Alterations of fasting glucose and fat metabolism in intrauterine growth-retarded newborn dogs.

PubMed

Kliegman, R M

1989-03-01

Maternal nutritional deprivation resulted in reduced fetal weight at term gestation (251 +/- 7 vs. 277 +/- 7 g, P less than 0.01) in newborn dogs. Growth-retarded pups developed lower blood glucose levels after 3, 6, and 9 h of neonatal fasting, reduced plasma levels of free fatty acids (FFA) at 9 and 24 h, and lower ketone bodies at 24 h compared with age-matched newborn control pups. Systemic rates of palmitate and alanine turnover were not affected, but systemic glucose turnover was reduced for 3-9 h after birth. The rate of alanine incorporation into glucose from 3 to 9 h was also reduced in growth-retarded pups compared with timed controls. Paradoxically, the rate of incorporation of palmitate into triglycerides was augmented in the smaller growth-retarded pups. Hepatic glycogen content was reduced at every time in the study among growth-retarded pups, whereas the rates of glycogenolysis between birth and 24 h were equivalent in the two pup groups. In contrast, hepatic triglyceride levels were augmented throughout the study in pups with growth retardation. Maternal starvation and lower glucose levels resulted in a lower hepatic energy charge, and augmented cytoplasmic and mitochondrial NAD-to-NADH ratios in intrauterine growth-retarded pups. These data suggest that intrauterine growth retardation in dogs results in fasting neonatal hypoglycemia that is due in part to reduced systemic glucose production. We speculate that reduced rates of gluconeogenesis from alanine and reduced oxidation of alternate fuels such as FFA contribute to hypoglycemia. FFA recycling to triglyceride synthesis rather than oxidative pathways may contribute to the observed reduction of circulating glucose levels.

A Randomized Controlled Trial to Compare Computer-assisted Motivational Intervention with Didactic Educational Counseling to Reduce Unprotected Sex in Female Adolescents.

PubMed

Gold, Melanie A; Tzilos, Golfo K; Stein, L A R; Anderson, Bradley J; Stein, Michael D; Ryan, Christopher M; Zuckoff, Allan; DiClemente, Carlo

2016-02-01

To examine a computer-assisted, counselor-guided motivational intervention (CAMI) aimed at reducing the risk of unprotected sexual intercourse. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: We conducted a 9-month, longitudinal randomized controlled trial with a multisite recruitment strategy including clinic, university, and social referrals, and compared the CAMI with didactic educational counseling in 572 female adolescents with a mean age of 17 years (SD = 2.2 years; range = 13-21 years; 59% African American) who were at risk for pregnancy and sexually transmitted diseases. The primary outcome was the acceptability of the CAMI according to self-reported rating scales. The secondary outcome was the reduction of pregnancy and sexually transmitted disease risk using a 9-month, self-report timeline follow-back calendar of unprotected sex. The CAMI was rated easy to use. Compared with the didactic educational counseling, there was a significant effect of the intervention which suggested that the CAMI helped reduce unprotected sex among participants who completed the study. However, because of the high attrition rate, the intent to treat analysis did not demonstrate a significant effect of the CAMI on reducing the rate of unprotected sex. Among those who completed the intervention, the CAMI reduced unprotected sex among an at-risk, predominantly minority sample of female adolescents. Modification of the CAMI to address methodological issues that contributed to a high drop-out rate are needed to make the intervention more acceptable and feasible for use among sexually active predominantly minority, at-risk, female adolescents. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Comparing Two Methods for Reducing Variability in Voice Quality Measurements

ERIC Educational Resources Information Center

Kreiman, Jody; Gerratt, Bruce R.

2011-01-01

Purpose: Interrater disagreements in ratings of quality plague the study of voice. This study compared 2 methods for handling this variability. Method: Listeners provided multiple breathiness ratings for 2 sets of pathological voices, one including 20 male and 20 female voices unselected for quality and one including 20 breathy female voices.…

South-East Asian strains of Plasmodium falciparum display higher ratio of non-synonymous to synonymous polymorphisms compared to African strains

PubMed Central

Singh, Gajinder Pal; Sharma, Amit

2016-01-01

Resistance to frontline anti-malarial drugs, including artemisinin, has repeatedly arisen in South-East Asia, but the reasons for this are not understood. Here we test whether evolutionary constraints on Plasmodium falciparum strains from South-East Asia differ from African strains. We find a significantly higher ratio of non-synonymous to synonymous polymorphisms in P. falciparum from South-East Asia compared to Africa, suggesting differences in the selective constraints on P. falciparum genome in these geographical regions. Furthermore, South-East Asian strains showed a higher proportion of non-synonymous polymorphism at conserved positions, suggesting reduced negative selection. There was a lower rate of mixed infection by multiple genotypes in samples from South-East Asia compared to Africa. We propose that a lower mixed infection rate in South-East Asia reduces intra-host competition between the parasite clones, reducing the efficiency of natural selection. This might increase the probability of fixation of fitness-reducing mutations including drug resistant ones. PMID:27853513

Clopidogrel (Plavix) reduces the rate of thrombosis in the rat tuck model for microvenous anastomosis.

PubMed

Moore, Michael G; Deschler, Daniel G

2007-04-01

To evaluate the effect of clopidogrel on the rate of thrombosis in a rat model for venous microvascular failure. Forty rats were treated with clopidogrel or saline control via gastric gavage in a randomized, blinded fashion. After allowing for absorption and activation, each femoral vein was isolated and a venous "tuck" procedure was performed. The bleeding time and vessel patency were subsequently evaluated. The rate of vessel thrombosis was decreased in the clopidogrel-treated group compared to controls (7.9% vs 31.4%, P < 0.025). The bleeding time was longer in the clopidogrel-treated group compared to controls (250 +/- 100 seconds vs 173 +/- 59 seconds, P < 0.015). Clopidogrel decreased the rate of thrombosis in the rat model for venous microvascular failure. The use of clopidogrel may reduce the rate of venous thrombosis after free tissue transfer and may be indicated in select patients.

An evaluation of welding processes to reduce hexavalent chromium exposures and reduce costs by using better welding techniques.

PubMed

Keane, Michael J

2014-01-01

A group of stainless steel arc welding processes was compared for emission rates of fume and hexavalent chromium, and costs per meter length of weld. The objective was to identify those with minimal emissions and also compare relative labor and consumables costs. The selection included flux-cored arc welding (FCAW), shielded-metal arc welding (SMAW), and multiple gas metal arc welding (GMAW) processes. Using a conical chamber, fumes were collected, and fume generation rates and hexavalent chromium (Cr(6+)) were measured. GMAW processes used were short-circuit (SC) and pulsed-spray modes. Flux-cored welding used gas shielding. Costs were estimated per meter of a 6.3-mm thick horizontal butt weld. Emission rates of Cr(6+) were lowest for GMAW processes and highest for SMAW; several GMAW processes had less than 2% of the SMAW generation rate. Labor and consumable costs for the processes studied were again highest for SMAW, with those of several GMAW types about half that cost. The results show that use of any of the GMAW processes (and flux-cored welding) could substantially reduce fume and Cr(6+) emissions, and greatly reduce costs relative to SMAW.

An Evaluation of Welding Processes to Reduce Hexavalent Chromium Exposures and Reduce Costs by Using Better Welding Techniques

PubMed Central

Keane, Michael J

2014-01-01

A group of stainless steel arc welding processes was compared for emission rates of fume and hexavalent chromium, and costs per meter length of weld. The objective was to identify those with minimal emissions and also compare relative labor and consumables costs. The selection included flux-cored arc welding (FCAW), shielded-metal arc welding (SMAW), and multiple gas metal arc welding (GMAW) processes. Using a conical chamber, fumes were collected, and fume generation rates and hexavalent chromium (Cr6+) were measured. GMAW processes used were short-circuit (SC) and pulsed-spray modes. Flux-cored welding used gas shielding. Costs were estimated per meter of a 6.3-mm thick horizontal butt weld. Emission rates of Cr6+ were lowest for GMAW processes and highest for SMAW; several GMAW processes had less than 2% of the SMAW generation rate. Labor and consumable costs for the processes studied were again highest for SMAW, with those of several GMAW types about half that cost. The results show that use of any of the GMAW processes (and flux-cored welding) could substantially reduce fume and Cr6+ emissions, and greatly reduce costs relative to SMAW. PMID:25574138

A prospective randomised study comparing the jubilee dressing method to a standard adhesive dressing for total hip and knee replacements.

PubMed

Burke, Neil G; Green, Connor; McHugh, Gavin; McGolderick, Niall; Kilcoyne, Carol; Kenny, Patrick

2012-08-01

It is important to reduce potential wound complications in total hip and total knee arthroplasty procedures. The purpose of this study was to compare the jubilee dressing method to a standard adhesive dressing. 124 patients (62 total hip replacements and 62 total knee replacements) were randomly selected to have either a standard adhesive dressing or jubilee method dressing. The number of dressing changes, incidence of blistering, leakage, appearance of inflammation, infection rate and the average stay in hospital was recorded for each patient. The jubilee dressing significantly reduced the rate of blistering, leakage and number of dressing changes when compare to a traditional adhesive dressing (p < 0.05). The rate of inflammation and average length of stay in hospital was not significantly different between the two groups. The authors recommend the use of this dressing for total hip and total knee arthroplasty procedures due to the associated lower complication rate. Copyright © 2012 Tissue Viability Society. Published by Elsevier Ltd. All rights reserved.

Effectiveness of forward collision warning and autonomous emergency braking systems in reducing front-to-rear crash rates.

PubMed

Cicchino, Jessica B

2017-02-01

The objective of this study was to evaluate the effectiveness of forward collision warning (FCW) alone, a low-speed autonomous emergency braking (AEB) system operational at speeds up to 19mph that does not warn the driver prior to braking, and FCW with AEB that operates at higher speeds in reducing front-to-rear crashes and injuries. Poisson regression was used to compare rates of police-reported crash involvements per insured vehicle year in 22 U.S. states during 2010-2014 between passenger vehicle models with FCW alone or with AEB and the same models where the optional systems were not purchased, controlling for other factors affecting crash risk. Similar analyses compared rates between Volvo 2011-2012 model S60 and 2010-2012 model XC60 vehicles with a standard low-speed AEB system to those of other luxury midsize cars and SUVs, respectively, without the system. FCW alone, low-speed AEB, and FCW with AEB reduced rear-end striking crash involvement rates by 27%, 43%, and 50%, respectively. Rates of rear-end striking crash involvements with injuries were reduced by 20%, 45%, and 56%, respectively, by FCW alone, low-speed AEB, and FCW with AEB, and rates of rear-end striking crash involvements with third-party injuries were reduced by 18%, 44%, and 59%, respectively. Reductions in rear-end striking crashes with third-party injuries were marginally significant for FCW alone, and all other reductions were statistically significant. FCW alone and low-speed AEB reduced rates of being rear struck in rear-end crashes by 13% and 12%, respectively, but FCW with AEB increased rates of rear-end struck crash involvements by 20%. Almost 1 million U.S. police-reported rear-end crashes in 2014 and more than 400,000 injuries in such crashes could have been prevented if all vehicles were equipped with FCW and AEB that perform similarly as systems did for study vehicles. Copyright © 2016 Elsevier Ltd. All rights reserved.

Highly Cross-Linked Polyethylene Reduces Osteolysis Incidence and Wear-Related Reoperation Rate in Cementless Total Hip Arthroplasty Compared With Conventional Polyethylene at a Mean 12-Year Follow-Up.

PubMed

Tsukamoto, Manabu; Mori, Toshiharu; Ohnishi, Hideo; Uchida, Soshi; Sakai, Akinori

2017-12-01

A number of studies on total hip arthroplasty have compared highly cross-linked polyethylene (HXLPE) with conventional polyethylene (CPE) liners beyond 10 years. However, the impact of HXLPE on the wear-related reoperation rate is unclear. The purpose of this study was to evaluate the clinical advantage of using a single manufacturer's HXLPE in terms of reducing the reoperation rate. The study was a follow-up retrospective cohort study over a mean of 12 years that examined patients aged 45-70 years with cementless total hip arthroplasty using a 26-mm-diameter cobalt-chromium head. Sixty-seven patients (79 hips; HXLPE group = 41 hips, CPE group = 38 hips) were evaluated for a minimum 10-year follow-up. Kaplan-Meier survival analysis was performed, with wear-related reoperations and radiographic osteolysis serving as the end points. The polyethylene wear rate was also assessed. The mean 12-year follow-up rates of survivorship that were evaluated using wear-related reoperations as the end point were 100% and 91.4% in the HXLPE and CPE groups, respectively (P = .007), and the mean 12-year follow-up rates of survivorship with osteolysis as the end point were 100% and 36.2%, respectively (P < .001). Compared with the CPE group, the HXLPE group presented a significantly reduced wear rate (HXLPE group, 0.035 mm/y; CPE group, 0.118 mm/y). A unique strength of this study is that we assessed a single manufacturer's HXLPE while keeping most other implant parameters uniform. This study reveals the clinical advantage of using a single manufacturer's HXLPE in terms of a reduced wear-related reoperation rate at a mean 12-year follow-up. Copyright © 2017 Elsevier Inc. All rights reserved.

Effects of age and gender on elderly suicide rates in Catholic and Orthodox countries: an inadvertent neglect?

PubMed

Pritchard, C; Baldwin, D

2000-10-01

When compared to suicide rates in the general population, it may be expected that elderly suicide rates would be lower in Catholic and Orthodox societies than in non-Catholic or non-Orthodox countries because of religious affiliations and extended family traditions. National suicide rates in the general population were compared with rates in the sub-population of those aged over 75 years. Proportionately, there are significantly higher suicide rates in elderly men in Catholic and Orthodox countries, compared to rates in other countries, with a trend for similar findings among women. There may be important implications on health and social policy and clinical practice in the efforts to reduce suicide rates among elderly people. Copyright 2000 John Wiley & Sons, Ltd.

Impact of autofluorescence-based identification of parathyroids during total thyroidectomy on postoperative hypocalcemia: a before and after controlled study.

PubMed

Benmiloud, Fares; Rebaudet, Stanislas; Varoquaux, Arthur; Penaranda, Guillaume; Bannier, Marie; Denizot, Anne

2018-01-01

The clinical impact of intraoperative autofluorescence-based identification of parathyroids using a near-infrared camera remains unknown. In a before and after controlled study, we compared all patients who underwent total thyroidectomy by the same surgeon during Period 1 (January 2015 to January 2016) without near-infrared (near-infrared- group) and those operated on during Period 2 (February 2016 to September 2016) using a near-infrared camera (near-infrared+ group). In parallel, we also compared all patients who underwent surgery without near-infrared during those same periods by another surgeon in the same unit (control groups). Main outcomes included postoperative hypocalcemia, parathyroid identification, autotransplantation, and inadvertent resection. The near-infrared+ group displayed significantly lower postoperative hypocalcemia rates (5.2%) than the near-infrared- group (20.9%; P < .001). Compared with the near-infrared- patients, the near-infrared+ group exhibited an increased mean number of identified parathyroids and reduced parathyroid autotransplantation rates, although no difference was observed in inadvertent resection rates. Parathyroids were identified via near-infrared before they were visualized by the surgeon in 68% patients. In the control groups, parathyroid identification improved significantly from Period 1 to Period 2, although autotransplantation, inadvertent resection and postoperative hypocalcemia rates did not differ. Near-infrared use during total thyroidectomy significantly reduced postoperative hypocalcemia, improved parathyroid identification and reduced their autotransplantation rate. Copyright © 2017 Elsevier Inc. All rights reserved.

Effect of 3 Weeks Use of Compression Garments on Stride and Impact Shock during a Fatiguing Run.

PubMed

Lucas-Cuevas, A G; Priego-Quesada, J I; Aparicio, I; Giménez, J V; Llana-Belloch, S; Pérez-Soriano, P

2015-10-01

Excessive and prolonged exposure to impact acceleration during running is associated with increased injury rate. Acute use of compressive garments has been speculated to improve attenuation. However, it is unknown how longer interventions of compressive garments influence attenuation in running. 40 runners trained with compressive and placebo stockings for 3 weeks. Perception of comfort, stride parameters (rate, length) and impact acceleration (head and tibial peak acceleration, magnitude, acceleration rate and attenuation) were measured every 5 min during a fatigue run (30 min at 80% of the individual's maximal aerobic speed). Compressive stockings reduced tibial peak acceleration and magnitude compared to placebo stockings at every minute (p<0.05) except for the initial measurement (p>0.05). Moreover, compressive stockings led to a lower rate of increase in tibial peak acceleration (14%, p<0.005) and magnitude (16%, p<0.001) as a result of the development of fatigue compared to placebo stockings (24% and 26% increase, p=0.014 and p=0.003, respectively). Similar perception of comfort was reported for both garments. Training with compressive stockings for 3 weeks reduced impact acceleration and the rate of increase in acceleration compared to placebo stockings. These findings suggest that compressive stockings may play a protective role by reducing impact accelerations during running. © Georg Thieme Verlag KG Stuttgart · New York.

Embryo reduction versus expectant management in triplet pregnancies.

PubMed

Antsaklis, A; Souka, A P; Daskalakis, G; Papantoniou, N; Koutra, P; Kavalakis, Y; Mesogitis, S

2004-10-01

In triplet pregnancies, to compare pregnancy outcome of expectant management with that after embryo reduction to twins. Retrospective study of 255 trichorionic triplet pregnancies, of which 185 had embryo reduction to twins (reduced group) and 70 were managed expectantly (non-reduced group). Median birth weight was higher by about 500 g and gestation prolonged by about 3 weeks in the reduced pregnancies compared with the expectantly managed pregnancies (2300 vs. 1760 g; 36 vs. 33 weeks). The rates of preterm delivery were significantly lower in the reduced group (11.17 vs. 36.76% for delivery at < or = 32 weeks and 40.58 vs. 83.82% for delivery at < or = 35 weeks, reduced vs. non-reduced group). The percentage of infants born with low birth weight was significantly higher in the expectantly managed triplets (10.98 vs. 28.44% for birth weight < or = 1500 g and 68.55 vs. 92.89% for birth weight < or = 2500 g, reduced vs. non-reduced group). Total fetal loss was significantly higher in the reduced group than in the non-reduced group (15.41 and 4.76%, respectively) and the difference was mainly due to the higher miscarriage rate in the reduced group (8.11 vs. 2.86% in the non-reduced group). With the expected rates of handicap in preterm infants, we would anticipate 0.63% of severely handicapped children due to extreme prematurity in the reduced group and 1.64% in the non-reduced group. In triplet pregnancies, embryo reduction to twins significantly reduces the risk of severe preterm delivery and very low birth weight by about one-third, at the expense of a significant increase in total fetal loss, by about one-quarter. The procedure is likely to reduce the risk of having a severely handicapped child due to extreme prematurity.

Using Aminocaproic Acid to Reduce Blood Loss After Primary Unilateral Total Knee Arthroplasty.

PubMed

Churchill, Jessica L; Toney, Victor A; Truchan, Susan; Anderson, Michael J

2016-01-01

xtensive blood loss after total knee arthroplasty (TKA) is common, and affected patients often require blood transfusions. Studies suggest that antifibrinolytic agents such as aminocaproic acid (ACA) reduce blood loss and blood transfusion rates in patients undergoing TKA. We conducted a study to evaluate whether a single intravenous 10-g dose of ACA given during primary unilateral TKA would decrease perioperative blood loss, raise postoperative hemoglobin levels, and reduce postoperative blood transfusion rates. We retrospectively reviewed the charts of 50 comparable cemented primary unilateral TKAs. Twenty-five patients had been given a single intraoperative 10-g dose of ACA (antifibrinolytic group), and the other 25 had not been given ACA (control group). Postoperative drain output was decreased significantly (P < .0001) in the antifibrinolytic group (155 mL) compared with the control group (410 mL), as was the number of units of blood transfused after surgery (antifibrinolytic group, 0 units; control group, 10 units; P < .002). There were no adverse events in the antifibrinolytic group. In TKA, perioperative blood loss and blood transfusion rates were reduced significantly in patients given a single intraoperative intravenous 10-g dose of ACA compared with patients not given antifibrinolytics. The positive effects of ACA were obtained without adverse events or complications.

Post-fire mulching for runoff and erosion mitigation; Part I: Effectiveness at reducing hillslope erosion rates

Treesearch

Peter R. Robichaud; Sarah A. Lewis; Joseph W. Wagenbrenner; Louise E. Ashmun; Robert E. Brown

2013-01-01

Mulch treatments often are used to mitigate post-fire increases in runoff and erosion rates but the comparative effectiveness of various mulches is not well established. The ability of mulch treatments to reduce sediment yields from natural rainfall and resulting overland flow was measured using hillslope plots on areas burned at high severity following four wildfires...

Preventing Australian football injuries with a targeted neuromuscular control exercise programme: comparative injury rates from a training intervention delivered in a clustered randomised controlled trial.

PubMed

Finch, Caroline F; Twomey, Dara M; Fortington, Lauren V; Doyle, Tim L A; Elliott, Bruce C; Akram, Muhammad; Lloyd, David G

2016-04-01

Exercise-based training programmes are commonly used to prevent sports injuries but programme effectiveness within community men's team sport is largely unknown. To present the intention-to-treat analysis of injury outcomes from a clustered randomised controlled trial in community Australian football. Players from 18 male, non-elite, community Australian football clubs across two states were randomly allocated to either a neuromuscular control (NMC) (intervention n=679 players) or standard-practice (control n=885 players) exercise training programme delivered as part of regular team training sessions (2× weekly for 8-week preseason and 18-week regular-season). All game-related injuries and hours of game participation were recorded. Generalised estimating equations, adjusted for clustering (club unit), were used to compute injury incidence rates (IIRs) for all injuries, lower limb injuries (LLIs) and knee injuries sustained during games. The IIRs were compared across groups with cluster-adjusted Injury Rate Ratios (IRRs). Overall, 773 game injuries were recorded. The lower limb was the most frequent body region injured, accounting for 50% of injuries overall, 96 (12%) of which were knee injuries. The NMC players had a reduced LLI rate compared with control players (IRR: 0.78 (95% CI 0.56 to 1.08), p=0.14.) The knee IIR was also reduced for NMC compared with control players (IRR: 0.50 (95% CI 0.24 to 1.05), p=0.07). These intention-to-treat results indicate that positive outcomes can be achieved from targeted training programmes for reducing knee and LLI injury rates in men's community sport. While not statistically significant, reducing the knee injury rate by 50% and the LLI rate by 22% is still a clinically important outcome. Further injury reductions could be achieved with improved training attendance and participation in the programme. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Modeling the Rate-Dependent Durability of Reduced-Ag SAC Interconnects for Area Array Packages Under Torsion Loads

NASA Astrophysics Data System (ADS)

Srinivas, Vikram; Menon, Sandeep; Osterman, Michael; Pecht, Michael G.

2013-08-01

Solder durability models frequently focus on the applied strain range; however, the rate of applied loading, or strain rate, is also important. In this study, an approach to incorporate strain rate dependency into durability estimation for solder interconnects is examined. Failure data were collected for SAC105 solder ball grid arrays assembled with SAC305 solder that were subjected to displacement-controlled torsion loads. Strain-rate-dependent (Johnson-Cook model) and strain-rate-independent elastic-plastic properties were used to model the solders in finite-element simulation. Test data were then used to extract damage model constants for the reduced-Ag SAC solder. A generalized Coffin-Manson damage model was used to estimate the durability. The mechanical fatigue durability curve for reduced-silver SAC solder was generated and compared with durability curves for SAC305 and Sn-Pb from the literature.

Electrical conductivity and rate-capability of Li 4Ti 5O 12 as a function of heat-treatment atmosphere

NASA Astrophysics Data System (ADS)

Wolfenstine, J.; Lee, U.; Allen, J. L.

Recently there has considerable interest in Li 4Ti 5O 12 as a potential anode for use in Li-ion batteries [1-8]. It has many advantages compared to the currently used graphite. For example, it is a zero-strain lithium insertion host suggesting virtually unlimited cycle life. It features a flat, operating voltage of about 1.5 V versus lithium, above the reduction potential of common electrolyte solvents thus, it does not form a solid electrolyte interface based on solvent reduction which should be a favorable property for high rate and low temperature operation. This voltage also is sufficiently high such that the dangers of lithium plating that can occur at high rate and/or low temperature are removed. However, several disadvantages exist compared to graphite. These include low rate-capability as a result of its low electronic conductivity [6]. Consequently, there have been several studies which have focused on improving electronic conductivity with the intent of improving its rate-capability [4,6,8]. For example, recently Huang et al. [8] have shown that the formation of a Li 4Ti 5O 12/Cu xO composite anode that was formed by heat-treatment under a 3 vol.% H 2 in N 2 atmosphere at high rates (>2C) had a higher capacity over a similar powders heat-treated under air. For example, at 10C the capacity of the powders heated under the 3 vol.% H 2 in N 2 atmosphere was about 1.8 X that for the powders heated under air and was attributed to the higher electrical conductivity of the composite heated under the reducing atmosphere compared to under air. The electrical conductivity of the composite formed under the reducing atmosphere was about an order magnitude higher than that for the composite heated under air. Huang et al. [8] suggested that the improved electrical conductivity was a result of the reduction of some Ti 4+ to Ti 3+ in Li 4Ti 5O 12 and/or reduction of Cu 2+/Cu + in Cu xO to Cu metal under the reducing atmosphere. However, they did not separate these effects. For example, they did not compare the results of the Li 4Ti 5O 12 matrix material heated under the reducing atmosphere to that for heat-treatment under air. It is the purpose of this letter to investigate and compare the electronic conductivity and rate-capability of Li 4Ti 5O 12 heated under a reducing atmosphere to that for heat-treatment under air and to determine the contribution of the Li 4Ti 5O 12 matrix to the excellent rate-capability of the Li 4Ti 5O 12/Cu xO composite heated under a reducing atmosphere.

The comparative effects of ICI 118551 and propranolol on essential tremor.

PubMed Central

Jefferson, D; Wharrad, H J; Birmingham, A T; Patrick, J M

1987-01-01

1. The effects of the selective beta 2-adrenoceptor antagonist ICI 118551 on essential tremor, heart rate and blood pressure were compared with those of propranolol. 2. ICI 118551 (150 mg daily for 7 days) and propranolol (120 mg daily for 7 days) were about equally effective in reducing essential tremor (by about 40%) and were more effective than placebo. 3. When compared with the effect of placebo, propranolol reduced blood pressure and exercise heart rate whereas ICI 118551 had no significant effect on blood pressure and produced a small but significant reduction in exercise-induced tachycardia. 4. ICI 118551 may be useful in the management of essential tremor while having fewer cardiovascular side-effects than non-selective beta-adrenoceptor antagonists. PMID:2894217

Very high rate programming in primary prevention patients with reduced ejection fraction implanted with a defibrillator: Results from a large multicenter controlled study.

PubMed

Clementy, Nicolas; Challal, Farid; Marijon, Eloi; Boveda, Serge; Defaye, Pascal; Leclercq, Christophe; Deharo, Jean-Claude; Sadoul, Nicolas; Klug, Didier; Piot, Olivier; Gras, Daniel; Bordachar, Pierre; Algalarrondo, Vincent; Fauchier, Laurent; Babuty, Dominique

2017-02-01

Programming implantable cardioverter-defibrillators (ICDs) with a high-rate therapy strategy has proven to be effective in reducing shocks and is associated with a reduced mortality. We sought to determine the impact of a very high rate cutoff programming strategy on outcomes in patients with a primary indication for an ICD due to reduced left ventricular ejection fraction. Using data from the multicenter French DAI-PP registry, this cohort-controlled study compared outcomes in 500 patients programmed with a very high rate cutoff (VH-RATE group: monitor zone 170-219 beats/min; ventricular fibrillation zone ≥220 beats/min with 13 ± 4 detection intervals) with 1500 matched control patients programmed with 1 or 2 therapy zone. All ICDs were implanted for primary prevention in patients with systolic dysfunction. Risks of events were compared after propensity score matching of sex, age, ejection fraction, New York Heart Association class, cardiomyopathy, atrial fibrillation, and type of device. After a mean follow-up of 3.6 ± 2.3 years, VH-RATE programming was associated with a reduction of appropriate therapy risk (hazard ratio [HR] 0.40; 95% confidence interval [CI] 0.31-0.51; P < .0001) and inappropriate shock (HR 0.42; 95% CI 0.27-0.63; P < .0001). It was also associated with a decreased risk of sudden cardiac death (HR 0.43; 95% CI 0.17-0.99; P = .04) as compared with patients programmed with 2 therapy zones. There was no significant difference in overall survival between the groups. In patients implanted with an ICD in primary prevention with left ventricular dysfunction, very high rate cutoff programming (single therapy zone ≥220 beats/min) was associated with a 60% reduction of appropriate therapies as well as inappropriate shocks, without affecting mortality. Copyright © 2016 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

Corneal Sensitivity in Tear Dysfunction and its Correlation with Clinical Parameters and Blink Rate

PubMed Central

Rahman, Effie Z.; Lam, Peter K.; Chu, Chia-Kai; Moore, Quianta; Pflugfelder, Stephen C.

2015-01-01

Purpose To compare corneal sensitivity in tear dysfunction due to a variety of causes using contact and non-contact esthesiometers and to evaluate correlations between corneal sensitivity, blink rate and clinical parameters. Design Comparative observational case series. Methods Ten normal and 33 subjects with tear dysfunction [meibomian gland disease (n = 11), aqueous tear deficiency (n = 10) - without (n = 7) and with (n = 3) Sjögren syndrome (SS) and conjunctivochalasis (n = 12)] were evaluated. Corneal sensitivity was measured with Cochet-Bonnet and air jet esthesiometers and blink rate by electromyelography. Eye irritation symptoms, tear meniscus height, tear break-up time (TBUT), and corneal and conjunctival dye staining were measured. Between group means were compared and correlations calculated. Results Compared with control (Cochet-Bonnet 5.45 mm, air esthesiometer 3.62 mg), mean sensory thresholds were significantly higher in aqueous tear deficiency using either Cochet-Bonnet (3.6 mm; P = 0.003) or air (11.7 mg; P = 0.046) esthesiometers, but were not significantly different in the other groups. Reduced corneal sensitivity significantly correlated with more rapid TBUT and blink rate, and greater irritation and ocular surface dye staining with one or both esthesiometers. Mean blink rates were significantly higher in both aqueous tear deficiency and conjunctivochalasis compared with control. Among all subjects, blink rate positively correlated with ocular surface staining and irritation and inversely correlated with TBUT. Conclusion Amongst conditions causing tear dysfunction, reduced corneal sensitivity is associated with greater irritation, tear instability, ocular surface disease and blink rate. Rapid blinking is associated with worse ocular surface disease and tear stability. PMID:26255576

Injury Rates on New and Old Technology Oil and Gas Rigs Operated by the Largest United States Onshore Drilling Contractor

PubMed Central

Blackley, David J.; Retzer, Kyla D.; Hubler, Warren G.; Hill, Ryan D.; Laney, A. Scott

2015-01-01

Background Occupational fatality rates among oil and gas extraction industry and specifically among drilling contractor workers are high compared to the U.S. all-industry average. There is scant literature focused on non-fatal injuries among drilling contractors, some of which have introduced engineering controls to improve rig efficiency and reduce injury risk. Methods We compared injury rates on new and old technology rigs operated by the largest U.S. drilling contractor during 2003–2012, stratifying by job type and grouping outcomes by injury severity and body part affected. Results Six hundred seventy-one injuries were recorded over 77.4 million person-hours. The rate on new rigs was 66% of that on old rigs. Roughnecks had lower injury rates on new rigs, largely through reduced limb injury rates. New rigs had lower rates in each non-fatal injury severity category. Conclusions For this company, new technology rigs appear to provide a safer environment for roughnecks. Future studies could include data from additional companies. PMID:25164118

Injury rates on new and old technology oil and gas rigs operated by the largest United States onshore drilling contractor.

PubMed

Blackley, David J; Retzer, Kyla D; Hubler, Warren G; Hill, Ryan D; Laney, A Scott

2014-10-01

Occupational fatality rates among oil and gas extraction industry and specifically among drilling contractor workers are high compared to the U.S. all-industry average. There is scant literature focused on non-fatal injuries among drilling contractors, some of which have introduced engineering controls to improve rig efficiency and reduce injury risk. We compared injury rates on new and old technology rigs operated by the largest U.S. drilling contractor during 2003-2012, stratifying by job type and grouping outcomes by injury severity and body part affected. Six hundred seventy-one injuries were recorded over 77.4 million person-hours. The rate on new rigs was 66% of that on old rigs. Roughnecks had lower injury rates on new rigs, largely through reduced limb injury rates. New rigs had lower rates in each non-fatal injury severity category. For this company, new technology rigs appear to provide a safer environment for roughnecks. Future studies could include data from additional companies. © 2014 Wiley Periodicals, Inc.

Reducing Non-Attendance Rates for Assessment at an Eating Disorders Service: A Quality Improvement Initiative.

PubMed

Jenkins, Paul E

2017-10-01

Rates of non-attendance at initial appointments within community eating disorder (ED) services are frequently high, although this has received relatively little research attention and no reports of interventions designed to address this. The current report describes outcomes following a change of procedure introducing a 'partial booking' system. Attendance rates at first appointments (N = 1260) were audited following introduction of a system designed to reduce non-attendance in January 2013 within a UK ED service. Rates were compared following implementation of the new system, using a historical control group for comparison, and showed a decline from 20.4 to 15.1%, a medium-sized effect. Use of a system asking patients to book an appointment reduced non-attendance at initial appointments and may be of use to similar services experiencing high non-attendance rates. Opt-in initiatives can reduce burden resulting from long waiting times and can be easily adapted to individual services.

The Efficacy of Chinese Medicinal Herbs towards Grape Phylloxera (Daktulosphaira vitifoliae Fitch) (Hemiptera, Phylloxeridae)

PubMed Central

Su, Junping; Liu, Weiwei; Hussain Dhiloo, Khalid; Guo, Yuyuan

2015-01-01

Bio-insecticidal effects of seven Chinese medicinal herbs on mortality, fecundity, developmental periods and life table parameters of the grape phylloxera were investigated. In an excised root bioassay experiment aqueous extracts from seven Chinese medicinal herbs increased grape phylloxera first instar mortality (26.00–38.50%) compared to other instars. The intrinsic rate of increase (rm), finite rate of increase (λ), fecundity rate and net reproductive rate (R0) were significantly reduced by A. bidentata, A. tataricus, O. basilicum, P. frutescens and N. cataria. In a glasshouse pot trial, eggs, nymphs, adults and total population were significantly reduced before population establishment compared to those after its population established, by A. bidentata, A. tataricus and O. basilicum. Overall, A. bidentata, A. tataricus and O. basilicum can be used to suppress all life-stages of grape phylloxera. PMID:26186216

Do workplace interventions reduce disability rates?

PubMed Central

Nielsen, R. A.

2016-01-01

Background Increasing life expectancy and decreasing fertility have led to a shift in the workforce age structure towards older age groups. Deteriorating health and reduced work capacity are among the challenges to retaining older workers in the labour force. Aims To examine whether workplace interventions to facilitate work among employees with health problems or reduced work capacity affect disability rates among employees aged 50 years and older. Methods Data from a survey of Norwegian companies (n = 713) were linked with registry data on their employees aged 50-61 years (n = 30771). By means of a difference-in-differences approach, we compared change in likelihood of receiving a full disability pension among employees in companies with and without workplace interventions. Results Employees in companies reporting to have workplace interventions in 2005 had a higher risk of receiving full disability pension during the period 2001-03 compared with employees in companies without such interventions [odds ratio (OR) 1.25, 95% confidence interval (CI) 1.07-1.45]. During the period 2005-07, there was an overall reduction in disability rates (OR 0.83, 95% CI 0.71-0.96) in both the intervention and control group. However, employees in companies reporting to have interventions in 2005 experienced an additional reduction in an employee’s likelihood of receiving a full disability pension (OR 0.80, 95% CI 0.64-0.99) compared with employees in companies without interventions. Conclusions Interventions to facilitate work among employees with health problems or reduced work capacity have reduced disability rates among employees aged 50-61. This suggests that companies’ preventive interventions are an effective means to retain older workers with deteriorating health. PMID:27986798

Early Dysphagia Screening by Trained Nurses Reduces Pneumonia Rate in Stroke Patients: A Clinical Intervention Study.

PubMed

Palli, Christoph; Fandler, Simon; Doppelhofer, Kathrin; Niederkorn, Kurt; Enzinger, Christian; Vetta, Christian; Trampusch, Esther; Schmidt, Reinhold; Fazekas, Franz; Gattringer, Thomas

2017-09-01

Dysphagia is a common stroke symptom and leads to serious complications such as aspiration and pneumonia. Early dysphagia screening can reduce these complications. In many hospitals, dysphagia screening is performed by speech-language therapists who are often not available on weekends/holidays, which results in delayed dysphagia assessment. We trained the nurses of our neurological department to perform formal dysphagia screening in every acute stroke patient by using the Gugging Swallowing Screen. The impact of a 24/7 dysphagia screening (intervention) over swallowing assessment by speech-language therapists during regular working hours only was compared in two 5-month periods with time to dysphagia screening, pneumonia rate, and length of hospitalization as outcome variables. Overall, 384 patients (mean age, 72.3±13.7 years; median National Institutes of Health Stroke Scale score of 3) were included in the study. Both groups (pre-intervention, n=198 versus post-intervention, n=186) were comparable regarding age, sex, and stroke severity. Time to dysphagia screening was significantly reduced in the intervention group (median, 7 hours; range, 1-69 hours) compared with the control group (median, 20 hours; range, 1-183; P =0.001). Patients in the intervention group had a lower rate of pneumonia (3.8% versus 11.6%; P =0.004) and also a reduced length of hospital stay (median, 8 days; range, 2-40 versus median, 9 days; range, 1-61 days; P =0.033). 24/7 dysphagia screening can be effectively performed by nurses and leads to reduced pneumonia rates. Therefore, empowering nurses to do a formal bedside screening for swallowing dysfunction in stroke patients timely after admission is warranted whenever speech-language therapists are not available. © 2017 American Heart Association, Inc.

Do workplace interventions reduce disability rates?

PubMed

Midtsundstad, T I; Nielsen, R A

2016-12-01

Increasing life expectancy and decreasing fertility have led to a shift in the workforce age structure towards older age groups. Deteriorating health and reduced work capacity are among the challenges to retaining older workers in the labour force. To examine whether workplace interventions to facilitate work among employees with health problems or reduced work capacity affect disability rates among employees aged 50 years and older. Data from a survey of Norwegian companies (n = 713) were linked with registry data on their employees aged 50-61 years (n = 30771). By means of a difference-in-differences approach, we compared change in likelihood of receiving a full disability pension among employees in companies with and without workplace interventions. Employees in companies reporting to have workplace interventions in 2005 had a higher risk of receiving full disability pension during the period 2001-03 compared with employees in companies without such interventions [odds ratio (OR) 1.25, 95% confidence interval (CI) 1.07-1.45]. During the period 2005-07, there was an overall reduction in disability rates (OR 0.83, 95% CI 0.71-0.96) in both the intervention and control group. However, employees in companies reporting to have interventions in 2005 experienced an additional reduction in an employee's likelihood of receiving a full disability pension (OR 0.80, 95% CI 0.64-0.99) compared with employees in companies without interventions. Interventions to facilitate work among employees with health problems or reduced work capacity have reduced disability rates among employees aged 50-61. This suggests that companies' preventive interventions are an effective means to retain older workers with deteriorating health. © The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Rearrest and linkage to mental health services among clients of the Clark County mental health court program.

PubMed

Herinckx, Heidi A; Swart, Sandra C; Ama, Shane M; Dolezal, Cheri D; King, Steve

2005-07-01

This study examined rearrest and linkage to mental health services among 368 misdemeanants with severe and persistent mental illness who were served by the Clark County Mental Health Court (MHC). This court, established in April 2000, is based on the concepts of therapeutic jurisprudence. This study addressed the following questions about the effectiveness of the Clark County MHC: Did MHC clients receive more comprehensive mental health services? Did the MHC successfully reduce recidivism? Were there any client or program characteristics associated with recidivism? A secondary analysis of use of mental health services and jail data for the MHC clients enrolled from April 2000 through April 2003 was conducted. The authors used a 12-month pre-post comparison design to determine whether MHC participants experienced reduced rearrest rates for new offenses, reduced probation violations, and increased mental health services 12 months postenrollment in the MHC compared with 12 months preenrollment. The overall crime rate for MHC participants was reduced 4.0 times one year postenrollment in the MHC compared with one year preenrollment. One year postenrollment, 54 percent of participants had no arrests, and probation violations were reduced by 62 percent. The most significant factor in determining the success of MHC participants was graduation status from the MHC, with graduates 3.7 times less likely to reoffend compared with nongraduates. The Clark County MHC successfully reduced rearrest rates for new criminal offenses and probation violations and provided the mental health support services to stabilize mental health consumers in the community.

The effect of four-phasic versus three-phasic contrast media injection protocols on extravasation rate in coronary CT angiography: a randomized controlled trial.

PubMed

Karády, Júlia; Panajotu, Alexisz; Kolossváry, Márton; Szilveszter, Bálint; Jermendy, Ádám L; Bartykowszki, Andrea; Károlyi, Mihály; Celeng, Csilla; Merkely, Béla; Maurovich-Horvat, Pál

2017-11-01

Contrast media (CM) extravasation is a well-known complication of CT angiography (CTA). Our prospective randomized control study aimed to assess whether a four-phasic CM administration protocol reduces the risk of extravasation compared to the routinely used three-phasic protocol in coronary CTA. Patients referred to coronary CTA due to suspected coronary artery disease were included in the study. All patients received 400 mg/ml iomeprol CM injected with dual-syringe automated injector. Patients were randomized into a three-phasic injection-protocol group, with a CM bolus of 85 ml followed by 40 ml of 75%:25% saline/CM mixture and 30 ml saline chaser bolus; and a four-phasic injection-protocol group, with a saline pacer bolus of 10 ml injected at a lower flow rate before the three-phasic protocol. 2,445 consecutive patients were enrolled (mean age 60.6 ± 12.1 years; females 43.6%). Overall rate of extravasation was 0.9% (23/2,445): 1.4% (17/1,229) in the three-phasic group and 0.5% (6/1,216) in the four-phasic group (p = 0.034). Four-phasic CM administration protocol is easy to implement in the clinical routine at no extra cost. The extravasation rate is reduced by 65% with the application of the four-phasic protocol compared to the three-phasic protocol in coronary CTA. • Four-phasic CM injection-protocol reduces extravasation rate by 65% compared to three-phasic. • The saline pacer bolus substantially reduces the risk of CM extravasation. • The implementation of four-phasic injection-protocol is at no cost.

Comparison of orally administered bisphosphonate drugs in reducing the risk of hip fracture in older adults: a population-based cohort study.

PubMed

Cadarette, Suzanne M; Lévesque, Linda; Mamdani, Muhammad; Perreault, Sylvie; Juurlink, David N; Paterson, J Michael; Carney, Greg; Gunraj, Nadia; Hawker, Gillian A; Tadrous, Mina; Wong, Lindsay; Dormuth, Colin R

2013-09-01

Orally administered bisphosphonate drugs (i.e., alendronate, etidronate, risedronate) can reduce the risk of vertebral fracture. However, only alendronate and risedronate have proven efficacy in reducing the risk of hip fracture. We sought to examine the comparative effectiveness of orally administered bisphosphonate drugs in reducing hip fractures among older adults. We identified new users of orally administered bisphosphonate drugs in British Columbia and Ontario between 2001 and 2008. We used province- and sex-specific propensity score-matching strategies to maximize comparability between exposure groups. We used Cox proportional hazards models to compare time-to-hip fracture within 1 year of treatment between exposures by sex in each province. Our secondary analyses considered hip fracture rates within 2 and 3 years' follow-up. We used alendronate as the reference for all comparisons and pooled provincial estimates using random effects variance-weighted meta-analysis. We identified 321 755 patients who were eligible for inclusion in the study. We found little difference in fracture rates between men (pooled hazard ratio [HR] 0.94, 95% confidence interval [CI] 0.74-1.14) or women (pooled HR 1.15, 95% CI 0.73-1.56) taking risedronate and those taking alendronate. We similarly identified little difference in fracture rates between women taking etidronate and those taking alendronate (pooled HR 1.00, 95% CI 0.82-1.18). However, we identified lower rates of hip fracture among men taking etidronate relative to alendronate (pooled HR 0.77, 95% CI 0.60-0.94). Results extended to 2 and 3 years' follow-up were similar. However, with 3 years' follow-up, rates of hip fracture were lower among women in British Columbia who had taken alendronate. We identified little overall difference between alendronate and risedronate in reducing the risk of hip fracture in men or women. Our finding that etidronate is associated with lower fracture risk among men is likely due to selection bias. The long-term comparative effects of orally administered bisphosphonate drugs warrant further study.

Reduced Tic Symptomatology in Tourette Syndrome After an Acute Bout of Exercise: An Observational Study.

PubMed

Nixon, Elena; Glazebrook, Cris; Hollis, Chris; Jackson, Georgina M

2014-03-01

In light of descriptive accounts of attenuating effects of physical activity on tics, we used an experimental design to assess the impact of an acute bout of aerobic exercise on tic expression in young people (N = 18) with Tourette Syndrome (TS). We compared video-based tic frequency estimates obtained during an exercise session with tic rates obtained during pre-exercise (baseline) and post-exercise interview-based sessions. Results showed significantly reduced tic rates during the exercise session compared with baseline, suggesting that acute exercise has an attenuating effect on tics. Tic rates also remained reduced relative to baseline during the post-exercise session, likely reflecting a sustained effect of exercise on tic reduction. Parallel to the observed tic attenuation, exercise also had a beneficial impact on self-reported anxiety and mood levels. The present findings provide novel empirical evidence for the beneficial effect of exercise on TS symptomatology bearing important research and clinical implications. © The Author(s) 2014.

Differential effects of total and partial sleep deprivation on salivary factors in Wistar rats.

PubMed

Lasisi, Dr T J; Shittu, S T; Meludu, C C; Salami, A A

2017-01-01

Aim of this study was to investigate the effects of sleep deprivation on salivary factors in rats. Animals were randomly assigned into three groups of 6 animals each as control, total sleep deprivation (TSD) and partial sleep deprivation (PSD) groups. The multiple platform method was used to induce partial and total sleep deprivation for 7days. On the 8th day, stimulated saliva samples were collected for the analysis of salivary lag time, flow rate, salivary amylase activity, immunoglobulin A secretion rate and corticosterone levels using ELISA and standard kinetic enzyme assay. Data were analyzed using ANOVA with Dunnett T3 post hoc tests. Salivary flow rate reduced significantly in the TSD group compared with the PSD group as well as the control group (p=0.01). The secretion rate of salivary IgA was significantly reduced in the TSD group compared with the control group (p=0.04). Salivary amylase activity was significantly elevated in the TSD group compared with the PSD group as well as control group (p<0.001). However, there were no significant changes in the salivary lag time and levels of corticosterone among the groups. These findings suggest that total sleep deprivation is associated with reduced salivary flow rate and secretion rate of IgA as well as elevated levels of salivary amylase activity in rats. However, sleep recovery of four hours in the PSD group produced ameliorative effects on the impaired functions of salivary glands. Copyright © 2016 Elsevier Ltd. All rights reserved.

Pre-emptive intrathecal vancomycin therapy reduces external ventricular drain infection: a single centre retrospective case-control study.

PubMed

Fu, Richard Z; Anwar, Durria R; Laban, James T; Maratos, Eleni C; Minhas, Pawanjit S; Martin, Andrew J

2017-02-01

External ventricular drain (EVD)-related infection is a significant source of morbidity in neurosurgical patients. Recently, there has been a drive to adopt new catheters with bactericidal properties to reduce infection rates. We propose that the use of standard catheters combined with pre-emptive intrathecal vancomycin (ITV) 10 mg daily provides an effective alternative. Retrospective study of all patients with EVDs between 2010 and 2012, comparing infection rates in those who did and did not receive pre-emptive ITV. All EVDs were of the standard silicon catheter type. CSF infection was defined, as per Centre for Disease Control (CDC) guidelines, as clinical suspicion ± positive CSF gram stain/culture or leucocytosis. Infection rates were compared using Pearson's chi-squared test. 262 EVDs were included in the study, of which 111 were managed with pre-emptive ITV. The infection rate was 2.7% in the vancomycin group and 11.9% in the control group (p<.01). There were no cases of vancomycin-resistant infection in either group. The use of pre-emptive ITV is associated with a significantly lower EVD infection rate. This compares favourably with those reported in the literature for bactericidal catheters.

High-Frame-Rate Doppler Ultrasound Using a Repeated Transmit Sequence

PubMed Central

Podkowa, Anthony S.; Oelze, Michael L.; Ketterling, Jeffrey A.

2018-01-01

The maximum detectable velocity of high-frame-rate color flow Doppler ultrasound is limited by the imaging frame rate when using coherent compounding techniques. Traditionally, high quality ultrasonic images are produced at a high frame rate via coherent compounding of steered plane wave reconstructions. However, this compounding operation results in an effective downsampling of the slow-time signal, thereby artificially reducing the frame rate. To alleviate this effect, a new transmit sequence is introduced where each transmit angle is repeated in succession. This transmit sequence allows for direct comparison between low resolution, pre-compounded frames at a short time interval in ways that are resistent to sidelobe motion. Use of this transmit sequence increases the maximum detectable velocity by a scale factor of the transmit sequence length. The performance of this new transmit sequence was evaluated using a rotating cylindrical phantom and compared with traditional methods using a 15-MHz linear array transducer. Axial velocity estimates were recorded for a range of ±300 mm/s and compared to the known ground truth. Using these new techniques, the root mean square error was reduced from over 400 mm/s to below 50 mm/s in the high-velocity regime compared to traditional techniques. The standard deviation of the velocity estimate in the same velocity range was reduced from 250 mm/s to 30 mm/s. This result demonstrates the viability of the repeated transmit sequence methods in detecting and quantifying high-velocity flow. PMID:29910966

Low Carbohydrate and Moderately Fat-Reduced Diets Similarly Affected Early Weight Gain in Varenicline-Treated Overweight or Obese Smokers.

PubMed

Heggen, Eli; Svendsen, Mette; Klemsdal, Tor Ole; Tonstad, Serena

2016-06-01

Weight gain is common when stopping smoking. This study compared the effect of advising smokers to follow a diet low in carbohydrates versus a usual fat-reduced diet on weight gain and nicotine withdrawal. In a randomized clinical trial, 122 men and women smokers with body mass index 25-40kg/m(2) were assigned low-carbohydrate versus moderately fat-reduced diets. Within a week thereafter all participants started treatment with a 12-week course of varenicline 10 days prior to the target quit date. Brief dietary and motivational counseling was given at all visits. Self-reported abstinence was validated. Protein intake in the low-carbohydrate versus fat-reduced diets was 26.4% of total energy versus 20.0%, fat 38.2% versus 30.1%, and carbohydrates 29.0% versus 41.7% (all P < .001). Mean weight changes for the low-carbohydrate versus fat-reduced groups were -1.2 (SD 2.2) versus -0.5 (SD 2.0) kg, -0.2 (SD 3.3) versus 0.5 (SD 2.6) kg, and 2.2 (SD 4.5) versus 2.1 (SD 3.9) kg at 4, 12, and 24 weeks after the target quit date, respectively (not statistically significant). Smoking abstinence rates did not differ between diets. In the combined groups, point prevalence abstinence rates were 71.0% at 12 weeks and 46.3% at 24 weeks. The Minnesota Nicotine Withdrawal Symptoms score was lower in the fat-reduced group compared with the low-carbohydrate group at weeks 4 and 12. In overweight or obese smokers using varenicline a low-carbohydrate diet was no better than a fat-reduced diet in reducing weight gain but may result in more severe nicotine withdrawal symptoms. Compared to previous studies, cessation rates with varenicline were not impaired by dietary counseling. The study implies that a popular low-carbohydrate diet does not result in greater weight loss than a moderately fat-reduced diet in overweight and obese smokers who are attempting to quit smoking with the aid of varenicline. Dietary counseling combined with varenicline treatment did not appear to unfavorably influence quit rates compared to previous studies in smokers not selected for overweight or obesity. Notably, the withdrawal symptoms score was lower in the fat-reduced dietary group than the low-carbohydrate group, suggesting a venue for further study. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Reducing Shrinkage in Convenience Stores by the Use of the PSI.

ERIC Educational Resources Information Center

Terris, William; Jones, John W.

This bibliography contains over 1,200 behavioral and property is a rapidly growing problem. Successful strategies are needed to reduce employee theft; new loss prevention techniques need to be developed and evaluated. Two loss prevention programs aimed at reducing employees' theft were compared by the measures of shrinkage rates. Initially, a…

Reducing Lake Erie's Harmful Algal Blooms: Projection and Adoption of Management Plans

NASA Astrophysics Data System (ADS)

Martin, J.; Aloysius, N.; Howard, G.; Kalcic, M. M.; Wilson, R. S.; Scavia, D.; Roe, B.

2016-12-01

In early 2016, the United States and Canada formally agreed to reduce phosphorus inputs to Lake Erie by 40% to reduce the severity of annual Harmful Algal Blooms (HABs). These blooms have become more severe, with record events occurring in 2011 and 2015, and have compromised public safety, shut down drinking water supplies, and negatively impacted the economy of the western Lake Erie basin. Now, key questions revolve around the ability to reach the 40% reduction, required management changes, and resources to support these changes. This presentation will highlight interdisciplinary research to compare the amount and types of practices needed for this reduction to the current and projected levels of adoption. Economic resources to support these management changes are also compared with the financial support from the general public to improve Lake Erie water quality. Multiple models of the Maumee watershed identified management plans and adoption rates needed to reach the reduction targets. For example, one successful scenario estimated necessary adoption rates of 50% for subsurface application of fertilizer on row crops, 58% for cover crops, and 78% for buffer strips. Current adoption is below these levels, but future projections based on farmer surveys shows these levels are possible. Public support is necessary to generate the funding to support cost sharing and other programs aimed at increasing adoption of recommended practices. Comparing results from willingness-to-pay surveys of the general public with the estimated need for these management plans shows a gap in resources to support these levels of adoption. In general, these results show that accelerated adoption of management plans is needed compared to past adoption rates, but that these rates are possible based on likely adoption rates. Projected support from the general public indicates it will be challenging to fund these rates of adoption, especially during climate changes that may require even greater adoption. To partially address this challenge, accelerated rates of adoption may be achieved through voluntary means by increasing the perceived efficacy of the practices.

Haemodynamic effects of a selective adenosine A2A receptor agonist, CGS 21680, in chronic heart failure in anaesthetized rats.

PubMed

Nekooeian, A A; Tabrizchi, R

1998-10-01

1. Recently we demonstrated that the administration of an A2A adenosine receptor agonist, CGS 21680, to anaesthetized rats with acute heart failure (1 h post-coronary artery ligation) resulted in an increase in cardiac output. In the present investigation, the effects of CGS 21680 on cardiac output, vascular resistance, heart rate, blood pressure and mean circulatory filling pressure (Pmcf) were investigated in anaesthetized rats with chronic heart failure (8 weeks post-coronary artery ligation). 2. Experiments were conducted in five groups (n = 6) of animals: sham-operated vehicle-treated (0.9% NaCl; 0.037 mL kg(-1) min(-1)) animals in which the occluder was placed but not pulled to ligate the coronary artery; coronary artery-ligated vehicle-treated animals; and coronary artery-ligated CGS 21680-treated (0.1. 0.3 or 1.0 microg kg(-1) min(-1)) animals. 3. Baseline blood pressure, cardiac output and rate of rise in left ventricular pressure (+dP/dt) were significantly reduced in animals with coronary artery ligation when compared to sham-operated animals. Coronary artery ligation resulted in a significant increase in left ventricular end-diastolic pressure, Pmcf and venous resistance when compared to sham-operated animals. 4. Administration of CGS 21680 at 0.3 and 1.0 microg kg(-1) min(-1) significantly (n = 6; P<0.05) increased cardiac output by 19+/-4% and 39+/-5%, and heart rate by 14+/-2% and 15+/-1%, respectively, when compared to vehicle treatment in coronary artery-ligated animals. Administration of CGS 21680 also significantly reduced blood pressure and arterial resistance when compared to coronary artery-ligated vehicle-treated animals. Infusion of CGS 21680 also significantly reduced venous resistance when compared to vehicle-treated coronary artery-ligated animals. 5. The results show that heart failure is characterized by reduced cardiac output, and increased left ventricular end-diastolic pressure, venous resistance and Pmcf. Acute treatment with CGS 21680 in animals with chronic heart failure decreased left ventricular end-diastolic pressure and increased cardiac output. This increase in cardiac output was the result of reduced arterial and venous resistances and increased heart rate.

A comparison of orthogonal transformations for digital speech processing.

NASA Technical Reports Server (NTRS)

Campanella, S. J.; Robinson, G. S.

1971-01-01

Discrete forms of the Fourier, Hadamard, and Karhunen-Loeve transforms are examined for their capacity to reduce the bit rate necessary to transmit speech signals. To rate their effectiveness in accomplishing this goal the quantizing error (or noise) resulting for each transformation method at various bit rates is computed and compared with that for conventional companded PCM processing. Based on this comparison, it is found that Karhunen-Loeve provides a reduction in bit rate of 13.5 kbits/s, Fourier 10 kbits/s, and Hadamard 7.5 kbits/s as compared with the bit rate required for companded PCM. These bit-rate reductions are shown to be somewhat independent of the transmission bit rate.

Running quietly reduces ground reaction force and vertical loading rate and alters foot strike technique.

PubMed

Phan, Xuan; Grisbrook, Tiffany L; Wernli, Kevin; Stearne, Sarah M; Davey, Paul; Ng, Leo

2017-08-01

This study aimed to determine if a quantifiable relationship exists between the peak sound amplitude and peak vertical ground reaction force (vGRF) and vertical loading rate during running. It also investigated whether differences in peak sound amplitude, contact time, lower limb kinematics, kinetics and foot strike technique existed when participants were verbally instructed to run quietly compared to their normal running. A total of 26 males completed running trials for two sound conditions: normal running and quiet running. Simple linear regressions revealed no significant relationships between impact sound and peak vGRF in the normal and quiet conditions and vertical loading rate in the normal condition. t-Tests revealed significant within-subject decreases in peak sound, peak vGRF and vertical loading rate during the quiet compared to the normal running condition. During the normal running condition, 15.4% of participants utilised a non-rearfoot strike technique compared to 76.9% in the quiet condition, which was corroborated by an increased ankle plantarflexion angle at initial contact. This study demonstrated that quieter impact sound is not directly associated with a lower peak vGRF or vertical loading rate. However, given the instructions to run quietly, participants effectively reduced peak impact sound, peak vGRF and vertical loading rate.

Intermittent pressure decreases human keratinocyte proliferation in vitro.

PubMed

Nasca, Maria R; Shih, Alan T; West, Dennis P; Martinez, Wanda M; Micali, Giuseppe; Landsman, Adam S

2007-01-01

The aim of this study was to investigate the correlation between pressure changes and keratinocyte proliferation by determining whether keratinocytes exposed to altered mechanical pressures would proliferate at different rates compared to control cells not subjected to pressure changes. Tissue culture flasks of human keratinocytes plated at an approximate density of 15,000 cells/cm(2) undergoing an intermittent cyclic pressure of 362 mm Hg at a frequency of 2.28 or 5.16 cycles/min (0.038 or 0.086 Hz) for 8 h were compared to control flasks grown at ambient room pressure. An in-line pressure transducer was used to monitor and adjust pressure within the cell chambers, using a solenoid valve. A thymidine incorporation assay assessed the amount of cell proliferation in each set of experiments. Differences in proliferation between keratinocytes subjected to cyclic pressure changes and control cells were found to be statistically significant (p < 0.05) in 4 out of 5 proliferation assays. Also, a higher frequency of pressure changes consistently generated a reduced proliferation rate compared to that seen in cells exposed to a lower frequency of pressure changes. These data indicate that keratinocytes undergoing intermittent pressure changes exhibit decreased proliferation rates compared to controls. Furthermore, an increased frequency rate seems to have a greater effect on proliferation than low-frequency rate pressure changes, suggesting that the stress caused by frequently changed pressure may play a greater role in reducing keratinocyte proliferation than the actual magnitude of load applied to the cells. Our results support the current treatment protocol of reducing speed and duration of walking on the site of the wound to promote healing of foot ulcers. (c) 2007 S. Karger AG, Basel.

Perceptions about Higher Education among Parents of Hispanic Students in Middle School: Implications for Community Colleges

ERIC Educational Resources Information Center

McCallister, Leslie; Evans, Joy; Illich, Paul

2010-01-01

Although the Hispanic population is growing at a much faster rate than other populations, college enrollment rates are relatively low compared to Anglos and African Americans. One of the reasons for the low enrollment rate is that the relatively high dropout rate among Hispanic high school students reduces the number of Hispanic students eligible…

Effects of voluntary wheel running on heart rate, body temperature, and locomotor activity in response to acute and repeated stressor exposures in rats.

PubMed

Masini, Cher V; Nyhuis, Tara J; Sasse, Sarah K; Day, Heidi E W; Campeau, Serge

2011-05-01

Stress often negatively impacts physical and mental health but it has been suggested that voluntary physical activity may benefit health by reducing some of the effects of stress. The present experiments tested whether voluntary exercise can reduce heart rate, core body temperature and locomotor activity responses to acute (novelty or loud noise) or repeated stress (loud noise). After 6 weeks of running-wheel access, rats exposed to a novel environment had reduced heart rate, core body temperature, and locomotor activity responses compared to rats housed under sedentary conditions. In contrast, none of these measures were different between exercised and sedentary rats following acute 30-min noise exposures, at either 85 or 98 dB. Following 10 weeks of running-wheel access, both groups displayed significant habituation of all these responses to 10 consecutive daily 30-min presentations of 98 dB noise stress. However, the extent of habituation of all three responses was significantly enhanced in exercised compared to sedentary animals on the last exposure to noise. These results suggest that in physically active animals, under some conditions, acute responses to stress exposure may be reduced, and response habituation to repeated stress may be enhanced, which ultimately may reduce the negative and cumulative impact of stress.

Effects of voluntary wheel running on heart rate, body temperature, and locomotor activity in response to acute and repeated stressor exposures in rats

PubMed Central

MASINI, CHER V.; NYHUIS, TARA J.; SASSE, SARAH K.; DAY, HEIDI E. W.; CAMPEAU, SERGE

2015-01-01

Stress often negatively impacts physical and mental health but it has been suggested that voluntary physical activity may benefit health by reducing some of the effects of stress. The present experiments tested whether voluntary exercise can reduce heart rate, core body temperature and locomotor activity responses to acute (novelty or loud noise) or repeated stress (loud noise). After 6 weeks of running-wheel access, rats exposed to a novel environment had reduced heart rate, core body temperature, and locomotor activity responses compared to rats housed under sedentary conditions. In contrast, none of these measures were different between exercised and sedentary rats following acute 30-min noise exposures, at either 85 or 98 dB. Following 10 weeks of running-wheel access, both groups displayed significant habituation of all these responses to 10 consecutive daily 30-min presentations of 98 dB noise stress. However, the extent of habituation of all three responses was significantly enhanced in exercised compared to sedentary animals on the last exposure to noise. These results suggest that in physically active animals, under some conditions, acute responses to stress exposure may be reduced, and response habituation to repeated stress may be enhanced, which ultimately may reduce the negative and cumulative impact of stress. PMID:21438772

Steroids and statins: an old and a new anti-inflammatory strategy compared.

PubMed

Vukovic, Petar M; Maravic-Stojkovic, Vera R; Peric, Miodrag S; Jovic, Miomir Dj; Cirkovic, Milan V; Gradinac, Sinisa Dj; Djukanovic, Bosko P; Milojevic, Predrag S

2011-01-01

This study compared the anti-inflammatory effects of methylprednisolone (MP) and atorvastatin and analysed their influences on clinical variables in patients undergoing coronary revascularization. Ninety patients with compromised left ventricular ejection fraction (≤30%) undergoing elective coronary surgery were equally randomized to one of three groups: statin group, treatment with atorvastatin (20 mg/day) 3 weeks before surgery; methylprednisolone group, a single shot of methylpredniosolone (10mg/kg); and control group. Postoperative IL-6 was higher in the control group when compared to the methylprednisolone and statin groups (p<0.01). IL-6 was higher in the statin-treated patients (p<0.05 versus methylprednisolone). Administration of methylprednisolone as well as statin treatment increased postoperative cardiac index, left ventricular stroke work index, decreased postoperative atrial fibrilation rate and reduced ICU stay (p<0.05 versus control). The number of patients requiring inotropic support was lower in the methylprednisolone group when compared with the other two groups (p<0.01). Tracheal intubation time was reduced in patients who received methylprednisolone (p<0.01 versus control). Preoperative administration of either methylprednisolone or atorvastatin reduced pro-inflammatory cytokine release, improved haemodynamics, decreased postoperative atrial fibrilation rate and reduced ICU stay in patients with significantly impaired cardiac function undergoing coronary revascularization. Treatment with methylprednisolone was associated with less inotropic support requirements and reduced mechanical ventilation time.

Effect of Dysphagia Screening Strategies on Clinical Outcomes After Stroke: A Systematic Review for the 2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke.

PubMed

Smith, Eric E; Kent, David M; Bulsara, Ketan R; Leung, Lester Y; Lichtman, Judith H; Reeves, Mathew J; Towfighi, Amytis; Whiteley, William N; Zahuranec, Darin B

2018-03-01

Dysphagia screening protocols have been recommended to identify patients at risk for aspiration. The American Heart Association convened an evidence review committee to systematically review evidence for the effectiveness of dysphagia screening protocols to reduce the risk of pneumonia, death, or dependency after stroke. The Medline, Embase, and Cochrane databases were searched on November 1, 2016, to identify randomized controlled trials (RCTs) comparing dysphagia screening protocols or quality interventions with increased dysphagia screening rates and reporting outcomes of pneumonia, death, or dependency. Three RCTs were identified. One RCT found that a combined nursing quality improvement intervention targeting fever and glucose management and dysphagia screening reduced death and dependency but without reducing the pneumonia rate. Another RCT failed to find evidence that pneumonia rates were reduced by adding the cough reflex to routine dysphagia screening. A smaller RCT randomly assigned 2 hospital wards to a stroke care pathway including dysphagia screening or regular care and found that patients on the stroke care pathway were less likely to require intubation and mechanical ventilation; however, the study was small and at risk for bias. There were insufficient RCT data to determine the effect of dysphagia screening protocols on reducing the rates of pneumonia, death, or dependency after stroke. Additional trials are needed to compare the validity, feasibility, and clinical effectiveness of different screening methods for dysphagia. © 2018 American Heart Association, Inc.

Evaluation of Apache Hadoop for parallel data analysis with ROOT

NASA Astrophysics Data System (ADS)

Lehrack, S.; Duckeck, G.; Ebke, J.

2014-06-01

The Apache Hadoop software is a Java based framework for distributed processing of large data sets across clusters of computers, using the Hadoop file system (HDFS) for data storage and backup and MapReduce as a processing platform. Hadoop is primarily designed for processing large textual data sets which can be processed in arbitrary chunks, and must be adapted to the use case of processing binary data files which cannot be split automatically. However, Hadoop offers attractive features in terms of fault tolerance, task supervision and control, multi-user functionality and job management. For this reason, we evaluated Apache Hadoop as an alternative approach to PROOF for ROOT data analysis. Two alternatives in distributing analysis data were discussed: either the data was stored in HDFS and processed with MapReduce, or the data was accessed via a standard Grid storage system (dCache Tier-2) and MapReduce was used only as execution back-end. The focus in the measurements were on the one hand to safely store analysis data on HDFS with reasonable data rates and on the other hand to process data fast and reliably with MapReduce. In the evaluation of the HDFS, read/write data rates from local Hadoop cluster have been measured and compared to standard data rates from the local NFS installation. In the evaluation of MapReduce, realistic ROOT analyses have been used and event rates have been compared to PROOF.

Protection reduces loss of natural land-cover at sites of conservation importance across Africa.

PubMed

Beresford, Alison E; Eshiamwata, George W; Donald, Paul F; Balmford, Andrew; Bertzky, Bastian; Brink, Andreas B; Fishpool, Lincoln D C; Mayaux, Philippe; Phalan, Ben; Simonetti, Dario; Buchanan, Graeme M

2013-01-01

There is an emerging consensus that protected areas are key in reducing adverse land-cover change, but their efficacy remains difficult to quantify. Many previous assessments of protected area effectiveness have compared changes between sets of protected and unprotected sites that differ systematically in other potentially confounding respects (e.g. altitude, accessibility), have considered only forest loss or changes at single sites, or have analysed changes derived from land-cover data of low spatial resolution. We assessed the effectiveness of protection in reducing land-cover change in Important Bird Areas (IBAs) across Africa using a dedicated visual interpretation of higher resolution satellite imagery. We compared rates of change in natural land-cover over a c. 20-year period from around 1990 at a large number of points across 45 protected IBAs to those from 48 unprotected IBAs. A matching algorithm was used to select sample points to control for potentially confounding differences between protected and unprotected IBAs. The rate of loss of natural land-cover at sample points within protected IBAs was just 42% of that at matched points in unprotected IBAs. Conversion was especially marked in forests, but protection reduced rates of forest loss by a similar relative amount. Rates of conversion increased from the centre to the edges of both protected and unprotected IBAs, but rates of loss in 20-km buffer zones surrounding protected IBAs and unprotected IBAs were similar, with no evidence of displacement of conversion from within protected areas to their immediate surrounds (leakage).

Massage therapy for cardiac surgery patients--a randomized trial.

PubMed

Braun, Lesley A; Stanguts, Catherine; Casanelia, Lisa; Spitzer, Ondine; Paul, Eldho; Vardaxis, Nicholas J; Rosenfeldt, Franklin

2012-12-01

To determine whether massage significantly reduces anxiety, pain, and muscular tension and enhances relaxation compared with an equivalent period of rest time after cardiac surgery. The feasibility of delivering the treatment, effects on heart rate, blood pressure, and respiratory rate, and patient satisfaction were also assessed. Elective cardiac surgery patients were randomized to receive massage or rest time at 2 points after surgery. Visual analog scales were used to measure pain, anxiety, relaxation, muscular tension, and satisfaction. Heart rate, respiratory rate, and blood pressure were measured before and after treatment. Focus groups and feedback were used to collect qualitative data about clinical significance and feasibility. A total of 152 patients (99% response rate) participated. Massage therapy produced a significantly greater reduction in pain (P = .001), anxiety (P < .0001), and muscular tension (P = .002) and increases in relaxation (P < .0001) and satisfaction (P = .016) compared to the rest time. No significant differences were seen for heart rate, respiratory rate, and blood pressure. Pain was significantly reduced after massage on day 3 or 4 (P < .0001) and day 5 or 6 (P = .003). The control group experienced no significant change at either time. Anxiety (P < .0001) and muscular tension (P < .0001) were also significantly reduced in the massage group at both points. Relaxation was significantly improved on day 3 or 4 for both groups (massage, P < .0001; rest time, P = .006), but only massage was effective on day 5 or 6 (P < .0001). Nurses and physiotherapists observed patient improvements and helped facilitate delivery of the treatment by the massage therapists on the ward. Massage therapy significantly reduced the pain, anxiety, and muscular tension and improves relaxation and satisfaction after cardiac surgery. Crown Copyright © 2012. Published by Mosby, Inc. All rights reserved.

Slow but not low: genomic comparisons reveal slower evolutionary rate and higher dN/dS in conifers compared to angiosperms.

PubMed

Buschiazzo, Emmanuel; Ritland, Carol; Bohlmann, Jörg; Ritland, Kermit

2012-01-20

Comparative genomics can inform us about the processes of mutation and selection across diverse taxa. Among seed plants, gymnosperms have been lacking in genomic comparisons. Recent EST and full-length cDNA collections for two conifers, Sitka spruce (Picea sitchensis) and loblolly pine (Pinus taeda), together with full genome sequences for two angiosperms, Arabidopsis thaliana and poplar (Populus trichocarpa), offer an opportunity to infer the evolutionary processes underlying thousands of orthologous protein-coding genes in gymnosperms compared with an angiosperm orthologue set. Based upon pairwise comparisons of 3,723 spruce and pine orthologues, we found an average synonymous genetic distance (dS) of 0.191, and an average dN/dS ratio of 0.314. Using a fossil-established divergence time of 140 million years between spruce and pine, we extrapolated a nucleotide substitution rate of 0.68 × 10(-9) synonymous substitutions per site per year. When compared to angiosperms, this indicates a dramatically slower rate of nucleotide substitution rates in conifers: on average 15-fold. Coincidentally, we found a three-fold higher dN/dS for the spruce-pine lineage compared to the poplar-Arabidopsis lineage. This joint occurrence of a slower evolutionary rate in conifers with higher dN/dS, and possibly positive selection, showcases the uniqueness of conifer genome evolution. Our results are in line with documented reduced nucleotide diversity, conservative genome evolution and low rates of diversification in conifers on the one hand and numerous examples of local adaptation in conifers on the other hand. We propose that reduced levels of nucleotide mutation in large and long-lived conifer trees, coupled with large effective population size, were the main factors leading to slow substitution rates but retention of beneficial mutations.

Safety of minimally invasive pituitary surgery (MIPS) compared with a traditional approach.

PubMed

White, David R; Sonnenburg, Robert E; Ewend, Matthew G; Senior, Brent A

2004-11-01

Transsphenoidal hypophysectomy is becoming progressively less invasive. Recent endoscopic techniques avoid nasal or intraoral incisions, use of nasal speculums, and nasal packing. Several case series of endoscopic endonasal pituitary surgery have been reported, but relatively little data exists comparing complication rates to more traditional approaches. We compare the complications of our first 50 cases of endoscopic, minimally invasive pituitary surgery (MIPS) to our last 50 sublabial transseptal (SLTS) procedures. Retrospective case control study. Fifty consecutive MIPS procedures and 50 consecutive SLTS procedures were reviewed retrospectively. Complication rates were analyzed and compared. Total complications per patient (P = .005), postoperative epistaxis (P = .031), lip anesthesia (P = .013), and deviated septum (P = .028) occurred more often in the SLTS group. No significant difference was seen in cerebrospinal fluid leak, meningitis, ophthalmoplegia, visual acuity loss, diabetes insipidus, intracranial hemorrhage, or death. In the MIPS group, length of stay (P < .001), use of lumbar drainage (P = .007), and nasal packing (P < .001) were also significantly reduced. Endoscopic endonasal pituitary surgery provides improved complication rates when compared with SLTS approaches. In addition, we note advantages of the MIPS approach, including reduced length of hospital stay and decreased use of lumbar drainage and nasal packing.

The HPTN 024 Study: the efficacy of antibiotics to prevent chorioamnionitis and preterm birth.

PubMed

Goldenberg, Robert L; Mwatha, Anthony; Read, Jennifer S; Adeniyi-Jones, Samuel; Sinkala, Moses; Msmanga, Gernard; Martinson, Francis; Hoffman, Irving; Fawzi, Wafaie; Valentine, Megan; Emel, Lynda; Brown, Elizabeth; Mudenda, Victor; Taha, Taha E

2006-03-01

The use of antibiotics to prevent preterm birth has achieved mixed results. Our goal in this study was to determine if antibiotics given prenatally and during labor reduce the incidence of preterm birth and histologic chorioamnionitis. A double-blind randomized placebo-controlled trial of antibiotics to reduce preterm birth was conducted in 4 African sites. Both HIV-infected and uninfected pregnant women were given 2 courses of antibiotics, prenatally at 24 weeks (metronidazole 250 mg and erythromycin 250 mg tid orally for 7 days), and during labor (metronidazole 250 mg and ampicillin 500 mg q 4 hours) or identically appearing placebos. Two thousand ninety-eight HIV-infected and 335 HIV-uninfected women had evaluable end points, including gestational age determined by both obstetric and pediatric criteria and birth weight (BWT). Pre- and post-treatment rates of various sexually transmitted infections (STI) were determined and placentas were evaluated for histologic chorioamnionitis. Comparing antibiotic versus placebo treated HIV-infected and uninfected women, there were few differences in mean gestational age at delivery, the percent of preterm births, the time between randomization and delivery, or BWT. Four weeks after the 24-week antibiotic/placebo course, bacterial vaginosis, and trichomoniasis were reduced by 49% to 61% in the antibiotic groups compared with the placebo groups. However, in both the HIV-infected and uninfected groups, the placentas showed no difference in the rate of histologic chorioamnionitis. There were significant differences between HIV-infected and uninfected women, with the former having less education, a history of more stillbirths, more STIs, and in this pregnancy, a lower BWT (2949 vs 3100 g, P < .0001). Despite reducing the rate of vaginal infections, the antibiotic regimen used in this study did not reduce the rate of preterm birth, increase the time to delivery, or increase BWT. Failure of this regimen to reduce the rate of histologic chorioamnionitis may explain the reason the antibiotics failed to reduce preterm birth.

Effect of Dietary Supplements in Reducing Probability of Death for Uremic Crises in Dogs Affected by Chronic Kidney Disease (Masked RCCT)

PubMed Central

Zatelli, Andrea; Pierantozzi, Marco; D'Ippolito, Paola; Bigliati, Mauro; Zini, Eric

2012-01-01

Chitosan and alkalinizing agents can decrease morbidity and mortality in humans with chronic kidney disease (CKD). Whether this holds true in dog is not known. Objective of the study was to determine whether a commercial dietary supplement containing chitosan, phosphate binders, and alkalinizing agents (Renal), compared to placebo, reduces mortality rate due to uremic crises in dogs with spontaneous CKD, fed a renal diet (RD). A masked RCCT was performed including 31 azotemic dogs with spontaneous CKD. Dogs enrolled in the study were randomly allocated to receive RD plus placebo (group A; 15 dogs) or RD plus Renal (group B; 16 dogs). During a first 4-week period, all dogs were fed an RD and then randomized and clinically evaluated up to 44 weeks. The effects of dietary supplements on mortality rate due to uremic crises were assessed. At 44 weeks, compared to group A, dogs in group B had approximately 50% lower mortality rate due to uremic crises (P = 0.015). Dietary supplementation with chitosan, phosphate binders, and alkalinizing agents, along with an RD, is beneficial in reducing mortality rate in dogs with spontaneous CKD. PMID:22593665

Rating the effectiveness of local tobacco policies for reducing youth smoking.

PubMed

Lipperman-Kreda, Sharon; Friend, Karen B; Grube, Joel W

2014-04-01

Important questions remain regarding the effectiveness of local tobacco policies for preventing and reducing youth tobacco use and the relative importance of these policies. The aims of this paper are to: (1) compare policy effectiveness ratings provided by researchers and tobacco prevention specialists for individual local tobacco policies, and (2) develop and describe a systematic approach to score communities for locally-implemented tobacco policies. We reviewed municipal codes of 50 California communities to identify local tobacco regulations in five sub-domains. We then developed an instrument to rate the effectiveness of these policies and administered it to an expert panel of 40 tobacco researchers and specialists. We compared mean policy effectiveness ratings obtained from researchers and prevention specialists and used it to score the 50 communities. High inter-rater reliabilities obtained for each sub-domain indicated substantial agreement among the raters about relative policy effectiveness. Results showed that, although researchers and prevention specialists differed on the mean levels of policy ratings, their relative rank ordering of the effectiveness of policy sub-domains were very similar. While both researchers and prevention specialists viewed local outdoor clean air policies as least effective in preventing and reducing youth cigarette smoking, they rated tobacco sales policies and advertising and promotion as more effective than the other policies. Moreover, we found high correlations between community scores generated from researchers' and prevention specialists' ratings. This approach can be used to inform research on local policies and prevention efforts and help bridge the gap between research and practice.

Footwear Matters: Influence of Footwear and Foot Strike on Load Rates during Running.

PubMed

Rice, Hannah M; Jamison, Steve T; Davis, Irene S

2016-12-01

Running with a forefoot strike (FFS) pattern has been suggested to reduce the risk of overuse running injuries, due to a reduced vertical load rate compared with rearfoot strike (RFS) running. However, resultant load rate has been reported to be similar between foot strikes when running in traditional shoes, leading to questions regarding the value of running with a FFS. The influence of minimal footwear on the resultant load rate has not been considered. This study aimed to compare component and resultant instantaneous loading rate (ILR) between runners with different foot strike patterns in their habitual footwear conditions. Twenty-nine injury-free participants (22 men, seven women) ran at 3.13 m·s along a 30-m runway, with their habitual foot strike and footwear condition. Ground reaction force data were collected. Peak ILR values were compared between three conditions; those who habitually run with an RFS in standard shoes, with an FFS in standard shoes, and with an FFS in minimal shoes. Peak resultant, vertical, lateral, and medial ILR were lower (P < 0.001) when running in minimal shoes with an FFS than in standard shoes with either foot strike. When running with an FFS, peak posterior ILR were lower (P < 0.001) in minimal than standard shoes. When running in a standard shoe, peak resultant and component ILR were similar between footstrike patterns. However, load rates were lower when running in minimal shoes with a FFS, compared with running in standard shoes with either foot strike. Therefore, it appears that footwear alters the load rates during running, even with similar foot strike patterns.

Does an oral care protocol reduce VAP in patients with a tracheostomy?

PubMed

Conley, Patricia; McKinsey, David; Graff, Jason; Ramsey, Anthony R

2013-07-01

Several studies have demonstrated that oral care with chlorhexidine gluconate (CHG) 0.12% solution reduces the incidence of ventilator-associated pneumonia (VAP) in mechanically ventilated patients with endotracheal tubes in the ICU. Minimal evidence shows the effectiveness of any oral care protocols in preventing VAP in mechanically ventilated patients with tracheostomies in a step-down or progressive care unit (PCU). To determine the effectiveness of an oral care protocol in reducing the VAP rate in mechanically ventilated patients with tracheostomies in the PCU. A 12-month prospective study was conducted on 75 mechanically ventilated patients who had tracheostomies. The oral care protocol consisted of tooth brushing with toothpaste and applying CHG 0.12% solution every 12 hours. At the conclusion of the study, the VAP rate in the study population was compared with the National Health and Safety Network (NHSN) report for 2009 benchmark of 1.5 per 1,000 ventilator days. After the oral care protocol was implemented in the PCU, the VAP rate was 1.1 per 1,000 ventilator days over 12 months, compared with the NHSN report for 2009 of 1.5 per 1,000 ventilator days. Tooth brushing with toothpaste and applying CHG 0.12% solution may be an effective oral care protocol to reduce the VAP rate in patients in PCUs with tracheostomies who are being mechanically ventilated.

Reduced knee flexion is a possible cause of increased loading rates in individuals with patellofemoral pain.

PubMed

Silva, Danilo de Oliveira; Briani, Ronaldo Valdir; Pazzinatto, Marcella Ferraz; Ferrari, Deisi; Aragão, Fernando Amâncio; Azevedo, Fábio Mícolis de

2015-11-01

Stair ascent is an activity that exacerbates symptoms of individuals with patellofemoral pain. The discomfort associated with this activity usually results in gait modification such as reduced knee flexion in an attempt to reduce pain. Although such compensatory strategy is a logical approach to decrease pain, it also reduces the normal active shock absorption increasing loading rates and may lead to deleterious and degenerative changes of the knee joint. Thus, the aims of this study were (i) to investigate whether there is reduced knee flexion in adults with PFP compared to healthy controls; and (ii) to analyze loading rates in these subjects, during stair climbing. Twenty-nine individuals with patellofemoral pain and twenty-five control individuals (18-30 years) participated in this study. Each subject underwent three-dimensional kinematic and kinetic analyses during stair climbing on two separate days. Between-groups analyses of variance were performed to identify differences in peak knee flexion and loading rates. Intraclass correlation coefficient was performed to verify the reliability of the variables. On both days, the patellofemoral pain group demonstrated significantly reduced peak knee flexion and increased loading rates. In addition, the two variables obtained high to very high reliability. Reduced knee flexion during stair climbing as a strategy to avoid anterior knee pain does not seem to be healthy for lower limb mechanical distributions. Repeated loading at higher loading rates may be damaging to lower limb joints. Copyright © 2015 Elsevier Ltd. All rights reserved.

Can High-flow Nasal Cannula Reduce the Rate of Endotracheal Intubation in Adult Patients With Acute Respiratory Failure Compared With Conventional Oxygen Therapy and Noninvasive Positive Pressure Ventilation?: A Systematic Review and Meta-analysis.

PubMed

Ni, Yue-Nan; Luo, Jian; Yu, He; Liu, Dan; Ni, Zhong; Cheng, Jiangli; Liang, Bin-Miao; Liang, Zong-An

2017-04-01

The effects of high-flow nasal cannula (HFNC) on adult patients with acute respiratory failure (ARF) are controversial. We aimed to further determine the effectiveness of HFNC in reducing the rate of endotracheal intubation in adult patients with ARF by comparison to noninvasive positive pressure ventilation (NIPPV) and conventional oxygen therapy (COT). The PubMed, Embase, Medline, and the Cochrane Central Register of Controlled Trials databases, as well as the Information Sciences Institute Web of Science, were searched for all controlled studies that compared HFNC with NIPPV and COT in adult patients with ARF. The primary outcome was the rate of endotracheal intubation; the secondary outcomes were ICU mortality and length of ICU stay. Eighteen trials with a total of 3,881 patients were pooled in our final studies. Except for ICU mortality (I 2  = 67%, χ 2  = 12.21, P = .02) and rate of endotracheal intubation (I 2  = 63%, χ 2  = 13.51, P = .02) between HFNC and NIPPV, no significant heterogeneity was found in outcome measures. Compared with COT, HFNC was associated with a lower rate of endotracheal intubation (z = 2.55, P = .01) while no significant difference was found in the comparison with NIPPV (z = 1.40, P = .16). As for ICU mortality and length of ICU stay, HFNC did not exhibit any advantage over either COT or NIPPV. In patients with ARF, HFNC is a more reliable alternative than NIPPV to reduce the rate of endotracheal intubation than COT. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

Structured Head and Neck CT Angiography Reporting Reduces Resident Revision Rates.

PubMed

Johnson, Tucker F; Brinjikji, Waleed; Doolittle, Derrick A; Nagelschneider, Alex A; Welch, Brian T; Kotsenas, Amy L

2018-04-12

This resident-driven quality improvement project was undertaken to assess the effectiveness of structured reporting to reduce revision rates for afterhours reports dictated by residents. The first part of the study assessed baseline revision rates for head and neck CT angiography (CTA) examinations dictated by residents during afterhours call. A structured report was subsequently created based on templates on the RSNA informatics reporting website and critical findings that should be assessed for on all CTA examinations. The template was made available to residents through the speech recognition software for all head and neck CTA examinations for a duration of 2 months. Report revision rates were then compared with and without use of the structured template. The structured template was found to reduce revision rates by approximately 50% with 10/41 unstructured reports revised and 2/17 structured reports revised. We believe that structured reporting can help reduce reporting errors, particularly in term of typographical errors, train residents to evaluate complex examinations in a systematic fashion, and assist them in recalling critical findings on these examinations. Copyright © 2018 Elsevier Inc. All rights reserved.

Does Increasing Home Care Nursing Reduce Emergency Department Visits at the End of Life? A Population-Based Cohort Study of Cancer Decedents.

PubMed

Seow, Hsien; Barbera, Lisa; Pataky, Reka; Lawson, Beverley; O'Leary, Erin; Fassbender, Konrad; McGrail, Kim; Burge, Fred; Brouwers, Melissa; Sutradhar, Rinku

2016-02-01

Despite being commonplace in health care systems, little research has described home care nursing's effectiveness to reduce acute care use at the end of life. To examine the temporal association between home care nursing rate on emergency department (ED) visit rate in the subsequent week during the last six months of life. We conducted a retrospective cohort study of end-of-life cancer decedents in Ontario, Canada, from 2004 to 2009 by linking administrative databases. We examined the association between home care nursing rate of one week with the ED rate in the subsequent week closer to death, controlling for covariates and repeated measures among decedents. Nursing was dichotomized into standard and end-of-life care intent. Our cohort included 54,576 decedents who used home care nursing services in the last six months before death, where 85% had an ED visit and 68% received end-of-life home care nursing. Patients receiving end-of-life nursing at any week had a significantly reduced ED rate in the subsequent week of 31% (relative rate [RR] 0.69; 95% confidence interval [CI] 0.68, 0.71) compared with standard nursing. In the last month of life, receiving end-of-life nursing and standard nursing rate of more than five hours/week was associated with a decreased ED rate of 41% (RR 0.59, 95% CI 0.58, 0.61) and 32% (RR 0.68, 95% CI 0.66, 0.70), respectively, compared with standard nursing of one hour/week. Our study showed a temporal association between receiving end-of-life nursing in a given week during the last six months of life, and of more standard nursing in the last month of life, with a reduced ED rate in the subsequent week. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Fluorescence-guided surgical resection of oral cancer reduces recurrence

NASA Astrophysics Data System (ADS)

Lane, Pierre; Poh, Catherine F.; Durham, J. Scott; Zhang, Lewei; Lam, Sylvia F.; Rosin, Miriam; MacAulay, Calum

2011-03-01

Approximately 36,000 people in the US will be newly diagnosed with oral cancer in 2010 and it will cause 8,000 new deaths. The death rate is unacceptably high because oral cancer is usually discovered late in its development and is often difficult to treat or remove completely. Data collected over the last 5 years at the BC Cancer Agency suggest that the surgical resection of oral lesions guided by the visualization of the alteration of endogenous tissue fluorescence can dramatically reduce the rate of cancer recurrence. Four years into a study which compares conventional versus fluorescence-guided surgical resection, we reported a recurrence rate of 25% (7 of 28 patients) for the control group compared to a recurrence rate of 0% (none of the 32 patients) for the fluorescence-guided group. Here we present resent results from this ongoing study in which patients undergo either conventional surgical resection of oral cancer under white light illumination or using tools that enable the visualization of naturally occurring tissue fluorescence.

Coding efficiency of AVS 2.0 for CBAC and CABAC engines

NASA Astrophysics Data System (ADS)

Cui, Jing; Choi, Youngkyu; Chae, Soo-Ik

2015-12-01

In this paper we compare the coding efficiency of AVS 2.0[1] for engines of the Context-based Binary Arithmetic Coding (CBAC)[2] in the AVS 2.0 and the Context-Adaptive Binary Arithmetic Coder (CABAC)[3] in the HEVC[4]. For fair comparison, the CABAC is embedded in the reference code RD10.1 because the CBAC is in the HEVC in our previous work[5]. The rate estimation table is employed only for RDOQ in the RD code. To reduce the computation complexity of the video encoder, therefore we modified the RD code so that the rate estimation table is employed for all RDO decision. Furthermore, we also simplify the complexity of rate estimation table by reducing the bit depth of its fractional part to 2 from 8. The simulation result shows that the CABAC has the BD-rate loss of about 0.7% compared to the CBAC. It seems that the CBAC is a little more efficient than that the CABAC in the AVS 2.0.

Donor predicted post-operative forced expiratory volume in one second predicts recipients' best forced expiratory volume in one second following size-reduced lung transplantation.

PubMed

Inci, Ilhan; Irani, Sarosh; Kestenholz, Peter; Benden, Christian; Boehler, Annette; Weder, Walter

2011-01-01

The limited number of available grafts is one of the major obstacles of lung transplantation. Size-reduced lung transplantation allows the use of oversized grafts for small recipients. Optimal lung size matching is vital to achieve best functional outcome and avoid potential problems when using oversized grafts. We hypothesise that donor-predicted postoperative forced expiratory volume in 1s (ppoFEV1) correlates with the recipient best FEV1 after size-reduced lung transplant, being useful for the estimation of function outcome. All patients undergoing size-reduced or standard bilateral lung transplantation were included (1992-2007). Donor ppoFEV1 was calculated and corrected with respect to size reduction and correlated with recipient measured best FEV1 post-transplant. In addition, pre- and postoperative clinical data including surgical complications and outcome of all size-reduced lung transplant recipients were compared with standard lung transplant recipients. A total of 61 size-reduced lung transplant recipients (lobar transplants, n=20; anatomic or non-anatomic resection, n=41) were included and compared to 145 standard transplants. The mean donor-recipient height difference was statistically significant between the two groups (p=0.0001). The mean donor ppoFEV1 was comparable with recipient best FEV1 (2.7±0.6 vs 2.6±0.7 l). There was a statistically significant correlation between donor ppoFEV1 and recipient best FEV1 (p=0.01, r=0.688). The 30-day mortality rate and 3-month, 1- and 5-year survival rates were comparable between the two groups. In size-reduced lung transplantation, postoperative recipient best FEV1 could be predicted from donor-calculated and corrected FEV1 with respect to its size reduction. Compared to standard lung transplantation, equivalent morbidity, mortality and functional results could be obtained after size-reduced lung transplantation. Copyright © 2010 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.

Are local laws the key to ending childhood lead poisoning?

PubMed

Korfmacher, Katrina S; Hanley, Michael L

2013-08-01

Although lead paint was banned by federal law in 1978, it continues to poison children living in homes built before that time. The lifelong effects of childhood exposure to even small amounts of lead are well established by medical research. Federal and state laws have reduced rates of lead poisoning significantly in the past three decades. However, pockets of high rates of lead poisoning remain, primarily in low-income urban neighborhoods with older housing stock. Recently, several municipalities have passed local lead laws to reduce lead hazards in high-risk areas. There has been no systematic attempt to compare the design and effectiveness of these local policies. To address this gap, we conducted comparative case studies of eight innovative lead laws promulgated since 2000. The laws used a wide variety of legal structures and tools, although certain elements were common. The impact of the policies was intertwined with local housing, economic, and legal environments. While data do not yet exist to systematically evaluate the impact of these laws on lead poisoning rates, our analysis suggests that local laws hold great promise for reducing lead hazards in children's homes.

The crime drop in comparative perspective: the impact of the economy and imprisonment on American and European burglary rates.

PubMed

Rosenfeld, Richard; Messner, Steven F

2009-09-01

Influential statements on recent American crime reductions maintain that the crime drop was confined to the USA. Yet other research has revealed comparable crime decreases in Europe. We suggest that the USA and European crime declines occurred in tandem because they were both brought about by upturns in the economy. In light of US research showing crime reductions resulting from growth in imprisonment, we also examine the possibility that rising imprisonment rates reduced European crime rates. We test these hypotheses in a pooled cross-sectional time-series analysis of burglary rates in the USA and nine European nations between 1993 and 2006. The results indicate that burglary declines in the US and Europe were associated with rising consumer confidence. By contrast, imprisonment appears to be significantly related to burglary rates only after unusual policy interventions, such as Italy's 2006 clemency measure that dramatically reduced the size of its prison population. We interpret these findings as reflecting the structural similarity and economic integration of the world's developed nations and the uneven convergence in US and European punishment policies.

Effect of Gravity Level on the Particle Shape and Size During Zeolite Crystal Growth

NASA Technical Reports Server (NTRS)

Song, Hong-Wei; Ilebusi, Olusegun J.; Sacco, Albert, Jr.

2003-01-01

A microscopic diffusion model is developed to represent solute transport in the boundary layer of a growing zeolite crystal. This model is used to describe the effect of gravity on particle shape and solute distribution. Particle dynamics and crystal growth kinetics serve as the boundary conditions of flow and convection-diffusion equations. A statistical rate theory is used to obtain the rate of solute transport across the growing interface, which is expressed in terms of concentration and velocity of solute species. Microgravity can significantly decrease the solute velocity across the growing interface compared to its earth-based counterpart. The extent of this reduction highly depends on solute diffusion constant in solution. Under gravity, the flow towards the crystal enhances solute transport rate across the growing interface while the flow away from crystals reduces this rate, suggesting a non-uniform growth rate and thus an elliptic final shape. However, microgravity can significantly reduce the influence of flow and obtain a final product with perfect spherical shape. The model predictions compare favorably with the data of space experiment of zeolites grown in space.

The Effectiveness of Policies and Programs that Attempt to Reduce Firearm Violence: A Meta-Analysis

ERIC Educational Resources Information Center

Makarios, Matthew D.; Pratt, Travis C.

2012-01-01

In response to rising rates of firearms violence that peaked in the mid-1990s, a wide range of policy interventions have been developed in an attempt to reduce violent crimes committed with firearms. Although some of these approaches appear to be effective at reducing gun violence, methodological variations make comparing effects across program…

Balloon-Assisted Tracking Use Reduces Radial Artery Access Failure in an Experienced Radial Center and is Feasible During Primary PCI for STEMI.

PubMed

Obaid, Daniel; Hailan, Ahmed; Chase, Alexander; Dorman, Stephen; Jenkins, Geraint; Raybould, Adrian; Ramsey, Mark; Thomas, Phillip; Smith, David; Ionescu, Adrian

2017-07-01

This prospective study assesses balloon-assisted tracking (BAT) in reducing radial access failure during percutaneous coronary intervention (PCI). Arterial spasm prevents PCI from the radial artery in a small percentage of cases. A total of 2223 consecutive patients undergoing PCI from the radial approach were analyzed. Radial access failure mode and requirement for crossover to femoral access during a 12-month run-in period were compared with the following 14-month period with routine BAT usage. During the 14-month study period, 1334 radial PCIs were attempted. Twenty-six patients switched to femoral at an early stage, while 76 encountered radial spasm and underwent successful BAT in 69 cases (91%), giving a total crossover rate to femoral of 33/1334 (2.5%). Utilizing BAT rather than a femoral puncture reduced our institution's radial-femoral crossover rate from 7.6% to 2.5% (P<.01), which is also significantly lower than the radial-femoral crossover rate in the 12 months before BAT implementation (6.1%; P<.01). Mean procedure times were similar for those requiring BAT compared with conventional radial access (51.3 ± 21.3 min vs 47.9 ± 23.7 min; P=.23), and those crossing straight to femoral (BAT not attempted) (60.7 ± 31.9 min; P=.10). Mean first device/balloon time for the BAT-assisted primary PCI cases (22.6 ± 9.4 min) was similar to cases that had radial difficulties and converted to femoral without attempting BAT (25.8 ± 13.4 min; P=.54). BAT allowed catheter passage despite radial spasm in 91% of cases, significantly reducing the institution's rate of femoral crossover. During radial spasm in primary PCI, using BAT did not delay reperfusion compared with femoral crossover.

Cognitive-Behavioral and Pharmacologic Interventions for Children's Distress during Painful Medical Procedures.

ERIC Educational Resources Information Center

Jay, Susan M.; And Others

1987-01-01

Evaluated efficacy of cognitive-behavioral intervention package and low-risk pharmacologic intervention (oral Valium) as compared with minimal treatment-attention control condition, in reducing children leukemia patients' distress during bone marrow aspirations. The cognitive-behavioral therapy reduced behavioral distress, pain ratings and pulse…

Applying Lean Six Sigma methodology to reduce cesarean section rate.

PubMed

Chai, Ze-Ying; Hu, Hua-Min; Ren, Xiu-Ling; Zeng, Bao-Jin; Zheng, Ling-Zhi; Qi, Feng

2017-06-01

This study aims to reduce cesarean section rate and increase rate of vaginal delivery. By using Lean Six Sigma (LSS) methodology, the cesarean section rate was investigated and analyzed through a 5-phase roadmap consisting of Define, Measure, Analyze, Improve, and Control. The principal causes of cesarean section were identified, improvement measures were implemented, and the rate of cesarean section before and after intervention was compared. After patients with a valid medical reason for cesarean were excluded, the main causes of cesarean section were maternal request, labor pain, parturient women assessment, and labor observation. A series of measures was implemented, including an improved parturient women assessment system, strengthened pregnancy nutrition guidance, implementation of painless labor techniques, enhanced midwifery team building, and promotion of childbirth-assist skills. Ten months after introduction of the improvement measures, the cesarean section rate decreased from 41.83% to 32.00%, and the Six Sigma score (ie, Z value) increased from 1.706 to 1.967 (P < .001). LSS is an effective way to reduce the rate of cesarean section. © 2016 John Wiley & Sons, Ltd.

Dissolution of Biogenic and Synthetic UO2 under Varied Reducing Conditions

PubMed Central

ULRICH, KAI – UWE; SINGH, ABHAS; SCHOFIELD, ELEANOR J.; BARGAR, JOHN R.; VEERAMANI, HARISH; SHARP, JONATHAN O.; LATMANI, RIZLAN BERNIER -; GIAMMAR, DANIEL E.

2008-01-01

The chemical stability of biogenic UO2, a nanoparticulate product of environmental bioremediation, may be impacted by the particles’ surface free energy, structural defects, and compositional variability in analogy to abiotic UO2+x (0 ≤ x ≤ 0.25). This study quantifies and compares intrinsic solubility and dissolution rate constants of biogenic nano-UO2 and synthetic bulk UO2.00, taking molecular-scale structure into account. Rates were determined under anoxic conditions as a function of pH and dissolved inorganic carbon in continuous-flow experiments. The dissolution rates of biogenic and synthetic UO2 solids were lowest at near neutral pH and increased with decreasing pH. Similar surface area-normalized rates of biogenic and synthetic UO2 suggest comparable reactive surface site densities. This finding is consistent with the identified structural homology of biogenic UO2 and stoichiometric UO2.00. Compared to carbonate-free anoxic conditions, dissolved inorganic carbon accelerated the dissolution rate of biogenic UO2 by 3 orders of magnitude. This phenomenon suggests continuous surface oxidation of U(IV) to U(VI), with detachment of U(VI) as the rate-determining step in dissolution. Although reducing conditions were maintained throughout the experiments, the UO2 surface can be oxidized by water and radiogenic oxidants. Even in anoxic aquifers, UO2 dissolution may be controlled by surface U(VI) rather than U(IV) phases. PMID:18754482

Studies on the prevalence of reduced salivary flow rate in relation to general health and dental caries, and effect of iron supplementation.

PubMed

Flink, Håkan

2007-01-01

Reduced salivary flow is a condition that affects oral health. Its prevalence is unknown in young and middle-aged adults and there is no known treatment that permanently increases the salivary flow rate. Reduced salivary flow is related to dental caries, the most common oral disease. Reduced salivary flow is often found in individuals with insufficient food intake and thereby insufficient nutrition to the salivary glands. One nutrition related factor that has been proposed to effect salivary flow rate is iron deficiency. The aims of the thesis were to investigate i) the prevalence of reduced salivary flow rate in different age groups of adults, ii) the relationship between reduced salivary flow rate, general health and dental caries, iii) the influence of time of measurement on reduced salivary flow rate, and iv) if reduced salivary flow rates could be increased by iron supplementation. In Study I saliva was collected from 1427 individuals aged 20-69 years. A questionnaire was answered regarding subjective oral dryness, general diseases, use of drugs, BMI (Body Mass Index) and use of tobacco. In Study II saliva was collected from 48 patients with active caries and 48 caries-inactive patients. A blood sample was analysed for serum ferritin. In Study III the unstimulated salivary flow rate was tested at 7:30 and 11:30 a.m. in 108 individuals, age 15-46 years. The participants were allocated to one of three groups (very low < 0.1 mL/min, low 0.1-0.2 mL/min and normal > 0.2 mL/min) based on the the unstimulated salivary flow rate at 7:30 a.m. Different aspects of the perception of oral dryness were rated using Visual Analogue Scales. In Study IV a double-blind, randomized controlled trial was carried out on 50 individuals with a low unstimulated whole salivary flow rate and low serum ferritin. Half the individuals received 60 mg of iron orally twice a day for 3 months, while the other half received placebo. In Study I it was found that the prevalence of very low (< 0.1 mL/min) and low (0.10-0.19 mL/min) unstimulated salivary flow rate were similar for different age groups up to 50 years, ranging between 10.9-17.8% and 17.3-22.7%, respectively. Multiple logistic regression revealed that above age 50, female gender, 'having fewer than 20 teeth', and taking xerogenic drugs significantly increased the risk of very low unstimulated salivary flow rate. In Study II 32 individuals (67%) in the caries active group had low unstimulated salivary flow rate compared with 13 individuals (27%) in the caries inactive group. There was no difference in serum ferritin levels between the two groups. Study III showed for all groups a statistically significant increase in unstimulated salivary flow rate at 11:30 a.m. compared with 7:30 a.m., all of similar magnitude (0.08-0.09 mL/min). In the group with very low salivary flow rate, 70% at 11:30 a.m. exceeded the 0.1 mL/min limit. There were significant difference in perception of oral dryness between the normal group and both the low and the very low groups. In Study IV no statistically significant difference was found between the groups after treatment for the unstimulated flow rate and in the subjective assessments of oral dryness. The prevalence of reduced salivary flow rates is consistent and prevalent in younger and middle-aged adults (< 50 years). Very low salivary flow rates are related to high Body Mass Index (BMI) and diagnosed diseases in younger adults, but to medication in older adults. Reduced salivary flow rate in young adult women is related to caries. The time of measurement of salivary flow rates influences diagnosis of hyposalivation. Iron supplementation does not enhance salivary flow.

Comparison of the effect of pindolol and propranolol on heart rate after acute and chronic administration.

PubMed Central

Finch, M B; O'Connor, P C; Harron, D W; Shanks, R G

1983-01-01

1 The present study compared the effects in healthy volunteers of the acute and chronic administration of placebo, pindolol and propranolol to see if the partial agonist activity of pindolol was reduced by the beta-adrenoceptor blocking activity of pindolol on chronic administration. 2 Five subjects received in random order for 8 days placebo, propranolol 160 mg and pindolol 10 mg; on days 1 and 8 treatments were given twice at 0 and 2 h. Heart rate in supine position and at end of exercise was recorded before dosing and at 2 and 4 h post-dosing on days 1 and 8. 3 Propranolol and pindolol reduced exercise heart rate to the same extent on days 1 and 8. 4 Propranolol reduced supine heart rate more than pindolol on days 1 and 8 but the difference was only significant on day 8. PMID:6849778

Incubation of boar spermatozoa in viscous media by addition of methylcellulose improves sperm quality and penetration rates during in vitro fertilization.

PubMed

González-Abreu, David; García-Martínez, Soledad; Fernández-Espín, Vanesa; Romar, Raquel; Gadea, Joaquín

2017-04-01

This work was designed to study whether viscous media can improve the in vitro sperm functionality in pigs by using methylcellulose as a thickener. Viscosity of porcine oviductal fluid (POF) was compared with culture medium (Tyrode's) supplemented with methylcellulose (MET 0, 0.5 and 1% w/v). Spermatozoa were incubated in the different media (0, 1 and 2 h) and sperm motion parameters, lipid membrane disorder, plasma membrane integrity and reactive oxygen species (ROS) formation were assessed. Fertilization results were assessed i) preincubating spermatozoa in the viscous media followed by gamete coculture in a non-viscous medium; and ii) gamete coculture in the viscous media. Viscosity of POF from early luteal phase was higher than late follicular phase. Medium without methylcellulose presented constant viscosity with increased shear rate, while viscosity of the POF and media with methylcellulose was reduced by increased shear rates. Methylcellulose improved sperm linearity, straightness and the proportion of fast-linear spermatozoa. Moreover, methylcellulose increased the rate of viable spermatozoa with intact acrosome and low lipid disorder, reducing the ROS generation. Preincubation in viscous media increased the penetration rate and the mean number of spermatozoa bound to the zona pellucida (both with 0.5 and 1% MET) and reduced monospermy with 1% MET. On the other hand fertilization in the viscous media reduced penetration rate and increased monospermy. The efficiency of the IVF system was not improved with the use of viscous media. The results show the relevance of increasing viscosity thus making the in vitro media more comparable to physiological conditions. Copyright © 2017 Elsevier Inc. All rights reserved.

Systolic Strain Abnormalities to Predict Hospital Readmission in Patients With Heart Failure and Normal Ejection Fraction

PubMed Central

Borer, Steven M.; Kokkirala, Aravind; O'Sullivan, David M.; Silverman, David I.

2011-01-01

Background Despite intensive investigation, the pathogenesis of heart failure with normal ejection fraction (HFNEF) remains unclear. We hypothesized that subtle abnormalities of systolic function might play a role, and that abnormal systolic strain and strain rate would provide a marker for adverse outcomes. Methods Patients of new CHF and left ventricular ejection fraction > 50% were included. Exclusion criteria were recent myocardial infarction, severe valvular heart disease, severe left ventricular hypertrophy (septum >1.8 cm), or a technically insufficient echocardiogram. Average peak systolic strain and strain rate were measured using an off-line grey scale imaging technique. Systolic strain and strain rate for readmitted patients were compared with those who remained readmission-free. Results One hundred consecutive patients with a 1st admission for HFNEF from January 1, 2004 through December 31, 2007, inclusive, were analyzed. Fifty two patients were readmitted with a primary diagnosis of heart failure. Systolic strain and strain rates were reduced in both study groups compared to controls. However, systolic strain did not differ significantly between the two groups (-11.7% for those readmitted compared with -12.9% for those free from readmission, P = 0.198) and systolic strain rates also were similar (-1.05 s-1 versus -1.09 s-1, P = 0.545). E/e’ was significantly higher in readmitted patients compared with those who remained free from readmission (14.5 versus 11.0, P = 0.013). E/e’ (OR 1.189, 95% CI 1.026-1.378; P = 0.021) was found to be an independent predictor for HFNEF readmission. Conclusions Among patients with new onset HFNEF, SS and SR rates are reduced compared with patients free of HFNEF, but do not predict hospital readmission. Elevated E/e’ is a predictor of readmission in these patients. PMID:28352395

N-doped structures and surface functional groups of reduced graphene oxide and their effect on the electrochemical performance of supercapacitor with organic electrolyte

NASA Astrophysics Data System (ADS)

Li, Shin-Ming; Yang, Shin-Yi; Wang, Yu-Sheng; Tsai, Hsiu-Ping; Tien, Hsi-Wen; Hsiao, Sheng-Tsung; Liao, Wei-Hao; Chang, Chien-Liang; Ma, Chen-Chi M.; Hu, Chi-Chang

2015-03-01

Nitrogen-doped reduced graphene oxide (N-rGO) has been synthesized using a simple, efficient method combining instant thermal exfoliation and covalent bond transformation from a melamine-graphene oxide mixture. The capacitive performance of N-rGO has been tested in both aqueous (0.5 M H2SO4) and organic (1 M tetraethyl-ammonium tetrafluoroborate (TEABF4) in propylene carbonate (PC)) electrolytes, which are compared with those obtained from thermal-reduced graphene oxide (T-rGO) and chemical-reduced graphene oxide (C-rGO). The contributions of scan-rate-independent (double-layer-like) and scan-rate-dependent (pseudo-capacitance-like) capacitance of all reduced graphene oxides in both aqueous and organic electrolytes were evaluated and compared. The results show that relatively rich oxygen-containing functional groups on C-rGO form significant ion-diffusion barrier, resulting in worse electrochemical responses in organic electrolyte. By contrast, the N-doped structures, large surface area, and lower density of oxygen-containing groups make N-rGO become a promising electrode material for organic electric double-layer capacitors (EDLCs). The capacitance rate-retention of N-rGO reaches 71.1% in 1 M TEABF4/PC electrolyte when the scan rate is elevated to 200 mVs-1, demonstrating that N-rGO improves the relatively low-power drawback of EDLCs in organic electrolytes. The specific energy and power of a symmetric N-rGO cell in the organic electrolyte reach 25 Wh kg-1 and 10 kW kg-1, respectively.

Patent Foramen Ovale Closure in the Setting of Cryptogenic Stroke: A Meta-Analysis of Five Randomized Trials.

PubMed

Garg, Lohit; Haleem, Affan; Varade, Shweta; Sivakumar, Keithan; Shah, Mahek; Patel, Brijesh; Agarwal, Manyoo; Agrawal, Sahil; Leary, Megan; Kluck, Bryan

2018-05-24

The clinical benefit of patent foramen ovale (PFO) closure after cryptogenic stroke has been a topic of debate for decades. Recently, 3 randomized controlled trials of PFO closure in patients with cryptogenic stroke demonstrated a significantly reduced risk of recurrent stroke compared with standard medical therapy alone. This meta-analysis was performed to clarify the efficacy of PFO closure for future stroke prevention in this population. A systematic literature search was undertaken. Published pooled data from 5 large randomized clinical trials (CLOSE, RESPECT, Gore REDUCE, CLOSURE I, and PC) were combined and then subsequently analyzed. Enrolled patients with cryptogenic stroke were assigned to receive standard medical care or to undergo endovascular PFO closure, with a primary outcome of reduction in stroke recurrence rate. Secondary outcomes included rates of transient ischemic attack (TIA), composite outcome of stroke, TIA, and death from all causes, and rates of atrial fibrillation events. We analyzed data for 3412 patients. Transcatheter PFO closure resulted in a statistically significant reduced rate of recurrent stroke, compared with medication alone. Patients undergoing closure were 58% less likely to have another stroke. The number needed to treat with PFO closure to reduce recurrent stroke for 1 patient was 40. Endovascular PFO closure was associated with a reduced risk of recurrent stroke in patients with a prior cryptogenic cerebral infarct. Although the absolute stroke reduction was small, these findings are clinically significant, given the young age of this patient population and the patients' lifetime risk of recurrent stroke. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Variation in Patient Profiles and Outcomes in US and Non-US Subgroups of the Cangrelor Versus Standard Therapy to Achieve Optimal Management of Platelet Inhibition (CHAMPION) PHOENIX Trial

PubMed Central

Vaduganathan, Muthiah; Harrington, Robert A.; Stone, Gregg W.; Steg, Ph. Gabriel; Gibson, C. Michael; Hamm, Christian W.; Price, Matthew J.; Prats, Jayne; Deliargyris, Efthymios N.; Mahaffey, Kenneth W.; White, Harvey D.

2016-01-01

Background— The Cangrelor Versus Standard Therapy to Achieve Optimal Management of Platelet Inhibition (CHAMPION) PHOENIX trial demonstrated superiority of cangrelor in reducing ischemic events at 48 hours in patients undergoing percutaneous coronary intervention compared with clopidogrel. Methods and Results— We analyzed all patients included in the modified intention-to-treat analysis in US (n=4097; 37.4%) and non-US subgroups (n=6845; 62.6%). The US cohort was older, had a higher burden of cardiovascular risk factors, and had more frequently undergone prior cardiovascular procedures. US patients more frequently underwent percutaneous coronary intervention for stable angina (77.9% versus 46.2%). Almost all US patients (99.1%) received clopidogrel loading doses of 600 mg, whereas 40.5% of non-US patients received 300 mg. Bivalirudin was more frequently used in US patients (56.7% versus 2.9%). At 48 hours, rates of the primary composite end point were comparable in the US and non-US cohorts (5.5% versus 5.2%; P=0.53). Cangrelor reduced rates of the primary composite end point compared with clopidogrel in US (4.5% versus 6.4%; odds ratio 0.70 [95% confidence interval 0.53–0.92]) and in non-US patients (4.8% versus 5.6%; odds ratio 0.85 [95% confidence interval 0.69–1.05]; interaction P=0.26). Similarly, rates of the key secondary end point, stent thrombosis, were reduced by cangrelor in both regions. Rates of Global Use of Strategies to Open Occluded Arteries (GUSTO)–defined severe bleeding were low and not significantly increased by cangrelor in either region. Conclusions— Despite broad differences in clinical profiles and indications for percutaneous coronary intervention by region in a large global cardiovascular clinical trial, cangrelor consistently reduced rates of ischemic end points compared with clopidogrel without an excess in severe bleeding in both the US and non-US subgroups. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT01156571. PMID:27313282

Comparative Analysis of Two Biological Warfare Air Samplers Using Live Surrogate Agents

DTIC Science & Technology

2012-03-01

extensively for Phosphate Buffer Saline (PBS) solution and water , and, to a very limited degree in AF evaluations, for virus preserving media, specifically...or water . Furthermore, viral studies have been conducted comparing the effectiveness of utilizing the reduced secondary flow rate on the XMX/2L...with using bioagent aerosols rated BSL-2 or higher. Male Specific Coliphage 2 (MS2), American Type Culture Collection (ATCC) 15597-B1, was selected

The piecewise-linear dynamic attenuator reduces the impact of count rate loss with photon-counting detectors

NASA Astrophysics Data System (ADS)

Hsieh, Scott S.; Pelc, Norbert J.

2014-06-01

Photon counting x-ray detectors (PCXDs) offer several advantages compared to standard energy-integrating x-ray detectors, but also face significant challenges. One key challenge is the high count rates required in CT. At high count rates, PCXDs exhibit count rate loss and show reduced detective quantum efficiency in signal-rich (or high flux) measurements. In order to reduce count rate requirements, a dynamic beam-shaping filter can be used to redistribute flux incident on the patient. We study the piecewise-linear attenuator in conjunction with PCXDs without energy discrimination capabilities. We examined three detector models: the classic nonparalyzable and paralyzable detector models, and a ‘hybrid’ detector model which is a weighted average of the two which approximates an existing, real detector (Taguchi et al 2011 Med. Phys. 38 1089-102 ). We derive analytic expressions for the variance of the CT measurements for these detectors. These expressions are used with raw data estimated from DICOM image files of an abdomen and a thorax to estimate variance in reconstructed images for both the dynamic attenuator and a static beam-shaping (‘bowtie’) filter. By redistributing flux, the dynamic attenuator reduces dose by 40% without increasing peak variance for the ideal detector. For non-ideal PCXDs, the impact of count rate loss is also reduced. The nonparalyzable detector shows little impact from count rate loss, but with the paralyzable model, count rate loss leads to noise streaks that can be controlled with the dynamic attenuator. With the hybrid model, the characteristic count rates required before noise streaks dominate the reconstruction are reduced by a factor of 2 to 3. We conclude that the piecewise-linear attenuator can reduce the count rate requirements of the PCXD in addition to improving dose efficiency. The magnitude of this reduction depends on the detector, with paralyzable detectors showing much greater benefit than nonparalyzable detectors.

Use of long-acting reversible contraceptives to reduce the rate of teen pregnancy.

PubMed

Rome, Ellen

2015-11-01

Long-acting reversible contraceptives (LARCs) are safe for use in adolescents and do not rely on compliance or adherence for effectiveness. Continuation rates are higher and pregnancy rates are lower for adolescent users of LARCs compared with short-acting methods such as oral contraceptives. Similarly, repeat pregnancy rates are lower when LARCs are used compared with other forms of contraception. Myths and misconceptions about LARCs and other contraceptives remain a barrier to their use. Health care providers are in a unique position to provide confidential care to adolescents, and should provide education to them about the various contraceptive options, especially LARCs. Copyright © 2015 Cleveland Clinic.

Use of Robson classification to assess cesarean section rate in Brazil: the role of source of payment for childbirth.

PubMed

Nakamura-Pereira, Marcos; do Carmo Leal, Maria; Esteves-Pereira, Ana Paula; Domingues, Rosa Maria Soares Madeira; Torres, Jacqueline Alves; Dias, Marcos Augusto Bastos; Moreira, Maria Elisabeth

2016-10-17

Cesarean section (CS) rates are increasing worldwide but there is some concern with this trend because of potential maternal and perinatal risks. The Robson classification is the standard method to monitor and compare CS rates. Our objective was to analyze CS rates in Brazil according to source of payment for childbirth (public or private) using the Robson classification. Data are from the 2011-2012 "Birth in Brazil" study, which used a national hospital-based sample of 23,940 women. We categorized all women into Robson groups and reported the relative size of each Robson group, the CS rate in each group and the absolute and relative contributions made by each to the overall CS rate. Differences were analyzed through chi-square and Z-test with a significance level of < 0.05. The overall CS rate in Brazil was 51.9 % (42.9 % in the public and 87.9 % in the private health sector). The Robson groups with the highest impact on Brazil's CS rate in both public and private sectors were group 2 (nulliparous, term, cephalic with induced or cesarean delivery before labor), group 5 (multiparous, term, cephalic presentation and previous cesarean section) and group 10 (cephalic preterm pregnancies), which accounted for more than 70 % of CS carried out in the country. High-risk women had significantly greater CS rates compared with low-risk women in almost all Robson groups in the public sector only. Public policies should be directed at reducing CS in nulliparous women, particularly by reducing the number of elective CS in these women, and encouraging vaginal birth after cesarean to reduce repeat CS in multiparous women.

Seasonal regulation of condensed tannin consumption by free-ranging goats in a semi-arid savanna

PubMed Central

Heitkӧnig, Ignas M. A.; Scogings, Peter F.; Hattas, Dawood; Dziba, Luthando E.; Prins, Herbert H. T.; de Boer, Willem F.

2018-01-01

Although condensed tannins (CTs) are known to reduce forage intake by mammalian herbivores in controlled experiments, few studies have tested these effects in the field. Thus the role of CTs on foraging ecology of free-ranging herbivores is inadequately understood. To investigate the effects of CTs under natural savanna conditions, we pre-dosed groups of goats with polyethylene glycol (PEG, a CT-neutralising chemical), CT powder or water before observing their foraging behaviour. While accounting for the effects of season and time of the day, we tested the hypothesis that herbivores forage in ways that reduce the intake rate (g DM per minute) of CTs. We expected pre-dosing goats with CTs to reduce CT intake rates by (1) consuming diets low in CTs, (2) reducing bite rates, (3) increasing the number of foraging bouts, or (4) reducing the length of foraging bouts. Lastly, (5) expected CT to have no influence the number of dietary forage species. In both wet and dry seasons, pre-dosing goats with CTs resulted in lower CT consumption rates compared to PEG goats which seemed relieved from the stress associated with CT consumption. During dry season, the number of dietary forage species was similar across treatments, although goats that were dosed with PEG significantly increased this number in the wet season. Dosing goats with PEG increased the number and length of browsing bouts compared to goats from the other treatments. Pre-loading goats with PEG also tended to increase bite rates on browse forages, which contributed to increased consumption rates of CTs. Based on the behavioural adjustments made by goats in this study and within the constraints imposed by chemical complexity in savanna systems, we concluded that herbivores under natural conditions foraged in ways that minimised CTs consumption. More research should further elucidate the mechanism through which CTs regulated feeding behaviour. PMID:29293513

Birth rates among male cancer survivors and mortality rates among their offspring: a population-based study from Sweden.

PubMed

Tang, Siau-Wei; Liu, Jenny; Juay, Lester; Czene, Kamila; Miao, Hui; Salim, Agus; Verkooijen, Helena M; Hartman, Mikael

2016-03-08

With improvements in treatment of cancer, more men of fertile age are survivors of cancer. This study evaluates trends in birth rates among male cancer survivors and mortality rates of their offspring. From the Swedish Multi-generation Register and Cancer Register, we identified 84,752 men ≤70 years with a history of cancer, for which we calculated relative birth rates as compared to the background population(Standardized Birth Ratios, SBRs). We also identified 126,696 offspring of men who had cancer, and compared their risks of death to the background population(Standardized Mortality Ratio, SMRs). Independent factors associated with reduced birth rates and mortality rates were estimated with Poisson modelling. Men with a history of cancer were 23 % less likely to father a child compared to the background population(SBR 0.77, 95 % Confidence Interval[CI] 0.75-0.79). Nulliparous men were significantly more likely to father a child after diagnosis (SBR 0.81, 95 % CI 0.79-0.83) compared to parous men (SBR 0.68, 95 % CI 0.66-0.74). Cancer site(prostate), onset of cancer during childhood or adolescence, parity status at diagnosis(parous), current age(>40 years) and a recent diagnosis were significant and independent predictors of a reduced probability of fathering a child after diagnosis. Of the 126,696 children born to men who have had a diagnosis of cancer, 2604(2.06 %) died during follow up. The overall mortality rate was similar to the background population(SMR of 1.00, 95 %CI 0.96-1.04) and was not affected by the timing of their birth in relation to father's cancer diagnosis. Male cancer survivors are less likely to father a child compared to the background population. This is influenced by cancer site, age of onset and parity status at diagnosis. However, their offspring are not at an increased risk of death.

Haemodynamic effects of a selective adenosine A2A receptor agonist, CGS 21680, in chronic heart failure in anaesthetized rats

PubMed Central

Nekooeian, Ali A; Tabrizchi, Reza

1998-01-01

Recently we demonstrated that the administration of an A2A adenosine receptor agonist, CGS 21680, to anaesthetized rats with acute heart failure (1 h post-coronary artery ligation) resulted in an increase in cardiac output. In the present investigation, the effects of CGS 21680 on cardiac output, vascular resistance, heart rate, blood pressure and mean circulatory filling pressure (Pmcf) were investigated in anaesthetized rats with chronic heart failure (8 weeks post-coronary artery ligation).Experiments were conducted in five groups (n=6) of animals: sham-operated vehicle-treated (0.9% NaCl; 0.037 mL kg−1 min−1) animals in which the occluder was placed but not pulled to ligate the coronary artery; coronary artery-ligated vehicle-treated animals; and coronary artery-ligated CGS 21680-treated (0.1, 0.3 or 1.0 μg kg−1 min−1) animals.Baseline blood pressure, cardiac output and rate of rise in left ventricular pressure (+dP/dt) were significantly reduced in animals with coronary artery ligation when compared to sham-operated animals. Coronary artery ligation resulted in a significant increase in left ventricular end-diastolic pressure, Pmcf and venous resistance when compared to sham-operated animals.Administration of CGS 21680 at 0.3 and 1.0 μg kg−1 min−1 significantly (n=6; P<0.05) increased cardiac output by 19±4% and 39±5%, and heart rate by 14±2% and 15±1%, respectively, when compared to vehicle treatment in coronary artery-ligated animals. Administration of CGS 21680 also significantly reduced blood pressure and arterial resistance when compared to coronary artery-ligated vehicle-treated animals. Infusion of CGS 21680 also significantly reduced venous resistance when compared to vehicle-treated coronary artery-ligated animals.The results show that heart failure is characterized by reduced cardiac output, and increased left ventricular end-diastolic pressure, venous resistance and Pmcf. Acute treatment with CGS 21680 in animals with chronic heart failure decreased left ventricular end-diastolic pressure and increased cardiac output. This increase in cardiac output was the result of reduced arterial and venous resistances and increased heart rate. PMID:9831898

Contraction frequency after administration of misoprostol in obese versus nonobese women.

PubMed

Stefely, Erin; Warshak, Carri R

2018-04-30

To examine impact of obesity on contraction frequency following misoprostol. Our hypothesis is that an increased volume of distribution reduces the bioavailability of misoprostol and may be an explanation for reduced efficacy. We examined the contraction frequency as a surrogate marker for bioavailability of misoprostol. We compared the rate of contractions at five time intervals in 313 subjects: prior to administration, and at four intervals post administration. We compared number of contractions in obese versus nonobese. As a planned secondary analysis, we then compared the rate of change in contractions per hour at four time intervals: a repeated measures analysis to compare the rate of change in contractions per hour over the 5-hour window controlling for race (White versus non-White) and parity (primiparous versus multiparous). General linear model and repeated measures analysis were conducted to report the parameter estimates, least square means, difference of least square means, and p values. Nonobese women presented with more contractions at baseline, 7 ± 5 versus 4 ± 5 c/h, p < .001. At all four time intervals after misoprostol administration obese women had fewer contractions per hour. The rate of change in contraction frequency after administration found obese women had a lower rate of increase in contraction frequency over the course of all four hours. We found a least squares means estimate (c/h): first hour (-0.87), p = .08, second hour (-2.43), p = .01, third hour (-1.80), p = .96, and fourth hour (-2.98), p = .007. Obese women have a lower rate of contractions per hour at baseline and at four intervals after misoprostol administration. In addition, the rate of change in the increase in contractions/hour also was reduced in obese women versus nonobese women. This suggests a lower bioavailability of misoprostol in women with a larger volume of distribution which would likely impact the efficacy of misoprostol in obese women when given the same dose of misoprostol. It is unknown if higher misoprostol dosing would increase efficacy of misoprostol in obese women.

Simultaneous Pure Laparoscopic Resection of Primary Colorectal Cancer and Synchronous Liver Metastases: A Single Institution Experience with Propensity Score Matching Analysis.

PubMed

Ivanecz, Arpad; Krebs, Bojan; Stozer, Andraz; Jagric, Tomaz; Plahuta, Irena; Potrc, Stojan

2018-03-01

The aim of the study was to compare the outcome of pure laparoscopic and open simultaneous resection of both the primary colorectal cancer and synchronous colorectal liver metastases (SCLM). From 2000 to 2016 all patients treated by simultaneous resection were assessed for entry in this single center, clinically nonrandomized trial. A propensity score matching was used to compare the laparoscopic group (LAP) to open surgery group (OPEN). Primary endpoints were perioperative and oncologic outcomes. Secondary endpoints were overall survival (OS) and disease-free survival (DFS). Of the 82 patients identified who underwent simultaneous liver resection for SCLM, 10 patients underwent LAP. All these consecutive patients from LAP were matched to 10 comparable OPEN. LAP reduced the length of hospital stay (P = 0.044) and solid food oral intake was faster (P = 0.006) in this group. No patient undergoing the laparoscopic procedure experienced conversion to the open technique. No difference was observed in operative time, blood loss, transfusion rate, narcotics requirement, clinical risk score, resection margin, R0 resections rate, morbidity, mortality and incisional hernias rate. The two groups did not differ significantly in terms of the 3-year OS rate (90 vs. 75%; P = 0.842) and DFS rate (60 vs. 57%; P = 0.724). LAP reduced the length of hospital stay and offers faster solid food oral intake. Comparable oncologic and survival outcomes can be achieved. LAP is beneficial for well selected patients in high volume centers with appropriate expertise.

The death of marriage? The effects of new forms of legal recognition on marriage rates in the United States.

PubMed

Dillender, Marcus

2014-04-01

Some conservative groups argue that allowing same-sex couples to marry reduces the value of marriage to opposite-sex couples. This article examines how changes in U.S. legal recognition laws occurring between 1995 and 2010 designed to include same-sex couples have altered marriage rates in the United States. Using a difference-in-differences strategy that compares how marriage rates change after legal recognition in U.S. states that alter legal recognition versus states that do not, I find no evidence that allowing same-sex couples to marry reduces the opposite-sex marriage rate. Although the opposite-sex marriage rate is unaffected by same-sex couples marrying, it decreases when domestic partnerships are available to opposite-sex couples.

Reduced Rift Valley fever virus infection rates in mosquitoes associated with pledget feedings.

PubMed

Turell, M J

1988-12-01

Infection rates were compared in Culex pipiens and Aedes taeniorhynchus after they fed on Rift Valley fever (RVF) viremic hamsters or ingested similar doses of RVF virus from blood-soaked pledgets. Infection rates were significantly lower for mosquitoes that ingested virus from a pledget than for those that ingested similar doses from viremic hamsters. The method used to prevent normal clot formation for the pledget feedings (i.e., defibrination by shaking with glass beads or addition of heparin) did not affect subsequent infection rates. Both inhibition of normal clot formation and freezing of virus after it had last been propagated were associated with significantly reduced infection rates with the pledget feedings. Laboratory studies using artificial feeding techniques may not give reliable estimates of the vector competence of mosquitoes for arboviruses.

Could Intermittent Energy Restriction and Intermittent Fasting Reduce Rates of Cancer in Obese, Overweight, and Normal-Weight Subjects? A Summary of Evidence.

PubMed

Harvie, Michelle N; Howell, Tony

2016-07-01

Animal studies and human observational data link energy restriction (ER) to reduced rates of carcinogenesis. Most of these studies have involved continuous energy restriction (CER), but there is increasing public and scientific interest in the potential health and anticancer effects of intermittent energy restriction (IER) or intermittent fasting (IF), which comprise periods of marked ER or total fasting interspersed with periods of normal eating. This review summarizes animal studies that assessed tumor rates with IER and IF compared with CER or ad libitum feed consumption. The relevance of these animal data to human cancer is also considered by summarizing available human studies of the effects of IER or IF compared with CER on cancer biomarkers in obese, overweight, and normal-weight subjects. IER regimens that include periods of ER alternating with ad libitum feed consumption for 1, 2, or 3 wk have been reported to be superior to CER in reducing tumor rates in most spontaneous mice tumor models. Limited human data from short-term studies (≤6 mo) in overweight and obese subjects have shown that IER can lead to greater improvements in insulin sensitivity (homeostasis model assessment) than can CER, with comparable reductions in adipokines and inflammatory markers and minor changes in the insulin-like growth factor axis. There are currently no data comparing IER or IF with CER in normal-weight subjects. The benefits of IER in these short-term trials are of interest, but not sufficient evidence to recommend the use of IER above CER. Longer-term human studies of adherence to and efficacy and safety of IER are required in obese and overweight subjects, as well as normal-weight subjects. © 2016 American Society for Nutrition.

A randomized, controlled comparison between arnica and steroids in the management of postrhinoplasty ecchymosis and edema.

PubMed

Totonchi, Ali; Guyuron, Bahman

2007-07-01

Both arnica and corticosteroids have been suggested for reducing the postoperative edema and bruising associated with rhinoplasty. This study compared the efficacy of these products following rhinoplasty. Forty-eight primary rhinoplasty patients were randomized into three groups: group P received 10 mg of dexamethasone (intravenously) intraoperatively followed by a 6-day oral tapering dose of methyl-prednisone; group A received arnica three times a day for 4 days; and group C received neither agent and served as the control. Three blinded panelists rated the extent of ecchymosis, the intensity of the ecchymosis, and the severity of the edema. On postoperative day 2, there were no significant differences in the ratings of extent and intensity of ecchymosis among the groups. There was a significant difference for the edema rating (p < 0.0001), with group C demonstrating more swelling compared with groups A and P. In addition, on postoperative day 8, group P demonstrated a significantly larger extent of ecchymosis (p < 0.05) and higher intensity of ecchymosis (p < 0.01) compared with groups A and C. There were no differences in the magnitude of edema by postoperative day 8 among the three groups. When the differences between day 2 and day 8 ratings were considered, groups A and C exhibited significantly more resolution of ecchymosis by day 8 compared with group P (p < 0.05). This study suggests that both arnica and corticosteroids may be effective in reducing edema during the early postoperative period. Arnica does not appear to provide any benefit with regard to extent and intensity of ecchymosis. The delay in resolution of ecchymosis for patients receiving corticosteroids may outweigh the benefit of reducing edema during the early postoperative period.

A randomised controlled trial of cognitive aids for emergency airway equipment preparation in a Paediatric Emergency Department.

PubMed

Long, Elliot; Fitzpatrick, Patrick; Cincotta, Domenic R; Grindlay, Joanne; Barrett, Michael Joseph

2016-01-27

Safety of emergency intubation may be improved by standardising equipment preparation; the efficacy of cognitive aids is unknown. This randomised controlled trial compared no cognitive aid (control) with the use of a checklist or picture template for emergency airway equipment preparation in the Emergency Department of The Royal Children's Hospital, Melbourne. Sixty-three participants were recruited, 21 randomised to each group. Equal numbers of nursing, junior medical, and senior medical staff were included in each group. Compared to controls, the checklist or template group had significantly lower equipment omission rates (median 30% IQR 20-40% control, median 10% IQR 5-10 % checklist, median 10% IQR 5-20% template; p < 0.05). The combined omission rate and sizing error rate was lower using a checklist or template (median 35 % IQR 30-45 % control, median 15% IQR 10-20% checklist, median 15% IQR 10-30% template; p < 0.05). The template group had less variation in equipment location compared to checklist or controls. There was no significant difference in preparation time in controls (mean 3 min 14 s sd 56 s) compared to checklist (mean 3 min 46 s sd 1 min 15 s) or template (mean 3 min 6 s sd 49 s; p = 0.06). Template use reduces variation in airway equipment location during preparation foremergency intubation, with an equivalent reduction in equipment omission rate to the use of a checklist. The use of a template for equipment preparation and a checklist for team, patient, and monitoring preparation may provide the best combination of both cognitive aids. The use of a cognitive aid for emergency airway equipment preparation reduces errors of omission. Template utilisation reduces variation in equipment location. Australian and New Zealand Trials Registry (ACTRN12615000541505).

Could Intermittent Energy Restriction and Intermittent Fasting Reduce Rates of Cancer in Obese, Overweight, and Normal-Weight Subjects? A Summary of Evidence12

PubMed Central

2016-01-01

Animal studies and human observational data link energy restriction (ER) to reduced rates of carcinogenesis. Most of these studies have involved continuous energy restriction (CER), but there is increasing public and scientific interest in the potential health and anticancer effects of intermittent energy restriction (IER) or intermittent fasting (IF), which comprise periods of marked ER or total fasting interspersed with periods of normal eating. This review summarizes animal studies that assessed tumor rates with IER and IF compared with CER or ad libitum feed consumption. The relevance of these animal data to human cancer is also considered by summarizing available human studies of the effects of IER or IF compared with CER on cancer biomarkers in obese, overweight, and normal-weight subjects. IER regimens that include periods of ER alternating with ad libitum feed consumption for 1, 2, or 3 wk have been reported to be superior to CER in reducing tumor rates in most spontaneous mice tumor models. Limited human data from short-term studies (≤6 mo) in overweight and obese subjects have shown that IER can lead to greater improvements in insulin sensitivity (homeostasis model assessment) than can CER, with comparable reductions in adipokines and inflammatory markers and minor changes in the insulin-like growth factor axis. There are currently no data comparing IER or IF with CER in normal-weight subjects. The benefits of IER in these short-term trials are of interest, but not sufficient evidence to recommend the use of IER above CER. Longer-term human studies of adherence to and efficacy and safety of IER are required in obese and overweight subjects, as well as normal-weight subjects. PMID:27422504

Historical cancer incidence and mortality assessment in an Illinois community proximal to a former manufactured gas plant

PubMed Central

Alexander, Dominik D; Jiang, Xiaohui; Bylsma, Lauren C; Garabrant, David H; Irvin, Sarah R; Fryzek, Jon P

2014-01-01

Objectives Concern has been raised that the occurrence of cancer may be increased in neighbourhoods around a former manufactured gas plant in Champaign, Illinois, USA. Thus, we compared historical rates of cancer in this area to comparison communities as well as with nationally standardised rates. Design Retrospective population-based community cancer assessment during 1990–2010. Setting Champaign County, Illinois, USA, and zip codes encompassing the location of the former manufactured gas plant to counties that were similar demographically. Participants Residents of the counties and zip codes studied between 1990 and 2010. Main outcome measures The relative risk (RR) and 95% CI were used to compare cancer incidence and mortality in the areas near the gas compression site to the comparison counties. Standardised incidence ratios (SIRs) were calculated to compare rates in the areas near the gas compression site to expected rates based on overall US cancer rates. Results Total cancer mortality (RR=0.91, 95% CI 0.88 to 0.94) and incidence (RR=0.95, 95% CI 0.94 to 0.97) were reduced significantly in Champaign County versus the comparison counties. Similarly, a reduced rate of total cancer was observed in analyses by zip code (proximal to the former gas plant) when compared with either similar counties (RR=0.89, 95% CI 0.86 to 0.93) or national standardised rates of cancer (SIR=0.88, 95% CI 0.85 to 0.91). Conclusions This historical cancer assessment did not find an increased risk of total cancer or specific cancer types in communities near a former manufactured gas plant site. PMID:25534215

Simulated effects of ground-water management scenarios on the Santa Fe group aquifer system, Middle Rio Grande Basin, New Mexico, 2001-40

USGS Publications Warehouse

Bexfield, Laura M.; McAda, Douglas P.

2003-01-01

Future conditions in the Santa Fe Group aquifer system through 2040 were simulated using the most recent revision of the U.S. Geological Survey groundwater- flow model for the Middle Rio Grande Basin. Three simulations were performed to investigate the likely effects of different scenarios of future groundwater pumping by the City of Albuquerque on the ground-water system. For simulation I, pumping was held constant at known year-2000 rates. For simulation II, pumping was increased to simulate the use of pumping to meet all projected city water demand through 2040. For simulation III, pumpingwas reduced in accordance with a plan by the City of Albuquerque to use surfacewater to meet most of the projectedwater demand. The simulations indicate that for each of the three pumping scenarios, substantial additional watertable declines would occur in some areas of the basin through 2040. However, the reduced pumping scenario of simulation III also results in water-table rise over a broad area of the city. All three scenarios indicate that the contributions of aquifer storage and river leakage to the ground-water system would change between 2000 and 2040. Comparisons among the results for simulations I, II, and III indicate that the various pumping scenarios have substantially different effects on water-level declines in the Albuquerque area and on the contribution of each water-budget component to the total budget for the ground-water system. Between 2000 and 2040, water-level declines for continued pumping at year-2000 rates are as much as 120 feet greater than for reduced pumping; water-level declines for increased pumping to meet all projected city demand are as much as 160 feet greater. Over the same time period, reduced pumping results in retention in aquifer storage of about 1,536,000 acre-feet of ground water as compared with continued pumping at year- 2000 rates and of about 2,257,000 acre-feet as compared with increased pumping. The quantity of water retained in the Rio Grande as a result of reduced pumping and the associated decrease in induced recharge from the river is about 731,000 acre-feet as compared with continued pumping at year-2000 rates and about 872,000 acre-feet as compared with increased pumping. Reduced pumping results in slight increases in the quantity of water lost from the groundwater system to evapotranspiration and agriculturaldrain flow compared with the other pumping scenarios.

A study on reducing the absorption of lidocaine from the airway in cats.

PubMed

Chen, Yunfeng; Zeng, Yiming; Zhang, Yin

2017-08-01

To determine if the combination of lidocaine with epinephrine or gamma globulin would decrease the rate or reduce the amount of local absorption of lidocaine through the airway. Twenty adult male cats were randomly and evenly distributed into four groups: 1) Group LG: lidocaine administered with gamma globulin; 2) Group LS: lidocaine administered with physiological saline); 3) Group LE: lidocaine administered with epinephrine; 4) Group C: control group. Invasive blood pressure, heart rate, and concentration of lidocaine were recorded before and after administration. The peak of plasma concentrations appeared difference (Group LG: 1.39 ± 0.23 mg/L; Group LS: 1.47 ± 0.29 mg/L and Group LE: 0.99 ± 0.08 mg/L). Compared to Group C, there were significant differences in the average heart rate of Groups LG, LS, and LE (P < 0.05). The average systolic blood pressures were significantly different when each group was compared to Group C (P < 0.05). The biological half-life, AUC0-120, peak time, and half-life of absorption among the three groups have not presented statistically significant differences (P > 0.05). Administering lidocaine in combination with gamma globulin through airway causes significant decrease the rate and reduce the amount of local absorption of lidocaine in cats.

Correcting haemoglobin cut-offs to define anaemia in high-altitude pregnant women in Peru reduces adverse perinatal outcomes.

PubMed

Gonzales, Gustavo F; Tapia, Vilma; Gasco, Manuel

2014-07-01

To determine if correction of cut-offs of haemoglobin levels to define anaemia at high altitudes affects rates of adverse perinatal outcomes. Data were obtained from 161,909 mothers and newborns whose births occurred between 1,000 and 4,500 m above sea level (masl). Anaemia was defined with or without correction of haemoglobin (Hb) for altitude as Hb <11 g/dL. Correction of haemoglobin per altitude was performed according to guidelines from the World Health Organization. Rates of stillbirths and preterm births were also calculated. Stillbirth and preterm rates were significantly reduced in cases of anaemia calculated after correction of haemoglobin for altitude compared to values obtained without Hb correction. At high altitudes (3,000-4,500 masl), after Hb correction, the rate of stillbirths was reduced from 37.7 to 18.3 per 1,000 live births (p < 0.01); similarly, preterm birth rates were reduced from 13.1 to 8.76 % (p < 0.01). The odds ratios for stillbirths and for preterm births were also reduced after haemoglobin correction. At high altitude, correction of maternal haemoglobin should not be performed to assess the risks for preterm birth and stillbirth. In fact, using low altitude Hb cut-off is associated with predicting those at risk.

Cardiac Autonomic Control in Individuals With Down Syndrome

ERIC Educational Resources Information Center

Goulopoulou, Styliani; Baynard, Tracy; Collier, Scott; Giannopoulou, Ifigenia; Figueroa, Arturo; Beets, Michael; Pitetti, Kenneth; Fernhall, Bo

2006-01-01

Our goal in this study was to compare cardiac autonomic control at rest between 50 individuals with Down syndrome and 24 control participants without disabilities. Resting autonomic function was assessed using analysis of heart rate variability. Participants with Down syndrome had reduced total heart rate variability, which indicates possible…

Micropatterned Protective Membranes Inhibit Lens Epithelial Cell Migration in Posterior Capsule Opacification Model

PubMed Central

Magin, Chelsea M.; May, Rhea M.; Drinker, Michael C.; Cuevas, Kevin H.; Brennan, Anthony B.; Reddy, Shravanthi T.

2015-01-01

Purpose To evaluate the ability of Sharklet (SK) micropatterns to inhibit lens epithelial cell (LEC) migration. Sharklet Technologies, Inc. (STI) and InSight Innovations, LLC have proposed to develop a Sharklet-patterned protective membrane (PM) to be implanted in combination with a posterior chamber intraocular lens (IOL) to inhibit cellular migration across the posterior capsule, and thereby reduce rates of posterior capsular opacification (PCO). Methods A variety of STI micropatterns were evaluated versus smooth (SM) controls in a modified scratch wound assay for the ability to reduce or inhibit LEC migration. The best performing topography was selected, translated to a radial design, and applied to PM prototypes. The PM prototypes were tested in an in vitro PCO model for reduction of cell migration behind an IOL versus unpatterned prototypes and IOLs with no PM. In both assays, cell migration was analyzed with fluorescent microscopy. Results All SK micropatterns significantly reduced LEC migration compared with SM controls. Micropatterns that protruded from the surface reduced migration more than recessed features. The best performing micropattern reduced LEC coverage by 80%, P = 0.0001 (ANOVA, Tukey Test). Micropatterned PMs reduced LEC migration in a PCO model by 50%, P = 0.0005 (ANOVA, Tukey Test) compared with both IOLs with no PM and IOLs with SM PMs. Conclusions Collectively, in vitro results indicate the implantation of micropatterned PMs in combination with posterior chamber IOLs could significantly reduce rates of clinically relevant PCO. This innovative technology is a globally accessible solution to high PCO rates. Translational Relevance A novel IOL incorporating the SK micropattern in a membrane design surrounding the optic may help increase the success of cataract surgery by reducing secondary cataract, or PCO. PMID:25883876

Efficacy of a radiation absorbing shield in reducing dose to the interventionalist during peripheral endovascular procedures: a single centre pilot study.

PubMed

Power, S; Mirza, M; Thakorlal, A; Ganai, B; Gavagan, L D; Given, M F; Lee, M J

2015-06-01

This prospective pilot study was undertaken to evaluate the feasibility and effectiveness of using a radiation absorbing shield to reduce operator dose from scatter during lower limb endovascular procedures. A commercially available bismuth shield system (RADPAD) was used. Sixty consecutive patients undergoing lower limb angioplasty were included. Thirty procedures were performed without the RADPAD (control group) and thirty with the RADPAD (study group). Two separate methods were used to measure dose to a single operator. Thermoluminescent dosimeter (TLD) badges were used to measure hand, eye, and unshielded body dose. A direct dosimeter with digital readout was also used to measure eye and unshielded body dose. To allow for variation between control and study groups, dose per unit time was calculated. TLD results demonstrated a significant reduction in median body dose per unit time for the study group compared with controls (p = 0.001), corresponding to a mean dose reduction rate of 65 %. Median eye and hand dose per unit time were also reduced in the study group compared with control group, however, this was not statistically significant (p = 0.081 for eye, p = 0.628 for hand). Direct dosimeter readings also showed statistically significant reduction in median unshielded body dose rate for the study group compared with controls (p = 0.037). Eye dose rate was reduced for the study group but this was not statistically significant (p = 0.142). Initial results are encouraging. Use of the shield resulted in a statistically significant reduction in unshielded dose to the operator's body. Measured dose to the eye and hand of operator were also reduced but did not reach statistical significance in this pilot study.

Everolimus Is Associated With Less Weight Gain Than Tacrolimus 2 Years After Liver Transplantation: Results of a Randomized Multicenter Study

PubMed Central

Charlton, Michael; Rinella, Mary; Patel, Dharmesh; McCague, Kevin; Heimbach, Julie; Watt, Kymberly

2017-01-01

Background Weight gain early after transplant is a risk factor for posttransplant metabolic syndrome (PTMS), cardiovascular events, and renal insufficiency. The impact of mammalian target of rapamycin inhibition on posttransplant weight gain and the development of PTMS components postliver transplantation were examined in a randomized, controlled study. Methods After a run-in period, patients (N = 719) were randomized at 30 ± 5 days posttransplant in a 1:1:1 ratio to 3 treatment groups: (i) everolimus (EVR) + reduced tacrolimus (TAC) (n = 245); (ii) TAC control (n = 243) or (iii) TAC elimination (n = 231). In this post hoc analysis, weight change at 12 and 24 months was compared between groups. Vital signs, lipids, and laboratory parameters at 12 and 24 months and rates of PTMS were assessed. Results Mean increase in weight from baseline was higher at month 12 in the TAC control arm (8.15 ± 9.27 kg) than in the EVR + reduced TAC (5.88 ± 12.60 kg, P = 0.056) and the TAC elimination arms (4.76 ± 9.94 kg, P = 0.007). At month 24, the TAC control arm displayed a significantly greater weight increase (9.54 ± 10.21 kg) than either the EVR + reduced TAC (6.69 ± 8.37 kg, P = 0.011) or the TAC elimination groups (6.01 ± 9.98 kg, P = 0.024). Rates of PTMS were similar for the EVR + reduced TAC (71.8%), TAC elimination (70.3%) and TAC control (67.4%) arms (P = NS). Conclusions EVR with reduced-exposure TAC attenuated weight gain at 1 and 2 years posttransplant compared with a standard TAC immunosuppression regimen. Rates of PTMS were comparable between EVR-containing and TAC control regimens. PMID:28817434

Does minimal access tubular assisted spine surgery increase or decrease complications in spinal decompression or fusion?

PubMed

Fourney, Daryl R; Dettori, Joseph R; Norvell, Daniel C; Dekutoski, Mark B

2010-04-20

Systematic review. The purpose of this review was to attempt to answer the following 2 clinical questions: (1) Does minimal access tubular assisted spine surgery (MAS) decrease the rate of complications in posterior thoracolumbar decompression and/or fusion surgery compared with traditional open techniques? (2) What strategies to reduce the risk of complications in MAS have been shown to be effective? The objective of minimal access spine surgery is to reduce damage to surrounding tissues while accomplishing the same goals as conventional surgery. Patient demand and marketing for MAS is driven by the perception of better outcomes, although the purported advantages remain unproven. Whether the risk of complications is affected by minimal access techniques is unknown. A systematic review of the English language literature was undertaken for articles published between 1990 and July 2009. Electronic databases and reference lists of key articles were searched to identify published studies that compared the rate of complications after MAS to a control group that underwent open surgery. Single-arm studies were excluded. Two independent reviewers assessed the strength of literature using GRADE criteria assessing quality, quantity, and consistency of results. Disagreements were resolved by consensus. From the 361 articles identified, 13 met a priori criteria and were included for review. All of the studies evaluated only lumbar spine surgery. The single large randomized study showed less favorable results for MAS discectomy, but no significant difference in complication rates. The quality of the other studies, particularly for fusion surgery, was low. Overall, the rates of reoperation, dural tear, cerebrospinal fluid leak, nerve injury, and infection occurred in similar proportions between MAS and open surgery. Blood loss was reduced in MAS fusion; however, the quality of those studies was very low. Operation time and hospital length of stay was variable across studies. There was no evidence to assess the effectiveness of strategies to reduce the risk of complications in MAS. Some data suggests that the rate of complications may decrease with experience. (1) Compared to open techniques, MAS does not decrease the rate of complications for posterior lumbar spinal decompression or fusion. (2) There is no evidence to assess the effectiveness of strategies to reduce the risk of MAS-related complications.

The effectiveness of automatic belts in reducing fatality rates in Toyota Cressidas.

PubMed

Nash, C E

1989-12-01

Toyota Cressidas have had motor driven automatic belts since 1981. Their observed use rates have been consistently close to 100%. This paper compares fatality rates in Toyota Cressidas with those in the similar Nissan Maximas (which are equipped with three-point manual belts) using the latest data from the Fatal Accident Reporting System. After making adjustments for differences in the average ages of front seat occupants of the two fleets, the Toyotas have a fatality rate that is about three-quarters that of the Nissans. From this, the fatality-reducing effectiveness for the Toyota automatic belts is estimated to be 40% with an uncertainty of +/- 8%. This effectiveness estimate is consistent with earlier estimates of automatic belt effectiveness.

Effects of nutrition (herbivore vs carnivore) on energy charge and nucleotide composition in Hyas araneus larvae

NASA Astrophysics Data System (ADS)

Harms, J.

1992-03-01

Growth rate expressed as dry weight, elemetnal composition (C, N, H), protein content and nucleotide composition (ATP, ADP, AMP, CTP, GTP and UTP) as well as adenosine were measured in laboratory cultured Hyas araneus larvae fed two different diets. One group was fed freshly hatched Artemia sp. nauplii, the other the diatom Odontella (Biddulphia) sinensis. Growth rate was reduced in the O. sinensis-fed group, reaching 20 to 50% of the growth rate of Artemia-fed larvae. In all cases, some further development to the next instar occurred when larvae were fed O. sinensis, although at reduced levels compared to Artemia-fed larvae. The adenylic energy charge was quite similar for the two nutritional conditions tested and therefore does not reflect the reduced growth rate in O. sinensis-fed larvae. The individual nucleotide content was clearly reduced in O. sinensis-fed larvae, reflecting the nutritional conditions already during early developmental periods. These reduced amount of nucleotides in O. sinensis-fed larvae were most obvious when adenylic nucleotide contents were pooled. Pooled adenylic nucleotides were found to be correlated with the individual content of carbon and protein, showing significant differences at both nutritional conditions tested.

Does tree species richness attenuate the effect of experimental irrigation and drought on decomposition rate in young plantation forests?

NASA Astrophysics Data System (ADS)

Masudur Rahman, Md; Verheyen, Kris; Castagneyrol, Bastien; Jactel, Hervé; Carnol, Monique

2017-04-01

Expected changes in precipitation in Europe due to climate change are likely to affect soil organic matter (OM) transformation. In forests, increasing tree species diversity might modulate the effect of changed precipitation. We evaluated the effect of tree species richness on the decomposition and stabilization rate in combination with reduced precipitation (FORBIO, Belgium) and irrigation treatment (ORPHEE, southern France) in young (6-8 yr.) experimental plantations. The species richness were one to four in FORBIO and one to five in ORPHEE. Twenty four rainout shelters of 3 m × 3 m were built around oak and beech trees in FORBIO plantation to impose a reduced precipitation treatment, whereas four of the eight blocks (175 m×100 m) in ORPHEE plantation was subjected to irrigation treatment. These treatments resulted in about 4% less soil moisture in FORBIO and about 7% higher soil moisture in ORPHEE compared to control. Commercially available green and rooibos tea bags were buried in the soil at 5-7 cm depth to measure two decomposition indices, known as 'tea bag index' (TBI). These TBI are (i) decomposition rate (k) and (ii) stabilization rate (S). The results showed no species richness effect on TBI indices in both reduced precipitation and irrigation treatment. In FORBIO, reduced precipitation resulted in decreased k and increased S compared to control around the beech trees only. In ORPHEE, both k and S were higher in the irrigation treatment compared to control. Overall, TBI indices were higher in FORBIO than ORPHEE and this might be explained by the sandy soils and poor nutrient content at the ORPHEE site. These results suggest that OM decomposition rate may be slower in drier condition and OM stabilization rate may be slower or faster in drier condition, depending on the site quality. The absence of tree species effects on OM transformation indicates that tree species richness would not be able to modulate the effects of changed precipitation patterns in young plantations. We conclude that in young afforestations, soil moisture has more influence on OM transformation than tree species richness.

Sprinklers and shade cool cows and reduce insect-avoidance behavior in pasture-based dairy systems.

PubMed

Kendall, P E; Verkerk, G A; Webster, J R; Tucker, C B

2007-08-01

The body temperature of dairy cows in pastoral systems during summer reaches a peak during and following the p.m. milking. Shade and sprinklers can be used separately or in combination at the milking parlor to reduce heat load. Farmers anecdotally report that the use of sprinklers reduces irritation from insects that occurs while cows are waiting for milking. Once daily, we assessed the effectiveness of short-term exposure to shade and sprinklers for cooling cows [via respiration rate and body (vaginal) temperature] and reducing insect-avoidance behaviors before the p.m. milking in a pasture-based dairy system. Head position was measured as an indicator of whether cattle were avoiding water from the sprinklers. Forty-eight Holstein-Friesian dairy cows were divided into 12 groups (4 cows per group, n = 3 groups/treatment) and were exposed to 1 of 4 treatments for 90 min before the p.m. milking: 1) shade, 2) sprinklers, 3) shade and sprinklers, or 4) uncooled control. Respiration rate was reduced by 30% with shade alone compared with controls [54 vs. 78 +/- 2.3 ( +/- SED) breaths/min, respectively]. Sprinklers alone (30 +/- 2.3 breaths/min) and the combined effects of shade and sprinklers (24 +/- 2.3 breaths/min) reduced the respiration rate by 60 and 67%, respectively, compared with controls. Shaded cows had lower body temperatures during the 90-min treatment period compared with controls (shade: 38.6 degrees C; shade and sprinklers: 38.6 degrees C; control: 38.9 +/- 0.09 degrees C). The decrease in body temperature of cows under sprinklers was more marked than for shade alone and remained lower for at least 4 h after milking (sprinklers: 38.7 degrees C; shade and sprinklers: 38.6 degrees C; shade: 38.9 degrees C; control: 39.2 +/- 0.10 degrees C). The sprinkler treatment reduced the number of tail flicks (control: 12.6 vs. sprinklers: 6.6 +/- 2.4 flicks/min) and hoof stamps (control: 4.4 vs. sprinkler: 2.2 +/- 0.5 stamps/min). Cows exposed to sprinklers spent more time with their heads lowered compared with cows in the shaded and control treatments. The reductions in body temperature and respiration rate attributable to shade and sprinklers were greatest when the temperature-humidity index and heat-load index were > or = 69 and 77, respectively, and cows benefited from cooling when these levels were exceeded.

Policies to Reduce Influenza in the Workplace: Impact Assessments Using an Agent-Based Model

PubMed Central

Grefenstette, John J.; Galloway, David; Albert, Steven M.; Burke, Donald S.

2013-01-01

Objectives. We examined the impact of access to paid sick days (PSDs) and stay-at-home behavior on the influenza attack rate in workplaces. Methods. We used an agent-based model of Allegheny County, Pennsylvania, with PSD data from the US Bureau of Labor Statistics, standard influenza epidemic parameters, and the probability of staying home when ill. We compared the influenza attack rate among employees resulting from workplace transmission, focusing on the effects of presenteeism (going to work when ill). Results. In a simulated influenza epidemic (R0 = 1.4), the attack rate among employees owing to workplace transmission was 11.54%. A large proportion (72.00%) of this attack rate resulted from exposure to employees engaging in presenteeism. Universal PSDs reduced workplace infections by 5.86%. Providing 1 or 2 “flu days”—allowing employees with influenza to stay home—reduced workplace infections by 25.33% and 39.22%, respectively. Conclusions. PSDs reduce influenza transmission owing to presenteeism and, hence, the burden of influenza illness in workplaces. PMID:23763426

Effectiveness and cost of failure mode and effects analysis methodology to reduce neurosurgical site infections.

PubMed

Hover, Alexander R; Sistrunk, William W; Cavagnol, Robert M; Scarrow, Alan; Finley, Phillip J; Kroencke, Audrey D; Walker, Judith L

2014-01-01

Mercy Hospital Springfield is a tertiary care facility with 32 000 discharges and 15 000 inpatient surgeries in 2011. From June 2009 through January 2011, a stable inpatient elective neurosurgery infection rate of 2.15% was observed. The failure mode and effects analysis (FMEA) methodology to reduce inpatient neurosurgery infections was utilized. Following FMEA implementation, overall elective neurosurgery infection rates were reduced to 1.51% and sustained through May 2012. Compared with baseline, the post-FMEA deep-space and organ infection rate was reduced by 41% (P = .052). Overall hospital inpatient clean surgery infection rates for the same time frame did not decrease to the same extent, suggesting a specific effect of the FMEA. The study team believes that the FMEA interventions resulted in 14 fewer expected infections, $270 270 in savings, a 168-day reduction in expected length of stay, and 22 fewer readmissions. Given the serious morbidity and cost of health care-associated infections, the study team concludes that FMEA implementation was clinically cost-effective. © 2013 by the American College of Medical Quality.

Reduced-risk pest management programs for eastern U.S. peach orchards: effects on arthropod predators, parasitoids, and select pests.

PubMed

Biddinger, David J; Leslie, Timothy W; Joshi, Neelendra K

2014-06-01

We developed new integrated pest management programs for eastern U.S. peaches with minimal use of organophosphates. From 2002-2005, we assessed the ecological impacts of these reduced-risk programs versus grower standard conventional programs that still relied primarily on the use of organophosphorous and carbamate insecticides. Using a split-plot design replicated at four commercial Pennsylvania peach orchards, we quantified pesticide rates, environmental impact, and arthropod community response. We used Environmental Impact Quotient (EIQ) analysis based on the growers' pesticide records from each orchard to calculate seasonal cumulative EIQ field ratings for all years. Ecological effects of the reduced-risk and conventional program were also measured as the abundance and diversity of nontarget arthropod predators, parasitoids, and selected pest taxa. Pesticide inputs and EIQ values were substantially lower in reduced-risk programs compared with conventional spray programs. Arthropod arrays differed significantly between pest management programs: most beneficial predator and parasitoid taxa were positively associated with the reduced-risk program and negatively associated with the standard grower program. Regardless of the pest management program, we observed significant differences in species arrays in the peach tree canopy compared with the ground cover of the orchards, but the arthropod community did not differ among the field sites or based on distance from the edge of the orchard. We conclude that reduced-risk programs not only provide control comparable with that of conventional programs, but they also reduce negative environmental effects while conserving key arthropod biological control agents within eastern U.S. peach orchards.

Comparative efficacy of tilmicosin versus tulathromycin as a metaphylactic antimicrobial in feedlot calves at moderate risk for respiratory disease.

PubMed

Van Donkersgoed, Joyce; Merrill, John; Hendrick, Steven

2008-01-01

The purpose of this study was to compare the efficacy and cost-effectiveness of tilmicosin (MIC) versus tulathromycin (DRAX) as a metaphylactic antimicrobial in feedlot calves at moderate risk for bovine respiratory disease (BRD). Calves that received DRAX had significantly (P < or = .05) lower initial BRD treatment rates compared with calves that received MIC. However, there were no significant differences in the BRD relapse rate, railer rate, total mortality rate, BRD mortality rate, average daily gain, and dry matter conversion between the two groups. The economic advantage of the MIC group was Can$8.29/animal. Based on these results, while DRAX was more efficacious in reducing initial treatments for BRD in feedlot calves at moderate risk for disease, MIC was more cost-effective. The lower initial BRD treatment costs in the DRAX group did not offset the higher metaphylactic cost of DRAX.

Effect of Expansion of Fertilization Width on Nitrogen Recovery Rate in Tea Plants

NASA Astrophysics Data System (ADS)

Nonaka, Kunihiko; Hirono, Yuhei; Watanabe, Iriki

In cultivation of tea plants, large amounts of nitrogen, compared to amounts used for other crops, have been used for fertilization, resulting in degradation of the soil environment between hedges and an increase in concentrations of nitrate nitrogen in surrounding water systems. To reduce the environmental load, new methods of fertilizer application are needed. This report deals with the effect of expansion of fertilization width on nitrogen recovery rate in tea plants. In the test field, 15 N-labeled ammonium sulfate had been applied over custom fertilization by between-hedges fertilization (fertilization width of 15cm) and wide fertilization (fertilization width of 40cm), nitrogen recovery rates were compared. Expansion of fertilization width resulted in an approximately 30% increase in nitrogen recovery rate compared to that in the case of fertilization between hedges. Increases in nitrogen recovery rates were observed with fallapplied fertilization, spring-applied fertilization, pop-up fertilizer application, and summerapplied fertilization.

Competition-Induced Reductions in Soil Water Availability Reduced Pine Root Extension Rates

Treesearch

K.H. Ludovici; L.A. Morris

1997-01-01

The relationship between soil water availability, root extension, and shoot growth of loblolly pine seedlings (Pinus taeda L.) was evaluated in a rhizotron sand mixture in the absence and presence of crabgrass (Digitaria spp.) competition. Heights and diameters of seedlings grown with crabgrass were reduced 33 and SO%, respectively, compared with...

Cost effectiveness of on- and off-field conservation practices designed to reduce nitrogen in downstream water

USDA-ARS?s Scientific Manuscript database

The objective of this analysis is to estimate and compare the cost-effectiveness of on- and off-field approaches to reducing nitrogen loadings. On-field practices include improving the timing, rate, and method of nitrogen application. Off-field practices include restoring wetlands and establishing v...

Intra Frame Coding In Advanced Video Coding Standard (H.264) to Obtain Consistent PSNR and Reduce Bit Rate for Diagonal Down Left Mode Using Gaussian Pulse

NASA Astrophysics Data System (ADS)

Manjanaik, N.; Parameshachari, B. D.; Hanumanthappa, S. N.; Banu, Reshma

2017-08-01

Intra prediction process of H.264 video coding standard used to code first frame i.e. Intra frame of video to obtain good coding efficiency compare to previous video coding standard series. More benefit of intra frame coding is to reduce spatial pixel redundancy with in current frame, reduces computational complexity and provides better rate distortion performance. To code Intra frame it use existing process Rate Distortion Optimization (RDO) method. This method increases computational complexity, increases in bit rate and reduces picture quality so it is difficult to implement in real time applications, so the many researcher has been developed fast mode decision algorithm for coding of intra frame. The previous work carried on Intra frame coding in H.264 standard using fast decision mode intra prediction algorithm based on different techniques was achieved increased in bit rate, degradation of picture quality(PSNR) for different quantization parameters. Many previous approaches of fast mode decision algorithms on intra frame coding achieved only reduction of computational complexity or it save encoding time and limitation was increase in bit rate with loss of quality of picture. In order to avoid increase in bit rate and loss of picture quality a better approach was developed. In this paper developed a better approach i.e. Gaussian pulse for Intra frame coding using diagonal down left intra prediction mode to achieve higher coding efficiency in terms of PSNR and bitrate. In proposed method Gaussian pulse is multiplied with each 4x4 frequency domain coefficients of 4x4 sub macro block of macro block of current frame before quantization process. Multiplication of Gaussian pulse for each 4x4 integer transformed coefficients at macro block levels scales the information of the coefficients in a reversible manner. The resulting signal would turn abstract. Frequency samples are abstract in a known and controllable manner without intermixing of coefficients, it avoids picture getting bad hit for higher values of quantization parameters. The proposed work was implemented using MATLAB and JM 18.6 reference software. The proposed work measure the performance parameters PSNR, bit rate and compression of intra frame of yuv video sequences in QCIF resolution under different values of quantization parameter with Gaussian value for diagonal down left intra prediction mode. The simulation results of proposed algorithm are tabulated and compared with previous algorithm i.e. Tian et al method. The proposed algorithm achieved reduced in bit rate averagely 30.98% and maintain consistent picture quality for QCIF sequences compared to previous algorithm i.e. Tian et al method.

Multi-point estimation of total energy expenditure: a comparison between zinc-reduction and platinum-equilibration methodologies.

PubMed

Sonko, Bakary J; Miller, Leland V; Jones, Richard H; Donnelly, Joseph E; Jacobsen, Dennis J; Hill, James O; Fennessey, Paul V

2003-12-15

Reducing water to hydrogen gas by zinc or uranium metal for determining D/H ratio is both tedious and time consuming. This has forced most energy metabolism investigators to use the "two-point" technique instead of the "Multi-point" technique for estimating total energy expenditure (TEE). Recently, we purchased a new platinum (Pt)-equilibration system that significantly reduces both time and labor required for D/H ratio determination. In this study, we compared TEE obtained from nine overweight but healthy subjects, estimated using the traditional Zn-reduction method to that obtained from the new Pt-equilibration system. Rate constants, pool spaces, and CO2 production rates obtained from use of the two methodologies were not significantly different. Correlation analysis demonstrated that TEEs estimated using the two methods were significantly correlated (r=0.925, p=0.0001). Sample equilibration time was reduced by 66% compared to those of similar methods. The data demonstrated that the Zn-reduction method could be replaced by the Pt-equilibration method when TEE was estimated using the "Multi-Point" technique. Furthermore, D equilibration time was significantly reduced.

Slow but not low: genomic comparisons reveal slower evolutionary rate and higher dN/dS in conifers compared to angiosperms

PubMed Central

2012-01-01

Background Comparative genomics can inform us about the processes of mutation and selection across diverse taxa. Among seed plants, gymnosperms have been lacking in genomic comparisons. Recent EST and full-length cDNA collections for two conifers, Sitka spruce (Picea sitchensis) and loblolly pine (Pinus taeda), together with full genome sequences for two angiosperms, Arabidopsis thaliana and poplar (Populus trichocarpa), offer an opportunity to infer the evolutionary processes underlying thousands of orthologous protein-coding genes in gymnosperms compared with an angiosperm orthologue set. Results Based upon pairwise comparisons of 3,723 spruce and pine orthologues, we found an average synonymous genetic distance (dS) of 0.191, and an average dN/dS ratio of 0.314. Using a fossil-established divergence time of 140 million years between spruce and pine, we extrapolated a nucleotide substitution rate of 0.68 × 10-9 synonymous substitutions per site per year. When compared to angiosperms, this indicates a dramatically slower rate of nucleotide substitution rates in conifers: on average 15-fold. Coincidentally, we found a three-fold higher dN/dS for the spruce-pine lineage compared to the poplar-Arabidopsis lineage. This joint occurrence of a slower evolutionary rate in conifers with higher dN/dS, and possibly positive selection, showcases the uniqueness of conifer genome evolution. Conclusions Our results are in line with documented reduced nucleotide diversity, conservative genome evolution and low rates of diversification in conifers on the one hand and numerous examples of local adaptation in conifers on the other hand. We propose that reduced levels of nucleotide mutation in large and long-lived conifer trees, coupled with large effective population size, were the main factors leading to slow substitution rates but retention of beneficial mutations. PMID:22264329

Sound-Intensity Feedback During Running Reduces Loading Rates and Impact Peak.

PubMed

Tate, Jeremiah J; Milner, Clare E

2017-08-01

Study Design Controlled laboratory study, within-session design. Background Gait retraining has been proposed as an effective intervention to reduce impact loading in runners at risk of stress fractures. Interventions that can be easily implemented in the clinic are needed. Objective To assess the immediate effects of sound-intensity feedback related to impact during running on vertical impact peak, peak vertical instantaneous loading rate, and vertical average loading rate. Methods Fourteen healthy, college-aged runners who ran at least 9.7 km/wk participated (4 male, 10 female; mean ± SD age, 23.7 ± 2.0 years; height, 1.67 ± 0.08 m; mass, 60.9 ± 8.7 kg). A decibel meter provided real-time sound-intensity feedback of treadmill running via an iPad application. Participants were asked to reduce the sound intensity of running while receiving continuous feedback for 15 minutes, while running at their self-selected preferred speed. Baseline and follow-up ground reaction force data were collected during overground running at participants' self-selected preferred running speed. Results Dependent t tests indicated a statistically significant reduction in vertical impact peak (1.56 BW to 1.13 BW, P≤.001), vertical instantaneous loading rate (95.48 BW/s to 62.79 BW/s, P = .001), and vertical average loading rate (69.09 BW/s to 43.91 BW/s, P≤.001) after gait retraining, compared to baseline. Conclusion The results of the current study support the use of sound-intensity feedback during treadmill running to immediately reduce loading rate and impact force. The transfer of within-session reductions in impact peak and loading rates to overground running was demonstrated. Decreases in loading were of comparable magnitude to those observed in other gait retraining methods. J Orthop Sports Phys Ther 2017;47(8):565-569. Epub 6 Jul 2017. doi:10.2519/jospt.2017.7275.

Do Bells Affect Behaviour and Heart Rate Variability in Grazing Dairy Cows?

PubMed Central

Johns, Julia; Patt, Antonia; Hillmann, Edna

2015-01-01

In alpine regions cows are often equipped with bells. The present study investigated the impact of wearing a bell on behaviour and heart rate variability in dairy cows. Nineteen non-lactating Brown-Swiss cows with bell experience were assigned to three different treatments. For 3 days each, cows were equipped with no bell (control), with a bell with inactivated clapper (silent bell) or with a functional bell (functional bell). The bells weighed 5.5 kg and had frequencies between 532 Hz and 2.8 kHz and amplitudes between 90 and 113 dB at a distance of 20 cm. Data were collected on either the first and third or on all 3 days of each treatment. Whereas duration of rumination was reduced with a functional bell and a silent bell compared with no bell, feeding duration was reduced with a silent bell and was intermediate with a functional bell. Head movements were reduced when wearing a silent bell compared with no bell and tended to be reduced when wearing a functional compared to no bell. With a functional bell, lying duration was reduced by almost 4 hours on the third day of treatment compared with the first day with a functional bell and compared with no bell or a silent bell. All additional behavioural measures are consistent with the hypothesis of a restriction in the behaviour of the cows wearing bells, although this pattern did not reach significance. There was no treatment effect on heart rate variability, suggesting that the bells did not affect vago-sympathetic balance. An effect of experimental day was found for only 1 out of 10 behavioural parameters, as shown by a decrease in lying with a functional bell on day 3. The results indicate behavioural changes in the cows wearing a bell over 3 days, without indication of habituation to the bell. Altogether, the behavioural changes suggest that the behaviour of the cows was disturbed by wearing a bell. If long-lasting, these effects may have implications for animal welfare. PMID:26110277

Cities with camera-equipped taxicabs experience reduced taxicab driver homicide rates: United States, 1996-2010.

PubMed

Menéndez, Cammie Chaumont; Amandus, Harlan; Damadi, Parisa; Wu, Nan; Konda, Srinivas; Hendricks, Scott

2014-05-01

Driving a taxicab remains one of the most dangerous occupations in the United States, with leading homicide rates. Although safety equipment designed to reduce robberies exists, it is not clear what effect it has on reducing taxicab driver homicides. Taxicab driver homicide crime reports for 1996 through 2010 were collected from 20 of the largest cities (>200,000) in the United States: 7 cities with cameras installed in cabs, 6 cities with partitions installed, and 7 cities with neither cameras nor partitions. Poisson regression modeling using generalized estimating equations provided city taxicab driver homicide rates while accounting for serial correlation and clustering of data within cities. Two separate models were constructed to compare (1) cities with cameras installed in taxicabs versus cities with neither cameras nor partitions and (2) cities with partitions installed in taxicabs versus cities with neither cameras nor partitions. Cities with cameras installed in cabs experienced a significant reduction in homicides after cameras were installed (adjRR = 0.11, CL 0.06-0.24) and compared to cities with neither cameras nor partitions (adjRR = 0.32, CL 0.15-0.67). Cities with partitions installed in taxicabs experienced a reduction in homicides (adjRR = 0.78, CL 0.41-1.47) compared to cities with neither cameras nor partitions, but it was not statistically significant. The findings suggest cameras installed in taxicabs are highly effective in reducing homicides among taxicab drivers. Although not statistically significant, the findings suggest partitions installed in taxicabs may be effective.

Treatment outcome of selective digestive decontamination and enteral nutrition in patients with severe acute pancreatitis.

PubMed

Sawa, Hidehiro; Ueda, Takashi; Takeyama, Yoshifumi; Yasuda, Takeo; Shinzeki, Makoto; Matsumura, Naoki; Nakajima, Takahiro; Matsumoto, Ippei; Fujita, Tsunenori; Ajiki, Tetsuo; Fujino, Yasuhiro; Kuroda, Yoshikazu

2007-01-01

Sepsis due to infected pancreatic necrosis is the most serious complication in the late phase of severe acute pancreatitis (SAP). Bacterial translocation from the gut is thought to be the main cause of pancreatic infection. The possibility has recently been reported that selective digestive decontamination (SDD) and enteral nutrition (EN) may alleviate the complications and reduce the mortality rate in patients with SAP. We analyzed the treatment outcome of SDD and EN in patients with SAP. We divided 90 patients with SAP into three groups: SDD(-)EN(-),group A; SDD(+)EN(-), group B; and SDD(+)EN(+), group C. Clinical outcome was analyzed retrospectively. The effect of SDD was compared in groups A and B, and the effect of EN was compared in groups B and C. The background of patients was not significantly different between the groups. SDD reduced the incidence of organ dysfunction (from 70% to 59%) and the mortality rate (from 40% to 28%), but the differences were not significant. EN reduced the incidence of infected pancreatic necrosis (from 31% to 24%) and the frequency of surgery for pancreas (from 28% to 18%), and further reduced the mortality rate (from 28% for SDD to 16%), but the differences were not significant. The peripheral lymphocyte count was significantly increased in patients with EN. SDD and EN did not significantly affect the treatment outcome in SAP. However, the results in this study raise the possibility that SDD and EN may decrease the complications and reduce the mortality rate in SAP. The efficacy of SDD and EN for SAP should be evaluated in a randomized controlled trial.

The effects of sibutramine on the microstructure of eating behaviour and energy expenditure in obese women.

PubMed

Halford, J C G; Boyland, E J; Cooper, S J; Dovey, T M; Huda, M S B; Dourish, C T; Dawson, G R; Wilding, J P H

2010-01-01

Given the suggestion that many potential anti-obesity drugs may enhance within-meal satiation, few studies have directly measured the effects of any drug on the microstructure of human eating behaviour. The effects of 7 days dosing with sibutramine 10 mg and 15 mg a day on appetite and energy balance were determined in 30 obese women (BMI 34.6 +/- 3.3 kg/m2, age 46.0 +/- 12.9 years) using a Universal Eating Monitor (UEM) and indirect calorimetry, in a double-blind, placebo-controlled crossover study. At day 7, sibutramine 10 mg and 15 mg reduced food intake by 16.6% and 22.3%, respectively (p < 0.001), compared with placebo. Sibutramine reduced eating rate compared with placebo rather than meal length (10 mg p < 0.05; 15 mg p < 0.001). In addition, sibutramine 10 mg significantly reduced hunger later in the meal (p < 0.05) and sibutramine 15 mg increased fullness early in the meal (p < 0.01), both of which are consistent with enhanced within-meal satiation. Sibutramine had little effect on resting metabolic rate, although 15 mg did significantly reduce respiratory quotient at several time points during the test day. These results provide novel evidence that decreased consumption of a test meal induced by sibutramine is primarily because of reduced eating rate, enhancing the deceleration in cumulative food intake within a meal associated with the development of satiety. Changes in within-meal appetite ratings appear particularly sensitive to drug-induced enhancement of satiation, and may provide key indices for assessing the therapeutic potential of novel anti-obesity drugs.

Once-only sigmoidoscopy in colorectal cancer screening: follow-up findings of the Italian Randomized Controlled Trial--SCORE.

PubMed

Segnan, Nereo; Armaroli, Paola; Bonelli, Luigina; Risio, Mauro; Sciallero, Stefania; Zappa, Marco; Andreoni, Bruno; Arrigoni, Arrigo; Bisanti, Luigi; Casella, Claudia; Crosta, Cristiano; Falcini, Fabio; Ferrero, Franco; Giacomin, Adriano; Giuliani, Orietta; Santarelli, Alessandra; Visioli, Carmen Beatriz; Zanetti, Roberto; Atkin, Wendy S; Senore, Carlo

2011-09-07

A single flexible sigmoidoscopy at around the age of 60 years has been proposed as an effective strategy for colorectal cancer (CRC) screening. We conducted a randomized controlled trial to evaluate the effect of flexible sigmoidoscopy screening on CRC incidence and mortality. A questionnaire to assess the eligibility and interest in screening was mailed to 236,568 men and women, aged 55-64 years, who were randomly selected from six trial centers in Italy. Of the 56,532 respondents, interested and eligible subjects were randomly assigned to the intervention group (invitation for flexible sigmoidoscopy; n = 17,148) or the control group (no further contact; n = 17,144), between June 14, 1995, and May 10, 1999. Flexible sigmoidoscopy was performed on 9911 subjects. Intention-to-treat and per-protocol analyses were performed to compare the CRC incidence and mortality rates in the intervention and control groups. Per-protocol analysis was adjusted for noncompliance. A total of 34,272 subjects (17,136 in each group) were included in the follow-up analysis. The median follow-up period was 10.5 years for incidence and 11.4 years for mortality; 251 subjects were diagnosed with CRC in the intervention group and 306 in the control group. Overall incidence rates in the intervention and control groups were 144.11 and 176.43, respectively, per 100,000 person-years. CRC-related death was noted in 65 subjects in the intervention group and 83 subjects in the control group. Mortality rates in the intervention and control groups were 34.66 and 44.45, respectively, per 100,000 person-years. In the intention-to-treat analysis, the rate of CRC incidence was statistically significantly reduced in the intervention group by 18% (rate ratio [RR] = 0.82, 95% confidence interval [CI] = 0.69 to 0.96), and the mortality rate was non-statistically significantly reduced by 22% (RR = 0.78; 95% CI = 0.56 to 1.08) compared with the control group. In the per-protocol analysis, both CRC incidence and mortality rates were statistically significantly reduced among the screened subjects; CRC incidence was reduced by 31% (RR = 0.69; 95% CI = 0.56 to 0.86) and mortality was reduced by 38% (RR = 0.62; 95% CI = 0.40 to 0.96) compared with the control group. A single flexible sigmoidoscopy screening between ages 55 and 64 years was associated with a substantial reduction of CRC incidence and mortality.

Prevention and control of fish-borne zoonotic trematodes in fish nurseries, Vietnam.

PubMed

Hedegaard Clausen, Jesper; Madsen, Henry; Murrell, K Darwin; Van, Phan Thi; Thu, Ha Nguyen Thi; Do, Dung Trung; Nguyen Thi, Lan Anh; Nguyen Manh, Hung; Dalsgaard, Anders

2012-09-01

Worldwide, >18 million persons were infected with fish-borne zoonotic trematodes in 2002. To evaluate the effectiveness of interventions for reducing prevalence and intensity of fish-borne zoonotic trematode infections in juvenile fish, we compared transmission rates at nurseries in the Red River Delta, northern Vietnam. Rates were significantly lower for nurseries that reduced snail populations and trematode egg contamination in ponds than for nurseries that did not. These interventions can be used in the development of programs for sustained control of zoonotic trematodes in farmed fish.

Prevention and Control of Fish-borne Zoonotic Trematodes in Fish Nurseries, Vietnam

PubMed Central

Madsen, Henry; Murrell, K. Darwin; Van, Phan Thi; Thu, Ha Nguyen Thi; Do, Dung Trung; Thi, Lan Anh Nguyen; Manh, Hung Nguyen; Dalsgaard, Anders

2012-01-01

Worldwide, >18 million persons were infected with fish-borne zoonotic trematodes in 2002. To evaluate the effectiveness of interventions for reducing prevalence and intensity of fish-borne zoonotic trematode infections in juvenile fish, we compared transmission rates at nurseries in the Red River Delta, northern Vietnam. Rates were significantly lower for nurseries that reduced snail populations and trematode egg contamination in ponds than for nurseries that did not. These interventions can be used in the development of programs for sustained control of zoonotic trematodes in farmed fish. PMID:22932069

Increasing preferred step rate during running reduces plantar pressures.

PubMed

Gerrard, James M; Bonanno, Daniel R

2018-01-01

Increasing preferred step rate during running is a commonly used strategy in the management of running-related injuries. This study investigated the effect of different step rates on plantar pressures during running. Thirty-two healthy runners ran at a comfortable speed on a treadmill at five step rates (preferred, ±5%, and ±10%). For each step rate, plantar pressure data were collected using the pedar-X in-shoe system. Compared to running with a preferred step rate, a 10% increase in step rate significantly reduced peak pressure (144.5±46.5 vs 129.3±51 kPa; P=.033) and maximum force (382.3±157.6 vs 334.0±159.8 N; P=.021) at the rearfoot, and reduced maximum force (426.4±130.4 vs 400.0±116.6 N; P=.001) at the midfoot. In contrast, a 10% decrease in step rate significantly increased peak pressure (144.5±46.5 vs 161.5±49.3 kPa; P=.011) and maximum force (382.3±157.6 vs 425.4±155.3 N; P=.032) at the rearfoot. Changing step rate by 5% provided no effect on plantar pressures, and no differences in plantar pressures were observed at the medial forefoot, lateral forefoot or hallux between the step rates. This study's findings indicate that increasing preferred step rate by 10% during running will reduce plantar pressures at the rearfoot and midfoot, while decreasing step rate by 10% will increase plantar pressures at the rearfoot. However, changing preferred step rate by 5% will provide no effect on plantar pressures, and forefoot pressures are unaffected by changes in step rate. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Increasing Running Step Rate Reduces Patellofemoral Joint Forces

PubMed Central

Lenhart, Rachel L.; Thelen, Darryl G.; Wille, Christa M.; Chumanov, Elizabeth S.; Heiderscheit, Bryan C.

2013-01-01

Purpose Increasing step rate has been shown to elicit changes in joint kinematics and kinetics during running, and has been suggested as a possible rehabilitation strategy for runners with patellofemoral pain. The purpose of this study was to determine how altering step rate affects internal muscle forces and patellofemoral joint loads, and then to determine what kinematic and kinetic factors best predict changes in joint loading. Methods We recorded whole body kinematics of 30 healthy adults running on an instrumented treadmill at three step rate conditions (90%, 100%, and 110% of preferred step rate). We then used a 3D lower extremity musculoskeletal model to estimate muscle, patellar tendon, and patellofemoral joint forces throughout the running gait cycles. Additionally, linear regression analysis allowed us to ascertain the relative influence of limb posture and external loads on patellofemoral joint force. Results Increasing step rate to 110% of preferred reduced peak patellofemoral joint force by 14%. Peak muscle forces were also altered as a result of the increased step rate with hip, knee and ankle extensor forces, and hip abductor forces all reduced in mid-stance. Compared to the 90% step rate condition, there was a concomitant increase in peak rectus femoris and hamstring loads during early and late swing, respectively, at higher step rates. Peak stance phase knee flexion decreased with increasing step rate, and was found to be the most important predictor of the reduction in patellofemoral joint loading. Conclusion Increasing step rate is an effective strategy to reduce patellofemoral joint forces and could be effective in modulating biomechanical factors that can contribute to patellofemoral pain. PMID:23917470

Brain metabolism in autism. Resting cerebral glucose utilization rates as measured with positron emission tomography

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

Rumsey, J.M.; Duara, R.; Grady, C.

The cerebral metabolic rate for glucose was studied in ten men (mean age = 26 years) with well-documented histories of infantile autism and in 15 age-matched normal male controls using positron emission tomography and (F-18) 2-fluoro-2-deoxy-D-glucose. Positron emission tomography was completed during rest, with reduced visual and auditory stimulation. While the autistic group as a whole showed significantly elevated glucose utilization in widespread regions of the brain, there was considerable overlap between the two groups. No brain region showed a reduced metabolic rate in the autistic group. Significantly more autistic, as compared with control, subjects showed extreme relative metabolic ratesmore » (ratios of regional metabolic rates to whole brain rates and asymmetries) in one or more brain regions.« less

Improved Completion Rates and Characterization of Drug Reactions with an Intensive Chagas Disease Treatment Program in Rural Bolivia

PubMed Central

Tornheim, Jeffrey A.; Lozano Beltran, Daniel F.; Gilman, Robert H.; Castellon, Mario; Solano Mercado, Marco A.; Sullca, Walter; Torrico, Faustino; Bern, Caryn

2013-01-01

Background Chagas disease treatment is limited by drug availability, adverse side effect profiles of available medications, and poor adherence. Methods Adult Chagas disease patients initiating 60-days of benznidazole were randomized to weekly or twice-weekly evaluations of medication adherence and screening for adverse drug events (ADEs). Mid-week evaluations employed phone-based evaluations. Adherence was measured by self-report, pill counts with intentional over-distribution, and Medication Event Monitoring Systems (MEMS). Prospective data were compared to historical controls treated with benznidazole at the same hospital. Results 162 prospective patients were compared to 172 historical patients. Pill counts correlated well with MEMS data (R = 0.498 for 7-day intervals, R = 0.872 for intervals >7 days). Treatment completion rates were higher among prospective than historical patients (82.1% vs. 65.1%), primarily due to lower abandonment rates. Rates of ADEs were lower among prospective than historical patients (56.8% vs. 66.9%). Twice-weekly evaluations increased identification of mild ADEs, prompting higher suspension rates than weekly evaluations. While twice-weekly evaluations identified ADEs earlier, they did not reduce incidence of moderate or severe ADEs. Many dermatologic ADEs were moderately severe upon presentation (35.6%), were not reduced by use of antihistamines, occurred among adult patients of all ages, and occurred throughout treatment, rather than the first few weeks alone. Conclusions Intensive management improved completion and identified more ADEs, but did not reduce moderate or severe ADEs. Risk of dermatologic ADEs cannot be reduced by selecting younger adults or monitoring only during the first few weeks of treatment. Pill counts and phone-based encounters are reliable tools for treatment programming in rural Bolivia. PMID:24069472

Effect of confinement on anharmonic phonon scattering and thermal conductivity in pristine silicon nanowires

NASA Astrophysics Data System (ADS)

Rashid, Zahid; Zhu, Liyan; Li, Wu

2018-02-01

The effect of confinement on the anharmonic phonon scattering rates and the consequences thereof on the thermal transport properties in ultrathin silicon nanowires with a diameter of 1-4 nm have been characterized using atomistic simulations and the phonon Boltzmann transport equation. The phonon density of states (PDOS) for ultrathin nanowires approaches a constant value in the vicinity of the Γ point and increases with decreasing diameter, which indicates the increasing importance of the low-frequency phonons as heat carriers. The anharmonic phonon scattering becomes dramatically enhanced with decreasing thickness of the nanowires. In the thinnest nanowire, the scattering rates for phonons above 1 THz are one order of magnitude higher than those in the bulk Si. Below 1 THz, the increase in scattering rates is even much more appreciable. Our numerical calculations revealed that the scattering rates for transverse (longitudinal) acoustic modes follow √{ω } (1 /√{ω } ) dependence at the low-frequency limit, whereas those for the degenerate flexural modes asymptotically approach a constant value. In addition, the group velocities of phonons are reduced compared with bulk Si except for low-frequency phonons (<1 -2 THz depending on the thickness of the nanowires). The increased scattering rates combined with reduced group velocities lead to a severely reduced thermal conductivity contribution from the high-frequency phonons. Although the thermal conductivity contributed by those phonons with low frequencies is instead increased mainly due to the increased PDOS, the total thermal conductivity is still reduced compared to that of the bulk. This work reveals an unexplored mechanism to understand the measured ultralow thermal conductivity of silicon nanowires.

Are Local Laws the Key to Ending Childhood Lead Poisoning?

PubMed Central

Korfmacher, Katrina S.; Hanley, Michael L.

2014-01-01

Although lead paint was banned by federal law in 1978, it continues to poison children living in homes built before that time. The lifelong effects of childhood exposure to even small amounts of lead are well established by medical research and include learning and behavior problems, hypertension, osteoporosis, and kidney disease. Federal and state laws have reduced rates of lead poisoning significantly in the past three decades. However, pockets of high rates of lead poisoning remain, primarily in low-income urban neighborhoods with older housing stock. Recently, several municipalities have passed local lead laws in an attempt to reduce lead hazards in these remaining areas. There has been no systematic attempt to compare the design and effectiveness of these local policies. To address this gap, we conducted comparative case studies of eight innovative lead laws promulgated since 2010. The laws used a wide variety of legal structures and tools, although certain elements were common. The impact of the policies was intertwined with local housing, economic, and legal environments. While data do not yet exist to systematically evaluate the impact on lead poisoning rates, our analysis suggests that local laws hold great promise for reducing lead hazards in children’s homes. PMID:23645870

Radiometric resolution enhancement by lossy compression as compared to truncation followed by lossless compression

NASA Technical Reports Server (NTRS)

Tilton, James C.; Manohar, Mareboyana

1994-01-01

Recent advances in imaging technology make it possible to obtain imagery data of the Earth at high spatial, spectral and radiometric resolutions from Earth orbiting satellites. The rate at which the data is collected from these satellites can far exceed the channel capacity of the data downlink. Reducing the data rate to within the channel capacity can often require painful trade-offs in which certain scientific returns are sacrificed for the sake of others. In this paper we model the radiometric version of this form of lossy compression by dropping a specified number of least significant bits from each data pixel and compressing the remaining bits using an appropriate lossless compression technique. We call this approach 'truncation followed by lossless compression' or TLLC. We compare the TLLC approach with applying a lossy compression technique to the data for reducing the data rate to the channel capacity, and demonstrate that each of three different lossy compression techniques (JPEG/DCT, VQ and Model-Based VQ) give a better effective radiometric resolution than TLLC for a given channel rate.

Results of a Medicare Bundled Payments for Care Improvement Initiative for Chronic Obstructive Pulmonary Disease Readmissions.

PubMed

Bhatt, Surya P; Wells, J Michael; Iyer, Anand S; Kirkpatrick, deNay P; Parekh, Trisha M; Leach, Lauren T; Anderson, Erica M; Sanders, J Greg; Nichols, Jessica K; Blackburn, Cindy C; Dransfield, Mark T

2017-05-01

Approximately 20% of Medicare beneficiaries hospitalized for acute exacerbations of chronic obstructive pulmonary disease (COPD) are readmitted within 30 days of discharge. In addition to implementing penalties for excess readmissions, the U.S. Centers for Medicare and Medicaid Services has developed Bundled Payments for Care Improvement (BPCI) initiatives to improve outcomes and control costs. To evaluate whether a comprehensive COPD multidisciplinary intervention focusing on inpatient, transitional, and outpatient care as part of our institution's BPCI participation would reduce 30-day all-cause readmission rates for COPD exacerbations and reduce overall costs. We performed a pre-postintervention study comparing all-cause readmissions and costs after index hospitalization for Medicare-only patients with acute exacerbation of COPD. The primary outcome was the difference in 30-day all-cause readmission rate compared with historical control subjects; secondary outcomes included the 90-day all-cause readmission rate and also health care costs compared with BPCI target prices. Seventy-eight consecutive Medicare patients were prospectively enrolled in the BPCI intervention in 2014 and compared with 109 patients in the historical group from 2012. Patients in BPCI were more likely to receive regular follow-up phone calls, pneumococcal and influenza vaccines, home health care, durable medical equipment, and pulmonary rehabilitation, and to attend pulmonary clinic. There was no difference in all-cause readmission rates at 30 days (BPCI, 12 events [15.4%] vs. non-BPCI, 19 events [17.4%]; P = 0.711), and 90 days (21 [26.9%] vs. 37 [33.9%]; P = 0.306). Compared with BPCI target prices, we incurred 4.3% lower 90-day costs before accounting for significant investment from the health system. A Medicare BPCI intervention did not reduce 30-day all-cause readmission rates or overall costs after hospitalization for acute exacerbation of COPD. Although additional studies enrolling larger numbers of patients at multiple centers may demonstrate the efficacy of our BPCI initiative for COPD readmissions, this is unlikely to be cost effective at any single center.

Phenobarbital reduces EEG amplitude and propagation of neonatal seizures but does not alter performance of automated seizure detection.

PubMed

Mathieson, Sean R; Livingstone, Vicki; Low, Evonne; Pressler, Ronit; Rennie, Janet M; Boylan, Geraldine B

2016-10-01

Phenobarbital increases electroclinical uncoupling and our preliminary observations suggest it may also affect electrographic seizure morphology. This may alter the performance of a novel seizure detection algorithm (SDA) developed by our group. The objectives of this study were to compare the morphology of seizures before and after phenobarbital administration in neonates and to determine the effect of any changes on automated seizure detection rates. The EEGs of 18 term neonates with seizures both pre- and post-phenobarbital (524 seizures) administration were studied. Ten features of seizures were manually quantified and summary measures for each neonate were statistically compared between pre- and post-phenobarbital seizures. SDA seizure detection rates were also compared. Post-phenobarbital seizures showed significantly lower amplitude (p<0.001) and involved fewer EEG channels at the peak of seizure (p<0.05). No other features or SDA detection rates showed a statistical difference. These findings show that phenobarbital reduces both the amplitude and propagation of seizures which may help to explain electroclinical uncoupling of seizures. The seizure detection rate of the algorithm was unaffected by these changes. The results suggest that users should not need to adjust the SDA sensitivity threshold after phenobarbital administration. Copyright © 2016 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Sick Populations and Sick Subpopulations: Reducing Disparities in Cardiovascular Disease Between Blacks and Whites in the United States.

PubMed

Lu, Yuan; Ezzati, Majid; Rimm, Eric B; Hajifathalian, Kaveh; Ueda, Peter; Danaei, Goodarz

2016-08-09

Cardiovascular disease (CVD) death rates are much higher in blacks than whites in the United States. It is unclear how CVD risk and events are distributed among blacks versus whites and how interventions reduce racial disparities. We developed risk models for fatal and for fatal and nonfatal CVD using 8 cohorts in the United States. We used 6154 adults who were 50 to 69 years of age in the National Health and Nutrition Examination Survey 1999 to 2012 to estimate the distributions of risk and events in blacks and whites. We estimated the total and disparity impacts of a range of population-wide, targeted, and risk-based interventions on 10-year CVD risks and event rates. Twenty-five percent (95% confidence interval [CI], 22-28) of black men and 12% (95% CI, 10-14) of black women were at ≥6.67% risk of fatal CVD (almost equivalent to 20% risk of fatal or nonfatal CVD) compared with 10% (95% CI, 8-12) of white men and 3% (95% CI, 2-4) of white women. These high-risk individuals accounted for 55% (95% CI, 49-59) of CVD deaths among black men and 42% (95% CI, 35-46) in black women compared with 30% (95% CI, 24-35) in white men and 18% (95% CI, 13-22) in white women. We estimated that an intervention that treated multiple risk factors in high-risk individuals could reduce black-white difference in CVD death rate from 1659 to 1244 per 100 000 in men and from 1320 to 897 in women. Rates of fatal and nonfatal CVD were generally similar between black and white men. In women, a larger proportion of women were at ≥7.5% risk of CVD (30% versus 19% in whites), and an intervention that targeted multiple risk factors among this group was estimated to reduce black-white differences in CVD rates from 1688 to 1197 per 100 000. A substantially larger proportion of blacks have a high risk of fatal CVD and bear a large share of CVD deaths. A risk-based intervention that reduces multiple risk factors could substantially reduce overall CVD rates and racial disparities in CVD death rates. © 2016 American Heart Association, Inc.

Robust Metabolic Responses to Varied Carbon Sources in Natural and Laboratory Strains of Saccharomyces cerevisiae

PubMed Central

Van Voorhies, Wayne A.

2012-01-01

Understanding factors that regulate the metabolism and growth of an organism is of fundamental biologic interest. This study compared the influence of two different carbon substrates, dextrose and galactose, on the metabolic and growth rates of the yeast Saccharomyces cerevisiae. Yeast metabolic and growth rates varied widely depending on the metabolic substrate supplied. The metabolic and growth rates of a yeast strain maintained under long-term laboratory conditions was compared to strain isolated from natural condition when grown on different substrates. Previous studies had determined that there are numerous genetic differences between these two strains. However, the overall metabolic and growth rates of a wild isolate of yeast was very similar to that of a strain that had been maintained under laboratory conditions for many decades. This indicates that, at in least this case, metabolism and growth appear to be well buffered against genetic differences. Metabolic rate and cell number did not co-vary in a simple linear manner. When grown in either dextrose or galactose, both strains showed a growth pattern in which the number of cells continued to increase well after the metabolic rate began a sharp decline. Previous studied have reported that O2 consumption in S. cerevisiae grown in reduced dextrose levels were elevated compared to higher levels. Low dextrose levels have been proposed to induce caloric restriction and increase life span in yeast. However, there was no evidence that reduced levels of dextrose increased metabolic rates, measured by either O2 consumption or CO2 production, in the strains used in this study. PMID:22253874

Specialized fungal parasites reduce fitness of their lichen hosts.

PubMed

Merinero, Sonia; Gauslaa, Yngvar

2018-01-25

Understanding to what extent parasites affect host fitness is a focus of research on ecological interactions. Fungal parasites usually affect the functions of vascular plants. However, parasitic interactions comprising effects of fungal parasites on the fitness of lichen hosts are less well known. This study assesses the effects of the abundance of two highly specialized gall-forming fungi on growth of their two respective lichen hosts and tests whether these fungal parasites reduce lichen fitness. The relative biomass and thallus area growth rates, and change in specific thallus mass of Lobaria pulmonaria and L. scrobiculata were compared between lichens with and without galls of the lichenicolous fungi Plectocarpon lichenum and P. scrobiculatae, cultivated in a growth chamber for 14 d. By estimating the thallus area occupied by the galls, it was also assessed whether growth rates varied with effective photosynthetic lichen surface area. Plectocarpon galls significantly reduced relative growth rates of the lichen hosts. Growth rates decreased with increasing cover of parasitic galls. The presence of Plectocarpon-galls per se, not the reduced photosynthetic thallus surface due to gall induction, reduced relative growth rates in infected hosts. Specific thallus mass in the hosts changed in species-specific ways. This study shows that specialized fungal parasites can reduce lichen fitness by reducing their growth rates. Higher parasite fitness correlated with lower host fitness, supporting the view that these associations are antagonistic. By reducing hosts' growth rates, these parasites in their symptomatic life stage may affect important lichen functions. This fungal parasite-lichen study widens the knowledge on the ecological effects of parasitism on autotrophic hosts and expands our understanding of parasitic interactions across overlooked taxonomic groups. © The Authors 2017. Published by Oxford University Press on behalf of the Annals of Botany Company. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Effect of Selective Heart Rate Slowing in Heart Failure With Preserved Ejection Fraction.

PubMed

Pal, Nikhil; Sivaswamy, Nadiya; Mahmod, Masliza; Yavari, Arash; Rudd, Amelia; Singh, Satnam; Dawson, Dana K; Francis, Jane M; Dwight, Jeremy S; Watkins, Hugh; Neubauer, Stefan; Frenneaux, Michael; Ashrafian, Houman

2015-11-03

Heart failure with preserved ejection fraction (HFpEF) is associated with significant morbidity and mortality but is currently refractory to therapy. Despite limited evidence, heart rate reduction has been advocated, on the basis of physiological considerations, as a therapeutic strategy in HFpEF. We tested the hypothesis that heart rate reduction improves exercise capacity in HFpEF. We conducted a randomized, crossover study comparing selective heart rate reduction with the If blocker ivabradine at 7.5 mg twice daily versus placebo for 2 weeks each in 22 symptomatic patients with HFpEF who had objective evidence of exercise limitation (peak oxygen consumption at maximal exercise [o2 peak] <80% predicted for age and sex). The result was compared with 22 similarly treated matched asymptomatic hypertensive volunteers. The primary end point was the change in o2 peak. Secondary outcomes included tissue Doppler-derived E/e' at echocardiography, plasma brain natriuretic peptide, and quality-of-life scores. Ivabradine significantly reduced peak heart rate compared with placebo in the HFpEF (107 versus 129 bpm; P<0.0001) and hypertensive (127 versus 145 bpm; P=0.003) cohorts. Ivabradine compared with placebo significantly worsened the change in o2 peak in the HFpEF cohort (-2.1 versus 0.9 mL·kg(-1)·min(-1); P=0.003) and significantly reduced submaximal exercise capacity, as determined by the oxygen uptake efficiency slope. No significant effects on the secondary end points were discernable. Our observations bring into question the value of heart rate reduction with ivabradine for improving symptoms in a HFpEF population characterized by exercise limitation. URL: http://www.clinicaltrials.gov. Unique identifier: NCT02354573. © 2015 The Authors.

Key factors influencing the incidence of hemolysis: A critical appraisal of current evidence.

PubMed

McCaughey, Euan James; Vecellio, Elia; Lake, Rebecca; Li, Ling; Burnett, Leslie; Chesher, Douglas; Braye, Stephen; Mackay, Mark; Gay, Stephanie; Badrick, Tony; Westbrook, Johanna; Georgiou, Andrew

2017-01-01

Hemolysis is a leading cause of pre-analytical laboratory errors. The identification of contributing factors is an important step towards the development of effective practices to reduce and prevent hemolysis. We performed a review of PUBMED, Embase, Medline and CINAHL to identify articles published between January 2000 and August 2016 that identified factors influencing in vitro hemolysis rates. The 40 studies included in this review provide excellent evidence that hemolysis rates are higher in Emergency Departments (EDs), for non-antecubital draws, for specimens drawn using an intravenous catheter compared to venipuncture and for samples transported by pneumatic tube compared to by hand. There is also good evidence that hemolysis rates are higher when specimens are not collected by professional phlebotomists, larger volume specimen tubes are used, specimen tubes are filled less than halfway and tourniquet time is greater than one minute. The results of this review suggest that hospitals and clinical laboratories should consider deploying phlebotomists in EDs, drawing all blood through a venipuncture, using the antecubital region as the optimum blood collection site and transporting specimens by laboratory assistant/other personnel, or if this in not practical, ensuring that pneumatic transport systems are validated, maintained and monitored. Studies also recommend making hemolysis a hospital-wide issue and ensuring high-quality staff training and adherence to standard operating procedures to reduce hemolysis rates. Awareness of the factors that influence hemolysis rates, and adoption of strategies to mitigate these risk factors, is an important step towards creating quality practices to reduce hemolysis rates and improve the quality of patient care.

Temporal trends of infant and birth outcomes in Minamata after severe methylmercury exposure.

PubMed

Yorifuji, Takashi; Kashima, Saori; Suryadhi, Made Ayu Hitapretiwi; Abudureyimu, Kawuli

2017-12-01

Severe methylmercury poisoning occurred in Minamata and neighboring communities in Japan during the 1950s and 1960s, causing what is known as Minamata disease. Although an increase in stillbirths and a reduced male proportion at birth (i.e., reduced sex ratio) have been reported, no studies have evaluated the impact of exposure on an entire set of infant and birth outcomes. We therefore evaluated the temporal trends of these outcomes in the Minamata area from 1950 to 1974. We focused on the spontaneous/artificial stillbirth rate, crude fertility rate, male proportion at birth, male proportion among stillbirths, and infant mortality. We obtained the number of stillbirths, live births, and infant deaths in Minamata City and Kumamoto Prefecture (as a reference) from 1950 to 1974. After plotting annual figures for each outcome, we divided the study period into five intervals and compared them between Minamata City and Kumamoto Prefecture using the chi-squared test. We observed a slightly increased spontaneous stillbirth rate and decreased artificial stillbirth rate in Minamata City, followed by a reduced crude fertility rate. The crude fertility rates in Minamata City during the period 1955-1965 were significantly lower compared with those in Kumamoto Prefecture (p < 0.001). An increase in the male proportion among stillbirths was observed, corresponding to a reduction in the proportion of males at birth in the late 1950s. The impact on infant mortality was equivocal. These descriptive analyses demonstrate a severe regional impact of methylmercury exposure on a series of birth outcomes in the Minamata area. Copyright © 2017 Elsevier Ltd. All rights reserved.

Infection Control Link Nurse Program: An interdisciplinary approach n targeting health care-acquired infection

PubMed Central

Sopirala, Madhuri M.; Yahle-Dunbar, Lisa; Smyer, Justin; Wellington, Linda; Dickman, Jeanne; Zikri, Nancy; Martin, Jennifer; Kulich, Pat; Taylor, David; Mekhjian, Hagop; Nash, Mary; Mansfield, Jerry; Pancholi, Preeti; Howard, Mary; Chase, Linda; Brown, Susan; Kipp, Kristopher; Lefeld, Kristen; Myers, Amber; Pan, Xueliang; Mangino, Julie E.

2014-01-01

Background We describe a successful interdisciplinary liaison program that effectively reduced health care-acquired (HCA), methicillin-resistant Staphylococcus aureus (MRSA) in a university hospital setting. Methods Baseline was from January 2006 to March 2008, and intervention period was April 2008 to September 2009. Staff nurses were trained to be liaisons (link nurses) to infection prevention (IP) personnel with clearly defined goals assigned and with ongoing monthly education. HCA-MRSA incidence per 1,000 patient-days (PD) was compared between baseline and intervention period along with total and non-HCA-MRSA, HCA and non-HCA-MRSA bacteremia, and hand soap/sanitizer usage. Hand hygiene compliance was assessed. Results A reduction in MRSA rates was as follows in intervention period compared with baseline: HCA-MRSA decreased by 28% from 0.92 to 0.67 cases per 1,000 PD (incidence rate ratio, 0.72; 95% confidence interval: 0.62–0.83, P < .001), and HCA-MRSA bacteremia rate was reduced by 41% from 0.18 to 0.10 per 1,000 PD (incidence rate ratio, 0.59; 95% confidence interval: 0.42–0.84, P = .003). Total MRSA rate and MRSA bacteremia rate also showed significant reduction with nonsignificant reductions in overall non-HCA-MRSA and non-HCA-MRSA bacteremia. Hand soap/sanitizer usage and compliance with hand hygiene also increased significantly during IP. Conclusion Link nurse program effectively reduced HCA-MRSA. Goal-defined metrics with ongoing reeducation for the nurses by IP personnel helped drive these results. PMID:24548456

Effect of sunn hemp (Crotalaria juncea L.) cutting date and planting density on weed suppression in Georgia, USA.

PubMed

Morris, J Bradley; Chase, Carlene; Treadwell, Danielle; Koenig, Rosie; Cho, Alyssa; Morales-Payan, Jose Pable; Murphy, Tim; Antonious, George F

2015-01-01

A field study was conducted in 2008 and 2009 at the USDA, ARS, Plant Genetic Resources Conservation Unit in Griffin, GA, to investigate weed suppression by sunn hemp (Crotalaria juncea L). The objectives were to (1) evaluate the effects of apical meristem removal (AMR) at three dates [5, 6, and 7 wks after planting (WAP) on May 14, 2008 and May 21, 2009] and (2) assess the impact of seeding rates (11, 28, and 45 kg ha(-1)) on weed biomass reduction. Weed species were identified at 4, 8, and 12 wks after sunn hemp planting. Sunn hemp cutting date had no significant effect on weed suppression in 2008 but significant differences for grass weeds at 4, 8, and 12 WAP and for yellow nutsedge at 8 and 12 WAP did occur when compared to the control in 2009. In comparison to the sunn hemp-free control plot in 2009, all three seeding rates had reduced grass weed dry weights at 4, 8, and 12 WAP. The total mass of yellow nutsedge when grown with sunn hemp was reduced compared to the total mass of yellow nutsedge grown in the weedy check for all seeding rates at 8 and 12 WAP. Lower grass weed biomass was observed by 12 WAP for cutting dates and seeding rates during 2008 and 2009. Sunn hemp cutting date and seeding rate reduced branch numbers in both years. The reduction in sunn hemp seeding rates revealed a decrease in weed populations.

Dual-stiffness flooring: can it reduce fracture rates associated with falls?

PubMed

Knoefel, Frank; Patrick, Louise; Taylor, Jodie; Goubran, Rafik

2013-04-01

Falls cause significant morbidity and mortality in long term care facilities. Dual-stiffness flooring (DSF) has previously shown promise in reducing such morbidity in experimental models. This study set out to measure the impact of SmartCell flooring on falls-related morbidity in a nursing home. All falls occurring at an Arizona nursing home between July 1, 2008, and December 31, 2010, were reviewed for age, sex, diagnosis of osteoporosis, number of medications, history of previous falls, type of flooring (normal vs DSF), time of day, type of injury, and resulting actions. Fall-related outcomes were compared across room types using chi-square and logistic regression methods. Eighty-two falls on the DSF were compared with 85 falls on the regular floor. There was a tendency for residents falling on DSF to have less bruising and abrasions, while having more redness and cuts. There were 2 fractures on regular flooring (2.4% fracture rate) and none on the DSF flooring (0% fracture rate). The fracture rate of 2.4% of falls on the regular floor is consistent with previous reports in the literature, whereas a 0% rate found on the DSF floor is a clinically significant improvement. This suggests that DSF may be a practical approach for institutions and consumers to reduce fall-related injuries. A larger scale controlled study to confirm these encouraging preliminary findings is warranted. Copyright © 2013 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

Overexpression of stress-inducible OsBURP16, the β subunit of polygalacturonase 1, decreases pectin content and cell adhesion and increases abiotic stress sensitivity in rice.

PubMed

Liu, Huanhuan; Ma, Yan; Chen, Na; Guo, Siyi; Liu, Huili; Guo, Xiaoyu; Chong, Kang; Xu, Yunyuan

2014-05-01

Polygalacturonase (PG), one of the hydrolases responsible for cell wall pectin degradation, is involved in organ consenescence and biotic stress in plants. PG1 is composed of a catalytic subunit, PG2, and a non-catalytic PG1β subunit. OsBURP16 belongs to the PG1β-like subfamily of BURP-family genes and encodes one putative PG1β subunit precursor in rice (Oryza sativa L.). Transcription of OsBURP16 is induced by cold, salinity and drought stresses, as well as by abscisic acid (ABA) treatment. Analysis of plant survival rates, relative ion leakage rates, accumulation levels of H2 O2 and water loss rates of leaves showed that overexpression of OsBURP16 enhanced sensitivity to cold, salinity and drought stresses compared with controls. Young leaves of Ubi::OsBURP16 transgenic plants showed reduced cell adhesion and increased cuticular transpiration rate. Mechanical strength measurement of Ubi::OsBURP16 plants showed that reduced force was required to break leaves as compared with wild type. Transgenic rice showed enhanced PG activity and reduced pectin content. All these results suggested that overexpression of OsBURP16 caused pectin degradation and affected cell wall integrity as well as transpiration rate, which decreased tolerance to abiotic stresses. © 2013 The Authors. Plant, Cell & Environment published by John Wiley & Sons Ltd.

Item Response Modeling of Paired Comparison and Ranking Data

ERIC Educational Resources Information Center

Maydeu-Olivares, Alberto; Brown, Anna

2010-01-01

The comparative format used in ranking and paired comparisons tasks can significantly reduce the impact of uniform response biases typically associated with rating scales. Thurstone's (1927, 1931) model provides a powerful framework for modeling comparative data such as paired comparisons and rankings. Although Thurstonian models are generally…

Balance Comparisons between Female Dancers and Active Nondancers

ERIC Educational Resources Information Center

Ambegaonkar, Jatin P.; Caswell, Shane V.; Winchester, Jason B.; Shimokochi, Yohei; Cortes, Nelson; Caswell, Amanda M.

2013-01-01

Purpose: Female dancers have lower anterior cruciate ligament (ACL) injury rates compared with physically active women. Enhanced balance can decrease musculoskeletal injury risk. Dancers are proposed to have superior balance compared with physically active nondancers, and this may reduce their risk for ACL injury. However, whether female dancers…

Fuel Efficient Strategies for Reducing Contrail Formations in United States Air Space

NASA Technical Reports Server (NTRS)

Sridhar, Banavar; Chen, Neil Y.; Ng, Hok K.

2010-01-01

This paper describes a class of strategies for reducing persistent contrail formation in the United States airspace. The primary objective is to minimize potential contrail formation regions by altering the aircraft's cruising altitude in a fuel-efficient way. The results show that the contrail formations can be reduced significantly without extra fuel consumption and without adversely affecting congestion in the airspace. The contrail formations can be further reduced by using extra fuel. For the day tested, the maximal reduction strategy has a 53% contrail reduction rate. The most fuel-efficient strategy has an 8% reduction rate with 2.86% less fuel-burnt compared to the maximal reduction strategy. Using a cost function which penalizes extra fuel consumed while maximizing the amount of contrail reduction provides a flexible way to trade off between contrail reduction and fuel consumption. It can achieve a 35% contrail reduction rate with only 0.23% extra fuel consumption. The proposed fuel-efficient contrail reduction strategy provides a solution to reduce aviation-induced environmental impact on a daily basis.

Hypnosis for the control of pain associated with external cephalic version: a comparative study.

PubMed

Guittier, Marie-Julia; Guillemin, Francis; Farinelli, Edith Brandao; Irion, Olivier; Boulvain, Michel; de Tejada, Begoña Martinez

2013-10-01

To assess the effectiveness of hypnosis to reduce pain and facilitate external cephalic version (ECV). Cohort study. Geneva University Hospitals, Switzerland. 63 women attempting ECV under hypnosis from 2010 to 2011 were compared with 122 women who received standard care from 2005 through 2008. Immediately after the ECV attempt, both groups completed the same questionnaire evaluating the participants' pain (visual analogue and verbal rating scales) and experience with the procedure. Physicians also completed a questionnaire that elicited their views on the effect of hypnosis on the intervention. A chi-squared test was used to compare differences in proportions, and the Mann-Whitney U test was used for differences in continuous variables. A thematic content analysis of the obstetricians' responses to the open question regarding their experience of hypnotist accompaniment was also performed. Pain evaluated by women (visual analogue and verbal rating scales) and success rate of ECV. Pain intensity reported by women did not significantly differ between the hypnosis group and the standard care group (visual analogue scale score, 6.0 versus 6.3, respectively; p=.25; difference for verbal rating scale, p=0.31. In 72% of cases, physicians reported that hypnosis facilitated the procedure. The success rates in both groups were not significantly different (30% with hypnosis compared with 38% without; p=.31). Most women in both groups found the ECV attempt painful and a source of anxiety but would undergo it again if necessary. Hypnosis accompaniment during ECV does not reduce pain intensity associated with the procedure or improve the probability of a successful version.

The Impact of Seat belts and Airbags on High Grade Renal Injuries and Nephrectomy Rates in Motor Vehicle Collisions

PubMed Central

Bjurlin, Marc A; Fantus, Richard J.; Mellett, Michele M.; Fantus, Richard J.; Villines, Dana

2015-01-01

Purpose Motor vehicle collisions (MVCs) are the most common cause of blunt genitourinary trauma. We compared renal injuries with no protective device to those with seat belts and/or airbags utilizing the National Trauma Data Bank (NTDB). Our primary endpoint was a reduction in high-grade renal injuries (grades III-V) with a secondary endpoint of reduction in nephrectomy rate. Materials and Methods The NTDB research datasets, admission year 2010, 2011, and 2012, were queried for MVC occupants with renal injury. Subjects were stratified by protective device and airbag deployment. Abbreviated Injury Score was converted to American Association for the Surgery of Trauma renal injury grade and nephrectomy rates were evaluated. Intergroup comparisons were analyzed for renal injury grades, nephrectomy, length of stay, and mortality with chi-square or one-way ANOVA. Protective device relative risk reduction was determined. Results A review of 466,028 MVCs revealed 3,846 renal injuries. Injured occupants without a protective device had a higher rate of high grade renal injury (45.1%) compared to those with seat belts (39.9%, p=0.008), airbags (42.3%, p=0.317), and seat belts with airbags (34.7%, p<0.001). Seat belts (20.0%, p<0.001), airbags (10.5% p<0.001), and seat belts with airbags (13.3%, p<0.001) reduced the rate of nephrectomy compared to no protective device (56.2%). The combination of seatbelts and airbags also reduced total hospital length of stay (p<0.001) and ICU days (p=0.005). Relative risk reduction of high-grade renal injuries (23.1%) and nephrectomy (39.9%) were highest for combined protective devices. Conclusions Occupants of MVCs with protective devices have reduced rates of high-grade renal injury and nephrectomy. Reduction appears most pronounced with the combination of seat belts and airbags. PMID:24846798

Evidence of reduced recombination rate in human regulatory domains.

PubMed

Liu, Yaping; Sarkar, Abhishek; Kheradpour, Pouya; Ernst, Jason; Kellis, Manolis

2017-10-20

Recombination rate is non-uniformly distributed across the human genome. The variation of recombination rate at both fine and large scales cannot be fully explained by DNA sequences alone. Epigenetic factors, particularly DNA methylation, have recently been proposed to influence the variation in recombination rate. We study the relationship between recombination rate and gene regulatory domains, defined by a gene and its linked control elements. We define these links using expression quantitative trait loci (eQTLs), methylation quantitative trait loci (meQTLs), chromatin conformation from publicly available datasets (Hi-C and ChIA-PET), and correlated activity links that we infer across cell types. Each link type shows a "recombination rate valley" of significantly reduced recombination rate compared to matched control regions. This recombination rate valley is most pronounced for gene regulatory domains of early embryonic development genes, housekeeping genes, and constitutive regulatory elements, which are known to show increased evolutionary constraint across species. Recombination rate valleys show increased DNA methylation, reduced doublestranded break initiation, and increased repair efficiency, specifically in the lineage leading to the germ line. Moreover, by using only the overlap of functional links and DNA methylation in germ cells, we are able to predict the recombination rate with high accuracy. Our results suggest the existence of a recombination rate valley at regulatory domains and provide a potential molecular mechanism to interpret the interplay between genetic and epigenetic variations.

Effect of Ambulatory Transitional Care Management on 30-Day Readmission Rates.

PubMed

Ballard, Jonathan; Rankin, Wade; Roper, Karen L; Weatherford, Sarah; Cardarelli, Roberto

2018-05-01

A process improvement initiative for transitional care management (TCM) was evaluated for effectiveness in reducing 30-day readmission rates in a retrospective cohort study. Regression models analyzed the association between level of TCM component implementation and readmission rates among patients discharged from a university medical center hospital. Of the 1884 patients meeting inclusion criteria, only 3.7% (70) experienced a 30-day readmission. Patients receiving the full complement of TCM had 86.6% decreased odds of readmission compared with patients who did not receive TCM ( P < .001). However, the complete package of TCM services under Medicare guidelines may not be essential. A postdischarge telephone call did not reduce readmission odds, provided a TCM office visit occurred. Important for risk assessment models targeting patients for TCM, the number of previous hospital admissions, not age, predicted 30-day readmission risk. This study provides evidence that primary care-based TCM can reduce 30-day readmissions even when overall rates are low.

Low-complexity R-peak detection for ambulatory fetal monitoring.

PubMed

Rooijakkers, Michael J; Rabotti, Chiara; Oei, S Guid; Mischi, Massimo

2012-07-01

Non-invasive fetal health monitoring during pregnancy is becoming increasingly important because of the increasing number of high-risk pregnancies. Despite recent advances in signal-processing technology, which have enabled fetal monitoring during pregnancy using abdominal electrocardiogram (ECG) recordings, ubiquitous fetal health monitoring is still unfeasible due to the computational complexity of noise-robust solutions. In this paper, an ECG R-peak detection algorithm for ambulatory R-peak detection is proposed, as part of a fetal ECG detection algorithm. The proposed algorithm is optimized to reduce computational complexity, without reducing the R-peak detection performance compared to the existing R-peak detection schemes. Validation of the algorithm is performed on three manually annotated datasets. With a detection error rate of 0.23%, 1.32% and 9.42% on the MIT/BIH Arrhythmia and in-house maternal and fetal databases, respectively, the detection rate of the proposed algorithm is comparable to the best state-of-the-art algorithms, at a reduced computational complexity.

Novel transgenic pigs with enhanced growth and reduced environmental impact

PubMed Central

Yang, Huaqiang; Liu, Dewu; Cai, Gengyuan; Li, Guoling; Mo, Jianxin; Wang, Dehua; Zhong, Cuili; Wang, Haoqiang; Sun, Yue; Shi, Junsong; Zheng, Enqin; Meng, Fanming; Zhang, Mao; He, Xiaoyan; Zhou, Rong; Zhang, Jian; Huang, Miaorong; Zhang, Ran; Li, Ning; Fan, Mingzhe; Yang, Jinzeng

2018-01-01

In pig production, inefficient feed digestion causes excessive nutrients such as phosphorus and nitrogen to be released to the environment. To address the issue of environmental emissions, we established transgenic pigs harboring a single-copy quad-cistronic transgene and simultaneously expressing three microbial enzymes, β-glucanase, xylanase, and phytase in the salivary glands. All the transgenic enzymes were successfully expressed, and the digestion of non-starch polysaccharides (NSPs) and phytate in the feedstuff was enhanced. Fecal nitrogen and phosphorus outputs in the transgenic pigs were reduced by 23.2–45.8%, and growth rate improved by 23.0% (gilts) and 24.4% (boars) compared with that of age-matched wild-type littermates under the same dietary treatment. The transgenic pigs showed an 11.5–14.5% improvement in feed conversion rate compared with the wild-type pigs. These findings indicate that the transgenic pigs are promising resources for improving feed efficiency and reducing environmental impact. PMID:29784082

Reduction of polyspermic penetration using biomimetic microfluidic technology during in vitro fertilization.

PubMed

Clark, Sherrie G; Haubert, Kathyrn; Beebe, David J; Ferguson, C Edward; Wheeler, Matthew B

2005-11-01

Efforts to improve the in vitro embryo production process in pigs have included modifying culture medium and number of spermatozoa inseminated in order to reduce the incidence of polyspermy. Polyspermy is a pathological condition which results in aberrant embryonic development. The microchannels are designed to more closely mimic the function of the oviduct and create a flow pattern of spermatozoa past the oocytes similar to the pattern in the oviduct. In vitro fertilization of porcine oocytes in the microchannels has produced a higher incidence of monospermic penetration (p<0.05) as compared to the oocytes fertilized in the traditional microdrop system with comparable penetration and male pronucleus formation rates. Additionally, cleavage rates of the embryos as well as development to the blastocyst stage are similar. Here we demonstrate that the biomimetic microchannel in vitro fertilization system can reduce polyspermy and, therefore, increase the number of potentially viable embryos without reducing the overall in vitro production efficiency.

Field study comparing the effect of hydraulic mixing on septic tank performance and sludge accumulation.

PubMed

Almomani, Fares

2016-01-01

This study investigates the effect of hydraulic mixing on anaerobic digestion and sludge accumulation in a septic tank. The performance of a septic tank equipped with a hydraulic mixer was compared with that of a similar standard septic tank over a period of 10 months. The study was conducted in two phases: Phase-I--from May to November 2013 (6 months); Phase-II--from January to May 2014 (4 months). Hydraulic mixing effectively reduced the effluent biological oxygen demand (BOD) and total suspended solids, and reduced the sludge accumulation rate in the septic tank. The BOD removal efficiencies during Phase-II were 65% and 75% in the standard septic tank and a septic tank equipped with hydraulic mixer (Smart Digester™), respectively. The effect of hydraulic mixing reduced the rate of sludge accumulation from 0.64 cm/day to 0.27 cm/day, and increased the pump-out interval by a factor of 3.

Patients with premenstrual syndrome have reduced sensitivity to midazolam compared to control subjects.

PubMed

Sundström, I; Nyberg, S; Bäckström, T

1997-12-01

Premenstrual syndrome (PMS) depends on gonadal hormones produced by the corpus luteum. Given the facilitory actions on GABAergic inhibitory neurotransmission exerted by certain progesterone metabolites, further studies on the GABAA receptor system in premenstrual syndrome are warranted. This study evaluated the benzodiazepine sensitivity in PMS patients and control subjects, using saccadic eye velocity (SEV) and visual analogue ratings of sedation as dependent measures. PMS patients displayed a significantly reduced SEV responsiveness to benzodiazepines compared to control subjects in the follicular phase, whereas there was no difference between groups in the luteal phase. In the luteal phase, the sedation response to benzodiazepines was significantly reduced in PMS patients compared to control subjects. There was also an influence of PMS symptom severity on these measures, as high-severity PMS patients displayed blunted SEV and sedation responses to benzodiazepines compared to low-severity patients. These results indicate that PMS patients have a reduced functional sensitivity at the GABAA/benzodiazepine receptor complex throughout the menstrual cycle.

On the Growth of Ice in Aqueous Solutions Contained in Capillaries

NASA Astrophysics Data System (ADS)

Pruppracher, H. R.

1967-06-01

The growth rate of ice in supercooled water and in dilute aqueous solutions of various salts which dissociate in water into univalent ions was studied. The solutions contained in polyethylene tubes of small bore had concentrations between 10-6 and 10-1 moles liter-1 and were investigated at bath supercoolings between 1° and 15°C. The growth rate of ice which in pure water was found to vary approximately with the square of the bath supercooling was affected in a systematic manner by the type and concentration of the salt in solution. At salt concentrations smaller than 5 × 10-2 moles liter-1 most salts did not affect the growth rate. However, the fluorides were found to increase the growth rate over and above the one in pure water. At concentrations larger than 5 × 10-2 moles liter-1 all the salts reduced the growth rate of ice below the one in pure water. By comparing solutions of salts with common anion it was found that at a particular bath supercooling and salt concentration the growth rate of ice was reduced most in lithium solutions and least in cesium and ammonium solutions. By comparing solutions of salts with common cation it was found that the growth rate of ice was reduced most in fluoride solutions and least in bromide solutions. It was concluded that in solutions with salt concentrations larger than 5 × 10-2 moles liter-1 the rate of dissipation of latent heat which controls the growth rate of ice is affected in a systematic manner by the freezing point lowering effects which result from pure mass transfer conditions prevailing at the ice-solution interface of a stagnant system. Some features of the observed growth rates are discussed in terms of the effect of dissolved salts on the growth forms of ice in aqueous solutions.

Uranium mobility during interaction of rhyolitic glass with alkaline solutions: dissolution of glass

USGS Publications Warehouse

Zielinski, Robert A.

1977-01-01

This report concerns investigations designed to identify the important physical and chemical parameters influencing the rate of release of uranium from glass shards of rhyolitic air-fall ash. Oxidizing, silica undersaturated, alkaline solutions are eluted through a column of rhyolitic glass shards at a carefully controlled temperature, pressure, and flow rate. The solutions are monitored for the concentration of uranium and selected additional elements (Si, K, Li, F), and the glass is recovered and examined for physical and/or chemical evidence of attack. The flushing mode is designed to mimic leaching of glass shards by intermittent, near-surface waters with which the glass is not in equilibrium. Reported rates are applicable only to the experimental conditions (120?C, 7,000 psi), but it is assumed that the reaction mechanisms and the relative importance of rate-influencing parameters remain unchanged, at reduced temperature and pressure. Results of the above experiment indicate that silica and uranium are released from glass shards at comparable rates, while lithium and potassium are released faster and fluorine slower than either Si or U. Rates of release of silica and uranium correlate positively with the surface area of the shards. Rhyolitic shards release uranium at faster rates than rhyodacitic shards of comparable surface area. Changes in the shards resulting from experimental treatment and observed in the original glass separates from an Oligocene ash (compared to a Pleistocene ash) include; surface pitting, increased surface area, devitrification rinds (<1l micron wide) and reduced lithium contents. Future investigations will study the effect of temperature, pressure, solution composition, and flow rate on the relative mobility of U, Si, Li, F, and K.

Why care about linear hair growth rates (LHGR)? a study using in vivo imaging and computer assisted image analysis after manual processing (CAIAMP) in unaffected male controls and men with male pattern hair loss (MPHL).

PubMed

Van Neste, Dominique

2014-01-01

The words "hair growth" frequently encompass many aspects other than just growth. Report on a validation method for precise non-invasive measurement of thickness together with linear hair growth rates of individual hair fibres. To verify the possible correlation between thickness and linear growth rate of scalp hair in male pattern hair loss as compared with healthy male controls. To document the process of validation of hair growth measurement from in vivo image capturing and manual processing, followed by computer assisted image analysis. We analysed 179 paired images obtained with the contrast-enhanced-phototrichogram method with exogen collection (CE-PTG-EC) in 13 healthy male controls and in 87 men with male pattern hair loss (MPHL). There was a global positive correlation between thickness and growth rate (ANOVA; p<0.0001) and a statistically significantly (ANOVA; p<0.0005) slower growth rate in MPHL as compared with equally thick hairs from controls. Finally, the growth rate recorded in the more severe patterns was significantly (ANOVA; P ≤ 0.001) reduced compared with equally thick hair from less severely affected MPHL or controls subjects. Reduced growth rate, together with thinning and shortening of the anagen phase duration in MPHL might contribute together to the global impression of decreased hair volume on the top of the head. Amongst other structural and functional parameters characterizing hair follicle regression, linear hair growth rate warrants further investigation, as it may be relevant in terms of self-perception of hair coverage, quantitative diagnosis and prognostic factor of the therapeutic response.

Comparing The Effects Of Reference Pricing And Centers-Of-Excellence Approaches To Value-Based Benefit Design.

PubMed

Zhang, Hui; Cowling, David W; Facer, Matthew

2017-12-01

Various health insurance benefit designs based on value-based purchasing have been promoted to steer patients to high-value providers, but little is known about the designs' relative effectiveness and underlying mechanisms. We compared the impact of two designs implemented by the California Public Employees' Retirement System on inpatient hospital total hip or knee replacement: a reference-based pricing design for preferred provider organizations (PPOs) and a centers-of-excellence design for health maintenance organizations (HMOs). Payment and utilization data for the procedures in the period 2008-13 were evaluated using pre-post and quasi-experimental designs at the system and health plan levels, adjusting for demographic characteristics, case-mix, and other confounders. We found that both designs prompted higher use of designated low-price high-quality facilities and reduced average replacement expenses per member at the plan and system levels. However, the designs used different routes: The reference-based pricing design reduced average replacement payments per case in PPOs by 26.7 percent in the first year, compared to HMOs, but did not lower PPO members' utilization rates. In contrast, the centers-of-excellence design lowered HMO members' utilization rates by 29.2 percent in the first year, compared to PPOs, but did not reduce HMO average replacement payments per case. The reference-based pricing design appears more suitable for reducing price variation, and the centers-of-excellence design for addressing variation in use.

Factors contributing to the failure of Humidified High-Flow Nasal Cannulae.

PubMed

Teoh, Sophia; Clyde, Elizabeth; Dassios, Theodore; Greenough, Anne

2018-05-24

The use of humidified high-flow nasal cannulae (HHFNC) as an alternative mode of non-invasive ventilation (NIV) in neonates has become widespread. A survey of UK neonatal units showed the proportion using HHFNC had increased from 56% in 2012 to 87% in 2015 (1). A recently reported Cochrane Review (2) comparing the use of HHFNC against other NIV modes of ventilation immediately after birth or following extubation showed no significant difference in the rates of bronchopulmonary dysplasia (BPD) or death and no significant difference in the rates of treatment failure/reintubation. Benefits cited include a significantly reduced risk of nasal trauma as compared to continuous positive airway pressure (CPAP). Furthermore, both medical staff and parents (3) were found to prefer HHFNC to CPAP. Identification of infants in whom use of HHFNC as either a primary or step-down mode of respiratory support may be inappropriate might further reduce the failure rate of HHFNC. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

An analysis of variations of indications and maternal-fetal prognosis for caesarean section in a tertiary hospital of Beijing: A population-based retrospective cohort study.

PubMed

Liu, Yajun; Wang, Xin; Zou, Liying; Ruan, Yan; Zhang, Weiyuan

2017-02-01

In recent decades, we have observed a remarkable increase in the rate of caesarean section (CS) in both developed and developing countries, especially in China. According to the World Health Organization (WHO) systematic review, if the increase in CS rate was between 10% and 15%, the maternal and neonatal mortality was decreased. However, above this level, increasing the rate of CS is no longer associated with reduced mortality. To date, no consensus has been reached on the main factors driving the cesarean epidemic. To reduce the progressively increasing rate of CS, we should find indications for the increasing CS rate. The aim of our study was to estimate the change of CS rate of Beijing Obstetrics and Gynecology Hospital and to find the variation of the indications.From January 1995 to December 2014, the CS rate of Beijing Obstetrics and Gynecology Hospital was analyzed. For our analysis, we selected 14,642 and 16,335 deliveries respectively that occurred during the year 2011 and 2014, to analyze the difference of indications, excluding incomplete data and miscarriages or termination of pregnancy before 28 weeks of gestation because of fatal malformations, intrauterine death, or other reasons.The average CS rate during the past 20 years was 51.15%. The highest caesarean delivery rate was 60.69% in 2002; however, the caesarean delivery rate declined to 34.53% in 2014. The obviously different indications were caesarean delivery on maternal request and previous CS delivery. The rate of CS due to maternal request in 2014 was decreased by 8.16% compared with the year 2011. However, the percentage of pregnancy women with a previous CS delivery increased from 9.61% to 20.42% in 3 years. Along with the decline of CS rate, the perinatal mortality and the rate of neonatal asphyxia decreased in 2014 compared with that in 2011.After a series of measures, the CS rate declined indeed. Compared with 2011, the perinatal mortality and the rate of neonatal asphyxia decreased in 2014. Caesarean delivery on maternal request (CDMR) cannot improve the maternal-fetal prognosis compared with the spontaneous vaginal delivery. With the releasing of China's 2 children policy, more CS will be implemented due to previous CS. There is a need for further research that evaluates interventions for increasing VBAC rates that target clinicians.

An energy-efficient rate adaptive media access protocol (RA-MAC) for long-lived sensor networks.

PubMed

Hu, Wen; Chen, Quanjun; Corke, Peter; O'Rourke, Damien

2010-01-01

We introduce an energy-efficient Rate Adaptive Media Access Control (RA-MAC) algorithm for long-lived Wireless Sensor Networks (WSNs). Previous research shows that the dynamic and lossy nature of wireless communications is one of the major challenges to reliable data delivery in WSNs. RA-MAC achieves high link reliability in such situations by dynamically trading off data rate for channel gain. The extra gain that can be achieved reduces the packet loss rate which contributes to reduced energy expenditure through a reduced numbers of retransmissions. We achieve this at the expense of raw bit rate which generally far exceeds the application's link requirement. To minimize communication energy consumption, RA-MAC selects the optimal data rate based on the estimated link quality at each data rate and an analytical model of the energy consumption. Our model shows how the selected data rate depends on different channel conditions in order to minimize energy consumption. We have implemented RA-MAC in TinyOS for an off-the-shelf sensor platform (the TinyNode) on top of a state-of-the-art WSN Media Access Control Protocol, SCP-MAC, and evaluated its performance by comparing our implementation with the original SCP-MAC using both simulation and experiment.

Which Route of Tranexamic Acid Administration is More Effective to Reduce Blood Loss Following Total Knee Arthroplasty?

PubMed

Keyhani, Sohrab; Esmailiejah, Ali Akbar; Abbasian, Mohammad Reza; Safdari, Farshad

2016-01-01

The most appropriate route of tranexamic acid administration is controversial. In the current study, we compared the efficacy of intravenous (IV) and topical intra-articular tranexamic acid in reducing blood loss and transfusion rate in patients who underwent primary total knee arthroplasty. One hundred twenty 120 patients were scheduled to undergo primary total knee arthroplasty. Patients were randomly allocated to three equal groups: IV tranexamic acid (500 mg), topical tranexamic acid (3 g in 100 mL normal saline) and the control. In the topical group, half of the volume was used to irrigate the joint and the other half was injected intra-articularly. The volume of blood loss, hemoglobin (Hb) level at 24 hours postoperative, and rate of transfusion was compared between groups. The blood loss and Hb level were significantly greater and lower in the control group, respectively (P=0.031). Also, the rate of transfusion was significantly greater in the control group (P=0.013). However, IV and topical groups did not differ significantly in terms of measured variables. No patient experienced a thromboembolic event in our study. Tranexamic acid is a useful antifibrinolytic drug to reduce postoperative blood loss, Hb drop, and rate of blood transfusion in patients undergoing total knee arthroplasty. The route of tranexamic acid administration did not affect the efficacy and safety.

Preservation of the Myofascial Cuff During Posterior Fossa Surgery to Reduce the Rate of Pseudomeningocele Formation and Cerebrospinal Fluid Leak: A Technical Note.

PubMed

Felbaum, Daniel R; Mueller, Kyle; Anaizi, Amjad; Mason, Robert B; Jean, Walter C; Voyadzis, Jean M

2016-12-28

 Suboccipital craniotomy is a workhorse neurosurgical operation for approaching the posterior fossa but carries a high risk of pseudomeningocele and cerebrospinal fluid (CSF) leak. We describe our experience with a simple T-shaped fascial opening that preserves the occipital myofascial cuff as compared to traditional methods to reduce this risk.  A single institution, retrospective review of prospectively collected database was performed of patients that underwent a suboccipital craniectomy or craniotomy. Patient data was reviewed for craniotomy or craniectomy, dural graft, and/or sealant use as well as CSF complications. A pseudomeningocele was defined as a subcutaneous collection of cerebrospinal fluid palpable clinically and confirmed on imaging. A CSF leak was defined as a CSF-cutaneous fistula manifested by CSF leaking through the wound. All patients underwent regular postoperative visits of two weeks, one month, and three months.  Our retrospective review identified 33 patients matching the inclusion criteria. Overall, our cohort had a 21% (7/33) rate of clinical and radiographic pseudomeningocele formation with 9% (3/33) requiring surgical revision or a separate procedure. The rate of clinical and radiographic pseudomeningocele formation in the myofascial cuff preservation technique was less than standard techniques (12% and 31%, respectively). Revision or further surgical procedures were also reduced in the myofascial cuff preservation technique vs. the standard technique (6% vs 13%).  Preservation of the myofascial cuff during posterior fossa surgery is a simple and adoptable technique that reduces the rate of pseudomeningocele formation and CSF leak as compared with standard techniques.

Analysis and Long-Term Follow-Up of the Surgical Treatment of Children With Craniopharyngioma.

PubMed

Cheng, Jing; Shao, Qiang; Pan, Zhiyong; You, Jin

2016-11-01

To investigate the relationship between the operative approach, clinical pathological factors, and curative effect of the surgical treatment in the patients with craniopharyngioma; to provide a theoretical basis for determining the prognosis and reducing the recurrence rate during the long-term postoperative follow-up in children. This was a retrospective analysis of the clinical data of 92 children who underwent surgical treatment in our department from May 2011 to January 2005. Long-term follow-up was performed from 12 months to 8 years. The pterional approach was used in 49 patients, the interhemispheric approach in 20 patients, the corpus callosum approach in 16 patients, and the butterfly approach in 7 patients. Pathological classification was performed by hematoxylin and eosin stain staining of the pathological tissues and evaluated according to the different surgical approaches, MRI calcification status, calcification type, pathological type, whether radiotherapy was performed, postoperative recurrence, and death. For the pterion approach resection, there was near total resection in 46 patients (93.9%) with the lowest recurrence rate. The operative approach and postoperative recurrence rates were compared; the difference was statistically significant (P <0.05). For comparison of the operative approach and postoperative mortality, the difference was not statistically significant (P >0.05). There was not a significant difference between the MRI classification and postoperative recurrence rate (P >0.05). Comparing the degree of tumor calcification with the recurrence rate after operation and the mortality rate, the difference was statistically significant (P <0.05). The recurrence rate and mortality rate of adamantimous craniopharyngioma and squamous papillary craniopharyngioma in 2 groups following operation were compared, and the differences were statistically significant (P <0.05). Postoperative adjuvant radiotherapy was compared with the postoperative recurrence rate and mortality; the differences were statistically significant (P <0.05). The main effects on tumor recurrence include the choice of surgical approach and degree of calcification. The adamantimous craniopharyngioma relapse rate is higher, which could be because invasion of craniopharyngioma only occurs with adamantimous craniopharyngioma. Postoperative radiotherapy can significantly prolong the recurrence time and reduce the mortality rate of patients with craniopharyngioma.

Estimating the variance for heterogeneity in arm-based network meta-analysis.

PubMed

Piepho, Hans-Peter; Madden, Laurence V; Roger, James; Payne, Roger; Williams, Emlyn R

2018-04-19

Network meta-analysis can be implemented by using arm-based or contrast-based models. Here we focus on arm-based models and fit them using generalized linear mixed model procedures. Full maximum likelihood (ML) estimation leads to biased trial-by-treatment interaction variance estimates for heterogeneity. Thus, our objective is to investigate alternative approaches to variance estimation that reduce bias compared with full ML. Specifically, we use penalized quasi-likelihood/pseudo-likelihood and hierarchical (h) likelihood approaches. In addition, we consider a novel model modification that yields estimators akin to the residual maximum likelihood estimator for linear mixed models. The proposed methods are compared by simulation, and 2 real datasets are used for illustration. Simulations show that penalized quasi-likelihood/pseudo-likelihood and h-likelihood reduce bias and yield satisfactory coverage rates. Sum-to-zero restriction and baseline contrasts for random trial-by-treatment interaction effects, as well as a residual ML-like adjustment, also reduce bias compared with an unconstrained model when ML is used, but coverage rates are not quite as good. Penalized quasi-likelihood/pseudo-likelihood and h-likelihood are therefore recommended. Copyright © 2018 John Wiley & Sons, Ltd.

Effects of conjugated linoleic acid (CLA) on fat accumulation, activity, and proteomics analysis in Caenorhabditis elegans.

PubMed

Shen, Peiyi; Kershaw, Jonathan C; Yue, Yiren; Wang, Ou; Kim, Kee-Hong; McClements, D Julian; Park, Yeonhwa

2018-05-30

Conjugated linoleic acid (CLA) has been reported to reduce fat storage in cell culture and animal models. In the current study, the effects of CLA on the fat accumulation, activities, and proteomics were investigated using Caenorhabditis elegans. 100 µM CLA-TG nanoemulsion significantly reduced fat accumulation by 29% compared to linoleic acid (LA)-TG treatment via sir-2.1 (the ortholog of Sirtuin 1), without altering the worm size, growth rate, and pumping rate of C. elegans. CLA significantly increased moving speed and amplitude (the average centroid displacement over the entire track) of wild type worms compared to the LA group and these effects were dependent on aak-2 (AMPKα ortholog) and sir-2.1. Proteomics analysis showed CLA treatment influences various proteins associated in reproduction and development, translation, metabolic processes, and catabolism and proteolysis, in C. elegans. We have also confirmed the proteomics data that CLA reduced the fat accumulation via abs-1 (ATP Synthase B homolog). However, there were no significant effects of CLA on brood size, progeny numbers, and hatchability compared to LA treatment. Copyright © 2018 Elsevier Ltd. All rights reserved.

Radiation resistance of oxide dispersion strengthened alloys: Perspectives from in situ observations and rate theory calculations

DOE PAGES

Liu, Xiang; Miao, Yinbin; Li, Meimei; ...

2018-04-15

Here, in situ ion irradiation and rate theory calculations were employed to directly compare the radiation resistance of an oxide dispersion strengthened alloy with that of a conventional ferritic/martensitic alloy. Compared to the rapid buildup of dislocation loops, loop growth, and formation of network dislocations in the conventional ferritic/martensitic alloy, the superior radiation resistance of the oxide dispersion strengthened alloy is manifested by its stable dislocation structure under the same irradiation conditions. Thus, the results are consistent with rate theory calculations, which show that high-density nanoparticles can significantly reduce freely migrating defects and suppress the buildup of clustered defects.

Radiation resistance of oxide dispersion strengthened alloys: Perspectives from in situ observations and rate theory calculations

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

Liu, Xiang; Miao, Yinbin; Li, Meimei

Here, in situ ion irradiation and rate theory calculations were employed to directly compare the radiation resistance of an oxide dispersion strengthened alloy with that of a conventional ferritic/martensitic alloy. Compared to the rapid buildup of dislocation loops, loop growth, and formation of network dislocations in the conventional ferritic/martensitic alloy, the superior radiation resistance of the oxide dispersion strengthened alloy is manifested by its stable dislocation structure under the same irradiation conditions. Thus, the results are consistent with rate theory calculations, which show that high-density nanoparticles can significantly reduce freely migrating defects and suppress the buildup of clustered defects.

Haploidentical transplant with posttransplant cyclophosphamide vs matched unrelated donor transplant for acute myeloid leukemia

PubMed Central

Zhang, Mei-Jie; Bacigalupo, Andrea A.; Bashey, Asad; Appelbaum, Frederick R.; Aljitawi, Omar S.; Armand, Philippe; Antin, Joseph H.; Chen, Junfang; Devine, Steven M.; Fowler, Daniel H.; Luznik, Leo; Nakamura, Ryotaro; O’Donnell, Paul V.; Perales, Miguel-Angel; Pingali, Sai Ravi; Porter, David L.; Riches, Marcie R.; Ringdén, Olle T. H.; Rocha, Vanderson; Vij, Ravi; Weisdorf, Daniel J.; Champlin, Richard E.; Horowitz, Mary M.; Fuchs, Ephraim J.; Eapen, Mary

2015-01-01

We studied adults with acute myeloid leukemia (AML) after haploidentical (n = 192) and 8/8 HLA-matched unrelated donor (n = 1982) transplantation. Haploidentical recipients received calcineurin inhibitor (CNI), mycophenolate, and posttransplant cyclophosphamide for graft-versus-host disease (GVHD) prophylaxis; 104 patients received myeloablative and 88 received reduced intensity conditioning regimens. Matched unrelated donor transplant recipients received CNI with mycophenolate or methotrexate for GVHD prophylaxis; 1245 patients received myeloablative and 737 received reduced intensity conditioning regimens. In the myeloablative setting, day 30 neutrophil recovery was lower after haploidentical compared with matched unrelated donor transplants (90% vs 97%, P = .02). Corresponding rates after reduced intensity conditioning transplants were 93% and 96% (P = .25). In the myeloablative setting, 3-month acute grade 2-4 (16% vs 33%, P < .0001) and 3-year chronic GVHD (30% vs 53%, P < .0001) were lower after haploidentical compared with matched unrelated donor transplants. Similar differences were observed after reduced intensity conditioning transplants, 19% vs 28% (P = .05) and 34% vs 52% (P = .002). Among patients receiving myeloablative regimens, 3-year probabilities of overall survival were 45% (95% CI, 36-54) and 50% (95% CI, 47-53) after haploidentical and matched unrelated donor transplants (P = .38). Corresponding rates after reduced intensity conditioning transplants were 46% (95% CI, 35-56) and 44% (95% CI, 0.40-47) (P = .71). Although statistical power is limited, these data suggests that survival for patients with AML after haploidentical transplantation with posttransplant cyclophosphamide is comparable with matched unrelated donor transplantation. PMID:26130705

Effect of Mowing Cotton Stalks and Preventing Plant Re-Growth on Post-Harvest Reproduction of Meloidogyne incognita

PubMed Central

Davis, Richard F.; Kemerait, Robert C.

2010-01-01

The southern root-knot nematode (Meloidogyne incognita) is a major parasite of cotton in the U.S., and management tactics for this nematode attempt to minimize population levels. We compared three post-harvest practices for their ability to reduce nematode population levels in the field, thereby reducing initial nematode population for the next year's crop. The three practices tested were: 1) chemical defoliation before harvest plus cutting cotton stalks after harvest, 2) chemical defoliation plus applying a herbicide to kill plants prior to cutting the stalks, and 3) chemical defoliation without cutting stalks. Experiments were conducted in both the greenhouse and in the field. The greenhouse experiments demonstrated that M. incognita reproduction (measured as egg counts and root gall rating indices) was significantly greater when stalks were not cut. Cutting stalks plus applying herbicide to kill cotton roots did not significantly reduce nematode reproduction compared to cutting stalks alone. In field experiments, cutting stalks reduced egg populations and root galling compared to defoliation without stalk cutting. In a greenhouse bioassay which used soil from the field plots, plants grown in soil from the defoliation only treatment had greater root gall ratings and egg counts than in the stalk cutting plus herbicide treatment. Therefore, we conclude that cutting cotton stalks immediately after harvest effectively reduces M. incognita reproduction, and may lead to a lower initial population density of this nematode in the following year. PMID:22736845

Asymmetrically pressing nasal splint for crooked nose deformity.

PubMed

Tugrul, Selahattin; Dogan, Remzi; Kocak, Ilker; Ozturan, Orhan

2015-01-01

Correcting crooked nose deformity is one of the most difficult procedure in rhinoplastic surgery. For that reason, the authors have been designed an asymmetrically pressing nasal splint. In this prospective study, the aim was to compare the effects of applying asymmetrically pressing nasal splint and normal symmetrically splint on the crooked nose. This study included 129 patients who were operated on for crooked nose deformity. Patients were divided into 2 groups. Normal symmetrically pressing nasal splint was applied to groups 1a (I type) and 1b (C type). Asymmetrically pressing nasal splint was applied to groups 2a (I type) and 2b (C type). All groups were compared according to deflection angle from the midline, the percentage of postoperative improvement, patient satisfaction with visual analog scale, and complication rate. I-type noses in both groups at postoperative angle values were reduced, and C-type noses in both groups at postoperative angle values were increased significantly compared with preoperative values. I-type noses of group 2 at postoperative angle values compared with group 1 were reduced, and C-type noses were increased in group 2 significantly. Patient satisfaction rate in group 2 were significantly better than in group 1. The closeness ratios to the ideal angles in group 1 were in "good" and "moderate" levels, whereas in group 2, it was in "excellent" level. There was no significant difference in complication rate in both groups. Asymmetrically pressing splint (novel design) showed increasing success rate clearly in crooked nose surgery than in normal splints.

Aromatherapy and massage intrapartum service impact on use of analgesia and anesthesia in women in labor: a retrospective case note analysis.

PubMed

Dhany, Asha Louise; Mitchell, Theresa; Foy, Chris

2012-10-01

Over the past decade, interest in complementary therapies and alternative medicine has escalated among midwives and the general public in response to increased demand from expectant mothers for more choice, control, and continuity in labor. The aim of this study was to explore if an aromatherapy and massage intrapartum service (AMIS) reduced the need for analgesia during labor. This article reports results related to the effects of an AMIS on type of analgesia chosen by women in labor, and on rates of anesthesia--one aspect of the full study. The study was conducted in a general maternity unit in southwest England, UK. A quantitative research approach was taken, whereby contemporaneously completed service evaluation forms of 1079 women (601 nulliparous women and 478 multiparous women; AMIS group) were retrospectively analyzed in comparison with the birth records of an equal number of similar women (comparison group). Data analysis was achieved by entering data from the forms and comparison sample into an SPSS package and running statistical tests. In the AMIS group, overall analgesia usage was higher for transcutaneous electrical stimulation at 34%, compared with 15.9% (p<0.001 allowing for parity), and for nitrous oxide and oxygen at 87.6%, compared with 80.8% (p<0.001). Pethidine use did not differ after adjustment for parity at 30.1%, compared with 24.2% (p=0.27) in the AMIS and comparison groups, respectively. Rates were lower in the AMIS group for epidural anesthesia at 29.7%, compared with 33.8% (p=0.004 allowing for parity) in the comparison group; spinal anesthesia at 6%; compared with 12.1% (p<0.001) in the comparison group; and general anesthesia at 0.8%, compared with 2.3% (p=0.033) in the comparison group. Having an AMIS appears to have a positive impact on reducing rates of all types of intrapartum anesthesia. The Service is a beneficial addition to conventional midwifery practice that may influence mode of delivery and reduce general anesthesia rates.

Increased extracellular volume and altered mechanics are associated with LVH in hypertensive heart disease, not hypertension alone.

PubMed

Kuruvilla, Sujith; Janardhanan, Rajesh; Antkowiak, Patrick; Keeley, Ellen C; Adenaw, Nebiyu; Brooks, Jeremy; Epstein, Frederick H; Kramer, Christopher M; Salerno, Michael

2015-02-01

The goal of this study was to assess the relationship among extracellular volume (ECV), native T1, and systolic strain in hypertensive patients with left ventricular hypertrophy (HTN LVH), hypertensive patients without LVH (HTN non-LVH), and normotensive controls. Diffuse myocardial fibrosis in HTN LVH patients, as reflected by increased ECV and native T1, may be an underlying mechanism contributing to increased cardiovascular risk compared with HTN non-LVH subjects and controls. Furthermore, increased diffuse fibrosis in HTN LVH subjects may be associated with reduced peak systolic and early diastolic strain rate compared with the other 2 groups. T1 mapping was performed in 20 HTN LVH (mean age, 55 ± 11 years), 23 HTN non-LVH (mean age, 61 ± 12 years), and 22 control subjects (mean age, 54 ± 7 years) on a Siemens 1.5-T Avanto (Siemens Healthcare, Erlangen, Germany) using a previously validated modified look-locker inversion-recovery pulse sequence. T1 was measured pre-contrast and 10, 15, and 20 min after injection of 0.15 mmol/kg gadopentetate dimeglumine, and the mean ECV and native T1 were determined for each subject. Measurement of circumferential strain parameters were performed using cine displacement encoding with stimulated echoes. HTN LVH subjects had higher native T1 compared with controls (p < 0.05). HTN LVH subjects had higher ECV compared with HTN non-LVH subjects and controls (p < 0.05). Peak systolic circumferential strain and early diastolic strain rates were reduced in HTN LVH subjects compared with HTN non-LVH subjects and controls (p < 0.05). Increased levels of ECV and native T1 were associated with reduced peak systolic and early diastolic circumferential strain rate across all subjects. HTN LVH patients had higher ECV, longer native T1 and associated reduction in peak systolic circumferential strain, and early diastolic strain rate compared with HTN non-LVH and control subjects. Measurement of ECV and native T1 provide a noninvasive assessment of diffuse fibrosis in hypertensive heart disease. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Influence of custom-made and prefabricated insoles before and after an intense run

PubMed Central

2017-01-01

Each time the foot contacts the ground during running there is a rapid deceleration that results in a shock wave that is transmitted from the foot to the head. The fatigue of the musculoskeletal system during running may decrease the ability of the body to absorb those shock waves and increase the risk of injury. Insoles are commonly prescribed to prevent injuries, and both custom-made and prefabricated insoles have been observed to reduce shock accelerations during running. However, no study to date has included a direct comparison of their behaviour measured over the same group of athletes, and therefore great controversy still exists regarding their effectiveness in reducing impact loading during running. The aim of the study was to analyse the acute differences in stride and shock parameters while running on a treadmill with custom-made and prefabricated insoles. Stride parameters (stride length, stride rate) and shock acceleration parameters (head and tibial peak acceleration, shock magnitude, acceleration rate, and shock attenuation) were measured using two triaxial accelerometers in 38 runners at 3.33 m/s before and after a 15-min intense run while using the sock liner of the shoe (control condition), prefabricated insoles and custom-made insoles. No differences in shock accelerations were found between the custom-made and the control insoles. The prefabricated insoles increased the head acceleration rate (post-fatigue, p = 0.029) compared to the control condition. The custom-made reduced tibial (pre-fatigue, p = 0.041) and head acceleration rates (pre-fatigue and post-fatigue, p = 0.01 and p = 0.046) compared to the prefabricated insoles. Neither the stride nor the acceleration parameters were modified as a result of the intense run. In the present study, the acute use of insoles (custom-made, prefabricated) did not reduce shock accelerations compared to the control insoles. Therefore, their effectiveness at protecting against injuries associated with elevated accelerations is not supported and remains unclear. PMID:28245273

Wearable Sweat Rate Sensors for Human Thermal Comfort Monitoring.

PubMed

Sim, Jai Kyoung; Yoon, Sunghyun; Cho, Young-Ho

2018-01-19

We propose watch-type sweat rate sensors capable of automatic natural ventilation by integrating miniaturized thermo-pneumatic actuators, and experimentally verify their performances and applicability. Previous sensors using natural ventilation require manual ventilation process or high-power bulky thermo-pneumatic actuators to lift sweat rate detection chambers above skin for continuous measurement. The proposed watch-type sweat rate sensors reduce operation power by minimizing expansion fluid volume to 0.4 ml through heat circuit modeling. The proposed sensors reduce operation power to 12.8% and weight to 47.6% compared to previous portable sensors, operating for 4 hours at 6 V batteries. Human experiment for thermal comfort monitoring is performed by using the proposed sensors having sensitivity of 0.039 (pF/s)/(g/m 2 h) and linearity of 97.9% in human sweat rate range. Average sweat rate difference for each thermal status measured in three subjects shows (32.06 ± 27.19) g/m 2 h in thermal statuses including 'comfortable', 'slightly warm', 'warm', and 'hot'. The proposed sensors thereby can discriminate and compare four stages of thermal status. Sweat rate measurement error of the proposed sensors is less than 10% under air velocity of 1.5 m/s corresponding to human walking speed. The proposed sensors are applicable for wearable and portable use, having potentials for daily thermal comfort monitoring applications.

Implementation of a multidisciplinary guideline improves preterm infant admission temperatures.

PubMed

Harer, M W; Vergales, B; Cady, T; Early, A; Chisholm, C; Swanson, J R

2017-11-01

Hypothermia is a common problem in preterm infants immediately following delivery.Local problem:The rate of admission hypothermia in our neonatal intensive care unit (NICU) was above the rate of comparable NICUs in the Vermont Oxford Network. To reduce the rate of preterm admission hypothermia, a quality improvement (QI) project was implemented, utilizing the plan-do-study-act (PDSA) methodology. A guideline for delivery room thermoregulation management in <35-week infants at the University of Virginia was created and put into practice by a multidisciplinary team. Clinical practice changes in the guideline included: increasing operating room temperatures, obtaining a 10-min axillary temperature, using an exothermic mattress for all infants <35 weeks, and using a polyethylene wrap for infants <32 weeks. The baseline rate of hypothermia (<36.5 °CC) was 63%. Three PDSA cycles data were completed on 168 consecutive preterm births. The post-implementation rate of hypothermia (<36.5 °C) was reduced to 30% (P<0.001). The incidence of moderate hypothermia (< 36 °C) was reduced from a baseline of 29% to a rate of 9% (P<0.001). Use of a multidisciplinary guideline to increase preterm NICU admission temperatures resulted in a decrease in hypothermic infants.

Effects of a Staff Training Intervention on Seclusion Rates on an Adult Inpatient Psychiatric Unit.

PubMed

Newman, Julie; Paun, Olimpia; Fogg, Louis

2018-06-01

The current article presents the effects of a 90-minute staff training intervention aimed at reducing inpatient psychiatric seclusion rates through strengthened staff commitment to seclusion alternatives and improved de-escalation skills. The intervention occurred at an 18-bed adult inpatient psychiatric unit whose seclusion rates in 2015 were seven times the national average. Although the project's primary outcome compared patient seclusion rates before and after the intervention, anonymous staff surveys measured several secondary outcomes. Seclusion rates were reduced from a 6-month pre-intervention average of 2.95 seclusion hours per 1,000 patient hours to a 6-month post-intervention average of 0.29 seclusion hours per 1,000 patient hours, a 90.2% reduction. Completed staff surveys showed significant staff knowledge gains, non-significant changes in staff attitudes about seclusion, non-significant changes in staff de-escalation skill confidence, and use of the new resource sheet by only 17% of staff. The key study implication is that time-limited, focused staff training interventions can have a measurable impact on reducing inpatient seclusion rates. [Journal of Psychosocial Nursing and Mental Health Services, 56(6), 23-30.]. Copyright 2018, SLACK Incorporated.

Sustained Reduction in Adolescent Pregnancy Rates through School and Community-Based Education, 1982-2000

ERIC Educational Resources Information Center

Vincent, Murray; Drane, J. Wanzer; Joshi, Praphul; Shankarnarayan, Saikiran; Nimmons, Michelle

2004-01-01

The resident population of Bamberg County, SC, has been exposed to multiples of public health information and education interventions since October 1982 with the intent to reduce the occurrence of unintended pregnancies among unmarried adolescents. Data analyses were conducted to compare 20 years of pregnancy rates among girls aged 14-17 years for…

Reduced and Compressed Cisplatin-Based Chemotherapy in Children and Adolescents With Intermediate-Risk Extracranial Malignant Germ Cell Tumors: A Report From the Children’s Oncology Group

PubMed Central

Cullen, John W.; Olson, Thomas A.; Pashankar, Farzana; Malogolowkin, Marcio H.; Amatruda, James F.; Villaluna, Doojduen; Krailo, Mark; Billmire, Deborah F.; Rescorla, Frederick J.; Egler, Rachel A.; Dicken, Bryan J.; Ross, Jonathan H.; Schlatter, Marc; Rodriguez-Galindo, Carlos; Frazier, A. Lindsay

2017-01-01

Purpose To investigate whether event-free survival (EFS) can be maintained among children and adolescents with intermediate-risk (IR) malignant germ cell tumors (MGCT) if the administration of cisplatin, etoposide, and bleomycin (PEb) is reduced from four to three cycles and compressed from 5 to 3 days per cycle. Patients and Methods In a phase 3, single-arm trial, patients with IR MGCT (stage II-IV testicular, II-III ovarian, I-II extragonadal, or stage I gonadal tumors with subsequent recurrence) received three cycles of PEb. A parametric comparator model specified that the observed EFS rate should not be significantly < 92%. As recommended for trials that test a reduction of therapy, a one-sided P value ≤ .10 was used to indicate statistical significance. In a post hoc analysis, we also compared results to the EFS rate of comparable patients treated with four cycles of PEb in two prior studies. Results Among 210 eligible patients enrolled from 2003 to 2011, 4-year EFS (EFS4) rate was 89% (95% confidence interval, 83% to 92%), which was significantly lower than the 92% threshold of the comparison model (P = .08). Among 181 newly diagnosed patients, the EFS4 rate was 87%, compared with 92% for 92 comparable children in the historical cohort (P = .15). The EFS4 rate was significantly associated with stage (stage I, 100%; stage II, 92%; stage III, 85%; and stage IV, 54%; P < .001). Conclusion The EFS rate for children with IR MGCT observed after three cycles of PEb was less than that of a prespecified parametric model, particularly for patients with higher-stage tumors. These data do not support a reduction in the number of cycles of PEb from four to three. However, further investigation of a reduction in the number of cycles for patients with lower-stage tumors is warranted. PMID:28240974

Population causes and consequences of leading chronic diseases: a comparative analysis of prevailing explanations.

PubMed

Stuckler, David

2008-06-01

The mortality numbers and rates of chronic disease are rising faster in developing than in developed countries. This article compares prevailing explanations of population chronic disease trends with theoretical and empirical models of population chronic disease epidemiology and assesses some economic consequences of the growth of chronic diseases in developing countries based on the experiences of developed countries. Four decades of male mortality rates of cardiovascular and chronic noncommunicable diseases were regressed on changes in and levels of country income per capita, market integration, foreign direct investment, urbanization rates, and population aging in fifty-six countries for which comparative data were available. Neoclassical economic growth models were used to estimate the effect of the mortality rates of chronic noncommunicable diseases on economic growth in high-income OECD countries. Processes of economic growth, market integration, foreign direct investment, and urbanization were significant determinants of long-term changes in mortality rates of heart disease and chronic noncommunicable disease, and the observed relationships with these social and economic factors were roughly three times stronger than the relationships with the population's aging. In low-income countries, higher levels of country income per capita, population urbanization, foreign direct investment, and market integration were associated with greater mortality rates of heart disease and chronic noncommunicable disease, less increased or sometimes reduced rates in middle-income countries, and decreased rates in high-income countries. Each 10 percent increase in the working-age mortality rates of chronic noncommunicable disease decreased economic growth rates by close to a half percent. Macrosocial and macroeconomic forces are major determinants of population rises in chronic disease mortality, and some prevailing demographic explanations, such as population aging, are incomplete on methodological, empirical, and policy grounds. Rising chronic disease mortality rates will significantly reduce economic growth in developing countries and further widen the health and economic gap between the developed and developing world.

Population Causes and Consequences of Leading Chronic Diseases: A Comparative Analysis of Prevailing Explanations

PubMed Central

Stuckler, David

2008-01-01

Context The mortality numbers and rates of chronic disease are rising faster in developing than in developed countries. This article compares prevailing explanations of population chronic disease trends with theoretical and empirical models of population chronic disease epidemiology and assesses some economic consequences of the growth of chronic diseases in developing countries based on the experiences of developed countries. Methods Four decades of male mortality rates of cardiovascular and chronic noncommunicable diseases were regressed on changes in and levels of country income per capita, market integration, foreign direct investment, urbanization rates, and population aging in fifty-six countries for which comparative data were available. Neoclassical economic growth models were used to estimate the effect of the mortality rates of chronic noncommunicable diseases on economic growth in high-income OECD countries. Findings Processes of economic growth, market integration, foreign direct investment, and urbanization were significant determinants of long-term changes in mortality rates of heart disease and chronic noncommunicable disease, and the observed relationships with these social and economic factors were roughly three times stronger than the relationships with the population's aging. In low-income countries, higher levels of country income per capita, population urbanization, foreign direct investment, and market integration were associated with greater mortality rates of heart disease and chronic noncommunicable disease, less increased or sometimes reduced rates in middle-income countries, and decreased rates in high-income countries. Each 10 percent increase in the working-age mortality rates of chronic noncommunicable disease decreased economic growth rates by close to a half percent. Conclusions Macrosocial and macroeconomic forces are major determinants of population rises in chronic disease mortality, and some prevailing demographic explanations, such as population aging, are incomplete on methodological, empirical, and policy grounds. Rising chronic disease mortality rates will significantly reduce economic growth in developing countries and further widen the health and economic gap between the developed and developing world. PMID:18522614

Application of Glomus sp. and Pseudomonas diminuta Reduce the Use of Chemical Fertilizers in Production of Potato Grown on Different Soil Types

NASA Astrophysics Data System (ADS)

Nurbaity, A.; Sofyan, E. T.; Hamdani, J. S.

2016-08-01

The use of high chemical fertilizer rates in potato production has been applied on the farm in Indonesia. Application of biofertilizer consists of arbuscular mycorrhizal fungi has been tested to reduce the use of NPK rates in production of potato and to determine whether different soil types will have different response to this biofertilizer. A greenhouse experiment was conducted using mixtures of spores of Glomus sp. and inoculant of mycorrhizal helper bacteria Pseudomonas diminuta, applied at different rates of NPK fertilizer (0, 25, 50, 75 and 100% of recommended rates) and different soil types (Andisols and Inceptisols). Results of experiment showed that application of Glomus sp. and P. diminuta reduced the use of NPK up to 50%, where the growth (plant height and tuber number), N,P,K uptake and tuber yields of potato had similar effect to the highest recommendation rate of NPK fertilizer. Inceptisols in general had better response to the biofertiliser compared to Andisols. Findings from this experiment confirmed the evidences that biofertilizer could reduce the use of chemical fertilizer, and the widely distributed soil in Indonesia such as Inceptisols, is potential to be used as a medium for potato production.

Strength training, but not endurance training, reduces motor unit discharge rate variability.

PubMed

Vila-Chã, Carolina; Falla, Deborah

2016-02-01

This study evaluates and compares the effects of strength and endurance training on motor unit discharge rate variability and force steadiness of knee extensor muscles. Thirty sedentary healthy men (age, 26.0±3.8yrs) were randomly assigned to strength training, endurance training or a control group. Conventional endurance and strength training was performed 3days per week, over a period of 6weeks. Maximum voluntary contraction (MVC), time to task failure (at 30% MVC), coefficient of variation (CoV) of force and of the discharges rates of motor units from the vastus medialis obliquus and vastus lateralis were determined as subjects performed 20% and 30% MVC knee extension contractions before and after training. CoV of motor unit discharges rates was significantly reduced for both muscles following strength training (P<0.001), but did not change in the endurance (P=0.875) or control group (P=0.995). CoV of force was reduced after the strength training intervention only (P<0.01). Strength training, but not endurance training, reduces motor unit discharge rate variability and enhances force steadiness of the knee extensors. These results provide new insights into the neuromuscular adaptations that occur with different training methods. Copyright © 2015 Elsevier Ltd. All rights reserved.

Phosphorus, nitrogen, and radionuclide retention and leaching from a Joel sand amended with red mud/gypsum

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

McPharlin, L.R.; Jeffery, R.C.; Toussaint, L.F.

1994-01-01

The leaching of phosphorus (P), nitrogen (N), and radionuclides [sup 232]Th, [sup 226]Ra, [sup 228]Ra, and [sup 40]K from Joel sands amended with red mud/gypsum (RMG) at 9 rates (0, 2, 4, 8, 16, 32, 64, 128, and 256 t/ha) was measured using columns. Intense leaching conditions (34 mm/day for 12 days) and a high rate of applied P (320 kg/ha as superphosphate) and N (680 kg/ha as ammonium nitrate) were used to simulate extremes of irrigated vegetable production on the Swan Coastal Plain. Addition of the highest rate of RMG (256 t/ha) reduced leaching of fertiliser P and ammonium-nitrogenmore » (NH4-N) by 85% and 50%, respectively, compared with 0 t/ha after 12 days. At 64 t RMG/ha P leaching was reduced 50% compared with 0 t/ha. Nitrate-nitrogen (NO3-N) leaching was not affected by addition of RMG. Reduced leaching of NH4-N was attributed to an increase in cation exchange capacity of the soil with the addition of RMG. Bicarbonate-extractable P in the soil increased with rate of RMG to >50 [mu]g P/g soil at 256 t/ha. This indicates that soil testing of residual P could be used to reduce P inputs to vegetable crops after soils were amended with RMG. This would further reduce the impact of vegetable production on the water systems of the Swan Coastal Plain and extend the period of effectiveness of RMG amended soils. The increase in [sup 232]Th specific activity in Joel sand amended with RMG was well below statutory limits even at the highest rate. Neither [sup 40]K nor [sup 226]Ra were detectable in RMG amended sands up to 256 t RMG/ha. There was no evidence of leaching of [sup 226]Ra or [sup 228]Ra at any rate of RMG. These results suggest that the use of RMG amendment on commercial horticultural properties on the Swan Coastal Plain could be feasible. 30 refs., 7 figs., 2 tabs.« less

Method of euthanasia influences the oocyte fertilization rate with fresh mouse sperm.

PubMed

Hazzard, Karen C; Watkins-Chow, Dawn E; Garrett, Lisa J

2014-11-01

In vitro fertilization (IVF) is used to produce mouse embryos for a variety of reasons. We evaluated the effect of the method of euthanasia on the fertilization rate in 2 different IVF protocols. Oocytes collected from C57BL/6J female mice euthanized by CO2 inhalation or cervical dislocation were used in IVF with fresh sperm from either wild-type or genetically engineered C57BL/6J. Compared with CO2 inhalation, cervical dislocation improved the resulting rate of fertilization by 18% in an IVF method using Cook media and by 13% in an IVF method using methyl-B cyclodextrin and reduced glutathione. The lower fertilization rate due to euthanasia by CO2 inhalation was accompanied by changes in blood pH and body temperature despite efforts to minimize temperature drops. In our hands, euthanasia by cervical dislocation improved fertilization rates and consequently reduced the number of egg-donor mice required.

Evaporation for Lithium Bromide Aqueous Solution in a Falling Film Heater under Reduced Pressures

NASA Astrophysics Data System (ADS)

Matsuda, Akira; Ide, Tetsuo; Yukino, Keiji

Experiments on evaporation for water and lithium bromide (LiBr) aqueous solution were made in a externally heated wetted-wall column under reduced pressures. For water, evaporation rate increased slightly as feed rate decreased. The heat transfer coefficients of falling film agreed with those for filmwise condensation. For LiBr solution, evaporation rate decreased and outlet temperature of LiBr solution increased as feed rate decreased. The equations of continuity, diffusion and energy which assume that only water moves to the surface and LiBr doesn't move through falling film of LiBr solution were solved numerically. Calculated values of evaporation rate and outlet temperature of solution agreed with experimental results. The results of this work were compared with pool boiling data reported previously, and it was shown that falling film heater is superior to pool boiling heater concerning heat transfer.

A study of the effect of relaxing music on heart rate recovery after exercise among healthy students.

PubMed

Tan, Fuitze; Tengah, Asrin; Nee, Lo Yah; Fredericks, Salim

2014-05-01

Music has been employed in various clinical settings to reduce anxiety. However, meta-analysis has shown music to have little influence on haemodynamic parameters. This study aimed at investigating the effect of relaxing music on heart rate recovery after exercise. Twenty-three student volunteers underwent treadmill exercise and were assessed for heart rate recovery and saliva analysis; comparing exposure to sedative music with exposure to silence during the recovery period immediately following exercise. No differences were found between music and non-music exposure regarding: heart rate recovery, resting pulse rate, and salivary cortisol. Music was no different to silence in affecting these physiological measures, which are all associated with anxiety. Relaxing music unaccompanied by meditation techniques or other such interventions may not have a major role in reducing anxiety in certain experimental settings. Copyright © 2014 Elsevier Ltd. All rights reserved.

Increased Ratio of Electron Transport to Net Assimilation Rate Supports Elevated Isoprenoid Emission Rate in Eucalypts under Drought1[W][OPEN

PubMed Central

Dani, Kaidala Ganesha Srikanta; Jamie, Ian McLeod; Prentice, Iain Colin; Atwell, Brian James

2014-01-01

Plants undergoing heat and low-CO2 stresses emit large amounts of volatile isoprenoids compared with those in stress-free conditions. One hypothesis posits that the balance between reducing power availability and its use in carbon assimilation determines constitutive isoprenoid emission rates in plants and potentially even their maximum emission capacity under brief periods of stress. To test this, we used abiotic stresses to manipulate the availability of reducing power. Specifically, we examined the effects of mild to severe drought on photosynthetic electron transport rate (ETR) and net carbon assimilation rate (NAR) and the relationship between estimated energy pools and constitutive volatile isoprenoid emission rates in two species of eucalypts: Eucalyptus occidentalis (drought tolerant) and Eucalyptus camaldulensis (drought sensitive). Isoprenoid emission rates were insensitive to mild drought, and the rates increased when the decline in NAR reached a certain species-specific threshold. ETR was sustained under drought and the ETR-NAR ratio increased, driving constitutive isoprenoid emission until severe drought caused carbon limitation of the methylerythritol phosphate pathway. The estimated residual reducing power unused for carbon assimilation, based on the energetic status model, significantly correlated with constitutive isoprenoid emission rates across gradients of drought (r2 > 0.8) and photorespiratory stress (r2 > 0.9). Carbon availability could critically limit emission rates under severe drought and photorespiratory stresses. Under most instances of moderate abiotic stress levels, increased isoprenoid emission rates compete with photorespiration for the residual reducing power not invested in carbon assimilation. A similar mechanism also explains the individual positive effects of low-CO2, heat, and drought stresses on isoprenoid emission. PMID:25139160

Prolonged remission from hepatic encephalopathy with rifaximin: results of a placebo crossover analysis

PubMed Central

Bajaj, J S; Barrett, A C; Bortey, E; Paterson, C; Forbes, W P

2015-01-01

Background Rifaximin therapy reduced risk of hepatic encephalopathy (HE) recurrence and HE-related hospitalisations during a 6-month, randomised, placebo-controlled trial (RCT) and a 24-month open-label maintenance (OLM) study. However, the impact of crossover from placebo to rifaximin therapy is unclear. Aim To study the impact of crossing over from placebo to rifaximin treatment on breakthrough HE and hospitalisation rates using a within-subjects design. Methods Adults with cirrhosis and history of overt HE episodes, currently in HE remission, received placebo during the RCT and crossed over to rifaximin 550 mg twice daily during the OLM study. Rate of breakthrough overt HE episodes, hospitalisations and incidence and rate of adverse events (AEs) were analysed during RCT and first 6 months of OLM. Results Of 82 patients randomised to placebo in the RCT who crossed over to the OLM study, 39 experienced an HE episode during the RCT compared with 14 during the OLM study (P < 0.0001). Significantly lower rates of HE events were observed with rifaximin treatment compared with placebo treatment (P < 0.0001). Rates of HE-related hospitalisation were numerically lower during rifaximin treatment compared with placebo treatment, although not significant. Rates of most common AEs, serious AEs and infection-related AEs were similar between the two treatments. Conclusions This analysis confirms the repeatability of results from the RCT on safety and efficacy of rifaximin 550 mg twice daily in reducing the risk of hepatic encephalopathy recurrence, and suggests these findings are translatable outside of a rigorous, controlled trial setting. PMID:25339518

Neural substrates of empathic accuracy in people with schizophrenia.

PubMed

Harvey, Philippe-Olivier; Zaki, Jamil; Lee, Junghee; Ochsner, Kevin; Green, Michael F

2013-05-01

Empathic deficits in schizophrenia may lead to social dysfunction, but previous studies of schizophrenia have not modeled empathy through paradigms that (1) present participants with naturalistic social stimuli and (2) link brain activity to "accuracy" about inferring other's emotional states. This study addressed this gap by investigating the neural correlates of empathic accuracy (EA) in schizophrenia. Fifteen schizophrenia patients and 15 controls were scanned while continuously rating the affective state of another person shown in a series of videos (ie, targets). These ratings were compared with targets' own self-rated affect, and EA was defined as the correlation between participants' ratings and targets' self-ratings. Targets' self-reported emotional expressivity also was measured. We searched for brain regions whose activity tracked parametrically with (1) perceivers' EA and (2) targets' expressivity. Patients showed reduced EA compared with controls. The left precuneus, left middle frontal gyrus, and bilateral thalamus were significantly more correlated with EA in controls compared with patients. High expressivity in targets was associated with better EA in controls but not in patients. High expressivity was associated with increased brain activity in a large set of regions in controls (eg, fusiform gyrus, medial prefrontal cortex) but not in patients. These results use a naturalistic performance measure to confirm that schizophrenic patients demonstrate impaired ability to understand others' internal states. They provide novel evidence about a potential mechanism for this impairment: schizophrenic patients failed to capitalize on targets' emotional expressivity and also demonstrate reduced neural sensitivity to targets' affective cues.

Economic impact study: neuromuscular training reduces the burden of injuries and costs compared to standard warm-up in youth soccer.

PubMed

Marshall, Deborah A; Lopatina, Elena; Lacny, Sarah; Emery, Carolyn A

2016-11-01

There is randomised controlled trial (RCT) evidence that neuromuscular training (NMT) programmes can reduce the risk of injury in youth soccer. We evaluated the cost-effectiveness of such an NMT prevention strategy compared to a standard of practice warm-up. A cost-effectiveness analysis was conducted alongside a cluster RCT. Injury incidence rates were adjusted for cluster using Poisson regression analyses. Direct healthcare costs and injury incidence proportions were adjusted for cluster using bootstrapping. The joint uncertainty surrounding the cost and injury rate and proportion differences was estimated using bootstrapping with 10 000 replicates. Along with a 38% reduction in injury risk (rate difference=-1.27/1000 player hours (95% CI -0.33 to -2.2)), healthcare costs were reduced by 43% in the NMT group (-$689/1000 player hours (95% CI -$1741 to $234)) compared with the control group. 90% of the bootstrapped ratios were in the south-west quadrant of the cost-effectiveness plane, showing that the NMT programme was dominant (more effective and less costly) over standard warm-up. Projecting results onto 58 100 Alberta youth soccer players, an estimated 4965 injuries and over $2.7 million in healthcare costs would be conservatively avoided in one season with implementation of a neuromuscular training prevention programme. Implementation of an NMT prevention programme in youth soccer is effective in reducing the burden of injury and leads to considerable reduction in costs. These findings inform practice and policy supporting the implementation of NMT prevention strategies in youth soccer nationally and internationally. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Evaluating the 'Focus on Normal Birth and Reducing Caesarean section Rates Rapid Improvement Programme': A mixed method study in England.

PubMed

Marshall, Joyce L; Spiby, Helen; McCormick, Felicia

2015-02-01

caesarean section plays an important role in ensuring safety of mother and infant but rising rates are not accompanied by measurable improvements in maternal or neonatal mortality or morbidity. The 'Focus on Normal Birth and Reducing Caesarean section Rates Rapid Improvement Programme' was a facilitative initiative developed to promote opportunities for normal birth and reduce caesarean section rates in England. to evaluate the 'Focus on Normal Birth and Reducing Caesarean section Rates' programme, by assessment of: impact on caesarean section rates, use of service improvements tools and participants׳ perceptions of factors that sustain or hinder work within participating maternity units. a mixed methods approach included analysis of mode of birth data, web-based questionnaires and in-depth semi-structured telephone interviews. twenty Hospital Trusts in England (selected from 68 who applied) took part in the 'Focus on Normal Birth and Reducing Caesarean section Rates Rapid Improvement Programme' initiative. In each hospital Trust, the head of midwifery, an obstetrician, the relevant lead for organisational development, a supervisor of midwives, or a clinical midwife and a service user representative were invited to participate in the independent evaluation. collection and analysis of mode of birth data from 20 participating hospital Trusts, web-based questionnaires administered to key individuals in all 20 Trusts and in-depth semi-structured telephone interviews conducted with key individuals in a sample of six Trusts. there was a marginal decline of 0.5% (25.9% from 26.4%) in mean total caesarean section rate in the period 1 January 2009 to 31 January 2010 compared to the baseline period (1 July-31 December 2008). Reduced total caesarean section rates were achieved in eight trusts, all with higher rates at the beginning of the initiative. Features associated with lower caesarean section rates included a shared philosophy prioritising normal birth, clear communication across disciplines and strong leadership at a range of levels, including executive support and clinical leaders within each discipline. it is important that the philosophy and organisational context of care are examined to identify potential barriers and facilitative factors. Copyright © 2014 Elsevier Ltd. All rights reserved.

[Meta-analysis on randomized trials comparing the results of low-molecular weight heparins to those of fractioned heparins in the prevention of deep venous thrombosis].

PubMed

Daures, J P; Schved, J F; Momas, I; Gril, J C; Azoulay, P; Gremy, F

1989-01-01

The main reason for using low molecular weight heparin (LMWH) is its capacity to keep the antithrombotic effect of standard non-fractioned heparin (NFH) while reducing its hemorrhagic power. Various studies comparing LMWH to NFH gave contradictory results, so we carried out a meta-analysis of randomized trials comparing these two treatments in prevention of deep-vein thrombosis (DVT) (and in prevention of deep-vein thrombosis or pulmonary embolism). From a selection of ten trials we could not show any significant difference in the DVT rates, as well as for the whole of surgical indications as for the subgroups of abdominal and orthopedic surgery. The weighted global difference between the DVT rates is so low that, in spite of the use of meta-analysis, the power is clearly insufficient. The hemorrhagic risk is not statistically reduced as well for the whole of surgical indications as for the subgroups.

Do Stimulants Reduce the Risk for Alcohol and Substance Use in Youth With ADHD? A Secondary Analysis of a Prospective, 24-Month Open-Label Study of Osmotic-Release Methylphenidate.

PubMed

Hammerness, Paul; Petty, Carter; Faraone, Stephen V; Biederman, Joseph

2017-01-01

The purpose of this study was to examine the impact of stimulant treatment on risk for alcohol and illicit drug use in adolescents with ADHD. Analysis of data derived from a prospective open-label treatment study of adolescent ADHD ( n = 115, 76% male), and a historical, naturalistic sample of ADHD ( n = 44, 68% male) and non-ADHD youth ( n = 52, 73% male) of similar age and sex. Treatment consisted of extended-release methylphenidate in the clinical trial or naturalistic stimulant treatment. Self-report of alcohol and drug use was derived from a modified version of the Drug Use Screening Inventory. Rates of alcohol and drug use in the past year were significantly lower in the clinical trial compared with untreated and treated naturalistic ADHD comparators, and similar to rates in non-ADHD comparators. Well-monitored stimulant treatment may reduce the risk for alcohol and substance use in adolescent ADHD.

Outrunning damage: Electrons vs X-rays-timescales and mechanisms.

PubMed

Spence, John C H

2017-07-01

Toward the end of his career, Zewail developed strong interest in fast electron spectroscopy and imaging, a field to which he made important contributions toward his aim of making molecular movies free of radiation damage. We therefore compare here the atomistic mechanisms leading to destruction of protein samples in diffract-and-destroy experiments for the cases of high-energy electron beam irradiation and X-ray laser pulses. The damage processes and their time-scales are compared and relevant elastic, inelastic, and photoelectron cross sections are given. Inelastic mean-free paths for ejected electrons at very low energies in insulators are compared with the bioparticle size. The dose rate and structural damage rate for electrons are found to be much lower, allowing longer pulses, reduced beam current, and Coulomb interactions for the formation of smaller probes. High-angle electron scattering from the nucleus, which has no parallel in the X-ray case, tracks the slowly moving nuclei during the explosion, just as the gain of the XFEL (X-ray free-electron laser) has no parallel in the electron case. Despite reduced damage and much larger elastic scattering cross sections in the electron case, leading to not dissimilar elastic scattering rates (when account is taken of the greatly increased incident XFEL fluence), progress for single-particle electron diffraction is seen to depend on the effort to reduce emittance growth due to Coulomb interactions, and so allow formation of intense sub-micron beams no larger than a virus.

Falls and health status in elderly women following first eye cataract surgery: a randomised controlled trial

PubMed Central

Harwood, R H; Foss, A J E; Osborn, F; Gregson, R M; Zaman, A; Masud, T

2005-01-01

Background/aim: A third of elderly people fall each year. Poor vision is associated with increased risk of falls. The authors aimed to determine if first eye cataract surgery reduces the risk of falling, and to measure associated health gain. Methods: 306 women aged over 70, with cataract, were randomised to expedited (approximately 4 weeks) or routine (12 months wait) surgery. Falls were ascertained by diary, with follow up every 3 months. Health status was measured after 6 months. Results: Visual function improved in the operated group (corrected binocular acuity improved by 0.25 logMAR units; 8% had acuity worse than 6/12 compared with 37% of controls). Over 12 months of follow up, 76 (49%) operated participants fell at least once, and 28 (18%) fell more than once. 69 (45%) unoperated participants fell at least once, 38 (25%) fell more than once. Rate of falling was reduced by 34% in the operated group (rate ratio 0.66, 95% confidence interval 0.45 to 0.96, p = 0.03). Activity, anxiety, depression, confidence, visual disability, and handicap all improved in the operated group compared with the control group. Four participants in the operated group had fractures (3%), compared with 12 (8%) in the control group (p = 0.04). Conclusion: First eye cataract surgery reduces the rate of falling, and risk of fractures and improves visual function and general health status. PMID:15615747

Outrunning damage: Electrons vs X-rays—timescales and mechanisms

PubMed Central

Spence, John C. H.

2017-01-01

Toward the end of his career, Zewail developed strong interest in fast electron spectroscopy and imaging, a field to which he made important contributions toward his aim of making molecular movies free of radiation damage. We therefore compare here the atomistic mechanisms leading to destruction of protein samples in diffract-and-destroy experiments for the cases of high-energy electron beam irradiation and X-ray laser pulses. The damage processes and their time-scales are compared and relevant elastic, inelastic, and photoelectron cross sections are given. Inelastic mean-free paths for ejected electrons at very low energies in insulators are compared with the bioparticle size. The dose rate and structural damage rate for electrons are found to be much lower, allowing longer pulses, reduced beam current, and Coulomb interactions for the formation of smaller probes. High-angle electron scattering from the nucleus, which has no parallel in the X-ray case, tracks the slowly moving nuclei during the explosion, just as the gain of the XFEL (X-ray free-electron laser) has no parallel in the electron case. Despite reduced damage and much larger elastic scattering cross sections in the electron case, leading to not dissimilar elastic scattering rates (when account is taken of the greatly increased incident XFEL fluence), progress for single-particle electron diffraction is seen to depend on the effort to reduce emittance growth due to Coulomb interactions, and so allow formation of intense sub-micron beams no larger than a virus. PMID:28653018

Does routine gowning reduce nosocomial infection and mortality rates in a neonatal nursery? A Singapore experience.

PubMed

Tan, S G; Lim, S H; Malathi, I

1995-11-01

A 1 year prospective study on routine gowning before entering a neonatal unit was conducted in a maternity hospital in Singapore. This study was done based on previous work by Donowitz, Haque and Chagla and Agbayani et al., as there have been no known studies done in Singapore. The aim of the study was to test the hypothesis that routine gowning before entering a neonatal nursery does not reduce nosocomial infection and mortality rate. A total of 212 neonates from the neonatal intensive care unit (NICU) and 1694 neonates from the neonatal special care unit (NSCU) were studied. Neonates admitted during the 1 year study were assigned to the gowning (control) and no routine gowning (trial) group on every alternate 2 months. The hospital infection control nurse provided data on nosocomial infection. The overall nosocomial infection rate in the NICU was 24% (25 of 104 admissions) during gowning periods compared to 16.6% (18 of 108 admissions) when plastic aprons were not worn before entry. In the NSCU, the overall infection rate was 1.5% (12 of 800 admissions) during gowning periods compared to 2.1% (19 of 894 admissions) when no gown was worn before entry. Results of the study found no significant differences in the incidences of nosocomial infection and mortality in the neonates. The cost of gowns used during the no routine gowning periods was S$2012.8 compared to S$3708 used during the routine gowning procedure. The investigators recommend that routine gowning before entering a neonatal unit is not essential and cost effective for the purpose of reducing infection. Rather the focus should be on adequate handwashing by all hospital personnel and visitors before handling neonates.

Synchronization of ovulation and fertility in weaned sows treated with intravaginal triptorelin is influenced by timing of administration and follicle size.

PubMed

Knox, R V; Willenburg, K L; Rodriguez-Zas, S L; Greger, D L; Hafs, H D; Swanson, M E

2011-01-15

A 100 μg dose of triptorelin was tested for synchronizing ovulation in sows. In Experiment 1, conducted in April through June, sows (n = 125) were assigned to Control (untreated), TG-96 (Triptorelin Gel (TG) given intravaginally at 96 h post-weaning), or TG-E (given intravaginally at estrus). To optimize AI timing, sows were inseminated at 2 and 26 h after estrus for Control and TG-E and at 8 and 32 h following TG-96. Ovulation by 48 h post-treatment tended to be affected by treatment (P = 0.08) and more (P < 0.05) TG-96 sows ovulated (57.9%) compared to Controls (34.2%), but TG-E (45.1%) did not differ (P > 0.10). Duration of estrus was reduced (P < 0.005) in TG-96 (51 h) and TG-E (58 h) compared to Controls (65 h). There was no treatment effect on farrowing rate (71%) or total born (10.4). Average follicle size <6.5 mm at 96 h after weaning was associated with reduced (P < 0.01) estrus, ovulation and farrowing rate. Experiment 2 was conducted in August through September using 503 weaned sows. The TG-96 treatment reduced duration of estrus (P = 0.03), but treatment did not affect estrus expression, farrowing rate or total pigs born. In conclusion, use of a 100 μg dose of triptorelin intravaginally at 96 h or at estrus advanced ovulation and when used with timed insemination, resulted in similar farrowing rates and litter sizes comparable to sows mated based on estrus. However, ovulation induction and timed AI success may benefit from an approach that ensures sows have adequate follicle development at time of treatment. Copyright © 2011 Elsevier Inc. All rights reserved.

Interactions between IGF-I, estrogen receptor-α (ERα), and ERβ in regulating growth/apoptosis of MCF-7 human breast cancer cells.

PubMed

Mendoza, Rhone A; Enriquez, Marlene I; Mejia, Sylvia M; Moody, Emily E; Thordarson, Gudmundur

2011-01-01

Understanding of the interactions between estradiol (E₂) and IGF-I is still incomplete. Cell lines derived from the MCF-7 breast cancer cells were generated with suppressed expression of the IGF-I receptor (IGF-IR), termed IGF-IR.low cells, by stable transfection using small interfering RNA (siRNA) expression vector. Vector for control cells carried sequence generating noninterfering RNA. Concomitant with reduction in the IGF-IR levels, the IGF-IR.low cells also showed a reduction in estrogen receptor α (ERα) and progesterone receptor expressions, and an elevation in the expression of ERβ. The number of the IGF-IR.low cells was reduced in response to IGF-I and human GH plus epidermal growth factor, but E₂ did not cause an increase in the number of the IGF-IR.low cells compared to controls. The proliferation rate of IGF-IR.low cells was only reduced in response to E₂ compared to controls, whereas their basal and hormone-stimulated apoptosis rate was increased. Phosphorylation of p38 mitogen-activated protein kinase (p38 MAPK) was increased in the IGF-IR.low cells after treatment with E₂, without affecting control cells. Furthermore, phosphorylation of the tumor suppressor protein p53 was elevated in the IGF-IR.low cells compared to the controls. In conclusion, suppressing IGF-IR expression decreased the level of ERα but increased the level of ERβ. Overall growth rate of the IGF-IR.low cells was reduced mostly through an increase in apoptosis without affecting proliferation substantially. We hypothesize that a decreased ERα:ERβ ratio triggered a rapid phosphorylation of p38 MAPK, which in turn phosphorylated the p53 tumor suppressor and accelerated apoptosis rate.

Exponentially Decelerated Contrast Media Injection Rate Combined With a Novel Patient-Specific Contrast Formula Reduces Contrast Volume Administration and Radiation Dose During Computed Tomography Pulmonary Angiography.

PubMed

Saade, Charbel; Mayat, Ahmad; El-Merhi, Fadi

2016-01-01

Matching contrast injection timing with vessel dynamics significantly improves vessel opacification and reduces contrast dose in the assessment of pulmonary embolism during computed tomography (CT) pulmonary angiography. The aim of this study was to investigate opacification of the pulmonary vasculature (PV) during CT pulmonary angiography using a patient-specific contrast formula (PSCF) and exponentially decelerated contrast media (EDCM) injection rate. Institutional review board approved this retrospective study. Computed tomography pulmonary angiography was performed on 200 patients with suspected pulmonary embolism using a 64-channel CT scanner. Patient demographics were equally distributed. Patients were randomly assigned to 2 equal protocol groups: protocol A used a PSCF, and protocol B involved the use of a PSCF combined with EDCM. The mean cross-sectional opacification profile of 8 central and 11 peripheral PVs were measured for each patient, and arteriovenous contrast ratio was calculated. Protocols were compared using Mann-Whitney U nonparametric statistics. Jackknife alternative free-response receiver operating characteristic analyses were used to assess diagnostic efficacy. Interobserver variations were investigated using kappa methods. A number of pulmonary arteries demonstrated increases in opacification (P < 0.02) for protocol B compared with A, whereas opacification in all veins was reduced in protocol B (P < 0.03). Subsequently, increased arteriovenous contrast ratio in protocol B compared with A was observed at all anatomic locations (P < 0.0002). An increase in jackknife alternative free-response receiver operating characteristic figure of merit (P < 0.0002) and interobserver variation was observed with protocol B compared with protocol A (κ = 0.3-0.73). Mean contrast volume was reduced in protocol B (29 [4] mL) compared with protocol A (33 [9] mL). Mean effective radiation dose in protocol B (1.2 [0.4] mSv) was reduced by 14% compared with protocol A (1.4 [0.6] mSv). Significant improvements in visualization of the PV can be achieved with a low contrast volume using an EDCM and PSCF. The reduced risk of cancer induction is highlighted.

Enhancement of the Rate of Pyrophosphate Hydrolysis by Nonenzymatic Catalysts and by Inorganic Pyrophosphatase*

PubMed Central

Stockbridge, Randy B.; Wolfenden, Richard

2011-01-01

To estimate the proficiency of inorganic pyrophosphatase as a catalyst, 31P NMR was used to determine rate constants and thermodynamics of activation for the spontaneous hydrolysis of inorganic pyrophosphate (PPi) in the presence and absence of Mg2+ at elevated temperatures. These values were compared with rate constants and activation parameters determined for the reaction catalyzed by Escherichia coli inorganic pyrophosphatase using isothermal titration calorimetry. At 25 °C and pH 8.5, the hydrolysis of MgPPi2− proceeds with a rate constant of 2.8 × 10−10 s−1, whereas E. coli pyrophosphatase was found to have a turnover number of 570 s−1 under the same conditions. The resulting rate enhancement (2 × 1012-fold) is achieved entirely by reducing the enthalpy of activation (ΔΔH‡ = −16.6 kcal/mol). The presence of Mg2+ ions or the transfer of the substrate from bulk water to dimethyl sulfoxide was found to increase the rate of pyrophosphate hydrolysis by as much as ∼106-fold. Transfer to dimethyl sulfoxide accelerated PPi hydrolysis by reducing the enthalpy of activation. Mg2+ increased the rate of PPi hydrolysis by both increasing the entropy of activation and reducing the enthalpy of activation. PMID:21460215

Reducing absenteeism from gastrointestinal and respiratory illness in elementary school students: a randomized, controlled trial of an infection-control intervention.

PubMed

Sandora, Thomas J; Shih, Mei-Chiung; Goldmann, Donald A

2008-06-01

Students often miss school because of gastrointestinal and respiratory illnesses. We assessed the effectiveness of a multifactorial intervention, including alcohol-based hand-sanitizer and surface disinfection, in reducing absenteeism caused by gastrointestinal and respiratory illnesses in elementary school students. We performed a school-based cluster-randomized, controlled trial at a single elementary school. Eligible students in third to fifth grade were enrolled. Intervention classrooms received alcohol-based hand sanitizer to use at school and quaternary ammonium wipes to disinfect classroom surfaces daily for 8 weeks; control classrooms followed usual hand-washing and cleaning practices. Parents completed a preintervention demographic survey. Absences were recorded along with the reason for absence. Swabs of environmental surfaces were evaluated by bacterial culture and polymerase chain reaction for norovirus, respiratory syncytial virus, influenza, and parainfluenza 3. The primary outcomes were rates of absenteeism caused by gastrointestinal or respiratory illness. Days absent were modeled as correlated Poisson variables and compared between groups by using generalized estimating equations. Analyses were adjusted for family size, race, health status, and home sanitizer use. We also compared the presence of viruses and the total bacterial colony counts on several classroom surfaces. A total of 285 students were randomly assigned; baseline demographics were similar in the 2 groups. The adjusted absenteeism rate for gastrointestinal illness was significantly lower in the intervention-group subjects compared with control subjects. The adjusted absenteeism rate for respiratory illness was not significantly different between groups. Norovirus was the only virus detected and was found less frequently on surfaces in intervention classrooms compared with control classrooms (9% vs 29%). A multifactorial intervention including hand sanitizer and surface disinfection reduced absenteeism caused by gastrointestinal illness in elementary school students. Norovirus was found less often on classroom surfaces in the intervention group. Schools should consider adopting these practices to reduce days lost to common illnesses.

Comparative effect of lens care solutions on blink rate, ocular discomfort and visual performance.

PubMed

Yang, Shun-nan; Tai, Yu-chi; Sheedy, James E; Kinoshita, Beth; Lampa, Matthew; Kern, Jami R

2012-09-01

To help maintain clear vision and ocular surface health, eye blinks occur to distribute natural tears over the ocular surface, especially the corneal surface. Contact lens wearers may suffer from poor vision and dry eye symptoms due to difficulty in lens surface wetting and reduced tear production. Sustained viewing of a computer screen reduces eye blinks and exacerbates such difficulties. The present study evaluated the wetting effect of lens care solutions (LCSs) on blink rate, dry eye symptoms, and vision performance. Sixty-five adult habitual soft contact lens wearers were recruited to adapt to different LCSs (Opti-free, ReNu, and ClearCare) in a cross-over design. Blink rate in pictorial viewing and reading (measured with an eyetracker), dry eye symptoms (measured with the Ocular Surface Disease Index questionnaire), and visual discrimination (identifying tumbling E) immediately before and after eye blinks were measured after 2 weeks of adaption to LCS. Repeated measures anova and mixed model ancova were conducted to evaluate effects of LCS on blink rate, symptom score, and discrimination accuracy. Opti-Free resulted in lower dry eye symptoms (p = 0.018) than ClearCare, and lower spontaneous blink rate (measured in picture viewing) than ClearCare (p = 0.014) and ReNu (p = 0.041). In reading, blink rate was higher for ClearCare compared to ReNu (p = 0.026) and control (p = 0.024). Visual discrimination time was longer for the control (daily disposable lens) than for Opti-Free (p = 0.007), ReNu (p = 0.009), and ClearCare (0.013) immediately before the blink. LCSs differently affected blink rate, subjective dry eye symptoms, and visual discrimination speed. Those with wetting agents led to significantly fewer eye blinks while affording better ocular comfort for contact lens wearers, compared to that without. LCSs with wetting agents also resulted in better visual performance compared to wearing daily disposable contact lenses. These presumably are because of improved tear film quality. © 2012 The College of Optometrists.

Causes and Disparities in Death Rates Among Urban American Indian and Alaska Native Populations, 1999-2009.

PubMed

Jacobs-Wingo, Jasmine L; Espey, David K; Groom, Amy V; Phillips, Leslie E; Haverkamp, Donald S; Stanley, Sandte L

2016-05-01

To characterize the leading causes of death for the urban American Indian/Alaska Native (AI/AN) population and compare with urban White and rural AI/AN populations. We linked Indian Health Service patient registration records with the National Death Index to reduce racial misclassification in death certificate data. We calculated age-adjusted urban AI/AN death rates for the period 1999-2009 and compared those with corresponding urban White and rural AI/AN death rates. The top-5 leading causes of death among urban AI/AN persons were heart disease, cancer, unintentional injury, diabetes, and chronic liver disease and cirrhosis. Compared with urban White persons, urban AI/AN persons experienced significantly higher death rates for all top-5 leading causes. The largest disparities were for diabetes and chronic liver disease and cirrhosis. In general, urban and rural AI/AN persons had the same leading causes of death, although urban AI/AN persons had lower death rates for most conditions. Urban AI/AN persons experience significant disparities in death rates compared with their White counterparts. Public health and clinical interventions should target urban AI/AN persons to address behaviors and conditions contributing to health disparities.

Reducing Error Rates for Iris Image using higher Contrast in Normalization process

NASA Astrophysics Data System (ADS)

Aminu Ghali, Abdulrahman; Jamel, Sapiee; Abubakar Pindar, Zahraddeen; Hasssan Disina, Abdulkadir; Mat Daris, Mustafa

2017-08-01

Iris recognition system is the most secured, and faster means of identification and authentication. However, iris recognition system suffers a setback from blurring, low contrast and illumination due to low quality image which compromises the accuracy of the system. The acceptance or rejection rates of verified user depend solely on the quality of the image. In many cases, iris recognition system with low image contrast could falsely accept or reject user. Therefore this paper adopts Histogram Equalization Technique to address the problem of False Rejection Rate (FRR) and False Acceptance Rate (FAR) by enhancing the contrast of the iris image. A histogram equalization technique enhances the image quality and neutralizes the low contrast of the image at normalization stage. The experimental result shows that Histogram Equalization Technique has reduced FRR and FAR compared to the existing techniques.

Use of an Orientation Clinic to Reduce Failed New Patient Appointments in Primary Care

PubMed Central

Jain, Sharad; Chou, Calvin L

2000-01-01

Patients who fail to attend initial appointments reduce clinic efficiency. To maximize attendance by newly referred outpatients, we introduced a mandatory group orientation clinic for all new patients and determined its effects on no-show rates. Orientation clinic also provided health care screening and opportunities for patient feedback. The new patient no-show rate for initial provider visits decreased significantly from 45% before institution of orientation clinic to 18% afterwards (P < .0001). The total no-show (patients who failed to attend orientation clinic or an initial provider visit) rate of the postintervention group was 51% (P = .28, compared with before the intervention). This intervention improved the efficiency and minimized the wasted time of our clinicians. PMID:11119184

Recovering a full dimensional quantum rate constant from a reduced dimensionality calculation: Application to the OH+CO{r_arrow}H+CO{sub 2} reaction

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

Dzegilenko, F.N.; Bowman, J.M.

1996-08-01

Two reduced dimensionality theories are used to calculate the thermal rate constant for the OH+CO{r_arrow}H+CO{sub 2} reaction. The standard theory employs energy-shift approximations to extract the full six degree-of-freedom quantum rate constant for this reaction from the previous two degree-of-freedom (2-DOF) quantum calculations of Hernandez and Clary [M.I. Hernandez and D.C. Clary, J. Chem. Phys. {bold 101}, 2779 (1994)]. Three extra bending modes and one extra {open_quote}{open_quote}spectator{close_quote}{close_quote} CO stretch mode are treated adiabatically in the harmonic fashion. The parameters of the exit channel transition state are used to evaluate the frequencies of those additional modes. A new reduced dimensionality theorymore » is also applied to this reaction. This theory explicitly addresses the finding from the 2-DOF calculations that the reaction proceeds mainly via complex formation. A J-shifting approximation has been used to take into account the initial states with non-zero values of total angular momentum in both reduced dimensionality theories. Cumulative reaction probabilities and thermal rate constants are calculated and compared with the previous quasiclassical and reduced dimensionality quantum calculations and with experiment. The rate constant from the new reduced dimensionality theory is between a factor of 5 and 100 times smaller than the statistical transition state theory result, and is in much better agreement with experiment. {copyright} {ital 1996 American Institute of Physics.}« less

A meta-analysis of robotic-assisted pancreatectomy versus laparoscopic and open pancreatectomy.

PubMed

Chen, Yigang; Yan, Jun; Yuan, Ziming; Yu, Song; Wang, Zhigang; Zheng, Qi

2013-12-01

To perform a meta-analysis of eligible studies from multiple medical centers to assess the safety, feasibility, and efficacy of robotic-assisted pancreatectomy (RP). We searched the electronic databases PubMed and EMBASE for studies comparing RP with laparoscopic pancreatectomy (LP) and open pancreatectomy (OP) for patients with pancreatic disease from June 2009 to June 2012. Continuous variables were pooled using the standardized mean difference (SMD) and odds ratio (OR), and dichotomous variables were pooled using the risk difference (RD) method. For all analyses, the 95% confidence interval (CI) was calculated. Three studies comparing RP and LP, and 4 studies comparing RP and OP were suitable for meta-analysis. Six published studies met the inclusion criteria. Our results showed that RP can reduce estimated blood loss and duration of hospitalization more than OP. For pancreatic fistula, there were no statistical differences between RP, OP, and LP, and no significant differences in intraoperative conversion rates between RP and LP. Robotic-assisted pancreatectomy may be able to increase microscopic negative margins of resection (R0) and spleen preserving rates. Robotic-assisted pancreatectomy was associated with increased R0 resection rates and spleen preserving rates than LP and OP. Moreover, RP can reduce estimated blood loss and duration of hospitalization more than OP. A robotic approach to pancreatectomy may be suited to patients with pancreatic disease.

External cephalic version for breech presentation before term.

PubMed

Hutton, E K; Hofmeyr, G J

2006-01-25

External cephalic version (ECV) of the breech fetus at term (after 37 weeks) has been shown to be effective in reducing the number of breech presentations and caesarean sections, but the rates of success are relatively low. This review examines studies initiating ECV prior to term (before 37 weeks' gestation). To assess the effectiveness of a policy of beginning ECV before term (before 37 weeks' gestation) for breech presentation on fetal presentation at birth, method of delivery, and the rate of preterm birth, perinatal morbidity, stillbirth or neonatal mortality. We searched the Cochrane Pregnancy and Childbirth Group Trials Register (April 2005), the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 1, 2005), MEDLINE (1965 to April 2005), EMBASE (1988 to April 2005), and Controlled Clinical Trials randomised controlled trials registry (April 2005). Randomised trials of ECV beginning before term (before 37 weeks' gestation) compared with a control group in women with breech presentation before term. Two review authors independently assessed eligibility and trial quality and extracted data. Three studies are included. One study reported on ECV that was undertaken and completed before 37 weeks' gestation compared to no ECV. No difference was found in the rate of non-cephalic presentation at birth. One study reported on a policy of ECV that was initiated before term (33 weeks) and up until 40 weeks' gestation and which could be repeated up until delivery compared to no ECV. This study showed a decrease in the rate of non-cephalic presentation at birth (relative risk 0.59, 95% confidence interval 0.45 to 0.77). One study reported on ECV started at between 34 to 35 weeks' gestation compared to beginning at 37 to 38 weeks' gestation. Although findings were not statistically significant, a 9.5% decrease in the rate of non-cephalic presentation at birth and a 7% decrease in the caesarean section rate were reported when ECV was started early. Compared with no ECV attempt, ECV commenced before term reduces non-cephalic births. Compared with ECV at term, beginning ECV at between 34 to 35 weeks may have some benefit in terms of decreasing the rate of non-cephalic presentation, and caesarean section. Further trials are needed to confirm this finding and to rule out increased rates of preterm birth, or other adverse perinatal outcomes. A large pragmatic trial is ongoing (www.utoronto.ca/miru/eecv2).

Using Watershed Models and Human Behavioral Analyses to identify Management Options to Reduce Lake Erie's Harmful Algal Blooms

NASA Astrophysics Data System (ADS)

Martin, J.; Wilson, R. S.; Aloysius, N.; Kalcic, M. M.; Roe, B.; Howard, G.; Irwin, E.; Zhang, W.; Liu, H.

2017-12-01

In early 2016, the United States and Canada formally agreed to reduce phosphorus inputs to Lake Erie by 40% to reduce the severity of annual Harmful Algal Blooms (HABs). These blooms have become more severe, with record events occurring in 2011 and 2015, and have compromised public safety, shut down drinking water supplies, and negatively impacted the economy of the western Lake Erie basin. Now, a key question is what management options should be pursued to reach the 40% reduction. This presentation will highlight interdisciplinary research to compare the amount and types of practices needed for this reduction to the current and projected levels of adoption. Multiple models of the Maumee watershed identified management plans and adoption rates needed to reach the reduction targets. For example, one successful scenario estimated necessary adoption rates of 50% for subsurface application of fertilizer on row crops, 58% for cover crops, and 78% for buffer strips. Current adoption is below these levels, but future projections based on farmer surveys shows these levels are possible. This information was then used to guide another round of watershed modeling analysis to evaluate scenarios that represented more realistic scenarios based on potential levels of management adoption. In general, these results show that accelerated adoption of management plans is needed compared to past adoption rates, and that some of these greater adoption levels are possible based on likely adoption rates. Increasing the perceived efficacy of the practices is one method that will support greater voluntary rates of adoption.

Comparative effectiveness of quality improvement interventions for pressure ulcer prevention in academic medical centers in the United States.

PubMed

Padula, William V; Makic, Mary Beth F; Mishra, Manish K; Campbell, Jonathan D; Nair, Kavita V; Wald, Heidi L; Valuck, Robert J

2015-06-01

Prevention of pressure ulcers, one of the hospital-acquired conditions (HACs) targeted by the 2008 nonpayment policy of the Centers for Medicare & Medicaid Services (CMS), is a critical issue. This study was conducted to determine the comparative effectiveness of quality improvement (QI) interventions associated with reduced hospital-acquired pressure ulcer (HAPU) rates. In an quasi-experimental design, interrupted time series analyses were conducted to determine the correlation between HAPU incidence rates and adoption of QI interventions. Among University HealthSystem Consortium hospitals, 55 academic medical centers were surveyed from September 2007 through February 2012 for adoption patterns of QI interventions for pressure ulcer prevention, and hospital-level data for 5,208 pressure ulcer cases were analyzed. Between- and within-hospital reduction significance was tested with t-tests post-CMS policy intervention. Fifty-three (96%) of the 55 hospitals used QI interventions for pressure ulcer prevention. The effect size analysis identified five effective interventions that each reduced pressure ulcer rates by greater than 1 case per 1,000 patient discharges per quarter: leadership initiatives, visual tools, pressure ulcer staging, skin care, and patient nutrition. The greatest reductions in rates occurred earlier in the adoption process (p<.05). Five QI interventions had clinically meaningful associations with reduced stage III and IV HAPU incidence rates in 55 academic medical centers. These QI interventions can be used in support of an evidence-based prevention protocol for pressure ulcers. Hospitals can not only use these findings from this study as part of a QI bundle for preventing HAPUs.

Efficacy of a Radiation Absorbing Shield in Reducing Dose to the Interventionalist During Peripheral Endovascular Procedures: A Single Centre Pilot Study

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

Power, S.; Mirza, M.; Thakorlal, A.

PurposeThis prospective pilot study was undertaken to evaluate the feasibility and effectiveness of using a radiation absorbing shield to reduce operator dose from scatter during lower limb endovascular procedures.Materials and MethodsA commercially available bismuth shield system (RADPAD) was used. Sixty consecutive patients undergoing lower limb angioplasty were included. Thirty procedures were performed without the RADPAD (control group) and thirty with the RADPAD (study group). Two separate methods were used to measure dose to a single operator. Thermoluminescent dosimeter (TLD) badges were used to measure hand, eye, and unshielded body dose. A direct dosimeter with digital readout was also used tomore » measure eye and unshielded body dose. To allow for variation between control and study groups, dose per unit time was calculated.ResultsTLD results demonstrated a significant reduction in median body dose per unit time for the study group compared with controls (p = 0.001), corresponding to a mean dose reduction rate of 65 %. Median eye and hand dose per unit time were also reduced in the study group compared with control group, however, this was not statistically significant (p = 0.081 for eye, p = 0.628 for hand). Direct dosimeter readings also showed statistically significant reduction in median unshielded body dose rate for the study group compared with controls (p = 0.037). Eye dose rate was reduced for the study group but this was not statistically significant (p = 0.142).ConclusionInitial results are encouraging. Use of the shield resulted in a statistically significant reduction in unshielded dose to the operator’s body. Measured dose to the eye and hand of operator were also reduced but did not reach statistical significance in this pilot study.« less

Gender differences in scalp hair growth rates are maintained but reduced in pattern hair loss compared to controls.

PubMed

Van Neste, D J J; Rushton, D H

2016-08-01

Hair loss is related to follicular density, programmed regrowth and hair productivity. The dissatisfaction with hair growth in patients experiencing hair loss might be due to slower linear hair growth rate (LHGR). LHGR and hair diameter was evaluated in Caucasian controls and patients with patterned hair loss employing the validated non-invasive, contrast-enhanced-phototrichogram with exogen collection. We evaluated 59,765 anagen hairs (controls 24,609, patients 35,156) and found thinner hairs grew slower than thicker hairs. LHGR in normal women was generally higher than in normal men. LHGR correlates with hair diameter (P < 0.006) and global thinning is associated with slower growth rates. Compared with hair of equal thickness in controls, subjects affected with patterned hair loss showed reduced hair growth rates, an observation found in both male and female patients. Males with pattern hair loss showed further reduction in growth rates as clinical severity worsened. However, sample size limitations prevented statistical evaluation of LHGR in severely affected females. Caucasian ethnicity. In pattern hair loss, LHGR significantly contributes to the apparent decrease in hair volume in affected areas. In early onset, LHRG might have a prognostic value in females but not in males. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Superior analgesic effect of an active distraction versus pleasant unfamiliar sounds and music: the influence of emotion and cognitive style.

PubMed

Villarreal, Eduardo A Garza; Brattico, Elvira; Vase, Lene; Østergaard, Leif; Vuust, Peter

2012-01-01

Listening to music has been found to reduce acute and chronic pain. The underlying mechanisms are poorly understood; however, emotion and cognitive mechanisms have been suggested to influence the analgesic effect of music. In this study we investigated the influence of familiarity, emotional and cognitive features, and cognitive style on music-induced analgesia. Forty-eight healthy participants were divided into three groups (empathizers, systemizers and balanced) and received acute pain induced by heat while listening to different sounds. Participants listened to unfamiliar Mozart music rated with high valence and low arousal, unfamiliar environmental sounds with similar valence and arousal as the music, an active distraction task (mental arithmetic) and a control, and rated the pain. Data showed that the active distraction led to significantly less pain than did the music or sounds. Both unfamiliar music and sounds reduced pain significantly when compared to the control condition; however, music was no more effective than sound to reduce pain. Furthermore, we found correlations between pain and emotion ratings. Finally, systemizers reported less pain during the mental arithmetic compared with the other two groups. These findings suggest that familiarity may be key in the influence of the cognitive and emotional mechanisms of music-induced analgesia, and that cognitive styles may influence pain perception.

Biotransformation of Momordica charantia fresh juice by Lactobacillus plantarum BET003 and its putative anti-diabetic potential.

PubMed

Mazlan, Farhaneen Afzal; Annuar, M Suffian M; Sharifuddin, Yusrizam

2015-01-01

Lactobacillus plantarum BET003 isolated from Momordica charantia fruit was used to ferment its juice. Momordica charantia fresh juice was able to support good growth of the lactic acid bacterium. High growth rate and cell viability were obtained without further nutrient supplementation. In stirred tank reactor batch fermentation, agitation rate showed significant effect on specific growth rate of the bacterium in the fruit juice. After the fermentation, initially abundant momordicoside 23-O-β-Allopyranosyle-cucurbita-5,24-dien-7α,3β,22(R),23(S)-tetraol-3-O-β-allopyranoside was transformed into its corresponding aglycone in addition to the emergence of new metabolites. The fermented M. charantia juice consistently reduced glucose production by 27.2%, 14.5%, 17.1% and 19.2% at 15-minute intervals respectively, when compared against the negative control. This putative anti-diabetic activity can be attributed to the increase in availability and concentration of aglycones as well as other phenolic compounds resulting from degradation of glycosidic momordicoside. Biotransformation of M. charantia fruit juice via lactic acid bacterium fermentation reduced its bitterness, reduced its sugar content, produced aglycones and other metabolites as well as improved its inhibition of α-glucosidase activity compared with the fresh, non-fermented juice.

The effect of information about false negative and false positive rates on people's attitudes towards colorectal cancer screening using faecal occult blood testing (FOBt).

PubMed

Miles, Anne; Rodrigues, Vania; Sevdalis, Nick

2013-11-01

To examine the impact of numeric risk information about false negative (FN) and false positive (FP) rates in faecal occult blood testing (FOBt) on attitudes towards screening. 95 people aged 45-59, living in England, read 6 hypothetical vignettes presented online about the use of FOB testing to detect bowel cancer, in which information about FN and FP rates was systematically varied. Both verbal and numeric FN risk information reduced people's interest in screening compared with no FN information. Numeric FN risk information reduced people's perceptions of screening effectiveness and lowered perceived trust in the results of screening compared with both verbal FN information and no FN information. FP information did not affect attitudes towards FOB testing. There was limited evidence that FN information reduced interest and perceptions of screening effectiveness more in educated groups. Numeric FN risk information decreased people's perceptions of screening effectiveness and trust in the results of screening but did not affect people's interest in screening anymore than verbal FN risk information. Numeric FN information could be added to patient information without affecting interest in screening, although this needs to be replicated in a larger, more representative sample. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

The effect of fruit in different forms on energy intake and satiety at a meal.

PubMed

Flood-Obbagy, Julie E; Rolls, Barbara J

2009-04-01

Consuming whole fruit reduces ratings of satiety more than fruit juice, but little is known about the effects of different forms of fruit on subsequent energy intake. This study tested how consuming preloads of apples in different forms prior to a meal (apple, applesauce, and apple juice with and without added fiber) influences satiety and energy intake at meal. Preloads were matched for weight, energy content, energy density, and ingestion rate. Once a week for 5 weeks, 58 adults consumed one of four preloads (266 g; 125 kcal [523 kJ]), or no preload (control), followed by a test meal consumed ad libitum 15 min later. Results showed that eating apple reduced lunch energy intake (preload+test meal) by 15% (187+/-36 kcal [782+/-151 kJ]) compared to control (p<0.0001) and decreased energy intake compared to applesauce and both juices. Fullness ratings differed significantly after preload consumption (apple>applesauce>both juices>control). Overall, whole apple increased satiety more than applesauce or apple juice. Adding naturally occurring levels of fiber to juice did not enhance satiety. These results suggest that solid fruit affects satiety more than pureed fruit or juice, and that eating fruit at the start of a meal can reduce energy intake.

The effect of fruit in different forms on energy intake and satiety at a meal

PubMed Central

Flood-Obbagy, Julie E.; Rolls, Barbara J.

2009-01-01

Consuming whole fruit reduces ratings of satiety more than fruit juice, but little is known about the effects of different forms of fruit on subsequent energy intake. This study tested how consuming preloads of apples in different forms prior to a meal (apple, applesauce, and apple juice with and without added fiber) influences satiety and energy intake at meal. Preloads were matched for weight, energy content, energy density, and ingestion rate. Once a week for 5 weeks, 58 adults consumed one of four preloads (266 g; 125 kcal [523 kJ]), or no preload (control), followed by a test meal consumed ad libitum 15 min later. Results showed that eating apple reduced lunch energy intake (preload + test meal) by 15% (187 ± 36 kcal [782 ± 151 kJ]) compared to control (p < 0.0001) and decreased energy intake compared to applesauce and both juices. Fullness ratings differed significantly after preload consumption (apple > applesauce > both juices > control). Overall, whole apple increased satiety more than applesauce or apple juice. Adding naturally occurring levels of fiber to juice did not enhance satiety. These results suggest that solid fruit affects satiety more than pureed fruit or juice, and that eating fruit at the start of a meal can reduce energy intake. PMID:19110020

The Efficacy Comparison of Tranexamic Acid for Reducing Blood Loss in Total Knee Arthroplasty at Different Dosage Time.

PubMed

Sun, Qi; Yu, Xiao; Nie, XiaoYang; Gong, JinPeng; Cai, Ming

2017-01-01

This study aimed to compare the efficacy of intravenous administration of tranexamic acid for reducing blood loss in total knee arthroplasty at different dosage time. From February 2013 to December 2015, a total of 180 patients (47 in male and 133 in female) who were planned to undergo total knee arthroplasty in our trauma center were recorded. Based on dosage time of tranexamic acid administration, participants were divided into groups A, B, C, and D randomly. In groups A, B, and C, tranexamic acid (30 mg/kg) was infused intravenously 15 minutes before or after tourniquet inflation or on tourniquet deflation respectively, tranexamic acid was not applied in group D. Total blood loss (intraoperative and postoperative blood loss), blood transfusion rate and volume, hemoglobin level, and incidence of deep vein thrombosis were recorded and analyzed. Compared with groups B, C, and D, there were significant reduction of blood loss, hemoglobin, and blood transfusion rate in group A (P < .05). Besides, there was no significant difference between groups B and C with superior efficacy than group D. Intravenous administration of tranexamic acid before tourniquet inflation was superior in terms of hemoglobin reduction, reducing blood loss and blood transfusion rate. Copyright © 2016 Elsevier Inc. All rights reserved.

Biotransformation of Momordica charantia fresh juice by Lactobacillus plantarum BET003 and its putative anti-diabetic potential

PubMed Central

Mazlan, Farhaneen Afzal; Annuar, M. Suffian M.

2015-01-01

Lactobacillus plantarum BET003 isolated from Momordica charantia fruit was used to ferment its juice. Momordica charantia fresh juice was able to support good growth of the lactic acid bacterium. High growth rate and cell viability were obtained without further nutrient supplementation. In stirred tank reactor batch fermentation, agitation rate showed significant effect on specific growth rate of the bacterium in the fruit juice. After the fermentation, initially abundant momordicoside 23-O-β-Allopyranosyle-cucurbita-5,24-dien-7α,3β,22(R),23(S)-tetraol-3-O-β-allopyranoside was transformed into its corresponding aglycone in addition to the emergence of new metabolites. The fermented M. charantia juice consistently reduced glucose production by 27.2%, 14.5%, 17.1% and 19.2% at 15-minute intervals respectively, when compared against the negative control. This putative anti-diabetic activity can be attributed to the increase in availability and concentration of aglycones as well as other phenolic compounds resulting from degradation of glycosidic momordicoside. Biotransformation of M. charantia fruit juice via lactic acid bacterium fermentation reduced its bitterness, reduced its sugar content, produced aglycones and other metabolites as well as improved its inhibition of α-glucosidase activity compared with the fresh, non-fermented juice. PMID:26539336

Comparison of ventilator-associated pneumonia (VAP) rates between different ICUs: Implications of a zero VAP rate.

PubMed

Sundar, Krishna M; Nielsen, David; Sperry, Paul

2012-02-01

Ventilator-associated pneumonia (VAP) is associated with significant morbidity and mortality. Measures to reduce the incidence of VAP have resulted in institutions reporting a zero or near-zero VAP rates. The implications of zero VAP rates are unclear. This study was done to compare outcomes between two intensive care units (ICU) with one of them reporting a zero VAP rate. This study retrospectively compared VAP rates between two ICUs: Utah Valley Regional Medical Center (UVRMC) with 25 ICU beds and American Fork Hospital (AFH) with 9 ICU beds. Both facilities are under the same management and attended by a single group of intensivists. Both ICUs have similar nursing and respiratory staffing patterns. Both ICUs use the same intensive care program for reduction of VAP rates. ICU outcomes between AFH (reporting zero VAP rate) and UVRMC (VAP rate of 2.41/1000 ventilator days) were compared for the years 2007-2008. UVRMC VAP rates during 2007 and 2008 were 2.31/1000 ventilator days and 2.5/1000 ventilator days respectively compared to a zero VAP rate at AFH. The total days of ventilation, mean days of ventilation per patient and mean duration of ICU stay per patient was higher in the UVRMC group as compared to AFH ICU group. There was no significant difference in mean age and APACHE II score between ICU patients at UVRMC and AFH. There was no statistical difference in rates of VAP and mortality between UVRMC and AFH. During comparisons of VAP rate between institutions, a zero VAP rate needs to be considered in the context of overall ventilator days, mean durations of ventilator stay and ICU mortality. Copyright © 2012 Elsevier Inc. All rights reserved.

The impact of community-based palliative care on acute hospital use in the last year of life is modified by time to death, age and underlying cause of death. A population-based retrospective cohort study

PubMed Central

Rosenwax, Lorna; Arendts, Glenn; Semmens, James B.

2017-01-01

Objective Community-based palliative care is known to be associated with reduced acute care health service use. Our objective was to investigate how reduced acute care hospital use in the last year of life varied temporally and by patient factors. Methods A retrospective cohort study of the last year of life of 12,763 Western Australians who died from cancer or one of seven non-cancer conditions. Outcome measures were rates of hospital admissions and mean length of hospital stays. Multivariate analyses involved time-to-event and population averaged log-link gamma models. Results There were 28,939 acute care overnight hospital admissions recorded in the last year of life, an average of 2.3 (SD 2.2) per decedent and a mean length of stay of 9.2 (SD 10.3) days. Overall, the rate of hospital admissions was reduced 34% (95%CI 1–66) and the mean length of stay reduced 6% (95%CI 2–10) during periods of time decedents received community-based palliative care compared to periods of time not receiving this care. Decedents aged <70 years receiving community-based palliative care showed a reduced rate of hospital admission around five months before death, whereas for older decedents the reduction in hospital admissions was apparent a year before death. All decedents who were receiving community-based palliative care tended towards shorter hospital stays in the last month of life. Decedents with neoplasms had a mean length of stay three weeks prior to death while not receiving community-based palliative care of 9.6 (95%CI 9.3–9.9) days compared to 8.2 (95% CI 7.9–8.7) days when receiving community-based palliative care. Conclusion Rates of hospital admission during periods of receiving community-based palliative care were reduced with benefits evident five months before death and even earlier for older decedents. The mean length of hospital stay was also reduced while receiving community-based palliative care, mostly in the last month of life. PMID:28934324

The impact of community-based palliative care on acute hospital use in the last year of life is modified by time to death, age and underlying cause of death. A population-based retrospective cohort study.

PubMed

Spilsbury, Katrina; Rosenwax, Lorna; Arendts, Glenn; Semmens, James B

2017-01-01

Community-based palliative care is known to be associated with reduced acute care health service use. Our objective was to investigate how reduced acute care hospital use in the last year of life varied temporally and by patient factors. A retrospective cohort study of the last year of life of 12,763 Western Australians who died from cancer or one of seven non-cancer conditions. Outcome measures were rates of hospital admissions and mean length of hospital stays. Multivariate analyses involved time-to-event and population averaged log-link gamma models. There were 28,939 acute care overnight hospital admissions recorded in the last year of life, an average of 2.3 (SD 2.2) per decedent and a mean length of stay of 9.2 (SD 10.3) days. Overall, the rate of hospital admissions was reduced 34% (95%CI 1-66) and the mean length of stay reduced 6% (95%CI 2-10) during periods of time decedents received community-based palliative care compared to periods of time not receiving this care. Decedents aged <70 years receiving community-based palliative care showed a reduced rate of hospital admission around five months before death, whereas for older decedents the reduction in hospital admissions was apparent a year before death. All decedents who were receiving community-based palliative care tended towards shorter hospital stays in the last month of life. Decedents with neoplasms had a mean length of stay three weeks prior to death while not receiving community-based palliative care of 9.6 (95%CI 9.3-9.9) days compared to 8.2 (95% CI 7.9-8.7) days when receiving community-based palliative care. Rates of hospital admission during periods of receiving community-based palliative care were reduced with benefits evident five months before death and even earlier for older decedents. The mean length of hospital stay was also reduced while receiving community-based palliative care, mostly in the last month of life.

System for corrosion monitoring in pipeline applying fuzzy logic mathematics

NASA Astrophysics Data System (ADS)

Kuzyakov, O. N.; Kolosova, A. L.; Andreeva, M. A.

2018-05-01

A list of factors influencing corrosion rate on the external side of underground pipeline is determined. Principles of constructing a corrosion monitoring system are described; the system performance algorithm and program are elaborated. A comparative analysis of methods for calculating corrosion rate is undertaken. Fuzzy logic mathematics is applied to reduce calculations while considering a wider range of corrosion factors.

Resting Metabolic Rate is Not Reduced in Obese Adults With Down Syndrome

ERIC Educational Resources Information Center

Fernhall, Bo; Figueroa, Arturo; Collier, Scott; Goulopoulou, Styliani; Giannopoulou, Ifigenia; Baynard, Tracy

2005-01-01

Resting metabolic rate (RMR) of 22 individuals with Down syndrome was compared to that of 20 nondisabled control individuals of similar age (25.7 and 27.4 years, respectively). Using a ventilated hood system, we measured RMR in the early morning after an overnight fast. Peak aerobic capacity Volume of Oxygen (VO2 peak) and body composition were…

A Miniaturized, 1.9F Integrated Optical Fiber and Stone Basket for Use in Thulium Fiber Laser Lithotripsy.

PubMed

Wilson, Christopher R; Hutchens, Thomas C; Hardy, Luke A; Irby, Pierce B; Fried, Nathaniel M

2015-10-01

The thulium fiber laser (TFL) is being explored as an alternative laser lithotripter to the standard holmium:yttrium-aluminum-garnet laser. The more uniform beam profile of the TFL enables higher power transmission through smaller fibers. In this study, a 100-μm core, 140-μm outer-diameter (OD) silica fiber with 5-mm length hollow steel tip was integrated with 1.3F (0.433-mm OD) nitinol wire basket to form a 1.9F (0.633-mm OD) device. TFL energy of 30 mJ, 500 μs pulse duration, and 500 Hz pulse rate was delivered to human uric acid stones, ex vivo. Stone ablation rates measured 1.5 ± 0.2 mg/s, comparable to 1.7 ± 0.3 mg/s using bare fiber tips separately with stone basket. With further development, this device may minimize stone retropulsion, allowing more efficient TFL lithotripsy at higher pulse rates. It may also provide increased flexibility, higher saline irrigation rates through the ureteroscope working channel, reduce fiber degradation compared with separate fiber and basket manipulation, and reduce laser-induced nitinol wire damage.

Use of double pigtail stent in hypospadias surgery.

PubMed

Chang, Paul C Y; Yeh, Ming-Lun; Chao, Chun-Chih; Chang, Chi-Jen

2011-01-01

Various types and materials of stents have been used for urinary diversion in hypospadias surgery. We evaluated whether double pigtail stents are superior to straight silicone stents. We conducted a retrospective chart review of all patients who underwent hypospadias surgery with straight silicone or double pigtail stents between November 1997 and October 2005. Comparisons were made between the two groups specifically with regard to the complication rates. A total of 86 patients were included. The complication rates in patients who received double pigtail stents were significantly reduced as compared with those who received straight silicon stents. There was less wound disruption associated with early stent dislodgement in the double pigtail group compared with the straight silicone group (3.2%vs. 17.4%, p< 0.05). The rate of urethrocutaneous fistula was also lower in the double pigtail stent group (12.7%vs. 30.4%). Subjectively, there was also improved patient comfort and parent anxiety in the double pigtail stent group. Double pigtail stent is a suitable material for urinary diversion in hypospadias surgery. It not only reduces patient discomfort, but also decreases complication rates in hypospadias surgery. Copyright © 2011 Asian Surgical Association. Published by Elsevier B.V. All rights reserved.

Mouse Betaine-Homocysteine S-Methyltransferase Deficiency Reduces Body Fat via Increasing Energy Expenditure and Impairing Lipid Synthesis and Enhancing Glucose Oxidation in White Adipose Tissue*

PubMed Central

Teng, Ya-Wen; Ellis, Jessica M.; Coleman, Rosalind A.; Zeisel, Steven H.

2012-01-01

Betaine-homocysteine S-methyltransferase (BHMT) catalyzes the synthesis of methionine from homocysteine. In our initial report, we observed a reduced body weight in Bhmt−/− mice. We initiated this study to investigate the potential role of BHMT in energy metabolism. Compared with the controls (Bhmt+/+), Bhmt−/− mice had less fat mass, smaller adipocytes, and better glucose and insulin sensitivities. Compared with the controls, Bhmt−/− mice had increased energy expenditure, with no changes in food intake, fat uptake or absorption, or in locomotor activity. The reduced adiposity in Bhmt−/− mice was not due to hyperthermogenesis. Bhmt−/− mice failed to maintain a normal body temperature upon cold exposure because of limited fuel supplies. In vivo and ex vivo tests showed that Bhmt−/− mice had normal lipolytic function. The rate of 14C-labeled fatty acid incorporated into [14C]triacylglycerol was the same in Bhmt+/+ and Bhmt−/− gonadal fat depots (GWAT), but it was 62% lower in Bhmt−/− inguinal fat depots (IWAT) compared with that of Bhmt+/+ mice. The rate of 14C-labeled fatty acid oxidation was the same in both GWAT and IWAT from Bhmt+/+ and Bhmt−/− mice. At basal level, Bhmt−/− GWAT had the same [14C]glucose oxidation as did the controls. When stimulated with insulin, Bhmt−/− GWAT oxidized 2.4-fold more glucose than did the controls. Compared with the controls, the rate of [14C]glucose oxidation was 2.4- and 1.8-fold higher, respectively, in Bhmt−/− IWAT without or with insulin stimulus. Our results show for the first time a role for BHMT in energy homeostasis. PMID:22362777

The Impact of Race on Survival After Hepatocellular Carcinoma in a Diverse American Population.

PubMed

Jones, Patricia D; Diaz, Carlos; Wang, Danlu; Gonzalez-Diaz, Joselin; Martin, Paul; Kobetz, Erin

2018-02-01

Hepatocellular carcinoma (HCC) incidence is increasing at differential rates depending on race. We aimed to identify associations between race and survival after HCC diagnosis in a diverse American population. Using the cancer registry from Sylvester Comprehensive Cancer Center, University of Miami and Jackson Memorial Hospitals, we performed retrospective analysis of 999 patients diagnosed with HCC between 9/24/2004 and 12/19/2014. We identified clinical characteristics by reviewing available electronic medical records. The association between race and survival was analyzed using Cox proportional hazards regression. Median survival in days was 425 in Blacks, 904.5 in non-Hispanic Whites, 652 in Hispanics, 570 in Asians, and 928 in others, p < 0.01. Blacks and Asians presented at more advanced stages with larger tumors. Although Whites had increased severity of liver disease at diagnosis compared to other races, they had 36% reduced rate of death compared to Blacks, [hazard ratio (HR) 0.64, 95% confidence interval (CI) 0.51-0.8, p < 0.01]. After adjusting for significant covariates, Whites had 22% (HR 0.78, 95% CI 0.61-0.99, p 0.04) reduced risk of death, compared to Blacks. Transplant significantly reduced rate of death; however, only 13.3% of Blacks had liver transplant, compared to 40.1% of Whites, p < 0.01. In this diverse sample of patients, survival among Blacks is the shortest after HCC diagnosis. Survival differences reflect a more advanced tumor stage at presentation rather than severity of underlying liver disease precluding treatment. Improving survival in minority populations, in whom HCC incidence is rapidly increasing, requires identification and modification of factors contributing to late-stage presentation.

The hydrophilic-coated inflatable penile prosthesis: 1-year experience.

PubMed

Wolter, Christopher E; Hellstrom, Wayne J G

2004-09-01

Penile prosthesis infections are a devastating complication for both patient and surgeon. Efforts to reduce the risk of infection from these elective procedures are a major focus of research and development by the major prosthesis companies. The Titan inflatable penile prosthesis (Mentor Corporation, Santa Barbara, CA) is coated with polyvinylpyrrolidone (PVP), a hydrophilic substance that reduces bacterial adherence and absorbs and elutes the antibiotics the device is immersed in intraoperatively. The Titan device was introduced to the American market in September 2002. This study reports the 1-year experience in the U.S. with the Titan and compares infection rates with the noncoated Alpha-1 IPP made by Mentor. Two thousand three hundred and fifty-seven Titan prostheses were implanted in the U.S. from September 2002 to August 2003, compared with the 482 noncoated Alpha-1 IPPs implanted over the same time period. Infection rates were compared, along with bacterial culture data. All data were collected from Mentor's internal database, as generated from the FDA's mandatory reporting of explanted medical devices, and available on the internet. The infection rate for the coated Titan IPP was 1.06% (25/2,357). During the same time period, the infection rate for the Alpha-1 noncoated prosthesis was 2.07% (10/482). Staphylococcus species predominated in both groups (9/25 Titan, 6/10 Alpha-1). At 1 year of follow-up, the data demonstrate that the hydrophilic coating on the Titan IPP confers a significant advantage in reducing the rate of infection over the noncoated device. Long-term follow-up on this first year database is needed before this innovation is accepted as the standard of care for prosthetic surgery. Nevertheless, the theoretical reduction in bacterial adhesion conferred by the hydrophilic PVP surface and the ability to choose which antibiotic the device is immersed in intraoperatively gives the implanting surgeon distinct advantages with this new product.

Overexpression of stress-inducible OsBURP16, the β subunit of polygalacturonase 1, decreases pectin content and cell adhesion and increases abiotic stress sensitivity in rice

PubMed Central

Liu, Huanhuan; Ma, Yan; Chen, Na; Guo, Siyi; Liu, Huili; Guo, Xiaoyu; Chong, Kang; Xu, Yunyuan

2014-01-01

Polygalacturonase (PG), one of the hydrolases responsible for cell wall pectin degradation, is involved in organ consenescence and biotic stress in plants. PG1 is composed of a catalytic subunit, PG2, and a non-catalytic PG1β subunit. OsBURP16 belongs to the PG1β-like subfamily of BURP-family genes and encodes one putative PG1β subunit precursor in rice (Oryza sativa L.). Transcription of OsBURP16 is induced by cold, salinity and drought stresses, as well as by abscisic acid (ABA) treatment. Analysis of plant survival rates, relative ion leakage rates, accumulation levels of H2O2 and water loss rates of leaves showed that overexpression of OsBURP16 enhanced sensitivity to cold, salinity and drought stresses compared with controls. Young leaves of Ubi::OsBURP16 transgenic plants showed reduced cell adhesion and increased cuticular transpiration rate. Mechanical strength measurement of Ubi::OsBURP16 plants showed that reduced force was required to break leaves as compared with wild type. Transgenic rice showed enhanced PG activity and reduced pectin content. All these results suggested that overexpression of OsBURP16 caused pectin degradation and affected cell wall integrity as well as transpiration rate, which decreased tolerance to abiotic stresses. The cell wall is a barrier against biotic and abiotic stresses. Overexpression of stress-inducible OsBURP16, the beta-subunit of polygalacturonase 1, decreases pectin contents and cell adhesion in rice. Analyses of plant survival, ion leakage, H2O2 levels, and leaf water loss showed that these effects of overexpression were accompanied by enhanced sensitivity to cold, salinity and drought compared to the wild-type. Our data therefore provide new information on links between polygalacturonase activity and abiotic stress resistance in rice. PMID:24237159

Competitive active video games: Physiological and psychological responses in children and adolescents.

PubMed

Lisón, Juan F; Cebolla, Ausias; Guixeres, Jaime; Álvarez-Pitti, Julio; Escobar, Patricia; Bruñó, Alejandro; Lurbe, Empar; Alcañiz, Mariano; Baños, Rosa

2015-10-01

Recent strategies to reduce sedentary behaviour in children include replacing sedentary screen time for active video games. Active video game studies have focused principally on the metabolic consumption of a single player, with physiological and psychological responses of opponent-based multiplayer games to be further evaluated. To determine whether adding a competitive component to playing active video games impacts physiological and psychological responses in players. Sixty-two healthy Caucasian children and adolescents, nine to 14 years years of age, completed three conditions (8 min each) in random order: treadmill walking, and single and opponent-based Kinect active video games. Affect, arousal, rate of perceived exertion, heart rate and percentage of heart rate reserve were measured for each participant and condition. Kinect conditions revealed significantly higher heart rate, percentage of heart rate reserve, rate of perceived exertion and arousal when compared with treadmill walking (P<0.001). Opponent-based condition revealed lower values for the rate of perceived exertion (P=0.02) and higher affect (P=0.022) when compared with single play. Competitive active video games improved children's psychological responses (affect and rate of perceived exertion) compared with single play, providing a solution that may contribute toward improved adherence to physical activity.

Maghemite Nanoparticles Acts as Nanozymes, Improving Growth and Abiotic Stress Tolerance in Brassica napus

NASA Astrophysics Data System (ADS)

Palmqvist, N. G. Martin; Seisenbaeva, Gulaim A.; Svedlindh, Peter; Kessler, Vadim G.

2017-12-01

Yttrium doping-stabilized γ-Fe2O3 nanoparticles were studied for its potential to serve as a plant fertilizer and, through enzymatic activity, support drought stress management. Levels of both hydrogen peroxide and lipid peroxidation, after drought, were reduced when γ-Fe2O3 nanoparticles were delivered by irrigation in a nutrient solution to Brassica napus plants grown in soil. Hydrogen peroxide was reduced from 151 to 83 μM g-1 compared to control, and the malondialdehyde formation was reduced from 36 to 26 mM g-1. Growth rate of leaves was enhanced from 33 to 50% growth compared to fully fertilized plants and SPAD-measurements of chlorophyll increased from 47 to 52 suggesting improved agronomic properties by use of γ-Fe2O3 nanoparticles as fertilizer as compared to chelated iron.

Masking as an effective quality control method for next-generation sequencing data analysis.

PubMed

Yun, Sajung; Yun, Sijung

2014-12-13

Next generation sequencing produces base calls with low quality scores that can affect the accuracy of identifying simple nucleotide variation calls, including single nucleotide polymorphisms and small insertions and deletions. Here we compare the effectiveness of two data preprocessing methods, masking and trimming, and the accuracy of simple nucleotide variation calls on whole-genome sequence data from Caenorhabditis elegans. Masking substitutes low quality base calls with 'N's (undetermined bases), whereas trimming removes low quality bases that results in a shorter read lengths. We demonstrate that masking is more effective than trimming in reducing the false-positive rate in single nucleotide polymorphism (SNP) calling. However, both of the preprocessing methods did not affect the false-negative rate in SNP calling with statistical significance compared to the data analysis without preprocessing. False-positive rate and false-negative rate for small insertions and deletions did not show differences between masking and trimming. We recommend masking over trimming as a more effective preprocessing method for next generation sequencing data analysis since masking reduces the false-positive rate in SNP calling without sacrificing the false-negative rate although trimming is more commonly used currently in the field. The perl script for masking is available at http://code.google.com/p/subn/. The sequencing data used in the study were deposited in the Sequence Read Archive (SRX450968 and SRX451773).

Effects of application of inhibitors and biochar to fertilizer on gaseous nitrogen emissions from an intensively managed wheat field.

PubMed

He, Tiehu; Liu, Deyan; Yuan, Junji; Luo, Jiafa; Lindsey, Stuart; Bolan, Nanthi; Ding, Weixin

2018-07-01

The effects of biochar combined with the urease inhibitor, hydroquinone, and nitrification inhibitor, dicyandiamide, on gaseous nitrogen (N 2 O, NO and NH 3 ) emissions and wheat yield were examined in a wheat crop cultivated in a rice-wheat rotation system in the Taihu Lake region of China. Eight treatments comprised N fertilizer at a conventional application rate of 150kgNha -1 (CN); N fertilizer at an optimal application rate of 125kgNha -1 (ON); ON+wheat-derived biochar at rates of 7.5 (ONB1) and 15tha -1 (ONB2); ON+nitrification and urease inhibitors (ONI); ONI+wheat-derived biochar at rates of 7.5 (ONIB1) and 15tha -1 (ONIB2); and, a control. The reduced N fertilizer application rate in the ON treatment decreased N 2 O, NO, and NH 3 emissions by 45.7%, 17.1%, and 12.3%, respectively, compared with the CN treatment. Biochar application increased soil organic carbon, total N, and pH, and also increased NH 3 and N 2 O emissions by 32.4-68.2% and 9.4-35.2%, respectively, compared with the ON treatment. In contrast, addition of urease and nitrification inhibitors decreased N 2 O, NO, and NH 3 emissions by 11.3%, 37.9%, and 38.5%, respectively. The combined application of biochar and inhibitors more effectively reduced N 2 O and NO emissions by 49.1-49.7% and 51.7-55.2%, respectively, compared with ON and decreased NH 3 emission by 33.4-35.2% compared with the ONB1 and ONB2 treatments. Compared with the ON treatment, biochar amendment, either alone or in combination with inhibitors, increased wheat yield and N use efficiency (NUE), while addition of inhibitors alone increased NUE but not wheat yield. We suggest that an optimal N fertilizer rate and combined application of inhibitors+biochar at a low application rate, instead of biochar application alone, could increase soil fertility and wheat yields, and mitigate gaseous N emissions. Copyright © 2018 Elsevier B.V. All rights reserved.

Cancer prevalence in Israeli men and women with schizophrenia.

PubMed

Agay, Nirit; Flaks-Manov, Natalie; Nitzan, Uri; Hoshen, Moshe B; Levkovitz, Yeheal; Munitz, Hanan

2017-12-01

The aim of this cross-sectional study was to compare cancer prevalence rates among patients with schizophrenia to those of the non-schizophrenia population. The study population included members of Clalit Health Services aged 25 to 74 years and all data was taken from patients' electronic health records. Of the 2,060,314 members who were included in the study, 32,748 had a diagnosis of schizophrenia. Cancer prevalence rates in women with and without schizophrenia were 491 per 10,000 and 439 per 10,000, respectively; in men, cancer prevalence rates were 226 per 10,000 and 296 per 10,000, respectively. The age-adjusted prevalence rate of all-type cancer was significantly lower among men with schizophrenia, compared to men without schizophrenia; specifically, men with schizophrenia had a lower rate of prostate cancer, and of cancers in the "other" category, compared to men without schizophrenia. Reduced cancer rates in men with schizophrenia may reflect under-diagnosis of some cancer types, likely due to insufficient medical attention. An effort to improve screening regimes should be made. Copyright © 2017 Elsevier B.V. All rights reserved.

Preservation of the Myofascial Cuff During Posterior Fossa Surgery to Reduce the Rate of Pseudomeningocele Formation and Cerebrospinal Fluid Leak: A Technical Note

PubMed Central

Felbaum, Daniel R; Anaizi, Amjad; Mason, Robert B; Jean, Walter C; Voyadzis, Jean M

2016-01-01

Introduction: Suboccipital craniotomy is a workhorse neurosurgical operation for approaching the posterior fossa but carries a high risk of pseudomeningocele and cerebrospinal fluid (CSF) leak. We describe our experience with a simple T-shaped fascial opening that preserves the occipital myofascial cuff as compared to traditional methods to reduce this risk. Methods: A single institution, retrospective review of prospectively collected database was performed of patients that underwent a suboccipital craniectomy or craniotomy. Patient data was reviewed for craniotomy or craniectomy, dural graft, and/or sealant use as well as CSF complications. A pseudomeningocele was defined as a subcutaneous collection of cerebrospinal fluid palpable clinically and confirmed on imaging. A CSF leak was defined as a CSF-cutaneous fistula manifested by CSF leaking through the wound. All patients underwent regular postoperative visits of two weeks, one month, and three months. Results: Our retrospective review identified 33 patients matching the inclusion criteria. Overall, our cohort had a 21% (7/33) rate of clinical and radiographic pseudomeningocele formation with 9% (3/33) requiring surgical revision or a separate procedure. The rate of clinical and radiographic pseudomeningocele formation in the myofascial cuff preservation technique was less than standard techniques (12% and 31%, respectively). Revision or further surgical procedures were also reduced in the myofascial cuff preservation technique vs. the standard technique (6% vs 13%). Conclusions: Preservation of the myofascial cuff during posterior fossa surgery is a simple and adoptable technique that reduces the rate of pseudomeningocele formation and CSF leak as compared with standard techniques.   PMID:28133584

Effective size of density-dependent two-sex populations: the effect of mating systems.

PubMed

Myhre, A M; Engen, S; SAEther, B-E

2017-08-01

Density dependence in vital rates is a key feature affecting temporal fluctuations of natural populations. This has important implications for the rate of random genetic drift. Mating systems also greatly affect effective population sizes, but knowledge of how mating system and density regulation interact to affect random genetic drift is poor. Using theoretical models and simulations, we compare N e in short-lived, density-dependent animal populations with different mating systems. We study the impact of a fluctuating, density-dependent sex ratio and consider both a stable and a fluctuating environment. We find a negative relationship between annual N e /N and adult population size N due to density dependence, suggesting that loss of genetic variation is reduced at small densities. The magnitude of this decrease was affected by mating system and life history. A male-biased, density-dependent sex ratio reduces the rate of genetic drift compared to an equal, density-independent sex ratio, but a stochastic change towards male bias reduces the N e /N ratio. Environmental stochasticity amplifies temporal fluctuations in population size and is thus vital to consider in estimation of effective population sizes over longer time periods. Our results on the reduced loss of genetic variation at small densities, particularly in polygamous populations, indicate that density regulation may facilitate adaptive evolution at small population sizes. © 2017 European Society For Evolutionary Biology. Journal of Evolutionary Biology © 2017 European Society For Evolutionary Biology.

The role of single-shot metronidazole in the prevention of Clostridium difficile infection following ileostomy reversal surgery.

PubMed

Fernandes, Roland; Robinson, Paul; Rangarajan, Karan; Scott, Sophie; Angco, Laura

2017-05-01

Symptomatic infection with Clostridium difficile is strongly linked to antibiotic use and rates are higher for colorectal surgery. In February 2015, trust policy for antibiotic prophylaxis of ileostomy reversal surgery was changed from three doses of metronidazole plus cefuroxime to single-dose metronidazole, in a bid to reduce rates of Clostridium difficile infection. A retrospective cohort study was conducted at a single, large hospital trust between February 2014 and February 2016, before and after change in antimicrobial policy. Theatre data, clinical notes and pathology results were all reviewed. Outcome data, patient age, gender, length of operation and hospital stay were extracted. One hundred three patients underwent ileostomy reversal surgery between February 2014 and February 2015. All received cefuroxime together with metronidazole at induction of anaesthesia followed by two further post-operative doses as operative prophylaxis. Ninety-six patients underwent ileostomy reversal surgery between February 2015 and February 2016. All received single-dose metronidazole at induction as prophylaxis. Post-operative diarrhoea was significantly reduced in patients given single-dose metronidazole compared with patients managed with multiple dose, dual antibiotic therapy (32 vs 12.5%, P 0.001). Rates of CDI were also significantly reduced in patients given single-dose metronidazole (6.8 vs 1%, P 0.038). Single-dose, pre-operative metronidazole is effective at reducing post-operative diarrhoea and CDI in ileostomy reversal surgery compared with multiple-dose cefuroxime plus metronidazole. Metronidazole may be effective as a prophylactic antibiotic against CDI in colonic surgery.

Low-Impact Flooring: Does It Reduce Fall-Related Injuries?

PubMed

Hanger, H Carl

2017-07-01

To compare fall rates and injuries from falls on low-impact flooring (LIF) compared with a standard vinyl flooring. Prospective, observational, nonrandomized controlled study. Subacute Older Persons Health ward (N = 20 beds). Older inpatients. Three different types of LIF. All falls in the ward were prospectively monitored using incident reporting, noting location and consequences of each fall. Fall rates (per 1000 bed days) and injuries, were compared between bedroom falls on LIF against those occurring on standard vinyl flooring (controls). Over 31 months, there were 278 bedroom falls (from 178 fallers). The bedroom fall rate (falls per 1000 bed days occupied) did not differ between the LIF and control groups (median 15 [IQR 8-18] versus 17 [IQR 9-23], respectively; P = .47). However, fall-related injuries were significantly less frequent when they occurred on LIFs (22% of falls versus 34% of falls on control flooring; P = .02). Fractures occurred in 0.7% of falls in the LIF cohort versus 2.3% in the control cohort. Rolling resistance when moving heavier equipment, such as beds or hoists, was an issue for staff on LIF. LIF significantly reduced fall-related injuries compared with a standard vinyl flooring, whereas they did not alter the overall risk of falling. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Motor cortical oscillations are abnormally suppressed during repetitive movement in patients with Parkinson's disease.

PubMed

Stegemöller, Elizabeth L; Allen, David P; Simuni, Tanya; MacKinnon, Colum D

2016-01-01

Impaired repetitive movement in persons with Parkinson's disease (PD) is associated with reduced amplitude, paradoxical hastening and hesitations or arrest at higher movement rates. This study examined the effects of movement rate and medication on movement-related cortical oscillations in persons with PD. Nine participants with PD were studied off and on medication and compared to nine control participants. Participants performed index finger movements cued by tones from 1 to 3 Hz. Movement-related oscillations were derived from electroencephalographic recordings over the region of the contralateral sensorimotor cortex (S1/M1) during rest, listening, or synchronized movement. At rest, spectral power recorded over the region of the contralateral S1/M1 was increased in the alpha band and decreased in the beta band in participants with PD relative to controls. During movement, the level of alpha and beta band power relative to baseline was significantly reduced in the PD group, off and on medication, compared to controls. Reduced movement amplitude and hastening at movement rates near 2 Hz was associated with abnormally suppressed and persistent desynchronization of oscillations in alpha and beta bands. Motor cortical oscillations in the alpha and beta bands are abnormally suppressed in PD, particularly during higher rate movements. These findings contribute to the understanding of mechanisms underlying impaired repetitive movement in PD. Copyright © 2015 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Quantum mechanical prediction of four-phonon scattering rates and reduced thermal conductivity of solids

NASA Astrophysics Data System (ADS)

Feng, Tianli; Ruan, Xiulin

2016-01-01

Recently, first principle-based predictions of lattice thermal conductivity κ from perturbation theory have achieved significant success. However, it only includes three-phonon scattering due to the assumption that four-phonon and higher-order processes are generally unimportant. Also, directly evaluating the scattering rates of four-phonon and higher-order processes has been a long-standing challenge. In this work, however, we have developed a formalism to explicitly determine quantum mechanical scattering probability matrices for four-phonon scattering in the full Brillouin zone, and by mitigating the computational challenge we have directly calculated four-phonon scattering rates. We find that four-phonon scattering rates are comparable to three-phonon scattering rates at medium and high temperatures, and they increase quadratically with temperature. As a consequence, κ of Lennard-Jones argon is reduced by more than 60% at 80 K when four-phonon scattering is included. Also, in less anharmonic materials—diamond, silicon, and germanium—κ is still reduced considerably at high temperature by four-phonon scattering by using the classical Tersoff potentials. Also, the thermal conductivity of optical phonons is dominated by the fourth- and higher-orders phonon scattering even at low temperature.

The Costs, Benefits, and Cost-Effectiveness of Interventions to Reduce Maternal Morbidity and Mortality in Mexico

PubMed Central

Hu, Delphine; Bertozzi, Stefano M.; Gakidou, Emmanuela; Sweet, Steve; Goldie, Sue J.

2007-01-01

Background In Mexico, the lifetime risk of dying from maternal causes is 1 in 370 compared to 1 in 2,500 in the U.S. Although national efforts have been made to improve maternal services in the last decade, it is unclear if Millennium Development Goal 5 - to reduce maternal mortality by three-quarters by 2015 - will be met. Methodology/Principal Findings We developed an empirically calibrated model that simulates the natural history of pregnancy and pregnancy-related complications in a cohort of 15-year-old women followed over their lifetime. After synthesizing national and sub-national trends in maternal mortality, the model was calibrated to current intervention-specific coverage levels and validated by comparing model-projected life expectancy, total fertility rate, crude birth rate and maternal mortality ratio with Mexico-specific data. Using both published and primary data, we assessed the comparative health and economic outcomes of alternative strategies to reduce maternal morbidity and mortality. A dual approach that increased coverage of family planning by 15%, and assured access to safe abortion for all women desiring elective termination of pregnancy, reduced mortality by 43% and was cost saving compared to current practice. The most effective strategy added a third component, enhanced access to comprehensive emergency obstetric care for at least 90% of women requiring referral. At a national level, this strategy reduced mortality by 75%, cost less than current practice, and had an incremental cost-effectiveness ratio of $300 per DALY relative to the next best strategy. Analyses conducted at the state level yielded similar results. Conclusions/Significance Increasing the provision of family planning and assuring access to safe abortion are feasible, complementary and cost-effective strategies that would provide the greatest benefit within a short-time frame. Incremental improvements in access to high-quality intrapartum and emergency obstetric care will further reduce maternal deaths and disability. PMID:17710149

Will musculoskeletal, visual and psychosocial stress change for visual display unit (VDU) operators when moving from a single-occupancy office to an office landscape?

PubMed

Helland, Magne; Horgen, Gunnar; Kvikstad, Tor Martin; Garthus, Tore; Aarås, Arne

2008-01-01

This study investigated the effect of moving from single-occupancy offices to a landscape environment. Thirty-two visual display unit (VDU) operators reported no significant change in visual discomfort. Lighting conditions and glare reported subjectively showed no significant correlation with visual discomfort. Experience of pain was found to reduce subjectively rated work capacity during VDU tasks. The correlation between visual discomfort and reduced work capacity for single-occupancy offices was rs=.88 (p=.000) and for office landscape rs=.82 (p=.000). Eye blink rate during habitual VDU work was recorded for 12 operators randomly selected from the 32 participants in the office landscape. A marked drop in eye blink rate during VDU work was found compared to eye blink rate during easy conversation. There were no significant changes in pain intensity in the neck, shoulder, forearm, wrist/hand, back or headache (.24

Comparison of physician referral and insurance claims data-based risk prediction as approaches to identify patients for care management in primary care: an observational study.

PubMed

Freund, Tobias; Gondan, Matthias; Rochon, Justine; Peters-Klimm, Frank; Campbell, Stephen; Wensing, Michel; Szecsenyi, Joachim

2013-10-20

Primary care-based care management (CM) could reduce hospital admissions in high-risk patients. Identification of patients most likely to benefit is needed as resources for CM are limited. This study aimed to compare hospitalization and mortality rates of patients identified for CM either by treating primary care physicians (PCPs) or predictive modelling software for hospitalization risk (PM). In 2009, a cohort of 6,026 beneficiaries of a German statutory health insurance served as a sample for patient identification for CM by PCPs or commercial PM (CSSG 0.8, Verisk Health). The resulting samples were compared regarding hospitalization and mortality rates in 2010 and in the two year period before patient selection. No CM-intervention was delivered until the end of 2010 and PCPs were blinded for the assessment of hospitalization rates. In 2010, hospitalization rates of PM-identified patients were 80% higher compared to PCP-identified patients. Mortality rates were also 8% higher in PM-identified patients if compared to PCP-identified patients (10% vs. 2%). The hospitalization rate of patients independently identified by both PM and PCPs was numerically between PM- and PCP-identified patients. Time trend between 2007 and 2010 showed decreasing hospitalization rates in PM-identified patients (-15% per year) compared to increasing rates in PCP-identified patients (+34% per year). PM identified patients with higher hospitalization and mortality rates compared to PCP-referred patients. But the latter showed increasing hospitalization rates over time thereby suggesting that PCPs may be able to predict future deterioration in patients with relatively good current health status. These patients may most likely benefit from preventive services like CM.

Cardiorespiratory response to exercise after renal sympathetic denervation in patients with resistant hypertension.

PubMed

Ukena, Christian; Mahfoud, Felix; Kindermann, Ingrid; Barth, Christine; Lenski, Matthias; Kindermann, Michael; Brandt, Mathias C; Hoppe, Uta C; Krum, Henry; Esler, Murray; Sobotka, Paul A; Böhm, Michael

2011-09-06

This study sought to investigate the effects of interventional renal sympathetic denervation (RD) on cardiorespiratory response to exercise. RD reduces blood pressure at rest in patients with resistant hypertension. We enrolled 46 patients with therapy-resistant hypertension as extended investigation of the Symplicity HTN-2 (Renal Denervation With Uncontrolled Hypertension) trial. Thirty-seven patients underwent bilateral RD and 9 patients were assigned to the control group. Cardiopulmonary exercise tests were performed at baseline and 3-month follow-up. In the RD group, compared with baseline examination, blood pressure at rest and at maximum exercise after 3 months was significantly reduced by 31 ± 13/9 ± 13 mm Hg (p < 0.0001) and by 21 ± 20/5 ± 14 mm Hg (p < 0.0001), respectively. Achieved work rate increased by 5 ± 13 W (p = 0.029) whereas peak oxygen uptake remained unchanged. Blood pressure 2 min after exercise was significantly reduced by 29 ± 17/8 ± 15 mm Hg (p < 0.001 for systolic blood pressure; p = 0.002 for diastolic blood pressure). Heart rate at rest decreased after RD (4 ± 11 beats/min; p = 0.028), whereas maximum heart rate and heart rate increase during exercise were not different. Heart rate recovery improved significantly by 4 ± 7 beats/min after renal denervation (p = 0.009). In the control group, there were no significant changes in blood pressure, heart rate, maximum work rate, or ventilatory parameters after 3 months. RD reduces blood pressure during exercise without compromising chronotropic competence in patients with resistant hypertension. Heart rate at rest decreased and heart rate recovery improved after the procedure. (Renal Denervation With Uncontrolled Hypertension; [Symplicity HTN-2]; NCT00888433). Copyright © 2011 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Design and Rationale for a Randomized Controlled Trial to Reduce Readmissions among Patients with Depressive Symptoms

PubMed Central

Mitchell, Suzanne E.; Martin, Jessica M.; Krizman, Katherine; Sadikova, Ekaterina; Culpepper, Larry; Stewart, Sabrina K.; Brown, Jennifer Rose; Jack, Brian W.

2016-01-01

Background The Re-Engineered Discharge (Project RED) reduces 30-day readmission rates by 30 percent. However, our data indicates that for patients displaying depressive symptoms during hospitalization, Project RED is less effective in preventing unplanned readmission. We aim to examine the effectiveness of RED-D, a modified brief Cognitive behavioral therapy (CBT) protocol delivered as a post-discharge extension of the Re-Engineered Discharge, in reducing 30-day readmissions rates and emergency department (ED) use as well as depressive symptoms for medical patients with comorbid depressive symptoms. Methods This paper details the study design and implementation of an ongoing, federally funded randomized controlled trial of our post-discharge mental health intervention, RED-D, compared to the RED plus usual care. This research has two primary objectives: (1) to determine whether RED-D delivered telephonically by a mental health professional immediately following discharge is effective in reducing hospital readmission and emergency department use for patients displaying depressive symptoms during their inpatient stay, and (2) to examine whether this approach yields a clinically significant reduction in depressive symptoms. We intend to recruit 1200 participants randomized to our intervention, RED-D (n=600), and to RED plus usual care (n=600). Conclusions Hospitalized patients with depressive symptoms are at increased risk for 30-day readmission. We aim to conduct a randomized clinical trial to evaluate the comparative effectiveness of RED-D, our post-discharge modified brief CBT intervention compared to RED alone in reducing readmissions and depressive symptoms for this at-risk population. PMID:26343332

Design and rationale for a randomized controlled trial to reduce readmissions among patients with depressive symptoms.

PubMed

Mitchell, Suzanne E; Martin, Jessica M; Krizman, Katherine; Sadikova, Ekaterina; Culpepper, Larry; Stewart, Sabrina K; Brown, Jennifer Rose; Jack, Brian W

2015-11-01

The Re-Engineered Discharge (Project RED) reduces 30-day readmission rates by 30%. However, our data indicates that for patients displaying depressive symptoms during hospitalization, Project RED is less effective in preventing unplanned readmission. We aim to examine the effectiveness of RED-D, a modified brief Cognitive behavioral therapy (CBT) protocol delivered as a post-discharge extension of the Re-Engineered Discharge, in reducing 30-day readmissions rates and emergency department (ED) use as well as depressive symptoms for medical patients with comorbid depressive symptoms. This paper details the study design and implementation of an ongoing, federally funded randomized controlled trial of our post-discharge mental health intervention, RED-D, compared to the RED plus usual care. This research has two primary objectives: (1) to determine whether RED-D delivered telephonically by a mental health professional immediately following discharge is effective in reducing hospital readmission and emergency department use for patients displaying depressive symptoms during their inpatient stay, and (2) to examine whether this approach yields a clinically significant reduction in depressive symptoms. We intend to recruit 1200 participants randomized to our intervention, RED-D (n=600), and to RED plus usual care (n=600). Hospitalized patients with depressive symptoms are at increased risk for 30-day readmission. We aim to conduct a randomized clinical trial to evaluate the comparative effectiveness of RED-D, our post-discharge modified brief CBT intervention compared to RED alone in reducing readmissions and depressive symptoms for this at-risk population. Copyright © 2015 Elsevier Inc. All rights reserved.

Surgical site infection in cesarean sections with the use of a plastic sheath wound retractor compared to the traditional self-retaining metal retractor.

PubMed

Hinkson, Larry; Siedentopf, Jan-Peter; Weichert, Alexander; Henrich, Wolfgang

2016-08-01

A cesarean section rate of up to 19.4% is reported worldwide. Surgical site infection occurs with rates of up to 13.5%. Plastic-sheath wound retractors show reduced rates of surgical site infections in abdominal surgery. There is limited evidence in women having cesarean sections. This study evaluates the use of the Alexis(®) O C-Section Retractor in the prevention of surgical site infection in patients undergoing their first planned cesarean section compared to the traditional Collins self-retaining metal retractor. A single center, prospective, randomized, controlled, observational trial. The primary outcome is surgical site infection as defined by the Centers for Disease Control and Prevention. The secondary outcomes included intraoperative surgical parameters, postoperative pain scores and the short and long-term satisfaction with wound healing. From October 2013 to December 2015 at the Charité University Hospital, Berlin. 98 patients to the Alexis(®) O C-Section Retractor group and 100 to the traditional Collins self-retaining metal retractor group. A statistically significant reduction in the rate of surgical site infections, when the Alexis(®) O C-Section Retractor was used for wound retraction compared to the traditional Collins metal self-retaining wound retractor, 1% vs. 8% (RR 7.84, 95% CI (2.45-70.71) p=0.035). The use of plastic-sheath wound retractors compared to the traditional self-retaining metal retractor in low risk women, having the first cesarean section is associated with a significantly reduced risk of surgical site infection. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Intensive postoperative glucose control reduces the surgical site infection rates in gynecologic oncology patients.

PubMed

Al-Niaimi, Ahmed N; Ahmed, Mostafa; Burish, Nikki; Chackmakchy, Saygin A; Seo, Songwon; Rose, Stephen; Hartenbach, Ellen; Kushner, David M; Safdar, Nasia; Rice, Laurel; Connor, Joseph

2015-01-01

SSI rates after gynecologic oncology surgery vary from 5% to 35%, but are up to 45% in patients with diabetes mellitus (DM). Strict postoperative glucose control by insulin infusion has been shown to lower morbidity, but not specifically SSI rates. Our project studied continuous postoperative insulin infusion for 24h for gynecologic oncology patients with DM and hyperglycemia with a target blood glucose of <139 mL/dL and a primary outcome of the protocol's impact on SSI rates. We compared SSI rates retrospectively among three groups. Group 1 was composed of patients with DM whose blood glucose was controlled with intermittent subcutaneous insulin injections. Group 2 was composed of patients with DM and postoperative hyperglycemia whose blood glucose was controlled by insulin infusion. Group 3 was composed of patients with neither DM nor hyperglycemia. We controlled for all relevant factors associated with SSI. We studied a total of 372 patients. Patients in Group 2 had an SSI rate of 26/135 (19%), similar to patients in Group 3 whose rate was 19/89 (21%). Both were significantly lower than the SSI rate (43/148, 29%) of patients in Group 1. This reduction of 35% is significant (p = 0.02). Multivariate analysis showed an odd ratio = 0.5 (0.28-0.91) in reducing SSI rates after instituting this protocol. Initiating intensive glycemic control for 24h after gynecologic oncology surgery in patients with DM and postoperative hyperglycemia lowers the SSI rate by 35% (OR = 0.5) compared to patients receiving intermittent sliding scale insulin and to a rate equivalent to non-diabetics. Copyright © 2014. Published by Elsevier Inc.

New stimulation pattern design to improve P300-based matrix speller performance at high flash rate

NASA Astrophysics Data System (ADS)

Polprasert, Chantri; Kukieattikool, Pratana; Demeechai, Tanee; Ritcey, James A.; Siwamogsatham, Siwaruk

2013-06-01

Objective. We propose a new stimulation pattern design for the P300-based matrix speller aimed at increasing the minimum target-to-target interval (TTI). Approach. Inspired by the simplicity and strong performance of the conventional row-column (RC) stimulation, the proposed stimulation is obtained by modifying the RC stimulation through alternating row and column flashes which are selected based on the proposed design rules. The second flash of the double-flash components is then delayed for a number of flashing instants to increase the minimum TTI. The trade-off inherited in this approach is the reduced randomness within the stimulation pattern. Main results. We test the proposed stimulation pattern and compare its performance in terms of selection accuracy, raw and practical bit rates with the conventional RC flashing paradigm over several flash rates. By increasing the minimum TTI within the stimulation sequence, the proposed stimulation has more event-related potentials that can be identified compared to that of the conventional RC stimulations, as the flash rate increases. This leads to significant performance improvement in terms of the letter selection accuracy, the raw and practical bit rates over the conventional RC stimulation. Significance. These studies demonstrate that significant performance improvement over the RC stimulation is obtained without additional testing or training samples to compensate for low P300 amplitude at high flash rate. We show that our proposed stimulation is more robust to reduced signal strength due to the increased flash rate than the RC stimulation.

Depersonalization Disorder: Disconnection of Cognitive Evaluation from Autonomic Responses to Emotional Stimuli

PubMed Central

Michal, Matthias; Koechel, Ansgar; Canterino, Marco; Adler, Julia; Reiner, Iris; Vossel, Gerhard; Beutel, Manfred E.; Gamer, Matthias

2013-01-01

Background Patients with depersonalization disorder (DPD) typically complain about emotional detachment. Previous studies found reduced autonomic responsiveness to emotional stimuli for DPD patients as compared to patients with anxiety disorders. We aimed to investigate autonomic responsiveness to emotional auditory stimuli of DPD patients as compared to patient controls. Furthermore, we examined the modulatory effect of mindful breathing on these responses as well as on depersonalization intensity. Methods 22 DPD patients and 15 patient controls balanced for severity of depression and anxiety, age, sex and education, were compared regarding 1) electrodermal and heart rate data during a resting period, and 2) autonomic responses and cognitive appraisal of standardized acoustic affective stimuli in two conditions (normal listening and mindful breathing). Results DPD patients rated the emotional sounds as significantly more neutral as compared to patient controls and standardized norm ratings. At the same time, however, they responded more strongly to acoustic emotional stimuli and their electrodermal response pattern was more modulated by valence and arousal as compared to patient controls. Mindful breathing reduced severity of depersonalization in DPD patients and increased the arousal modulation of electrodermal responses in the whole sample. Finally, DPD patients showed an increased electrodermal lability in the rest period as compared to patient controls. Conclusions These findings demonstrated that the cognitive evaluation of emotional sounds in DPD patients is disconnected from their autonomic responses to those emotional stimuli. The increased electrodermal lability in DPD may reflect increased introversion and cognitive control of emotional impulses. The findings have important psychotherapeutic implications. PMID:24058547

Heart failure with preserved left ventricular systolic function: a hospital cohort study

PubMed Central

Berry, C; Hogg, K; Norrie, J; Stevenson, K; Brett, M; McMurray, J

2005-01-01

Objective: To investigate how patients with heart failure with preserved left ventricular systolic function (LVSF) compare with patients with reduced LVSF. Design: Cohort study. Setting: Urban university hospital. Patients: 528 index emergency admissions with heart failure during the year 2000. Information on LVSF and follow up was available for 445 (84%) of these patients. Results: 130 (29%) patients had preserved LVSF (defined as an ejection fraction > 40%). The median follow up was 814 days (range 632–978 days). The average (SD) age was 72 (13) years. Women accounted for 62% and 45% of patients with preserved and reduced LVSF, respectively (p  =  0.001). Patients with preserved LVSF (compared with those with reduced LVSF) had a higher prevalence of left ventricular hypertrophy (56% v 29%) and aortic valve disease (mean gradient > 20 mm Hg; 31% v 9%). Fewer patients with preserved LVSF received an angiotensin converting enzyme inhibitor (65% v 78%, p  =  0.008) or spironolactone (12% v 21%, p  =  0.027). Anaemia tended to occur more often in patients with preserved LVSF than in those with reduced LVSF (43% v 33% for women, p  =  0.12; 59% v 49% for men, p  =  0.22). There was a similarly high prevalence of significant renal dysfunction in both groups (estimated glomerular filtration rate < 60 ml/min/1.73 m2 in 68% with preserved and 64% with reduced LVSF, p  =  0.40). Mortality was similar in both groups (preserved versus reduced 51 (39%) v 132 (42%), p  =  0.51). Compared with patients with reduced LVSF, patients with preserved LVSF tended to have a lower risk of death or hospital admission for heart failure (56 (42%) v 165 (53%), p  =  0.072) but a similar rate of death or readmission for any reason. Conclusion: Patients with preserved LVSF had more co-morbid problems than those with reduced LVSF; however, prognosis was similar for both groups. PMID:15958359

Enhancing Friction Stir Weldability of 6061-T6 Al and AZ31B Mg Alloys Assisted by External Non-rotational Shoulder

NASA Astrophysics Data System (ADS)

Ji, Shude; Huang, Ruofei; Meng, Xiangchen; Zhang, Liguo; Huang, Yongxian

2017-05-01

In order to increase cooling rate and then reduce the amounts of intermetallic compounds, external non-rotational shoulder tool system derived from traditional tool in friction stir welding was used to join dissimilar Al and Mg alloys. In this study, based on the external non-rotational shoulder, the weldability of Al and Mg alloys was significantly improved. The non-rotational shoulder tool is propitious to make more materials into weld, increase cooling rate and then reduce material adhesion of rotational pin, obtaining sound joint with smaller flashes and smooth surface. Importantly, the thickness of intermetallic compounds layer is reduced compared with traditional tool. Meanwhile, hardness values of dissimilar joint present uneven distribution, resulting from complex intercalated structures in nugget zone (NZ) featured by intermetallic compound layers and fine recrystallized Mg and Al grains. Compared with traditional tool, non-rotational shoulder is beneficial to higher tensile properties of joint. Due to the intermetallic compound layer formed in the interface of Al-Mg, the welding joint easily fractures at the NZ, presenting the typical brittle fracture mode.

Introducing an antibiotic stewardship program in a pediatric center in China.

PubMed

Zhang, Zhi-Gang; Chen, Fei; Chen, Jian-Zhong

2018-06-01

This study aimed to investigate the effect of antibiotic stewardship programs (ASP) on reducing antimicrobial resistance rate, antibiotics consumption and multi-drug resistance bacterial infections in the pediatric patients. This study was carried out in the Pediatric Center of a tertiary hospital of Shandong Province, China. The study duration was separated into two periods according to introduction of ASP (began from April 2011). Before intervention: from April 2009 to March 2011; after intervention: from April 2012 to March 2014. The consumption of antibiotics, defined daily dose (DDD), isolation of multidrug-resistant organisms (MDRO) and resistance rate of antibiotics were analyzed and compared between the two study periods. Total antibiotics consumption (DDDs) reduced from 56,725 in 2011 to 31,380 in 2014; antibiotic use density (AUD) reduced from 93.8 to 43.5; mean (± SD) antibiotic costs per patient (per quarter) decreased from 637 (± 29) RMB to 462 (± 49) RMB; and the mean total drug consumption (g)/DDD (DDDs) for inpatients decreased from 90.4 (± 3.3) to 56.4 (± 9.5). Multidrug-resistant microorganisms isolation reduced significantly from 463 (20.0) to 216 (6.9%). Resistance rate of general spectrum antibiotics reduced remarkably after intervention. The proportion of patients colonized or infected with Carbapenems-resistant Acinetobacter baumannii was correlated with DDDs of carbapenem. Implementation of ASP leads to reduced medical expense, decrease of improper and abuse of antibiotics, and reduced antibiotics resistance rate and MDRO isolation. Continuous efforts to improve antibiotic use are required.

Acute neurorehabilitation: does a neurosensory and coordinated interdisciplinary programme reduce tracheostomy weaning time and weaning failure?

PubMed

Berney, Loric; Wasserfallen, Jean-Blaise; Grant, Kathleen; Levivier, Marc; Simon, Christian; Faouzi, Mohamed; Paillex, Roland; Schweizer, Valérie; Diserens, Karin

2014-01-01

A new coordinated interdisciplinary unit was created in the acute section of the department of clinical neurosciences, the Acute NeuroRehabilitation (NRA) unit. The objective was to evaluate the impact of the unit and its neurosensory programme on the management of tracheostomy patients in terms of reduction in the average time taken for weaning, weaning success rate and therapeutic efficiency. This 49-month retrospective study compares 2 groups of tracheostomy patients before (n = 34) and after (n = 46) NRA intervention. The outcome measures evaluate the benefits of the NRA unit intervention (time to decannulation, weaning and complication rates) and the benefits of the coordination (time to registration in a rehabilitation centre and rate of non-compliance with standards of care). Weaning failure rate was reduced from 27.3% to 9.1%, no complications or recannulations were observed in the post-intervention group after weaning and time to decannulation following admission to our unit decreased from 19.13 to 12.75 days. The rate of non-compliance with patient standards of care was significantly reduced from 45% to 30% (Mann-Whitney p = 0.003). This interdisciplinary weaning programme helped to reduce weaning time and weaning failure, without increased complications, in the sample studied. Coordination improved the efficiency of the interdisciplinary team in the multiplicity and complexity of the different treatments.

Parametric Decay Instability and Dissipation of Low-frequency Alfvén Waves in Low-beta Turbulent Plasmas

NASA Astrophysics Data System (ADS)

Fu, Xiangrong; Li, Hui; Guo, Fan; Li, Xiaocan; Roytershteyn, Vadim

2018-03-01

Evolution of the parametric decay instability (PDI) of a circularly polarized Alfvén wave in a turbulent low-beta plasma background is investigated using 3D hybrid simulations. It is shown that the turbulence reduces the growth rate of PDI as compared to the linear theory predictions, but PDI can still exist. Interestingly, the damping rate of the ion acoustic mode (as the product of PDI) is also reduced as compared to the linear Vlasov predictions. Nonetheless, significant heating of ions in the direction parallel to the background magnetic field is observed due to resonant Landau damping of the ion acoustic waves. In low-beta turbulent plasmas, PDI can provide an important channel for energy dissipation of low-frequency Alfvén waves at a scale much larger than the ion kinetic scales, different from the traditional turbulence dissipation models.

Honey and green/black tea consumption may reduce the risk of Helicobacter pylori infection.

PubMed

Boyanova, Lyudmila; Ilieva, Juliana; Gergova, Galina; Vladimirov, Borislav; Nikolov, Rossen; Mitov, Ivan

2015-05-01

The aim of the study was to evaluate the influence of dietary and demographic factors and some habits on the prevalence of Helicobacter pylori infection in 150 dyspeptic patients examined endoscopically and by the urea breath test. Positivity rate was lower (50.6%) in patients consuming honey ≥1 day weekly compared with the remainder (70.8%) and in those consuming green/black tea ≥1 day weekly (45.2%) compared with the other patients (64.8%). Logistic regression confirmed that the factors associated with significantly lower H. pylori positivity rate were the consumption of honey (odds ratio [OR], 0.38; 95% confidence interval [CI], 0.19-0.78) and green/black tea (OR, 0.45; 95% CI, 0.21-0.95). In conclusion, honey and green/black tea intake is associated with reduced prevalence of H. pylori infection. Copyright © 2015 Elsevier Inc. All rights reserved.

G protein-coupled estrogen receptor regulates embryonic heart rate in zebrafish

PubMed Central

Romano, Shannon N.; Edwards, Hailey E.; Ryan, Kevin J.

2017-01-01

Estrogens act by binding to estrogen receptors alpha and beta (ERα, ERβ), ligand-dependent transcription factors that play crucial roles in sex differentiation, tumor growth and cardiovascular physiology. Estrogens also activate the G protein-coupled estrogen receptor (GPER), however the function of GPER in vivo is less well understood. Here we find that GPER is required for normal heart rate in zebrafish embryos. Acute exposure to estrogens increased heart rate in wildtype and in ERα and ERβ mutant embryos but not in GPER mutants. GPER mutant embryos exhibited reduced basal heart rate, while heart rate was normal in ERα and ERβ mutants. We detected gper transcript in discrete regions of the brain and pituitary but not in the heart, suggesting that GPER acts centrally to regulate heart rate. In the pituitary, we observed gper expression in cells that regulate levels of thyroid hormone triiodothyronine (T3), a hormone known to increase heart rate. Compared to wild type, GPER mutants had reduced levels of T3 and estrogens, suggesting pituitary abnormalities. Exposure to exogenous T3, but not estradiol, rescued the reduced heart rate phenotype in gper mutant embryos, demonstrating that T3 acts downstream of GPER to regulate heart rate. Using genetic and mass spectrometry approaches, we find that GPER regulates maternal estrogen levels, which are required for normal embryonic heart rate. Our results demonstrate that estradiol plays a previously unappreciated role in the acute modulation of heart rate during zebrafish embryonic development and suggest that GPER regulates embryonic heart rate by altering maternal estrogen levels and embryonic T3 levels. PMID:29065151

G protein-coupled estrogen receptor regulates embryonic heart rate in zebrafish.

PubMed

Romano, Shannon N; Edwards, Hailey E; Souder, Jaclyn Paige; Ryan, Kevin J; Cui, Xiangqin; Gorelick, Daniel A

2017-10-01

Estrogens act by binding to estrogen receptors alpha and beta (ERα, ERβ), ligand-dependent transcription factors that play crucial roles in sex differentiation, tumor growth and cardiovascular physiology. Estrogens also activate the G protein-coupled estrogen receptor (GPER), however the function of GPER in vivo is less well understood. Here we find that GPER is required for normal heart rate in zebrafish embryos. Acute exposure to estrogens increased heart rate in wildtype and in ERα and ERβ mutant embryos but not in GPER mutants. GPER mutant embryos exhibited reduced basal heart rate, while heart rate was normal in ERα and ERβ mutants. We detected gper transcript in discrete regions of the brain and pituitary but not in the heart, suggesting that GPER acts centrally to regulate heart rate. In the pituitary, we observed gper expression in cells that regulate levels of thyroid hormone triiodothyronine (T3), a hormone known to increase heart rate. Compared to wild type, GPER mutants had reduced levels of T3 and estrogens, suggesting pituitary abnormalities. Exposure to exogenous T3, but not estradiol, rescued the reduced heart rate phenotype in gper mutant embryos, demonstrating that T3 acts downstream of GPER to regulate heart rate. Using genetic and mass spectrometry approaches, we find that GPER regulates maternal estrogen levels, which are required for normal embryonic heart rate. Our results demonstrate that estradiol plays a previously unappreciated role in the acute modulation of heart rate during zebrafish embryonic development and suggest that GPER regulates embryonic heart rate by altering maternal estrogen levels and embryonic T3 levels.

Efficacy comparison between cryoablation and radiofrequency ablation for patients with cavotricuspid valve isthmus dependent atrial flutter: a meta-analysis

NASA Astrophysics Data System (ADS)

Chen, Yi-He; Lin, Hui; Xie, Cheng-Long; Zhang, Xiao-Ting; Li, Yi-Gang

2015-06-01

We perform this meta-analysis to compare the efficacy and safety of cryoablation versus radiofrequency ablation for patients with cavotricuspid valve isthmus dependent atrial flutter. By searching EMBASE, MEDLINE, PubMed and Cochrane electronic databases from March 1986 to September 2014, 7 randomized clinical trials were included. Acute (risk ratio[RR]: 0.93; P = 0.14) and long-term (RR: 0.94; P = 0.08) success rate were slightly lower in cryoablation group than in radiofrequency ablation group, but the difference was not statistically significant. Additionally, the fluoroscopy time was nonsignificantly reduced (weighted mean difference[WMD]: -2.83 P = 0.29), whereas procedure time was significantly longer (WMD: 25.95; P = 0.01) in cryoablation group compared with radiofrequency ablation group. Furthermore, Pain perception during the catheter ablation was substantially less in cryoabaltion group than in radiofrequency ablation group (standardized mean difference[SMD]: -2.36 P < 0.00001). Thus, our meta-analysis demonstrated that cryoablation and radiofrequency ablation produce comparable acute and long-term success rate for patients with cavotricuspid valve isthmus dependent atrial flutter. Meanwhile, cryoablation ablation tends to reduce the fluoroscopy time and significantly reduce pain perception in cost of significantly prolonged procedure time.

Efficacy comparison between cryoablation and radiofrequency ablation for patients with cavotricuspid valve isthmus dependent atrial flutter: a meta-analysis

PubMed Central

Chen, Yi-He; Lin, Hui; Xie, Cheng-Long; Zhang, Xiao-Ting; Li, Yi-Gang

2015-01-01

We perform this meta-analysis to compare the efficacy and safety of cryoablation versus radiofrequency ablation for patients with cavotricuspid valve isthmus dependent atrial flutter. By searching EMBASE, MEDLINE, PubMed and Cochrane electronic databases from March 1986 to September 2014, 7 randomized clinical trials were included. Acute (risk ratio[RR]: 0.93; P = 0.14) and long-term (RR: 0.94; P = 0.08) success rate were slightly lower in cryoablation group than in radiofrequency ablation group, but the difference was not statistically significant. Additionally, the fluoroscopy time was nonsignificantly reduced (weighted mean difference[WMD]: −2.83; P = 0.29), whereas procedure time was significantly longer (WMD: 25.95; P = 0.01) in cryoablation group compared with radiofrequency ablation group. Furthermore, Pain perception during the catheter ablation was substantially less in cryoabaltion group than in radiofrequency ablation group (standardized mean difference[SMD]: −2.36; P < 0.00001). Thus, our meta-analysis demonstrated that cryoablation and radiofrequency ablation produce comparable acute and long-term success rate for patients with cavotricuspid valve isthmus dependent atrial flutter. Meanwhile, cryoablation ablation tends to reduce the fluoroscopy time and significantly reduce pain perception in cost of significantly prolonged procedure time. PMID:26039980

Effects of high flavanol dark chocolate on cardiovascular function and platelet aggregation.

PubMed

Rull, Gurvinder; Mohd-Zain, Zetty N; Shiel, Julian; Lundberg, Martina H; Collier, David J; Johnston, Atholl; Warner, Timothy D; Corder, Roger

2015-08-01

Regular consumption of chocolate and cocoa products has been linked to reduced cardiovascular mortality. This study compared the effects of high flavanol dark chocolate (HFDC; 1064mg flavanols/day for 6weeks) and low flavanol dark chocolate (LFDC; 88mg flavanols/day for 6weeks) on blood pressure, heart rate, vascular function and platelet aggregation in men with pre-hypertension or mild hypertension. Vascular function was assessed by pulse wave analysis using radial artery applanation tonometry in combination with inhaled salbutamol (0.4mg) to assess changes due to endothelium-dependent vasodilatation. HFDC did not significantly reduce blood pressure compared to baseline or LFDC. Heart rate was increased by LFDC compared to baseline, but not by HFDC. Vascular responses to salbutamol tended to be greater after HFDC. Platelet aggregation induced by collagen or the thromboxane analogue U46619 was unchanged after LFDC or HFDC, whereas both chocolates reduced responses to ADP and the thrombin receptor activator peptide, SFLLRNamide (TRAP6), relative to baseline. Pre-incubation of platelets with theobromine also attenuated platelet aggregation induced by ADP or TRAP6. We conclude that consumption of HFDC confers modest improvements in cardiovascular function. Platelet aggregation is modulated by a flavanol-independent mechanism that is likely due to theobromine. Copyright © 2015 Elsevier Inc. All rights reserved.

The combinational effect of E6/E7 siRNA and anti-miR-182 on apoptosis induction in HPV16-positive cervical cells.

PubMed

Javadi, Hamidreza; Lotfi, Abbas Sahebghadam; Hosseinkhani, Saman; Mehrani, Hossein; Amani, Jafar; Soheili, Zahra Soheila; Hojati, Zahra; Kamali, Mehdi

2018-06-06

In the present research, we assumed that reducing the amounts of E6 and E7 oncoproteins by a specific siRNA sequence and recovering p53 and RB proteins, along with the recovery of the FOXO1 protein by applying anti-miR-182, would increase apoptosis and reduce proliferation rate in cancer cells. The HPV16-positive CaSki cervical cancer cell line was used. 48 hours after transfection of siRNA for targeting E6 and E7 oncoproteins and anti-miR-182, expression of its cellular targets p53, p21 and FOXO1 was assessed by real-time PCR, western blot analysis and immunocytofluorescence staining. In all treatments, apoptosis rate and viability were evaluated using Annexin-V-FITC apoptosis detection kits and MTT assays, respectively. Among the designed siRNAs, E6-1 and E7-2 proved the most effective in reducing E6 and E7 expressions by increasing the apoptotic rates to 12.4% and 16%, respectively, after 48 hours. Also, using anti-miR-182 increased apoptotic rate to 12.7% 48 hours after transfection of cervical cancer cells. The combinational use of either E6-1 or E7-2 siRNAs with anti-miR-182 resulted in a rise in apoptosis to 19.3% and 26%, respectively, higher than those obtained from the individual application of either without anti-miR-182. The simultaneous use of siRNA E6-1 and siRNA E7-2 with cisplatin increased sensitivity to cisplatin and reduced the viability of the cancer cells as compared to the use of cisplatin alone. The simultaneous use of cisplatin and anti-miR-182 had no considerable effect on viability or apoptosis rate compared to cisplatin alone.

A general circulation model study of the effects of faster rotation rate, enhanced CO2 concentration, and reduced solar forcing: Implications for the faint young sun paradox

NASA Technical Reports Server (NTRS)

Jenkins, Gregory S.

1993-01-01

Solar energy at the top of the atmosphere (solar constant), rotation rate, and carbon dioxide (CO2) may have varied significantly over Earth's history, especially during the earliest times. The sensitivity of a general circulation model to faster rotation, enhanced CO2 concentration, and reduced solar constant is presented. The control simulation of this study has a solar constant reduced by 10% the present amount, zero land fraction using a swamp ocean surface, CO2 concentrations of 330 ppmv, present-day rotation rate, and is integrated under mean diurnal and seasonal solar forcing. Four sensitivity test are performed under zero land fraction and reduced solar constant conditions by varying the earth's rotation rate atmospheric CO2 concentration and solar constant. The global mean sea surface temperatures (SSTs) compared to the control simulation: were 6.6 K to 12 K higher than the control's global mean temperature of 264.7 K. Sea ice is confined to higher latitudes in each experiment compared to the control, with ice-free areas equatorward of the subtropics. The warm SSTs are associated with a 20% reduction in clouds for the rotation rate experiments and higher CO2 concentrations in the other experiments. These results are in contrast to previous studies that have used energy balance and radiative convective models. Previous studies required a much larger atmospheric CO2 increase to prevent an ice-covered Earth. The results of the study, suggest that because of its possible feedback with clouds, the general circulation of the atmosphere should be taken into account in understanding the climate of early Earth. While higher CO2 concentrations are likely in view of the results, very large atmospheric CO2 concentrations may not be necessary to counterbalance the lower solar constant that existed early in Earth's history.

Is Transient Ischemic Attack a Medical Emergency? An Evidence-Based Analysis

PubMed Central

Sehatzadeh, S

2015-01-01

Background Transient ischemic attack (TIA) is a brief episode of dysfunction in a confined area of the brain. The risk of stroke following TIA is approximately 4% within the first 2 days and 9% within the first month. Therefore, early diagnosis and treatment is critical to reduce mortality and risk of stroke in patients who have experienced a TIA. Objectives This systematic review aimed to investigate the impact of the urgent evaluation and initiation of treatment of patients with TIA on the risk of subsequent stroke and death. Data Sources A literature search was performed for studies published from January 1, 2007, until December 21, 2012. The search was updated monthly to April 1, 2013. Results All identified studies showed that urgent assessment and initiation of treatment of TIA is an effective strategy in reducing the incidence of stroke. Among these, a large observational study found a large effect in that the risk of stroke was reduced by 80%, and a Canadian study found that providing urgent care significantly reduced the rate of stroke in high-risk patients. Another Canadian study reported a significant reduction in the rate of death among patients referred to stroke prevention clinics, compared to patients not referred to such services. One study showed that patients discharged from an emergency department with standard care had significantly higher rates of stroke and subsequent TIA in the first month, compared to those who were hospitalized. However, another study showed that for patients at low to moderate risk, rate of stroke was similar between inpatients and those managed in a TIA clinic. Limitations Our analysis was restricted to the effect of the combined interventions. The magnitude of benefit of each individual component of the intervention cannot be determined through this review. Conclusions The results of this systematic review have important clinical and health system implications. Urgent management of TIA patients in specialized TIA clinics rather than regular practice results in a lower rate of stroke and disability. PMID:26355823

Facility-Level Variation in Hospitalization, Mortality, and Costs in the 30 Days After Percutaneous Coronary Intervention: Insights on Short-Term Healthcare Value From the Veterans Affairs Clinical Assessment, Reporting, and Tracking System (VA CART) Program.

PubMed

Bradley, Steven M; O'Donnell, Colin I; Grunwald, Gary K; Liu, Chuan-Fen; Hebert, Paul L; Maddox, Thomas M; Jesse, Robert L; Fihn, Stephan D; Rumsfeld, John S; Ho, P Michael

2015-07-14

Policies to reduce unnecessary hospitalizations after percutaneous coronary intervention (PCI) are intended to improve healthcare value by reducing costs while maintaining patient outcomes. Whether facility-level hospitalization rates after PCI are associated with cost of care is unknown. We studied 32,080 patients who received PCI at any 1 of 62 Veterans Affairs hospitals from 2008 to 2011. We identified facility outliers for 30-day risk-standardized hospitalization, mortality, and cost. Compared with the risk-standardized average, 2 hospitals (3.2%) had a lower-than-expected hospitalization rate, and 2 hospitals (3.2%) had a higher-than-expected hospitalization rate. We observed no statistically significant variation in facility-level risk-standardized mortality. The facility-level unadjusted median per patient 30-day total cost was $23,820 (interquartile range, $19,604-$29,958). Compared with the risk-standardized average, 17 hospitals (27.4%) had lower-than-expected costs, and 14 hospitals (22.6%) had higher-than-expected costs. At the facility level, the index PCI accounted for 83.1% of the total cost (range, 60.3%-92.2%), whereas hospitalization after PCI accounted for only 5.8% (range, 2.0%-12.7%) of the 30-day total cost. Facilities with higher hospitalization rates were not more expensive (Spearman ρ=0.16; 95% confidence interval, -0.09 to 0.39; P=0.21). In this national study, hospitalizations in the 30 day after PCI accounted for only 5.8% of 30-day cost, and facility-level cost was not correlated with hospitalization rates. This challenges the focus on reducing hospitalizations after PCI as an effective means of improving healthcare value. Opportunities remain to improve PCI value by reducing the variation in total cost of PCI without compromising patient outcomes. © 2015 American Heart Association, Inc.

Has reducing fine particulate matter and ozone caused reduced mortality rates in the United States?

PubMed

Cox, Louis Anthony Tony; Popken, Douglas A

2015-03-01

Between 2000 and 2010, air pollutant levels in counties throughout the United States changed significantly, with fine particulate matter (PM2.5) declining over 30% in some counties and ozone (O3) exhibiting large variations from year to year. This history provides an opportunity to compare county-level changes in average annual ambient pollutant levels to corresponding changes in all-cause (AC) and cardiovascular disease (CVD) mortality rates over the course of a decade. Past studies have demonstrated associations and subsequently either interpreted associations causally or relied on subjective judgments to infer causation. This article applies more quantitative methods to assess causality. This article examines data from these "natural experiments" of changing pollutant levels for 483 counties in the 15 most populated US states using quantitative methods for causal hypothesis testing, such as conditional independence and Granger causality tests. We assessed whether changes in historical pollution levels helped to predict and explain changes in CVD and AC mortality rates. A causal relation between pollutant concentrations and AC or CVD mortality rates cannot be inferred from these historical data, although a statistical association between them is well supported. There were no significant positive associations between changes in PM2.5 or O3 levels and corresponding changes in disease mortality rates between 2000 and 2010, nor for shorter time intervals of 1 to 3 years. These findings suggest that predicted substantial human longevity benefits resulting from reducing PM2.5 and O3 may not occur or may be smaller than previously estimated. Our results highlight the potential for heterogeneity in air pollution health effects across regions, and the high potential value of accountability research comparing model-based predictions of health benefits from reducing air pollutants to historical records of what actually occurred. Copyright © 2015 Elsevier Inc. All rights reserved.

A rapid and simple method for estimating sulfate reduction activity and quantifying inorganic sulfides

USGS Publications Warehouse

Ulrich, G.A.; Krumholz, L.R.; Suflita, J.M.

1997-01-01

A simplified passive extraction procedure for quantifying reduced inorganic sulfur compounds from sediments and water is presented. This method may also be used for the estimation of sulfate reduction rates. Efficient extraction of FeS, FeS(inf2), and S(sup2-) was obtained with this procedure; however, the efficiency for S(sup0) depended on the form that was tested. Passive extraction can be used with samples containing up to 20 mg of reduced sulfur. We demonstrated the utility of this technique in a determination of both sulfate reduction rates and reduced inorganic sulfur pools in marine and freshwater sediments. A side-by-side comparison of the passive extraction method with the established single-step distillation technique yielded comparable results with a fraction of the effort.

Prolonged remission from hepatic encephalopathy with rifaximin: results of a placebo crossover analysis.

PubMed

Bajaj, J S; Barrett, A C; Bortey, E; Paterson, C; Forbes, W P

2015-01-01

Rifaximin therapy reduced risk of hepatic encephalopathy (HE) recurrence and HE-related hospitalisations during a 6-month, randomised, placebo-controlled trial (RCT) and a 24-month open-label maintenance (OLM) study. However, the impact of crossover from placebo to rifaximin therapy is unclear. To study the impact of crossing over from placebo to rifaximin treatment on breakthrough HE and hospitalisation rates using a within-subjects design. Adults with cirrhosis and history of overt HE episodes, currently in HE remission, received placebo during the RCT and crossed over to rifaximin 550 mg twice daily during the OLM study. Rate of breakthrough overt HE episodes, hospitalisations and incidence and rate of adverse events (AEs) were analysed during RCT and first 6 months of OLM. Of 82 patients randomised to placebo in the RCT who crossed over to the OLM study, 39 experienced an HE episode during the RCT compared with 14 during the OLM study (P < 0.0001). Significantly lower rates of HE events were observed with rifaximin treatment compared with placebo treatment (P < 0.0001). Rates of HE-related hospitalisation were numerically lower during rifaximin treatment compared with placebo treatment, although not significant. Rates of most common AEs, serious AEs and infection-related AEs were similar between the two treatments. This analysis confirms the repeatability of results from the RCT on safety and efficacy of rifaximin 550 mg twice daily in reducing the risk of hepatic encephalopathy recurrence, and suggests these findings are translatable outside of a rigorous, controlled trial setting. © 2014 The Authors. Alimentary Pharmacology & Therapeutics published by John Wiley & Sons Ltd.

Withdrawal of statins increases event rates in patients with acute coronary syndromes.

PubMed

Heeschen, Christopher; Hamm, Christian W; Laufs, Ulrich; Snapinn, Steven; Böhm, Michael; White, Harvey D

2002-03-26

HMG-CoA Reductase Inhibitors (statins) reduce cardiac event rates in patients with stable coronary heart disease. Withdrawal of chronic statin treatment during acute coronary syndromes may impair vascular function independent of lipid-lowering effects and thus increase cardiac event rate. We investigated the effects of statins on the cardiac event rate in 1616 patients of the Platelet Receptor Inhibition in Ischemic Syndrome Management (PRISM) study who had coronary artery disease and chest pain in the previous 24 hours. We recorded death and nonfatal myocardial infarction during the 30-day follow-up. Baseline clinical characteristics did not differ among 1249 patients without statin therapy, 379 patients with continued statin therapy, and 86 patients with discontinued statin therapy after hospitalization. Statin therapy was associated with a reduced event rate at 30-day follow-up compared with patients without statins (adjusted hazard ratio, 0.49 [95% CI, 0.21 to 0.86]; P=0.004). If the statin therapy was withdrawn after admission, cardiac risk increased compared with patients who continued to receive statins (2.93 [95% CI, 1.64 to 6.27]; P=0.005) and tended to be higher compared with patients who never received statins (1.69 [95% CI, 0.92 to 3.56]; P=0.15). This was related to an increased event rate during the first week after onset of symptoms and was independent of cholesterol levels. In a multivariate model, troponin T elevation (P=0.005), ST changes (P=0.02), and continuation of statin therapy (P=0.008) were the only independent predictors of patient outcome. Statin pretreatment in patients with acute coronary syndromes is associated with improved clinical outcome. However, discontinuation of statins after onset of symptoms completely abrogates this beneficial effect.

Economic Evaluation of Pharmacologic Pre- and Postconditioning With Sevoflurane Compared With Total Intravenous Anesthesia in Liver Surgery: A Cost Analysis.

PubMed

Eichler, Klaus; Urner, Martin; Twerenbold, Claudia; Kern, Sabine; Brügger, Urs; Spahn, Donat R; Beck-Schimmer, Beatrice; Ganter, Michael T

2017-03-01

Pharmacologic pre- and postconditioning with sevoflurane compared with total IV anesthesia in patients undergoing liver surgery reduced complication rates as shown in 2 recent randomized controlled trials. However, the potential health economic consequences of these different anesthesia regimens have not yet been assessed. An expostcost analysis of these 2 trials in 129 patients treated between 2006 and 2010 was performed. We analyzed direct medical costs for in-hospital stay and compared pharmacologic pre- and postconditioning with sevoflurane (intervention) with total IV anesthesia (control) from the perspective of a Swiss university hospital. Year 2015 costs, converted to US dollars, were derived from hospital cost accounting data and compared with a multivariable regression analysis adjusting for relevant covariables. Costs with negative prefix indicate savings and costs with positive prefix represent higher spending in our analysis. Treatment-related costs per patient showed a nonsignificant change by -12,697 US dollars (95% confidence interval [CI], 10,956 to -36,352; P = .29) with preconditioning and by -6139 US dollars (95% CI, 6723 to -19,000; P = .35) with postconditioning compared with the control group. Results were robust in our sensitivity analysis. For both procedures (control and intervention) together, major complications led to a significant increase in costs by 86,018 US dollars (95% CI, 13,839-158,198; P = .02) per patient compared with patients with no major complications. In this cost analysis, reduced in-hospital costs by pharmacologic conditioning with sevoflurane in patients undergoing liver surgery are suggested. This possible difference in costs compared with total IV anesthesia is the result of reduced complication rates with pharmacologic conditioning, because major complications have significant cost implications.

Economic Evaluation of Pharmacologic Pre- and Postconditioning With Sevoflurane Compared With Total Intravenous Anesthesia in Liver Surgery: A Cost Analysis

PubMed Central

Urner, Martin; Twerenbold, Claudia; Kern, Sabine; Brügger, Urs; Spahn, Donat R.; Beck-Schimmer, Beatrice; Ganter, Michael T.

2017-01-01

BACKGROUND: Pharmacologic pre- and postconditioning with sevoflurane compared with total IV anesthesia in patients undergoing liver surgery reduced complication rates as shown in 2 recent randomized controlled trials. However, the potential health economic consequences of these different anesthesia regimens have not yet been assessed. METHODS: An expostcost analysis of these 2 trials in 129 patients treated between 2006 and 2010 was performed. We analyzed direct medical costs for in-hospital stay and compared pharmacologic pre- and postconditioning with sevoflurane (intervention) with total IV anesthesia (control) from the perspective of a Swiss university hospital. Year 2015 costs, converted to US dollars, were derived from hospital cost accounting data and compared with a multivariable regression analysis adjusting for relevant covariables. Costs with negative prefix indicate savings and costs with positive prefix represent higher spending in our analysis. RESULTS: Treatment-related costs per patient showed a nonsignificant change by −12,697 US dollars (95% confidence interval [CI], 10,956 to −36,352; P = .29) with preconditioning and by −6139 US dollars (95% CI, 6723 to −19,000; P = .35) with postconditioning compared with the control group. Results were robust in our sensitivity analysis. For both procedures (control and intervention) together, major complications led to a significant increase in costs by 86,018 US dollars (95% CI, 13,839-158,198; P = .02) per patient compared with patients with no major complications. CONCLUSIONS: In this cost analysis, reduced in-hospital costs by pharmacologic conditioning with sevoflurane in patients undergoing liver surgery are suggested. This possible difference in costs compared with total IV anesthesia is the result of reduced complication rates with pharmacologic conditioning, because major complications have significant cost implications. PMID:28067701

Randomized controlled trial of relaxation music to reduce heart rate in patients undergoing cardiac CT.

PubMed

Ng, Ming Yen; Karimzad, Yasser; Menezes, Ravi J; Wintersperger, Bernd J; Li, Qin; Forero, Julian; Paul, Narinder S; Nguyen, Elsie T

2016-10-01

To evaluate the heart rate lowering effect of relaxation music in patients undergoing coronary CT angiography (CCTA), pulmonary vein CT (PVCT) and coronary calcium score CT (CCS). Patients were randomised to a control group (i.e. standard of care protocol) or to a relaxation music group (ie. standard of care protocol with music). The groups were compared for heart rate, radiation dose, image quality and dose of IV metoprolol. Both groups completed State-Trait Anxiety Inventory anxiety questionnaires to assess patient experience. One hundred and ninety-seven patients were recruited (61.9 % males); mean age 56y (19-86 y); 127 CCTA, 17 PVCT, 53 CCS. No significant difference in heart rate, radiation dose, image quality, metoprolol dose and anxiety scores. 86 % of patients enjoyed the music. 90 % of patients in the music group expressed a strong preference to have music for future examinations. The patient cohort demonstrated low anxiety levels prior to CT. Relaxation music in CCTA, PVCT and CCS does not reduce heart rate or IV metoprolol use. Patients showed low levels of anxiety indicating that anxiolytics may not have a significant role in lowering heart rate. Music can be used in cardiac CT to improve patient experience. • Relaxation music does not reduce heart rate in cardiac CT • Relaxation music does not reduce beta-blocker use in cardiac CT • Relaxation music has no effect on cardiac CT image quality • Low levels of anxiety are present in patients prior to cardiac CT • Patients enjoyed the relaxation music and this results in improved patient experience.

Kinetic comparison of microbial assemblages for the anaerobic treatment of wastewater with high sulfate and heavy metal contents.

PubMed

Sinbuathong, Nusara; Sirirote, Pramote; Liengcharernsit, Winai; Khaodhiar, Sutha; Watts, Daniel J

2009-01-01

Mixed-microbial assemblages enriched from a septic tank, coastal sediment samples, the digester sludge of a brewery wastewater treatment plant and acidic sulfate soil samples were compared on the basis of growth rate, waste and sulfate reduction rate under sulfate reducing conditions at 30 degrees C. The specific growth rate of various cultures was in the range 0.0013-0.0022 hr(-1). Estimates of waste and sulfate reduction rate were obtained by fitting substrate depletion and sulfate reduction data with the Michaelis-Menten equation. The waste reduction rates were in the range 4x10(-8)-1x10(-7) I mg(-1) hr(-1) and generally increased in the presence of copper, likely by copper sulfide precipitation that reduced sulfide and copper toxicity and thus protected the anaerobic microbes. Anaerobic microorganisms from a brewery digester sludge were found to be the most appropriate culture for the treatment of wastewater with high sulfate and heavy metal content due to their growth rate, and waste and sulfate reduction rate.

Neural Substrates of Empathic Accuracy in People With Schizophrenia

PubMed Central

Harvey, Philippe-Olivier; Zaki, Jamil; Lee, Junghee; Ochsner, Kevin; Green, Michael F.

2013-01-01

Introduction Empathic deficits in schizophrenia may lead to social dysfunction, but previous studies of schizophrenia have not modeled empathy through paradigms that (1) present participants with naturalistic social stimuli and (2) link brain activity to “accuracy” about inferring other’s emotional states. This study addressed this gap by investigating the neural correlates of empathic accuracy (EA) in schizophrenia. Methods Fifteen schizophrenia patients and 15 controls were scanned while continuously rating the affective state of another person shown in a series of videos (ie, targets). These ratings were compared with targets’ own self-rated affect, and EA was defined as the correlation between participants’ ratings and targets’ self-ratings. Targets’ self-reported emotional expressivity also was measured. We searched for brain regions whose activity tracked parametrically with (1) perceivers’ EA and (2) targets’ expressivity. Results Patients showed reduced EA compared with controls. The left precuneus, left middle frontal gyrus, and bilateral thalamus were significantly more correlated with EA in controls compared with patients. High expressivity in targets was associated with better EA in controls but not in patients. High expressivity was associated with increased brain activity in a large set of regions in controls (eg, fusiform gyrus, medial prefrontal cortex) but not in patients. Discussion These results use a naturalistic performance measure to confirm that schizophrenic patients demonstrate impaired ability to understand others’ internal states. They provide novel evidence about a potential mechanism for this impairment: schizophrenic patients failed to capitalize on targets’ emotional expressivity and also demonstrate reduced neural sensitivity to targets’ affective cues. PMID:22451493

Filamentation instability in a quantum plasma

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

Bret, A.

2007-08-15

The growth rate of the filamentation instability triggered when a diluted cold electron beam passes through a cold plasma is evaluated using the quantum hydrodynamic equations. Compared with a cold fluid model, quantum effects reduce both the unstable wave vector domain and the maximum growth rate. Stabilization of large wave vector modes is always achieved, but significant reduction of the maximum growth rate depends on a dimensionless parameter that is provided. Although calculations are extended to the relativistic regime, they are mostly relevant to the nonrelativistic one.

Breast cancer screening controversies: who, when, why, and how?

PubMed

Chetlen, Alison; Mack, Julie; Chan, Tiffany

2016-01-01

Mammographic screening is effective in reducing mortality from breast cancer. The issue is not whether mammography is effective, but whether the false positive rate and false negative rates can be reduced. This review will discuss controversies including the reduction in breast cancer mortality, overdiagnosis, the ideal screening candidate, and the optimal imaging modality for breast cancer screening. The article will compare and contrast screening mammography, tomosynthesis, whole-breast screening ultrasound, magnetic resonance imaging, and molecular breast imaging. Though supplemental imaging modalities are being utilized to improve breast cancer diagnosis, mammography still remains the gold standard for breast cancer screening. Copyright © 2015 Elsevier Inc. All rights reserved.

Clinical trial of acetazolamide in SCA6, with assessment using the Ataxia Rating Scale and body stabilometry.

PubMed

Yabe, I; Sasaki, H; Yamashita, I; Takei, A; Tashiro, K

2001-07-01

To investigate the effect of acetazolamide on spinocerebellar ataxia type 6 (SCA6). Acetazolamide (250-500 mg/day) was administered orally for 88 weeks to 6 patients with SCA6, and its effect was quantitatively monitored using the Ataxia Rating Scale (ARS) and body sway analysis by stabilometry. During administration of acetazolamide, the ARS score and the amplitude of body sway were significantly reduced compared with before administration. However, the response became weaker after 1 year of treatment. Although this was an open trial, the results suggested that acetazolamide can temporarily reduce the severity of symptoms during the progression of SCA6.

Characterization of a high-pressure diesel fuel injection system as a control technology option to improve engine performance and reduce exhaust emissions

NASA Technical Reports Server (NTRS)

Mcfadden, J. J.; Dezelick, R. A.; Barrows, R. R.

1983-01-01

Test results from a high pressure electronically controlled fuel injection system are compared with a commercial mechanical injection system on a single cylinder, diesel test engine using an inlet boost pressure of 2.6:1. The electronic fuel injection system achieved high pressure by means of a fluid intensifier with peak injection pressures of 47 to 69 MPa. Reduced exhaust emissions were demonstrated with an increasing rate of injection followed by a fast cutoff of injection. The reduction in emissions is more responsive to the rate of injection and injection timing than to high peak injection pressure.

Balancing quality and cost for Adult Tobacco Telephone Surveys.

PubMed

Fernandez, Barbara M; Hannah, Kristie M; Wallack, Randal S Zu; Hicks, Jennifer K D; Gorrigan, Anne M; Mariolis, Peter

2007-01-01

To demonstrate the ability to cost-effectively coordinate Adult Tobacco Survey stakeholder interests while reducing the risk of potential bias. Key smoking indicators were compared across 2 surveys and analyzed based on modifications to calling protocols. Mixed results were found when comparing smoking rates across 2 surveys, by early, mid, and late respondents, and by the number of rufusals. Significant cost sayings can be obtained by reducing the number of telephone call attempts. Few significant differences may encourage reductions in protocol, but this must be weighed against the possibility of cost-saving measures resulting in biased estimates.

Disparity in rates of HPV infection and cervical cancer in underserved US populations

PubMed Central

Karuri, Asok Ranjan; Kashyap, Vivek Kumar; Yallapu, Murali Mohan; Zafar, Nadeem; Kedia, Satish K.; Jaggi, Meena; Chauhan, Subhash C.

2018-01-01

There is a higher rate of HPV infection and cervical cancer incidence and mortality in underserved US population who reside in Appalachian mountain region compared to Northern Plains. Social and behavioral factors such as smoking and alcohol consumption are for such a high incidence. However, by and large, the reasons for these discrepancies lie in the reluctance of the underserved population to adopt preventive measures such as prophylactic Human papilloma virus (HPV) vaccines and Pap smear screening that have significantly reduced the incidence and mortality rate of cervical cancer in Caucasian women. Thus, it is clear that drastic change in social behavior and implementation of preventive measures is required to effectively reduce the incidence and mortality from cervical cancer in this underserved population. PMID:28410118

Simultaneous biodegradation of phenol and carbon tetrachloride mediated by humic acids.

PubMed

Martínez, Claudia M; Alvarez, Luis H; Cervantes, Francisco J

2012-09-01

The capacity of an anaerobic sediment to achieve the simultaneous biodegradation of phenol and carbon tetrachloride (CT) was evaluated, using humic acids (HA) as redox mediator. The presence of HA in sediment incubations increased the rate of biodegradation of phenol and the rate of dehalogenation (2.5-fold) of CT compared to controls lacking HA. Further experiments revealed that the electron-accepting capacity of HA derived from different organic-rich environments was not associated with their reducing capacity to achieve CT dechlorination. The collected kinetic data suggest that the reduction of CT by reduced HA was the rate-limiting step during the simultaneous biodegradation of phenol and CT. To our knowledge, the present study constitutes the first demonstration of the simultaneous biodegradation of two priority pollutants mediated by HA.

Boar taint, meat quality and fail rate in entire male pigs and male pigs immunized against gonadotrophin releasing factor as related to body weight and feeding regime.

PubMed

Moore, K L; Mullan, B P; Dunshea, F R

2017-03-01

The objective of this experiment was to compare the pork quality of entire male pigs and pigs immunized against GnRF (IC males) at both light (64.8kg) and heavy (106kg) liveweights and two feeding regimes (restricted at 2.5 times maintenance and ad libitum). There was no difference in objective measurements (P>0.05) or eating pork quality (P>0.1) between entire male and IC males. Fail rates were reduced by 9.1% and 12% for pork from IC males for quality grade (P=0.007) and re-purchase intention (P=0.001), respectively, compared to pork from entire males. Skatole (P=0.001) and androstenone (P<0.001) levels in belly fat were higher in entire male than IC male pigs. In addition, 37.5% of the light entire male pigs fed ad libitum showed skatole levels that exceeded the sensory threshold of 0.2μg/g. This work confirms that immunization against GnRF is effective in eliminating boar taint and reducing pork quality fail rates by approximately 10% compared to pork from entire males. Copyright © 2016 Elsevier Ltd. All rights reserved.

Comparing alcohol mortality in Tsarist and contemporary Russia: is the current situation historically unique?

PubMed

Andreev, Evgeny; Bogoyavlensky, Dmitri; Stickley, Andrew

2013-01-01

This study compared the level of alcohol mortality in tsarist and contemporary Russia. Cross-sectional and annual time-series data from 1870 to 1894, 2008 and 2009 on the mortality rate from deaths due to 'drunkenness' were compared for men in the 50 provinces of tsarist 'European Russia': an area that today corresponds with the territory occupied by the Baltic countries, Belarus, Moldova, Ukraine and the Russian provinces to the west of the Ural Mountains. In 1870-1894, the male death rate from 'drunkenness' in the Russian provinces (15.9 per 100,000) was much higher than in the non-Russian provinces. However, the rate recorded in Russia in the contemporary period was even higher--23.3. Russia has had high levels of alcohol mortality from at least the late 19th century onwards. While a dangerous drinking pattern and spirits consumption may underpin high alcohol mortality across time, the seemingly much higher levels in the contemporary period seem to be also driven by an unprecedented level of consumption, and also possibly, surrogate alcohol use. This study highlights the urgent need to reduce the level of alcohol consumption among the population in order to reduce high levels of alcohol mortality in contemporary Russia.

Music therapy can lower the heart rates of severely sick children.

PubMed

Uggla, L; Bonde, L O; Svahn, B M; Remberger, M; Wrangsjö, B; Gustafsson, B

2016-10-01

Paediatric recipients of haematopoietic stem cell transplants (HSCT) are at increased risk of developing post-traumatic stress disorder (PTSD), and there is a need to identify interventions that can alleviate stress in this group. The aim of this study was to examine the previously unexplored effect of music therapy on children undergoing HSCT, by analysing physiological parameters and comparing them with a control group. We performed a randomised clinical pilot study of 24 patients up to the age of 16 undergoing HSCT at Karolinska University Hospital, Huddinge, Sweden. Music therapy, including expressive and receptive elements, was performed twice a week in the treatment group and compared to standard care in the control group. Physiological parameters were evaluated according to the hospital's protocols. The music therapy group had significantly reduced evening heart rates compared to the control group (p < 0.001), and the effect was sustainable for four to eight hours after the intervention. There were no significant differences in saturation or blood pressure observed between the groups. Music therapy significantly lowered the heart rate of children undergoing HSCT for at least four to eight hours, indicating reduced stress levels and potentially lowering the risk of developing PTSD. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Enclosed nests may provide greater thermal than nest predation benefits compared with open nests across latitudes

USGS Publications Warehouse

Martin, Thomas E.; Boyce, Andy J.; Fierro-Calderon, Karolina; Mitchell, Adam E.; Armstad, Connor E.; Mouton, James C.; Bin Soudi, Evertius E.

2017-01-01

Nest structure is thought to provide benefits that have fitness consequences for several taxa. Traditionally, reduced nest predation has been considered the primary benefit underlying evolution of nest structure, whereas thermal benefits have been considered a secondary or even non-existent factor. Yet, the relative roles of these factors on nest structures remain largely unexplored.Enclosed nests have a constructed or natural roof connected to sides that allow a restricted opening or tube entrance that provides cover in all directions except the entrance, whereas open nests are cups or platforms that are open above. We show that construction of enclosed nests is more common among songbirds (Passeriformes) in tropical and southern hemisphere regions than in north temperate regions. This geographic pattern may reflect selection from predation risk, under long-standing assumptions that nest predation rates are higher in southern regions and that enclosed nests reduce predation risk compared with open cup nests. We therefore compared nest predation rates between enclosed vs. open nests in 114 songbird species that do not nest in tree holes among five communities of coexisting birds, and for 205 non-hole-nesting species from the literature, across northern temperate, tropical, and southern hemisphere regions.Among coexisting species, enclosed nests had lower nest predation rates than open nests in two south temperate sites, but not in either of two tropical sites or a north temperate site. Nest predation did not differ between nest types at any latitude based on literature data. Among 319 species from both our field studies and the literature, enclosed nests did not show consistent benefits of reduced predation and, in fact, predation was not consistently higher in the tropics, contrary to long-standing perspectives.Thermal benefits of enclosed nests were indicated based on three indirect results. First, species that built enclosed nests were smaller than species using open nests both among coexisting species and among species from the literature. Smaller species lose heat fastest and thereby may gain important thermal benefits from reduced convective cooling. Second, eggs were warmed by parents for less time in species with enclosed nests, as can be expected if egg cooling rates are slower. Finally, species using enclosed nests exhibited enhanced growth of mass and wings compared with species using open nests, suggesting reduced thermoregulatory costs allowed increased energy for growth.Enclosed nests may therefore provide more consistent thermal than nest predation benefits, counter to long-standing perspectives.

Effects of CGS 21680, a selective A2A adenosine receptor agonist, on cardiac output and vascular resistance in acute heart failure in the anaesthetized rat

PubMed Central

Nekooeian, Ali A; Tabrizchi, Reza

1998-01-01

The effects of CGS 21680, a selective A2A adenosine receptor agonist, on cardiac output, blood pressure, mean circulatory filling pressure (Pmcf), arterial and venous resistances, heart rate and left ventricular end-diastolic pressure were assessed in rats with acute heart failure by means of coronary artery occlusion.Animals (n=6 in each group) were divided into five groups: group I, sham-operated vehicle-treated (0.9% saline; 0.018 mL min−1); groups II-V, subject to coronary artery occlusion and treated with vehicle (0.9% saline; 0.018 ml min−1) and CGS 21680 (0.1, 0.3 and 1.0 μg kg−1 min−1), respectively. Haemodynamic measurements were taken one hour after completion of surgery, ninety minutes after coronary artery occlusion (except in group I), and fifteen minutes after infusion of saline or CGS 21680.Baseline haemodynamic measurements before occlusion were found not to differ significantly between the different groups of animals. However, after occlusion, cardiac output, rate of rise in left ventricular pressure (+dP/dt) and blood pressure were significantly reduced when compared to corresponding values in sham-operated animals. In addition, occlusion of the coronary artery resulted in a significant elevation in venous resistance, Pmcf and left ventricular end-diastolic pressure as compared to corresponding values in sham-operated animals.Infusion with CGS 21680 at the highest dose significantly reduced blood pressure, arterial resistance and left ventricular end-diastolic pressure when compared to occluded vehicle-treated animals (group II). Administration of CGS 21680 at the highest dose also significantly increased cardiac output (28%) and heart rate (10%) in comparison to occluded vehicle-treated animals. In addition, the highest dose of CGS 21680 significantly reduced Pmcf (9%) and venous resistance (62%) in comparison to occluded vehicle-treated animals. Administration of CGS 21680 did not significantly affect +dP/dt when compared to occluded vehicle-treated animals.The results from the present investigation indicate that occlusion of the coronary artery in rats results in a state of heart failure characterized by reduced arterial pressure and cardiac output, and increased venous resistance, Pmcf and left ventricular end-diastolic pressure. Administration of CGS 21680 to animals with acute heart failure resulted in increased cardiac output which was due to reduced venous resistance, as well as increased heart rate. PMID:9605574

Effects of CGS 21680, a selective A2A adenosine receptor agonist, on cardiac output and vascular resistance in acute heart failure in the anaesthetized rat.

PubMed

Nekooeian, A A; Tabrizchi, R

1998-04-01

1. The effects of CGS 21680, a selective A2A adenosine receptor agonist, on cardiac output, blood pressure, mean circulatory filling pressure (Pmcf), arterial and venous resistances, heart rate and left ventricular end-diastolic pressure were assessed in rats with acute heart failure by means of coronary artery occlusion. 2. Animals (n=6 in each group) were divided into five groups: group I, sham-operated vehicle-treated (0.9% saline; 0.018 mL min(-1)); groups II-V, subject to coronary artery occlusion and treated with vehicle (0.9% saline; 0.018 ml min(-1)) and CGS 21680 (0.1, 0.3 and 1.0 microg kg(-1) min(-1)), respectively. Haemodynamic measurements were taken one hour after completion of surgery, ninety minutes after coronary artery occlusion (except in group I), and fifteen minutes after infusion of saline or CGS 21680. 3. Baseline haemodynamic measurements before occlusion were found not to differ significantly between the different groups of animals. However, after occlusion, cardiac output, rate of rise in left ventricular pressure (+ dP/dt) and blood pressure were significantly reduced when compared to corresponding values in sham-operated animals. In addition, occlusion of the coronary artery resulted in a significant elevation in venous resistance, Pmcf and left ventricular end-diastolic pressure as compared to corresponding values in sham-operated animals. 4. Infusion with CGS 21680 at the highest dose significantly reduced blood pressure, arterial resistance and left ventricular end-diastolic pressure when compared to occluded vehicle-treated animals (group II). Administration of CGS 21680 at the highest dose also significantly increased cardiac output (28%) and heart rate (10%) in comparison to occluded vehicle-treated animals. In addition, the highest dose of CGS 21680 significantly reduced Pmcf (9%) and venous resistance (62%) in comparison to occluded vehicle-treated animals. Administration of CGS 21680 did not significantly affect +dP/dt when compared to occluded vehicle-treated animals. 5. The results from the present investigation indicate that occlusion of the coronary artery in rats results in a state of heart failure characterized by reduced arterial pressure and cardiac output, and increased venous resistance, Pmcf and left ventricular end-diastolic pressure. Administration of CGS 21680 to animals with acute heart failure resulted in increased cardiac output which was due to reduced venous resistance, as well as increased heart rate.

Stability and control of the Gossamer human powered aircraft by analysis and flight test

NASA Technical Reports Server (NTRS)

Jex, H. R.; Mitchell, D. G.

1982-01-01

The slow flight speed, very light wing loading, and neutral stability of the Gossamer Condor and the Gossamer Albatross emphasized apparent-mass aerodynamic effects and unusual modes of motion response. These are analyzed, approximated, and discussed, and the resulting transfer functions and dynamic properties are summarized and compared. To verify these analytical models, flight tests were conducted with and electrically powered Gossamer Albatross II. Sensors were installed and their outputs were telemetered to records on the ground. Frequency sweeps of the various controls were made and the data were reduced to frequency domain measures. Results are given for the response of: pitch rate, airspeed and normal acceleration from canard-elevator deflection; roll rate and yaw rate from canard-rudder tilt; and roll rate and yaw rate from wing warp. The reliable data are compared with the analytical predictions.

Interventions for preventing falls in older people living in the community.

PubMed

Gillespie, Lesley D; Robertson, M Clare; Gillespie, William J; Sherrington, Catherine; Gates, Simon; Clemson, Lindy M; Lamb, Sarah E

2012-09-12

Approximately 30% of people over 65 years of age living in the community fall each year. This is an update of a Cochrane review first published in 2009. To assess the effects of interventions designed to reduce the incidence of falls in older people living in the community. We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (February 2012), CENTRAL (The Cochrane Library 2012, Issue 3), MEDLINE (1946 to March 2012), EMBASE (1947 to March 2012), CINAHL (1982 to February 2012), and online trial registers. Randomised trials of interventions to reduce falls in community-dwelling older people. Two review authors independently assessed risk of bias and extracted data. We used a rate ratio (RaR) and 95% confidence interval (CI) to compare the rate of falls (e.g. falls per person year) between intervention and control groups. For risk of falling, we used a risk ratio (RR) and 95% CI based on the number of people falling (fallers) in each group. We pooled data where appropriate. We included 159 trials with 79,193 participants. Most trials compared a fall prevention intervention with no intervention or an intervention not expected to reduce falls. The most common interventions tested were exercise as a single intervention (59 trials) and multifactorial programmes (40 trials). Sixty-two per cent (99/159) of trials were at low risk of bias for sequence generation, 60% for attrition bias for falls (66/110), 73% for attrition bias for fallers (96/131), and only 38% (60/159) for allocation concealment.Multiple-component group exercise significantly reduced rate of falls (RaR 0.71, 95% CI 0.63 to 0.82; 16 trials; 3622 participants) and risk of falling (RR 0.85, 95% CI 0.76 to 0.96; 22 trials; 5333 participants), as did multiple-component home-based exercise (RaR 0.68, 95% CI 0.58 to 0.80; seven trials; 951 participants and RR 0.78, 95% CI 0.64 to 0.94; six trials; 714 participants). For Tai Chi, the reduction in rate of falls bordered on statistical significance (RaR 0.72, 95% CI 0.52 to 1.00; five trials; 1563 participants) but Tai Chi did significantly reduce risk of falling (RR 0.71, 95% CI 0.57 to 0.87; six trials; 1625 participants).Multifactorial interventions, which include individual risk assessment, reduced rate of falls (RaR 0.76, 95% CI 0.67 to 0.86; 19 trials; 9503 participants), but not risk of falling (RR 0.93, 95% CI 0.86 to 1.02; 34 trials; 13,617 participants).Overall, vitamin D did not reduce rate of falls (RaR 1.00, 95% CI 0.90 to 1.11; seven trials; 9324 participants) or risk of falling (RR 0.96, 95% CI 0.89 to 1.03; 13 trials; 26,747 participants), but may do so in people with lower vitamin D levels before treatment.Home safety assessment and modification interventions were effective in reducing rate of falls (RR 0.81, 95% CI 0.68 to 0.97; six trials; 4208 participants) and risk of falling (RR 0.88, 95% CI 0.80 to 0.96; seven trials; 4051 participants). These interventions were more effective in people at higher risk of falling, including those with severe visual impairment. Home safety interventions appear to be more effective when delivered by an occupational therapist.An intervention to treat vision problems (616 participants) resulted in a significant increase in the rate of falls (RaR 1.57, 95% CI 1.19 to 2.06) and risk of falling (RR 1.54, 95% CI 1.24 to 1.91). When regular wearers of multifocal glasses (597 participants) were given single lens glasses, all falls and outside falls were significantly reduced in the subgroup that regularly took part in outside activities. Conversely, there was a significant increase in outside falls in intervention group participants who took part in little outside activity.Pacemakers reduced rate of falls in people with carotid sinus hypersensitivity (RaR 0.73, 95% CI 0.57 to 0.93; three trials; 349 participants) but not risk of falling. First eye cataract surgery in women reduced rate of falls (RaR 0.66, 95% CI 0.45 to 0.95; one trial; 306 participants), but second eye cataract surgery did not.Gradual withdrawal of psychotropic medication reduced rate of falls (RaR 0.34, 95% CI 0.16 to 0.73; one trial; 93 participants), but not risk of falling. A prescribing modification programme for primary care physicians significantly reduced risk of falling (RR 0.61, 95% CI 0.41 to 0.91; one trial; 659 participants).An anti-slip shoe device reduced rate of falls in icy conditions (RaR 0.42, 95% CI 0.22 to 0.78; one trial; 109 participants). One trial (305 participants) comparing multifaceted podiatry including foot and ankle exercises with standard podiatry in people with disabling foot pain significantly reduced the rate of falls (RaR 0.64, 95% CI 0.45 to 0.91) but not the risk of falling.There is no evidence of effect for cognitive behavioural interventions on rate of falls (RaR 1.00, 95% CI 0.37 to 2.72; one trial; 120 participants) or risk of falling (RR 1.11, 95% CI 0.80 to 1.54; two trials; 350 participants).Trials testing interventions to increase knowledge/educate about fall prevention alone did not significantly reduce the rate of falls (RaR 0.33, 95% CI 0.09 to 1.20; one trial; 45 participants) or risk of falling (RR 0.88, 95% CI 0.75 to 1.03; four trials; 2555 participants).No conclusions can be drawn from the 47 trials reporting fall-related fractures.Thirteen trials provided a comprehensive economic evaluation. Three of these indicated cost savings for their interventions during the trial period: home-based exercise in over 80-year-olds, home safety assessment and modification in those with a previous fall, and one multifactorial programme targeting eight specific risk factors. Group and home-based exercise programmes, and home safety interventions reduce rate of falls and risk of falling.Multifactorial assessment and intervention programmes reduce rate of falls but not risk of falling; Tai Chi reduces risk of falling.Overall, vitamin D supplementation does not appear to reduce falls but may be effective in people who have lower vitamin D levels before treatment.

An analysis of the effectiveness of two topical anesthetics.

PubMed Central

Rosivack, R. G.; Koenigsberg, S. R.; Maxwell, K. C.

1990-01-01

This study compared the effectiveness of topical benzocaine 20%, lidocaine 5%, and a placebo in reducing the pain caused by needle insertion when the medicament was placed in the mucobuccal fold above the maxillary canine eminence. Both topical anesthetics and the placebo were randomly tested against each other bilaterally. For uniformity the agents were left in place for three minutes before needle insertion. A 27 gauge short needle mounted on an aspirating syringe was then inserted just past the bevel. Each subject rated the degree of pain on a visual analogue scale 100 mm in length. A pulse oximeter was used to record the heart rate. The results indicate that both topical anesthetics are significantly better than the placebo in reducing pain caused by needle insertion, although no statistically significant differences were found between the two topical anesthetics. Statistically significant differences in heart rate were seen, but these differences were not clinically significant. It is concluded that benzocaine 20% and lidocaine 5% significantly reduce the pain during needle insertion. PMID:2097909

Racial disparities in BRCA testing and cancer risk management across a population-based sample of young breast cancer survivors.

PubMed

Cragun, Deborah; Weidner, Anne; Lewis, Courtney; Bonner, Devon; Kim, Jongphil; Vadaparampil, Susan T; Pal, Tuya

2017-07-01

Breast cancer (BC) disparities may widen with genomic advances. The authors compared non-Hispanic white (NHW), black, and Hispanic BC survivors for 1) cancer risk-management practices among BRCA carriers and 2) provider discussion and receipt of genetic testing. A population-based sample of NHW, black, and Hispanic women who had been diagnosed with invasive BC at age 50 years or younger from 2009 to 2012 were recruited through the state cancer registry. Multiple logistic regression was used to compare cancer risk-management practices in BRCA carriers and associations of demographic and clinical variables with provider discussion and receipt of testing. Of 1622 participants, 159 of 440 (36.1%) black women, 579 of 897 (64.5%) NHW women, 58 of 117 (49.6%) Spanish-speaking Hispanic women, and 116 of 168 (69%) English-speaking Hispanic women underwent BRCA testing, of whom 90 had a pathogenic BRCA mutation identified. Among BRCA carriers, the rates of risk-reducing mastectomy and risk-reducing salpingo-oophorectomy were significantly lower among black women compared with Hispanic and NHW women after controlling for clinical and demographic variables (P = .025 and P = .008, respectively). Compared with NHW women, discussion of genetic testing with a provider was 16 times less likely among black women (P < .0001) and nearly 2 times less likely among Spanish-speaking Hispanic women (P = .04) after controlling for clinical and sociodemographic factors. The current results suggest that the rates of risk-reducing salpingo-oophorectomy are lower among black BRCA carriers compared with their Hispanic and NHW counterparts, which is concerning because benefits from genetic testing arise from cancer risk-management practice options. Furthermore, lower BRCA testing rates among blacks may partially be because of a lower likelihood of provider discussion. Future studies are needed to improve cancer risk identification and management practices across all populations to prevent the widening of disparities. Cancer 2017;123:2497-05. © 2017 American Cancer Society. © 2017 American Cancer Society.

Remnant Pachira quinata pasture trees have greater opportunities to self and suffer reduced reproductive success due to inbreeding depression.

PubMed

Rymer, P D; Sandiford, M; Harris, S A; Billingham, M R; Boshier, D H

2015-08-01

Habitat fragmentation is extensive throughout the world, converting natural ecosystems into fragments of varying size, density and connectivity. The potential value of remnant trees in agricultural landscapes as seed sources and in connecting fragments has formed a fertile area of debate. This study contrasted the mating patterns of bat-pollinated Pachira quinata trees in a continuous forest to those in pasture through microsatellite-based paternity analysis of progeny. The breeding system was determined by analysis of pollen tube growth and seed production from controlled pollinations. Fitness of selfed and outcrossed seed was compared by germination and seedling growth. There was more inbreeding within pasture trees (outcrossing=0.828±0.015) compared with forest trees (0.926±0.005). Pasture trees had fewer sires contributing to mating events, but pollen dispersal distances were greater than those in the forest. Paternity analysis showed variation in outcrossing rates among pasture trees with high proportions of external and self pollen sources detected. A leaky self-incompatibility system was found, with self pollen having reduced germination on stigmas and slower growth rate through the style. Controlled pollinations also showed a varied ability to self among trees, which was reflected in the selfing rates among pasture trees shown by the paternity analysis (0-80% selfing). Self pollination resulted in lower seed set, germination and seedling growth compared with outcrossing. While remnant trees in agricultural landscapes are involved in broader mating patterns, they show increased but varied levels of inbreeding, which result in reduced fitness.

Photosynthetic capacity and leaf nitrogen decline along a controlled climate gradient in provenances of two widely distributed Eucalyptus species.

PubMed

Crous, Kristine Y; Drake, John E; Aspinwall, Michael J; Sharwood, Robert E; Tjoelker, Mark G; Ghannoum, Oula

2018-05-27

Climate is an important factor limiting tree distributions and adaptation to different thermal environments may influence how tree populations respond to climate warming. Given the current rate of warming, it has been hypothesized that tree populations in warmer, more thermally stable climates may have limited capacity to respond physiologically to warming compared to populations from cooler, more seasonal climates. We determined in a controlled environment how several provenances of widely distributed Eucalyptus tereticornis and E. grandis adjusted their photosynthetic capacity to +3.5°C warming along their native distribution range (~16-38°S) and whether climate of seed origin of the provenances influenced their response to different growth temperatures. We also tested how temperature optima (T opt ) of photosynthesis and J max responded to higher growth temperatures. Our results showed increased photosynthesis rates at a standardized temperature with warming in temperate provenances, while rates in tropical provenances were reduced by about 40% compared to their temperate counterparts. Temperature optima of photosynthesis increased as provenances were exposed to warmer growth temperatures. Both species had ~30% reduced photosynthetic capacity in tropical and subtropical provenances related to reduced leaf nitrogen and leaf Rubisco content compared to temperate provenances. Tropical provenances operated closer to their thermal optimum and came within 3% of the T opt of J max during the daily temperature maxima. Hence, further warming may negatively affect C uptake and tree growth in warmer climates, whereas eucalypts in cooler climates may benefit from moderate warming. © 2018 John Wiley & Sons Ltd.

Remnant Pachira quinata pasture trees have greater opportunities to self and suffer reduced reproductive success due to inbreeding depression

PubMed Central

Rymer, P D; Sandiford, M; Harris, S A; Billingham, M R; Boshier, D H

2015-01-01

Habitat fragmentation is extensive throughout the world, converting natural ecosystems into fragments of varying size, density and connectivity. The potential value of remnant trees in agricultural landscapes as seed sources and in connecting fragments has formed a fertile area of debate. This study contrasted the mating patterns of bat-pollinated Pachira quinata trees in a continuous forest to those in pasture through microsatellite-based paternity analysis of progeny. The breeding system was determined by analysis of pollen tube growth and seed production from controlled pollinations. Fitness of selfed and outcrossed seed was compared by germination and seedling growth. There was more inbreeding within pasture trees (outcrossing=0.828±0.015) compared with forest trees (0.926±0.005). Pasture trees had fewer sires contributing to mating events, but pollen dispersal distances were greater than those in the forest. Paternity analysis showed variation in outcrossing rates among pasture trees with high proportions of external and self pollen sources detected. A leaky self-incompatibility system was found, with self pollen having reduced germination on stigmas and slower growth rate through the style. Controlled pollinations also showed a varied ability to self among trees, which was reflected in the selfing rates among pasture trees shown by the paternity analysis (0–80% selfing). Self pollination resulted in lower seed set, germination and seedling growth compared with outcrossing. While remnant trees in agricultural landscapes are involved in broader mating patterns, they show increased but varied levels of inbreeding, which result in reduced fitness. PMID:23963342

Early Impairment of Cardiac Function and Asynchronization of Systemic Amyloidosis with Preserved Ejection Fraction Using Two-Dimensional Speckle Tracking Echocardiography.

PubMed

Huang, He; Jing, Xian-chao; Hu, Zhang-xue; Chen, Xi; Liu, Xiao-qin

2015-12-01

To observe the ventricular global and regional function of the patients with systemic amyloidosis using two-dimensional speckle tracking echocardiography. The study enrolled 31 consecutive biopsy-proved patients with systemic amyloidosis who underwent echocardiographic examination and EF ≥ 55% and 37 age- and gender-matched healthy controls. We compared systolic strain and strain rate, diastolic strain rate, time to peak strain, peak delay time in longitudinal, radial, circumferential directions in 16 left ventricular segments. The global peak systolic longitudinal and radial strain of left ventricle, peak systolic longitudinal strain and strain rate, diastolic strain rate of right ventricular free wall were also compared. (1) Global peak systolic longitudinal strain (GPSLS), peak systolic longitudinal strain (PSLS) and strain rate (PSLSR), peak early diastolic longitudinal strain rate (PELSR) in 16 segments were decreased in case (P < 0.05). (2) Peak systolic radial strain and strain rate of inferoseptum and inferolateral at the level of papillary muscle were lower (P < 0.05), and peak early diastolic radial strain rate (PERSR) was reduced (P < 0.05). (3) Peak early diastolic circumferential strain rate was lower (P < 0.05). (4) Time to peak systolic longitudinal, radial, circumferential strain was longer, and peak delay time at the same level retarded (P < 0.05). (5) Into right ventricular wall, PSLS and PSLSR at mid-segment, and PSLSR, PELSR, peak atrial systolic longitudinal strain rate (PALSR) at basal were reduced (P < 0.05). (6) Inverse correlation between interventricular septum (IVS) thickness and GPSLS and GPSRS was found (P < 0.05). Systolic and diastolic dysfunction existed in systemic amyloidosis with preserved EF. Mechanical contraction disorder may be one reason for systolic dysfunction. GPLSR and GPRSR were negatively related to IVS thickness. © 2015, Wiley Periodicals, Inc.

The Effect of Pleural Abrasion on the Treatment of Primary Spontaneous Pneumothorax: A Systematic Review of Randomized Controlled Trials

PubMed Central

Ming, Mo-yu; Cai, Shuang-qi; Chen, Yi-Qiang

2015-01-01

Background Pleural abrasion has been widely used to control the recurrence of primary spontaneous pneumothorax (PSP). However, controversy still exists regarding the advantages and disadvantages of pleural abrasion compared with other interventions in preventing the recurrence of PSP. Methods The PubMed, Embase, and Cochrane Central Register of Controlled Trials databases were searched up to December 15, 2014 to identify randomized controlled trials (RCTs) that compared the effects of pleural abrasion with those of other interventions in the treatment of PSP. The study outcomes included the PSP recurrence rate and the occurrence rate of adverse effects. Results Mechanical pleural abrasion and apical pleurectomy after thoracoscopic stapled bullectomy exhibited similarly persistent postoperative air leak occurrence rates (p = 0.978) and 1-year PSP recurrence rates (p = 0.821), whereas pleural abrasion led to reduced residual chest pain and discomfort (p = 0.001) and a smaller rate of hemothorax (p = 0.036) than did apical pleurectomy. However, the addition of minocycline pleurodesis to pleural abrasion did not reduce the pneumothorax recurrence rate compared with apical pleurectomy (3.8% for both procedures) but was associated with fewer complications. There was no statistical difference in the pneumothorax recurrence rate between mechanical pleural abrasion and chemical pleurodesis with minocycline on either an intention-to-treat basis (4 of 42 versus 0 of 42, p = 0.12; Fisher exact test) or after exclusions (2 of 40 versus 0 of 42, p = 0.24; Fisher exact test). Pleural abrasion plus minocycline pleurodesis also did not reduce the pneumothorax recurrence rate compared with pleural abrasion alone (p = 0.055). Moreover, pleural abrasion plus minocycline pleurodesis was associated with more intense acute chest pain. The postoperative overall recurrence rate in patients who underwent staple line coverage with absorbable cellulose mesh and fibrin glue was similar to that with mechanical abrasion after thoracoscopic bullectomy (13.8% vs. 14.2%, respectively; p = 0.555), but staple line coverage resulted in less postoperative residual pain than mechanical abrasion (0.4% vs.3.2%; p<0.0001). Pleural abrasion after thoracoscopic wedge resection did not decrease the recurrence of pneumothorax compared with wedge resection alone (p = 0.791), but the intraoperative bleeding and postoperative pleural drainage rates were higher when pleural abrasion was performed. Conclusions In addition to resulting in the same pneumothorax recurrence rate, thoracoscopic pleural abrasion with or without minocycline pleurodesis is safer than apical pleurectomy in the treatment of PSP. However, minocycline pleurodesis with or without pleural abrasion is not any more effective than pleural abrasion alone. Moreover, additional mechanical abrasion is not safer than additional staple line coverage with absorbable cellulose mesh and fibrin glue after thoracoscopic bullectomy because of increased postoperative pain. Additionally, pleural abrasion after thoracoscopic wedge resection should not be recommended for routine application due to the greater incidence of adverse effects than wedge resection alone. However, further large-scale, well-designed RCTs are needed to confirm the best procedure. PMID:26042737

Reducing the rate of early primary hip dislocation by combining a change in surgical technique and an increase in femoral head diameter to 36 mm.

PubMed

Ho, Ki Wai Kevin; Whitwell, George S; Young, Steve K

2012-07-01

We report how changes to our total hip arthroplasty (THA) surgical practise lead to a decrease in early hip dislocation rates. Group B consisted of 421 consecutive primary THA operations performed via a posterior approach. The operative technique included a meticulous repair of the posterior capsule, alignment of the acetabular cup with the transverse acetabular ligament (TAL) and a 36-mm-diameter femoral head. We compared the dislocation rates and cost implications of this technique to a historical control Group A consisting of 389 patients. The control group had their THA performed with no repair of the capsule, no identification of the TAL and all received a 28-mm-diameter head. Our primary outcome is the rate of early hip dislocation and we hypothesised that we can reduce the rate of early hip dislocation with this new regime. In Group B there were no early dislocations (within 6 months) and two (0.5 %) dislocations within 18 months; minimum follow-up time was 18 months with a range of (18-96 months). This compared to a 1.8 % early dislocation rate and a 2.6 % rate at 18 months in Group A; minimum follow-up time was 60 months with a range of (60-112 months). These results were statistically significant (p = 0.006). We suggest that when primary hip arthroplasty is performed through a posterior approach, a low early dislocation rate can be achieved using the described methods.

Internal or External Stenting of the Ureterovesical Anastomosis in Renal Transplantation.

PubMed

Fockens, M Matthijs; Alberts, Victor P; Bemelman, Frederike J; Laguna Pes, M Pilar; Idu, Mirza M

2016-01-01

Stenting of the ureterovesical anastomosis reduces the incidence of urological complications (UCs) after renal transplantation, but there are multiple stenting techniques, and there is no consensus regarding which technique is preferred. The aim of this study was to compare an internal versus an external stenting technique on the incidence of UCs. This is a retrospective analysis of 419 deceased donor renal transplantations performed between January 2008 and December 2013. Until 2011, 183 patients received an external stent through the ureterovesical anastomosis placed by suprapubic bladder puncture (SP stent). From 2011, 236 recipients received an internal double-J (JJ) stent. The rate of UC was 3.8% in JJ stents, compared to 9.3% in SP stents (p = 0.021). No difference in surgical ureter revision rate was observed between the groups (2.1 vs. 5.5%; p = 0.068). Urinary tract infection (UTI) rate and graft function were comparable between both groups. Internal JJ stenting significantly decreased the incidence of UC compared to an external SP stent. There was no difference in surgical ureter revision rate, UTI or graft function. © 2015 S. Karger AG, Basel.

Method of Euthanasia Influences the Oocyte Fertilization Rate with Fresh Mouse Sperm

PubMed Central

Hazzard, Karen C; Watkins-Chow, Dawn E; Garrett, Lisa J

2014-01-01

In vitro fertilization (IVF) is used to produce mouse embryos for a variety of reasons. We evaluated the effect of the method of euthanasia on the fertilization rate in 2 different IVF protocols. Oocytes collected from C57BL/6J female mice euthanized by CO2 inhalation or cervical dislocation were used in IVF with fresh sperm from either wild-type or genetically engineered C57BL/6J. Compared with CO2 inhalation, cervical dislocation improved the resulting rate of fertilization by 18% in an IVF method using Cook media and by 13% in an IVF method using methyl-B cyclodextrin and reduced glutathione. The lower fertilization rate due to euthanasia by CO2 inhalation was accompanied by changes in blood pH and body temperature despite efforts to minimize temperature drops. In our hands, euthanasia by cervical dislocation improved fertilization rates and consequently reduced the number of egg-donor mice required. PMID:25650969

A non-contact method based on multiple signal classification algorithm to reduce the measurement time for accurately heart rate detection

NASA Astrophysics Data System (ADS)

Bechet, P.; Mitran, R.; Munteanu, M.

2013-08-01

Non-contact methods for the assessment of vital signs are of great interest for specialists due to the benefits obtained in both medical and special applications, such as those for surveillance, monitoring, and search and rescue. This paper investigates the possibility of implementing a digital processing algorithm based on the MUSIC (Multiple Signal Classification) parametric spectral estimation in order to reduce the observation time needed to accurately measure the heart rate. It demonstrates that, by proper dimensioning the signal subspace, the MUSIC algorithm can be optimized in order to accurately assess the heart rate during an 8-28 s time interval. The validation of the processing algorithm performance was achieved by minimizing the mean error of the heart rate after performing simultaneous comparative measurements on several subjects. In order to calculate the error the reference value of heart rate was measured using a classic measurement system through direct contact.

Reducing non-attendance rates in a community mental health team.

PubMed

Filippidou, Maria; Lingwood, Susie; Mirza, Ilyas

2014-01-01

The project aimed to improve productivity of psychiatric out patient clinic using quality improvement techniques through "Listening Into Action", a national programme designed to engage and support front-line clinicians to make improvements to patient care. We identified reasons as to why our patients missed appointments and then introduced a system to reduce "did not attend" (DNA) rates. Non-attendance at appointments results in a waste of resources and increases waiting times. It has been reported that DNA rates in mental health are higher compared to other settings. Therefore, reducing DNA rates are a priority for mental health care providers. We collected DNA rates over a period of months over May 2013 to September 2013. We conducted a patient survey to inquire why the patients missed their appointments. The aim of the project and results from the survey were presented and discussed at the multi-disciplinary team meeting to generate ideas for improvement and engage the team with the project. As the most frequent response from the survey was 'forgetting the appointment', we decided to introduce text messaging as an intervention to remind patients of their appointments. We also ensured that staff updated the mobile phone records for the patients at each appointment. We monitored the DNA rates after introducing this change on a monthly basis. Following our intervention, there was an overall reduction in DNA rates for all disciplines from 11.4% to 10.62% with the greatest change for medical DNA's from 17.7% to 11.8 %. Results from a patient survey showed that the reasons for non-attendance are multi-factorial and require a complex approach. Our intervention was a simple one but still it demonstrated some effectiveness. Reducing DNA rates requires interventions to be regularly monitored so that their effect is sustained over a period of time.

Linking mileage to auto accident risk and urban form.

DOT National Transportation Integrated Search

2013-08-01

Pricing auto insurance on a per-mile basis provides a beneficial, cost-based incentive to : reduce vehicle miles traveled compared with traditional rating plans that charge annual : premiums with little or no consideration of miles driven. : The rese...

Cracking and debonding of a thin fiber reinforced concrete overlay.

DOT National Transportation Integrated Search

2017-04-01

Previous field studies suggested that macro-fibers incorporated in thin overlay pavements will result in reduced crack opening widths, vertical deflections, and debonding rates compared to that of unreinforced overlays. A simple finite element (FE) m...

Assessment of grass root effects on soil piping in sandy soils using the pinhole test

NASA Astrophysics Data System (ADS)

Bernatek-Jakiel, Anita; Vannoppen, Wouter; Poesen, Jean

2017-10-01

Soil piping is an important land degradation process that occurs in a wide range of environments. Despite an increasing number of studies on this type of subsurface erosion, the impact of vegetation on piping erosion is still unclear. It can be hypothesized that vegetation, and in particular plant roots, may reduce piping susceptibility of soils because roots of vegetation also control concentrated flow erosion rates or shallow mass movements. Therefore, this paper aims to assess the impact of grass roots on piping erosion susceptibility of a sandy soil. The pinhole test was used as it provides quantitative data on pipeflow discharge, sediment concentration and sediment discharge. Tests were conducted at different hydraulic heads (i.e., 50 mm, 180 mm, 380 mm and 1020 mm). Results showed that the hydraulic head was positively correlated with pipeflow discharge, sediment concentration and sediment discharge, while the presence of grass roots (expressed as root density) was negatively correlated with these pipeflow characteristics. Smaller sediment concentrations and sediment discharges were observed in root-permeated samples compared to root-free samples. When root density exceeds 0.5 kg m- 3, piping erosion rates decreased by 50% compared to root-free soil samples. Moreover, if grass roots are present, the positive correlation between hydraulic head and both sediment discharge and sediment concentration is less pronounced, demonstrating that grass roots become more effective in reducing piping erosion rates at larger hydraulic heads. Overall, this study demonstrates that grass roots are quite efficient in reducing piping erosion rates in sandy soils, even at high hydraulic head (> 1 m). As such, grass roots may therefore be used to efficiently control piping erosion rates in topsoils.

Causes and Disparities in Death Rates Among Urban American Indian and Alaska Native Populations, 1999–2009

PubMed Central

Espey, David K.; Groom, Amy V.; Phillips, Leslie E.; Haverkamp, Donald S.; Stanley, Sandte L.

2016-01-01

Objectives. To characterize the leading causes of death for the urban American Indian/Alaska Native (AI/AN) population and compare with urban White and rural AI/AN populations. Methods. We linked Indian Health Service patient registration records with the National Death Index to reduce racial misclassification in death certificate data. We calculated age-adjusted urban AI/AN death rates for the period 1999–2009 and compared those with corresponding urban White and rural AI/AN death rates. Results. The top-5 leading causes of death among urban AI/AN persons were heart disease, cancer, unintentional injury, diabetes, and chronic liver disease and cirrhosis. Compared with urban White persons, urban AI/AN persons experienced significantly higher death rates for all top-5 leading causes. The largest disparities were for diabetes and chronic liver disease and cirrhosis. In general, urban and rural AI/AN persons had the same leading causes of death, although urban AI/AN persons had lower death rates for most conditions. Conclusions. Urban AI/AN persons experience significant disparities in death rates compared with their White counterparts. Public health and clinical interventions should target urban AI/AN persons to address behaviors and conditions contributing to health disparities. PMID:26890168

SU-F-J-45: Sparing Normal Tissue with Ultra-High Dose Rate in Radiation Therapy

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

Feng, Y

Purpose: To spare normal tissue by reducing the location uncertainty of a moving target, we proposed an ultra-high dose rate system and evaluated. Methods: High energy electrons generated with a linear accelerator were injected into a storage ring to be accumulated. The number of the electrons in the ring was determined based on the prescribed radiation dose. The dose was delivered within a millisecond, when an online imaging system found that the target was in the position that was consistent with that in a treatment plan. In such a short time period, the displacement of the target was negligible. Themore » margin added to the clinical target volume (CTV) could be reduced that was evaluated by comparing of volumes between CTV and ITV in 14 cases of lung stereotactic body radiation therapy (SBRT) treatments. A design of the ultra-high dose rate system was evaluated based clinical needs and the recent developments of low energy (a few MeV) electron storage ring. Results: This design of ultra-high dose rate system was feasible based on the techniques currently available. The reduction of a target volume was significant by reducing the margin that accounted the motion of the target. ∼50% volume reduction of the internal target volume (ITV) could be achieved in lung SBRT treatments. Conclusion: With this innovation of ultra-high dose rate system, the margin of target is able to be significantly reduced. It will reduce treatment time of gating and allow precisely specified gating window to improve the accuracy of dose delivering.« less

Clomiphene citrate increases nitric oxide, interleukin-10 and reduces matrix metalloproteinase-9 in women with polycystic ovary syndrome.

PubMed

Sylus, Angel Mercy; Nandeesha, Hanumanthappa; Sridhar, Magadi Gopalakrishna; Chitra, Thyagaraju; Sreenivasulu, Karli

2018-06-08

Matrix metalloproteinase-9, Nitric oxide and inflammation plays a role in the pathogenesis of poly cystic ovary syndrome (PCOS). Even though these parameters are altered in PCOS, the effect of clomiphene citrate on them has not been studied till date. The present study was done to assess the effect of clomiphene citrate on matrix metalloproteinase-9, nitric oxide and interleukin-10 levels in women with PCOS. 72 women diagnosed with PCOS were enrolled in the study. Matrix metalloproteinase-9, nitric oxide and interleukin-10 levels were compared at baseline and after three weeks following Clomiphene citrate treatment. Clomiphene citrate increases both nitric oxide (p = 0.03) and interleukin-10 (p < 0.001) levels and reduces matrix metalloproteinase-9 levels (p < 0.001) in women with PCOS. It also improves the ovulation rate (52.8%) and clinical pregnancy rate (19.4%) in PCOS. Also there was a significant reduction in matrix metalloproteinase-9 levels in both the ovulatory (p < 0.001) and conceived groups (p = 0.024) compared to non ovulatory and non conceived group. There was no difference in nitric oxide and interleukin-10 levels in ovulatory and conceived groups compared to non ovulatory and non conceived group. We conclude that clomiphene citrate increases the levels of nitric oxide and interleukin-10 and decreases the matrix metalloproteinase - 9 levels and improves the ovulation rate and clinical pregnancy rate in PCOS. Copyright © 2018 Elsevier B.V. All rights reserved.

Low body mass index compromises live birth rate in fresh transfer in vitro fertilization cycles: a retrospective study in a Chinese population.

PubMed

Cai, Jiali; Liu, Lanlan; Zhang, Junwen; Qiu, Huiling; Jiang, Xiaoming; Li, Ping; Sha, Aiguo; Ren, Jianzhi

2017-02-01

To evaluate the effects of low body mass index (BMI) on in vitro fertilization (IVF) outcomes in fresh transfer cycles. Retrospective cohort study. University-affiliated hospital. A total of 4,798 cycles with conventional stimulation and fresh transfer in a single IVF center during the period 2013-2014. Low BMI (<18.5 kg/m 2 ) was defined according to World Health Organization guidelines, and cycles within a normal weight range (18.5-24.9 kg/m 2 ) were used as reference. None. Live birth rate per fresh embryo transfer. Low BMI was associated with reduced live birth rates and increased miscarriage rates compared with normal weight, controlling for important covariates known to influence IVF outcomes. Patient age was the most potent confounder, causing a 10.5% reduction in the odds ratio (OR) for live birth between the groups compared. When an interaction term (age × BMI) was introduced, the OR for live birth was reduced in cycles of those aged ≥35 years compared with cycles of those aged 28-34 years, whereas the change in OR between cycles in those aged <28 and cycles in those aged 28-34 years was insignificant. Low BMI is associated with negative outcomes in fresh transfer cycles, especially for women of advanced age. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

A randomized trial of povidone-iodine compared with iodine tincture for venipuncture site disinfection: effects on rates of blood culture contamination.

PubMed

Little, J R; Murray, P R; Traynor, P S; Spitznagel, E

1999-08-01

Contamination of blood cultures creates problems in their interpretation and unneeded resource utilization. Because skin flora comprise the major group of contaminant species, more effective skin disinfection at the venipuncture site could reduce contamination. We performed a randomized trial in adult inpatients at a tertiary care teaching hospital. Antecubital venipuncture sites were randomly disinfected with povidone-iodine or iodine tincture, and blood cultures (two bottles, 10 mL of blood) were drawn by professional phlebotomists. Scoring of contaminant species was restricted to skin flora. Hospital resource utilization was compared among patients with contaminated blood cultures and those with sterile blood cultures. Of the 3,851 blood cultures collected during the study, 120 (3.1%) were contaminated with skin flora. The contamination rate for blood cultures collected after povidone-iodine was 3.8% (74 of 1,947), compared with a rate of 2.4% (46 of 1,904, P = 0.01) after iodine tincture. The difference in mean total hospital costs for patients with contaminated blood cultures and those with sterile blood cultures was $4,100 (95% confidence interval: $740 to $7,400, P = 0.02). Iodine tincture is superior to povidone-iodine for venipuncture site antisepsis before blood culture sampling. Because of the high costs associated with contaminated blood cultures, hospitals should consider switching from povidone-iodine to iodine tincture. Reduction of the contamination rate may improve the quality of patient care and reduce hospital costs.

Effect of loss control service on reported injury incidence.

PubMed

Nave, Michael E; Veltri, Anthony

2004-01-01

A retrospective analysis evaluated the effectiveness of an insurance carrier's flexible loss control service strategy in reducing workers' compensation policyholders' reported injury and illness claims. To assess the effects of a loss control service strategy on workers' compensation claim frequency rates, on medical-only claim rates, on severity-claim rates, and on claim cost among a group of California employers. Eighty-two small- and medium-sized companies with workers' compensation policies expiring in 1999 were randomly selected from a population of policyholders assigned to loss control consultants for two or more years. Claim performance data were obtained for each company's first expired in-force policy year and its 1999 expired policy year. The retrospective design was combined with a control component based on a randomly selected comparison group of 45 companies whose first policy year with the insurer expired in 1999 and who received safety services from the loss control staff. The flexible loss control consultation service strategy was associated with lower average claim rates and costs. Companies assigned to a loss control consultant for two or more years (the "outcome group") had an average claim rate of 1.24 per $10,000 premium, compared with a rate of 1.62 in the "initial group" and a rate of 1.60 in the "comparison group." The average severity-claim rate of the outcome group was 0.32, compared with the initial-year and comparison-group means of 0.48 and 0.46, respectively. The average medical-only claim rate was 0.92, compared with the initial- and comparison-group means of 1.14 and 1.14. The outcome group's average loss ratio was over 10% lower than that of the initial and comparison groups. Statistical analysis indicated that differences among the groups' claim rates and severity-claim rates were [F=(2,206) 4.938, P=0.008] and [F=(2,206) 8.208, P<0.001], respectively. A loss control service strategy that provides service flexibility and develops partnership between employer and consultant can help reduce the frequency and severity of workers' compensation claims. Barriers to consultation service flexibility, both internal and external, should be identified and removed to enhance service efficacy.

Depression and reduced heart rate variability after cardiac surgery: the mediating role of emotion regulation.

PubMed

Patron, Elisabetta; Messerotti Benvenuti, Simone; Favretto, Giuseppe; Gasparotto, Renata; Palomba, Daniela

2014-02-01

Heart rate variability (HRV), as an index of autonomic nervous system (ANS) functioning, is reduced by depression after cardiac surgery, but the underlying mechanisms of this relationship are poorly understood. Poor emotion regulation as a core symptom of depression has also been associated with altered ANS functioning. The present study aimed to examine whether emotion dysregulation could be a mediator of the depression-reduced HRV relationship observed after cardiac surgery. Self-reported emotion regulation and four-minute HRV were measured in 25 depressed and 43 nondepressed patients after cardiac surgery. Mediation analysis was conducted to evaluate emotion regulation as a mediator of the depression-reduced HRV relationship. Compared to nondepressed patients, those with depression showed lower standard deviation of normal-to-normal (NN) intervals (p<.05), root mean square successive difference of NN intervals (p<.004), and number of interval differences of successive NN intervals greater than 50ms (NN50) (p<.05). Increased low frequency (LF) in normalized units (n.u.) and reduced high frequency (HF) n.u. were also found in depressed compared to nondepressed patients (p's<.01). Mediation analysis revealed that suppression of emotion-expressive behavior partially mediated the effect of depression on LF n.u. and HF n.u. Results confirmed previous findings showing that depression is associated with reduced HRV, especially a reduced vagal tone and a sympathovagal imbalance, after cardiac surgery. This study also provides preliminary evidence that increased trait levels of suppression of emotion-expressive behavior may mediate the depression-related sympathovagal imbalance after cardiac surgery. Copyright © 2013 Elsevier B.V. All rights reserved.

The benefit of heart rate variability biofeedback and relaxation training in reducing trait anxiety.

PubMed

Lee, Jieun; Kim, Jung K; Wachholtz, Amy

Previous research studies have indicated that biofeedback treatment and relaxation techniques are effective in reducing psychological and physical symptoms (Hammond, 2005; Manzoni, G. M., Pagnini, F., Castelnuovo, G., & Molinari, E., 2008). However, dearth of studies has compared heart rate variability (HRV) biofeedback treatment and relaxation training to reduce trait anxiety. The objective of this study was to determine the effect of HRV biofeedback treatment and relaxation training in reducing trait anxiety compared to control group without any treatment using students in a science and engineering university of South Korea. For the present study, a total of 15 graduate students with moderate level of trait anxiety were recruited for 4 individual sessions every two weeks. They were randomly assigned into three groups: biofeedback treatment (n = 5), relaxation training (n = 5), and no treatment control group (n = 5). Our results revealed significant difference in change score of trait anxiety between the HRV biofeedback treatment and the no treatment control group. However, no significant difference was found between the relaxation training group and the no treatment control group. In addition, there was no significant difference between the HRV biofeedback treatment and the relaxation training. Results of the present study indicate that there is potential benefit in utilizing HRV biofeedback treatment for stress management programs and/or anxiety reduction treatment.

Comparison of polyvinyl alcohol and tris-acryl gelatin microsphere materials in embolization for symptomatic leiomyomas: a systematic review.

PubMed

Jiang, Wenxiao; Shen, Zhaojun; Luo, Hui; Hu, Xiaoli; Zhu, Xueqiong

2016-12-01

Use systematic reviews and meta-analyses to assess the effect of polyvinyl alcohol and tris-acryl gelatin microsphere materials in leiomyoma embolization for symptomatic leiomyomas. We included randomised controlled studies published before January 2015 comparing polyvinyl alcohol and tris-acryl gelatin microsphere materials in uterine leiomyoma embolization for women with symptomatic leiomyomas. The main outcome measures included change of overall quality of life, change of overall symptom severity, changes of uterine and leiomyoma volumes, leiomyoma infarction rate, treatment failure and complications. A total of six randomized controlled studies from 335 studies accounting for 351 women with leiomyomas were identified in this meta-analysis. Compared to polyvinyl alcohol, tris-acryl gelatin microsphere showed a significant benefit in improving the overall quality of life and in reducing uterine volume at three and six months, in reducing overall symptom severity at 6 and 12 months, and furthermore in reducing treatment failure. In addition, tris-acryl gelatin microsphere could significantly reduce leiomyoma volume and decrease <90% complete leiomyoma infarction rate at three months. There were no differences in pain severity, other post-procedural symptoms or medication use in the two groups. A better effect of tris-acryl gelatin microsphere in leiomyoma embolization for patients with symptomatic leiomyoma.

Quantifying sources of bias in National Healthcare Safety Network laboratory-identified Clostridium difficile infection rates.

PubMed

Haley, Valerie B; DiRienzo, A Gregory; Lutterloh, Emily C; Stricof, Rachel L

2014-01-01

To assess the effect of multiple sources of bias on state- and hospital-specific National Healthcare Safety Network (NHSN) laboratory-identified Clostridium difficile infection (CDI) rates. Sensitivity analysis. A total of 124 New York hospitals in 2010. New York NHSN CDI events from audited hospitals were matched to New York hospital discharge billing records to obtain additional information on patient age, length of stay, and previous hospital discharges. "Corrected" hospital-onset (HO) CDI rates were calculated after (1) correcting inaccurate case reporting found during audits, (2) incorporating knowledge of laboratory results from outside hospitals, (3) excluding days when patients were not at risk from the denominator of the rates, and (4) adjusting for patient age. Data sets were simulated with each of these sources of bias reintroduced individually and combined. The simulated rates were compared with the corrected rates. Performance (ie, better, worse, or average compared with the state average) was categorized, and misclassification compared with the corrected data set was measured. Counting days patients were not at risk in the denominator reduced the state HO rate by 45% and resulted in 8% misclassification. Age adjustment and reporting errors also shifted rates (7% and 6% misclassification, respectively). Changing the NHSN protocol to require reporting of age-stratified patient-days and adjusting for patient-days at risk would improve comparability of rates across hospitals. Further research is needed to validate the risk-adjustment model before these data should be used as hospital performance measures.

Effects of Mycoplasma anatis and cold stress on hatching success and growth of mallard ducklings

USGS Publications Warehouse

Samuel, M.D.; Goldberg, Diana R.; Thomas, C.B.; Sharp, P.

1995-01-01

We inoculated game-farm mallard (Anas platyrhynchos) eggs and 1-day-old birds with Mycoplasma anatis to determine its effect on hatching success and growth rates of ducklings. Inoculations of eggs reduced hatching success, hatchling size, and duckling growth rates, compared to controls. Intratracheal inoculations of 1-day-old birds did not affect growth rates. Hatchlings and 1-day-old ducklings grew much slower for the first 7 to 10 days when raised at 17 to 19 C, compared to controls raised at 30 to 35 C. The effect of cold stress on growth was greater than the effect of M. anatis infection; we found no synergistic effects between cold stress and M. anatis infection.

Performance study of thin epitaxial silicon PIN detectors for thermal neutron measurements with reduced γ sensitivity

NASA Astrophysics Data System (ADS)

Singh, Arvind; Desai, Shraddha; Kumar, Arvind; Topkar, Anita

2018-05-01

A novel approach of using thin epitaxial silicon PIN detectors for thermal neutron measurements with reduced γ sensitivity has been presented. Monte Carlo simulations showed that there is a significant reduction in the gamma sensitivity for thin detectors with the thickness of 10- 25 μm compared to a detector of thickness of 300 μm. Epitaxial PIN silicon detectors with the thickness of 10 μm, 15 μm and 25 μm were fabricated using a custom process. The detectors exhibited low leakage currents of a few nano-amperes. The gamma sensitivity of the detectors was experimentally studied using a 33 μCi, 662 keV, 137Cs source. Considering the count rates, compared to a 300 μm thick detector, the gamma sensitivity of the 10 μm, 15 μm and 25 μm thick detectors was reduced by factors of 1874, 187 and 18 respectively. The detector performance for thermal neutrons was subsequently investigated with a thermal neutron beam using an enriched 10B film as a neutron converter layer. The thermal neutron spectra for all three detectors exhibited three distinct regions corresponding to the 4He and 7Li charge products released in the 10B-n reaction. With a 10B converter, the count rates were 1466 cps, 3170 cps and 2980 cps for the detectors of thicknesses of 10 μm, 25 μm and 300 μm respectively. The thermal neutron response of thin detectors with 10 μm and 25 μm thickness showed significant reduction in the gamma sensitivity compared to that observed for the 300 μm thick detector. Considering the total count rate obtained for thermal neutrons with a 10B converter film, the count rate without the converter layer were about 4%, 7% and 36% for detectors with thicknesses of 10 μm, 25 μm and 300 μm respectively. The detector with 10 μm thickness showed negligible gamma sensitivity of 4 cps, but higher electronic noise and reduced pulse heights. The detector with 25 μm thickness demonstrated the best performance with respect to electronic noise, thermal neutron response and gamma sensitivity.

Cladribine tablets: in relapsing-remitting multiple sclerosis.

PubMed

Muir, Victoria J; Plosker, Greg L

2011-03-01

Cladribine, an immunosuppressant that selectively reduces peripheral lymphocyte levels, has potential as an oral therapy for relapsing-remitting multiple sclerosis. An oral (tablet) formulation is being investigated in clinical trials. In the large, well designed, phase III CLARITY trial, short-course treatment with oral cladribine (cumulative dose of 3.5 or 5.25 mg/kg) resulted in a significantly greater reduction in annualized relapse rates at 96 weeks compared with placebo in patients with relapsing-remitting multiple sclerosis. Improvements in the annualized relapse rate with oral cladribine were independent of key baseline patient characteristics which included age, sex, previous treatment with disease-modifying drugs and the number of relapses in the previous 12 months. In addition, a significantly higher proportion of patients were relapse-free at 96 weeks and there were significant reductions in the risk of 3-month sustained progression of disability in cladribine recipients compared with placebo recipients. The mean numbers of brain lesions on magnetic resonance imaging were also significantly reduced with cladribine compared with placebo in the CLARITY trial. Lymphocytopenia, herpes zoster infections and neoplasms (including malignancies) were more common in cladribine than placebo recipients.

Television food advertising viewed by preschoolers, children and adolescents: contributors to differences in exposure for black and white youth in the United States.

PubMed

Fleming-Milici, F; Harris, J L

2018-02-01

Public health experts raise concerns about adolescents' and black youth's greater exposure to TV advertising for unhealthy foods and beverages compared with children and white youth. Examine how television-viewing patterns and rates of advertising during targeted programming contribute to this greater exposure. Nielsen panel data provided viewing times and amount of food advertising viewed on U.S. television in 2008 and 2012. Researchers compared results by network type (black-, child- and youth-targeted), age group (preschoolers, children and adolescents) and race (black and white youth). Food advertising exposure increased with age for both black and white youth, but black youth viewed approximately 50% or more ads than did white youth of the same age. Higher rates of food advertising on youth-targeted networks explained greater adolescent exposure. However, greater television viewing and higher rates of advertising on youth- and black-targeted networks both contributed to black youth's greater exposure. From 2008 to 2012, increases in food-ads-per-hour increased exposure for all youth. Food advertisers and networks, especially those targeting adolescents and black youth, must do more to reduce advertising that negatively impacts young people's health. Furthermore, reducing commercial-television viewing by black youth may help reduce health disparities affecting their communities. © 2016 World Obesity Federation.

Long-term microplastic retention causes reduced body condition in the langoustine, Nephrops norvegicus.

PubMed

Welden, Natalie A C; Cowie, Phillip R

2016-11-01

Microplastic represents a rising proportion of marine litter and is widely distributed throughout a range of marine habitats. Correspondingly, the number of reports of species containing microplastics increases annually. Nephrops norvegicus in the Firth of Clyde have previously been shown to retain large aggregations of microplastic fibres. The potential for N. norvegicus to retain plastic over an extended time period increases the likelihood of any associated negative impacts to the individual. This study represents the longest observation of the impacts of microplastic retention in invertebrates. We exposed N. norvegicus to plastic over eight months to determine the impacts of extended exposure. Over this period we compared the feeding rate, body mass, and nutritional state of plastic-fed N. norvegicus to that of fed and starved control groups. Following the experimental period, the plastic-fed langoustine contained microplastic aggregations comparable to those of small individuals from the Clyde Sea Area. Comparisons between fed, unfed and plastic-fed individuals indicated a reduction in feeding rate, body mass, and metabolic rate as well as catabolism of stored lipids in plastic contaminated animals. We conclude that N. norvegicus exposed to high levels of environmental microplastic pollution may experience reduced nutrient availability. This can result in reduced population stability and may affect the viability of local fisheries. Copyright © 2016 Elsevier Ltd. All rights reserved.

Models to compare management options for a protogynous fish.

PubMed

Heppell, Selina S; Heppell, Scott A; Coleman, Felicia C; Koenig, Christopher C

2006-02-01

Populations of gag (Mycteroperca microlepis), a hermaphroditic grouper, have experienced a dramatic shift in sex ratio over the past 25 years due to a decline in older age classes. The highly female-skewed sex ratio can be predicted as a consequence of increased fishing mortality that truncates the age distribution, and raises some concern about the overall fitness of the population. Management efforts may need to be directed toward maintenance of sex ratio as well as stock size, with evaluations of recruitment based on sex ratio or male stock size in addition to the traditional female-based stock-recruitment relationship. We used two stochastic, age-structured models to heuristically compare the effects of reducing fishing mortality on different life history stages and the relative impact of reductions in fertilization rates that may occur with highly skewed sex ratios. Our response variables included population size, sex ratio, lost egg fertility, and female spawning stock biomass. Population growth rates were highest for scenarios that reduced mortality for female gag (nearshore closure), while improved sex ratios were obtained most quickly with spawning reserves. The effect of reduced fertility through sex ratio bias was generally low but depended on the management scenario employed. Our results demonstrate the utility of evaluation of fishery management scenarios through model analysis and simulation, the synergistic interaction of life history and response to changes in mortality rates, and the importance of defining management goals.

Superior Analgesic Effect of an Active Distraction versus Pleasant Unfamiliar Sounds and Music: The Influence of Emotion and Cognitive Style

PubMed Central

Garza Villarreal, Eduardo A.; Brattico, Elvira; Vase, Lene; Østergaard, Leif; Vuust, Peter

2012-01-01

Listening to music has been found to reduce acute and chronic pain. The underlying mechanisms are poorly understood; however, emotion and cognitive mechanisms have been suggested to influence the analgesic effect of music. In this study we investigated the influence of familiarity, emotional and cognitive features, and cognitive style on music-induced analgesia. Forty-eight healthy participants were divided into three groups (empathizers, systemizers and balanced) and received acute pain induced by heat while listening to different sounds. Participants listened to unfamiliar Mozart music rated with high valence and low arousal, unfamiliar environmental sounds with similar valence and arousal as the music, an active distraction task (mental arithmetic) and a control, and rated the pain. Data showed that the active distraction led to significantly less pain than did the music or sounds. Both unfamiliar music and sounds reduced pain significantly when compared to the control condition; however, music was no more effective than sound to reduce pain. Furthermore, we found correlations between pain and emotion ratings. Finally, systemizers reported less pain during the mental arithmetic compared with the other two groups. These findings suggest that familiarity may be key in the influence of the cognitive and emotional mechanisms of music-induced analgesia, and that cognitive styles may influence pain perception. PMID:22242169

Tooth wear prevention: a quantitative and qualitative in vitro study.

PubMed

Kaidonis, J A; Gratiaen, J; Bhatia, N; Richards, L C; Townsend, G C

2003-03-01

Management of tooth wear from grinding presents a significant clinical challenge. Acrylic nightguards are often used to protect the teeth, but many patients still grind with these appliances. This study aimed to test the effectiveness of three lubricants in reducing enamel wear by using an electro-mechanical machine under controlled conditions, with a view to undertaking a subsequent longitudinal clinical study. Sectioned tooth specimens were worn against each other under different loads and with the addition of three different lubricants: calcium fluoride (CaF) powder, olive-oil, and a combination of calcium fluoride with olive-oil in the form of a slurry. Wear rates of enamel only were quantified by weighing the specimens, and resin replicas of the worn tooth surfaces were made for examination under a scanning electron microscope. All three lubricants reduced the amount of enamel wear significantly compared with wearing specimens without adding lubricants. Wear rate was influenced by the type of lubricant and the load applied. Wear rates were significantly less for olive-oil and the olive-oil/CaF slurry compared with CaF alone. The microwear detail differed between the three lubricants. This study has shown that enamel wear can be reduced using dry or wet lubricants between opposing teeth that are worn under controlled conditions. Further research is required to clarify their possible clinical applications.

Characterization and minimization of the stress response to trapping in free-ranging wolves (Canis lupus): insights from physiology and behavior.

PubMed

Santos, Nuno; Rio-Maior, Helena; Nakamura, Mónia; Roque, Sara; Brandão, Ricardo; Álvares, Francisco

2017-09-01

Wildlife capture is an essential management tool that induces a reactive homeostasis response in the captured animals. The aim of this study was to characterize the reactive homeostatic response to trapping in free-ranging wolves and assess the mitigation achieved by reducing the duration of restraint. Making use of wolves captured for ecological research as a model for wildlife acute stress, we characterize 25 reactive homeostasis mediators and we assess the effect on these mediators of reducing the duration of restraint in trap by using remote trap activation alarms. Free-ranging wolves trapped by leg-hold snares (n = 15) showed higher stress leukogram, tissue injury and hematocrit; while lower glucose, ions and cardiac rate compared with captive wolves. They also showed higher leukocyte count and creatine kinase; but lower hematocrit, cardiac rate and rectal body temperature compared to wolves captured by darting from a helicopter. Daily distance travelled was significantly lower up to day 12 post-capture compared to the remainder of the telemetry follow-up and this effect was more noticeable on the nocturnal distance travelled. Reducing the duration of restraint on trap significantly lowered the stress leukogram and dehydration. Daily distance travelled during the night by wolves captured using trap-alarms was significantly lower only up to day 4 post-capture compared to up to day 28 for wolves captured without trap-alarms. The capture method and duration of restraint influence the reactive homeostasis response of free-ranging wolves. Technological solutions that reduce the duration of restraint on trap significantly dampen this influence. Wildlife trapping actions should strive to minimize the delay from capture to manipulation.

Frequent Hemodialysis Schedules Are Associated with Reduced Levels of Dialysis-induced Cardiac Injury (Myocardial Stunning)

PubMed Central

Jefferies, Helen J.; Virk, Bhupinder; Schiller, Brigitte; Moran, John

2011-01-01

Summary Background and objectives Recurrent hemodialysis (HD)-induced ischemic cardiac injury (myocardial stunning) is common and associated with high ultrafiltration (UF) requirements, intradialytic hypotension, long-term loss of systolic function, increased likelihood of cardiovascular events, and death. More frequent HD regimens are associated with lower UF requirements and improved hemodynamic tolerability, improved cardiovascular outcomes, and reduced mortality compared with conventional thrice-weekly HD. This study investigated the hypothesis that modification of UF volume and rate with more frequent HD therapies would abrogate dialysis-induced myocardial stunning. Design, settings, participants, & measurements A cross-sectional study of 46 patients established on hemodialysis >3 months compared four groups receiving the current range of quotidian therapies: conventional thrice-weekly HD (CHD3); more-frequent HD five to six times/week in a center (CSD) and at home (HSD); and home nocturnal HD (HN). Serial echocardiography quantitatively assessed regional systolic function to identify intradialytic left ventricular regional wall motion abnormalities (RWMAs). Cardiac troponin T (cTnT), N-terminal prohormone brain natriuretic peptide (NT-proBNP), and inflammatory markers were quantified. Results More frequent HD regimens were associated with lower UF volumes and rates compared with CHD3. Intradialytic fall in systolic BP was reduced in CSD and HSD groups and abolished in HN group. Mean RWMAs per patient reduced with increasing dialysis intensity (CHD3 > CSD > HSD > HN). Home-based groups demonstrated lower high-sensitivity C-reative protein levels, with trends to lower cTnT and NT-proBNP levels in the more frequent groups. Conclusions Frequent HD regimes are associated with less dialysis-induced myocardial stunning compared with conventional HD. This may contribute to improved outcomes associated with frequent HD therapies. PMID:21597028

Dynamics of heart rate variability analysed through nonlinear and linear dynamics is already impaired in young type 1 diabetic subjects.

PubMed

Souza, Naiara M; Giacon, Thais R; Pacagnelli, Francis L; Barbosa, Marianne P C R; Valenti, Vitor E; Vanderlei, Luiz C M

2016-10-01

Autonomic diabetic neuropathy is one of the most common complications of type 1 diabetes mellitus, and studies using heart rate variability to investigate these individuals have shown inconclusive results regarding autonomic nervous system activation. Aims To investigate the dynamics of heart rate in young subjects with type 1 diabetes mellitus through nonlinear and linear methods of heart rate variability. We evaluated 20 subjects with type 1 diabetes mellitus and 23 healthy control subjects. We obtained the following nonlinear indices from the recurrence plot: recurrence rate (REC), determinism (DET), and Shanon entropy (ES), and we analysed indices in the frequency (LF and HF in ms2 and normalised units - nu - and LF/HF ratio) and time domains (SDNN and RMSSD), through analysis of 1000 R-R intervals, captured by a heart rate monitor. There were reduced values (p<0.05) for individuals with type 1 diabetes mellitus compared with healthy subjects in the following indices: DET, REC, ES, RMSSD, SDNN, LF (ms2), and HF (ms2). In relation to the recurrence plot, subjects with type 1 diabetes mellitus demonstrated lower recurrence and greater variation in their plot, inter-group and intra-group, respectively. Young subjects with type 1 diabetes mellitus have autonomic nervous system behaviour that tends to randomness compared with healthy young subjects. Moreover, this behaviour is related to reduced sympathetic and parasympathetic activity of the autonomic nervous system.

Impact of severity of congenital heart diseases on university graduation rate among male patients.

PubMed

Özcan, Emin Evren; Küçük, Alaattin

2012-04-01

This study examines university graduation rates among individuals with congenital heart disease (CHD) in comparison to their healthy peers. The effect of disease severity, type of surgery, and timing of surgery on graduation rate was also evaluated. One hundred forty-five male patients with CHD at military age were enrolled in the study between the dates of January 2005 and May 2007. Severity of disease was operationalised in term of initial diagnosis (According to classification of 32th ACC Bethesta Conference Task Force 1). University graduation rates of among two groups of CHD patients (mild disease (group 1) or moderate to severe disease (group 2)) are compared to each other and to healthy peers. Patients with CHD have reduced rates of participation in higher education compared with healthy individuals (13.1% vs 20.7%, p=0.01). Furthermore, this negative effect on education participation rate is independent of the severity of disease (group 1, 16.4%, p=0.01; group 2, 9.7%, p<0.001). Although the university graduation rate was relatively higher in patients with mild disease severity, no significant difference was found between the two patient groups (p=0.23). Having an operation does not effect graduation rate (p=0.58), however greater age at the time of operation increases the likelihood of graduation (p=0.02). Being born with CHD significantly reduces the chance of completing higher education. This negative impact on university graduation rate is independent of the severity of the disease. No negative effects of disease related surgery or subsequent corrective surgery on education were observed. Patients who were operated on later in life were more likely to complete university education. Mean operation age of this group corresponds to the typical age during the last year of elementary school in Turkey.

Effects of Speaking Rate on Word Recognition in Parkinson’s Disease and Normal Aging

PubMed Central

Forrest, Karen; Nygaard, Lynne; Pisoni, David B.; Siemers, Eric

2011-01-01

Current theories of basal ganglia function emphasize their role in the integration of sensory information into motor activities, particularly in the control of movement timing. People with basal ganglia disorders such as Parkinson’s disease exhibit poor temporal control of movements, in general and articulation in particular, as demonstrated by irregular speaking rate, reduced stress contrasts, and reduced movement durations and velocities. Previous research has implicated sensory deficits as contributory factors in limb movement control in patients with Parkinson’s disease; however, the relation between sensory deficits and speech-movement abnormalities has not been documented. In the present study, the existence of perceptual processing difficulties of speaking rate was investigated in subjects with Parkinsonian dysarthria (PD). Comparisons in perception were made between subjects with PD, neurologically normal geriatrics (GN) and neurologically normal young adults (YN) for accuracy in identification of words presented at different speaking rates. We hypothesized that word-identification scores would be lower for PD and GN subjects compared to the YN subjects, an effect that was supported by the data. We also expected that there would be differences between the GN and PD subjects in their accuracy of word identification at a faster speaking rate, an hypothesis that was not supported by the data. Rather, GN and PD subjects differed in identification scores for words spoken at a slow rate. PD subjects who had faster habitual speaking rates (HSR) had significantly lower word-identification scores in the slow compared to conversational rate conditions, a relation that was significant r = +0.64). These data suggest the need to consider perceptual deficits as an additional factor that contributes to rate variations in PD speech. PMID:21637728

Age-related changes in the auditory brainstem response.

PubMed

Konrad-Martin, Dawn; Dille, Marilyn F; McMillan, Garnett; Griest, Susan; McDermott, Daniel; Fausti, Stephen A; Austin, Donald F

2012-01-01

This cross-sectional study had two goals: (1) Identify and quantify the effects of aging on the auditory brainstem response (ABR); (2) Describe how click rate and hearing impairment modify effects of aging. RESEARCH DESIGN AND ANALYSIS: ABR measures were obtained from 131 predominately male Veteran participants aged 26 to 71 yr. Metrics analyzed include amplitude and latency for waves I, III, and V, and the I-V interpeak latency interval (IPI) at three repetition rates (11, 51, and 71 clicks/sec) using both polarities. In order to avoid confounding from missing data due to hearing impairment, participants had hearing thresholds <40 dB HL at 2 kHz and 70 dB HL at 4 kHz in at least one ear. Additionally, the median 2, 3, and 4 kHz pure tone threshold average (PTA2,3,4) for the sample, ∼17 dB HL, was used to delineate subgroups of better and worse hearing ears, and only the better hearing sample was modeled statistically. We modeled ABR responses using age, repetition rate, and PTA2,3,4 as covariates. Random effects were used to model correlation between the two ears of a subject and across repetition rates. Inferences regarding effects of aging on ABR measures at each rate were derived from the fitted model. Results were compared to data from subjects with poorer hearing. Aging substantially diminished amplitudes of all of the principal ABR peaks, largely independent of any threshold differences within the group. For waves I and III, age-related amplitude decrements were greatest at a low (11/sec) click rate. At the 11/sec rate, the model-based mean wave III amplitude was significantly smaller in older compared with younger subjects even after adjusting for wave I amplitude. Aging also increased ABR peak latencies, with significant shifts limited to early waves. The I-V IPI did not change with age. For both younger and older subjects, increasing click presentation rate significantly decreased amplitudes of early peaks and prolonged latencies of later peaks, resulting in increased IPIs. Advanced age did not enhance effects of rate. Instead, the rate effect on wave I and III amplitudes was attenuated for the older subjects due to reduced peak amplitudes at lower click rates. Compared with model predictions from the sample of better hearing subjects, mean ABR amplitudes were diminished in the group with poorer hearing, and wave V latencies were prolonged. In a sample of veterans, aging substantially reduced amplitudes of all principal ABR peaks, with significant latency shifts limited to waves I and III. Aging did not influence the I-V IPI even at high click rates, suggesting that the observed absolute latency changes associated with aging can be attributed to changes in auditory nerve input. In contrast, ABR amplitude changes with age are not adequately explained by changes in wave I. Results suggest that aging reduces the numbers and/or synchrony of contributing auditory nerve units. Results also support the concept that aging reduces the numbers, though perhaps not the synchrony, of central ABR generators. American Academy of Audiology.

Dark chocolate supplementation reduces the oxygen cost of moderate intensity cycling.

PubMed

Patel, Rishikesh Kankesh; Brouner, James; Spendiff, Owen

2015-01-01

Dark chocolate (DC) is abundant in flavanols which have been reported to increase the bioavailability and bioactivity of nitric oxide (NO). Increasing NO bioavailability has often demonstrated reduced oxygen cost and performance enhancement during submaximal exercise. Nine moderately-trained male participants volunteered to undertake baseline (BL) measurements that comprised a cycle V̇O(2max) test followed by cycling at 80% of their established gas exchange threshold (GET) for 20-min and then immediately followed by a two-minute time-trial (TT). Using a randomised crossover design participants performed two further trials, two weeks apart, with either 40 g of DC or white chocolate (WC) being consumed daily. Oxygen consumption, RER, heart rate and blood lactate (BLa) were measured during each trial. DC consumption increased GET and TT performance compared to both BL and WC (P < 0.05). DC consumption increased V̇O(2max) by 6% compared to BL (P < 0.05), but did not reach statistical significance compared to WC. There were no differences in the moderate-intensity cycling for V̇O₂, RER, BLa and heart rate between conditions, although, V̇O₂ and RER exhibited consistently lower trends following DC consumption compared to BL and WC, these did not reach statistical significance. Chronic supplementation with DC resulted in a higher GET and enhanced TT performance. Consequently, ingestion of DC reduced the oxygen cost of moderate intensity exercise and may be an effective ergogenic aid for short-duration moderate intensity exercise.

Comparative responses of the Savanna grasses Cenchrus ciliaris and Themeda triandra to defoliation.

PubMed

Hodgkinson, K C; Ludlow, M M; Mott, J J; Baruch, Z

1989-04-01

Two perennial tussock grasses of savannas were compared in a glasshouse study to determine why they differed in their ability to withstand frequent, heavy grazing; Cenchrus ciliaris is tolerant and Themeda triandra is intolerant of heavy grazing. Frequent defoliation at weekly intervals for six weeks reduced shoot biomass production over a subsequent 42 day regrowth period compared with previously undefoliated plants (infrequent) in T. triandra, but not in C. ciliaris. Leaf area of T. triandra expanded rapidly following defoliation but high initial relative growth rates of shoots were not sustained after 14 days of regrowth because of reducing light utilising efficiency of leaves. Frequently defoliated plants were slower in rate of leaf area expansion and this was associated with reduced photosynthetic capacity of newly formed leaves, lower allocation of photosynthate to leaves but not lower tiller numbers. T. triandra appears well adapted to a regime where defoliation is sufficiently infrequent to allow carbon to be fixed to replace that used in initial leaf area expansion. In contrast, C. ciliaris is better adapted to frequent defoliation than is T. triandra, because horizontally orientated nodal tillers are produced below the defoliation level. This morphological adaptation resulted in a 10-fold higher leaf area remaining after defoliation compared with similarly defoliated T. triandra, which together with the maintenance of moderate levels of light utilising efficiency, contributed to the higher leaf area and shoot weight throughout the regrowth period.

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

Apte, Michael G.; Mendell, Mark J.; Sohn, Michael D.

Through mass-balance modeling of various ventilation scenarios that might satisfy the ASHRAE 62.1 Indoor Air Quality (IAQ) Procedure, we estimate indoor concentrations of contaminants of concern (COCs) in California “big box” stores, compare estimates to available thresholds, and for selected scenarios estimate differences in energy consumption. Findings are intended to inform decisions on adding performance-based approaches to ventilation rate (VR) standards for commercial buildings. Using multi-zone mass-balance models and available contaminant source rates, we estimated concentrations of 34 COCs for multiple ventilation scenarios: VRmin (0.04 cfm/ft2 ), VRmax (0.24 cfm/ft2 ), and VRmid (0.14 cfm/ft2 ). We compared COC concentrationsmore » with available health, olfactory, and irritant thresholds. We estimated building energy consumption at different VRs using a previously developed EnergyPlus model. VRmax did control all contaminants adequately, but VRmin did not, and VRmid did so only marginally. Air cleaning and local ventilation near strong sources both showed promise. Higher VRs increased indoor concentrations of outdoor air pollutants. Lowering VRs in big box stores in California from VRmax to VRmid would reduce total energy use by an estimated 6.6% and energy costs by 2.5%. Reducing the required VRs in California’s big box stores could reduce energy use and costs, but poses challenges for health and comfort of occupants. Source removal, air cleaning, and local ventilation may be needed at reduced VRs, and even at current recommended VRs. Also, alternative ventilation strategies taking climate and season into account in ventilation schedules may provide greater energy cost savings than constant ventilation rates, while improving IAQ.« less

LanzaTech- Capturing Carbon. Fueling Growth.

ScienceCinema

NONE

2018-01-16

LanzaTech will design a gas fermentation system that will significantly improve the rate at which methane gas is delivered to a biocatalyst. Current gas fermentation processes are not cost effective compared to other gas-to-liquid technologies because they are too slow for large-scale production. If successful, LanzaTech's system will process large amounts of methane at a high rate, reducing the energy inputs and costs associated with methane conversion.

Measuring Glial Metabolism in Repetitive Brain Trauma and Alzheimers Disease

DTIC Science & Technology

2017-09-01

mechanism (excitoxicity?) that results in increased cerebral glutamate and glutamine (Glx) levels by comparing glial metabolic rates in NFL athletes...reduces the proton glutamate signal. This reduction in signal can be tracked, to provide the rate of metabolism of 13C glutamate and glutamine as...disadvantage to this method is that the specificity of the glutamate and glutamine are impacted by the overlap between the two resonances. Thus the

Research on the output bit error rate of 2DPSK signal based on stochastic resonance theory

NASA Astrophysics Data System (ADS)

Yan, Daqin; Wang, Fuzhong; Wang, Shuo

2017-12-01

Binary differential phase-shift keying (2DPSK) signal is mainly used for high speed data transmission. However, the bit error rate of digital signal receiver is high in the case of wicked channel environment. In view of this situation, a novel method based on stochastic resonance (SR) is proposed, which is aimed to reduce the bit error rate of 2DPSK signal by coherent demodulation receiving. According to the theory of SR, a nonlinear receiver model is established, which is used to receive 2DPSK signal under small signal-to-noise ratio (SNR) circumstances (between -15 dB and 5 dB), and compared with the conventional demodulation method. The experimental results demonstrate that when the input SNR is in the range of -15 dB to 5 dB, the output bit error rate of nonlinear system model based on SR has a significant decline compared to the conventional model. It could reduce 86.15% when the input SNR equals -7 dB. Meanwhile, the peak value of the output signal spectrum is 4.25 times as that of the conventional model. Consequently, the output signal of the system is more likely to be detected and the accuracy can be greatly improved.

Endurance- and Resistance-Trained Men Exhibit Lower Cardiovascular Responses to Psychosocial Stress Than Untrained Men.

PubMed

Gröpel, Peter; Urner, Maren; Pruessner, Jens C; Quirin, Markus

2018-01-01

Evidence shows that regular physical exercise reduces physiological reactivity to psychosocial stress. However, previous research mainly focused on the effect of endurance exercise, with only a few studies looking at the effect of resistance exercise. The current study tested whether individuals who regularly participate in either endurance or resistance training differ from untrained individuals in adrenal and cardiovascular reactivity to psychosocial stress. Twelve endurance-trained men, 10 resistance-trained men, and 12 healthy but untrained men were exposed to a standardized psychosocial stressor, the Trier Social Stress Test. Measurements of heart rate, free salivary cortisol levels, and mood were obtained throughout the test and compared among the three groups. Overall, both endurance- and resistance-trained men had lower heart rate levels than untrained men, indicating higher cardiac performance of the trained groups. Trained men also exhibited lower heart rate responses to psychosocial stress compared with untrained men. There were no significant group differences in either cortisol responses or mood responses to the stressor. The heart rate results are consistent with previous studies indicating reduced cardiovascular reactivity to psychosocial stress in trained individuals. These findings suggest that long-term endurance and resistance trainings may be related to the same cardiovascular benefits, without exhibiting strong effects on the cortisol reactivity to stress.

The effect of variable-dose diazepam on dreaming and emergence phenomena in 400 cases of ketamine-fentanyl anaesthesia.

PubMed

Grace, R F

2003-09-01

This randomised double-blind field study compared 400 anaesthetics using diazepam (0, 0.025, 0.5, 0.1, 0.175 mg.kg-1) with ketamine (1 mg.kg-1) and fentanyl (1 microg.kg-1) in Melanesian patients. Dreams were very common and generally positive in nature. A minimum of 0.1 mg.kg-1 of diazepam was needed to significantly reduce dreaming when compared with water (67.5% vs. 94.6%; p < 0.0001), and to significantly lower median (95% CI) emergence delirium scores (4 (3-4) vs. 6 (5-7)). Gender and age did not affect the rate of dreaming. Increasing the dose of diazepam did not improve the dream experience. Patient satisfaction scores were similar between groups. Increases in blood pressure and heart rate were greater in dreamers than in non-dreamers. All groups had high rate-pressure products but this was highest when diazepam was not used. Higher diazepam doses significantly reduced the increase in blood pressure and heart rate at 3 and 6 min postketamine. When used with ketamine and fentanyl, 0.1 mg.kg-1 of diazepam has favourable psychic and cardiovascular effects. Lower diazepam doses generally had little effect whereas larger doses did not enhance the benefits further.

Firearm Prevalence and Homicides of Law Enforcement Officers in the United States

PubMed Central

Simmons, Molly M.; Dominici, Francesca; Hemenway, David

2015-01-01

Objectives. In the United States, state firearm ownership has been correlated with homicide rates. More than 90% of homicides of law enforcement officers (LEOs) are committed with firearms. We examined the relationship between state firearm ownership rates and LEO occupational homicide rates. Methods. We obtained the number LEOs killed from 1996 to 2010 from a Federal Bureau of Investigation (FBI) database. We calculated homicide rates per state as the number of officers killed per number of LEOs per state, obtained from another FBI database. We obtained the mean household firearm ownership for each state from the Behavioral Risk Factor Surveillance System. Results. Using Poisson regression and controlling for factors known to affect homicide rates, we associated firearm ownership with the homicide rates for LEOs (incidence rate ratio = 1.044; P = .005); our results were supported by cross-sectional and longitudinal sensitivity analyses. LEO homicide rates were 3 times higher in states with high firearm ownership compared with states with low firearm ownership. Conclusions. High public gun ownership is a risk for occupational mortality for LEOs in the United States. States could consider methods for reducing firearm ownership as a way to reduce occupational deaths of LEOs. PMID:26270316

Firearm Prevalence and Homicides of Law Enforcement Officers in the United States.

PubMed

Swedler, David I; Simmons, Molly M; Dominici, Francesca; Hemenway, David

2015-10-01

In the United States, state firearm ownership has been correlated with homicide rates. More than 90% of homicides of law enforcement officers (LEOs) are committed with firearms. We examined the relationship between state firearm ownership rates and LEO occupational homicide rates. We obtained the number LEOs killed from 1996 to 2010 from a Federal Bureau of Investigation (FBI) database. We calculated homicide rates per state as the number of officers killed per number of LEOs per state, obtained from another FBI database. We obtained the mean household firearm ownership for each state from the Behavioral Risk Factor Surveillance System. Using Poisson regression and controlling for factors known to affect homicide rates, we associated firearm ownership with the homicide rates for LEOs (incidence rate ratio = 1.044; P = .005); our results were supported by cross-sectional and longitudinal sensitivity analyses. LEO homicide rates were 3 times higher in states with high firearm ownership compared with states with low firearm ownership. High public gun ownership is a risk for occupational mortality for LEOs in the United States. States could consider methods for reducing firearm ownership as a way to reduce occupational deaths of LEOs.

Leak Rate Quantification Method for Gas Pressure Seals with Controlled Pressure Differential

NASA Technical Reports Server (NTRS)

Daniels, Christopher C.; Braun, Minel J.; Oravec, Heather A.; Mather, Janice L.; Taylor, Shawn C.

2015-01-01

An enhancement to the pressure decay leak rate method with mass point analysis solved deficiencies in the standard method. By adding a control system, a constant gas pressure differential across the test article was maintained. As a result, the desired pressure condition was met at the onset of the test, and the mass leak rate and measurement uncertainty were computed in real-time. The data acquisition and control system were programmed to automatically stop when specified criteria were met. Typically, the test was stopped when a specified level of measurement uncertainty was attained. Using silicone O-ring test articles, the new method was compared with the standard method that permitted the downstream pressure to be non-constant atmospheric pressure. The two methods recorded comparable leak rates, but the new method recorded leak rates with significantly lower measurement uncertainty, statistical variance, and test duration. Utilizing this new method in leak rate quantification, projects will reduce cost and schedule, improve test results, and ease interpretation between data sets.

Reducing Acute Kidney Injury Due to Contrast Material: How Nurses Can Improve Patient Safety.

PubMed

Lambert, Peggy; Chaisson, Kristine; Horton, Susan; Petrin, Carmen; Marshall, Emily; Bowden, Sue; Scott, Lynn; Conley, Sheila; Stender, Janette; Kent, Gertrude; Hopkins, Ellen; Smith, Brian; Nicholson, Anita; Roy, Nancy; Homsted, Brenda; Downs, Cindy; Ross, Cathy S; Brown, Jeremiah

2017-02-01

Acute kidney injury due to contrast material occurs in 3% to 15% of the 2 million cardiac catheterizations done in the United States each year. To reduce acute kidney injury due to contrast material after cardiovascular interventional procedures. Nurse leaders in the Northern New England Cardiovascular Disease Study Group, a 10-center quality improvement consortium in Maine, New Hampshire, and Vermont, formed a nursing task force to reduce acute kidney injury due to contrast material after cardiovascular interventional procedures. Data were prospectively collected January 1, 2007, through June 30, 2012, on consecutive nonemergent patients (n = 20 147) undergoing percutaneous coronary interventions. Compared with baseline rates, adjusted rates of acute kidney injury among the 10 centers were significantly reduced by 21% and by 28% in patients with baseline estimated glomerular filtration rate less than 60 mL/min per 1.73 m 2 . Key qualitative system factors associated with improvement included use of multidisciplinary teams, standardized fluid orders, use of an intravenous fluid bolus, patient education about oral hydration, and limiting the volume of contrast material. Standardization of evidence-based best practices in nursing care may reduce the incidence of acute kidney injury due to contrast material. ©2017 American Association of Critical-Care Nurses.

Dose-dependent heart rate reducing effect of nizatidine, a histamine H2-receptor antagonist.

PubMed Central

Hinrichsen, H; Halabi, A; Fuhrmann, G; Kirch, W

1993-01-01

1. Twelve healthy subjects were treated in a randomised placebo-controlled crossover study with placebo, 150 mg, 300 mg, and 600 mg nizatidine, 100 mg pirenzepine, and 300 mg nizatidine plus 100 mg pirenzepine for 1 week each. 2. On the seventh treatment day, heart rate, blood pressure, systolic time intervals, impedance cardiographic and Doppler ultrasound variables were measured. 3. Stroke volume and blood pressure were not altered by nizatidine and/or pirenzepine. By contrast, heart rate and cardiac output significantly (P < 0.05) decreased in a dose-dependent manner 1.5 and 3 h after administration of 300 and 600 mg nizatidine. Treatment with 150 mg nizatidine led to similar though non-significant trends. 4. While a slightly insignificant rise in heart rate was detected with pirenzepine alone, heart rate and cardiac output remained unchanged upon combined nizatidine and pirenzepine treatment as compared with placebo and baseline values. 5. In conclusion, nizatidine reduced heart rate and cardiac output in a dose-dependent manner, whereas this negative chronotropic effect was counteracted by concurrent administration of the anti-cholinergic drug pirenzepine. PMID:8099802

Alternating anoxic feast/aerobic famine condition for improving granular sludge formation in sequencing batch airlift reactor at reduced aeration rate.

PubMed

Wan, Junfeng; Bessière, Yolaine; Spérandio, Mathieu

2009-12-01

In this study the influence of a pre-anoxic feast period on granular sludge formation in a sequencing batch airlift reactor is evaluated. Whereas a purely aerobic SBR was operated as a reference (reactor R2), another reactor (R1) was run with a reduced aeration rate and an alternating anoxic-aerobic cycle reinforced by nitrate feeding. The presence of pre-anoxic phase clearly improved the densification of aggregates and allowed granular sludge formation at reduced air flow rate (superficial air velocity (SAV)=0.63cms(-1)). A low sludge volume index (SVI(30)=45mLg(-1)) and a high MLSS concentration (9-10gL(-1)) were obtained in the anoxic/aerobic system compared to more conventional results for the aerobic reactor. A granular sludge was observed in the anoxic/aerobic system whilst only flocs were observed in the aerobic reference even when operated at a high aeration rate (SAV=2.83cms(-1)). Nitrification was maintained efficiently in the anoxic/aerobic system even when organic loading rate (OLR) was increased up to 2.8kgCODm(-3)d(-1). In the contrary nitrification was unstable in the aerobic system and dropped at high OLR due to competition between autotrophic and heterotrophic growth. The presence of a pre-anoxic period positively affected granulation process via different mechanisms: enhancing heterotrophic growth/storage deeper in the internal anoxic layer of granule, reducing the competition between autotrophic and heterotrophic growth. These processes help to develop dense granular sludge at a moderate aeration rate. This tends to confirm that oxygen transfer is the most limiting factor for granulation at reduced aeration. Hence the use of an alternative electron acceptor (nitrate or nitrite) should be encouraged during feast period for reducing energy demand of the granular sludge process.

Strategies that reduce 90-day readmissions and inpatient costs after liver transplantation.

PubMed

Zeidan, Joseph H; Levi, David M; Pierce, Ruth; Russo, Mark W

2018-04-25

Liver transplantation is hospital-resource intensive and associated with high rates of readmission. We have previously shown a reduction in 30-day readmission rates by implementing a specifically designed protocol to increase access to outpatient care. To determine if strategies that reduce 30-day readmission after liver transplant were effective in also reducing 90-day readmission rates and costs. A protocol was developed to reduce inpatient readmissions after liver transplant that expanded outpatient services and provided alternatives to readmission. The 90-day readmission rates and costs were compared before and implementing strategies outlined in the protocol. Multivariable analysis was used to control for potential confounding factors. Over the study period 304 adult primary liver transplants were performed on patients with a median biologic MELD of 22. 112 (37%) patients were readmitted within 90 days of transplant. The readmission rates before and after implementation of the protocol were 53% and 26% respectively, p<0.001. The most common reason for readmission was elevated liver tests/rejection (24%). In multivariable analysis, the protocol remained associated with avoiding readmission, OR=0.33, [95% CI 0.20,0.55], p<0.001. The median length of stay after transplant preprotocol and postprotocol was 8 and 7 days, respectively. A greater proportion of patients were discharged to hospital lodging post protocol, 10% versus 19%, p=0.03. 90-day readmissions costs were reduced by 55% but total 90 day costs by only 2.7% due to higher outpatient costs and index admission costs. 90-day readmission rates and readmission costs can be reduced by improving access to outpatient services and hospital local lodging. Total 90-day costs were similar between the two groups because of higher outpatient costs after the protocol was introduced. This article is protected by copyright. All rights reserved. © 2018 by the American Association for the Study of Liver Diseases.

The relation of autonomic function to physical fitness in patients suffering from alcohol dependence.

PubMed

Herbsleb, Marco; Schulz, Steffen; Ostermann, Stephanie; Donath, Lars; Eisenträger, Daniela; Puta, Christian; Voss, Andreas; Gabriel, Holger W; Bär, Karl-Jürgen

2013-10-01

Reduced cardio-vascular health has been found in patients suffering from alcohol dependence. Low cardio-respiratory fitness is an independent predictor of cardio-vascular disease. We investigated physical fitness in 22 alcohol-dependent patients 10 days after acute alcohol withdrawal and compared results with matched controls. The standardized 6-min walk test (6 MWT) was used to analyze the relationship of autonomic dysfunction and physical fitness. Ventilatory indices and gas exchanges were assessed using a portable spiroergometric system while heart rate recordings were obtained separately. We calculated walking distance, indices of heart rate variability and efficiency parameters of heart rate and breathing. In addition, levels of exhaled carbon monoxide were measured in all participants to account for differences in smoking behaviour. Multivariate analyses of variance (MANOVA) were performed to investigate differences between patients and controls with regard to autonomic and efficiency parameters. Patients walked a significantly shorter distance in comparison to healthy subjects during the 6 MWT. Significantly decreased heart rate variability was observed before and after the test in patients when compared to controls, while no such difference was observed during exercise. The efficiency parameters indicated significantly reduced efficiency in physiological regulation when the obtained parameters were normalized to the distance. The 6 MWT is an easily applied instrument to measure physical fitness in alcohol dependent patients. It can also be used during exercise interventions. Reduced physical fitness, as observed in our study, might partly be caused by autonomic dysfunction, leading to less efficient regulation of physiological processes during exercise. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Reduced nephron endowment in the neonates of Indigenous Australian peoples.

PubMed

Kandasamy, Y; Smith, R; Wright, I M R; Lumbers, E R

2014-02-01

Rates of chronic kidney disease (CKD) among Indigenous groups in Australia exceed non-Indigenous rates eight-fold. Using kidney volume as a surrogate for nephron number, we carried out a study to determine if Indigenous neonates have a smaller kidney volume (and thus a reduced nephron number) from birth compared with non-Indigenous neonates. We recruited term and preterm neonates (<32 weeks) at a tertiary care neonatal unit over a 12 months period. Preterm neonates were assessed (renal sonography and renal function measurement) at 32 weeks corrected age (CA) and again at 38 weeks CA when blood pressure was also measured. All term neonates were assessed in the first post-natal week, including renal sonography, renal function and blood pressure measurement. The primary outcome measured was total kidney volume (TKV) and estimated glomerular filtration rate (eGFR) was a secondary outcome. Data was available for 44 preterm (11 Indigenous) and 39 term (13 Indigenous) neonates. TKV of Indigenous neonates was significantly lower at 32 weeks [12.0 (2.0) v. 15.4 (5.1) ml; P=0.03] and 38 weeks CA [18.6 (4.0) v. 22.6 (5.9) ml; P=0.04] respectively. Term Indigenous neonates also had smaller kidney volumes compared with non-Indigenous neonates. Despite a smaller kidney volume (and reduced nephron number), Indigenous neonates did not have a significantly lower eGFR. Indigenous neonates achieve similar eGFRs to Non-Indigenous neonates, presumably through a higher single nephron filtration rate. This places Indigenous neonates at a greater risk of long-term kidney damage later in life.

Toxic coral gobies reduce the feeding rate of a corallivorous butterflyfish on Acropora corals

NASA Astrophysics Data System (ADS)

Dirnwoeber, M.; Herler, J.

2013-03-01

The obligate coral-dwelling gobiid genus Gobiodon inhabits Acropora corals and has developed various physiological, morphological and ethological adaptations towards this life habit. While the advantages of this coral-fish association are well documented for Gobiodon, possible fitness-increasing factors for the host coral are unknown. This study examines the influence of coral-dwelling gobies on the feeding behaviour of obligate corallivorous butterflyfishes. In an aquarium experiment using video observation, the corallivorous butterflyfish Chaetodon austriacus fed significantly less on corals inhabited by two Gobiodon species compared to unoccupied coral colonies of similar size. The more agonistic species G. histrio, which mostly displayed directed movements towards butterflyfishes, decreased butterflyfish bite rate by 62-98 % compared to uninhabited colonies. For Gobiodon sp. 3, which mostly displayed undirected movements in response to visits by C. austriacus, bite rate reduction was 64-68 %. The scale-less skin of Gobiodon spp. is covered by mucus that is toxic and multi-functional by reducing predation as well as affecting parasite attachment. A choice flume experiment suggests that the highly diluted skin mucus of Gobiodon spp. also functions as a corallivore repellent. This study demonstrates that Gobiodon spp. exhibit resource defence against coral-feeding butterflyfishes and also that coral colonies without resident Gobiodon suffer higher predation rates. Although the genus Gobiodon is probably a facultative corallivore, this study shows that by reducing predation on inhabited colonies by other fishes, these obligate coral-dwellers either compensate for their own fitness-decreasing impact on host colonies or live in a mutualistic association with them.

Computerized Dose Range Checking Using Hard and Soft Stop Alerts Reduces Prescribing Errors in a Pediatric Intensive Care Unit.

PubMed

Balasuriya, Lilanthi; Vyles, David; Bakerman, Paul; Holton, Vanessa; Vaidya, Vinay; Garcia-Filion, Pamela; Westdorp, Joan; Sanchez, Christine; Kurz, Rhonda

2017-09-01

An enhanced dose range checking (DRC) system was developed to evaluate prescription error rates in the pediatric intensive care unit and the pediatric cardiovascular intensive care unit. An enhanced DRC system incorporating "soft" and "hard" alerts was designed and implemented. Practitioner responses to alerts for patients admitted to the pediatric intensive care unit and the pediatric cardiovascular intensive care unit were retrospectively reviewed. Alert rates increased from 0.3% to 3.4% after "go-live" (P < 0.001). Before go-live, all alerts were soft alerts. In the period after go-live, 68% of alerts were soft alerts and 32% were hard alerts. Before go-live, providers reduced doses only 1 time for every 10 dose alerts. After implementation of the enhanced computerized physician order entry system, the practitioners responded to soft alerts by reducing doses to more appropriate levels in 24.7% of orders (70/283), compared with 10% (3/30) before go-live (P = 0.0701). The practitioners deleted orders in 9.5% of cases (27/283) after implementation of the enhanced DRC system, as compared with no cancelled orders before go-live (P = 0.0774). Medication orders that triggered a soft alert were submitted unmodified in 65.7% (186/283) as compared with 90% (27/30) of orders before go-live (P = 0.0067). After go-live, 28.7% of hard alerts resulted in a reduced dose, 64% resulted in a cancelled order, and 7.4% were submitted as written. Before go-live, alerts were often clinically irrelevant. After go-live, there was a statistically significant decrease in orders that were submitted unmodified and an increase in the number of orders that were reduced or cancelled.

Sperm DNA damage or progressive motility: which one is the better predictor of fertilization in vitro?

PubMed

Simon, Luke; Lewis, Sheena E M

2011-06-01

Sperm progressive motility has been reported to be one of the key factors influencing in vitro fertilization rates. However, recent studies have shown that sperm DNA fragmentation is a more robust predictor of assisted reproductive outcomes including reduced fertilization rates, embryo quality, and pregnancy rates. This study aimed to compare the usefulness of sperm progressive motility and DNA damage as predictive tools of in vitro fertilization rates. Here, 136 couples provided 1,767 eggs with an overall fertilization rate of 64.2%. The fertilization rate in vitro correlated with both sperm progressive motility (r² = 0.236; P = 0.002) and DNA fragmentation (r² = -0.318; P < 0.001). The relative risk of a poor fertilization rate was 9.5 times higher in sperm of men with high DNA fragmentation (>40%) compared with 2.6 times in sperm with poor motility (<40%). Further, sperm DNA fragmentation gave a higher specificity (93.3%) in predicting the fertilization rate than progressive motility (77.8%). Finally, the odds ratio to determine fertilization rate (>70%) was 4.81 (1.89-12.65) using progressive motility compared with 24.18 (5.21-154.51) using DNA fragmentation. This study shows that fertilization rates are directly dependent upon both sperm progressive motility and DNA fragmentation, but sperm DNA fragmentation is a much stronger test.

Living with tics: reduced impairment and improved quality of life for youth with chronic tic disorders.

PubMed

McGuire, Joseph F; Arnold, Elysse; Park, Jennifer M; Nadeau, Joshua M; Lewin, Adam B; Murphy, Tanya K; Storch, Eric A

2015-02-28

Pharmacological and behavioral interventions have focused on reducing tic severity to alleviate tic-related impairment for youth with chronic tic disorders (CTDs), with no existing intervention focused on the adverse psychosocial consequences of tics. This study examined the preliminary efficacy of a modularized cognitive behavioral intervention ("Living with Tics", LWT) in reducing tic-related impairment and improving quality of life relative to a waitlist control of equal duration. Twenty-four youth (ages 7-17 years) with Tourette Disorder or Chronic Motor Tic Disorder and psychosocial impairment participated. A treatment-blind evaluator conducted all pre- and post-treatment clinician-rated measures. Youth were randomly assigned to receive the LWT intervention (n=12) or a 10-week waitlist (n=12). The LWT intervention consisted of up to 10 weekly sessions targeted at reducing tic-related impairment and developing skills to manage psychosocial consequences of tics. Youth in the LWT condition experienced significantly reduced clinician-rated tic-impairment, and improved child-rated quality of life. Ten youth (83%) in the LWT group were classified as treatment responders compared to four youth in the waitlist condition (33%). Treatment gains were maintained at one-month follow-up. Findings provide preliminary data that the LWT intervention reduces tic-related impairment and improves quality of life for youth with CTDs. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Living with Tics: Reduced Impairment and Improved Quality of Life for Youth with Chronic Tic Disorders

PubMed Central

McGuire, Joseph F.; Arnold, Elysse; Park, Jennifer M.; Nadeau, Joshua M.; Lewin, Adam B.; Murphy, Tanya K.; Storch, Eric A.

2014-01-01

Pharmacological and behavioral interventions have focused on reducing tic severity to alleviate tic-related impairment for youth with chronic tic disorders (CTDs), with no existing intervention focused on the adverse psychosocial consequences of tics. This study examined the preliminary efficacy of a modularized cognitive behavioral intervention ("Living with Tics", LWT) in reducing tic-related impairment and improving quality of life relative to a waitlist control of equal duration. Twenty-four youth (ages 7–17 years) with Tourette Disorder or Chronic Motor Tic Disorder and psychosocial impairment participated. A treatment-blind evaluator conducted all pre- and post-treatment clinician-rated measures. Youth were randomly assigned to receive the LWT intervention (n=12) or a 10-week waitlist (n=12). The LWT intervention consisted of up to 10 weekly sessions targeted at reducing tic-related impairment and developing skills to manage psychosocial consequences of tics. Youth in the LWT condition experienced significantly reduced clinician-rated tic-impairment, and improved child-rated quality of life. Ten youth (83%) in the LWT group were classified as treatment responders compared to four youth in the waitlist condition (33%). Treatment gains were maintained at one-month follow-up. Findings provide preliminary data that the LWT intervention reduces tic-related impairment and improves quality of life for youth with CTDs. PMID:25500348

Adjusted indirect comparison of new oral anticoagulants for stroke prevention in atrial fibrillation.

PubMed

Testa, L; Agnifili, M; Latini, R A; Mattioli, R; Lanotte, S; De Marco, F; Oreglia, J; Latib, A; Pizzocri, S; Laudisa, M L; Brambilla, N; Bedogni, F

2012-10-01

Vit-K antagonists are the therapy of choice to prevent thromboembolic events due to atrial fibrillation since many years. New oral anticoagulants (NOA) showed encouraging results vs. warfarin but there are no data directly comparing different NOA. We performed an adjusted indirect meta-analysis. Randomized controlled trials (RCTs) were searched. Efficacy end points were the cumulative rate of thomboembolic stroke (TES) and systemic embolism (SE). Main safety end point was the rate of hemorrhagic stroke (HS). Three RCTs (50578 patients) were included. Overall, NOA were comparable to warfarin according to the cumulative risk of TES and SE, as well as for TES alone. NOA were associated with a reduced rate of SE [OR 0.64 (0.44, 0.94], P=0.02]. Compared to warfarin, NOA were associated with a significantly reduced risk of HS [OR 0.43 (0.34, 0.55), P<0.001, NNT to avoid a HS 153] and all cause death [OR 0.90 [0.84, 0.96], P=0.03, NNT to save one fatality 43]. Head to head comparison showed that in terms of cumulative rate of TES/SE, as well as of TES, none of the NOA was significantly superior to the others (all Ps>0.05). Rivaroxaban showed superiority in the prevention of SE. Dabigatran 150 mg/twice daily was associated with the largest reduction in the risk of HS vs. warfarin and vs. other NOA. Overall mortality was quite comparable across NOA. Overall superiority of NOA over warfarin is largely influenced by the reduction of HS. Dabigatran 150 mg/twice daily seems to have the best risk/benefit profile.

Filling the gap between lab and clinical impact: An open randomized diagnostic trial comparing urinary ethylglucuronide and ethanol in alcohol dependent outpatients.

PubMed

Barrio, Pablo; Teixidor, Lídia; Ortega, Lluisa; Lligoña, Anna; Rico, Nayra; Bedini, José Luis; Vieta, Eduard; Gual, Antoni

2018-02-01

Efforts aimed at reducing alcohol-related harm include early detection of risky drinkers as well as detection of early relapse in patients with alcohol dependence. Ethyl glucuronide (EtG) has been proven to be a reliable biomarker for the detection of recent drinking; however, no randomized, diagnostic trial to date has tested its impact on drinking outcomes. The aim of this study was to assess, in a randomized design, the implications of EtG screening on alcohol outcomes, compared to screening with a low sensitivity biomarker such as ethanol. Alcohol dependent outpatients were randomized to either 24 weeks of continuous screening with EtG or ethanol. Patients were aware of screening methods and results. After 24 weeks, all participants were screened with EtG. Self-reports were also gathered. A logistic regression compared the rate of EtG positive results at study end between groups. Generalized estimating equations evaluated the descending monthly rate of EtG positive patients in the EtG group. A total of 162 patients were randomized. During the study period, the ethanol group showed less patients with positive screens (19/64 (29.7%) vs 58/98 (59%)). After 24 weeks, the EtG group showed a greater number of patients having a negative screening test compared to ethanol subjects when they were all screened with EtG (5/62 (8.1%) vs 13/39 (33.3%)). A significant decrease in the rate of EtG positive patients was found for the first three months of the study. Routine screening with EtG seems to reduce drinking and improve abstinence rates in alcohol dependent outpatients. Copyright © 2017 Elsevier B.V. All rights reserved.

Antiemetic efficacy of smoked marijuana: subjective and behavioral effects on nausea induced by syrup of ipecac.

PubMed

Söderpalm, A H; Schuster, A; de Wit, H

2001-01-01

Although the public debate about the legalization of marijuana has continued for as long as 25 years, few controlled studies have been conducted to assess its potential medical benefits. The present study examined the antiemetic effect of smoked marijuana cigarettes (8.4 and 16.9 mg Delta(9)-tetrahydrocannabinol [THC]) compared to a highly potent antiemetic drug, ondansetron (8 mg) in 13 healthy volunteers. Nausea and emesis were induced by syrup of ipecac. Marijuana significantly reduced ratings of "queasiness" and slightly reduced the incidence of vomiting compared to placebo. Ondansetron completely eliminated the emetic effects of ipecac. These findings support and extend previous results, indicating that smoked marijuana reduces feelings of nausea and also reduces emesis in this model. However, its effects are very modest relative to ondansetron, and the psychoactive effects of marijuana are likely to limit its clinical usefulness in the general population.

Effects of sublethal exposure to boric acid sugar bait on adult survival, host-seeking, bloodfeeding behavior, and reproduction of Stegomyia albopicta.

PubMed

Ali, Arshad; Xue, Rui-De; Barnard, Donald R

2006-09-01

Effects of sublethal exposure to 0.1% boric acid sugar bait on adult survival, host-seeking, bloodfeeding behavior, and reproduction of Stegomyia albopicta were studied in the laboratory. Survival of males as well as females was significantly reduced when exposed to the bait, compared to control adults. The host-seeking and bloodfeeding activities in the baited females decreased, but the mean duration of blood engorgement (probing to voluntary withdrawal of proboscis) was not significantly different between the baited and control females. The landing and biting rates (human forearm) were significantly reduced in the baited females compared to nonbaited controls. Fecundity and fertility (based on number of laid eggs per female and percentage egg hatch, respectively) in the baited females were significantly reduced, and ovarian development was retarded. Sublethal exposure to sugar-based boric acid bait has the potential to reduce adult populations of St. albopicta.

Can deaths in police cells be prevented? Experience from Norway and death rates in other countries.

PubMed

Aasebø, Willy; Orskaug, Gunnar; Erikssen, Jan

2016-01-01

To describe the changes in death rates and causes of deaths in Norwegian police cells during the last 2 decades. To review reports on death rates in police cells that have been published in medical journals and elsewhere, and discuss the difficulties of comparing death rates between countries. Data on deaths in Norwegian police cells were collected retrospectively in 2002 and 2012 for two time periods: 1993-2001 (period 1) and 2003-2012 (period 2). Several databases were searched to find reports on deaths in police cells from as many countries as possible. The death rates in Norwegian police cells reduced significantly from 0.83 deaths per year per million inhabitants (DYM) in period 1 to 0.22 DYM in period 2 (p < 0.05). The most common cause of death in period 1 was alcohol intoxication including intracranial bleeding in persons with high blood alcohol levels, and the number declined from 16 persons in period 1 to 1 person in period 2 (p = 0.032). The median death rate in the surveyed Western countries was 0.44 DYM (range: 0.14-1.46 DYM). The number of deaths in Norwegian police cells reduced by about 75% over a period of approximately 10 years. This is probably mainly due to individuals with severe alcohol intoxication no longer being placed in police cells. However, there remain large methodology difficulties in comparing deaths rates between countries. Copyright © 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

South Asian women with polycystic ovary syndrome exhibit greater sensitivity to gonadotropin stimulation with reduced fertilization and ongoing pregnancy rates than their Caucasian counterparts.

PubMed

Palep-Singh, M; Picton, H M; Vrotsou, K; Maruthini, D; Balen, A H

2007-10-01

Polycystic ovary syndrome (PCOS) is a heterogeneous syndrome. In vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) is required for PCOS cases that are refractory to standard ovulation induction or have co-existing infertility factors in women with PCOS and Tubal factor subfertility. Assess ethnic variations in response to IVF/ICSI treatment. Observational Comparative study in a University hospital fertility clinic in women with PCOS and Tubal factor subfertility. Women with PCOS (Asians: AP=104; Caucasians: CP=220) and those with tubal factor infertility seeking fertility treatment were assessed (Asians: AC=84; Caucasians: CC=200). Six hundred and eight fresh IVF or ICSI cycles using long protocol of GnRHa suppression and resulting in a fresh embryo transfer were compared. The primary endpoint was to assess the dose of gonadotropins used in the cycles. The secondary outcomes were: total number of oocytes retrieved, fertilization and ongoing clinical pregnancy rates. We found that the South Asian women presented at a younger age for the management of sub-fertility. An extended stimulation phase and Caucasian ethnicity showed an inverse correlation with the number of oocytes retrieved in the PCOS subgroup. Caucasian ethnicity was associated with a higher fertilization rate however increase in body mass index (BMI) and the laboratory technique of IVF appeared to have a negative impact on fertilization rates in the PCOS subgroup. Commencing down regulation on day 1 of the cycles was negatively associated with fertilization rates in the tubal group. In terms of clinical pregnancy rates, the Caucasian PCOS had a 2.5 times (95% CI: 1.25-5) higher chance of an ongoing clinical pregnancy as compared with their Asian counterpart. Also, a unit increase in the basal FSH concentration reduced the odds of pregnancy by 18.6% (95% CI: 1.8-32.6%) in the PCOS group. The Asian PCOS have a greater sensitivity to gonadotropin stimulation with lower fertilization and ongoing clinical pregnancy rates as compared with their Caucasian counterparts.

SU-F-P-52: A Meta-Analysis of Controlled Clinical Trials Comparing Elective Nodal Irradiation with Involved-Field Irradiation for Conformal Or Intensity-Modulated Radiotherapy in Patients with Esophageal Cancer

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

Bai, W; Zhang, R; Zhou, Z

Purpose: To compare elective nodal irradiation with involved-field irradiation for three-dimensional conformal radiotherapy or intensity-modulated radiotherapy in patients with esophageal cancer by a metaanalysis. Methods: Wanfang, CNKI, VIP, CBM databases, PubMed, Embase and Cochrane Library were searched to identify the controlled clinical trials of elective nodal irradiation with involved-field irradiation for three-dimensional conformal radiotherapy or intensity-modulated radiotherapy in patients with esophageal cancer. The obtained data were analyzed using Stata 11.0. The difference between two groups was estimated by calculating the odds ratio (OR) with 95% confidence interval (95% CI). Results: A total of 12 controlled clinical trials involving 1095 esophagealmore » cancer patients, which were selected according to inclusion and exclusion criteria, were included in this meta-analysis. The meta-analysis showed that the elective nodal irradiation group reduced the rates of out-field failure comparing with involved-field irradiation group (OR=3.727, P=0.007). However, the rates of ≥grades 3 acute radiation pneumonitis and esophagitis were significantly higher in the elective nodal irradiation group than in the involved-field irradiation group (OR=0.348, P=0.001, OR=0.385, P=0.000). 1-, 2-, 3-year local control rates (OR=0.966, P=0.837, OR=0.946, P=0.781; OR=0.732P=0.098) and 1-, 3-, 5-year survival rates were similar in the two groups ( OR=0.966, P=0.837; OR=0.946, P=0.781; OR=0.732, P=0.098; OR=0.952, P=0.756; OR=1.149, P=0.422; OR=0.768, P=0.120). It is the same with the rates of distant metastasis (OR=0.986, P=0.937). Conclusion: Compared with involved-field irradiation, the elective nodal irradiation can reduce the rates of out-field failure for three-dimensional conformal radiotherapy or intensity-modulated radiotherapy in patients with esophageal cancer. However, its advantage of local control and survival rates is not obvious and it increases the incidence of toxicities.« less

An automatic method to calculate heart rate from zebrafish larval cardiac videos.

PubMed

Kang, Chia-Pin; Tu, Hung-Chi; Fu, Tzu-Fun; Wu, Jhe-Ming; Chu, Po-Hsun; Chang, Darby Tien-Hao

2018-05-09

Zebrafish is a widely used model organism for studying heart development and cardiac-related pathogenesis. With the ability of surviving without a functional circulation at larval stages, strong genetic similarity between zebrafish and mammals, prolific reproduction and optically transparent embryos, zebrafish is powerful in modeling mammalian cardiac physiology and pathology as well as in large-scale high throughput screening. However, an economical and convenient tool for rapid evaluation of fish cardiac function is still in need. There have been several image analysis methods to assess cardiac functions in zebrafish embryos/larvae, but they are still improvable to reduce manual intervention in the entire process. This work developed a fully automatic method to calculate heart rate, an important parameter to analyze cardiac function, from videos. It contains several filters to identify the heart region, to reduce video noise and to calculate heart rates. The proposed method was evaluated with 32 zebrafish larval cardiac videos that were recording at three-day post-fertilization. The heart rate measured by the proposed method was comparable to that determined by manual counting. The experimental results show that the proposed method does not lose accuracy while largely reducing the labor cost and uncertainty of manual counting. With the proposed method, researchers do not have to manually select a region of interest before analyzing videos. Moreover, filters designed to reduce video noise can alleviate background fluctuations during the video recording stage (e.g. shifting), which makes recorders generate usable videos easily and therefore reduce manual efforts while recording.

Effect of lullaby and classical music on physiologic stability of hospitalized preterm infants: a randomized trial.

PubMed

Amini, E; Rafiei, P; Zarei, K; Gohari, M; Hamidi, M

2013-01-01

Music is considered a subset of developmental supportive care. It may act as a suitable auditory stimulant in preterm infants. Also, it may reduce stress responses in autonomic, motor and state systems. To assess and compare the influence of lullaby and classical music on physiologic parameters. This is a randomized clinical trial with cross-over design. A total of 25 stable preterm infants with birth weight of 1000-2500 grams were studied for six consecutive days. Each infant was exposed to three phases: lullaby music, classical music, and no music (control) for two days each. The sequence of these phases was assigned randomly to each subject. Babies were continuously monitored for heart rate, respiratory rate, and oxygen saturation and changes between phases were analyzed. Lullaby reduced heart rate (p < 0.001) and respiratory rate (p = 0.004). These effects extended in the period after the exposure (p < .001 and p = 0.001, respectively). Classical music reduced heart rate (p = 0.018). The effects of classical music disappeared once the music stopped. Oxygen saturation did not change during intervention. Music can affect vital signs of preterm infants; this effect can possibly be related to the reduction of stress during hospitalization. The implications of these findings on clinical and developmental outcomes need further study.

Sympathovagal imbalance in hyperthyroidism.

PubMed

Burggraaf, J; Tulen, J H; Lalezari, S; Schoemaker, R C; De Meyer, P H; Meinders, A E; Cohen, A F; Pijl, H

2001-07-01

We assessed sympathovagal balance in thyrotoxicosis. Fourteen patients with Graves' hyperthyroidism were studied before and after 7 days of treatment with propranolol (40 mg 3 times a day) and in the euthyroid state. Data were compared with those obtained in a group of age-, sex-, and weight-matched controls. Autonomic inputs to the heart were assessed by power spectral analysis of heart rate variability. Systemic exposure to sympathetic neurohormones was estimated on the basis of 24-h urinary catecholamine excretion. The spectral power in the high-frequency domain was considerably reduced in hyperthyroid patients, indicating diminished vagal inputs to the heart. Increased heart rate and mid-frequency/high-frequency power ratio in the presence of reduced total spectral power and increased urinary catecholamine excretion strongly suggest enhanced sympathetic inputs in thyrotoxicosis. All abnormal features of autonomic balance were completely restored to normal in the euthyroid state. beta-Adrenoceptor antagonism reduced heart rate in hyperthyroid patients but did not significantly affect heart rate variability or catecholamine excretion. This is in keeping with the concept of a joint disruption of sympathetic and vagal inputs to the heart underlying changes in heart rate variability. Thus thyrotoxicosis is characterized by profound sympathovagal imbalance, brought about by increased sympathetic activity in the presence of diminished vagal tone.

Specific food structures supress appetite through reduced gastric emptying rate

PubMed Central

Rafiee, Hameed; Malcolm, Paul; Salt, Louise; van Aken, George

2013-01-01

The aim of this study was to determine the extent to which gastric layering and retention of a meal could be used to reduce appetite using the same caloric load. Liquid (control) and semi-solid (active) meals were produced with the same protein, fat, carbohydrate, and mass. These were fed to 10 volunteers on separate days in a crossover study, and subjective appetite ratings, gastric contents, and plasma cholecystokinin (CCK) were assessed over a period of 3 h. The active meal showed food boluses in the stomach persisting for ∼45 min, slower emptying rates, and lower plasma CCK levels over the first hour. After the first hour, both gastric emptying rates and plasma CCK levels were similar for both systems and slightly increased compared with the unfed situation. Despite the lower plasma CCK levels for the active meal over the first hour, this meal reduced appetite more than the control meal over the 3 h of the study. For a moderately increased plasma CCK level in the fed state, appetite was correlated with the volume of gastric contents rather than gastric emptying rates or plasma CCK. This suggests that enhanced gastric retention was the key factor in decreasing appetite and was probably mediated by a combination of intestinal nutrient sensing and increased viscosity in the stomach. PMID:23578786

Effectiveness of Extracorporeal Shock Wave Therapy Without Local Anesthesia in Patients With Recalcitrant Plantar Fasciitis: A Meta-Analysis of Randomized Controlled Trials.

PubMed

Lou, Jing; Wang, Shuai; Liu, Shuitao; Xing, Gengyan

2017-08-01

The objective of this meta-analysis was to investigate the efficacy of extracorporeal shock wave therapy in the treatment of recalcitrant plantar fasciitis without local anesthesia. The Cochrane Library, EMBASE, PubMed, and Web of Science databases were searched from inception to September 2015 for randomized controlled trials comparing ESWT without local anesthesia versus placebo for treatment of plantar fasciitis in adults. The primary outcome was the 12-week post-intervention success rate of reducing the visual analog scale score by 60% from baseline at the first step in the morning, reducing the VAS score by 60% from baseline during daily activities, reducing the Roles and Maudsley score, reducing overall heel pain, and reducing pain after applying a force meter. Nine studies were included in the meta-analysis. Compared with placebo, ESWT significantly improved the success rate of reducing overall heel pain, reducing the VAS score by 60% at the first step in the morning and during daily activities, improving the Roles and Maudsley score to excellent or good, and reducing heel pain after application of a pressure meter. ESWT seems to be particularly effective in relieving pain associated with RPF. ESWT should be considered when traditional treatments have failed. Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES: Upon completion of this article, the reader should be able to (1) understand the recovery rates for nonsurgical treatment of plantar fasciitis, (2) understand the role of extracorporeal shockwave therapy (ESWT) in the treatment of recalcitrant plantar fasciitis, and (3) understand the indications to incorporate ESWT in the treatment plan of recalcitrant plantar fasciitis. Advanced ACCREDITATION: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this activity for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Sedation improves early outcome in severely septic Sprague Dawley rats

PubMed Central

2009-01-01

Introduction Sepsis, a systemic inflammatory response to infective etiologies, has a high mortality rate that is linked both to excess cytokine activity and apoptosis of critical immune cells. Dexmedetomidine has recently been shown to improve outcome in a septic cohort of patients when compared to patients randomized to a benzodiazepine-based sedative regimen. We sought to compare the effects of dexmedetomidine and midazolam, at equi-sedative doses, on inflammation and apoptosis in an animal model of severe sepsis. Methods After central venous access, Sprague Dawley rats underwent cecal ligation and intestinal puncture (CLIP) with an 18 G needle without antibiotic cover and received either saline, or an infusion of comparable volume of saline containing midazolam (0.6 mg.kg-1.h-1) or dexmedetomidine (5 ug.kg-1.h-1) for 8 hours. Following baseline measurements and CLIP, blood was sampled for cytokine measurement (tumour necrosis factor (TNF)-alpha and interleukin (IL)-6; n = 4-6 per group) at 2, 4 and 5 hours, and animal mortality rate (MR) was monitored (n = 10 per group) every 2 hours until 2 hours had elapsed. In addition, spleens were harvested and apoptosis was assessed by immunoblotting (n = 4 per group). Results The 24 hour MR in CLIP animals (90%) was significantly reduced by sedative doses of either dexmedetomidine (MR = 20%) or midazolam (MR = 30%). While both sedatives reduced systemic levels of the inflammatory cytokine TNF-alpha (P < 0.05); only dexmedetomidine reduced the IL-6 response to CLIP, though this narrowly missed achieving significance (P = 0.05). Dexmedetomidine reduced splenic caspase-3 expression (P < 0.05), a marker of apoptosis, when compared to either midazolam or saline. Conclusions Sedation with midazolam and dexmedetomidine both improve outcome in polymicrobial severely septic rats. Possible benefits conveyed by one sedative regimen over another may become evident over a more prolonged time-course as both IL-6 and apoptosis were reduced by dexmedetomidine but not midazolam. Further studies are required to evaluate this hypothesis. PMID:19691839

Comparative Analysis of Sequential Proximal Optimizing Technique Versus Kissing Balloon Inflation Technique in Provisional Bifurcation Stenting: Fractal Coronary Bifurcation Bench Test.

PubMed

Finet, Gérard; Derimay, François; Motreff, Pascal; Guerin, Patrice; Pilet, Paul; Ohayon, Jacques; Darremont, Olivier; Rioufol, Gilles

2015-08-24

This study used a fractal bifurcation bench model to compare 6 optimization sequences for coronary bifurcation provisional stenting, including 1 novel sequence without kissing balloon inflation (KBI), comprising initial proximal optimizing technique (POT) + side-branch inflation (SBI) + final POT, called "re-POT." In provisional bifurcation stenting, KBI fails to improve the rate of major adverse cardiac events. Proximal geometric deformation increases the rate of in-stent restenosis and target lesion revascularization. A bifurcation bench model was used to compare KBI alone, KBI after POT, KBI with asymmetric inflation pressure after POT, and 2 sequences without KBI: initial POT plus SBI, and initial POT plus SBI with final POT (called "re-POT"). For each protocol, 5 stents were tested using 2 different drug-eluting stent designs: that is, a total of 60 tests. Compared with the classic KBI-only sequence and those associating POT with modified KBI, the re-POT sequence gave significantly (p < 0.05) better geometric results: it reduced SB ostium stent-strut obstruction from 23.2 ± 6.0% to 5.6 ± 8.3%, provided perfect proximal stent apposition with almost perfect circularity (ellipticity index reduced from 1.23 ± 0.02 to 1.04 ± 0.01), reduced proximal area overstretch from 24.2 ± 7.6% to 8.0 ± 0.4%, and reduced global strut malapposition from 40 ± 6.2% to 2.6 ± 1.4%. In comparison with 5 other techniques, the re-POT sequence significantly optimized the final result of provisional coronary bifurcation stenting, maintaining circular geometry while significantly reducing SB ostium strut obstruction and global strut malapposition. These experimental findings confirm that provisional stenting may be optimized more effectively without KBI using re-POT. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

In vitro fertilization treatments with the use of clomiphene citrate or letrozole.

PubMed

Haas, Jigal; Casper, Robert F

2017-10-01

There has been increasing interest in combining the oral agents clomiphene citrate (CC) and letrozole with gonadotropins in IVF: for poor responders to reduce the amount of gonadotropins used, and in normal responders to reduce the incidence of ovarian hyperstimulation (OHSS). In normal responders, mild stimulation with the use of CC and gonadotropins was found to decrease the number of oocytes retrieved and result in good pregnancy rates, but in most studies the cumulative pregnancy rate was lower compared with conventional ovarian stimulation when frozen embryo transfers were considered. Coadministration of letrozole and gonadotropins has mainly been used in patients with breast cancer to prevent the massive elevation of serum E 2 concentrations with the use of standard controlled ovarian hyperstimulation. CC and letrozole have both been used with gonadotropins in poor responders and have been shown to reduce the amount of gonadotropin used without reducing the pregnancy rate. Letrozole use with gonadotropins in IVF cycles may increase endometrial receptivity by increasing integrin expression in the endometrium and by lowering estrogen concentrations to more physiologic levels. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Modulation of mitochondrial metabolism as a biochemical trait in blood feeding organisms: the redox vampire hypothesis redux.

PubMed

Ferreira, Caroline M; Oliveira, Matheus P; Paes, Marcia C; Oliveira, Marcus F

2018-06-01

Hematophagous organisms undergo remarkable metabolic changes during the blood digestion process, increasing fermentative glucose metabolism, and reducing respiratory rates, both consequence of functional mitochondrial remodeling. Here, we review the pathways involved in energy metabolism and mitochondrial functionality in a comparative framework across different hematophagous species, and consider how these processes regulate redox homeostasis during blood digestion. The trend across distinct species indicate that a switch in energy metabolism might represent an important defensive mechanism to avoid the potential harmful interaction of oxidants generated from aerobic energy metabolism with products derived from blood digestion. Indeed, in insect vectors, blood feeding transiently reduces respiratory rates and oxidant production, irrespective of tissue and insect model. On the other hand, a different scenario is observed in several unrelated parasite species when exposed to blood digestion products, as respiratory rates reduce and mitochondrial oxidant production increase. The emerging picture indicates that re-wiring of energy metabolism, through reduced mitochondrial function, culminates in improved tolerance to redox insults and seems to represent a key step for hematophagous organisms to cope with the overwhelming and potentially toxic blood meal. © 2018 International Federation for Cell Biology.

Temperature dependence of carrier capture by defects in gallium arsenide

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

Wampler, William R.; Modine, Normand A.

2015-08-01

This report examines the temperature dependence of the capture rate of carriers by defects in gallium arsenide and compares two previously published theoretical treatments of this based on multi phonon emission (MPE). The objective is to reduce uncertainty in atomistic simulations of gain degradation in III-V HBTs from neutron irradiation. A major source of uncertainty in those simulations is poor knowledge of carrier capture rates, whose values can differ by several orders of magnitude between various defect types. Most of this variation is due to different dependence on temperature, which is closely related to the relaxation of the defect structuremore » that occurs as a result of the change in charge state of the defect. The uncertainty in capture rate can therefore be greatly reduced by better knowledge of the defect relaxation.« less

Efficacy of a proactive health and safety risk management system in the fire service.

PubMed

Poplin, Gerald S; Griffin, Stephanie; Pollack Porter, Keshia; Mallett, Joshua; Hu, Chengcheng; Day-Nash, Virginia; Burgess, Jefferey L

2018-04-16

This study evaluated the efficacy of a fire department proactive risk management program aimed at reducing firefighter injuries and their associated costs. Injury data were collected for the intervention fire department and a contemporary control department. Workers' compensation claim frequency and costs were analyzed for the intervention fire department only. Total, exercise, patient transport, and fireground operations injury rates were calculated for both fire departments. There was a post-intervention average annual reduction in injuries (13%), workers' compensation injury claims (30%) and claims costs (21%). Median monthly injury rates comparing the post-intervention to the pre-intervention period did not show statistically significant changes in either the intervention or control fire department. Reduced workers' compensation claims and costs were observed following the risk management intervention, but changes in injury rates were not statistically significant.

Friction-reducing devices for lateral patient transfers: a clinical evaluation.

PubMed

Baptiste, Andrea; Boda, Sruthi V; Nelson, Audrey L; Lloyd, John D; Lee, William E

2006-04-01

The purpose of this study was to assess the performance of lateral transfer devices compared with the traditional draw sheet method in acute care settings through subjective feedback of caregivers actually using the devices. Every 2 weeks, the eight participating acute care units each received one of the devices, which had been randomly selected. Data were collected through caregiver surveys, which rated comfort, ease of use, perceived injury risk, time efficiency, and patient safety. An overall performance rating was calculated as the sum of these five categories. Caregivers rated air-assisted devices significantly higher (p < .05) than other devices. Lateral transfer devices are recommended over the traditional draw sheet method for performing lateral patient transfers. These friction-reducing devices are a cost-effective solution to the load of lateral patient transfers and should be favorably considered when purchasing patient-handling technologies.

Educational intervention as an effective step for reducing blood culture contamination: a prospective cohort study.

PubMed

Park, W B; Myung, S J; Oh, M-d; Lee, J; Kim, N-J; Kim, E-C; Park, J S

2015-10-01

Contaminated blood cultures lead to diagnostic challenges and place a burden on healthcare services. To determine the impact of introducing a clinical skills test (CST) as part of the medical licensing examination and an institutional education programme on the contamination rates of blood cultures. A prospective cohort study was conducted from 2009 through 2013 in all wards of a tertiary-care teaching hospital. We evaluated the effects of the CST, which was added to the National Medical Licensing Examination in Korea (KMLE) in 2010 and our institutional education programme, which began in 2013. The medical interns in charge of collection of blood for culture were divided in three groups with presence or absence of CST and the institutional education programme. The primary outcome was the percentage of blood cultures contaminated in each group, which were compared using the Poisson regression model. Participants' self-rated scores for the blood draw procedure were also analysed. Although introduction of the CST in the KMLE failed to reduce blood culture contamination rate (1.36% vs 1.35%; P = 0.734), the institutional education programme significantly reduced the contamination rate (1.35% vs 1.00%; P < 0.0001). Most participants answered that they always followed each step correctly except for waiting the recommended contact time after applying the antiseptic. The educational intervention, not the introduction of CST in the KMLE, was effective in reducing overall contamination rates. Copyright © 2015 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Simply delivered meals: a tale of collaboration.

PubMed

Martin, Sarah L; Connelly, Nancy; Parsons, Cassandra; Blackstone, Katlyn

2018-06-01

Western medicine is undergoing a transition toward transparency of quality and costs, and healthcare systems are striving to achieve the Triple Aim, a framework for improving the patient experience of care, improving the health of populations, and reducing the per capita cost of healthcare. Meanwhile, there is growing recognition of the impact of social determinants of health and a new federal requirement for nonprofit hospitals to implement prevention strategies. A specialized meal delivery program called Simply Delivered for ME (SDM) was formed in an effort to improve care and reduce 30-day hospital readmission rates.The Maine Medical Center (MMC) partnered with the Southern Maine Agency on Aging to offer SDM on a voluntary basis to high-risk Medicare patients already enrolled in the Community-based Care Transition Program (CCTP) at MMC. We report the results of the 2-year intervention in terms of 30-day hospital readmission rates and cost measures (ie, return on investment and cost savings).Of the 622 MMC patients who received SDM during the 24 months, the 30-day readmission rate was 10.3% (compared with the 16.6% 30-day rate of hospital readmission at baseline [ie, before the adoption of CCTP]) for all-cause readmissions. The cost savings for reduced readmissions were $212,160. The return on investment was 387%, or a benefit-cost ratio of $3.87 for every $1.00 spent on meals. Programs such as SDM may reduce the rate of hospital readmission among high-risk older adults and, thereby, yield lower healthcare costs.

Kinetics of de-N-acetylation of the chitin disaccharide in aqueous sodium hydroxide solution.

PubMed

Khong, Thang Trung; Aachmann, Finn L; Vårum, Kjell M

2012-05-01

Chitosan is prepared from chitin, a process which is carried out at highly alkaline conditions, and that can be performed either on chitin in solution (homogeneous deacetylation) or heterogeneously with the chitin as a solid throughout the reaction. We report here a study of the de-N-acetylation reaction of the chitin dimer (GlcNAc-GlcNAc) in solution. The reaction was followed by (1)H NMR spectroscopy in deuterated aqueous sodium hydroxide solution as a function of time, sodium-hydroxide concentration and temperature. The (1)H NMR spectrum of GlcNAc-GlcNAc in 2.77 M deuterated aqueous sodium hydroxide solution was assigned. The interpretation of the (1)H NMR spectra allowed us to determine the rates of de-N-acetylation of the reducing and non-reducing ends, showing that the reaction rate at the reducing end is twice the rate at the non-reducing end. The total deacetylation reaction rate was determined as a function of the hydroxide ion concentration, showing for the first time that this de-N-acetylation reaction is second order with respect to hydroxide ion concentration. No significant difference in the deacetylation rates in deuterated water compared to water was observed. The activation energy for the reaction (26-54 °C) was determined to 114.4 and 98.6 kJ/mol at 2.77 and 5.5 M in deuterated aqueous sodium hydroxide solution, respectively. Copyright © 2012 Elsevier Ltd. All rights reserved.

Ignition and Combustion of Bulk Metals in a Microgravity Environment

NASA Technical Reports Server (NTRS)

Branch, Melvyn C.; Daily, John W.; Abbud-Madrid, Angel

1999-01-01

Results of a study of heterogeneous and homogeneous combustion of metals in reduced gravity are presented. Cylindrical titanium and magnesium samples are radiatively ignited in pure-oxygen at 1 atm. Qualitative observations, propagation rates, and burning times are extracted from high-speed cinematography. Time-resolved emission spectra of gas-phase reactions are acquired with an imaging spectrograph. Lower propagation rates of the reacting mass on titanium and of ignition waves on magnesium are obtained at reduced gravity. These rates are compared to theoretical results from fire-spread analyses with a diffusion/convection controlled reaction. The close agreement found between experimental and theoretical propagation rates indicates the strong influence of natural-convection-enhanced oxygen transp6rt on burning rates. Lower oxygen flux and lack of condensed product removal appear to be responsible for longer burning times of magnesium gas-phase diffusion flames in reduced gravity. Spherically symmetric explosions in magnesium flames at reduced gravity (termed radiation-induced metal explosions, or RIME) may be driven by increased radiation heat transfer from accumulated condensed products to an evaporating metal core covered by a porous, flexible oxide coating. In titanium specimens, predominantly heterogeneous burning characterizes the initial steady propagation of the molten mass, while homogeneous gas-phase reactions are detected around particles ejected from the molten mixture. In magnesium specimens, band and line reversal of all the UV spectral systems of Mg and MgO are attributed to the interaction between small oxide particles and the principal gaseous emitters.

Reduced central line infection rates in children with leukemia following caregiver training

PubMed Central

Lo Vecchio, Andrea; Schaffzin, Joshua K.; Ruberto, Eliana; Caiazzo, Maria Angela; Saggiomo, Loredana; Mambretti, Daniela; Russo, Danila; Crispo, Sara; Continisio, Grazia Isabella; Dello Iacovo, Rossano; Poggi, Vincenzo; Guarino, Alfredo

2016-01-01

Abstract Infections are a leading cause of morbidity and mortality in children with acute leukemia. Central-line (CL) devices increase this population's risk of serious infections. Within the context of a quality improvement (QI) project, we tested the effect of caregiver education on CL management on the CL-associated bloodstream infection (CLABSI) rate among children with acute leukemia seen at a large referral center in Italy. The intervention consisted of 9 in-person sessions for education and practice using mannequins and children. One hundred and twenty caregivers agreed to participate in the initiative. One hundred and five (87.5%) completed the training, 5 (4.1%) withdrew after the first session, and 10 (8.3%) withdrew during practical sessions. After educational intervention, the overall CLABSI rate was reduced by 46% (from 6.86 to 3.70/1000 CL-days). CLABSI rate was lower in children whose caregivers completed the training (1.74/1000 CL-days, 95% CI 0.43–6.94) compared with those who did not receive any training (12.2/1000 CL-days, 95% CI 7.08–21.0, P < 0.05) or were in-training (3.96/1000 CL-days, 95% CI 1.98–7.91) at the time of infection. Caregiver training in CL management, applied within a multifaceted QI approach, reduced the rate of CLABSI in children with acute leukemia. Specific training and active involvement of caregivers in CL management may be effective to reduce CLABSI in high-risk children. PMID:27336888

A novel approach to reducing admissions for children with sickle cell disease in pain crisis through individualization and standardization in the emergency department.

PubMed

Schefft, Matthew R; Swaffar, Caitlan; Newlin, Jennifer; Noda, Cady; Sisler, India

2018-06-01

Vaso-occlusive crisis (VOC) is frequent in children with sickle cell disease (SCD) creating significant burden on patients, families, and emergency departments (ED). The objective of the project was to reduce the admission rate for children with SCD presenting to our ED with VOC by >20% within 6 months of initiating individualized pain plans (IPP). A multi-disciplinary quality improvement team was assembled. A Plan-Do-Study-Act (PDSA) format was employed. The IPP document was created in a unique folder within the electronic medical record. IPPs were created through retrospective chart review for our 80 highest resource users. Pediatric residents, ED residents, and ED attending physicians were instructed on use of the IPPs. Our study measured the presence of an IPP, adherence to the IPP, and time to opiate administration. Our primary outcome was admission rate. Length of stay and 72-hr return to the ED were assessed as balancing measures. Overall, admission rate decreased by 24% following implementation compared with the previous 5 years (P = 0.046). IPPs were created for 78% of patients and followed by ED staff in 86% of visits. Admission rate was significantly lower for patients receiving a second opiate dose within 45 min of the first dose (P < 0.01). There was no difference in readmission rate or 72-hr return rate to ED. This study presents an effective strategy to reduce admission rate for children with SCD presenting with VOC. Shorter time to second opiate dosing was also associated with reduced risk of admission. © 2018 Wiley Periodicals, Inc.

Effects of aeration method and aeration rate on greenhouse gas emissions during composting of pig feces in pilot scale.

PubMed

Jiang, Tao; Li, Guoxue; Tang, Qiong; Ma, Xuguang; Wang, Gang; Schuchardt, Frank

2015-05-01

The aim of this study was to uncover ways to mitigate greenhouse gas (GHG) emissions and reduce energy consumption during the composting process. We assessed the effects of different aeration rates (0, 0.18, 0.36, and 0.54 L/(kg dry matter (dm)·min)) and methods (continuous and intermittent) on GHG emissions. Pig feces and corn stalks were mixed at a ratio of 7:1. The composting process lasted for 10 weeks, and the compost was turned approximately every 2 weeks. Results showed that both aeration rate and method significantly affected GHG emissions. Higher aeration rates increased NH3 and N2O losses, but reduced CH4 emissions. The exception is that the CH4 emission of the passive aeration treatment was lower than that of the low aeration rate treatment. Without forced aeration, the CH4 diffusion rates in the center of the piles were very low and part of the CH4 was oxidized in the surface layer. Intermittent aeration reduced NH3 and CH4 losses, but significantly increased N2O production during the maturing periods. Intermittent aeration increased the nitrification/denitrification alternation and thus enhanced the N2O production. Forced aeration treatments had higher GHG emission rates than the passive aeration treatment. Forced aeration accelerated the maturing process, but could not improve the quality of the end product. Compared with continuous aeration, intermittent aeration could increase the O2 supply efficiency and reduced the total GHG emission by 17.8%, and this reduction increased to 47.4% when composting was ended after 36 days. Copyright © 2015. Published by Elsevier B.V.

Active Chest Tube Clearance After Cardiac Surgery Is Associated With Reduced Reexploration Rates.

PubMed

Grieshaber, Philippe; Heim, Nicolas; Herzberg, Moritz; Niemann, Bernd; Roth, Peter; Boening, Andreas

2018-06-01

Ineffective evacuation of intrathoracic fluid after cardiac surgery (retained blood syndrome [RBS]) might increase postoperative complications, morbidity, and mortality. Active tube clearance (ATC) technology using an intraluminal clearing apparatus aims at increasing chest tube drainage efficiency. This study evaluated whether ATC reduces RBS in an all-comers collective undergoing scheduled cardiac surgery with cardiopulmonary bypass and full or partial median sternotomy. In this nonrandomized prospective trial, 581 consecutive patients undergoing scheduled cardiac surgery with median sternotomy between January 2016 and December 2016 were assigned to receive conventional chest tubes (control group) or a combination of conventional tubes and as many as two ATC devices (ATC group), depending on their operation date. Postoperative occurrence of RBS (one or more of the following: reexploration for bleeding or tamponade, pericardial drainage procedure, pleural drainage procedure) and other endpoints were compared. Propensity score matching was applied. In 222 ATC patients and 222 matched control patients, RBS occurrence did not differ between the groups (ATC 16%, control 22%; p = 0.15). However, reexploration rate for bleeding or tamponade was significantly reduced in the ATC group compared with the control group (4.1% versus 9.1%, respectively; p = 0.015). The mortality of RBS patients (21%) was higher compared with patients without RBS (3.9%, p < 0.001). Among the RBS components, only reexploration (odds ratio 16, 95% confidence interval: 5.8 to 43, p < 0.001) was relevant for inhospital mortality (ATC 6.8%, control 7.7%; p = 0.71). Active tube clearance is associated with reduced reexploration rates in an all-comers collective undergoing cardiac surgery. Reexploration is the only RBS component relevant for mortality. The ATC effect does not translate into improved overall survival. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Planned secondary wound closure at the circular stapler insertion site after laparoscopic gastric bypass reduces postoperative morbidity, costs, and hospital stay.

PubMed

Vetter, Diana; Raptis, Dimitri Aristotle; Giama, Mira; Hosa, Hanna; Muller, Markus K; Nocito, Antonio; Schiesser, Marc; Moos, Rudolf; Bueter, Marco

2017-12-01

The aims of the present study were to assess whether planned secondary wound closure at the insertion site of the circular stapler reduces wound infection rate and postoperative morbidity after laparoscopic Roux-en-Y gastric bypass (RYGB) and to identify independent predictive factors increasing the risk for wound infections after RYGB. This paper is a retrospective single-center analysis of a prospectively collected database of 1400 patients undergoing RYGB surgery in circular technique between June 2000 and June 2016. Planned secondary wound closure at the circular stapler introduction site was performed at postoperative day 3 in 291 (20.8%) consecutive patients and compared to a historical control of 1109 (79.2%) consecutive patients with primary wound closure. Independent predictive factors for wound infection were assessed by multivariable analysis. Secondary wound closure significantly decreased wound infection rate from 9.3% (103/1109) to 1% (3/291) (p < 0.001) leading to a shorter hospital stay (mean 9 (SD8) vs. 7 days (SD2), p < 0.001), lower costs (p = 0.039), and reduced postoperative morbidity (mean 90-day Comprehensive Complication Index (CCI) 7.4 (SD14.0) vs. 5.1 (SD11.1) p = 0.008) when compared to primary wound closure. Primary wound closure, dyslipidemia, and preoperative gastritis were independent predictive risk factors for developing wound infections both in the univariate (p < 0.001; p = 0.048; p = 0.003) and multivariable analysis (p < 0.001; p = 0.040; p = 0.012). Further, on multivariable analysis, the female gender was a predictive factor (p = 0.034) for wound infection development. Secondary wound closure at the circular stapler introduction site in laparoscopic RYGB significantly reduces the overall wound infection rate as well as postoperative morbidity, costs, and hospital stay when compared to primary wound closure.

Effect of container, vitrification volume and warming solution on cryosurvival of in vitro-produced bovine embryos.

PubMed

Rios, G L; Mucci, N C; Kaiser, G G; Alberio, R H

2010-03-01

The aim of the present research was to develop a low cost and easy to perform vitrification method for in vitro-produced cattle embryos. Effect of container material was evaluated (plastic straw compared to glass capillary, experiment 1), two volume sample (1 compared to 0.5 microL, experiment 2) and warming solution composition medium (Tissue Culture Medium 199 (TCM-199) compared to phosphate buffered saline (PBS), experiment 3) as modifications of the open pulled straw (OPS) system in order to reduce embryo damage caused by exposure to cold. In all experiments, day 7 and expanded blastocysts of cattle were exposed to the vitrification solution 1 for 3 min and 30s in solution 2. After this, embryos were placed in a droplet and loaded in a narrow end container, and immediately submerged into liquid nitrogen. For warming, vitrified embryos were plunged into warming solution 1 for 3 min, and transferred into warming solution 2 for 1 min. Fresh embryos kept in culture were used as control group. Hatching rates were recorded in all cases at day 13. In experiment 1 there was no significant effect of container material on hatching rates. Postwarming survival rate of vitrified embryos was lower than control (27.5% plastic straws, 18.9% glass capillary and 80.5% control, P<0.05). In experiment 2, there was no significant effect of volume in hatching rates (58.3% 1 microL, 61.3% 0.5 microL and 80.5% control, P<0.05). In experiment 3, the composition of the holding medium of warming solution influenced hatching rates (84.1% TCM-199, 74.8% PBS and 91.1% control P<0.05). These data suggest that neither glass capillaries nor reduced sample volume could improve hatching rates after vitrification-warming with open pulled straw (OPS) procedure, and that PBS can replace TCM-199 in warming solutions, but lesser hatching rates should be expected.

A visible light imaging device for cardiac rate detection with reduced effect of body movement

NASA Astrophysics Data System (ADS)

Jiang, Xiaotian; Liu, Ming; Zhao, Yuejin

2014-09-01

A visible light imaging system to detect human cardiac rate is proposed in this paper. A color camera and several LEDs, acting as lighting source, were used to avoid the interference of ambient light. From people's forehead, the cardiac rate could be acquired based on photoplethysmography (PPG) theory. The template matching method was used after the capture of video. The video signal was discomposed into three signal channels (RGB) and the region of interest was chosen to take the average gray value. The green channel signal could provide an excellent waveform of pulse wave on the account of green lights' absorptive characteristics of blood. Through the fast Fourier transform, the cardiac rate was exactly achieved. But the research goal was not just to achieve the cardiac rate accurately. With the template matching method, the effects of body movement are reduced to a large extent, therefore the pulse wave can be detected even while people are in the moving state and the waveform is largely optimized. Several experiments are conducted on volunteers, and the results are compared with the ones gained by a finger clamped pulse oximeter. The contrast results between these two ways are exactly agreeable. This method to detect the cardiac rate and the pulse wave largely reduces the effects of body movement and can probably be widely used in the future.

Low-Speed Flight Dynamic Tests and Analysis of the Orion Crew Module Drogue Parachute System

NASA Technical Reports Server (NTRS)

Hahne, David E.; Fremaux, C. Michael

2008-01-01

A test of a dynamically scaled model of the NASA Orion Crew Module (CM) with drogue parachutes was conducted in the NASA-Langley 20-Foot Vertical Spin Tunnel. The primary test objective was to assess the ability of the Orion Crew Module drogue parachute system to adequately stabilize the CM and reduce angular rates at low subsonic Mach numbers. Two attachment locations were tested: the current design nominal and an alternate. Experimental results indicated that the alternate attachment location showed a somewhat greater tendency to attenuate initial roll rate and reduce roll rate oscillations than the nominal location. Comparison of the experimental data to a Program To Optimize Simulated Trajectories (POST II) simulation of the experiment yielded results for the nominal attachment point that indicate differences between the low-speed pitch and yaw damping derivatives in the aerodynamic database and the physical model. Comparisons for the alternate attachment location indicate that riser twist plays a significant role in determining roll rate attenuation characteristics. Reevaluating the impact of the alternate attachment points using a simulation modified to account for these results showed significantly reduced roll rate attenuation tendencies when compared to the original simulation. Based on this modified simulation the alternate attachment point does not appear to offer a significant increase in allowable roll rate over the nominal configuration.

Direct stenting versus balloon predilation: Jury is still out.

PubMed

Belardi, Jorge A; Albertal, Mariano

2017-08-01

Compared to balloon predilation, direct stenting (DS) shortens procedural time and reduces radiation and contrast exposure. A meta-analysis that included 7 studies comparing these 2 strategies revealed lower adverse event rate with DS. Studies included in the present meta-analysis were mostly observational and utilized first generation drug-eluting stent. Patient and lesion selection may explain these positive results. © 2017 Wiley Periodicals, Inc.

Feeling safe but appearing anxious: Differential effects of alcohol on anxiety and social performance in individuals with social anxiety disorder.

PubMed

Stevens, Stephan; Cooper, Ruth; Bantin, Trisha; Hermann, Christiane; Gerlach, Alexander L

2017-07-01

Social anxiety disorder (SAD) and alcohol use disorders (AUD) co-occur frequently and there is preliminary evidence that alcohol might reduce social anxiety. It is, however, unclear which mechanisms contribute to the anxiety reducing effect, particularly regarding key aspects of social anxiety such as deficits in social performance. We compared self-rated and physiological measures of anxiety as well as self- and observer-rated social performance in a sample of 62 individuals with SAD and 60 nonanxious control participants during a speech task after receiving either alcohol, an alcohol-free placebo drink or orange juice. SAD patients reported more anxiety during the speech task than did control participants. Furthermore, SAD patients underestimated their performance in comparison to observer ratings. Alcohol reduced self-report anxiety only in SAD patients, while observers rated all participants as less competent when intoxicated. Although individuals with SAD experience a reduction in anxiety when drinking alcohol, simultaneous decreases in social performance might contribute to negative reactions from others and consequently increase the risk of further alcohol use to cope with these negative reactions. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effect of groundwater flow on remediation of dissolved-phase VOC contamination using air sparging.

PubMed

Reddy, K R; Adams, J A

2000-02-25

This paper presents two-dimensional laboratory experiments performed to study how groundwater flow may affect the injected air zone of influence and remedial performance, and how injected air may alter subsurface groundwater flow and contaminant migration during in situ air sparging. Tests were performed by subjecting uniform sand profiles contaminated with dissolved-phase benzene to a hydraulic gradient and two different air flow rates. The results of the tests were compared to a test subjected to a similar air flow rate but a static groundwater condition. The test results revealed that the size and shape of the zone of influence were negligibly affected by groundwater flow, and as a result, similar rates of contaminant removal were realized within the zone of influence with and without groundwater flow. The air flow, however, reduced the hydraulic conductivity within the zone of influence, reducing groundwater flow and subsequent downgradient contaminant migration. The use of a higher air flow rate further reduced the hydraulic conductivity and decreased groundwater flow and contaminant migration. Overall, this study demonstrated that air sparging may be effectively implemented to intercept and treat a migrating contaminant plume.

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

Azhar, A.; Hamdy, M.K.

Use of ultrafiltration membrane systems in stirred cell and in thin-channel systems for immobilizing enzyme (sweet potato intrinsic and crystalline beta-amylase) in hydrolysis of sweet potato through a continuous operation mode were studied. Both the filtration rate and reducing sugars, produced as the result of enzymic hydrolysis, decreased with the filtration time. The immobilized enzymes in the thin-channel system showed a much better performance compared to that in the stirred cell system. Addition of crystalline sweet potato beta-amylase to the sweet potato increased both the filtration rate and reducing-sugars content. Alcohol fermentation of the filtrate resulted in an alcohol contentmore » of 4.2%. This represented fermentation of 95% of the sugars with an efficiency of 88%.« less

[Effect of CP Metronomic Chemotherapy on RPMI 8226 Cell Proli-feration and Notch1/NF-κB Signaling Pathway In Vitro].

PubMed

Guo, Lie-Ping; Zhou, Fan; Shi, Hao-Tian; Chen, Hai-Min; Lin, Chen-Hui; Chen, Xiao-Ling; Hou, Jian

2016-10-01

To investigate the effect of metronomic chemotherapy of low dose phosphoramide combined with prednisolone (CP metronomic chemotherapy) on proliferation and apoptosis of RPMI 8226 cells, and to explore its regulating effect on Notch1/NF-κB signaling pathways. Experiment was divided into the DMSO control group, and the phosphoramide mustard (PM) group, the prednisolone group, the phosphoramide mustard plus prednisolone group (the CP group). RPMI 8226 cells were treated with different drugs, CCK-8 method was used to detect cell proliferation, flow cytometry was used to detect the cell cycle and apoptosis, reverse transcription PCR was used to detect Notch1 and NF-κB mRNA expression level. Compared with DMSO control group, RPMI8226 cell proliferation inhibition rate in all the PM, prednisolone and CP groups increased significantly with prolonging of time (r of 0.994,0.996,0.999, respectively, P<0.001). And at the same time, the inhibitory rate of cell proliferation was significantly different; the cell inhibitory rate in PM group was lowest, that in CP group was highgest, that in prednissone group was intermediate (P<0.01). After 48 hours, compared with the DMSO control group, the G 1 /G 0 cell proportion in treatment group increased significantly, S phase cell proportion decreased significantly, especially in PM and CP groups. The G 2 /M phase cell proportion increased in PM group, while reduced in the prednisolone and the CP groups. After 48 hours, compared with the DMSO control group, RPMI 8226 cell apoptosis rate increased as follow: in PM, pre-dnisolone and CP group(P<0.01). After 48 hours, compared with the DMSO control group, Notch1 and NF-κB mRNA expression in the prednisolone, the PM and the CP group decreased significantly(P<0.001). CP metronomic chemotherapy can significantly reduce RPMI 8226 cell proliferation, promote RPMI 8226 cell apoptosis, arrest RPMI 8226 cells mainly in the G 1 /G 0 phase, and significantly reduce Notch1 and NF-κB expression levels. It is suggested that Notch1/NF-κB signaling pathways is involved in CP metronomic chemotherapy for MM.

Role of innate immunity and altered intestinal motility in LPS- and MnCl2-induced intestinal intussusception in mice

PubMed Central

Killoran, Kristin E.; Miller, Amber D.; Uray, Karen S.; Weisbrodt, Norman W.; Pautler, Robia G.; Goyert, Sanna M.; van Rooijen, Nico

2014-01-01

Intestinal intussusception (ISS) commonly causes intestinal obstruction in children. One mechanism that has been proposed to cause ISS is inflammation-induced alteration of intestinal motility. We investigated whether innate inflammatory factors or altered motility is required for induction of ISS by LPS. We compared rates of ISS among BALB/c and C57BL/6 mice, mice lacking lymphocytes or depleted of phagocytes, or mice with defects in the Toll-like receptor 4 (TLR4) signaling pathway following administration of LPS or the Ca2+ analog MnCl2. At 6 or 2 h after administration of LPS or MnCl2, respectively, mice underwent image analysis to assess intestinal contraction rate or laparotomy to identify ISS. LPS-induced ISS (LPS-ISS) was observed in BALB/c mice, but not in C57BL/6 mice or any BALB/c mice with disruptions of TLR4 signaling. LPS-induced serum TNF-α, IL-6, and nitric oxide (NO) and intestinal NO levels were similar in BALB/c and C57BL/6 mice. The rate of LPS-ISS was significantly reduced in phagocyte-depleted, but not lymphocyte-deficient, mice. Intestinal contraction rates were reduced in LPS-ISS-susceptible BALB/c mice, but not in LPS-ISS-resistant C57BL/6 or TLR4 mutant mice, suggesting a role for reduced intestinal contraction rate in LPS-ISS susceptibility. This was tested with MnCl2, a Ca2+ antagonist that reduced intestinal contraction rates and induced ISS, irrespective of mouse strain. Therefore, LPS-ISS is initiated by innate immune signaling that requires TLR4 and phagocytes but may be independent of TNF-α, IL-6, and NO levels. Furthermore, alteration of intestinal motility, specifically, reduced intestinal contraction rate, is a key factor in the development of ISS. PMID:24407593

RECURRENT STROKE IN THE WARFARIN VERSUS ASPIRIN IN REDUCED EJECTION FRACTION (WARCEF) TRIAL

PubMed Central

Pullicino, Patrick M.; Qian, Min; Sacco, Ralph L.; Freudenberger, Ron; Graham, Susan; Teerlink, John R.; Mann, Douglas; Di Tullio, Marco R.; Ponikowski, Piotr; Lok, Dirk J.; Anker, Stefan D.; Lip, Gregory Y.H.; Estol, Conrado J.; Levin, Bruce; Mohr, J.P.; Thompson, John L. P.; Homma, Shunichi

2014-01-01

Background and Purpose WARCEF randomized 2305 patients in sinus rhythm with ejection fraction (EF) ≤35% to warfarin (INR 2.0–3.5) or aspirin 325 mg. Warfarin reduced the incident ischemic stroke (IIS) hazard rate by 48% over aspirin in a secondary analysis. The IIS rate in heart failure (HF) is too low to warrant routine anticoagulation but epidemiologic studies show that prior stroke increases the stroke risk in HF. We here explore IIS rates in WARCEF patients with and without baseline stroke to look for risk factors for IIS and determine if a subgroup with an IIS rate high enough to give a clinically relevant stroke risk reduction can be identified. Methods We compared potential stroke risk factors between patients with baseline stroke and those without using the exact conditional score test for Poisson variables. We looked for risk factors for IIS, by comparing IIS rates between different risk factors. For EF we tried cutoff points of 10%, 15% and 20%. 15% was used as it was the highest EF that was associated with a significant increase in IIS rate. IIS and EF strata were balanced as to warfarin/aspirin assignment by the stratified randomized design. A multiple Poisson regression examined the simultaneous effects of all risk factors on IIS rate. IIS rates per hundred patient years (/100PY) were calculated in patient groups with significant risk factors. Missing values were assigned the modal value. Results Twenty of 248 (8.1%) patients with baseline stroke and 64 of 2048 (3.1%) without had IIS. IIS rate in patients with baseline stroke (2.37/100PY) was greater than patients without (0.89/100PY)(rate ratio 2.68, p<0.001). Fourteen of 219 (6.4%) patients with ejection fraction (EF)<15% and 70 of 2079 (3.4%) with EF ≥15% had IIS. In the multiple regression analysis stroke at baseline (p<0.001) and EF<15% vs. ≥15% (p=.005) remained significant predictors of IIS. IIS rate was 2.04/100PY in patients with EF<15% and 0.95/100PY in patients with EF ≥15% (p=0.009). IIS rate in patients with baseline stroke and reduced EF was 5.88/100PY with EF<15% decreasing to 2.62/100PY with EF<30%. Conclusions In a WARCEF exploratory analysis, prior stroke and EF<15% were risk factors for IIS. Further research is needed to determine if a clinically relevant stroke risk reduction is obtainable with warfarin in HF patients with prior stroke and reduced EF. PMID:25300706

Prophylactic Mesh Reinforcement versus Sutured Closure to Prevent Incisional Hernias after Open Abdominal Aortic Aneurysm Repair via Midline Laparotomy: A Systematic Review and Meta-Analysis.

PubMed

Indrakusuma, Reza; Jalalzadeh, Hamid; van der Meij, Jessica E; Balm, Ron; Koelemay, Mark J W

2018-04-20

Incisional hernia is a frequent late complication after open abdominal aortic aneurysm (AAA) repair. We aimed to determine whether prophylactic mesh reinforcement of the abdominal wall at open AAA repair via midline laparotomy reduces the rate of incisional hernia compared to standard sutured closure. A systematic review and meta-analysis was carried out in accordance with the PRISMA statement (PROSPERO registration CRD42017072508). Randomised controlled trials (RCTs) comparing prophylactic mesh reinforcement with standard sutured closure were eligible for inclusion. MEDLINE, Embase, and the Cochrane Library were searched. A meta-analysis with a random effects model was carried out to estimate pooled risk ratios (RR) with 95% confidence intervals (CIs) for the incidence of, and re-operation rate for, incisional hernias. Assessments of methodological quality, quality of evidence, and strength of recommendations were done with the Cochrane Collaboration's tool for assessing risk of bias and the GRADE approach. Four RCTs with a total of 388 patients were included in the meta-analysis. Pooled analysis showed that mesh reinforcement significantly reduced the risk of incisional hernia after AAA repair compared with standard sutured closure (RR 0.27, 95% CI 0.11-0.66). The pooled rate of re-operations was not different between groups (RR 0.23, 95% CI 0.11-1.05). Mesh reinforcement did not cause more intra-operative or post-operative complications than sutured closure. The risk of bias in studies was low and the quality of evidence was rated as moderate. Prophylactic mesh reinforcement of the abdominal wall after open AAA repair via midline laparotomy significantly reduces the risk of incisional hernia. However, no significant difference in re-operation for incisional hernia was found. Copyright © 2018 European Society for Vascular Surgery. Published by Elsevier B.V. All rights reserved.

Interactions between insulin-like growth factor-I, estrogen receptor-α (ERα) and ERβ in regulating growth/apoptosis of MCF-7 human breast cancer cells

PubMed Central

Mendoza, Rhone A.; Enriquez, Marlene I; Mejia, Sylvia M; Moody, Emily E; Thordarson, Gudmundur

2011-01-01

Understanding of the interactions between estradiol (E2) and insulin-like growth factor-I (IGF-I) is still incomplete. Cell lines derived from the MCF-7 breast cancer cells were generated with suppressed expression of the IGF-I receptor (IGF-IR), termed IGF-IR.low cells, by stable transfection using small interfering RNA (siRNA) expression vector. Vector for control cells carried sequence generating non-interfering RNA. Concomitant with reduction in the IGF-IR levels, the IGF-IR.low cells also showed a reduction in estrogen receptor α (ERα) and progesterone receptor expressions and an elevation in the expression of ERβ. The number of the IGF-IR.low cells was reduced in response to IGF-I and human growth hormone plus epidermal growth factor, but E2 did not cause increase in the number of the IGF-IR.low cells compared to controls. Proliferation rate of IGF-IR.low cells was only reduced in response to E2 compared to controls, whereas their basal and hormone stimulated apoptosis rate was increased. Phosphorylation of p38 mitogen activated protein kinase (p38 MAPK) was increased in the IGF-IR.low cells after treatment with E2, without affecting control cells. Further, phosphorylation of the tumor suppressor protein p53 was elevated in the IGF-IR.low cells compared to the controls. Summary, suppressing the IGF-IR expression decreased the level of ERα but increased the level of ERβ. Overall growth rate of the IGF-IR.low cells was reduced mostly through an increase in apoptosis without affecting proliferation substantially. We hypothesize that a decreased ERα:ERβ ratio triggered a rapid phosphorylation of p38 MAPK which in turn phosphorylated the p53 tumor suppressor and accelerated apoptosis rate. PMID:20974640

Fatigue reduction during aggregated and distributed sequential stimulation.

PubMed

Bergquist, Austin J; Babbar, Vishvek; Ali, Saima; Popovic, Milos R; Masani, Kei

2017-08-01

Transcutaneous neuromuscular electrical stimulation (NMES) can generate muscle contractions for rehabilitation and exercise. However, NMES-evoked contractions are limited by fatigue when they are delivered "conventionally" (CONV) using a single active electrode. Researchers have developed "sequential" (SEQ) stimulation, involving rotation of pulses between multiple "aggregated" (AGGR-SEQ) or "distributed" (DISTR-SEQ) active electrodes, to reduce fatigue (torque-decline) by reducing motor unit discharge rates. The primary objective was to compare fatigue-related outcomes, "potentiation," "variability," and "efficiency" between CONV, AGGR-SEQ, and DISTR-SEQ stimulation of knee extensors in healthy participants. Torque and current were recorded during testing with fatiguing trains using each NMES type under isometric and isokinetic (180°/s) conditions. Compared with CONV stimulation, SEQ techniques reduced fatigue-related outcomes, increased potentiation, did not affect variability, and reduced efficiency. SEQ techniques hold promise for reducing fatigue during NMES-based rehabilitation and exercise; however, optimization is required to improve efficiency. Muscle Nerve 56: 271-281, 2017. © 2016 Wiley Periodicals, Inc.

Model-based Iterative Reconstruction: Effect on Patient Radiation Dose and Image Quality in Pediatric Body CT

PubMed Central

Dillman, Jonathan R.; Goodsitt, Mitchell M.; Christodoulou, Emmanuel G.; Keshavarzi, Nahid; Strouse, Peter J.

2014-01-01

Purpose To retrospectively compare image quality and radiation dose between a reduced-dose computed tomographic (CT) protocol that uses model-based iterative reconstruction (MBIR) and a standard-dose CT protocol that uses 30% adaptive statistical iterative reconstruction (ASIR) with filtered back projection. Materials and Methods Institutional review board approval was obtained. Clinical CT images of the chest, abdomen, and pelvis obtained with a reduced-dose protocol were identified. Images were reconstructed with two algorithms: MBIR and 100% ASIR. All subjects had undergone standard-dose CT within the prior year, and the images were reconstructed with 30% ASIR. Reduced- and standard-dose images were evaluated objectively and subjectively. Reduced-dose images were evaluated for lesion detectability. Spatial resolution was assessed in a phantom. Radiation dose was estimated by using volumetric CT dose index (CTDIvol) and calculated size-specific dose estimates (SSDE). A combination of descriptive statistics, analysis of variance, and t tests was used for statistical analysis. Results In the 25 patients who underwent the reduced-dose protocol, mean decrease in CTDIvol was 46% (range, 19%–65%) and mean decrease in SSDE was 44% (range, 19%–64%). Reduced-dose MBIR images had less noise (P > .004). Spatial resolution was superior for reduced-dose MBIR images. Reduced-dose MBIR images were equivalent to standard-dose images for lungs and soft tissues (P > .05) but were inferior for bones (P = .004). Reduced-dose 100% ASIR images were inferior for soft tissues (P < .002), lungs (P < .001), and bones (P < .001). By using the same reduced-dose acquisition, lesion detectability was better (38% [32 of 84 rated lesions]) or the same (62% [52 of 84 rated lesions]) with MBIR as compared with 100% ASIR. Conclusion CT performed with a reduced-dose protocol and MBIR is feasible in the pediatric population, and it maintains diagnostic quality. © RSNA, 2013 Online supplemental material is available for this article. PMID:24091359

The association of graduated driver licensing with miles driven and fatal crash rates per miles driven among adolescents

PubMed Central

Zhu, Motao; Cummings, Peter; Zhao, Songzhu; Coben, Jeffrey H.; Smith, Gordon S.

2014-01-01

Background Graduated driver licensing (GDL) laws are associated with reduced crash rates per person-year among adolescents. It is unknown whether adolescents crash less per miles driven or drive less under GDL policies. Methods We used data from the US National Household Travel Survey and Fatality Analysis Reporting System for 1995–1996, 2001–2002, and 2008–2009. We compared adolescents subject to GDL laws with those not, by estimating adjusted incidence rate ratios for being a driver in a crash with a death per person-year (aIRRpy) and per miles driven (aIRRm), and adjusted miles driven ratios (aMR) controlling for changes in rates over time. Results Comparing persons subject to GDL policies with those not, 16-year-olds had fewer fatal crashes per person-year (aIRRpy 0.63, 95% confidence interval [CI] 0.47, 0.91), drove fewer miles (aMR 0.79, 95% CI 0.63, 0.98), and had lower crash rates per miles driven (aIRRm 0.83, 95% CI 0.65, 1.06). For age 17, the aIRRpy was 0.83 (95% CI 0.60, 1.17), the aMR 0.80 (95% CI 0.63, 1.03), and the aIRRm 1.03 (95% CI 0.80, 1.35). For age 18, the aIRRpy was 0.93 (95% CI 0.72, 1.19), the aMR 0.92 (95% CI 0.77, 1.09), and the aIRRm 1.01 (95% CI 0.84, 1.23). Conclusions If these associations are causal, GDL laws reduced crashes per person-year by about one-third among 16-year-olds; half the reduction was due to fewer crashes per miles driven and half to less driving. For ages 17 and 18, there was no evidence of reduced crash rates per miles driven. PMID:24525908

Control of Viscous Fingering in Miscible Displacements in Porous Media with a Periodic Change of Injection Rate

NASA Astrophysics Data System (ADS)

Yuan, Q.; Zeng, F.; Knorr, K. D.; Imran, M.

2017-12-01

Context/PurposeThe viscous fingering (VF) is widely encountered in a series of miscible displacements such as CO2 sequestration and solvent-based enhanced oil recovery (EOR). Accurate prediction and effective control of its development are significant. Commercial simulators cannot capture VF because of large numerical diffusion. Moreover, previous measures for controlling VF using polymer are very expensive. In the present study, a periodic change of injection rate involving injection and extraction is used to control and reduce VF instabilities at zero cost. MethodsHighly accurate spectral method and fully implicit alternating direction implicit method are used to simulate VF with concentration-dependent diffusion (CDD) and velocity-induced dispersion (VID), although the consideration of CDD and VID may result in strong nonlinearity and stiff problem under unfavourable viscosity ratio. In-house code is developed. The VF is reduced by optimizing period and amplitude of injection rate. ResultsThe results show that the periodic change of injection rates can strongly affect VF and sweep efficiency. In particular, a period-stabilizing range is found in which the VF is reduced compared with widely used constant injection with the same amount of fluid injected. The frequent change of rate results in high sweep efficiency. The optimal injection scheme, when compared with constant injection, can improve sweep efficiency by 20-35%. InterpretationDispersion plays a key role in the mitigation of VF in periodic displacement rates. It enhances the uniform mixing of two fluids in injection stage in any period, while it can more effectively attenuate VF instabilities through the following extraction stage. Fast switch of injection and extraction can mitigate flow instability once it develops. ConclusionThis finding is very novel and significant as it is the first time to control VF instability in porous media without any additional cost. It shows great potential for EOR at zero cost.

Changes to injury profile (and recommended cricket injury definitions) based on the increased frequency of Twenty20 cricket matches

PubMed Central

Orchard, John; James, Trefor; Kountouris, Alex; Portus, Marc

2010-01-01

This study analyzes injuries occurring prospectively in Australian men’s cricket at the state and national levels over 11 seasons (concluding in season 2008–09). In the last four of these seasons, there was more cricket played, with most of the growth being a new form of the game – Twenty20 cricket. Since the introduction of a regular Twenty20 program, injury incidence rates in each form of cricket have been fairly steady. Because of the short match duration, Twenty20 cricket exhibits a high match injury incidence, expressed as injuries per 10,000 hours of play. Expressed as injuries per days of play, Twenty20 cricket injury rates compare more favorably to other forms of cricket. Domestic level Twenty20 cricket resulted in 145 injuries per 1000 days of play (compared to 219 injuries per 1000 days of domestic one day cricket, and 112 injuries per 1000 days of play in first class domestic cricket). It is therefore recommended that match injury incidence measures be expressed in units of injuries per 1000 days of play. Given the high numbers of injuries which are of gradual onset, seasonal injury incidence rates (which typically range from 15–20 injuries per team per defined ‘season’) are probably a superior incidence measure. Thigh and hamstring strains have become clearly the most common injury in the past two years (greater than four injuries per team per season), perhaps associated with the increased amount of Twenty20 cricket. Injury prevalence rates have risen in conjunction with an increase in the density of the cricket calendar. Annual injury prevalence rates (average proportion of players missing through injury) have exceeded 10% in the last three years, with the injury prevalence rates for fast bowlers exceeding 18%. As the amount of scheduled cricket is unlikely to be reduced in future years, teams may need to develop a squad rotation for fast bowlers, similar to pitching staff in baseball, to reduce the injury rates for fast bowlers. Consideration should be given to rule changes which may reduce the impact of injury. In particular, allowing the 12th man to play as a full substitute in first class cricket (and therefore take some of the bowling workload in the second innings) would probably reduce bowling injury prevalence in cricket. PMID:24198544

Corrosion of Tungsten Microelectrodes used in Neural Recording Applications

PubMed Central

Patrick, Erin; Orazem, Mark E.; Sanchez, Justin C.; Nishida, Toshikazu

2011-01-01

In neuroprosthetic applications, long-term electrode viability is necessary for robust recording of the activity of neural populations used for generating communication and control signals. The corrosion of tungsten microwire electrodes used for intracortical recording applications was analyzed in a controlled bench-top study and compared to the corrosion of tungsten microwires used in an in vivo study. Two electrolytes were investigated for the benchtop electrochemical analysis: 0.9% phosphate buffered saline (PBS) and 0.9% PBS containing 30 mM of hydrogen peroxide. The oxidation and reduction reactions responsible for corrosion were found by measurement of the open circuit potential and analysis of Pourbaix diagrams. Dissolution of tungsten to form the tungstic ion was found to be the corrosion mechanism. The corrosion rate was estimated from the polarization resistance, which was extrapolated from the electrochemical impedance spectroscopy data. The results show that tungsten microwires in an electrolyte of PBS have a corrosion rate of 300–700 µm/yr. The corrosion rate for tungsten microwires in an electrolyte containing PBS and 30 mM H2O2 is accelerated to 10,000–20,000 µm/yr. The corrosion rate was found to be controlled by the concentration of the reacting species in the cathodic reaction (e.g. O2 and H2O2). The in vivo corrosion rate, averaged over the duration of implantation, was estimated to be 100 µm/yr. The reduced in vivo corrosion rate as compared to the benchtop rate is attributed to decreased rate of oxygen diffusion caused by the presence of a biological film and a reduced concentration of available oxygen in the brain. PMID:21470563

Corrosion of tungsten microelectrodes used in neural recording applications.

PubMed

Patrick, Erin; Orazem, Mark E; Sanchez, Justin C; Nishida, Toshikazu

2011-06-15

In neuroprosthetic applications, long-term electrode viability is necessary for robust recording of the activity of neural populations used for generating communication and control signals. The corrosion of tungsten microwire electrodes used for intracortical recording applications was analyzed in a controlled bench-top study and compared to the corrosion of tungsten microwires used in an in vivo study. Two electrolytes were investigated for the bench-top electrochemical analysis: 0.9% phosphate buffered saline (PBS) and 0.9% PBS containing 30 mM of hydrogen peroxide. The oxidation and reduction reactions responsible for corrosion were found by measurement of the open circuit potential and analysis of Pourbaix diagrams. Dissolution of tungsten to form the tungstic ion was found to be the corrosion mechanism. The corrosion rate was estimated from the polarization resistance, which was extrapolated from the electrochemical impedance spectroscopy data. The results show that tungsten microwires in an electrolyte of PBS have a corrosion rate of 300-700 μm/yr. The corrosion rate for tungsten microwires in an electrolyte containing PBS and 30 mM H₂O₂ is accelerated to 10,000-20,000 μm/yr. The corrosion rate was found to be controlled by the concentration of the reacting species in the cathodic reaction (e.g. O₂ and H₂O₂). The in vivo corrosion rate, averaged over the duration of implantation, was estimated to be 100 μm/yr. The reduced in vivo corrosion rate as compared to the bench-top rate is attributed to decreased rate of oxygen diffusion caused by the presence of a biological film and a reduced concentration of available oxygen in the brain. Copyright © 2011 Elsevier B.V. All rights reserved.

A higher chest compression rate may be necessary for metronome-guided cardiopulmonary resuscitation.

PubMed

Chung, Tae Nyoung; Kim, Sun Wook; You, Je Sung; Cho, Young Soon; Chung, Sung Phil; Park, Incheol

2012-01-01

Metronome guidance is a simple and economical feedback system for guiding cardiopulmonary resuscitation (CPR). However, a recent study showed that metronome guidance reduced the depth of chest compression. The results of previous studies suggest that a higher chest compression rate is associated with a better CPR outcome as compared with a lower chest compression rate, irrespective of metronome use. Based on this finding, we hypothesized that a lower chest compression rate promotes a reduction in chest compression depth in the recent study rather than metronome use itself. One minute of chest compression-only CPR was performed following the metronome sound played at 1 of 4 different rates: 80, 100, 120, and 140 ticks/min. Average compression depths (ACDs) and duty cycles were compared using repeated measures analysis of variance, and the values in the absence and presence of metronome guidance were compared. Both the ACD and duty cycle increased when the metronome rate increased (P = .017, <.001). Average compression depths for the CPR procedures following the metronome rates of 80 and 100 ticks/min were significantly lower than those for the procedures without metronome guidance. The ACD and duty cyle for chest compression increase as the metronome rate increases during metronome-guided CPR. A higher rate of chest compression is necessary for metronome-guided CPR to prevent suboptimal quality of chest compression. Copyright © 2012 Elsevier Inc. All rights reserved.

Lead Time to Appointment and No-Show Rates for New and Follow-up Patients in an Ambulatory Clinic.

PubMed

Drewek, Rupali; Mirea, Lucia; Adelson, P David

High rates of no-shows in outpatient clinics are problematic for revenue and for quality of patient care. Longer lead time to appointment has variably been implicated as a risk factor for no-shows, but the evidence within pediatric clinics is inconclusive. The goal of this study was to estimate no-show rates and test for association between appointment lead time and no-show rates for new and follow-up patients. Analyses included 534 new and 1920 follow-up patients from pulmonology and gastroenterology clinics at a freestanding children's hospital. The overall rate of no-shows was lower for visits scheduled within 0 to 30 days compared with 30 days or more (23% compared with 47%, P < .0001). Patient type significantly modified the association of appointment lead time; the rate of no-shows was higher (30%) among new patients compared with (21%) follow-up patients with appointments scheduled within 30 days (P = .004). For appointments scheduled 30 or more days' lead time, no-show rates were statistically similar for new patients (46%) and follow-up patients (0.48%). Time to appointment is a risk factor associated with no-shows, and further study is needed to identify and implement effective approaches to reduce appointment lead time, especially for new patients in pediatric subspecialties.

Physical heterogeneity control on effective mineral dissolution rates

NASA Astrophysics Data System (ADS)

Jung, Heewon; Navarre-Sitchler, Alexis

2018-04-01

Hydrologic heterogeneity may be an important factor contributing to the discrepancy in laboratory and field measured dissolution rates, but the governing factors influencing mineral dissolution rates among various representations of physical heterogeneity remain poorly understood. Here, we present multiple reactive transport simulations of anorthite dissolution in 2D latticed random permeability fields and link the information from local grid scale (1 cm or 4 m) dissolution rates to domain-scale (1m or 400 m) effective dissolution rates measured by the flux-weighted average of an ensemble of flow paths. We compare results of homogeneous models to heterogeneous models with different structure and layered permeability distributions within the model domain. Chemistry is simplified to a single dissolving primary mineral (anorthite) distributed homogeneously throughout the domain and a single secondary mineral (kaolinite) that is allowed to dissolve or precipitate. Results show that increasing size in correlation structure (i.e. long integral scales) and high variance in permeability distribution are two important factors inducing a reduction in effective mineral dissolution rates compared to homogeneous permeability domains. Larger correlation structures produce larger zones of low permeability where diffusion is an important transport mechanism. Due to the increased residence time under slow diffusive transport, the saturation state of a solute with respect to a reacting mineral approaches equilibrium and reduces the reaction rate. High variance in permeability distribution favorably develops large low permeability zones that intensifies the reduction in mixing and effective dissolution rate. However, the degree of reduction in effective dissolution rate observed in 1 m × 1 m domains is too small (<1% reduction from the corresponding homogeneous case) to explain several orders of magnitude reduction observed in many field studies. When multimodality in permeability distribution is approximated by high permeability variance in 400 m × 400 m domains, the reduction in effective dissolution rate increases due to the effect of long diffusion length scales through zones with very slow reaction rates. The observed scale dependence becomes complicated when pH dependent kinetics are compared to the results from pH independent rate constants. In small domains where the entire domain is reactive, faster anorthite dissolution rates and slower kaolinite precipitation rates relative to pH independent rates at far-from-equilibrium conditions reduce the effective dissolution rate by increasing the saturation state. However, in large domains where less- or non-reactive zones develop, higher kaolinite precipitation rates in less reactive zones increase the effective anorthite dissolution rates relative to the rates observed in pH independent cases.

Defective bone formation and anabolic response to exogenous estrogen in mice with targeted disruption of endothelial nitric oxide synthase.

PubMed

Armour, K E; Armour, K J; Gallagher, M E; Gödecke, A; Helfrich, M H; Reid, D M; Ralston, S H

2001-02-01

Nitric oxide (NO) is a pleiotropic signaling molecule that is produced by bone cells constitutively and in response to diverse stimuli such as proinflammatory cytokines, mechanical strain, and sex hormones. Endothelial nitric oxide synthase (eNOS) is the predominant NOS isoform expressed in bone, but its physiological role in regulating bone metabolism remains unclear. Here we studied various aspects of bone metabolism in female mice with targeted disruption of the eNOS gene. Mice with eNOS deficiency (eNOS KO) had reduced bone mineral density, and cortical thinning when compared with WT controls and histomorphometric analysis of bone revealed profound abnormalities of bone formation, with reduced osteoblast numbers, surfaces and mineral apposition rate. Studies in vitro showed that osteoblasts derived from eNOS KO mice had reduced rates of growth when compared with WT and were less well differentiated as reflected by lower levels of alkaline phosphatase activity. Mice with eNOS deficiency lost bone normally following ovariectomy but exhibited a significantly blunted anabolic response to high dose exogenous estrogen. We conclude that the eNOS pathway plays an essential role in regulating bone mass and bone turnover by modulating osteoblast function.

Does adding antibiotics to cement reduce the need for early revision in total knee arthroplasty?

PubMed

Bohm, Eric; Zhu, Naisu; Gu, Jing; de Guia, Nicole; Linton, Cassandra; Anderson, Tammy; Paton, David; Dunbar, Michael

2014-01-01

There is considerable debate about whether antibiotic-loaded bone cement should be used for fixation of TKAs. While antibiotics offer the theoretical benefit of lowering early revision due to infection, they may weaken the cement and thus increase the likelihood of aseptic loosening, perhaps resulting in a higher revision rate. We (1) compared the frequency of early knee revision arthroplasty in patients treated with antibiotic-loaded or non-antibiotic-loaded cement for initial fixation, (2) determined effects of age, sex, comorbidities, and surgeons' antibiotic-loaded cement usage patterns on revision rate, and (3) compared causes of revision (aseptic or septic) between groups. Our study sample was taken from the Canadian Joint Replacement Registry and Canada's Hospital Morbidity Database and included cemented TKAs performed between April 1, 2003, and March 31, 2008, including 20,016 TKAs inserted with non-antibiotic-loaded cement and 16,665 inserted with antibiotic-loaded cement. Chi-square test was used to compare the frequency of early revisions between groups. Cox regression modeling was used to determine whether revision rate would change by age, sex, comorbidities, or use of antibiotic-loaded cement. Similar Cox regression modeling was used to compare cause of revision between groups. Two-year revision rates were similar between the groups treated with non-antibiotic-loaded cement and antibiotic-loaded cement (1.40% versus 1.51%, p = 0.41). When controlling for age, sex, comorbidities, diabetes, and surgeons' antibiotic-loaded cement usage patterns, the revision risk likewise was similar between groups. Revision rates for infection were similar between groups; however, there were more revisions for aseptic loosening in the group treated with non-antibiotic-loaded cement (p = 0.02). The use of antibiotic-loaded cement in TKAs performed for osteoarthritis has no clinically significant effect on reducing revision within 2 years in patients who received perioperative antibiotics. Longer followup and confirmation of these findings with other national registries are warranted.

Reducing the cesarean delivery rates for breech presentations: administration of spinal anesthesia facilitates manipulation to cephalic presentation, but is it cost saving?

PubMed Central

2014-01-01

Background External cephalic version (ECV) is infrequently performed and 98% of breech presenting fetuses are delivered surgically. Neuraxial analgesia can increase the success rate of ECV significantly, potentially reducing cesarean delivery rates for breech presentation. The current study aims to determine whether the additional cost to the hospital of spinal anesthesia for ECV is offset by cost savings generated by reduced cesarean delivery. Methods In our tertiary hospital, three variables manpower, disposables, and fixed costs were calculated for ECV, ECV plus anesthetic doses of spinal block, vaginal delivery and cesarean delivery. Total procedure costs were compared for possible delivery pathways. Manpower data were obtained from management payroll, fixed costs by calculating cost/lifetime usage rate and disposables were micro-costed in 2008, expressed in 2013 NIS. Results Cesarean delivery is the most expensive option, 11670.54 NIS and vaginal delivery following successful ECV under spinal block costs 5497.2 NIS. ECV alone costs 960.21 NIS, ECV plus spinal anesthesia costs 1386.97 NIS. The highest individual cost items for vaginal, cesarean delivery and ECV were for manpower. Expensive fixed costs for cesarean delivery included operating room trays and postnatal hospitalization (minimum 3 days). ECV with spinal block is cheaper due to lower expected cesarean delivery rate and its lower associated costs. Conclusions The additional cost of the spinal anesthesia is offset by increased success rates for the ECV procedure resulting in reduction in the cesarean delivery rate. PMID:24564984

Effects of oxygen concentrations on driver fatigue during simulated driving.

PubMed

Sung, Eun-Jung; Min, Byung-Chan; Kim, Seung-Chul; Kim, Chul-Jung

2005-01-01

Driver fatigue has been the cause of traffic accidents. Despite this, the amount of time that drivers spend within cars has been increasing due to complex city life, traffic congestion, and particular occupational requirements. Consequently, fatigue and stress cannot be avoided. In present study, in order to find out the possibility for reducing fatigue while driving due to the supply of oxygen, driver fatigue resulting from the passage of time when different oxygen concentrations are supplied has been examined through subjective evaluations and reaction times using driving simulator for 10 male subjects. The results revealed the subjective fatigue feeling was highest in the low rate (18%) oxygen condition, while in the high rate (30%), it decreased to a certain extent. The feeling of sleepiness also showed the tendency to decrease somewhat in the case of the driving time having passed over 1h in the high-rate conditions. Also, the reaction time for braking after being instructed to suddenly stop following more than 2h of driving was reduced in the high-rate oxygen conditions compared to the low-rate oxygen condition. From the above results, it was shown that while driving a car, if the oxygen rate is lowered, fatigue is felt severely, and that in the case of supplying a high-rate of oxygen, the feeling of fatigue is lowered to some extent and the reaction time is shortened. It was suggested that the driver's fatigue can be reduced according to the supply of oxygen.

Development and evaluation of deep intra-uterine artificial insemination using cryopreserved sexed spermatozoa in bottlenose dolphins (Tursiops truncatus).

PubMed

Robeck, Todd R; Montano, G A; Steinman, K J; Smolensky, P; Sweeney, J; Osborn, S; O'Brien, J K

2013-06-01

Since its development in bottlenose dolphins, widespread application of AI with sex-selected, frozen-thawed (FT) spermatozoa has been limited by the significant expense of the sorting process. Reducing the total number of progressively motile sperm (PMS) required for an AI would reduce the sorting cost. As such, this research compared the efficacy of small-dose deep uterine AI with sexed FT spermatozoa (SEXED-SMALL; ~50×10(6)PMS, n=20), to a moderate dose deposited mid-horn (SEXED-STD, ~200×10(6)PMS; n=20), and a large dose of FT non-sexed spermatozoa deposited in the uterine body (NONSEXED-LARGE, 660×10(6)PMS, n=9). Ten of the 11 calves resulting from use of sexed spermatozoa were of the predetermined sex. Similar rates of conception (NONSEXED-LARGE: 78%, SEXED-STD: 60%, SEXED-SMALL: 57%) and total pregnancy loss (TPL: NONSEXED-LARGE: 28.6%; SEXED-STD: 41.0%; SEXED-SMALL: 63.6%) were observed across groups, but early pregnancy loss (EPL,

Examination of the impact of airbags on renal injury using a national database.

PubMed

Smith, Thomas G; Wessells, Hunter B; Mack, Chris D; Kaufman, Robert; Bulger, Eileen M; Voelzke, Bryan B

2010-09-01

Little is known about preventative measures to lessen solid organ injury in motor vehicle collisions (MVCs). To evaluate the efficacy of airbags in reducing renal injuries in MVC, we analyzed renal injury rates in vehicles with and without airbags using the Crash Injury Research and Engineering Network (CIREN) database. The CIREN database was queried for MVC and renal injury from 1996 to September 2008. CIREN is weighted toward late model vehicles and selects more severely injured patients. Search fields were primary direction of force (PDOF), presence of airbags, and location of airbags (steering wheel, instrument panel, seat back, door panel, and roof-side curtain). Abdominal Abbreviated Injury Score was converted to AAST renal injury grade. Renal injury rates were compared between vehicles with and without frontal and side airbags. We reviewed 2,864 records and identified 139 renal injuries (28.9% AAST grade III to V). In MVCs with renal injuries, frontal impact was 54.7% of total (n = 76) and side impact was 45.3% of total (n = 63). Most occupants in frontal impact MVCs had exposure to a steering wheel airbag (74.9%); 16.6% had an instrument panel (passenger) airbags. In side impact MVCs, 32.2% of occupants had a side airbag. Compared with the non-airbags cohort, frontal airbags and side airbags were associated with a 45.3% and 52.8% reduction in renal injury, respectively. Passengers in automobiles with frontal and side airbags have a reduced rate of renal injury compared with those without airbags. Our data support further study of the role of airbags in reducing renal injury after MVC. Copyright 2010 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Influenza vaccination and risk of stroke: Self-controlled case-series study.

PubMed

Asghar, Zahid; Coupland, Carol; Siriwardena, Niroshan

2015-10-05

Stroke may be triggered by respiratory infections, including influenza. Influenza vaccination could therefore reduce risk of stroke. Previous studies of this association have shown conflicting results. We aimed to investigate whether influenza vaccination was associated with reduced risk of stroke. We used a self-controlled case series design. The General Practice Research Database (GPRD) was used to extract records of patients aged 18 years or over recorded with stroke (fatal or non-fatal) from September 2001 to May 2009. Statistical modelling with conditional Poisson regression was employed to compute incidence rate ratios (IRR). The incidence rate of stroke in fixed time periods after influenza vaccination was compared with the incidence rate during a baseline period. There were 17,853 eligible individuals who received one or more influenza vaccinations and experienced a stroke during the observation period. The incidence of stroke was significantly reduced in the first 59 days following influenza vaccination compared with the baseline period. We found reductions of 55% (IRR 0.45; 95% CI 0.36-0.57) in the first 1-3 days after vaccination, 36% (0.64; 0.53-0.76) at 4-7 days, 30% (0.70; 0.61-0.79) at 8-14 days, 24% (0.76; 0.70-0.84) at 15-28 days and 17% (0.83; 0.77-0.89) at 29-59 days after vaccination. Early vaccination between 1 September and 15 November showed a greater reduction in IRR compared to later vaccination given after mid-November. Influenza vaccination is associated with a reduction in incidence of stroke. This study supports previous studies which have shown a beneficial association of influenza vaccination for stroke prevention. Copyright © 2015 Elsevier Ltd. All rights reserved.

Impacts of changing hydrology on permanent gully growth: experimental results

NASA Astrophysics Data System (ADS)

Day, Stephanie S.; Gran, Karen B.; Paola, Chris

2018-06-01

Permanent gullies grow through head cut propagation in response to overland flow coupled with incision and widening in the channel bottom leading to hillslope failures. Altered hydrology can impact the rate at which permanent gullies grow by changing head cut propagation, channel incision, and channel widening rates. Using a set of small physical experiments, we tested how changing overland flow rates and flow volumes alter the total volume of erosion and resulting gully morphology. Permanent gullies were modeled as both detachment-limited and transport-limited systems, using two different substrates with varying cohesion. In both cases, the erosion rate varied linearly with water discharge, such that the volume of sediment eroded was a function not of flow rate, but of total water volume. This implies that efforts to reduce peak flow rates alone without addressing flow volumes entering gully systems may not reduce erosion. The documented response in these experiments is not typical when compared to larger preexisting channels where higher flow rates result in greater erosion through nonlinear relationships between water discharge and sediment discharge. Permanent gullies do not respond like preexisting channels because channel slope remains a free parameter and can adjust relatively quickly in response to changing flows.

The Effect of Lace-up Ankle Braces on Injury Rates in High School Football Players

PubMed Central

McGuine, Timothy A.; Hetzel, Scott; Wilson, John; Brooks, Alison

2013-01-01

Background Although a nkle injuries occur frequently in high school football players no prospective studies have been performed to determine if wearing lace-up ankle braces will reduce the incidence and severity of ankle and other lower extremity injuries in these athletes. Purpose Determine if lace-up ankle braces reduce the incidence and severity of lower extremity injuries sustained by high school football players. Design Cluster randomized controlled trial. Methods 2081 players from 50 high schools were randomly-assigned to braced or control group. Braced group subjects wore lace-up ankle braces during the 2010 football season. Athletic trainers recorded brace compliance, athletic exposures and injuries. Cox Proportional Hazards models were utilized to compare injury rates between groups. Injury severity (days lost) was tested with Wilcoxon Rank Sum. Results The rate of acute ankle injury (per 1,000 exposures) was 0.48 in the braced group compared to 1.12 in the control group (Cox Hazard Ratio (HR)=0.39, 95% Confidence Interval [CI] 0.24, 0.65, p<0.001). The severity (median days lost) of acute ankle injuries was the same (5 days) in both groups (p=0.985). The rate of acute knee injury was 0.70 in the braced group compared to 0.69 in the control group, (HR=0.92 [0.57, 1.47], p=0.721). There was no difference (p=0.242) in the severity of knee injuries between the groups (controls 11.5 days, braced =17 days. The rate of other lower extremity injuries was 0.95 in the braced group and 1.32 in the control group, (HR=0.72 [0.48, 1.09], p=0.117) while the severity was similar in both groups (6 days versus 7 days, p=0.295). Conclusions Players who used lace-up ankle braces had a lower incidence of acute ankle injuries but no difference in the incidence of acute knee or other lower extremity injuries. Braces did not reduce the severity of ankle, knee or other lower extremity injuries. PMID:21926383

Reducing the metabolic cost of walking with an ankle exoskeleton: interaction between actuation timing and power.

PubMed

Galle, Samuel; Malcolm, Philippe; Collins, Steven Hartley; De Clercq, Dirk

2017-04-27

Powered ankle-foot exoskeletons can reduce the metabolic cost of human walking to below normal levels, but optimal assistance properties remain unclear. The purpose of this study was to test the effects of different assistance timing and power characteristics in an experiment with a tethered ankle-foot exoskeleton. Ten healthy female subjects walked on a treadmill with bilateral ankle-foot exoskeletons in 10 different assistance conditions. Artificial pneumatic muscles assisted plantarflexion during ankle push-off using one of four actuation onset timings (36, 42, 48 and 54% of the stride) and three power levels (average positive exoskeleton power over a stride, summed for both legs, of 0.2, 0.4 and 0.5 W∙kg -1 ). We compared metabolic rate, kinematics and electromyography (EMG) between conditions. Optimal assistance was achieved with an onset of 42% stride and average power of 0.4 W∙kg -1 , leading to 21% reduction in metabolic cost compared to walking with the exoskeleton deactivated and 12% reduction compared to normal walking without the exoskeleton. With suboptimal timing or power, the exoskeleton still reduced metabolic cost, but substantially less so. The relationship between timing, power and metabolic rate was well-characterized by a two-dimensional quadratic function. The assistive mechanisms leading to these improvements included reducing muscular activity in the ankle plantarflexors and assisting leg swing initiation. These results emphasize the importance of optimizing exoskeleton actuation properties when assisting or augmenting human locomotion. Our optimal assistance onset timing and average power levels could be used for other exoskeletons to improve assistance and resulting benefits.

Self-rated health among Mayan women participating in a randomised intervention trial reducing indoor air pollution in Guatemala.

PubMed

Díaz, Esperanza; Bruce, Nigel; Pope, Dan; Díaz, Anaité; Smith, Kirk R; Smith-Sivertsen, Tone

2008-06-05

Indoor air pollution (IAP) from solid fuels is a serious health problem in low-income countries that can be alleviated using improved stoves. Although women are the principal users, few studies have investigated the self-assessed impact of the stoves on their health and lives. This study was conducted in rural highland Guatemala, involving 89 intervention and 80 control Mayan Indian young women (mean 27.8 years, SD 7.2). Outcomes were assessed after approximately 18 months use of the new stove. Our objectives were to compare self-rated health and change in health among women participating in a randomised control trial comparing a chimney stove with an open fire, to describe impacts on women's daily lives and their perceptions of how reduced kitchen smoke affects their own and their children's health. On intention-to-treat analysis, 52.8% of intervention women reported improvement in health, compared to 23.8% of control women (p < 0.001). Among 84 intervention women who reported reduced kitchen smoke as an important change, 88% linked this to improvement in their own health, particularly for non-respiratory symptoms (for example eye discomfort, headache); 57% linked reduced smoke to improvement in their children's health, particularly sore eyes. Women's perception of their health was improved, but although smoke reduction was valued, this was linked mainly with alleviation of non-respiratory symptoms like eye discomfort and headache. More focus on such symptoms may help in promoting demand for improved stoves and cleaner fuels, but education about more severe consequences of IAP exposure is also required.

Consumption-leisure tradeoffs in pigeons: Effects of changing marginal wage rates by varying amount of reinforcement.

PubMed

Green, L; Kagel, J H; Battalio, R C

1987-01-01

Pigeons' rates of responding and food reinforcement under simple random-ratio schedules were compared with those obtained under comparable ratio schedules in which free food deliveries were added, but the duration of each food delivery was halved. These ratio-with-free-food schedules were constructed so that, were the pigeon to maintain the same rate of responding as it had under the simple ratio schedule, total food obtained (earned plus free) would remain unchanged. However, any reduction in responding would reduce total food consumption below that under the simple ratio schedule. These "compensated wage decreases" led to decreases in responding and decreases in food consumption, as predicted by an economic model of labor supply. Moreover, the reductions in responding increased as the ratio value increased (i.e., as wage rates decreased). Pigeons, therefore, substituted leisure for consumption. The relationship between these procedures and negative-income-tax programs is noted.

Bubble–CPAP vs. Ventilatory–CPAP in Preterm Infants with Respiratory Distress

PubMed Central

Bahman-Bijari, Bahareh; Malekiyan, Arash; Niknafs, Pedram; Baneshi, Mohammad-Reza

2011-01-01

Objective Application of Continuous Positive Airway Pressure (CPAP) in neonate with respiratory distress is associated with reduction of respiratory failure, reduced complications and mortality. Bubble CPAP (B-CPAP) and ventilator-derived CPAP (V-CPAP) are two most popular CPAP modes. We aimed to determine whether B-CPAP and V-CPAP would have different survival rate and possible complications. Methods This prospective clinical trial was performed on 50 preterm neonates weighing 1000-2000 gr who were admitted to the neonatal intensive care unit of Afzalipoor Hospital because of respiratory distress between June 2009 and May 2010. Patients were randomly allocated into treatment groups using minimization technique. Survival analysis was applied to estimate and compare survival rates. Duration of oxygen therapy, hospital stay as well as hospitalization costs were compared using independent sample t-test. Findings Estimated survival rates at 24 hours in B-CPAP and V-CPAP groups were 100% and 77% respectively. Corresponding figures at 48 hours were 100% and 71%. In addition the hospitalization cost in V-CPAP group was significantly higher than in B-CPAP group. Conclusion According to our results, B-CPAP was effective in the treatment of neonates who were suffering from respiratory distress and reduced the duration of hospital stay. In addition to mentioned benefits, its low cost may be the reason to use B-CPAP broadly compared with V-CPAP. PMID:23056781

A Bayesian sequential design with adaptive randomization for 2-sided hypothesis test.

PubMed

Yu, Qingzhao; Zhu, Lin; Zhu, Han

2017-11-01

Bayesian sequential and adaptive randomization designs are gaining popularity in clinical trials thanks to their potentials to reduce the number of required participants and save resources. We propose a Bayesian sequential design with adaptive randomization rates so as to more efficiently attribute newly recruited patients to different treatment arms. In this paper, we consider 2-arm clinical trials. Patients are allocated to the 2 arms with a randomization rate to achieve minimum variance for the test statistic. Algorithms are presented to calculate the optimal randomization rate, critical values, and power for the proposed design. Sensitivity analysis is implemented to check the influence on design by changing the prior distributions. Simulation studies are applied to compare the proposed method and traditional methods in terms of power and actual sample sizes. Simulations show that, when total sample size is fixed, the proposed design can obtain greater power and/or cost smaller actual sample size than the traditional Bayesian sequential design. Finally, we apply the proposed method to a real data set and compare the results with the Bayesian sequential design without adaptive randomization in terms of sample sizes. The proposed method can further reduce required sample size. Copyright © 2017 John Wiley & Sons, Ltd.

Nonequilibrium quantum solvation with a time-dependent Onsager cavity

NASA Astrophysics Data System (ADS)

Kirchberg, H.; Nalbach, P.; Thorwart, M.

2018-04-01

We formulate a theory of nonequilibrium quantum solvation in which parameters of the solvent are explicitly depending on time. We assume in a simplest approach a spherical molecular Onsager cavity with a time-dependent radius. We analyze the relaxation properties of a test molecular point dipole in a dielectric solvent and consider two cases: (i) a shrinking Onsager sphere and (ii) a breathing Onsager sphere. Due to the time-dependent solvent, the frequency-dependent response function of the dipole becomes time-dependent. For a shrinking Onsager sphere, the dipole relaxation is in general enhanced. This is reflected in a temporally increasing linewidth of the absorptive part of the response. Furthermore, the effective frequency-dependent response function shows two peaks in the absorptive part which are symmetrically shifted around the eigenfrequency. By contrast, a breathing sphere reduces damping as compared to the static sphere. Interestingly, we find a non-monotonous dependence of the relaxation rate on the breathing rate and a resonant suppression of damping when both rates are comparable. Moreover, the linewidth of the absorptive part of the response function is strongly reduced for times when the breathing sphere reaches its maximal extension.

Nonequilibrium quantum solvation with a time-dependent Onsager cavity.

PubMed

Kirchberg, H; Nalbach, P; Thorwart, M

2018-04-28

We formulate a theory of nonequilibrium quantum solvation in which parameters of the solvent are explicitly depending on time. We assume in a simplest approach a spherical molecular Onsager cavity with a time-dependent radius. We analyze the relaxation properties of a test molecular point dipole in a dielectric solvent and consider two cases: (i) a shrinking Onsager sphere and (ii) a breathing Onsager sphere. Due to the time-dependent solvent, the frequency-dependent response function of the dipole becomes time-dependent. For a shrinking Onsager sphere, the dipole relaxation is in general enhanced. This is reflected in a temporally increasing linewidth of the absorptive part of the response. Furthermore, the effective frequency-dependent response function shows two peaks in the absorptive part which are symmetrically shifted around the eigenfrequency. By contrast, a breathing sphere reduces damping as compared to the static sphere. Interestingly, we find a non-monotonous dependence of the relaxation rate on the breathing rate and a resonant suppression of damping when both rates are comparable. Moreover, the linewidth of the absorptive part of the response function is strongly reduced for times when the breathing sphere reaches its maximal extension.

Antibacterial Envelope Is Associated With Low Infection Rates After Implantable Cardioverter-Defibrillator and Cardiac Resynchronization Therapy Device Replacement: Results of the Citadel and Centurion Studies.

PubMed

Henrikson, Charles A; Sohail, M Rizwan; Acosta, Helbert; Johnson, Eric E; Rosenthal, Lawrence; Pachulski, Roman; Dan, Dan; Paladino, Walter; Khairallah, Farhat S; Gleed, Kent; Hanna, Ibrahim; Cheng, Alan; Lexcen, Daniel R; Simons, Grant R

2017-10-01

This study sought to determine whether the nonabsorbable TYRX Antibacterial Envelope (TYRX) reduces major cardiovascular implantable electronic device (CIED) infections 12 months after implant. TYRX is a monofilament polypropylene mesh impregnated with minocycline and rifampin specifically designed to hold a CIED in place and elute antimicrobials over time. There are limited data on its ability to reduce CIED infections. We prospectively enrolled patients who underwent generator replacement with an implantable cardioverter-defibrillator (ICD) or cardiac resynchronization therapy device (CRT), treated with TYRX. The primary endpoints were major CIED infection and CIED mechanical complications. Given the differences in infection rates among ICD and CRT patients, 3 different control populations were used: a published benchmark rate for ICD patients, and both site-matched and comorbidity-matched controls groups for CRT patients. Overall, a major CIED infection occurred in 5 of 1,129 patients treated with TYRX (0.4%; 95% confidence interval: 0.0% to 0.9%), significantly lower than the 12-month benchmark rate of 2.2% (p = 0.0023). Among the TYRX-treated CRT cohort, the major CIED infection rate was 0.7% compared with an infection rate of 1.0% and 1.3% (p = 0.38 and p = 0.02) in site-matched and comorbidity-matched control groups, respectively. Among the ICD group, the 12-month infection rate was 0.2% compared with the published benchmark of 2.2% (p = 0.0052). The most common CIED mechanical complication in study patients was pocket hematoma, which occurred in 18 of the 1,129 patients (1.6%; 95% confidence interval: 0.8 to 2.5), which is comparable with a published rate of 1.6%. Use of TYRX was associated with a lower major CIED infection rate. (TYRX™ Envelope for Prevention of Infection Following Replacement With a CRT or ICD; [Centurion]; NCT01043861/NCT01043705). Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Vat rates on medical devices: foreign experience and Ukrainian practice.

PubMed

Pashkov, Vitalii; Hutorova, Nataliia; Harkusha, Andrii

2017-01-01

In Ukraine differentiated VAT rates is a matter of debate. Today the Cabinet approved a list of medical products that has been changed three times resulting in changed VAT rates for specific products. European Union provides another method of regulation of VAT rates on medical devices. The abovementioned demonstrates the relevance of this study. Comparative analysis of Ukrainian and European Union legislation based on dialectical, comparative, analytic, synthetic and comprehensive research methods were used in this article. In Ukraine general rate of VAT for all business activities is 20 %. But for medical devices, Tax Code of Ukraine provides special rules. VAT rate of 7% for transactions supplies into Ukraine and imported into the customs territory of Ukraine of medical products on the list approved by the Cabinet. The list generated by the medical product name and nomenclature code that does not correspond to European experience and Council Directive 2006/112/EC. In our opinion, reduced VAT rates should to be established for all medical devices that are in a stream of commerce, have all necessary documents, that proved their quality and safety and fall under definition of medical devices.

Randomized government safety inspections reduce worker injuries with no detectable job loss.

PubMed

Levine, David I; Toffel, Michael W; Johnson, Matthew S

2012-05-18

Controversy surrounds occupational health and safety regulators, with some observers claiming that workplace regulations damage firms' competitiveness and destroy jobs and others arguing that they make workplaces safer at little cost to employers and employees. We analyzed a natural field experiment to examine how workplace safety inspections affected injury rates and other outcomes. We compared 409 randomly inspected establishments in California with 409 matched-control establishments that were eligible, but not chosen, for inspection. Compared with controls, randomly inspected employers experienced a 9.4% decline in injury rates (95% confidence interval = -0.177 to -0.021) and a 26% reduction in injury cost (95% confidence interval = -0.513 to -0.083). We find no evidence that these improvements came at the expense of employment, sales, credit ratings, or firm survival.

Fracture behavior of the Fe-8Al alloy FAP-Y

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

Alexander, D.J.

The tensile and impact properties of two heats of the reduced aluminum alloy FAP-Y have been measured and compared to the Fe{sub 3}Al alloy FA-129. The FAP-Y material has similar yield strengths up to 400{degrees}C, and much better ductility and impact properties, as compared to the FA-129. Despite excellent room-temperature ductility, the ductile-to-brittle transition temperature is still quite high, around 150{degrees}C. The material is found to be strain-rate sensitive, with a significant increase in the yield strength at strain rates of about 10{sup 3} s{sup {minus}1}. It is believed that this strain-rate sensitivity is responsible, at least in part, formore » the high ductile-to-brittle transition temperature.« less

Graduated driver licensing for reducing motor vehicle crashes among young drivers.

PubMed

Russell, Kelly F; Vandermeer, Ben; Hartling, Lisa

2011-10-05

Graduated driver licensing (GDL) has been proposed as a means of reducing crash rates among novice drivers by gradually introducing them to higher risk driving situations. To examine the effectiveness of GDL in reducing crash rates among young drivers. Studies were identified through searching MEDLINE, EMBASE, CINAHL, Healthstar, Web of Science, NTIS Bibliographic Database, TRIS Online, SIGLE, the World Wide Web, conference proceedings, consultation with experts and reference lists in relevant published literature. The searches were conducted from the time of inception to May 2009, and the Cochrane Injuries Group conducted an updated search of the TRANSPORT database in September 2009. Studies were included if: 1) they compared outcomes pre- and post-implementation of a GDL program within the same jurisdiction, 2) comparisons were made between jurisdictions with and without GDL, or 3) both. Studies had to report at least one objective, quantified outcome. Results were not pooled due to substantial heterogeneity. Percentage change was calculated for each year after the intervention, using one year prior to the intervention as baseline. Results were adjusted by internal controls. Analyses were stratified by denominators (population, licensed drivers). Results were calculated for the different crash types and presented for 16 year-olds alone as well as all teenage drivers. We included 34 studies evaluating 21 GDL programs and 2 analyses of >40 US states. GDL programs were implemented in the US (n=16), Canada (n=3), New Zealand (n=1), and Australia (n=1) and varied in their restrictions during the intermediate stage. Based on the Insurance Institute for Highway Safety (IIHS) classification, eleven programs were good, four were fair, five were marginal, one was poor and two could not be assessed. Reductions in crash rates were seen in all jurisdictions and for all crash types. Among 16 year-old drivers, the median decrease in per population adjusted overall crash rates during the first year was 15.5% (range -27 to -8%, five studies). There was a decrease in per population adjusted injury crash rates (median -21%, range -46 to -2%, five studies). Results for all teenage drivers, rates per licensed driver, and rates adjusting for internal controls were generally reduced when comparing within jurisdictions. GDL is effective in reducing crash rates among young drivers, although the magnitude of the effect varies. The conclusions are supported by consistent findings, temporal relationship, and plausibility of the association. Stronger GDL programs (i.e. more restrictions or higher quality based on IIHS classification) appear to result in greater fatality reduction. Future studies should focus on which components and combination of components yield the greatest reductions.

Diabetes Care Management Teams Did Not Reduce Utilization When Compared With Traditional Care: A Randomized Cluster Trial.

PubMed

Kearns, Patrick

2017-10-01

PURPOSE: Health services research evaluates redesign models for primary care. Care management is one alternative. Evaluation includes resource utilization as a criterion. Compare the impact of care-manager teams on resource utilization. The comparison includes entire panes of patients and the subset of patients with diabetes. DESIGN: Randomized, prospective, cohort study comparing change in utilization rates between groups, pre- and post-intervention. METHODOLOGY: Ten primary care physician panels in a safety-net setting. Ten physicians were randomized to either a care-management approach (Group 1) or a traditional approach (Group 2). Care managers focused on diabetes and the cardiovascular cluster of diseases. Analysis compared rates of hospitalization, 30-day readmission, emergency room visits, and urgent care visits. Analysis compared baseline rates to annual rates after a yearlong run-in for entire panels and the subset of patients with diabetes. RESULTS: Resource utilization showed no statistically significant change between baseline and Year 3 (P=.79). Emergency room visits and hospital readmission increased for both groups (P=.90), while hospital admissions and urgent care visits decreased (P=.73). Similarly, utilization was not significantly different for patients with diabetes (P=.69). CONCLUSIONS: A care-management team approach failed to improve resource utilization rates by entire panels and the subset of diabetic patients compared to traditional care. This reinforces the need for further evidentiary support for the care-management model's hypothesis in the safety net.

Improving performance in thermodynamics: Integrating learning by teaching pedagogy

NASA Astrophysics Data System (ADS)

Campagni, Jamie Anthony

Historically, Thermo is perceived to be the most challenging course in the MET Curriculum at UNC Charlotte. The complexity and difficulties of this course have contributed to the some of the highest DFW rates compared to any other courses offered within the MET program. One hypothesis contributing to high DFW rates is the pedagogy in which Thermo is taught, which is the foundation of this study. Implementation of LBT in the spring 2014 offering of Thermo was deemed a success. The DFW rate in spring 2014 was reduced by 19 percentage points compared to the DFW rate in spring 2013, which exceeded the target of 10 percentage points. However, only cumulative GPA was a significant predictor of whether a student passed or failed the course. The semester in which students took Thermo was not a significant predictor. Students in the spring 2014 semester also exhibited statistically significant higher final exam averages compared to the 2012 and 2013 semesters. In general, students felt that LBT activities enhanced their learning and application of Thermodynamic concepts. Students had a very positive perception of LBT compared to traditional lecture in that 100% of students would recommend this teaching style to other students.

Cell growth and water relations of the halophyte, Atriplex nummularia L., in response to NaCl.

PubMed

Casas, A M; Bressan, R A; Hasegawa, P M

1991-06-01

Growth reduction or cessation is an initial response of Atriplex nummularia L. cells to NaCl. However, A. nummularia L. cells that are adapted to 342 and 428 mM NaCl are capable of sustained growth in the presence of salt. Cells that are adapted to NaCl exhibit a reduced rate of division compared to unadapted cells. Unlike salt adapted cells of the glycophyte Nicotiana tabacum L., A. nummularia L. cells do not exhibit reduced rate of cell expansion after adaptation. However, the cell expansion rate of unadapted A. nummularia L. cells is considerably slower than that of unadapted glycophyte cells and this normally low rate of cell expansion may contribute to the enhanced capacity of the halophyte to tolerate salt. Turgor of NaCl adapted cells was equivalent to unadapted cells indicating that the cells of the halophyte do not respond to salt by osmotic "over adjustment" as reported for the glycophyte tobacco (Binzel et al. 1985, Plant Physiol. 79:118-125).

Tocolysis in term breech external cephalic version.

PubMed

Nor Azlin, M I; Haliza, H; Mahdy, Z A; Anson, I; Fahya, M N; Jamil, M A

2005-01-01

To study the effect of ritodrine tocolysis on the success of external cephalic version (ECV) and to assess the role of ECV in breech presentation at our centre. A prospective randomized double-blind-controlled trial comparing ritodrine and placebo in ECV of singleton term breech pregnancy at a tertiary hospital. Among the 60 patients who were recruited, there was a success rate of 36.7%. Ritodrine tocolysis significantly improved the success rate of ECV (50% vs. 23%; P=0.032). There was a marked effect of ritodrine tocolysis on the ECV success in nulliparae (36.4% vs. 13.0%) and multiparae (87.5% vs. 57.1%). External cephalic version has shown to reduce the rate of cesarean section for breech presentation by 33.5% in our unit. External cephalic version significantly reduced the rate of cesarean section in breech presentation, and ritodrine tocolysis improved the success of ECV and should be offered to both nulliparous and parous women in the case of term breech presentation.

A learning curve-based method to implement multifunctional work teams in the Brazilian footwear sector.

PubMed

Guimarães, L B de M; Anzanello, M J; Renner, J S

2012-05-01

This paper presents a method for implementing multifunctional work teams in a footwear company that followed the Taylor/Ford system for decades. The suggested framework first applies a Learning Curve (LC) modeling to assess whether rotation between tasks of different complexities affects workers' learning rate and performance. Next, the Macroergonomic Work Analysis (MA) method (Guimarães, 1999, 2009) introduces multifunctional principles in work teams towards workers' training and resources improvement. When applied to a pilot line consisting of 100 workers, the intervention-reduced work related accidents in 80%, absenteeism in 45.65%, and eliminated work related musculoskeletal disorders (WMSD), medical consultations, and turnover. Further, the output rate of the multifunctional team increased average 3% compared to the production rate of the regular lines following the Taylor/Ford system (with the same shoe model being manufactured), while the rework and spoilage rates were reduced 85% and 69%, respectively. Copyright © 2011 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Autolytic activity and molecular characteristics of Staphylococcus haemolyticus strains with induced vancomycin resistance.

PubMed

Kim, Jung Wook; Chung, Gyung Tae; Yoo, Jung Sik; Lee, Yeong Seon; Yoo, Jae Il

2012-10-01

The aim of this study was to investigate the molecular characteristics of induced vancomycin resistance in Staphylococcus haemolyticus. Autolytic properties and phenotypic characteristics of passage-selected vancomycin-resistant S. haemolyticus strains were examined. In addition, expression of autolysis-related genes (atl, lrgAB, sarA and lytS) was investigated using the RNase protection assay (RPA). The RPA results indicated that only the expression of the atl gene was significantly upregulated (2.5- to 6-fold increase) in vancomycin-intermediate and vancomycin-resistant strains. The vancomycin-resistant strains exhibited lower expression of murein hydrolase proteins and reduced autolytic activity compared with the parent strain. In addition, a reduced growth rate, cell wall thickening and higher survival rate in the presence of lysostaphin were observed in vancomycin-intermediate and vancomycin-resistant induced strains compared with the parent strain. In conclusion, altered autolytic properties, in particular upregulation of the atl gene, may contribute to vancomycin resistance in S. haemolyticus.

Oxidation behaviour of silicon-free tungsten alloys for use as the first wall material

NASA Astrophysics Data System (ADS)

Koch, F.; Brinkmann, J.; Lindig, S.; Mishra, T. P.; Linsmeier, Ch

2011-12-01

The use of self-passivating tungsten alloys as armour material of the first wall of a fusion power reactor may be advantageous concerning safety issues. In earlier studies good performance of the system W-Cr-Si was demonstrated. Thin films of such alloys showed a strongly reduced oxidation rate compared to pure tungsten. However, the formation of brittle tungsten silicides may be disadvantageous for the powder metallurgical production of bulk W-Cr-Si alloys if a good workability is needed. This paper shows the results of screening tests to identify suitable silicon-free alloys with distinguished self-passivation and a potentially good workability. Of all the tested systems W-Cr-Ti alloys showed the most promising results. The oxidation rate was even lower than the one of W-Cr-Si alloys, the reduction factor was about four orders of magnitude compared to pure tungsten. This performance could be conserved even if the content of alloying elements was reduced.

Decreased Emotional Perception in Obesity.

PubMed

Giel, Katrin Elisabeth; Hartmann, Armin; Zeeck, Almut; Jux, Anna; Vuck, Alexander; Gierthmuehlen, Petra C Guess; Wetzler-Burmeister, Edda; Sandholz, Angelika; Marjanovic, Goran; Joos, Andreas

2016-07-01

There is hardly any empirical evidence on emotion processing by controlled studies in obesity. Participants rated their emotions in response to visual emotional stimuli from the International Affective Picture System. Study 1 compared obese women with normal-weight controls and women with eating disorders. Study 2 compared obese men with normal-weight controls. Obese women had reduced emotional intensity scores for all basic emotions and the mixed emotion sadness-fear. Obese men had reduced scores for all emotions except happiness and disgust; anger showed a trend towards significance. The results were mainly based on ratings from non-depressed obese individuals. Obese men and women scored significantly lower on most basic and mixed emotions. Non-depressed obese subjects seem particularly affected. These new findings must be validated by further study, and longitudinal evaluation after weight loss, e.g. by bariatric surgery, will be of interest. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.

Inhibition of EGF expression and NF-κB activity by treatment with quercetin leads to suppression of angiogenesis in nasopharyngeal carcinoma.

PubMed

Huang, Dong-Yan; Dai, Zhi-Rao; Li, Wei-Min; Wang, Rong-Guan; Yang, Shi-Ming

2018-05-01

The present study was performed to investigate the effect of quercetin on nasopharyngeal carcinoma (NPC) angiogenesis. The real-time RT-PCR and enzyme-linked immunosorbent assays (ELISA) were performed to analyze the expression levels of vascular endothelial growth factor (VEGF) in nasopharyngeal carcinoma cell lines prior to and after the quercetin treatment. Effect of quercetin on the rate of cell proliferation was measured by MTT assay. It was observed that quercetin treatment at a concentration of 10 mg/mL reduced the rate of NPC039 cell viability to 36% compared to control after 24 h. The expression of VEGF and activity of NF-κB was also markedly reduced. The ability of tube formation in HUVECs was inhibited significantly on exposure to quercetin compared to the untreated cells. Therefore, quercetin plays an important role in the inhibition of NPC039 nasopharyngeal carcinoma and can be of therapeutic importance.

Electrochemical characteristics of flexible micro supercapacitors with reduced graphene oxide-carbon nanotubes composite electrodes

NASA Astrophysics Data System (ADS)

Yang, Kyungwhan; Cho, Kyoungah; Kim, Sangsig

2018-06-01

In this study, we fabricate solid-state flexible micro-supercapacitors (MSCs) with reduced graphene oxide-carbon nanotube (rGO-CNT) composite electrodes and investigate the electrochemical characteristics by comparing with those of an MSC with rGO electrodes. Regarding the resistance-capacitance time constant and IR drop, the addition of CNTs into the rGO electrodes shows a significant effect owing to both the decrease in the resistance and the increase in the permeability of the electrolytes. Compared to the rGO MSCs, the rGO-CNT MSCs show an excellent areal capacitance of 2.6 mF/cm2, a smaller IR drop of 11 mV, a lower RC time constant of 6 ms, and faster charging/discharging rates with a high scan rate ability up to 100 V/s. The mechanical stability of the flexible rGO-CNT MSCs is verified by 1000 bending cycles. In addition, the electrochemical characteristics of the flexible rGO-CNT MSCs are maintained regardless of the MSC array type.

Efficacy of Gastrografin® Compared with Standard Conservative Treatment in Management of Adhesive Small Bowel Obstruction at Mulago National Referral Hospital

PubMed Central

Haule, Caspar; Ongom, Peter A; Kimuli, Timothy

2013-01-01

Introduction The treatment of adhesive small bowel obstruction is controversial, with both operative and non-operative management practiced in different centers worldwide. Non-operative management is increasingly getting popular, though operative rates still remain high. A study to compare the efficacy of an oral water-soluble medium (Gastrografin®) with standard conservative management, both non-operative methods, in the management of this condition was conducted in a tertiary Sub Saharan hospital. Methods An open randomised controlled clinical trial was conducted between September 2012 and March 2013 at Mulago National Referral and Teaching Hospital, Uganda. Fifty patients of both genders, with adhesive small bowel obstruction, in the hospital’s emergency and general surgical wards were included. Randomisation was to Gastrografin® and standard conservative treatment groups. The primary outcomes were: the time interval between admission and relief of obstruction, the length of hospital stay, and the rates of operative surgery. Results All 50 recruited patients were followed up and analysed; 25 for each group. In the Gastrografin® group, 22 (88%) patients had relief of obstruction following the intervention, with 3 (12%) requiring surgery. The conservative treatment group had 16 (64%) patients relieved of obstruction conservatively, and 9 (36%) required surgery. The difference in operative rates between the two groups was not statistically significance (P = 0.67). Average time to relief of obstruction was shorter in the Gastrografin® group (72.52 hrs) compared to the conservative treatment group (117.75 hrs), a significant difference (P = 0.023). The average length of hospital stay was shorter in the Gastrografin® group (5.62 days) compared to the conservative treatment group (10.88 days), a significant difference (P = 0.04). Conclusion The use of Gastrografin® in patients with adhesive small bowel obstruction helps in earlier resolution of obstruction and reduces the length of hospital stay compared with standard conservative management. Its role in reducing the rate of laparotomies remains inconclusive. PMID:24729947

Efficacy of Gastrografin® Compared with Standard Conservative Treatment in Management of Adhesive Small Bowel Obstruction at Mulago National Referral Hospital.

PubMed

Haule, Caspar; Ongom, Peter A; Kimuli, Timothy

2013-12-01

The treatment of adhesive small bowel obstruction is controversial, with both operative and non-operative management practiced in different centers worldwide. Non-operative management is increasingly getting popular, though operative rates still remain high. A study to compare the efficacy of an oral water-soluble medium (Gastrografin ® ) with standard conservative management, both non-operative methods, in the management of this condition was conducted in a tertiary Sub Saharan hospital. An open randomised controlled clinical trial was conducted between September 2012 and March 2013 at Mulago National Referral and Teaching Hospital, Uganda. Fifty patients of both genders, with adhesive small bowel obstruction, in the hospital's emergency and general surgical wards were included. Randomisation was to Gastrografin ® and standard conservative treatment groups. The primary outcomes were: the time interval between admission and relief of obstruction, the length of hospital stay, and the rates of operative surgery. All 50 recruited patients were followed up and analysed; 25 for each group. In the Gastrografin ® group, 22 (88%) patients had relief of obstruction following the intervention, with 3 (12%) requiring surgery. The conservative treatment group had 16 (64%) patients relieved of obstruction conservatively, and 9 (36%) required surgery. The difference in operative rates between the two groups was not statistically significance ( P = 0.67 ). Average time to relief of obstruction was shorter in the Gastrografin ® group (72.52 hrs) compared to the conservative treatment group (117.75 hrs), a significant difference ( P = 0.023 ). The average length of hospital stay was shorter in the Gastrografin ® group (5.62 days) compared to the conservative treatment group (10.88 days), a significant difference ( P = 0.04 ). The use of Gastrografin ® in patients with adhesive small bowel obstruction helps in earlier resolution of obstruction and reduces the length of hospital stay compared with standard conservative management. Its role in reducing the rate of laparotomies remains inconclusive.

Comparing salt tolerance of beet cultivars and their halophytic ancestor: consequences of domestication and breeding programmes

PubMed Central

Rozema, Jelte; Cornelisse, Danny; Zhang, Yuancheng; Li, Hongxiu; Bruning, Bas; Katschnig, Diana; Broekman, Rob; Ji, Bin; van Bodegom, Peter

2015-01-01

Salt tolerance of higher plants is determined by a complex set of traits, the timing and rate of evolution of which are largely unknown. We compared the salt tolerance of cultivars of sugar beet and their ancestor, sea beet, in hydroponic studies and evaluated whether traditional domestication and more recent breeding have changed salt tolerance of the cultivars relative to their ancestor. Our comparison of salt tolerance of crop cultivars is based on values of the relative growth rate (RGR) of the entire plant at various salinity levels. We found considerable salt tolerance of the sea beet and slightly, but significantly, reduced salt tolerance of the sugar beet cultivars. This indicates that traditional domestication by selection for morphological traits such as leaf size, beet shape and size, enhanced productivity, sugar content and palatability slightly affected salt tolerance of sugar beet cultivars. Salt tolerance among four sugar beet cultivars, three of which have been claimed to be salt tolerant, did not differ. We analysed the components of RGR to understand the mechanism of salt tolerance at the whole-plant level. The growth rate reduction at higher salinity was linked with reduced leaf area at the whole-plant level (leaf area ratio) and at the individual leaf level (specific leaf area). The leaf weight fraction was not affected by increased salinity. On the other hand, succulence and leaf thickness and the net assimilation per unit of leaf area (unit leaf rate) increased in response to salt treatment, thus partially counteracting reduced capture of light by lower leaf area. This compensatory mechanism may form part of the salt tolerance mechanism of sea beet and the four studied sugar beet cultivars. Together, our results indicate that domestication of the halophytic ancestor sea beet slightly reduced salt tolerance and that breeding for improved salt tolerance of sugar beet cultivars has not been effective. PMID:25492122

Dissolution of cinnabar (HgS) in the presence of natural organic matter

USGS Publications Warehouse

Waples, J.S.; Nagy, K.L.; Aiken, G.R.; Ryan, J.N.

2005-01-01

Cinnabar (HgS) dissolution rates were measured in the presence of 12 different natural dissolved organic matter (DOM) isolates including humic, fulvic, and hydrophobic acid fractions. Initial dissolution rates varied by 1.3 orders of magnitude, from 2.31 ?? 10-13 to 7.16 ?? 10-12 mol Hg (mg C)-1 m-2 s-1. Rates correlate positively with three DOM characteristics: specific ultraviolet absorbance (R2 = 0.88), aromaticity (R2 = 0.80), and molecular weight (R2 = 0.76). Three experimental observations demonstrate that dissolution was controlled by the interaction of DOM with the cinnabar surface: (1) linear rates of Hg release with time, (2) significantly reduced rates when DOM was physically separated from the surface by dialysis membranes, and (3) rates that approached constant values at a specific ratio of DOM concentration to cinnabar surface area, suggesting a maximum surface coverage by dissolution-reactive DOM. Dissolution rates for the hydrophobic acid fractions correlate negatively with sorbed DOM concentrations, indicating the presence of a DOM component that reduced the surface area of cinnabar that can be dissolved. When two hydrophobic acid isolates that enhanced dissolution to different extents were mixed equally, a 20% reduction in rate occurred compared to the rate with the more dissolution-enhancing isolate alone. Rates in the presence of the more dissolution-enhancing isolate were reduced by as much as 60% when cinnabar was prereacted with the isolate that enhanced dissolution to a lesser extent. The data, taken together, imply that the property of DOM that enhances cinnabar dissolution is distinct from the property that causes it to sorb irreversibly to the cinnabar surface. Copyright ?? 2005 Elsevier Ltd.

Chronic cardiovascular disease mortality in mountaintop mining areas of central Appalachian states.

PubMed

Esch, Laura; Hendryx, Michael

2011-01-01

To determine if chronic cardiovascular disease (CVD) mortality rates are higher among residents of mountaintop mining (MTM) areas compared to mining and nonmining areas, and to examine the association between greater levels of MTM surface mining and CVD mortality. Age-adjusted chronic CVD mortality rates from 1999 to 2006 for counties in 4 Appalachian states where MTM occurs (N = 404) were linked with county coal mining data. Three groups of counties were compared: MTM, coal mining but not MTM, and nonmining. Covariates included smoking rate, rural-urban status, percent male population, primary care physician supply, obesity rate, diabetes rate, poverty rate, race/ethnicity rates, high school and college education rates, and Appalachian county. Linear regression analyses examined the association of mortality rates with mining in MTM areas and non-MTM areas and the association of mortality with quantity of surface coal mined in MTM areas. Prior to covariate adjustment, chronic CVD mortality rates were significantly higher in both mining areas compared to nonmining areas and significantly highest in MTM areas. After adjustment, mortality rates in MTM areas remained significantly higher and increased as a function of greater levels of surface mining. Higher obesity and poverty rates and lower college education rates also significantly predicted CVD mortality overall and in rural counties. MTM activity is significantly associated with elevated chronic CVD mortality rates. Future research is necessary to examine the socioeconomic and environmental impacts of MTM on health to reduce health disparities in rural coal mining areas. © 2011 National Rural Health Association.

Surgical Mortality Audit-lessons Learned in a Developing Nation.

PubMed

Bindroo, Sandiya; Saraf, Rakesh

2015-06-01

Surgical audit is a systematic, critical analysis of the quality of surgical care that is reviewed by peers against explicit criteria or recognized standards. It is used to improve surgical practice with the ultimate goal of improving patient care. As the pattern of surgical care is different in the developing world, we analyzed mortalities in a referral medical institute of India to suggest interventions for improvement. An analysis of total admissions, different surgeries, and mortalities over 1 year in an urban referral medical institute of northern India was performed, followed by "peer review" of the mortalities. Mortality rates as outcomes and classification was done to provide comparative results. Of 10,005 surgical patients, 337 (male = 221, female = 116) deaths were reported over 1 year. The overall mortality rate was 3.36%, while mortality in operative cases was 1.76%. Total deaths were classified into (1) Viable: 153 (45%), (2) Nonviable: 174 (52%), and (3) Indeterminate: 10 (3%). Exclusion of the nonviable group reduced the mortality rate from 3.36% to 1.62%. Trauma was the major cause of mortality (n = 235; 70%) as compared to other surgical patients (n = 102; 30%). Increased mortality was also associated with emergency procedures (3.66%) as compared to elective surgeries (0.34%). In conclusion, audit of mortality and morbidity helps in initiating and implementing preventive strategies to improve surgical practice and patient care, and to reduce mortality rates. The mortality and morbidity forum is an important educational activity. It should be considered a mandatory activity in all postgraduate training programs.

Impact of a COPD comprehensive case management program on hospital length of stay and readmission rates.

PubMed

Alshabanat, Abdulmajeed; Otterstatter, Michael C; Sin, Don D; Road, Jeremy; Rempel, Carmen; Burns, Jane; van Eeden, Stephan F; FitzGerald, J M

2017-01-01

COPD accounts for the highest rate of hospital admissions among major chronic diseases. COPD hospitalizations are associated with impaired quality of life, high health care utilization, and poor prognosis and result in an economic and a social burden that is both substantial and increasing. The aim of this study is to determine the efficacy of a comprehensive case management program (CCMP) in reducing length of stay (LOS) and risk of hospital admissions and readmissions in patients with COPD. We retrospectively compared outcomes across five large hospitals in Vancouver, BC, Canada, following the implementation of a systems approach to the management of COPD patients who were identified in the hospital and followed up in the community for 90 days. We compared numbers, rates, and intervals of readmission and LOS during 2 years of active program delivery compared to 1 year prior to program implementation. A total of 1,564 patients with a clinical diagnosis of COPD were identified from 2,719 hospital admissions during the 3 years of study. The disease management program reduced COPD-related hospitalizations by 30% and hospitalizations for all causes by 13.6%. Similarly, the rate of readmission for all causes showed a significant decline, with hazard ratios (HRs) of 0.55 (year 1) and 0.51 (year 2) of intervention ( P <0.001). In addition, patients' mean LOS (days) for COPD-related admissions declined significantly from 10.8 to 6.8 ( P <0.05). A comprehensive disease management program for COPD patients, including education, case management, and follow-up, was associated with significant reduction in hospital admissions and LOS.

Birth rates among female cancer survivors: a population-based cohort study in Sweden.

PubMed

Hartman, Mikael; Liu, Jenny; Czene, Kamila; Miao, Hui; Chia, Kee Seng; Salim, Agus; Verkooijen, Helena M

2013-05-15

More women of fertile age are long-term survivors of cancer. However, population-based data on birth rates of female cancer survivors are rare. A total of 42,691 women ≤ 45 years with a history of cancer were identified from the Swedish Multi-Generation Register and the Swedish Cancer Register, for whom relative birth rates were calculated as compared to the background population, ie, standardized birth ratios (SBRs). Independent factors associated with reduced birth rates among cancer survivors were estimated using Poisson modeling. Compared to the background population, cancer survivors were 27% less likely to give birth (SBR = 0.73, 95% confidence interval [CI] = 0.72-0.75). Large difference in SBRs existed by cancer site, with high SBRs for survivors of melanoma skin, thoracic, head and neck, and thyroid cancers, and low SBRs for reproductive, breast, brain and eye, and hematopoietic cancer survivors. Parity status at diagnosis affected fertility: women who already had a child at the time of diagnosis were less likely to give birth (SBR = 0.50, 95% CI = 0.48-0.53) than were nulliparous women (SBR = 0.87, 95% CI = 0.85-0.90). Multivariate analysis showed that cancer site (reproductive organs), age at onset of cancer (< 12 years), and parity status were all significant and independent predictors of a reduced probability of giving birth after diagnosis. Cancer survivors are less likely to give birth compared with the background population. Large variations in the likelihood to give birth after diagnosis were seen according to age at onset, cancer site, and parity status at diagnosis. Copyright © 2013 American Cancer Society.

Effects of stair-climbing on balance, gait, strength, resting heart rate, and submaximal endurance in healthy seniors.

PubMed

Donath, L; Faude, O; Roth, R; Zahner, L

2014-04-01

Stair-climbing serves as a feasible opportunity to remain physically active within everyday-life. Data on neuromuscular and cardiorespiratory performance after regular stair-climbing in seniors are scarce. Forty-eight seniors were stratified to a one- (taking every step, INT1) or two-step strategy (every second step, INT2) or a control group (CON). Thirty-nine seniors [females: n = 22, males: n = 17; age: 70.5 (SD 5.1) years; BMI: 25.8 (3.1) kg/m(2)] completed the 8-week intervention (three weekly sessions). Before and after the intervention, balance, gait, strength, and submaximal endurance (at different intensities) were assessed. Maximal strength and explosive power did not improve significantly (0.10 < P < 0.78). Resting heart rate was significantly reduced in INT2 (-8/min) compared with INT1 (0/min, P = 0.02) and CON (0/min, P = 0.03). Compared with CON, perceived exertion for all intensities (0.007 < P < 0.03) and submaximal exercise heart rate during moderate uphill walking significantly decreased (-11/min; P < 0.05) in INT2. Step counts for forward beam balancing (4.5 cm width) increased in INT2 (P = 0.007) compared with CON. With more pronounced effects in INT2, stair-climbing significantly improved resting and exercise heart rates, perceived exertion, and dynamic balance performance in healthy seniors and may contribute to better overall fitness, reduced fall risk, and less perceived strain during daily life activities. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Stage selection and restricted oviposition period improves cryopreservation of dipteran embryos.

PubMed

Rajamohan, Arun; Rinehart, Joseph P; Leopold, Roger A

2015-04-01

Embryos of two dipteran species (Musca domestica and Lucilia sericata) were assessed for an effective sampling time that would result in the highest post-cryopreservation hatch rate, with a primary goal to define species-specific egg collection periods and the effects of manual stage selection on post cryopreservation yield. The effects of the time taken to collect eggs on, (a) the proportion of embryos reaching a specific developmental stage between 17 and 20 h of development, and (b) the post-cryopreservation hatch rate were assessed. Permeabilization treatment applied at any stage of embryonic development did not significantly reduce embryo viability. Eggs collected over longer durations significantly reduced the number of embryos available in a specific developmental stage amenable to cryopreservation. Hatch percentage after cryopreservation of the embryos of M. domestica collected over a 60 min period was 10.7 ± 8.7% compared to 31 ± 5% for the eggs collected for just 15 min. Similarly, percent hatch in L. sericata resulted in 17.0 ± 3.9 and <2% for 15 and 60 min samples, respectively. Significantly higher hatching rates were obtained for cryopreservation after manual selection of specific embryonic developmental stages from the dechorionated samples. Post-cryopreservation hatching rate for stage-selected M. domestica embryos was 86.5 ± 5.5% compared to 33.3 ± 4.5% for embryos staged only by an overall visual confirmation. In the case of L. sericata, the hatching percentage was 79.0 ± 11.1 for stage-selected embryos compared to 17.0 ± 3.9% without individual selection. Published by Elsevier Inc.

Update of a cohort mortality study of workers exposed to methylene chloride employed at a plant producing cellulose triacetate film base.

PubMed

Tomenson, John A

2011-12-01

To update the mortality experience of employees of a factory that produced cellulose triacetate film base at Brantham in the United Kingdom and generate information on the effects of exposure to methylene chloride, in particular, mortality from cardiovascular disease and cancers of the lung, liver and biliary tract, pancreas and brain. All 1,785 male employees with a record of employment at the film factory in 1946-1988 were followed through 2006, including 1,473 subjects exposed to methylene chloride on average for 9 years at a concentration of 19 ppm (8 h time-weighted average). A total of 559 deaths occurred during the follow-up period. In the subcohort of workers exposed to methylene chloride, substantially reduced mortalities compared with national and local rates were found for all causes, all cancers, and all the principal cancer sites of interest except for brain cancer. There was a small excess of brain cancer deaths (8 observed and 4.4 expected), but no evidence of an association with exposure to methylene chloride. Lung cancer mortality was significantly reduced in exposed workers, even compared to the low mortality rate in the local population (SMR 55). In contrast, mortality from ischaemic heart disease in exposed workers was slightly increased compared with local rates (SMR 102), but was lower in active employees (SMR 94; local rates), where a direct effect of exposure to methylene chloride should be concentrated. The study provided no indication that employment at the plant, or exposure to methylene chloride, had adversely affected the mortalities of workers.

Comparison of Three Whole-Cell Pertussis Vaccines in the Baboon Model of Pertussis

PubMed Central

Warfel, Jason M.; Zimmerman, Lindsey I.

2015-01-01

Pertussis is a highly contagious respiratory illness caused by the bacterial pathogen Bordetella pertussis. Pertussis rates in the United States have escalated since the 1990s and reached a 50-year high of 48,000 cases in 2012. While this pertussis resurgence is not completely understood, we previously showed that the current acellular pertussis vaccines do not prevent colonization or transmission following challenge. In contrast, a whole-cell pertussis vaccine accelerated the rate of clearance compared to rates in unvaccinated animals and animals treated with the acellular vaccine. In order to understand if these results are generalizable, we used our baboon model to compare immunity from whole-cell vaccines from three different manufacturers that are approved outside the United States. We found that, compared to clearance rates with no vaccine and with an acellular pertussis vaccine, immunization with any of the three whole-cell vaccines significantly accelerated the clearance of B. pertussis following challenge. Whole-cell vaccination also significantly reduced the total nasopharyngeal B. pertussis burden, suggesting that these vaccines reduce the opportunity for pertussis transmission. Meanwhile, there was no difference in either the duration or in B. pertussis burden between unvaccinated and acellular-pertussis-vaccinated animals, while previously infected animals were not colonized following reinfection. We also determined that transcription of the gene encoding interleukin-17 (IL-17) was increased in whole-cell-vaccinated and previously infected animals but not in acellular-pertussis-vaccinated animals following challenge. Together with our previous findings, these data are consistent with a role for Th17 responses in the clearance of B. pertussis infection. PMID:26561389

Totally asymmetric simple exclusion process with entrance rate sin(x)

NASA Astrophysics Data System (ADS)

Liang, Yifan; Chen, Xiaoyu; Liu, Yanna; Xiao, Song

2017-03-01

In recently, traffic jams have become the focus and one used different approaches to study them. In this paper, the function of sin(x) is used to simulate the enter rate α of the peak period to work. The mean field approach has been used to calculate the phase diagrams and these results were compared with Monte Carlo simulations. They are good agreement. When traffic accidents occur at the exit, the exit rate β will be less than 1 and traffic jams will occur. Different fixed the exit rate β is used to calculate the additional energy consumption. The additional energy consumption will increase with the reducing of the exit rate β.

Home health agency work environments and hospitalizations.

PubMed

Jarrín, Olga; Flynn, Linda; Lake, Eileen T; Aiken, Linda H

2014-10-01

An important goal of home health care is to assist patients to remain in community living arrangements. Yet home care often fails to prevent hospitalizations and to facilitate discharges to community living, thus putting patients at risk of additional health challenges and increasing care costs. To determine the relationship between home health agency work environments and agency-level rates of acute hospitalization and discharges to community living. Analysis of linked Center for Medicare and Medicaid Services Home Health Compare data and nurse survey data from 118 home health agencies. Robust regression models were used to estimate the effect of work environment ratings on between-agency variation in rates of acute hospitalization and community discharge. Home health agencies with good work environments had lower rates of acute hospitalizations and higher rates of patient discharges to community living arrangements compared with home health agencies with poor work environments. Improved work environments in home health agencies hold promise for optimizing patient outcomes and reducing use of expensive hospital and institutional care.

Protecting Construction Worker Health and Safety in Ontario, Canada: Identifying a Union Safety Effect.

PubMed

Amick, Benjamin C; Hogg-Johnson, Sheilah; Latour-Villamil, Desiree; Saunders, Ron

2015-12-01

Do Ontario unionized construction firms have lower workers' compensation claims rates compared with nonunion firms? Building trade and construction trade association lists of union contractors were linked to Workplace Safety and Insurance Board claims data for 2006 to 2012. Data were pooled for 2006 to 2012, and negative binomial regressions conducted with adjustment to estimate a union safety effect. The sample included 5797 unionized and 38,626 nonunion construction firms. Total claims rates were 13% higher (1.13, 1.09 to 1.18) in unionized firms because of higher allowed no-lost-time claim rates (1.28, 1.23 to 1.34), whereas the lost-time claims rate was 14% lower (0.86, 0.82 to 0.91). Unionized construction firms compared with nonunion firms have higher no-lost-time and lower lost-time claims rates. Unionized firms may encourage occupational injury reporting and reduce risks through training and hazard identification and control strategies.

Shoaling reduces metabolic rate in a gregarious coral reef fish species

PubMed Central

Killen, Shaun S.; McClure, Eva C.; Munday, Philip L.; McCormick, Mark I.

2016-01-01

ABSTRACT Many animals live in groups because of the potential benefits associated with defense and foraging. Group living may also induce a ‘calming effect’ on individuals, reducing overall metabolic demand. This effect could occur by minimising the need for individual vigilance and reducing stress through social buffering. However, this effect has proved difficult to quantify. We examined the effect of shoaling on metabolism and body condition in the gregarious damselfish Chromis viridis. Using a novel respirometry methodology for social species, we found that the presence of shoal-mate visual and olfactory cues led to a reduction in the minimum metabolic rate of individuals. Fish held in isolation for 1 week also exhibited a reduction in body condition when compared with those held in shoals. These results indicate that social isolation as a result of environmental disturbance could have physiological consequences for gregarious species. PMID:27655821

Rheological measurements in reduced gravity

NASA Astrophysics Data System (ADS)

Bakhtiyarov, Sayavur I.; Overfelt, Ruel A.

1999-01-01

Rheology of fluidized beds and settling suspensions were studied experimentally in a series of reduced gravity parabolic flights aboard NASA's KC-135 aircraft. Silica sands of two different size distributions were fluidized by air. The slurries were made using silica sand and Glycerol solution. The experimental set up incorporated instrumentation to measure the air flow rate, the pressure drop and the apparent viscosity of the fluidized sand and sand suspensions at a wide range of the shear rates. The fluidization chamber and container had transparent walls to allow visualization of the structure changes involved in fluidization and in Couette flow in reduced gravity. Experiments were performed over a broad range of gravitational accelerations including microgravity and double gravity conditions. The results of the flight and ground experiments reveal significant differences in overall void fraction and hence in the apparent viscosity of fluidized sand and sand suspensions under microgravity as compared to one-g conditions.

Disinfection of low quality wastewaters by ultraviolet irradiation

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

Zukovs, G.; Kollar, J.; Monteith, H.D.

1986-03-01

Pilot-scale disinfection of simulated combined sewer overflow (CSO) by ultraviolet light (UV) and by high-rate chlorination were compared. Disinfection efficiency was evaluated over a range of dosages and contact times for fecal coliforms, enterococci, P. Aeruginosa, and Salmonella spp. Fecal coliform were reduced 3.0 to 3.2 logs at a UV dose of approximately 350,000..mu.. W s/cm/sup 2/. High-rate chlorination, at a contact time of 2.0 minutes and total residual chlorine concentration of approximately 25 mg/L (as Cl/sub 2/), reduced fecal coliforms by 4.0 logs. Pathogens were reduced to detection limits by both processes. Neither photoreactivation nor regrowth occurred int hemore » disinfected effluents. The estimated capital costs of CSO disinfection by UV irradiation were consistently higher than for chlorination/dechlorination; operation and maintenance costs were similar. 19 references.« less

Aggression in autism spectrum disorder: presentation and treatment options

PubMed Central

Fitzpatrick, Sarah E; Srivorakiat, Laura; Wink, Logan K; Pedapati, Ernest V; Erickson, Craig A

2016-01-01

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by persistent difficulties in social communication and social interaction, coupled with restricted, repetitive patterns of behavior or interest. Research indicates that aggression rates may be higher in individuals with ASD compared to those with other developmental disabilities. Aggression is associated with negative outcomes for children with ASD and their caregivers, including decreased quality of life, increased stress levels, and reduced availability of educational and social support. Therapeutic strategies including functional behavioral assessment, reinforcement strategies, and functional communication training may have a significant impact in reducing the frequency and intensity of aggressive behavior in individuals with ASD. Pharmacologic treatments, particularly the use of second-generation antipsychotics, may also be of some benefit in reducing aggression in individuals with ASD. With the ever-increasing rate of ASD diagnosis, development of effective therapeutic and pharmacologic methods for preventing and treating aggression are essential to improving outcomes in this disorder. PMID:27382295

Cold-water immersion decreases cerebral oxygenation but improves recovery after intermittent-sprint exercise in the heat.

PubMed

Minett, G M; Duffield, R; Billaut, F; Cannon, J; Portus, M R; Marino, F E

2014-08-01

This study examined the effects of post-exercise cooling on recovery of neuromuscular, physiological, and cerebral hemodynamic responses after intermittent-sprint exercise in the heat. Nine participants underwent three post-exercise recovery trials, including a control (CONT), mixed-method cooling (MIX), and cold-water immersion (10 °C; CWI). Voluntary force and activation were assessed simultaneously with cerebral oxygenation (near-infrared spectroscopy) pre- and post-exercise, post-intervention, and 1-h and 24-h post-exercise. Measures of heart rate, core temperature, skin temperature, muscle damage, and inflammation were also collected. Both cooling interventions reduced heart rate, core, and skin temperature post-intervention (P < 0.05). CWI hastened the recovery of voluntary force by 12.7 ± 11.7% (mean ± SD) and 16.3 ± 10.5% 1-h post-exercise compared to MIX and CONT, respectively (P < 0.01). Voluntary force remained elevated by 16.1 ± 20.5% 24-h post-exercise after CWI compared to CONT (P < 0.05). Central activation was increased post-intervention and 1-h post-exercise with CWI compared to CONT (P < 0.05), without differences between conditions 24-h post-exercise (P > 0.05). CWI reduced cerebral oxygenation compared to MIX and CONT post-intervention (P < 0.01). Furthermore, cooling interventions reduced cortisol 1-h post-exercise (P < 0.01), although only CWI blunted creatine kinase 24-h post-exercise compared to CONT (P < 0.05). Accordingly, improvements in neuromuscular recovery after post-exercise cooling appear to be disassociated with cerebral oxygenation, rather reflecting reductions in thermoregulatory demands to sustain force production. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Viterbi equalization for long-distance, high-speed underwater laser communication

NASA Astrophysics Data System (ADS)

Hu, Siqi; Mi, Le; Zhou, Tianhua; Chen, Weibiao

2017-07-01

In long-distance, high-speed underwater laser communication, because of the strong absorption and scattering processes, the laser pulse is stretched with the increase in communication distance and the decrease in water clarity. The maximum communication bandwidth is limited by laser-pulse stretching. Improving the communication rate increases the intersymbol interference (ISI). To reduce the effect of ISI, the Viterbi equalization (VE) algorithm is used to estimate the maximum-likelihood receiving sequence. The Monte Carlo method is used to simulate the stretching of the received laser pulse and the maximum communication rate at a wavelength of 532 nm in Jerlov IB and Jerlov II water channels with communication distances of 80, 100, and 130 m, respectively. The high-data rate communication performance for the VE and hard-decision algorithms is compared. The simulation results show that the VE algorithm can be used to reduce the ISI by selecting the minimum error path. The trade-off between the high-data rate communication performance and minor bit-error rate performance loss makes VE a promising option for applications in long-distance, high-speed underwater laser communication systems.

Influence of redox mediators and salinity level on the (bio)transformation of Direct Blue 71: kinetics aspects.

PubMed

Alvarez, Luis H; Meza-Escalante, Edna R; Gortáres-Moroyoqui, Pablo; Morales, Luz; Rosas, Krystal; García-Reyes, Bernardo; García-González, Alicone

2016-12-01

The rate-limiting step of azo dye decolorization was elucidated by exploring the microbial reduction of a model quinone and the chemical decolorization by previously reduced quinone at different salinity conditions (2-8%). Microbial experiments were performed in batch with a marine consortium. The decolorization of Direct Blue 71 (DB71) by the marine consortium at 2% salinity, mediated with anthraquinone-2,6-disulfonate (AQDS), showed the highest rate of decolorization as compared with those obtained with riboflavin, and two samples of humic acids. Moreover, the incubations at different salinity conditions (0-8%) performed with AQDS showed that the highest rate of decolorization of DB71 by the marine consortium occurred at 2% and 4% salinity. In addition, the highest microbial reduction rate of AQDS occurred in incubations at 0%, 2%, and 4% of salinity. The chemical reduction of DB71 by reduced AQDS occurred in two stages and proceeded faster at 4% and 6% salinity. The results indicate that the rate-limiting step during azo decolorization was the microbial reduction of AQDS. Copyright © 2016 Elsevier Ltd. All rights reserved.

The global burden of congenital heart disease.

PubMed

Hoffman, Julien Ie

2013-05-01

Although the incidence of congenital heart disease (CHD) is similar worldwide, the burden of supporting these patients falls more heavily on countries with high fertility rates. In a country with a fertility rate of about eight per woman, the population has to support four times as many children with CHD as in a country with a fertility rate of two. Countries with the highest fertility rates tend to have the lowest incomes per capita, thus accentuating the disparity. Countries with high fertility rates have more children with congenital heart disease per wage earner. Improving local health services and controlling infectious diseases (diarrhoeal illness, rheumatic fever, measles, rotoviral infection) are important but are mere 'band-aids' compared to improving education, empowering women and reducing birth rates.

Reactors as a Source of Antineutrinos: Effects of Fuel Loading and Burnup for Mixed-Oxide Fuels

NASA Astrophysics Data System (ADS)

Bernstein, Adam; Bowden, Nathaniel S.; Erickson, Anna S.

2018-01-01

In a conventional light-water reactor loaded with a range of uranium and plutonium-based fuel mixtures, the variation in antineutrino production over the cycle reflects both the initial core fissile inventory and its evolution. Under an assumption of constant thermal power, we calculate the rate at which antineutrinos are emitted from variously fueled cores, and the evolution of that rate as measured by a representative ton-scale antineutrino detector. We find that antineutrino flux decreases with burnup for low-enriched uranium cores, increases for full mixed-oxide (MOX) cores, and does not appreciably change for cores with a MOX fraction of approximately 75%. Accounting for uncertainties in the fission yields in the emitted antineutrino spectra and the detector response function, we show that the difference in corewide MOX fractions at least as small as 8% can be distinguished using a hypothesis test. The test compares the evolution of the antineutrino rate relative to an initial value over part or all of the cycle. The use of relative rates reduces the sensitivity of the test to an independent thermal power measurement, making the result more robust against possible countermeasures. This rate-only approach also offers the potential advantage of reducing the cost and complexity of the antineutrino detectors used to verify the diversion, compared to methods that depend on the use of the antineutrino spectrum. A possible application is the verification of the disposition of surplus plutonium in nuclear reactors.

Economic considerations in the use of inhaled anesthetic agents.

PubMed

Golembiewski, Julie

2010-04-15

To describe the components of and factors contributing to the costs of inhaled anesthesia, basis for quantifying and comparing these costs, and practical strategies for performing pharmacoeconomic analyses and reducing the costs of inhaled anesthetic agents. Inhaled anesthesia can be costly, and some of the variable costs, including fresh gas flow rates and vaporizer settings, are potential targets for cost savings. The use of a low fresh gas flow rate maximizes rebreathing of exhaled anesthetic gas and is less costly than a high flow rate, but it provides less control of the level of anesthesia. The minimum alveolar concentration (MAC) hour is a measure that can be used to compare the cost of inhaled anesthetic agents at various fresh gas flow rates. Anesthesia records provide a sense of patterns of inhaled anesthetic agent use, but the amount of detail can be limited. Cost savings have resulted from efforts to reduce the direct costs of inhaled anesthetic agents, but reductions in indirect costs through shortened times to patient recovery and discharge following the judicious use of these agents are more difficult to demonstrate. The patient case mix, fresh gas flow rates typically used during inhaled anesthesia, availability and location of vaporizers, and anesthesia care provider preferences and practices should be taken into consideration in pharmacoeconomic evaluations and recommendations for controlling the costs of inhaled anesthesia. Understanding factors that contribute to the costs of inhaled anesthesia and considering those factors in pharmacoeconomic analyses and recommendations for use of these agents can result in cost savings.

Reduced dimer production in solar-simulator-pumped continuous wave iodine lasers based on model simulations and scaling and pumping studies

NASA Technical Reports Server (NTRS)

Costen, Robert C.; Heinbockel, John H.; Miner, Gilda A.; Meador, Willard E., Jr.; Tabibi, Bagher M.; Lee, Ja H.; Williams, Michael D.

1995-01-01

A numerical rate equation model for a continuous wave iodine laser with longitudinally flowing gaseous lasant is validated by approximating two experiments that compare the perfluoroalkyl iodine lasants n-C3F7I and t-C4F9I. The salient feature of the simulations is that the production rate of the dimer (C4F9)2 is reduced by one order of magnitude relative to the dimer (C3F7)2. The model is then used to investigate the kinetic effects of this reduced dimer production, especially how it improves output power. Related parametric and scaling studies are also presented. When dimer production is reduced, more monomer radicals (t-C4F9) are available to combine with iodine ions, thus enhancing depletion of the laser lower level and reducing buildup of the principal quencher, molecular iodine. Fewer iodine molecules result in fewer downward transitions from quenching and more transitions from stimulated emission of lasing photons. Enhanced depletion of the lower level reduces the absorption of lasing photons. The combined result is more lasing photons and proportionally increased output power.

Potential nitrification in alum-treated soil slurries amended with poultry manure.

PubMed

Gandhapudi, S K; Coyne, M S; D'Angelo, E M; Matocha, C

2006-03-01

Alum is used to reduce environmental pollutants in poultry production. Alum decreases NH3 volatilization and increases total N and NH4+-N compared to untreated poultry manure. Nitrification in poultry wastes could therefore be stimulated due to higher NH4+ concentrations or could be inhibited because the soil environment is acidified. A 10-day laboratory study was conducted to study potential nitrification rates in soil slurries (20 g soil in 150 ml water) amended with 2.0 g alum-treated poultry manure. Fecal bacteria, NH4+, NO2-, NO3-, orthophosphate, pH, and NH3 were measured at 2-day intervals. Alum significantly reduced fecal bacteria concentrations through day 6. Water-soluble P was reduced 82% by day 10. Alum-treated manure had significantly increased NH4+ concentrations by day 8 and 10, and significantly decreased NO2- and NO3- concentrations by days 6-10. Alum's effect on potential nitrification was inhibitory in the soil environment. Slurries with alum-treated poultry manure had reduced nitrification rates, fecal bacteria, and soluble P. Therefore, in addition to reducing P loss, alum could temporarily reduce the risk for environmental pollution from land-applied manures in terms of both NO3- and fecal bacteria loss.

Import Bans as an Element of Nigerian Trade Policy, a Failed Approach

DTIC Science & Technology

2012-11-01

then receive greater revenues from the 16 increased taxes paid by these citizens. 28 Figure 5 depicts Nigerian CPI and compares it to a phase...come from the increased taxes collected from citizens leaving poverty due to the reduced cost of living. With these increased revenues, GON can...crime rates are lowered and the stress on a family is reduced. More taxes are collected and GON revenues increase . These revenues can be reinvested

A Randomized Controlled Trial Comparing Endoscopic-Assisted Versus Open Neck Tissue Expander Placement in Reconstruction of Post-Burn Facial Scar Deformities.

PubMed

As'adi, Kamran; Emami, Seyed Abolhassan; Salehi, Seyed Hamid; Shoar, Saeed

2016-08-01

Tissue expansion has evolved reconstruction surgery by providing a great source of additional tissue for large skin defects. Nevertheless, wide application of tissue expander reconstruction is challenging due to high complication rates and uncertainty about final outcomes. Recently, endoscopy has shown promise in reconstructive surgeries using tissue expander placement. This study aimed to compare outcomes between open and endoscopic-assisted neck tissue expander placement in reconstruction of post-burn facial scar deformities. Through a randomized clinical trial, 63 patients with facial burn scars were assigned to an open group or endoscopic group for placement of 81 tissue expanders. The complication rate, operative time, length of hospital stay, and time to full expansion were compared between the two groups. Thirty-one patients were assigned to the open group and 32 patients to the endoscopic group. The average operative time was significantly reduced in the endoscopic group compared with the open group (42.2 ± 3.6, 56.5 ± 4.5 min, p < 0.05). The complication rate was significantly lower in the endoscopic group than the open group (6 vs. 16, p < 0.05). Hospital stay was also significantly diminished from 26.3 ± 7.7 h in open group to 7.4 ± 4.5 h in endoscopic group (p < 0.0001). There was a significant reduction in time to full expansion in the endoscopic group as compared with the open group (93.5 ± 10.2 vs. 112.1 ± 14.2 days, p = 0.002). Endoscopic neck tissue expander placement significantly reduced operative time, the postoperative complication rate, length of hospital stay, and time to achieve full expansion and allowed early initiation of expansion and remote placement of the port in relation to the expander pocket. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

The benefit of heart rate variability biofeedback and relaxation training in reducing trait anxiety†

PubMed Central

Lee, Jieun; Kim, Jung K; Wachholtz, Amy

2016-01-01

Previous research studies have indicated that biofeedback treatment and relaxation techniques are effective in reducing psychological and physical symptoms (Hammond, 2005; Manzoni, G. M., Pagnini, F., Castelnuovo, G., & Molinari, E., 2008). However, dearth of studies has compared heart rate variability (HRV) biofeedback treatment and relaxation training to reduce trait anxiety. The objective of this study was to determine the effect of HRV biofeedback treatment and relaxation training in reducing trait anxiety compared to control group without any treatment using students in a science and engineering university of South Korea. For the present study, a total of 15 graduate students with moderate level of trait anxiety were recruited for 4 individual sessions every two weeks. They were randomly assigned into three groups: biofeedback treatment (n = 5), relaxation training (n = 5), and no treatment control group (n = 5). Our results revealed significant difference in change score of trait anxiety between the HRV biofeedback treatment and the no treatment control group. However, no significant difference was found between the relaxation training group and the no treatment control group. In addition, there was no significant difference between the HRV biofeedback treatment and the relaxation training. Results of the present study indicate that there is potential benefit in utilizing HRV biofeedback treatment for stress management programs and/or anxiety reduction treatment PMID:27099546

A randomized, controlled trial of a multifaceted intervention including alcohol-based hand sanitizer and hand-hygiene education to reduce illness transmission in the home.

PubMed

Sandora, Thomas J; Taveras, Elsie M; Shih, Mei-Chiung; Resnick, Elissa A; Lee, Grace M; Ross-Degnan, Dennis; Goldmann, Donald A

2005-09-01

Good hand hygiene may reduce the spread of infections in families with children who are in out-of-home child care. Alcohol-based hand sanitizers rapidly kill viruses that are commonly associated with respiratory and gastrointestinal (GI) infections. The objective of this study was to determine whether a multifactorial campaign centered on increasing alcohol-based hand sanitizer use and hand-hygiene education reduces illness transmission in the home. A cluster randomized, controlled trial was conducted of homes of 292 families with children who were enrolled in out-of-home child care in 26 child care centers. Eligible families had > or =1 child who was 6 months to 5 years of age and in child care for > or =10 hours/week. Intervention families received a supply of hand sanitizer and biweekly hand-hygiene educational materials for 5 months; control families received only materials promoting good nutrition. Primary caregivers were phoned biweekly and reported respiratory and GI illnesses in family members. Respiratory and GI-illness-transmission rates (measured as secondary illnesses per susceptible person-month) were compared between groups, adjusting for demographic variables, hand-hygiene practices, and previous experience using hand sanitizers. Baseline demographics were similar in the 2 groups. A total of 1802 respiratory illnesses occurred during the study; 443 (25%) were secondary illnesses. A total of 252 GI illnesses occurred during the study; 28 (11%) were secondary illnesses. The secondary GI-illness rate was significantly lower in intervention families compared with control families (incidence rate ratio [IRR]: 0.41; 95% confidence interval [CI]: 0.19-0.90). The overall rate of secondary respiratory illness was not significantly different between groups (IRR: 0.97; 95% CI: 0.72-1.30). However, families with higher sanitizer usage had a marginally lower secondary respiratory illness rate than those with less usage (IRR: 0.81; 95% CI: 0.65-1.09). A multifactorial intervention emphasizing alcohol-based hand sanitizer use in the home reduced transmission of GI illnesses within families with children in child care. Hand sanitizers and multifaceted educational messages may have a role in improving hand-hygiene practices within the home setting.

SU-E-J-169: The Dosimetric and Temporal Effects of Respiratory-Gated Radiation Therapy in Lung Cancer Patients

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

Rouabhi, O; Gross, B; Xia, J

2015-06-15

Purpose: To evaluate the dosimetric and temporal effects of high dose rate treatment mode for respiratory-gated radiation therapy in lung cancer patients. Methods: Treatment plans from five lung cancer patients (3 nongated (Group 1), 2 gated at 80EX-80IN (Group 2)) were retrospectively evaluated. The maximum tumor motions range from 6–12 mm. Using the same planning criteria, four new treatment plans, corresponding to four gating windows (20EX–20IN, 40EX–40IN, 60EX–60IN, and 80EX–80IN), were generated for each patient. Mean tumor dose (MTD), mean lung dose (MLD), and lung V20 were used to assess the dosimetric effects. A MATLAB algorithm was developed to computemore » treatment time by considering gantry rotation time, time to position collimator leaves, dose delivery time (scaled relative to the gating window), and communication overhead. Treatment delivery time for each plan was estimated using a 500 MU/min dose rate for the original plans and a 1500 MU/min dose rate for the gated plans. Results: Differences in MTD were less than 1Gy across plans for all five patients. MLD and lung V20 were on average reduced between −16.1% to −6.0% and −20.0% to −7.2%, respectively for non-gated plans when compared with the corresponding gated plans, and between − 5.8% to −4.2% and −7.0% to −5.4%, respectively for plans originally gated at 80EX–80IN when compared with the corresponding 20EX-20IN to 60EX– 60IN gated plans. Treatment delivery times of gated plans using high dose rate were reduced on average between −19.7% (−1.9min) to −27.2% (−2.7min) for originally non-gated plans and −15.6% (−0.9min) to −20.3% (−1.2min) for originally 80EX-80IN gated plans. Conclusion: Respiratory-gated radiation therapy in lung cancer patients can reduce lung toxicity, while maintaining tumor dose. Using a gated high-dose-rate treatment, delivery time comparable to non-gated normal-dose-rate treatment can be achieved. This research is supported by Siemens Medical Solutions USA, Inc.« less

Heart rate autonomic regulation system at rest and during paced breathing among patients with CRPS as compared to age-matched healthy controls.

PubMed

Bartur, Gadi; Vatine, Jean-Jacques; Raphaely-Beer, Noa; Peleg, Sara; Katz-Leurer, Michal

2014-09-01

The objective of this study is to assess the autonomic nerve heart rate regulation system at rest and its immediate response to paced breathing among patients with complex regional pain syndrome (CRPS) as compared with age-matched healthy controls. Quasiexperimental. Outpatient clinic. Ten patients with CRPS and 10 age- and sex-matched controls. Participants underwent Holter ECG (NorthEast Monitoring, Inc., Maynard, MA, USA) recording during rest and biofeedback-paced breathing session. Heart rate variability (HRV), time, and frequency measures were assessed. HRV and time domain values were significantly lower at rest among patients with CRPS as compared with controls. A significant association was noted between pain rank and HRV frequency measures at rest and during paced breathing; although both groups reduced breathing rate significantly during paced breathing, HRV time domain parameters increased only among the control group. The increased heart rate and decreased HRV at rest in patients with CRPS suggest a general autonomic imbalance. The inability of the patients to increase HRV time domain values during paced breathing may suggest that these patients have sustained stress response with minimal changeability in response to slow-paced breathing stimuli. Wiley Periodicals, Inc.

Water depth effects on impact loading, kinematic and physiological variables during water treadmill running.

PubMed

Macdermid, Paul W; Wharton, Josh; Schill, Carina; Fink, Philip W

2017-07-01

The purpose of this study was to compare impact loading, kinematic and physiological responses to three different immersion depths (mid-shin, mid-thigh, and xiphoid process) while running at the same speed on a water based treadmill. Participants (N=8) ran on a water treadmill at three depths for 3min. Tri-axial accelerometers were used to identify running dynamics plus measures associated with impact loading rates, while heart rate data were logged to indicate physiological demand. Participants had greater peak impact accelerations (p<0.01), greater impact loading rates (p<0.0001), greater stride frequency (p<0.05), shorter stride length (p<0.01), and greater rate of acceleration development at toe-off (p<0.0001) for the mid-shin and mid-thigh compared to running immersed to the xiphoid process. Physiological effort determined by heart rate was also significantly less (p<0.0001) when running immersed to the xiphoid process. Water immersed treadmill running above the waistline alters kinematics of gait, reduces variables associated with impact, while decreasing physiological demand compared to depths below the waistline. Copyright © 2017 Elsevier B.V. All rights reserved.

Cortisol reduces cell proliferation in the telencephalon of rainbow trout (Oncorhynchus mykiss).

PubMed

Sørensen, Christina; Bohlin, Linda C; Øverli, Øyvind; Nilsson, Göran E

2011-03-28

The fish brain grows throughout life, and new cells are added continuously in all major brain areas. As in mammals, the rate of adult brain cell proliferation in fish can be regulated by external factors including environmental complexity and interaction with conspecifics. We have recently demonstrated that the stress experienced by subordinate rainbow trout in social hierarchies leads to a marked suppression of brain cell proliferation in the telencephalon, and that this is accompanied by an increase in plasma levels of cortisol. Corticosteroid hormones are known to suppress adult neurogenesis in mammals, and to investigate whether this is also the case in fish, rainbow trout were fed feed containing either a low or a high dose of cortisol for 6 days. Compared to control animals receiving regular feed, both cortisol treated groups had significantly elevated cortisol levels 24h after the last feeding, with the high group having levels comparable to those previously reported in socially stressed fish. To quantify cell proliferation, immunohistochemistry for proliferating cell nuclear antigen (PCNA) was performed to identify actively cycling cells. The density of PCNA-positive nuclei in the telencephalon was reduced by about 50% in both cortisol treated groups. The effect of cortisol on brain cell proliferation did not reflect a general down regulation of growth, as only the high cortisol group had reduced growth rate, and there was no correlation between brain cell proliferation and growth rate in any group. These results indicate that the reduced proliferative activity seen in brains of socially stressed fish is mediated by cortisol, and that there is a similar suppressive effect of cortisol on brain cell proliferation in the teleost forebrain as in the mammalian hippocampus. Copyright © 2010 Elsevier Inc. All rights reserved.

Sulfur recirculation for increased electricity production in Waste-to-Energy plants.

PubMed

Andersson, Sven; Blomqvist, Evalena W; Bäfver, Linda; Jones, Frida; Davidsson, Kent; Froitzheim, Jan; Karlsson, Martin; Larsson, Erik; Liske, Jesper

2014-01-01

Sulfur recirculation is a new technology for reducing boiler corrosion and dioxin formation. It was demonstrated in full-scale tests at a Waste to Energy plant in Göteborg (Sweden) during nearly two months of operation. Sulfur was recirculated as sulfuric acid from the flue gas cleaning back to the boiler, thus creating a sulfur loop. The new technology was evaluated by extensive measurement campaigns during operation under normal conditions (reference case) and operation with sulfur recirculation. The chlorine content of both fly ash and boiler ash decreased and the sulfur content increased during the sulfur recirculation tests. The deposit growth and the particle concentration decreased with sulfur recirculation and the dioxin concentration (I-TEQ) of the flue gas was reduced by approximately 25%. Sulfuric acid dew point measurements showed that the sulfuric acid dosage did not lead to elevated SO3 concentrations, which may otherwise induce low temperature corrosion. In the sulfur recirculation corrosion probe exposures, the corrosion rate decreased for all tested materials (16Mo3, Sanicro 28 and Inconel 625) and material temperatures (450 °C and 525 °C) compared to the reference exposure. The corrosion rates were reduced by 60-90%. Sulfur recirculation prevented the formation of transition metal chlorides at the metal/oxide interface, formation of chromate and reduced the presence of zinc in the corrosion products. Furthermore, measured corrosion rates at 525 °C with sulfur recirculation in operation were similar or lower compared to those measured at 450 °C material temperature in reference conditions, which corresponds to normal operation at normal steam temperatures. This implies that sulfur recirculation allows for higher steam data and electricity production without increasing corrosion. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

Non-fluoroscopic navigation systems for radiofrequency catheter ablation for supraventricular tachycardia reduce ionising radiation exposure.

PubMed

See, Jason; Amora, Jonah L; Lee, Sheldon; Lim, Paul; Teo, Wee Siong; Tan, Boon Yew; Ho, Kah Leng; Lee, Chee Wan; Ching, Chi-Keong

2016-07-01

The use of non-fluoroscopic systems (NFS) to guide radiofrequency catheter ablation (RFCA) for the treatment of supraventricular tachycardia (SVT) is associated with lower radiation exposure. This study aimed to determine if NFS reduces fluoroscopy time, radiation dose and procedure time. We prospectively enrolled patients undergoing RFCA for SVT. NFS included EnSiteTM NavXTM or CARTO® mapping. We compared procedure and fluoroscopy times, and radiation exposure between NFS and conventional fluoroscopy (CF) cohorts. Procedural success, complications and one-year success rates were reported. A total of 200 patients over 27 months were included and RFCA was guided by NFS for 79 patients; those with atrioventricular nodal reentrant tachycardia (AVNRT), left-sided atrioventricular reentrant tachycardia (AVRT) and right-sided AVRT were included (n = 101, 63 and 36, respectively). Fluoroscopy times were significantly lower with NFS than with CF (10.8 ± 11.1 minutes vs. 32.0 ± 27.5 minutes; p < 0.001). The mean fluoroscopic dose area product was also significantly reduced with NFS (NSF: 5,382 ± 5,768 mGy*cm2 vs. CF: 21,070 ± 23,311 mGy*cm2; p < 0.001); for all SVT subtypes. There was no significant reduction in procedure time, except for left-sided AVRT ablation (NFS: 79.2 minutes vs. CF: 116.4 minutes; p = 0.001). Procedural success rates were comparable (NFS: 97.5% vs. CF: 98.3%) and at one-year follow-up, there was no significant difference in the recurrence rates (NFS: 5.2% vs. CF: 4.2%). No clinically significant complications were observed in both groups. The use of NFS for RFCA for SVT is safe, with significantly reduced radiation dose and fluoroscopy time. Copyright © Singapore Medical Association.

PCSK9 inhibition with alirocumab reduces lipoprotein(a) levels in nonhuman primates by lowering apolipoprotein(a) production rate.

PubMed

Croyal, Mikaël; Tran, Thi-Thu-Trang; Blanchard, Rose Hélène; Le Bail, Jean-Christophe; Villard, Elise F; Poirier, Bruno; Aguesse, Audrey; Billon-Crossouard, Stéphanie; Ramin-Mangata, Stéphane; Blanchard, Valentin; Nativel, Brice; Chemello, Kévin; Khantalin, Ilya; Thedrez, Aurélie; Janiak, Philip; Krempf, Michel; Boixel, Christophe; Lambert, Gilles; Guillot, Etienne

2018-05-31

Therapeutic antibodies targeting proprotein convertase subtilisin kexin type 9 (PCSK9) (e.g. alirocumab) lower low-density lipoprotein cholesterol (LDL-C) and lipoprotein (a) [Lp(a)] levels in clinical trials. We recently showed that PCSK9 enhances apolipoprotein(a) [apo(a)] secretion from primary human hepatocytes but does not affect Lp(a) cellular uptake. Here, we aimed to determine how PCSK9 neutralization modulates Lp(a) levels in vivo Six nonhuman primates (NHP) were treated with alirocumab or a control antibody (IgG1) in a crossover protocol. After the lowering of lipids reached steady state, NHP received an intravenous injection of [ 2 H 3 ]-leucine, and blood samples were collected sequentially over 48 h. Enrichment of apolipoproteins in [ 2 H 3 ]-leucine was assessed by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Kinetic parameters were calculated using numerical models with the SAAMII software. Compared with IgG1, alirocumab significantly reduced total cholesterol (TC) (-28%), LDL-C (-67%), Lp(a) (-56%), apolipoprotein B100 (apoB100) (-53%), and apo(a) (-53%). Alirocumab significantly increased the fractional catabolic rate of apoB100 (+29%) but not that of apo(a). Conversely, alirocumab sharply and significantly reduced the production rate (PR) of apo(a) (-42%), but not significantly that of apoB100, compared with IgG1, respectively.In line with the observations made in human hepatocytes, the present kinetic study establishes that PCSK9 neutralization with alirocumab efficiently reduces circulating apoB100 and apo(a) levels by distinct mechanisms: apoB primarily by enhancing its catabolism and apo(a) primarily by lowering its production. © 2018 The Author(s). Published by Portland Press Limited on behalf of the Biochemical Society.

NKTR-181: A Novel Mu-Opioid Analgesic with Inherently Low Abuse Potential.

PubMed

Miyazaki, Takahiro; Choi, Irene Y; Rubas, Werner; Anand, Neel K; Ali, Cherie; Evans, Juli; Gursahani, Hema; Hennessy, Marlene; Kim, Grace; McWeeney, Daniel; Pfeiffer, Juergen; Quach, Phi; Gauvin, David; Riley, Timothy A; Riggs, Jennifer A; Gogas, Kathleen; Zalevsky, Jonathan; Doberstein, Stephen K

2017-10-01

The increasing availability of prescription opioid analgesics for the treatment of pain has been paralleled by an epidemic of opioid misuse, diversion, and overdose. The development of abuse-deterrent formulations (ADFs) of conventional opioids such as oxycodone and morphine represents an advance in the field and has had a positive but insufficient impact, as most opioids are still prescribed in highly abusable, non-ADF forms, and abusers can tamper with ADF medications to liberate the abusable opioid within. The abuse liability of mu-opioid agonists appears to be dependent on their rapid rate of entry into the central nervous system (CNS), whereas analgesic activity appears to be a function of CNS exposure alone, suggesting that a new opioid agonist with an inherently low rate of influx across the blood-brain barrier could mediate analgesia with low abuse liability, regardless of formulation or route of administration. NKTR-181 is a novel, long-acting, selective mu-opioid agonist with structural properties that reduce its rate of entry across the blood-brain barrier compared with traditional mu-opioid agonists. NKTR-181 demonstrated maximum analgesic activity comparable to that of oxycodone in hot-plate latency and acetic-acid writhing models. NKTR-181 was distinguishable from oxycodone by its reduced abuse potential in self-administration and progressive-ratio break point models, with behavioral effects similar to those of saline, as well as reduced CNS side effects as measured by the modified Irwin test. The in vitro and in vivo studies presented here demonstrate that NKTR-181 is the first selective mu-opioid agonist to combine analgesic efficacy and reduced abuse liability through the alteration of brain-entry kinetics. Copyright © 2017 by The American Society for Pharmacology and Experimental Therapeutics.

A Defined Esophagectomy Perioperative Clinical Care Process Can Improve Outcomes and Costs.

PubMed

Cooke, David T; Calhoun, Royce F; Kuderer, Valerie; David, Elizabeth A

2017-01-01

Esophagectomy (EG) is a high-risk therapy for esophageal cancer and end-stage benign disease. This study compares the results of EG before and after implementation of a perioperative clinical care process including a health provider education program (EP) and institutional uncomplicated postoperative clinical pathway (POP) for purpose quality improvement. This is a single institution retrospective cohort study. The EP was provided to critical care and telemetry unit nurses and the POP was imbedded in the electronic health record. Patients undergoing elective EG with reconstruction with the stomach for benign disease or cancer were included from 2005 to 2011. Cohorts were pre- and postimplementation (PreI and PostI) of an EP and 8-day POP (August 2008). Patient, tumor and peri/postoperative-specific variables were compared between cohorts, as well as resource utilization and hospital costs. We identified 33 PreI and 41 PostI patients. Both cohorts had similar patient demographics, preoperative comorbidities, majority cancer diagnosis, and for cancer patients, majority adenocarcinoma and IIB/III pathologic stage. Both groups had one death and similar rate of discharge to home. The PostI cohort demonstrated reduced 30-day readmission rate (2.4% vs 24.2%); P < 0.05. In regard to clinical outcomes, the PostI group exhibited reduced deep venous thrombosis/pulmonary emboli (2.4% vs 18.2%); P < 0.05. The PostI group demonstrated significantly reduced radiographic test utilization and costs, as well as total overall 30-day readmission costs. A defined perioperative clinical process involving educating the patient care team and implementing a widely disseminated POP can reduce complications, 30-day readmission rates, and hospital costs after EG.

The 15 years of comet photometry: A comparative analysis of 80 comets

NASA Technical Reports Server (NTRS)

Osip, David J.; Schleicher, David G.; Millis, Robert L.; Ahearn, Michael F.; Birch, Peter V.

1991-01-01

In 1976, a program of narrowband photometry of comets was initiated that has encompassed well over 400 nights of observations. To date, the program has provided detailed information on 80 comets, 11 of which were observed during multiple apparitions. The filters (initially isolating CN, C2, and continuum and later including C3, OH, and NH) as well as the detectors used for the observations were changed over time, and the parameters adopted in the reduction and modeling of the data have likewise evolved. Accordingly, we have re-reduced the entire database and have derived production rates using current values for scalelengths and fluorescence efficiencies. Having completed this task, the results for different comets can now be meaningfully compared. The general characteristics that are discussed include ranges in composition (molecular production rate ratios) and dustiness (gas production compared with Af(rho)). Additionally an analysis of trends on how the production rates vary with heliocentric distance and on pre- and post-perihelion asymmetries in the production rates of individual comets. Possible taxonomic groupings are also described.

A single ultrasound determination of ≥25 follicles ≥3 mm in diameter in dairy heifers is predictive of a reduced productive herd life.

PubMed

Jimenez-Krassel, F; Scheetz, D M; Neuder, L M; Pursley, J R; Ireland, J J

2017-06-01

Fertility and productive herd life (time in herd after birth of first calf) are inferior in dairy cows with relatively low compared with intermediate but not high numbers of follicles growing during ovarian follicular waves. The present study, therefore, tested the hypothesis that fertility and productive herd life are lower in dairy heifers with high follicle numbers compared with age-matched herdmates with fewer follicles. To test this hypothesis, 11 to 15 mo old Holstein heifers were subjected to a single ultrasound measurement of the number of follicles ≥3 mm in diameter. Heifers were classified into a high- (≥25 follicles), mid- (16-24), or low-range (≤15) follicle number group (FNG). All heifers not removed from the herd before first calving (n = 408) had the opportunity to start their fifth or sixth lactation after birth of their first calf. During this time, performance and health parameters for each individual were recorded daily by herd managers. Results showed that heifers in the high-range FNG had a 180-d shorter productive herd life, reduced survival rate, and greater probability of being culled after birth of the first calf, as well as fewer lactations compared with heifers in the low-range FNG. Cows in the high-compared with the mid- or low-range FNG also had greater involuntary culling rates, days open, and services per conception, and lower pregnancy rates during the first, second, or third lactations. We concluded that dairy heifers with ≥25 follicles ≥3 mm in diameter have suboptimal fertility and a shorter productive herd life compared with herdmates with fewer follicles. Copyright © 2017 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Antiseptic mouth rinses: an update on comparative effectiveness, risks and recommendations.

PubMed

Osso, Diane; Kanani, Nehal

2013-02-01

Antiseptic mouth rinses are widely recommended and marketed to improve oral health. This article summarizes current studies on the comparative effectiveness of selected antiseptic mouth rinses in controlling plaque and gingivitis, as well as risks associated with daily exposure, including salivary flow rate, oral cancer and wear of composite restorations. Electronic database searches were conducted using Google Scholar and PubMed to identify articles comparing the effectiveness of 4 commercially marketed antiseptic mouth rinses differing in active ingredients (0.12% chlorhexidine gluconate, essential oils (menthol, thymol and eucalyptol) and methyl salicylate, 0.7% cetylpyridinium chloride and 20% aloe vera gel) for controlling plaque and gingivitis. Criteria for inclusion included controlled clinical trials and systematic reviews appearing in English language publications evaluating the comparative effectiveness of the mouth rinses in controlling plaque and gingivitis, as well as risks associated with daily usage. The majority of studies have shown mouth rinses containing chlorhexidine gluconate or essential oils and methyl salicylate provide clinically significant anti-gingivitis and anti-plaque benefits. Cetylpyridinium chloride has been found to provide only limited clinical benefits compared to inactive control mouth rinse. Inadequate evidence is available to evaluate the clinical effectiveness of aloe vera gel. Chlorhexidine, essential oils and cetylpyridinium have been found to be safe. However, limited data are available on the effects of the mouth rinse on wear patterns of dental restorations. Studies reviewed reported no significant difference in salivary flow rate related to alcohol based mouth rinse. Research supports the effectiveness of antiseptic mouth rinses in reducing plaque and gingivitis as an adjunct to home care. Insufficient evidence is available to support the claim that oral antiseptics can reduce the risk of developing periodontitis or the rate of progression of periodontitis.