cells after chronic opiate exposure. The failure of disinhibition was associated with a loss of glutamatergic input to DA neurons after chronic morphine. These findings reveal mechanisms by which the tVTA may play a key role in long-term negative affective states during opiate withdrawal. PMID:26180204

40 CFR 63.1360 - Applicability.

Code of Federal Regulations, 2014 CFR

2014-07-01

... process unit. If the greatest input to and/or output from a shared storage vessel is the same for two or... not have an intervening storage vessel. If two or more PAI process units have the same input to or... process unit that sends the most material to or receives the most material from the storage vessel. If two...

Shifts in allochthonous input and autochthonous production in streams along an agricultural land-use gradient

Treesearch

Elizabeth Hagen; Matthew McTammany; Jackson Webster; Ernest Benfield

2010-01-01

Relative contributions of allochthonous inputs and autochthonous production vary depending on terrestrial land use and biome. Terrestrially derived organic matter and in-stream primary production were measured in 12 headwater streams along an agricultural land-use gradient. Streams were examined to see how carbon (C) supply shifts from forested streams receiving...

Soil-test biological activity with the flush of CO2: III. Corn yield responses to applied nitrogen

USDA-ARS?s Scientific Manuscript database

Corn (Zea mays L.) is an important cereal grain in many states and typically receives large N fertilizer inputs, irrespective of historical management. Tailoring N inputs to soil-specific conditions would help to increase efficiency of N use and avoid environmental contamination. A total of 47 tri...

MURI: Impact of Oceanographic Variability on Acoustic Communications

DTIC Science & Technology

2011-09-01

multiplexing ( OFDM ), multiple- input/multiple-output ( MIMO ) transmissions, and multi-user single-input/multiple-output (SIMO) communications. Lastly... MIMO - OFDM communications: Receiver design for Doppler distorted underwater acoustic channels,” Proc. Asilomar Conf. on Signals, Systems, and... MIMO ) will be of particular interest. Validating experimental data will be obtained during the ONR acoustic communications experiment in summer 2008

76 FR 67146 - Certain Preserved Mushrooms From the People's Republic of China: Final Results of Antidumping...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-31

... surrogate value to use for the input cow manure. We received comments from Hengyong, Hongda, and Monterey... the correct valuation of the input cow manure. Our September 8, 2011, letter included eight exhibits each consisting of a valuation source for cow manure different from the source we used in the...

ENHANCED AIR POLLUTION EPIDEMIOLOGY USING A SOURCE-ORIENTED CHEMICAL TRANSPORT MODEL

EPA Science Inventory

Air quality model predictions describing source-oriented PM component concentrations in multiple size cuts will provide new inputs to examine the effects of acute and chronic PM exposure on mortality and morbidity. Associations between adverse health effects and PM sources/com...

Somatosensory Projections to Cochlear Nucleus are Up-regulated after Unilateral Deafness

PubMed Central

Zeng, Chunhua; Yang, Ziheng; Shreve, Lauren; Bledsoe, Sanford; Shore, Susan

2012-01-01

The cochlear nucleus (CN) receives innervation from auditory and somatosensory structures, which can be identified using vesicular glutamate transporters, VGLUT1 and VGLUT2. VGLUT1 is highly expressed in the magnocellular ventral CN (VCN), which receives auditory nerve inputs. VGLUT2 is predominantly expressed in the granule cell domain (GCD), which receives non-auditory inputs from somatosensory nuclei, including spinal trigeminal nucleus (Sp5) and cuneate nucleus (Cu). Two weeks after unilateral deafening VGLUT1 is significantly decreased in ipsilateral VCN while VGLUT2 is significantly increased in the ipsilateral GCD (Zeng et al., 2009), putatively reflecting decreased inputs from auditory nerve and increased inputs from non-auditory structures in guinea pigs. Here we wished to determine whether the upregulation of VGLUT2 represents increases in the number of somatosensory projections to the CN that are maintained for longer periods of time. Thus we examined concurrent changes in VGLUT levels and somatosensory projections in the CN using immunohistochemistry combined with anterograde tract tracing three and six weeks following unilateral deafening. The data reveal that unilateral deafness leads to increased numbers of VGLUT2-colabeled Sp5 and Cu projections to the ventral and dorsal CN. These findings suggest that Sp5 and Cu play significant and unique roles in cross-modal compensation and that, unlike after shorter term deafness, neurons in the magnocelluar regions also participate in the compensation. The enhanced glutamatergic somatosensory projections to the CN may play a role in neural spontaneous hyperactivity associated with tinnitus. PMID:23136418

Chronic escalating cocaine exposure, abstinence/withdrawal, and chronic re-exposure: Effects on striatal dopamine and opioid systems in C57BL/6J mice

PubMed Central

Zhang, Yong; Schlussman, Stefan D.; Rabkin, Jacqui; Butelman, Eduardo R.; Ho, Ann; Kreek, Mary Jeanne

2013-01-01

Cocaine addiction is a chronic relapsing disease with periods of chronic escalating self-exposure, separated by periods of abstinence/withdrawal of varying duration. Few studies compare such cycles in preclinical models. This study models an “addiction-like cycle” in mice to determine neurochemical/molecular alterations that underlie the chronic, relapsing nature of this disease. Groups of male C57BL/6J mice received acute cocaine exposure (14-day saline/14-day withdrawal /13-day saline + 1-day cocaine), chronic cocaine exposure (14 day cocaine) or chronic re-exposure (14-day cocaine/14-day withdrawal /14-day cocaine). Escalating-dose binge cocaine (15-30 mg/kg/injection x 3/day, i.p. at hourly intervals) or saline (14-day saline) was administered, modeling initial exposure. In “re-exposure” groups, after a 14-day injection-free period (modeling abstinence/withdrawal), mice that had received cocaine were re-injected with 14-day escalating-dose binge cocaine, whereas controls received saline. Microdialysis was conducted on the 14th day of exposure or re-exposure to determine striatal dopamine content. Messenger RNA levels of preprodynorphin (Pdyn), dopamine D1 (Drd1) and D2 (Drd2) in the caudate putamen were determined by real-time PCR. Basal striatal dopamine levels were lower in mice after 14-day escalating exposure or re-exposure than in those in the acute cocaine group and controls. Pdyn mRNA levels were higher in the cocaine groups than in controls. Long-term adaptation was observed across the stages of this addiction-like cycle, in that the effects of cocaine on dopamine levels were increased after re-exposure compared to exposure. Changes in striatal dopaminergic responses across chronic escalating cocaine exposure and re-exposure are a central feature of the neurobiology of relapsing addictive states. PMID:23164614

Arsenic in New Jersey Coastal Plain streams, sediments, and shallow groundwater: effects from different geologic sources and anthropogenic inputs on biogeochemical and physical mobilization processes

USGS Publications Warehouse

Barringer, Julia L.; Reilly, Pamela A.; Eberl, Dennis D.; Mumford, Adam C.; Benzel, William M.; Szabo, Zoltan; Shourds, Jennifer L.; Young, Lily Y.

2013-01-01

With a history of agriculture in the New Jersey Coastal Plain, anthropogenic inputs of As, such as residues from former pesticide applications in soils, can amplify any geogenic As in runoff. Such inputs contribute to an increased total As load to a stream at high stages of flow. As a result of yet another anthropogenic influence, microbes that reduce and mobilize As beneath the streambeds are stimulated by inputs of dissolved organic carbon (DOC). Although DOC is naturally occurring, anthropogenic contributions from wastewater inputs may deliver increased levels of DOC to subsurface soils and ultimately groundwater. Arsenic concentrations may increase with the increases in pH of groundwater and stream water in developed areas receiving wastewater inputs, as As mobilization caused by pH-controlled sorption and desorption reactions are likely to occur in waters of neutral or alkaline pH (for example, Nimick and others, 1998; Barringer and others, 2007b). Because of the difference in As content of the geologic materials in the two sub-provinces of the Coastal Plain, the amount of As that is mobile in groundwater and stream water is, potentially, substantially greater in the Inner Coastal Plain than in the Outer Coastal Plain. In turn, streams within the Inner and Outer Coastal Plain can receive substantially more As in groundwater discharge from developed areas than from environments where DOC appears to be of natural origin.

Reduction of perception of chronic fatigue in an observational study of patients receiving 12 weeks of Kampo therapy.

PubMed

Sekiya, Nobuyasu; Shimada, Yutaka; Shintani, Takahiro; Tahara, Eiichi; Kouta, Kazufumi; Shibahara, Naotoshi; Terasawa, Katsutoshi

2005-10-01

The aim of this study was to observe the influence of Kampo therapy on latent chronic fatigue of patients with chronic diseases. One hundred and seventy-three (173) consecutive patients with chronic diseases came to our department for the first time. This was a prospective study. Patients were divided into two groups: a chronic fatigue group (CFG) and a nonchronic fatigue group (NCFG). Based on Kampo diagnosis, both groups were prescribed Kampo formulae as an extract or decoction for 12 weeks. By using questionnaires, patients were assessed concerning their physical and mental types of fatigue, their sleep situation, and their attitude toward work or housekeeping, both before and after 12 weeks of treatment, according to Kampo diagnosis. The mental fatigue, physical fatigue, and sleep scores of both groups, and the work score of CFG, were decreased. The rate of reduction of the fatigue score was significantly greater in CFG than in NCFG. The factor responsible for this difference in fatigue score was physical fatigue. A reduction of the perception of chronic fatigue was observed in patients receiving 12 weeks of Kampo therapy.

Acute and chronic ethanol intake: effects on spatial and non-spatial memory in rats.

PubMed

García-Moreno, Luis M; Cimadevilla, Jose M

2012-12-01

Abusive alcohol consumption produces neuronal damage and biochemical alterations in the mammal brain followed by cognitive disturbances. In this work rats receiving chronic and acute alcohol intake were evaluated in a spontaneous delayed non-matching to sample/position test. Chronic alcohol-treated rats had free access to an aqueous ethanol solution as the only available liquid source from the postnatal day 21 to the end of experiment (postnatal day 90). Acute alcoholic animals received an injection of 2 g/kg ethanol solution once per week. Subjects were evaluated in two tests (object recognition and spatial recognition) based on the spontaneous delayed non-matching to sample or to position paradigm using delays of 1 min, 15 min and 60 min. Results showed that chronic and acute alcohol intake impairs the rats' performance in both tests. Moreover, chronic alcohol-treated rats were more altered than acute treated animals in both tasks. Our results support the idea that chronic and acute alcohol administration during postnatal development caused widespread brain damage resulting in behavioral disturbances and learning disabilities. Copyright © 2012 Elsevier Inc. All rights reserved.

Social skills training as nursing intervention to improve the social skills and self-esteem of inpatients with chronic schizophrenia.

PubMed

Seo, Ji-Min; Ahn, Sukhee; Byun, Eun-Kyung; Kim, Chul-Kweon

2007-12-01

The effects of social skills training on the social skills and self-esteem of 66 patients with chronic schizophrenia were evaluated using the basic training and problem-solving training models. The experimental group received 16 group training sessions, and the control group received routine nursing care. The training program consisted of two parts: conversational skills and assertiveness skills. Data were collected at pretreatment and posttreatment. The conversational, interpersonal relationship, and assertiveness skills, and self-esteem of the experimental group showed significant improvement, whereas problem-solving skills did not improve. The results indicate that training in social skills is effective for improving the social skills and self-esteem of inpatients with chronic schizophrenia.

47 CFR 80.409 - Station logs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... calling (DSC) equipment has been verified by actual communications or a test call; (ii) The portable... devices which do not have integral navigation receivers, including: VHF DSC, MF DSC, satellite EPIRB and HF DSC or INMARSAT SES. On a ship without integral or directly connected navigation receiver input to...

47 CFR 80.409 - Station logs.

Code of Federal Regulations, 2011 CFR

2011-10-01

... calling (DSC) equipment has been verified by actual communications or a test call; (ii) The portable... devices which do not have integral navigation receivers, including: VHF DSC, MF DSC, satellite EPIRB and HF DSC or INMARSAT SES. On a ship without integral or directly connected navigation receiver input to...

Solar central receiver hybrid power system, phase 1. Volume 3: Appendices

NASA Astrophysics Data System (ADS)

1979-09-01

Parametric salt piping data, sample heat exchanger calculations, and salt/materials compatibility evaluations are presented. Data lists that include the heliostat field coordinates, the STEAEC program input data, the hybrid receiver design drawings and models, and the piping stress analysis are also presented.

Beta-blockers and cardiovascular outcomes in dialysis patients: a cohort study in Ontario, Canada.

PubMed

Kitchlu, Abhijat; Clemens, Kristin; Gomes, Tara; Hackam, Daniel G; Juurlink, David N; Mamdani, Muhammad; Manno, Michael; Oliver, Matthew J; Quinn, Robert R; Suri, Rita S; Wald, Ron; Yan, Andrew T; Garg, Amit X

2012-04-01

Beta-blockers may be cardioprotective in patients receiving chronic dialysis. We examined cardiovascular outcomes among incident dialysis patients receiving beta-blocker therapy. We conducted a retrospective cohort study employing linked healthcare databases in Ontario, Canada. We studied all consecutive chronic dialysis patients aged≥66 years who initiated dialysis between 1 July 1991 and 31 July 2007. Patients were divided into three groups according to new medication use after the initiation of chronic dialysis. The three groups were patients initiated on beta-blockers, calcium channel blockers and statins only. Patients in the beta-blocker and calcium channel blocker groups could also be concurrently receiving a statin. The primary outcome was time to a composite endpoint of death, myocardial infarction, stroke or coronary revascularization. There were a total of 1836 patients (504 beta-blocker, 570 calcium channel blocker and 762 statin-only users). Compared to statin-only use, beta-blocker use was not associated with improved cardiovascular outcomes [adjusted hazard ratio (aHR) 1.07, 95% confidence interval (CI) 0.92-1.23]. As expected, calcium channel blocker use was also not associated with improved cardiovascular outcomes (aHR 0.91, 95% CI 0.79-1.06). Among all subgroup analyses by beta-blocker attributes, only high-dose beta-blocker therapy was associated with better cardiovascular outcomes as compared to low-dose beta-blockers (aHR 0.50, 95% CI 0.29-0.88). We observed no beneficial effect of beta-blocker use among patients receiving chronic dialysis relative to our comparator groups. Given current uncertainty around the cardioprotective benefits of beta-blockers in patients receiving dialysis, a large randomized clinical trial is warranted.

Impact of ELN recommendations in the management of first-line treated chronic myeloid leukaemia patients: a French cross-sectional study.

PubMed

Etienne, Gabriel; Huguet, Francoise; Guerci-Bresler, Agnès; Nicolini, Franck E; Maloisel, Frédéric; Coiteux, Valérie; Dauriac, Charles; Carpentier, Nathalie; Bourdeix, Isabelle; Tulliez, Michel; Cony-Makhoul, Pascale

2016-07-01

The availability of tyrosine kinase inhibitors has extended therapeutic options for chronic myeloid leukaemia (CML) patients. Monitoring recommendations and clinical response goals have recently been updated. The objective of this study was to describe the profile of CML patients in chronic phase currently receiving first-line therapy, including treatment, monitoring and response kinetics. A multicentre, cross-sectional, epidemiological survey in unselected chronic phase CML patients in France attending consultations during a one-month period was performed. 438 of 697 (62·8%) reported patients were currently receiving first-line treatment and were analysed. Imatinib was the most frequently received treatment (72·4% of patients). Retrospective cytogenetic and molecular assessments at 3, 6, 12 or 18 months were available in 88·4% of patients. At the 12-month assessment, 32·2% were not in major molecular response (MMR). At last assessment, among 355 patients with duration of treatment ≥ 12 months, 91·5% had achieved MMR and 66·5% were in deep molecular response. This study, performed in everyday practice population of CML patients, suggests that monitoring of molecular responses in real-life practice is aligned with European LeukaemiaNet recommendations. The majority of patients still receiving first-line treatment are in optimal response, with a few being classified as in the warning area or responding to failure. © 2016 John Wiley & Sons Ltd.

Problematic Use of Prescription Opioids and Medicinal Cannabis Among Patients Suffering from Chronic Pain.

PubMed

Feingold, Daniel; Goor-Aryeh, Itay; Bril, Silviu; Delayahu, Yael; Lev-Ran, Shaul

2017-02-01

To assess prevalence rates and correlates of problematic use of prescription opioids and medicinal cannabis (MC) among patients receiving treatment for chronic pain. Cross-sectional study. Two leading pain clinics in Israel. Our sample included 888 individuals receiving treatment for chronic pain, of whom 99.4% received treatment with prescription opioids or MC. Problematic use of prescription opioids and MC was assessed using DSM-IV criteria, Portenoy’s Criteria (PC), and the Current Opioid Misuse Measure (COMM) questionnaire. Additional sociodemographic and clinical correlates of problematic use were also assessed. Among individuals treated with prescription opioids, prevalence of problematic use of opioids according to DSM-IV, PC, and COMM was 52.6%, 17.1%, and 28.7%, respectively. Among those treated with MC, prevalence of problematic use of cannabis according to DSM-IV and PC was 21.2% and 10.6%, respectively. Problematic use of opioids and cannabis was more common in individuals using medications for longer periods of time, reporting higher levels of depression and anxiety, and using alcohol or drugs. Problematic use of opioids was associated with higher self-reported levels of pain, and problematic use of cannabis was more common among individuals using larger amounts of MC. Problematic use of opioids is common among chronic pain patients treated with prescription opioids and is more prevalent than problematic use of cannabis among those receiving MC. Pain patients should be screened for risk factors for problematic use before initiating long-term treatment for pain-control.

Young adult outcomes of children growing up with chronic illness: an analysis of the National Longitudinal Study of Adolescent Health.

PubMed

Maslow, Gary R; Haydon, Abigail A; Ford, Carol Ann; Halpern, Carolyn Tucker

2011-03-01

To examine young adult outcomes in a nationally representative US cohort of young adults growing up with a chronic illness. Secondary analysis of nationally representative data from wave III (in 2001) of the National Longitudinal Study of Adolescent Health. United States. The analytic sample comprised 13 236 young adults aged 18 to 28 years at wave III. Self-report of a chronic physical illness (asthma, cancer, diabetes mellitus, or epilepsy) in adolescence. Respondents with asthma or nonasthmatic chronic illness (cancer, diabetes mellitus, or epilepsy) were compared with individuals without these conditions. Self-report of high school graduation, ever having employment, currently having employment, living with a parent/guardian, and ever receiving public assistance. Three percent of young adults had nonasthmatic chronic illness (cancer, diabetes, or epilepsy), and 16.0% had asthma. Most young adults with chronic illness graduated high school (81.3%) and currently had employment (60.4%). However, compared with healthy young adults, those with nonasthmatic chronic illness were significantly less likely to graduate high school, ever have had employment, or currently have employment and were more likely to receive public assistance. Compared with young adults with asthma, those with nonasthmatic chronic illness again had significantly worse young adult outcomes on all measures. Most young adults growing up with a chronic illness graduate high school and have employment. However, these young adults are significantly less likely than their healthy peers to achieve these important educational and vocational milestones.

A Transcriptional Signature of Fatigue Derived from Patients with Primary Sjögren’s Syndrome

PubMed Central

James, Katherine; Al-Ali, Shereen; Tarn, Jessica; Cockell, Simon J.; Gillespie, Colin S.; Hindmarsh, Victoria; Locke, James; Mitchell, Sheryl; Lendrem, Dennis; Bowman, Simon; Price, Elizabeth; Pease, Colin T.; Emery, Paul; Lanyon, Peter; Hunter, John A.; Gupta, Monica; Bombardieri, Michele; Sutcliffe, Nurhan; Pitzalis, Costantino; McLaren, John; Cooper, Annie; Regan, Marian; Giles, Ian; Isenberg, David; Saravanan, Vadivelu; Coady, David; Dasgupta, Bhaskar; McHugh, Neil; Young-Min, Steven; Moots, Robert; Gendi, Nagui; Akil, Mohammed; Griffiths, Bridget; Wipat, Anil; Newton, Julia; Jones, David E.; Isaacs, John; Hallinan, Jennifer; Ng, Wan-Fai

2015-01-01

Background Fatigue is a debilitating condition with a significant impact on patients’ quality of life. Fatigue is frequently reported by patients suffering from primary Sjögren’s Syndrome (pSS), a chronic autoimmune condition characterised by dryness of the eyes and the mouth. However, although fatigue is common in pSS, it does not manifest in all sufferers, providing an excellent model with which to explore the potential underpinning biological mechanisms. Methods Whole blood samples from 133 fully-phenotyped pSS patients stratified for the presence of fatigue, collected by the UK primary Sjögren’s Syndrome Registry, were used for whole genome microarray. The resulting data were analysed both on a gene by gene basis and using pre-defined groups of genes. Finally, gene set enrichment analysis (GSEA) was used as a feature selection technique for input into a support vector machine (SVM) classifier. Classification was assessed using area under curve (AUC) of receiver operator characteristic and standard error of Wilcoxon statistic, SE(W). Results Although no genes were individually found to be associated with fatigue, 19 metabolic pathways were enriched in the high fatigue patient group using GSEA. Analysis revealed that these enrichments arose from the presence of a subset of 55 genes. A radial kernel SVM classifier with this subset of genes as input displayed significantly improved performance over classifiers using all pathway genes as input. The classifiers had AUCs of 0.866 (SE(W) 0.002) and 0.525 (SE(W) 0.006), respectively. Conclusions Systematic analysis of gene expression data from pSS patients discordant for fatigue identified 55 genes which are predictive of fatigue level using SVM classification. This list represents the first step in understanding the underlying pathophysiological mechanisms of fatigue in patients with pSS. PMID:26694930

Chronic Pain: How Challenging Are DDIs in the Analgesic Treatment of Inpatients with Multiple Chronic Conditions?

PubMed Central

Siebenhuener, Klarissa; Eschmann, Emmanuel; Kienast, Alexander; Schneider, Dominik; Minder, Christoph E.; Saller, Reinhard; Zimmerli, Lukas; Blaser, Jürg; Battegay, Edouard

2017-01-01

Background Chronic pain is common in multimorbid patients. However, little is known about the implications of chronic pain and analgesic treatment on multimorbid patients. This study aimed to assess chronic pain therapy with regard to the interaction potential in a sample of inpatients with multiple chronic conditions. Methods and Findings We conducted a retrospective study with all multimorbid inpatients aged ≥18 years admitted to the Department of Internal Medicine of University Hospital Zurich in 2011 (n = 1,039 patients). Data were extracted from the electronic health records and reviewed. We identified 433 hospitalizations of patients with chronic pain and analyzed their combinations of chronic conditions (multimorbidity). We then classified all analgesic prescriptions according to the World Health Organization (WHO) analgesic ladder. Furthermore, we used a Swiss drug-drug interactions knowledge base to identify potential interactions between opioids and other drug classes, in particular coanalgesics and other concomitant drugs. Chronic pain was present in 38% of patients with multimorbidity. On average, patients with chronic pain were aged 65.7 years and had a mean number of 6.6 diagnoses. Hypertension was the most common chronic condition. Chronic back pain was the most common painful condition. Almost 90% of patients were exposed to polypharmacotherapy. Of the chronic pain patients, 71.1% received opioids for moderate to severe pain, 43.4% received coanalgesics. We identified 3,186 potential drug-drug interactions, with 17% classified between analgesics (without coanalgesics). Conclusions Analgesic drugs-related DDIs, in particular opioids, in multimorbid patients are often complex and difficult to assess by using DDI knowledge bases alone. Drug-multimorbidity interactions are not sufficiently investigated and understood. Today, the scientific literature is scarce for chronic pain in combination with multiple coexisting medical conditions and medication regimens. Our work may provide useful information to enable further investigations in multimorbidity research within the scope of potential interactions and chronic pain. PMID:28046033

Chronic Pain: How Challenging Are DDIs in the Analgesic Treatment of Inpatients with Multiple Chronic Conditions?

PubMed

Siebenhuener, Klarissa; Eschmann, Emmanuel; Kienast, Alexander; Schneider, Dominik; Minder, Christoph E; Saller, Reinhard; Zimmerli, Lukas; Blaser, Jürg; Battegay, Edouard; Holzer, Barbara M

2017-01-01

Chronic pain is common in multimorbid patients. However, little is known about the implications of chronic pain and analgesic treatment on multimorbid patients. This study aimed to assess chronic pain therapy with regard to the interaction potential in a sample of inpatients with multiple chronic conditions. We conducted a retrospective study with all multimorbid inpatients aged ≥18 years admitted to the Department of Internal Medicine of University Hospital Zurich in 2011 (n = 1,039 patients). Data were extracted from the electronic health records and reviewed. We identified 433 hospitalizations of patients with chronic pain and analyzed their combinations of chronic conditions (multimorbidity). We then classified all analgesic prescriptions according to the World Health Organization (WHO) analgesic ladder. Furthermore, we used a Swiss drug-drug interactions knowledge base to identify potential interactions between opioids and other drug classes, in particular coanalgesics and other concomitant drugs. Chronic pain was present in 38% of patients with multimorbidity. On average, patients with chronic pain were aged 65.7 years and had a mean number of 6.6 diagnoses. Hypertension was the most common chronic condition. Chronic back pain was the most common painful condition. Almost 90% of patients were exposed to polypharmacotherapy. Of the chronic pain patients, 71.1% received opioids for moderate to severe pain, 43.4% received coanalgesics. We identified 3,186 potential drug-drug interactions, with 17% classified between analgesics (without coanalgesics). Analgesic drugs-related DDIs, in particular opioids, in multimorbid patients are often complex and difficult to assess by using DDI knowledge bases alone. Drug-multimorbidity interactions are not sufficiently investigated and understood. Today, the scientific literature is scarce for chronic pain in combination with multiple coexisting medical conditions and medication regimens. Our work may provide useful information to enable further investigations in multimorbidity research within the scope of potential interactions and chronic pain.

The influence of chronic hypoxia upon chemoreception

PubMed Central

Powell, Frank L.

2007-01-01

Carotid body chemoreceptors are essential for time-dependent changes in ventilatory control during chronic hypoxia. Early theories of ventilatory acclimatization to hypoxia focused on time-dependent changes in known ventilatory stimuli, such as small changes in arterial pH that may play a significant role in some species. However, plasticity in the cellular and molecular mechanisms of carotid body chemoreception play a major role in ventilatory acclimatization to hypoxia in all species studied. Chronic hypoxia causes changes in (a) ion channels (potassium, sodium, calcium) to increase glomus cell excitability, and (b) neurotransmitters (dopamine, acetylcholine, ATP) and neuromodulators (endothelin-1) to increase carotid body afferent activity for a given PO2 and optimize O2-sensitivity. O2-sensing heme-containing molecules in the carotid body have not been studied in chronic hypoxia. Plasticity in medullary respiratory centers processing carotid body afferent input also contributes to ventilatory acclimatization to hypoxia. It is not known if the same mechanisms occur in patients with chronic hypoxemia from lung disease or high altitude natives. PMID:17291837

Bacterial population and biodegradation potential in chronically crude oil-contaminated marine sediments are strongly linked to temperature.

PubMed

Bargiela, Rafael; Mapelli, Francesca; Rojo, David; Chouaia, Bessem; Tornés, Jesús; Borin, Sara; Richter, Michael; Del Pozo, Mercedes V; Cappello, Simone; Gertler, Christoph; Genovese, María; Denaro, Renata; Martínez-Martínez, Mónica; Fodelianakis, Stilianos; Amer, Ranya A; Bigazzi, David; Han, Xifang; Chen, Jianwei; Chernikova, Tatyana N; Golyshina, Olga V; Mahjoubi, Mouna; Jaouanil, Atef; Benzha, Fatima; Magagnini, Mirko; Hussein, Emad; Al-Horani, Fuad; Cherif, Ameur; Blaghen, Mohamed; Abdel-Fattah, Yasser R; Kalogerakis, Nicolas; Barbas, Coral; Malkawi, Hanan I; Golyshin, Peter N; Yakimov, Michail M; Daffonchio, Daniele; Ferrer, Manuel

2015-06-29

Two of the largest crude oil-polluted areas in the world are the semi-enclosed Mediterranean and Red Seas, but the effect of chronic pollution remains incompletely understood on a large scale. We compared the influence of environmental and geographical constraints and anthropogenic forces (hydrocarbon input) on bacterial communities in eight geographically separated oil-polluted sites along the coastlines of the Mediterranean and Red Seas. The differences in community compositions and their biodegradation potential were primarily associated (P < 0.05) with both temperature and chemical diversity. Furthermore, we observed a link between temperature and chemical and biological diversity that was stronger in chronically polluted sites than in pristine ones where accidental oil spills occurred. We propose that low temperature increases bacterial richness while decreasing catabolic diversity and that chronic pollution promotes catabolic diversification. Our results further suggest that the bacterial populations in chronically polluted sites may respond more promptly in degrading petroleum after accidental oil spills.

Bacterial population and biodegradation potential in chronically crude oil-contaminated marine sediments are strongly linked to temperature

PubMed Central

Bargiela, Rafael; Mapelli, Francesca; Rojo, David; Chouaia, Bessem; Tornés, Jesús; Borin, Sara; Richter, Michael; Del Pozo, Mercedes V.; Cappello, Simone; Gertler, Christoph; Genovese, María; Denaro, Renata; Martínez-Martínez, Mónica; Fodelianakis, Stilianos; Amer, Ranya A.; Bigazzi, David; Han, Xifang; Chen, Jianwei; Chernikova, Tatyana N.; Golyshina, Olga V.; Mahjoubi, Mouna; Jaouanil, Atef; Benzha, Fatima; Magagnini, Mirko; Hussein, Emad; Al-Horani, Fuad; Cherif, Ameur; Blaghen, Mohamed; Abdel-Fattah, Yasser R.; Kalogerakis, Nicolas; Barbas, Coral; Malkawi, Hanan I.; Golyshin, Peter N.; Yakimov, Michail M.; Daffonchio, Daniele; Ferrer, Manuel

2015-01-01

Two of the largest crude oil-polluted areas in the world are the semi-enclosed Mediterranean and Red Seas, but the effect of chronic pollution remains incompletely understood on a large scale. We compared the influence of environmental and geographical constraints and anthropogenic forces (hydrocarbon input) on bacterial communities in eight geographically separated oil-polluted sites along the coastlines of the Mediterranean and Red Seas. The differences in community compositions and their biodegradation potential were primarily associated (P < 0.05) with both temperature and chemical diversity. Furthermore, we observed a link between temperature and chemical and biological diversity that was stronger in chronically polluted sites than in pristine ones where accidental oil spills occurred. We propose that low temperature increases bacterial richness while decreasing catabolic diversity and that chronic pollution promotes catabolic diversification. Our results further suggest that the bacterial populations in chronically polluted sites may respond more promptly in degrading petroleum after accidental oil spills. PMID:26119183

Effect of Three Classroom Listening Conditions on Speech Intelligibility

ERIC Educational Resources Information Center

Ross, Mark; Giolas, Thomas G.

1971-01-01

Speech discrimination scores for 13 deaf children were obtained in a classroom under: usual listening condition (hearing aid or not), binaural listening situation using auditory trainer/FM receiver with wireless microphone transmitter turned off, and binaural condition with inputs from auditory trainer/FM receiver and wireless microphone/FM…

[Use of decamethoxine in the complex treatment of chronic bronchitis].

PubMed

Iukhimets, V A; Pilipchuk, V N

1990-02-01

Seventy-two patients with chronic bronchitis were examined and divided into 3 groups. Group I consisted of patients with chronic catarrhal bronchitis (CCB) group II of those with chronic purulent bronchitis (CPB), group III of subjects with bronchitis associated with purulent destructive pulmonary diseases. All the patients received combined treatment with decamethoxin as an antibacterial modality. It was found that decamethoxin promotes elimination of the infection of the bronchial secretion in 60% of chronic bronchitis suffers, the incidence of microorganisms resistent to several antibiotics reduced 2-fold. Local use of decamethoxin as an antibacterial and antiinflammatory drug in multimodality treatment of chronic purulent bronchitis proved highly effective.

Association of socioeconomic status with the use of chronic therapies and healthcare utilization in children with cystic fibrosis.

PubMed

Schechter, Michael S; McColley, Susanna A; Silva, Stefanie; Haselkorn, Tmirah; Konstan, Michael W; Wagener, Jeffrey S

2009-11-01

To determine whether previously reported socioeconomic status (SES)-related disparities in cystic fibrosis (CF) health outcomes vary by the indicator used (median household income by zip code [MIZ], maternal educational attainment [MEA], and state insurance coverage [MA]), and whether these disparities can be explained by differences in medical treatment. A cross-sectional analysis of data on patients age <18 years from the Epidemiologic Study of Cystic Fibrosis (ESCF). Disease severity showed a similar inverse correlation with all 3 SES measures. The number of stable clinic visits was unrelated to SES. Patients with MA had more sick outpatient visits and more courses of intravenous (IV) antibiotics for pulmonary exacerbations, and were more likely to be prescribed all chronic therapies. Low-MIZ patients had slightly fewer sick visits and more courses of IV antibiotics, and were more likely to receive oral nutrition supplements but less likely to receive macrolide prescriptions. Low-MEA patients were less likely to receive IV antibiotics at home, more likely to receive oral nutrition supplements, but less likely to receive macrolide prescriptions. CF health outcomes are correlated with the SES spectrum, but these disparities are not explained by differential use of health services or prescription of chronic therapy. Future investigations should focus on the possible impact of environmental exposures and differences in disease self-management.

EURELIOS, the world's first thermomechanical helioelectric power plant

NASA Astrophysics Data System (ADS)

Gretz, J.

Characteristics of the power source, design, costs and operating mechanisms and performance of the EURELIOS central receiver solar electric power plant are described. Noting that the solar input at the earth's surface is about 1 kW/sq m, 6200 sq m of float glass mirrors mounted on 182 heliostats were fabricated to focus the incoming radiation onto a receiver aperture atop a 55 m high tower. The curved mirrors permit the focus of 80% of the energy input to be deposited on a 2.2 m diam aperture which is equipped with heat exchangers imbedded in pyrex and darkened and finned to maximize absorption. Feedwater is superheated in the receiver and is transferred to a buffer tank of hot water at 19 bar and molten salt at 410 C, and then on to turbines for actual power production. The grid serves as back-up power system. Total costs are calculated at $1600/kWe.

Power inverter implementing phase skipping control

DOEpatents

Somani, Utsav; Amirahmadi, Ahmadreza; Jourdan, Charles; Batarseh, Issa

2016-10-18

A power inverter includes a DC/AC inverter having first, second and third phase circuitry coupled to receive power from a power source. A controller is coupled to a driver for each of the first, second and third phase circuitry (control input drivers). The controller includes an associated memory storing a phase skipping control algorithm, wherein the controller is coupled to receive updating information including a power level generated by the power source. The drivers are coupled to control inputs of the first, second and third phase circuitry, where the drivers are configured for receiving phase skipping control signals from the controller and outputting mode selection signals configured to dynamically select an operating mode for the DC/AC inverter from a Normal Control operation and a Phase Skipping Control operation which have different power injection patterns through the first, second and third phase circuitry depending upon the power level.

Investigating the Effect of Extensive Reading on EFL Learners' Reading Attitudes at Hail University in KSA

ERIC Educational Resources Information Center

Salameh, Lina Abedelqader Mohmmad

2017-01-01

Extensive reading approach (ER) has received conceptual support from views and theories that prioritize the importance of input in second language acquisition. ER is probably one of the easiest ways to implement an input-rich learning environment in a pedagogical setting. Accordingly, the current study is an attempt to investigate the effect of ER…

The Effect of Tongue Exercise on Serotonergic Input to the Hypoglossal Nucleus in Young and Old Rats

ERIC Educational Resources Information Center

Behan, Mary; Moeser, Adam E.; Thomas, Cathy F.; Russell, John A.; Wang, Hao; Leverson, Glen E.; Connor, Nadine P.

2012-01-01

Purpose: Breathing and swallowing problems affect elderly people and may be related to age-associated tongue dysfunction. Hypoglossal motoneurons that innervate the tongue receive a robust, excitatory serotonergic (5HT) input and may be affected by aging. We used a rat model of aging and progressive resistance tongue exercise to determine whether…

First Parity Evaluation of Body Condition, Weight, and Blood Beta-Hydroxybutyrate During Lactation of Range Cows Developed in the Same Ecophysiological System but Receiving Different Harvested Feed Inputs

USDA-ARS?s Scientific Manuscript database

Reduction of harvested feed inputs during heifer development could optimize range livestock production and improve economic feasibility for producers. The objective of this study was to measure body condition and weight as well as blood beta-hydroxybutyrate (BHB) concentrations for primiparous beef ...

First parity evaluation of body condition, weight, and blood beta-hydroxybutyrate during lactation of range cows developed in the same ecophysiological system but receiving different harvested feed inputs

USDA-ARS?s Scientific Manuscript database

Reduction of harvested feed inputs during heifer development could optimize range livestock production and improve economic feasibility for producers. The objective of this study was to measure body condition and weight as well as blood beta-hydroxybutyrate (BHB) concentrations for primiparous beef ...

First parity evaluation of peak milk yield for range cows developed in the same ecophysiological system but receiving different concentrations of harvested feed inputs

USDA-ARS?s Scientific Manuscript database

Can range livestock producers reduce harvested feed inputs, during heifer development, and maintain production goals? To address this, we conducted a two year study measuring milk production (kg/d) and milk constituent concentrations (g/d) for 16 primiparous beef cows each year that were born from d...

First parity evaluation of peak milk yield for range cows developed in the same ecophysiological system but receiving different concentrations of harvested feed inputs

USDA-ARS?s Scientific Manuscript database

Reduction of harvested feed inputs during heifer development could optimize range livestock production and improve economic feasibility. The objective for this two year study was to measure milk production (kg/d) and milk constituent concentrations (g/d) for 16 primiparous beef cows each year that w...

Microwave applicator for in-drum processing of radioactive waste slurry

DOEpatents

White, Terry L.

1994-01-01

A microwave applicator for processing of radioactive waste slurry uses a waveguide network which splits an input microwave of TE.sub.10 rectangular mode to TE.sub.01 circular mode. A cylindrical body has four openings, each receiving 1/4 of the power input. The waveguide network includes a plurality of splitters to effect the 1/4 divisions of power.

Can 28-Month-Old Children Learn Spatial Prepositions Robustly from Pictures? Yes, When Narrative Input Is Provided

PubMed Central

Rohlfing, Katharina J.; Nachtigäller, Kerstin

2016-01-01

The learning of spatial prepositions is assumed to be based on experience in space. In a slow mapping study, we investigated whether 31 German 28-month-old children could robustly learn the German spatial prepositions hinter [behind] and neben [next to] from pictures, and whether a narrative input can compensate for a lack of immediate experience in space. One group of children received pictures with a narrative input as a training to understand spatial prepositions. In two further groups, we controlled (a) for the narrative input by providing unconnected speech during the training and (b) for the learning material by training the children on toys rather than pictures. We assessed children’s understanding of spatial prepositions at three different time points: pretest, immediate test, and delayed posttest. Results showed improved word retention in children from the narrative but not the control group receiving unconnected speech. Neither of the trained groups succeeded in generalization to novel referents. Finally, all groups were instructed to deal with untrained material in the test to investigate the robustness of learning across tasks. None of the groups succeeded in this task transfer. PMID:27471479

Team Electronic Gameplay Combining Different Means of Control

NASA Technical Reports Server (NTRS)

Palsson, Olafur S. (Inventor); Pope, Alan T. (Inventor)

2014-01-01

Disclosed are methods and apparatuses provided for modifying the effect of an operator controlled input device on an interactive device to encourage the self-regulation of at least one physiological activity by a person different than the operator. The interactive device comprises a display area which depicts images and apparatus for receiving at least one input from the operator controlled input device to thus permit the operator to control and interact with at least some of the depicted images. One effect modification comprises measurement of the physiological activity of a person different from the operator, while modifying the ability of the operator to control and interact with at least some of the depicted images by modifying the input from the operator controlled input device in response to changes in the measured physiological signal.

[Stress-induced hyperalgesia (SIH) as a consequence of emotional deprivation and psychosocial traumatization in childhood : Implications for the treatment of chronic pain].

PubMed

Egle, U T; Egloff, N; von Känel, R

2016-12-01

It is now widely recognized that in many chronic pain syndromes the intensity and severity of individually perceived pain does not correlate consistently with the degree of peripheral nervous system tissue damage or with the intensity of primary afferent or spinal nociceptive neurone activity. In particular, stress and anxiety exert modulatory influences on pain depending on the nature, duration and intensity of the stressor and developmental influences on the maturation of the stress as well as the pain system. In some chronic pain syndromes, e. g. fibromyalgia, TMD or somatoform disorders, no nociceptive or neuropathic input is detectable. We summarise the studies investigating the neural substrates and neurobiological mechanisms of stress-induced hyperalgesia (SIH) in animals and humans. The review provides new perspectives and challenges for the current and future treatment of chronic pain.

Comparison of Three Non-Imaging Angle-Diversity Receivers as Input Sensors of Nodes for Indoor Infrared Wireless Sensor Networks: Theory and Simulation

PubMed Central

Mendoza, Beatriz R.; Rodríguez, Silvestre; Pérez-Jiménez, Rafael; Ayala, Alejandro; González, Oswaldo

2016-01-01

In general, the use of angle-diversity receivers makes it possible to reduce the impact of ambient light noise, path loss and multipath distortion, in part by exploiting the fact that they often receive the desired signal from different directions. Angle-diversity detection can be performed using a composite receiver with multiple detector elements looking in different directions. These are called non-imaging angle-diversity receivers. In this paper, a comparison of three non-imaging angle-diversity receivers as input sensors of nodes for an indoor infrared (IR) wireless sensor network is presented. The receivers considered are the conventional angle-diversity receiver (CDR), the sectored angle-diversity receiver (SDR), and the self-orienting receiver (SOR), which have been proposed or studied by research groups in Spain. To this end, the effective signal-collection area of the three receivers is modelled and a Monte-Carlo-based ray-tracing algorithm is implemented which allows us to investigate the effect on the signal to noise ratio and main IR channel parameters, such as path loss and rms delay spread, of using the three receivers in conjunction with different combination techniques in IR links operating at low bit rates. Based on the results of the simulations, we show that the use of a conventional angle-diversity receiver in conjunction with the equal-gain combining technique provides the solution with the best signal to noise ratio, the lowest computational capacity and the lowest transmitted power requirements, which comprise the main limitations for sensor nodes in an indoor infrared wireless sensor network. PMID:27428966

Chronic stress experience in young physicians: impact of person- and workplace-related factors.

PubMed

Buddeberg-Fischer, Barbara; Stamm, Martina; Buddeberg, Claus; Klaghofer, Richard

2010-04-01

The objectives of the present study are to investigate and compare the relative impact of workplace-related factors and personal characteristics on chronic psychosocial stress experience in young physicians. In a prospective study, a cohort of Swiss medical school graduates was followed up, beginning in 2001. In their fourth and eighth year after graduation, 443 physicians assessed their workplace conditions, the experienced effort-reward imbalance, the received professional and emotional support as well as their personal characteristics. The chronic stress experience was measured by the Trier Inventory for the Assessment of Chronic Stress-Screening Subscale of Chronic Stress (TICS-SCSS), 7 years after graduation. The model of influencing factors on chronic stress experience was tested with a hierarchical regression analysis. The mean in chronic stress (TICS-SCSS) in our study sample is significantly higher (p < 0.001) compared to an age-matched population representative sample. In the prediction of chronic stress, the workplace-related factor effort-reward imbalance as well as the personal characteristic overcommitment turned out to be the most important risk factors. Stress protective are high satisfaction with career support, sense of coherence and occupational self-efficacy. The whole set of variables used in the regression model explains 51% of the variance of chronic stress experience. In the prediction of chronic stress, gender has no significant moderator effect. It is a matter of concern that young physicians report to feel chronically stressed early in their professional career. Actions have to be taken to reduce the stress level mainly in regard to re-establish reciprocity between perceived effort invested and rewards received, in the form of esteem, monetary gain and career opportunities including job security.

Behavioral tolerance to lysergic acid diethylamide is associated with reduced serotonin-2A receptor signaling in rat cortex.

PubMed

Gresch, Paul J; Smith, Randy L; Barrett, Robert J; Sanders-Bush, Elaine

2005-09-01

Tolerance is defined as a decrease in responsiveness to a drug after repeated administration. Tolerance to the behavioral effects of hallucinogens occurs in humans and animals. In this study, we used drug discrimination to establish a behavioral model of lysergic acid diethylamide (LSD) tolerance and examined whether tolerance to the stimulus properties of LSD is related to altered serotonin receptor signaling. Rats were trained to discriminate 60 microg/kg LSD from saline in a two-lever drug discrimination paradigm. Two groups of animals were assigned to either chronic saline treatment or chronic LSD treatment. For chronic treatment, rats from each group were injected once per day with either 130 microg/kg LSD or saline for 5 days. Rats were tested for their ability to discriminate either saline or 60 microg/kg LSD, 24 h after the last chronic injection. Rats receiving chronic LSD showed a 44% reduction in LSD lever selection, while rats receiving chronic vehicle showed no change in percent choice on the LSD lever. In another group of rats receiving the identical chronic LSD treatment, LSD-stimulated [35S]GTPgammaS binding, an index of G-protein coupling, was measured in the rat brain by autoradiography. After chronic LSD, a significant reduction in LSD-stimulated [35S]GTPgammaS binding was observed in the medial prefrontal cortex and anterior cingulate cortex. Furthermore, chronic LSD produced a significant reduction in 2,5-dimethoxy-4-iodoamphetamine-stimulated [35S]GTPgammaS binding in medial prefrontal cortex and anterior cingulate cortex, which was blocked by MDL 100907, a selective 5-HT2A receptor antagonist, but not SB206553, a 5-HT2C receptor antagonist, indicating a reduction in 5-HT2A receptor signaling. 125I-LSD binding to 5-HT2A receptors was reduced in cortical regions, demonstrating a reduction in 5-HT2A receptor density. Taken together, these results indicate that adaptive changes in LSD-stimulated serotonin receptor signaling may mediate tolerance to the discriminative stimulus effects of LSD.

[Magnetic therapy for complex treatment of chronic periodontal disease].

PubMed

P'yanzina, A V

The aim of the study was to elaborate the methodology of magnetic therapy for complex treatment of chronic periodontal disease (CPD). The study included 60 patients aged 35 to 65 years with moderate CPD divided in 2 groups. Patients in group 1 (controls) received impulse carbonate irrigation for 12 min №10, group 2 additionally received magnetic therapy for 5 min №10 in maxillary and mandibular areas. periodontal and rheological indices proved magnetic therapy to be useful tool for eradication of inflammation, periodontal tissue functional recovery and stabilization.

The impact of input quality on early sign development in native and non-native language learners.

PubMed

Lu, Jenny; Jones, Anna; Morgan, Gary

2016-05-01

There is debate about how input variation influences child language. Most deaf children are exposed to a sign language from their non-fluent hearing parents and experience a delay in exposure to accessible language. A small number of children receive language input from their deaf parents who are fluent signers. Thus it is possible to document the impact of quality of input on early sign acquisition. The current study explores the outcomes of differential input in two groups of children aged two to five years: deaf children of hearing parents (DCHP) and deaf children of deaf parents (DCDP). Analysis of child sign language revealed DCDP had a more developed vocabulary and more phonological handshape types compared with DCHP. In naturalistic conversations deaf parents used more sign tokens and more phonological types than hearing parents. Results are discussed in terms of the effects of early input on subsequent language abilities.

On-Chip Power-Combining for High-Power Schottky Diode Based Frequency Multipliers

NASA Technical Reports Server (NTRS)

Siles Perez, Jose Vicente (Inventor); Chattopadhyay, Goutam (Inventor); Lee, Choonsup (Inventor); Schlecht, Erich T. (Inventor); Jung-Kubiak, Cecile D. (Inventor); Mehdi, Imran (Inventor)

2015-01-01

A novel MMIC on-chip power-combined frequency multiplier device and a method of fabricating the same, comprising two or more multiplying structures integrated on a single chip, wherein each of the integrated multiplying structures are electrically identical and each of the multiplying structures include one input antenna (E-probe) for receiving an input signal in the millimeter-wave, submillimeter-wave or terahertz frequency range inputted on the chip, a stripline based input matching network electrically connecting the input antennas to two or more Schottky diodes in a balanced configuration, two or more Schottky diodes that are used as nonlinear semiconductor devices to generate harmonics out of the input signal and produce the multiplied output signal, stripline based output matching networks for transmitting the output signal from the Schottky diodes to an output antenna, and an output antenna (E-probe) for transmitting the output signal off the chip into the output waveguide transmission line.

Remedying Social Skills Deficits in a Chronic Schizophrenic-Retarded Person.

ERIC Educational Resources Information Center

Jackson, Henry J.; Martin, Rose

1983-01-01

An adult chronic schizophrenic, residual type, with an additional diagnosis of mild-moderate retardation, received social skills training (SST). Videotaped role-play assessments showed change occurred following SST, while a multiple-baseline design demonstrated functional control over the behaviors. (Author/CL)

Water-carbon Links in a Tropical Forest: How Interbasin Groundwater Flow Affects Carbon Fluxes and Ecosystem Carbon Budgets

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

Genereux, David; Osburn, Christopher; Oberbauer, Steven

This report covers the outcomes from a quantitative, interdisciplinary field investigation of how carbon fluxes and budgets in a lowland tropical rainforest are affected by the discharge of old regional groundwater into streams, springs, and wetlands in the forest. The work was carried out in a lowland rainforest of Costa Rica, at La Selva Biological Station. The research shows that discharge of regional groundwater high in dissolved carbon dioxide represents a significant input of carbon to the rainforest "from below", an input that is on average larger than the carbon input "from above" from the atmosphere. A stream receiving dischargemore » of regional groundwater had greatly elevated emissions of carbon dioxide (but not methane) to the overlying air, and elevated downstream export of carbon from its watershed with stream flow. The emission of deep geological carbon dioxide from stream water elevates the carbon dioxide concentrations in air above the streams. Carbon-14 tracing revealed the presence of geological carbon in the leaves and stems of some riparian plants near streams that receive inputs of regional groundwater. Also, discharge of regional groundwater is responsible for input of dissolved organic matter with distinctive chemistry to rainforest streams and wetlands. The discharge of regional groundwater in lowland surface waters has a major impact on the carbon cycle in this and likely other tropical and non-tropical forests.« less

Multi-channel detector readout method and integrated circuit

DOEpatents

Moses, William W.; Beuville, Eric; Pedrali-Noy, Marzio

2006-12-12

An integrated circuit which provides multi-channel detector readout from a detector array. The circuit receives multiple signals from the elements of a detector array and compares the sampled amplitudes of these signals against a noise-floor threshold and against one another. A digital signal is generated which corresponds to the location of the highest of these signal amplitudes which exceeds the noise floor threshold. The digital signal is received by a multiplexing circuit which outputs an analog signal corresponding the highest of the input signal amplitudes. In addition a digital control section provides for programmatic control of the multiplexer circuit, amplifier gain, amplifier reset, masking selection, and test circuit functionality on each input thereof.

Multi-channel detector readout method and integrated circuit

DOEpatents

Moses, William W.; Beuville, Eric; Pedrali-Noy, Marzio

2004-05-18

An integrated circuit which provides multi-channel detector readout from a detector array. The circuit receives multiple signals from the elements of a detector array and compares the sampled amplitudes of these signals against a noise-floor threshold and against one another. A digital signal is generated which corresponds to the location of the highest of these signal amplitudes which exceeds the noise floor threshold. The digital signal is received by a multiplexing circuit which outputs an analog signal corresponding the highest of the input signal amplitudes. In addition a digital control section provides for programmatic control of the multiplexer circuit, amplifier gain, amplifier reset, masking selection, and test circuit functionality on each input thereof.

Contrasting Patterns of Cortical Input to Architectural Subdivisions of the Area 8 Complex: A Retrograde Tracing Study in Marmoset Monkeys

PubMed Central

Reser, David H.; Burman, Kathleen J.; Yu, Hsin-Hao; Chaplin, Tristan A.; Richardson, Karyn E.; Worthy, Katrina H.; Rosa, Marcello G.P.

2013-01-01

Contemporary studies recognize 3 distinct cytoarchitectural and functional areas within the Brodmann area 8 complex, in the caudal prefrontal cortex: 8b, 8aD, and 8aV. Here, we report on the quantitative characteristics of the cortical projections to these areas, using injections of fluorescent tracers in marmoset monkeys. Area 8b was distinct from both 8aD and 8aV due to its connections with medial prefrontal, anterior cingulate, superior temporal polysensory, and ventral midline/retrosplenial areas. In contrast, areas 8aD and 8aV received the bulk of the projections from posterior parietal cortex and dorsal midline areas. In the frontal lobe, area 8aV received projections primarily from ventrolateral areas, while both 8aD and 8b received dense inputs from areas on the dorsolateral surface. Whereas area 8aD received the most significant auditory projections, these were relatively sparse, in comparison with those previously reported in macaques. Finally, area 8aV was distinct from both 8aD and 8b by virtue of its widespread input from the extrastriate visual areas. These results are compatible with a homologous organization of the prefrontal cortex in New and Old World monkeys, and suggest significant parallels between the present pathways, revealed by tract-tracing, and networks revealed by functional connectivity analysis in Old World monkeys and humans. PMID:22735155

A Design Methodology for Optoelectronic VLSI

DTIC Science & Technology

2007-01-01

current gets converted to a CMOS voltage level through a transimpedance amplifier circuit called a receiver. The output of the receiver is then...change the current flowing from the diode to a voltage that the logic inputs can use. That circuit is called a receiver. It is a transimpedance amplifier ...incorpo- rate random access memory circuits, SRAM or dynamic RAM (DRAM). These circuits use weak internal analog signals that are amplified by sense

Advancing Underwater Acoustic Communication for Autonomous Distributed Networks via Sparse Channel Sensing, Coding, and Navigation Support

DTIC Science & Technology

2012-09-30

Estimation Methods for Underwater OFDM 5) Two Iterative Receivers for Distributed MIMO - OFDM with Large Doppler Deviations. 6) Asynchronous Multiuser...multi-input multi-output ( MIMO ) OFDM is also pursued, where it is shown that the proposed hybrid initialization enables drastically improved receiver...are investigated. 5) Two Iterative Receivers for Distributed MIMO - OFDM with Large Doppler Deviations. This work studies a distributed system with

Reconfigurable Drive Current System

NASA Technical Reports Server (NTRS)

Alhorn, Dean C. (Inventor); Dutton, Kenneth R. (Inventor); Howard, David E. (Inventor); Smith, Dennis A. (Inventor)

2017-01-01

A reconfigurable drive current system includes drive stages, each of which includes a high-side transistor and a low-side transistor in a totem pole configuration. A current monitor is coupled to an output of each drive stage. Input channels are provided to receive input signals. A processor is coupled to the input channels and to each current monitor for generating at least one drive signal using at least one of the input signals and current measured by at least one of the current monitors. A pulse width modulation generator is coupled to the processor and each drive stage for varying the drive signals as a function of time prior to being supplied to at least one of the drive stages.

Clock Controller For Ac Self-Timing Analysis Of Logic System

DOEpatents

Lo, Tinchee; Flanagan, John D.

2004-05-18

A clock controller and clock generating method are provided for AC self-test timing analysis of a logic system. The controller includes latch circuitry which receives a DC input signal at a data input, and a pair of continuous out-of-phase clock signals at capture and launch clock inputs thereof. The latch circuitry outputs two overlapping pulses responsive to the DC input signal going high. The two overlapping pulses are provided to waveform shaper circuitry which produces therefrom two non-overlapping pulses at clock speed of the logic system to be tested. The two non-overlapping pulses are a single pair of clock pulses which facilitate AC self-test timing analysis of the logic system.

Using quantum theory to simplify input-output processes

NASA Astrophysics Data System (ADS)

Thompson, Jayne; Garner, Andrew J. P.; Vedral, Vlatko; Gu, Mile

2017-02-01

All natural things process and transform information. They receive environmental information as input, and transform it into appropriate output responses. Much of science is dedicated to building models of such systems-algorithmic abstractions of their input-output behavior that allow us to simulate how such systems can behave in the future, conditioned on what has transpired in the past. Here, we show that classical models cannot avoid inefficiency-storing past information that is unnecessary for correct future simulation. We construct quantum models that mitigate this waste, whenever it is physically possible to do so. This suggests that the complexity of general input-output processes depends fundamentally on what sort of information theory we use to describe them.

75 FR 30410 - Disease, Disability, and Injury Prevention and Control Special Interest Project (SIP): Provider...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-01

..., Disability, and Injury Prevention and Control Special Interest Project (SIP): Provider and Public Health... and Public Health Input for Vaccine Policy Decisions, SIP 10-036.'' Contact Person for More Information: Michelle Mathieson, Public Health Analyst, National Center for Chronic Disease and Health...

ROAD SALT APPLICATION CREATES A UNIQUE CHLORIDE BIOCHEMISTRY IN AN URBAN STREAM OF THE CHESAPEAKE BAY WATERSHED

EPA Science Inventory

Recent evidence from the mid-Atlantic suggests that freshwater supplies are threatened by chronic chloride inputs from road salts applied to improve highway safety. Elevated chloride levels also may limit the ability of aquatic systems to microbially process nitrate nitrogen, a ...

Variability in the organisation and management of hospital care for COPD exacerbations in the UK.

PubMed

Hosker, Harold; Anstey, Katharine; Lowe, Derek; Pearson, Michael; Roberts, C Michael

2007-04-01

Previous smaller UK audits have demonstrated wide variation in organisation, resources, and process of care for acute chronic obstructive pulmonary disease (COPD) admissions. Smallest units appeared to do less well. UK acute hospitals supplied information on (1) resources and organisation of care, (2) clinical data on process of care and outcomes for up to 40 consecutive COPD admissions. Comparisons were made against national recommendations. Eight thousand and thirteen admissions involved 7529 patients from 233 units (93% of UK acute Trusts). Twenty-six percent of units had at most one whole-time equivalent respiratory consultant while 12% had at least four. Thirty percent patients were admitted under a respiratory specialist and 48% discharged under their care whilst 28% had no specialist input at all. Variation in care provision was wide across all hospitals but patients in smaller hospitals had less access to specialist respiratory or admission wards, pulmonary rehabilitation programs, specialty triage or an early discharge scheme. Six percent of units did not have access to NIV and 18% to invasive ventilatory support. There remains wide variation in all aspects of acute hospital COPD care in the UK, with smaller hospitals offering fewest services. Those receiving specialist input are more likely to be offered interventions of proven effect. Management guidelines alone are insufficient to address inequalities of care and a clear statement of minimum national standards for resource provision and organisation of COPD care are required. This study provides a unique insight into the current state of care for patients admitted with COPD exacerbations in the UK.

A Brain-Machine Interface Instructed by Direct Intracortical Microstimulation

PubMed Central

O'Doherty, Joseph E.; Lebedev, Mikhail A.; Hanson, Timothy L.; Fitzsimmons, Nathan A.; Nicolelis, Miguel A. L.

2009-01-01

Brain–machine interfaces (BMIs) establish direct communication between the brain and artificial actuators. As such, they hold considerable promise for restoring mobility and communication in patients suffering from severe body paralysis. To achieve this end, future BMIs must also provide a means for delivering sensory signals from the actuators back to the brain. Prosthetic sensation is needed so that neuroprostheses can be better perceived and controlled. Here we show that a direct intracortical input can be added to a BMI to instruct rhesus monkeys in choosing the direction of reaching movements generated by the BMI. Somatosensory instructions were provided to two monkeys operating the BMI using either: (a) vibrotactile stimulation of the monkey's hands or (b) multi-channel intracortical microstimulation (ICMS) delivered to the primary somatosensory cortex (S1) in one monkey and posterior parietal cortex (PP) in the other. Stimulus delivery was contingent on the position of the computer cursor: the monkey placed it in the center of the screen to receive machine–brain recursive input. After 2 weeks of training, the same level of proficiency in utilizing somatosensory information was achieved with ICMS of S1 as with the stimulus delivered to the hand skin. ICMS of PP was not effective. These results indicate that direct, bi-directional communication between the brain and neuroprosthetic devices can be achieved through the combination of chronic multi-electrode recording and microstimulation of S1. We propose that in the future, bidirectional BMIs incorporating ICMS may become an effective paradigm for sensorizing neuroprosthetic devices. PMID:19750199

Alveolar ventilation to perfusion heterogeneity and diffusion impairment in a mathematical model of gas exchange

NASA Technical Reports Server (NTRS)

Vidal Melo, M. F.; Loeppky, J. A.; Caprihan, A.; Luft, U. C.

1993-01-01

This study describes a two-compartment model of pulmonary gas exchange in which alveolar ventilation to perfusion (VA/Q) heterogeneity and impairment of pulmonary diffusing capacity (D) are simultaneously taken into account. The mathematical model uses as input data measurements usually obtained in the lung function laboratory. It consists of two compartments and an anatomical shunt. Each compartment receives fractions of alveolar ventilation and blood flow. Mass balance equations and integration of Fick's law of diffusion are used to compute alveolar and blood O2 and CO2 values compatible with input O2 uptake and CO2 elimination. Two applications are presented. The first is a method to partition O2 and CO2 alveolar-arterial gradients into VA/Q and D components. The technique is evaluated in data of patients with chronic obstructive pulmonary disease (COPD). The second is a theoretical analysis of the effects of blood flow variation in alveolar and blood O2 partial pressures. The results show the importance of simultaneous consideration of D to estimate VA/Q heterogeneity in patients with diffusion impairment. This factor plays an increasing role in gas alveolar-arterial gradients as severity of COPD increases. Association of VA/Q heterogeneity and D may produce an increase of O2 arterial pressure with decreasing QT which would not be observed if only D were considered. We conclude that the presented computer model is a useful tool for description and interpretation of data from COPD patients and for performing theoretical analysis of variables involved in the gas exchange process.

Rhomboid prism pair for rotating the plane of parallel light beams

NASA Technical Reports Server (NTRS)

Orloff, K. L. (Inventor); Yanagita, H.

1982-01-01

An optical system is described for rotating the plane defined by a pair of parallel light beams. In one embodiment a single pair of rhomboid prisms have their respective input faces disposed to receive the respective input beams. Each prism is rotated about an axis of revolution coaxial with each of the respective input beams by means of a suitable motor and gear arrangement to cause the plane of the parallel output beams to be rotated relative to the plane of the input beams. In a second embodiment, two pairs of rhomboid prisms are provided. In a first angular orientation of the output beams, the prisms merely decrease the lateral displacement of the output beams in order to keep in the same plane as the input beams. In a second angular orientation of the prisms, the input faces of the second pair of prisms are brought into coincidence with the input beams for rotating the plane of the output beams by a substantial angle such as 90 deg.

Closing the gate in the limbic striatum: prefrontal suppression of hippocampal and thalamic inputs

PubMed Central

Calhoon, Gwendolyn G.; O’Donnell, Patricio

2013-01-01

SUMMARY Many brain circuits control behavior by integrating information arising from separate inputs onto a common target neuron. Neurons in the ventral striatum (VS) receive converging excitatory afferents from the prefrontal cortex (PFC), hippocampus (HP), and thalamus, among other structures, and the integration of these inputs is critical for shaping goal-directed behaviors. Although HP inputs have been described as gating PFC throughput in the VS, recent data reveal that the VS desynchronizes from the HP during epochs of burst-like PFC activity related to decision-making. It is therefore possible that PFC inputs locally attenuate responses to other glutamatergic inputs to the VS. Here, we found that delivering trains of stimuli to the PFC suppresses HP- and thalamus-evoked synaptic responses in the VS, in part through activation of inhibitory processes. This interaction may enable the PFC to exert influence on basal ganglia loops during decision-making instances with minimal disturbance from ongoing contextual inputs. PMID:23583113

Differential inputs to striatal cholinergic and parvalbumin interneurons imply functional distinctions

PubMed Central

Klug, Jason R; Engelhardt, Max D; Cadman, Cara N; Li, Hao; Smith, Jared B; Ayala, Sarah; Williams, Elora W; Hoffman, Hilary

2018-01-01

Striatal cholinergic (ChAT) and parvalbumin (PV) interneurons exert powerful influences on striatal function in health and disease, yet little is known about the organization of their inputs. Here using rabies tracing, electrophysiology and genetic tools, we compare the whole-brain inputs to these two types of striatal interneurons and dissect their functional connectivity in mice. ChAT interneurons receive a substantial cortical input from associative regions of cortex, such as the orbitofrontal cortex. Amongst subcortical inputs, a previously unknown inhibitory thalamic reticular nucleus input to striatal PV interneurons is identified. Additionally, the external segment of the globus pallidus targets striatal ChAT interneurons, which is sufficient to inhibit tonic ChAT interneuron firing. Finally, we describe a novel excitatory pathway from the pedunculopontine nucleus that innervates ChAT interneurons. These results establish the brain-wide direct inputs of two major types of striatal interneurons and allude to distinct roles in regulating striatal activity and controlling behavior. PMID:29714166

Application of convolve-multiply-convolve SAW processor for satellite communications

NASA Technical Reports Server (NTRS)

Lie, Y. S.; Ching, M.

1991-01-01

There is a need for a satellite communications receiver than can perform simultaneous multi-channel processing of single channel per carrier (SCPC) signals originating from various small (mobile or fixed) earth stations. The number of ground users can be as many as 1000. Conventional techniques of simultaneously processing these signals is by employing as many RF-bandpass filters as the number of channels. Consequently, such an approach would result in a bulky receiver, which becomes impractical for satellite applications. A unique approach utilizing a realtime surface acoustic wave (SAW) chirp transform processor is presented. The application of a Convolve-Multiply-Convolve (CMC) chirp transform processor is described. The CMC processor transforms each input channel into a unique timeslot, while preserving its modulation content (in this case QPSK). Subsequently, each channel is individually demodulated without the need of input channel filters. Circuit complexity is significantly reduced, because the output frequency of the CMC processor is common for all input channel frequencies. The results of theoretical analysis and experimental results are in good agreement.

Effects of Organic and Conventional Crop Nutrition on Profiles of Polar Metabolites in Grain of Wheat.

PubMed

Shewry, Peter; Rakszegi, Marianna; Lovegrove, Alison; Amos, Dominic; Corol, Delia-Irina; Tawfike, Ahmed; Mikó, Péter; Ward, Jane L

2018-05-30

The profiles of polar metabolites were determined in wholemeal flours of grain from the Broadbalk wheat experiment and from plants grown under organic and low-input systems to study the effects of nutrition on composition. The Broadbalk samples showed increased amino acids, acetate, and choline and decreased fructose and succinate with increasing nitrogen fertilization. Samples receiving farm yard manure had similar grain nitrogen to those receiving 96 kg of N/ha but had higher contents of amino acids, sugars, and organic acids. A comparison of the profiles of grain from organic and low-input systems showed only partial separation, with clear effects of climate and agronomy. However, supervised multivariate analysis showed that the low-input samples had higher contents of many amino acids, raffinose, glucose, organic acids, and choline and lower sucrose, fructose, and glycine. Consequently, although differences between organic and conventional grain occur, these cannot be used to confirm sample identity.

Three Types of Cortical L5 Neurons that Differ in Brain-Wide Connectivity and Function

PubMed Central

Kim, Euiseok J.; Juavinett, Ashley L.; Kyubwa, Espoir M.; Jacobs, Matthew W.; Callaway, Edward M.

2015-01-01

SUMMARY Cortical layer 5 (L5) pyramidal neurons integrate inputs from many sources and distribute outputs to cortical and subcortical structures. Previous studies demonstrate two L5 pyramid types: cortico-cortical (CC) and cortico-subcortical (CS). We characterize connectivity and function of these cell types in mouse primary visual cortex and reveal a new subtype. Unlike previously described L5 CC and CS neurons, this new subtype does not project to striatum [cortico-cortical, non-striatal (CC-NS)] and has distinct morphology, physiology and visual responses. Monosynaptic rabies tracing reveals that CC neurons preferentially receive input from higher visual areas, while CS neurons receive more input from structures implicated in top-down modulation of brain states. CS neurons are also more direction-selective and prefer faster stimuli than CC neurons. These differences suggest distinct roles as specialized output channels, with CS neurons integrating information and generating responses more relevant to movement control and CC neurons being more important in visual perception. PMID:26671462

Three Types of Cortical Layer 5 Neurons That Differ in Brain-wide Connectivity and Function.

PubMed

Kim, Euiseok J; Juavinett, Ashley L; Kyubwa, Espoir M; Jacobs, Matthew W; Callaway, Edward M

2015-12-16

Cortical layer 5 (L5) pyramidal neurons integrate inputs from many sources and distribute outputs to cortical and subcortical structures. Previous studies demonstrate two L5 pyramid types: cortico-cortical (CC) and cortico-subcortical (CS). We characterize connectivity and function of these cell types in mouse primary visual cortex and reveal a new subtype. Unlike previously described L5 CC and CS neurons, this new subtype does not project to striatum [cortico-cortical, non-striatal (CC-NS)] and has distinct morphology, physiology, and visual responses. Monosynaptic rabies tracing reveals that CC neurons preferentially receive input from higher visual areas, while CS neurons receive more input from structures implicated in top-down modulation of brain states. CS neurons are also more direction-selective and prefer faster stimuli than CC neurons. These differences suggest distinct roles as specialized output channels, with CS neurons integrating information and generating responses more relevant to movement control and CC neurons being more important in visual perception. Copyright © 2015 Elsevier Inc. All rights reserved.

75 FR 80734 - Chronic Beryllium Disease Prevention Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-23

... Disease Prevention Program AGENCY: Office of Health, Safety and Security, Department of Energy. ACTION... and comments on issues related to its current chronic beryllium disease prevention program. The... disease prevention program. DATES: All comments on the issues presented in this document must be received...

Effect of Schizandra chinensis lignans on cell division in the corneal epithelium and tongue of albino rats exposed to chronic cold stress

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

Mel'nik, E.I.; Lupandin, A.V.; Timoshin, S.S.

The authors study the possibility of correcting cellular manifestations of disadaptation following chronic exposure to cold stress by means of preparations of Sch. chinensis. The model of chronic stress was cooling male albino rats daily for 1.5 h to a temperature of 28-30 C for 28 days. Since differences between levels of proliferation in intact animals and in the rats receiving 1.9% ethanol solution were absent, values obtained in the group of intact animals are presented in a table as the control. The animals underwent euthanasia 48 hours after the final exposure to the cold. The rats received an injectionmore » of tritium-thymidine one hour before sacrifice. It is shown that the results confirm those in previous studies of stimulation of DNA synthesis and mitotic activity in the corneal and lingual epithelium of albino rats during chronic exposure to stress.« less

Single- and multi-channel underwater acoustic communication channel capacity: a computational study.

PubMed

Hayward, Thomas J; Yang, T C

2007-09-01

Acoustic communication channel capacity determines the maximum data rate that can be supported by an acoustic channel for a given source power and source/receiver configuration. In this paper, broadband acoustic propagation modeling is applied to estimate the channel capacity for a time-invariant shallow-water waveguide for a single source-receiver pair and for vertical source and receiver arrays. Without bandwidth constraints, estimated single-input, single-output (SISO) capacities approach 10 megabitss at 1 km range, but beyond 2 km range they decay at a rate consistent with previous estimates by Peloquin and Leinhos (unpublished, 1997), which were based on a sonar equation calculation. Channel capacities subject to source bandwidth constraints are approximately 30-90% lower than for the unconstrained case, and exhibit a significant wind speed dependence. Channel capacity is investigated for single-input, multi-output (SIMO) and multi-input, multi-output (MIMO) systems, both for finite arrays and in the limit of a dense array spanning the entire water column. The limiting values of the SIMO and MIMO channel capacities for the modeled environment are found to be about four times higher and up to 200-400 times higher, respectively, than for the SISO case. Implications for underwater acoustic communication systems are discussed.

Delta Modulation Technique for Improving the Sensitivity of Monobit Subsamplers in Radar and Coherent Receiver Applications

DOE PAGES

Rodenbeck, Christopher T.; Tracey, Keith J.; Barkley, Keith R.; ...

2014-08-01

This paper introduces a technique for improving the sensitivity of RF subsamplers in radar and coherent receiver applications. The technique, referred to herein as “delta modulation” (DM), feeds the time-average output of a monobit analog-to-digital converter (ADC) back to the ADC input, but with opposite polarity. Assuming pseudo-stationary modulation statistics on the sampled RF waveform, the feedback signal corrects for aggregate DC offsets present in the ADC that otherwise degrade ADC sensitivity. Two RF integrated circuits (RFICs) are designed to demonstrate the approach. One uses analog DM to create the feedback signal; the other uses digital DM to achieve themore » same result. A series of tests validates the designs. The dynamic time-domain response confirms the feedback loop’s basic operation. Measured output quantization imbalance, under noise-only input drive, significantly improves with the use of the DM circuit, even for large, deliberately induced DC offsets and wide temperature variation from -55°C to +85 °C. Examination of the corrected vs. uncorrected baseband spectrum under swept input signal-tonoise ratio (SNR) conditions demonstrates the effectiveness of this approach for realistic radar and coherent receiver applications. In conclusion, two-tone testing shows no impact of the DM technique on ADC linearity.« less

An inductorless multi-mode RF front end for GNSS receiver in 55 nm CMOS

NASA Astrophysics Data System (ADS)

Yanbin, Luo; Chengyan, Ma; Yebing, Gan; Min, Qian; Tianchun, Ye

2015-10-01

An inductorless multi-mode RF front end for a global navigation satellite system (GNSS) receiver is presented. Unlike the traditional topology of a low noise amplifier (LNA), the inductorless current-mode noise-canceling LNA is applied in this design. The high-impedance-input radio frequency amplifier (RFA) further amplifies the GNSS signals and changes the single-end signal path into fully differential. The passive mixer down-converts the signals to the intermediate frequency (IF) band and conveys the signals to the analogue blocks. The local oscillator (LO) buffer divides the output frequency of the voltage controlled oscillator (VCO) and generates 25%-duty-cycle quadrature square waves to drive the mixer. Our measurement results display that the implemented RF front end achieves good overall performance while consuming only 6.7 mA from 1.2 V supply. The input return loss is better than -26 dB and the ultra low noise figure of 1.43 dB leads to high sensitivity of the GNSS receiver. The input 1 dB compression point is -43 dBm at the high gain of 48 dB. The designed circuit is fabricated in 55 nm CMOS technology and the die area, which is much smaller than traditional circuit, is around 220 × 280 μm2.

Young Adult Outcomes of Children Growing up with Chronic Illness: An analysis of the National Longitudinal Study of Adolescent Health

PubMed Central

Maslow, Gary R.; Haydon, Abigail; Ford, Carol Ann; Halpern, Carolyn Tucker

2012-01-01

Objective To examine young adult outcomes in a nationally representative US cohort of young adults who grew up with a chronic illness. Design Secondary analysis of nationally representative data from Wave III (2001) of the National Longitudinal Study of Adolescent Health. Setting United States Participants The analytic sample included 13,236 young adults 18–28 years old at Wave III. Main Exposure Self-report of a chronic physical illness (asthma, cancer, diabetes or epilepsy) in adolescence. Respondents with (1) asthma or (2) non-asthma chronic illness (cancer, diabetes, or epilepsy) were compared to subjects without these conditions. Main Outcome Measures Self-report of high school graduation, ever having a job, having a current job, living with parents, and ever receiving public assistance. Results Three percent of young adults had non-asthma chronic illness (cancer, diabetes, or epilepsy) and 16% had asthma. The majority of young adults with chronic illness graduated high school (81%) and were currently employed (60%). However, compared to healthy young adults, those with a non-asthma chronic illness were significantly less likely to graduate high school, ever have a job, or have a current job and were more likely to receive public assistance. When compared to young adults with asthma, young adults with non-asthma chronic illness again had significantly worse young adult outcomes on all measures. Conclusions Most young adults growing up with chronic illness graduate high school and are employed. However, these young adults are significantly less likely than their healthy peers to achieve these important educational and vocational milestones. PMID:21383274

Heterosynaptic modulation of evoked synaptic potentials in layer II of the entorhinal cortex by activation of the parasubiculum

PubMed Central

Sparks, Daniel W.

2016-01-01

The superficial layers of the entorhinal cortex receive sensory and associational cortical inputs and provide the hippocampus with the majority of its cortical sensory input. The parasubiculum, which receives input from multiple hippocampal subfields, sends its single major output projection to layer II of the entorhinal cortex, suggesting that it may modulate processing of synaptic inputs to the entorhinal cortex. Indeed, stimulation of the parasubiculum can enhance entorhinal responses to synaptic input from the piriform cortex in vivo. Theta EEG activity contributes to spatial and mnemonic processes in this region, and the current study assessed how stimulation of the parasubiculum with either single pulses or short, five-pulse, theta-frequency trains may modulate synaptic responses in layer II entorhinal stellate neurons evoked by stimulation of layer I afferents in vitro. Parasubicular stimulation pulses or trains suppressed responses to layer I stimulation at intervals of 5 ms, and parasubicular stimulation trains facilitated layer I responses at a train-pulse interval of 25 ms. This suggests that firing of parasubicular neurons during theta activity may heterosynaptically enhance incoming sensory inputs to the entorhinal cortex. Bath application of the hyperpolarization-activated cation current (Ih) blocker ZD7288 enhanced the facilitation effect, suggesting that cholinergic inhibition of Ih may contribute. In addition, repetitive pairing of parasubicular trains and layer I stimulation induced a lasting depression of entorhinal responses to layer I stimulation. These findings provide evidence that theta activity in the parasubiculum may promote heterosynaptic modulation effects that may alter sensory processing in the entorhinal cortex. PMID:27146979

Excitatory inputs to four types of spinocerebellar tract neurons in the cat and the rat thoraco-lumbar spinal cord

PubMed Central

Shrestha, Sony Shakya; Bannatyne, B Anne; Jankowska, Elzbieta; Hammar, Ingela; Nilsson, Elin; Maxwell, David J

2012-01-01

The cerebellum receives information from the hindlimbs through several populations of spinocerebellar tract neurons. Although the role of these neurons has been established in electrophysiological experiments, the relative contribution of afferent fibres and central neurons to their excitatory input has only been estimated approximately so far. Taking advantage of differences in the immunohistochemistry of glutamatergic terminals of peripheral afferents and of central neurons (with vesicular glutamate transporters VGLUT1 or VGLUT2, respectively), we compared sources of excitatory input to four populations of spinocerebellar neurons in the thoraco-lumbar spinal cord: dorsal spinocerebellar tract neurons located in Clarke's column (ccDSCT) and in the dorsal horn (dhDSCT) and ventral spinocerebellar tract (VSCT) neurons including spinal border (SB) neurons. This was done on 22 electrophysiologically identified intracellularly labelled neurons in cats and on 80 neurons labelled by retrograde transport of cholera toxin b subunit injected into the cerebellum of rats. In both species distribution of antibodies against VGLUT1 and VGLUT2 on SB neurons (which have dominating inhibitory input from limb muscles), revealed very few VGLUT1 contacts and remarkably high numbers of VGLUT2 contacts. In VSCT neurons with excitatory afferent input, the number of VGLUT1 contacts was relatively high although VGLUT2 contacts likewise dominated, while the proportions of VGLUT1 and VGLUT2 immunoreactive terminals were the reverse on the two populations of DSCT neurons. These findings provide morphological evidence that SB neurons principally receive excitatory inputs from central neurons and provide the cerebellum with information regarding central neuronal activity. PMID:22371473

Excitatory inputs to four types of spinocerebellar tract neurons in the cat and the rat thoraco-lumbar spinal cord.

PubMed

Shrestha, Sony Shakya; Bannatyne, B Anne; Jankowska, Elzbieta; Hammar, Ingela; Nilsson, Elin; Maxwell, David J

2012-04-01

The cerebellum receives information from the hindlimbs through several populations of spinocerebellar tract neurons. Although the role of these neurons has been established in electrophysiological experiments, the relative contribution of afferent fibres and central neurons to their excitatory input has only been estimated approximately so far. Taking advantage of differences in the immunohistochemistry of glutamatergic terminals of peripheral afferents and of central neurons (with vesicular glutamate transporters VGLUT1 or VGLUT2, respectively), we compared sources of excitatory input to four populations of spinocerebellar neurons in the thoraco-lumbar spinal cord: dorsal spinocerebellar tract neurons located in Clarke's column (ccDSCT) and in the dorsal horn (dhDSCT) and ventral spinocerebellar tract (VSCT) neurons including spinal border (SB) neurons. This was done on 22 electrophysiologically identified intracellularly labelled neurons in cats and on 80 neurons labelled by retrograde transport of cholera toxin b subunit injected into the cerebellum of rats. In both species distribution of antibodies against VGLUT1 and VGLUT2 on SB neurons (which have dominating inhibitory input from limb muscles), revealed very few VGLUT1 contacts and remarkably high numbers of VGLUT2 contacts. In VSCT neurons with excitatory afferent input, the number of VGLUT1 contacts was relatively high although VGLUT2 contacts likewise dominated, while the proportions of VGLUT1 and VGLUT2 immunoreactive terminals were the reverse on the two populations of DSCT neurons. These findings provide morphological evidence that SB neurons principally receive excitatory inputs from central neurons and provide the cerebellum with information regarding central neuronal activity.

Does random urine drug testing reduce illicit drug use in chronic pain patients receiving opioids?

PubMed

Manchikanti, Laxmaiah; Manchukonda, Rajeev; Pampati, Vidyasagar; Damron, Kim S; Brandon, Doris E; Cash, Kim A; McManus, Carla D

2006-04-01

Prescription drug abuse and illicit drug use are common in chronic pain patients. Adherence monitoring with screening tests, and urine drug testing, periodic monitoring with prescription monitoring programs, has become a common practice in recent years. Random drug testing for appropriate use of opioids and use of illicit drugs is often used in pain management practices. Thus, it is expected that random urine drug testing will deter use of illicit drugs, and also improve compliance. To study the prevalence of illicit drug use in patients receiving opioids for chronic pain management and to compare the results of illicit drug use with the results from a previous study. A prospective, consecutive study. Interventional pain management practice setting in the United States. A total of 500 consecutive patients on opioids, considered to be receiving stable doses of opioids supplemental to their interventional techniques, were studied by random drug testing. Testing was performed by rapid drug screen. Results were considered positive if one or more of the monitored illicit drugs including cocaine, marijuana (THC), methamphetamine or amphetamines were present. Illicit drug use was evident in 80 patients, or 16%, with marijuana in 11%, cocaine in 5%, and methamphetamine and/or amphetamines in 2%. When compared with previous data, the overall illicit drug use was significantly less. Illicit drug use in elderly patients was absent. The prevalence of illicit drug abuse in patients with chronic pain receiving opioids continues to be a common occurence. This study showed significant reductions in overall illicit drug use with adherence monitoring combined with random urine drug testing.

Analysis of the performance of a wireless optical multi-input to multi-output communication system.

PubMed

Bushuev, Denis; Arnon, Shlomi

2006-07-01

We investigate robust optical wireless communication in a highly scattering propagation medium using multielement optical detector arrays. The communication setup consists of synchronized multiple transmitters that send information to a receiver array and an atmospheric propagation channel. The mathematical model that best describes this scenario is multi-input to multi-output communication through stochastic slow changing channels. In this model, signals from m transmitters are received by n receiver-detectors. The channel transfer function matrix is G, and its size is n x m. G(i,j) is the transfer function from transmitter i to detector j, and m > or = n. We adopt a quasi-stationary approach in which the channel time variation has a negligible effect on communication performance over a burst. The G matrix is calculated on the basis of the optical transfer function of the atmospheric channel (composed of aerosol and turbulence elements) and the receiver's optics. In this work we derive a performance model using environmental data, such as documented turbulence and aerosol models and noise statistics. We also present the results of simulations conducted for the proposed detection algorithm.

State-space estimation of the input stimulus function using the Kalman filter: a communication system model for fMRI experiments.

PubMed

Ward, B Douglas; Mazaheri, Yousef

2006-12-15

The blood oxygenation level-dependent (BOLD) signal measured in functional magnetic resonance imaging (fMRI) experiments in response to input stimuli is temporally delayed and distorted due to the blurring effect of the voxel hemodynamic impulse response function (IRF). Knowledge of the IRF, obtained during the same experiment, or as the result of a separate experiment, can be used to dynamically obtain an estimate of the input stimulus function. Reconstruction of the input stimulus function allows the fMRI experiment to be evaluated as a communication system. The input stimulus function may be considered as a "message" which is being transmitted over a noisy "channel", where the "channel" is characterized by the voxel IRF. Following reconstruction of the input stimulus function, the received message is compared with the transmitted message on a voxel-by-voxel basis to determine the transmission error rate. Reconstruction of the input stimulus function provides insight into actual brain activity during task activation with less temporal blurring, and may be considered as a first step toward estimation of the true neuronal input function.

Development of Denitrifying and Nitrifying Bacteria and Their Co-occurrence in Newly Created Biofilms in Urban Streams

NASA Astrophysics Data System (ADS)

Vaessen, T. N.; Martí Roca, E.; Pinay, G.; Merbt, S. N.

2015-12-01

Biofilms play a pivotal role on nutrient cycling in streams, which ultimately dictates the export of nutrients to downstream ecosystems. The extent to which biofilms influence the concentration of dissolved nutrients, oxygen and pH in the water column may be determined by the composition of the microbial assemblages and their activity. Evidence of biological interactions among bacteria and algae are well documented. However, the development, succession and co-occurence of nitrifying and denitrifying bacteria remain poorly understood. These bacteria play a relevant role on the biogeochemical process associated to N cycling, and their relative abundance can dictate the fate of dissolved inorganic nitrogen in streams. In particular, previous studies indicated that nitrifiers are enhanced in streams receiving inputs from wastewater treatment plant (WWTP) effluents due to both increases in ammonium concentration and inputs of nitrifiers. However, less is known about the development of denitrifiers in receiving streams, although environmental conditions seem to favor it. We conducted an in situ colonization experiment in a stream receiving effluent from a WWTP to examine how this input influences the development and co-occurrence of nitrifying and denitrifying bacteria. We placed artificial substrata at different locations relative to the effluent and sampled them over time to characterize the developed biofilm in terms of bulk measurements (organic matter content and algae) as well as in terms of abundance of nitrifiers and denitrifiers (using qPCR). The results of this study contribute to a better understanding of the temporal dynamics of denitrifiers and nitrifiers in relation to the developed organic matter, dissolved oxygen and pH and the biomass accrual in stream biofilms under the influence of nutrients inputs from WWTP effluent. Ultimately, the results provide insights on the potential role of nitrifiers and denitrifiers on N cycling in WWTP effluent receiving streams.

Vocabulary Input from School Textbooks as a Potential Contributor to the Small Vocabulary Uptake Gained by English as a Foreign Language Learners in Saudi Arabia

ERIC Educational Resources Information Center

Alsaif, Abdullah; Milton, James

2012-01-01

Research repeatedly reports very little vocabulary uptake by English as a foreign language (EFL) learners in public schools in Saudi Arabia. Factors such as the teaching methodology employed and learner motivation have been suggested to explain this but a further explanation, the vocabulary input these learners receive, remains uninvestigated. An…

Microwave applicator for in-drum processing of radioactive waste slurry

DOEpatents

White, T.L.

1994-06-28

A microwave applicator for processing of radioactive waste slurry uses a waveguide network which splits an input microwave of TE[sub 10] rectangular mode to TE[sub 01] circular mode. A cylindrical body has four openings, each receiving 1/4 of the power input. The waveguide network includes a plurality of splitters to effect the 1/4 divisions of power. 4 figures.

76 FR 24901 - Request for Input To Inform a Possible Surgeon General Action on Prescription Drug Abuse in Youth

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-03

... ``nonmedical'' use, a term employed by many of the National Surveys. This definition does not include use for... response. To date, the work group has received expert input on the state of the science for addressing... submitted by any one of the following methods: Mail: Anna Staton, M.P.A., Office of Science Policy and...

Identified Serotonergic Modulatory Neurons Have Heterogeneous Synaptic Connectivity within the Olfactory System of Drosophila.

PubMed

Coates, Kaylynn E; Majot, Adam T; Zhang, Xiaonan; Michael, Cole T; Spitzer, Stacy L; Gaudry, Quentin; Dacks, Andrew M

2017-08-02

Modulatory neurons project widely throughout the brain, dynamically altering network processing based on an animal's physiological state. The connectivity of individual modulatory neurons can be complex, as they often receive input from a variety of sources and are diverse in their physiology, structure, and gene expression profiles. To establish basic principles about the connectivity of individual modulatory neurons, we examined a pair of identified neurons, the "contralaterally projecting, serotonin-immunoreactive deutocerebral neurons" (CSDns), within the olfactory system of Drosophila Specifically, we determined the neuronal classes providing synaptic input to the CSDns within the antennal lobe (AL), an olfactory network targeted by the CSDns, and the degree to which CSDn active zones are uniformly distributed across the AL. Using anatomical techniques, we found that the CSDns received glomerulus-specific input from olfactory receptor neurons (ORNs) and projection neurons (PNs), and networkwide input from local interneurons (LNs). Furthermore, we quantified the number of CSDn active zones in each glomerulus and found that CSDn output is not uniform, but rather heterogeneous, across glomeruli and stereotyped from animal to animal. Finally, we demonstrate that the CSDns synapse broadly onto LNs and PNs throughout the AL but do not synapse upon ORNs. Our results demonstrate that modulatory neurons do not necessarily provide purely top-down input but rather receive neuron class-specific input from the networks that they target, and that even a two cell modulatory network has highly heterogeneous, yet stereotyped, pattern of connectivity. SIGNIFICANCE STATEMENT Modulatory neurons often project broadly throughout the brain to alter processing based on physiological state. However, the connectivity of individual modulatory neurons to their target networks is not well understood, as modulatory neuron populations are heterogeneous in their physiology, morphology, and gene expression. In this study, we use a pair of identified serotonergic neurons within the Drosophila olfactory system as a model to establish a framework for modulatory neuron connectivity. We demonstrate that individual modulatory neurons can integrate neuron class-specific input from their target network, which is often nonreciprocal. Additionally, modulatory neuron output can be stereotyped, yet nonuniform, across network regions. Our results provide new insight into the synaptic relationships that underlie network function of modulatory neurons. Copyright © 2017 the authors 0270-6474/17/377318-14$15.00/0.

Acute and chronic craniofacial pain: brainstem mechanisms of nociceptive transmission and neuroplasticity, and their clinical correlates.

PubMed

Sessle, B J

2000-01-01

This paper reviews the recent advances in knowledge of brainstem mechanisms related to craniofacial pain. It also draws attention to their clinical implications, and concludes with a brief overview and suggestions for future research directions. It first describes the general organizational features of the trigeminal brainstem sensory nuclear complex (VBSNC), including its input and output properties and intrinsic characteristics that are commensurate with its strategic role as the major brainstem relay of many types of somatosensory information derived from the face and mouth. The VBSNC plays a crucial role in craniofacial nociceptive transmission, as evidenced by clinical, behavioral, morphological, and electrophysiological data that have been especially derived from studies of the relay of cutaneous nociceptive afferent inputs through the subnucleus caudalis of the VBSNC. The recent literature, however, indicates that some fundamental differences exist in the processing of cutaneous vs. other craniofacial nociceptive inputs to the VBSNC, and that rostral components of the VBSNC may also play important roles in some of these processes. Modulatory mechanisms are also highlighted, including the neurochemical substrate by which nociceptive transmission in the VBSNC can be modulated. In addition, the long-term consequences of peripheral injury and inflammation and, in particular, the neuroplastic changes that can be induced in the VBSNC are emphasized in view of the likely role that central sensitization, as well as peripheral sensitization, can play in acute and chronic pain. The recent findings also provide new insights into craniofacial pain behavior and are particularly relevant to many approaches currently in use for the management of pain and to the development of new diagnostic and therapeutic procedures aimed at manipulating peripheral inputs and central processes underlying nociceptive transmission and its control within the VBSNC.

Detecting bladder fullness through the ensemble activity patterns of the spinal cord unit population in a somatovisceral convergence environment.

PubMed

Park, Jae Hong; Kim, Chang-Eop; Shin, Jaewoo; Im, Changkyun; Koh, Chin Su; Seo, In Seok; Kim, Sang Jeong; Shin, Hyung-Cheul

2013-10-01

Chronic monitoring of the state of the bladder can be used to notify patients with urinary dysfunction when the bladder should be voided. Given that many spinal neurons respond both to somatic and visceral inputs, it is necessary to extract bladder information selectively from the spinal cord. Here, we hypothesize that sensory information with distinct modalities should be represented by the distinct ensemble activity patterns within the neuronal population and, therefore, analyzing the activity patterns of the neuronal population could distinguish bladder fullness from somatic stimuli. We simultaneously recorded 26-27 single unit activities in response to bladder distension or tactile stimuli in the dorsal spinal cord of each Sprague-Dawley rat. In order to discriminate between bladder fullness and tactile stimulus inputs, we analyzed the ensemble activity patterns of the entire neuronal population. A support vector machine (SVM) was employed as a classifier, and discrimination performance was measured by k-fold cross-validation tests. Most of the units responding to bladder fullness also responded to the tactile stimuli (88.9-100%). The SVM classifier precisely distinguished the bladder fullness from the somatic input (100%), indicating that the ensemble activity patterns of the unit population in the spinal cord are distinct enough to identify the current input modality. Moreover, our ensemble activity pattern-based classifier showed high robustness against random losses of signals. This study is the first to demonstrate that the two main issues of electroneurographic monitoring of bladder fullness, low signals and selectiveness, can be solved by an ensemble activity pattern-based approach, improving the feasibility of chronic monitoring of bladder fullness by neural recording.

Using Technology to Affect Influenza Vaccine Coverage Among Children With Chronic Respiratory Conditions.

PubMed

Bay, Sarah L; Crawford, Daniel J

Influenza presents additional burdens for children with chronic respiratory conditions. Influenza vaccinations may reduce complications, yet approximately half of children remain unprotected. Evidence supports integration of text and e-mail into multicomponent strategies to increase influenza vaccination rates among children with chronic respiratory conditions. A single text and e-mail message was sent to those with enabled preferences in the patient portal. A follow-up survey assessed aspects of message receipt. Surveys were completed without collection of demographics. A total of 3,206 messages were successfully delivered. Surveys were initiated by 107 recipients. Frequency analysis showed that text and e-mail messages were preferred forms of communication. A statistically significant relationship was found between receiving a message and receiving an influenza vaccination (p = .027). Text and e-mail messaging are cost effective and well received, and they can be easily integrated into existing systems. These methods are translatable across populations and can convey various types of messages. Copyright © 2016 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

Chronic active Epstein-Barr virus infection mimicking Henoch-Schönlein purpura.

PubMed

Guissa, Vanessa R; Aragão, Paula A; Marques, Heloisa H; Jacob, Cristina M; Silva, Clovis A

2010-01-01

Chronic active Epstein-Barr virus (CAEBV) infection is characterized by chronic or recurrent symptoms for at least 3 months, such as fever, hepatosplenomegaly and lymphadenopathy. The diagnosis is established due to the presence of anti-EBV antibodies or isolation of this infectious agent in affected tissues. Three cases of CAEBV infection mimicking Henoch-Schönlein purpura (HSP) were described. CASE 1: Female 3-year old patient with cervical adenomegaly, anemia and fever developed palpable purpura, haematuria and arthritis. CAEBV infection was established by serology test. She received methylprednisolone and acyclovir. She had generalized lymphadenopathy, hepatomegaly, splenomegaly, disseminated intravascular coagulation and deceased. CASE 2: Male 12-year old patient with persistent anemia, lymphadenopathy, hepatomegaly and splenomegaly had CAEBV infection diagnosis by serology test. He developed purpura and arthritis and received methylprednisolone. CASE 3: Male 13-year old patient had purpura, abdominal pain, haematuria, hepatomegaly, splenomegaly, lymphadenopathy, anemia and elevated liver enzymes. The cervical lymph node biopsy was positive to EBV infection. He received methylprednisolone and acyclovir, developing acute fulminant hepatitis and death. CAEBV infection mimicking HSP was rarely observed in our population.

Frequency-Modulated Orocutaneous Stimulation Promotes Non-nutritive Suck Development in Preterm Infants with Respiratory Distress Syndrome or Chronic Lung Disease

PubMed Central

Barlow, Steven M; Lee, Jaehoon; Wang, Jingyan; Oder, Austin; Hall, Sue; Knox, Kendi; Weatherstone, Kathleen; Thompson, Diane

2013-01-01

Background For the premature infant, extrauterine life is a pathological condition which greatly amplifies the challenges to the brain in establishing functional oromotor behaviors. The extent to which suck can be entrained using a synthetically patterned orocutaneous input to promote its development in preterm infants who manifest chronic lung disease is unknown. Objective To evaluate the effects of a frequency-modulated orocutaneous pulse train delivered through a pneumatically-charged pacifier capable of enhancing non-nutritive suck (NNS) activity in tube-fed premature infants. Methods A randomized trial to evaluate the efficacy of pneumatic orocutaneous stimulation 3x/day on NNS development and length of stay (LOS) in the NICU among 160 newborn infants distributed among 3 subpopulations, including healthy preterm infants (HI), respiratory distress syndrome (RDS), and chronic lung disease (CLD). Study infants received a regimen of orocutaneous pulse trains through a PULSED pressurized silicone pacifier or a SHAM control (blind pacifier) during gavage feeds for up to 10 days. Results Mixed modeling, adjusted for the infant’s gender, gestational age, postmenstrual age, and birth weight, was used to handle interdependency among repeated measures within subjects. A significant main effect for stimulation mode (SHAM pacifier vs PULSED orosensory) was found among preterm infants for NNS Bursts/minute (p=.003), NNS events/minute (p=.033), and for Total Oral Compressions/minute [NNS+nonNNS] (p=.016). Pairwise comparison of adjusted means using Bonferroni adjustment indicated RDS and CLD infants showed the most significant gains on these NNS performance indices. CLD infants in the treatment group showed significantly shorter LOS by an average of 2.5 days. Conclusion Frequency-modulated PULSED orocutaneous pulse train stimuli delivered through a silicone pacifier are effective in facilitating NNS burst development in tube-fed RDS and CLD preterm infants, with an added benefit of reduced LOS for CLD infants. PMID:24310444

Transcranial direct current stimulation (tDCS) of the primary motor cortex and robot-assisted arm training in chronic incomplete cervical spinal cord injury: A proof of concept sham-randomized clinical study.

PubMed

Yozbatiran, Nuray; Keser, Zafer; Davis, Matthew; Stampas, Argyrios; O'Malley, Marcia K; Cooper-Hay, Catherine; Frontera, Joel; Fregni, Felipe; Francisco, Gerard E

2016-07-15

After cervical spinal cord injury, current options for treatment of upper extremity motor functions have been limited to traditional approaches. However, there is a substantial need to explore more rigorous alternative treatments to facilitate motor recovery. To demonstrate whether anodal-primary motor cortex (M1) excitability enhancement (with cathodal-supra orbital area) (atDCS) combined with robot-assisted arm training (R-AAT) will provide greater improvement in contralateral arm and hand motor functions compared to sham stimulation (stDCS) and R-AAT in patients with chronic, incomplete cervical spinal cord injury (iCSCI). In this parallel-group, double-blinded, randomized and sham-controlled trial, nine participants with chronic iCSCI (AIS C and D level) were randomized to receive 10 sessions of atDCS or stDSC combined with R-AAT. Feasibility and tolerability was assessed with attrition rate and occurrence of adverse events, Changes in arm and hand function were assessed with Jebson Taylor Hand Function Test (JTHFT). Amount of Use Scale of Motor Activity Log (AOU-MAL), American Spinal Injury Association Upper Extremity Motor Score and Modified Ashworth Scale (MAS) at baseline, after treatment, and at two-month follow-up. None of the participants missed a treatment session or dropped-out due to adverse events related to the treatment protocol. Participants tended to perform better in JTHFT and AOU-MAL after treatment. Active group at post-treatment and two-month follow-up demonstrated better arm and hand performance compared to sham group. These preliminary findings support that modulating excitatory input of the corticospinal tracts on spinal circuits may be a promising strategy in improving arm and hand functions in persons with incomplete tetraplegia. Further study is needed to explore the underlying mechanisms of recovery.

Effects of a Chronic Lower Range of Triclosan Exposure on a Stream Mesocosm Community

EPA Science Inventory

Triclosan (5-chloro-2-(2,4-dichlorophenoxy)phenol) is an antimicrobial found in consumer soaps and toothpaste. It is in treated wastewater effluents at low part per billion concentrations, representing a potentially chronic exposure condition for biota inhabiting receiving strea...

SDR input power estimation algorithms

NASA Astrophysics Data System (ADS)

Briones, J. C.; Nappier, J. M.

The General Dynamics (GD) S-Band software defined radio (SDR) in the Space Communications and Navigation (SCAN) Testbed on the International Space Station (ISS) provides experimenters an opportunity to develop and demonstrate experimental waveforms in space. The SDR has an analog and a digital automatic gain control (AGC) and the response of the AGCs to changes in SDR input power and temperature was characterized prior to the launch and installation of the SCAN Testbed on the ISS. The AGCs were used to estimate the SDR input power and SNR of the received signal and the characterization results showed a nonlinear response to SDR input power and temperature. In order to estimate the SDR input from the AGCs, three algorithms were developed and implemented on the ground software of the SCAN Testbed. The algorithms include a linear straight line estimator, which used the digital AGC and the temperature to estimate the SDR input power over a narrower section of the SDR input power range. There is a linear adaptive filter algorithm that uses both AGCs and the temperature to estimate the SDR input power over a wide input power range. Finally, an algorithm that uses neural networks was designed to estimate the input power over a wide range. This paper describes the algorithms in detail and their associated performance in estimating the SDR input power.

SDR Input Power Estimation Algorithms

NASA Technical Reports Server (NTRS)

Nappier, Jennifer M.; Briones, Janette C.

2013-01-01

The General Dynamics (GD) S-Band software defined radio (SDR) in the Space Communications and Navigation (SCAN) Testbed on the International Space Station (ISS) provides experimenters an opportunity to develop and demonstrate experimental waveforms in space. The SDR has an analog and a digital automatic gain control (AGC) and the response of the AGCs to changes in SDR input power and temperature was characterized prior to the launch and installation of the SCAN Testbed on the ISS. The AGCs were used to estimate the SDR input power and SNR of the received signal and the characterization results showed a nonlinear response to SDR input power and temperature. In order to estimate the SDR input from the AGCs, three algorithms were developed and implemented on the ground software of the SCAN Testbed. The algorithms include a linear straight line estimator, which used the digital AGC and the temperature to estimate the SDR input power over a narrower section of the SDR input power range. There is a linear adaptive filter algorithm that uses both AGCs and the temperature to estimate the SDR input power over a wide input power range. Finally, an algorithm that uses neural networks was designed to estimate the input power over a wide range. This paper describes the algorithms in detail and their associated performance in estimating the SDR input power.

Performance measurement results for a 220 Mbps QPPM optical communication receiver with an EG/G Slik APD

NASA Technical Reports Server (NTRS)

Davidson, Frederic M.; Sun, Xiaoli

1992-01-01

The performance of a 220 Mbps quaternary pulse position modulation (QPPM) optical communication receiver with a 'Slik' silicon avalanche photodiode (APD) and a wideband transimpedance preamplifier in a small hybrid circuit module was measured. The receiver performance had been poor due to the lack of a wideband and low noise transimpedance preamplifier. With the new APB preamplifier module, the receiver achieved a bit error rate (BER) of 10 exp -6 at an average received input optical signal power of 4.2 nW, which corresponds to an average of 80 received (incident) signal photons per information bit.

High temperature solar receiver

NASA Technical Reports Server (NTRS)

1981-01-01

The development of a high temperature solar thermal receiver is described. A prototype receiver and associated test support (auxiliary) hardware was fabricated. Shakedown and initial performance tests of the prototype receiver were performed. Maximum outlet temperatures of 1600 F were achieved at 100% solar (70-75 kW) input power with 900 F inlet temperatures and a subsequent testing was concluded by a 2550 F outlet run. The window retaining assembly was modified to improve its tolerance for thermal distortion of the flanges. It is shown that cost effective receiver designs can be implemented within the framework of present materials technology.

Duloxetine, an antidepressant with analgesic properties – a preliminary analysis

PubMed Central

Onuţu, Adela Hilda

2015-01-01

Serotonin and norepinephrine reuptake inhibitors are second-line antidepressants largely used because of their good tolerance and their reduced side effects. Two of these drugs, duloxetine and venlafaxine, are used also in chronic pain management. In this review we present recent data regarding duloxetine’s effects on the central nervous system, linked to acute pain management, and their efficiency in reducing postoperative chronic pain. The drug’s efficacy results from its modulating effect on the descending inhibitory pain pathways and the inhibition of the nociceptive input. There are already several studies in favor of the analgesic properties of duloxetine. However, further and larger randomized studies are necessary in order to clarify duloxetine efficiency in acute postoperative settings, and thereafter on persistent chronic postoperative pain. PMID:28913467

Managing Multiple Chronic Conditions: A Strategic Framework for Improving Health Outcomes and Quality of Life

PubMed Central

Parekh, Anand K.; Goodman, Richard A.; Gordon, Catherine; Koh, Howard K.

2011-01-01

The escalating problem of multiple chronic conditions (MCC) among Americans is now a major public health and medical challenge, associated with suboptimal health outcomes and rising health-care expenses. Despite this problem's growth, the delivery of health services has continued to employ outmoded “siloed” approaches that focus on individual chronic diseases. We describe an action-oriented framework—developed by the U.S. Department of Health and Human Services with additional input provided by stakeholder organizations—that outlines national strategies for maximizing care coordination and for improving health and quality of life for individuals with MCC. We note how the framework's potential can be optimized through some of the provisions of the new Patient Protection and Affordable Care Act, and through public-private partnerships. PMID:21800741

Glutamate synaptic inputs to ventral tegmental area neurons in the rat derive primarily from subcortical sources.

PubMed

Omelchenko, N; Sesack, S R

2007-05-25

Dopamine and GABA neurons in the ventral tegmental area project to the nucleus accumbens and prefrontal cortex and modulate locomotor and reward behaviors as well as cognitive and affective processes. Both midbrain cell types receive synapses from glutamate afferents that provide an essential control of behaviorally-linked activity patterns, although the sources of glutamate inputs have not yet been completely characterized. We used antibodies against the vesicular glutamate transporter subtypes 1 and 2 (VGlut1 and VGlut2) to investigate the morphology and synaptic organization of axons containing these proteins as putative markers of glutamate afferents from cortical versus subcortical sites, respectively, in rats. We also characterized the ventral tegmental area cell populations receiving VGlut1+ or VGlut2+ synapses according to their transmitter phenotype (dopamine or GABA) and major projection target (nucleus accumbens or prefrontal cortex). By light and electron microscopic examination, VGlut2+ as opposed to VGlut1+ axon terminals were more numerous, had a larger average size, synapsed more proximally, and were more likely to form convergent synapses onto the same target. Both axon types formed predominantly asymmetric synapses, although VGlut2+ terminals more often formed synapses with symmetric morphology. No absolute selectivity was observed for VGlut1+ or VGlut2+ axons to target any particular cell population. However, the synapses onto mesoaccumbens neurons more often involved VGlut2+ terminals, whereas mesoprefrontal neurons received relatively equal synaptic inputs from VGlut1+ and VGlut2+ profiles. The distinct morphological features of VGlut1 and VGlut2 positive axons suggest that glutamate inputs from presumed cortical and subcortical sources, respectively, differ in the nature and intensity of their physiological actions on midbrain neurons. More specifically, our findings imply that subcortical glutamate inputs to the ventral tegmental area expressing VGlut2 predominate over cortical sources of excitation expressing VGlut1 and are more likely to drive the behaviorally-linked bursts in dopamine cells that signal future expectancy or attentional shifting.

The effects of ketamine on sexual behavior, anxiety, and locomotion in female rats.

PubMed

Guarraci, Fay A; Gonzalez, Chantal M F; Lucero, Devon; Womble, Paige D; Abdel-Rahim, Heba; DeVore, Jennie; Kunkel, Marcela Nicole; Quadlander, Emma; Stinnett, Morgan; Boyette-Davis, Jessica

2018-02-01

The present study characterized the effects of ketamine on sexual behavior and anxiety in female rats. In Experiment 1, female subjects received an injection of ketamine (10.0mg/kg) or saline 30min prior to a sexual partner-preference test during which each female subject was given the opportunity to interact with a female stimulus or a sexually vigorous male stimulus. Immediately afterwards, female subjects were tested for locomotion in an open field test. Ketamine-treated subjects spent significantly more time with the male stimulus than saline-treated subjects. No other measures of mating behavior (i.e., paced mating behavior, lordosis) were affected by ketamine. Ketamine also had no effect on locomotion. In Experiment 2, female subjects received an injection of ketamine (10.0mg/kg), or saline daily for 10days to investigate the possibility that sexual dysfunction emerges only after repeated exposure. Similar to the results of Experiment 1, ketamine-treated subjects spent significantly more time with the male stimulus than saline-treated subjects. Chronic ketamine treatment also decreased the likelihood of leaving the male after mounts, without affecting any other measures of sexual behavior. Chronic ketamine had no effect on locomotion. In Experiment 3, female subjects received an injection of ketamine (10.0mg/kg) or saline and were tested for anxiety in an elevated plus maze test and for locomotion in an open field test. Acute ketamine had no effect on anxiety or locomotion. In Experiment 4, female subjects received an injection of ketamine (10.0mg/kg) or saline daily for 10days to investigate the possibility that anxiety emerges only after repeated exposure. Chronic ketamine exposure had no effect on any measure of anxiety. However, chronic ketamine exposure increased locomotion. The results from these experiments indicate that unlike other medications prescribed for depression, neither acute nor chronic ketamine treatment causes anxiety or disruption of sexual behavior. Copyright © 2018 Elsevier Inc. All rights reserved.

A Randomized Trial Comparing Acupuncture, Simulated Acupuncture, and Usual Care for Chronic Low Back Pain

PubMed Central

Cherkin, Daniel C.; Sherman, Karen J.; Avins, Andrew L.; Erro, Janet H.; Ichikawa, Laura; Barlow, William E.; Delaney, Kristin; Hawkes, Rene; Hamilton, Luisa; Pressman, Alice; Khalsa, Partap S.; Deyo, Richard A.

2009-01-01

Background Acupuncture is a popular complementary and alternative treatment for chronic back pain. Recent European trials suggest similar short-term benefits from real and sham acupuncture needling. This trial addresses the importance of needle placement and skin penetration in eliciting acupuncture effects for patients with chronic low back pain. Methods 638 adults with chronic mechanical low back pain were randomized to: individualized acupuncture, standardized acupuncture, simulated acupuncture, or usual care. Ten treatments were provided over 7 weeks by experienced acupuncturists. The primary outcomes were back-related dysfunction (Roland Disability score, range: 0 to 23) and symptom bothersomeness (0 to 10 scale). Outcomes were assessed at baseline and after 8, 26 and 52 weeks. Results At 8 weeks, mean dysfunction scores for the individualized, standardized, and simulated acupuncture groups improved by 4.4, 4.5, and 4.4 points, respectively, compared with 2.1 points for those receiving usual care (P<0.001). Participants receiving real or simulated acupuncture were more likely than those receiving usual care to experience clinically meaningful improvements on the dysfunction scale (60% vs. 39%, P<0.0001). Symptoms improved by 1.6 to 1.9 points in the treatment groups compared with 0.7 points in the usual care group (P<0.0001). After one year, participants in the treatment groups were more likely than those receiving usual care group to experience clinically meaningful improvements in dysfunction (59% to 65% versus 50%, respectively, P=0.02) but not in symptoms (P>0.05). Conclusions Although acupuncture was found effective for chronic low back pain, tailoring needling sites to each patient and penetration of the skin appear to be unimportant in eliciting therapeutic benefits. These findings raise questions about acupuncture’s purported mechanisms of action. It remains unclear whether acupuncture, or our simulated method of acupuncture, provide physiologically important stimulation or represent placebo or non-specific effects. PMID:19433697

Risk of Hepatitis B Virus Reactivation in Patients With Inflammatory Arthritis Receiving Disease-Modifying Antirheumatic Drugs: A Systematic Review and Meta-Analysis.

PubMed

Lin, Tzu-Chieh; Yoshida, Kazuki; Tedeschi, Sara K; de Abreu, Mirhelen Mendes; Hashemi, Nikroo; Solomon, Daniel H

2018-05-01

To assess hepatitis B virus (HBV) reactivation rates in patients with resolved or chronic HBV infection, receiving disease-modifying antirheumatic drugs (DMARDs) and with or without antiviral prophylaxis. We conducted a systematic review and meta-analysis. Electronic searches were conducted in PubMed, Medline, and Embase using Ovid through December 31, 2015. A search strategy was developed for each database using the following inclusion criteria: for participants, rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and resolved or chronic HBV infection; for intervention, tumor necrosis factor (TNF) inhibitors or non-TNF biologic or nonbiologic DMARDs; and for outcome, HBV reactivation. Four reviewers independently extracted study data and assessed study quality using the Newcastle-Ottawa Scale. To determine the pooled HBV reactivation rate, the variances of the raw proportions were stabilized using a Freeman-Tukey-type arcsine square root transformation, using a random-effects model. Twenty-five studies met the inclusion criteria. The overall pooled rate of HBV reactivation was 1.6% (95% confidence interval [95% CI] 0.8-2.6) in patients with resolved HBV. Similar rates were observed in resolved patients taking TNF inhibitors (1.4% [95% CI 0.5-2.6]), non-TNF biologics (6.1% [95% CI 0.0-16.6]), and nonbiologic DMARDs (1.7% [95% CI 0.2-4.2]). We also found that the reactivation rate was lower in patients with chronic HBV infection who received antiviral prophylaxis (9.0% [95% CI 4.1-15.5]) than in those who did not (14.6% [95% CI 4.3-29.0]). We found that the HBV reactivation rate in inflammatory arthritis patients receiving DMARDs was low in resolved patients and moderate in patients with chronic HBV infection. Further, lower rates were observed in patients with chronic HBV infection who were using antiviral prophylaxis. © 2017, American College of Rheumatology.

Hypnosis Enhances the Effects of Pain Education in Patients with Chronic Non-Specific Low Back Pain: a Randomized Controlled Trial.

PubMed

Rizzo, Rodrigo R N; Medeiros, Flavia C; Pires, Leandro G; Pimenta, Rafael M; McAuley, James H; Jensen, Mark P; Costa, Leonardo O P

2018-04-11

The potential benefits of combining pain education (PE) with clinical hypnosis (CH) has not yet been investigated in individuals with chronic pain. A total of 100 patients with chronic non-specific low back pain were randomized to receive either (1) PE alone or (2) PE plus CH. Outcomes were collected by a blinded assessor at 2 weeks and 3 months after randomization. The primary outcomes were average pain intensity, worst pain intensity (both assessed with 11-point Numerical Rating Scales), and disability (24-item Roland Morris Disabilty Questionnaire) at 2 weeks. At 2 weeks, participants who received PE plus CH reported lower worst pain intensity (mean difference = 1.35 points, 95% confidence interval [CI] = 0.32 to 2.37) and disability (mean difference = 2.34 points, 95% CI = 0.06 to 4.61), but not average pain intensity (mean difference = 0.67 point, 95% CI = -0.27 to 1.62), relative to participants who received PE alone. PE plus CH participants also reported more global perceived benefits at 2 weeks (mean difference = -1.98 points 95% CI = -3.21 to -0.75). At three months, participants who received PE plus CH reported lower worst pain intensity (mean difference = 1.32 points, 95% CI = 0.29 to 2.34) and catastrophizing (mean difference = 5.30 points, 95% CI = 1.20 to 9.41). No adverse effects in either treatment condition were reported. This is the first trial showing that adding hypnosis to PE results in improved outcomes over PE alone in patients with chronic non-specific low back pain. This trial was prospectively registered at clinicaltrials.gov: NCT02638753 PERSPECTIVE: This study provides evidence supporting the efficacy of another treatment option for teaching patients to self-manage chronic low back pain that has a relatively low cost and that can be offered in groups. Copyright © 2018. Published by Elsevier Inc.

Modulation of the subthalamic nucleus activity by serotonergic agents and fluoxetine administration.

PubMed

Aristieta, A; Morera-Herreras, T; Ruiz-Ortega, J A; Miguelez, C; Vidaurrazaga, I; Arrue, A; Zumarraga, M; Ugedo, L

2014-05-01

Within the basal ganglia, the subthalamic nucleus (STN) is the only glutamatergic structure and occupies a central position in the indirect pathway. In rat, the STN receives serotonergic input from the dorsal raphe nucleus and expresses serotonergic receptors. This study examined the consequences of serotonergic neurotransmission modulation on STN neuron activity. In vivo single-unit extracellular recordings, HPLC determination, and rotarod and bar test were performed in control, 4-chloro-DL-phenylalanine methyl ester hydrochloride- (pCPA, a serotonin synthesis inhibitor) and chronically fluoxetine-treated rats. The pCPA treatment and the administration of serotonin (5-HT) receptor antagonists increased number of bursting neurons in the STN. The systemic administration of the 5-HT(1A) agonist, 8-OH-DPAT, decreased the firing rate and increased the coefficient of variation of STN neurons in pCPA-treated rats but not in control animals. Additionally, microinjection of 8-OH-DPAT into the STN reduced the firing rate of STN neurons, while microinjection of the 5-HT(2C) agonist, Ro 60-0175, increased the firing rate in both control and fluoxetine-treated animals. Finally, the fluoxetine challenge increased the firing rate of STN neurons in fluoxetine-treated rats and induced catalepsy. Our results indicate that the depletion and the blockage of 5-HT modify STN neuron firing pattern. STN neuron activity is under the control of 5-HT(1A) and 5-HT(2C) receptors located both inside and outside the STN. Finally, fluoxetine increases STN neuron activity in chronically fluoxetine-treated rats, which may explain the role of this nucleus in fluoxetine-induced extrapyramidal side effects.

Operant conditioning of enhanced pain sensitivity by heat-pain titration.

PubMed

Becker, Susanne; Kleinböhl, Dieter; Klossika, Iris; Hölzl, Rupert

2008-11-15

Operant conditioning mechanisms have been demonstrated to be important in the development of chronic pain. Most experimental studies have investigated the operant modulation of verbal pain reports with extrinsic reinforcement, such as verbal reinforcement. Whether this reflects actual changes in the subjective experience of the nociceptive stimulus remained unclear. This study replicates and extends our previous demonstration that enhanced pain sensitivity to prolonged heat-pain stimulation could be learned in healthy participants through intrinsic reinforcement (contingent changes in nociceptive input) independent of verbal pain reports. In addition, we examine whether different magnitudes of reinforcement differentially enhance pain sensitivity using an operant heat-pain titration paradigm. It is based on the previously developed non-verbal behavioral discrimination task for the assessment of sensitization, which uses discriminative down- or up-regulation of stimulus temperatures in response to changes in subjective intensity. In operant heat-pain titration, this discriminative behavior and not verbal pain report was contingently reinforced or punished by acute decreases or increases in heat-pain intensity. The magnitude of reinforcement was varied between three groups: low (N1=13), medium (N2=11) and high reinforcement (N3=12). Continuous reinforcement was applied to acquire and train the operant behavior, followed by partial reinforcement to analyze the underlying learning mechanisms. Results demonstrated that sensitization to prolonged heat-pain stimulation was enhanced by operant learning within 1h. The extent of sensitization was directly dependent on the received magnitude of reinforcement. Thus, operant learning mechanisms based on intrinsic reinforcement may provide an explanation for the gradual development of sustained hypersensitivity during pain that is becoming chronic.

Does China's new cooperative medical scheme promote rural elders' access to healthcare services in relation to chronic conditions?

PubMed Central

Dai, Baozhen

2015-01-01

Background This study examined use of healthcare services by elderly people with a long-term condition living in rural China and participating in that country's New Cooperative Medical Scheme (NCMS). Methods Data were taken from the 2009 China Health and Nutrition Survey. Results The study results showed that education level and annual income were low among rural elders (aged ≥65 years); the illiteracy rate was 58.0% (200/345) and 67.6% (92/136) had an annual income of less than 5000 Chinese yuan renminbi. The elders had low rates of treatment and use of preventive healthcare services while the prevalence of chronic disease was highest among them when compared to other age groups. Among the few elders who received preventive healthcare, most received it at village clinics. Conclusions Preventive healthcare services and chronic disease management are urgently needed by rural elders in China. NCMS should initiate payments to township health centers to enable them to undertake community outreach and education campaigns among rural residents, and train village doctors in standard chronic condition management and prevention, with prioritization of the provision of prevention and management of chronic conditions by village clinics. PMID:25091022

High throughput reconfigurable data analysis system

NASA Technical Reports Server (NTRS)

Bearman, Greg (Inventor); Pelletier, Michael J. (Inventor); Seshadri, Suresh (Inventor); Pain, Bedabrata (Inventor)

2008-01-01

The present invention relates to a system and method for performing rapid and programmable analysis of data. The present invention relates to a reconfigurable detector comprising at least one array of a plurality of pixels, where each of the plurality of pixels can be selected to receive and read-out an input. The pixel array is divided into at least one pixel group for conducting a common predefined analysis. Each of the pixels has a programmable circuitry programmed with a dynamically configurable user-defined function to modify the input. The present detector also comprises a summing circuit designed to sum the modified input.

A potentized homeopathic drug, Arsenicum Album 200, can ameliorate genotoxicity induced by repeated injections of arsenic trioxide in mice.

PubMed

Banerjee, P; Biswas, S J; Belon, P; Khuda-Bukhsh, A R

2007-09-01

Groundwater arsenic contamination has become a menacing global problem. No drug is available until now to combat chronic arsenic poisoning. To examine if a potentized homeopathic remedy, Arsenicum Album-200, can effectively combat chronic arsenic toxicity induced by repeated injections of Arsenic trioxide in mice, the following experimental design was adopted. Mice (Mus musculus) were injected subcutaneously with 0.016% arsenic trioxide at the rate of 1 ml/100 g body weight, at an interval of 7 days until they were killed at day 30, 60, 90 or 120 and were divided into three groups: (i) one receiving a daily dose of Arsenicum Album-200 through oral administration, (ii) one receiving the same dose of diluted succussed alcohol (Alcohol-200) and (iii) another receiving neither drug, nor succussed alcohol. The remedy or the placebo, as the case may be, was fed from the next day onwards after injection until the day before the next injection, and the cycle was repeated until the mice were killed. Two other control groups were also maintained: one receiving only normal diet, and the other receiving normal diet and succussed alcohol. Several toxicity assays, such as cytogenetical (chromosome aberrations, micronuclei, mitotic index, sperm head anomaly) and biochemical (acid and alkaline phosphatases, lipid peroxidation), were periodically made. Compared with controls, the drug fed mice showed reduced toxicity at statistically significant levels in respect of all the parameters studied, thereby indicating protective potentials of the homeopathic drug against chronic arsenic poisoning.

[Long-term treatment results and quality of life of the patients, operated on the reason of chronic pancreatitis, complicated by the obstructive jaundice].

PubMed

Gagua, A K; Zagaĭnov, V E; Evtikhova, E Iu

2013-01-01

Methods of surgical treatment of the patients, operated on the reason of chronic pancreatitis, complicated by the obstructive jaundice, were comparatively analyzed. 25 patients received pancreatoduodenal resection, 19 patients had the Bern variant of Beger operation. The quality of life was assessed with the use of MOS-SF-36. The duodenum preserving resection of the head of the pancreas showed better long-term results then pancreatoduodenal resection. Those patients, who received biliodigestive anastomosis as the basic operation, showed no good results at all.

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

Lentine, Anthony L.; Cox, Jonathan Albert

Methods and systems for stabilizing a resonant modulator include receiving pre-modulation and post-modulation portions of a carrier signal, determining the average power from these portions, comparing an average input power to the average output power, and operating a heater coupled to the modulator based on the comparison. One system includes a pair of input structures, one or more processing elements, a comparator, and a control element. The input structures are configured to extract pre-modulation and post-modulation portions of a carrier signal. The processing elements are configured to determine average powers from the extracted portions. The comparator is configured to comparemore » the average input power and the average output power. The control element operates a heater coupled to the modulator based on the comparison.« less

7 CFR 3418.6 - Prohibition.

Code of Federal Regulations, 2010 CFR

2010-01-01

... SERVICE, DEPARTMENT OF AGRICULTURE STAKEHOLDER INPUT REQUIREMENTS FOR RECIPIENTS OF AGRICULTURAL RESEARCH... from stakeholders as a condition of receiving the benefits of, or participating in, the agricultural...

solar thermal power systems advanced solar thermal technology project, advanced subsystems development

NASA Technical Reports Server (NTRS)

1979-01-01

The preliminary design for a prototype small (20 kWe) solar thermal electric generating unit was completed, consisting of several subsystems. The concentrator and the receiver collect solar energy and a thermal buffer storage with a transport system is used to provide a partially smoothed heat input to the Stirling engine. A fossil-fuel combustor is included in the receiver designs to permit operation with partial or no solar insolation (hybrid). The engine converts the heat input into mechanical action that powers a generator. To obtain electric power on a large scale, multiple solar modules will be required to operate in parallel. The small solar electric power plant used as a baseline design will provide electricity at remote sites and small communities.

Treatment of Tularemia in Patient with Chronic Graft-versus-Host Disease

PubMed Central

Seibold, Erik; Knabbe, Cornelius; Kaufmann, Martin; Splettstoesser, Wolf

2013-01-01

We describe a case of human tularemia caused by Francisella tularensis subsp. holarctica in a stem cell transplant recipient with chronic graft-versus-host disease who was receiving levofloxacin prophylaxis. The infection was characterized by pneumonia with septic complications. The patient was successfully treated with doxycycline. PMID:23647853

Protease biosensors based on peptide-nanocellulose conjugates: from molecular design to dressing interface

USDA-ARS?s Scientific Manuscript database

The development of point of care diagnostic protease sensors applied to wound healing has received increased interest for chronic wound treatment and as an interface with chronic wound dressings. Biosensor technology has grown exponentially in recent years. Here we focus on nanocelluosic biosensor t...

Introduction to Health Promotion for People with Chronic Illness and Disability

ERIC Educational Resources Information Center

Chan, Fong; Chiu, Chung-Yi; Bezyak, Jill L.; Keegan, John

2012-01-01

Health promotion has received increasing attention in rehabilitation counseling research. Health promotion research contributes to theory building and provides the foundation for empirically supported interventions that can improve the health-related quality of life and employment outcomes of people with chronic illness and disability. In this…

Biofeedback and Relaxation Therapy for Chronic Temporomandibular Joint Pain: Predicting Successful Outcomes.

ERIC Educational Resources Information Center

Funch, Donna P.; Gale, Elliot N.

1984-01-01

Randomly assigned 57 patients with chronic temporomandibular joint (TMJ) pain to receive either relaxation or biofeedback therapy. Successful patients in the relaxation condition tended to be younger and had experienced TMJ pain for a shorter period of time than the successful biofeedback patients. (BH)

Commutated automatic gain control system

NASA Technical Reports Server (NTRS)

Yost, S. R.

1982-01-01

The commutated automatic gain control (AGC) system was designed and built for the prototype Loran-C receiver is discussed. The current version of the prototype receiver, the Mini L-80, was tested initially in 1980. The receiver uses a super jolt microcomputer to control a memory aided phase loop (MAPLL). The microcomputer also controls the input/output, latitude/longitude conversion, and the recently added AGC system. The AGC control adjusts the level of each station signal, such that the early portion of each envelope rise is about at the same amplitude in the receiver envelope detector.

Stance Postural Strategies in Patients with Chronic Inflammatory Demyelinating Polyradiculoneuropathy

PubMed Central

Missori, Paolo; Trompetto, Carlo; Fattapposta, Francesco

2016-01-01

Introduction Polyneuropathy leads to postural instability and an increased risk of falling. We investigated how impaired motor impairment and proprioceptive input due to neuropathy influences postural strategies. Methods Platformless bisegmental posturography data were recorded in healthy subjects and patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). Each subject stood on the floor, wore a head and a hip electromagnetic tracker. Sway amplitude and velocity were recorded and the mean direction difference (MDD) in the velocity vector between trackers was calculated as a flexibility index. Results Head and hip postural sway increased more in patients with CIDP than in healthy controls. MDD values reflecting hip strategies also increased more in patients than in controls. In the eyes closed condition MDD values in healthy subjects decreased but in patients remained unchanged. Discussion Sensori-motor impairment changes the balance between postural strategies that patients adopt to maintain upright quiet stance. Motor impairment leads to hip postural strategy overweight (eyes open), and prevents strategy re-balancing when the sensory context predominantly relies on proprioceptive input (eyes closed). PMID:26977594

Dynamics and fates of trace metals chronically input in a Mediterranean coastal zone impacted by a large urban area.

PubMed

Oursel, B; Garnier, C; Durrieu, G; Mounier, S; Omanović, D; Lucas, Y

2013-04-15

Quantification and characterization of chronic inputs of trace metals and organic carbon in a coastal Mediterranean area (the city of Marseille) during the dry season was carried out. The 625 km(2) watershed includes two small coastal rivers whose waters are mixed with treated wastewater (TWW) just before their outlet into the sea. Dissolved and particulate Cu, Pb, Cd, Zn, Co, Ni and organic carbon concentrations in the rivers were comparable to those in other Mediterranean coastal areas, whereas at the outlet, 2- to 18-fold higher concentrations reflected the impact of the TWW. A non-conservative behavior observed for most of the studied metals in the mixing zone was validated by a remobilization experiment performed in the laboratory. The results showed that sorption/desorption processes could occur with slow kinetics with respect to the mixing time in the plume, indicating non-equilibrium in the dissolved/particulate metal distribution. Thus, a sample filtration immediately after sampling is strictly required. Copyright © 2013 Elsevier Ltd. All rights reserved.

Persistent Adaptations in Afferents to Ventral Tegmental Dopamine Neurons after Opiate Withdrawal.

PubMed

Kaufling, Jennifer; Aston-Jones, Gary

2015-07-15

Protracted opiate withdrawal is accompanied by altered responsiveness of midbrain dopaminergic (DA) neurons, including a loss of DA cell response to morphine, and by behavioral alterations, including affective disorders. GABAergic neurons in the tail of the ventral tegmental area (tVTA), also called the rostromedial tegmental nucleus, are important for behavioral responses to opiates. We investigated the tVTA-VTA circuit in rats after chronic morphine exposure to determine whether tVTA neurons participate in the loss of opiate-induced disinhibition of VTA DA neurons observed during protracted withdrawal. In vivo recording revealed that VTA DA neurons, but not tVTA GABAergic neurons, are tolerant to morphine after 2 weeks of withdrawal. Optogenetic stimulation of tVTA neurons inhibited VTA DA neurons similarly in opiate-naive and long-term withdrawn rats. However, tVTA inactivation increased VTA DA activity in opiate-naive rats, but not in withdrawn rats, resembling the opiate tolerance effect in DA cells. Thus, although inhibitory control of DA neurons by tVTA is maintained during protracted withdrawal, the capacity for disinhibitory control is impaired. In addition, morphine withdrawal reduced both tVTA neural activity and tonic glutamatergic input to VTA DA neurons. We propose that these changes in glutamate and GABA inputs underlie the apparent tolerance of VTA DA neurons to opiates after chronic exposure. These alterations in the tVTA-VTA DA circuit could be an important factor in opiate tolerance and addiction. Moreover, the capacity of the tVTA to inhibit, but not disinhibit, DA cells after chronic opiate exposure may contribute to long-term negative affective states during withdrawal. Dopaminergic (DA) cells of the ventral tegmental area (VTA) are the origin of a brain reward system and are critically involved in drug abuse. Morphine has long been known to affect VTA DA cells via GABAergic interneurons. Recently, GABAergic neurons caudal to the VTA were discovered and named the tail of VTA (tVTA). Here, we show that tVTA GABA neurons lose their capacity to disinhibit, but not to inhibit, VTA DA cells after chronic opiate exposure. The failure of disinhibition was associated with a loss of glutamatergic input to DA neurons after chronic morphine. These findings reveal mechanisms by which the tVTA may play a key role in long-term negative affective states during opiate withdrawal. Copyright © 2015 the authors 0270-6474/15/3510290-14$15.00/0.

Primate paneth cell degeneration following methylmercury hydroxide ingestion.

PubMed Central

Mottet, N. K.; Body, R. L.

1976-01-01

The effects of methylmercury on the intestinal epithelium were studied in 14 adolescent male Macaca mulatta monkeys weighing 3 to 5 kg. They were divided into three groups: two controls received daily applesauce vehicle without methylmercury. Nine chronic low-dose animals received 0.2 to 1.0 mg of methylmercury per day for 80 to 491 days. Three acute high-dose animals received 2.0 mg methylmercury for 17 to 18 days, when they became terminally ill. Light and electron microscopic observations were made on samples of duodenum and ileum following perfusion and immersion fixation in a glutaraldehyde-paraformaldehyde fixative. Numerous uniquely structured inclusions were prominent in the Paneth cells of the chronic low-dose animals and some necrotic Paneth cells were seen, especially in the most chronic and higher dosed animals of the group. Acute high-dose treatment produced some inclusions in the Paneth cells similar to those of the chronic low-dose group, but degenerative and necrotic cells were more frequently seen. These alterations were not seen in other intestinal epithelial cells. Paneth cells are selectively altered. These findings suggest that a function of Paneth cells may be to eliminate metals from the body. Images Figure 11 Figure 12 Figure 13 Figure 1 Figure 2 Figure 3 Figures 4 and 5 Figure 14 Figure 15 Figures 16-18 Figures 6-10 PMID:820204

Topical Administration of Pirfenidone Increases Healing of Chronic Diabetic Foot Ulcers: A Randomized Crossover Study

PubMed Central

Janka-Zires, Marcela; Uribe-Wiechers, Ana Cecilia; Juárez-Comboni, Sonia Citlali; López-Gutiérrez, Joel; Escobar-Jiménez, Jarod Jazek; Gómez-Pérez, Francisco J.

2016-01-01

Only 30 percent of chronic diabetic foot ulcers heal after 20 weeks of standard treatment. Pirfenidone is a drug with biological, anti-inflammatory, and antifibrotic effects. The aim of this study was to evaluate the effect of topical pirfenidone added to conventional treatment in noninfected chronic diabetic foot ulcers. This was a randomized crossover study. Group 1 received topical pirfenidone plus conventional treatment for 8 weeks; after this period, they were switched to receive conventional treatment only for 8 more weeks. In group 2, the order of the treatments was the opposite. The end points were complete ulcer healing and size reduction. Final data were obtained from 35 ulcers in 24 patients. Fifty-two percent of ulcers treated with pirfenidone healed before 8 weeks versus 14.3% treated with conventional treatment only (P = 0.025). Between 8 and 16 weeks, 30.8% ulcers that received pirfenidone healed versus 0% with conventional treatment (P = 0.081). By week 8, the reduction in ulcer size was 100% [73–100] with pirfenidone versus 57.5% with conventional treatment [28.9–74] (P = 0.011). By week 16, the reduction was 93% [42.7–100] with pirfenidone and 21.8% [8–77.5] with conventional treatment (P = 0.050). The addition of topical pirfenidone to conventional treatment significantly improves the healing of chronic diabetic noninfected foot ulcers. PMID:27478849

Topical Administration of Pirfenidone Increases Healing of Chronic Diabetic Foot Ulcers: A Randomized Crossover Study.

PubMed

Janka-Zires, Marcela; Almeda-Valdes, Paloma; Uribe-Wiechers, Ana Cecilia; Juárez-Comboni, Sonia Citlali; López-Gutiérrez, Joel; Escobar-Jiménez, Jarod Jazek; Gómez-Pérez, Francisco J

2016-01-01

Only 30 percent of chronic diabetic foot ulcers heal after 20 weeks of standard treatment. Pirfenidone is a drug with biological, anti-inflammatory, and antifibrotic effects. The aim of this study was to evaluate the effect of topical pirfenidone added to conventional treatment in noninfected chronic diabetic foot ulcers. This was a randomized crossover study. Group 1 received topical pirfenidone plus conventional treatment for 8 weeks; after this period, they were switched to receive conventional treatment only for 8 more weeks. In group 2, the order of the treatments was the opposite. The end points were complete ulcer healing and size reduction. Final data were obtained from 35 ulcers in 24 patients. Fifty-two percent of ulcers treated with pirfenidone healed before 8 weeks versus 14.3% treated with conventional treatment only (P = 0.025). Between 8 and 16 weeks, 30.8% ulcers that received pirfenidone healed versus 0% with conventional treatment (P = 0.081). By week 8, the reduction in ulcer size was 100% [73-100] with pirfenidone versus 57.5% with conventional treatment [28.9-74] (P = 0.011). By week 16, the reduction was 93% [42.7-100] with pirfenidone and 21.8% [8-77.5] with conventional treatment (P = 0.050). The addition of topical pirfenidone to conventional treatment significantly improves the healing of chronic diabetic noninfected foot ulcers.

Efficient “Communication through Coherence” Requires Oscillations Structured to Minimize Interference between Signals

PubMed Central

Akam, Thomas E.; Kullmann, Dimitri M.

2012-01-01

The ‘communication through coherence’ (CTC) hypothesis proposes that selective communication among neural networks is achieved by coherence between firing rate oscillation in a sending region and gain modulation in a receiving region. Although this hypothesis has stimulated extensive work, it remains unclear whether the mechanism can in principle allow reliable and selective information transfer. Here we use a simple mathematical model to investigate how accurately coherent gain modulation can filter a population-coded target signal from task-irrelevant distracting inputs. We show that selective communication can indeed be achieved, although the structure of oscillatory activity in the target and distracting networks must satisfy certain previously unrecognized constraints. Firstly, the target input must be differentiated from distractors by the amplitude, phase or frequency of its oscillatory modulation. When distracting inputs oscillate incoherently in the same frequency band as the target, communication accuracy is severely degraded because of varying overlap between the firing rate oscillations of distracting inputs and the gain modulation in the receiving region. Secondly, the oscillatory modulation of the target input must be strong in order to achieve a high signal-to-noise ratio relative to stochastic spiking of individual neurons. Thus, whilst providing a quantitative demonstration of the power of coherent oscillatory gain modulation to flexibly control information flow, our results identify constraints imposed by the need to avoid interference between signals, and reveal a likely organizing principle for the structure of neural oscillations in the brain. PMID:23144603

Forebrain pathway for auditory space processing in the barn owl.

PubMed

Cohen, Y E; Miller, G L; Knudsen, E I

1998-02-01

The forebrain plays an important role in many aspects of sound localization behavior. Yet, the forebrain pathway that processes auditory spatial information is not known for any species. Using standard anatomic labeling techniques, we used a "top-down" approach to trace the flow of auditory spatial information from an output area of the forebrain sound localization pathway (the auditory archistriatum, AAr), back through the forebrain, and into the auditory midbrain. Previous work has demonstrated that AAr units are specialized for auditory space processing. The results presented here show that the AAr receives afferent input from Field L both directly and indirectly via the caudolateral neostriatum. Afferent input to Field L originates mainly in the auditory thalamus, nucleus ovoidalis, which, in turn, receives input from the central nucleus of the inferior colliculus. In addition, we confirmed previously reported projections of the AAr to the basal ganglia, the external nucleus of the inferior colliculus (ICX), the deep layers of the optic tectum, and various brain stem nuclei. A series of inactivation experiments demonstrated that the sharp tuning of AAr sites for binaural spatial cues depends on Field L input but not on input from the auditory space map in the midbrain ICX: pharmacological inactivation of Field L eliminated completely auditory responses in the AAr, whereas bilateral ablation of the midbrain ICX had no appreciable effect on AAr responses. We conclude, therefore, that the forebrain sound localization pathway can process auditory spatial information independently of the midbrain localization pathway.

Parallel processing of afferent olfactory sensory information

PubMed Central

Vaaga, Christopher E.

2016-01-01

Key points The functional synaptic connectivity between olfactory receptor neurons and principal cells within the olfactory bulb is not well understood.One view suggests that mitral cells, the primary output neuron of the olfactory bulb, are solely activated by feedforward excitation.Using focal, single glomerular stimulation, we demonstrate that mitral cells receive direct, monosynaptic input from olfactory receptor neurons.Compared to external tufted cells, mitral cells have a prolonged afferent‐evoked EPSC, which serves to amplify the synaptic input.The properties of presynaptic glutamate release from olfactory receptor neurons are similar between mitral and external tufted cells.Our data suggest that afferent input enters the olfactory bulb in a parallel fashion. Abstract Primary olfactory receptor neurons terminate in anatomically and functionally discrete cortical modules known as olfactory bulb glomeruli. The synaptic connectivity and postsynaptic responses of mitral and external tufted cells within the glomerulus may involve both direct and indirect components. For example, it has been suggested that sensory input to mitral cells is indirect through feedforward excitation from external tufted cells. We also observed feedforward excitation of mitral cells with weak stimulation of the olfactory nerve layer; however, focal stimulation of an axon bundle entering an individual glomerulus revealed that mitral cells receive monosynaptic afferent inputs. Although external tufted cells had a 4.1‐fold larger peak EPSC amplitude, integration of the evoked currents showed that the synaptic charge was 5‐fold larger in mitral cells, reflecting the prolonged response in mitral cells. Presynaptic afferents onto mitral and external tufted cells had similar quantal amplitude and release probability, suggesting that the larger peak EPSC in external tufted cells was the result of more synaptic contacts. The results of the present study indicate that the monosynaptic afferent input to mitral cells depends on the strength of odorant stimulation. The enhanced spiking that we observed in response to brief afferent input provides a mechanism for amplifying sensory information and contrasts with the transient response in external tufted cells. These parallel input paths may have discrete functions in processing olfactory sensory input. PMID:27377344

Scanned Laser Illuminator/Receiver

DTIC Science & Technology

1976-11-01

0.21/cm | | Optical Power 20 Watts i input I Optical Power 100 Watts | output ! Input Power 10 kW The oscillator ...8217.rectional due to the oscillating mirror. Again, con- siderable optical magnification is provided between object space and the scan mirror to minimize the...for a 100W (14) R. A. McClatchey, et al, " Optical Properties of the Atmosphere (Third Edition)," Air Force Cambridge Research Laboratories, Tech

Transfer of Training and Processing Instruction: From Input to Output

ERIC Educational Resources Information Center

VanPatten, Bill; Uludag, Onur

2011-01-01

In this paper we report the findings of an experiment to test whether training via processing instruction transfers to output tasks. Two groups of Turkish L1-English L2 learners participated: one that received processing instruction on passive structures and a control group that did not receive any instruction on passives. A pre-test/multiple…

A high gain wide dynamic range transimpedance amplifier for optical receivers

NASA Astrophysics Data System (ADS)

Lianxi, Liu; Jiao, Zou; Yunfei, En; Shubin, Liu; Yue, Niu; Zhangming, Zhu; Yintang, Yang

2014-01-01

As the front-end preamplifiers in optical receivers, transimpedance amplifiers (TIAs) are commonly required to have a high gain and low input noise to amplify the weak and susceptible input signal. At the same time, the TIAs should possess a wide dynamic range (DR) to prevent the circuit from becoming saturated by high input currents. Based on the above, this paper presents a CMOS transimpedance amplifier with high gain and a wide DR for 2.5 Gbit/s communications. The TIA proposed consists of a three-stage cascade pull push inverter, an automatic gain control circuit, and a shunt transistor controlled by the resistive divider. The inductive-series peaking technique is used to further extend the bandwidth. The TIA proposed displays a maximum transimpedance gain of 88.3 dBΩ with the -3 dB bandwidth of 1.8 GHz, exhibits an input current dynamic range from 100 nA to 10 mA. The output voltage noise is less than 48.23 nV/√Hz within the -3 dB bandwidth. The circuit is fabricated using an SMIC 0.18 μm 1P6M RFCMOS process and dissipates a dc power of 9.4 mW with 1.8 V supply voltage.

Frequency downconversion and phase noise in MIT.

PubMed

Watson, S; Williams, R J; Griffiths, H; Gough, W; Morris, A

2002-02-01

High-frequency (3-30 MHz) operation of MIT systems offers advantages in terms of the larger induced signal amplitudes compared to systems operating in the low- or medium-frequency ranges. Signal distribution at HF, however, presents difficulties, in particular with isolation and phase stability. It is therefore valuable to translate received signals to a lower frequency range through heterodyne downconversion, a process in which relative signal amplitude and phase information is in theory retained. Measurement of signal amplitude and phase is also simplified at lower frequencies. The paper presents details of measurements on a direct phase measurement system utilizing heterodyne downconversion and compares the relative performance of three circuit configurations. The 100-sample average precision of a circuit suitable for use as a receiver within an MIT system was 0.008 degrees for input amplitude -21 dBV. As the input amplitude was reduced from -21 to -72 dBV variation in the measured phase offset was observed, with the offset varying by 1.8 degrees. The precision of the circuit deteriorated with decreasing input amplitude, but was found to provide a 100-sample average precision of <0.022 degrees down to an input amplitude of -60 dBV. The characteristics of phase noise within the system are discussed.

Short-wavelength cone-opponent retinal ganglion cells in mammals.

PubMed

Marshak, David W; Mills, Stephen L

2014-03-01

In all of the mammalian species studied to date, the short-wavelength-sensitive (S) cones and the S-cone bipolar cells that receive their input are very similar, but the retinal ganglion cells that receive synapses from the S-cone bipolar cells appear to be quite different. Here, we review the literature on mammalian retinal ganglion cells that respond selectively to stimulation of S-cones and respond with opposite polarity to longer wavelength stimuli. There are at least three basic mechanisms to generate these color-opponent responses, including: (1) opponency is generated in the outer plexiform layer by horizontal cells and is conveyed to the ganglion cells via S-cone bipolar cells, (2) inputs from bipolar cells with different cone inputs and opposite response polarity converge directly on the ganglion cells, and (3) inputs from S-cone bipolar cells are inverted by S-cone amacrine cells. These are not mutually exclusive; some mammalian ganglion cells that respond selectively to S-cone stimulation seem to utilize at least two of them. Based on these findings, we suggest that the small bistratified ganglion cells described in primates are not the ancestral type, as proposed previously. Instead, the known types of ganglion cells in this pathway evolved from monostratified ancestral types and became bistratified in some mammalian lineages.

Frequency Agile Lidar Receiver for Chem-Bio Sensing

DTIC Science & Technology

2010-06-01

receiver module design is based on the following key attributes: 1) The use of an inexpensive COTS PV MCT , 2) A custom detector amplifier with ultra low...input-referenced noise density of 0.8 nV/ Hz0.5 that is carefully matched to the electrical properties of the detector and temporal characteristics of...LIDAR transmitter. The low- noise amplifier matched to the receiver detector was developed in order to realize the BLIP noise reduction resulting from

Case of relentless chronic phase of chronic myeloid leukaemia.

PubMed

Chan, Onyee; Chen, Hao; Krishnadasan, Ravitharan; Anwer, Faiz

2016-06-22

Initial treatment of chronic phase chronic myeloid leukaemia is straightforward in today's era of tyrosine kinase inhibitors. However, managing refractory cases remain a major challenge due to the multiple factors that can influence decision-making, including medication tolerance, disease burden, mutation status, comorbidities, availability of donor, and fitness for an ablative conditioning. We report a male patient presenting with chronic phase chronic myeloid leukaemia who was treated with 5 different tyrosine kinase inhibitors either due to intolerance and/or failed response. He subsequently received 2 haploidentical haematopoietic stem cells transplants before achieving complete remission. This case highlights various treatment options, need for vigilant disease monitoring, and the possibility of complete positive response even after many lines of therapy failure. 2016 BMJ Publishing Group Ltd.

Distinct Translaminar Glutamatergic Circuits to GABAergic Interneurons in the Neonatal Auditory Cortex.

PubMed

Deng, Rongkang; Kao, Joseph P Y; Kanold, Patrick O

2017-05-09

GABAergic activity is important in neocortical development and plasticity. Because the maturation of GABAergic interneurons is regulated by neural activity, the source of excitatory inputs to GABAergic interneurons plays a key role in development. We show, by laser-scanning photostimulation, that layer 4 and layer 5 GABAergic interneurons in the auditory cortex in neonatal mice (

Implementation of chronic illness care in German primary care practices--how do multimorbid older patients view routine care? A cross-sectional study using multilevel hierarchical modeling.

PubMed

Petersen, Juliana J; Paulitsch, Michael A; Mergenthal, Karola; Gensichen, Jochen; Hansen, Heike; Weyerer, Siegfried; Riedel-Heller, Steffi G; Fuchs, Angela; Maier, Wolfgang; Bickel, Horst; König, Hans-Helmut; Wiese, Birgitt; van den Bussche, Hendrik; Scherer, Martin; Dahlhaus, Anne

2014-08-07

In primary care, patients with multiple chronic conditions are the rule rather than the exception. The Chronic Care Model (CCM) is an evidence-based framework for improving chronic illness care, but little is known about the extent to which it has been implemented in routine primary care. The aim of this study was to describe how multimorbid older patients assess the routine chronic care they receive in primary care practices in Germany, and to explore the extent to which factors at both the practice and patient level determine their views. This cross-sectional study used baseline data from an observational cohort study involving 158 general practitioners (GP) and 3189 multimorbid patients. Standardized questionnaires were employed to collect data, and the Patient Assessment of Chronic Illness Care (PACIC) questionnaire used to assess the quality of care received. Multilevel hierarchical modeling was used to identify any existing association between the dependent variable, PACIC, and independent variables at the patient level (socio-economic factors, weighted count of chronic conditions, instrumental activities of daily living, health-related quality of life, graded chronic pain, no. of contacts with GP, existence of a disease management program (DMP) disease, self-efficacy, and social support) and the practice level (age and sex of GP, years in current practice, size and type of practice). The overall mean PACIC score was 2.4 (SD 0.8), with the mean subscale scores ranging from 2.0 (SD 1.0, subscale goal setting/tailoring) to 3.5 (SD 0.7, delivery system design). At the patient level, higher PACIC scores were associated with a DMP disease, more frequent GP contacts, higher social support, and higher autonomy of past occupation. At the practice level, solo practices were associated with higher PACIC values than other types of practice. This study shows that from the perspective of multimorbid patients receiving care in German primary care practices, the implementation of structured care and counseling could be improved, particularly by helping patients set specific goals, coordinating care, and arranging follow-up contacts. Studies evaluating chronic care should take into consideration that a patient's assessment is associated not only with practice-level factors, but also with individual, patient-level factors. Current Controlled Trials ISRCTN89818205.

Input dependent cell assembly dynamics in a model of the striatal medium spiny neuron network.

PubMed

Ponzi, Adam; Wickens, Jeff

2012-01-01

The striatal medium spiny neuron (MSN) network is sparsely connected with fairly weak GABAergic collaterals receiving an excitatory glutamatergic cortical projection. Peri-stimulus time histograms (PSTH) of MSN population response investigated in various experimental studies display strong firing rate modulations distributed throughout behavioral task epochs. In previous work we have shown by numerical simulation that sparse random networks of inhibitory spiking neurons with characteristics appropriate for UP state MSNs form cell assemblies which fire together coherently in sequences on long behaviorally relevant timescales when the network receives a fixed pattern of constant input excitation. Here we first extend that model to the case where cortical excitation is composed of many independent noisy Poisson processes and demonstrate that cell assembly dynamics is still observed when the input is sufficiently weak. However if cortical excitation strength is increased more regularly firing and completely quiescent cells are found, which depend on the cortical stimulation. Subsequently we further extend previous work to consider what happens when the excitatory input varies as it would when the animal is engaged in behavior. We investigate how sudden switches in excitation interact with network generated patterned activity. We show that sequences of cell assembly activations can be locked to the excitatory input sequence and outline the range of parameters where this behavior is shown. Model cell population PSTH display both stimulus and temporal specificity, with large population firing rate modulations locked to elapsed time from task events. Thus the random network can generate a large diversity of temporally evolving stimulus dependent responses even though the input is fixed between switches. We suggest the MSN network is well suited to the generation of such slow coherent task dependent response which could be utilized by the animal in behavior.

Input Dependent Cell Assembly Dynamics in a Model of the Striatal Medium Spiny Neuron Network

PubMed Central

Ponzi, Adam; Wickens, Jeff

2012-01-01

The striatal medium spiny neuron (MSN) network is sparsely connected with fairly weak GABAergic collaterals receiving an excitatory glutamatergic cortical projection. Peri-stimulus time histograms (PSTH) of MSN population response investigated in various experimental studies display strong firing rate modulations distributed throughout behavioral task epochs. In previous work we have shown by numerical simulation that sparse random networks of inhibitory spiking neurons with characteristics appropriate for UP state MSNs form cell assemblies which fire together coherently in sequences on long behaviorally relevant timescales when the network receives a fixed pattern of constant input excitation. Here we first extend that model to the case where cortical excitation is composed of many independent noisy Poisson processes and demonstrate that cell assembly dynamics is still observed when the input is sufficiently weak. However if cortical excitation strength is increased more regularly firing and completely quiescent cells are found, which depend on the cortical stimulation. Subsequently we further extend previous work to consider what happens when the excitatory input varies as it would when the animal is engaged in behavior. We investigate how sudden switches in excitation interact with network generated patterned activity. We show that sequences of cell assembly activations can be locked to the excitatory input sequence and outline the range of parameters where this behavior is shown. Model cell population PSTH display both stimulus and temporal specificity, with large population firing rate modulations locked to elapsed time from task events. Thus the random network can generate a large diversity of temporally evolving stimulus dependent responses even though the input is fixed between switches. We suggest the MSN network is well suited to the generation of such slow coherent task dependent response which could be utilized by the animal in behavior. PMID:22438838

CB1 Cannabinoid Receptor Expression in the Striatum: Association with Corticostriatal Circuits and Developmental Regulation

PubMed Central

Van Waes, Vincent; Beverley, Joel A.; Siman, Homayoun; Tseng, Kuei Y.; Steiner, Heinz

2012-01-01

Corticostriatal circuits mediate various aspects of goal-directed behavior and are critically important for basal ganglia-related disorders. Activity in these circuits is regulated by the endocannabinoid system via stimulation of CB1 cannabinoid receptors. CB1 receptors are highly expressed in projection neurons and select interneurons of the striatum, but expression levels vary considerably between different striatal regions (functional domains). We investigated CB1 receptor expression within specific corticostriatal circuits by mapping CB1 mRNA levels in striatal sectors defined by their cortical inputs in rats. We also assessed changes in CB1 expression in the striatum during development. Our results show that CB1 expression is highest in juveniles (P25) and then progressively decreases toward adolescent (P40) and adult (P70) levels. At every age, CB1 receptors are predominantly expressed in sensorimotor striatal sectors, with considerably lower expression in associative and limbic sectors. Moreover, for most corticostriatal circuits there is an inverse relationship between cortical and striatal expression levels. Thus, striatal sectors with high CB1 expression (sensorimotor sectors) tend to receive inputs from cortical areas with low expression, while striatal sectors with low expression (associative/limbic sectors) receive inputs from cortical regions with higher expression (medial prefrontal cortex). In so far as CB1 mRNA levels reflect receptor function, our findings suggest differential CB1 signaling between different developmental stages and between sensorimotor and associative/limbic circuits. The regional distribution of CB1 receptor expression in the striatum further suggests that, in sensorimotor sectors, CB1 receptors mostly regulate GABA inputs from local axon collaterals of projection neurons, whereas in associative/limbic sectors, CB1 regulation of GABA inputs from interneurons and glutamate inputs may be more important. PMID:22416230

Origin and function of short-latency inputs to the neural substrates underlying the acoustic startle reflex

PubMed Central

Gómez-Nieto, Ricardo; Horta-Júnior, José de Anchieta C.; Castellano, Orlando; Millian-Morell, Lymarie; Rubio, Maria E.; López, Dolores E.

2014-01-01

The acoustic startle reflex (ASR) is a survival mechanism of alarm, which rapidly alerts the organism to a sudden loud auditory stimulus. In rats, the primary ASR circuit encompasses three serially connected structures: cochlear root neurons (CRNs), neurons in the caudal pontine reticular nucleus (PnC), and motoneurons in the medulla and spinal cord. It is well-established that both CRNs and PnC neurons receive short-latency auditory inputs to mediate the ASR. Here, we investigated the anatomical origin and functional role of these inputs using a multidisciplinary approach that combines morphological, electrophysiological and behavioral techniques. Anterograde tracer injections into the cochlea suggest that CRNs somata and dendrites receive inputs depending, respectively, on their basal or apical cochlear origin. Confocal colocalization experiments demonstrated that these cochlear inputs are immunopositive for the vesicular glutamate transporter 1 (VGLUT1). Using extracellular recordings in vivo followed by subsequent tracer injections, we investigated the response of PnC neurons after contra-, ipsi-, and bilateral acoustic stimulation and identified the source of their auditory afferents. Our results showed that the binaural firing rate of PnC neurons was higher than the monaural, exhibiting higher spike discharges with contralateral than ipsilateral acoustic stimulations. Our histological analysis confirmed the CRNs as the principal source of short-latency acoustic inputs, and indicated that other areas of the cochlear nucleus complex are not likely to innervate PnC. Behaviorally, we observed a strong reduction of ASR amplitude in monaural earplugged rats that corresponds with the binaural summation process shown in our electrophysiological findings. Our study contributes to understand better the role of neuronal mechanisms in auditory alerting behaviors and provides strong evidence that the CRNs-PnC pathway mediates fast neurotransmission and binaural summation of the ASR. PMID:25120419

SEPs to finger joint input lack the N20-P20 response that is evoked by tactile inputs: contrast between cortical generators in areas 3b and 2 in humans.

PubMed

Desmedt, J E; Ozaki, I

1991-01-01

A method using a DC servo motor is described to produce brisk angular movements at finger interphalangeal joints in humans. Small passive flexions of 2 degrees elicited sizable somatosensory evoked potentials (SEPs) starting with a contralateral positive P34 parietal response thought to reflect activation of a radial equivalent dipole generator in area 2 which receives joint inputs. By contrast, electric stimulation of tactile (non-joint) inputs from the distal phalanx evoked the usual contralateral negative N20 reflecting a tangential equivalent dipole generator in area 3b. Finger joint inputs also evoked a precentral positivity equivalent to the P22 of motor area 4, and a large frontal negativity equivalent to N30. It is suggested that natural stimulation allows human SEP components to be differentiated in conjunction with distinct cortical somatotopic projections.

Aircraft signal definition for flight safety system monitoring system

NASA Technical Reports Server (NTRS)

Gibbs, Michael (Inventor); Omen, Debi Van (Inventor)

2003-01-01

A system and method compares combinations of vehicle variable values against known combinations of potentially dangerous vehicle input signal values. Alarms and error messages are selectively generated based on such comparisons. An aircraft signal definition is provided to enable definition and monitoring of sets of aircraft input signals to customize such signals for different aircraft. The input signals are compared against known combinations of potentially dangerous values by operational software and hardware of a monitoring function. The aircraft signal definition is created using a text editor or custom application. A compiler receives the aircraft signal definition to generate a binary file that comprises the definition of all the input signals used by the monitoring function. The binary file also contains logic that specifies how the inputs are to be interpreted. The file is then loaded into the monitor function, where it is validated and used to continuously monitor the condition of the aircraft.

Impact of imatinib interruption and duration of prior hydroxyurea on the treatment outcome in patients with chronic myeloid leukemia: Single institution experience.

PubMed

Edesa, Wael Abdelgawad; Abdel-malek, Raafat Ragaey

2015-06-01

Optimal response requires that patients should be maintained on the drug continuously. To evaluate the influence of imatinib interruption and prior hydroxyurea use on the outcome of patients with chronic myeloid leukemia. Between January 2010 and November 2013, patients with chronic phase who received imatinib at the Kasr Al-ainy Center of Clinical Oncology were included. Sixty patients were included in this study, thirty three patients (55%) received imatinib upfront, while 27 (45%) received imatinib post hydroxyurea. Imatinib was not given regularly in 50% of patients. In terms of response, only major molecular response and complete molecular response were statistically significant in favor of patients who were receiving imatinib regularly compared to those who had interruption (p<0.001, p<0.001, respectively) , while there was no difference in patients stratified according to prior hydroxyurea. The median progression free survival was 30.3 months (95% CI 24.3-36.3). Among the group of patients who received imatinib regularly, progression free survival was longer (p=0.049), there was no difference between those who received prior hydroxyurea versus those who did not (p=0.67). Duration of prior hydroxyurea had no impact on response or progression free survival, while patients regular on imatinib had statistically significant difference with respect to major molecular response, complete molecular response and progression free survival compared to those who had periods of drug interruption, thus we need more governmental support to supply the drug without interruption to improve the outcome of therapy. Copyright © 2015 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

[Efficacy and safety of vaccination against hepatitis A and B in patients with chronic liver disease].

PubMed

de Artaza Varasa, Tomás; Sánchez Ruano, Juan José; García Vela, Almudena; Gómez Rodríguez, Rafael; Romero Gutiérrez, Marta; de la Cruz Pérez, Gema; Gómez Moreno, Ana Zaida; Carrobles Jiménez, José María

2009-01-01

Vaccination to protect against hepatitis A and B should be part of the routine management of patients with chronic liver disease (CLD). To evaluate the efficacy and safety of hepatitis A virus (HAV) and hepatitis B virus (HBV) vaccination in a group of patients with CLD and to assess the presence of factors predictive of response. We performed a prospective, single-center study in 194 patients (123 men, 71 women; mean age, 48.9+/-10.7 years) with CLD: 107 with chronic hepatitis (CH) and 87 with hepatic cirrhosis (HC), all Child-Pugh class A. The most frequent causes of CLD were HCV infection and alcohol. Patients negative for anti-HAV IgG received the HAV vaccination (1440 ELISA units in two doses) and those with negative HBV serology received the HBV vaccination ( three 20 microg doses). Patients with inadequate response to the latter vaccine received an additional double dose. Thirty patients received a combination vaccine (three doses). Sixty patients (31%) received the HAV vaccine and 150 (77%) patients received the HBV vaccine. Seroconversion was achieved by 91.6% of patients for HAV and by 57% of the patients for HBV. After the additional dose, the response increased to 74%. Efficacy was similar between CH and HC. HBV vaccination was less effective in HC than in CH and the seroconversion rate was significantly lower in patients with HC and previous decompensation. The combination vaccine (30 patients) was highly immunogenic. No adverse effects were registered. HAV vaccination has high efficacy in patients with CLD. Patients with HC respond weakly to HBV vaccination compared with those with CH and especially if there is prior decompensation. The combination vaccine seems particularly effective in patients with CLD. The three vaccines are safe.

Adaptive gain, equalization, and wavelength stabilization techniques for silicon photonic microring resonator-based optical receivers

NASA Astrophysics Data System (ADS)

Palermo, Samuel; Chiang, Patrick; Yu, Kunzhi; Bai, Rui; Li, Cheng; Chen, Chin-Hui; Fiorentino, Marco; Beausoleil, Ray; Li, Hao; Shafik, Ayman; Titriku, Alex

2016-03-01

Interconnect architectures based on high-Q silicon photonic microring resonator devices offer a promising solution to address the dramatic increase in datacenter I/O bandwidth demands due to their ability to realize wavelength-division multiplexing (WDM) in a compact and energy efficient manner. However, challenges exist in realizing efficient receivers for these systems due to varying per-channel link budgets, sensitivity requirements, and ring resonance wavelength shifts. This paper reports on adaptive optical receiver design techniques which address these issues and have been demonstrated in two hybrid-integrated prototypes based on microring drop filters and waveguide photodetectors implemented in a 130nm SOI process and high-speed optical front-ends designed in 65nm CMOS. A 10Gb/s powerscalable architecture employs supply voltage scaling of a three inverter-stage transimpedance amplifier (TIA) that is adapted with an eye-monitor control loop to yield the necessary sensitivity for a given channel. As reduction of TIA input-referred noise is more critical at higher data rates, a 25Gb/s design utilizes a large input-stage feedback resistor TIA cascaded with a continuous-time linear equalizer (CTLE) that compensates for the increased input pole. When tested with a waveguide Ge PD with 0.45A/W responsivity, this topology achieves 25Gb/s operation with -8.2dBm sensitivity at a BER=10-12. In order to address microring drop filters sensitivity to fabrication tolerances and thermal variations, efficient wavelength-stabilization control loops are necessary. A peak-power-based monitoring loop which locks the drop filter to the input wavelength, while achieving compatibility with the high-speed TIA offset-correction feedback loop is implemented with a 0.7nm tuning range at 43μW/GHz efficiency.

A prospective randomized trial of 1 versus 2 injections during EUS-guided celiac plexus block for chronic pancreatitis pain.

PubMed

LeBlanc, Julia K; DeWitt, Jon; Johnson, Cynthia; Okumu, Wycliffe; McGreevy, Kathleen; Symms, Michelle; McHenry, Lee; Sherman, Stuart; Imperiale, Thomas

2009-04-01

The efficacy of 1-injection versus a 2-injections method of EUS-guided celiac plexus block (EUS-CPB) in patients with chronic pancreatitis is not known. To compare the clinical effectiveness and safety of EUS-CPB by using 1 versus 2 injections in patients with chronic pancreatitis and pain. The secondary aim is to identify factors that predict responsiveness. A prospective randomized study. EUS-CPB was performed by using bupivacaine and triamcinolone injected into 1 or 2 sites at the level of the celiac trunk during a single EUS-CPB procedure. Duration of pain relief, onset of pain relief, and complications. Fifty [corrected] subjects were enrolled (23 received 1 injection, 27 [corrected] received 2 injections). The median duration of pain relief in the 31 responders was 28 days (range 1-673 days). [corrected] Fifteen [corrected] of 23 (65%) [corrected] subjects who received 1 injection [corrected] had relief from pain compared with 16 of 27 (59%) [corrected] subjects who received 2 injections [corrected] (P = .67). [corrected] The median times to onset in the 1-injection and 2-injections groups were 21 and 14 days, respectively (P = .99). No correlation existed between duration of pain relief and time to onset of pain relief or onset within 24 hours. Age, sex, race, prior EUS-CPB, and smoking or alcohol history did not predict duration of pain relief. Telephone interviewers were not blinded. There was no difference in duration of pain relief or onset of pain relief in subjects with chronic pancreatitis and pain when the same total amount of medication was delivered in 1 or 2 injections during a single EUS-CPB procedure. Both methods were safe.

Meeting vaccination quality measures for hepatitis A and B virus in patients with chronic hepatitis C infection.

PubMed

Kramer, Jennifer R; Hachem, Christine Y; Kanwal, Fasiha; Mei, Minghua; El-Serag, Hashem B

2011-01-01

Coinfection with hepatitis A virus (HAV) or hepatitis B virus (HBV) in patients with chronic hepatitis C virus (HCV) is associated with increased morbidity and mortality. The Center for Medicare and Medicaid Services has identified HAV and HBV vaccination as a priority area for quality measurement in HCV. It is unclear to what extent patients with HCV meet these recommendations. We used national data from the Department of Veterans Affairs HCV Clinical Case Registry to evaluate the prevalence and predictors of meeting the quality measure (QM) of receiving vaccination or documented immunity to HAV and HBV in patients with chronic HCV. We identified 88,456 patients who had overall vaccination rates of 21.9% and 20.7% for HBV and HAV, respectively. The QM rates were 57.0% and 45.5% for HBV and HAV, respectively. Patients who were nonwhite or who had elevated alanine aminotransferase levels, cirrhosis, or human immunodeficiency virus were more likely to meet the HBV QM. Factors related to HCV care were also determinants of meeting the HBV QM. These factors included receiving a specialist consult, genotype testing, or HCV treatment. Patients who were older, had psychosis, and had a higher comorbidity score were less likely to meet the HBV QM. With a few exceptions, similar variables were related to meeting the HAV QM. The incidence of superinfection with acute HBV and HAV was low, but it was significantly lower in patients who received vaccination than in those who did not. Quality measure rates for HAV and HBV are suboptimal for patients with chronic HCV. In addition, several patient-related factors and receiving HCV-related care are associated with a higher likelihood of meeting QMs. Copyright © 2010 American Association for the Study of Liver Diseases.

Magnetic Resonance Neurography in Chronic Lumbosacral and Pelvic Pain: Diagnostic and Management Impact-Institutional Audit.

PubMed

Dessouky, Riham; Xi, Yin; Scott, Kelly M; Khaleel, Mohammed; Gill, Kevin; Jones, Stephanie; Khalifa, Dalia N; Tantawy, Hazim I; Aidaros, Magdy A; Chhabra, Avneesh

2018-06-01

Low back and pelvic pain are among the most prevalent conditions worldwide, with major social and economic costs. The aim of this study was to evaluate the role of magnetic resonance neurography (MRN) of lumbosacral plexus in the management and outcomes of these patients with chronic pain. Consecutive patients with chronic lumbosacral and pelvic pain referred for MRN over a year were included. Preimaging and postimaging clinical diagnosis and treatment, pain levels, and location were recorded. Pain-free survival was compared between treatments using a Cox proportional hazards model. A total of 202 patients with mean age 53.7 ± 14.8 years and a male/female ratio of 1:1.53 were included. Of these patients, 115 presented with radiculopathy (57%), 56 with pelvic pain (28%), and 31 with groin pain (15%). Mean initial pain level was 6.9 ± 1.9. Mean symptom duration was 4.21 ± 5.86 years. Of these patients, 143 (71%) had a change in management because of MRN. After MRN, reduction in pain levels was observed in 21 of 32 patients receiving conservative treatment (66%), 42 of 67 receiving injections (63%), and 27 of 33 receiving surgery (82%). Follow-ups were available in 131 patients. Median pain-free survival was 12 months. Patients treated with surgery had significantly lower pain recurrence than patients receiving other treatments in the same time frame (hazard ratio, 3.6; 95% confidence interval, 1.4-9.2; P = 0.0061). MRN use in chronic lumbosacral and pelvic pain led to a meaningful change in diagnosis and treatment. After MRN, conservative treatment and injections provided pain relief; however, patients benefited more from surgery than from any other treatment. Copyright © 2018 Elsevier Inc. All rights reserved.

A three-channel LED driver with single line transportation technique

NASA Astrophysics Data System (ADS)

Yu, Caideng; Du, Yiying; Jiang, Qiao; Zhou, Yun; Lv, Jian

2012-10-01

Designed a three-channel LED driver, realized the single-wire transmission of cascade signal between the drive IC of LED. Including the MCU digital interface, date register, clock synchronization, PWM grayscale adjustment circuit, as well as high voltage driver circuit for LED, etc… The driver control LED displaying 256 gray. Chip will generate synchronous sampling clock signals according to the received serial signals, when 24 bits dates have been received, the output pin begins to transport the dates followed-up which are automotive shaped to the input of the next chip. When the date receiving becomes low level that represent RESET, the red, green and blue channels will export different signals based on different input dates. Through the external MCU, it is realized the Separate luminance, and by connecting chips in series it achieved the control of outdoor big screen' colorful display. The automatic shaping forward technique makes the number of chips cascading immune to the limitations of signal transmission, but only limited by the refresh speed.

Dissociation and Convergence of the Dorsal and Ventral Visual Streams in the Human Prefrontal Cortex

PubMed Central

Takahashi, Emi; Ohki, Kenichi; Kim, Dae-Shik

2012-01-01

Visual information is largely processed through two pathways in the primate brain: an object pathway from the primary visual cortex to the temporal cortex (ventral stream) and a spatial pathway to the parietal cortex (dorsal stream). Whether and to what extent dissociation exists in the human prefrontal cortex (PFC) has long been debated. We examined anatomical connections from functionally defined areas in the temporal and parietal cortices to the PFC, using noninvasive functional and diffusion-weighted magnetic resonance imaging. The right inferior frontal gyrus (IFG) received converging input from both streams, while the right superior frontal gyrus received input only from the dorsal stream. Interstream functional connectivity to the IFG was dynamically recruited only when both object and spatial information were processed. These results suggest that the human PFC receives dissociated and converging visual pathways, and that the right IFG region serves as an integrator of the two types of information. PMID:23063444

Self-reported prevalence, description and management of pain in adults with haemophilia: methods, demographics and results from the Pain, Functional Impairment, and Quality of life (P-FiQ) study.

PubMed

Witkop, M; Neff, A; Buckner, T W; Wang, M; Batt, K; Kessler, C M; Quon, D; Boggio, L; Recht, M; Baumann, K; Gut, R Z; Cooper, D L; Kempton, C L

2017-07-01

Haemophilia is characterized by frequent haemarthrosis, leading to acute/chronic joint pain. To assess self-reported prevalence, description and management of pain in adult males with mild-to-severe haemophilia and history of joint pain/bleeding. Participants completed a pain survey and five patient-reported outcome instruments assessing pain, functional impairment and health-related quality of life (HRQoL). Of 381 participants enrolled, median age was 34 years; 77% had haemophilia A, 71% had severe disease and 65% were overweight/obese. Many (56%) were not receiving routine infusions; 30% never received routine infusions. During the prior 6 months, 20% experienced acute pain, 34% chronic pain and 32% both acute/chronic pain. Subjects with both acute/chronic pain (vs. none, acute or chronic) were more likely to be depressed (30% vs. 0-15%), obese (35% vs. 20-29%) and have lower HRQoL (mean EQ-5D visual analog scale, 69 vs. 83-86) and function (median overall Hemophilia Activities List, 60 vs. 88-99). Most common analgesics used for acute/chronic pain during the prior 6 months were acetaminophen (62%/55%) and non-steroidal anti-inflammatory drugs (34%/49%); most common non-pharmacologic strategies were ice (65%/33%) and rest (51%/33%). Hydrocodone-acetaminophen was the most common opioid for both acute/chronic pain (30%); other long-acting opioids were infrequently used specifically for chronic but not acute pain (morphine, 7%; methadone, 6%; fentanyl patch, 2%). Patients with chronic pain, particularly those with both acute/chronic pain, frequently experience psychological issues, functional disability and reduced HRQoL. Treatment strategies for acute pain (e.g. routine infusions to prevent bleeding) and for chronic pain (e.g. long-acting opioids) may be underused. © 2017 The Authors. Haemophilia Published by John Wiley & Sons Ltd.

Is altered central pain processing related to disease stage in chronic pancreatitis patients with pain? An exploratory study.

PubMed

Bouwense, Stefan A W; Olesen, Søren S; Drewes, Asbjørn M; Frøkjær, Jens B; van Goor, Harry; Wilder-Smith, Oliver H G

2013-01-01

The most dominant feature in chronic pancreatitis is intense abdominal pain. Changes in spinal and/or supraspinal central nervous system pain processing due to visceral nociceptive input play an important role in this pain. How altered pain processing is related to disease stage still needs study. Sixty chronic pancreatitis patients were compared to 15 healthy controls. Two subgroups of pancreatitis patients were defined based on the M-ANNHEIM severity index of chronic pancreatitis; i.e. moderate and severe. Pain detection and tolerance thresholds for pressure and electric stimuli were measured in six selected dermatomes (C5, T4, T10, L1, L4 and T10BACK). In addition, the conditioned pain modulation response to cold pressor task was determined. These measures were compared between the healthy controls and chronic pancreatitis patients. Severe pancreatitis patients showed lower pain thresholds than moderate pancreatitis patients or healthy volunteers. Healthy controls showed a significantly larger conditioned pain modulation response compared to all chronic pancreatitis patients taken together. The present study confirms that chronic pancreatitis patients show signs of altered central processing of nociception compared to healthy controls. The study further suggests that these changes, i.e. central sensitization, may be influenced by disease stage. These findings underline the need to take altered central pain processing into account when managing the pain of chronic pancreatitis.

Radiation tolerant combinational logic cell

NASA Technical Reports Server (NTRS)

Maki, Gary R. (Inventor); Whitaker, Sterling (Inventor); Gambles, Jody W. (Inventor)

2009-01-01

A system has a reduced sensitivity to Single Event Upset and/or Single Event Transient(s) compared to traditional logic devices. In a particular embodiment, the system includes an input, a logic block, a bias stage, a state machine, and an output. The logic block is coupled to the input. The logic block is for implementing a logic function, receiving a data set via the input, and generating a result f by applying the data set to the logic function. The bias stage is coupled to the logic block. The bias stage is for receiving the result from the logic block and presenting it to the state machine. The state machine is coupled to the bias stage. The state machine is for receiving, via the bias stage, the result generated by the logic block. The state machine is configured to retain a state value for the system. The state value is typically based on the result generated by the logic block. The output is coupled to the state machine. The output is for providing the value stored by the state machine. Some embodiments of the invention produce dual rail outputs Q and Q'. The logic block typically contains combinational logic and is similar, in size and transistor configuration, to a conventional CMOS combinational logic design. However, only a very small portion of the circuits of these embodiments, is sensitive to Single Event Upset and/or Single Event Transients.

Cryptococcal infections in two patients receiving ibrutinib therapy for chronic lymphocytic leukemia.

PubMed

Stankowicz, Matthew; Banaszynski, Megan; Crawford, Russell

2018-01-01

Cryptococcal infections are responsible for significant morbidity and mortality in immunocompromised patients. Reports of these infections in patients on small molecular kinase inhibitors have not been widely reported in clinical trials. We describe one case of cryptococcal meningoencephalitis and one case of cryptococcal pneumonia in two patients who were receiving ibrutinib for chronic lymphocytic leukemia. Despite different sites of cryptococcal infection, both patients had similar presentations of acute illness. Patient 1 was worked up for health care-associated pneumonia, as well as acute sinusitis prior to the diagnosis of cryptococcal meningoencephalitis. He also had a more complex past medical history than patient 2. Patient 2 developed atrial fibrillation from ibrutinib prior to admission for presumed health care-associated pneumonia. Cryptococcal antigen testing was done sooner in this patient due to patient receiving high-dose steroids for the treatment of underlying hemolytic anemia. We conclude that patients who develop acute illness while receiving ibrutinib should be considered for cryptococcal antigen testing.

Wireless power transmission for battery charging

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

Mi, Chris; Li, Siqi; Nguyen, Trong-Duy

A wireless power transmission system is provided for high power applications. The power transmission system is comprised generally of a charging unit configured to generate an alternating electromagnetic field and a receive unit configured to receive the alternating electromagnetic field from the charging unit. The charging unit includes a power source; an input rectifier; an inverter; and a transmit coil. The transmit coil has a spirangle arrangement segmented into n coil segments with capacitors interconnecting adjacent coil segments. The receive unit includes a receive coil and an output rectifier. The receive coil also has a spirangle arrangement segmented into mmore » coil segments with capacitors interconnecting adjacent coil segments.« less

Providing Effective Early Intervention Vocational Rehabilitation at the Community Level

ERIC Educational Resources Information Center

Allaire, Saralynn J.; Niu, Jingbo; Zhu, Yanyan; Brett, Belle

2011-01-01

The purpose of this study was to evaluate the translation of positive research findings about a job retention intervention for persons with chronic illnesses to rehabilitation practice. A program to provide the intervention was developed and marketed in the community. Fifty-seven consumers with chronic illnesses received the intervention provided…

Lubiprostone for chronic constipation in adults.

PubMed

2014-04-01

Lubiprostone (Amitiza-Sucampo Pharma Europe), a chloride-channel activator is licensed for the treatment of chronic idiopathic constipation in adults. It received a marketing authorisation in the UK in September 2012. In this article, we consider the evidence for lubiprostone in the management of constipation and how the treatment fits with current management strategies for constipation.

The development of an air Brayton and a steam Rankine solar receiver

NASA Technical Reports Server (NTRS)

Greeven, M. V.

1980-01-01

An air Brayton and a steam Rankine solar receiver now under development are described. These cavity receivers accept concentrated insolation from a single point focus, parabolic concentrator, and use this energy to heat the working fluid. Both receivers were designed for a solar input of 85 kw. The air Brayton receiver heats the air to 816 C. A metallic plate-fin heat transfer surface is used in this unit to effect the energy transfer. The steam Rankine receiver was designed as a once-through boiler with reheat. The receiver heats the water to 704 C to produce steam at 17.22 MPa in the boiler section. The reheat section operates at 1.2 MPA, reheating the steam to 704 C.

The Case for Chronic Disease Management for Addiction

PubMed Central

Saitz, Richard; Larson, Mary Jo; LaBelle, Colleen; Richardson, Jessica; Samet, Jeffrey H.

2009-01-01

Chronic disease (care) management (CDM) is a patient-centered model of care that involves longitudinal care delivery; integrated, and coordinated primary medical and specialty care; patient and clinician education; explicit evidence-based care plans; and expert care availability. The model, incorporating mental health and specialty addiction care, holds promise for improving care for patients with substance dependence who often receive no care or fragmented ineffective care. We describe a CDM model for substance dependence and discuss a conceptual framework, the extensive current evidence for component elements, and a promising strategy to reorganize primary and specialty health care to facilitate access for people with substance dependence. The CDM model goes beyond integrated case management by a professional, colocation of services, and integrated medical and addiction care—elements that individually can improve outcomes. Supporting evidence is presented that: 1) substance dependence is a chronic disease requiring longitudinal care, although most patients with addictions receive no treatment (eg, detoxification only) or short-term interventions, and 2) for other chronic diseases requiring longitudinal care (eg, diabetes, congestive heart failure), CDM has been proven effective. PMID:19809579

Assessment of a Business-to-Consumer (B2C) model for Telemonitoring patients with Chronic Heart Failure (CHF).

PubMed

Grustam, Andrija S; Vrijhoef, Hubertus J M; Koymans, Ron; Hukal, Philipp; Severens, Johan L

2017-10-11

The purpose of this study is to assess the Business-to-Consumer (B2C) model for telemonitoring patients with Chronic Heart Failure (CHF) by analysing the value it creates, both for organizations or ventures that provide telemonitoring services based on it, and for society. The business model assessment was based on the following categories: caveats, venture type, six-factor alignment, strategic market assessment, financial viability, valuation analysis, sustainability, societal impact, and technology assessment. The venture valuation was performed for three jurisdictions (countries) - Singapore, the Netherlands and the United States - in order to show the opportunities in a small, medium-sized, and large country (i.e. population). The business model assessment revealed that B2C telemonitoring is viable and profitable in the Innovating in Healthcare Framework. Analysis of the ecosystem revealed an average-to-excellent fit with the six factors. The structure and financing fit was average, public policy and technology alignment was good, while consumer alignment and accountability fit was deemed excellent. The financial prognosis revealed that the venture is viable and profitable in Singapore and the Netherlands but not in the United States due to relatively high salary inputs. The B2C model in telemonitoring CHF potentially creates value for patients, shareholders of the service provider, and society. However, the validity of the results could be improved, for instance by using a peer-reviewed framework, a systematic literature search, case-based cost/efficiency inputs, and varied scenario inputs.

Stochastic empirical loading and dilution model (SELDM) version 1.0.0

USGS Publications Warehouse

Granato, Gregory E.

2013-01-01

The Stochastic Empirical Loading and Dilution Model (SELDM) is designed to transform complex scientific data into meaningful information about the risk of adverse effects of runoff on receiving waters, the potential need for mitigation measures, and the potential effectiveness of such management measures for reducing these risks. The U.S. Geological Survey developed SELDM in cooperation with the Federal Highway Administration to help develop planning-level estimates of event mean concentrations, flows, and loads in stormwater from a site of interest and from an upstream basin. Planning-level estimates are defined as the results of analyses used to evaluate alternative management measures; planning-level estimates are recognized to include substantial uncertainties (commonly orders of magnitude). SELDM uses information about a highway site, the associated receiving-water basin, precipitation events, stormflow, water quality, and the performance of mitigation measures to produce a stochastic population of runoff-quality variables. SELDM provides input statistics for precipitation, prestorm flow, runoff coefficients, and concentrations of selected water-quality constituents from National datasets. Input statistics may be selected on the basis of the latitude, longitude, and physical characteristics of the site of interest and the upstream basin. The user also may derive and input statistics for each variable that are specific to a given site of interest or a given area. SELDM is a stochastic model because it uses Monte Carlo methods to produce the random combinations of input variable values needed to generate the stochastic population of values for each component variable. SELDM calculates the dilution of runoff in the receiving waters and the resulting downstream event mean concentrations and annual average lake concentrations. Results are ranked, and plotting positions are calculated, to indicate the level of risk of adverse effects caused by runoff concentrations, flows, and loads on receiving waters by storm and by year. Unlike deterministic hydrologic models, SELDM is not calibrated by changing values of input variables to match a historical record of values. Instead, input values for SELDM are based on site characteristics and representative statistics for each hydrologic variable. Thus, SELDM is an empirical model based on data and statistics rather than theoretical physiochemical equations. SELDM is a lumped parameter model because the highway site, the upstream basin, and the lake basin each are represented as a single homogeneous unit. Each of these source areas is represented by average basin properties, and results from SELDM are calculated as point estimates for the site of interest. Use of the lumped parameter approach facilitates rapid specification of model parameters to develop planning-level estimates with available data. The approach allows for parsimony in the required inputs to and outputs from the model and flexibility in the use of the model. For example, SELDM can be used to model runoff from various land covers or land uses by using the highway-site definition as long as representative water quality and impervious-fraction data are available.

Negotiating vulnerabilities: how older adults with multiple chronic conditions interact with physicians.

PubMed

Clarke, Laura Hurd; Bennett, Erica V; Korotchenko, Alexandra

2014-03-01

The literature on patient-physician interactions has largely ignored the perspectives of older adults with multiple morbidities. Featuring in-depth interview data from 16 men and 19 women with an average of six chronic conditions, this study focused on how participants perceived and experienced the care provided by their primary care physicians. Participants suggested that physicians caring for patients with multiple chronic conditions should be thorough, amenable to gate keeping, trustworthy, and open to different decision-making styles. However, many study participants perceived that they received inadequate care due to the personal failings of their physicians, constraints of medical consultations, and societal ageism. Consequently, many of the participants, especially the women, employed various strategies to maximize the care they received and manage their physicians' impressions of them as worthy patients. Our findings suggest that elderly patients with multiple morbidities perceive that their health needs are not being adequately met.

Pharmaceutical manufacturing facility discharges can substantially increase the pharmaceutical load to U.S. wastewaters

USGS Publications Warehouse

Scott, Tia-Marie; Phillips, Patrick J.; Kolpin, Dana W.; Colella, Kaitlyn M.; Furlong, Edward T.; Foreman, William T.; Gray, James L.

2018-01-01

Discharges from pharmaceutical manufacturing facilities (PMFs) previously have been identified as important sources of pharmaceuticals to the environment. Yet few studies are available to establish the influence of PMFs on the pharmaceutical source contribution to wastewater treatment plants (WWTPs) and waterways at the national scale. Consequently, a national network of 13 WWTPs receiving PMF discharges, six WWTPs with no PMF input, and one WWTP that transitioned through a PMF closure were selected from across the United States to assess the influence of PMF inputs on pharmaceutical loading to WWTPs. Effluent samples were analyzed for 120 pharmaceuticals and pharmaceutical degradates. Of these, 33 pharmaceuticals had concentrations substantially higher in PMF-influenced effluent (maximum 555,000 ng/L) compared to effluent from control sites (maximum 175 ng/L). Concentrations in WWTP receiving PMF input are variable, as discharges from PMFs are episodic, indicating that production activities can vary substantially over relatively short (several months) periods and have the potential to rapidly transition to other pharmaceutical products. Results show that PMFs are an important, national-scale source of pharmaceuticals to the environment.

Triboelectric generators and sensors

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

Wang, Zhong Lin; Wang, Sihong; Zhu, Guang

2017-10-17

A triboelectric power system includes a triboelectric generator, a rechargeable energy storage unit and a power management circuit. The rechargeable energy storage unit is associated to the triboelectric generator. The power management circuit is configured to receive an input current from the triboelectric generator and to deliver an output current corresponding to the input current to the rechargeable battery so that the output current has a current direction and a voltage that will recharge the rechargeable battery.

Borehole geological assessment

NASA Technical Reports Server (NTRS)

Spuck, W. H., III (Inventor)

1979-01-01

A method and apparatus are discussed for performing geological assessments of a formation located along a borehole, and a boring tool that bores a pair of holes into the walls of the borehole and into the surrounding strata along with a pair of probes which are installed in the holes. One of the probes applies an input such as a current or pressured fluid, and the other probe senses a corresponding input which it receives from the strata.

Arbitrary waveform generator to improve laser diode driver performance

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

Fulkerson, Jr, Edward Steven

2015-11-03

An arbitrary waveform generator modifies the input signal to a laser diode driver circuit in order to reduce the overshoot/undershoot and provide a "flat-top" signal to the laser diode driver circuit. The input signal is modified based on the original received signal and the feedback from the laser diode by measuring the actual current flowing in the laser diode after the original signal is applied to the laser diode.

Coupling induced logical stochastic resonance

NASA Astrophysics Data System (ADS)

Aravind, Manaoj; Murali, K.; Sinha, Sudeshna

2018-06-01

In this work we will demonstrate the following result: when we have two coupled bistable sub-systems, each driven separately by an external logic input signal, the coupled system yields outputs that can be mapped to specific logic gate operations in a robust manner, in an optimal window of noise. So, though the individual systems receive only one logic input each, due to the interplay of coupling, nonlinearity and noise, they cooperatively respond to give a logic output that is a function of both inputs. Thus the emergent collective response of the system, due to the inherent coupling, in the presence of a noise floor, maps consistently to that of logic outputs of the two inputs, a phenomenon we term coupling induced Logical Stochastic Resonance. Lastly, we demonstrate our idea in proof of principle circuit experiments.

Solid-state radar switchboard

NASA Astrophysics Data System (ADS)

Thiebaud, P.; Cross, D. C.

1980-07-01

A new solid-state radar switchboard equipped with 16 input ports which will output data to 16 displays is presented. Each of the ports will handle a single two-dimensional radar input, or three ports will accommodate a three-dimensional radar input. A video switch card of the switchboard is used to switch all signals, with the exception of the IFF-mode-control lines. Each card accepts inputs from up to 16 sources and can pass a signal with bandwidth greater than 20 MHz to the display assigned to that card. The synchro amplifier of current systems has been eliminated and in the new design each PPI receives radar data via a single coaxial cable. This significant reduction in cabling is achieved by adding a serial-to-parallel interface and a digital-to-synchro converter located at the PPI.

Development and characterization of a cell line from Pacific herring, Clupea harengus pallasi, sensitive to both naphthalene cytotoxicity and infection by viral hemorrhagic septicemia virus.

PubMed

Ganassin, R C; Sanders, S M; Kennedy, C J; Joyce, E M; Bols, N C

1999-01-01

A cell line, PHL, has been successfully established from newly hatched herring larvae. The cells are maintained in growth medium consisting of Leibovitz's L-15 supplemented with 15% fetal bovine serum (FBS), and have been cryopreserved and maintain viability after thawing. These cells retain a diploid karotype after 65 population doublings. PHL are susceptible to infection by the North American strain of viral hemorrhagic septicemia (VHS) virus, and are sensitive to the cytotoxic effects of naphthalene, a common environmental contaminant. Naphthalene is a component of crude and refined oil, and may be found in the marine environment following acute events such as oil spills. In addition, chronic sources of naphthalene contamination include offshore drilling and petroleum contamination from areas such as docks and marinas that have creosote-treated docks and pilings and also receive constant small inputs of petroleum products. This cell line should be useful for investigations of the toxicity of naphthalene and other petroleum components to juvenile herring. In addition, studies of the VHS virus will be facilitated by the availability of a susceptible cell line from an alternative species.

A microcontroller-based telemetry system for sympathetic nerve activity and ECG measurement.

PubMed

Harada, E; Yonezawa, Y; Caldwell, W M; Hahn, A W

1999-01-01

A telemetry system employing a low power 8-bit microcontroller has been developed for chronic unanesthetized small animal studies. The two-channel system is designed for use with animals in shielded cages. Analog signals from implantable ECG and nerve electrodes are converted to an 8-bit serial digital format. This is accomplished by individual 8 bit A/D converters included in the microcontroller, which also has serial I/O port. The converted serial binary code is applied directly to an antenna wire. Therefore, the system does not need to employ a separate transmitter, such as in FM or infrared optical telemeters. The system is used in a shielded animal cage to reduce interference from external radio signals and 60 Hz power line fields. The code is received by a high input impedance amplifier in the cage and is then demodulated. The telemeter is powered by a small 3 V lithium battery, which provides 100 hours of continuous operation. The circuit is constructed on two 25 x 25 mm. printed circuit boards and encapsulated in epoxy, yielding a total volume of 6.25 cc. The weight is 15 g.

Trellis coded multilevel DPSK system with doppler correction for mobile satellite channels

NASA Technical Reports Server (NTRS)

Divsalar, Dariush (Inventor); Simon, Marvin K. (Inventor)

1991-01-01

A trellis coded multilevel differential phase shift keyed mobile communication system. The system of the present invention includes a trellis encoder for translating input signals into trellis codes; a differential encoder for differentially encoding the trellis coded signals; a transmitter for transmitting the differentially encoded trellis coded signals; a receiver for receiving the transmitted signals; a differential demodulator for demodulating the received differentially encoded trellis coded signals; and a trellis decoder for decoding the differentially demodulated signals.

Plasmatron-catalyst system

DOEpatents

Bromberg, Leslie; Cohn, Daniel R.; Rabinovich, Alexander; Alexeev, Nikolai

2004-09-21

A plasmatron-catalyst system. The system generates hydrogen-rich gas and comprises a plasmatron and at least one catalyst for receiving an output from the plasmatron to produce hydrogen-rich gas. In a preferred embodiment, the plasmatron receives as an input air, fuel and water/steam for use in the reforming process. The system increases the hydrogen yield and decreases the amount of carbon monoxide.

Plasmatron-catalyst system

DOEpatents

Bromberg, Leslie; Cohn, Daniel R.; Rabinovich, Alexander; Alexeev, Nikolai

2007-10-09

A plasmatron-catalyst system. The system generates hydrogen-rich gas and comprises a plasmatron and at least one catalyst for receiving an output from the plasmatron to produce hydrogen-rich gas. In a preferred embodiment, the plasmatron receives as an input air, fuel and water/steam for use in the reforming process. The system increases the hydrogen yield and decreases the amount of carbon monoxide.

76 FR 11980 - Stakeholder Input: Listening Session to Provide Information and Solicit Suggestions for...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-04

... organisms to the surrounding water. Coatings used to deter organism growth on vessel hulls can release heavy metals and/or other biocides, which can lead to acute or chronic toxicity in non-targeted organisms. Bilgewater can contain oils, dissolved heavy metals, and other chemical constituents that can result in toxic...

High power RF solid state power amplifier system

NASA Technical Reports Server (NTRS)

Sims, III, William Herbert (Inventor); Chavers, Donald Gregory (Inventor); Richeson, James J. (Inventor)

2011-01-01

A high power, high frequency, solid state power amplifier system includes a plurality of input multiple port splitters for receiving a high-frequency input and for dividing the input into a plurality of outputs and a plurality of solid state amplifier units. Each amplifier unit includes a plurality of amplifiers, and each amplifier is individually connected to one of the outputs of multiport splitters and produces a corresponding amplified output. A plurality of multiport combiners combine the amplified outputs of the amplifiers of each of the amplifier units to a combined output. Automatic level control protection circuitry protects the amplifiers and maintains a substantial constant amplifier power output.

ATCA-based ATLAS FTK input interface system

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

Okumura, Yasuyuki; Liu, Tiehui Ted; Olsen, Jamieson

The first stage of the ATLAS Fast TracKer (FTK) is an ATCA-based input interface system, where hits from the entire silicon tracker are clustered and organized into overlapping eta-phi trigger towers before being sent to the tracking engines. First, FTK Input Mezzanine cards receive hit data and perform clustering to reduce data volume. Then, the ATCA-based Data Formatter system will organize the trigger tower data, sharing data among boards over full mesh backplanes and optic fibers. The board and system level design concepts and implementation details, as well as the operation experiences from the FTK full-chain testing, will be presented.

Memory device for two-dimensional radiant energy array computers

NASA Technical Reports Server (NTRS)

Schaefer, D. H.; Strong, J. P., III (Inventor)

1977-01-01

A memory device for two dimensional radiant energy array computers was developed, in which the memory device stores digital information in an input array of radiant energy digital signals that are characterized by ordered rows and columns. The memory device contains a radiant energy logic storing device having a pair of input surface locations for receiving a pair of separate radiant energy digital signal arrays and an output surface location adapted to transmit a radiant energy digital signal array. A regenerative feedback device that couples one of the input surface locations to the output surface location in a manner for causing regenerative feedback is also included

Multiple-input multiple-output visible light communication system based on disorder dispersion components

NASA Astrophysics Data System (ADS)

Yang, Tao; Zhang, Qi; Hao, Yue; Zhou, Xin-hui; Yi, Ming-dong; Wei, Wei; Huang, Wei; Li, Xing-ao

2017-10-01

A multiple-input multiple-output visible light communication (VLC) system based on disorder dispersion components is presented. Instead of monochromatic sources and large size photodetectors used in the traditional VLC systems, broadband sources with different spectra act as the transmitters and a compact imaging chip sensor accompanied by a disorder dispersion component and a calculating component serve as the receivers in the proposed system. This system has the merits of small size, more channels, simple structure, easy integration, and low cost. Simultaneously, the broadband sources are suitable to act as illumination sources for their white color. A regularized procedure is designed to solve a matrix equation for decoding the signals at the receivers. A proof-of-concept experiment using on-off keying modulation has been done to prove the feasibility of the design. The experimental results show that the signals decoded by the receivers fit well with those generated from the transmitters, but the bit error ratio is increased with the number of the signal channels. The experimental results can be further improved using a high-speed charge-coupled device, decreasing noises, and increasing the distance between the transmitters and the receivers.

Real world outcomes and management strategies for venetoclax-treated chronic lymphocytic leukemia patients in the United States.

PubMed

Mato, Anthony R; Thompson, Meghan; Allan, John N; Brander, Danielle M; Pagel, John M; Ujjani, Chaitra S; Hill, Brian T; Lamanna, Nicole; Lansigan, Frederick; Jacobs, Ryan; Shadman, Mazyar; Skarbnik, Alan P; Pu, Jeffrey J; Barr, Paul M; Sehgal, Alison R; Cheson, Bruce D; Zent, Clive S; Tuncer, Hande H; Schuster, Stephen J; Pickens, Peter V; Shah, Nirav N; Goy, Andre; Winter, Allison M; Garcia, Christine; Kennard, Kaitlin; Isaac, Krista; Dorsey, Colleen; Gashonia, Lisa M; Singavi, Arun K; Roeker, Lindsey E; Zelenetz, Andrew; Williams, Annalynn; Howlett, Christina; Weissbrot, Hanna; Ali, Naveed; Khajavian, Sirin; Sitlinger, Andrea; Tranchito, Eve; Rhodes, Joanna; Felsenfeld, Joshua; Bailey, Neil; Patel, Bhavisha; Burns, Timothy F; Yacur, Melissa; Malhotra, Mansi; Svoboda, Jakub; Furman, Richard R; Nabhan, Chadi

2018-06-07

Venetoclax is a BCL2 inhibitor approved for 17p-deleted relapsed/refractory chronic lymphocytic leukemia with activity following kinase inhibitors. We conducted a multicenter retrospective cohort analysis of patients with CLL treated with venetoclax to describe outcomes, toxicities, and treatment selection following venetoclax discontinuation. A total of 141 chronic lymphocytic leukemia patients were included (98% relapsed/refractory). Median age at venetoclax initiation was 67 years (range 37-91), median prior therapies was 3 (0-11), 81% unmutated IGHV, 45% del(17p), and 26.8% complex karyotype (≥ 3 abnormalities). Prior to venetoclax initiation, 89% received a B-cell receptor antagonist. For tumor lysis syndrome prophylaxis, 93% received allopurinol, 92% normal saline, and 45% rasburicase. Dose escalation to the maximum recommended dose of 400 mg daily was achieved in 85% of patients. Adverse events of interest included neutropenia in 47.4%, thrombocytopenia in 36%, tumor lysis syndrome in 13.4%, neutropenic fever in 11.6%, and diarrhea in 7.3%. The overall response rate to venetoclax was 72% (19.4% complete remission). With a median follow up of 7 months, median progression free survival and overall survival for the entire cohort have not been reached. To date, 41 venetoclax treated patients have discontinued therapy and 24 have received a subsequent therapy, most commonly ibrutinib. In the largest clinical experience of venetoclax-treated chronic lymphocytic leukemia patients , the majority successfully completed and maintained a maximum recommended dose. Response rates and duration of response appear comparable to clinical trial data. Venetoclax was active in patients with mutations known to confer ibrutinib resistance. Optimal sequencing of newer chronic lymphocytic leukemia therapies requires further study. Copyright © 2018, Ferrata Storti Foundation.

Post-Transplant Cyclophosphamide and Tacrolimus-Mycophenolate Mofetil Combination Prevents Graft-versus-Host Disease in Allogeneic Peripheral Blood Hematopoietic Cell Transplantation from HLA-Matched Donors.

PubMed

Carnevale-Schianca, Fabrizio; Caravelli, Daniela; Gallo, Susanna; Coha, Valentina; D'Ambrosio, Lorenzo; Vassallo, Elena; Fizzotti, Marco; Nesi, Francesca; Gioeni, Luisa; Berger, Massimo; Polo, Alessandra; Gammaitoni, Loretta; Becco, Paolo; Giraudo, Lidia; Mangioni, Monica; Sangiolo, Dario; Grignani, Giovanni; Rota-Scalabrini, Delia; Sottile, Antonino; Fagioli, Franca; Aglietta, Massimo

2017-03-01

Allogeneic hematopoietic cell transplant (HCT) remains the only curative therapy for many hematologic malignancies but it is limited by high nonrelapse mortality (NRM), primarily from unpredictable control of graft-versus-host disease (GVHD). Recently, post-transplant cyclophosphamide demonstrated improved GVHD control in allogeneic bone marrow HCT. Here we explore cyclophosphamide in allogeneic peripheral blood stem cell transplantation (alloPBSCT). Patients with high-risk hematologic malignancies received alloPBSCT from HLA-matched unrelated/related donors. GVHD prophylaxis included combination post-HCT cyclophosphamide 50 mg/kg (days +3 and +4) and tacrolimus/mofetil mycophenolate (T/MMF) (day +5 forward). The primary objective was the cumulative incidence of acute and chronic GVHD. Between March 2011 and May 2015, 35 consecutive patients received the proposed regimen. MMF was stopped in all patients at day +28; the median discontinuation of tacrolimus was day +113. Acute and chronic GVHD cumulative incidences were 17% and 7%, respectively, with no grade IV GVHD events, only 2 patients requiring chronic GVHD immunosuppression control, and no deaths from GVHD. Two-year NRM, overall survival, event-free survival, and chronic GVHD event-free survival rates were 3%, 77%, 54%, and 49%, respectively. The graft-versus-tumor effect was maintained as 5 of 15 patients (33%) who received HCT with evidence of disease experienced further disease response. A post-transplant cyclophosphamide + T/MMF combination strategy effectively prevented acute and chronic GVHD after alloPBSCT from HLA-matched donors and achieved an unprecedented low NRM without losing efficacy in disease control or impaired development of the graft-versus-tumor effect. This trial is registered at clinicaltrials.gov as NCT02300571. Copyright © 2017 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

Vital signs: disability and physical activity--United States, 2009-2012.

PubMed

Carroll, Dianna D; Courtney-Long, Elizabeth A; Stevens, Alissa C; Sloan, Michelle L; Lullo, Carolyn; Visser, Susanna N; Fox, Michael H; Armour, Brian S; Campbell, Vincent A; Brown, David R; Dorn, Joan M

2014-05-09

Adults with disabilities are less active and have higher rates of chronic disease than the general population. Given the health benefits of physical activity, understanding physical activity, its relationship with chronic disease, and health professional recommendations for physical activity among young to middle-age adults with disabilities could help increase the effectiveness of health promotion efforts. Data from the 2009-2012 National Health Interview Survey (NHIS) were used to estimate the prevalence of, and association between, aerobic physical activity (inactive, insufficiently active, or active) and chronic diseases (heart disease, stroke, diabetes, and cancer) among adults aged 18-64 years by disability status and type (hearing, vision, cognitive, and mobility). The prevalence of, and association between, receiving a health professional recommendation for physical activity and level of aerobic physical activity was assessed using 2010 data. Overall, 11.6% of U.S. adults aged 18-64 years reported a disability, with estimates for disability type ranging from 1.7% (vision) to 5.8% (mobility). Compared with adults without disabilities, inactivity was more prevalent among adults with any disability (47.1% versus 26.1%) and for adults with each type of disability. Inactive adults with disabilities were 50% more likely to report one or more chronic diseases than those who were physically active. Approximately 44% of adults with disabilities received a recommendation from a health professional for physical activity in the past 12 months. Almost half of adults with disabilities are physically inactive and are more likely to have a chronic disease. Among adults with disabilities who visited a health professional in the past 12 months, the majority (56%) did not receive a recommendation for physical activity. These data highlight the need for increased physical activity among persons with disabilities, which might require support across societal sectors, including government and health care.

Interdisciplinary team-based care for patients with chronic pain on long-term opioid treatment in primary care (PPACT) - Protocol for a pragmatic cluster randomized trial.

PubMed

DeBar, Lynn; Benes, Lindsay; Bonifay, Allison; Deyo, Richard A; Elder, Charles R; Keefe, Francis J; Leo, Michael C; McMullen, Carmit; Mayhew, Meghan; Owen-Smith, Ashli; Smith, David H; Trinacty, Connie M; Vollmer, William M

2018-04-01

Chronic pain is one of the most common, disabling, and expensive public health problems in the United States. Interdisciplinary pain management treatments that employ behavioral approaches have been successful in helping patients with chronic pain reduce symptoms and regain functioning. However, most patients lack access to such treatments. We are conducting a pragmatic clinical trial to test the hypothesis that patients who receive an interdisciplinary biopsychosocial intervention, the Pain Program for Active Coping and Training (PPACT), at their primary care clinic will have a greater reduction in pain impact in the year following than patients receiving usual care. This is an effectiveness-implementation hybrid pragmatic clinical trial in which we randomize clusters of primary care providers and their patients with chronic pain who are on long-term opioid therapy to 1) receive an interdisciplinary behavioral intervention in conjunction with their current health care or 2) continue with current health care services. Our primary outcome is pain impact (a composite of pain intensity and pain-related interference) measured using the PEG, a validated three-item assessment. Secondary outcomes include pain-related disability, patient satisfaction, opioids dispensed and health care utilization. An economic evaluation assesses the resources and costs necessary to deliver the intervention and its cost-effectiveness compared with usual care. A formative evaluation employs mixed methods to understand the context for implementation in the participating health care systems. This trial will inform the feasibility of implementing interdisciplinary behavioral approaches to pain management in the primary care setting, potentially providing a more effective, safer, and more satisfactory alternative to opioid-based chronic pain treatment. Clinical Trials Registration Number: NCT02113592. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Interdisciplinary team-based care for patients with chronic pain on long-term opioid treatment in primary care (PPACT) – Protocol for a pragmatic cluster randomized trial

PubMed Central

DeBar, Lynn; Benes, Lindsay; Bonifay, Allison; Deyo, Richard A.; Elder, Charles R.; Keefe, Francis J.; Leo, Michael C.; McMullen, Carmit; Mayhew, Meghan; Owen-Smith, Ashli; Smith, David H.; Trinacty, Connie M.; Vollmer, William M.

2018-01-01

Background Chronic pain is one of the most common, disabling, and expensive public health problems in the United States. Interdisciplinary pain management treatments that employ behavioral approaches have been successful in helping patients with chronic pain reduce symptoms and regain functioning. However, most patients lack access to such treatments. We are conducting a pragmatic clinical trial to test the hypothesis that patients who receive an interdisciplinary biopsychosocial intervention, the Pain Program for Active Coping and Training (PPACT), at their primary care clinic will have a greater reduction in pain impact in the year following than patients receiving usual care. Methods/design This is an effectiveness-implementation hybrid pragmatic clinical trial in which we randomize clusters of primary care providers and their patients with chronic pain who are on long-term opioid therapy to 1) receive an interdisciplinary behavioral intervention in conjunction with their current health care or 2) continue with current health care services. Our primary outcome is pain impact (a composite of pain intensity and pain-related interference) measured using the PEG, a validated three-item assessment. Secondary outcomes include pain-related disability, patient satisfaction, opioids dispensed and health care utilization. An economic evaluation assesses the resources and costs necessary to deliver the intervention and its cost-effectiveness compared with usual care. A formative evaluation employs mixed methods to understand the context for implementation in the participating health care systems. Discussion This trial will inform the feasibility of implementing interdisciplinary behavioral approaches to pain management in the primary care setting, potentially providing a more effective, safer, and more satisfactory alternative to opioid-based chronic pain treatment. Clinical Trials Registration Number: NCT02113592 PMID:29522897

Comparison of percutaneous electrical nerve stimulation with transcutaneous electrical nerve stimulation for long-term pain relief in patients with chronic low back pain.

PubMed

Yokoyama, Masataka; Sun, Xiaohui; Oku, Satoru; Taga, Naoyuki; Sato, Kenji; Mizobuchi, Satoshi; Takahashi, Toru; Morita, Kiyoshi

2004-06-01

The long-term effect of percutaneous electrical nerve stimulation (PENS) on chronic low back pain (LBP) is unclear. We evaluated the number of sessions for which PENS should be performed to alleviate chronic LBP and how long analgesia is sustained. Patients underwent treatment on a twice-weekly schedule for 8 wk. Group A (n = 18) received PENS for 8 wk, group B (n = 17) received PENS for the first 4 wk and transcutaneous electrical nerve stimulation (TENS) for the second 4 wk, and group C (n = 18) received TENS for 8 wk. Pain level, degree of physical impairment, and the daily intake of nonsteroidal antiinflammatory drugs (NSAIDs) were assessed before the first treatment, 3 days after Week 2, Week 4, and Week 8 treatments, and at 1 and 2 mo after the sessions. During PENS therapy, the pain level decreased significantly from Week 2 in Groups A and B (P < 0.05 or 0.01), and physical impairment and required NSAIDs decreased significantly from Week 4 (P < 0.05 or 0.01) in Group A but only at Week 4 in Group B (P < 0.05 or 0.01). These effects were sustained until 1-mo follow-up (P < 0.01) in Group A but not in Group B; these effects were not observed at 2-mo follow-up even in Group A. In Group C, pain level decreased significantly only at Week 8 (P < 0.05). Our results indicate that repeated PENS is more effective than TENS for chronic LBP but must be continued to sustain the analgesic effect. A cumulative analgesic effect was observed in patients with chronic low back pain (LBP) after repeated percutaneous electrical nerve stimulation (PENS), but this effect gradually faded after the treatment was terminated. Results indicate that although PENS is effective for chronic LBP, treatments need to be continued to sustain analgesia.

Implementation and quantitative evaluation of chronic disease self-management programme in Shanghai, China: randomized controlled trial.

PubMed Central

Fu, Dongbo; Fu, Hua; McGowan, Patrick; Shen, Yi-e; Zhu, Lizhen; Yang, Huiqin; Mao, Jianguo; Zhu, Shitai; Ding, Yongming; Wei, Zhihua

2003-01-01

OBJECTIVE: To evaluate the effectiveness of the Shanghai Chronic Disease Self-Management Program (CDSMP). METHODS: A randomized controlled trial with six-month follow-up compared patients who received treatment with those who did not receive treatment (waiting-list controls) in five urban communities in Shanghai, China. Participants in the treatment group received education from a lay-led CDSMP course and one copy of a help book immediately; those in the control group received the same education and book six months later. FINDINGS: In total, 954 volunteer patients with a medical record that confirmed a diagnosis of hypertension, heart disease, chronic lung disease, arthritis, stroke, or diabetes who lived in communities were assigned randomly to treatment (n = 526) and control (n = 428) groups. Overall, 430 (81.7%) and 349 (81.5%) patients in the treatment and control groups completed the six-month study. Patients who received treatment had significant improvements in weekly minutes of aerobic exercise, practice of cognitive symptom management, self-efficacy to manage own symptoms, and self-efficacy to manage own disease in general compared with controls. They also had significant improvements in eight indices of health status and, on average, fewer hospitalizations. CONCLUSION: When implemented in Shanghai, the CDSMP was acceptable culturally to Chinese patients. The programme improved participants' health behaviour, self-efficacy, and health status and reduced the number of hospitalizations six months after the course. The locally based delivery model was integrated into the routine of community government organizations and community health services. Chinese lay leaders taught the CDSMP courses as successfully as professionals. PMID:12764513

The Drought Monitor.

NASA Astrophysics Data System (ADS)

Svoboda, Mark; Lecomte, Doug; Hayes, Mike; Heim, Richard; Gleason, Karin; Angel, Jim; Rippey, Brad; Tinker, Rich; Palecki, Mike; Stooksbury, David; Miskus, David; Stephens, Scott

2002-08-01

information about drought and to receive regional and local input that is in turn incorporated into the product. This paper describes the Drought Monitor and the interactive process through which it is created.

Systematic Review Workshop (August 2013)

EPA Pesticide Factsheets

The goal for this workshop is to receive scientific input regarding approaches for different steps within a systematic review, such as evaluating individual studies, synthesizing evidence within a particular discipline, etc.

Input Subject Diversity Accelerates the Growth of Tense and Agreement: Indirect Benefits From a Parent-Implemented Intervention

PubMed Central

Rispoli, Matthew; Holt, Janet K.

2017-01-01

Purpose This follow-up study examined whether a parent intervention that increased the diversity of lexical noun phrase subjects in parent input and accelerated children's sentence diversity (Hadley et al., 2017) had indirect benefits on tense/agreement (T/A) morphemes in parent input and children's spontaneous speech. Method Differences in input variables related to T/A marking were compared for parents who received toy talk instruction and a quasi-control group: input informativeness and full is declaratives. Language growth on tense agreement productivity (TAP) was modeled for 38 children from language samples obtained at 21, 24, 27, and 30 months. Parent input properties following instruction and children's growth in lexical diversity and sentence diversity were examined as predictors of TAP growth. Results Instruction increased parent use of full is declaratives (ηp 2 ≥ .25) but not input informativeness. Children's sentence diversity was also a significant time-varying predictor of TAP growth. Two input variables, lexical noun phrase subject diversity and full is declaratives, were also significant predictors, even after controlling for children's sentence diversity. Conclusions These findings establish a link between children's sentence diversity and the development of T/A morphemes and provide evidence about characteristics of input that facilitate growth in this grammatical system. PMID:28892819

Chronic transfusion practice for children with sickle cell anaemia and stroke.

PubMed

Aygun, Banu; McMurray, Marsha A; Schultz, William H; Kwiatkowski, Janet L; Hilliard, Lee; Alvarez, Ofelia; Heeney, Matthew; Kalinyak, Karen; Lee, Margaret T; Miller, Scott; Helms, Ronald W; Ware, Russell E

2009-05-01

Chronic transfusions to maintain haemoglobin S (HbS) < or =30% are the mainstay of treatment for children with sickle cell anaemia (SCA) and previous stroke. This HbS target is often hard to maintain, however, and values achieved in current practice are unknown. In preparation for the Phase III Stroke With Transfusions Changing to Hydroxyurea (SWiTCH) trial, we collected data on 295 children with SCA and stroke who received transfusions at 23 institutions. The overall average pre-transfusion %HbS was 35 +/- 11% (institutional range 22-51%). Receiving scheduled transfusions on time was the most predictive variable for maintaining HbS at the < or =30% goal.

Surveillance and medical therapy following endovascular treatment of chronic cerebrospinal venous insufficiency.

PubMed

Forbes, Thomas L; Harris, Jeremy R; Kribs, Stewart W

2012-06-01

The debate regarding the possible link between chronic cerebrospinal venous insufficiency and multiple sclerosis (MS) is continuously becoming more and more contentious due to the current lack of level 1 evidence from randomized trials. Regardless of this continued uncertainty surrounding the safety and efficacy of this therapy, MS patients from Canada, and other jurisdictions, are traveling abroad to receive central venous angioplasty and, unfortunately, some also receive venous stents. They often return home with few instructions regarding follow-up or medical therapy. In response we propose some interim, practical recommendations for post-procedural surveillance and medical therapy, until further information is available.

Biobriefcase electrostatic aerosol collector

DOEpatents

Bell, Perry M [Tracy, CA; Christian, Allen T [Madison, WI; Bailey, Christopher G [Pleasanton, CA; Willis, Ladona [Manteca, CA; Masquelier, Donald A [Tracy, CA; Nasarabadi, Shanavaz L [Livermore, CA

2009-03-17

A system for sampling air and collecting particles entrained in the air comprising a receiving surface, a liquid input that directs liquid to the receiving surface and produces a liquid surface, an air input that directs the air so that the air with particles entrained in the air impact the liquid surface, and an electrostatic contact connected to the liquid that imparts an electric charge to the liquid. The particles potentially including bioagents become captured in the liquid by the air with particles entrained in the air impacting the liquid surface. Collection efficiency is improved by the electrostatic contact electrically charging the liquid. The effects of impaction and adhesion due to electrically charging the liquid allows a unique combination in a particle capture medium that has a low fluid consumption rate while maintaining high efficiency.

Iterative MMSE Detection for MIMO/BLAST DS-CDMA Systems in Frequency Selective Fading Channels - Achieving High Performance in Fully Loaded Systems

NASA Astrophysics Data System (ADS)

Silva, João Carlos; Souto, Nuno; Cercas, Francisco; Dinis, Rui

A MMSE (Minimum Mean Square Error) DS-CDMA (Direct Sequence-Code Division Multiple Access) receiver coupled with a low-complexity iterative interference suppression algorithm was devised for a MIMO/BLAST (Multiple Input, Multiple Output / Bell Laboratories Layered Space Time) system in order to improve system performance, considering frequency selective fading channels. The scheme is compared against the simple MMSE receiver, for both QPSK and 16QAM modulations, under SISO (Single Input, Single Output) and MIMO systems, the latter with 2Tx by 2Rx and 4Tx by 4Rx (MIMO order 2 and 4 respectively) antennas. To assess its performance in an existing system, the uncoded UMTS HSDPA (High Speed Downlink Packet Access) standard was considered.

Plasma inflammatory biomarkers response to aerobic versus resisted exercise training for chronic obstructive pulmonary disease patients.

PubMed

Abd El-Kader, Shehab M; Al-Jiffri, Osama H; Al-Shreef, Fadwa M

2016-06-01

Chronic obstructive pulmonary disease (COPD) is a main risk for morbidity, associated with alterations in systemic inflammation. Recent studies proved that morbidity and mortality of COPD is related to systemic inflammation as it contributes to the pathogenesis of atherosclerosis and cardiovascular disease. However, increase of inflammatory cytokines adversely affects quality of life, alteration in ventilatory and skeletal muscles functions. Moreover, exercise training has many beneficial effects in correction of the adverse effects of COPD. This study aimed to compare the response of inflammatory cytokines of COPD to aerobic versus resisted exercises. One hundred COPD diseased patients participated in this study and were randomly included in two groups; the first group received aerobic exercise, whereas the second group received resisted exercise training for 12 weeks. The mean values of TNF-α, Il-2, IL-4, IL-6 and CRP were significantly decreased in both groups. Also; there was a significant difference between both groups at the end of the study with more reduction in patients who received aerobic exercise training. Aerobic exercise is more appropriate than resisted exercise training in modulating inflammatory cytokines level in patients with chronic obstructive pulmonary disease.

Modulation of alcohol preference by NMDA antagonists in male rats.

PubMed

Lamblin, F; Deuceuninck, D; De Witte, P

1993-11-01

Chronic alcoholization by alcohol inhalation was used to study the properties of magnesium, a non-competitive NMDA receptor antagonist, and CGP 39551, a competitive NMDA receptor antagonist, on behavioural dependence as estimated by the free-choice paradigm [alcohol 10% (v/v) vs. water], on the hypermotility after alcohol withdrawal, and finally on the cortical vascularization. The first experimental group received the drugs per os during the whole alcoholization period. Magnesium (20 mg/kg/day) decreased the alcohol dependence while CGP 39551 (5 and 10 mg/kg/day) increased, in a dose-dependent manner, the dependence to alcohol. A second group of animals received the same drugs at the same dosages, not simultaneously during chronic alcoholization, but immediately after alcoholization in one shot i.p. injection. In this case, rats receiving 5 mg/kg CGP 39551 never showed any dependence towards alcohol, while 10 mg/kg CGP 39551 or 20 mg/kg magnesium prolonged the number of days of alcohol dependence. These results thus indicate the close interaction between NMDA receptor function and dependence for alcohol. Magnesium had no effects on hypermotility, while CGP 39551-treated animals presented a decrease in the hypermotility observed after alcohol withdrawal. Neither drug affected the hypervascularization accompanying the chronic alcoholization.

Patients with Spinal Cord Injuries Favor Administration of Methylprednisolone

PubMed Central

Bowers, Christian A.; Kundu, Bornali; Rosenbluth, Jeffrey; Hawryluk, Gregory W. J.

2016-01-01

Methylprednisolone sodium succinate (MPSS) for treatment of acute spinal cord injury (SCI) has been associated with both benefits and adverse events. MPSS administration was the standard of care for acute SCI until recently when its use has become controversial. Patients with SCI have had little input in the debate, thus we sought to learn their opinions regarding administration of MPSS. A summary of the published literature to date on MPSS use for acute SCI was created and adjudicated by 28 SCI experts. This summary was then emailed to 384 chronic SCI patients along with a survey that interrogated the patients’ neurological deficits, communication with physicians and their views on MPSS administration. 77 out of 384 patients completed the survey. 28 respondents indicated being able to speak early after injury and of these 24 reported arriving at the hospital within 8 hours of injury. One recalled a physician speaking to them about MPSS and one patient reported choosing whether or not to receive MPSS. 59.4% felt that the small neurological benefits associated with MPSS were ‘very important’ to them (p<0.0001). Patients had ‘little concern’ for potential side-effects of MPSS (p = 0.001). Only 1.4% felt that MPSS should not be given to SCI patients regardless of degree of injury (p<0.0001). This is the first study to report SCI patients’ preferences regarding MPSS treatment for acute SCI. Patients favor the administration of MPSS for acute SCI, however few had input into whether or not it was administered. Conscious patients should be given greater opportunity to decide their treatment. These results also provide some guidance regarding MPSS administration in patients unable to communicate. PMID:26789007

Drug-primed reinstatement of cocaine seeking in mice: increased excitability of medium-sized spiny neurons in the nucleus accumbens

PubMed Central

Ma, Yao-Ying; Henley, Sandy M.; Toll, Jeff; Jentsch, James D.; Evans, Christopher J.; Levine, Michael S.; Cepeda, Carlos

2013-01-01

To examine the mechanisms of drug relapse, we first established a model for cocaine IVSA (intravenous self-administration) in mice, and subsequently examined electrophysiological alterations of MSNs (medium-sized spiny neurons) in the NAc (nucleus accumbens) before and after acute application of cocaine in slices. Three groups were included: master mice trained by AL (active lever) pressings followed by IV (intravenous) cocaine delivery, yoked mice that received passive IV cocaine administration initiated by paired master mice, and saline controls. MSNs recorded in the NAc shell in master mice exhibited higher membrane input resistances but lower frequencies and smaller amplitudes of sEPSCs (spontaneous excitatory postsynaptic currents) compared with neurons recorded from saline control mice, whereas cells in the NAc core had higher sEPSCs frequencies and larger amplitudes. Furthermore, sEPSCs in MSNs of the shell compartment displayed longer decay times, suggesting that both pre- and postsynaptic mechanisms were involved. After acute re-exposure to a low-dose of cocaine in vitro, an AP (action potential)-dependent, persistent increase in sEPSC frequency was observed in both NAc shell and core MSNs from master, but not yoked or saline control mice. Furthermore, re-exposure to cocaine induced membrane hyperpolarization, but concomitantly increased excitability of MSNs from master mice, as evidenced by increased membrane input resistance, decreased depolarizing current to generate APs, and a more negative Thr (threshold) for firing. These data demonstrate functional differences in NAc MSNs after chronic contingent versus non-contingent IV cocaine administration in mice, as well as synaptic adaptations of MSNs before and after acute re-exposure to cocaine. Reversing these functional alterations in NAc could represent a rational target for the treatment of some reward-related behaviors, including drug addiction. PMID:24000958

Development of a patient decision aid for type 2 diabetes mellitus for patients not achieving glycemic control on metformin alone

PubMed Central

Shillington, Alicia C; Col, Nananda; Bailey, Robert A; Jewell, Mark A

2015-01-01

Purpose To describe the process used to develop an evidence-based patient decision aid (PDA) that facilitates shared decision-making for treatment intensification in inadequately controlled type 2 diabetes mellitus (T2DM) consistent with International Patient Decision Aids Standards. Methods A PDA was developed by a multidisciplinary steering committee of clinicians, patient advocate, nurse, certified diabetes educators, and decision scientist, using a systematic development process. The process included defining the PDA scope and purpose, outlining the framework, content creation, and designing for integration into clinical practice. This was accomplished through a review of the literature and publically available educational materials and input from practicing clinicians and patients during development and iteratively refining content based on input. Patients with poorly controlled T2DM on metformin considering additional medication assessed the PDA during a pilot. Results Testing identified six preference-sensitive domains important for choosing T2DM treatment: degree of glycemic response, avoiding weight gain, hypoglycemia risk and other adverse events, avoiding injections, convenience of dose administration, blood glucose monitoring, and cost of therapy. Patient feedback guided content revision. Treatment options were offered after presenting medication class risk–benefit information and eliciting patient values, goals, and preferences. The PDA received the highest International Patient Decision Aids Standards global score to date, 88/100, with 100% of criteria fully met for the following dimensions: development process, disclosures, evaluation process, evidence quality, guidance for users, information quality, language/readability, testing, and eliciting patient values. Conclusion A PDA was developed to help T2DM patients make decisions regarding medication choice. This approach may be applicable to other chronic conditions. PMID:25995622

HEAP: Heat Energy Analysis Program, a computer model simulating solar receivers. [solving the heat transfer problem

NASA Technical Reports Server (NTRS)

Lansing, F. L.

1979-01-01

A computer program which can distinguish between different receiver designs, and predict transient performance under variable solar flux, or ambient temperatures, etc. has a basic structure that fits a general heat transfer problem, but with specific features that are custom-made for solar receivers. The code is written in MBASIC computer language. The methodology followed in solving the heat transfer problem is explained. A program flow chart, an explanation of input and output tables, and an example of the simulation of a cavity-type solar receiver are included.

The impacts of using community health volunteers to coach medication safety behaviors among rural elders with chronic illnesses.

PubMed

Wang, Chi-Jane; Fetzer, Susan J; Yang, Yi-Ching; Wang, Jing-Jy

2013-01-01

It is a challenge for rural health professionals to promote medication safety among older adults taking multiple medications. A volunteer coaching program to promote medication safety among rural elders with chronic illnesses was designed and evaluated. A community-based interventional study randomly assigned 62 rural elders with at least two chronic illnesses to routine care plus volunteer coaching or routine care alone. The volunteer coaching group received a medication safety program, including a coach and reminders by well-trained volunteers, as well as three home visits and five telephone calls over a two-month period. All the subjects received routine medication safety instructions for their chronic illnesses. The program was evaluated using pre- and post-tests of knowledge, attitude and behaviors with regard to medication safety. Results show the volunteer coaching group improved their knowledge of medication safety, but there was no change in attitude after the two-month study period. Moreover, the group demonstrated three improved medication safety behaviors compared to the routine care group. The volunteer coaching program and instructions with pictorial aids can provide a reference for community health professionals who wish to improve the medication safety of chronically ill elders. Copyright © 2013 Mosby, Inc. All rights reserved.

Neuropeptide Y stimulation as primary target for preventive measures of maladaptative cardiovascular reactions in occupational chronic stress exposure.

PubMed

Ciumaşu-Rîmbu, Mălina; Popa, Livia; Vulpoi, Carmen

2012-01-01

Chronic stress may produce a decrease in central NPY expression and subjects exposed to it may prove hypersensitivity to a novel stressor with dysfunctions in the NPY system and cardiovascular maladaptation to stress, even hypertension. Upregulation of NPY expression may contribute to successful behavioral adaptation to stress by reducing cardiovascular tone and suppressing anxious behaviors. Adaptogens, a new class of metabolic regulators stimulate NPY expression and release. The aim of this study is to increase tolerance and adaptation to stress of hypersensitive to novel stressor, occupational chronic stress exposed subjects with cardiovascular maladaptation to mild new stressor using adaptogens as part of prevention protocol. 40 military personnel with known cardiostressor reactional mode and occupational chronic stress exposure were exposed to mild novel stressor: occupational medicine routine evaluation and clinically assessed for maladaptative cardiovascular response prior and before application of 30 day prevention protocol. Employees were randomly split in two groups, one receiving standard prevention protocol (lifestyle counseling) plus adaptogens in multiple dose administration, twice daily and the other receiving only standard prevention protocol. We found significant statistic differences in all cardiovascular parameters in adaptogen group and only in diastolic blood pressure in control group. Adaptogens could be an important factor in successful prevention protocols of chronic occupational stress dysfunctions involving NPY systems.

Patient attitudes regarding healthcare utilization and referral: a descriptive comparison in African- and Caucasian Americans with chronic pain.

PubMed Central

Green, Carmen R.; Baker, Tamara A.; Ndao-Brumblay, S. Khady

2004-01-01

The purpose of this study was to evaluate healthcare utilization and referral patterns for pain management services in a racially and ethnically diverse population. A study-specific mail survey was directed at African- (N=324) and Caucasian Americans (N=300) receiving chronic pain treatment at a tertiary care pain center to address their healthcare access, referral, and utilization patterns. Overall, 46% (N=286) responded, with the majority of respondents being Caucasian Americans (57%) and women (68%). The majority (58%) reported asking their physicians to refer them to a pain physician. African Americans were more likely to report that chronic pain was a major reason for financial problems. They made significantly more visits to the emergency room for pain care. African Americans agreed more that ethnicity and culture affected access to healthcare and pain management. They also tended to agree more than Caucasian Americans that pain medication could not control pain. These results demonstrate significant differences in healthcare utilization, access, and attitudes amongst African- and Caucasian Americans receiving chronic pain management. In light of the socioeconomic and health consequences of chronic pain, these results suggest the need for further studies addressing variability in pain care access and utilization in diverse populations. PMID:14746352

Is refractory angina pectoris a form of chronic pain? A comparison of two patient groups receiving spinal cord stimulation therapy.

PubMed

Pak, Nick; Devcich, Daniel A; Johnson, Malcolm H; Merry, Alan F

2014-03-28

To compare psychological and pain-related characteristics of patients with chronic pain and patients with refractory angina pectoris who had been treated with spinal cord stimulation (SCS) therapy. Twenty-four patients receiving SCS therapy were interviewed. Four psychological variables were assessed using standardised questionnaires for pain catastrophising, health locus of control, anxiety sensitivity, and self-efficacy. Patients also completed the revised version of the Short-Form McGill Pain Questionnaire, the Short-Form Health Survey, and self-reported measures of global perceived effect, pain, functionality, and satisfaction with SCS therapy. Most patients reported improvements in pain, functionality, and improvement overall. Some health locus of control dimensions were significantly higher for the angina group than the chronic pain group, and chronic angina patients reported significantly lower levels of intermittent pain. Virtually all patients reported being satisfied with SCS therapy. Most self-rated psychological and pain-related characteristics were no different between the two groups, which gives some support to the view that refractory angina is a form of chronic pain. The results also add to evidence supporting the use of SCS therapy for refractory angina pectoris; however, differences observed on a few variables may indicate points of focus for the assessment and treatment of such patients.

Diagnosis of chronic conditions with modifiable lifestyle risk factors in selected urban and rural areas of Bangladesh and sociodemographic variability therein

PubMed Central

2011-01-01

Background Bangladesh suffers from a lack of healthcare providers. The growing chronic disease epidemic's demand for healthcare resources will further strain Bangladesh's limited healthcare workforce. Little is known about how Bangladeshis with chronic disease seek care. This study describes chronic disease patients' care seeking behavior by analyzing which providers diagnose these diseases. Methods During 2 month periods in 2009, a cross-sectional survey collected descriptive data on chronic disease diagnoses among 3 surveillance populations within the International Center for Diarrheal Disease Research, Bangladesh (ICDDR, B) network. The maximum number of respondents (over age 25) who reported having ever been diagnosed with a chronic disease determined the sample size. Using SAS software (version 8.0) multivariate regression analyses were preformed on related sociodemographic factors. Results Of the 32,665 survey respondents, 8,591 self reported having a chronic disease. Chronically ill respondents were 63.4% rural residents. Hypertension was the most prevalent disease in rural (12.4%) and urban (16.1%) areas. In rural areas chronic disease diagnoses were made by MBBS doctors (59.7%) and Informal Allopathic Providers (IAPs) (34.9%). In urban areas chronic disease diagnoses were made by MBBS doctors (88.0%) and IAP (7.9%). Our analysis identified several groups that depended heavily on IAP for coverage, particularly rural, poor and women. Conclusion IAPs play important roles in chronic disease care, particularly in rural areas. Input and cooperation from IAPs are needed to minimize rural health disparities. More research on IAP knowledge and practices regarding chronic disease is needed to properly utilize this potential healthcare resource. PMID:22078128

Computers in the treatment of chronic aphasia.

PubMed

Katz, Richard C

2010-02-01

Computers and related technology can increase the amount of treatment received by adults with chronic aphasia. Computers used in treatment, however, are only valuable to the patient if the intervention is efficacious. Real and potential applications of computer technology are discussed in the context of three roles of computerized aphasia treatment for adults with chronic aphasia. Pertinent studies regarding Phases 1 and 2 are briefly described. The only Phase 3 study of efficacy of computerized aphasia treatment is more fully described and its implications discussed.

Prognostic and predictive implications of Sokal, Euro and EUTOS scores in chronic myeloid leukaemia in the imatinib era-experience from a tertiary oncology centre in Southern India.

PubMed

Kuntegowdanahalli, Lakshmaiah Chinnagiriyappa; Kanakasetty, Govind Babu; Thanky, Aditi Harsh; Dasappa, Lokanatha; Jacob, Linu Abraham; Mallekavu, Suresh Babu; Lakkavalli, Rajeev Krishnappa; Kadabur, Lokesh N; Haleshappa, Rudresha Antapura

2016-01-01

Chronic myeloid leukaemia (CML) is a myeloproliferative disorder. Over the years many prognostic models have been developed to better risk stratify this disease at baseline. Sokal, Euro, and EUTOS scores were developed in varied populations initially receiving various therapies. Here we try to identify their predictive and prognostic implication in a larger population of Indian patients with CML-CP (chronic phase) in the imatinib era.

Systemic Lupus Erythematosus, Radiotherapy, and the Risk of Acute and Chronic Toxicity: The Mayo Clinic Experience

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

Pinn, Melva E.; Gold, Douglas G. M.; Petersen, Ivy A.

2008-06-01

Purpose: To determine the acute and chronic toxic effects of radiotherapy in patients with systemic lupus erythematosus (SLE). Methods and Materials: Medical records of 21 consecutive patients with SLE, who had received 34 courses of external beam radiotherapy and one low-dose-rate prostate implant, were retrospectively reviewed. Patients with discoid lupus erythematosus were excluded. Results: Median survival was 2.3 years and median follow-up 5.6 years. Eight (42%) of 19 patients evaluable for acute toxicity during radiotherapy experienced acute toxicity of Grade 1 or greater, and 4 (21%) had acute toxicity of Grade 3 or greater. The 5- and 10-year incidence ofmore » chronic toxicity of Grade 1 or greater was 45% (95% confidence interval [CI], 22-72%) and 56% (95% CI, 28-81%), respectively. The 5- and 10-year incidence of chronic toxicity of Grade 3 or greater was 28% (95% CI, 18-60%) and 40% (95% CI, 16-72%), respectively. Univariate analysis showed that chronic toxicity of Grade 1 or greater correlated with SLE renal involvement (p < 0.006) and possibly with the presence of five or more American Rheumatism Association criteria (p < 0.053). Chronic toxicity of Grade 3 or greater correlated with an absence of photosensitivity (p < 0.02), absence of arthritis (p < 0.03), and presence of a malar rash (p < 0.04). Conclusions: The risk of acute and chronic toxicity in patients with SLE who received radiotherapy was moderate but was not prohibitive of the use of radiotherapy. Patients with more advanced SLE may be at increased risk for chronic toxicity.« less

A 10-yr Analysis of Chronic Pelvic Pain and Chronic Opioid Therapy in the Women Veteran Population.

PubMed

Cichowski, Sara B; Rogers, Rebecca G; Komesu, Yuko; Murata, Erin; Qualls, Clifford; Murata, Allison; Murata, Glen

2018-05-18

Chronic pelvic pain (CPP) affects an estimated 30% of women Veterans. Previous research shows high rates of narcotic abuse in the women Veteran population. Narcotics are not recommended for the treatment of CPP. Understanding how CPP impacts narcotic prescribing in the women Veteran population is critical to addressing the public health crisis of opioid abuse. Our objective was to compare chronic opioid therapy (COT) prescribed 5 yr prior to and following CPP diagnosis and to identify predictors of COT as well as adverse events associated with COT. We choose to look at 10 yr of data because we thought this time period would provide unique insight into the longitudinal associations of CPP and COT and was available in the database. Women with non-cancer CPP were included for analyses from the Veteran's Affairs Corporate Database Warehouse. COT was defined as 90 d of opiates/calendar year for each of the 5 yr proceeding and following the diagnosis of CPP. Patient characteristics and potential variables influencing COT were collected. We compared baseline demographics between the women who received COT to the women who did not receive COT to find additional demographic predictors of COT in association with CPP. Multivariable analysis identified predictors of COT in this population of women with CPP. We utilized an interrupted time series analysis to understand the impact of the diagnosis of CPP on COT. A total of 49,601 women met inclusion criteria with an average age of 40.1 ± 11.5 yr; 37.3% self-characterized as being a racial minority and 24% had a history of military sexual trauma. Chronic use increased significantly (p < 0.001) in the 5 yr preceding the diagnosis of CPP from 6.3% (n = 3124) of women at time -5 to 13.6% (n = 6746) at time 0. In the first year following the diagnosis of CPP, 16.8% (n = 8,333) of women with CPP met the criteria for COT (p < 0.001) and 15% (n = 7440) of women with CPP remained in the COT group for the remaining 5 yr following the diagnosis. On average women in the COT group had 250-292 d of opioids/year. When comparing women who received chronic narcotics following the diagnosis of CPP versus those who did not receive chronic narcotics, women who received COT were older, more likely to smoke and more frequently diagnosed with other pain conditions such as back pain, headaches, and fibromyalgia. (All p < 0.001). In the multivariable model, predictors of COT following CPP diagnosis included prior COT (OR = 10.0 (95% CI 9.4, 10.6), a positive history of military sexual trauma, smoking, and other chronic pain conditions. The distinct pattern of prescribing shown in this cohort may mean COT is prescribed for CPP and this prescribing pattern contributes to the adverse events associated with COT. As COT is not recommended for CPP, physicians need more education on the therapies available to help CPP patients.

49 CFR 390.5 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... device used to input, write, send, receive, or read text. Emergency means any hurricane, tornado, storm... public welfare, provided such hurricane, tornado, or other event results in: (1) A declaration of an...

49 CFR 390.5 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... device used to input, write, send, receive, or read text. Emergency means any hurricane, tornado, storm... public welfare, provided such hurricane, tornado, or other event results in: (1) A declaration of an...

Lack of evidence for central sensitization in idiopathic, non-traumatic neck pain: a systematic review.

PubMed

Malfliet, Annaleen; Kregel, Jeroen; Cagnie, Barbara; Kuipers, Mandy; Dolphens, Mieke; Roussel, Nathalie; Meeus, Mira; Danneels, Lieven; Bramer, Wichor M; Nijs, Jo

2015-01-01

Chronic neck pain is a common problem with a poorly understood pathophysiology. Often no underlying structural pathology can be found and radiological imaging findings are more related to age than to a patient's symptoms. Besides its common occurrence, chronic idiopathic neck pain is also very disabling with almost 50% of all neck pain patients showing moderate disability at long-term follow-up. Central sensitization (CS) is defined as "an amplification of neural signaling within the central nervous system that elicits pain hypersensitivity," "increased responsiveness of nociceptive neurons in the central nervous system to their normal or subthreshold afferent input," or "an augmentation of responsiveness of central neurons to input from unimodal and polymodal receptors." There is increasing evidence for involvement of CS in many chronic pain conditions. Within the area of chronic idiopathic neck pain, there is consistent evidence for the presence and clinical importance of CS in patients with traumatic neck pain, or whiplash-associated disorders. However, the majority of chronic idiopathic neck pain patients are unrelated to a traumatic injury, and hence are termed chronic idiopathic non-traumatic neck pain. When comparing whiplash with idiopathic non-traumatic neck pain, indications for different underlying mechanisms are found. The goal of this article was to review the existing scientific literature on the role of CS in patients with chronic idiopathic non-traumatic neck pain. Systematic review. All selected studies were case control studies. A systematic search of existing, relevant literature was performed via the electronic databases Medline, Embase, Web of Science, Cinahl, PubMed, and Google Scholar. All titles and abstracts were checked to identify relevant articles. An article was considered eligible if it met following inclusion criteria: (1) participants had to be human adults (> 18 years) diagnosed with idiopathic non-traumatic chronic (present for at least 3 months) neck pain; (2) papers had to report outcomes related to CS; and (3) articles had to be full-text reports or original research (no abstracts, case-reports, reviews, meta-analysis, letters, or editorials). Six articles were found eligible after screening the title, abstract and - when necessary - the full text for in- and exclusion criteria. All selected studies were case-control studies. Overall, results regarding the presence of CS were divergent. While the majority of patients with chronic traumatic neck pain (i.e. whiplash) are characterized by CS, this is not the case for patients with chronic idiopathic neck pain. The available evidence suggests that CS is not a major feature of chronic idiopathic neck pain. Individual cases might have CS pain, but further work should reveal how they can be characterized. Very few studies available. Literature about CS in patients with chronic idiopathic non-traumatic neck pain is rare and results from the available studies provide an inconclusive message. CS is not a characteristic feature of chronic idiopathic and non-traumatic neck pain, but can be present in some individuals of the population. In the future a subgroup with CS might be defined, but based on current knowledge it is not possible to characterize this subgroup. Such information is important in order to provide targeted treatment.

GABAergic neurons in nucleus accumbens are correlated to resilience and vulnerability to chronic stress for major depression

PubMed Central

Cui, Shan; Wang, Jin-Hui

2017-01-01

Background Major depression, persistent low mood, is one of common psychiatric diseases. Chronic stressful life is believed to be a major risk factor that leads to dysfunctions of the limbic system. However, a large number of the individuals with experiencing chronic stress do not suffer from major depression, called as resilience. Endogenous mechanisms underlying neuronal invulnerability to chronic stress versus major depression are largely unknown. As GABAergic neurons are vulnerable to chronic stress and their impairments is associated with major depression, we have examined whether the invulnerability of GABAergic neurons in the limbic system is involved in resilience. Results GABAergic neurons in the nucleus accumbens from depression-like mice induced by chronic unpredictable mild stress appear the decreases in their GABA release, spiking capability and excitatory input reception, compared with those in resilience mice. The levels of decarboxylase and vesicular GABA transporters decrease in depression-like mice, but not resilience. Materials and Methods Mice were treated by chronic unpredictable mild stress for three weeks. Depression-like behaviors or resilience was confirmed by seeing whether their behaviors change significantly in sucrose preference, Y-maze and forced swimming tests. Mice from controls as well as depression and resilience in response to chronic unpredictable mild stress were studied in terms of GABAergic neuron activity in the nucleus accumbens by cell electrophysiology and protein chemistry. Conclusions The impairment of GABAergic neurons in the nucleus accumbens is associated with major depression. The invulnerability of GABAergic neurons to chronic stress may be one of cellular mechanisms for the resilience to chronic stress. PMID:28415589

Effect of thoracic mobilization on respiratory parameters in chronic non-specific low back pain: A randomized controlled trial.

PubMed

Babina, R; Mohanty, P P; Pattnaik, M

2016-02-19

Altered respiratory function has been found to be associated with back pain. Limited chest excursion in subjects with chronic low back pain (CLBP) may be due to co-contraction or bracing of erector spinae and abdominal muscles; their flexed spinal posture; and/or their compromised spinal stability resulting from dysfunctional transversus abdominis. To check for the effects of thoracic mobilization on respiratory parameters in subjects with chronic non-specific low back pain. Sixty-two subjects (excluding 11 dropouts) with CLBP of age group 30-60 were randomly allocated to two groups. Both groups received individualized treatment for low back pain (LBP) and HEP (home exercise program) regime of breathing exercises. In addition, group 1 received Maitland's Central postero-anterior vertebral pressure for thoracic spine (T1-T8). Total treatment duration was 10 sessions in 2 weeks (5 sessions/week). Results showed significant improvement in respiratory parameters viz. Forced Vital Capacity (FVC), Sustained Maximal Inspiratory Pressure (SMIP) and Chest Wall Expansion (CWE) and Oswestry Disability Index (ODI) in both groups (p< 0.05) at end of 2 weeks of intervention. However, improvement was significantly more in group 1 (p < 0.05) receiving additional thoracic mobilization. Subjects with non-specific chronic low back pain with or without radiation to lower limbs when treated with thoracic central PA mobilization, in addition to LBP specific treatment and breathing exercises, show an improvement in respiratory parameters and reduction in disability.

Association of Long-term Proton Pump Inhibitor Therapy with Bone Fractures and effects on Absorption of Calcium, Vitamin B12, Iron, and Magnesium

PubMed Central

Ito, Tetsuhide; Jensen, Robert T.

2010-01-01

Proton pump inhibitors (PPI) are now one of the most widely used classes of drugs. PPIs have proven to have a very favorable safety profile and it is unusual for a patient to stop these drugs because of side effects. However, increasing numbers of patients are chronically taking PPIs for gastroesophageal reflux disease and a number of other common persistent conditions, therefore the long-term potential adverse effects are receiving increasing attention. One area that is receiving much attention and generally has been poorly studied, is the long-term effects of chronic acid suppression on the absorption of vitamins and nutrients. This area has received increased attention because of the reported potential adverse effect of chronic PPI treatment leading to an increased occurrence of bone fractures. This has led to an increased examination of the effects of PPIs on calcium absorption/metabolism as well as numerous cohort, case control and prospective studies of their ability to affect bone density and cause bone fractures. In this article these studies are systematically examined, as well as the studies of the effects of chronic PPI usage on VB12, iron and magnesium absorption. In general the studies in each of thee areas have led to differing conclusions, but when examined systematically, a number of the studies are showing consistent results that support the conclusion that long-term adverse effects on these processes can have important clinical implications. PMID:20882439

Heterogeneity of Intrinsic and Synaptic Properties of Neurons in the Ventral and Dorsal Parts of the Ventral Nucleus of the Lateral Lemniscus

PubMed Central

Caspari, Franziska; Baumann, Veronika J.; Garcia-Pino, Elisabet; Koch, Ursula

2015-01-01

The ventral nucleus of the lateral lemniscus (VNLL) provides a major inhibitory projection to the inferior colliculus (IC). Neurons in the VNLL respond with various firing patterns and different temporal precision to acoustic stimulation. The present study investigates the underlying intrinsic and synaptic properties of various cell types in different regions of the VNLL, using in vitro electrophysiological recordings from acute brain slices of mice and immunohistochemistry. We show that the biophysical membrane properties and excitatory input characteristics differed between dorsal and ventral VNLL neurons. Neurons in the ventral VNLL displayed an onset-type firing pattern and little hyperpolarization-activated current (Ih). Stimulation of lemniscal inputs evoked a large all-or-none excitatory response similar to Calyx of Held synapses in neurons in the lateral part of the ventral VNLL. Neurons that were located within the fiber tract of the lateral lemniscus, received several and weak excitatory input fibers. In the dorsal VNLL onset-type and sustained firing neurons were intermingled. These neurons showed large Ih and were strongly immunopositive for the hyperpolarization-activated cyclic nucleotide-gated channel 1 (HCN1) subunit. Both neuron types received several excitatory inputs that were weaker and slower compared to ventrolateral VNLL neurons. Using a mouse model that expresses channelrhodopsin under the promotor of the vesicular GABA transporter (VGAT) suggests that dorsal and ventral neurons were inhibitory since they were all depolarized by light stimulation. The diverse membrane and input properties in dorsal and ventral VNLL neurons suggest differential roles of these neurons for sound processing. PMID:26635535

Responses of neurons in the caudal medullary lateral tegmental field to visceral inputs and vestibular stimulation in vertical planes

PubMed Central

Moy, Jennifer D.; Miller, Daniel J.; Catanzaro, Michael F.; Boyle, Bret M.; Ogburn, Sarah W.; Cotter, Lucy A.; McCall, Andrew A.

2012-01-01

The dorsolateral reticular formation of the caudal medulla, or the lateral tegmental field (LTF), has been classified as the brain's “vomiting center”, as well as an important region in regulating sympathetic outflow. We examined the responses of LTF neurons in cats to rotations of the body that activate vestibular receptors, as well as to stimulation of baroreceptors (through mechanical stretch of the carotid sinus) and gastrointestinal receptors (through the intragastric administration of the emetic compound copper sulfate). Approximately half of the LTF neurons exhibited graviceptive responses to vestibular stimulation, similar to primary afferents innervating otolith organs. The other half of the neurons had complex responses, including spatiotemporal convergence behavior, suggesting that they received convergent inputs from a variety of vestibular receptors. Neurons that received gastrointestinal and baroreceptor inputs had similar complex responses to vestibular stimulation; such responses are expected for neurons that contribute to the generation of motion sickness. LTF units with convergent baroreceptor and vestibular inputs may participate in producing the cardiovascular system components of motion sickness, such as the changes in skin blood flow that result in pallor. The administration of copper sulfate often modulated the gain of responses of LTF neurons to vestibular stimulation, particularly for units whose spontaneous firing rate was altered by infusion of drug (median of 459%). The present results raise the prospect that emetic signals from the gastrointestinal tract modify the processing of vestibular inputs by LTF neurons, thereby affecting the probability that vomiting will occur as a consequence of motion sickness. PMID:22955058

Novel Fast Adapting Interneurons Mediate Cholinergic-Induced Fast GABAA IPSCs In Striatal Spiny Neurons

PubMed Central

Faust, Thomas W.; Assous, Maxime; Shah, Fulva; Tepper, James M.; Koós, Tibor

2015-01-01

Previous work suggests that neostriatal cholinergic interneurons control the activity of several classes of GABAergic interneurons through fast nicotinic receptor mediated synaptic inputs. Although indirect evidence has suggested the existence of several classes of interneurons controlled by this mechanism only one such cell type, the neuropeptide-Y expressing neurogliaform neuron, has been identified to date. Here we tested the hypothesis that in addition to the neurogliaform neurons that elicit slow GABAergic inhibitory responses, another interneuron type exists in the striatum that receives strong nicotinic cholinergic input and elicits conventional fast GABAergic synaptic responses in projection neurons. We obtained in vitro slice recordings from double transgenic mice in which Channelrhodopsin-2 was natively expressed in cholinergic neurons and a population of serotonin receptor-3a-Cre expressing GABAergic interneurons were visualized with tdTomato. We show that among the targeted GABAergic interneurons a novel type of interneuron, termed the fast-adapting interneuron, can be identified that is distinct from previously known interneurons based on immunocytochemical and electrophysiological criteria. We show using optogenetic activation of cholinergic inputs that fast-adapting interneurons receive a powerful supra-threshold nicotinic cholinergic input in vitro. Moreover, fast adapting neurons are densely connected to projection neurons and elicit fast, GABAA receptor mediated inhibitory postsynaptic responses. The nicotinic receptor mediated activation of fast-adapting interneurons may constitute an important mechanism through which cholinergic interneurons control the activity of projection neurons and perhaps the plasticity of their synaptic inputs when animals encounter reinforcing or otherwise salient stimuli. PMID:25865337

Health Care Utilization for Chronic Pain in Low-Income Settings.

PubMed

Newman, Andrea K; Kapoor, Shweta; Thorn, Beverly E

2018-06-13

Chronic pain is a serious health problem with high rates of health care utilization (HCU). Many patients become stymied in a perpetual cycle of unsuccessful attempts to find relief from suffering through frequent health care visits. Especially within low-income populations, the burdens of health care services are especially unpleasant due to significant financial costs, barriers to transportation, and high levels of stress. This study aimed to examine factors associated with HCU for chronic pain in low-income settings. As part of the Learning About My Pain (LAMP) trial, a randomized comparative effectiveness study of group-based psychosocial interventions (PCORI Contract #941, Beverly Thorn, PI; clinicaltrials.gov identifier NCT01967342) for patients receiving care for chronic pain at low-income clinics in Alabama, medical records one-year prior to randomization were retrospectively collected for data analysis. HCU was defined as the sum of health care visits for chronic pain over this one-year period. Sociodemographic traits (age, sex, race, poverty status, primary literacy, education level), pain related variables (pain severity, pain interference, disability, number of pain sites, number of pain types, opioid prescriptions), and psychological variables (depressive symptoms, pain catastrophizing) were entered into a hierarchical multiple regression model to predict HCU. Results suggested that race/ethnicity, having received an opioid prescription in the year prior to treatment onset, and higher depressive symptoms were associated with increased HCU for chronic pain conditions. Depressive symptoms are an essential aspect of increased health care use. Study findings support the need for a biopsychosocial approach to chronic pain management.

Pain Volatility and Prescription Opioid Addiction Treatment Outcomes in Patients with Chronic Pain

PubMed Central

Worley, Matthew J.; Heinzerling, Keith G.; Shoptaw, Steven; Ling, Walter

2015-01-01

The combination of prescription opioid dependence and chronic pain is increasingly prevalent and hazardous to public health. Variability in pain may explain poor prescription opioid addiction treatment outcomes in persons with chronic pain. This study examined pain trajectories and pain volatility in patients with chronic pain receiving treatment for prescription opioid addiction. We conducted secondary analyses of adults with chronic pain (N = 149) who received buprenorphine-naloxone (BUP-NLX) and counseling for 12 weeks in an outpatient, multi-site clinical trial. Good treatment outcome was defined as urine-verified abstinence from opioids at treatment endpoint (Week 12) and during at least two of the previous three weeks. Pain severity significantly declined over time during treatment (b = − 0.36, p < .001). Patients with greater pain volatility were less likely to have a good treatment outcome (OR = 0.55, p < .05), controlling for baseline pain severity and rate of change in pain over time. A one standard deviation increase in pain volatility was associated with a 44% reduction in the probability of endpoint abstinence. The significant reduction in subjective pain during treatment provides observational support for the analgesic effects of BUP-NLX in patients with chronic pain and opioid dependence. Patients with greater volatility in subjective pain during treatment have increased risk for returning to opioid use by the conclusion of an intensive treatment with BUP-NLX and counseling. Future research should examine underlying mechanisms of pain volatility and identify related therapeutic targets to optimize interventions for prescription opioid addiction and co-occurring chronic pain. PMID:26302337

Pain volatility and prescription opioid addiction treatment outcomes in patients with chronic pain.

PubMed

Worley, Matthew J; Heinzerling, Keith G; Shoptaw, Steven; Ling, Walter

2015-12-01

The combination of prescription opioid dependence and chronic pain is increasingly prevalent and hazardous to public health. Variability in pain may explain poor prescription opioid addiction treatment outcomes in persons with chronic pain. This study examined pain trajectories and pain volatility in patients with chronic pain receiving treatment for prescription opioid addiction. We conducted secondary analyses of adults with chronic pain (n = 149) who received buprenorphine/naloxone (BUP/NLX) and counseling for 12 weeks in an outpatient, multisite clinical trial. Good treatment outcome was defined as urine-verified abstinence from opioids at treatment endpoint (Week 12) and during at least 2 of the previous 3 weeks. Pain severity significantly declined over time during treatment (b = -0.36, p < .001). Patients with greater pain volatility were less likely to have a good treatment outcome (odds ratio = 0.55, p < .05), controlling for baseline pain severity and rate of change in pain over time. A 1 standard deviation increase in pain volatility was associated with a 44% reduction in the probability of endpoint abstinence. The significant reduction in subjective pain during treatment provides observational support for the analgesic effects of BUP/NLX in patients with chronic pain and opioid dependence. Patients with greater volatility in subjective pain during treatment have increased risk of returning to opioid use by the conclusion of an intensive treatment with BUP/NLX and counseling. Future research should examine underlying mechanisms of pain volatility and identify related therapeutic targets to optimize interventions for prescription opioid addiction and co-occurring chronic pain. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

Effect of Depression Treatment on Chronic Pain Outcomes

PubMed Central

Teh, Carrie Farmer; Zaslavsky, Alan; Reynolds, Charles F.; Cleary, Paul D.

2011-01-01

Objective People with chronic pain and depression have worse health outcomes than those with chronic pain alone. Little is known about the effectiveness of depression treatment for this population. We examined the effect of depression treatment on medical and social outcomes for individuals with chronic pain and depression Methods Propensity score weighted analyses using both waves (1997-1998 and 2000-2001) of the National Survey of Alcohol, Drug, and Mental Health Problems were used to examine the effect of (1) any depression treatment and (2) minimally adequate depression treatment on persistence of depression symptoms, depression severity, pain severity, overall health, mental health status, physical health status, social functioning, employment status, and number of work days missed. Analyses were limited to those who met CIDI-SF criteria for major depressive disorder, reported having at least one chronic pain condition, and completed both interviews (n=553). Results Receiving any depression treatment was associated with higher scores on the mental component summary of the MOS SF-12, indicating better mental health (difference = 2.65 points, p=0.002) and less interference of pain on work (OR=0.57, p=0.02). Among those receiving treatment, minimal adequacy of treatment was not significantly associated with better outcomes. Conclusions Depression treatment improves mental health and reduces the effects of pain on work among those with chronic pain and depression. Understanding the effect of depression treatment on outcomes for this population is important for employers, healthcare providers treating this population, and policymakers working in this Decade of Pain Control and Research to improve care for chronic pain sufferers. PMID:19875633

Effect of depression treatment on chronic pain outcomes.

PubMed

Teh, Carrie Farmer; Zaslavsky, Alan M; Reynolds, Charles F; Cleary, Paul D

2010-01-01

To examine the effect of depression treatment on medical and social outcomes for individuals with chronic pain and depression. People with chronic pain and depression have worse health outcomes than those with chronic pain alone. Little is known about the effectiveness of depression treatment for this population. Propensity score-weighted analyses, using both waves (1997-1998 and 2000-2001) of the National Survey of Alcohol, Drug, and Mental Health Problems, were used to examine the effect of a) any depression treatment and b) minimally adequate depression treatment on persistence of depression symptoms, depression severity, pain severity, overall health, mental health status, physical health status, social functioning, employment status, and number of workdays missed. Analyses were limited to those who met Composite International Diagnostic Interview Short-Form criteria for major depressive disorder, reported having at least one chronic pain condition, and completed both interviews (n = 553). Receiving any depression treatment was associated with higher scores on the mental component summary of the Medical Outcomes Study Short Form-12, indicating better mental health (difference = 2.65 points, p = .002) and less interference of pain on work (odds ratio = 0.57, p = .02). Among those receiving treatment, minimal adequacy of treatment was not significantly associated with better outcomes. Depression treatment improves mental health and reduces the effects of pain on work among those with chronic pain and depression. Understanding the effect of depression treatment on outcomes for this population is important for employers, healthcare providers treating this population, and policymakers working in this decade of pain control and research to improve care for chronic pain sufferers.

Employment and Satisfaction Outcomes From a Job Retention Intervention Delivered to Persons with Chronic Diseases

ERIC Educational Resources Information Center

Allaire, Saralynn H.; Niu, Jingbo; LaValley, Michael P.

2005-01-01

Job retention services are recommended for people with chronic diseases based on their high risk for work disability. This randomized trial tested the effectiveness of a job retention intervention in a sample of employed persons with rheumatic diseases at risk for work disability. One hundred and twenty-two experimental participants received the…