Bistatic Space Borne Radar for Early Warning

DTIC Science & Technology

2006-08-01

bandwidth of about 1.2 MHz. hr ht RX TX z x α α α α αr αt y R30 R10 R31 R11 vRx vTx P Bistatic Space Borne Radar for Early Warning...B V R == (12) where VRX is the receiver velocity and BA is the Doppler chirp bandwidth defined by equation (5). The time necessary to obtain

Growth performance, carcass characteristics, meat quality and muscle amino-acid profile of different rabbits breeds and their crosses.

PubMed

Nasr, Mohammed A F; Abd-Elhamid, Tamer; Hussein, Mohamed A

2017-12-01

Meat production efficiency can be enhanced by crossbreeding to capture heterosis. This study aimed to investigate the impact of rabbit genotype on growth performance, carcass traits, meat quality and amino acids profile. A total of 504 weaned rabbits from nine genotypes of full factorial crossing of New Zealand White (NZW), Californian (CA) and Rex (RX) were used. Longissimus thoracis et lumborum muscles were assessed for meat quality and amino acids profile. There were no differences between groups at weaning and 6weeks, but by 10weeks differences were significant (P<0.001) and the numerically heaviest groups were CA×RX and RX×NZW (1970g, P<0.001) with to some extent better amino acids profile. In conclusion, RX growth performance was improved by crossing CA sire with RX dam and RX sire with NZW dam and to have dual purpose breed with better growth performance without hazard on carcass and meat quality. CA×RX and RX×NZW had the heaviest body weight at 10weeks of age and highest body weight gain during the whole finishing period. Copyright © 2017 Elsevier Ltd. All rights reserved.

Evaluation of RxNorm for Medication Clinical Decision Support.

PubMed

Freimuth, Robert R; Wix, Kelly; Zhu, Qian; Siska, Mark; Chute, Christopher G

2014-01-01

We evaluated the potential use of RxNorm to provide standardized representations of generic drug name and route of administration to facilitate management of drug lists for clinical decision support (CDS) rules. We found a clear representation of generic drug name but not route of administration. We identified several issues related to data quality, including erroneous or missing defined relationships, and the use of different concept hierarchies to represent the same drug. More importantly, we found extensive semantic precoordination of orthogonal concepts related to route and dose form, which would complicate the use of RxNorm for drug-based CDS. This study demonstrated that while RxNorm is a valuable resource for the standardization of medications used in clinical practice, additional work is required to enhance the terminology so that it can support expanded use cases, such as managing drug lists for CDS.

Evaluation of RxNorm for Medication Clinical Decision Support

PubMed Central

Freimuth, Robert R.; Wix, Kelly; Zhu, Qian; Siska, Mark; Chute, Christopher G.

2014-01-01

We evaluated the potential use of RxNorm to provide standardized representations of generic drug name and route of administration to facilitate management of drug lists for clinical decision support (CDS) rules. We found a clear representation of generic drug name but not route of administration. We identified several issues related to data quality, including erroneous or missing defined relationships, and the use of different concept hierarchies to represent the same drug. More importantly, we found extensive semantic precoordination of orthogonal concepts related to route and dose form, which would complicate the use of RxNorm for drug-based CDS. This study demonstrated that while RxNorm is a valuable resource for the standardization of medications used in clinical practice, additional work is required to enhance the terminology so that it can support expanded use cases, such as managing drug lists for CDS. PMID:25954360

Retrospective study of rapid-exchange monorail versus over-the-wire technique for femoropopliteal angioplasty.

PubMed

Jahnke, Thomas; Schäfer, Jost Philipp; Bolte, Hendrik; Schäfer, Fritz; Michalek, Jens; Charalambous, Nicholas; Sapoval, Marc; Müller-Hülsbeck, Stefan

2008-01-01

The purpose of this study was to compare procedural outcome of rapid-exchange (RX) monorail versus conventional over-the-wire (OTW) technique for femoropopliteal angioplasty. Demographic data, procedure details, angioplasty success, and complications of 328 consecutive percutaneous transluminal angioplasties (PTAs) were collected from a prospective database and retrospectively analyzed. Procedure details included duration of fluoroscopy, area-dose product, amount of contrast agent, sheath sizes, access route, length of stenosis, presence of total occlusion, technical and anatomical success (residual stenosis < 30% in the absence of complications), need for bail-out stenting, and periprocedural complications. The RX technique alone was used in 102 of 328 cases (31%); the OTW technique, in 226 of 328 of cases (68%). Technical success was 98% for the RX versus 95.4% for the OTW technique (p = 0.2). A significantly greater number of stents had to be implanted due to angioplasty failure when the OTW technique was used (RX, 5.9%; OTW, 13.7%; p = 0.04). There were no significant differences in fluoroscopy time, dose-area product, or amount of contrast medium used. The RX system facilitated the use of smaller sheath sizes (5 Fr = 38% and 6 Fr = 59% for RX versus 5 Fr = 16.8% and > or = 6 Fr = 82.5% for OTW) but showed only a tendency toward lower overall complication rates (16.6% [17/102] in the RX group versus 19.9% [45/226] in the OTW group; p = 0.09). There was no effect on length of hospitalization. RX monorail systems were not associated with higher procedural costs when compared to conventional OTW technique. We conclude that RX monorail systems seem to enhance the technical success of femoropopliteal angioplasty. Although smaller sheath sizes can be used due to the lower profile of the RX systems, there is only a tendency toward lower complication rates.

Alpha-Actinin-3 R577X Polymorphism Influences Muscle Damage and Hormonal Responses After a Soccer Game.

PubMed

Coelho, Daniel B; Pimenta, Eduardo M; Rosse, Izinara C; Veneroso, Christiano; Pussieldi, Guilherme De Azambuja; Becker, Lenice K; Oliveira, Emerson C; Carvalho, Maria R S; Silami-Garcia, Emerson

2018-05-17

Coelho, DB, Pimenta, EM, Rosse, IC, Veneroso, C, Pussieldi, GDA, Becker, LK, De Oliveira, EC, Carvalho, MRS, and Silami-Garcia, E. Alpha-actinin-3 R577X polymorphism influences muscle damage and hormonal responses after a soccer game. J Strength Cond Res XX(X): 000-000, 2018-The purpose of this study was to evaluate indicators of muscle damage and hormonal responses after soccer matches and its relation to alpha-actinin-3 (ACTN3) gene expression (XX vs. RR/RX), considering that the R allele produces alpha-actinin-3 and provides greater muscle strength and power. Thirty players (10 XX and 20 RR/RX) younger than 16 years were evaluated in this study. Blood samples were collected immediately before, after, 2, and 4 hours after the games to assess muscle damage (creatine kinase [CK] and alpha-actin) and hormonal responses (interleukin-6 [IL-6], cortisol, and testosterone). Postgame CK was higher as compared to the pregame values in both groups and it was also higher in the RR/RX (p < 0.05) than in the XX. The concentrations of alpha-actin and IL-6 were similar for both groups and did not change over time. Testosterone was increased after the game only in the RR/RX group (p < 0.05). Cortisol concentrations in group RR/RX were higher immediately after the game than before the game, and 2 and 4 hours after the game the concentration decreased (p < 0.05). The RR and RX individuals presented higher markers of muscle microtrauma and hormonal stress, probably because they performed more speed and power actions during the game, which is a self-regulated activity. From the different responses presented by RR/RX and XX genotypes, we conclude that the genotypic profile should be taken into account when planning training workloads and recovery of athletes.

SU-E-T-453: Optimization of Dose Gradient for Gamma Knife Radiosurgery.

PubMed

Sheth, N; Chen, Y; Yang, J

2012-06-01

The goals of stereotactic radiosurgery (SRS) are the ablation of target tissue and sparing of critical normal tissue. We develop tools to aid in the selection of collimation and prescription (Rx) isodose line to optimize the dose gradient for single isocenter intracranial stereotactic radiosurgery (SRS) with GammaKnife 4C utilizing the updated physics data in GammaPlan v10.1. Single isocenter intracranial SRS plans were created to treat the center of a solid water anthropomorphism head phantom for each GammaKnife collimator (4 mm, 8 mm, 14 mm, and 18 mm). The dose gradient, defined as the difference of effective radii of spheres equal to half and full Rx volumes, and Rx treatment volume was analyzed for isodoses from 99% to 20% of Rx. The dosimetric data on Rx volume and dose gradient vs. Rx isodose for each collimator was compiled into an easy to read nomogram as well as plotted graphically. The 4, 8, 14, and 18 mm collimators have the sharpest dose gradient at the 64%, 70%, 76%, and 77% Rx isodose lines, respectively. This corresponds to treating 4.77 mm, 8.86 mm, 14.78 mm, and 18.77 mm diameter targets with dose gradients radii of 1.06 mm, 1.63 mm, 2.54 mm, and 3.17 mm, respectively. We analyzed the dosimetric data for the most recent version of GammaPlan treatment planning software to develop tools that when applied clinically will aid in the selection of a collimator and Rx isodose line for optimal dose gradient and target coverage for single isocenter intracranial SRS with GammaKnife 4C. © 2012 American Association of Physicists in Medicine.

Prescription Drug Misuse Among Club Drug-Using Young Adults

PubMed Central

Kelly, Brian C.; Parsons, Jeffrey T.

2009-01-01

Nonmedical prescription (Rx) drug use has recently increased, particularly among young adults. Using time-space sampling to generate a probability-based sample of club-going young adults (18–29), 400 subjects provided data on Rx drug misuse. Club-going young adults misuse Rx drugs at high rates. An overwhelming majority of the sample indicated lifetime use of pain killers, sedatives, and stimulants. A majority indicated recent pain killer use. Variations by gender and sexuality exist in this population. Young lesbian/bisexual women emerged as the group most likely to abuse Rx drugs. Research into the contexts influencing these patterns is imperative. PMID:17994483

Mid- and long-term device migration after endovascular abdominal aortic aneurysm repair: a comparison of AneuRx and Zenith endografts.

PubMed

Tonnessen, Britt H; Sternbergh, W Charles; Money, Samuel R

2005-09-01

Freedom from migration is key to the durability of endovascular aneurysm repair (EVAR). This study evaluates the mid- and long-term incidence of migration with two different endografts. Between September 1997 and June 2004, 235 patients were scheduled for EVAR with an AneuRx (Medtronic/AVE Inc.) or Zenith (Cook) endograft. Patients with fusiform, infrarenal aneurysms and a minimum 12 months of follow-up were analyzed, for a final cohort of 130 patients. Migration was assessed on axial computed tomography (CT) (2.5 to 3 mm cuts) as the distance from the most caudal renal artery to the first slice containing endograft (AneuRx) or to the top of the bare suprarenal stent (Zenith). Aortic neck diameters were measured at the most caudal renal artery. The initial postoperative CT scan was the baseline. Migration was defined by caudal movement of the endograft at two thresholds, > or =5 mm and > or =10 mm, or any migration with a related clinical event. Life-table analysis demonstrated AneuRx freedom from migration (> or =10 mm or clinical event) was 96.1%, 89.5%, 78.0%, and 72.0% at 1, 2, 3, and 4 years, respectively. Zenith freedom from migration was 100%, 97.6%, 97.6%, and 97.6% at 1, 2, 3, and 4 years, respectively (P = .01, log-rank test). The stricter 5-mm migration threshold found 67.4% of AneuRx and 90.1% of Zenith patients free from migration at 4 years of follow-up. Twelve out of 14 (85.7%) AneuRx patients (12/14) with migration (> or =10 mm or clinical event) underwent 14 related secondary procedures (13 endovascular, 1 open conversion). The single Zenith patient with migration (> or =10 mm) has not required adjuvant treatment. Mean follow-up was 39.0 +/- 2.3 months (AneuRx) and 30.8 +/- 1.9 months (Zenith, P = .01). Patients with and without migration did not differ in age, gender ratio, aneurysm diameter, and neck diameter. However, initial neck length was shorter in patients with migration (22.1 +/- 2.1 mm vs 31.2 +/- 1.2 mm, P = .02). A subset of patients (21.6%) experienced significant (defined as > or =3 mm) maximum aortic neck dilation. Of the AneuRx patients, > or =3 mm aortic neck dilation affected 30.8% of migrators vs 13.0% of nonmigrators (P = .20). Endograft migration is a time-dependent phenomenon affected by both device choice and aortic neck length. A great majority of patients (85.7%) with migration of the AneuRx device ultimately required treatment. A minority of patients experienced aortic neck dilation that could be considered clinically significant. Careful surveillance for migration is an essential component of long-term follow-up after EVAR.

In vitro translocation experiments with RxLR-reporter fusion proteins of Avr1b from Phytophthora sojae and AVR3a from Phytophthora infestans fail to demonstrate specific autonomous uptake in plant and animal cells.

PubMed

Wawra, Stephan; Djamei, Armin; Albert, Isabell; Nürnberger, Thorsten; Kahmann, Regine; van West, Pieter

2013-05-01

Plant-pathogenic oomycetes have a large set of secreted effectors that can be translocated into their host cells during infection. One group of these effectors are the RxLR effectors for which it has been shown, in a few cases, that the RxLR motif is important for their translocation. It has been suggested that the RxLR-leader sequences alone are enough to translocate the respective effectors into eukaryotic cells through binding to surface-exposed phosphoinositol-3-phosphate. These conclusions were primary based on translocation experiments conducted with recombinant fusion proteins whereby the RxLR leader of RxLR effectors (i.e., Avr1b from Phytophthora sojae) were fused to the green fluorescent protein reporter-protein. However, we failed to observe specific cellular uptake for a comparable fusion protein where the RxLR leader of the P. infestans AVR3a was fused to monomeric red fluorescent protein. Therefore, we reexamined the ability of the reported P. sojae AVR1b RxLR leader to enter eukaryotic cells. Different relevant experiments were performed in three independent laboratories, using fluorescent reporter fusion constructs of AVR3a and Avr1b proteins in a side-by-side comparative study on plant tissue and human and animal cells. We report that we were unable to obtain conclusive evidence for specific RxLR-mediated translocation.

Optimization of physiological parameter for macroscopic modeling of reacted singlet oxygen concentration in an in-vivo model

NASA Astrophysics Data System (ADS)

Wang, Ken Kang-Hsin; Busch, Theresa M.; Finlay, Jarod C.; Zhu, Timothy C.

2009-02-01

Singlet oxygen (1O2) is generally believed to be the major cytotoxic agent during photodynamic therapy (PDT), and the reaction between 1O2 and tumor cells define the treatment efficacy. From a complete set of the macroscopic kinetic equations which describe the photochemical processes of PDT, we can express the reacted 1O2 concentration, [1O2]rx, in a form related to time integration of the product of 1O2 quantum yield and the PDT dose rate. The production of [1O2]rx involves physiological and photophysical parameters which need to be determined explicitly for the photosensitizer of interest. Once these parameters are determined, we expect the computed [1O2]rx to be an explicit dosimetric indicator for clinical PDT. Incorporating the diffusion equation governing the light transport in turbid medium, the spatially and temporally-resolved [1O2]rx described by the macroscopic kinetic equations can be numerically calculated. A sudden drop of the calculated [1O2]rx along with the distance following the decrease of light fluence rate is observed. This suggests that a possible correlation between [1O2]rx and necrosis boundary may occur in the tumor subject to PDT irradiation. In this study, we have theoretically examined the sensitivity of the physiological parameter from two clinical related conditions: (1) collimated light source on semi-infinite turbid medium and (2) linear light source in turbid medium. In order to accurately determine the parameter in a clinical relevant environment, the results of the computed [1O2]rx are expected to be used to fit the experimentally-measured necrosis data obtained from an in vivo animal model.

Antisense oligonucleotides targeting apolipoprotein(a) in people with raised lipoprotein(a): two randomised, double-blind, placebo-controlled, dose-ranging trials.

PubMed

Viney, Nicholas J; van Capelleveen, Julian C; Geary, Richard S; Xia, Shuting; Tami, Joseph A; Yu, Rosie Z; Marcovina, Santica M; Hughes, Steven G; Graham, Mark J; Crooke, Rosanne M; Crooke, Stanley T; Witztum, Joseph L; Stroes, Erik S; Tsimikas, Sotirios

2016-11-05

Elevated lipoprotein(a) (Lp[a]) is a highly prevalent (around 20% of people) genetic risk factor for cardiovascular disease and calcific aortic valve stenosis, but no approved specific therapy exists to substantially lower Lp(a) concentrations. We aimed to assess the efficacy, safety, and tolerability of two unique antisense oligonucleotides designed to lower Lp(a) concentrations. We did two randomised, double-blind, placebo-controlled trials. In a phase 2 trial (done in 13 study centres in Canada, the Netherlands, Germany, Denmark, and the UK), we assessed the effect of IONIS-APO(a) Rx , an oligonucleotide targeting apolipoprotein(a). Participants with elevated Lp(a) concentrations (125-437 nmol/L in cohort A; ≥438 nmol/L in cohort B) were randomly assigned (in a 1:1 ratio in cohort A and in a 4:1 ratio in cohort B) with an interactive response system to escalating-dose subcutaneous IONIS-APO(a) Rx (100 mg, 200 mg, and then 300 mg, once a week for 4 weeks each) or injections of saline placebo, once a week, for 12 weeks. Primary endpoints were mean percentage change in fasting plasma Lp(a) concentration at day 85 or 99 in the per-protocol population (participants who received more than six doses of study drug) and safety and tolerability in the safety population. In a phase 1/2a first-in-man trial, we assessed the effect of IONIS-APO(a)-L Rx , a ligand-conjugated antisense oligonucleotide designed to be highly and selectively taken up by hepatocytes, at the BioPharma Services phase 1 unit (Toronto, ON, Canada). Healthy volunteers (Lp[a] ≥75 nmol/L) were randomly assigned to receive a single dose of 10-120 mg IONIS-APO(a)L Rx subcutaneously in an ascending-dose design or placebo (in a 3:1 ratio; single-ascending-dose phase), or multiple doses of 10 mg, 20 mg, or 40 mg IONIS-APO(a)L Rx subcutaneously in an ascending-dose design or placebo (in an 8:2 ratio) at day 1, 3, 5, 8, 15, and 22 (multiple-ascending-dose phase). Primary endpoints were mean percentage change in fasting plasma Lp(a) concentration, safety, and tolerability at day 30 in the single-ascending-dose phase and day 36 in the multiple-ascending-dose phase in participants who were randomised and received at least one dose of study drug. In both trials, the randomised allocation sequence was generated by Ionis Biometrics or external vendor with a permuted-block randomisation method. Participants, investigators, sponsor personnel, and clinical research organisation staff who analysed the data were all masked to the treatment assignments. Both trials are registered with ClinicalTrials.gov, numbers NCT02160899 and NCT02414594. From June 25, 2014, to Nov 18, 2015, we enrolled 64 participants to the phase 2 trial (51 in cohort A and 13 in cohort B). 35 were randomly assigned to IONIS-APO(a) Rx and 29 to placebo. At day 85/99, participants assigned to IONIS-APO(a) Rx had mean Lp(a) reductions of 66·8% (SD 20·6) in cohort A and 71·6% (13·0) in cohort B (both p<0·0001 vs pooled placebo). From April 15, 2015, to Jan 11, 2016, we enrolled 58 healthy volunteers to the phase 1/2a trial of IONIS-APO(a)-L Rx . Of 28 participants in the single-ascending-dose phase, three were randomly assigned to 10 mg, three to 20 mg, three to 40 mg, six to 80 mg, six to 120 mg, and seven to placebo. Of 30 participants in the multiple-ascending-dose phase, eight were randomly assigned to 10 mg, eight to 20 mg, eight to 40 mg, and six to placebo. Significant dose-dependent reductions in mean Lp(a) concentrations were noted in all single-dose IONIS-APO(a)-L Rx groups at day 30. In the multidose groups, IONIS-APO(a)-L Rx resulted in mean reductions in Lp(a) of 66% (SD 21·8) in the 10 mg group, 80% (SD 13·7%) in the 20 mg group, and 92% (6·5) in the 40 mg group (p=0·0007 for all vs placebo) at day 36. Both antisense oligonucleotides were safe. There were two serious adverse events (myocardial infarctions) in the IONIS-APO(a) Rx phase 2 trial, one in the IONIS-APO(a) Rx and one in the placebo group, but neither were thought to be treatment related. 12% of injections with IONIS-APO(a) Rx were associated with injection-site reactions. IONIS-APO(a)-L Rx was associated with no injection-site reactions. IONIS-APO(a)-L Rx is a novel, tolerable, potent therapy to reduce Lp(a) concentrations. IONIS-APO(a)-L Rx might mitigate Lp(a)-mediated cardiovascular risk and is being developed for patients with elevated Lp(a) concentrations with existing cardiovascular disease or calcific aortic valve stenosis. Ionis Pharmaceuticals. Copyright © 2016 Elsevier Ltd. All rights reserved.

VizieR Online Data Catalog: RX J105453.3+552102 cluster SDSS photometry (Aguerri+, 2011)

NASA Astrophysics Data System (ADS)

Aguerri, J. A. L.; Girardi, M.; Boschin, W.; Barrena, R.; Mendez-Abreu, J.; Sanchez-Janssen, R.; Borgani, S.; Castro-Rodriguez, N.; Corsini, E. M.; Del Burgo, C.; D'Onghia, E.; Iglesias-Paramo, J.; Napolitano, N.; Vilchez, J. M.

2011-08-01

Optical imaging of RX J105453.3+552102 was carried out at the 2.5m NOT telescope in March 2008. Optical deep images were used for studying the properties of the brightest group galaxy and for computing the photometric luminosity function of the group. We have also performed a detail dynamical analysis of the system based on redshift data for 116 galaxies. Combining galaxy velocities and positions we selected 78 group members. (1 data file).

Fossil group origins. VIII. RX J075243.6+455653 a transitionary fossil group

NASA Astrophysics Data System (ADS)

Aguerri, J. A. L.; Longobardi, A.; Zarattini, S.; Kundert, A.; D'Onghia, E.; Domínguez-Palmero, L.

2018-01-01

Context. It is thought that fossil systems are relics of structure formation in the primitive Universe. They are galaxy aggregations that have assembled their mass at high redshift with few or no subsequent accretion. Observationally these systems are selected by large magnitude gaps between their 1st and 2nd ranked galaxies (Δm12). Nevertheless, there is still debate over whether or not this observational criterium selects dynamically evolved ancient systems. Aims: We have studied the properties of the nearby fossil group RX J075243.6+455653 in order to understand the mass assembly of this system. Methods: Deep spectroscopic observations allow us to construct the galaxy luminosity function (LF) of RX J075243.6+455653 down to Mr*+6. The analysis of the faint-end of the LF in groups and clusters provides valuable information about the mass assembly of the system. In addition, we have analyzed the nearby large-scale structure around this group. Results: We identified 26 group members within r200 0.96 Mpc. These galaxies are located at Vc = 15551 ± 65 km s-1 and have a velocity dispersion of σc = 333 ± 46 km s-1. The X-ray luminosity of the group is LX = 2.2 × 1043 h70-2 erg s-1, resulting in a mass of M = 4.2 × 1013 h70-1 within 0.5r200. The group has Δm12 = 2.1 within 0.5r200, confirming the fossil nature of this system. RX J075243.6+455653 has a central brightest group galaxy (BGG) with Mr = -22.67, one of the faintest BGGs observed in fossil systems. The LF of the group shows a flat faint-end slope (α = -1.08 ± 0.33). This low density of dwarf galaxies is confirmed by the low value of the dwarf-to-giant ratio (DGR = 0.99 ± 0.49) for this system. Both the lack of dwarf galaxies and the low luminosity of the BGG suggests that RX J075243.6+455653 still has to accrete mass from its nearby environment. This mass accretion will be achieved because it is the dominant structure of a rich environment formed by several groups of galaxies (15) within 7 Mpc from the group center and with ± 1000 km s-1. Conclusions: RX J075243.6+455653 is a group of galaxies that has not yet completed the process of its mass assembly. This new mass accretion will change the fossil state of the group. This group is an example of a galaxy aggregation selected by a large magnitude gap but still in the process of the accretion of its mass.

Temporal variability in lipoprotein(a) levels in patients enrolled in the placebo arms of IONIS-APO(a)Rx and IONIS-APO(a)-LRx antisense oligonucleotide clinical trials.

PubMed

Marcovina, Santica M; Viney, Nicholas J; Hughes, Steven G; Xia, Shuting; Witztum, Joseph L; Tsimikas, Sotirios

Lipoprotein(a) [Lp(a)] levels are primarily genetically determined, but their natural variability is not well known. The aim of the study was to evaluate the short-term temporal variability in Lp(a) in 3 placebo groups from the IONIS-APO(a) Rx and IONIS-APO(a)-L Rx trials. The placebo groups comprised 3 studies: Study 1 with 10 subjects with any Lp(a) concentration; Study 2 with 13 subjects with Lp(a) ≥75 nmol/L (∼30 mg/dL); and Study 3 with 29 patients with Lp(a) ≥125 nmol/L (≥∼50 mg/dL). Lp(a) was measured in serial blood samples (range 7-12 samples up to 190 days of follow-up) and analyzed as absolute change and mean percent change from baseline. Outliers were defined as having a > ±25% difference in Lp(a) from baseline at any future time point. No significant temporal differences in mean absolute Lp(a) levels were present in any group. However, among individuals, the mean change in absolute Lp(a) levels at any time point ranged from -16.2 to +7.0 nmol/L in Study 1, -15.8 to +9.8 nmol/L in Study 2, and -60.2 to +16.6 nmol/L in Study 3. The mean percent change from baseline ranged from -9.4% to +21.6% for Study 1, -13.1% to 2.8% for Study 2, and -12.1% to +4.9% in Study 3. A total of 21 of 52 subjects (40.4%) were outliers, with 13 (62%) >25% up and 8 (38%) >25% down. Significant variability was also noted in other lipid parameters, but no outliers were noted with serum albumin. In subjects randomized to placebo in Lp(a) lowering trials, modest intra-individual temporal variability of mean Lp(a) levels was present. Significant number of subjects had > ±25% variation in Lp(a) in at least 1 time point. Although Lp(a) levels are primarily genetically determined, further study is required to define additional factors mediating short-term variability. Copyright © 2017 National Lipid Association. Published by Elsevier Inc. All rights reserved.

Potentially Inappropriate Prescribing to Older Patients: Criteria, Prevalence and an Intervention to Reduce it: The Prescription Peer Academic Detailing (Rx-PAD) Study - A Cluster-Randomized, Educational Intervention in Norwegian General Practice.

PubMed

Rognstad, Sture; Brekke, Mette; Gjelstad, Svein; Straand, Jørund; Fetveit, Arne

2018-05-12

Potentially Inappropriate Prescriptions (PIP) is drug treatment, which in general, at the group level for a median/mean patient, can be considered unfavorable meaning that the risks commonly may outweigh the benefits. This MiniReview reports and discusses the main findings in a large cluster-randomized educational intervention in Norwegian general practice, aimed at reducing the prevalence of PIPs to patients ≥ 70 years (The Rx-PAD study). Targets for the intervention were general practitioners (GPs) in continuing medical education (CME) groups receiving educational outreach visits (i.e., peer academic detailing). A Delphi consensus process, with a panel of medical experts was undertaken to elaborate a list of explicit criteria defining PIPs for patients ≥ 70 years in general practice. Agreement was achieved for 36 explicit PIP criteria, the so-called Norwegian General Practice (NorGeP) criteria. Using a selection (n = 24) of these criteria during a one-year baseline period on the prescribing practice of 454 GPs (i.e., those enrolled to participate in the intervention trial), we found a prevalence rate of 24.7 PIPs per 100 patients ≥70 years per year. In the Rx-PAD study, 449 GPs completed an educational intervention (96.6% of the included GPs), 250 in the intervention group and 199 in the control arm. Following the intervention, PIPs were reduced by 13% (95% CI 8.6 - 17.3), and the number of patients who were no longer exposed to one or more PIPs was reduced by 1173 (8.1%). The GPs who responded most strongly to the educational intervention were the oldest GPs (57-68 years) and these were the GPs with the highest prevalence of PIPs at baseline before the intervention. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Singlet oxygen explicit dosimetry to predict long-term local tumor control for Photofrin-mediated photodynamic therapy

NASA Astrophysics Data System (ADS)

Penjweini, Rozhin; Kim, Michele M.; Ong, Yi Hong; Zhu, Timothy C.

2017-02-01

Although photodynamic therapy (PDT) is an established modality for the treatment of cancer, current dosimetric quantities do not account for the variations in PDT oxygen consumption for different fluence rates (φ). In this study we examine the efficacy of reacted singlet oxygen concentration ([1O2]rx) to predict long-term local control rate (LCR) for Photofrin-mediated PDT. Radiation-induced fibrosarcoma (RIF) tumors in the right shoulders of female C3H mice are treated with different in-air fluences of 225-540 J/cm2 and in-air fluence rate (φair) of 50 and 75 mW/cm2 at 5 mg/kg Photofrin and a drug-light interval of 24 hours using a 1 cm diameter collimated laser beam at 630 nm wavelength. [1O2]rx is calculated by using a macroscopic model based on explicit dosimetry of Photofrin concentration, tissue optical properties, tissue oxygenation and blood flow changes during PDT. The tumor volume of each mouse is tracked for 90 days after PDT and Kaplan-Meier analyses for LCR are performed based on a tumor volume <=100 mm3, for the four dose metrics light fluence, photosensitizer photobleaching rate, PDT dose and [1O2]rx. PDT dose is defined as a temporal integral of photosensitizer concentration and Φ at a 3 mm tumor depth. φ is calculated throughout the treatment volume based on Monte-Carlo simulation and measured tissue optical properties. Our preliminary studies show that [1O2]rx is the best dosimetric quantity that can predict tumor response and correlate with LCR. Moreover, [1O2]rx calculated using the blood flow changes was in agreement with [1O2]rx calculated based on the actual tissue oxygenation.

A Survey of Women's Awareness of and Reasons for Lack of Postfracture Osteoporotic Care.

PubMed

Boudreau, Denise M; Yu, Onchee; Balasubramanian, Akhila; Wirtz, Heidi; Grauer, Andreas; Crittenden, Daria B; Scholes, Delia

2017-08-01

To identify women's beliefs and other factors associated with lack of osteoporosis (OP) pharmacotherapy (OP-RX) during the 6 months after a fragility fracture, including the woman's perspective on fracture risk, OP, and treatment. Cross-sectional. Group Health Cooperative, a mixed-model delivery system. Female Group Health Cooperative enrollees aged 55 and older with an OP-related fracture according to diagnostic and procedure codes from January 1, 2013, to March 30, 2014 (N = 985). OP-RX and participant characteristics were ascertained from electronic health records including medications dispensed. A mailed survey was used to obtain data on health behaviors; OP-related history; concern about, knowledge of, and perceived risk of future fracture; beliefs about OP-RX; sources of information on OP; postfracture discussions with providers; and provider recommendations. The response rate was 73%. Of 634 eligible respondents, 84% did not undergo OP-RX during the 6 months after fracture. Fewer than 20% of women thought that OP caused their fracture, 52% did not think they were at risk of future fracture, and 75% did not think or know whether OP-RX reduces risk of fracture. Knowledge about OP and the benefits of treatment was higher in the 16% of women who underwent OP-RX after their fracture. Women reported low levels of engagement with their healthcare providers regarding OP and fracture risk management. These findings suggest low awareness about OP and its contribution to fracture risk, lack of understanding about the benefits of pharmacotherapy, and limited discussion about OP with primary care physicians. Information about individual's beliefs and knowledge gaps can help design targeted patient and provider education to improve treatment rates. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

Sequence alterations in RX in patients with microphthalmia, anophthalmia, and coloboma

PubMed Central

London, Nikolas J.S.; Kessler, Patricia; Williams, Bryan; Pauer, Gayle J.; Hagstrom, Stephanie A.

2009-01-01

Purpose Microphthalmia, anophthalmia, and coloboma are ocular malformations with a significant genetic component. Rx is a homeobox gene expressed early in the developing retina and is important in retinal cell fate specification as well as stem cell proliferation. We screened a group of 24 patients with microphthalmia, coloboma, and/or anophthalmia for RX mutations. Methods We used standard PCR and automated sequencing techniques to amplify and sequence each of the three RX exons. Patients’ charts were reviewed for clinical information. The pathologic impact of the identified sequence variant was analyzed by computational methods using PolyPhen and PMut algorithms. Results In addition to the polymorphisms we identified a single patient with coloboma having a heterozygous nucleotide change (g.197G>C) in the first exon that results in a missense mutation of arginine to threonine at amino acid position 66 (R66T). In silico analysis predicted R66T to be a deleterious mutation. Conclusions Sequence variations in RX are uncommon in patients with congenital ocular malformations, but may play a role in disease pathogenesis. We observed a missense mutation in RX in a patient with a small, typical chorioretinal coloboma, and postulate that the mutation is responsible for the patient’s phenotype. PMID:19158959

Using RxNorm and NDF-RT to classify medication data extracted from electronic health records: experiences from the Rochester Epidemiology Project.

PubMed

Pathak, Jyotishman; Murphy, Sean P; Willaert, Brian N; Kremers, Hilal M; Yawn, Barbara P; Rocca, Walter A; Chute, Christopher G

2011-01-01

RxNorm and NDF-RT published by the National Library of Medicine (NLM) and Veterans Affairs (VA), respectively, are two publicly available federal medication terminologies. In this study, we evaluate the applicability of RxNorm and National Drug File-Reference Terminology (NDF-RT) for extraction and classification of medication data retrieved using structured querying and natural language processing techniques from electronic health records at two different medical centers within the Rochester Epidemiology Project (REP). Specifically, we explore how mappings between RxNorm concept codes and NDF-RT drug classes can be leveraged for hierarchical organization and grouping of REP medication data, identify gaps and coverage issues, and analyze the recently released NLM's NDF-RT Web service API. Our study concludes that RxNorm and NDF-RT can be applied together for classification of medication extracted from multiple EHR systems, although several issues and challenges remain to be addressed. We further conclude that the Web service APIs developed by the NLM provide useful functionalities for such activities.

Safety and tolerability of prescription omega-3 fatty acids: A systematic review and meta-analysis of randomized controlled trials.

PubMed

Chang, Cheng-Ho; Tseng, Ping-Tao; Chen, Nai-Yu; Lin, Pei-Chin; Lin, Pao-Yen; Chang, Jane Pei-Chen; Kuo, Feng-Yu; Lin, Jenshinn; Wu, Ming-Chang; Su, Kuan-Pin

2018-02-01

Omega-3 fatty acids [eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)] are widely recommended for health promotion. Over the last decade, prescription omega-3 fatty acid products (RxOME3FAs) have been approved for medical indications. Nonetheless, there is no comprehensive analysis of safety and tolerability of RxOME3FAs so far. A systematic review of randomized controlled trials (RCTs) was carried out based on searches in six electronic databases. The studies involving marketed RxOME3FA products were included, and adverse-effect data were extracted for meta-analysis. Subgroup analysis and meta-regression were conducted to explore the sources of potential heterogeneity. Among the 21 included RCTs (total 24,460 participants; 12,750 from RxOME3FA treatment cohort and 11,710 from control cohort), there was no definite evidence of any RxOME3FA-emerging serious adverse event. Compared with the control group, RxOME3FAs were associated with more treatment-related dysgeusia (fishy taste; p = 0.011) and skin abnormalities (eruption, itching, exanthema, or eczema; p < 0.001). Besides, RxOME3FAs had mild adverse effects upon some non-lipid laboratory measurements [elevated fasting blood sugar (p = 0.005); elevated alanine transaminase (p = 0.022); elevated blood urea nitrogen (p = 0.047); decreased hemoglobin (p = 0.002); decreased hematocrit (p = 0.009)]. Subgroup analysis revealed that EPA/DHA combination products were associated with more treatment-related gastrointestinal adverse events [eructation (belching; p = 0.010); nausea (p = 0.044)] and low-density lipoprotein cholesterol elevation (p = 0.009; difference in means = 4.106mg/dL). RxOME3FAs are generally safe and well tolerated but not free of adverse effects. Post-marketing surveillance and observational studies are still necessary to identify long-term adverse effects and to confirm the safety and tolerability profiles of RxOME3FAs. Copyright © 2018 Elsevier Ltd. All rights reserved.

Development of redox-sensitive red fluorescent proteins for imaging redox dynamics in cellular compartments.

PubMed

Fan, Yichong; Ai, Hui-wang

2016-04-01

We recently reported a redox-sensitive red fluorescent protein, rxRFP1, which is one of the first genetically encoded red-fluorescent probes for general redox states in living cells. As individual cellular compartments have different basal redox potentials, we hereby describe a group of rxRFP1 mutants, showing different midpoint redox potentials for detection of redox dynamics in various subcellular domains, such as mitochondria, the cell nucleus, and endoplasmic reticulum (ER). When these redox probes were expressed and subcellularly localized in human embryonic kidney (HEK) 293 T cells, they responded to membrane-permeable oxidants and reductants. In addition, a mitochondrially localized rxRFP1 mutant, Mito-rxRFP1.1, was used to detect mitochondrial oxidative stress induced by doxorubicin-a widely used cancer chemotherapy drug. Our work has expanded the fluorescent protein toolkit with new research tools for studying compartmentalized redox dynamics and oxidative stress under various pathophysiological conditions.

Moving towards the New International Study Group for Pancreatic Surgery (ISGPS) definitions in pancreaticoduodenectomy: a comparison between the old and new.

PubMed

Tan, Winson Jianhong; Kow, Alfred Wei Chieh; Liau, Kui Hin

2011-08-01

The International Study Group for Pancreatic Surgery (ISGPS) has proposed several definitions for postoperative pancreatic fistula (POPF), delayed gastric emptying (DGE) and post-pancreatectomy haemorrhage (PPH). We assessed the effects of implementing these definitions on predicting outcomes. A database of 77 patients who underwent pancreaticoduodenectomy between January 2005 and December 2009 was analysed. Morbidities were defined and classified using the ISGPS definitions and recalculated based on the definitions adopted by our institution ('Old' definitions) prior to the implementation of ISGPS definitions. Data for the two groups were then compared. The morbidity rate rose to 70.1% from 27.2% when ISGPS rather than Old definitions were used to define morbidities (P < 0.001). Incidences of DGE, POPF and PPH were 20.7%, 39.0% and 10.4%, respectively. Rates of DGE and POPF were significantly higher according to ISGPS definitions than to Old definitions (20.7% vs. 5.2% [P= 0.001] and 39.0% vs. 15.6% [P= 0.004], respectively). According to the ISGPS definitions, all of the 12 additional patients with DGE and 12 of the 18 additional patients with POPF had grade A morbidities. Patients with ISGPS-defined morbidity had a longer intensive care unit (ICU) stay, longer postoperative stay and longer total stay (P= 0.030, P= 0.007 and P= 0.001, respectively). The morbidity rate more than doubled when ISGPS definitions were applied (an additional 42.9% of patients demonstrated morbidities). The majority of patients with DGE and POPF had grade A morbidities. The ISGPS definitions correlate well with ICU stay, postoperative stay and total length of stay. © 2011 International Hepato-Pancreato-Biliary Association.

RX J1548.9+0851, a fossil cluster?

NASA Astrophysics Data System (ADS)

Eigenthaler, P.; Zeilinger, W. W.

2012-04-01

Context. Fossil galaxy groups are spatially extended X-ray sources with X-ray luminosities above L{X, bol ≥ 1042 h50-2} erg s-1 and a central elliptical galaxy dominating the optical, the second-brightest galaxy being at least 2 mag fainter in the R band. Whether these systems are a distinct class of objects resulting from exceptional formation and evolution histories is still unclear, mainly due to the small number of objects studied so far, mostly lacking spectroscopy of group members for group membership confirmation and a detailed kinematical analysis. Aims: To complement the scarce sample of spectroscopically studied fossils down to their faint galaxy populations, the fossil candidate RX J1548.9+0851 (z = 0.072) is studied in this work. Our results are compared with existing data from fossils in the literature. Methods: We use ESO VLT VIMOS multi-object spectroscopy to determine redshifts of the faint galaxy population and study the luminosity-weighted dynamics and luminosity function of the system. The full-spectrum fitting package ULySS is used to determine ages and metallicities of group members. VIMOS imaging data are used to study the morphology of the central elliptical. Results: We identify 40 group members spectroscopically within the central 300 kpc of the system and find 31 additional redshifts from the literature, resulting in a total number of 54 spectroscopically confirmed group members within 1 Mpc. RX J1548.9+0851 is made up of two bright ellipticals in the central region with a magnitude gap of Δm1,2 = 1.34 in the SDSS r' band leaving the definition of RX J1548.9+0851 being a fossil to the assumption of the virial radius. We find a luminosity-weighted velocity dispersion of 568 km s-1 and a mass of 2.5 × 1014 M⊙ for the system confirming previous studies that revealed fossils to be massive. An average mass-to-light ratio of M/L 400 M⊙/L⊙ is derived from the SDSS g', r', and i' bands. The central elliptical is well-fitted by a pure deVaucouleurs r1/4 law without a cD envelope. Symmetric shells are revealed along the major axis of the galaxy indicating a recent minor merger. RX J1548.9+0851 shows a steep, increasing luminosity function with a faint-end slope of α = -1.4 ± 0.1. Satellite galaxies show a clear spatial segregation with respect to their stellar populations - objects with old stars are confined to an elongated, central distribution aligned with the major axis of the central elliptical. Conclusions: Although RX J1548.9+0851 shows similar properties compared to other fossils studied recently, it might not be a fossil at all, being dominated by 2 bright central ellipticals. Comparing RX J1548.9+0851 with scaling relations from ordinary poor groups and clusters confirm the idea that fossils might simply be normal clusters with the richness and optical luminosity of poor groups.

Is fetal manipulation during shoulder dystocia management associated with severe maternal and neonatal morbidities?

PubMed

Gachon, Bertrand; Desseauve, David; Fritel, Xavier; Pierre, Fabrice

2016-09-01

There is a lack of data regarding maternal morbidity and neonatal hypoxia associated with shoulder dystocia (SD), particularly with respect to whether SD is managed with our without fetal manipulation (FM). Our main objective was to compare severe maternal and neonatal morbidities associated with SD according to FM execution. We conducted a retrospective study based on a medical record analysis that included all SD cases from 2007 to 2012. SD was considered when additional maneuvers were required to complete a delivery. Severe maternal morbidity was defined as the occurrence of an obstetric anal sphincter injury. Severe neonatal morbidity was defined as the occurrence of one of these complications: permanent brachial plexus palsy, arterial cord pH < 7.1, Apgar score < 7 at 5 min. We compared severe maternal and neonatal morbidities in the FM and the no-FM group. We report an SD incidence of 2.4 % (n = 227) with 93.8 % of patients treated without FM. We identified two cases of permanent brachial plexus palsy, fifteen cases of arterial cord pH < 7.1 and six cases with an Apgar score < 7 at 5 min; all of them were from the no-FM group. There were more cases of OASI in the FM group (odd ratio = 9.2 [1.32-50.71]). No statistical differences between these groups were observed with respect to severe neonatal morbidity. Severe neonatal morbidity does not appear to be associated with FM during SD management, but severe maternal morbidity is associated with FM execution.

High prevalence of Escherichia coli sequence type 131 among antimicrobial-resistant E. coli isolates from geriatric patients.

PubMed

Ho, Pak-Leung; Chu, Yuki Pui-Shan; Lo, Wai-U; Chow, Kin-Hung; Law, Pierra Y; Tse, Cindy Wing-Sze; Ng, Tak-Keung; Cheng, Vincent Chi-Chung; Que, Tak-Lun

2015-03-01

Previous work on the subclones within Escherichia coli ST131 predominantly involved isolates from Western countries. This study assessed the prevalence and antimicrobial resistance attributed to this clonal group. A total of 340 consecutive, non-duplicated urinary E. coli isolates originating from four clinical laboratories in Hong Kong in 2013 were tested. ST131 prevalence among the total isolates was 18.5 % (63/340) and was higher among inpatient isolates (23.0 %) than outpatient isolates (11.8 %, P<0.001), and higher among isolates from patients aged ≥65 years than from patients aged 18-50 years and 51-64 years (25.4 vs 3.4 and 4.0 %, respectively, P<0.001). Of the 63 ST131 isolates, 43 (68.3 %) isolates belonged to the H30 subclone, whereas the remaining isolates belonged to H41 (n = 17), H54 (n = 2) and H22 (n = 1). All H30 isolates were ciprofloxacin-resistant, of which 18.6 % (8/43) belonged to the H30-Rx subclone. Twenty-six (41.3 %) ST131 isolates were ESBL-producers, of which 19 had blaCTX-M-14 (12 non-H30-Rx, two H30-Rx and five H41), six had blaCTX-M-15 (five non-H30-Rx and one H30-Rx) and one was blaCTX-M-negative (H30). In conclusion, ST131 accounts for a large share of the antimicrobial-resistant E. coli isolates from geriatric patients. Unlike previous reports, ESBL-producing ST131 strains mainly belonged to non-H30-Rx rather than the H30-Rx subclone, with blaCTX-M-14 as the dominant enzyme type. © 2015 The Authors.

AN OPTICAL AND X-RAY STUDY OF THE FOSSIL GROUP RX J1340.6+4018

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

Mendes de Oliveira, Claudia L.; Cypriano, Eduardo S.; Sodre, Laerte

2009-08-15

Fossil groups are systems with one single central elliptical galaxy and an unusual lack of luminous galaxies in the inner regions. The standard explanation for the formation of these systems suggests that the lack of bright galaxies is due to galactic cannibalism. In this study, we show the results of an optical and X-ray analysis of RX J1340.6+4018, the prototype fossil group. The data indicate that RX J1340.6+4018 is similar to clusters in almost every sense (dynamical mass, X-ray luminosity, M/L, and luminosity function) except for the lack of L* galaxies. There are claims in the literature that fossil systemsmore » have a lack of small mass halos, compared to predictions based on the lambda cold dark matter scenario. The observational data gathered on this and other fossil groups so far offer no support for this idea. Analysis of the SN Ia/SN II ejecta ratio in the inner and outer regions shows a marginally significant central dominance of SN Ia material. This suggests that either the merger which originated in the central galaxy was dry or the group has been formed at early epochs, although better data are needed to confirm this result.« less

Singlet oxygen explicit dosimetry to predict long-term local tumor control for BPD-mediated photodynamic therapy

NASA Astrophysics Data System (ADS)

Kim, Michele M.; Penjweini, Rozhin; Ong, Yi Hong; Zhu, Timothy C.

2017-02-01

Photodynamic therapy (PDT) is a well-established treatment modality for cancer and other malignant diseases; however, quantities such as light fluence, photosensitizer photobleaching rate, and PDT dose do not fully account for all of the dynamic interactions between the key components involved. In particular, fluence rate (Φ) effects are not accounted for, which has a large effect on the oxygen consumption rate. In this preclinical study, reacted singlet oxygen [1O2]rx was investigated as a dosimetric quantity for PDT outcome. The ability of [1O2]rx to predict the long-term local tumor control rate (LCR) for BPD-mediated PDT was examined. Mice bearing radioactivelyinduced fibrosarcoma (RIF) tumors were treated with different in-air fluences (250, 300, and 350 J/cm2) and in-air ϕ (75, 100, and150 mW/cm2) with a BPD dose of 1 mg/kg and a drug-light interval of 3 hours. Treatment was delivered with a collimated laser beam of 1 cm diameter at 690 nm. Explicit dosimetry of initial tissue oxygen concentration, tissue optical properties, and BPD concentration was used to calculate [1O2]rx. Φ was calculated for the treatment volume based on Monte-Carlo simulations and measured tissue optical properties. Kaplan-Meier analyses for LCR were done for an endpoint of tumor volume <= 100 mm3 using four dose metrics: light fluence, photosensitizer photobleaching rate, PDT dose, and [1O2]rx. PDT dose was defined as the product of the timeintegral of photosensitizer concentration and Φ at a 3 mm tumor depth. Preliminary studies show that [1O2]rx better correlates with LCR and is an effective dosimetric quantity that can predict treatment outcome.

Sequence Exchange between Homologous NB-LRR Genes Converts Virus Resistance into Nematode Resistance, and Vice Versa1[OPEN

PubMed Central

Koropacka, Kamila; Roosien, Jan; Dees, Robert; Overmars, Hein; van Schaik, Casper; Pomp, Rikus; Bouwman, Liesbeth; Helder, Johannes; Bakker, Jaap; Smant, Geert

2017-01-01

Plants have evolved a limited repertoire of NB-LRR disease resistance (R) genes to protect themselves against myriad pathogens. This limitation is thought to be counterbalanced by the rapid evolution of NB-LRR proteins, as only a few sequence changes have been shown to be sufficient to alter resistance specificities toward novel strains of a pathogen. However, little is known about the flexibility of NB-LRR R genes to switch resistance specificities between phylogenetically unrelated pathogens. To investigate this, we created domain swaps between the close homologs Gpa2 and Rx1, which confer resistance in potato (Solanum tuberosum) to the cyst nematode Globodera pallida and Potato virus X, respectively. The genetic fusion of the CC-NB-ARC of Gpa2 with the LRR of Rx1 (Gpa2CN/Rx1L) results in autoactivity, but lowering the protein levels restored its specific activation response, including extreme resistance to Potato virus X in potato shoots. The reciprocal chimera (Rx1CN/Gpa2L) shows a loss-of-function phenotype, but exchange of the first three LRRs of Gpa2 by the corresponding region of Rx1 was sufficient to regain a wild-type resistance response to G. pallida in the roots. These data demonstrate that exchanging the recognition moiety in the LRR is sufficient to convert extreme virus resistance in the leaves into mild nematode resistance in the roots, and vice versa. In addition, we show that the CC-NB-ARC can operate independently of the recognition specificities defined by the LRR domain, either aboveground or belowground. These data show the versatility of NB-LRR genes to generate resistance to unrelated pathogens with completely different lifestyles and routes of invasion. PMID:28747428

Sequence Exchange between Homologous NB-LRR Genes Converts Virus Resistance into Nematode Resistance, and Vice Versa.

PubMed

Slootweg, Erik; Koropacka, Kamila; Roosien, Jan; Dees, Robert; Overmars, Hein; Lankhorst, Rene Klein; van Schaik, Casper; Pomp, Rikus; Bouwman, Liesbeth; Helder, Johannes; Schots, Arjen; Bakker, Jaap; Smant, Geert; Goverse, Aska

2017-09-01

Plants have evolved a limited repertoire of NB-LRR disease resistance ( R ) genes to protect themselves against myriad pathogens. This limitation is thought to be counterbalanced by the rapid evolution of NB-LRR proteins, as only a few sequence changes have been shown to be sufficient to alter resistance specificities toward novel strains of a pathogen. However, little is known about the flexibility of NB-LRR R genes to switch resistance specificities between phylogenetically unrelated pathogens. To investigate this, we created domain swaps between the close homologs Gpa2 and Rx1 , which confer resistance in potato ( Solanum tuberosum ) to the cyst nematode Globodera pallida and Potato virus X , respectively. The genetic fusion of the CC-NB-ARC of Gpa2 with the LRR of Rx1 (Gpa2 CN /Rx1 L ) results in autoactivity, but lowering the protein levels restored its specific activation response, including extreme resistance to Potato virus X in potato shoots. The reciprocal chimera (Rx1 CN /Gpa2 L ) shows a loss-of-function phenotype, but exchange of the first three LRRs of Gpa2 by the corresponding region of Rx1 was sufficient to regain a wild-type resistance response to G. pallida in the roots. These data demonstrate that exchanging the recognition moiety in the LRR is sufficient to convert extreme virus resistance in the leaves into mild nematode resistance in the roots, and vice versa. In addition, we show that the CC-NB-ARC can operate independently of the recognition specificities defined by the LRR domain, either aboveground or belowground. These data show the versatility of NB-LRR genes to generate resistance to unrelated pathogens with completely different lifestyles and routes of invasion. © 2017 American Society of Plant Biologists. All Rights Reserved.

Equation of State for RX-08-EL and RX-08-EP

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

Lee, E.L.; Walton, J.

1985-05-07

JWL Equations of State (EOS's) have been estimated for RX-08-EL and RX-08-EP. The estimated JWL EOS parameters are listed. Previously, we derived a JWL EOS for RX-08-EN based on DYNA2D hydrodynamic code cylinder computations and comparisons with experimental cylinder test results are shown. The experimental cylinder shot results for RX-08-EL, shot K-473, were compared to the experimental cylinder shot results for RX-08-EN, shot K-463, as a reference. 10 figs., 6 tabs.

Using the RxNorm web services API for quality assurance purposes.

PubMed

Peters, Lee; Bodenreider, Olivier

2008-11-06

Auditing large, rapidly evolving terminological systems is still a challenge. In the case of RxNorm, a standardized nomenclature for clinical drugs, we argue that quality assurance processes can benefit from the recently released application programming interface (API) provided by RxNav. We demonstrate the usefulness of the API by performing a systematic comparison of alternative paths in the RxNorm graph, over several thousands of drug entities. This study revealed potential errors in RxNorm, currently under review. The results also prompted us to modify the implementation of RxNav to navigate the RxNorm graph more accurately. The RxNav web services API used in this experiment is robust and fast.

Using the RxNorm Web Services API for Quality Assurance Purposes

PubMed Central

Peters, Lee; Bodenreider, Olivier

2008-01-01

Auditing large, rapidly evolving terminological systems is still a challenge. In the case of RxNorm, a standardized nomenclature for clinical drugs, we argue that quality assurance processes can benefit from the recently released application programming interface (API) provided by RxNav. We demonstrate the usefulness of the API by performing a systematic comparison of alternative paths in the RxNorm graph, over several thousands of drug entities. This study revealed potential errors in RxNorm, currently under review. The results also prompted us to modify the implementation of RxNav to navigate the RxNorm graph more accurately. The RxNorm web services API used in this experiment is robust and fast. PMID:18999038

RxTerms - a drug interface terminology derived from RxNorm.

PubMed

Fung, Kin Wah; McDonald, Clement; Bray, Bruce E

2008-11-06

A good interface terminology is an essential component of any Computerized Provider Order Entry system. RxTerms is a drug interface terminology derived from RxNorm. By reorganizing the drug information into two dimensions as prescribers do when writing prescriptions and by eliminating drug names that are less likely to be needed in a prescribing environment, RxTerms helps the user to efficiently enter complete prescription orders. Preliminary evaluation of RxTerms using a list of most commonly prescribed drugs showed that its coverage was very good (99% for both generic and branded drug names). There was significant efficiency gain compared to using the unprocessed RxNorm names. RxTerms fills the gap for a free, up-to-date drug interface terminology that is linked to RxNorm, the U.S. designated standard for clinical drugs.

Resistance exercise training attenuates exercise-induced lipid peroxidation in the elderly.

PubMed

Vincent, Kevin R; Vincent, Heather K; Braith, Randy W; Lennon, Shannon L; Lowenthal, David T

2002-08-01

This study examined the effects of 6 months of resistance exercise (RX) on basal and post-aerobic exercise lipid peroxidation (LIPOX). Men and women [n = 62, mean (SD) age 68.4 (6) years] were divided randomly into either a control (n = 16, CON), low-intensity training [LEX n = 24; 50% one-repetition maximum (1RM), 13 repetitions/exercise], or high-intensity training (HEX n = 22, 80% 1RM, 8 repetitions/exercise) group. Pre- and post-training, subjects performed a graded aerobic exercise test (GXT). Blood samples were collected prior to and 10 min following each GXT. Subjects trained 3 times per week for 6 months using 12 RX machines. LIPOX was determined by measuring levels of thiobarbituric reactive acid substances (TBARS) and lipid hydroperoxides (PEROX). RX had no effect on resting LIPOX. Post-training, post-GXT TBARS were lower in the LEX and HEX groups by 14% and 18%, respectively, compared to CON (P < 0.05). Post-GXT PEROX levels were lower (P < 0.05) in LEX and HEX compared to CON [CON 3.51 (0.56) nmol/ml, LEX 2.89 (0.80) nmol/ml, HEX 2.99 (0.63) nmol/ml]. Serum total and non-protein (glutathione) thiols were higher in the LEX and HEX groups following training compared to CON (P < 0.05). These data suggest that RX can (1) reduce serum LIPOX, (2) provide protection against oxidizing agents in vitro, and (3) provide a "cross-protection" against the oxidative stress generated by aerobic exercise, perhaps mediated by improvements in the thiol portion of the antioxidant defense.

Singlet oxygen explicit dosimetry to predict local tumor control for HPPH-mediated photodynamic therapy

NASA Astrophysics Data System (ADS)

Penjweini, Rozhin; Kim, Michele M.; Ong, Yi Hong; Zhu, Timothy C.

2017-02-01

This preclinical study examines four dosimetric quantities (light fluence, photosensitizer photobleaching ratio, PDT dose, and reacted singlet oxygen ([1O2]rx)) to predict local control rate (LCR) for 2-(1-Hexyloxyethyl)-2-devinyl pyropheophorbide (HPPH)-mediated photodynamic therapy (PDT). Mice bearing radiation-induced fibrosarcoma (RIF) tumors were treated with different in-air fluences (135, 250 and 350 J/cm2) and in-air fluence rates (50, 75 and 150 mW/cm2) at 0.25 mg/kg HPPH and a drug-light interval of 24 hours using a 1 cm diameter collimated laser beam at 665 nm wavelength. A macroscopic model was used to calculate ([1O2]rx)) based on in vivo explicit dosimetry of the initial tissue oxygenation, photosensitizer concentration, and tissue optical properties. PDT dose was defined as a temporal integral of drug concentration and fluence rate (φ) at a 3 mm tumor depth. Light fluence rate was calculated throughout the treatment volume based on Monte-Carlo simulation and measured tissue optical properties. The tumor volume of each mouse was tracked for 30 days after PDT and Kaplan-Meier analyses for LCR were performed based on a tumor volume <=100 mm3, for four dose metrics: fluence, HPPH photobleaching rate, PDT dose, and ([1O2]rx)). The results of this study showed that ([1O2]rx)) is the best dosimetric quantity that can predict tumor response and correlate with LCR.

The Cytidine Analog Fluorocyclopentenylcytosine (RX-3117) Is Activated by Uridine-Cytidine Kinase 2

PubMed Central

Smid, Kees; de Klerk, Daniël; van Kuilenburg, André B. P.; Meinsma, Rutger; Lee, Young B.; Kim, Deog J.; Peters, Godefridus J.

2016-01-01

Fluorocyclopentenylcytosine (RX-3117) is an orally available cytidine analog, currently in Phase I clinical trial. RX-3117 has promising antitumor activity in various human tumor xenografts including gemcitabine resistant tumors. RX-3117 is activated by uridine-cytidine kinase (UCK). Since UCK exists in two forms, UCK1 and UCK2, we investigated which form is responsible for RX-3117 phosphorylation. For that purpose we transfected A549 and SW1573 cell lines with UCK-siRNAs. Transfection of UCK1-siRNA efficiently downregulated UCK1-mRNA, but not UCK2-mRNA expression, and did not affect sensitivity to RX-3117. However, transfection of UCK2-siRNA completely downregulated UCK2-mRNA and protein and protected both A549 and SW1573 against RX-3117. UCK enzyme activity in two panels of tumor cell lines and xenograft cells correlated only with UCK2-mRNA expression (r = 0.803 and 0.915, respectively), but not with UCK1-mRNA. Moreover, accumulation of RX-3117 nucleotides correlated with UCK2 expression. In conclusion, RX-3117 is activated by UCK2 which may be used to select patients potentially sensitive to RX-3117. PMID:27612203

Treatment utilization among persons with opioid use disorder in the United States.

PubMed

Wu, Li-Tzy; Zhu, He; Swartz, Marvin S

2016-12-01

The United States is experiencing an opioid overdose epidemic. Treatment use data from diverse racial/ethnic groups with opioid use disorder (OUD) are needed to inform treatment expansion efforts. We examined demographic characteristics and behavioral health of persons aged ≥12 years that met criteria for past-year OUD (n=6,125) in the 2005-2013 National Surveys on Drug Use and Health (N=503,101). We determined the prevalence and correlates of past-year use of alcohol/drug use treatment and opioid-specific treatment to inform efforts for improving OUD treatment. Among persons with OUD, 81.93% had prescription (Rx) OUD only, 9.75% had heroin use disorder (HUD) only, and 8.32% had Rx OUD+HUD. Persons with Rx OUD+HUD tended to be white, adults aged 18-49, males, or uninsured. The majority (80.09%) of persons with OUD had another substance use disorder (SUD), and major depressive episode (MDE) was common (28.74%). Of persons with OUD, 26.19% used any alcohol or drug use treatment, and 19.44% used opioid-specific treatment. Adolescents, the uninsured, blacks, native-Hawaiians/Pacific-Islanders/Asian-Americans, persons with Rx OUD only, and persons without MDE or SUD particularly underutilized opioid-specific treatment. Among alcohol/drug use treatment users, self-help group and outpatient rehabilitation treatment were commonly used services. Most people with OUD report no use of OUD treatment. Multifaceted interventions, including efforts to access insurance coverage, are required to change attitudes and knowledge towards addiction treatment in order to develop a supportive culture and infrastructure to enable treatment-seeking. Outreach efforts could target adolescents, minority groups, and the uninsured to improve access to treatment. Copyright © 2016 The Author(s). Published by Elsevier Ireland Ltd.. All rights reserved.

Tissue Expander versus Tissue Expander and Latissimus Flap in Morbidly Obese Breast Reconstruction Patients

PubMed Central

Adams, Robert L.; Chandler, Robert G.; Parks, Joseph

2015-01-01

Background: Immediate postmastectomy breast reconstruction in morbidly obese patients represents a challenge because neither prosthetic nor abdominal-based options may be suitable. Methods: This study compared a previously published cohort of immediate prosthetic reconstruction of 346 patients (511 breasts) of whom 49 patients (67 breasts) were morbidly obese (defined as a body mass index > 35) with a morbidly obese patient population whose breasts were reconstructed immediately following postmastectomy with latissimus flap and tissue expander (21 patients and 22 breasts) in the same time period. The preoperative risk factors of mastectomy such as tobacco use, diabetes, and prior radiation and the postoperative complications of mastectomy such as skin necrosis, seroma, and prosthesis loss were examined. The explantation of the tissue expander provided a defined endpoint of reconstruction failure. Results: The average body mass index in the tissue expander/implant group and in the latissimus flap plus tissue expander/implant group was 40.9 and 40.1, respectively. The risk profile of diabetes and tobacco use was similar in both groups. Fifteen of the 67 breasts (22.3%) of the tissue expander/implant group and 15 of the 23 breasts (65.2%) of the latissimus flap group had received prior radiation. The prosthesis loss was 13 of 67 breasts (19.4%) that had tissue-expander–alone reconstruction and 1 of 22 (4.8%) in the latissimus group that had tissue expander reconstruction. Modification of donor-site incision and skin-island location in the latissimus group of patients can minimize scar deformity. Conclusion: The loss rate in immediate postmastectomy reconstruction in morbidly obese patients with latissimus flap plus tissue expander was substantially lower than the loss rate in those with breast reconstructed with tissue expander alone. PMID:25878934

Evaluation of language concordant, patient-centered drug label instructions.

PubMed

Bailey, Stacy Cooper; Sarkar, Urmimala; Chen, Alice Hm; Schillinger, Dean; Wolf, Michael S

2012-12-01

Despite federal laws requiring language access in healthcare settings, most US pharmacies are unable to provide prescription (Rx) medication instructions to limited English proficient (LEP) patients in their native language. To evaluate the efficacy of health literacy-informed, multilingual Rx instructions (the ConcordantRx instructions) to improve Rx understanding, regimen dosing and regimen consolidation in comparison to standard, language-concordant Rx instructions. Randomized, experimental evaluation. Two hundred and two LEP adults speaking five non-English languages (Chinese, Korean, Russian, Spanish, Vietnamese), recruited from nine clinics and community organizations in San Francisco and Chicago. Subjects were randomized to review Rx bottles with either ConcordantRx or standard instructions. Proper demonstration of common prescription label instructions for single and multi-drug medication regimens. Regimen consolidation was assessed by determining how many times per day subjects would take medicine for a multi-drug regimen. Subjects receiving the ConcordantRx instructions demonstrated significantly greater Rx understanding, regimen dosing and regimen consolidation in comparison to those receiving standard instructions (incidence rate ratio [IRR]: 1.25, 95 % confidence interval [CI]: 1.06-1.48; P= 0.007 for Rx understanding, IRR: 1.19, 95 % CI: 1.03-1.39; P= 0.02 for regimen dosing and IRR: 0.76, 95 % CI: 0.64-0.90; P= 0.001 for regimen consolidation). In most cases, instruction type was the sole, independent predictor of outcomes in multivariate models controlling for relevant covariates. There is a need for standardized, multilingual Rx instructions that can be implemented in pharmacy practices to promote safe medication use among LEP patients. The ConcordantRx instructions represent an important step towards achieving this goal.

The effect of insurance type on prescription drug use and expenditures among elderly Medicare beneficiaries.

PubMed

Saleh, Shadi S; Weller, Wendy; Hannan, Edward

2007-01-01

The debate over the impact of the new Medicare prescription drug benefit (Part D) has intensified in anticipation of its implementation. This paper contributes additional information related to the effect of different types of prescription drug coverage plans on use and expenditures among elderly Medicare beneficiaries. Cross-sectional design using data from the 2002 Medical Expenditures Panel Survey (MEPS). The two dependent variables were (1) prescription drug use and (2) expenditures. The main independent variable was the type of drug insurance (Medicare FFS only [no Rx insurance], Medicare FFS + Rx insurance and Medicare HMO). Bivariate and multivariate analyses were used to test the effect of insurance type, and beneficiaries' characteristics, on likelihood and level of drug use, as well as expenditures. The findings showed that average total drug expenditures among Medicare FFS enrollees who had Rx insurance (non-HMO) were higher ($182.51) than that of Medicare FFS enrollees with no Rx insurance. In addition, the former group had a higher likelihood (any use) of using prescribed medications. On the other hand, no differences in the likelihood of use were detected between Medicare HMO and Medicare FFS (no Rx insurance) enrollees. However, Medicare HMO enrollees had a higher level of drug use. In conclusion, The differences in drug use and expenditures by insurance type imply that each party (Medicare, Medicare Advantage plans, employers) will have a different set of disincentives for involvement in Medicare Part D.

A castor oil-containing dental luting agent: effects of cyclic loading and storage time on flexural strength

PubMed Central

DERCELI, Juliana dos Reis; FAIS, Laiza Maria Grassi; PINELLI, Lígia Antunes Pereira

2014-01-01

Favorable results in the use of castor oil polyurethane (COP) as pulp capping, membrane material, sealer, mouthwash and in bone repair, associated with the fact that Ricinus communis is not derived from petroleum and it is abundant in Brazil, encourage researches in the development of luting agents. Objectives This study compared the flexural strength (FS) of a castor oil-containing dental luting agent with a weight percentage of 10% (wt%) of calcium carbonate (COP10) with RelyX ARC (RX) after mechanical cycling (MC) and distilled water storage. Material and Methods Sixty-four specimens (25x2x2 mm) were fabricated and divided into two groups, COP10 and RX (control). Each group was divided into 4 subgroups (n=8) according to the storage time, 24 hours (24 h) or 60 days (60 d), and the performance (MC+FS) or not (only FS) of the mechanical cycling test. The FS (10 kN; 0.5 mm/min) and MC tests (10,000 cycles, 5 Hz, 0.5 mm/min) were carried out using an MTS-810 machine. The data were analyzed using ANOVA (α=0.05). Results The obtained FS (MPa) values were: COP10 24h- 19.04±2.41; COP10 60d- 17.92±3.54; RX 24h- 75.19±3.43; RX 60d- 88.77±6.89. All the RX specimens submitted to MC fractured, while the values for COP10 after MC were as follows: COP10 24h- 17.90±1.87 and COP10 60d- 18.60±1.60. Conclusions A castor oil-containing dental luting agent with a weight percentage of 10% (wt%) of calcium carbonate is resistant to mechanical cycling without decreases in flexural strength. However, mean COP10 showed only about 25% of the RelyX ARC mean flexural strength. PMID:25591018

Spatiotemporal patterns of precipitation extremes in the Poyang Lake basin, China: Changing properties and causes

NASA Astrophysics Data System (ADS)

Xiao, M.

2016-12-01

Under the background of climate change, extensive attentions have been paid on the increased extreme precipitation from the public and government. To analyze the influences of large-scale climate indices on the precipitation extremes, the spatiotemporal patterns of precipitation extremes in the Poyang Lake basin have been investigated using the Bayesian hierarchical method. The seasonal maximum one-day precipitation amount (Rx1day) was used to represent the seasonal precipitation extremes. Results indicated that spring Rx1day was affected by El Niño/Southern Oscillation (ENSO) and North Atlantic Oscillation (NAO), a positive ENSO event in the same year tends to decrease the spring Rx1day in the northern part of Poyang Lake Basin while increase the spring Rx1day in southeastern Poyang Lake Basin, a positive NAO events in the same year tends to increase the spring Rx1day in the southwest and northwest part of Poyang Lake basin while decrease the spring Rx1day in the eastern part of Poyang Lake basin; summer Rx1day was affected by Indian Ocean Dipole (IOD), positive IOD events in the same year tend to increase the summer Rx1day of northern Poyang Lake basin while decrease summer Rx1day of southern Poyang Lake basin; autumn Rx1day was affected by ENSO, positive ENSO events in the same year tend to mainly increase the autumn Rx1day in the west part of Poyang Lake basin; winter Rx1day was mainly affected by the NAO, positive NAO events in the same year tend to mainly increase the winter Rx1day of southern Poyang Lake basin, while positive NAO events in the previous year tend to mainly increase the winter Rx1day in the central and northeast part of Poyang Lake basin. It is considered that the region with the negative vertical velocity is dominated by more precipitation and vice versa. Furthermore, field patterns of 500 hPa vertical velocity anomalies related to each climate index have further corroborated the influences of climate indices on the seasonal Rx1day, and these will be important to further understand the possible geophysical processes linking the teleconnections of each climate index on the seasonal extreme precipitation in the Poyang Lake basin.

Homologous RXLR effectors from Hyaloperonospora arabidopsidis and Phytophthora sojae suppress immunity in distantly related plants.

PubMed

Anderson, Ryan G; Casady, Megan S; Fee, Rachel A; Vaughan, Martha M; Deb, Devdutta; Fedkenheuer, Kevin; Huffaker, Alisa; Schmelz, Eric A; Tyler, Brett M; McDowell, John M

2012-12-01

Diverse pathogens secrete effector proteins into plant cells to manipulate host cellular processes. Oomycete pathogens contain large complements of predicted effector genes defined by an RXLR host cell entry motif. The genome of Hyaloperonospora arabidopsidis (Hpa, downy mildew of Arabidopsis) contains at least 134 candidate RXLR effector genes. Only a small subset of these genes is conserved in related oomycetes from the Phytophthora genus. Here, we describe a comparative functional characterization of the Hpa RXLR effector gene HaRxL96 and a homologous gene, PsAvh163, from the Glycine max (soybean) pathogen Phytophthora sojae. HaRxL96 and PsAvh163 are induced during the early stages of infection and carry a functional RXLR motif that is sufficient for protein uptake into plant cells. Both effectors can suppress immune responses in soybean. HaRxL96 suppresses immunity in Nicotiana benthamiana, whereas PsAvh163 induces an HR-like cell death response in Nicotiana that is dependent on RAR1 and Hsp90.1. Transgenic Arabidopsis plants expressing HaRxL96 or PsAvh163 exhibit elevated susceptibility to virulent and avirulent Hpa, as well as decreased callose deposition in response to non-pathogenic Pseudomonas syringae. Both effectors interfere with defense marker gene induction, but do not affect salicylic acid biosynthesis. Together, these experiments demonstrate that evolutionarily conserved effectors from different oomycete species can suppress immunity in plant species that are divergent from the source pathogen's host. © 2012 The Authors. The Plant Journal © 2012 Blackwell Publishing Ltd.

Relationship Between ACTN3 R577X Polymorphism and Physical Abilities in Polish Athletes.

PubMed

Orysiak, Joanna; Busko, Krzysztof; Mazur-RóŻycka, Joanna; Michalski, Radoslaw; Gajewski, Jan; Malczewska-Lenczowska, Jadwiga; Sitkowski, Dariusz

2015-08-01

The purpose of this study was to examine the association between α-actinin 3 (ACTN3) R577X polymorphism and physical abilities of male athletes performing various sports (volleyball, ice hockey, canoeing, swimming). One hundred eighty-five subjects were recruited for the study. The following measurements were taken: height of jump and power output in countermovement jump and spike jump (SPJ) and muscle strength of 10 muscle groups. The R577X polymorphism of ACTN3 was typed using polymerase chain reaction restriction fragment length polymorphism. The results showed that RR genotype carriers develop greater power output in SPJ than RX and XX individuals (44.6 ± 11.1, 42.6 ± 11.0, and 38.4 ± 7.9 W·kg(-1) for RR, RX, and XX genotypes, respectively) and height of jump in SPJ (0.537 ± 0.075, 0.523 ± 0.072, and 0.498 ± 0.053 m for RR, RX, and XX genotypes, respectively). Muscle strength did not differ between genotype groups. This suggests that the ACTN3 gene has a greater impact on determining dynamic movements than influencing static muscle strength.

Diabetes during Pregnancy: Influence of Body Mass Index on Composite Morbidity.

PubMed

O'Neil Dudley, Amy E; Jenner, Zachary B; Mendez-Figueroa, Hector; Ellis, Viviana S; Chauhan, Suneet P

2017-04-01

Objective  This study aims to compare composite maternal and neonatal morbidities (MM, NM) among pregnant women with diabetes mellitus whose body mass index (BMI) at delivery was < 30 (group 1), 30.0 to 39.9 (group 2), and ≥ 40 kg/m 2 (group 3). We hypothesized that increased BMI class at delivery would be associated with worsening maternal and neonatal outcomes. Methods  This is a retrospective cohort study. MM was defined as: chorioamnionitis, wound infection, eclampsia, diabetic ketoacidosis, hypoglycemia admission, third/fourth degree laceration, and/or death. NM was defined as umbilical arterial pH < 7.0, 5 minute Apgar < 4, respiratory distress syndrome, mechanical ventilation, neonatal sepsis, stillbirth, and/or death. Odds ratios were adjusted for possible confounders. Results  MM was noted in 8, 13, and 24% of groups 1, 2, and 3, respectively, and significantly more common in group 2 versus 1 (adjusted odds ratio [aOR]: 1.66) and group 3 versus 1 (aOR: 3.06). NM was noted in 7, 8, and 15% of each BMI group, respectively, and differed significantly between group 3 vs. 2 (aOR: 1.77). Conclusions  The increased rate of morbidities between the BMI groups is useful to inform diabetic women and highlights the need for further investigation of diabetes and obesity as comorbidities in pregnancy.

Rubbing ointments and asthma morbidity in adolescents.

PubMed

Reznik, Marina; Sharif, Iman; Ozuah, Philip O

2004-12-01

To determine the relationship between the use of rubbing ointments and asthma morbidity in adolescents. Cross-sectional study. Inner-city high school in the Bronx, New York. 165 adolescents with asthma. Asthma morbidity, defined as emergency department (ED) use for asthma in the past year and over the lifetime. While 127 (77%) of subjects used albuterol as the first treatment for their last asthma attack, 18 (11%) used rubbing ointments. The rubs and albuterol groups were similar in asthma severity, mean age, gender, and ethnicity. However, subjects in the the rubs group were less likely than subjects in the albuterol group to have made an ED visit over the past 12 months or over their lifetime. Regression analysis revealed that, after controlling for asthma severity, use of rubs independently predicted less lifetime ED use. After controlling for asthma severity, use of rubs by adolescents with asthma was associated with lower asthma morbidity as measured by ED use.

Optimal wireless receiver structure for omnidirectional inductive power transmission to biomedical implants.

PubMed

Gougheri, Hesam Sadeghi; Kiani, Mehdi

2016-08-01

In order to achieve omnidirectional inductive power transmission to biomedical implants, the use of several orthogonal coils in the receiver side (Rx) has been proposed in the past. In this paper, the optimal Rx structure for connecting three orthogonal Rx coils and the power management is found to achieve the maximum power delivered to the load (PDL) in the presence of any Rx coil tilting. Unlike previous works, in which a separate power management has been used for each coil to deliver power to the load, different resonant Rx structures for connecting three Rx coils to a single power management are studied. In simulations, connecting three Rx coils with the diameters of 3 mm, 3.3 mm, and 3.6 mm in series and resonating them with a single capacitor at the operation frequency of 100 MHz led to the maximum PDL for large loads when the implant was tilted for 45o. This optimal Rx structure achieves higher PDL in worst-case scenarios as well as reduces the number of power managements to only one.

Microbe-independent entry of oomycete RxLR effectors and fungal RxLR-like effectors into plant and animal cells is specific and reproducible.

PubMed

Tyler, Brett M; Kale, Shiv D; Wang, Qunqing; Tao, Kai; Clark, Helen R; Drews, Kelly; Antignani, Vincenzo; Rumore, Amanda; Hayes, Tristan; Plett, Jonathan M; Fudal, Isabelle; Gu, Biao; Chen, Qinghe; Affeldt, Katharyn J; Berthier, Erwin; Fischer, Gregory J; Dou, Daolong; Shan, Weixing; Keller, Nancy P; Martin, Francis; Rouxel, Thierry; Lawrence, Christopher B

2013-06-01

A wide diversity of pathogens and mutualists of plant and animal hosts, including oomycetes and fungi, produce effector proteins that enter the cytoplasm of host cells. A major question has been whether or not entry by these effectors can occur independently of the microbe or requires machinery provided by the microbe. Numerous publications have documented that oomycete RxLR effectors and fungal RxLR-like effectors can enter plant and animal cells independent of the microbe. A recent reexamination of whether the RxLR domain of oomycete RxLR effectors is sufficient for microbe-independent entry into host cells concluded that the RxLR domains of Phytophthora infestans Avr3a and of P. sojae Avr1b alone are NOT sufficient to enable microbe-independent entry of proteins into host and nonhost plant and animal cells. Here, we present new, more detailed data that unambiguously demonstrate that the RxLR domain of Avr1b does show efficient and specific entry into soybean root cells and also into wheat leaf cells, at levels well above background nonspecific entry. We also summarize host cell entry experiments with a wide diversity of oomycete and fungal effectors with RxLR or RxLR-like motifs that have been independently carried out by the seven different labs that coauthored this letter. Finally we discuss possible technical reasons why specific cell entry may have been not detected by Wawra et al. (2013).

System Framework for a Multi-Band, Multi-Mode Software Defined Radio

DTIC Science & Technology

2014-06-01

detection, while the VITA Radio Transport ( VRT ) protocol over Gigabit Ethernet (GIGE) is implemented for the data interface. In addition to the SoC...CTRL VGA CTRL C2 GPP C2 CORE SW ARM0 RX SYN CTRL PL MEMORY MAP DR CTRL GENERIC INTERRUPT CONTROLLER DR GPP VITERBI ALGORITHM & VRT INTERFACE ARM1

Purinergic receptors P2RX4 and P2RX7 in familial multiple sclerosis

PubMed Central

Sadovnick, A Dessa; Gu, Ben J; Traboulsee, Anthony L; Bernales, Cecily Q; Encarnacion, Mary; Yee, Irene M; Criscuoli, Maria G; Huang, Xin; Ou, Amber; Milligan, Carol J; Petrou, Steven; Wiley, James S; Vilariño-Güell, Carles

2017-01-01

Genetic variants in the purinergic receptors P2RX4 and P2RX7 have been shown to affect susceptibility to multiple sclerosis (MS). In this study we set out to evaluate whether rare coding variants of major effect could also be identified in these purinergic receptors. Sequencing analysis of P2RX4 and P2RX7 in 193 MS patients and 100 controls led to the identification of a rare three variant haplotype (P2RX7 rs140915863:C>T (p.T205M), P2RX7 rs201921967:A>G (p.N361S) and P2RX4 rs765866317:G>A (p.G135S)) segregating with disease in a multi-incident family with six family members diagnosed with MS (LOD=3.07). Functional analysis of this haplotype in HEK293 cells revealed impaired P2X7 surface expression (p<0.01), resulting in over 95% inhibition of ATP-induced pore function (p<0.001) and a marked reduction in phagocytic ability (p<0.05). In addition, transfected cells showed 40% increased peak ATP-induced inward current (p<0.01), and a greater Ca2+ response to the P2X4 135S variant compared to wild type (p<0.0001). Our study nominates rare genetic variants in P2RX4 and P2RX7 as major genetic contributors to disease, further supporting a role for these purinergic receptors in MS and suggesting the disruption of transmembrane cation channels leading to impairment of phagocytosis as the pathological mechanisms of disease. PMID:28326637

Evaluating the implementation of RxNorm in ambulatory electronic prescriptions

PubMed Central

Ward-Charlerie, Stacy; Rupp, Michael T; Kilbourne, John; Amin, Vishal P; Ruiz, Joshua

2016-01-01

Objective RxNorm is a standardized drug nomenclature maintained by the National Library of Medicine that has been recommended as an alternative to the National Drug Code (NDC) terminology for use in electronic prescribing. The objective of this study was to evaluate the implementation of RxNorm in ambulatory care electronic prescriptions (e-prescriptions). Methods We analyzed a random sample of 49 997 e-prescriptions that were received by 7391 locations of a national retail pharmacy chain during a single day in April 2014. The e-prescriptions in the sample were generated by 37 801 ambulatory care prescribers using 519 different e-prescribing software applications. Results We found that 97.9% of e-prescriptions in the study sample could be accurately represented by an RxNorm identifier. However, RxNorm identifiers were actually used as drug identifiers in only 16 433 (33.0%) e-prescriptions. Another 431 (2.5%) e-prescriptions that used RxNorm identifiers had a discrepancy in the corresponding Drug Database Code qualifier field or did not have a qualifier (Term Type) at all. In 10 e-prescriptions (0.06%), the free-text drug description and the RxNorm concept unique identifier pointed to completely different drug concepts, and in 7 e-prescriptions (0.04%), the NDC and RxNorm drug identifiers pointed to completely different drug concepts. Discussion The National Library of Medicine continues to enhance the RxNorm terminology and expand its scope. This study illustrates the need for technology vendors to improve their implementation of RxNorm; doing so will accelerate the adoption of RxNorm as the preferred alternative to using the NDC terminology in e-prescribing. PMID:26510879

Effects of caffeine or RX821002 in rats with a neonatal ventral hippocampal lesion

PubMed Central

Sandner, Guy; Angst, Marie-Josée; Guiberteau, Thierry; Guignard, Blandine; Nehlig, Astrid

2014-01-01

Rats with a neonatal ventral hippocampal lesion (NVHL) are used to model schizophrenia. They show enhanced locomotion and difficulties in learning after puberty. Such behavioral modifications are strengthened by dopaminergic psychostimulant drugs, which is also relevant for schizophrenia because illustrating its dopaminergic facet. But it remains questionable that only dopaminergic drugs elicit such effects. The behavioral effects could simply represent a non specific arousal, in which case NVHL rats should also be hyper-responsive to other vigilance enhancing drugs. We administered an adenosine (caffeine) or an adrenaline receptor antagonist, (RX821002) at doses documented to modify alertness of rats, respectively 5 mg/kg and 1 mg/kg. Rats were selected prior to the experiments using magnetic resonance imaging (MRI). Each group contained typical and similar NVHL lesions. They were compared to sham lesioned rats. We evaluated locomotion in a new environment and the capacity to remember a visual or acoustic cue that announced the occurrence of food. Both caffeine and RX82100 enhanced locomotion in the novel environment, particularly in NVHL rats. But, RX82100 had a biphasic effect on locomotion, consisting of an initial reduction preceding the enhancement. It was independent of the lesion. Caffeine did not modify the learning performance of NVHL rats. But, RX821002 was found to facilitate learning. Patients tend to intake much more caffeine than healthy people, which has been interpreted as a means to counter some cognitive deficits. This idea was not validated with the present results. But adrenergic drugs could be helpful for attenuating some of their cognitive deficits. PMID:24478661

Visualization of self-delivering hydrophobically modified siRNA cellular internalization

PubMed Central

Ly, Socheata; Navaroli, Deanna M.; Didiot, Marie-Cécile; Cardia, James; Pandarinathan, Lakshmipathi; Alterman, Julia F.; Fogarty, Kevin; Standley, Clive; Lifshitz, Lawrence M.; Bellve, Karl D.; Prot, Matthieu; Echeverria, Dimas; Corvera, Silvia; Khvorova, Anastasia

2017-01-01

siRNAs are a new class of therapeutic modalities with promising clinical efficacy that requires modification or formulation for delivery to the tissue and cell of interest. Conjugation of siRNAs to lipophilic groups supports efficient cellular uptake by a mechanism that is not well characterized. Here we study the mechanism of internalization of asymmetric, chemically stabilized, cholesterol-modified siRNAs (sd-rxRNAs®) that efficiently enter cells and tissues without the need for formulation. We demonstrate that uptake is rapid with significant membrane association within minutes of exposure followed by the formation of vesicular structures and internalization. Furthermore, sd-rxRNAs are internalized by a specific class of early endosomes and show preferential association with epidermal growth factor (EGF) but not transferrin (Tf) trafficking pathways as shown by live cell TIRF and structured illumination microscopy (SIM). In fixed cells, we observe ∼25% of sd-rxRNA co-localizing with EGF and <5% with Tf, which is indicative of selective endosomal sorting. Likewise, preferential sd-rxRNA co-localization was demonstrated with EEA1 but not RBSN-containing endosomes, consistent with preferential EGF-like trafficking through EEA1-containing endosomes. sd-rxRNA cellular uptake is a two-step process, with rapid membrane association followed by internalization through a selective, saturable subset of the endocytic process. However, the mechanistic role of EEA1 is not yet known. This method of visualization can be used to better understand the kinetics and mechanisms of hydrophobic siRNA cellular uptake and will assist in further optimization of these types of compounds for therapeutic intervention. PMID:27899655

Identification and characterisation of a previously unknown drought tolerance-associated microRNA in barley.

PubMed

Zhou, Hui; Hussain, Syed Sarfraz; Hackenberg, Michael; Bazanova, Natalia; Eini, Omid; Li, Jie; Gustafson, Perry; Shi, Bujun

2018-04-22

Drought is the most serious abiotic stress, which causes crop losses on worldwide scale. The present study identified a previously unknown microRNA (designated as hvu-miRX) of 21 nucleotides (nt) in barley. Its precursor (designated pre-miRX) and primary transcript (designated pri-miRX) were also identified, with lengths of 73 nt and 559 nt, respectively. The identified upstream sequence of pri-miRX contains both the TATA box and the CAAT box, which are both required for transcription initiation. Transient promoter activation assays showed that the core promoter region of pri-miRX ranged 500 nt from the transcription start site. In transgenic barley over-expressing the wheat DREB3 transcription factor (TaDREB3) caused hvu-miRX to be highly expressed as compared to the same miRNA in non-transgenic barley. However, the high expression was not directly associated with TaDREB3. Genomic analysis revealed that the hvu-miRX gene was a single copy located on the short arm of chromosome 2 and appeared to be only conserved in Triticeae, but not in other plant species. Notably, transgenic barley overexpressing hvu-miRX showed drought tolerance. Degradome library analysis and other tests showed that hvu-miRX targeted various genes including transcription factors via the cleavage mode. Our data open an excellent opportunity to develop drought stress tolerant cereals with hvu-miRX. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

A conserved RxLR effector interacts with host RABA-type GTPases to inhibit vesicle-mediated secretion of antimicrobial proteins.

PubMed

Tomczynska, Iga; Stumpe, Michael; Mauch, Felix

2018-04-19

Plant pathogens of the oomycete genus Phytophthora produce virulence factors, known as RxLR effector proteins that are transferred into host cells to suppress disease resistance. Here, we analyse the function of the highly conserved RxLR24 effector of Phytophthora brassicae. RxLR24 was expressed early in the interaction with Arabidopsis plants and ectopic expression in the host enhanced leaf colonization and zoosporangia formation. Co-immunoprecipitation (Co-IP) experiments followed by mass spectrometry identified different members of the RABA GTPase family as putative RxLR24 targets. Physical interaction of RxLR24 or its homologue from the potato pathogen Phytophthora infestans with different RABA GTPases of Arabidopsis or potato, respectively, was confirmed by reciprocal Co-IP. In line with the function of RABA GTPases in vesicular secretion, RxLR24 co-localized with RABA1a to vesicles and the plasma membrane. The effect of RxLR24 on the secretory process was analysed with fusion constructs of secreted antimicrobial proteins with a pH-sensitive GFP tag. PATHOGENESIS RELATED PROTEIN 1 (PR-1) and DEFENSIN (PDF1.2) were efficiently exported in control tissue, whereas in the presence of RxLR24 they both accumulated in the endoplasmic reticulum. Together our results imply a virulence function of RxLR24 effectors as inhibitors of RABA GTPase-mediated vesicular secretion of antimicrobial PR-1, PDF1.2 and possibly other defence-related compounds. © 2018 The Authors The Plant Journal © 2018 John Wiley & Sons Ltd.

CommunityRx: A Population Health Improvement Innovation That Connects Clinics To Communities.

PubMed

Lindau, Stacy T; Makelarski, Jennifer; Abramsohn, Emily; Beiser, David G; Escamilla, Veronica; Jerome, Jessica; Johnson, Daniel; Kho, Abel N; Lee, Karen K; Long, Timothy; Miller, Doriane C

2016-11-01

The CommunityRx system, a population health innovation, combined an e-prescribing model and community engagement to strengthen links between clinics and community resources for basic, wellness, and disease self-management needs in Chicago. The components of CommunityRx were a youth workforce, whose members identified 19,589 public-serving entities in the 106-square-mile implementation region between 2012 and 2014; community health information specialists, who used the workforce's findings to generate an inventory of 14,914 health-promoting resources; and a health information technology (IT) platform that was integrated with three electronic health record systems at thirty-three clinical sites. By mapping thirty-seven prevalent social and medical conditions to community resources, CommunityRx generated 253,479 personalized HealtheRx prescriptions for more than 113,000 participants. Eighty-three percent of the recipients found the HealtheRx very useful, and 19 percent went to a place they learned about from the HealtheRx. All but one organization continued using the CommunityRx system after the study period ended. This study demonstrates the feasibility of using health IT and workforce innovation to bridge the gap between clinical and other health-promoting sectors. Project HOPE—The People-to-People Health Foundation, Inc.

Measurements, datasets and preliminary results from the RxCADRE project-2008, 2011 and 2012

Treesearch

Roger D. Ottmar; J. Kevin Hiers; Bret W. Butler; Craig B. Clements; Matthew B. Dickinson; Andrew T. Hudak; Joseph O' Brien; Brian E. Potter; Eric M. Rowell; Tara M. Strand; Thomas J. Zajkowski

2016-01-01

The lack of independent, quality-assured field data prevents scientists from effectively evaluating and advancing wildland fire models. To rectify this, scientists and technicians convened in the southeastern United States in 2008, 2011 and 2012 to collect wildland fire data in six integrated core science disciplines defined by the fire modelling community. These were...

Burning mechanism and regression rate of RX-35-AU and RX-35-AV as a function of HMX particle size measured by the hybrid closed bomb-strand burner

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

Tao, W.C.; Costantino, M.S.; Ornellas, D.L.

1990-04-01

In this study, the average surface regression rate of two HMX-based cast explosives, RX-35-AU and RX-35-AV, is measured to pressures above 750 MPa using a hybrid closed bomb-strand burner. The hybrid design allows the simultaneous measurement of pressure and regression rate over a large range of pressures in each experiment. Nitroglycerin/Triacetin (75/25) and polyethylene glycol (PEG) are used as the energetic plasticizer and polymeric binder, respectively, in both formulations. The HMX solids loading in each formulation is 50 wt %, consisting of a narrow particle size distribution of 6--8 {mu}m for RX-35-AU and 150--177 {mu}m for RX-35-AV. Of special interestmore » are the regression rate and burning mechanism as a function of the initial particle size distribution and the mechanical properties fo the cast explosives. In general, the regression rate for the larger particle size formulation, RX-35-AV, is two to three times faster compared to that for RX-35-AU. Up to 750 MPa and independent of the initial confinement pressure, RX-35-AU exhibits a planar burning mechanism with the regression rate obeying the classical aP{sup n} formalism. For RX-35-AV, however, the burning behavior is erratic for samples ignited at 200 MPa confinement pressure. At confinement pressures above 400 MPa, the regression exhibits more of a planar burning mechanism. The unstable combustion behavior for RX-35-AV at lower confinement pressures is related to several mechanisms: (1) an abrupt increase in surface area due to particle fracture and subsequent translation and rotation, resulting in debonding and creating porosity, (2) thixotropic'' separation of the binder and nitramine, causing the significantly greater fracture damage to the nitramine during the loading cycle, (3) microscopic damage to the nitramine crystals that increase its intrinsic burning rate. 12 refs., 8 figs., 2 tabs.« less

Effects of exercise on knee joints with osteoarthritis: a pilot study of biologic markers

NASA Technical Reports Server (NTRS)

Bautch, J. C.; Malone, D. G.; Vailas, A. C.

1997-01-01

OBJECTIVE: To determine the effects of low intensity weight-bearing exercise on osteoarthritis (OA) of the knee. METHODS: Synovial fluid keratan sulfate (KS) and hydroxyproline were measured as markers of cartilage degradation. The Arthritis Impact Measurement Scales (AIMS) were used to measure health status, and a visual analog scale for pain assessment was used before and after intervention. An exercise (EX) group (n = 15) received a thrice-weekly 12-week low intensity exercise program and a weekly educational program, and a minimal treatment (Min RX) group (n = 15) received only the education program. RESULTS: Pain levels declined in the EX group, and the Min RX group showed improvement on the AIMS. Synovial fluid was obtained in 11 subjects before and after the intervention. Levels of KS and hydroxyproline did not change. CONCLUSION: Further study of exercise effects should include both clinical and biologic parameters to examine the outcome of exercise as a therapeutic intervention in OA of the knee.

MedXN: an open source medication extraction and normalization tool for clinical text

PubMed Central

Sohn, Sunghwan; Clark, Cheryl; Halgrim, Scott R; Murphy, Sean P; Chute, Christopher G; Liu, Hongfang

2014-01-01

Objective We developed the Medication Extraction and Normalization (MedXN) system to extract comprehensive medication information and normalize it to the most appropriate RxNorm concept unique identifier (RxCUI) as specifically as possible. Methods Medication descriptions in clinical notes were decomposed into medication name and attributes, which were separately extracted using RxNorm dictionary lookup and regular expression. Then, each medication name and its attributes were combined together according to RxNorm convention to find the most appropriate RxNorm representation. To do this, we employed serialized hierarchical steps implemented in Apache's Unstructured Information Management Architecture. We also performed synonym expansion, removed false medications, and employed inference rules to improve the medication extraction and normalization performance. Results An evaluation on test data of 397 medication mentions showed F-measures of 0.975 for medication name and over 0.90 for most attributes. The RxCUI assignment produced F-measures of 0.932 for medication name and 0.864 for full medication information. Most false negative RxCUI assignments in full medication information are due to human assumption of missing attributes and medication names in the gold standard. Conclusions The MedXN system (http://sourceforge.net/projects/ohnlp/files/MedXN/) was able to extract comprehensive medication information with high accuracy and demonstrated good normalization capability to RxCUI as long as explicit evidence existed. More sophisticated inference rules might result in further improvements to specific RxCUI assignments for incomplete medication descriptions. PMID:24637954

An Evaluation of Performance Characteristics of Primary Display Devices.

PubMed

Ekpo, Ernest U; McEntee, Mark F

2016-04-01

The aim of this study was to complete a full evaluation of the new EIZO RX850 liquid crystal display and compare it to two currently used medical displays in Australia (EIZO GS510 and Barco MDCG 5121). The American Association of Physicists in Medicine (AAPM) Task Group 18 Quality Control test pattern was used to assess the performance of three high-resolution primary medical displays: EIZO RX850, EIZO GS510, and Barco MDCG 5121. A Konica Minolta spectroradiometer (CS-2000) was used to assess luminance response, non-uniformity, veiling glare, and color uniformity. Qualitative evaluation of noise was also performed. Seven breast lesions were displayed on each monitor and photographed with a calibrated 5.5-MP Olympus E-1 digital SLR camera. ImageJ software was used to sample pixel information from each lesion and surrounding background to calculate their conspicuity index on each of the displays. All monitor fulfilled all AAPM acceptance criteria. The performance characteristics for EIZO RX850, Barco MDCG 5121, and EIZO GS510 respectively were as follows: maximum luminance (490, 500.5, and 413 cd/m(2)), minimum luminance (0.724, 1.170, and 0.92 cd/m(2)), contrast ratio (675:1, 428:1, 449:1), just-noticeable difference index (635, 622, 609), non-uniformity (20, 5.92, and 8.5 %), veiling glare (GR = 2465.6, 720.4, 1249.8), and color uniformity (Δu'v' = +0.003, +0.002, +0.002). All monitors demonstrated low noise levels. The conspicuity index (χ) of the lesions was slightly higher in the EIZO RX850 display. All medical displays fulfilled AAPM performance criteria, and performance characteristics of EIZO RX850 are equal to or better than those of the Barco MDCG 5121 and EIZO GS510 displays.

THE ENTIRE VIRIAL RADIUS OF THE FOSSIL CLUSTER RX J1159+5531. I. GAS PROPERTIES

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

Su, Yuanyuan; Buote, David; Gastaldello, Fabio

2015-06-01

Previous analysis of the fossil-group/cluster RX J1159+5531 with X-ray observations from a central Chandra pointing and an offset-north Suzaku pointing indicate a radial intracluster medium (ICM) entropy profile at the virial radius (R{sub vir}) consistent with predictions from gravity-only cosmological simulations, in contrast to other cool-core clusters. To examine the generality of these results, we present three new Suzaku observations that, in conjunction with the north pointing, provide complete azimuthal coverage out to R{sub vir}. With two new Chandra ACIS-I observations overlapping the north Suzaku pointing, we have resolved ≳50% of the cosmic X-ray background there. We present radial profilesmore » of the ICM density, temperature, entropy, and pressure obtained for each of the four directions. We measure only modest azimuthal scatter in the ICM properties at R{sub 200} between the Suzaku pointings: 7.6% in temperature and 8.6% in density, while the systematic errors can be significant. The temperature scatter, in particular, is lower than that studied at R{sub 200} for a small number of other clusters observed with Suzaku. These azimuthal measurements verify that RX J1159+5531 is a regular, highly relaxed system. The well-behaved entropy profiles we have measured for RX J1159+5531 disfavor the weakening of the accretion shock as an explanation of the entropy flattening found in other cool-core clusters but is consistent with other explanations such as gas clumping, electron-ion non-equilibrium, non-thermal pressure support, and cosmic-ray acceleration. Finally, we mention that the large-scale galaxy density distribution of RX J1159+5531 seems to have little impact on its gas properties near R{sub vir}.« less

Psychological treatment of depression and anxiety in patients with co-morbid personality disorder: A scoping study of trial evidence.

PubMed

French, L R M; Turner, K M; Dawson, S; Moran, P

2017-05-01

It is unclear what the best psychological treatment is for depression and anxiety in people with co-morbid personality disorder. Trials of different psychological treatment options for this patient group have been conducted, but this evidence has not previously been systematically reviewed or critically appraised. We set out to conduct a scoping review in order to describe which psychological therapies appear most effective in treating depression and/or anxiety in patients with co-morbid personality disorder. PsycINFO, Cochrane library trials, Medline and Embase databases were searched for studies involving randomized, controlled, experimental, parallel-arm comparisons, examining any well-defined, psychotherapeutic intervention for adults, in an outpatient setting, with a clearly defined diagnosis of depression and/or anxiety, and co-morbid personality disorder. A total of 1662 papers were identified. Fifteen met criteria for inclusion and were reviewed. There was weak evidence to support the use of cognitive behavioural therapy as a psychological treatment for depression in patients with co-morbid personality disorder. However, the literature is characterized by considerable methodological heterogeneity, and further research is needed before there is sufficient evidence to indicate which psychological treatment would be most effective in treating anxiety and/or depression in this patient group. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

Co-morbid depression is associated with poor work outcomes in persons with cardiovascular disease (CVD): A large, nationally representative survey in the Australian population

PubMed Central

2012-01-01

Background Co-morbid major depressive disorder (MDD) and cardiovascular disease (CVD) is associated with poor clinical and psychological outcomes. However, the full extent of the burden of, and interaction between, this co-morbidity on important vocational outcomes remains less clear, particularly at the population level. We examine the association of co-morbid MDD with work outcomes in persons with and without CVD. Methods This study utilised cross-sectional, population-based data from the 2007 Australian National Survey of Mental Health and Wellbeing (n = 8841) to compare work outcomes of individuals with diagnostically-defined MDD and CVD, MDD but not CVD, CVD but not MDD, with a reference group of "healthy" Australians. Workforce participation was defined as being in full- or part-time employment. Work functioning was measured using a WHO Disability Assessment Schedule item. Absenteeism was assessed using the 'days out of role' item. Results Of the four groups, those with co-morbid MDD and CVD were least likely to report workforce participation (adj OR:0.4, 95% CI: 0.3-0.6). Those with MDD only (adj OR:0.8, 95% CI:0.7-0.9) and CVD only (adj OR:0.8, 95% CI: 0.6-0.9) also reported significantly reduced odds of participation. Employed individuals with co-morbid MDD and CVD were 8 times as likely to experience impairments in work functioning (adj OR:8.1, 95% CI: 3.8- 17.3) compared with the reference group. MDD was associated with a four-fold increase in impaired functioning. Further, individuals with co-morbid MDD and CVD reported greatest likelihood of workplace absenteeism (adj. OR:3.0, 95% CI: 1.4-6.6). Simultaneous exposure to MDD and CVD conferred an even greater likelihood of poorer work functioning. Conclusions Co-morbid MDD and CVD is associated with significantly poorer work outcomes. Specifically, the effects of these conditions on work functioning are synergistic. The development of specialised treatment programs for those with co-morbid MDD and CVD is required. PMID:22257700

RxGen General Optical Model Prescription Generator

NASA Technical Reports Server (NTRS)

Sigrist, Norbert

2012-01-01

RxGen is a prescription generator for JPL's in-house optical modeling software package called MACOS (Modeling and Analysis for Controlled Optical Systems), which is an expert optical analysis software package focusing on modeling optics on dynamic structures, deformable optics, and controlled optics. The objectives of RxGen are to simplify and automate MACOS prescription generations, reducing errors associated with creating such optical prescriptions, and improving user efficiency without requiring MACOS proficiency. RxGen uses MATLAB (a high-level language and interactive environment developed by MathWorks) as the development and deployment platform, but RxGen can easily be ported to another optical modeling/analysis platform. Running RxGen within the modeling environment has the huge benefit that variations in optical models can be made an integral part of the modeling state. For instance, optical prescription parameters determined as external functional dependencies, optical variations by controlling the in-/exclusion of optical components like sub-systems, and/or controlling the state of all components. Combining the mentioned capabilities and flexibilities with RxGen's optical abstraction layer completely eliminates the hindering aspects for requiring proficiency in writing/editing MACOS prescriptions, allowing users to focus on the modeling aspects of optical systems, i.e., increasing productivity and efficiency. RxGen provides significant enhancements to MACOS and delivers a framework for fast prototyping as well as for developing very complex controlled optical systems.

An 8/15-channel Tx/Rx head neck RF coil combination with region-specific B1 + shimming for whole-brain MRI focused on the cerebellum at 7T.

PubMed

Pfaffenrot, Viktor; Brunheim, Sascha; Rietsch, Stefan H G; Koopmans, Peter J; Ernst, Thomas M; Kraff, Oliver; Orzada, Stephan; Quick, Harald H

2018-02-09

To design and evaluate an 8/15-channel transmit/receive (Tx/Rx) head-neck RF coil combination with region-specific B1+ shimming for whole-brain MRI with focus on improved functional MRI of the cerebellum at 7 T. An 8-channel transceiver RF head coil was combined with a 7-channel receive-only array. The noise parameters and acceleration capabilities of this 8Tx/15Rx coil setup were compared with a commercially available 1Tx/32Rx RF head coil. Region-specific 8-channel B1+ shimming was applied when using the 8Tx/15Rx RF coil. To evaluate the capability for functional MRI of the cerebellum, temporal SNR and statistical nonparametric maps for finger-tapping experiments with 14 healthy subjects were derived by applying a variable slice thickness gradient-echo echo-planar functional MRI sequence. The 8Tx/15Rx setup had a lower maximum noise correlation between channels, but higher average correlations compared with the 1Tx/32Rx coil. Both RF coils exhibited identical g-factors in the cerebellum with R = 3 acceleration. The enlarged FOV of the 8Tx/15Rx coil in combination with region-specific B1+ shimming increased homogeneity of the transmission field and temporal SNR in caudal cerebellar regions. Temporal SNR losses in cranial parts were reduced, resulting in more highly significant voxels in the caudally activated areas and identical patterns in the cranial cerebellar parts during a finger-tapping task. Compared with the 1Tx/32Rx RF coil, the presented 8Tx/15Rx RF coil combination successfully improves functional MRI of the human cerebellum at 7 T while maintaining whole-brain coverage. A clear temporal SNR gain in caudal cerebellar regions is shown. © 2018 International Society for Magnetic Resonance in Medicine.

A novel mechanism of autophagic cell death in dystrophic muscle regulated by P2RX7 receptor large-pore formation and HSP90.

PubMed

Young, Christopher N J; Sinadinos, Anthony; Lefebvre, Alexis; Chan, Philippe; Arkle, Stephen; Vaudry, David; Gorecki, Dariusz C

2015-01-01

P2RX7 is an ATP-gated ion channel, which can also exhibit an open state with a considerably wider permeation. However, the functional significance of the movement of molecules through the large pore (LP) and the intracellular signaling events involved are not known. Here, analyzing the consequences of P2RX7 activation in primary myoblasts and myotubes from the Dmd(mdx) mouse model of Duchenne muscular dystrophy, we found ATP-induced P2RX7-dependent autophagic flux, leading to CASP3-CASP7-independent cell death. P2RX7-evoked autophagy was triggered by LP formation but not Ca(2+) influx or MAPK1-MAPK3 phosphorylation, 2 canonical P2RX7-evoked signals. Phosphoproteomics, protein expression inference and signaling pathway prediction analysis of P2RX7 signaling mediators pointed to HSPA2 and HSP90 proteins. Indeed, specific HSP90 inhibitors prevented LP formation, LC3-II accumulation, and cell death in myoblasts and myotubes but not in macrophages. Pharmacological blockade or genetic ablation of p2rx7 also proved protective against ATP-induced death of muscle cells, as did inhibition of autophagy with 3-MA. The functional significance of the P2RX7 LP is one of the great unknowns of purinergic signaling. Our data demonstrate a novel outcome--autophagy--and show that molecules entering through the LP can be targeted to phagophores. Moreover, we show that in muscles but not in macrophages, autophagy is needed for the formation of this LP. Given that P2RX7-dependent LP and HSP90 are critically interacting in the ATP-evoked autophagic death of dystrophic muscles, treatments targeting this axis could be of therapeutic benefit in this debilitating and incurable form of muscular dystrophy.

Models are likely to underestimate increase in heavy rainfall in regions with high rainfall intensity

NASA Astrophysics Data System (ADS)

Borodina, Aleksandra; Fischer, Erich M.; Knutti, Reto

2017-04-01

Model projections of heavy rainfall are uncertain. On timescales of few decades, internal variability plays an important role and therefore poses a challenge to detect robust model responses. We show that spatial aggregation across regions with intense heavy rainfall events, - defined as grid cells with high annual precipitation maxima (Rx1day), - allows to reduce the role of internal variability and thus to detect a robust signal during the historical period. This enables us to evaluate models with observational datasets and to constrain long-term projections of the intensification of heavy rainfall, i.e., to recalibrate full model ensemble consistent with observations resulting in narrower range of projections. In the regions of intense heavy rainfall, we found two present-day metrics that are related to a model's projection. The first metric is the observed relationship between the area-weighted mean of the annual precipitation maxima (Rx1day) and the global land temperatures. The second is the fraction of land exhibiting statistically significant relationships between local annual precipitation maxima (Rx1day) and global land temperatures over the historical period. The models that simulate high values in both metrics are those that are in better agreement with observations and show strong future intensification of heavy rainfall. This implies that changes in heavy rainfall are likely to be more intense than anticipated from the multi-model mean.

Efficient Application of Continuous Fractional Component Monte Carlo in the Reaction Ensemble

PubMed Central

2017-01-01

A new formulation of the Reaction Ensemble Monte Carlo technique (RxMC) combined with the Continuous Fractional Component Monte Carlo method is presented. This method is denoted by serial Rx/CFC. The key ingredient is that fractional molecules of either reactants or reaction products are present and that chemical reactions always involve fractional molecules. Serial Rx/CFC has the following advantages compared to other approaches: (1) One directly obtains chemical potentials of all reactants and reaction products. Obtained chemical potentials can be used directly as an independent check to ensure that chemical equilibrium is achieved. (2) Independent biasing is applied to the fractional molecules of reactants and reaction products. Therefore, the efficiency of the algorithm is significantly increased, compared to the other approaches. (3) Changes in the maximum scaling parameter of intermolecular interactions can be chosen differently for reactants and reaction products. (4) The number of fractional molecules is reduced. As a proof of principle, our method is tested for Lennard-Jones systems at various pressures and for various chemical reactions. Excellent agreement was found both for average densities and equilibrium mixture compositions computed using serial Rx/CFC, RxMC/CFCMC previously introduced by Rosch and Maginn (Journal of Chemical Theory and Computation, 2011, 7, 269–279), and the conventional RxMC approach. The serial Rx/CFC approach is also tested for the reaction of ammonia synthesis at various temperatures and pressures. Excellent agreement was found between results obtained from serial Rx/CFC, experimental results from literature, and thermodynamic modeling using the Peng–Robinson equation of state. The efficiency of reaction trial moves is improved by a factor of 2 to 3 (depending on the system) compared to the RxMC/CFCMC formulation by Rosch and Maginn. PMID:28737933

Potential Savings From Increasing Adherence to Inhaled Corticosteroid Therapy in Medicaid-Enrolled Children

PubMed Central

Rust, George; Zhang, Shun; McRoy, Luceta; Pisu, Maria

2016-01-01

Background Many asthma-related exacerbations could be prevented by consistent use of daily inhaled corticosteroid therapy (ICS-Rx). Objectives We sought to measure the potential cost savings that could accrue from increasing ICS-Rx adherence in children. Study Design We measured observed costs for a cohort of 43,156 Medicaid-enrolled children in 14 southern states whose initial ICS-Rx was prescribed in 2007. Methods Adherence rates and associated costs were calculated from Medicaid claims. Children were categorized as high or low adherence based on the ratio of ICS-Rx claims filled to total asthma drug claims. Branching tree simulation was used to project the potential cost savings achieved by increasing the proportion of children with ICS-Rx to total asthma Rx ratios greater than 0.5 to 20%, 40%, 60%, 80%, and 100%. Results Increasing the proportion of children who maintain higher adherence after initial ICS-Rx to 40% would generate savings of $95 per child per year. An intervention costing $10 per member per month that resulted in even half of the children maintaining high adherence would generate a 98% return on investment for managed care plans or state Medicaid programs. Net costs decreased incrementally at each level of increase in ICS-Rx adherence. The projected Medicaid cost savings for these 14 states in 2007 ranged from $8.2 million if 40% of the children achieved high adherence, to $57.5 million if 80% achieved high adherence. Conclusions If effective large-scale interventions can be found, there are substantial cost savings to be gained from even modest increases in real-world adherence to ICS-Rx among Medicaid-enrolled children with asthma. PMID:25880622

Building a standards-based and collaborative e-prescribing tool: MyRxPad.

PubMed

Nelson, Stuart J; Zeng, Kelly; Kilbourne, John

2011-01-01

MyRxPad (rxp.nlm.nih.gov) is a prototype application intended to enable a practitioner-patient collaborative approach towards e-prescribing: patients play an active role by maintaining up-to-date and accurate medication lists. Prescribers make well-informed and safe prescribing decisions based on personal medication records contributed by patients. MyRxPad is thus the vehicle for collaborations with patients using MyMedicationList (MML). Integration with personal medication records in the context of e-prescribing is thus enabled. We present our experience in applying RxNorm in an e-prescribing setting: using standard names and codes to capture prescribed medication as well as extracting information from RxNorm to support medication-related clinical decision.

Impact of Medium and Substrate on Growth of Pseudomonas Fluorescens Biofilms on Polyurethane Paint

DTIC Science & Technology

2011-02-01

biofilm formation on polyurethane (PU) coatings, and to define how those parameters contribute to polyurethane biodegradation. We used a batch flow system...determine which factors best support the growth and persistence of Pseudomonas fluorescens biofilms . Factors that enhance biofilm formation and...AFRL-RX-WP-TP-2011-4131 IMPACT OF MEDIUM AND SUBSTRATE ON GROWTH OF PSEUDOMONAS FLUORESCENS BIOFILMS ON POLYURETHANE PAINT Wendy L. Goodson

Visible light communications using predistortion signal to enhance the response of passive optical receiver

NASA Astrophysics Data System (ADS)

Liu, Yang; Chen, Hung-Yu; Liang, Kevin; Wei, Liang-Yu; Chow, Chi-Wai; Yeh, Chien-Hung

2016-01-01

Traditional visible light communication (VLC) uses positive-intrinsic-negative photodiode (PD) or avalanche PD as the optical receivers (Rx). We demonstrate using a solar cell as the VLC Rx. The solar cell is flexible and low cost and converts the optical signal into an electrical signal directly without the need of external power supply. In addition to acting as the VLC passive Rx, the converted electrical signal from the solar cell can charge up the battery of the Rx nodes. Hence, the proposed scheme can be a promising candidate for the future Internet of Things network. However, a solar cell acting as a VLC Rx is very challenging, since the response of the solar cell is limited. Here, we propose and demonstrate using predistortion to significantly enhance the solar cell Rx response for the first time up to the authors' knowledge. Experimental results show that the response of the solar cell Rx is significantly enhanced; and the original 2-kHz detection bandwidth of the solar cell can be enhanced by 250 times for receiving 500-kbit/s VLC signal at a transmission distance of 1 m. The operation principle, the generated voltage by the solar cell, and the maximum data rates achieved at different transmission distances are also studied.

Investigation into the association between P2RX7 gene polymorphisms and susceptibility to primary gout and hyperuricemia in a Chinese Han male population.

PubMed

Ying, Ying; Chen, Yong; Li, Zhen; Huang, Haiyan; Gong, Qiongyao

2017-04-01

The purpose of this study was to investigate the relationship between P2RX7 gene single nucleotide polymorphisms and primary gout and hyperuricemia in a Chinese Han male population. The genetic distributions of the single nucleotide polymorphisms (SNPs) rs2230911, rs208294, rs435309, rs28360447, rs1718119, rs28360457, and rs3751143 in P2RX7 were detected in 293 primary gout patients, 187 hyperuricemia patients and 269 controls using SNaPshot technology. Statistical analyses were implemented using SPSS version 20.0. The genetic distributions of each group were tested for Hardy-Weinberg equilibrium (HWE). T test, analysis of variance, rank sum test and Chi-square test were measured to assess differences in clinical data and polymorphisms among groups. Logistic regression was used to assess susceptibility to disease with odds ratios (ORs) and 95% confidence intervals (95% CIs). SHEsis software was used to calculate linkage disequilibrium blocks and haplotype association risk. P < .05 was regarded as statistically significant. Three SNPs (rs2230911, rs208294 and rs435309) did not deviate significantly from HWE (P > .05). In the comparison between primary gout and control, the frequencies of rs2230911 genotypes were significantly different (P = .002), and allele G was associated with a higher risk of primary gout than allele C [OR (95% CI) = 1.755 (1.278, 2.410), P < .001]. There was also a higher risk of primary gout in genotype (CG + GG) compared with genotype CC [OR (95% CI) = 1.876 (1.303, 2.701), P = .001]. However, no significant difference in allelic or genotypic frequency was observed between primary gout patients and hyperuricemia patients (P > .0167). Similarly, there were no obvious differences in the other two polymorphisms among the three groups (P > .05). Our results reveal that P2RX7 rs2230911 may be associated with primary gout risk in a Chinese Han male population and allele G may be a susceptibility factor for primary gout.

Multiple Candidate Effectors from the Oomycete Pathogen Hyaloperonospora arabidopsidis Suppress Host Plant Immunity

PubMed Central

Fabro, Georgina; Steinbrenner, Jens; Coates, Mary; Ishaque, Naveed; Baxter, Laura; Studholme, David J.; Körner, Evelyn; Allen, Rebecca L.; Piquerez, Sophie J. M.; Rougon-Cardoso, Alejandra; Greenshields, David; Lei, Rita; Badel, Jorge L.; Caillaud, Marie-Cecile; Sohn, Kee-Hoon; Van den Ackerveken, Guido; Parker, Jane E.; Beynon, Jim; Jones, Jonathan D. G.

2011-01-01

Oomycete pathogens cause diverse plant diseases. To successfully colonize their hosts, they deliver a suite of effector proteins that can attenuate plant defenses. In the oomycete downy mildews, effectors carry a signal peptide and an RxLR motif. Hyaloperonospora arabidopsidis (Hpa) causes downy mildew on the model plant Arabidopsis thaliana (Arabidopsis). We investigated if candidate effectors predicted in the genome sequence of Hpa isolate Emoy2 (HaRxLs) were able to manipulate host defenses in different Arabidopsis accessions. We developed a rapid and sensitive screening method to test HaRxLs by delivering them via the bacterial type-three secretion system (TTSS) of Pseudomonas syringae pv tomato DC3000-LUX (Pst-LUX) and assessing changes in Pst-LUX growth in planta on 12 Arabidopsis accessions. The majority (∼70%) of the 64 candidates tested positively contributed to Pst-LUX growth on more than one accession indicating that Hpa virulence likely involves multiple effectors with weak accession-specific effects. Further screening with a Pst mutant (ΔCEL) showed that HaRxLs that allow enhanced Pst-LUX growth usually suppress callose deposition, a hallmark of pathogen-associated molecular pattern (PAMP)-triggered immunity (PTI). We found that HaRxLs are rarely strong avirulence determinants. Although some decreased Pst-LUX growth in particular accessions, none activated macroscopic cell death. Fewer HaRxLs conferred enhanced Pst growth on turnip, a non-host for Hpa, while several reduced it, consistent with the idea that turnip's non-host resistance against Hpa could involve a combination of recognized HaRxLs and ineffective HaRxLs. We verified our results by constitutively expressing in Arabidopsis a sub-set of HaRxLs. Several transgenic lines showed increased susceptibility to Hpa and attenuation of Arabidopsis PTI responses, confirming the HaRxLs' role in Hpa virulence. This study shows TTSS screening system provides a useful tool to test whether candidate effectors from eukaryotic pathogens can suppress/trigger plant defense mechanisms and to rank their effectiveness prior to subsequent mechanistic investigation. PMID:22072967

Placenta previa without morbidly adherent placenta: comparison of characteristics and outcomes between planned and emergent deliveries in a tertiary center.

PubMed

Erfani, Hadi; Kassir, Elias; Fox, Karin A; Clark, Steven L; Karbasian, Niloofar; Salmanian, Bahram; Shamshirsaz, Amir A; Espinoza, Jimmy; Nassr, Ahmed A; Eppes, Catherine S; Belfort, Michael A; Shamshirsaz, Alireza A

2017-11-05

The objective of this study is to compare patient outcomes between planned and emergent cesarean deliveries for placenta previa without morbidly adherent placenta. All patients with confirmed, persistent placenta previa (without morbidly adherent placentation) who underwent the surgery between January 2010 and April 2016 were included in this retrospective study. Primary outcome was composite maternal morbidity defined as the presence of at least one of the followings: death, red blood cell (RBC) transfusion, hysterectomy, reoperation, hospital stay >7 d, ureteral injury, bowel injury, or cystotomy. Three hundred and four patients with placenta previa were identified during the study period, of whom 154 (50.65%) had an antenatal and 10 (3.28%) had an intraoperative diagnosis of morbidly adherent placenta. One hundred and forty patients met the inclusion criteria. Eighty (57.1%) underwent planned cesarean delivery (planned cesarean delivery (PCD) group), and 60 (42.8%) required emergent cesarean delivery due to uterine contractions and/or bleeding (emergent cesarean delivery (ECD) group). Baseline characteristics were similar between the two groups except for the gestational age at delivery (36.0 weeks (36.0, 37.0) in PCD versus 34.0 weeks (32.0, 36.0) in ECP, p < .001). Composite maternal morbidity was not significantly different between two groups: 11 (18.3%) in ECD and 10 (12.5%) in PCD (p = .35) Conclusions: In our referral tertiary centre, emergent and planned cesarean deliveries for placenta previa without morbidly adherent placenta have similar maternal outcomes. In patients without significant hemorrhage, delivery may be safely deferred until 36-37 weeks.

Subcellular localization of the Hpa RxLR effector repertoire identifies a tonoplast-associated protein HaRxL17 that confers enhanced plant susceptibility.

PubMed

Caillaud, Marie-Cécile; Piquerez, Sophie J M; Fabro, Georgina; Steinbrenner, Jens; Ishaque, Naveed; Beynon, Jim; Jones, Jonathan D G

2012-01-01

Filamentous phytopathogens form sophisticated intracellular feeding structures called haustoria in plant cells. Pathogen effectors are likely to play a role in the establishment and maintenance of haustoria in addition to their better-characterized role in suppressing plant defence. However, the specific mechanisms by which these effectors promote virulence remain unclear. To address this question, we examined changes in subcellular architecture using live-cell imaging during the compatible interaction between the oomycete Hyaloperonospora arabidopsidis (Hpa) and its host Arabidopsis. We monitored host-cell restructuring of subcellular compartments within plant mesophyll cells during haustoria ontogenesis. Live-cell imaging highlighted rearrangements in plant cell membranes upon infection, in particular to the tonoplast, which was located close to the extra-haustorial membrane surrounding the haustorium. We also investigated the subcellular localization patterns of Hpa RxLR effector candidates (HaRxLs) in planta. We identified two major classes of HaRxL effector based on localization: nuclear-localized effectors and membrane-localized effectors. Further, we identified a single effector, HaRxL17, that associated with the tonoplast in uninfected cells and with membranes around haustoria, probably the extra-haustorial membrane, in infected cells. Functional analysis of selected effector candidates in planta revealed that HaRxL17 enhances plant susceptibility. The roles of subcellular changes and effector localization, with specific reference to the potential role of HaRxL17 in plant cell membrane trafficking, are discussed with respect to Hpa virulence. © 2011 The Authors. The Plant Journal © 2011 Blackwell Publishing Ltd.

Correlates of low back pain outcomes in a community clinic.

PubMed

Lowdermilk, A; Panus, P C; Kalbfleisch, J H

1999-08-01

Both governmental and private agencies have focused on the multiple outcome variables that may affect patient treatment. Our investigation examined treatment-independent outcome variables and correlates in patients with the sole complaint of low back pain. Treatment was conducted in an outpatient physical therapy clinic serving a rural/suburban Tennessee population. The review collected data on nine variables from 54 clinic records. The study group was 56% female, with ages for all subjects ranging from 26 to 84 years. Twenty-five patients carried private insurance, 14 were TennCare recipients (state Medicaid), 9 were covered by workers compensation, and 6 were Medicare based. The prescribed number of treatment sessions (Rx) varied from 1 to 3 visits to as many as 18. The Rx was not related to sex, age, or payer type. The compliance index (Cx) (mean = 76.3%, range = 6% to 150%) was related to payer type (P < .02), but not related to sex, age, or Rx. TennCare patients had lower compliance levels (mean Cx = 51.1) than all other insurer groups combined (mean Cx = 85.0). Self-assessed improvement by the patient (Patient Status) was related to Cx (P < 0.005) but not sex, age, payer type, or Rx. Completion by the patient of long-term physical therapy goals as determined by the therapist was related to Cx (P < .03) and self-assessed patient status (P < .02), while disposition at discharge was associated with Cx, self-assessed patient status, and payer type (P < .001). Compliance by patients significantly influences the outcome measures of self-assessed improvement, therapist assessment of achieving long-term treatment goals, and disposition at discharge. TennCare patients demonstrated both low compliance and poor outcome at discharge. These results suggest that the lower potential for positive treatment outcome may exist for the TennCare patient population.

Flight Test Experiments Foreseen for USV

DTIC Science & Technology

2005-10-01

USA W.T. - Japan W .T. - Australia: ANU ( National University) W .T. - USA: NASA , AEDC, CALTEC, CUBRC W .T. - Japan: NAL 1.0E-05 1.0E-04... reflectometry ”. • Active (TX / RX) / passive (RX only) mode experiments • Main on-board elements: • RX • TX (possibly shared with system TX) • antennas

Potential value of electronic prescribing in health economic and outcomes research.

PubMed

Cooke, Catherine E; Isetts, Brian J; Sullivan, Thomas E; Fustgaard, Maren; Belletti, Daniel A

2010-07-01

Improving access and quality while reducing expenditures in the United States health system is expected to be a priority for many years. The use of health information technology (HIT), including electronic prescribing (eRx), is an important initiative in efforts aimed at improving safety and outcomes, increasing quality, and decreasing costs. Data from eRx has been used in studies that document reductions in medication errors, adverse drug events, and pharmacy order-processing time. Evaluating programs and initiatives intended to improve health care can be facilitated through the use of HIT and eRx. eRx data can be used to conduct research to answer questions about the outcomes of health care products, services, and new clinical initiatives with the goal of providing guidance for clinicians and policy makers. Given the recent explosive growth of eRx in the United States, the purpose of this manuscript is to assess the value and suggest enhanced uses and applications of eRx to facilitate the role of the practitioner in contributing to health economics and outcomes research.

Potential value of electronic prescribing in health economic and outcomes research

PubMed Central

Cooke, Catherine E; Isetts, Brian J; Sullivan, Thomas E; Fustgaard, Maren; Belletti, Daniel A

2010-01-01

Improving access and quality while reducing expenditures in the United States health system is expected to be a priority for many years. The use of health information technology (HIT), including electronic prescribing (eRx), is an important initiative in efforts aimed at improving safety and outcomes, increasing quality, and decreasing costs. Data from eRx has been used in studies that document reductions in medication errors, adverse drug events, and pharmacy order-processing time. Evaluating programs and initiatives intended to improve health care can be facilitated through the use of HIT and eRx. eRx data can be used to conduct research to answer questions about the outcomes of health care products, services, and new clinical initiatives with the goal of providing guidance for clinicians and policy makers. Given the recent explosive growth of eRx in the United States, the purpose of this manuscript is to assess the value and suggest enhanced uses and applications of eRx to facilitate the role of the practitioner in contributing to health economics and outcomes research. PMID:22915962

Three-Phase Time-Multiplexed Planar Power Transmission to Distributed Implants.

PubMed

Lee, Byunghun; Ahn, Dukju; Ghovanloo, Maysam

2016-03-01

A platform has been presented for wireless powering of receivers (Rx's) that are arbitrarily distributed over a large area. A potential application could be powering of small Rx implants, distributed over large areas of the brain. The transmitter (Tx) consists of three overlapping layers of hexagonal planar spiral coils (hex-PSC) that are horizontally shifted to provide the strongest and most homogeneous electromagnetic flux coverage. The three-layer hex-PSC array is driven by a three-phase time-division-multiplexed power Tx that takes the advantage of the carrier phase shift, coil geometries, and Rx time constant to homogeneously power the arbitrarily distributed Rx's regardless of their misalignments. The functionality of the proposed three-phase power transmission concept has been verified in a detailed scaled-up high-frequency structure simulator Advanced Design System simulation model and measurement setup, and compared with a conventional Tx. The new Tx delivers 5.4 mW to each Rx and achieves, on average, 5.8% power transfer efficiency to the Rx at the worst case 90° angular misalignment, compared with 1.4% by the conventional Tx.

Evaluation in Monkey of Two Candidate PET Radioligands, [11C]RX-1 and [18F]RX-2, for Imaging Brain 5-HT4 Receptors

PubMed Central

LOHITH, TALAKAD G.; XU, RONG; TSUJIKAWA, TETSUYA; MORSE, CHERYL L.; ANDERSON, KACEY B.; GLADDING, ROBERT L.; ZOGHBI, SAMI S.; FUJITA, MASAHIRO; INNIS, ROBERT B.; PIKE, VICTOR W.

2014-01-01

The serotonin subtype-4 (5-HT4) receptor, which is known to be involved physiologically in learning and memory, and pathologically in Alzheimer’s disease, anxiety and other neuropsychiatric disorders – has few radioligands readily available for imaging in vivo. We have previously reported two novel 5-HT4 receptor radioligands, namely [methoxy-11C](1-butylpiperidin-4-yl)methyl 4-amino-3-methoxybenzoate; [11C]RX-1) and the [18F]3-fluoromethoxy analog ([18F]RX-2), and in this study we evaluated them by PET in rhesus monkey. Brain scans were performed at baseline, receptor preblock or displacement conditions using SB 207710, a 5-HT4 receptor antagonist, on the same day for [11C]RX-1 and on different days for [18F]RX-2. Specific-to-nondisplaceable ratio (BPND) was measured with the simplified reference tissue model from all baseline scans. To determine specific binding, total distribution volume (VT) was also measured in some monkeys by radiometabolite-corrected arterial input function after ex vivo inhibition of esterases from baseline and blocked scans. Both radioligands showed moderate to high peak brain uptake of radioactivity (2–6 SUV). Regional BPND values were in the rank order of known 5-HT4 receptor distribution with a trend for higher BPND values from [18F]RX-2. One-tissue compartmental model provided good fits with well identified VT values for both radioligands. In the highest 5-HT4 receptor density region, striatum, 50–60% of total binding was specific. The VT in receptor-poor cerebellum reached stable values by about 60 min for both radioligands indicating little influence of radiometabolites on brain signal. In conclusion, both [11C]RX-1 and [18F]RX-2 showed positive attributes for PET imaging of brain 5-HT4 receptors, validating the radioligand design strategy. PMID:25088028

Evaluation of the Variable Reluctance Transducer/Carrier Amplifier Method of Measuring Low Pneumatic Pressures in Aerodynamic and Propulsion Testing.

DTIC Science & Technology

1983-02-01

in ZT position, adjust Rx and VT to give the following conditions simul taneously: a) Vc to be specifiied value * RMS Volts. b) VRX Vz. 3. Record: RX...conditions simultaneously: a) V to be specified value as before.c b) VRX Vc. 2. Record: Rx = Q_ ; VT = ; VR =Vc (Volts). C. CALCULATE VOLTAGE AND...2 _V2 cos 8 = cos (180-,) = VRX V2 . VT 2VRX* V Z =R (cos + isino) = Rz + JWTLZ (OHMS) VT x10 (MILLIAMPERES) E(Rx+Rz)2 + LZ2 󈧏 2 • =TLz COIL "Q

RX: a nonimaging concentrator.

PubMed

Miñano, J C; Benítez, P; González, J C

1995-05-01

A detailed description of the design procedure for a new concentrator, RX, and some examples of it's use are given. The method of design is basically the same as that used in the design of two other concentrators: the RR and the XR [Appl. Opt. 31, 3051 (1992)]. The RX is ideal in two-dimensional geometry. The performance of the rotational RX is good when the average angular spread of the input bundle is small: up to 95% of the power of the input bundle can be transferred to the output bundle (with the assumption of a constant radiance for the rays of the input bundle).

Expression and Properties of the Highly Alkalophilic Phenylalanine Ammonia-Lyase of Thermophilic Rubrobacter xylanophilus

PubMed Central

Kovács, Klaudia; Bánóczi, Gergely; Varga, Andrea; Szabó, Izabella; Holczinger, András; Hornyánszky, Gábor; Zagyva, Imre

2014-01-01

The sequence of a phenylalanine ammonia-lyase (PAL; EC: 4.3.1.24) of the thermophilic and radiotolerant bacterium Rubrobacter xylanophilus (RxPAL) was identified by screening the genomes of bacteria for members of the phenylalanine ammonia-lyase family. A synthetic gene encoding the RxPAL protein was cloned and overexpressed in Escherichia coli TOP 10 in a soluble form with an N-terminal His6-tag and the recombinant RxPAL protein was purified by Ni-NTA affinity chromatography. The activity assay of RxPAL with l-phenylalanine at various pH values exhibited a local maximum at pH 8.5 and a global maximum at pH 11.5. Circular dichroism (CD) studies showed that RxPAL is associated with an extensive α-helical character (far UV CD) and two distinctive near-UV CD peaks. These structural characteristics were well preserved up to pH 11.0. The extremely high pH optimum of RxPAL can be rationalized by a three-dimensional homology model indicating possible disulfide bridges, extensive salt-bridge formation and an excess of negative electrostatic potential on the surface. Due to these properties, RxPAL may be a candidate as biocatalyst in synthetic biotransformations leading to unnatural l- or d-amino acids or as therapeutic enzyme in treatment of phenylketonuria or leukemia. PMID:24475062

Medicalized addiction, self-medication, or nonmedical prescription drug use? How trust figures into incarcerated women's conceptualization of illicit prescription drug use.

PubMed

Smirnova, Michelle; Owens, Jennifer Gatewood

2017-06-01

Trust is crucial to optimal care. When trust is compromised, patients, doctors, and others involved in the provision of health care may not act in patients' best interests, particularly when dealing with prescription (Rx) drugs. Patients must trust that doctors are giving them the proper treatment, including access to Rx drugs only when medically necessary. They must also trust themselves to use these drugs properly. Likewise, doctors must trust the patient's ability to use medications appropriately. Given the recent rise in illicit Rx drug use in the U.S., we seek to understand how women articulate levels of trust in doctors and themselves and if different combinations of trust and distrust impact how they acquire, use, and articulate their experiences with Rx drugs. To this end, we identified and interviewed 40 women incarcerated in the U.S., who were deeply entrenched in illicit Rx drug use prior to prison. Based upon this research, we argue that illicit Rx drug use may be tied to different combinations of trust and distrust in individual doctors (interpersonal trust), the field of medicine (institutional trust), and the users themselves (self trust). How these women acquire Rx drugs: through doctors, friends, family, or the street market are influenced by combinations of interpersonal, institutional, and self trust. Copyright © 2017 Elsevier Ltd. All rights reserved.

Polymorphisms of genes encoding P2X7R, IL-1B, OPG and RANK in orthodontic-induced apical root resorption.

PubMed

Pereira, S; Lavado, N; Nogueira, L; Lopez, M; Abreu, J; Silva, H

2014-10-01

Orthodontic-induced external apical root resorption (EARR) is a complex phenotype determined by poorly defined mechanical and patient intrinsic factors. The aim of this work was to construct a multifactorial integrative model, including clinical and genetic susceptibility factors, to analyze the risk of developing this common orthodontic complication. This retrospective study included 195 orthodontic patients. Using a multiple-linear regression model, where the dependent variable was the maximum% of root resorption (%EARRmax) for each patient, we assessed the contribution of nine clinical variables and four polymorphisms of genes involved in bone and tooth root remodeling (rs1718119 from P2RX7, rs1143634 from IL1B, rs3102735 from TNFRSF11B, encoding OPG, and rs1805034 from TNFRSF11A, encoding RANK). Clinical and genetic variables explained 30% of%EARRmax variability. The variables with the most significant unique contribution to the model were: gender (P < 0.05), treatment duration (P < 0.001), premolar extractions (P < 0.01), Hyrax appliance (P < 0.001) and GG genotype of rs1718119 from P2RX7 gene (P < 0.01). Age, overjet, tongue thrust, skeletal class II and the other polymorphisms made minor contributions. This study highlights the P2RX7 gene as a possible factor of susceptibility to EARR. A more extensive genetic profile may improve this model. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Real-time implementation of a multispectral mine target detection algorithm

NASA Astrophysics Data System (ADS)

Samson, Joseph W.; Witter, Lester J.; Kenton, Arthur C.; Holloway, John H., Jr.

2003-09-01

Spatial-spectral anomaly detection (the "RX Algorithm") has been exploited on the USMC's Coastal Battlefield Reconnaissance and Analysis (COBRA) Advanced Technology Demonstration (ATD) and several associated technology base studies, and has been found to be a useful method for the automated detection of surface-emplaced antitank land mines in airborne multispectral imagery. RX is a complex image processing algorithm that involves the direct spatial convolution of a target/background mask template over each multispectral image, coupled with a spatially variant background spectral covariance matrix estimation and inversion. The RX throughput on the ATD was about 38X real time using a single Sun UltraSparc system. A goal to demonstrate RX in real-time was begun in FY01. We now report the development and demonstration of a Field Programmable Gate Array (FPGA) solution that achieves a real-time implementation of the RX algorithm at video rates using COBRA ATD data. The approach uses an Annapolis Microsystems Firebird PMC card containing a Xilinx XCV2000E FPGA with over 2,500,000 logic gates and 18MBytes of memory. A prototype system was configured using a Tek Microsystems VME board with dual-PowerPC G4 processors and two PMC slots. The RX algorithm was translated from its C programming implementation into the VHDL language and synthesized into gates that were loaded into the FPGA. The VHDL/synthesizer approach allows key RX parameters to be quickly changed and a new implementation automatically generated. Reprogramming the FPGA is done rapidly and in-circuit. Implementation of the RX algorithm in a single FPGA is a major first step toward achieving real-time land mine detection.

P2X7 Receptors Drive Spine Synapse Plasticity in the Learned Helplessness Model of Depression

PubMed Central

Otrokocsi, Lilla; Sperlágh, Beáta

2017-01-01

Abstract Background Major depressive disorder is characterized by structural and functional abnormalities of cortical and limbic brain areas, including a decrease in spine synapse number in the dentate gyrus of the hippocampus. Recent studies highlighted that both genetic and pharmacological invalidation of the purinergic P2X7 receptor (P2rx7) leads to antidepressant-like phenotype in animal experiments; however, the impact of P2rx7 on depression-related structural changes in the hippocampus is not clarified yet. Methods Effects of genetic deletion of P2rx7s on depressive-like behavior and spine synapse density in the dentate gyrus were investigated using the learned helplessness mouse model of depression. Results We demonstrate that in wild-type animals, inescapable footshocks lead to learned helplessness behavior reflected in increased latency and number of escape failures to subsequent escapable footshocks. This behavior is accompanied with downregulation of mRNA encoding P2rx7 and decrease of spine synapse density in the dentate gyrus as determined by electron microscopic stereology. In addition, a decrease in synaptopodin but not in PSD95 and NR2B/GluN2B protein level was also observed under these conditions. Whereas the absence of P2rx7 was characterized by escape deficit, no learned helpless behavior is observed in these animals. Likewise, no decrease in spine synapse number and synaptopodin protein levels was detected in response to inescapable footshocks in P2rx7-deficient animals. Conclusion Our findings suggest the endogenous activation of P2rx7s in the learned helplessness model of depression and decreased plasticity of spine synapses in P2rx7-deficient mice might explain the resistance of these animals to repeated stressful stimuli. PMID:28633291

Neonatal outcome of very preterm twins: policy of planned vaginal or cesarean delivery.

PubMed

Sentilhes, Loïc; Oppenheimer, Anne; Bouhours, Anne-Charlotte; Normand, Estelle; Haddad, Bassam; Descamps, Philippe; Marpeau, Loïc; Goffinet, François; Kayem, Gilles

2015-07-01

The objective of the study was to compare neonatal mortality and morbidity in very preterm twins with the first twin in cephalic presentation in hospitals with a policy of planned vaginal delivery (PVD) and those with a policy of planned cesarean delivery (PCD). Women with preterm cephalic first twins delivered after preterm labor and/or premature preterm rupture of membranes from 26(0/7) to 31(6/7) weeks of gestation were identified from the databases of 6 perinatal centers and classified as PVD or PCD according to the center's management policy from 1999 to 2010. Severe neonatal morbidity was defined as any of the following: intraventricular hemorrhage grades 3-4, periventricular leukomalacia, necrotizing enterocolitis, bronchopulmonary dysplasia, and hospital death. The independent effect of the planned mode of delivery, defined by the center's management policy, was tested and quantified with a 2-level multivariable logistic regression. The PVD group included 248 women, and the PCD group 63. Maternal characteristics did not differ between the 2 groups. The rate of vaginal delivery was 85.9% (213 of 248) vs 20.6% (13 of 63) (P < .001), and the rate of cesarean delivery for the second twin was 1.6% (4 of 248) vs 4.8% (3 of 63) (P = .13) for PVD and PCD. PVD had no independent effect on either newborn hospital mortality or severe neonatal composite morbidity. A policy of planned vaginal delivery of very preterm twins with the first twin in cephalic presentation does not increase either severe neonatal morbidity or mortality. Copyright © 2015 Elsevier Inc. All rights reserved.

Locality-constrained anomaly detection for hyperspectral imagery

NASA Astrophysics Data System (ADS)

Liu, Jiabin; Li, Wei; Du, Qian; Liu, Kui

2015-12-01

Detecting a target with low-occurrence-probability from unknown background in a hyperspectral image, namely anomaly detection, is of practical significance. Reed-Xiaoli (RX) algorithm is considered as a classic anomaly detector, which calculates the Mahalanobis distance between local background and the pixel under test. Local RX, as an adaptive RX detector, employs a dual-window strategy to consider pixels within the frame between inner and outer windows as local background. However, the detector is sensitive if such a local region contains anomalous pixels (i.e., outliers). In this paper, a locality-constrained anomaly detector is proposed to remove outliers in the local background region before employing the RX algorithm. Specifically, a local linear representation is designed to exploit the internal relationship between linearly correlated pixels in the local background region and the pixel under test and its neighbors. Experimental results demonstrate that the proposed detector improves the original local RX algorithm.

Genome analyses of the sunflower pathogen Plasmopara halstedii provide insights into effector evolution in downy mildews and Phytophthora.

PubMed

Sharma, Rahul; Xia, Xiaojuan; Cano, Liliana M; Evangelisti, Edouard; Kemen, Eric; Judelson, Howard; Oome, Stan; Sambles, Christine; van den Hoogen, D Johan; Kitner, Miloslav; Klein, Joël; Meijer, Harold J G; Spring, Otmar; Win, Joe; Zipper, Reinhard; Bode, Helge B; Govers, Francine; Kamoun, Sophien; Schornack, Sebastian; Studholme, David J; Van den Ackerveken, Guido; Thines, Marco

2015-10-05

Downy mildews are the most speciose group of oomycetes and affect crops of great economic importance. So far, there is only a single deeply-sequenced downy mildew genome available, from Hyaloperonospora arabidopsidis. Further genomic resources for downy mildews are required to study their evolution, including pathogenicity effector proteins, such as RxLR effectors. Plasmopara halstedii is a devastating pathogen of sunflower and a potential pathosystem model to study downy mildews, as several Avr-genes and R-genes have been predicted and unlike Arabidopsis downy mildew, large quantities of almost contamination-free material can be obtained easily. Here a high-quality draft genome of Plasmopara halstedii is reported and analysed with respect to various aspects, including genome organisation, secondary metabolism, effector proteins and comparative genomics with other sequenced oomycetes. Interestingly, the present analyses revealed further variation of the RxLR motif, suggesting an important role of the conservation of the dEER-motif. Orthology analyses revealed the conservation of 28 RxLR-like core effectors among Phytophthora species. Only six putative RxLR-like effectors were shared by the two sequenced downy mildews, highlighting the fast and largely independent evolution of two of the three major downy mildew lineages. This is seemingly supported by phylogenomic results, in which downy mildews did not appear to be monophyletic. The genome resource will be useful for developing markers for monitoring the pathogen population and might provide the basis for new approaches to fight Phytophthora and downy mildew pathogens by targeting core pathogenicity effectors.

Report details eRx challenges and provides suggestions for increased adoption.

PubMed

2004-07-01

A new report by the eHealth Initiative (http://www.ehealthinitiative.org) looks at electronic prescribing, or "eRx," and discusses its benefits, challenges to adoption, and movements toward adoption. Released in April 2004, the 154-page report--Electronic Prescribing: Toward Maximum Value and Rapid Adoption--also highlights recommendations for the optimal design of an eRx system.

Fade Analysis of ORCA DATA Beam at NTTR and Pax River

DTIC Science & Technology

2010-08-01

bit-error-rate (BER) of the data beam on the downlink path. 15 Start Time-PST (Duration) Range Scin Index 1 Rx=5.1cm... Scin Index 2 Rx=13.7cm Scin Index 3 Rx=27.2cm Path Ave Cn2 (m-2/3) Path Ave Inner Scale Path Ave Outer Scale Flight 2 May 16

Determination of plutonium in spent nuclear fuel using high resolution X-ray

DOE PAGES

McIntosh, Kathryn G.; Reilly, Sean D.; Havrilla, George J.

2015-05-30

Characterization of Pu is an essential aspect of safeguards operations at nuclear fuel reprocessing facilities. A novel analysis technique called hiRX (high resolution X-ray) has been developed for the direct measurement of Pu in spent nuclear fuel dissolver solutions. hiRX is based on monochromatic wavelength dispersive X-ray fluorescence (MWDXRF), which provides enhanced sensitivity and specificity compared with conventional XRF techniques. A breadboard setup of the hiRX instrument was calibrated using spiked surrogate spent fuel (SSF) standards prepared as dried residues. Samples of actual spent fuel were utilized to evaluate the performance of the hiRX. The direct detection of just 39more » ng of Pu is demonstrated. Initial quantitative results, with error of 4–27% and precision of 2% relative standard deviation (RSD), were obtained for spent fuel samples. The limit of detection for Pu (100 s) within an excitation spot of 200 μm diameter was 375 pg. This study demonstrates the potential for the hiRX technique to be utilized for the rapid, accurate, and precise determination of Pu. Moreover, the results highlight the analytical capability of hiRX for other applications requiring sensitive and selective nondestructive analyses.« less

Prescription safety eyewear: impact studies of lens and frame failure.

PubMed

Vinger, P F; Woods, T A

2000-02-01

To determine if a plano lens could be the test lens for all prescription (Rx) lenses and to investigate why Rx lenses pop out of safety eyewear. Plano and Rx polycarbonate lenses (n = 641) with varying thickness and edge geometry, mounted on steel lens holders, and Rx safety eyewear (n = 128) placed on headforms were impacted with test objects of varying diameter and hardness. Impacts were studied with 500 to 2,000 frames-per-second motion analysis. Plano lenses were at least, or more, prone to failure (dislodgment, perforation, shatter, or crack) than -3.00 or +3.00 lenses of the same minimum thickness. More than 40% of safety frames with removable lenses broke or had lenses pop out when impacted with energies expected in industry and sports. Plano lenses can be used as the test lenses for all Rx lenses made of the same material with the same minimal thickness. The ANSI Z87.1-1989 industrial standard for Rx eyewear is inadequate for sports or other activities with high-impact potential. The best lens-retention system has, as a component, a frame with a bevel perpendicular to a frontal impact force.

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

McIntosh, Kathryn G.; Reilly, Sean D.; Havrilla, George J.

Characterization of Pu is an essential aspect of safeguards operations at nuclear fuel reprocessing facilities. A novel analysis technique called hiRX (high resolution X-ray) has been developed for the direct measurement of Pu in spent nuclear fuel dissolver solutions. hiRX is based on monochromatic wavelength dispersive X-ray fluorescence (MWDXRF), which provides enhanced sensitivity and specificity compared with conventional XRF techniques. A breadboard setup of the hiRX instrument was calibrated using spiked surrogate spent fuel (SSF) standards prepared as dried residues. Samples of actual spent fuel were utilized to evaluate the performance of the hiRX. The direct detection of just 39more » ng of Pu is demonstrated. Initial quantitative results, with error of 4–27% and precision of 2% relative standard deviation (RSD), were obtained for spent fuel samples. The limit of detection for Pu (100 s) within an excitation spot of 200 μm diameter was 375 pg. This study demonstrates the potential for the hiRX technique to be utilized for the rapid, accurate, and precise determination of Pu. Moreover, the results highlight the analytical capability of hiRX for other applications requiring sensitive and selective nondestructive analyses.« less

Integrating Comparative Effectiveness Design Elements and Endpoints Into a Phase III, Randomized Clinical Trial (SWOG S1007) Evaluating OncotypeDX-Guided Management for Women With Breast Cancer Involving Lymph Nodes

PubMed Central

Ramsey, Scott D.; Barlow, William E.; Gonzalez-Angulo, Ana M.; Tunis, Sean; Baker, Laurence; Crowley, John; Deverka, Patricia; Veenstra, David; Hortobagyi, Gabriel N.

2012-01-01

Women with breast cancer involving the lymph nodes are typically treated with cytotoxic chemotherapy. Retrospective evaluations of prior studies suggest that the 21-gene test (OncotypeDX®), may allow identification of those who can safely avoid chemotherapy. To better understand the performance of the 21-gene test, the RxPONDER (Rx for Positive Node, Endocrine Responsive breast cancer) study was designed, a multicenter Phase III trial randomizing women with hormone receptor-positive and HER2-negative breast cancer involving 1–3 lymph nodes and a 21-gene assay recurrence score (RS) of 25 or less to endocrine therapy alone versus chemotherapy followed by endocrine therapy. As one of the first large-scale comparative-effectiveness studies in oncology, RxPONDER utilized an external stakeholder group to help inform the design of the trial. Stakeholders met with representatives of SWOG over several months through a structured discussion process. The stakeholder engagement process resulted in several changes being made to the trial design. In addition, stakeholder representatives from the health insurance industry provided guidance regarding a mechanism whereby the costs of OncotypeDX® would be paid by the majority of health insurers as part of the trial. The process may serve as a template for future studies evaluating the comparative effectiveness of genomic tests in oncology, particularly those that are conducted within cooperative clinical trials groups. PMID:23000081

Resolvin E1 (RX-10001) reduces corneal epithelial barrier disruption and protects against goblet cell loss in a murine model of dry eye.

PubMed

de Paiva, Cintia S; Schwartz, C Eric; Gjörstrup, Per; Pflugfelder, Stephen C

2012-11-01

Resolvin E1 (RvE1; RX-10001) belongs to a new class of endogenous immunoregulating mediators, originally identified as a metabolite of the omega-3 polyunsaturated fatty acid, eicosapentaenoic acid. Based on its proven efficacy in models of chronic inflammation, this study investigated the efficacy of resolvin E1 in a murine model of dry eye. C57/B6 mice, aged 6 to 8 weeks, were treated with systemic scopolamine and exposed to air draft and low humidity for 16 hours/day for 5 days and allocated to the following groups: unexposed controls, disease controls, treatment with vehicle or RvE1 delivered topically as its methyl ester prodrug, RX-10005, to enhance corneal surface penetration. Treatment was initiated at the time of desiccating stress induction. Treatment efficacy was assessed by corneal permeability using Oregon Green Dextran and by conjunctival goblet cell density using periodic acid-Schiff reagent. RvE1 reduced the increase in corneal staining by 80% compared with untreated disease controls. Goblet cell density was reduced by 20% in disease controls but fully maintained in the group receiving RvE1. RvE1, delivered as its methyl ester prodrug, improved the outcome measures of corneal staining and goblet cell density in this murine model of dry eye, indicating the potential utility of endogenous resolvins and resolvin analogues in the treatment of dry eye.

[Morbidity with temporary disability in railway tunnel workers].

PubMed

Kudrin, V A; Prokhorov, A A

2003-01-01

The paper presents data on the health status of a large professional group of transport building workers--those who build BAM railway tunnels and those who build Moscow and Saint Petersburg underground stations. Major factors that are associated with underground work and that form the level of morbidity with temporary disability are identified. Respiratory, osteomuscular, digestive diseases, accidents, intoxications, and injuries are predominant in the structure of temporary disability. Lines of better organization of therapeutical-and-prophylactic aid to this contingent are defined.

Phytophthora parasitica Effector PpRxLR2 Suppresses Nicotiana benthamiana Immunity.

PubMed

Dalio, R J D; Maximo, H J; Oliveira, T S; Dias, R O; Breton, M C; Felizatti, H; Machado, M

2018-04-01

Phytophthora species secrete several classes of effector proteins during interaction with their hosts. These proteins can have multiple functions including modulation of host physiology and immunity. The RxLR effectors have the ability to enter plant cells using the plant machinery. Some of these effectors have been characterized as immunity suppressors; however, very little is known about their functions in the interaction between Phytophthora parasitica and its hosts. Using a bioinformatics pipeline, we have identified 172 candidate RxLR effectors (CREs) in the isolate IAC 01_95 of P. parasitica. Of these 172 CREs, 93 were found to be also present in eight other genomes of P. parasitica, isolated from different hosts and continents. After transcriptomics and gene expression analysis, we have found five CREs to be up-regulated in in-vitro and in-planta samples. Subsequently, we selected three CREs for functional characterization in the model plant Nicotiana benthamiana. We show that PpRxLR2 is able to completely suppress INF-1-induced cell death, whereas PpRxLR3 and PpRxLR5 moderately suppressed N. benthamiana immunity in a less-extensive manner. Moreover, we confirmed the effector-triggered susceptibility activity of these proteins after transient transformation and infection of N. benthamiana plants. All three CREs enhanced virulence of P. parasitica during the interaction with N. benthamiana. These effectors, in particular PpRxLR2, can be targeted for the development of biotechnology-based control strategies of P. parasitica diseases.

Alpha-actinin-3 (ACTN3) R577X polymorphism influences knee extensor peak power response to strength training in older men and women.

PubMed

Delmonico, Matthew J; Kostek, Matthew C; Doldo, Neil A; Hand, Brian D; Walsh, Sean; Conway, Joan M; Carignan, Craig R; Roth, Stephen M; Hurley, Ben F

2007-02-01

The alpha-actinin-3 (ACTN3) R577X polymorphism has been associated with muscle power performance in cross-sectional studies. We examined baseline knee extensor concentric peak power (PP) and PP change with approximately 10 weeks of unilateral knee extensor strength training (ST) using air-powered resistance machines in 71 older men (65 [standard deviation = 8] years) and 86 older women (64 [standard deviation = 9] years). At baseline in women, the XX genotype group had an absolute (same resistance) PP that was higher than the RR (p =.005) and RX genotype groups (p =.02). The women XX group also had a relative (70% of one-repetition maximum [1-RM]) PP that was higher than that in the RR (p =.002) and RX groups (p =.008). No differences in baseline absolute or relative PP were observed between ACTN3 genotype groups in men. In men, absolute PP change with ST in the RR (n = 16) group approached a significantly higher value than in the XX group (n = 9; p =.07). In women, relative PP change with ST in the RR group (n = 16) was higher than in the XX group (n = 17; p =.02). The results indicate that the ACTN3 R577X polymorphism influences the response of quadriceps muscle power to ST in older adults.

Legislative and non-legislative regulations concerning Rx drug advertisement in the European Union and the United States--comparative analysis.

PubMed

Czerw, Aleksandra; Religioni, Urszula

2012-01-01

Drug advertising is one of the most popular forms of communication between pharmaceutical companies and prospect drug purchasers. In the face of strong competition on the pharmaceutical market on the one hand, and patient's high susceptibility to various forms of advertising on the other, drug producers try to reach as wide group of recipients as possible. However, proper medicine use requires not only doctor's wide knowledge and experience, but also patient's awareness of necessity of rational drug usage. Advertising activities related to this group of medicines are covered by rigorous law regulations, with taking into account above-mentioned issues, and other specific features of drugs available with prescription. The aim of this article is to present legislative and non-legislative regulations concerning Rx drugs, taking into consideration law regulations that are in force in the European Union and the United States. Ethic codes implemented by drug producers associations were also used.

The origin of RX J1856.5-3754 and RX J0720.4-3125 - updated using new parallax measurements

NASA Astrophysics Data System (ADS)

Tetzlaff, N.; Eisenbeiss, T.; Neuhäuser, R.; Hohle, M. M.

2011-10-01

RX J1856.5-3754 and RX J0720.4-3125 are the only young isolated radio-quiet neutron stars (NSs) for which trigonometric parallaxes were measured. Due to detection of their thermal emission in X-rays, they are important to study NS cooling and to probe theoretical cooling models. Hence, a precise determination of their age is essential. Recently, new parallax measurements of RX J1856.5-3754 and RX J0720.4-3125 were obtained. Considering that NSs may originate from binary systems that got disrupted due to an asymmetric supernova, we attempt to identify runaway stars which may have been former companions to the NS progenitors. Such an identification would strongly support a particular birth scenario with time and place. We trace back each NS, runaway star and the centres of possible birth associations (assuming that most NSs are ejected directly from their parent association) to find close encounters. The kinematic age is then given by the time since the encounter. We use Monte Carlo simulations to account for observational uncertainties and evaluate the outcome statistically. Using the most recent parallax measurement of 8.16 ± 0.80 mas for RX J1856.5-3754 by Walter et al., we find that it originated in the Upper Scorpius association 0.46 ± 0.05 Myr ago. This kinematic age is slightly larger than the value we reported earlier (0.3 Myr) using the old parallax value of 5.6 ± 0.6 mas by Kaplan. Our result is strongly supported by its current radial velocity which we predict to be 6+19- 20 km s-1. This implies an inclination angle to the line of sight of 88°± 6° consistent with estimates by van Kerkwijk & Kulkarni from the bow shock. No suitable runaway star was found to be a potential former companion of RX J1856.5-3754. Making use of a recent parallax measurement for RX J0720.4-3125 of 3.6 ± 1.6 mas by Eisenbeiss, we find that this NS was possibly born in Trumpler 10 0.85 ± 0.15 Myr ago. This kinematic age is somewhat larger than the one obtained using the old parallax value of 2.77 ± 1.29 mas by Kaplan et al. (0.5 Myr). We suggest the B0 runaway supergiant HIP 43158 as a candidate for a former companion of the progenitor star. Then, the current distance of RX J0720.4-3125 to the Sun should be 286+27- 23 pc, in agreement with recent measurements. We then expect the radial velocity of RX J0720.4-3125 to be -76+34- 17 km s-1.

Neonatal Morbidity Associated with Shoulder Dystocia Maneuvers

PubMed Central

Spain, Janine E.; Frey, Heather A.; Tuuli, Methodius G.; Colvin, Ryan; Macones, George A.; Cahill, Alison G.

2015-01-01

Objective To examine neonatal morbidity associated with different maneuvers used among term patients who experience a shoulder dystocia. Study Design A retrospective cohort study of all women who experienced a clinically diagnosed shoulder dystocia at term requiring obstetric maneuvers at a single tertiary care hospital from 2005-2008. We excluded women with major fetal anomaly, intrauterine death, multiple gestation, and preterm. Women exposed to Rubin maneuver, Wood's screw maneuver, or delivery of the posterior arm were compared to women delivered by McRoberts/suprapubic pressure only, which served as the reference group. The primary outcome was a composite morbidity of neonatal injury (defined as clavicular or humeral fracture or brachial plexus injury) and neonatal depression (defined as Apgar <7 at 5 minutes, arterial cord pH <7.1, CPAP use, intubation, or respiratory distress). Logistic regression was used to adjust for nulliparity and duration of shoulder dystocia, defined as time from delivery of fetal head to delivery of shoulders. Results Among the 231 women who met inclusion criteria, 135 were delivered by McRoberts/suprapubic pressure alone (57.9%), 83 women were exposed to Rubin maneuver, 53 women were exposed to Wood's screw, and 36 women were exposed to delivery of posterior arm. Individual maneuvers were not associated with composite morbidity, neonatal injury, or neonatal depression after adjusting for nulliparity and duration of shoulder dystocia. Conclusion We found no association between shoulder dystocia maneuvers and neonatal morbidity after adjusting for duration, a surrogate for severity. Our results demonstrate that clinicians should utilize the maneuver most likely to result in successful delivery. PMID:25291256

Neonatal morbidity associated with shoulder dystocia maneuvers.

PubMed

Spain, Janine E; Frey, Heather A; Tuuli, Methodius G; Colvin, Ryan; Macones, George A; Cahill, Alison G

2015-03-01

We sought to examine neonatal morbidity associated with different maneuvers used among term patients who experience a shoulder dystocia. We conducted a retrospective cohort study of all women who experienced a clinically diagnosed shoulder dystocia at term requiring obstetric maneuvers at a single tertiary care hospital from 2005 through 2008. We excluded women with major fetal anomaly, intrauterine death, multiple gestation, and preterm. Women exposed to Rubin maneuver, Wood's screw maneuver, or delivery of the posterior arm were compared to women delivered by McRoberts/suprapubic pressure only, which served as the reference group. The primary outcome was a composite morbidity of neonatal injury (defined as clavicular or humeral fracture or brachial plexus injury) and neonatal depression (defined as Apgar <7 at 5 minutes, arterial cord pH <7.1, continuous positive airway pressure use, intubation, or respiratory distress). Logistic regression was used to adjust for nulliparity and duration of shoulder dystocia, defined as time from delivery of fetal head to delivery of shoulders. Among the 231 women who met inclusion criteria, 135 were delivered by McRoberts/suprapubic pressure alone (57.9%), 83 women were exposed to Rubin maneuver, 53 women were exposed to Wood's screw, and 36 women were exposed to delivery of posterior arm. Individual maneuvers were not associated with composite morbidity, neonatal injury, or neonatal depression after adjusting for nulliparity and duration of shoulder dystocia. We found no association between shoulder dystocia maneuvers and neonatal morbidity after adjusting for duration, a surrogate for severity. Our results demonstrate that clinicians should utilize the maneuver most likely to result in successful delivery. Copyright © 2015 Elsevier Inc. All rights reserved.

A photometric study of the eclipsing binary RX Hercules

NASA Technical Reports Server (NTRS)

Jeffreys, K. W.

1980-01-01

A new photoelectric light curve of RX Hercules, a binary system with similar components, has been analyzed using Wood's computer model. RX Her, using Popper's spectroscopic mass ratio of q = 0.8472, turned out to be composed of a dimmer AO component and a larger B9.5 component. This detached system, upon analysis of the residuals in secondary minimum, shows some asymmetry during ingress which then disappears just before secondary minimum. The eccentricity e = 0.022 determined in this study is a little larger than previously published values of e = 0.018. In combination with the spectroscopic analysis of Popper, and ubvy data of Olson and Hill and Hilditch new photometric elements for RX Her were found.

Association Between P2RX7 Gene and Hepatocellular Carcinoma Susceptibility: A Case-Control Study in a Chinese Han Population

PubMed Central

Duan, Shaobo; Yu, Jie; Han, Zhiyu; Cheng, Zhigang; Liang, Ping

2016-01-01

Background Hepatocellular carcinoma (HCC) is one of the most common types of liver cancer. It is hypothesized that P2RX7 genetic polymorphisms have strong association with HCC susceptibility. Therefore, a case-control study was designed and performed to verify the association between P2RX7 gene polymorphisms and HCC susceptibility. Material/Methods A total of 646 subjects were recruited in our study, including 323 HCC patients and 323 healthy controls. Five gene polymorphisms, −762C>T (rs2393799), 946G>A (rs28360457), 1513A>C (rs3751143), 1068G>A (rs1718119), and 1096C>G (rs2230911), were selected. Odds ratio (ORs) and 95% confidence interval (CI) were used to quantify the association between P2RX7 gene polymorphisms and the susceptibility to HCC. All tests were performed using SPSS 20 and a 2-sided P value of less than 0.05 was considered to be statistically significant. Results Our results suggest that allelic frequencies of these 5 SNPs all conformed to Hardy-Weinberg equilibrium (HWE). There was no significant difference in genotype and allele distributions of −762C>T and 1096C>G between the case group and the control group. However, an increased risk of HCC was associated with 946G>A (A vs. G: OR=1.48, 95%CI=1.09–2.01, P=0.013; GA+AA vs. GG: OR=1.46, 95%CI=1.03–2.07, P=0.033). A similar increased risk was associated with 1513A>C polymorphism (C vs. A: OR=1.37, 95%CI=1.05–1.79, P=0.021; AC+CC vs. AA: OR=1.40, 95%CI=1.01–1.93, P=0.041). On the other hand, a decreased risk of HCC was associated with gene polymorphism of 1068G>A (A vs. G: OR=0.68, 95%CI=0.51–0.91, P=0.010; GA+AA vs. GG: OR=0.68, 95%CI=0.49–0.96, P=0.027; AA vs. GG: OR=0.42, 95%CI=0.18–0.99, P=0.048). Conclusions Our results suggest that 3 of the 5 polymorphisms of P2RX7 described above (1513A>C, 946G>A, and 1068G>A) are significantly associated with HCC susceptibility in a Chinese Han population. Studies with larger sample sizes are recommended to confirm whether our results will be applicable to different ethnic populations in China. PMID:27272229

New equations for predicting postoperative risk in patients with hip fracture.

PubMed

Hirose, Jun; Ide, Junji; Irie, Hiroki; Kikukawa, Kenshi; Mizuta, Hiroshi

2009-12-01

Predicting the postoperative course of patients with hip fractures would be helpful for surgical planning and risk management. We therefore established equations to predict the morbidity and mortality rates in candidates for hip fracture surgery using the Estimation of Physiologic Ability and Surgical Stress (E-PASS) risk-scoring system. First we evaluated the correlation between the E-PASS scores and postoperative morbidity and mortality rates in all 722 patients surgically treated for hip fractures during the study period (Group A). Next we established equations to predict morbidity and mortality rates. We then applied these equations to all 633 patients with hip fractures treated at seven other hospitals (Group B) and compared the predicted and actual morbidity and mortality rates to assess the predictive ability of the E-PASS and Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM) systems. The ratio of actual to predicted morbidity and mortality rates was closer to 1.0 with the E-PASS than the POSSUM system. Our data suggest the E-PASS scoring system is useful for defining postoperative risk and its underlying algorithm accurately predicts morbidity and mortality rates in patients with hip fractures before surgery. This information then can be used to manage their condition and potentially improve treatment outcomes. Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.

Transcriptome Engineering with RNA-Targeting Type VI-D CRISPR Effectors.

PubMed

Konermann, Silvana; Lotfy, Peter; Brideau, Nicholas J; Oki, Jennifer; Shokhirev, Maxim N; Hsu, Patrick D

2018-04-19

Class 2 CRISPR-Cas systems endow microbes with diverse mechanisms for adaptive immunity. Here, we analyzed prokaryotic genome and metagenome sequences to identify an uncharacterized family of RNA-guided, RNA-targeting CRISPR systems that we classify as type VI-D. Biochemical characterization and protein engineering of seven distinct orthologs generated a ribonuclease effector derived from Ruminococcus flavefaciens XPD3002 (CasRx) with robust activity in human cells. CasRx-mediated knockdown exhibits high efficiency and specificity relative to RNA interference across diverse endogenous transcripts. As one of the most compact single-effector Cas enzymes, CasRx can also be flexibly packaged into adeno-associated virus. We target virally encoded, catalytically inactive CasRx to cis elements of pre-mRNA to manipulate alternative splicing, alleviating dysregulated tau isoform ratios in a neuronal model of frontotemporal dementia. Our results present CasRx as a programmable RNA-binding module for efficient targeting of cellular RNA, enabling a general platform for transcriptome engineering and future therapeutic development. Copyright © 2018 Elsevier Inc. All rights reserved.

Optimal resonance configuration for ultrasonic wireless power transmission to millimeter-sized biomedical implants.

PubMed

Miao Meng; Kiani, Mehdi

2016-08-01

In order to achieve efficient wireless power transmission (WPT) to biomedical implants with millimeter (mm) dimensions, ultrasonic WPT links have recently been proposed. Operating both transmitter (Tx) and receiver (Rx) ultrasonic transducers at their resonance frequency (fr) is key in improving power transmission efficiency (PTE). In this paper, different resonance configurations for Tx and Rx transducers, including series and parallel resonance, have been studied to help the designers of ultrasonic WPT links to choose the optimal resonance configuration for Tx and Rx that maximizes PTE. The geometries for disk-shaped transducers of four different sets of links, operating at series-series, series-parallel, parallel-series, and parallel-parallel resonance configurations in Tx and Rx, have been found through finite-element method (FEM) simulation tools for operation at fr of 1.4 MHz. Our simulation results suggest that operating the Tx transducer with parallel resonance increases PTE, while the resonance configuration of the mm-sized Rx transducer highly depends on the load resistance, Rl. For applications that involve large Rl in the order of tens of kΩ, a parallel resonance for a mm-sized Rx leads to higher PTE, while series resonance is preferred for Rl in the order of several kΩ and below.

RX and Z Mode Growth Rates and Propagation at Cavity Boundaries

NASA Astrophysics Data System (ADS)

Mutel, R. L.; Christopher, I. W.; Menietti, J. D.; Gurnett, D. A.; Pickett, J. S.; Masson, A.; Fazakerley, A.; Lucek, E.

Recent Cluster WBD observations in the Earth's auroral acceleration region have detected trapped Z mode auroral kilometric radiation while the spacecraft were entering a deep density cavity. The Z mode has a clear cutoff at the local upper hybrid resonance frequency, while RX mode radiation is detected above the RX mode cutoff frequency. The small gap between the upper hybrid resonance and the RX mode cutoff frequencies is proportional to the local electron density as expected from cold plasma theory. The width of the observed gap provides a new sensitive measure of the ambient electron density. In addition, the relative intensities of RX and Z mode radiation provide a sensitive probe of the plasma β = Ω_pe /Ω_ce at the source since the growth rates, although identical in form, have different ranges of allowed resonant radii which depend on β. In particular, the RX mode growth is favored for low β, while the Z mode is favored at higher β. The observed mode intensities and β's appear to be consistent with this model, and favor generation of Z mode at the source over models in which Z mode is generated by mode-conversion at cavity boundaries. These are the first multi-point direct measurements of mode-specific AKR propagation in the auroral acceleration region of any planet.

First-in-human experience using the Volcano VIBE-RX vascular imaging balloon catheter system (Volcano IVUS-guided Balloon Evaluation - New Zealand: VIBE-NZ Study).

PubMed

Watson, Timothy; El-Jack, Seifeddin; Stewart, James T; Ormiston, John

2013-09-01

Intravascular ultrasound (IVUS) is a proven and safe imaging modality used to guide percutaneous coronary intervention (PCI). The Volcano VIBE™ RX Vascular Imaging Balloon Catheter is a novel rapid exchange, 0.014" wire-compatible multi-lumen conventional balloon catheter modified with the addition of an IVUS transducer proximal to the balloon, delivered via a standard 6 Fr sheath. We sought to evaluate the safety, balloon performance, and image quality of the VIBE™ RX in patients scheduled for coronary intervention. Patients aged >21 and <85 years with single or multivessel coronary disease scheduled for PCI due to coronary ischaemic symptoms were included. Those with angiographic features that precluded the safe or informative use of the device were excluded. Twenty-nine patients having angiography because of ischaemic symptoms underwent 44 VIBE RX imaging runs, with balloon dilation in 20. Successful device deployment was achieved in all but one patient. All images were adequate and reproducible. One patient had a non-ST-elevation MI felt to be due to the complexity of the procedure rather than directly related to the VIBE™ RX. The study demonstrated the safety and effectiveness of the VIBE™ RX for its intended purpose with minimal failure rate and no directly related complications.

Critical Involvement of Extracellular ATP Acting on P2RX7 Purinergic Receptors in Photoreceptor Cell Death

PubMed Central

Notomi, Shoji; Hisatomi, Toshio; Kanemaru, Takaaki; Takeda, Atsunobu; Ikeda, Yasuhiro; Enaida, Hiroshi; Kroemer, Guido; Ishibashi, Tatsuro

2011-01-01

Stressed cells release ATP, which participates in neurodegenerative processes through the specific ligation of P2RX7 purinergic receptors. Here, we demonstrate that extracellular ATP and the more specific P2RX7 agonist, 2′- and 3′-O-(4-benzoylbenzoyl)-ATP, both induce photoreceptor cell death when added to primary retinal cell cultures or when injected into the eyes from wild-type mice, but not into the eyes from P2RX7−/− mice. Photoreceptor cell death was accompanied by the activation of caspase-8 and -9, translocation of apoptosis-inducing factor from mitochondria to nuclei, and TUNEL-detectable chromatin fragmentation. All hallmarks of photoreceptor apoptosis were prevented by premedication or co-application of Brilliant Blue G, a selective P2RX7 antagonist that is already approved for the staining of internal limiting membranes during ocular surgery. ATP release is up-regulated by nutrient starvation in primary retinal cell cultures and seems to be an initializing event that triggers primary and/or secondary cell death via the positive feedback loop on P2RX7. Our results encourage the potential application of Brilliant Blue G as a novel neuroprotective agent in retinal diseases or similar neurodegenerative pathologies linked to excessive extracellular ATP. PMID:21983632

Beta Testing a Novel Smartphone Application to Improve Medication Adherence.

PubMed

Sarzynski, Erin; Decker, Brian; Thul, Aaron; Weismantel, David; Melaragni, Ronald; Cholakis, Elizabeth; Tewari, Megha; Beckholt, Kristy; Zaroukian, Michael; Kennedy, Angie C; Given, Charles

2017-04-01

We developed and beta-tested a patient-centered medication management application, PresRx optical character recognition (OCR), a mobile health (m-health) tool that auto-populates drug name and dosing instructions directly from patients' medication labels by OCR. We employed a single-subject design study to evaluate PresRx OCR for three outcomes: (1) accuracy of auto-populated medication dosing instructions, (2) acceptability of the user interface, and (3) patients' adherence to chronic medications. Eight patients beta-tested PresRx OCR. Five patients used the software for ≥6 months, and four completed exit interviews (n = 4 completers). At baseline, patients used 3.4 chronic prescription medications and exhibited moderate-to-high adherence rates. Accuracy of auto-populated information by OCR was 95% for drug name, 98% for dose, and 96% for frequency. Study completers rated PresRx OCR 74 on the System Usability Scale, where scores ≥70 indicate an acceptable user interface (scale 0-100). Adherence rates measured by PresRx OCR were high during the first month of app use (93%), but waned midway through the 6-month testing period (78%). Compared with pharmacy fill rates, PresRx OCR underestimated adherence among completers by 3%, while it overestimated adherence among noncompleters by 8%. Results suggest smartphone applications supporting medication management are feasible and accurately assess adherence compared with objective measures. Future efforts to improve medication-taking behavior using m-health tools should target specific patient populations and leverage common application programming interfaces to promote generalizability. Our medication management application PresRx OCR is innovative, acceptable for patient use, and accurately tracks medication adherence.

Profiling structured product labeling with NDF-RT and RxNorm

PubMed Central

2012-01-01

Background Structured Product Labeling (SPL) is a document markup standard approved by Health Level Seven (HL7) and adopted by United States Food and Drug Administration (FDA) as a mechanism for exchanging drug product information. The SPL drug labels contain rich information about FDA approved clinical drugs. However, the lack of linkage to standard drug ontologies hinders their meaningful use. NDF-RT (National Drug File Reference Terminology) and NLM RxNorm as standard drug ontology were used to standardize and profile the product labels. Methods In this paper, we present a framework that intends to map SPL drug labels with existing drug ontologies: NDF-RT and RxNorm. We also applied existing categorical annotations from the drug ontologies to classify SPL drug labels into corresponding classes. We established the classification and relevant linkage for SPL drug labels using the following three approaches. First, we retrieved NDF-RT categorical information from the External Pharmacologic Class (EPC) indexing SPLs. Second, we used the RxNorm and NDF-RT mappings to classify and link SPLs with NDF-RT categories. Third, we profiled SPLs using RxNorm term type information. In the implementation process, we employed a Semantic Web technology framework, in which we stored the data sets from NDF-RT and SPLs into a RDF triple store, and executed SPARQL queries to retrieve data from customized SPARQL endpoints. Meanwhile, we imported RxNorm data into MySQL relational database. Results In total, 96.0% SPL drug labels were mapped with NDF-RT categories whereas 97.0% SPL drug labels are linked to RxNorm codes. We found that the majority of SPL drug labels are mapped to chemical ingredient concepts in both drug ontologies whereas a relatively small portion of SPL drug labels are mapped to clinical drug concepts. Conclusions The profiling outcomes produced by this study would provide useful insights on meaningful use of FDA SPL drug labels in clinical applications through standard drug ontologies such as NDF-RT and RxNorm. PMID:23256517

Profiling structured product labeling with NDF-RT and RxNorm.

PubMed

Zhu, Qian; Jiang, Guoqian; Chute, Christopher G

2012-12-20

Structured Product Labeling (SPL) is a document markup standard approved by Health Level Seven (HL7) and adopted by United States Food and Drug Administration (FDA) as a mechanism for exchanging drug product information. The SPL drug labels contain rich information about FDA approved clinical drugs. However, the lack of linkage to standard drug ontologies hinders their meaningful use. NDF-RT (National Drug File Reference Terminology) and NLM RxNorm as standard drug ontology were used to standardize and profile the product labels. In this paper, we present a framework that intends to map SPL drug labels with existing drug ontologies: NDF-RT and RxNorm. We also applied existing categorical annotations from the drug ontologies to classify SPL drug labels into corresponding classes. We established the classification and relevant linkage for SPL drug labels using the following three approaches. First, we retrieved NDF-RT categorical information from the External Pharmacologic Class (EPC) indexing SPLs. Second, we used the RxNorm and NDF-RT mappings to classify and link SPLs with NDF-RT categories. Third, we profiled SPLs using RxNorm term type information. In the implementation process, we employed a Semantic Web technology framework, in which we stored the data sets from NDF-RT and SPLs into a RDF triple store, and executed SPARQL queries to retrieve data from customized SPARQL endpoints. Meanwhile, we imported RxNorm data into MySQL relational database. In total, 96.0% SPL drug labels were mapped with NDF-RT categories whereas 97.0% SPL drug labels are linked to RxNorm codes. We found that the majority of SPL drug labels are mapped to chemical ingredient concepts in both drug ontologies whereas a relatively small portion of SPL drug labels are mapped to clinical drug concepts. The profiling outcomes produced by this study would provide useful insights on meaningful use of FDA SPL drug labels in clinical applications through standard drug ontologies such as NDF-RT and RxNorm.

Tx/Rx Head Coil Induces Less RF Transmit-Related Heating than Body Coil in Conductive Metallic Objects Outside the Active Area of the Head Coil

PubMed Central

Nagy, Zoltan; Oliver-Taylor, Aaron; Kuehne, Andre; Goluch, Sigrun; Weiskopf, Nikolaus

2017-01-01

The transmit–receive (Tx/Rx) birdcage head coil is often used for excitation instead of the body coil because of the presumably lower risk of heating in and around conductive implants. However, this common practice has not been systematically tested. To investigate whether the Tx/Rx birdcage head coil produces less heating than the body coil when scanning individuals with implants, we used a 3T clinical scanner and made temperature measurements around a straight 15 cm conductor using either the Tx/Rx body or the head coil for excitation. Additionally, the transmitted fields of a Tx/Rx head coil were measured both in air and in gel using a resonant and a non-resonant B field probes as well as a non-resonant E field probe. Simulations using a finite-difference time domain solver were compared with the experimental findings. When the body coil was used for excitation, we observed heating around the 15 cm wire at various anatomical locations (both within and outside of the active volume of the head coil). Outside its active area, no such heating was observed while using the Tx/Rx head coil for excitation. The E and B fields of the Tx/Rx birdcage head coil extended well-beyond the physical dimensions of the coil. In air, the fields were monotonically decreasing, while in gel they were more complex with local maxima at the end of the ASTM phantom. These experimental findings were line with the simulations. While caution must always be exercised when scanning individuals with metallic implants, these findings support the use of the Tx/Rx birdcage head coil in place of the body coil at 3T in order to reduce the risk of heating in and around conductive implants that are remote from the head coil. PMID:28184184

RX-P873, a Novel Protein Synthesis Inhibitor, Accumulates in Human THP-1 Monocytes and Is Active against Intracellular Infections by Gram-Positive (Staphylococcus aureus) and Gram-Negative (Pseudomonas aeruginosa) Bacteria

PubMed Central

Buyck, Julien M.; Peyrusson, Frédéric

2015-01-01

The pyrrolocytosine RX-P873, a new broad-spectrum antibiotic in preclinical development, inhibits protein synthesis at the translation step. The aims of this work were to study RX-P873's ability to accumulate in eukaryotic cells, together with its activity against extracellular and intracellular forms of infection by Staphylococcus aureus and Pseudomonas aeruginosa, using a pharmacodynamic approach allowing the determination of maximal relative efficacies (Emax values) and bacteriostatic concentrations (Cs values) on the basis of Hill equations of the concentration-response curves. RX-P873's apparent concentration in human THP-1 monocytes was about 6-fold higher than the extracellular one. In broth, MICs ranged from 0.125 to 0.5 mg/liter (S. aureus) and 2 to 8 mg/liter (P. aeruginosa), with no significant shift in these values against strains resistant to currently used antibiotics being noted. In concentration-dependent experiments, the pharmacodynamic profile of RX-P873 was not influenced by the resistance phenotype of the strains. Emax values (expressed as the decrease in the number of CFU from that in the initial inoculum) against S. aureus and P. aeruginosa reached more than 4 log units and 5 log units in broth, respectively, and 0.7 log unit and 2.7 log units in infected THP-1 cells, respectively, after 24 h. Cs values remained close to the MIC in all cases, making RX-P873 more potent than antibiotics to which the strains were resistant (moxifloxacin, vancomycin, and daptomycin for S. aureus; ciprofloxacin and ceftazidime for P. aeruginosa). Kill curves in broth showed that RX-P873 was more rapidly bactericidal against P. aeruginosa than against S. aureus. Taken together, these data suggest that RX-P873 may constitute a useful alternative for infections involving intracellular bacteria, especially Gram-negative species. PMID:26014952

P2X7 Receptors Drive Spine Synapse Plasticity in the Learned Helplessness Model of Depression.

PubMed

Otrokocsi, Lilla; Kittel, Ágnes; Sperlágh, Beáta

2017-10-01

Major depressive disorder is characterized by structural and functional abnormalities of cortical and limbic brain areas, including a decrease in spine synapse number in the dentate gyrus of the hippocampus. Recent studies highlighted that both genetic and pharmacological invalidation of the purinergic P2X7 receptor (P2rx7) leads to antidepressant-like phenotype in animal experiments; however, the impact of P2rx7 on depression-related structural changes in the hippocampus is not clarified yet. Effects of genetic deletion of P2rx7s on depressive-like behavior and spine synapse density in the dentate gyrus were investigated using the learned helplessness mouse model of depression. We demonstrate that in wild-type animals, inescapable footshocks lead to learned helplessness behavior reflected in increased latency and number of escape failures to subsequent escapable footshocks. This behavior is accompanied with downregulation of mRNA encoding P2rx7 and decrease of spine synapse density in the dentate gyrus as determined by electron microscopic stereology. In addition, a decrease in synaptopodin but not in PSD95 and NR2B/GluN2B protein level was also observed under these conditions. Whereas the absence of P2rx7 was characterized by escape deficit, no learned helpless behavior is observed in these animals. Likewise, no decrease in spine synapse number and synaptopodin protein levels was detected in response to inescapable footshocks in P2rx7-deficient animals. Our findings suggest the endogenous activation of P2rx7s in the learned helplessness model of depression and decreased plasticity of spine synapses in P2rx7-deficient mice might explain the resistance of these animals to repeated stressful stimuli. © The Author 2017. Published by Oxford University Press on behalf of CINP.

Five-year Experience With Arterial Switch Operation in the First Hours of Life.

PubMed

Chasovskyi, Kyrylo; Mykychak, Yaroslav; Rudenko, Nadiia; Vorobyova, Hanna; Yemets, Illya

2017-01-01

We assessed morbidity after 2 management strategies for arterial switch operation (ASO) in a single institution: first hours of life surgery and conventional approach. From September 2009 to September 2014, 346 consecutive patients who underwent ASO were enrolled. The study group included 92 patients who underwent ASO in the first 24 hours after birth (group I). The control group consisted of 254 patients who underwent ASO after 24 hours of life in the conventional way (group II). Three outcomes were analyzed: postoperative ventilation time (VT), post-extubation hospital length of stay (peLOS), and a composite morbidity index, defined as postoperative VT + peLOS + occurrence of selected major complications. Overall 30-day survival was 98% (2 [2%] group I vs 5 [2%] group II, P = 1.000). Fifty (13.3%) major complications were observed: 14 (15%) in group I and 36 (15%) in group II (P = 0.635). Although peLOS and morbidity index did not differ significantly between groups, postoperative VT (42 hours [24, 67] vs 27 hours [22, 47], P = 0.008) and total hospital stay were significantly longer in group II (18 days [10, 19] vs 14 days [12, 18]). A median volume of 80 mL (60-100 mL) of autologous umbilical cord blood was collected (80 mL, group 1 vs 60 mL, group II; P = 0.090). Homologous blood cell transfusion was avoided in 70 patients (78%) in group I and in 13 patients (6%) in group II (P < 0.001). Arterial switch operation during the initial 24 hours of life has similar outcomes in view of morbidity and mortality to the conventional approach. Copyright © 2017 Elsevier Inc. All rights reserved.

A Wirelessly-Powered Homecage With Segmented Copper Foils and Closed-Loop Power Control.

PubMed

Mirbozorgi, S Abdollah; Jia, Yaoyao; Canales, Daniel; Ghovanloo, Maysam

2016-10-01

A new wireless electrophysiology data acquisition system, built around a standard homecage, is presented in this paper, which can power up and communicate with sensors and actuators/stimulators attached to or implanted in small freely behaving animal subjects, such as rodents. Key abilities of the energized homecage (EnerCage) system is enabling longitudinal experiments with minimal operator involvement or interruption, while providing test subjects with an enriched environment closer to their natural habitat, without the burden of being tethered or carrying bulky batteries. The magnetic resonant multi-coil design used in the new EnerCage-HC2 automatically localizes the transmitted electromagnetic power from a single transmitter (Tx) coil at the bottom of the cage toward the receiver coil (Rx), carried on/in the animal body, obviating the need for tracking the animal or switching the coils. In order to increase the resonators' quality factor (Q > 166) at the desired operating frequency of 13.56 MHz, while maintaining a high self-resonance frequency [Formula: see text], they are made of wide copper foils and optimally segmented based on a set of design rules that can be adopted for experimental arenas with different shapes and dimensions. The Rx rectified voltage is regulated at a user-defined window [Formula: see text] by a Tx-Rx closed-loop power control (CLPC) mechanism that creates a volume inside the homecage with 42 mW of power delivered to the load (PDL), and a homogeneous power transfer efficiency (PTE) plane of 14% on average at ∼7 cm height, plus stability against angular mis-alignments of up to 80°.

Reliability and Validity of a Smartphone-Paired Pulse Oximeter for Screening of Critical Congenital Heart Defects in Newborns.

PubMed

Huizing, Maurice J; Villamor-Martínez, Eduardo; Chavagne, Ingrid A; Vanagt, Ward Y; Spaanderman, Marc A E; Villamor, Eduardo

2017-01-01

Barriers to widespread implementation of pulse oximetry screening of critical congenital heart defects (CCHD) in newborns include increasing trends of out-of-hospital births and cost of equipment. In recent years, smartphone-compatible pulse oximeters have appeared on the market, but the validity of such devices in the setting of CCHD screening has not been evaluated. To compare the performance in CCHD screening of a smartphone-paired pulse oximeter (Masimo iSpO2-Rx™) and a hospital-grade pulse oximeter (Masimo Radical-7™). Preductal (right hand) and postductal (either foot) saturations were determined in a population of 201 term newborns by 2 independent teams, one using the Radical-7 and the other using the iSpO2-Rx. Bland-Altman analysis was applied to calculate mean bias and 95% limits of agreement between the 2 pulse oximeters. For the preductal oxygen saturation, the mean bias (Radical-7 minus iSpO2-Rx) was -0.08 (SD 1.76) and the lower and upper limits of agreement were -3.52 and 3.36, respectively. For the postductal oxygen saturation, the mean bias was -0.11 (SD 1.68) and the lower and upper limits of agreement were -3.49 and 3.18, respectively. In addition, the iSpO2-Rx provided reliable measurements of saturations below 95% in a group of 12 infants admitted to the neonatal intensive care unit. Our data suggest that CCHD screening with the Masimo iSpO2-Rx is feasible and accurate. The use of reliable smartphone-paired pulse oximeters may contribute to the extension of CCHD screening to home births and low resource settings. © 2017 S. Karger AG, Basel.

Smart Mirrors for Photorefractive Control of Light with Tim Bunning, RX - Agile Filters Application

DTIC Science & Technology

2016-11-08

AFRL-AFOSR-UK-TR-2017-0008 Smart Mirrors for photorefractive control of light with Tim Bunning, RX-- Agile filters application Luciano De Sio...photorefractive control of light with Tim Bunning, RX-- Agile filters application 5a.  CONTRACT NUMBER 5b.  GRANT NUMBER FA9550-14-1-0050 5c.  PROGRAM...photorefractive, switchable optical filters , liquide crystalline composite materials, Switchable reflective holographic gratings, polymer-dispersed liquid

Custom modular electromagnetic induction system for shallow electrical conductivity measurements

NASA Astrophysics Data System (ADS)

Mester, Achim; Zimmermann, Egon; Tan, Xihe; von Hebel, Christian; van der Kruk, Jan; van Waasen, Stefan

2017-04-01

Electromagnetic induction (EMI) is a contactless measurement method that offers fast and easy investigations of the shallow electrical conductivity, e.g. on the field-scale. Available frequency domain EMI systems offer multiple fixed transmitter-receiver (Tx-Rx) pairs with Tx-Rx separations between 0.3 and 4.0 m and investigation depths of up to six meters. Here, we present our custom EMI system that consists of modular sensor units that can either be transmitters or receivers, and a backpack containing the data acquisition system. The prototype system is optimized for frequencies between 5 and 30 kHz and Tx-Rx separations between 0.4 and 2.0 m. Each Tx and Rx signal is digitized separately and stored on a notebook computer. The soil conductivity information is determined after the measurements with advanced digital processing of the data using optimized correction and calibration procedures. The system stores the raw data throughout the entire procedure, which offers many advantages: (1) comprehensive accuracy and error analysis as well as the reproducibility of corrections and calibration procedures; (2) easy customizability of the number of Tx-/Rx-units and their arrangement and frequencies; (3) signals from simultaneously working transmitters can be separated within the received data using orthogonal signals, resulting in additional Tx-Rx pairs and maximized soil information; and (4) later improvements in the post-processing algorithms can be applied to old data sets. Exemplary, here we present an innovative setup with two transmitters and five receivers using orthogonal signals yielding ten Tx-Rx pairs. Note that orthogonal signals enable for redundant Tx-Rx pairs that are useful for verification of the transmitter signals and for data stacking. In contrast to commercial systems, only adjustments in the post-processing were necessary to realize such measurement configurations with flexibly combined Tx and Rx modules. The presented system reaches an accuracy of up to 1 mS/m and was also evaluated by surface measurements with the sensor modules mounted to a sled and moved along a bare soil field transect. Measured data were calibrated for quantitative apparent electrical conductivity using reference data at certain calibration locations. Afterwards, data were inverted for electrical conductivity over depth using a multi-layer inversion showing similar conductivity distributions as the reference data.

Hearing loss caused by a P2RX2 mutation identified in a MELAS family with a coexisting mitochondrial 3243AG mutation

PubMed Central

Moteki, Hideaki; Azaiez, Hela; Booth, Kevin T; Hattori, Mitsuru; Sato, Ai; Sato, Yoshihiko; Motobayashi, Mitsuo; Sloan, Christina M; Kolbe, Diana L; Shearer, A Eliot; Smith, Richard J H; Usami, Shin-ichi

2015-01-01

Objective We present a family with a mitochondrial DNA 3243A>G mutation resulting in MELAS, of which some members have hearing loss where a novel mutation in the P2RX2 gene was identified. Methods One hundred ninety-four (194) Japanese subjects from unrelated families were enrolled in the study. Targeted genomic enrichment and massively parallel sequencing of all known non-syndromic hearing loss genes were performed to identify the genetic causes of hearing loss. Results A novel mutation in the P2RX2 gene, that corresponded to c.601G>A (p.Asp201Tyr) was identified. Two patients carried the mutation, and had severe SNHL, while other members with MELAS (who did not carry the P2RX2 mutation) had normal hearing. Conclusion This is the first case report of a diagnosis of hearing loss caused by P2RX2 mutation in patients with MELAS. A potential explanation is that decreasing ATP production due to MELAS with mitochondrial 3243A>G mutation might suppress activation of P2X2 receptors. We also suggest that hearing loss caused by the P2RX2 mutation might be influenced by the decrease in ATP production due to MELAS, and that nuclear genetic factors may play a modifying role in mitochondrial dysfunction. PMID:25788561

Explicit dosimetry for 2-(1-hexyloxyethyl)-2-devinyl pyropheophorbide-a-mediated photodynamic therapy: macroscopic singlet oxygen modeling.

PubMed

Penjweini, Rozhin; Liu, Baochang; Kim, Michele M; Zhu, Timothy C

2015-01-01

Type II photodynamic therapy (PDT) is based on the photochemical reactions mediated through an interaction between a photosensitizer, ground-state oxygen ([(3)O2]), and light excitation at an appropriate wavelength, which results in production of reactive singlet oxygen ([(1)O2]rx). We use an empirical macroscopic model based on four photochemical parameters for the calculation of [(1)O2]rx threshold concentration ([(1)O2]rx,sh) causing tissue necrosis in tumors after PDT. For this reason, 2-(1-hexyloxyethyl)-2-devinyl pyropheophorbide-a (HPPH)-mediated PDT was performed interstitially on mice with radiation-induced fibrosarcoma (RIF) tumors. A linear light source at 665 nm with total energy released per unit length of 12 to 100  J/cm and source power per unit length (LS) of 12 to 150  mW/cm was used to induce different radii of necrosis. Then the amount of [(1)O2]rx calculated by the macroscopic model incorporating explicit PDT dosimetry of light fluence distribution, tissue optical properties, and HPPH concentration was correlated to the necrotic radius to obtain the model parameters and [(1)O2]rx,sh. We provide evidence that [(1)O2]rx is a better dosimetric quantity for predicting the treatment outcome than PDT dose, which is proportional to the time integral of the products of the photosensitizer concentration and light fluence rate.

Explicit dosimetry for 2-(1-hexyloxyethyl)-2-devinyl pyropheophorbide-a-mediated photodynamic therapy: macroscopic singlet oxygen modeling

PubMed Central

Penjweini, Rozhin; Liu, Baochang; Kim, Michele M.; Zhu, Timothy C.

2015-01-01

Abstract. Type II photodynamic therapy (PDT) is based on the photochemical reactions mediated through an interaction between a photosensitizer, ground-state oxygen ([O32]), and light excitation at an appropriate wavelength, which results in production of reactive singlet oxygen ([O12]rx). We use an empirical macroscopic model based on four photochemical parameters for the calculation of [O12]rx threshold concentration ([O12]rx,sh) causing tissue necrosis in tumors after PDT. For this reason, 2-(1-hexyloxyethyl)-2-devinyl pyropheophorbide-a (HPPH)-mediated PDT was performed interstitially on mice with radiation-induced fibrosarcoma (RIF) tumors. A linear light source at 665 nm with total energy released per unit length of 12 to 100  J/cm and source power per unit length (LS) of 12 to 150  mW/cm was used to induce different radii of necrosis. Then the amount of [O12]rx calculated by the macroscopic model incorporating explicit PDT dosimetry of light fluence distribution, tissue optical properties, and HPPH concentration was correlated to the necrotic radius to obtain the model parameters and [O12]rx,sh. We provide evidence that [O12]rx is a better dosimetric quantity for predicting the treatment outcome than PDT dose, which is proportional to the time integral of the products of the photosensitizer concentration and light fluence rate. PMID:26720883

Explicit dosimetry for 2-(1-hexyloxyethyl)-2-devinyl pyropheophorbide-a-mediated photodynamic therapy: macroscopic singlet oxygen modeling

NASA Astrophysics Data System (ADS)

Penjweini, Rozhin; Liu, Baochang; Kim, Michele M.; Zhu, Timothy C.

2015-12-01

Type II photodynamic therapy (PDT) is based on the photochemical reactions mediated through an interaction between a photosensitizer, ground-state oxygen ([O]), and light excitation at an appropriate wavelength, which results in production of reactive singlet oxygen ([]rx). We use an empirical macroscopic model based on four photochemical parameters for the calculation of []rx threshold concentration ([]rx,sh) causing tissue necrosis in tumors after PDT. For this reason, 2-(1-hexyloxyethyl)-2-devinyl pyropheophorbide-a (HPPH)-mediated PDT was performed interstitially on mice with radiation-induced fibrosarcoma (RIF) tumors. A linear light source at 665 nm with total energy released per unit length of 12 to 100 J/cm and source power per unit length (LS) of 12 to 150 mW/cm was used to induce different radii of necrosis. Then the amount of []rx calculated by the macroscopic model incorporating explicit PDT dosimetry of light fluence distribution, tissue optical properties, and HPPH concentration was correlated to the necrotic radius to obtain the model parameters and []rx,sh. We provide evidence that []rx is a better dosimetric quantity for predicting the treatment outcome than PDT dose, which is proportional to the time integral of the products of the photosensitizer concentration and light fluence rate.

Cardiovascular disease and omega-3s: Prescription products and fish oil dietary supplements are not the same.

PubMed

Gutstein, Adina S; Copple, Tina

2017-12-01

Despite achievement of optimal low-density lipoprotein cholesterol (LDL-C) control with statin therapy, patients with elevated triglycerides (TGs) and residual cardiovascular risk are commonly encountered in clinical practice. We present information from completed and ongoing clinical trials examining Rx omega-3s for TG-lowering and omega-3 dietary supplements to highlight important differences affecting patient management for nurse practitioners. Rx omega-3s demonstrate robust reductions in TGs and may have a role in reducing residual cardiovascular risk. Products containing docosahexaenoic acid (DHA) may raise LDL-C and should not be substituted for Rx eicosapentaenoic acid (EPA)-only icosapent ethyl, which does not raise LDL-C. Omega-3 dietary supplements (e.g., fish oils containing EPA and DHA) may be used for general health promotion; however, they are not regulated as medications and concerns regarding quality, purity, safety, and variability of content exist. It is important to advise patients that omega-3 dietary supplements are not medications and should not be substituted for Rx omega-3s. Large-scale cardiovascular outcomes studies are underway for Rx omega-3s in statin-treated patients. Nurse practitioners can take an active role in reducing residual cardiovascular risk and educating patients about important differences between Rx omega-3s and fish oil supplements. ©2017 American Association of Nurse Practitioners.

Development of a chemotherapy regimen interaction database for the mobile internet: detecting interactions with psychotropics through OncoRx-MI.

PubMed

Yap, Kevin Yi-Lwern; Chui, Wai Keung; Chan, Alexandre

2011-09-01

Cancer patients are at high risks of drug-drug interactions (DDIs). Clinicians need to know the magnitude of DDIs so as to better manage their patients' drug therapies. We have previously created a novel interaction database for oncology prescriptions (OncoRx). In this project, we leverage on 3G networks to further develop this database into an iPhone-specific application for the mobile internet (OncoRx-MI). Data on anticancer drugs (ACDs), chemotherapy regimens (CRegs) and DDIs with psychotropics were compiled from various hardcopy and online resources, and published articles from PubMed, Scopus and Science Direct. The database and iPhone web documents were designed using Adobe Dreamweaver CS4 and associated with a combination of open-source programming scripts. OncoRx-MI currently detects over 5000 DDIs (69.3% pharmacokinetic, 30.7% pharmacodynamic) between 256 single-agent and combination CRegs with 51 psychotropic drugs. OncoRx-MI fits the iPhone screen configuration, and displays information regarding the regimen, pharmacokinetics of the drugs and detected DDIs in tabular format for improved usability. OncoRx-MI is the first mobile DDI application of its kind which detects interactions for combination CRegs. Future versions will include DDIs with other drug categories. Usability studies on its impact in clinical practice will also be carried out.

Resistance Exercise for Knee Osteoarthritis

PubMed Central

Vincent, Kevin R.; Vincent, Heather K.

2013-01-01

The initiation, progression, and severity of knee osteoarthritis (OA) has been associated with decreased muscular strength and alterations in joint biomechanics. Chronic OA pain may lead to anxiety, depression, fear of movement, and poor psychological outlook. The fear of movement may prevent participation in exercise and social events which could lead to further physical and social isolation. Resistance exercise (RX) has been shown to be an effective intervention both for decreasing pain and for improving physical function and self-efficacy. RX may restore muscle strength and joint mechanics while improving physical function. RX may also normalize muscle firing patterns and joint biomechanics leading to reductions in joint pain and cartilage degradation. These physical adaptations could lead to improved self-efficacy and decreased anxiety and depression. RX can be prescribed and performed by patients across the OA severity spectrum. When designing and implementing an RX program for a patient with knee OA, it is important to consider both the degree of OA severity as well as the level of pain. RX, either in the home or at a fitness facility, is an important component of a comprehensive regimen designed to offset the physical and psychological limitations associated with knee OA. Unique considerations for this population include: 1) monitoring pain during and after exercise, 2) providing days of rest when disease flares occur, and 3) infusing variety into the exercise regimen to encourage adherence. PMID:22632702

Critical involvement of extracellular ATP acting on P2RX7 purinergic receptors in photoreceptor cell death.

PubMed

Notomi, Shoji; Hisatomi, Toshio; Kanemaru, Takaaki; Takeda, Atsunobu; Ikeda, Yasuhiro; Enaida, Hiroshi; Kroemer, Guido; Ishibashi, Tatsuro

2011-12-01

Stressed cells release ATP, which participates in neurodegenerative processes through the specific ligation of P2RX7 purinergic receptors. Here, we demonstrate that extracellular ATP and the more specific P2RX7 agonist, 2'- and 3'-O-(4-benzoylbenzoyl)-ATP, both induce photoreceptor cell death when added to primary retinal cell cultures or when injected into the eyes from wild-type mice, but not into the eyes from P2RX7(-/-) mice. Photoreceptor cell death was accompanied by the activation of caspase-8 and -9, translocation of apoptosis-inducing factor from mitochondria to nuclei, and TUNEL-detectable chromatin fragmentation. All hallmarks of photoreceptor apoptosis were prevented by premedication or co-application of Brilliant Blue G, a selective P2RX7 antagonist that is already approved for the staining of internal limiting membranes during ocular surgery. ATP release is up-regulated by nutrient starvation in primary retinal cell cultures and seems to be an initializing event that triggers primary and/or secondary cell death via the positive feedback loop on P2RX7. Our results encourage the potential application of Brilliant Blue G as a novel neuroprotective agent in retinal diseases or similar neurodegenerative pathologies linked to excessive extracellular ATP. Copyright © 2011 American Society for Investigative Pathology. Published by Elsevier Inc. All rights reserved.

Mapping Partners Master Drug Dictionary to RxNorm using an NLP-based approach.

PubMed

Zhou, Li; Plasek, Joseph M; Mahoney, Lisa M; Chang, Frank Y; DiMaggio, Dana; Rocha, Roberto A

2012-08-01

To develop an automated method based on natural language processing (NLP) to facilitate the creation and maintenance of a mapping between RxNorm and a local medication terminology for interoperability and meaningful use purposes. We mapped 5961 terms from Partners Master Drug Dictionary (MDD) and 99 of the top prescribed medications to RxNorm. The mapping was conducted at both term and concept levels using an NLP tool, called MTERMS, followed by a manual review conducted by domain experts who created a gold standard mapping. The gold standard was used to assess the overall mapping between MDD and RxNorm and evaluate the performance of MTERMS. Overall, 74.7% of MDD terms and 82.8% of the top 99 terms had an exact semantic match to RxNorm. Compared to the gold standard, MTERMS achieved a precision of 99.8% and a recall of 73.9% when mapping all MDD terms, and a precision of 100% and a recall of 72.6% when mapping the top prescribed medications. The challenges and gaps in mapping MDD to RxNorm are mainly due to unique user or application requirements for representing drug concepts and the different modeling approaches inherent in the two terminologies. An automated approach based on NLP followed by human expert review is an efficient and feasible way for conducting dynamic mapping. Copyright © 2011 Elsevier Inc. All rights reserved.

Long chain omega-3 dietary supplements: a review of the National Library of Medicine Herbal Supplement Database.

PubMed

Zargar, Atanaz; Ito, Matthew K

2011-08-01

Dietary fish oil supplements are increasingly used as an alternative to prescription-grade omega-3 fatty acids (P-OM3) for the treatment of hypertriglyceridemia. The content of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in these supplement products varies widely and may result in a suboptimal response. The aim of this study was to review marketed fish oil supplements and to develop a reference for clinicians to compare products. The National Library of Medicine Herbal Supplement Database was systematically searched using fish oil, EPA, DHA, and omega-3 fatty acid as search terms. Daily doses needed to achieve the Food and Drug Administration (FDA)-approved dose (RxDose) (3,360 mg of combined EPA and DHA) were calculated from the milligrams of EPA and DHA per serving, and suggested retail prices were used to calculate monthly cost of each product. A "usage criteria" was set to highlight products at the RxDose with a monthly cost of <$50, daily servings <8, daily amount of vitamins A and D less than or equal to the U.S. Dietary Reference Intake upper limit defined as 10,000 and 4,000 IU, respectively, and if the product was U.S. Pharmacopeia verified. A total of 163 products were identified, and 102 nonliquid and liquid products met our entry criteria. The median amount of EPA and DHA per serving in the nonliquid products was 216 mg and 200 mg, respectively, and the median number of servings at the RxDose was 11.2 at a median monthly cost of $63.49. The median amount of EPA (460 mg) and DHA (400 mg) per serving in the liquid products was higher than the nonliquid products. Thus, the median number of servings at the RxDose was only 3.6 teaspoons and the median monthly cost of $13.60. Only 22% of products met our "usage criteria." The amount of EPA and DHA per recommended serving in these products was highly variable. Clinicians should heighten their scrutiny in terms of selection of the appropriate product.

RxPATROL: a Web-based tool for combating pharmacy theft.

PubMed

Smith, Meredith Y; Graham, J Aaron; Haddox, J David; Steffey, Amy

2009-01-01

To report the incidence of pharmacy-related burglaries and robberies and characteristics of pharmacies where such crimes have occurred using recent data from Rx Pattern Analysis Tracking Robberies & Other Losses (RxPATROL), a national Web-based information clearinghouse on pharmacy-related theft of prescription medications and over-the-counter products. Descriptive, nonexperimental study. United States between 2005 and 2006. Not applicable. Not applicable. Number of pharmacy theft reports received; incident type, date, and location; point of entry; and pharmacy security features. Between 2005 and 2006, 202 pharmacy burglary and 299 pharmacy robbery reports from 45 different states were filed with RxPATROL. More than 70% of pharmacies reporting such crimes lacked a security camera. Among those reporting a burglary, 60% lacked dead bolt locks, a solid exterior door, a motion detector device, or a safe or vault for storage of controlled substances. Burglars most often obtained access to the pharmacy via the front door. RxPATROL is a Web-based tool that can assist pharmacies and law enforcement in collaborating more effectively to combat and prevent pharmacy-related crimes.

Ultra low-power transceiver with novel FSK modulation technique and efficient FSK-to-ASK demodulation.

PubMed

Zgaren, Mohamed; Moradi, Arash; Sawan, Mohamad

2015-01-01

Energy-efficient and high-data rate are desired in biomedical devices transceivers. A high-performance transmitter (Tx) and an ultra-low-power receiver (Rx) dedicated to medical implants communications operating at Industrial, Scientific and Medical (ISM) frequency band are presented. Tx benefits from a new efficient Frequency-Shift Keying (FSK) modulation technique which provides up to 20 Mb/s of data-rate and consumes only 0.084 nJ/b validated through fabrication. The receiver consists of an FSK-to-ASK conversion based receiver with OOK fully passive wake-up device (WuRx). This WuRx is battery less with energy harvesting technique which plays an important role in making the RF transceiver energy-efficient. The Rx is achieved with a reduced hardware architecture which does not use an accurate local oscillator, high-Q external inductor and I/Q signal path. The Rx shows -78 dBm sensitivity for 8 Mbps data rate while consuming 639 μW. The proposed circuits are implemented in IBM 0.13 μm CMOS technology with 1.2 V supply voltage.

Performance enhancement technique of visible light communications using passive photovoltaic cell

NASA Astrophysics Data System (ADS)

Wu, Jhao-Ting; Chow, Chi-Wai; Liu, Yang; Hsu, Chin-Wei; Yeh, Chien-Hung

2017-06-01

The light emitting diode (LED) based visible light communication (VLC) system can provide lighting and communication simultaneously. It has attracted much attenuation recently. As the photovoltaic cell (also known as solar cell) is physically flexible, low cost, and easily available, it could be a good choice for the VLC receiver (Rx). Furthermore, besides acting as the VLC Rx, the solar cell can convert VLC signal into electricity for charging up the Rx devices. Hence, it could be a promising candidate for the future internet-of-thing (IoT) networks. However, using solar cell as VLC Rx is challenging, since the response of the solar cell is highly limited and it will limit the VLC data rate. In this work, we propose and demonstrate for the first time using pre-distortion Manchester coding (MC) signal to enhance the signal performance of solar cell Rx based VLC. The proposed scheme can significantly mitigate the slow response, as well as the direct-current (DC) wandering effect of the solar cell; hence 50 times increase in data rate can be experimentally achieved.

Longitudinal spin Seebeck effect in various garnet ferrites

NASA Astrophysics Data System (ADS)

Uchida, K.; Nonaka, T.; Kikkawa, T.; Kajiwara, Y.; Saitoh, E.

2013-03-01

The longitudinal spin Seebeck effect (LSSE) is investigated in various garnet ferrites Y3-xRxFe5-yMyO12 (R=Gd, Ca; M=Al, Mn, V, In, Zr) by means of the inverse spin Hall effect in Pt films. The magnitude of the LSSE voltage in the Pt/Y3-xRxFe5-yMyO12 samples is found to be enhanced with increasing concentration of Fe in the garnet ferrites, which can be explained by a change in the spin-mixing conductance at the Pt/Y3-xRxFe5-yMyO12 interfaces. We also investigate the dependence of the LSSE voltage on macroscopic magnetic parameters of Y3-xRxFe5-yMyO12. The experimental results show that the LSSE voltage in the Pt/Y3-xRxFe5-yMyO12 samples has a positive correlation with the Curie temperature and the saturation magnetization, but no clear correlation with the gyromagnetic ratio and the Gilbert damping constant of the samples.

Evaluation of xylazine hydrochloride as the sole immobilizing agent in moose and caribou--and its subsequent reversal with idazoxan.

PubMed

Doherty, T J; Tweedie, D P

1989-01-01

Xylazine hydrochloride was used as the sole immobilizing agent in moose and caribou. The animals were free-ranging and immobilization was accomplished from a helicopter using powered darts. Following a period of immobilization during which radiotelemetry collars were fitted, the animals were revived using idazoxan (RX 781094) or its methoxy analogue RX 821002. Xylazine was administered at dose rates of approximately 3.0 mg/kg and 5.0 mg/kg to the moose and caribou, respectively. Moose received 430 +/- 27 mg of xylazine and a mean dose of 10 mg idazoxan (RX 781094). Caribou received 485 +/- 30 mg xylazine and a mean dose of 4 mg idazoxan (RX 821002). This technique gave adequate immobilization with rapid recovery of consciousness in both species.

Water vapour masers in long-period variable stars. I. RX Bootis and SV Pegasi

NASA Astrophysics Data System (ADS)

Winnberg, A.; Engels, D.; Brand, J.; Baldacci, L.; Walmsley, C. M.

2008-05-01

Context: Water vapour maser emission from late-type stars characterises them as asymptotic-giant-branch stars with oxygen-rich chemistry that are losing mass at a substantial rate. Further conclusions on the properties of the stars, however, are hampered by the strong variability of the emission. Aims: We wish to understand the reasons for the strong variability of H2O masers in circumstellar shells of late-type stars. In this paper we study RX Bootis and SV Pegasi as representatives of semiregular variable stars (SRVs). Methods: We monitored RX Boo and SV Peg in the 22-GHz maser line of water vapour with single-dish telescopes. The monitoring period covered two decades for RX Boo (1987-2007) and 12 years for SV Peg (1990-1995, 2000-2007). In addition, maps were obtained of RX Boo with the Very Large Array over several years. Results: We find that most of the emission in the circumstellar shell of RX Boo is located in an incomplete ring with an inner radius of 91 mas (15 AU). A velocity gradient is found in a NW-SE direction. The maser region can be modelled as a shell with a thickness of 22 AU, which is only partially filled. The gas crossing time is 16.5 years. The ring-like structure and the velocity gradient remained stable for at least 11 years, while the maser line profiles varied strongly. This suggests that the spatial asymmetry is not accidental, so that either the mass loss process or the maser excitation conditions in RX Boo are not spherically symmetric. The strong variability of the maser spectral features is mainly due to incoherent intensity fluctuations of maser emission spots, which have lifetimes of the order of 1 year. We found no correlation between the optical and the maser variability in either star. The variability properties of the SV Peg masers do not differ substantially from those of RX Boo. There were fewer spectral features present, and the range of variations was narrower. The maser was active on the >10-Jy level only 1990-1992 and 2006/2007. At other times the maser was either absent (<1 Jy) or barely detectable. Conclusions: The variability of H2O masers in the SRVs RX Boo and SV Peg is due to the emergence and disappearance of maser clouds with lifetimes of ~1 year. The emission regions do not evenly fill the shell of RX Boo leading to asymmetry in the spatial distribution, which persists at least an order of magnitude longer. Appendix A is only available in electronic form at http://www.aanda.org

TRX-4 (TolerRx Inc).

PubMed

Brown, William M

2006-04-01

TolerRx Inc, under license from BTG plc, is developing TRX-4, an anti-CD3 humanized monoclonal antibody for the potential treatment of type 1 diabetes and psoriasis. Phase II trials of the therapeutic antibody in type 1 diabetes have been completed and the company is planning a pivotal phase III trial for this indication. TolerRx is also enrolling psoriasis patients in a phase Ib clinical study of TRX-4. TRX-4 has been awarded Orphan Drug status for recent-onset type 1 diabetes.

Telemetry Standards, Part 1

DTIC Science & Technology

2015-07-01

IMAGE FRAME RATE (R-x\\ IFR -n) PRE-TRIGGER FRAMES (R-x\\PTG-n) TOTAL FRAMES (R-x\\TOTF-n) EXPOSURE TIME (R-x\\EXP-n) SENSOR ROTATION (R-x...0” (Single frame). “1” (Multi-frame). “2” (Continuous). Allowed when: When R\\CDT is “IMGIN” IMAGE FRAME RATE R-x\\ IFR -n R/R Ch 10 Status: RO...the settings that the user wishes to modify. Return Value The impact : A partial IHAL <configuration> element containing only the new settings for

A remote fuzzy multicriteria diagnosis of sore throat.

PubMed

Dalalah, Doraid; Magableh, Sami

2008-09-01

A sore throat (also known as pharyngitis or tonsillitis) is most commonly caused by a contagious viral infection (such as the flu, cold, or mononucleosis), although more serious throat infections can be caused by a bacterial infection (such as strep, mycoplasma, or Haemophilus). Bacterial sore throats respond well to antibiotics, whereas viral ones do not. However, strep throat remains a leading cause for physician visits, and researchers have long struggled to determine how best to treat it. The current practice guidelines offer different management options for adult patients presenting with a sore throat. Thus, when a physician treats a patient with acute pharyngitis, the clinical decision that usually needs to be made is whether the pharyngitis is attributable to group A streptococci. The key concern is the degree to which the clinical possibility of a group A streptococcal infection should affect clinician's decisions. To determine the best treatment of pharyngitis, we conducted a multicriteria decision analysis using fuzzy reasoning for remote health service delivery between a healthcare provider and patients. The approach can be adopted for interactive phone use or online system application. Five alternative treatment options were considered, particularly: (a) no test no Rx, (b) rapid strep, (c) culture, (d) rapid strep and culture, and (e) empiric Rx. Fuzzy reasoning is used to examine the signs/symptoms and their ratings. The study includes seven criteria factors that can be rated according to each alternative clinical treatment using linguistic statements. The model shows that no test no Rx is the best option for the cases of low prevalence of group A streptococcal infection. Two strategies--culture and treat if positive and rapid strep with culture of negative results--are equally preferable for patients with moderate prevalence likelihood. Rapid strep and culture of negative results is the best management strategy for patients with high population prevalence of group A streptococcal infection. In conclusion, the best clinical management of patients with sore throat depends on both the clinical probability of group A streptococcal infection and clinical judgments that incorporate the importance ratings of the individual patients as well as practice circumstances.

Explanted Diseased Livers – A Possible Source of Metabolic Competent Primary Human Hepatocytes

PubMed Central

Krech, Till; DeTemple, Daphne; Jäger, Mark D.; Lehner, Frank; Manns, Michael P.; Klempnauer, Jürgen; Borlak, Jürgen; Bektas, Hueseyin; Vondran, Florian W. R.

2014-01-01

Being an integral part of basic, translational and clinical research, the demand for primary human hepatocytes (PHH) is continuously growing while the availability of tissue resection material for the isolation of metabolically competent PHH remains limited. To overcome current shortcomings, this study evaluated the use of explanted diseased organs from liver transplantation patients as a potential source of PHH. Therefore, PHH were isolated from resected surgical specimens (Rx-group; n = 60) and explanted diseased livers obtained from graft recipients with low labMELD-score (Ex-group; n = 5). Using established protocols PHH were subsequently cultured for a period of 7 days. The viability and metabolic competence of cultured PHH was assessed by the following parameters: morphology and cell count (CyQuant assay), albumin synthesis, urea production, AST-leakage, and phase I and II metabolism. Both groups were compared in terms of cell yield and metabolic function, and results were correlated with clinical parameters of tissue donors. Notably, cellular yields and viabilities were comparable between the Rx- and Ex-group and were 5.3±0.5 and 2.9±0.7×106 cells/g liver tissue with 84.3±1.3 and 76.0±8.6% viability, respectively. Moreover, PHH isolated from the Rx- or Ex-group did not differ in regards to loss of cell number in culture, albumin synthesis, urea production, AST-leakage, and phase I and II metabolism (measured by the 7-ethoxycoumarin-O-deethylase and uracil-5′-diphosphate-glucuronyltransferase activity). Likewise, basal transcript expressions of the CYP monooxygenases 1A1, 2C8 and 3A4 were comparable as was their induction when treated with a cocktail that consisted of 3-methylcholantren, rifampicin and phenobarbital, with increased expression of CYP 1A1 and 3A4 mRNA while transcript expression of CYP 2C8 was only marginally changed. In conclusion, the use of explanted diseased livers obtained from recipients with low labMELD-score might represent a valuable source of metabolically competent PHH which are comparable in viability and function to cells obtained from specimens following partial liver resection. PMID:24999631

Cancer morbidity in British military veterans included in chemical warfare agent experiments at Porton Down: cohort study

PubMed Central

Linsell, L; Brooks, C; Keegan, T J; Langdon, T; Doyle, P; Maconochie, N E S; Fletcher, T; Nieuwenhuijsen, M J; Beral, V

2009-01-01

Objective To determine cancer morbidity in members of the armed forces who took part in tests of chemical warfare agents from 1941 to 1989. Design Historical cohort study, with cohort members followed up to December 2004. Data source Archive of UK government research facility at Porton Down, UK military personnel records, and national death and cancer records. Participants All veterans included in the cohort study of mortality, excluding those known to have died or been lost to follow-up before 1 January 1971 when the UK cancer registration system commenced: 17 013 male members of the UK armed forces who took part in tests (Porton Down veterans) and a similar group of 16 520 men who did not (non-Porton Down veterans). Main outcome measures Cancer morbidity in each group of veterans; rate ratios, with 95% confidence intervals, adjusted for age group and calendar period. Results 3457 cancers were reported in the Porton Down veterans compared with 3380 cancers in the non-Porton Down veterans. While overall cancer morbidity was the same in both groups (rate ratio 1.00, 95% confidence interval 0.95 to 1.05), Porton Down veterans had higher rates of ill defined malignant neoplasms (1.12, 1.02 to 1.22), in situ neoplasms (1.45, 1.06 to 2.00), and those of uncertain or unknown behaviour (1.32, 1.01 to 1.73). Conclusion Overall cancer morbidity in Porton Down veterans was no different from that in non-Porton Down veterans. PMID:19318700

Geometrical Design of a Scalable Overlapping Planar Spiral Coil Array to Generate a Homogeneous Magnetic Field.

PubMed

Jow, Uei-Ming; Ghovanloo, Maysam

2012-12-21

We present a design methodology for an overlapping hexagonal planar spiral coil (hex-PSC) array, optimized for creation of a homogenous magnetic field for wireless power transmission to randomly moving objects. The modular hex-PSC array has been implemented in the form of three parallel conductive layers, for which an iterative optimization procedure defines the PSC geometries. Since the overlapping hex-PSCs in different layers have different characteristics, the worst case coil-coupling condition should be designed to provide the maximum power transfer efficiency (PTE) in order to minimize the spatial received power fluctuations. In the worst case, the transmitter (Tx) hex-PSC is overlapped by six PSCs and surrounded by six other adjacent PSCs. Using a receiver (Rx) coil, 20 mm in radius, at the coupling distance of 78 mm and maximum lateral misalignment of 49.1 mm (1/√3 of the PSC radius) we can receive power at a PTE of 19.6% from the worst case PSC. Furthermore, we have studied the effects of Rx coil tilting and concluded that the PTE degrades significantly when θ > 60°. Solutions are: 1) activating two adjacent overlapping hex-PSCs simultaneously with out-of-phase excitations to create horizontal magnetic flux and 2) inclusion of a small energy storage element in the Rx module to maintain power in the worst case scenarios. In order to verify the proposed design methodology, we have developed the EnerCage system, which aims to power up biological instruments attached to or implanted in freely behaving small animal subjects' bodies in long-term electrophysiology experiments within large experimental arenas.

Progress on TSV technology for Medipix3RX chip

NASA Astrophysics Data System (ADS)

Sarajlić, M.; Pennicard, D.; Smoljanin, S.; Fritzsch, T.; Zoschke, K.; Graafsma, H.

2017-12-01

The progress of Through Silicon Via (TSV) technology for Medipix3RX chip done at DESY is presented here. The goal of this development is to replace the wire bonds in X-ray detectors with TSVs, in order to reduce the dead area between detectors. We obtained the first working chips assembled together with Si based sensors for X-ray detection. The 3D integration technology, including TSV, Re-distribution layer deposition, bump bonding to the Si sensor and bump bonding to the carrier PCB, was done by Fraunhofer Institute IZM in Berlin. After assembly, the module was successfully tested by recording background radiation and making X-ray images of small objects. The active area of the Medipix3RX chip is 14.1 mm×14.1 mm or 256×256 pixels. During TSV processing, the Medipix3RX chip was thinned from 775 μm original thickness, to 130 μm. The diameter of the vias is 40 μm, and the pitch between the vias is 120 μm. A liner filling approach was used to contact the TSV with the RDL on the backside of the Medipix3RX readout chip.

Morbidity and prostate-specific antigen control of external beam radiation therapy plus low-dose-rate brachytherapy boost for low, intermediate, and high-risk prostate cancer.

PubMed

Koontz, Bridget F; Chino, Junzo; Lee, W Robert; Hahn, Carol A; Buckley, Niall; Huang, Samuel; Kim, Jay; Reagan, Robert; Joyner, Raymond; Anscher, Mitchell S

2009-01-01

Dose escalation has been shown beneficial in prostate cancer. Brachytherapy (BT) provides an opportunity for dose escalation beyond what can be safely delivered using only teletherapy methods. The purpose of this study was to determine cancer control and morbidity of external beam radiation therapy (EBRT) plus low-dose-rate (LDR) BT boost in patients with prostate cancer treated at Duke University Health System. Between June 1997 and August 2007, 199 patients were consecutively treated at our facility with 46Gy EBRT followed by 100Gy palladium-103 ((103)Pd) or 120Gy iodine-125 ((125)I) LDR prostate implant. Treatment characteristics and followup data were retrospectively analyzed. Intermediate risk was defined as T2b-c, Gleason score 7 (GS 7), or prostate-specific antigen (PSA) of 10.1-19.9ng/mL. High risk was defined as GS 8-10, PSA>20, T3+, or two intermediate risk factors. The Radiation Therapy Oncology Group toxicity scale was used to report morbidity for gastrointestinal (GI) and genitourinary (GU) effects. PSA recurrence was defined as nadir+2ng/mL. Median followup was 4.2 years for all patients, 4.8 years for high-risk patients. Risk categories were as follows: 20% low risk, 47% intermediate risk, and 33% high risk. Forty five percent of patients received adjuvant androgen deprivation therapy (ADT). The median length of time since end of ADT to last followup was 2.7 years in all patients, 2.0 years for high-risk patients. Five-year biochemical relapse-free survival was 87% for all, 81% for high-risk patients. PSA control was similar at 92% for all and 86% for high-risk patients. Five-year actuarial risk of any and Grade 3 late GI morbidity was 38% and 7% respectively, and any and Grade 3 late GU morbidity was 21% and 3%, respectively. There were no significant differences in risk of Grade 2+GI or GU morbidity with choice of isotope. EBRT plus LDR BT has acceptable morbidity and, with 5-year followup, provides excellent cancer control even in high-risk patients.

Assessing the economic impact of Rx-to-OTC switches: systematic review and guidelines for future development.

PubMed

Cohen, J; Millier, A; Karray, S; Toumi, M

2013-01-01

Switching drugs from prescription to non-prescription status (Rx-to-OTC) presents a unique set of challenges and opportunities to policy-makers and the industry in terms of managing health outcomes, pharmaceutical spending, and steering of consumer choices of therapy. Decision-analytic models are used to address uncertainty and produce reasonable estimates of the economic impact of switches for payers. This article presents a critical literature review of existing models which assess the economic impact of Rx-to-OTC switches, and provides guidelines in which future economic evaluations of Rx-to-OTC switches could be improved. A comprehensive search strategy was implemented in Medline and Embase, to retrieve published economic evaluations on Rx-to-OTC switches from 1995-2010. The research digest of the International Society of Pharmacoeconomics and Outcomes Research (ISPOR) was reviewed for potentially relevant abstracts for the past 3 years. Each model used was critically evaluated in terms of structure, relevance of inputs, methodology used, and robustness of results. Worldwide, the economic impact of Rx-to-OTC switches has only been evaluated in a total of 12 peer-reviewed publications. Ten out of 12 studies were US-based, and two European-based. The models covered various disease categories, including allergy, hypercholesterolemia, gastroenterology, contraception, pulmonology, and virology. Seventy-five per cent of the models predicted cost savings for payers and patients. Limitations of the models mainly included use of strong assumptions and non-inclusion of specific populations due to lack of data. Guidelines were developed to help future model development. They cover structural issues on decision context, health states, and clinical outcomes, and other considerations for model specifications. Although reviewed studies lacked quality, this review of economic evidence of Rx-to-OTC switches suggests that switches may produce cost savings to public and private payers. This is especially important in light of the trend towards more switches.

Genomic Analysis of Multidrug-Resistant Escherichia coli from North Carolina Community Hospitals: Ongoing Circulation of CTX-M-Producing ST131-H30Rx and ST131-H30R1 Strains.

PubMed

Kanamori, Hajime; Parobek, Christian M; Juliano, Jonathan J; Johnson, James R; Johnston, Brian D; Johnson, Timothy J; Weber, David J; Rutala, William A; Anderson, Deverick J

2017-08-01

Escherichia coli sequence type 131 (ST131) predominates globally among multidrug-resistant (MDR) E. coli strains. We used whole-genome sequencing (WGS) to investigate 63 MDR E. coli isolates from 7 North Carolina community hospitals (2010 to 2015). Of these, 39 (62%) represented ST131, including 37 (95%) from the ST131- H 30R subclone: 10 (27%) from its H 30R1 subset and 27 (69%) from its H 30Rx subset. ST131 core genomes differed by a median of 15 (range, 0 to 490) single-nucleotide variants (SNVs) overall versus only 7 within H 30R1 (range, 3 to 12 SNVs) and 11 within H 30Rx (range, 0 to 21). The four isolates with identical core genomes were all H 30Rx. Epidemiological and clinical characteristics did not vary significantly by strain type, but many patients with MDR E. coli or H 30Rx infection were critically ill and had poor outcomes. H 30Rx isolates characteristically exhibited fluoroquinolone resistance and CTX-M-15 production, had a high prevalence of trimethoprim-sulfamethoxazole resistance (89%), sul1 (89%), and dfrA17 (85%), and were enriched for specific virulence traits, and all qualified as extraintestinal pathogenic E. coli The high overall prevalence of CTX-M-15 appeared to be possibly attributable to its association with the ST131- H 30Rx subclone and IncF[F2:A1:B-] plasmids. Some phylogenetically clustered non-ST131 MDR E. coli isolates also had distinctive serotypes/ fimH types, fluoroquinolone mutations, CTX-M variants, and IncF types. Thus, WGS analysis of our community hospital source MDR E. coli isolates suggested ongoing circulation and differentiation of E. coli ST131 subclones, with clonal segregation of CTX-M variants, other resistance genes, Inc-type plasmids, and virulence genes. Copyright © 2017 American Society for Microbiology.

Proton exchange membranes prepared by grafting of styrene/divinylbenzene into crosslinked PTFE membranes

NASA Astrophysics Data System (ADS)

Li, Jingye; Ichizuri, Shogo; Asano, Saneto; Mutou, Fumihiro; Ikeda, Shigetoshi; Iida, Minoru; Miura, Takaharu; Oshima, Akihiro; Tabata, Yoneho; Washio, Masakazu

2005-07-01

Thin PTFE membranes were prepared by coating the PTFE dispersion onto the aluminum films. Thus the thin crosslinked PTFE (RX-PTFE) membranes were obtained by means of electron beam irradiation above the melting temperature of PTFE under oxygen-free atmosphere. The RX-PTFE membranes were pre-irradiated and grafted by styrene with or without divinylbenzene (DVB) in liquid phase. The existence of DVB accelerated the initial grafting rate. The styrene grafted RX-PTFE membranes are white colored, on the other hand, the styrene/DVB grafted RX-PTFE membranes are colorless. The proton exchange membranes (PEMs) were obtained by sulfonating the grafted membranes using chlorosulfonic acid. The ion exchange capacity (IEC) values of the PEMs ranging from 1.5 to 2.8 meq/g were obtained. The PEMs made from the styrene/DVB grafted membranes showed higher chemical stability than those of the styrene grafted membranes under oxidative circumstance.

77 FR 28671 - Notice of Intent To Grant an Exclusive License

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-15

... Affairs (VA), Office of Research and Development, intends to grant to algorithmRx, LLC, 7400 Beaufont... license is awarded to algorithmRx, LLC because the invention can lead to a more efficacious use of statins...

Future precipitation changes over China under 1.5 °C and 2.0 °C global warming targets by using CORDEX regional climate models.

PubMed

Li, Huixin; Chen, Huopo; Wang, Huijun; Yu, Entao

2018-06-01

This study aims to characterize future changes in precipitation extremes over China based on regional climate models (RCMs) participating in the Coordinated Regional Climate Downscaling Experiment (CORDEX)-East Asia project. The results of five RCMs involved in CORDEX-East Asia project that driven by HadGEM2-AO are compared with the simulation of CMA-RegCM driven by BCC-CSM1.1. Eleven precipitation extreme indices that developed by the Expert Team on Climate Change Detection and Indices are employed to evaluate precipitation extreme changes over China. Generally, RCMs can reproduce their spatiotemporal characteristics over China in comparison with observations. For future climate projections, RCMs indicate that both the occurrence and intensity of precipitation extremes in most regions of China will increase when the global temperature increases by 1.5/2.0 °C. The yearly maximum five-day precipitation (RX5D) averaged over China is reported to increase by 4.4% via the CMA-RegCM under the 1.5 °C warming in comparison with the baseline period (1986-2005); however, a relatively large increase of 11.1% is reported by the multi-model ensemble median (MME) when using the other five models. Furthermore, the reoccurring risks of precipitation extremes over most regions of China will further increase due to the additional 0.5 °C warming. For example, RX5D will further increase by approximately 8.9% over NWC, 3.8% over NC, 2.3% over SC, and approximately 1.0% over China. Extremes, such as the historical 20-year return period event of yearly maximum one-day precipitation (RX1D) and RX5D, will become more frequent, with occurrences happening once every 8.8 years (RX1D) and 11.5 years (RX5D) under the 1.5 °C warming target, and there will be two fewer years due to the additional 0.5 °C warming. In addition, the intensity of these events will increase by approximately 9.2% (8.5%) under the 1.5 °C warming target and 12.6% (11.0%) under the 2.0 °C warming target for RX1D (RX5D). Copyright © 2018 Elsevier B.V. All rights reserved.

EUTEMPE-RX, an EC supported FP7 project for the training and education of medical physics experts in radiology.

PubMed

Bosmans, H; Bliznakova, K; Padovani, R; Christofides, S; Van Peteghem, N; Tsapaki, V; Caruana, C J; Vassileva, J

2015-07-01

The core activity of the medical physics expert (MPE) is to ensure optimal use of ionising radiation in healthcare. It is essential that these healthcare professionals are trained to the highest level, defined as European Qualifications Framework for Lifelong Learning (EQF) level 8 by the European Commission's Radiation Protection Report 174 'Guidelines on the MPE'. The main objective of the EUTEMPE-RX project is to provide a model training scheme that allows the medical physicist in diagnostic and interventional radiology (D&IR) to reach this high level. A European network of partners was brought together in this FP7 EC project to ensure sufficient expertise in all aspects of the subject and to create a harmonised course programme. Targeted participants are medical physicists in D&IR in hospitals, engineers and scientists in medical device industries and officers working in regulatory authorities. Twelve course modules will be developed at EQF level 8, with radiation safety and diagnostic effectiveness being prevalent subjects. The modules will combine online with face-to-face teaching using a blended learning approach. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Are ‘Endurance’ Alleles ‘Survival’ Alleles? Insights from the ACTN3 R577X Polymorphism

PubMed Central

Fiuza-Luces, Carmen; Ruiz, Jonatan R.; Rodríguez-Romo, Gabriel; Santiago, Catalina; Gómez-Gallego, Félix; Yvert, Thomas; Cano-Nieto, Amalia; Garatachea, Nuria

2011-01-01

Exercise phenotypes have played a key role for ensuring survival over human evolution. We speculated that some genetic variants that influence exercise phenotypes could be associated with exceptional survival (i.e. reaching ≥100years of age). Owing to its effects on muscle structure/function, a potential candidate is the Arg(R)577Ter(X) polymorphism (rs1815739) in ACTN3, the structural gene encoding the skeletal muscle protein α-actinin-3. We compared the ACTN3 R577X genotype/allele frequencies between the following groups of ethnically-matched (Spanish) individuals: centenarians (cases, n = 64; 57 female; age range: 100–108 years), young healthy controls (n = 283, 67 females, 216 males; 21±2 years), and humans who are at the two end-points of exercise capacity phenotypes, i.e. muscle endurance (50 male professional road cyclists) and muscle power (63 male jumpers/sprinters). Although there were no differences in genotype/allele frequencies between centenarians (RR:28.8%; RX:47.5%; XX:23.7%), and controls (RR:31.8%; RX:49.8%; XX:18.4%) or endurance athletes (RR:28.0%; RX:46%; XX:26.0%), we observed a significantly higher frequency of the X allele (P = 0.019) and XX genotype (P = 0.011) in centenarians compared with power athletes (RR:47.6%; RX:36.5%;XX:15.9%). Notably, the frequency of the null XX (α-actinin-3 deficient) genotype in centenarians was the highest ever reported in non-athletic Caucasian populations. In conclusion, despite there were no significant differences with the younger, control population, overall the ACTN3 genotype of centenarians resembles that of world-class elite endurance athletes and differs from that of elite power athletes. Our preliminary data would suggest a certain ‘survival’ advantage brought about by α-actinin-3 deficiency and the ‘endurance’/oxidative muscle phenotype that is commonly associated with this condition. PMID:21407828

First-Principles Monte Carlo Simulations of Reaction Equilibria in Compressed Vapors

PubMed Central

2016-01-01

Predictive modeling of reaction equilibria presents one of the grand challenges in the field of molecular simulation. Difficulties in the study of such systems arise from the need (i) to accurately model both strong, short-ranged interactions leading to the formation of chemical bonds and weak interactions arising from the environment, and (ii) to sample the range of time scales involving frequent molecular collisions, slow diffusion, and infrequent reactive events. Here we present a novel reactive first-principles Monte Carlo (RxFPMC) approach that allows for investigation of reaction equilibria without the need to prespecify a set of chemical reactions and their ideal-gas equilibrium constants. We apply RxFPMC to investigate a nitrogen/oxygen mixture at T = 3000 K and p = 30 GPa, i.e., conditions that are present in atmospheric lightning strikes and explosions. The RxFPMC simulations show that the solvation environment leads to a significantly enhanced NO concentration that reaches a maximum when oxygen is present in slight excess. In addition, the RxFPMC simulations indicate the formation of NO2 and N2O in mole fractions approaching 1%, whereas N3 and O3 are not observed. The equilibrium distributions obtained from the RxFPMC simulations agree well with those from a thermochemical computer code parametrized to experimental data. PMID:27413785

Genetic and physical mapping of homologues of the virus resistance gene Rx1 and the cyst nematode resistance gene Gpa2 in potato.

PubMed

Bakker, E; Butterbach, P; Rouppe van der Voort, J; van der Vossen, E; van Vliet, J; Bakker, J; Goverse, A

2003-05-01

Nine resistance gene homologues (RGHs) were identified in two diploid potato clones (SH and RH), with a specific primer pair based on conserved motifs in the LRR domain of the potato cyst nematode resistance gene Gpa2 and the potato virus X resistance gene Rx1. A modified AFLP method was used to facilitate the genetic mapping of the RGHs in the four haplotypes under investigation. All nine RGHs appeared to be located in the Gpa2/ Rx1 cluster on chromosome XII. Construction of a physical map using bacterial artificial chromosome (BAC) clones for both the Solanum tuberosum ssp. tuberosum and the S. tuberosum ssp. andigena haplotype of SH showed that the RGHs are located within a stretch of less than 200 kb. Sequence analysis of the RGHs revealed that they are highly similar (93 to 95%) to Gpa2 and Rx1. The sequence identities among all RGHs range from 85 to 100%. Two pairs of RGHs are identical, or nearly so (100 and 99.9%), with each member located in a different genotype. Southern-blot analysis on genomic DNA revealed no evidence for additional homologues outside the Gpa2/ Rx1 cluster on chromosome XII.

Laparoscopic colorectal surgery in obese and nonobese patients: do differences in body mass indices lead to different outcomes?

PubMed

Schwandner, O; Farke, S; Schiedeck, T H K; Bruch, H-P

2004-10-01

The aim of this prospective study was to compare the outcome of laparoscopic colorectal surgery in obese and nonobese patients. All patients who underwent laparoscopic surgery for both benign and malignant disease within the past 5 years were entered into the prospective database registry. Body mass index (BMI; kg/m(2)) was used as the objective measure to indicate morbid obesity. Patients with a BMI >30 were defined as obese, and patients with a BMI <30 were defined as nonobese. The parameters analyzed included age, gender, comorbid conditions, diagnosis, procedure, duration of surgery, transfusion requirements, conversion rate, overall morbidity rate including major complications (requiring reoperation), minor complications (conservative treatment) and late-onset complications (postdischarge), stay on intensive case unit, hospitalization, and mortality. For objective evaluation, only laparoscopically completed procedures were analyzed. Statistics included Student's t test and chi-square analysis. Statistical significance was assessed at the 5% level (p < 0. 05 statistically significant). A total of 589 patients were evaluated, including 95 patients in the obese group and 494 patients in the nonobese group. There was no significant difference in conversion rate (7.3% in the obese group vs 9.5% in the nonobese group, p > 0.05) so that the laparoscopic completion rate was 90.5% (n = 86) in the obese and 92.7% (n = 458) in the nonobese group. The rate of females was significantly lower among obese patients (55.8% in the obese group vs 74.2% in the nonobese group, p = 0.001). No significant differences were observed with respect to age, diagnosis, procedure, duration of surgery, and transfusion requirements (p > 0.05). In terms of morbidity, there were no significant differences related to overall complication rates with respect to BMI (23.3% in the obese group vs 24.5% in the nonobese group, p > 0.05). Major complications were more common in the obese group without showing statistical significance (12.8% in the obese group vs 6.6% in the nonobese group, p = 0.078). Conversely, minor complications were more frequently documented in the nonobese group (8.1% in the obese group vs 15.5% in the nonobese group, p = 0.080). In the postoperative course, no differences were documented in terms of return of bowel function, duration of analgesics required, oral feeding, and length of hospitalization (p > 0.05). These data indicate that laparoscopic colorectal surgery is feasible and effective in both obese and nonobese patients. Obese patients who are thought to be at increased risk of postoperative morbidity have the similar benefit of laparoscopic surgery as nonobese patients with colorectal disease.

Have precipitation extremes and annual totals been increasing in the world's dry regions over the last 60 years?

NASA Astrophysics Data System (ADS)

Sippel, Sebastian; Zscheischler, Jakob; Heimann, Martin; Lange, Holger; Mahecha, Miguel D.; van Oldenborgh, Geert Jan; Otto, Friederike E. L.; Reichstein, Markus

2017-01-01

Daily precipitation extremes and annual totals have increased in large parts of the global land area over the past decades. These observations are consistent with theoretical considerations of a warming climate. However, until recently these trends have not been shown to consistently affect dry regions over land. A recent study, published by Donat et al. (2016), now identified significant increases in annual-maximum daily extreme precipitation (Rx1d) and annual precipitation totals (PRCPTOT) in dry regions. Here, we revisit the applied methods and explore the sensitivity of changes in precipitation extremes and annual totals to alternative choices of defining a dry region (i.e. in terms of aridity as opposed to precipitation characteristics alone). We find that (a) statistical artifacts introduced by data pre-processing based on a time-invariant reference period lead to an overestimation of the reported trends by up to 40 %, and that (b) the reported trends of globally aggregated extremes and annual totals are highly sensitive to the definition of a dry region of the globe. For example, using the same observational dataset, accounting for the statistical artifacts, and based on different aridity-based dryness definitions, we find a reduction in the positive trend of Rx1d from the originally reported +1.6 % decade-1 to +0.2 to +0.9 % decade-1 (period changes for 1981-2010 averages relative to 1951-1980 are reduced to -1.32 to +0.97 % as opposed to +4.85 % in the original study). If we include additional but less homogenized data to cover larger regions, the global trend increases slightly (Rx1d: +0.4 to +1.1 % decade-1), and in this case we can indeed confirm (partly) significant increases in Rx1d. However, these globally aggregated estimates remain uncertain as considerable gaps in long-term observations in the Earth's arid and semi-arid regions remain. In summary, adequate data pre-processing and accounting for uncertainties regarding the definition of dryness are crucial to the quantification of spatially aggregated trends in precipitation extremes in the world's dry regions. In view of the high relevance of the question to many potentially affected stakeholders, we call for a well-reflected choice of specific data processing methods and the inclusion of alternative dryness definitions to guarantee that communicated results related to climate change be robust.

Themoanaerobacterium calidifontis sp. nov., a novel anaerobic, thermophilic, ethanol-producing bacterium from hot springs in China.

PubMed

Shang, Shu-mei; Qian, Long; Zhang, Xu; Li, Kun-zhi; Chagan, Irbis

2013-06-01

A novel thermophilic Gram staining positive strain Rx1 was isolated from hot springs in Baoshan of Yunnan Province, China. The strain was characterized as a hemicellulose-decomposing obligate anaerobe bacterium that is rod-shaped (diameter: 0.5-0.7 μm; length: 2.0-6.7 μm), spore-forming, and motile. Its growth temperature range is 38-68 °C (optimum 50-55 °C) and pH range is 4.5-8.0 (optimum 7.0). The maximum tolerance concentration of NaCl was 3 %. Rx1 converted thiosulfate to elemental sulfur and reduced sulfite to hydrogen sulfide. The bacterium grew by utilizing xylan and starch, as well as a wide range of monosaccharide and polysaccharides, including glucose and xylose. The main products of fermentation were ethanol, lactate, acetate, CO2, and H2. The maximum xylanase activity in the culture supernatant after 30 h of incubation at 55 °C was 16.2 U/ml. Rx1 DNA G + C content was 36 mol %. 16S rRNA gene sequence analysis indicated that strain Rx1 belonged to the genus Thermoanaerobacterium of the family 'Thermoanaerobacteriaceae' (Firmicutes), with Thermoanaerobacterium aciditolerans 761-119 (99.2 % 16S rRNA gene sequence similarity) being its closest relative. DNA-DNA hybridization between Rx1 and T. aciditolerans 761-119 showed 36 % relatedness. Based on its physiological and biochemical tests and DNA-DNA hybridization analyses, the isolate is considered to represent a novel species in the genus Thermoanaerobacterium, for which the name Thermoanaerobacterium calidifontis sp. nov. is proposed, with the type strain is Rx1 (=JCM 18270 = CCTCC M 2011109).

Timing of Emergency Department Visits for Childhood Asthma after Initial Inhaled Corticosteroid Use

PubMed Central

Zhang, Shun; Holloway, Kelvin; Tyler-Hill, Yasmin

2015-01-01

Abstract Inhaled corticosteroids can prevent acute exacerbations and emergency visits when used as part of a chronic care plan for long-term control of asthma, but low patient adherence and inadequate provider prescribing (clinical inertia) can limit these benefits. State Medicaid programs are a major source of insurance coverage for low-income children, paying for medications and preventive care, as well as bearing the cost of adverse outcomes for common chronic conditions in childhood, such as asthma. This study measured the incidence and timing of emergency department (ED) visits in the first 90 days after an initial inhaled corticosteroid prescription (ICS-Rx) among 43,156 Medicaid-enrolled children with a diagnosis of asthma in 14 southern states in 2007. One in 5 children (19.6%) with asthma had at least 1 ED visit in the first 90 days after initial ICS-Rx; 10% of these visits occurred within the first 48 hours, and 25% occurred within the first week. Continued ICS-Rx use was associated with lower risk of an ED visit. There were no racial differences in the ED visit rates. Initial ICS-Rx for Medicaid-enrolled children is a warning flag for short-term risk of asthma-related ED visits, whereas continued ICS-Rx use is protective for at least 90 days. Primary care follow-up may be needed within the first 2 days after initial ICS-Rx to prevent adverse outcomes. Medicaid programs could use claims data for surveillance of adherence to guideline-concordant therapy and for sentinel events marking windows of a higher risk for ED visits. Population Health Management 2015;18:54–60. PMID:25046059

Comparison of the efficacy and morbidity of flexible ureterorenoscopy for lower pole stones compared with other renal locations.

PubMed

Jacquemet, Baptiste; Martin, Lucille; Pastori, Julie; Bailly, Vincent; Guichard, Guillaume; Bernardini, Stéphane; Chabannes, Eric; Bittard, Hugues; Kleinclauss, François

2014-10-01

Flexible ureterorenoscopy (f-URS) for lower pole stones (LPS) compared with other renal locations can be challenging because of anatomic and technical considerations. We aimed to compare the stone-free rate (SFR) and surgical complication rate with f-URS for LPS vs other renal locations. We performed a retrospective, single-center study including 371 f-URS for renal stone retrieval performed in our institution between January 2004 and December 2010. Among the 371 procedures included in this analysis, 139 were performed for stones located in a single renal location other than the lower pole (group 1), and 232 for at least one stone located in the lower pole (group 2). We compared the efficacy (SFR) and the morbidity of f-URS between the two groups. The success of the procedure was defined as a complete SFR 6 months after f-URS. Age, sex, history of urolithiasis, body mass index, and preoperative stent placement did not differ between the two groups. No differences in stone characteristics were observed between both groups except stone size under 10 mm that was significantly higher in group 2 (P=0.018). Technical aspects of the procedure did not differ between the groups, except for more frequent use of an access sheath in group 2 (P=0.007). SFR was comparable between groups (P=0.774). The complication rate was similar in both groups, as was the severity of complications. By multivariate analysis, stone size >10 mm (P<0.0001) and multiple stone locations (P=0.001) were associated with f-URS failure, but lower pole location did not impact on SFR. In our study, stone location, in particular LPS, did not have any impact on efficacy and morbidity of f-URS. Only multiple locations and stone size >10 mm seemed to significantly decrease the SFR, without impacting morbidity.

ValiRx plc.

PubMed

Eccleston, Mark; Morris, George

2008-09-01

ValiRx plc is a therapeutics and diagnostics company developing an integrated approach to the diagnosis, treatment and prognosis of cancer through its two subsidiaries; ValiPharma and ValiBio. Over 95% of cellular DNA is tightly packaged into a complex structure called chromatin, with only 1% available to be read by cell's machinery. ValiRx's two proprietary technology platforms exploit this epigenomic structure. ValiBio is developing low-cost, rapid, high-throughput, noninvasive screening tests for the early detection, differential diagnosis and prognosis of cancer using its patented Hypergenomics™ and Nucleosomics™ technology. Its therapeutics subsidiary, ValiPharma, is developing novel gene-silencing therapeutics based on its GeneICE™ technology platform, which works by repackaging specific open areas of DNA, resulting in targeted gene deactivation. HyperGenomics and GeneICE are synergistic but independent business areas based on the company's core patent portfolio. ValiRx intends to facilitate early, optimal personalized treatment regimes by correlating 'hypersensitive' site profiles within the genome to specific types of cancer.

Low resistance tunnel junctions with remote plasma underoxidized thick barriers

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

Ferreira, R.; Freitas, P.P.; MacKenzie, M.

2005-05-15

Low resistance tunnel junctions suitable for >200 Gb/inch{sup 2} read heads require RxA<1 {omega}{mu}m{sup 2} and TMR>10%, usually achieved by natural oxidation with tAl<0.7 nm barriers. This paper shows that as-deposited junctions with competitive electrical and magnetic properties can be produced starting from 0.9 nm Al barriers and remote plasma oxidation in ion beam-deposited stacks using Co{sub 73.8}Fe{sub 16.2}B{sub 10} electrodes. TMR{approx}20% for RxA{approx}2-15 {omega}{mu}m{sup 2} is obtained, while in the RxA{approx}40-140 {omega}{mu}m{sup 2} range TMR can reach 40%-45%, in as-deposited samples. A limited number of junctions exhibits considerably lower RxA values with respect to the average while keeping similarmore » MR (down to 0.44 {omega}{mu}m{sup 2} with 20% and down to 2.2 {omega}{mu}m{sup 2} with 51%)« less

Association of Intended Route of Delivery and Maternal Morbidity in Twin Pregnancy.

PubMed

Easter, Sarah Rae; Robinson, Julian N; Lieberman, Ellice; Carusi, Daniela

2017-02-01

To evaluate maternal morbidity in twin pregnancies according to intended mode of delivery. We assembled a 7-year retrospective cohort (2007-2014) of women delivering viable, vertex-presenting twins at or beyond 32 weeks of gestation without contraindication to labor or uterine scar. We classified women as undergoing a trial of labor to attempt vaginal birth or choosing an elective cesarean delivery. Our primary outcome was a measure of composite maternal morbidity including death, postpartum hemorrhage, infection, major procedure, readmission for infection or reoperation, need for dilation and evacuation for hemorrhage or infection, venous thromboembolism, small bowel obstruction or ileus, or intensive care unit admission. Postpartum hemorrhage was defined as estimated blood loss greater than or equal to 1,500 mL or need for transfusion. The rate of lacerations in each group was also determined. Using logistic regression to control for confounders, we examined the odds of maternal morbidity according to intended mode of delivery. Of 2,272 twin pregnancies at or beyond 32 weeks of gestation, 1,140 (50%) met inclusion criteria with 571 (50%) electing cesarean delivery and 569 (50%) undergoing a trial of labor to attempt vaginal birth. Vaginal delivery of both twins was achieved in 74% (n=418) of women choosing a trial of labor. The rate of maternal morbidity was 12.3% in the trial of labor group compared with 9.1% in the elective cesarean delivery group (P=.08, adjusted odds ratio [OR] 1.6, 95% confidence interval [CI] 1.1-2.4). Postpartum hemorrhage was more common among women who attempted vaginal delivery (n=52) compared with those electing cesarean delivery (n=28) with rates of 9.1% compared with 4.9%, respectively (P<.01, adjusted OR 2.2, 95% CI 1.4-3.6) and was responsible for the difference in the composite morbidity rate between groups. When adjustment is made for potential confounders, women undergoing a trial of labor with twins experience a higher odds of maternal morbidity than those electing cesarean delivery, primarily as a result of hemorrhage. In pragmatic terms, the tradeoff for a 74% chance of vaginal delivery is a 4% absolute increase in the rate of serious postpartum hemorrhage.

Automated mapping of pharmacy orders from two electronic health record systems to RxNorm within the STRIDE clinical data warehouse.

PubMed

Hernandez, Penni; Podchiyska, Tanya; Weber, Susan; Ferris, Todd; Lowe, Henry

2009-11-14

The Stanford Translational Research Integrated Database Environment (STRIDE) clinical data warehouse integrates medication information from two Stanford hospitals that use different drug representation systems. To merge this pharmacy data into a single, standards-based model supporting research we developed an algorithm to map HL7 pharmacy orders to RxNorm concepts. A formal evaluation of this algorithm on 1.5 million pharmacy orders showed that the system could accurately assign pharmacy orders in over 96% of cases. This paper describes the algorithm and discusses some of the causes of failures in mapping to RxNorm.

Rx for Library Management.

ERIC Educational Resources Information Center

Cage, Alvin C.

1986-01-01

Examines recent developments in field of systems theory that can improve library management practices by broadening perspective in which these problems may be approached. The concept of organizational life cycles is discussed and a paradigm for application of its principles is developed. An Rx decision chart is appended. (9 references) (EJS)

A Comparative Analysis of CMUT Receiving Architectures for the Design Optimization of Integrated Transceiver Front Ends.

PubMed

Sautto, Marco; Savoia, Alessandro Stuart; Quaglia, Fabio; Caliano, Giosue; Mazzanti, Andrea

2017-05-01

A formal comparison between fundamental RX amplifier configurations for capacitive micromachined ultrasonic transducers (CMUTs) is proposed in this paper. The impact on both RX and the pulse-echo frequency response and on the output SNR is thoroughly analyzed and discussed. It is shown that the resistive-feedback amplifier yields a bandpass RX frequency response, while both open-loop voltage and capacitive-feedback amplifiers exhibit a low-pass frequency response. For a given power dissipation, it is formally proved that a capacitive-feedback amplifier provides a remarkable SNR improvement against the commonly adopted resistive feedback stage, achieved at the expense of a reduced pulse-echo center frequency, making its use convenient in low-frequency and midfrequency ultrasound imaging applications. The advantage mostly comes from a much lower noise contributed by the active devices, especially with low- Q , broadband transducers. The results of the analysis are applied to the design of a CMUT front end in BIPOLAR-CMOS-DMOS Silicon-on-Insulator technology operating at 10-MHz center frequency. It comprises a low-power RX amplifier, a high-voltage Transmission/Reception switch, and a 100-V TX driver. Extensive electrical characterization, pulse-echo measurements, and imaging results are shown. Compared with previously reported CMUT front ends, this transceiver demonstrates the highest dynamic range and state-of-the-art noise performance with an RX amplifier power dissipation of 1 mW.

First-principles Monte Carlo simulations of reaction equilibria in compressed vapors

DOE PAGES

Fetisov, Evgenii O.; Kuo, I-Feng William; Knight, Chris; ...

2016-06-13

Predictive modeling of reaction equilibria presents one of the grand challenges in the field of molecular simulation. Difficulties in the study of such systems arise from the need (i) to accurately model both strong, short-ranged interactions leading to the formation of chemical bonds and weak interactions arising from the environment, and (ii) to sample the range of time scales involving frequent molecular collisions, slow diffusion, and infrequent reactive events. Here we present a novel reactive first-principles Monte Carlo (RxFPMC) approach that allows for investigation of reaction equilibria without the need to prespecify a set of chemical reactions and their ideal-gasmore » equilibrium constants. We apply RxFPMC to investigate a nitrogen/oxygen mixture at T = 3000 K and p = 30 GPa, i.e., conditions that are present in atmospheric lightning strikes and explosions. The RxFPMC simulations show that the solvation environment leads to a significantly enhanced NO concentration that reaches a maximum when oxygen is present in slight excess. In addition, the RxFPMC simulations indicate the formation of NO 2 and N 2O in mole fractions approaching 1%, whereas N 3 and O 3 are not observed. Lastly, the equilibrium distributions obtained from the RxFPMC simulations agree well with those from a thermochemical computer code parametrized to experimental data.« less

First-principles Monte Carlo simulations of reaction equilibria in compressed vapors

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

Fetisov, Evgenii O.; Kuo, I-Feng William; Knight, Chris

Predictive modeling of reaction equilibria presents one of the grand challenges in the field of molecular simulation. Difficulties in the study of such systems arise from the need (i) to accurately model both strong, short-ranged interactions leading to the formation of chemical bonds and weak interactions arising from the environment, and (ii) to sample the range of time scales involving frequent molecular collisions, slow diffusion, and infrequent reactive events. Here we present a novel reactive first-principles Monte Carlo (RxFPMC) approach that allows for investigation of reaction equilibria without the need to prespecify a set of chemical reactions and their ideal-gasmore » equilibrium constants. We apply RxFPMC to investigate a nitrogen/oxygen mixture at T = 3000 K and p = 30 GPa, i.e., conditions that are present in atmospheric lightning strikes and explosions. The RxFPMC simulations show that the solvation environment leads to a significantly enhanced NO concentration that reaches a maximum when oxygen is present in slight excess. In addition, the RxFPMC simulations indicate the formation of NO 2 and N 2O in mole fractions approaching 1%, whereas N 3 and O 3 are not observed. Lastly, the equilibrium distributions obtained from the RxFPMC simulations agree well with those from a thermochemical computer code parametrized to experimental data.« less

Stepwise artificial evolution of a plant disease resistance gene.

PubMed

Harris, C Jake; Slootweg, Erik J; Goverse, Aska; Baulcombe, David C

2013-12-24

Genes encoding plant nucleotide-binding leucine-rich repeat (NB-LRR) proteins confer dominant resistance to diverse pathogens. The wild-type potato NB-LRR protein Rx confers resistance against a single strain of potato virus X (PVX), whereas LRR mutants protect against both a second PVX strain and the distantly related poplar mosaic virus (PopMV). In one of the Rx mutants there was a cost to the broad-spectrum resistance because the response to PopMV was transformed from a mild disease on plants carrying wild-type Rx to a trailing necrosis that killed the plant. To explore the use of secondary mutagenesis to eliminate this cost of broad-spectrum resistance, we performed random mutagenesis of the N-terminal domains of this broad-recognition version of Rx and isolated four mutants with a stronger response against the PopMV coat protein due to enhanced activation sensitivity. These mutations are located close to the nucleotide-binding pocket, a highly conserved structure that likely controls the "switch" between active and inactive NB-LRR conformations. Stable transgenic plants expressing one of these versions of Rx are resistant to the strains of PVX and the PopMV that previously caused trailing necrosis. We conclude from this work that artificial evolution of NB-LRR disease resistance genes in crops can be enhanced by modification of both activation and recognition phases, to both accentuate the positive and eliminate the negative aspects of disease resistance.

The Proper Motion of the Central Compact Object RX J0822-4300 in the Supernova Remnant Puppis A

NASA Technical Reports Server (NTRS)

Becker, Werner; Prinz, Tobias; Winkler, P. Frank; Petre, Robert

2012-01-01

Using the High Resolution Camera (HRC) aboard the Chandra X-ray Observatory, we have re-examined the proper motion of the central compact object RX J0822-4300 in the supernova remnant Puppis A. New data from 2010 August, combined with three archival data sets from as early as 1999 December, provide a baseline of 3886 days (more than 10 1/2 years) to perform the measurement. Correlating the four positions of RX J0822-4300 measured in each data set implies a projected proper motion of mu = 71 +/- 12 mas/yr. For a distance of 2 kpc this proper motion is equivalent to a recoil velocity of 672 +/- 115 km/s. The position angle is found to be 244 +/- 11 degrees. Both the magnitude and direction of the proper motion are in agreement with RX J0822-4300 originating near the optical expansion center of the supernova remnant. For a displacement of 371 +/- 31 arcsec between its birth place and today's position we deduce an age of (5.2 +/- 1.0) 10(exp 3) yrs for RX J0822-4300. The age inferred from the neutron star proper motion and filament motions can be considered as two independent measurements of the same quantity. They average to 4450 +/- 750 yrs for the age of the supernova remnant Puppis A.

Greater muscle damage in athletes with ACTN3 R577X (RS1815739) gene polymorphism after an ultra-endurance race: a pilot study

PubMed Central

Crisp, AH; Verlengia, R

2017-01-01

In this study, we aimed to investigate the influence of ACTN3 R577X gene polymorphism on muscle damage responses in athletes competing in an ultra-endurance race. Twenty moderate to well-trained ultra-runners who had entered in an official 37.1 km adventure race (22.1 km mountain biking, 10.9 km trekking, 4.1 km water trekking, 30 m rope course, and orienteering) volunteered for the study. Blood samples were collected for genotyping and analysis of muscle protein levels before and after the race. Percentage changes (pre- to post-race) of serum myoglobin [XX = 5,377% vs. RX/RR = 1,666%; P = 0.005, effect size (ES) = 1.73], creatine kinase (XX = 836.5% vs. RX/RR = 455%; P = 0.04, ES = 1.29), lactate dehydrogenase (XX = 82% vs. RX/RR = 65%; P = 0.002, ES = 1.61), and aspartate aminotransferase (XX = 148% vs. RX/RR = 75%; P = 0.02, ES = 1.77) were significantly greater for XX than RX/RR genotypes. ES analysis confirmed a large magnitude of muscle damage in XX genotype ultra-runners. Therefore, athletes with the ACTN3 577XX genotype experienced more muscle damage after an adventure race. This suggests that ultra-runners with alpha-actinin-3 deficiency may be more susceptible to rhabdomyolysis and associated health complications during ultra-endurance competitions. PMID:28566803

Tet1 and Tet2 maintain mesenchymal stem cell homeostasis via demethylation of the P2rX7 promoter.

PubMed

Yang, Ruili; Yu, Tingting; Kou, Xiaoxing; Gao, Xiang; Chen, Chider; Liu, Dawei; Zhou, Yanheng; Shi, Songtao

2018-06-01

Ten-eleven translocation (Tet) family-mediated DNA oxidation represents an epigenetic modification capable of converting 5-methylcytosine (5-mC) to 5-hydroxymethylcytosine (5-hmC), which regulates various biological processes. However, it is unknown whether Tet family affects mesenchymal stem cells (MSCs) or the skeletal system. Here we show that depletion of Tet1 and Tet2 results in impaired self-renewal and differentiation of bone marrow MSCs (BMMSCs) and a significant osteopenia phenotype. Tet1 and Tet2 deficiency reduces demethylation of the P2rX7 promoter and downregulates exosome release, leading to intracellular accumulation of miR-297a-5p, miR-297b-5p, and miR-297c-5p. These miRNAs inhibit Runx2 signaling to impair BMMSC function. We show that overexpression of P2rX7 rescues the impaired BMMSCs and osteoporotic phenotype in Tet1 and Tet2 double knockout mice. These results indicate that Tet1 and Tet2 play a critical role in maintaining BMMSC and bone homeostasis through demethylation of P2rX7 to control exosome and miRNA release. This Tet/P2rX7/Runx2 cascade may serve as a target for the development of novel therapies for osteopenia disorders.

Oral 5-Aminosalicylate, Mesalamine Suppository, and Mesalamine Enema as Initial Therapy for Ulcerative Proctitis in Clinical Practice with Quality of Care Implications.

PubMed

Richter, James M; Arshi, Nabeela K; Oster, Gerry

2016-01-01

Background. Ulcerative proctitis (UP) is typically treated initially with oral 5-aminosalicylate ("5-ASA"), mesalamine suppository, or mesalamine enema ("UP Rx"). Little is known about their effectiveness in practice. Methods. Using a US health insurance database, we identified new-onset UP patients between January 1, 2005, and December 31, 2007, based on the following: (1) initiation of UP Rx; (2) endoscopy in prior 30 days resulting in diagnosis of UP; and (3) no prior encounters for ulcerative colitis or Crohn's disease. We examined the incidence of therapy escalation and total costs in relation to initial UP Rx. Results. We identified 548 patients: 327 received mesalamine suppository, 138 received oral 5-ASA, and 83 received mesalamine enema, as initial UP Rx. One-third receiving oral 5-ASA experienced therapy escalation over 12 months, 21% for both mesalamine suppository and enema. Mean cumulative total cost of UP Rx over 12 months was $1552, $996, and $986 for patients beginning therapy with oral 5-ASA, mesalamine enema, and mesalamine suppository, respectively. Contrary to expert recommendations the treatments were often not continued prophylactically. Conclusions. Treatment escalation was common, and total costs of therapy were higher, in patients who initiated treatment with oral 5-ASA. Further study is necessary to assess the significance of these observations.

CMOS analog baseband circuitry for an IEEE 802.11 b/g/n WLAN transceiver

NASA Astrophysics Data System (ADS)

Zheng, Gong; Xiaojie, Chu; Qianqian, Lei; Min, Lin; Yin, Shi

2012-11-01

An analog baseband circuit for a direct conversion wireless local area network (WLAN) transceiver in a standard 0.13-μm CMOS occupying 1.26 mm2 is presented. The circuit consists of active-RC receiver (RX) 4th order elliptic lowpass filters(LPFs), transmit (PGAs) with DC offset cancellation (DCOC) servo loops, and on-chip output buffers. The RX baseband gain can be programmed in the range of -11 to 49 dB in 2 dB steps with 50-30.2 nV/√Hz input referred noise (IRN) and a 21 to -41 dBm in-band 3rd order interception point (IIP3). The RX/TX LPF cutoff frequencies can be switched between 5 MHz, 10 MHz, and 20 MHz to fulfill the multimode 802.11b/g/n requirements. The TX baseband gain of the I/Q paths are tuned separately from -1.6 to 0.9 dB in 0.1 dB steps to calibrate TX I/Q gain mismatches. By using an identical integrator based elliptic filter synthesis method together with global compensation applied to the LPF capacitor array, the power consumption of the RX LPF is considerably reduced and the proposed chip draws 26.8 mA/8 mA by the RX/TX baseband paths from a 1.2 V supply.

Perioperative outcomes of pancreaticoduodenectomy: Nepalese experience.

PubMed

Lakhey, Paleswan Joshi; Bhandari, Ramesh Singh; Ghimire, Bikal; Khakurel, Mahesh

2010-08-01

Pancreaticodudenectomy (PD) is a high-risk, technically demanding operation associated with substantial perioperative morbidity and mortality. This review is intended to evaluate the perioperative outcomes of PD done in a single gastrointestinal surgery unit of a university teaching hospital. A retrospective review of medical records of patients who underwent PD from April 2005 through May 2009 was done. Perioperative morbidity was defined according to the standard of the International Study Group for Pancreatic Fistula (ISGPF). The patient demographics, type of surgery, and perioperative morbidity and mortality were evaluated. The factors associated with increased morbidity were analyzed. Twenty-four patients underwent PD, and there were no perioperative deaths. The overall morbidity was 58%, with a pancreatic fistula rate of 13%. None of the associated parameters, like increasing age, the presence of co-morbidity, preoperative biliary drainage, and duration of surgery, were found to increase the morbidity. These results of PD, though a small case series, are comparable to the international standard. Better outcomes can be achieved even in low- to medium-volume centers in developing countries where a dedicated team with special interest in pancreatic surgery is in place. Although there were no deaths after PD in our series, the morbidity was higher than that observed in other high-volume centers. To decrease the morbidity associated with PD, various factors must be streamlined, among them, the operative technique and the intensive perioperative management of the patient, as well as uniform definition of complications, use of a multidisciplinary approach, and identification of associated risk factors.

Diagnosability of Stochastic Chemical Kinetic Systems: A Discrete Event Systems Approach (PREPRINT)

DTIC Science & Technology

2010-01-01

USA. E -mail: thorsley@u.washington.edu. This research is partially supported by the 2006 AFOSR MURI award “High Confidence Design for Distributed...occurrence of the finite sample path ω. These distributions are defined recursively to be π0(x) := π0(x), πωσ(x ′) := ∑ x∈X πω(x)r(x ′,σ | x) e −r(x ′,σ|x... e −rxτ . (2) This probability is this probability that the arrival time of the first event is greater than τ . For finite sample paths with strings

What Factors Affect the Separation of Substances Using Thin-Layer Chromatography? An Undergraduate Experiment.

ERIC Educational Resources Information Center

Nash, John J.; Meyer, Jeanne A.; Everson, Barbara

2001-01-01

Rx values in thin-layer chromatography (TLC) depend strongly on the solvent saturation of the atmosphere above the liquid in the TLC developing chamber. Presents an experiment illustrating the potentially dramatic effects on TLC Rx values of not equilibrating the solvent atmosphere during development. (ASK)

78 FR 35936 - Agency Information Collection Activities: Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-14

... Reporting System (PQRS) and Electronic Prescribing (eRx) Incentive Program Under the Paperwork Reduction Act... Collection: Evaluation of the Physician Quality Reporting System (PQRS) and Electronic Prescribing (eRx) Incentive Program; Use: The Physician Quality Reporting System (PQRS) was first implemented in 2007 as an...

Impact of hospital volume on hospital mortality, length of stay and total costs after pancreaticoduodenectomy.

PubMed

Yoshioka, R; Yasunaga, H; Hasegawa, K; Horiguchi, H; Fushimi, K; Aoki, T; Sakamoto, Y; Sugawara, Y; Kokudo, N

2014-04-01

High morbidity and mortality rates after pancreaticoduodenectomy (PD) have led to concentration of this surgery in high-volume centres, with improved outcomes. The extent to which better outcomes might be apparent in a healthcare system where the mortality rate is already low is unclear. The Japanese Diagnosis Procedure Combination database was used to identify patients undergoing PD between 2007 and 2010. Patient data included age, sex, co-morbidities at admission, type of hospital, type of PD, and the year in which the patient was treated. Hospital volume was defined as the number of PDs performed annually at each hospital, and categorized into quintiles: very low-, low-, medium-, high- and very high-volume groups. The Charlson co-morbidity index was calculated using the International Classification of Diseases, tenth revision, codes of co-morbidities. A total of 10 652 patients who underwent PD in 848 hospitals were identified. The overall in-hospital mortality rate after PD was 3·3 per cent (350 of 10 652), and for the groups ranged from 5·0 per cent for the very low-volume group to 1·4 per cent for the very high-volume group (P < 0·001). Multivariable analysis revealed a significant linear relationship between higher hospital volume and shorter postoperative length of stay compared with the very low-volume group, and between increasing hospital volume and lower total costs. A significant relationship exists between increasing hospital volume, lower in-hospital mortality, shorter length of stay and lower costs for patients undergoing PD in Japan. Centralization of PD in this healthcare system is therefore justified. © 2014 BJS Society Ltd. Published by John Wiley & Sons Ltd.

IPS Empress inlays luted with a self-adhesive resin cement after 1 year.

PubMed

Taschner, Michael; Frankenberger, Roland; García-Godoy, Franklin; Rosenbusch, Silke; Petschelt, Anselm; Krämer, Norbert

2009-02-01

To prospectively compare the clinical performance of two different resin composites for luting IPS Empress inlays and onlays. 83 IPS Empress restorations were placed in 30 subjects. All restorations were inserted under rubber dam. 43 inlays/onlays were luted with a self-adhesive resin cement [RelyX Unicem (RX)]. A multistep adhesive (Syntac) was used with Variolink II low viscosity (SV) and served as control (n=40). The restorations were evaluated after 2 weeks: Baseline = 1st recall (R1), after 6 months (R2) and after 1 year (R3) by two calibrated examiners using the modified USPHS criteria. From R1 to R3, one failure was noticed in the SV group (R2) due to marginal enamel chipping. After 1 year of clinical service, SV revealed significantly better results regarding color match and integrity inlay (Mann-Whitney U-test, P< 0.05). No statistically significant differences were observed between SV and RX for the remaining criteria (Mann-Whitney U-test, P>0.05).

Assessment of Sensor Technologies for Advanced Reactors

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

Korsah, Kofi; Ramuhalli, Pradeep; Vlim, R.

2016-10-01

Sensors and measurement technologies provide information on processes, support operations and provide indications of component health. They are therefore crucial to plant operations and to commercialization of advanced reactors (AdvRx). This report, developed by a three-laboratory team consisting of Argonne National Laboratory (ANL), Oak Ridge National Laboratory (ORNL) and Pacific Northwest National Laboratory (PNNL), provides an assessment of sensor technologies and a determination of measurement needs for AdvRx. It provides the technical basis for identifying and prioritizing research targets within the instrumentation and control (I&C) Technology Area under the Department of Energy’s (DOE’s) Advanced Reactor Technology (ART) program and contributesmore » to the design and implementation of AdvRx concepts.« less

Using Computer-Based "Experiments" in the Analysis of Chemical Reaction Equilibria

ERIC Educational Resources Information Center

Li, Zhao; Corti, David S.

2018-01-01

The application of the Reaction Monte Carlo (RxMC) algorithm to standard textbook problems in chemical reaction equilibria is discussed. The RxMC method is a molecular simulation algorithm for studying the equilibrium properties of reactive systems, and therefore provides the opportunity to develop computer-based "experiments" for the…

Economic impact of a triptan Rx-to-OTC switch in six EU countries.

PubMed

Millier, Aurelie; Cohen, Joshua; Toumi, Mondher

2013-01-01

Triptans have been safely and effectively used in the management of migraine for more than fifteen years, and it seems reasonable to wonder what would be the economic impact of moving a specific triptan to OTC availability. The objective of this study was then to examine the economic impact of payer policies of a triptan Rx-to-OTC switch in six EU countries (France, UK, Spain, Italy, Germany and Poland). A decision model was used to model the budgetary impact of a triptan Rx-to-OTC switch from the third-party payer (TPP) and the societal perspectives, using a one-year timeframe. From the TPP perspective, it is estimated that the current overall direct spending on the management of migraine attacks across the 6 EU Member States is €582 million annually, and that the savings would reach €75 million (13% of the overall direct economic burden of migraine). From the societal perspective, €86 million annually would be added. Given evidence of effectiveness and safety, and given the potential savings, a triptan Rx-to-OTC switch is a reasonable public policy decision.

PEMFs: new post-surgical management in dentristry

NASA Astrophysics Data System (ADS)

Tonetti, Luca

2014-01-01

Aim of study: the possible effects on dental postsurgical management using small and not invasive devices: RecoveryRx or ActiPatch producted by Bioelectronics company (USA) Materials and methods: review of literature using searching engines Keywords: PEMFs, postsurgical treatment, pain, wound healing, RecoveryRx, ActiPatch Results: Pulsed Electro Magnetic Fields have been used extensively for decades for many conditions and medical disciplines. Imperceptible cell dysfunction that is not corrected early can lead to disease. Fine-tuning can be done daily in only minutes, using pulsed electromagnetic fields (PEMFs). In addition, when there is a known imbalance (when symptoms are present) or there is a known disease or condition, PEMF treatments, used either alone or along with other therapies, can often help cells rebalance dysfunction faster. It is seen in literature that RecoveryRX and ActiPatch improve the cell metabolism, rebalance the membrane potential difference, improve the circulation and the oxigenation of the tissues, acceleration of osteogenesis, acceleration repair of soft tissues, reduce pain. Conclusion: the RecoveryRX and ActiPatch devices could improve the postsurgical healing reducing the patient discomfort.

Fabrication of a TFF-Attached WDM-Type Triplex Transceiver Module Using Silica PLC Hybrid Integration Technology

NASA Astrophysics Data System (ADS)

Han, Young-Tak; Park, Yoon-Jung; Park, Sang-Ho; Shin, Jang-Uk; Lee, Chul-Wook; Ko, Hyunsung; Baek, Yongsoon; Park, Chul-Hee; Kwon, Yoon-Koo; Hwang, Wol-Yon; Oh, Kwang-Ryong; Sung, Heekyung

2006-12-01

An optical triplex transceiver (TRx) module, which consists of thin-film filter (TFF)-attached wavelength-division multiplexer (WDM) and photodiode (PD) carriers, has been fabricated using a silica planar lightwave circuit (PLC) hybrid integration technology. Two types of TFFs were attached to a diced sidewall of a silica-terraced PLC platform to realize the TFF-attached WDM. The PD carriers with a 45° mirror, on which receiving surface-illuminated PDs were bonded, were assembled with the PLC platform to form receiver (Rx) parts. As the main performances of the packaged TRx module, a very clear transmitter (Tx) eye pattern and minimum Rx sensitivity of -25.7 dBm were obtained under a 1.25-Gb/s Tx Rx operation for digital applications. For an analog Rx application, a module responsivity of about 0.8 A/W was achieved, and a second-order intermodulation distortion value of less than -70 dBc at an optical modulation index of 40% was obtained under a two-tone test of 400 and 450 MHz.

An 8-channel transceiver 7-channel receive RF coil setup for high SNR ultrahigh-field MRI of the shoulder at 7T.

PubMed

Rietsch, Stefan H G; Pfaffenrot, Viktor; Bitz, Andreas K; Orzada, Stephan; Brunheim, Sascha; Lazik-Palm, Andrea; Theysohn, Jens M; Ladd, Mark E; Quick, Harald H; Kraff, Oliver

2017-12-01

In this work, we present an 8-channel transceiver (Tx/Rx) 7-channel receive (Rx) radiofrequency (RF) coil setup for 7 T ultrahigh-field MR imaging of the shoulder. A C-shaped 8-channel Tx/Rx coil was combined with an anatomically close-fitting 7-channel Rx-only coil. The safety and performance parameters of this coil setup were evaluated on the bench and in phantom experiments. The 7 T MR imaging performance of the shoulder RF coil setup was evaluated in in vivo measurements using a 3D DESS, a 2D PD-weighted TSE sequence, and safety supervision based on virtual observation points. Distinct SNR gain and acceleration capabilities provided by the additional 7-channel Rx-only coil were demonstrated in phantom and in vivo measurements. The power efficiency indicated good performance of each channel and a maximum B 1 + of 19 μT if the hardware RF power limits of the MR system were exploited. MR imaging of the shoulder was demonstrated with clinically excellent image quality and submillimeter spatial resolution. The presented 8-channel transceiver 7-channel receive RF coil setup was successfully applied for in vivo 7 T MRI of the shoulder providing a clear SNR gain vs the transceiver array without the additional receive array. Homogeneous images across the shoulder region were obtained using 8-channel subject-specific phase-only RF shimming. © 2017 American Association of Physicists in Medicine.

Building a drug ontology based on RxNorm and other sources

PubMed Central

2013-01-01

Background We built the Drug Ontology (DrOn) because we required correct and consistent drug information in a format for use in semantic web applications, and no existing resource met this requirement or could be altered to meet it. One of the obstacles we faced when creating DrOn was the difficulty in reusing drug information from existing sources. The primary external source we have used at this stage in DrOn’s development is RxNorm, a standard drug terminology curated by the National Library of Medicine (NLM). To build DrOn, we (1) mined data from historical releases of RxNorm and (2) mapped many RxNorm entities to Chemical Entities of Biological Interest (ChEBI) classes, pulling relevant information from ChEBI while doing so. Results We built DrOn in a modular fashion to facilitate simpler extension and development of the ontology and to allow reasoning and construction to scale. Classes derived from each source are serialized in separate modules. For example, the classes in DrOn that are programmatically derived from RxNorm are stored in a separate module and subsumed by classes in a manually-curated, realist, upper-level module of DrOn with terms such as 'clinical drug role’, 'tablet’, 'capsule’, etc. Conclusions DrOn is a modular, extensible ontology of drug products, their ingredients, and their biological activity that avoids many of the fundamental flaws found in other, similar artifacts and meets the requirements of our comparative-effectiveness research use-case. PMID:24345026

Building a drug ontology based on RxNorm and other sources.

PubMed

Hanna, Josh; Joseph, Eric; Brochhausen, Mathias; Hogan, William R

2013-12-18

We built the Drug Ontology (DrOn) because we required correct and consistent drug information in a format for use in semantic web applications, and no existing resource met this requirement or could be altered to meet it. One of the obstacles we faced when creating DrOn was the difficulty in reusing drug information from existing sources. The primary external source we have used at this stage in DrOn's development is RxNorm, a standard drug terminology curated by the National Library of Medicine (NLM). To build DrOn, we (1) mined data from historical releases of RxNorm and (2) mapped many RxNorm entities to Chemical Entities of Biological Interest (ChEBI) classes, pulling relevant information from ChEBI while doing so. We built DrOn in a modular fashion to facilitate simpler extension and development of the ontology and to allow reasoning and construction to scale. Classes derived from each source are serialized in separate modules. For example, the classes in DrOn that are programmatically derived from RxNorm are stored in a separate module and subsumed by classes in a manually-curated, realist, upper-level module of DrOn with terms such as 'clinical drug role', 'tablet', 'capsule', etc. DrOn is a modular, extensible ontology of drug products, their ingredients, and their biological activity that avoids many of the fundamental flaws found in other, similar artifacts and meets the requirements of our comparative-effectiveness research use-case.

Dosimetry study of PHOTOFRIN-mediated photodynamic therapy in a mouse tumor model

NASA Astrophysics Data System (ADS)

Qiu, Haixia; Kim, Michele M.; Penjweini, Rozhin; Zhu, Timothy C.

2016-03-01

It is well known in photodynamic therapy (PDT) that there is a large variability between PDT light dose and therapeutic outcomes. An explicit dosimetry model using apparent reacted 1O2 concentration [1O2]rx has been developed as a PDT dosimetric quantity to improve the accuracy of the predicted ability of therapeutic efficacy. In this study, this explicit macroscopic singlet oxygen model was adopted to establish the correlation between calculated reacted [1O2]rx and the tumor growth using Photofrin-mediated PDT in a mouse tumor model. Mice with radiation-induced fibrosarcoma (RIF) tumors were injected with Photofrin at a dose of 5 mg/kg. PDT was performed 24h later with different fluence rates (50, 75 and 150 mW/cm2) and different fluences (50 and 135 J/cm2) using a collimated light applicator coupled to a 630nm laser. The tumor volume was monitored daily after PDT and correlated with the total light fluence and [1O2]rx. Photophysical parameters as well as the singlet oxygen threshold dose for this sensitizer and the RIF tumor model were determined previously. The result showed that tumor growth rate varied greatly with light fluence for different fluence rates while [1O2]rx had a good correlation with the PDT-induced tumor growth rate. This preliminary study indicated that [1O2]rx could serve as a better dosimetric predictor for predicting PDT outcome than PDT light dose.

Design and Build of Reactor Simulator for Fission Surface Power Technology Demonstrator Unit

NASA Technical Reports Server (NTRS)

Godfroy, Thomas; Dickens, Ricky; Houts, Michael; Pearson, Boise; Webster, Kenny; Gibson, Marc; Qualls, Lou; Poston, Dave; Werner, Jim; Radel, Ross

2011-01-01

The Nuclear Systems Team at NASA Marshall Space Flight Center (MSFC) focuses on technology development for state of the art capability in non-nuclear testing of nuclear system and Space Nuclear Power for fission reactor systems for lunar and Mars surface power generation as well as radioisotope power systems for both spacecraft and surface applications. Currently being designed and developed is a reactor simulator (RxSim) for incorporation into the Technology Demonstrator Unit (TDU) for the Fission Surface Power System (FSPS) Program, which is supported by multiple national laboratories and NASA centers. The ultimate purpose of the RxSim is to provide heated NaK to a pair of Stirling engines in the TDU. The RxSim includes many different systems, components, and instrumentation that have been developed at MSFC while working with pumped NaK systems and in partnership with the national laboratories and NASA centers. The main components of the RxSim are a core, a pump, a heat exchanger (to mimic the thermal load of the Stirling engines), and a flow meter for tests at MSFC. When tested at NASA Glenn Research Center (GRC) the heat exchanger will be replaced with a Stirling power conversion engine. Additional components include storage reservoirs, expansion volumes, overflow catch tanks, safety and support hardware, instrumentation (temperature, pressure, flow) for data collection, and power supplies. This paper will discuss the design and current build status of the RxSim for delivery to GRC in early 2012.

Design and Build of Reactor Simulator for Fission Surface Power Technology Demonstrator Unit

NASA Astrophysics Data System (ADS)

Godfroy, T.; Dickens, R.; Houts, M.; Pearson, B.; Webster, K.; Gibson, M.; Qualls, L.; Poston, D.; Werner, J.; Radel, R.

The Nuclear Systems Team at Marshall Space Flight Center (MSFC) focuses on technology development for state of the art capability in non-nuclear testing of nuclear system and Space Nuclear Power for fission reactor systems for lunar and mars surface power generation as well as radioisotope power systems for both spacecraft and surface applications. Currently being designed and developed is a reactor simulator (RxSim) for incorporation into the Technology Demonstrator Unit (TDU) for the Fission Surface Power System (FSPS) Program which is supported by multiple national laboratories and NASA centers. The ultimate purpose of the RxSim is to provide heated NaK to a pair of Stirling engines in the TDU. The RxSim includes many different systems, components, and instrumentation that have been developed at MSFC while working with pumped NaK systems and in partnership with the national laboratories and NASA centers. The main components of the RxSim are a core, a pump, a heat exchanger (to mimic the thermal load of the Stirling engines), and a flow meter when being tested at MSFC. When tested at GRC the heat exchanger will be replaced with a Stirling power conversion engine. Additional components include storage reservoirs, expansion volumes, overflow catch tanks, safety and support hardware, instrumenta- tion (temperature, pressure, flow) data collection, and power supplies. This paper will discuss the design and current build status of the RxSim for delivery to GRC in early 2012.

Effects of anthropogenic activity emerging as intensified extreme precipitation over China

NASA Astrophysics Data System (ADS)

Li, Huixin; Chen, Huopo; Wang, Huijun

2017-07-01

This study aims to provide an assessment of the effects of anthropogenic (ANT) forcings and other external factors on observed increases in extreme precipitation over China from 1961 to 2005. Extreme precipitation is represented by the annual maximum 1 day precipitation (RX1D) and the annual maximum 5 day consecutive precipitation (RX5D), and these variables are investigated using observations and simulations from the Coupled Model Intercomparison Project phase 5. The analyses mainly focus on the probability-based index (PI), which is derived from RX1D and RX5D by fitting generalized extreme value distributions. The results indicate that the simulations that include the ANT forcings provide the best representation of the spatial and temporal characteristics of extreme precipitation over China. We use the optimal fingerprint method to obtain the univariate and multivariate fingerprints of the responses to external forcings. The results show that only the ANT forcings are detectable at a 90% confidence level, both individually and when natural forcings are considered simultaneously. The impact of the forcing associated with greenhouse gases (GHGs) is also detectable in RX1D, but its effects cannot be separated from those of combinations of forcings that exclude the GHG forcings in the two-signal analyses. Besides, the estimated changes of PI, extreme precipitation, and events with a 20 year return period under nonstationary climate states are potentially attributable to ANT or GHG forcings, and the relationships between extreme precipitation and temperature from ANT forcings show agreement with observations.

Monitoring childbirth morbidity using hospital discharge data: further development and application of a composite measure.

PubMed

Korst, Lisa M; Fridman, Moshe; Lu, Michael C; Mitchell, Connie; Lawton, Elizabeth; Griffin, Flojaune; Gregory, Kimberly D

2014-09-01

The purpose of this study was to evaluate the use of a childbirth composite morbidity indicator for monitoring childbirth morbidity at hospital and regional levels in California. Study data were obtained from the 2005 linked maternal and neonatal discharge dataset for California hospitals. The study population was limited to laboring women with singleton, term (≥37 weeks' gestation), inborn, and live births. Women with and without pregnancy complications were stratified into high- and low-risk groups. The composite outcome was defined as any significant morbidity of the mother or newborn infant during the childbirth admission. Submeasures for maternal and neonatal composite morbidity and for severe maternal morbidity were examined with both aggregate and hospital-level analyses. Of 377,869 eligible deliveries, 120,218 (31.8%) were categorized as high risk and 257,651 (68.2%) were categorized as low risk. High-risk women had higher morbidity rates for all comparisons. The mean childbirth composite morbidity rate was 21% overall: 28% for high-risk women and 18% for low-risk women. For high- and low-risk strata, the rates of maternal complications were 18% and 13%, and the rates of severe maternal morbidity were 1.4% and 0.5%, respectively. There was substantial variation across hospitals for all measures. The childbirth composite morbidity rate is designed to report childbirth complication rates that combine maternal and neonatal morbidity. This measure and its submeasures met the criteria for quality indicator evaluation as specified by the Agency for Healthcare Research and Quality and can be used for benchmarking or for monitoring childbirth outcomes at regional levels. Copyright © 2014. Published by Elsevier Inc.

Outcomes of General Anesthesia and Conscious Sedation in Endovascular Treatment for Stroke.

PubMed

Just, Caroline; Rizek, Philippe; Tryphonopoulos, Peter; Pelz, David; Arango, Miguel

2016-09-01

Background Recent studies have strongly indicated the benefits of endovascular therapy for acute ischemic stroke, but what remains a continued debate is the role for general anaesthesia versus conscious sedation (CS) for such procedures. Retrospective studies have found poorer neurological outcomes in patients who underwent general anesthesia (GA); however, some have revealed worse baseline stroke severity in these patients. Methods This study is a retrospective cohort study aimed at comparing mortality and morbidity of GA versus CS in patients treated with endovascular intervention in acute ischemic stroke. Chi-square and t-test analyses were used. Results Patients in the GA (n=42) group were more likely to be deceased than those in the CS (n=67) group at hospital discharge, 3 months, and 6 months poststroke onset. Morbidity, as defined by modified Rankin Score, was significantly greater in the GA group at hospital discharge, and a similar trend was seen in morbidity at 3 months postdischarge. Conclusion General anesthesia for endovascular intervention in acute ischemic stroke was associated with increased mortality and poorer neurological incomes compared with conscious sedation. In our study, age, gender, history of hypertension, history of diabetes, and baseline National Institute of Health Stroke Scale were not significantly different between the groups. Although the need for a randomized, prospective study on this topic is clear, our study represents further corroboration of the safety and efficacy of conscious sedation in these procedures.

Telemedicine delivery of patient education in remote Ontario communities: feasibility of an Advanced Clinician Practitioner in Arthritis Care (ACPAC)-led inflammatory arthritis education program.

PubMed

Warmington, Kelly; Flewelling, Carol; Kennedy, Carol A; Shupak, Rachel; Papachristos, Angelo; Jones, Caroline; Linton, Denise; Beaton, Dorcas E; Lineker, Sydney

2017-01-01

Telemedicine-based approaches to health care service delivery improve access to care. It was recognized that adults with inflammatory arthritis (IA) living in remote areas had limited access to patient education and could benefit from the 1-day Prescription for Education (RxEd) program. The program was delivered by extended role practitioners with advanced training in arthritis care. Normally offered at one urban center, RxEd was adapted for videoconference delivery through two educator development workshops that addressed telemedicine and adult education best practices. This study explores the feasibility of and participant satisfaction with telemedicine delivery of the RxEd program in remote communities. Participants included adults with IA attending the RxEd program at one of six rural sites. They completed post-course program evaluations and follow-up interviews. Educators provided post-course feedback to identify program improvements that were later implemented. In total, 123 people (36 in-person and 87 remote, across 6 sites) participated, attending one of three RxEd sessions. Remote participants were satisfied with the quality of the video-conference (% agree/strongly agree): could hear the presenter (92.9%) and discussion between sites (82.4%); could see who was speaking at other remote sites (85.7%); could see the slides (95.3%); and interaction between sites adequately facilitated (94.0%). Educator and participant feedback were consistent. Suggested improvements included: use of two screens (speaker and slides); frontal camera angles; equal interaction with remote sites; and slide modifications to improve the readability on screen. Interview data included similar constructive feedback but highlighted the educational and social benefits of the program, which participants noted would have been inaccessible if not offered via telemedicine. Study findings confirm the feasibility of delivering the RxEd program to remote communities by using telemedicine. Future research with a focus on the sustainability of this and other models of technology-supported patient education for adults with IA across Ontario is warranted.

Multiwavelength study of RX J2015.6+3711: a magnetic cataclysmic variable with a 2-h spin period

NASA Astrophysics Data System (ADS)

Coti Zelati, F.; Rea, N.; Campana, S.; de Martino, D.; Papitto, A.; Safi-Harb, S.; Torres, D. F.

2016-02-01

The X-ray source RX J2015.6+3711 was discovered by ROSAT in 1996 and recently proposed to be a cataclysmic variable (CV). Here, we report on an XMM-Newton observation of RX J2015.6+3711 performed in 2014, where we detected a coherent X-ray modulation at a period of 7196 ± 11 s and discovered other significant (>6σ) small-amplitude periodicities which we interpret as the CV spin period and the sidebands of a possible ˜12-h periodicity, respectively. The 0.3-10 keV spectrum can be described by a power law (Γ = 1.15 ± 0.04) with a complex absorption pattern, a broad emission feature at 6.60 ± 0.01 keV, and an unabsorbed flux of (3.16 ± 0.05) × 10-12 erg cm-2 s-1. We observed a significant spectral variability along the spin phase, which can be ascribed mainly to changes in the density of a partial absorber and the power law normalization. Archival X-ray observations carried out by the Chandra satellite, and two simultaneous X-ray and UV/optical pointings with Swift, revealed a gradual fading of the source in the soft X-rays over the last 13 yr, and a rather stable X-ray-to-optical flux ratio (FX/FV ≈ 1.4-1.7). Based on all these properties, we identify this source with a magnetic CV, most probably of the intermediate polar type. The 2-h spin period makes RX J2015.6+3711, the second slowest rotator of the class, after RX J0524+4244 (`Paloma'; Pspin ˜ 2.3 h). Although we cannot unambiguously establish the true orbital period with these observations, RX J2015.6+3711 appears to be a key system in the evolution of magnetic CVs.

Super-Eddington QSO RX J0439.6-5311 - II. Multiwavelength constraints on the global structure of the accretion flow

NASA Astrophysics Data System (ADS)

Jin, Chichuan; Done, Chris; Ward, Martin; Gardner, Emma

2017-10-01

We present a detailed multiwavelength study of an unobscured, highly super-Eddington Type-1 QSO RX J0439.6-5311. We combine the latest XMM-Newton observation with all archival data from infrared to hard X-rays. The optical spectrum is very similar to that of 1H 0707-495 in having extremely weak [O III] and strong Fe II emission lines, although the black hole mass is probably slightly higher at 5-10 × 106 M⊙. The broad-band spectral energy distribution is uniquely well defined due to the extremely low Galactic and intrinsic absorption, so the bolometric luminosity is tightly constrained. The optical/UV accretion disc continuum is seen down to 900 Å, showing that there is a standard thin disc structure down to R ≥ 190-380 Rg and determining the mass accretion rate through the outer disc. This predicts a much higher bolometric luminosity than observed, indicating that there must be strong wind and/or advective energy losses from the inner disc, as expected for a highly super-Eddington accretion flow. Significant outflows are detected in both the narrow-line region (NLR) and broad-line region (BLR) emission lines, confirming the presence of a wind. We propose a global picture for the structure of a super-Eddington accretion flow where the inner disc puffs up, shielding much of the potential NLR material, and show how inclination angle with respect to this and the wind can explain very different X-ray properties of RX J0439.6-5311 and 1H 0707-495. Therefore, this source provides strong supporting evidence that 'simple' and 'complex' super-Eddington NLS1s can be unified within the same accretion flow scenario but with different inclination angles. We also propose that these extreme NLS1s could be the low-redshift analogues of weak emission-line quasars.

Bonding efficacy of new self-etching, self-adhesive dual-curing resin cements to dental enamel.

PubMed

Benetti, Paula; Fernandes, Virgílio Vilas; Torres, Carlos Rocha; Pagani, Clovis

2011-06-01

This study evaluated the efficacy of the union between two new self-etching self-adhesive resin cements and enamel using the microtensile bond strength test. Buccal enamel of 80 bovine teeth was submitted to finishing and polishing with metallographic paper to a refinement of #600, in order to obtain a 5-mm2 flat area. Blocks (2 x 4 x 4 mm) of laboratory composite resin were cemented to enamel according to different protocols: (1) untreated enamel + RelyX Unicem cement (RX group); (2) untreated enamel + Bifix SE cement (BF group); (3) enamel acid etching and application of resin adhesive Single Bond + RelyX Unicem (RXA group); (4) enamel acid etching and application of resin adhesive Solobond M + Bifix SE (BFA group). After 7 days of storage in distillated water at 37°C, the blocks were sectioned for obtaining microbar specimens with an adhesive area of 1 mm2 (n = 120). Specimens were submitted to the microtensile bond strength test at a crosshead speed of 0.5 mm/min. The results (in MPa) were analyzed statistically by ANOVA and Tukey's test. Enamel pre-treatment with phosphoric acid and resin adhesive (27.9 and 30.3 for RXA and BFA groups) significantly improved (p ≤ 0.05) the adhesion of both cements to enamel compared to the union achieved with as-polished enamel (9.9 and 6.0 for RX and BF). Enamel pre-treatment with acid etching and the application of resin adhesive significantly improved the bond efficacy of both luting agents compared to the union achieved with as-polished enamel.

Long-term health effects in adults born during the Holocaust.

PubMed

Bercovich, Eyal; Keinan-Boker, Lital; Shasha, Shaul M

2014-04-01

Previous studies suggest that exposure to starvation and stress between conception and early infancy may have deleterious effects on health later in life; this phenomenon is termed fetal origin of adult disease. To determine whether exposure to the Holocaust from preconception to early infancy is a cause of chronic morbidity in adulthood. This pilot study involved 70 European Jews born in countries under Nazi rule (exposed group) during the period 1940-1945 who were interviewed to determine the presence of chronic diseases. A control group of 230 Israeli-born individuals of the same descent, age, and gender distribution were extracted from the Israel National Health Interview Survey-2 (unexposed group). The prevalence of selected risk factors and chronic diseases was compared between the groups. The prevalence of cardiovascular risk factors and morbidity was significantly higher in the exposed group: body mass index (BMI) (29.06 +/- 3.2 vs. 26.97 +/- 4.42, P = 0.015), hypertension (62.9% vs. 43%, P = 0.003), dyslipidemia (72.9% vs. 46.1%, P < 0.001), diabetes (32.9% vs. 17.4%, P = 0.006), angina pectoris (18.6% vs. 4.8%, P = 0.001) and congestive heart failure (8.6% vs. 1.7%, P = 0.013). The prevalence of cancer (30.0% vs. 8.7% P < 0.001), peptic ulcer disease (21.4% vs. 7%, P = 0.001), headaches/migraines (24.3% vs. 12.6%, P < 0.001) and anxiety/depression (50.0% vs. 8.3%, P < 0.001) was also higher in the exposed group. These results suggest that exposure to Holocaust conditions in early life may be associated with a higher prevalence of obesity, dyslipidemia, diabetes, hypertension, cardiovascular morbidity, malignancy and peptic diseases in adulthood. These findings set the stage for further research, which might define those exposed as a high risk group for chronic morbidity.

Intensity and Mechanisms of Fluoroquinolone Resistance within the H30 and H30Rx Subclones of Escherichia coli Sequence Type 131 Compared with Other Fluoroquinolone-Resistant E. coli.

PubMed

Johnson, James R; Johnston, Brian; Kuskowski, Michael A; Sokurenko, Evgeni V; Tchesnokova, Veronika

2015-08-01

The recent expansion of the H30 subclone of Escherichia coli sequence type 131 (ST131) and its CTX-M-15-associated H30Rx subset remains unexplained. Although ST131 H30 typically exhibits fluoroquinolone resistance, so do multiple other E. coli lineages that have not expanded similarly. To determine whether H30 isolates have more intense fluoroquinolone resistance than other fluoroquinolone-resistant E. coli isolates and to identify possible mechanisms, we determined the MICs for four fluoroquinolones (ciprofloxacin, levofloxacin, moxifloxacin, and norfloxacin) among 89 well-characterized, genetically diverse fluoroquinolone-resistant E. coli isolates (48 non-H30 and 41 H30 [23 H30Rx and 18 H30 non-Rx]). We compared the MICs with the H30 and H30Rx status, the presence/number of nonsynonymous mutations in gyrA, parC, and parE, the presence of aac(6')-1b-cr (an aminoglycoside/fluoroquinolone agent-modifying enzyme), and the efflux pump activity (measured as organic solvent tolerance [OST]). Among 1,518 recent E. coli clinical isolates, ST131 H30 predominated clonally, both overall and among the fluoroquinolone-resistant isolates. Among the 89 study isolates, compared with non-H30 isolates, H30 isolates exhibited categorically higher MICs for all four fluoroquinolone agents, higher absolute ciprofloxacin and norfloxacin MICs, more nonsynonymous mutations in gyrA, parC, and parE (specifically gyrA D87N, parC E84V, and parE I529L), and a numerically higher prevalence of (H30Rx-associated) aac(6')-1b-cr but lower OST scores. All putative resistance mechanisms were significantly associated with the MICs [for aac(6')-1b-cr: ciprofloxacin and norfloxacin only]. parC D87N corresponded with ST131 H30 and parE I529L with ST131 generally. Thus, more intense fluoroquinolone resistance may provide ST131 H30, especially H30Rx [if aac(6')-1b-cr positive], with subtle fitness advantages over other fluoroquinolone-resistant E. coli strains. This urges both parsimonious fluoroquinolone use and a search for other fitness-enhancing traits within ST131 H30. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

The Efficacy of the LearningRx Cognitive Training Program: Modality and Transfer Effects

ERIC Educational Resources Information Center

Hill, Oliver W.; Serpell, Zewelanji; Faison, M. Omar

2016-01-01

This article describes two studies testing the efficacy of a commercial one-on-one cognitive training program (LearningRx) and its computer-based version (Brainskills) in laboratory and school settings. Study 1 tested Brainskills in a laboratory setting with 322 middle school students. Paired "t"-tests revealed significant gains on all…

Gum-compliant uncertainty propagations for Pu and U concentration measurements using the 1st-prototype XOS/LANL hiRX instrument; an SRNL H-Canyon Test Bed performance evaluation project

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

Holland, Michael K.; O'Rourke, Patrick E.

An SRNL H-Canyon Test Bed performance evaluation project was completed jointly by SRNL and LANL on a prototype monochromatic energy dispersive x-ray fluorescence instrument, the hiRX. A series of uncertainty propagations were generated based upon plutonium and uranium measurements performed using the alpha-prototype hiRX instrument. Data reduction and uncertainty modeling provided in this report were performed by the SRNL authors. Observations and lessons learned from this evaluation were also used to predict the expected uncertainties that should be achievable at multiple plutonium and uranium concentration levels provided instrument hardware and software upgrades being recommended by LANL and SRNL are performed.

Clinical Impact of Detectable Antithyroglobulin Antibodies Below the Reference Limit (Borderline) in Patients with Papillary Thyroid Carcinoma with Undetectable Serum Thyroglobulin and Normal Neck Ultrasonography After Ablation: A Prospective Study.

PubMed

Côrtes, Marina Carvalho Souza; Rosario, Pedro Weslley; Oliveira, Luís Fernando Faria; Calsolari, Maria Regina

2018-02-01

Interference of antithyroglobulin antibodies (TgAb) with serum thyroglobulin (Tg) can occur even at detectable TgAb concentrations below the reference limit (borderline TgAb). Thus, borderline TgAb is considered as TgAb positivity in patients with thyroid cancer. This prospective study evaluated patients with papillary thyroid carcinoma with undetectable Tg and normal neck ultrasonography (US) after total thyroidectomy and ablation with 131 I, and compared tumor persistence/recurrence and long-term Tg and TgAb behavior in those with borderline versus undetectable TgAb. A total of 576 patients were evaluated, divided into two groups: group A with undetectable TgAb (n = 420), and group B with borderline TgAb (n = 156). Groups A and B were similar in terms of patient and tumor characteristics. The time of follow-up ranged from 24 to 120 months. During follow-up, 11 (2.6%) patients in group A and 5 (3.2%) in group B developed a recurrence (p = 0.77). In group A, recurrences occurred in 9/390 patients who continued to have undetectable TgAb and in 1/9 patients who progressed to borderline TgAb. In group B, recurrences were detected in 1/84 patients who progressed to have undetectable TgAb, in 1/45 who still had borderline TgAb, and in 3/12 who developed elevated TgAb. In the presence of Tg levels <0.2 ng/mL, recurrences were detected in 2/486 patients with undetectable TgAb, in 0/67 with borderline TgAb, and in 3/12 with elevated TgAb. The results of post-therapy whole-body scanning (RxWBS) of 216 patients with Tg ≤0.2 ng/mL and normal US at the time of ablation were also analyzed. In low-risk patients, none of the 40 patients with borderline TgAb and none of the 94 with undetectable TgAb exhibited ectopic uptake on RxWBS. In intermediate-risk patients, lymph node metastases were detected by RxWBS in 1/25 (4%) with borderline TgAb and in 2/57 (3.5%) with undetectable TgAb. The results suggest that among low- or intermediate-risk patients with undetectable Tg and normal US after thyroidectomy, those with borderline TgAb are at no greater risk of tumor persistence or recurrence than those with undetectable TgAb. When undetectable Tg levels persist, recurrence should be suspected in the case of a TgAb elevation above the reference limit.

Evidence for associations between the purinergic receptor P2X7 (P2RX7) and toxoplasmosis

PubMed Central

Jamieson, Sarra E.; Peixoto-Rangel, Alba L.; Hargrave, Aubrey C.; de Roubaix, Lee-Anne; Mui, Ernest J.; Boulter, Nicola R.; Miller, E. Nancy; Fuller, Stephen J.; Wiley, James S.; Castellucci, Léa; Boyer, Kenneth; Peixe, Ricardo Guerra; Kirisits, Michael J.; de Souza Elias, Liliani; Coyne, Jessica J.; Correa-Oliveira, Rodrigo; Sautter, Mari; Smith, Nicholas C.; Lees, Michael P.; Swisher, Charles N.; Heydemann, Peter; Noble, A. Gwendolyn; Patel, Dushyant; Bardo, Dianna; Burrowes, Delilah; McLone, David; Roizen, Nancy; Withers, Shawn; Bahia-Oliveira, Lílian M. G.; McLeod, Rima; Blackwell, Jenefer M.

2010-01-01

Congenital Toxoplasma gondii infection can result in intracranial calcification, hydrocephalus, and retinochoroiditis. Acquired infection is commonly associated with ocular disease. Pathology is characterized by strong pro-inflammatory responses. Ligation of ATP by purinergic receptor P2X7, encoded by P2RX7, stimulates pro-inflammatory cytokines and can lead directly to killing of intracellular pathogens. To determine whether P2X7 plays a role in susceptibility to congenital toxoplasmosis, we examined polymorphisms at P2RX7 in 149 child/parent trios from North America. We found association (FBAT Z scores ±2.429; P= 0.015) between the derived C(+)G(−) allele (f= 0.68; OR= 2.06; 95% CI: 1.14–3.75) at SNP rs1718119 (1068T>C; Thr-348-Ala), and a second synonymous variant rs1621388 in linkage disequilibrium with it, and clinical signs of disease per se. Analysis of clinical sub-groups showed no association with hydrocephalus, with effect sizes for associations with retinal disease and brain calcifications enhanced (OR=3.0 to 4.25; 0.004

Association of angiotensin-converting enzyme I/D and α-actinin-3 R577X genotypes with metabolic syndrome risk factors in Korean children.

PubMed

Kim, Kijin; Ahn, Nayoung; Park, Jusik; Koh, Jinho; Jung, Suryun; Kim, Sanghyun; Moon, Sangbok

2016-09-01

This study analysed the risk factors associated with metabolic syndrome through the interaction between ACTN3 and ACE gene polymorphism in Korean children. The subjects of the study consisted of elementary school students (n=788, age 10.10±0.07 yr). The anthropometric parameters, blood lipid profiles, and metabolic markers were compared among groups of the ACE I/D or the ACTN3 R577X polymorphisms. The subjects with the DD genotype showed significantly higher systolic blood pressure than the subjects with the II and ID genotype of the ACE gene polymorphism. XX genotype had significantly lower waist-hip ratio than those with RR genotype of the ACTN3 gene polymorphism. Also, the subjects with XX genotype exhibited significantly higher blood HDL cholesterol level than those with RR or RX genotype. The interaction of ACTN3 and ACE gene polymorphism in subjects having both ACE DD and ACTN3 RR genotypes demonstrated a significantly higher metabolic syndrome score than any other groups. The children having both ACTN3 RR or RX genotype and ACE DD genotype showed high systolic blood pressure and low blood HDL cholesterol level, which may be considered a high-risk in metabolic syndrome. Copyright © 2015. Published by Elsevier Ltd.

ACTN3 R577X polymorphism and explosive leg-muscle power in elite basketball players.

PubMed

Garatachea, Nuria; Verde, Zoraida; Santos-Lozano, Alejandro; Yvert, Thomas; Rodriguez-Romo, Gabriel; Sarasa, Francisco J; Hernández-Sánchez, Sonsoles; Santiago, Catalina; Lucia, Alejandro

2014-03-01

To determine the association of the ACTN3 R577X polymorphism with leg-muscle explosive power in Spanish (white) elite basketball players and controls. 100 (60 men) elite basketball players (cases) and 283 nonathletic controls. The authors assessed power performance by means of the vertical-squat and countermovement-jump tests. Genotype distributions did not differ between groups (cases: 37.0% [RR], 42.0% [RX], and 21.0% [XX]; controls: 31.8% [RR], 49.8% [RX], and 18.4% [XX]; P = .353). The authors did not observe any effect of the ACTN3 R577X polymorphism on study phenotypes in either group, including when they performed the analyses separately in men and women. They found no association between the ACTN3 R577X polymorphism and the likelihood of being an elite basketball player using the dominant or the recessive model, and the results remained unaltered when the analyses were adjusted for sex, weight, height, and age or when performed for men and women separately. Although the ACTN3 R577X is associated with explosive muscle performance and this phenotype is important in the sport of basketball (ie, during jumps), the authors found no association with leg explosive power in elite basket players or with the status of being this type of athlete.

Chandra Discovers Cosmic Cannonball

NASA Astrophysics Data System (ADS)

2007-11-01

One of the fastest moving stars ever seen has been discovered with NASA's Chandra X-ray Observatory. This cosmic cannonball is challenging theories to explain its blistering speed. Astronomers used Chandra to observe a neutron star, known as RX J0822-4300, over a period of about five years. During that span, three Chandra observations clearly show the neutron star moving away from the center of the Puppis A supernova remnant. This remnant is the stellar debris field created during the same explosion in which the neutron star was created about 3700 years ago. Chandra X-ray Image of RX J0822-4300 in Puppis A Chandra X-ray Image of RX J0822-4300 in Puppis A By combining how far it has moved across the sky with its distance from Earth, astronomers determined the neutron star is moving at over 3 million miles per hour. At this rate, RX J0822-4300 is destined to escape from the Milky Way after millions of years, even though it has only traveled about 20 light years so far. "This star is moving at 3 million miles an hour, but it's so far away that the apparent motion we see in five years is less than the height of the numerals in the date on a penny, seen from the length of a football field," said Frank Winkler of Middlebury College in Vermont. "It's remarkable, and a real testament to the power of Chandra, that such a tiny motion can be measured." Labeled Image of RX J0822-4300 in Puppis A Labeled Image of RX J0822-4300 in Puppis A "Just after it was born, this neutron star got a one-way ticket out of the Galaxy," said co-author Robert Petre of NASA's Goddard Space Flight Center in Greenbelt, Md. "Astronomers have seen other stars being flung out of the Milky Way, but few as fast as this." So-called hypervelocity stars have been previously discovered shooting out of the Milky Way with speeds around one million miles per hour. One key difference between RX J0822-4300 and these other reported galactic escapees is the source of their speed. The hypervelocity stars are thought to have been ejected by interactions with the supermassive black hole in the Galaxy's center. CTIO Optical Images of Puppis A CTIO Optical Images of Puppis A This neutron star, by contrast, was flung into motion by the supernova that created Puppis A. The data suggest the explosion was lop-sided, kicking the neutron star in one direction and the debris from the explosion in the other. The supernova was precipitated when the core of a massive star imploded to form a neutron star. Computer simulations show that the infall of the outer layers of the star onto a neutron star releases an enormous amount of energy. As this energy propagates outward, it can reverse the infall and eject the outer layers of the star at speeds of millions of miles per hour. Due to the complexity of the flow, the ejection is not symmetric, leading to a rocket effect that propels the neutron star in the opposite direction. ROSAT X-ray ROSAT X-ray The breakneck speed of the Puppis A neutron star, plus an apparent lack of pulsations from it, is not easily explained by even the most sophisticated supernova explosion models. "The problem with discovering this cosmic cannonball is we aren't sure how to make the cannon powerful enough." said Winkler. "The high speed might be explained by an unusually energetic explosion, but the models are complicated and hard to apply to real explosions." Other recent work on RX J0822-4300 was published by C.Y. Hui and Wolfgang Becker, both from the Max Planck Institute for Extraterrestrial Physics in Munich, in the journal Astronomy and Astrophysics in late 2006. Using two of the three Chandra observations reported in the Winkler paper and a different analysis technique, the Hui group found a speed for RX J0822-4300 that is about two-thirds as fast, but with larger reported margins of error. The research by Winkler and Petre was published in the November 20 issue of The Astrophysical Journal. NASA's Marshall Space Flight Center, Huntsville, Ala., manages the Chandra program for the agency's Science Mission Directorate. The Smithsonian Astrophysical Observatory controls science and flight operations from the Chandra X-ray Center in Cambridge, Mass.

Measuring radiant emissions from entire prescribed fires with ground, airborne and satellite sensors - RxCADRE 2012

Treesearch

Matthew B. Dickinson; Andrew T. Hudak; Thomas Zajkowski; E. Louise Loudermilk; Wilfrid Schroeder; Luke Ellison; Robert L. Kremens; William Holley; Otto Martinez; Alexander Paxton; Benjamin C. Bright; Joseph O' Brien; Ben Hornsby; Charles Ichoku; Jason Faulring; Aaron Gerace; David Peterson; Joseph Mauceri

2016-01-01

Characterising radiation from wildland fires is an important focus of fire science because radiation relates directly to the combustion process and can be measured across a wide range of spatial extents and resolutions. As part of a more comprehensive set of measurements collected during the 2012 Prescribed Fire Combustion and Atmospheric Dynamics Research (RxCADRE)...

Development and validation of fuel height models for terrestrial lidar - RxCADRE 2012

Treesearch

Eric M. Rowell; Carl A. Seielstad; Roger D. Ottmar

2016-01-01

Terrestrial laser scanning (TLS) was used to collect spatially continuous measurements of fuelbed characteristics across the plots and burn blocks of the 2012 RxCADRE experiments in Florida. Fuelbeds were scanned obliquely from plot/block edges at a height of 20 m above ground. Pre-fire blocks were scanned from six perspectives and four perspectives for post-...

Implementation and evaluation of an automated dispensing system.

PubMed

Schwarz, H O; Brodowy, B A

1995-04-15

An institution's experience in replacing a traditional unit dose cassette-exchange system with an automated dispensing system is described. A 24-hour unit dose cassette-exchange system was replaced with an automated dispensing system (Pyxis's Medstation Rx) on a 36-bed cardiovascular surgery unit and an 8-bed cardiovascular intensive care unit. Significantly fewer missing doses were reported after Medstation Rx was implemented. No conclusions could be made about the impact of the system on the reporting of medication errors. The time savings for pharmacy associated with the filling, checking, and delivery of new medication orders equated to about 0.5 full-time equivalent (FTE). Medstation Rx also saved substantial nursing time for acquisition of controlled substances and for controlled-substance inventory taking at shift changes. A financial analysis showed that Medstation Rx could save the institution about $1 million over five years if all personnel time savings could be translated into FTE reductions. The automated system was given high marks by the nurses in a survey; 80% wanted to keep the system on their unit. Pilot implementation of an automated dispensing system improved the efficiency of drug distribution over that of the traditional unit dose cassette-exchange system.

Cognitive Effects of ThinkRx Cognitive Rehabilitation Training for Eleven Soldiers with Brain Injury: A Retrospective Chart Review

PubMed Central

Ledbetter, Christina; Moore, Amy Lawson; Mitchell, Tanya

2017-01-01

Cognitive rehabilitation training is a promising technique for remediating the cognitive deficits associated with brain injury. Extant research is dominated by computer-based interventions with varied results. Results from clinician-delivered cognitive rehabilitation are notably lacking in the literature. The current study examined the cognitive outcomes following ThinkRx, a clinician-delivered cognitive rehabilitation training program for soldiers recovering from traumatic brain injury and acquired brain injury. In a retrospective chart review, we examined cognitive outcomes of 11 cases who had completed an average of 80 h of ThinkRx cognitive rehabilitation training delivered by clinicians and supplemented with digital training exercises. Outcome measures included scores from six cognitive skill batteries on the Woodcock Johnson – III Tests of Cognitive Abilities. Participants achieved gains in all cognitive skills tested and achieved statistically significant changes in long-term memory, processing speed, auditory processing, and fluid reasoning with very large effect sizes. Clinically significant changes in multiple cognitive skills were also noted across cases. Results of the study suggest that ThinkRx clinician-delivered cognitive training supplemented with digital exercises may be a viable method for targeting the cognitive deficits associated with brain injury. PMID:28588534

The Effect of Complementary and Alternative Medicine Claims on Risk Adjustment

PubMed Central

Lind, Bonnie K.; Abrams, Chad; Lafferty, William E.; Kiehr, Paula K.; Grembowski, David E.

2006-01-01

Objective To assess how the inclusion of diagnoses from complementary and alternative medicine (CAM) providers affects measures of morbidity burden and expectations of health care resource use for insured patients. Methods Claims data from Washington State were used to create two versions of a case-mix index. One version included claims from all provider types; the second version omitted claims from CAM providers who are covered under commercial insurance. Expected resource use was also calculated. The distribution of expected and actual resource use was then compared for the two indices. Results Inclusion of CAM providers shifts many patients into higher morbidity categories; 54% of 61,914 CAM users had higher risk scores in the index which included CAM providers. When expected resource use categories were defined based on all providers, CAM users in the highest morbidity category had average (± s.d.) annual expenditures of $6661 (± $13,863). This was less than those in the highest morbidity category when CAM providers were not included in the index ($8562 ± $16,354), and was also lower than the highest morbidity patients who did not use any CAM services ($8419 ± $18,885). Conclusions Inclusion of services from CAM providers under third party payment increases risk scores for their patients but expectations of costs for this group are lower than expected had costs been estimated based only on services from traditional providers. Additional work is needed to validate risk adjustment indices when adding services from provider groups not included in the development of the index. PMID:17122711

Psychiatric morbidity and its correlates among informal caregivers of older adults.

PubMed

Vaingankar, Janhavi Ajit; Chong, Siow Ann; Abdin, Edimansyah; Picco, Louisa; Shafie, Saleha; Seow, Esmond; Pang, Shirlene; Sagayadevan, Vathsala; Chua, Boon Yiang; Chua, Hong Choon; Subramaniam, Mythily

2016-07-01

This present study estimated the psychiatric morbidity among informal caregivers of older adults and investigated its association with their socio-demographic factors and older adult's health status, including dementia, depression and physical health conditions. Data from a national cross-sectional survey were used. For each participating older adult, an informal caregiver who 'knew the older adult best' and was aware of their health condition, was also interviewed to collect information on the older adults' care needs, and behavioral and psychological symptoms of dementia (BPSD). Data from 693 pairs was used. Informal caregivers were administered the Self Reporting Questionnaire (SRQ)-20 and psychiatric morbidity was defined as those with a total SRQ score of ≥8. Measures included informal caregivers' socio-demographic characteristics, assessment of dementia and depression in the older adults and self-report on their lifetime and current physical conditions. The association of socio-demographic characteristics, health conditions, care assistance and BPSD was investigated using backward stepwise logistic regression analysis where psychiatric morbidity (total SRQ score

Evaluation of acute and late radiation morbidity in patients with gynaecologic malignancy using the RTOG criteria and Franco-Italian glossary.

PubMed

Yildirim, G; Ozsaran, Z; Yalman, D; Kamer, S; Aras, A

2008-01-01

The purpose of this study was to evaluate acute and late radiation morbidity in patients with gynaecologic malignancy using the RTOG criteria and Franco-Italian glossary, and to compare the usefulness and disadvantages of each system. Between February 2001 and February 2003, 107 patients with gynaecologic malignancy who received either radical or djuvant external radiotherapy +/- intracavitary brachytherapy or radiochemotherapy were enrolled in this study. The patients were evaluated before radiotherapy and weekly during radiotherapy for acute morbidity using the RTOG grading system and Franco-Italian glossary. Postradiotherapy evaluation was done one month after radiotherapy and at 3-month intervals thereafter. Median follow-up duration was 17 months. Morbidity was graded and recorded according to each scoring system. Median age was 46 years (range 37-82). Sixty-four patients (59.8%) had endometrial cancer. Radical radiotherapy was applied to 26 patients because of inoperability and 81 patients received postoperative radiotherapy. Biologically effective doses for the bladder, rectum and vagina were 98.39, 103.54 and 121.81, respectively, for late morbidity (BED3); 70.88, 72.84 and 80.92, respectively, for acute morbidity (BED10). According to the RTOG grading system acute morbidity rate for the genitourinary and gastrointestinal systems, and skin were 52.3%, 83.2% and 63.5%, respectively. Late morbidity rate for the bladder, colon-rectum, skin and vagina were 16.8%, 20.6%, 47.7% and 51.4%, respectively. The morbidity rate for the bladder, nonspecific abdominal, hematopoietic system, uterus-vulva-vagina, skin and rectum were 35.4%, 29.9%, 5.6%, 60.8%, 40.1% and 32.7%, respectively using the Franco-Italian glossary. In patients with carcinoma of the vulva--whose treatment fields were wider--acute morbidity rate according to RTOG criteria was higher (p = 0.057); photon energy (6 Mv rather than 1.25 MV) (p = 0.01) and treatment interruption of more than eight days (p = 0.019) were correlated with decreased long-term morbidity. According to the Franco-Italian glossary morbidity rates were higher in patients who received chemotherapy (p = 0.047), both external radiotherapy and brachytherapy (p = 0.022) and treatment interruption of less than eight days (p = 0.019). There is no common language between the RTOG grading system and Franco-Italian glossary for defining and scoring radiation morbidity. Up to date no standard and well-defined system has been developed for recording and reporting acute and late radiation morbidity in gynaecologic malignancy, but rather it depends on the subjective evaluation and experience of a radiation oncologist and subjective complaints of the patient, and sometimes on clinical findings. A standard and well-defined user friendly objective scoring system is needed to define and predict the morbidity rate more properly.

Costing transurethral resection of the prostate and diagnosis related group in Australia compared with United States costs.

PubMed

Gordon, N S

1994-02-01

The cost of a transurethral resection of the prostate is of considerable concern to the community. More of these procedures are being performed as the number of patients in the aged population increases. The costs of wages and salaries, purchase of equipment and depreciation, stationery, linen, investigations (pathology) and pharmaceuticals are compared with the bed charges (as charged to a private patient), the cost per inpatient day and the cost per inpatient treated, which is calculated from the operating fund budget expenditure of The Bendigo Hospital. The cost per diagnosis related group (DRG) 336 (defined as: transurethral prostatectomy, age greater than 69 and/or complication/co-morbidity; mean length of stay 7.0; relative weight = 0.9869) and DRG 337 (defined as: transurethral prostatectomy, age less than 70 without complication/co-morbidity; mean length of stay 5.8; relative weight = 0.7788) are compared with the figures for a similar procedure in 1987 in a United States hospital and extrapolated, by the use of the Consumer Price Index, to 1992 levels. The findings demonstrate that transurethral resection of the prostate as costed in this hospital compares very favourably with that in a US hospital, and favourably from the point of view of health care costs.

Using a tailored health information technology- driven intervention to improve health literacy and medication adherence in a Pakistani population with vascular disease (Talking Rx) - study protocol for a randomized controlled trial.

PubMed

Kamal, Ayeesha Kamran; Muqeet, Abdul; Farhat, Kashfa; Khalid, Wardah; Jamil, Anum; Gowani, Ambreen; Muhammad, Aliya Amin; Zaidi, Fabiha; Khan, Danyal; Elahi, Touseef; Sharif, Shahrukh; Raz, Sibtain; Zafar, Taha; Bokhari, Syedah Saira; Rahman, Nasir; Sultan, Fateh Ali Tipoo; Sayani, Saleem; Virani, Salim S

2016-03-05

Vascular disease, manifesting as myocardial infarction and stroke, is a major cause of morbidity and mortality, especially in low- and middle-income countries. Current estimates are that only one in six patients have good adherence to medications and very few have sufficient health literacy. Our aim is to explore the effectiveness and acceptability of Prescription Interactive Voice Response (IVR) Talking Prescriptions (Talking Rx) and SMS reminders in increasing medication adherence and health literacy in Pakistani patients with vascular disease. This is a randomized, controlled, single center trial. Adult participants, with access to a cell phone and a history of vascular disease, taking multiple risk-modifying medications (inclusive of anti-platelets and statins) will be selected from cerebrovascular and cardiovascular clinics. They will be randomized in a 1:1 ratio via a block design to the intervention or the control arm with both groups having access to a helpline number to address their queries in addition to standard of care as per institutional guidelines. Participants in the intervention group will also have access to Interactive Voice Response (IVR) technology tailored to their respective prescriptions in the native language (Urdu) and will have the ability to hear information about their medication dosage, correct use, side effects, mechanism of action and how and why they should use their medication, as many times as they like. Participants in the intervention arm will also receive scheduled SMS messages reminding them to take their medications. The primary outcome measure will be the comparison of the difference in adherence to anti-platelet and statin medication between baseline and at 3-month follow-up in each group measured by the Morisky Medication Adherence Scale. To ascertain the impact of our intervention on health literacy, we will also compare a local content-validated and modified version of Test of Health Literacy in Adults (TOFHLA) between the intervention and the control arm. We estimate that a sample size of 86 participants in each arm will be able to detect a difference of 1 point on the MMAS with a power of 90 % and significance level of 5 %. Accounting for an attrition rate of 15 %, we plan to enroll 100 participants in each arm (total study population = 200). We hypothesize that a linguistically tailored health IT intervention based on IVR and SMS will be associated with an improvement in adherence (to anti-platelet and lipid-lowering medications) and an improvement in health literacy in Pakistani patients with vascular disease. This innovative study will provide early data for the feasibility of the use of IT based prescriptions in an lower middle incorme country setting with limited numeracy and literacy skills. Clinical Trials.gov: NCT02354040 - 2 February 2015.

Rx-CADRE (Prescribed Fire Combustion-Atmospheric Dynamics Research Experiments) collaborative research in the core fire sciences

Treesearch

D. Jimenez; B. Butler; K. Hiers; R. Ottmar; M. Dickinson; R. Kremens; J. O' Brien; A. Hudak; C. Clements

2009-01-01

The Rx-CADRE project was the combination of local and national fire expertise in the field of core fire research. The project brought together approximately 30 fire scientists from six geographic regions and seven diff erent agencies. The project objectives were to demonstrate the capacity for collaborative research by bringing together individuals and teams with a...

Analysis of Non-contact Acousto Thermal Signature Data (Postprint)

DTIC Science & Technology

2016-02-01

AFRL-RX-WP-JA-2016-0321 ANALYSIS OF NON- CONTACT ACOUSTO-THERMAL SIGNATURE DATA (POSTPRINT) Amanda K. Criner AFRL/RX...October 2014 – 16 September 2015 4. TITLE AND SUBTITLE ANALYSIS OF NON- CONTACT ACOUSTO-THERMAL SIGNATURE DATA (POSTPRINT) 5a. CONTRACT NUMBER...words) The non- contact acousto-thermal signature (NCATS) is a nondestructive evaluation technique with potential to detect fatigue in materials such as

Compact and portable X-ray imager system using Medipix3RX

NASA Astrophysics Data System (ADS)

Garcia-Nathan, T. B.; Kachatkou, A.; Jiang, C.; Omar, D.; Marchal, J.; Changani, H.; Tartoni, N.; van Silfhout, R. G.

2017-10-01

In this paper the design and implementation of a novel portable X-ray imager system is presented. The design features a direct X-ray detection scheme by making use of a hybrid detector (Medipix3RX). Taking advantages of the capabilities of the Medipix3RX, like a high resolution, zero dead-time, single photon detection and charge-sharing mode, the imager has a better resolution and higher sensitivity compared to using traditional indirect detection schemes. A detailed description of the system is presented, which consists of a vacuum chamber containing the sensor, an electronic board for temperature management, conditioning and readout of the sensor and a data processing unit which also handles network connection and allow communication with clients by acting as a server. A field programmable gate array (FPGA) device is used to implement the readout protocol for the Medipix3RX, apart from the readout the FPGA can perform complex image processing functions such as feature extraction, histogram, profiling and image compression at high speeds. The temperature of the sensor is monitored and controlled through a PID algorithm making use of a Peltier cooler, improving the energy resolution and response stability of the sensor. Without implementing data compression techniques, the system is capable of transferring 680 profiles/s or 240 images/s in a continuous mode. Implementation of equalization procedures and tests on colour mode are presented in this paper. For the experimental measurements the Medipix3RX sensor was used with a Silicon layer. One of the tested applications of the system is as an X-ray beam position monitor (XBPM) device for synchrotron applications. The XBPM allows a non-destructive real time measurement of the beam position, size and intensity. A Kapton foil is placed in the beam path scattering radiation towards a pinhole camera setup that allows the sensor to obtain an image of the beam. By using profiles of the synchrotron X-ray beam, high frequency movement of the beam position can be studied, up to 340 Hz. The system is capable of realizing an independent energy measure of the beam by using the Medipix3RX variable energy threshold feature.

Complications and outcomes of repeat cesarean section in adolescent women

PubMed Central

Kaplanoglu, Mustafa; Karateke, Atilla; Un, Burak; Akgor, Utku; Baloğlu, Ali

2014-01-01

Aim: The evaluation of the effect of repeat cesarean sections in adolescent pregnancies on the morbidity, obstetric and perinatal results. Materials and methods: We reviewed the patient file and hospital records of patients who underwent at least one cesarean section among adolescent age group pregnant women who gave birth at our clinic between January 2010 and May 2013. The patients were divided into two groups as the patients who underwent the second cesarean section (116 patients) and those who underwent the third cesarean section (36 patients). The demographic data, maternal data and obstetric and perinatal results of the patients were evaluated. Results: A significant difference was present between the patients in the evaluation of the total number of examinations during pregnancy (P = 0.001), total maternal weight gain during pregnancy (P = 0.006), and the first examination gestational age (P = 0.006) and all values were less favorable in the third cesarean group. The gestational week at birth (P < 0.001), birth weight (P < 0.001), and APGAR score (P < 0.001) in the group with the third cesarean section were statistically significantly lower than the second cesarean section. The third cesarean cesarean was found to cause a significant risk increase for placenta accreta risk in adolescent pregnancies (P = 0.042). Conclusion: The increasing number of cesarean sections in the adolescent group is seen to be a significant risk factor for low gestational week of birth, low birth weight and related morbidities. The most important reason for the increased morbidity with increasing cesarean sections in the adolescent age has been defined as placenta accreta. PMID:25664081

Dietary glutamine and oral antibiotics each improve indexes of gut barrier function in rat short bowel syndrome.

PubMed

Tian, Junqiang; Hao, Li; Chandra, Prakash; Jones, Dean P; Willams, Ifor R; Gewirtz, Andrew T; Ziegler, Thomas R

2009-02-01

Short bowel syndrome (SBS) is associated with gut barrier dysfunction. We examined effects of dietary glutamine (GLN) or oral antibiotics (ABX) on indexes of gut barrier function in a rat model of SBS. Adult rats underwent a 60% distal small bowel + proximal colonic resection (RX) or bowel transection (TX; control). Rats were pair fed diets with or without l-GLN for 20 days after operation. Oral ABX (neomycin, metronidazole, and polymyxin B) were given in some RX rats fed control diet. Stool secretory immunoglobulin A (sIgA) was measured serially. On day 21, mesenteric lymph nodes (MLN) were cultured for gram-negative bacteria. IgA-positive plasma cells in jejunum, stool levels of flagellin- and lipopolysaccharide (LPS)-specific sIgA, and serum total, anti-flagellin- and anti-LPS IgG levels were determined. RX caused gram-negative bacterial translocation to MLN, increased serum total and anti-LPS IgG and increased stool total sIgA. After RX, dietary GLN tended to blunt bacterial translocation to MLN (-29%, P = NS) and significantly decreased anti-LPS IgG levels in serum, increased both stool and jejunal mucosal sIgA and increased stool anti-LPS-specific IgA. Oral ABX eliminated RX-induced bacterial translocation, significantly decreased total and anti-LPS IgG levels in serum, significantly decreased stool total IgA and increased stool LPS-specific IgA. Partial small bowel-colonic resection in rats is associated with gram-negative bacterial translocation from the gut and a concomitant adaptive immune response to LPS. These indexes of gut barrier dysfunction are ameliorated or blunted by administration of dietary GLN or oral ABX, respectively. Dietary GLN upregulates small bowel sIgA in this model.

Investigating the impact of oxygen concentration and blood flow variation on photodynamic therapy

NASA Astrophysics Data System (ADS)

Penjweini, Rozhin; Kim, Michele M.; Finlay, Jarod C.; Zhu, Timothy C.

2016-03-01

Type II photodynamic therapy (PDT) is used for cancer treatment based on the combined action of a photosensitizer, a special wavelength of light, oxygen (3O2) and generation of singlet oxygen (1O2). Intra-patient and inter-patient variability of oxygen concentration ([3O2]) before and after the treatment as well as photosensitizer concentration and hemodynamic parameters such as blood flow during PDT has been reported. Simulation of these variations is valuable, as it would be a means for the rapid assessment of treatment effect. A mathematical model has been previously developed to incorporate the diffusion equation for light transport in tissue and the macroscopic kinetic equations for simulation of [3O2], photosensitizers in ground and triplet states and concentration of the reacted singlet oxygen ([1O₂]rx) during PDT. In this study, the finite-element based calculation of the macroscopic kinetic equations is done for 2-(1- Hexyloxyethyl)-2-devinyl pyropheophorbide (HPPH)-mediated PDT by incorporating the information of the photosensitizer photochemical parameters as well as the tissue optical properties, photosensitizer concentration, initial oxygen concentration ([3O2]0), blood flow changes and Φ that have been measured in mice bearing radiation-induced fibrosarcoma (RIF) tumors. Then, [1O2]rx calculated by using the measured [3O2] during the PDT is compared with [1O2]rx calculated based on the simulated [3O₂]; both calculations showed a reasonably good agreement. Moreover, the impacts of the blood flow changes and [3O2]0 on [1O2]rx have been investigated, which showed no pronounced effect of the blood flow changes on the long-term 1O2 generation. When [3O2]0 becomes limiting, small changes in [3O₂] have large effects on [1O2]rx.

Variation in Glucose Homeostasis Traits Associated With P2RX7 Polymorphisms in Mice and Humans

PubMed Central

Todd, Jennifer N.; Poon, Wenny; Lyssenko, Valeriya; Groop, Leif; Nichols, Brendan; Wilmot, Michael; Robson, Simon; Enjyoji, Keiichi; Herman, Mark A.; Hu, Cheng; Zhang, Rong; Jia, Weiping; Ma, Ronald

2015-01-01

Context: Extracellular nucleotide receptors are expressed in pancreatic B-cells. Purinergic signaling via these receptors may regulate pancreatic B-cell function. Objective: We hypothesized that purinergic signaling might influence glucose regulation and sought evidence in human studies of glycemic variation and a mouse model of purinergic signaling dysfunction. Design: In humans, we mined genome-wide meta-analysis data sets to examine purinergic signaling genes for association with glycemic traits and type 2 diabetes. We performed additional testing in two genomic regions (P2RX4/P2RX7 and P2RY1) in a cohort from the Prevalence, Prediction, and Prevention of Diabetes in Botnia (n = 3504), which includes more refined measures of glucose homeostasis. In mice, we generated a congenic model of purinergic signaling dysfunction by crossing the naturally hypomorphic C57BL6 P2rx7 allele onto the 129SvJ background. Results: Variants in five genes were associated with glycemic traits and in three genes with diabetes risk. In the Prevalence, Prediction, and Prevention of Diabetes in Botnia study, the minor allele in the missense functional variant rs1718119 (A348T) in P2RX7 was associated with increased insulin sensitivity and secretion, consistent with its known effect on increased pore function. Both male and female P2x7-C57 mice demonstrated impaired glucose tolerance compared with matched P2x7-129 mice. Insulin tolerance testing showed that P2x7-C57 mice were also less responsive to insulin than P2x7-129 mice. Conclusions: We show association of the purinergic signaling pathway in general and hypofunctioning P2X7 variants in particular with impaired glucose homeostasis in both mice and humans. PMID:25719930

ACTN3 R577X genotype and athletic performance in a large cohort of Japanese athletes.

PubMed

Kikuchi, Naoki; Miyamoto-Mikami, Eri; Murakami, Haruka; Nakamura, Tomohiro; Min, Seok-Ki; Mizuno, Masuhiko; Naito, Hisashi; Miyachi, Motohiko; Nakazato, Koichi; Fuku, Noriyuki

2016-09-01

Recent meta-analyses of the literature confirmed the association between the RR+RX genotype of the ACTN3 R577X polymorphism and elite sprint/power athletic status in Europeans but not in Asians and Africans, while the association between the R577X genotype and elite endurance athlete status is less convincing. The aim of the present study was to investigate the association between the ACTN3 R577X genotype and elite athlete status in a large Asian (Japanese) cohort of track and field athletes. One-thousand fifty-seven Japanese track and field athletes (627 sprint/power athletes and 430 endurance athletes) and 810 Japanese controls were genotyped for the ACTN3 R577X polymorphism (rs1815739) by using the TaqMan® SNP Genotyping Assay. Elite sprint/power athletes had a higher frequency of the RR+RX genotype than the controls (OR: 1.59, 95% CI: 1.16-2.18; P = .003). A significant linear correlation was found between the RR + RX genotype and athlete status (i.e. regional < national < international) in sprint/power athletes (regional: 71%, national: 81%, international: 84%; P = .001 for trend) and long-distance runners (regional: 65%, national: 72%, international: 82%; P = .030 for trend). The data obtained for this large Asian (Japanese) cohort of track and field athletes served to confirm the association between the RR + RX genotype of the ACTN3 R577X polymorphism and elite sprint/power athlete status and also the association between the ACTN3 RR + RX genotype and long-distance running athletic status.

A 13.56-mbps pulse delay modulation based transceiver for simultaneous near-field data and power transmission.

PubMed

Kiani, Mehdi; Ghovanloo, Maysam

2015-02-01

A fully-integrated near-field wireless transceiver has been presented for simultaneous data and power transmission across inductive links, which operates based on pulse delay modulation (PDM) technique. PDM is a low-power carrier-less modulation scheme that offers wide bandwidth along with robustness against strong power carrier interference, which makes it suitable for implantable neuroprosthetic devices, such as retinal implants. To transmit each bit, a pattern of narrow pulses are generated at the same frequency of the power carrier across the transmitter (Tx) data coil with specific time delays to initiate decaying ringing across the tuned receiver (Rx) data coil. This ringing shifts the zero-crossing times of the undesired power carrier interference on the Rx data coil, resulting in a phase shift between the signals across Rx power and data coils, from which the data bit stream can be recovered. A PDM transceiver prototype was fabricated in a 0.35- μm standard CMOS process, occupying 1.6 mm(2). The transceiver achieved a measured 13.56 Mbps data rate with a raw bit error rate (BER) of 4.3×10(-7) at 10 mm distance between figure-8 data coils, despite a signal-to-interference ratio (SIR) of -18.5 dB across the Rx data coil. At the same time, a class-D power amplifier, operating at 13.56 MHz, delivered 42 mW of regulated power across a separate pair of high-Q power coils, aligned with the data coils. The PDM data Tx and Rx power consumptions were 960 pJ/bit and 162 pJ/bit, respectively, at 1.8 V supply voltage.

Structural characterization of β-catenin and RX-5902 binding to phospho-p68 RNA helicase by molecular dynamics simulation.

PubMed

Ali, Waqar; Shafique, Shagufta; Rashid, Sajid

2018-05-02

Emerging implications of probable ATP-dependent RNA helicase p68 in tumorigenesis and progression makes it a discerning target for cancer therapy. Recently it has been reported that tyrosyl-phosphorylation of p68 promotes β-catenin nuclear translocation and cancer metastasis through elevating the epithelial-mesenchymal transition. Despite recent advances, the structural characterization of this interaction, mode of action and induced conformational changes remain elusive. Here, through comparative structure analysis and molecular dynamics simulation assays, we explored comparative binding pattern of phospho-p68 against β-catenin. Conversely, due to the promising therapeutic potential of p68 in blocking the invasiveness and metastasis of cancer cells, we investigated the binding of heterocyclic N-substituted piperazine derivative-RX-5902 that inhibits the binding of phospho-p68 and β-catenin. Evidently, transactivation and C-terminal helicase domains of phospho-p68 exhibited dramatic conformational alterations to assist β-catenin and RX-5902 binding. As compared to unbound phospho-p68 (56.1 Å), the residual distances between transactivation domain-Ser79 and C-terminal helicase domain-Gln555 were reduced to 34.1 Å and 31 Å upon binding to β-catenin and RX-5902, respectively. In contrast, helicase ATP-binding domain remained conformationally stable throughout simulations. Clearly, the comparative docking-for-functional analysis of phospho-p68 against RX-5902 and β-catenin uncovered a spectrum of structural linkages associated with the molecular basis of β-catenin-dependent ATPase activity. Thus the outcomes of this study may provide a platform for the rational design of specific and potent inhibitors against phospho-p68 with a special emphasis on anticancer activity. Copyright © 2018 Elsevier Ltd. All rights reserved.

Modelling high arctic percent vegetation cover using field digital images and high resolution satellite data

NASA Astrophysics Data System (ADS)

Liu, Nanfeng; Treitz, Paul

2016-10-01

In this study, digital images collected at a study site in the Canadian High Arctic were processed and classified to examine the spatial-temporal patterns of percent vegetation cover (PVC). To obtain the PVC of different plant functional groups (i.e., forbs, graminoids/sedges and mosses), field near infrared-green-blue (NGB) digital images were classified using an object-based image analysis (OBIA) approach. The PVC analyses comparing different vegetation types confirmed: (i) the polar semi-desert exhibited the lowest PVC with a large proportion of bare soil/rock cover; (ii) the mesic tundra cover consisted of approximately 60% mosses; and (iii) the wet sedge consisted almost exclusively of graminoids and sedges. As expected, the PVC and green normalized difference vegetation index (GNDVI; (RNIR - RGreen)/(RNIR + RGreen)), derived from field NGB digital images, increased during the summer growing season for each vegetation type: i.e., ∼5% (0.01) for polar semi-desert; ∼10% (0.04) for mesic tundra; and ∼12% (0.03) for wet sedge respectively. PVC derived from field images was found to be strongly correlated with WorldView-2 derived normalized difference spectral indices (NDSI; (Rx - Ry)/(Rx + Ry)), where Rx is the reflectance of the red edge (724.1 nm) or near infrared (832.9 nm and 949.3 nm) bands; Ry is the reflectance of the yellow (607.7 nm) or red (658.8 nm) bands with R2's ranging from 0.74 to 0.81. NDSIs that incorporated the yellow band (607.7 nm) performed slightly better than the NDSIs without, indicating that this band may be more useful for investigating Arctic vegetation that often includes large proportions of senescent vegetation throughout the growing season.

[Patterns of drug consumption and the occurrence of adverse drug reactions among students of public health].

PubMed

Plichta, Danuta; Doryńska, Agnieszka; Spiewak, Radosław

2012-04-01

The research of drug consumption is focused mainly upon the elderly, while the knowledge of drug consumption patterns among young people remains insufficient. Public health students (PHS) seem of particular interest as future opinion leaders and drug policy makers. The aim of the study was to analyze opinions and patterns of drug consumption, and adverse drug reactions (ADR) in this group. 130 PHS took part in the anonymous questionnaire survey. All students admitted to using some drug at least once in their lives. While purchasing over-the-counter (OTC) drugs, 51.6% students trusted their own knowledge and experience. Women more often relied on a pharmacist's recommendation (47.2% vs 21.7% men; p = 0.045), while men were more influenced by advertising (34.8% vs 12.3% women, p = 0.008). Strict adherence to recommended dosage of OTC and prescription drugs (Rx) was declared by 41.1% and 71.9% students, respectively. Every fourth student (24.8%) admitted to having purchased a Rx drug at least once without having the prescription. Past episodes of ADR to OTC were reported by 7.8% students and to Rx by 38.4% (p < 0.001). Respectively 27.2% and 34.4% students were never, or hardly ever asked about past ADR by prescribing physicians. According to 89.2% students, drug advertising should be subject to regulation and policing, and 66.1% considered it inaccurate and unreliable. Forty-five percent of students had an OTC drug on them while responding the questionnaire, 20.0% had a prescription drug. Students of public health seem to be notorious consumers of drugs and their attitude seems not fully rational.

A Platform to Optimize the Field Emission Properties of Carbon Nanotube Based Fibers (Postprint)

DTIC Science & Technology

2016-08-25

University of Dayton Research Institute 300 College Park Ave., Dayton, OH 45469 6) AFRL /RD, Kirtland AFB, Albuquerque, NM 8717... AFRL -RX-WP-JA-2017-0351 A PLATFORM TO OPTIMIZE THE FIELD EMISSION PROPERTIES OF CARBON-NANOTUBE-BASED FIBERS (POSTPRINT) Steven B...Fairchild AFRL /RX M. Cahay and W. Zhu University of Cincinnati K.L. Jensen Naval Research Laboratory R.G. Forbes University of Surrey

Locked modes in two reversed-field pinch devices of different size and shell system

NASA Astrophysics Data System (ADS)

Malmberg, J.-A.; Brunsell, P. R.; Yagi, Y.; Koguchi, H.

2000-10-01

The behavior of locked modes in two reversed-field pinch devices, the Toroidal Pinch Experiment (TPE-RX) [Y. Yagi et al., Plasma Phys. Control. Fusion 41, 2552 (1999)] and Extrap T2 [J. R. Drake et al., in Plasma Physics and Controlled Nuclear Fusion Research 1996, Montreal (International Atomic Energy Agency, Vienna, 1996), Vol. 2, p. 193] is analyzed and compared. The main characteristics of the locked mode are qualitatively similar. The toroidal distribution of the mode locking shows that field errors play a role in both devices. The probability of phase locking is found to increase with increasing magnetic fluctuation levels in both machines. Furthermore, the probability of phase locking increases with plasma current in TPE-RX despite the fact that the magnetic fluctuation levels decrease. A comparison with computations using a theoretical model estimating the critical mode amplitude for locking [R. Fitzpatrick et al., Phys. Plasmas 6, 3878 (1999)] shows a good correlation with experimental results in TPE-RX. In Extrap T2, the magnetic fluctuations scale weakly with both plasma current and electron densities. This is also reflected in the weak scaling of the magnetic fluctuation levels with the Lundquist number (˜S-0.06). In TPE-RX, the corresponding scaling is ˜S-0.18.

Shock Simulations of Single-Site Coarse-Grain RDX using the Dissipative Particle Dynamics Method with Reactivity

NASA Astrophysics Data System (ADS)

Sellers, Michael; Lisal, Martin; Schweigert, Igor; Larentzos, James; Brennan, John

2015-06-01

In discrete particle simulations, when an atomistic model is coarse-grained, a trade-off is made: a boost in computational speed for a reduction in accuracy. Dissipative Particle Dynamics (DPD) methods help to recover accuracy in viscous and thermal properties, while giving back a small amount of computational speed. One of the most notable extensions of DPD has been the introduction of chemical reactivity, called DPD-RX. Today, pairing the current evolution of DPD-RX with a coarse-grained potential and its chemical decomposition reactions allows for the simulation of the shock behavior of energetic materials at a timescale faster than an atomistic counterpart. In 2007, Maillet et al. introduced implicit chemical reactivity in DPD through the concept of particle reactors and simulated the decomposition of liquid nitromethane. We have recently extended the DPD-RX method and have applied it to solid hexahydro-1,3,5-trinitro-1,3,5-triazine (RDX) under shock conditions using a recently developed single-site coarse-grain model and a reduced RDX decomposition mechanism. A description of the methods used to simulate RDX and its tranition to hot product gases within DPD-RX will be presented. Additionally, examples of the effect of microstructure on shock behavior will be shown. Approved for public release. Distribution is unlimited.

A Tuned-RF Duty-Cycled Wake-Up Receiver with -90 dBm Sensitivity.

PubMed

Bdiri, Sadok; Derbel, Faouzi; Kanoun, Olfa

2017-12-29

A novel wake-up receiver for wireless sensor networks is introduced. It operates with a modified medium access protocol (MAC), allowing low-energy consumption and practical latency. The ultra-low-power wake-up receiver operates with enhanced duty-cycled listening. The analysis of energy models of the duty-cycle-based communication is presented. All the WuRx blocks are studied to obey the duty-cycle operation. For a mean interval time for the data exchange cycle between a transmitter and a receiver over 1.7 s and a 64-bit wake-up packet detection latency of 32 ms, the average power consumption of the wake-up receiver (WuRx) reaches down to 3 μ W . It also features scalable addressing of more than 512 bit at a data rate of 128 k bit / s -1 . At a wake-up packet error rate of 10 - 2 , the detection sensitivity reaches a minimum of - 90 dBm . The combination of the MAC protocol and the WuRx eases the adoption of different kinds of wireless sensor networks. In low traffic communication, the WuRx dramatically saves more energy than that of a network that is implementing conventional duty-cycling. In this work, a prototype was realized to evaluate the intended performance.

Studies of free-space optical links through simulated boundary layer and long-path turbulence

NASA Astrophysics Data System (ADS)

Wasiczko, Linda; Smolyaninov, Igor I.; Milner, Stuart D.; Davis, Christopher C.

2004-02-01

There is recent interest from the US Department of Defense in free space optical communication networks involving aircraft flying at various altitudes. The optical links between these aircraft may be as long as 100km, and involve communication between network nodes that are moving at sub-sonic speeds. An unresolved issue for links of this kind between pairs of aircraft is the effect of boundary layer turbulence near each aircraft, as well as along the atmospheric path between them. The deployment of optical wireless links in several different scenarios will be described. These include links near to the ground for which the turbulence parameter Cn2 varies along the path between transmitter (TX) and receiver (RX), high altitude links between aircraft, and ground to aircraft links. The last two of these may involve boundary layer turbulence near the aircraft node where the turbulence is localized either at the TX or at the RX. Some of the theoretical approaches to examining these situations will be described, as well as an ongoing program of research to examine these situations experimentally. Ways to mitigate the effects of node motion, and scintillation at the RX will be discussed, including the use of non-imaging concentrators at the RX.

Multi-static networked 3D ladar for surveillance and access control

NASA Astrophysics Data System (ADS)

Wang, Y.; Ogirala, S. S. R.; Hu, B.; Le, Han Q.

2007-04-01

A theoretical design and simulation of a 3D ladar system concept for surveillance, intrusion detection, and access control is described. It is a non-conventional system architecture that consists of: i) multi-static configuration with an arbitrarily scalable number of transmitters (Tx's) and receivers (Rx's) that form an optical wireless code-division-multiple-access (CDMA) network, and ii) flexible system architecture with modular plug-and-play components that can be deployed for any facility with arbitrary topology. Affordability is a driving consideration; and a key feature for low cost is an asymmetric use of many inexpensive Rx's in conjunction with fewer Tx's, which are generally more expensive. The Rx's are spatially distributed close to the surveyed area for large coverage, and capable of receiving signals from multiple Tx's with moderate laser power. The system produces sensing information that scales as NxM, where N, M are the number of Tx's and Rx's, as opposed to linear scaling ~N in non-network system. Also, for target positioning, besides laser pointing direction and time-of-flight, the algorithm includes multiple point-of-view image fusion and triangulation for enhanced accuracy, which is not applicable to non-networked monostatic ladars. Simulation and scaled model experiments on some aspects of this concept are discussed.

A study on geometry effect of transmission coil for micro size magnetic induction coil

NASA Astrophysics Data System (ADS)

Lee, Kyung Hwa; Jun, Byoung Ok; Kim, Seunguk; Lee, Gwang Jun; Ryu, Mingyu; Choi, Ji-Woong; Jang, Jae Eun

2016-05-01

The effects of transmission (Tx) coil structure have been studied for micro-size magnetic induction coil. The size of the receiving (Rx) coil should be shrunk to the micrometer level for the various new applications such as micro-robot and wireless body implanted devices. In case of the macro-scale magnetic induction coil, the power transmission efficiency is generally considered to be higher as the inductance of the transmission coil became larger; however, the large size difference between macro-size Tx coil and micro-size Rx coil can decrease the power transmission efficiency due to the difference of resonance frequency. Here, we study a correlation of the power transmission with the size and distance between the macro-size Tx and micro-size Rx coils using magnetic induction technique. The maximum power efficiency was 0.28/0.23/0.13/0.12% at the distance of 0.3/1/3/5 cm between Rx and Tx coil. In addition, more efficient wireless power transferring method is suggested with a floating coil for the body implantable devices. The voltage output increased up to 5.4 mV than the original one Tx coil system. The results demonstrated the foundational wireless power transferring system with enhanced power efficiency.

A Tuned-RF Duty-Cycled Wake-Up Receiver with −90 dBm Sensitivity

PubMed Central

Derbel, Faouzi; Kanoun, Olfa

2017-01-01

A novel wake-up receiver for wireless sensor networks is introduced. It operates with a modified medium access protocol (MAC), allowing low-energy consumption and practical latency. The ultra-low-power wake-up receiver operates with enhanced duty-cycled listening. The analysis of energy models of the duty-cycle-based communication is presented. All the WuRx blocks are studied to obey the duty-cycle operation. For a mean interval time for the data exchange cycle between a transmitter and a receiver over 1.7 s and a 64-bit wake-up packet detection latency of 32 ms, the average power consumption of the wake-up receiver (WuRx) reaches down to 3 μW. It also features scalable addressing of more than 512 bit at a data rate of 128kbit/s−1. At a wake-up packet error rate of 10−2, the detection sensitivity reaches a minimum of −90 dBm. The combination of the MAC protocol and the WuRx eases the adoption of different kinds of wireless sensor networks. In low traffic communication, the WuRx dramatically saves more energy than that of a network that is implementing conventional duty-cycling. In this work, a prototype was realized to evaluate the intended performance. PMID:29286345

A Core Outcome Set for Evaluation of Interventions to Prevent Preterm Birth.

PubMed

van ʼt Hooft, Janneke; Duffy, James M N; Daly, Mandy; Williamson, Paula R; Meher, Shireen; Thom, Elizabeth; Saade, George R; Alfirevic, Zarko; Mol, Ben Willem J; Khan, Khalid S

2016-01-01

To develop a consensus on a set of key clinical outcomes for the evaluation of preventive interventions for preterm birth in asymptomatic pregnant women. A two-stage web-based Delphi survey and a face-to-face meeting of key stakeholders were used to develop a consensus on a set of critical and important outcomes. We approached five stakeholder groups (parents, midwives, obstetricians, neonatologists, and researchers) from middle- and high-income countries. Outcomes subjected to the Delphi survey were identified by systematic literature review and stakeholder input. Survey participants scored each outcome on a 9-point Likert scale anchored between 1 (limited importance) and 9 (critical importance). They had the opportunity to reflect on total and stakeholder subgroup feedback between survey stages. For consensus, defined a priori, outcomes required at least 70% of participants of each stakeholder group to score them as "critical" and less than 15% as "limited." A total of 228 participants from five stakeholder groups from three lower middle-income countries, seven upper middle-income countries, and 17 high-income countries were asked to score 31 outcomes. Of these participants, 195 completed the first survey and 174 the second. Consensus was reached on 13 core outcomes: four were related to pregnant women: maternal mortality, maternal infection or inflammation, prelabor rupture of membranes, and harm to mother from intervention. Nine were related to offspring: gestational age at birth, offspring mortality, birth weight, early neurodevelopmental morbidity, late neurodevelopmental morbidity, gastrointestinal morbidity, infection, respiratory morbidity, and harm to offspring from intervention. This core outcome set for studies that evaluate prevention of preterm birth developed with an international multidisciplinary perspective will ensure that data from trials that assess prevention of preterm birth can be compared and combined. COMET Initiative, http://www.comet-initiative.org/studies/details/603, REGISTRATION NUMBER: 603.

Mortality and morbidity risks vary with birth weight standard deviation score in growth restricted extremely preterm infants.

PubMed

Yamakawa, Takuji; Itabashi, Kazuo; Kusuda, Satoshi

2016-01-01

To assess whether the mortality and morbidity risks vary with birth weight standard deviation score (BWSDS) in growth restricted extremely preterm infants. This was a multicenter retrospective cohort study using the database of the Neonatal Research Network of Japan and including 9149 infants born between 2003 and 2010 at <28 weeks gestation. According to the BWSDSs, the infants were classified as: <-2.0, -2.0 to -1.5, -1.5 to -1.0, -1.0 to -0.5, and ≥-0.5. Infants with BWSDS≥-0.5 were defined as non-growth restricted group. After adjusting for covariates, the risks of mortality and some morbidities were different among the BWSDS groups. Compared with non-growth restricted group, the adjusted odds ratio (aOR) for mortality [aOR, 1.69; 95% confidence interval (CI), 1.35-2.12] and chronic lung disease (CLD) (aOR, 1.28; 95% CI, 1.07-1.54) were higher among the infants with BWSDS -1.5 to <-1.0. The aOR for severe retinopathy of prematurity (ROP) (aOR, 1.36; 95% CI, 1.09-1.71) and sepsis (aOR, 1.72; 95% CI, 1.32-2.24) were higher among the infants with BWSDS -2.0 to <-1.5. The aOR for necrotizing enterocolitis (NEC) (aOR, 2.41; 95% CI, 1.64-3.55) was increased at a BWSDS<-2.0. Being growth restricted extremely preterm infants confer additional risks for mortality and morbidities such as CLD, ROP, sepsis and NEC, and these risks may vary with BWSDS. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Management and risk factors for mortality in very elderly patients with acute myocardial infarction.

PubMed

Renilla, Alfredo; Barreiro, Manuel; Barriales, Vicente; Torres, Francisco; Alvarez, Paloma; Lambert, Jose L

2013-01-01

Elderly patients often remain underrepresented in clinical trials. The aim of our study was to analyze the treatment, clinical outcome and risk factors for mortality in patients aged ≥85 years with ST-segment elevation myocardial infarction (STEMI). From 2005-2011, 102 patients aged ≥85 years with STEMI admitted to a coronary care unit were retrospectively reviewed. Clinical data, treatment and outcome were recorded. Reperfusion strategy and its influence in hospital morbidity and mortality were evaluated. Morbidity was defined as the presence of heart failure (Killip-Kimball >1), arrhythmias, mechanical complications, stroke or major bleeding. Risk factors for mortality were assessed by multivariate analysis. The mean age was 87.5±2.5 years (range 85-96). Therapeutic strategy on admission was: primary-angioplasty (PCI) for 33 patients (32.3%) fibrinolysis for 30 patients (29.4%) and conservative treatment for 35 patients (34.3%). In the four remaining patients, rescue angioplasty was required. A total of 29 patients (28.4%) died, and morbidity was seen in 63 patients (61.7%). The morbidity and mortality rates in the conservative treatment group (77.1% and 48.5%) were higher than that found in the reperfusion strategy group (primary-PCI and fibrinolysis; 53.7% and 17.9%; P=0.02 and P=0.002, respectively). Regarding mortality, the univariate analysis showed that heart failure on admission (P=0.0001) and previous coronary artery disease (P=0.01) were prognostic variables. Only heart failure was an independent risk factor for mortality (odds ratio=3.64, 95% CI 0.78-21.87, P<0.0001). Mortality and morbidity in very elderly patients with STEMI are very high, especially in those not receiving reperfusion therapies. Heart failure on admission was an independent risk factor for hospital mortality. © 2012 Japan Geriatrics Society.

Safety of carotid endarterectomy while on clopidogrel (Plavix). Clinical article.

PubMed

Wait, Scott D; Abla, Adib A; Killory, Brendan D; Starke, Robert M; Spetzler, Robert F; Nakaji, Peter

2010-10-01

Many patients undergoing carotid endarterectomy (CEA) regularly take clopidogrel, a permanent platelet inhibitor. The authors sought to determine whether taking clopidogrel in the period before CEA leads to more bleeding or other complications. The authors performed a retrospective, institutional review board–approved review of 182 consecutive patients who underwent CEA. Clinical, radiographic, and surgical data were gleaned from hospital and clinic records. Analysis was based on the presence or absence of clopidogrel in patients undergoing CEA and was performed twice by considering clopidogrel use within 8 days and within 5 days of surgery to define the groups. Taking clopidogrel within 8 days before surgery resulted in no statistical increase in any measure of morbidity or death. Taking clopidogrel within 5 days was associated with a small but significant increase in operative blood loss and conservatively managed postoperative neck swelling. No measure of permanent morbidity or death was increased in either clopidogrel group. Findings in this study support the safety of preoperative clopidogrel in patients undergoing CEA.

Efficacy of a behavioral self-help treatment with or without therapist guidance for co-morbid and primary insomnia--a randomized controlled trial.

PubMed

Jernelöv, Susanna; Lekander, Mats; Blom, Kerstin; Rydh, Sara; Ljótsson, Brjánn; Axelsson, John; Kaldo, Viktor

2012-01-22

Cognitive behavioral therapy is treatment of choice for insomnia, but availability is scarce. Self-help can increase availability at low cost, but evidence for its efficacy is limited, especially for the typical insomnia patient with co-morbid problems. We hypothesized that a cognitive behaviorally based self-help book is effective to treat insomnia in individuals, also with co-morbid problems, and that the effect is enhanced by adding brief therapist telephone support. Volunteer sample; 133 media-recruited adults with insomnia. History of sleep difficulties (mean [SD]) 11.8 [12.0] years. 92.5% had co-morbid problems (e.g. allergy, pain, and depression). Parallel randomized (block-randomization, n ≥ 21) controlled "open label" trial; three groups-bibliotherapy with (n = 44) and without (n = 45) therapist support, and waiting list control (n = 44). Assessments before and after treatment, and at three-month follow-up. Intervention was six weeks of bibliotherapeutic self-help, with established cognitive behavioral methods including sleep restriction, stimulus control, and cognitive restructuring. Therapist support was a 15-minute structured telephone call scheduled weekly. Main outcome measures were sleep diary data, and the Insomnia Severity Index. Intention-to-treat analyses of 133 participants showed significant improvements in both self-help groups from pre to post treatment compared to waiting list. For example, treatment with and without support gave shorter sleep onset latency (improvement minutes [95% Confidence Interval], 35.4 [24.2 to 46.6], and 20.6 [10.6 to 30.6] respectively), and support gave a higher remission rate (defined as ISI score below 8; 61.4%), than bibliotherapy alone (24.4%, p's < .001). Improvements were not seen in the control group (sleep onset latency 4.6 minutes shorter [-1.5 to 10.7], and remission rate 2.3%). Self-help groups maintained gains at three-month follow-up. Participants receiving self-help for insomnia benefited markedly. Self-help, especially if therapist-supported, has considerable potential to be as effective as individual treatment at lower cost, also for individuals with co-morbid problems. ClinicalTrials.gov: NCT01105052.

Conditions for the invertibility of the nonlinear difference operator (\\mathscr Rx)(n)=H(x(n),x(n+1)), n\\in\\mathbb Z, in the space of bounded number sequences

NASA Astrophysics Data System (ADS)

Slyusarchuk, Vasilii E.

2009-02-01

Necessary and sufficient conditions are found for the invertibility of the nonlinear difference operator \\displaystyle (\\mathscr Rx)(n)=H(x(n),x(n+1)),\\qquad n\\in\\mathbb Z, in the space of bounded two-sided number sequences. Here H\\colon \\mathbb R^2\\to \\mathbb R is a continuous function. Bibliography: 29 titles.

Implementation of envelope detection based Wake-Up Receiver for IEEE 802.15.4 WPAN from off-the-shelf components

NASA Astrophysics Data System (ADS)

Arndt, Josua; Krystofiak, Lukas; Bonehi, Vahid; Wunderlich, Ralf; Heinen, Stefan

2017-09-01

Power consumption in wireless networks is crucial. In most scenarios the transmission time is short compared to the idle listening time for data transmission, the most power is consumed by the receiver. In low latency systems there is a need for low power wake-up receivers (WuRx) that reduce the power consumption when the node is idle, but keep it responsive. This work presents a WuRx designed out of commercial components to investigate the needs of a WuRx when it is embedded in a Wireless Personal Area Network (WPAN) system in a real environment setup including WLAN and LTE communication and considering interferer rejection. The calculation necessary for the attenuation of those interferers is explained in detail. Furthermore, a system design is presented that fulfills the requirements for this environment and is build from off-the-shelf components.

Prescribing Outdoor Play: Outdoors Rx.

PubMed

James, Aisha K; Hess, Pam; Perkins, Meghan E; Taveras, Elsie M; Scirica, Christina S

2017-06-01

Studies support the use of exercise prescriptions in adults, but few studies have evaluated their use in children. One common barrier to effective physical activity counseling is lack of resources. Outdoors Rx is a collaboration between the Appalachian Mountain Club and the Massachusetts General Hospital for Children that pairs exercise prescriptions with guided outdoor programs to increase physical activity among children. This article describes the design and implementation of Outdoors Rx at 2 community health centers serving ethnically diverse, low-income, urban families, as well as evaluates feedback from participating pediatricians regarding the utility of the program, barriers to success, and suggestions for improvement. Our results illustrate the feasibility of implementing a pediatric physical activity prescription program in community health centers serving traditionally underserved populations. Our data suggest that physical activity prescription programs are well received by both pediatricians and families and are a useful tool for facilitating physical activity counseling.

Exploring the effect of diffuse reflection on indoor localization systems based on RSSI-VLC.

PubMed

Mohammed, Nazmi A; Elkarim, Mohammed Abd

2015-08-10

This work explores and evaluates the effect of diffuse light reflection on the accuracy of indoor localization systems based on visible light communication (VLC) in a high reflectivity environment using a received signal strength indication (RSSI) technique. The effect of the essential receiver (Rx) and transmitter (Tx) parameters on the localization error with different transmitted LED power and wall reflectivity factors is investigated at the worst Rx coordinates for a directed/overall link. Since this work assumes harsh operating conditions (i.e., a multipath model, high reflectivity surfaces, worst Rx position), an error of ≥ 1.46 m is found. To achieve a localization error in the range of 30 cm under these conditions with moderate LED power (i.e., P = 0.45 W), low reflectivity walls (i.e., ρ = 0.1) should be used, which would enable a localization error of approximately 7 mm at the room's center.

An underwater optical wireless communication system based on LED source

NASA Astrophysics Data System (ADS)

Rao, Jionghui; Wei, Wei; Wang, Feng; Zhang, Xiaohui

2011-11-01

Compared with other communication methods, optical wireless communication (OWC) holds the merits of higher transmitting rate and sufficient secrecy. So it is an efficacious communicating measure for data transmitting between underwater carriers. However, due to the water attenuation and the transmitter & the receiver (TX/RX) collimation, this application is restrained in underwater mobile carriers. A prototype for underwater OWC was developed, in which a high-powered green LED array was used as the light source which partly raveled the TX/RX collimation out. A small pumped-multiple-tube (PMT) was used as the detector to increase the communicating range, and FPGA chips were employed to code and decode the communicating data. The data rate of the prototype approached to 4 Mb/s at 8.4m and 1 Mb/s at 22m where voice and Morse communications were achieved in a scope of 30 degree TX/RX angle.

Risk of preterm delivery and hypertensive disorders of pregnancy in relation to maternal co-morbid mood and migraine disorders during pregnancy.

PubMed

Cripe, Swee May; Frederick, Ihunnaya O; Qiu, Chunfang; Williams, Michelle A

2011-03-01

We evaluated the risks of preterm delivery and hypertensive disorders of pregnancy among pregnant women with mood and migraine disorders, using a cohort study of 3432 pregnant women. Maternal pre-pregnancy or early pregnancy (<20 weeks gestation) mood disorder and pre-pregnancy migraine diagnoses were ascertained from interview and medical record review. We fitted generalised linear models to derive risk ratios (RR) and 95% confidence intervals (CI) of preterm delivery and hypertensive disorders of pregnancy for women with isolated mood, isolated migraine and co-morbid mood-migraine disorders, respectively. Reported RR were adjusted for maternal age, race/ethnicity, marital status, parity, smoking status, chronic hypertension or pre-existing diabetes mellitus, and pre-pregnancy body mass index. Women without mood or migraine disorders were defined as the reference group. The risks for preterm delivery and hypertensive disorders of pregnancy were more consistently elevated among women with co-morbid mood-migraine disorders than among women with isolated mood or migraine disorder. Women with co-morbid disorders were almost twice as likely to deliver preterm (adjusted RR=1.87, 95% CI 1.05, 3.34) compared with the reference group. There was no clear evidence of increased risks of preterm delivery and its subtypes with isolated migraine disorder. Women with mood disorder had elevated risks of pre-eclampsia (adjusted RR=3.57, 95% CI 1.83, 6.99). Our results suggest an association between isolated migraine disorder and pregnancy-induced hypertension (adjusted RR=1.42, 95% CI 1.00, 2.01). This is the first study examining perinatal outcomes in women with co-morbid mood-migraine disorders. Pregnant women with a history of migraine may benefit from screening for depression during prenatal care and vigilant monitoring, especially for women with co-morbid mood and migraine disorders. © 2011 Blackwell Publishing Ltd.

The effect of changing the sequence of cuff inflation and device fixation with the LMA-Supreme® on device position, ventilatory complications, and airway morbidity: a clinical and fiberscopic study.

PubMed

Bergmann, Ingo; Crozier, Thomas Allen; Roessler, Markus; Schotola, Hanna; Mansur, Ashham; Büttner, Benedikt; Hinz, José Maria; Bauer, Martin

2014-01-04

The conventional sequence when using supraglottic airway devices is insertion, cuff inflation and fixation. Our hypothesis was that a tighter fit of the cuff and tip could be achieved with a consequently lower incidence of air leak, better separation of gastrointestinal and respiratory tracts and less airway morbidity if the device were first affixed and the cuff then inflated. Our clinical review board approved the study (public registry number DRKS00003174). An LMA Supreme® was inserted into 184 patients undergoing lower limb arthroscopy in propofol-remifentanil anaesthesia who were randomly assigned to either the control (inflation then fixation; n = 92) or study group (fixation then inflation; n = 92). The cuff was inflated to 60 cmH2O. The patients' lungs were ventilated in pressure-controlled mode with 5 cmH2O PEEP, Pmax to give 6 ml kg-1 tidal volume, and respiratory rate adjusted to end-tidal CO2 of 4.8 and 5.6 kPa. Correct cuff and tip position were determined by leak detection, capnometry trace, oropharyngeal leak pressure, suprasternal notch test, and lube-tube test. Bowl and cuff position and the presence of glottic narrowing were assessed by fiberscopic examination. Postoperative dysphagia, hoarseness and sore throat were assessed with a questionnaire. Ventilatory impairment was defined as a tidal volume < 6 ml kg-1 with Pmax at oropharyngeal leak pressure, glottic narrowing was defined as an angle between the vocal cords under 16 degrees. The incidence of incorrect device position (18% vs. 21%), failed ventilation (10% vs. 9%), leak pressure (24.8 vs. 25.2 cmH2O, p = 0.63), failed lube-tube test (16.3% vs. 17.6%) and glottic narrowing (19.3% vs. 14.1%, p = 0.35) was similar in both groups (control vs. study, resp.). When glottic narrowing occurred, it was more frequently associated with ventilatory impairment in the control group (77% vs. 39%; p = 0.04). Airway morbidity was more common in the control group (33% vs. 19%; p < 0.05). Altering the sequence of cuff inflation and device fixation does not affect device position, oropharyngeal leak pressures or separation of gastrointestinal and respiratory tracts. It reduces the incidence of glottic narrowing with impaired ventilation and also perioperative airway morbidity.

A small and active ring X chromosome in a female with features of Kabuki syndrome.

PubMed

Rodríguez, L; Diego-Alvarez, D; Lorda-Sanchez, I; Gallardo, F L; Martínez-Fernández, M L; Arroyo-Muñoz, M E; Martínez-Frías, M L

2008-11-01

A ring X chromosome is found in about 6% of patients with Turner syndrome (TS), often with mosaicism for a 45,X cell line. Patients with this karyotype are reported to have a higher incidence of a more severe phenotype including mental retardation. In fact, some studies have shown a correlation between this severity and the presence or absence of an intact and functional X inactivation center (XIST). However, the phenotype of the individuals with r(X) cannot be entirely defined in terms of their X-inactivation patterns. Nevertheless, a small group of these patients have been described to manifest clinical features reminiscent of the Kabuki syndrome. Here we present a female patient with clinical features resembling Kabuki syndrome and a mos 45,X/46,X,r(X) karyotype. Methylation analyses of polymorphic alleles of the androgen receptor gene showed that both alleles were unmethylated suggesting an active ring chromosome. A specific X chromosome array CGH was performed estimating the size of the ring to be 17 Mb, lacking the XIST gene, and including some genes with possible implications in the phenotype of the patient. Copyright 2008 Wiley-Liss, Inc.

Restorative Justice as the Rx for Mistreatment in Academic Medicine: Applications to Consider for Learners, Faculty, and Staff.

PubMed

Acosta, David; Karp, David R

2018-03-01

The mistreatment of learners is an ongoing issue at U.S. medical schools. According to responses to the 2017 Association of American Medical Colleges Graduation Questionnaire, 39.3% of medical students nationally reported being mistreated. Many articles have been published on the topic of mistreatment at medical schools over the last 20 years. These articles have focused primarily on the definition of mistreatment, the impact of mistreatment, and initiatives put into place to help mitigate the problem. To date, very little attention has been paid to repairing the harm caused by mistreatment and rebuilding community trust. Academic medicine is in need of new forums of interaction to achieve more positive learning and workplace environments.The authors discuss restorative justice practices and the potential applications that they may have in academic medicine learning and workplace environments to serve vulnerable students, faculty, and staff who are targets of mistreatment. Restorative justice practices are used to convene groups of people to engage in substantive dialogue about consequential issues that impede community functioning. This process can help a group identify and gain mutual understanding of the personal and collective harm that has occurred, create the conditions that incentivize offenders to admit responsibility rather than deny or minimize the harm, and explore and define a set of problem-solving steps to address the harm and rebuild community trust.

Multi-Morbidity in Hospitalised Older Patients: Who Are the Complex Elderly?

PubMed Central

Ruiz, Milagros; Bottle, Alex; Long, Susannah; Aylin, Paul

2015-01-01

Background No formal definition for the “complex elderly” exists; moreover, these older patients with high levels of multi-morbidity are not readily identified as such at point of hospitalisation, thus missing a valuable opportunity to manage the older patient appropriately within the hospital setting. Objectives To empirically identify the complex elderly patient based on degree of multi-morbidity. Design Retrospective observational study using administrative data. Setting English hospitals during the financial year 2012–13. Subjects All admitted patients aged 65 years and over. Methods By using exploratory analysis (correspondence analysis) we identify multi-morbidity groups based on 20 target conditions whose hospital prevalence was ≥ 1%. Results We examined a total of 2788900 hospital admissions. Multi-morbidity was highly prevalent, 62.8% had 2 or more of the targeted conditions while 4.7% had six or more. Multi-morbidity increased with age from 56% (65-69yr age-groups) up to 67% (80-84yr age-group). The average multi-morbidity was 3.2±1.2 (SD). Correspondence analysis revealed 3 distinct groups of older patients. Group 1 (multi-morbidity ≤2), associated with cancer and/or metastasis; Group 2 (multi-morbidity of 3, 4 or 5), associated with chronic pulmonary disease, lung disease, rheumatism and osteoporosis; finally Group 3 with the highest level of multi-morbidity (≥6) and associated with heart failure, cerebrovascular accident, diabetes, hypertension and myocardial infarction. Conclusions By using widely available hospital administrative data, we propose patients in Groups 2 and 3 to be identified as the complex elderly. Identification of multi-morbidity patterns can help to predict the needs of the older patient and improve resource provision. PMID:26716440

RX J0848.6+4453: The evolution of galaxy sizes and stellar populations in A z = 1.27 cluster

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

Jørgensen, Inger; Chiboucas, Kristin; Schiavon, Ricardo P.

2014-12-01

RX J0848.6+4453 (Lynx W) at redshift 1.27 is part of the Lynx Supercluster of galaxies. We present an analysis of the stellar populations and star formation history for a sample of 24 members of the cluster. Our study is based on deep optical spectroscopy obtained with Gemini North combined with imaging data from Hubble Space Telescope. Focusing on the 13 bulge-dominated galaxies for which we can determine central velocity dispersions, we find that these show a smaller evolution with redshift of sizes and velocity dispersions than reported for field galaxies and galaxies in poorer clusters. Our data show that themore » galaxies in RX J0848.6+4453 populate the fundamental plane (FP) similar to that found for lower-redshift clusters. The zero-point offset for the FP is smaller than expected if the cluster's galaxies are to evolve passively through the location of the FP we established in our previous work for z = 0.8-0.9 cluster galaxies and then to the present-day FP. The FP zero point for RX J0848.6+4453 corresponds to an epoch of last star formation at z{sub form}=1.95{sub −0.15}{sup +0.22}. Further, we find that the spectra of the galaxies in RX J0848.6+4453 are dominated by young stellar populations at all galaxy masses and in many cases show emission indicating low-level ongoing star formation. The average age of the young stellar populations as estimated from the strength of the high-order Balmer line Hζ is consistent with a major star formation episode 1-2 Gyr prior, which in turn agrees with z {sub form} = 1.95. These galaxies dominated by young stellar populations are distributed throughout the cluster. We speculate that low-level star formation has not yet been fully quenched in the center of this cluster, possibly because the cluster is significantly poorer than other clusters previously studied at similar redshifts, which appear to have very little ongoing star formation in their centers. The mixture in RX J0848.6+4453 of passive galaxies with young stellar populations and massive galaxies still experiencing some star formation appears similar to the galaxy populations recently identified in two z ≈ 2 clusters.« less

The Malarial Host-Targeting Signal Is Conserved in the Irish Potato Famine Pathogen

PubMed Central

Liolios, Konstantinos; Win, Joe; Kanneganti, Thirumala-Devi; Young, Carolyn; Kamoun, Sophien; Haldar, Kasturi

2006-01-01

Animal and plant eukaryotic pathogens, such as the human malaria parasite Plasmodium falciparum and the potato late blight agent Phytophthora infestans, are widely divergent eukaryotic microbes. Yet they both produce secretory virulence and pathogenic proteins that alter host cell functions. In P. falciparum, export of parasite proteins to the host erythrocyte is mediated by leader sequences shown to contain a host-targeting (HT) motif centered on an RxLx (E, D, or Q) core: this motif appears to signify a major pathogenic export pathway with hundreds of putative effectors. Here we show that a secretory protein of P. infestans, which is perceived by plant disease resistance proteins and induces hypersensitive plant cell death, contains a leader sequence that is equivalent to the Plasmodium HT-leader in its ability to export fusion of green fluorescent protein (GFP) from the P. falciparum parasite to the host erythrocyte. This export is dependent on an RxLR sequence conserved in P. infestans leaders, as well as in leaders of all ten secretory oomycete proteins shown to function inside plant cells. The RxLR motif is also detected in hundreds of secretory proteins of P. infestans, Phytophthora sojae, and Phytophthora ramorum and has high value in predicting host-targeted leaders. A consensus motif further reveals E/D residues enriched within ~25 amino acids downstream of the RxLR, which are also needed for export. Together the data suggest that in these plant pathogenic oomycetes, a consensus HT motif may reside in an extended sequence of ~25–30 amino acids, rather than in a short linear sequence. Evidence is presented that although the consensus is much shorter in P. falciparum, information sufficient for vacuolar export is contained in a region of ~30 amino acids, which includes sequences flanking the HT core. Finally, positional conservation between Phytophthora RxLR and P. falciparum RxLx (E, D, Q) is consistent with the idea that the context of their presentation is constrained. These studies provide the first evidence to our knowledge that eukaryotic microbes share equivalent pathogenic HT signals and thus conserved mechanisms to access host cells across plant and animal kingdoms that may present unique targets for prophylaxis across divergent pathogens. PMID:16733545

Tight intra-operative blood pressure control versus standard care for patients undergoing hip fracture repair - Hip Fracture Intervention Study for Prevention of Hypotension (HIP-HOP) trial: study protocol for a randomised controlled trial.

PubMed

Moppett, Iain Keith; White, Stuart; Griffiths, Richard; Buggy, Donal

2017-07-25

Hypotension during anaesthesia for hip fracture surgery is common. Recent data suggest that there is an association between the lowest intra-operative blood pressure and mortality, even when adjusted for co-morbidities. This is consistent with data derived from the wider surgical population, where magnitude and duration of hypotension are associated with mortality and peri-operative complications. However, there are no trial to data to support more aggressive blood pressure control. We are conducting a three-centre, randomised, double-blinded pilot study in three hospitals in the United Kingdom. The sample size will be 75 patients (25 from each centre). Randomisation will be done using computer-generated concealed tables. Both participants and investigators will be blinded to group allocation. Participants will be aged >70 years, cognitively intact (Abbreviated Mental Test Score 7 or greater), able to give informed consent and admitted directly through the emergency department with a fractured neck of the femur requiring operative repair. Patients randomised to tight blood pressure control or avoidance of intra-operative hypotension will receive active treatment as required to maintain both of the following: systolic arterial blood pressure >80% of baseline pre-operative value and mean arterial pressure >75 mmHg throughout. All participants will receive standard hospital care, including spinal or general anaesthesia, at the discretion of the clinical team. The primary outcome is a composite of the presence or absence of defined cardiovascular, renal and delirium morbidity within 7 days of surgery (myocardial injury, stroke, acute kidney injury, delirium). Secondary endpoints will include the defined individual morbidities, mortality, early mobility and discharge to usual residence. This is a small-scale pilot study investigating the feasibility of a trial of tight intra-operative blood pressure control in a frail elderly patient group with known high morbidity and mortality. Positive findings will provide the basis for a larger-scale study. ISRCTN Registry identifier: ISRCTN89812075 . Registered on 30 August 2016.

Effect of a pulsating electric field on ECR heating in the CERA-RX(C) X-ray generator

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

Balmashnov, A. A., E-mail: abalmashnov@sci.pfu.edu.ru; Kalashnikov, A. V.; Kalashnikov, V. V.

2016-03-15

3D particle-in-cell plasma simulations for the field configurations implemented in the CERA-RX(C) ECR X-ray generator (2.45 GHz) have been conducted. Dependences of the energy spectra of electrons incident on the target electrode on the amplitude and frequency of pulsations of the electric field in a megahertz range are derived. The simulation data are compared with the results of the full-scale experiment.

First 2.2 micrometer results from the iota interferometer

NASA Technical Reports Server (NTRS)

Dyck, H. M.; Benson, J. A.; Carlton, N. P.; Coldwell, C.; Lacasse, M. G.; Nisenson, P.; Panasyuk, A.; Papaliolios, C.; Pearlman, R. D.; Reasenberg, R. D.

1995-01-01

We present the first infrared fringe visibility measurements made with the Infrared Optical Telescope Array on Mt. Hopkins. Effective temperatures are derived for RX Boo, RS Cnc, and Beta Peg. RX Boo is the coolest small-amplitude variable giant star to have an effective temperature determination. We compare the size of its photosphere at infrared wavelengths with the sizes of its SiO and H20 radio emission regions. We also discuss initial performance parameters for the interferometer.

78 FR 15783 - Self-Regulatory Organizations; EDGX Exchange, Inc.; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-12

..., L, O, Q, R, S, T, U, X, Z, 2, 7, CL, RQ, RR, RT, RX, and SW. The Exchange notes that this proposal..., O, Q, R, S, T, U, X, Z, 2, 7, CL, RQ, RR, RT, RX, and SW for securities priced below $1.00 that... dividing that result by two (2) to account for each side of the transaction: (0.30% x 1 share x $0.99...

Addressing Social Determinants of Health in a Clinic Setting: The WellRx Pilot in Albuquerque, New Mexico.

PubMed

Page-Reeves, Janet; Kaufman, Will; Bleecker, Molly; Norris, Jeffrey; McCalmont, Kate; Ianakieva, Veneta; Ianakieva, Dessislava; Kaufman, Arthur

2016-01-01

Although it is known that the social determinants of health have a larger influence on health outcomes than health care, there currently is no structured way for primary care providers to identify and address nonmedical social needs experienced by patients seen in a clinic setting. We developed and piloted WellRx, an 11-question instrument used to screen 3048 patients for social determinants in 3 family medicine clinics over a 90-day period. Results showed that 46% of patients screened positive for at least 1 area of social need, and 63% of those had multiple needs. Most of these needs were previously unknown to the clinicians. Medical assistants and community health workers then offered to connect patients with appropriate services and resources to address the identified needs. The WellRx pilot demonstrated that it is feasible for a clinic to implement such an assessment system, that the assessment can reveal important information, and that having information about patients' social needs improves provider ease of practice. Demonstrated feasibility and favorable outcomes led to institutionalization of the WellRx process at a university teaching hospital and influenced the state department of health to require managed care organizations to have community health workers available to care for Medicaid patients. © Copyright 2016 by the American Board of Family Medicine.

Experimental Design for Evaluating Selected Nondestructive Measurement Technologies - Advanced Reactor Technology Milestone: M3AT-16PN2301043

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

Ramuhalli, Pradeep; Hirt, Evelyn H.; Pitman, Stan G.

The harsh environments in advanced reactors (AdvRx) increase the possibility of degradation of safety-critical passive components, and therefore pose a particular challenge for deployment and extended operation of these concepts. Nondestructive evaluation technologies are an essential element for obtaining information on passive component condition in AdvRx, with the development of sensor technologies for nondestructively inspecting AdvRx passive components identified as a key need. Given the challenges posed by AdvRx environments and the potential needs for reducing the burden posed by periodic in-service inspection of hard-to-access and hard-to-replace components, a viable solution may be provided by online condition monitoring of components.more » This report identifies the key challenges that will need to be overcome for sensor development in this context, and documents an experimental plan for sensor development, test, and evaluation. The focus of initial research and development is on sodium fast reactors, with the eventual goal of the research being developing the necessary sensor technology, quantifying sensor survivability and long-term measurement reliability for nondestructively inspecting critical components. Materials for sensor development that are likely to withstand the harsh environments are described, along with a status on the fabrication of reference specimens, and the planned approach for design and evaluation of the sensor and measurement technology.« less

Pressure Loss Predictions of the Reactor Simulator Subsystem at NASA GRC

NASA Technical Reports Server (NTRS)

Reid, Terry V.

2015-01-01

Testing of the Fission Power System (FPS) Technology Demonstration Unit (TDU) is being conducted at NASA GRC. The TDU consists of three subsystems: the Reactor Simulator (RxSim), the Stirling Power Conversion Unit (PCU), and the Heat Exchanger Manifold (HXM). An Annular Linear Induction Pump (ALIP) is used to drive the working fluid. A preliminary version of the TDU system (which excludes the PCU for now), is referred to as the RxSim subsystem and was used to conduct flow tests in Vacuum Facility 6 (VF 6). In parallel, a computational model of the RxSim subsystem was created based on the CAD model and was used to predict loop pressure losses over a range of mass flows. This was done to assess the ability of the pump to meet the design intent mass flow demand. Measured data indicates that the pump can produce 2.333 kg/sec of flow, which is enough to supply the RxSim subsystem with a nominal flow of 1.75 kg/sec. Computational predictions indicated that the pump could provide 2.157 kg/sec (using the Spalart-Allmaras turbulence model), and 2.223 kg/sec (using the k-? turbulence model). The computational error of the predictions for the available mass flow is -0.176 kg/sec (with the S-A turbulence model) and -0.110 kg/sec (with the k-epsilon turbulence model) when compared to measured data.

Optimal Design of a Resonance-Based Voltage Boosting Rectifier for Wireless Power Transmission.

PubMed

Lim, Jaemyung; Lee, Byunghun; Ghovanloo, Maysam

2018-02-01

This paper presents the design procedure for a new multi-cycle resonance-based voltage boosting rectifier (MCRR) capable of delivering a desired amount of power to the load (PDL) at a designated high voltage (HV) through a loosely-coupled inductive link. This is achieved by shorting the receiver (Rx) LC-tank for several cycles to harvest and accumulate the wireless energy in the RX inductor before boosting the voltage by breaking the loop and transferring the energy to the load in a quarter cycle. By optimizing the geometries of the transmitter (Tx) and Rx coils and the number of cycles, N , for energy harvesting, through an iterative design procedure, the MCRR can achieve the highest PDL under a given set of design constraints. Governing equations in the MCRR operation are derived to identify key specifications and the design guidelines. Using an exemplary set of specs, the optimized MCRR was able to generate 20.9 V DC across a 100 kΩ load from a 1.8 V p , 6.78 MHz sinusoid input in the ISM-band at a Tx/Rx coil separation of 1.3 cm, power transfer efficiency (PTE) of 2.2%, and N = 9 cycles. At the same coil distance and loading, coils optimized for a conventional half-wave rectifier (CHWR) were able to reach only 13.6 V DC from the same source.

Reactor Simulator Testing

NASA Technical Reports Server (NTRS)

Schoenfeld, Michael P.; Webster, Kenny L.; Pearson, Boise J.

2013-01-01

As part of the Nuclear Systems Office Fission Surface Power Technology Demonstration Unit (TDU) project, a reactor simulator test loop (RxSim) was design & built to perform integrated testing of the TDU components. In particular, the objectives of RxSim testing was to verify the operation of the core simulator, the instrumentation and control system, and the ground support gas and vacuum test equipment. In addition, it was decided to include a thermal test of a cold trap purification design and a pump performance test at pump voltages up to 150 V since the targeted mass flow rate of 1.75 kg/s was not obtained in the RxSim at the originally constrained voltage of 120 V. This paper summarizes RxSim testing. The gas and vacuum ground support test equipment performed effectively in NaK fill, loop pressurization, and NaK drain operations. The instrumentation and control system effectively controlled loop temperature and flow rates or pump voltage to targeted settings. The cold trap design was able to obtain the targeted cold temperature of 480 K. An outlet temperature of 636 K was obtained which was lower than the predicted 750 K but 156 K higher than the cold temperature indicating the design provided some heat regeneration. The annular linear induction pump (ALIP) tested was able to produce a maximum flow rate of 1.53 kg/s at 800 K when operated at 150 V and 53 Hz.

Reactor Simulator Integration and Testing

NASA Technical Reports Server (NTRS)

Schoenfield, M. P.; Webster, K. L.; Pearson, J. B.

2013-01-01

As part of the Nuclear Systems Office Fission Surface Power Technology Demonstration Unit (TDU) project, a reactor simulator (RxSim) test loop was designed and built to perform integrated testing of the TDU components. In particular, the objectives of RxSim testing were to verify the operation of the core simulator, the instrumentation and control system, and the ground support gas and vacuum test equipment. In addition, it was decided to include a thermal test of a cold trap purification design and a pump performance test at pump voltages up to 150 V because the targeted mass flow rate of 1.75 kg/s was not obtained in the RxSim at the originally constrained voltage of 120 V. This Technical Memorandum summarizes RxSim testing. The gas and vacuum ground support test equipment performed effectively in NaK fill, loop pressurization, and NaK drain operations. The instrumentation and control system effectively controlled loop temperature and flow rates or pump voltage to targeted settings. The cold trap design was able to obtain the targeted cold temperature of 480 K. An outlet temperature of 636 K was obtained, which was lower than the predicted 750 K but 156 K higher than the cold temperature, indicating the design provided some heat regeneration. The annular linear induction pump tested was able to produce a maximum flow rate of 1.53 kg/s at 800 K when operated at 150 V and 53 Hz.

Measuring the Innermost Stable Circular Orbits of Supermassive Black Holes

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

Chartas, G.; Zalesky, L.; Krawczynski, H.

We present a promising new technique, the g -distribution method, for measuring the inclination angle ( i ), the innermost stable circular orbit (ISCO), and the spin of a supermassive black hole. The g -distribution method uses measurements of the energy shifts in the relativistic iron line emitted by the accretion disk of a supermassive black hole due to microlensing by stars in a foreground galaxy relative to the g -distribution shifts predicted from microlensing caustic calculations. We apply the method to the gravitationally lensed quasars RX J1131–1231 ( z {sub s} = 0.658, z {sub l} = 0.295), QJmore » 0158–4325 ( z {sub s} = 1.294, z {sub l} = 0.317), and SDSS 1004+4112 ( z {sub s} = 1.734, z {sub l} = 0.68). For RX J1131−1231, our initial results indicate that r {sub ISCO} ≲ 8.5 gravitational radii ( r {sub g}) and i ≳ 55° (99% confidence level). We detect two shifted Fe lines in several observations, as predicted in our numerical simulations of caustic crossings. The current Δ E distribution of RX J1131–1231 is sparsely sampled, but further X-ray monitoring of RX J1131–1231 and other lensed quasars will provide improved constraints on the inclination angles, ISCO radii, and spins of the black holes of distant quasars.« less

Oral 5-Aminosalicylate, Mesalamine Suppository, and Mesalamine Enema as Initial Therapy for Ulcerative Proctitis in Clinical Practice with Quality of Care Implications

PubMed Central

Richter, James M.; Arshi, Nabeela K.; Oster, Gerry

2016-01-01

Background. Ulcerative proctitis (UP) is typically treated initially with oral 5-aminosalicylate (“5-ASA”), mesalamine suppository, or mesalamine enema (“UP Rx”). Little is known about their effectiveness in practice. Methods. Using a US health insurance database, we identified new-onset UP patients between January 1, 2005, and December 31, 2007, based on the following: (1) initiation of UP Rx; (2) endoscopy in prior 30 days resulting in diagnosis of UP; and (3) no prior encounters for ulcerative colitis or Crohn's disease. We examined the incidence of therapy escalation and total costs in relation to initial UP Rx. Results. We identified 548 patients: 327 received mesalamine suppository, 138 received oral 5-ASA, and 83 received mesalamine enema, as initial UP Rx. One-third receiving oral 5-ASA experienced therapy escalation over 12 months, 21% for both mesalamine suppository and enema. Mean cumulative total cost of UP Rx over 12 months was $1552, $996, and $986 for patients beginning therapy with oral 5-ASA, mesalamine enema, and mesalamine suppository, respectively. Contrary to expert recommendations the treatments were often not continued prophylactically. Conclusions. Treatment escalation was common, and total costs of therapy were higher, in patients who initiated treatment with oral 5-ASA. Further study is necessary to assess the significance of these observations. PMID:27446860

An ultra-low-power RF transceiver for WBANs in medical applications

NASA Astrophysics Data System (ADS)

Qi, Zhang; Xiaofei, Kuang; Nanjian, Wu

2011-06-01

A 2.4 GHz ultra-low-power RF transceiver with a 900 MHz auxiliary wake-up link for wireless body area networks (WBANs) in medical applications is presented. The RF transceiver with an asymmetric architecture is proposed to achieve high energy efficiency according to the asymmetric communication in WBANs. The transceiver consists of a main receiver (RX) with an ultra-low-power free-running ring oscillator and a high speed main transmitter (TX) with fast lock-in PLL. A passive wake-up receiver (WuRx) for wake-up function with a high power conversion efficiency (PCE) CMOS rectifier is designed to offer the sensor node the capability of work-on-demand with zero standby power. The chip is implemented in a 0.18 μm CMOS process. Its core area is 1.6 mm2. The main RX achieves a sensitivity of -55 dBm at a 100 kbps OOK data rate while consuming just 210 μA current from the 1 V power supply. The main TX achieves +3 dBm output power with a 4 Mbps/500 kbps/200 kbps data rate for OOK/4 FSK/2 FSK modulation and dissipates 3.25 mA/6.5 mA/6.5 mA current from a 1.8 V power supply. The minimum detectable RF input energy for the wake-up RX is -15 dBm and the PCE is more than 25%.

A prospective comparison of telemedicine versus in-person delivery of an interprofessional education program for adults with inflammatory arthritis.

PubMed

Kennedy, Carol A; Warmington, Kelly; Flewelling, Carol; Shupak, Rachel; Papachristos, Angelo; Jones, Caroline; Linton, Denise; Beaton, Dorcas E; Lineker, Sydney; Hogg-Johnson, Sheilah

2017-02-01

Introduction We evaluated two modes of delivery of an inflammatory arthritis education program ("Prescription for Education" (RxEd)) in improving arthritis self-efficacy and other secondary outcomes. Methods We used a non-randomized, pre-post design to compare videoconferencing (R, remote using telemedicine) versus local (I, in-person) delivery of the program. Data were collected at baseline (T 1 ), immediately following RxEd (T 2 ), and at six months (T 3 ). Self-report questionnaires served as the data collection tool. Measures included demographics, disorder-related, Arthritis Self-Efficacy Scale (SE), previous knowledge (Arthritis Community Research and Evaluation Unit (ACREU) rheumatoid arthritis knowledge questionnaire), coping efficacy, Illness Intrusiveness, and Effective Consumer Scale. Analysis included: baseline comparisons and longitudinal trends (R vs I groups); direct between-group comparisons; and Generalized Estimating Equations (GEE) analysis. Results A total of 123 persons attended the program (I: n = 36; R: n = 87) and 111 completed the baseline questionnaire (T 1 ), with follow-up completed by 95% ( n = 117) at T 2 and 62% ( n = 76) at T 3 . No significant baseline differences were found across patient characteristics and outcome measures. Both groups (R and I) showed immediate effect (improved arthritis SE, mean change (95% confidence interval (CI)): R 1.07 (0.67, 1.48); I 1.48 (0.74, 2.23)) after the program that diminished over six months (mean change (95% CI): R 0.45 (-0.1, 0.1); I 0.73 (-0.25, 1.7)). For each of the secondary outcomes, both groups showed similar trends for improvement (mean change scores (95% CI)) over time. GEE analysis did not show any meaningful differences between groups (R vs I) over time. Discussion Improvements in arthritis self-efficacy and secondary outcomes displayed similar trends for I and R participant groups.

Frequency band adjustment match filtering based on variable frequency GPR antennas pairing scheme for shallow subsurface investigations

NASA Astrophysics Data System (ADS)

Shaikh, Shahid Ali; Tian, Gang; Shi, Zhanjie; Zhao, Wenke; Junejo, S. A.

2018-02-01

Ground penetrating Radar (GPR) is an efficient tool for subsurface geophysical investigations, particularly at shallow depths. The non-destructiveness, cost efficiency, and data reliability are the important factors that make it an ideal tool for the shallow subsurface investigations. Present study encompasses; variations in central frequency of transmitting and receiving GPR antennas (Tx-Rx) have been analyzed and frequency band adjustment match filters are fabricated and tested accordingly. Normally, the frequency of both the antennas remains similar to each other whereas in this study we have experimentally changed the frequencies of Tx-Rx and deduce the response. Instead of normally adopted three pairs, a total of nine Tx-Rx pairs were made from 50 MHz, 100 MHz, and 200 MHz antennas. The experimental data was acquired at the designated near surface geophysics test site of the Zhejiang University, Hangzhou, China. After the impulse response analysis of acquired data through conventional as well as varied Tx-Rx pairs, different swap effects were observed. The frequency band and exploration depth are influenced by transmitting frequencies rather than the receiving frequencies. The impact of receiving frequencies was noticed on the resolution; the more noises were observed using the combination of high frequency transmitting with respect to low frequency receiving. On the basis of above said variable results we have fabricated two frequency band adjustment match filters, the constant frequency transmitting (CFT) and the variable frequency transmitting (VFT) frequency band adjustment match filters. By the principle, the lower and higher frequency components were matched and then incorporated with intermediate one. Therefore, this study reveals that a Tx-Rx combination of low frequency transmitting with high frequency receiving is a better choice. Moreover, both the filters provide better radargram than raw one, the result of VFT frequency band adjustment filter is much better than CFT frequency band adjustment filter.

Zidovudine ameliorates pathology in the mouse model of Duchenne muscular dystrophy via P2RX7 purinoceptor antagonism.

PubMed

Al-Khalidi, Rasha; Panicucci, Chiara; Cox, Paul; Chira, Natalia; Róg, Justyna; Young, Christopher N J; McGeehan, Rhiannon E; Ambati, Kameshwari; Ambati, Jayakrishna; Zabłocki, Krzysztof; Gazzerro, Elisabetta; Arkle, Stephen; Bruno, Claudio; Górecki, Dariusz C

2018-04-11

Duchenne muscular dystrophy (DMD) is the most common inherited muscle disorder that causes severe disability and death of young men. This disease is characterized by progressive muscle degeneration aggravated by sterile inflammation and is also associated with cognitive impairment and low bone density. Given that no current treatment can improve the long-term outcome, approaches with a strong translational potential are urgently needed. Duchenne muscular dystrophy (DMD) alters P2RX7 signaling in both muscle and inflammatory cells and inhibition of this receptor resulted in a significant attenuation of muscle and non-muscle symptoms in DMD mdx mouse model. As P2RX7 is an attractive target in a range of human diseases, specific antagonists have been developed. Yet, these will require lengthy safety testing in the pediatric population of Duchenne muscular dystrophy (DMD) patients. In contrast, Nucleoside Reverse Transcriptase Inhibitors (NRTIs) can act as P2RX7 antagonists and are drugs with an established safety record, including in children. We demonstrate here that AZT (Zidovudine) inhibits P2RX7 functions acting via the same allosteric site as other antagonists. Moreover, short-term AZT treatment at the peak of disease in DMD mdx mice attenuated the phenotype without any detectable side effects. Recovery was evident in the key parameters such as reduced sarcolemma permeability confirmed by lower serum creatine kinase levels and IgG influx into myofibres, decreased inflammatory cell numbers and inflammation markers in leg and heart muscles of treated mice. Moreover, this short-term therapy had some positive impact on muscle strength in vivo and no detrimental effect on mitochondria, which is the main side-effect of Nucleoside Reverse Transcriptase Inhibitors (NRTIs). Given these results, we postulate that AZT could be quickly re-purposed for the treatment of this highly debilitating and lethal disease. This approach is not constrained by causative DMD mutations and may be effective in alleviating both muscle and non-muscle abnormalities.

Evidence for Orbital Decay of RX J1914.4+2456: Gravitational Radiation and the Nature of the X-Ray Emission

NASA Technical Reports Server (NTRS)

Strohmayer, Tod E.; White, Nicholas E. (Technical Monitor)

2002-01-01

RX J1914.4+2456 is a candidate double-degenerate binary (AM CVn) with a putative 569 s orbital period. If this identification is correct, then it has one of the shortest binary orbital periods known, and gravitational radiation should drive the orbital evolution and mass transfer if the binary is semi-detached. Here we report the results of a coherent timing study of the archival ROSAT data for RX J1914.4+2456. We performed a phase coherent timing analysis using all five ROSAT observations spanning a four-year period. We demonstrate that all the data can be phase connected, and we show that the 1.756 mHz orbital frequency is increasing at a rate of 1.5 +/- 0.4 x 10(exp -17) Hz/s consistent with the expected loss of angular momentum from the binary system via gravitational radiation. In addition to providing evidence for the emission of gravitational waves, our measurement of the orbital v(dot) constrains models for the X-ray emission and the nature of the secondary. If stable mass accretion drives the X-ray flux, then a positive v(dot) is inconsistent with a degenerate donor. A helium burning dwarf is compatible if indeed such systems can have periods as short as that of RX J1914.4+2456, an open theoretical question. Our measurement of a positive v(dot) is consistent with the unipolar induction model of Wu et al. which does not require accretion to drive the X-ray flux. We discuss how future timing measurements of RX J1914.4+2456 (and systems like it) with for example, Chandra and XMM-Newton, can provide a unique probe of the interaction between mass loss and gravitational radiation. We also discuss the importance of such measurements in the context of gravitational wave detection from space, such as is expected in the future with the LISA mission.

A downy mildew effector attenuates salicylic acid-triggered immunity in Arabidopsis by interacting with the host mediator complex.

PubMed

Caillaud, Marie-Cécile; Asai, Shuta; Rallapalli, Ghanasyam; Piquerez, Sophie; Fabro, Georgina; Jones, Jonathan D G

2013-12-01

Plants are continually exposed to pathogen attack but usually remain healthy because they can activate defences upon perception of microbes. However, pathogens have evolved to overcome plant immunity by delivering effectors into the plant cell to attenuate defence, resulting in disease. Recent studies suggest that some effectors may manipulate host transcription, but the specific mechanisms by which such effectors promote susceptibility remain unclear. We study the oomycete downy mildew pathogen of Arabidopsis, Hyaloperonospora arabidopsidis (Hpa), and show here that the nuclear-localized effector HaRxL44 interacts with Mediator subunit 19a (MED19a), resulting in the degradation of MED19a in a proteasome-dependent manner. The Mediator complex of ∼25 proteins is broadly conserved in eukaryotes and mediates the interaction between transcriptional regulators and RNA polymerase II. We found MED19a to be a positive regulator of immunity against Hpa. Expression profiling experiments reveal transcriptional changes resembling jasmonic acid/ethylene (JA/ET) signalling in the presence of HaRxL44, and also 3 d after infection with Hpa. Elevated JA/ET signalling is associated with a decrease in salicylic acid (SA)-triggered immunity (SATI) in Arabidopsis plants expressing HaRxL44 and in med19a loss-of-function mutants, whereas SATI is elevated in plants overexpressing MED19a. Using a PR1::GUS reporter, we discovered that Hpa suppresses PR1 expression specifically in cells containing haustoria, into which RxLR effectors are delivered, but not in nonhaustoriated adjacent cells, which show high PR1::GUS expression levels. Thus, HaRxL44 interferes with Mediator function by degrading MED19, shifting the balance of defence transcription from SA-responsive defence to JA/ET-signalling, and enhancing susceptibility to biotrophs by attenuating SA-dependent gene expression.

A Downy Mildew Effector Attenuates Salicylic Acid–Triggered Immunity in Arabidopsis by Interacting with the Host Mediator Complex

PubMed Central

Caillaud, Marie-Cécile; Asai, Shuta; Rallapalli, Ghanasyam; Piquerez, Sophie; Fabro, Georgina; Jones, Jonathan D. G.

2013-01-01

Plants are continually exposed to pathogen attack but usually remain healthy because they can activate defences upon perception of microbes. However, pathogens have evolved to overcome plant immunity by delivering effectors into the plant cell to attenuate defence, resulting in disease. Recent studies suggest that some effectors may manipulate host transcription, but the specific mechanisms by which such effectors promote susceptibility remain unclear. We study the oomycete downy mildew pathogen of Arabidopsis, Hyaloperonospora arabidopsidis (Hpa), and show here that the nuclear-localized effector HaRxL44 interacts with Mediator subunit 19a (MED19a), resulting in the degradation of MED19a in a proteasome-dependent manner. The Mediator complex of ∼25 proteins is broadly conserved in eukaryotes and mediates the interaction between transcriptional regulators and RNA polymerase II. We found MED19a to be a positive regulator of immunity against Hpa. Expression profiling experiments reveal transcriptional changes resembling jasmonic acid/ethylene (JA/ET) signalling in the presence of HaRxL44, and also 3 d after infection with Hpa. Elevated JA/ET signalling is associated with a decrease in salicylic acid (SA)–triggered immunity (SATI) in Arabidopsis plants expressing HaRxL44 and in med19a loss-of-function mutants, whereas SATI is elevated in plants overexpressing MED19a. Using a PR1::GUS reporter, we discovered that Hpa suppresses PR1 expression specifically in cells containing haustoria, into which RxLR effectors are delivered, but not in nonhaustoriated adjacent cells, which show high PR1::GUS expression levels. Thus, HaRxL44 interferes with Mediator function by degrading MED19, shifting the balance of defence transcription from SA-responsive defence to JA/ET-signalling, and enhancing susceptibility to biotrophs by attenuating SA-dependent gene expression. PMID:24339748

High peak and high average radiofrequency power transmit/receive switch for thermal magnetic resonance.

PubMed

Ji, Yiyi; Hoffmann, Werner; Pham, Michal; Dunn, Alexander E; Han, Haopeng; Özerdem, Celal; Waiczies, Helmar; Rohloff, Michael; Endemann, Beate; Boyer, Cyrille; Lim, May; Niendorf, Thoralf; Winter, Lukas

2018-04-01

To study the role of temperature in biological systems, diagnostic contrasts and thermal therapies, RF pulses for MR spin excitation can be deliberately used to apply a thermal stimulus. This application requires dedicated transmit/receive (Tx/Rx) switches that support high peak powers for MRI and high average powers for RF heating. To meet this goal, we propose a high-performance Tx/Rx switch based on positive-intrinsic-negative diodes and quarter-wavelength (λ/4) stubs. The λ/4 stubs in the proposed Tx/Rx switch design route the transmitted RF signal directly to the RF coil/antenna without passing through any electronic components (e.g., positive-intrinsic-negative diodes). Bench measurements, MRI, MR thermometry, and RF heating experiments were performed at f = 297 MHz (B 0  = 7 T) to examine the characteristics and applicability of the switch. The proposed design provided an isolation of -35.7dB/-41.5dB during transmission/reception. The insertion loss was -0.41dB/-0.27dB during transmission/reception. The switch supports high peak (3.9 kW) and high average (120 W) RF powers for MRI and RF heating at f = 297 MHz. High-resolution MRI of the wrist yielded image quality competitive with that obtained with a conventional Tx/Rx switch. Radiofrequency heating in phantom monitored by MR thermometry demonstrated the switch applicability for thermal modulation. Upon these findings, thermally activated release of a model drug attached to thermoresponsive polymers was demonstrated. The high-power Tx/Rx switch enables thermal MR applications at 7 T, contributing to the study of the role of temperature in biological systems and diseases. All design files of the switch will be made available open source at www.opensourceimaging.org. © 2018 International Society for Magnetic Resonance in Medicine.

A wideband dual-antenna receiver for wireless recording from animals behaving in large arenas.

PubMed

Lee, Seung Bae; Yin, Ming; Manns, Joseph R; Ghovanloo, Maysam

2013-07-01

A low-noise wideband receiver (Rx) is presented for a multichannel wireless implantable neural recording (WINeR) system that utilizes time-division multiplexing of pulse width modulated (PWM) samples. The WINeR-6 Rx consists of four parts: 1) RF front end; 2) signal conditioning; 3) analog output (AO); and 4) field-programmable gate array (FPGA) back end. The RF front end receives RF-modulated neural signals in the 403-490 MHz band with a wide bandwidth of 18 MHz. The frequency-shift keying (FSK) PWM demodulator in the FPGA is a time-to-digital converter with 304 ps resolution, which converts the analog pulse width information to 16-bit digital samples. Automated frequency tracking has been implemented in the Rx to lock onto the free-running voltage-controlled oscillator in the transmitter (Tx). Two antennas and two parallel RF paths are used to increase the wireless coverage area. BCI-2000 graphical user interface has been adopted and modified to acquire, visualize, and record the recovered neural signals in real time. The AO module picks three demultiplexed channels and converts them into analog signals for direct observation on an oscilloscope. One of these signals is further amplified to generate an audio output, offering users the ability to listen to ongoing neural activity. Bench-top testing of the Rx performance with a 32-channel WINeR-6 Tx showed that the input referred noise of the entire system at a Tx-Rx distance of 1.5 m was 4.58 μV rms with 8-bit resolution at 640 kSps. In an in vivo experiment, location-specific receptive fields of hippocampal place cells were mapped during a behavioral experiment in which a rat completed 40 laps in a large circular track. Results were compared against those acquired from the same animal and the same set of electrodes by a commercial hardwired recording system to validate the wirelessly recorded signals.

A Wideband Dual-Antenna Receiver for Wireless Recording From Animals Behaving in Large Arenas

PubMed Central

Lee, Seung Bae; Yin, Ming; Manns, Joseph R.

2014-01-01

A low-noise wideband receiver (Rx) is presented for a multichannel wireless implantable neural recording (WINeR) system that utilizes time-division multiplexing of pulse width modulated (PWM) samples. The WINeR-6 Rx consists of four parts: 1) RF front end; 2) signal conditioning; 3) analog output (AO); and 4) field-programmable gate array (FPGA) back end. The RF front end receives RF-modulated neural signals in the 403–490 MHz band with a wide bandwidth of 18 MHz. The frequency-shift keying (FSK) PWM demodulator in the FPGA is a time-to-digital converter with 304 ps resolution, which converts the analog pulse width information to 16-bit digital samples. Automated frequency tracking has been implemented in the Rx to lock onto the free-running voltage-controlled oscillator in the transmitter (Tx). Two antennas and two parallel RF paths are used to increase the wireless coverage area. BCI-2000 graphical user interface has been adopted and modified to acquire, visualize, and record the recovered neural signals in real time. The AO module picks three demultiplexed channels and converts them into analog signals for direct observation on an oscilloscope. One of these signals is further amplified to generate an audio output, offering users the ability to listen to ongoing neural activity. Bench-top testing of the Rx performance with a 32-channel WINeR-6 Tx showed that the input referred noise of the entire system at a Tx–Rx distance of 1.5 m was 4.58 μVrms with 8-bit resolution at 640 kSps. In an in vivo experiment, location-specific receptive fields of hippocampal place cells were mapped during a behavioral experiment in which a rat completed 40 laps in a large circular track. Results were compared against those acquired from the same animal and the same set of electrodes by a commercial hardwired recording system to validate the wirelessly recorded signals. PMID:23428612

Reinstating the M31 X-Ray System RX J0042.3+4115 as a Black Hole X-Ray Binary and Compelling Evidence for an Extended Corona

NASA Astrophysics Data System (ADS)

Barnard, R.; Garcia, M. R.; Murray, S. S.

2011-12-01

The M31 X-ray source RX J0042.3+4115 was originally identified as a black hole (BH) binary because it displayed characteristic low-state variability at conspicuously high luminosities; unfortunately, this variability was later found to be artificial. However, analysis of 84 Chandra ACIS observations, a Hubble Space Telescope Advanced Camera for Surveys (ACS)/WFC observation, and a 60 ks XMM-Newton observation has supplied new evidence that RX J0042.3+4115 is indeed a BH binary. The brightest optical star within 3σ of the position of RXJ0042.3+4115 had a F435W (~B) magnitude of 25.4 ± 0.2; M B > -0.4, hence we find a low-mass donor likely. RX J0042.3+4115 was persistently bright over ~12 years. Spectral fits revealed characteristic BH binary states: a low/hard state at 2.08 ± 0.08 × 1038 erg s-1 and a steep power-law state at 2.41 ± 0.05 × 1038 erg s-1 (0.3-10 keV). The high-luminosity low state suggests a ~20 M ⊙ primary; this is high, but within the range of known stellar BH masses. The inner disk temperature during the steep power-law state is 2.24 ± 0.15 keV, high but strikingly similar to that of GRS 1915+105, the only known Galactic BH binary with a low-mass donor to be persistently bright. Therefore, RX J0042.3+4115 may be an analog for GRS 1915+105; however, other mechanisms may account for its behavior. We find compelling evidence for an extended corona during the steep power-law state, because compact corona models where the seed photons for Comptonization are tied to the inner disk temperature are rejected.

Search for A-F Spectral type pulsating components in Algol-type eclipsing binary systems

NASA Astrophysics Data System (ADS)

Kim, S.-L.; Lee, J. W.; Kwon, S.-G.; Youn, J.-H.; Mkrtichian, D. E.; Kim, C.

2003-07-01

We present the results of a systematic search for pulsating components in Algol-type eclipsing binary systems. A total number of 14 eclipsing binaries with A-F spectral type primary components were observed for 22 nights. We confirmed small-amplitude oscillating features of a recently detected pulsator TW Dra, which has a pulsating period of 0.053 day and a semi-amplitude of about 5 mmag in B-passband. We discovered new pulsating components in two eclipsing binaries of RX Hya and AB Per. The primary component of RX Hya is pulsating with a dominant period of 0.052 day and a semi-amplitude of about 7 mmag. AB Per has also a pulsating component with a period of 0.196 day and a semi-amplitude of about 10 mmag in B-passband. We suggest that these two new pulsators are members of the newly introduced group of mass-accreting pulsating stars in semi-detached Algol-type eclipsing binary systems. Table 4 is only available in electronic form at the CDS via anonymous ftp to cdsarc.u-strasbg.fr (130.79.128.5) or via http://cdsweb.u-strasbg.fr/cgi-bin/qcat?J/A+A/405/231

Impact of airbags on a Level I trauma center: injury patterns, infectious morbidity, and hospital costs.

PubMed

Williams, Regan F; Fabian, Timothy C; Fischer, Peter E; Zarzaur, Ben L; Magnotti, Louis J; Croce, Martin A

2008-05-01

To date, no study has evaluated the potential impact of supplemental restraint use on resource use at a Level I trauma center. We hypothesized that airbag use would be related to decreased injury severity of motor vehicle collision survivors admitted to a Level I trauma center, leading to a decrease in infectious morbidity and hospital resource use. Using the trauma registry, motor vehicle collision victims admitted during an 11-year period were identified. Restraint groups were defined as unrestrained (reference group), seatbelt only, airbag only, or airbag and seatbelt. Multivariable logistic regression was used to determine the relationship between restraint type and injury patterns. Other outcomes measured included prevalence of ventilator-associated pneumonia and bacteremia, hospital length of stay, days in the ICU, and hospital mortality. A total of 14,390 patients (unrestrained, n = 7,881; airbag only, n = 692; seatbelt only, n = 4,909; airbag and seatbelt, n = 908) had restraint data available. Both airbag and seatbelt use were associated with a substantial reduction in injury to the brain, face, cervical spine, thorax, and abdomen. The largest reduction occurred when these restraints were used in combination. The only injury associated with airbag deployment was extremity fractures. Compared with unrestrained persons, any restraint use was associated with substantially reduced injury severity, significant infectious morbidity, and resource use. Airbags are associated with reduced in-hospital mortality. Airbags are also associated with decreased injury severity, substantial infectious morbidity, and resource use. Cost savings from reduced resource use associated with supplemental restraints could be tremendous.

Disease identification based on ambulatory drugs dispensation and in-hospital ICD-10 diagnoses: a comparison.

PubMed

Halfon, Patricia; Eggli, Yves; Decollogny, Anne; Seker, Erol

2013-10-31

Pharmacy-based case mix measures are an alternative source of information to the relatively scarce outpatient diagnoses data. But most published tools use national drug nomenclatures and offer no head-to-head comparisons between drugs-related and diagnoses-based categories. The objective of the study was to test the accuracy of drugs-based morbidity groups derived from the World Health Organization Anatomical Therapeutic Chemical Classification of drugs by checking them against diagnoses-based groups. We compared drugs-based categories with their diagnoses-based analogues using anonymous data on 108,915 individuals insured with one of four companies. They were followed throughout 2005 and 2006 and hospitalized at least once during this period. The agreement between the two approaches was measured by weighted kappa coefficients. The reproducibility of the drugs-based morbidity measure over the 2 years was assessed for all enrollees. Eighty percent used a drug associated with at least one of the 60 morbidity categories derived from drugs dispensation. After accounting for inpatient under-coding, fifteen conditions agreed sufficiently with their diagnoses-based counterparts to be considered alternative strategies to diagnoses. In addition, they exhibited good reproducibility and allowed prevalence estimates in accordance with national estimates. For 22 conditions, drugs-based information identified accurately a subset of the population defined by diagnoses. Most categories provide insurers with health status information that could be exploited for healthcare expenditure prediction or ambulatory cost control, especially when ambulatory diagnoses are not available. However, due to insufficient concordance with their diagnoses-based analogues, their use for morbidity indicators is limited.

A Tutorial on RxODE: Simulating Differential Equation Pharmacometric Models in R.

PubMed

Wang, W; Hallow, K M; James, D A

2016-01-01

This tutorial presents the application of an R package, RxODE, that facilitates quick, efficient simulations of ordinary differential equation models completely within R. Its application is illustrated through simulation of design decision effects on an adaptive dosing regimen. The package provides an efficient, versatile way to specify dosing scenarios and to perform simulation with variability with minimal custom coding. Models can be directly translated to Rshiny applications to facilitate interactive, real-time evaluation/iteration on simulation scenarios.

VizieR Online Data Catalog: Chandra sources in 5 galaxy clusters (Martel+, 2007)

NASA Astrophysics Data System (ADS)

Martel, A. R.; Menanteau, F.; Tozzi, P.; Ford, H. C.; Infante, L.

2009-08-01

All five clusters of the sample were observed as part of the ACS GTO programs 9290 and 9919 in Cycles 11 and 12. Chandra observations were made for RX J0152-1357 was observed on 2000 Sep 8, RX J0849+4452 on 2000 May 3-4, RDCS J0910+5422 on 2001 Apr 24 and 28, MS 1054-0321 on 2000 Apr 21, and RDCS J1252-2927 on 2003 Mar 18 and 20. (1 data file).

How best to capture the respiratory consequences of prematurity?

PubMed

Ciuffini, Francesca; Robertson, Colin F; Tingay, David G

2018-03-31

Chronic respiratory morbidity is a common complication of premature birth, generally defined by the presence of bronchopulmonary dysplasia, both clinically and in trials of respiratory therapies. However, recent data have highlighted that bronchopulmonary dysplasia does not correlate with chronic respiratory morbidity in older children born preterm. Longitudinally evaluating pulmonary morbidity from early life through to childhood provides a more rational method of defining the continuum of chronic respiratory morbidity of prematurity, and offers new insights into the efficacy of neonatal respiratory interventions. The changing nature of preterm lung disease suggests that a multimodal approach using dynamic lung function assessment will be needed to assess the efficacy of a neonatal respiratory therapy and predict the long-term respiratory consequences of premature birth. Our aim is to review the literature regarding the long-term respiratory outcomes of neonatal respiratory strategies, the difficulties of assessing dynamic lung function in infants, and potential new solutions. Copyright ©ERS 2018.

Morbidity ranking of U.S. workers employed in 206 occupations: the National Health Interview Survey (NHIS) 1986-1994.

PubMed

Lee, David J; Fleming, Lora E; Gómez-Marín, Orlando; LeBlanc, William G; Arheart, Kristopher L; Caban, Alberto J; Christ, Sharon L; Chung-Bridges, Katherine; Pitman, Terry

2006-02-01

The objective of this study was to rank U.S. occupations by worker morbidity. From 1986 through 1994, morbidity information was collected on over 410,000 U.S. workers who participated in the National Health Interview Survey, an annual household survey representative of the U.S. civilian noninstitutionalized population. A multivariate adjusted logistic regression morbidity summary score was created for each worker group based on seven indicators: days of restricted activity, bedrest, and missed work in the previous 2 weeks; doctor visits and hospitalizations in the previous 12 months; reported health conditions; and health status. Worker groups reporting the greatest morbidity included social workers, inspectors, postal clerks, psychologists, and grinding machine operators; worker groups reporting the least morbidity included dentists, pilots, physicians, pharmacists, and dietitians. These findings aid in the identification of worker groups that require increased attention for morbidity research and prevention.

Contrasting patterns of hot spell effects on morbidity and mortality for cardiovascular diseases in the Czech Republic, 1994-2009

NASA Astrophysics Data System (ADS)

Hanzlíková, Hana; Plavcová, Eva; Kynčl, Jan; Kříž, Bohumír; Kyselý, Jan

2015-11-01

The study examines effects of hot spells on cardiovascular disease (CVD) morbidity and mortality in the population of the Czech Republic, with emphasis on differences between ischaemic heart disease (IHD) and cerebrovascular disease (CD) and between morbidity and mortality. Daily data on CVD morbidity (hospital admissions) and mortality over 1994-2009 were obtained from national hospitalization and mortality registers and standardized to account for long-term changes as well as seasonal and weekly cycles. Hot spells were defined as periods of at least two consecutive days with average daily air temperature anomalies above the 95 % quantile during June to August. Relative deviations of mortality and morbidity from the baseline were evaluated. Hot spells were associated with excess mortality for all examined cardiovascular causes (CVD, IHD and CD). The increases were more pronounced for CD than IHD mortality in most population groups, mainly in males. In the younger population (0-64 years), however, significant excess mortality was observed for IHD while there was no excess mortality for CD. A short-term displacement effect was found to be much larger for mortality due to CD than IHD. Excess CVD mortality was not accompanied by increases in hospital admissions and below-expected-levels of morbidity prevailed during hot spells, particularly for IHD in the elderly. This suggests that out-of-hospital deaths represent a major part of excess CVD mortality during heat and that for in-hospital excess deaths CVD is a masked comorbid condition rather than the primary diagnosis responsible for hospitalization.

[Health status, use of health services and reported morbidity: application of correspondence analysis].

PubMed

Espinàs, J A; Riba, M D; Borràs, J M; Sánchez, V

1995-01-01

The study of the relationship between self-reported morbidity, health status and health care utilization presents methodological problems due to the variety of illnesses and medical conditions that one individual may report. In this article, correspondence analysis was use to analyse these relationships. Data from the Spanish National Health Survey pertaining to the region of Catalonia was studied. Statistical analysis included multi-way correspondence analysis (MCA) followed by cluster analysis. The first factor extracted is defined by self-assessed health perception; the second, by limitation of activities, and the third is related to self-reported morbidity caused by chronic and acute health problems. Fourth and fifth factors, capture residual variability and missing values. Acute problems are more related to perception of poor health while chronic problems are related to perception of fair health. Also, it may be possible to distinguish self-reported morbidity due to relapses of chronic diseases from true acute health problems. Cluster analysis classified individuals into four groups: 1) healthy people; 2) people who assess their health as being poor and those with acute health problems; 3) people with chronic health problems, limited activity and a perception of fair health; and 4) missing values. Correspondence analysis is a useful tool when analyzing qualitative variables like those in a health survey.

Effective arrangement of separated transmit-only/receive-only RF coil for improvement of B1 homogeneity at 7 Tesla

NASA Astrophysics Data System (ADS)

Im, Geun Ho; Seo, Jeong-Hoon; Kim, Kyoung-Nam; Heo, Phil; Chung, Julius Juhyun; Jang, Moon-Sun; Lee, Jung Hee; Kim, Jae-Hun; Kim, Sun I.

2014-09-01

This article presents an effective arrangement with shifted transmit (Tx)-only and receive (Rx)-only (TORO) radiofrequency (RF) coils in a single-channel surface coil for improving the magnetic flux ( B 1) homogeneity in an ultra-high field (UHF) magnetic resonance imaging (MRI) scanner. The proposed new methodology for the coil arrangement using the shifted TORO RF coils was demonstrated for coils with 50-mm, 100-mm, and 150-mm-square surfaces and the results were compared to those for general Tx/Rx surface coils with the same dimensions. The computational analysis indicated that a homogeneous B1 field was achieved when the Rx-only coil was shifted in the two-dimensional xy-plane away from the Tx-only coils. Because the proposed coil configuration provides a unique opportunity for increasing the B 1 homogeneity, this feature is likely to increase the feasibility via new coil arrangements of UHF surface design and fabrication.

Implementing the information prescription protocol in a family medicine practice: a case study*†‡

PubMed Central

Carey, Peggy; Haines, Laura; Lampson, Alan P; Pond, Fred

2010-01-01

Question: Can an information prescription protocol be successfully integrated into a family medicine practice seeking to enhance patient education and self-management? Setting: Milton Family Practice, an outpatient clinic and resident teaching site of the University of Vermont and Fletcher Allen Health Care, is located in a semirural area fifteen miles from main campus. Objectives: The objectives were to increase physicians' knowledge and use of information prescriptions, sustain integration of information prescription use, and increase physicians' ability to provide patient education information. Methods: Methods used were promotion of the National Library of Medicine's Information Rx, physician instruction, installation of patient and provider workstations, and a collaborative approach to practice integration. Main Results: A post-intervention survey showed increased physician knowledge and use of the Information Rx protocol. Support procedures were integrated at the practice. Conclusions: Sustainable integration of Information Rx in a primary care clinic requires not only promotion and education, but also attention to clinic organization and procedures. PMID:20648257

The Gamma-Ray Bright BL Lac Object RX J1211+2242

NASA Technical Reports Server (NTRS)

Beckmann, V.; Favre, P.; Tavecchio, F.; Bussien, T.; Fliri, J.; Wolter, A.

2004-01-01

RX J1211+2242 is an optically faint (B approximately equal to 19.2mag) but X-ray bright (f2-10kev = 5 x l0(exp -12)erg per square centimeter per second) AGN, which has been shown to be a BL Lac object at redshift z = 0.455. The ROSAT X-ray, Calar Alto optical, and NVSS radio data suggest that the peak of the synchrotron emission of this object is at energies as high as several keV. BeppoSAX observations have been carried out simultaneously with optical observations in order to extend the coverage to higher energies. The new data indeed indicate a turn-over in the 2 - 10keV energy region. We propose that RX J1211+2242 is the counterpart of the unidentified EGRET source 3EG J1212+2304, making it a gamma-ray emitter with properties similar to, for example, Markarian 501 in its bright state, though being at a much larger distance.

New constraints on the TeV SNR shells RX J1713.7-3946 and HESS J1731-347

NASA Astrophysics Data System (ADS)

Puehlhofer, G.; Eger, P.; Doroshenko, V.; Cui, Y.; H. E. S. S. Collaboration

2016-06-01

Resolved TeV-emitting supernova remnants remain a small and precious class of sources to study cosmic ray acceleration in SNRs. We present new multi-wavelength results of the two prominent objects RX J1713.7-3946 and HESS J1731-347. For RX J1713.7-3946, extensive new H.E.S.S. data have permitted to study the nature of the TeV-emitting CR particles through improved broadband spectral studies, as well as through detailed investigations of morphological differences between TeV gamma-rays and X-rays. Concerning HESS J1731-347, the TeV morphology of the object and its surroundings has been studied using cosmic ray acceleration simulations of the object. The SNR also hosts a luminous X-ray emitting central compact object (CCO). Investigations of the CCO in X-rays and in the infrared have permitted to set interesting constraints on the SNR and its progenitor.

The Nearest Neutron Stars

NASA Technical Reports Server (NTRS)

Halpern, Jules P.

1996-01-01

Extreme Ultraviolet Explorer (EUVE) satellite observations of the Pulsar PSR J0437-4715, the Seyfert Galaxy RX J0437.4-4711, and the Geminga Pulsar are reported on. The main purpose of the PSR J0437-4715 investigation was to examine its soft X-ray flux. The 20 day EUVE observation of RX J0437.4-4711 constitutes a uniformly sampled soft X-ray light curve of a highly variable Seyfert galaxy whose power spectrum can be examined on timescales from 3 hrs. to several days. A unique aspect of the EUVE observation of RX J0437.4-4711 is its long light curve which we have used to measure the power spectrum of soft X-ray variability at low frequencies. Approximately 2100 counts were detected for the Geminga pulsar in a period of 251,000 s by the EUVE Deep Survey instrument. Geminga presents an unusually difficult problem because its multicomponent X-ray spectrum and pulse profile are indicative of a complex distribution of surface emission, and possibly a contribution from nonthermal emission as well.

VizieR Online Data Catalog: WINGS-SPE II catalog (Fritz+, 2011)

NASA Astrophysics Data System (ADS)

Fritz, J.; Poggianti, B. M.; Cava, A.; Valentinuzzi, T.; Moretti, A.; Bettoni, D.; Bressan, A.; Couch, W. J.; D'Onofrio, M.; Dressler, A.; Fasano, G.; Kjaergaard, P.; Moles, M.; Omizzolo, A.; Varela, J.

2010-10-01

Total stellar mass, stellar mass as a function of age, luminosity- and mass-weighted ages, and dust extinction values are presented for 5299 galaxies in 48 nearby galaxy clusters. Galaxies in the following clusters have been observed: A1069, A119, A151, A160, A193, A1291, A1631a, A1644, A1795, A1831, A1983, A1991, A2107, A2124, A2169, A2382, A2399, A2415, A2457, A2572a, A2589, A2593, A2622, A2626, A3128, A3158, A3266, A3376, A3395, A3490, A3497, A3556, A3560, A376, A3809, A500, A671, A754, A957x, A970, IIZw108, MKW3s,RX0058, RX1022, RX1740, Z2844, Z8338, and Z8852. Together with the afore mentioned parameters, we also provide model-derived observed and absolute magnitudes in Johnson and SLOAN photometric systems. (1 data file).

RX GEMINORUM: PHOTOMETRIC SOLUTIONS, (NEARLY UNIFORM) GAINER ROTATION, DONOR RADIAL VELOCITY SOLUTION, NON-LTE ACCRETION DISK MODELS OF Hα EMISSION PROFILES, AND SECULAR LIGHT CURVE CHANGES IN THE 20TH CENTURY

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

Olson, Edward C.; Etzel, Paul B., E-mail: olsoneco@aol.com, E-mail: pbetzel@mail.sdsu.edu

We obtained full-orbit Iybvu intermediate-band photometry and CCD spectroscopy of the long-period Algol eclipsing binary RX Geminorum. Photometric solutions using the Wilson–Devinney code give a gainer rotation (hotter, mass-accreting component) about 15 times the synchronous rate. We describe a simple technique to detect departures from uniform rotation of the hotter component. These binaries radiate double-peaked Hα emission from a low-mass accretion disk around the gainer. We used an approximate non-LTE disk code to predict models in fair agreement with observations, except in the far wings of the emission profile, where the star–inner disk boundary layer emits extra radiation. Variations inmore » Hα emission derive from modulations in the transfer rate. A study of times of minima during the 20th century suggests that a perturbing third body is present near RX Gem.« less

RX J1856-3754: Evidence for a Stiff Equation of State

NASA Astrophysics Data System (ADS)

Braje, Timothy M.; Romani, Roger W.

2002-12-01

We have examined the soft X-ray plus optical/UV spectrum of the nearby isolated neutron star RX J1856-3754, comparing it with detailed models of a thermally emitting surface. Like previous investigators, we find that the spectrum is best fitted by a two-temperature blackbody model. In addition, our simulations constrain the allowed viewing geometry from the observed pulse fraction upper limits. These simulations show that RX J1856-3754 is very likely to be a normal young pulsar, with the nonthermal radio beam missing Earth's line of sight. The spectral energy distribution limits on the model parameter space put a strong constraint on the star's M/R. At the measured parallax distance, the allowed range for MNS=1.5Msolar is RNS=13.7+/-0.6km. Under this interpretation, the equation of state (EOS) is relatively stiff near nuclear density, and the quark star EOS posited in some previous studies is strongly excluded. The data also constrain the surface T distribution over the polar cap.

E-Prescribing: History, Issues, and Potentials

PubMed Central

Salmon, J. Warren; Jiang, Ruixuan

2012-01-01

Electronic-Prescribing, Computerized Prescribing, or E-RX has increased dramatically of late in the American health care system, a long overdue alternative to the written form for the almost five billion drug treatments annually. This paper examines the history and selected issues in the rise of E-RX by a review of salient literature, interviews, and field observations in Pharmacy. Pharmacies were early adopters of computerization for a variety of factors. The profession in its new corporate forms of chain drug stores and pharmacy benefits firms has sought efficiencies, profit enhancements, and clinical improvements through managed care strategies that rely upon data automation. E-RX seems to be a leading factor in overall physician acceptance of Electronic Medical Records (EMRs), although the Centers for Medicare and Medicaid (CMS) incentives seem to be the propelling force in acceptance. We conclude that greater research should be conducted by public health professionals to focus on resolutions to pharmaceutical use, safety, and cost escalation, which persist and remain dire following health reform. PMID:23569654

Observations of the young supernova remnant RX J1713.7–3946 with the Fermi Large Area Telescope

DOE PAGES

Abdo, A. A.; Ackermann, M.; Ajello, M.; ...

2011-05-23

Here, we present observations of the young supernova remnant (SNR) RX J1713.7–3946 with the Fermi Large Area Telescope (LAT). We clearly detect a source positionally coincident with the SNR. The source is extended with a best-fit extension of 0°.55 ± 0°.04 matching the size of the non-thermal X-ray and TeV gamma-ray emission from the remnant. The positional coincidence and the matching extended emission allow us to identify the LAT source with SNR RX J1713.7–3946. The spectrum of the source can be described by a very hard power law with a photon index of Γ = 1.5 ± 0.1 that coincidesmore » in normalization with the steeper H.E.S.S.-detected gamma-ray spectrum at higher energies. The broadband gamma-ray emission is consistent with a leptonic origin as the dominant mechanism for the gamma-ray emission.« less

OBSERVATIONS OF THE YOUNG SUPERNOVA REMNANT RX J1713.7-3946 WITH THE FERMI LARGE AREA TELESCOPE

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

Abdo, A. A.; Ackermann, M.; Ajello, M.

We present observations of the young supernova remnant (SNR) RX J1713.7-3946 with the Fermi Large Area Telescope (LAT). We clearly detect a source positionally coincident with the SNR. The source is extended with a best-fit extension of 0.{sup 0}55 {+-} 0.{sup 0}04 matching the size of the non-thermal X-ray and TeV gamma-ray emission from the remnant. The positional coincidence and the matching extended emission allow us to identify the LAT source with SNR RX J1713.7-3946. The spectrum of the source can be described by a very hard power law with a photon index of {Gamma} = 1.5 {+-} 0.1 thatmore » coincides in normalization with the steeper H.E.S.S.-detected gamma-ray spectrum at higher energies. The broadband gamma-ray emission is consistent with a leptonic origin as the dominant mechanism for the gamma-ray emission.« less

Reducing beam hardening effects and metal artefacts in spectral CT using Medipix3RX

NASA Astrophysics Data System (ADS)

Rajendran, K.; Walsh, M. F.; de Ruiter, N. J. A.; Chernoglazov, A. I.; Panta, R. K.; Butler, A. P. H.; Butler, P. H.; Bell, S. T.; Anderson, N. G.; Woodfield, T. B. F.; Tredinnick, S. J.; Healy, J. L.; Bateman, C. J.; Aamir, R.; Doesburg, R. M. N.; Renaud, P. F.; Gieseg, S. P.; Smithies, D. J.; Mohr, J. L.; Mandalika, V. B. H.; Opie, A. M. T.; Cook, N. J.; Ronaldson, J. P.; Nik, S. J.; Atharifard, A.; Clyne, M.; Bones, P. J.; Bartneck, C.; Grasset, R.; Schleich, N.; Billinghurst, M.

2014-03-01

This paper discusses methods for reducing beam hardening effects and metal artefacts using spectral x-ray information in biomaterial samples. A small-animal spectral scanner was operated in the 15 to 80 keV x-ray energy range for this study. We use the photon-processing features of a CdTe-Medipix3RX ASIC in charge summing mode to reduce beam hardening and associated artefacts. We present spectral data collected for metal alloy samples, its analysis using algebraic 3D reconstruction software and volume visualisation using a custom volume rendering software. The cupping effect and streak artefacts are quantified in the spectral datasets. The results show reduction in beam hardening effects and metal artefacts in the narrow high energy range acquired using the spectroscopic detector. A post-reconstruction comparison between CdTe-Medipix3RX and Si-Medipix3.1 is discussed. The raw data and processed data are made available (http://hdl.handle.net/10092/8851) for testing with other software routines.

Physical co-morbidity among treatment resistant vs. treatment responsive patients with major depressive disorder.

PubMed

Amital, D; Fostick, L; Silberman, A; Calati, R; Spindelegger, C; Serretti, A; Juven-Wetzler, A; Souery, D; Mendlewicz, J; Montgomery, S; Kasper, S; Zohar, J

2013-08-01

Co-morbid physical illness has been suggested to play an important role among the factors contributing to treatment resistance in patients with major depressive disorder. In the current study we compared the rate of physical co-morbidity, defined by ICD-10, among a large multicenter sample of 702 patients with major depressive disorder. A total of 356 of the participants were defined as treatment resistant depression (TRD) patients-having failed two or more adequate antidepressant trials. No significant difference was found between TRD and non-TRD participants in the prevalence of any ICD-10 category. This finding suggests that although physical conditions such as diabetes, thyroid dysfunction, hypertension, ischemic heart disease, and peptic diseases are often accompanied by co-morbid MDD, they do not necessarily have an impact on the course of MDD or the likelihood to respond to treatment. Marginally higher rates of co-morbid breast cancer, migraine and glaucoma were found among TRD participants. Possible explanations for these findings and their possible relation to TRD are discussed. Copyright © 2012 Elsevier B.V. and ECNP. All rights reserved.

Gas spectroscopy system with 245 GHz transmitter and receiver in SiGe BiCMOS

NASA Astrophysics Data System (ADS)

Schmalz, Klaus; Rothbart, Nick; Borngräber, Johannes; Yilmaz, Selahattin Berk; Kissinger, Dietmar; Hübers, Heinz-Wilhelm

2017-02-01

The implementation of an integrated mm-wave transmitter (TX) and receiver (RX) in SiGe BiCMOS or CMOS technology offers a path towards a compact and low-cost system for gas spectroscopy. Previously, we have demonstrated TXs and RXs for spectroscopy at 238 -252 GHz and 495 - 497 GHz using external phase-locked loops (PLLs) with signal generators for the reference frequency ramps. Here, we present a more compact system by using two external fractional-N PLLs allowing frequency ramps for the TX and RX, and for TX with superimposed frequency shift keying (FSK) or reference frequency modulation realized by a direct digital synthesizer (DDS) or an arbitrary waveform generator. The 1.9 m folded gas absorption cell, the vacuum pumps, as well as the TX and RX are placed on a portable breadboard with dimensions of 75 cm x 45 cm. The system performance is evaluated by high-resolution absorption spectra of gaseous methanol at 13 Pa for 241 - 242 GHz. The 2f (second harmonic) content of the absorption spectrum of the methanol was obtained by detecting the IF power of RX using a diode power sensor connected to a lock-in amplifier. The reference frequency modulation reveals a higher SNR (signal-noise-ratio) of 98 within 32 s acquisition compared to 66 for FSK. The setup allows for jumping to preselected frequency regions according to the spectral signature thus reducing the acquisition time by up to one order of magnitude.

Protective effect of HOE642, a selective blocker of Na+-H+ exchange, against the development of rigor contracture in rat ventricular myocytes.

PubMed

Ruiz-Meana, M; Garcia-Dorado, D; Juliá, M; Inserte, J; Siegmund, B; Ladilov, Y; Piper, M; Tritto, F P; González, M A; Soler-Soler, J

2000-01-01

The objective of this study was to investigate the effect of Na+-H+ exchange (NHE) and HCO3--Na+ symport inhibition on the development of rigor contracture. Freshly isolated adult rat cardiomyocytes were subjected to 60 min metabolic inhibition (MI) and 5 min re-energization (Rx). The effects of perfusion of HCO3- or HCO3--free buffer with or without the NHE inhibitor HOE642 (7 microM) were investigated during MI and Rx. In HCO3--free conditions, HOE642 reduced the percentage of cells developing rigor during MI from 79 +/- 1% to 40 +/- 4% (P < 0.001) without modifying the time at which rigor appeared. This resulted in a 30% reduction of hypercontracture during Rx (P < 0.01). The presence of HCO3- abolished the protective effect of HOE642 against rigor. Cells that had developed rigor underwent hypercontracture during Rx independently of treatment allocation. Ratiofluorescence measurement demonstrated that the rise in cytosolic Ca2+ (fura-2) occurred only after the onset of rigor, and was not influenced by HOE642. NHE inhibition did not modify Na+ rise (SBFI) during MI, but exaggerated the initial fall of intracellular pH (BCEFC). In conclusion, HOE642 has a protective effect against rigor during energy deprivation, but only when HCO3--dependent transporters are inhibited. This effect is independent of changes in cytosolic Na+ or Ca2+ concentrations.

A Comparison of Singlet Oxygen Explicit Dosimetry (SOED) and Singlet Oxygen Luminescence Dosimetry (SOLD) for Photofrin-Mediated Photodynamic Therapy

PubMed Central

Kim, Michele M.; Penjweini, Rozhin; Gemmell, Nathan R.; Veilleux, Israel; McCarthy, Aongus; Buller, Gerald S.; Hadfield, Robert H.; Wilson, Brian C.; Zhu, Timothy C.

2016-01-01

Accurate photodynamic therapy (PDT) dosimetry is critical for the use of PDT in the treatment of malignant and nonmalignant localized diseases. A singlet oxygen explicit dosimetry (SOED) model has been developed for in vivo purposes. It involves the measurement of the key components in PDT—light fluence (rate), photosensitizer concentration, and ground-state oxygen concentration ([3O2])—to calculate the amount of reacted singlet oxygen ([1O2]rx), the main cytotoxic component in type II PDT. Experiments were performed in phantoms with the photosensitizer Photofrin and in solution using phosphorescence-based singlet oxygen luminescence dosimetry (SOLD) to validate the SOED model. Oxygen concentration and photosensitizer photobleaching versus time were measured during PDT, along with direct SOLD measurements of singlet oxygen and triplet state lifetime (τΔ and τt), for various photosensitizer concentrations to determine necessary photophysical parameters. SOLD-determined cumulative [1O2]rx was compared to SOED-calculated [1O2]rx for various photosensitizer concentrations to show a clear correlation between the two methods. This illustrates that explicit dosimetry can be used when phosphorescence-based dosimetry is not feasible. Using SOED modeling, we have also shown evidence that SOLD-measured [1O2]rx using a 523 nm pulsed laser can be used to correlate to singlet oxygen generated by a 630 nm laser during a clinical malignant pleural mesothelioma (MPM) PDT protocol by using a conversion formula. PMID:27929427

A Comparison of Singlet Oxygen Explicit Dosimetry (SOED) and Singlet Oxygen Luminescence Dosimetry (SOLD) for Photofrin-Mediated Photodynamic Therapy.

PubMed

Kim, Michele M; Penjweini, Rozhin; Gemmell, Nathan R; Veilleux, Israel; McCarthy, Aongus; Buller, Gerald S; Hadfield, Robert H; Wilson, Brian C; Zhu, Timothy C

2016-12-06

Accurate photodynamic therapy (PDT) dosimetry is critical for the use of PDT in the treatment of malignant and nonmalignant localized diseases. A singlet oxygen explicit dosimetry (SOED) model has been developed for in vivo purposes. It involves the measurement of the key components in PDT-light fluence (rate), photosensitizer concentration, and ground-state oxygen concentration ([³ O ₂])-to calculate the amount of reacted singlet oxygen ([¹ O ₂] rx ), the main cytotoxic component in type II PDT. Experiments were performed in phantoms with the photosensitizer Photofrin and in solution using phosphorescence-based singlet oxygen luminescence dosimetry (SOLD) to validate the SOED model. Oxygen concentration and photosensitizer photobleaching versus time were measured during PDT, along with direct SOLD measurements of singlet oxygen and triplet state lifetime ( τ Δ and τ t ), for various photosensitizer concentrations to determine necessary photophysical parameters. SOLD-determined cumulative [¹ O ₂] rx was compared to SOED-calculated [¹ O ₂] rx for various photosensitizer concentrations to show a clear correlation between the two methods. This illustrates that explicit dosimetry can be used when phosphorescence-based dosimetry is not feasible. Using SOED modeling, we have also shown evidence that SOLD-measured [¹ O ₂] rx using a 523 nm pulsed laser can be used to correlate to singlet oxygen generated by a 630 nm laser during a clinical malignant pleural mesothelioma (MPM) PDT protocol by using a conversion formula.

From prescription-only (Rx) to over-the-counter (OTC) status in Germany 2006-2015: pharmacological perspectives on regulatory decisions.

PubMed

Barrenberg, Eva; Garbe, Edeltraut

2017-07-01

Little is known about the extent of switches from prescription-only (Rx) to over-the-counter (OTC) status in Europe and about the pharmacological properties of the switched substances. The objectives of this study were to provide an overview of the substances that were switched from Rx to OTC status in Germany between 2006 and 2015 and to assess their pharmacological properties. Session minutes of the German Expert Advisory Committee for Prescription-Only Issues, changes to the German Ordinance on Prescription-Only Medicines and the Summary of Product Characteristics of the switched substances were analysed. Pharmacological properties were studied in relation to the EU Guideline on Changing the Classification for the Supply of a Medicinal Product for Human Use (the 'EU switch guide'). Between 2006 and 2015, seven substances (almotriptan, omeprazole, benzydamine, ibuprofen/pseudoephedrine, racecadotril, ketotifen and levonorgestrel) were switched from Rx to OTC status in Germany. In all cases, the OTC status was restricted to certain indications, doses, pack sizes, or other limitations. Notwithstanding recommendations of the EU switch guide, some of the switched substances might interact with commonly used drugs potentially resulting in serious adverse drug reactions or have contraindications or warnings regarding substantial parts of the population. The stipulations of the EU switch guide were fully met for only some switches, while this was not completely the case for others. Further development of guidance on balancing risks and benefits of OTC availability is recommended.

Evaluation of Propagation Characteristics Using the Human Body as an Antenna

PubMed Central

Li, Jingzhen; Liu, Yuhang; Hao, Yang

2017-01-01

In this paper, an inhomogeneous human body model was presented to investigate the propagation characteristics when the human body was used as an antenna to achieve signal transmission. Specifically, the channel gain of four scenarios, namely, (1) both TX electrode and RX electrode were placed in the air, (2) TX electrode was attached on the human body, and RX electrode was placed in the air, (3) TX electrode was placed in the air, and RX electrode was attached on the human body, (4) both the TX electrode and RX electrode were attached on the human body, were studied through numerical simulation in the frequency range 1 MHz to 90 MHz. Furthermore, the comparisons of input efficiency, accepted efficiency, total efficiency, absorption power of human body, and electric field distribution of different distances of four aforementioned scenarios were explored when the frequency was at 44 MHz. In addition, the influences of different human tissues, electrode position, and the distance between electrode and human body on the propagation characteristics were investigated respectively at 44 MHz. The results showed that the channel gain of Scenario 4 was the maximum when the frequency was from 1 MHz to 90 MHz. The propagation characteristics were almost independent of electrode position when the human body was using as an antenna. However, as the distance between TX electrode and human body increased, the channel gain decreased rapidly. The simulations were verified by experimental measurements. The results showed that the simulations were in agreement with the measurements. PMID:29232905

Evaluation of Propagation Characteristics Using the Human Body as an Antenna.

PubMed

Li, Jingzhen; Nie, Zedong; Liu, Yuhang; Wang, Lei; Hao, Yang

2017-12-11

In this paper, an inhomogeneous human body model was presented to investigate the propagation characteristics when the human body was used as an antenna to achieve signal transmission. Specifically, the channel gain of four scenarios, namely, (1) both TX electrode and RX electrode were placed in the air, (2) TX electrode was attached on the human body, and RX electrode was placed in the air, (3) TX electrode was placed in the air, and RX electrode was attached on the human body, (4) both the TX electrode and RX electrode were attached on the human body, were studied through numerical simulation in the frequency range 1 MHz to 90 MHz. Furthermore, the comparisons of input efficiency, accepted efficiency, total efficiency, absorption power of human body, and electric field distribution of different distances of four aforementioned scenarios were explored when the frequency was at 44 MHz. In addition, the influences of different human tissues, electrode position, and the distance between electrode and human body on the propagation characteristics were investigated respectively at 44 MHz. The results showed that the channel gain of Scenario 4 was the maximum when the frequency was from 1 MHz to 90 MHz. The propagation characteristics were almost independent of electrode position when the human body was using as an antenna. However, as the distance between TX electrode and human body increased, the channel gain decreased rapidly. The simulations were verified by experimental measurements. The results showed that the simulations were in agreement with the measurements.

A Low Cost Bluetooth Low Energy Transceiver for Wireless Sensor Network Applications with a Front-end Receiver-Matching Network-Reusing Power Amplifier Load Inductor.

PubMed

Liang, Zhen; Li, Bin; Huang, Mo; Zheng, Yanqi; Ye, Hui; Xu, Ken; Deng, Fangming

2017-04-19

In this work, a low cost Bluetooth Low Energy (BLE) transceiver for wireless sensor network (WSN) applications, with a receiver (RX)-matching network-reusing power amplifier (PA) load inductor, is presented. In order to decrease the die area, only two inductors were used in this work. Besides the one used in the voltage control oscillator (VCO), the PA load inductor was reused as the RX impedance matching component in the front-end. Proper controls have been applied to achieve high transmitter (TX) input impedance when the transceiver is in the receiving mode, and vice versa. This allows the TRX-switch/matching network integration without significant performance degradation. The RX adopted a low-IF structure and integrated a single-ended low noise amplifier (LNA), a current bleeding mixer, a 4th complex filter and a delta-sigma continuous time (CT) analog-to-digital converter (ADC). The TX employed a two-point PLL-based architecture with a non-linear PA. The RX achieved a sensitivity of -93 dBm and consumes 9.7 mW, while the TX achieved a 2.97% error vector magnitude (EVM) with 9.4 mW at 0 dBm output power. This design was fabricated in a 0.11 μm complementary metal oxide semiconductor (CMOS) technology and the front-end circuit only occupies 0.24 mm². The measurement results verify the effectiveness and applicability of the proposed BLE transceiver for WSN applications.

Pressure Loss Predictions of the Reactor Simulator Subsystem at NASA Glenn Research Center

NASA Technical Reports Server (NTRS)

Reid, Terry V.

2016-01-01

Testing of the Fission Power System (FPS) Technology Demonstration Unit (TDU) is being conducted at NASA Glenn Research Center. The TDU consists of three subsystems: the reactor simulator (RxSim), the Stirling Power Conversion Unit (PCU), and the heat exchanger manifold (HXM). An annular linear induction pump (ALIP) is used to drive the working fluid. A preliminary version of the TDU system (which excludes the PCU for now) is referred to as the "RxSim subsystem" and was used to conduct flow tests in Vacuum Facility 6 (VF 6). In parallel, a computational model of the RxSim subsystem was created based on the computer-aided-design (CAD) model and was used to predict loop pressure losses over a range of mass flows. This was done to assess the ability of the pump to meet the design intent mass flow demand. Measured data indicates that the pump can produce 2.333 kg/sec of flow, which is enough to supply the RxSim subsystem with a nominal flow of 1.75 kg/sec. Computational predictions indicated that the pump could provide 2.157 kg/sec (using the Spalart-Allmaras (S?A) turbulence model) and 2.223 kg/sec (using the k- turbulence model). The computational error of the predictions for the available mass flow is ?0.176 kg/sec (with the S-A turbulence model) and -0.110 kg/sec (with the k- turbulence model) when compared to measured data.

Association between ACTN3 R577X Polymorphism and Trunk Flexibility in 2 Different Cohorts.

PubMed

Kikuchi, Naoki; Zempo, Hirofumi; Fuku, Noriyuki; Murakami, Haruka; Sakamaki-Sunaga, Mikako; Okamoto, Takanobu; Nakazato, Koichi; Miyachi, Motohiko

2017-05-01

α-Actinin-3 (ACTN3) R577X polymorphism is associated with muscular strength and power. This study was performed to investigate the association between ACTN3 R577X polymorphisms and flexibility as another component of fitness in 2 cohorts. Cohort 1 consisted of 208 men and 568 women (ages 23-88), while Cohort 2 consisted of 529 men and 728 women (ages 23-87). All participants were recruited from the Tokyo metropolitan area and underwent a battery of tests to assess their grip strength and sit-and-reach flexibility. Genotyping results were analyzed for ACTN3 (rs1815739) polymorphism using the TaqMan approach. In Cohort 1, sit-and-reach in the RR genotype (35.3±0.7 cm) was significantly lower than those in the RX and XX genotypes (37.2±0.3 cm) even after adjusting for sex, age, and exercise habit as covariates (P<0.01). In Cohort 2, sit-and-reach tended to be lower in RR (38.1±0.6 cm) than in RX and XX (39.1±0.3 cm), but the differences were not significant (P=0.114). Analysis in pooled subjects indicated that RR was associated with significantly lower flexibility than RX and XX (P=0.009). The RR genotype of ACTN3 R577X in the general Japanese population showed lower flexibility compared to the RX and XX genotypes. © Georg Thieme Verlag KG Stuttgart · New York.

Anomaly detection in hyperspectral imagery: statistics vs. graph-based algorithms

NASA Astrophysics Data System (ADS)

Berkson, Emily E.; Messinger, David W.

2016-05-01

Anomaly detection (AD) algorithms are frequently applied to hyperspectral imagery, but different algorithms produce different outlier results depending on the image scene content and the assumed background model. This work provides the first comparison of anomaly score distributions between common statistics-based anomaly detection algorithms (RX and subspace-RX) and the graph-based Topological Anomaly Detector (TAD). Anomaly scores in statistical AD algorithms should theoretically approximate a chi-squared distribution; however, this is rarely the case with real hyperspectral imagery. The expected distribution of scores found with graph-based methods remains unclear. We also look for general trends in algorithm performance with varied scene content. Three separate scenes were extracted from the hyperspectral MegaScene image taken over downtown Rochester, NY with the VIS-NIR-SWIR ProSpecTIR instrument. In order of most to least cluttered, we study an urban, suburban, and rural scene. The three AD algorithms were applied to each scene, and the distributions of the most anomalous 5% of pixels were compared. We find that subspace-RX performs better than RX, because the data becomes more normal when the highest variance principal components are removed. We also see that compared to statistical detectors, anomalies detected by TAD are easier to separate from the background. Due to their different underlying assumptions, the statistical and graph-based algorithms highlighted different anomalies within the urban scene. These results will lead to a deeper understanding of these algorithms and their applicability across different types of imagery.

Reactor Simulator Testing

NASA Technical Reports Server (NTRS)

Schoenfeld, Michael P.; Webster, Kenny L.; Pearson, Boise Jon

2013-01-01

As part of the Nuclear Systems Office Fission Surface Power Technology Demonstration Unit (TDU) project, a reactor simulator test loop (RxSim) was design & built to perform integrated testing of the TDU components. In particular, the objectives of RxSim testing was to verify the operation of the core simulator, the instrumentation and control system, and the ground support gas and vacuum test equipment. In addition, it was decided to include a thermal test of a cold trap purification design and a pump performance test at pump voltages up to 150 V since the targeted mass flow rate of 1.75 kg/s was not obtained in the RxSim at the originally constrained voltage of 120 V. This paper summarizes RxSim testing. The gas and vacuum ground support test equipment performed effectively in NaK fill, loop pressurization, and NaK drain operations. The instrumentation and control system effectively controlled loop temperature and flow rates or pump voltage to targeted settings. The cold trap design was able to obtain the targeted cold temperature of 480 K. An outlet temperature of 636 K was obtained which was lower than the predicted 750 K but 156 K higher than the cold temperature indicating the design provided some heat regeneration. The annular linear induction pump (ALIP) tested was able to produce a maximum flow rate of 1.53 kg/s at 800 K when operated at 150 V and 53 Hz. Keywords: fission, space power, nuclear, liquid metal, NaK.

Regulation of Nicotine Biosynthesis by an Endogenous Target Mimicry of MicroRNA in Tobacco1[OPEN

PubMed Central

Li, Fangfang; Wang, Weidi; Zhao, Nan; Xiao, Bingguang; Cao, Peijian; Wu, Xingfu; Ye, Chuyu; Shen, Enhui; Qiu, Jie; Zhu, Qian-Hao; Xie, Jiahua; Zhou, Xueping; Fan, Longjiang

2015-01-01

The interaction between noncoding endogenous target mimicry (eTM) and its corresponding microRNA (miRNA) is a newly discovered regulatory mechanism and plays pivotal roles in various biological processes in plants. Tobacco (Nicotiana tabacum) is a model plant for studying secondary metabolite alkaloids, of which nicotine accounts for approximately 90%. In this work, we identified four unique tobacco-specific miRNAs that were predicted to target key genes of the nicotine biosynthesis and catabolism pathways and an eTM, novel tobacco miRNA (nta)-eTMX27, for nta-miRX27 that targets QUINOLINATE PHOSPHORIBOSYLTRANSFERASE2 (QPT2) encoding a quinolinate phosphoribosyltransferase. The expression level of nta-miRX27 was significantly down-regulated, while that of QPT2 and nta-eTMX27 was significantly up-regulated after topping, and consequently, nicotine content increased in the topping-treated plants. The topping-induced down-regulation of nta-miRX27 and up-regulation of QPT2 were only observed in plants with a functional nta-eTMX27 but not in transgenic plants containing an RNA interference construct targeting nta-eTMX27. Our results demonstrated that enhanced nicotine biosynthesis in the topping-treated tobacco plants is achieved by nta-eTMX27-mediated inhibition of the expression and functions of nta-miRX27. To our knowledge, this is the first report about regulation of secondary metabolite biosynthesis by an miRNA-eTM regulatory module in plants. PMID:26246450

Upregulation of P2RX7 in Cx3cr1-Deficient Mononuclear Phagocytes Leads to Increased Interleukin-1β Secretion and Photoreceptor Neurodegeneration.

PubMed

Hu, Shulong J; Calippe, Bertrand; Lavalette, Sophie; Roubeix, Christophe; Montassar, Fadoua; Housset, Michael; Levy, Olivier; Delarasse, Cecile; Paques, Michel; Sahel, José-Alain; Sennlaub, Florian; Guillonneau, Xavier

2015-05-06

Photoreceptor degeneration in age-related macular degeneration (AMD) is associated with an infiltration and chronic accumulation of mononuclear phagocytes (MPs). We have previously shown that Cx3cr1-deficient mice develop age- and stress- related subretinal accumulation of MPs, which is associated with photoreceptor degeneration. Cx3cr1-deficient MPs have been shown to increase neuronal apoptosis through IL-1β in neuroinflammation of the brain. The reason for increased IL-1β secretion from Cx3cr1-deficient MPs, and whether IL-1β is responsible for increased photoreceptor apoptosis in Cx3cr1-deficient mice, has not been elucidated. Here we show that Cx3cr1-deficient MPs express increased surface P2X7 receptor (P2RX7), which stimulates IL-1β maturation and secretion. P2RX7 and IL-1β inhibition efficiently blunted Cx3cr1-MP-dependent photoreceptor apoptosis in a monocyte/retina coculture system and in light-induced subretinal inflammation of Cx3cr1-deficient mice in vivo. Our results provide an explanation for increased CX3CR1-dependent IL-1β secretion and suggest that IL-1β or P2RX7 inhibition can help inhibit the inflammation-associated photoreceptor cell loss in late AMD, including geographic atrophy, for which no efficient treatment currently exists. Copyright © 2015 the authors 0270-6474/15/356987-10$15.00/0.

Consumer Opinions of Health Information Exchange, e-Prescribing, and Personal Health Records.

PubMed

Cochran, Gary L; Lander, Lina; Morien, Marsha; Lomelin, Daniel E; Brittin, Jeri; Reker, Celeste; Klepser, Donald G

2015-01-01

Consumer satisfaction is a crucial component of health information technology (HIT) utilization, as high satisfaction is expected to increase HIT utilization among providers and to allow consumers to become full participants in their own healthcare management. The primary objective of this pilot study was to identify consumer perspectives on health information technologies including health information exchange (HIE), e-prescribing (e-Rx), and personal health records (PHRs). Eight focus groups were conducted in seven towns and cities across Nebraska in 2013. Each group consisted of 10-12 participants. Discussions were organized topically in the following categories: HIE, e-Rx, and PHR. The qualitative analysis consisted of immersion and crystallization to develop a coding scheme that included both preconceived and emergent themes. Common themes across focus groups were identified and compiled for each discussion category. The study had 67 participants, of which 18 (27 percent) were male. Focus group findings revealed both perceived barriers and benefits to the adoption of HIT. Common HIT concerns expressed across focus groups included privacy and security of medical information, decreases in quality of care, inconsistent provider participation, and the potential cost of implementation. Positive expectations regarding HIT included better accuracy and completeness of information, and improved communication and coordination between healthcare providers. Improvements in patient care were expected as a result of easy physician access to consolidated information across providers as well as the speed of sharing and availability of information in an emergency. In addition, participants were optimistic about patient empowerment and convenient access to and control of personal health data. Consumer concerns focused on privacy and security of the health information, as well as the cost of implementing the technologies and the possibility of an unintended negative impact on the quality of care. While negative perceptions present barriers for potential patient acceptance, benefits such as speed and convenience, patient oversight of health data, and safety improvements may counterbalance these concerns.

Consumer Opinions of Health Information Exchange, e-Prescribing, and Personal Health Records

PubMed Central

Cochran, Gary L.; Lander, Lina; Morien, Marsha; Lomelin, Daniel E.; Brittin, Jeri; Reker, Celeste; Klepser, Donald G.

2015-01-01

Background Consumer satisfaction is a crucial component of health information technology (HIT) utilization, as high satisfaction is expected to increase HIT utilization among providers and to allow consumers to become full participants in their own healthcare management. Objective The primary objective of this pilot study was to identify consumer perspectives on health information technologies including health information exchange (HIE), e-prescribing (e-Rx), and personal health records (PHRs). Methods Eight focus groups were conducted in seven towns and cities across Nebraska in 2013. Each group consisted of 10–12 participants. Discussions were organized topically in the following categories: HIE, e-Rx, and PHR. The qualitative analysis consisted of immersion and crystallization to develop a coding scheme that included both preconceived and emergent themes. Common themes across focus groups were identified and compiled for each discussion category. Results The study had 67 participants, of which 18 (27 percent) were male. Focus group findings revealed both perceived barriers and benefits to the adoption of HIT. Common HIT concerns expressed across focus groups included privacy and security of medical information, decreases in quality of care, inconsistent provider participation, and the potential cost of implementation. Positive expectations regarding HIT included better accuracy and completeness of information, and improved communication and coordination between healthcare providers. Improvements in patient care were expected as a result of easy physician access to consolidated information across providers as well as the speed of sharing and availability of information in an emergency. In addition, participants were optimistic about patient empowerment and convenient access to and control of personal health data. Conclusion Consumer concerns focused on privacy and security of the health information, as well as the cost of implementing the technologies and the possibility of an unintended negative impact on the quality of care. While negative perceptions present barriers for potential patient acceptance, benefits such as speed and convenience, patient oversight of health data, and safety improvements may counterbalance these concerns. PMID:26604874

Instrumental rotation for persistent fetal occiput posterior position: a way to decrease maternal and neonatal injury?

PubMed

Vidal, Fabien; Simon, Caroline; Cristini, Christelle; Arnaud, Catherine; Parant, Olivier

2013-01-01

To evaluate immediate perineal and neonatal morbidity associated with instrumental rotations performed with Thierry's spatulas for the management of persistent posterior occiput (OP) positions. Retrospective study including all persistent occiput posterior positions with vaginal OP delivery, from August 2006 to September 2007. Occiput anterior deliveries following successful instrumental rotation were included as well. We compared maternal and neonatal immediate outcomes between spontaneous deliveries, rotational and non rotational assisted deliveries, using χ(2) and Anova tests. 157 patients were enrolled, comprising 46 OP spontaneous deliveries, 58 assisted OP deliveries and 53 deliveries after rotational procedure. Instrumental rotation failed in 9 cases. Mean age and parity were significantly higher in the spontaneous delivery group, while labor duration was shorter. There were no significant differences in the rate of severe perineal tears and neonatal adverse outcomes between the 3 groups. Instrumental rotation using Thierry's spatulas was not associated with a reduced risk of maternal and neonatal morbidity for persistent OP deliveries. Further studies are required to define the true interest of such procedure in modern obstetrics.

Instrumental Rotation for Persistent Fetal Occiput Posterior Position: A Way to Decrease Maternal and Neonatal Injury?

PubMed Central

Vidal, Fabien; Simon, Caroline; Cristini, Christelle; Arnaud, Catherine; Parant, Olivier

2013-01-01

Objective To evaluate immediate perineal and neonatal morbidity associated with instrumental rotations performed with Thierry’s spatulas for the management of persistent posterior occiput (OP) positions. Methods Retrospective study including all persistent occiput posterior positions with vaginal OP delivery, from August 2006 to September 2007. Occiput anterior deliveries following successful instrumental rotation were included as well. We compared maternal and neonatal immediate outcomes between spontaneous deliveries, rotational and non rotational assisted deliveries, using χ2 and Anova tests. Results 157 patients were enrolled, comprising 46 OP spontaneous deliveries, 58 assisted OP deliveries and 53 deliveries after rotational procedure. Instrumental rotation failed in 9 cases. Mean age and parity were significantly higher in the spontaneous delivery group, while labor duration was shorter. There were no significant differences in the rate of severe perineal tears and neonatal adverse outcomes between the 3 groups. Conclusion Instrumental rotation using Thierry’s spatulas was not associated with a reduced risk of maternal and neonatal morbidity for persistent OP deliveries. Further studies are required to define the true interest of such procedure in modern obstetrics. PMID:24205122

Roadmap to Wellness: Exploring Live Customized Music at the Bedside for Hospitalized Children.

PubMed

Perkins, R Serene; Boyce, Maura; Byrtek, Megan C; Ellis, Regina C; Hill, Cindy; Fitzpatrick, Paul S; Demirel, Shaban

2018-01-01

Randomized trials on clinical outcomes of music are conflicting, with few performed in the postoperative pediatric population. We aimed to determine if there was a benefit of a live, customized bedside music delivery program (MyMusicRx ® ) for children hospitalized after pediatric surgery. We present our perspective on the utility of music medicine, review others' work in this area, and discuss future directions. All admitted postsurgical patients aged between 5 and 18 years were considered. One live, customized music session was delivered by a MyMusicRx ® music specialist to intervention participants, and compared with matched controls who did not receive music intervention. Pain, cumulative analgesia dosage, and vital signs within 12 h after unit arrival were compared between groups. Thirty-two participants (16 intervention, 16 controls; 8:8 females:males per group) were enrolled. No differences in age, surgery length, or duration of music intervention were found between groups. No differences in pain scores ( p  = 0.73), heart rate ( p  = 0.82), respirations ( p  = 84), narcotic ( p  = 0.92) or non-narcotic medication usage ( p  = 0.88, 0.86, 0.95; ibuprofen, acetaminophen, and ketorolac, respectively), or time to first narcotic dose ( p  = 0.64) were found. A single music intervention in the acute postoperative period did not appear to be adequate to augment traditional methods of pain and hemodynamic control. Prior studies have similar outcome measures but conflicting results. We did not evaluate psychological well-being, patient engagement, or family perception in this pilot study. Future directions include developing and validating a tool that explores the observable impact of music medicine on children's emotions and behaviors.

International consensus on a complications list after gastrectomy for cancer.

PubMed

Baiocchi, Gian Luca; Giacopuzzi, Simone; Marrelli, Daniele; Reim, Daniel; Piessen, Guillaume; Matos da Costa, Paulo; Reynolds, John V; Meyer, Hans-Joachim; Morgagni, Paolo; Gockel, Ines; Lara Santos, Lucio; Jensen, Lone Susanne; Murphy, Thomas; Preston, Shaun R; Ter-Ovanesov, Mikhail; Fumagalli Romario, Uberto; Degiuli, Maurizio; Kielan, Wojciech; Mönig, Stefan; Kołodziejczyk, Piotr; Polkowski, Wojciech; Hardwick, Richard; Pera, Manuel; Johansson, Jan; Schneider, Paul M; de Steur, Wobbe O; Gisbertz, Suzanne S; Hartgrink, Henk; van Sandick, Joanna W; Portolani, Nazario; Hölscher, Arnulf H; Botticini, Maristella; Roviello, Franco; Mariette, Christophe; Allum, William; De Manzoni, Giovanni

2018-05-30

Perioperative complications can affect outcomes after gastrectomy for cancer, with high mortality and morbidity rates ranging between 10 and 40%. The absence of a standardized system for recording complications generates wide variation in evaluating their impacts on outcomes and hinders proposals of quality-improvement projects. The aim of this study was to provide a list of defined gastrectomy complications approved through international consensus. The Gastrectomy Complications Consensus Group consists of 34 European gastric cancer experts who are members of the International Gastric Cancer Association. A group meeting established the work plan for study implementation through Delphi surveys. A consensus was reached regarding a set of standardized methods to define gastrectomy complications. A standardized list of 27 defined complications (grouped into 3 intraoperative, 14 postoperative general, and 10 postoperative surgical complications) was created to provide a simple but accurate template for recording individual gastrectomy complications. A consensus was reached for both the list of complications that should be considered major adverse events after gastrectomy for cancer and their specific definitions. The study group also agreed that an assessment of each surgical case should be completed at patient discharge and 90 days postoperatively using a Complication Recording Sheet. The list of defined complications (soon to be validated in an international multicenter study) and the ongoing development of an electronic datasheet app to record them provide the basic infrastructure to reach the ultimate goals of standardized international data collection, establishment of benchmark results, and fostering of quality-improvement projects.

Morbidity and mortality disparities among colonist and indigenous populations in the Ecuadorian Amazon.

PubMed

Kuang-Yao Pan, William; Erlien, Christine; Bilsborrow, Richard E

2010-02-01

Rural populations living in the northern Ecuadorian Amazon (NEA) experience the highest health burden of any region in the country. Two independent studies of colonist and indigenous groups living in the NEA are used to compare their morbidity and mortality experiences. Colonist data are from a probability sample of land plots in 1999, while indigenous data are from a representative sample of the five largest ethnicities (Quichua, Shuar, Huaorani, Cofan, Secoya) collected in 2001. Poisson regression was used to compare morbidity. Results indicate clear differences in health between populations. Indigenous groups had 30% higher probability of mortality and 63% higher incidence rate of all-cause morbidity compared to colonists. Vector-borne, chronic, gastrointestinal, and diseases of unknown origin were particularly high among indigenous groups. Factors associated with morbidity varied: morbidity rates were similar for the two youngest age groups (0-4 and 5-9), but indigenous people aged 15-39 and 40+ had almost double the morbidity compared to colonists; larger households, later months of data collection and less pollution were associated with less morbidity in both groups; better infrastructure access (electricity and roads) was generally associated with lower morbidity in both groups; and associations of land use were different by group with more cultivation of perennials and fewer annuals associated with less morbidity for colonists, but more for indigenous groups. These results demonstrate the health disparities that exist among indigenous and non-indigenous populations even when living in the same geographic region. Land use itself exemplifies the cultural and contextual differences that are evident in health, since land use decisions are related to broader demographic and economic factors that influence overall ecological and human health. Ongoing population-environment and/or environment-health research needs to recognize the broader factors involved when studying relationships between population health, development and deforestation. Copyright 2009 Elsevier Ltd. All rights reserved.

Morbidity and mortality disparities among colonist and indigenous populations in the Ecuadorian Amazon

PubMed Central

Pan, William Kuang-Yao; Erlien, Christine; Bilsborrow, Richard E

2009-01-01

Rural populations living in the northern Ecuadorian Amazon (NEA) experience the highest health burden of any region in the country. Two independent studies of colonist and indigenous groups living in the NEA are used to compare their morbidity and mortality experiences. Colonist data are from a probability sample of land plots in 1999, while indigenous data are from a representative sample of the five largest ethnicities (Quichua, Shuar, Huaorani, Cofan, Secoya) collected in 2001. Poisson regression was used to compare morbidity. Results indicate clear differences in health between populations. Indigenous groups had 30% higher probability of mortality and 63% higher incidence rate of all-cause morbidity compared to colonists. Vector-borne, chronic, gastrointestinal, and diseases of unknown origin were particularly high among indigenous groups. Factors associated with morbidity varied: morbidity rates were similar for the two youngest age groups (0–4 and 5–9), but indigenous people aged 15–39 and 40+ had almost double the morbidity compared to colonists; larger households, later months of data collection and less pollution were associated with less morbidity in both groups; better infrastructure access (electricity and roads) was generally associated with lower morbidity in both groups; and associations of land use were different by group with more cultivation of perennials and fewer annuals associated with less morbidity for colonists, but more for indigenous groups. These results demonstrate the health disparities that exist among indigenous and non-indigenous populations even when living in the same geographic region. Land use itself exemplifies the cultural and contextual differences that are evident in health, since land use decisions are related to broader demographic and economic factors that influence overall ecological and human health. Ongoing population-environment and/or environment-health research needs to recognize the broader factors involved when studying relationships between population health, development and deforestation. PMID:19906478

A failure management prototype: DR/Rx

NASA Technical Reports Server (NTRS)

Hammen, David G.; Baker, Carolyn G.; Kelly, Christine M.; Marsh, Christopher A.

1991-01-01

This failure management prototype performs failure diagnosis and recovery management of hierarchical, distributed systems. The prototype, which evolved from a series of previous prototypes following a spiral model for development, focuses on two functions: (1) the diagnostic reasoner (DR) performs integrated failure diagnosis in distributed systems; and (2) the recovery expert (Rx) develops plans to recover from the failure. Issues related to expert system prototype design and the previous history of this prototype are discussed. The architecture of the current prototype is described in terms of the knowledge representation and functionality of its components.

Relativistic scattered wave calculations on UF6

NASA Technical Reports Server (NTRS)

Case, D. A.; Yang, C. Y.

1980-01-01

Self-consistent Dirac-Slater multiple scattering calculations are presented for UF6. The results are compared critically to other relativistic calculations, showing that the results of all molecular orbital calculations are in qualitative agreement, as measured by energy levels, population analyses, and spin-orbit splittings. A detailed comparison is made to the relativistic X alpha(RX alpha) method of Wood and Boring, which also uses multiple scattering theory, but incorporates relativistic effects in a more approximate fashion. For the most part, the RX alpha results are in agreement with the present results.

Extended pancreatectomy as defined by the ISGPS: useful in selected cases of pancreatic cancer but invaluable in other complex pancreatic tumors.

PubMed

Mitra, Abhishek; Pai, Esha; Dusane, Rohit; Ranganathan, Priya; DeSouza, Ashwin; Goel, Mahesh; Shrikhande, Shailesh V

2018-03-01

Extended pancreatectomy aimed at R0 resection of pancreatic tumors with adjacent vessel and organ involvement may be the only option for cure. This study was done with an objective to analyze the short- and long-term outcomes of extended pancreatic resections. All pancreatectomies performed between 2006 and 2015 were included. The pancreatectomies were classified as standard or extended, as per the International Study Group for Pancreatic Surgery. All surgical complications and terminologies were according to Clavien-Dindo classification and International Study Group for Pancreatic Surgery guidelines. Morbidity and mortality were primary outcomes and disease-free survival was a secondary outcome. Sixty-three extended and 620 standard pancreatectomies were performed. Major morbidity (Clavien grades III, IV and V) (37 vs. 29%, p = 0.21) and mortality (6 vs. 4%, p = 0.3) for extended pancreatectomies were comparable to those for standard pancreatectomies. Blood loss > 855 ml, need for blood transfusion, and tumor size were independent risk factors for morbidity, and the latter two for mortality. Standard pancreatectomies were associated with better 3-year disease-free survival than extended pancreatectomies (67 vs. 41%, p < 0.001). Extended pancreatectomies resulted in a significantly better median disease-free survival for non-pancreatic adenocarcinoma vs. pancreatic adenocarcinoma (33.3 vs. 9.5 months, p = 0.01). Extended pancreatectomies resulted in similar peri-operative morbidity and mortality compared to standard pancreatectomies. Although the survival of patients undergoing these complex procedures is inferior to standard pancreatectomies, they should be undertaken not only in selected cases of pancreatic cancer but even more so in other complex pancreatic tumors.

[Odontoid process fracture in elderly patients over 70 years: morbidity, handicap, and role of surgical treatment in a retrospective series of 27 cases].

PubMed

Lefranc, M; Peltier, J; Fichten, A; Desenclos, C; Toussaint, P; Le Gars, D

2009-12-01

Odontoid process fractures of the axis are frequent in elderly patients. However, the impact in terms of handicap and morbidity in this particular population are unknown. The role of surgical treatment remains controversial. We present a retrospective series of patients aged 70 years or older with odontoid fractures treated in our department between 1998 and 2006. Two cohorts were defined (surgery versus conservative) and compared. Morbidity, handicap, and radiographic fusion were analyzed. Twenty-seven patients were treated. The mean age was 80.67 years. Five patients died early during hospitalization. Fractures were type II in 66.7% of the cases and type III in 33.3%. Orthopedic treatment was chosen in 44.4% of the cases. A non-union at the fracture site was found in 33% of the cases and morbidity in 41.7% of the cases was found after a 1-year follow-up. Surgery was performed in 40.7% of the cases. There was 18% non-union and no morbidity after 1-year of follow-up. Morbidity was statistically lower in the surgery group (p=0.037), particularly in cases of type II fracture (p=0.0063); no statistically significant difference was found for non-union at the fracture site (p=0.64) except for type II fractures (p=0.028). Odontoid fractures in the elderly are a very frequent problem. Immediate mortality is still high but appears correlated to associated lesions. Today's treatments must preserve autonomy for these patients. For elderly patients, the treatment must be chosen in relation to the fracture analysis. In our opinion, surgical management is the treatment of choice for unstable fractures (type II). Conservative management is indicated for stable fractures.

Predicted detonation properties at the Chapman-Jouguet state for proposed energetic materials (MTO and MTO3N) from combined ReaxFF and quantum mechanics reactive dynamics.

PubMed

Zhou, Tingting; Zybin, Sergey V; Goddard, William A; Cheng, Tao; Naserifar, Saber; Jaramillo-Botero, Andres; Huang, Fenglei

2018-02-07

The development of new energetic materials (EMs) with improved detonation performance but low sensitivity and environmental impact is of considerable importance for applications in civilian and military fields. Often new designs are difficult to synthesize so predictions of performance in advance is most valuable. Examples include MTO (2,4,6-triamino-1,3,5-triazine-1,3,5-trioxide) and MTO3N (2,4,6-trinitro-1,3,5-triazine-1,3,5-trioxide) suggested by Klapötke as candidate EMs but not yet successfully synthesized. We propose and apply to these materials a new approach, RxMD(cQM), in which ReaxFF Reactive Molecular Dynamics (RxMD) is first used to predict the reaction products and thermochemical properties at the Chapman Jouguet (CJ) state for which the system is fully reacted and at chemical equilibrium. Quantum mechanics dynamics (QMD) is then applied to refine the pressure of the ReaxFF predicted CJ state to predict a more accurate final CJ point, leading to a very practical calculation that includes accurate long range vdW interactions needed for accurate pressure. For MTO, this RxMD(cQM) method predicts a detonation pressure of P CJ = 40.5 GPa and a detonation velocity of D CJ = 8.8 km s -1 , while for MTO3N it predicts P CJ = 39.9 GPa and D CJ = 8.4 km s -1 , making them comparable to HMX (P CJ = 39.5 GPa, D CJ = 9.1 km s -1 ) and worth synthesizing. This first-principles-based RxMD(cQM) methodology provides an excellent compromise between computational cost and accuracy including the formation of clusters that burn too slowly, providing a practical mean of assessing detonation performances for novel candidate EMs. This RxMD(cQM) method that links first principles atomistic molecular dynamics simulations with macroscopic properties to promote in silico design of new EMs should also be of general applicability to materials synthesis and processing.

SU-E-T-320: Dosimetric Evaluation of Intracranial Stereotactic Radiotherapy Plans Using Jaws-Only Collimation On a LINAC

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

Mistry, N; Kim, A; Schaum, J

2015-06-15

Purpose: To evaluate the dosimetry of cranial stereotactic radiotherapy (SRT) plans using jaws-only collimation on linac that meets appropriate TG-142 tolerances. Methods: Seventeen spherical targets were generated in the center of a head phantom with diameters ranging from 8 mm to 40 mm. Plans balanced treatment time with dose gradient and conformity using 13 static fields and 3 couch angles: 9 non-opposed and coplanar fields and 4 non-coplanar fields. The symmetrical jaws field size was target diameter plus 2 mm. The prescription (Rx) was 7 Gy per fraction to the 80% isodose line. Two plans were created for each target:more » one kept the collimator at 0° (C0), one adjusted the collimator angle 40° for each field to create a 360° sweep over the 9 coplanar fields (CR).Conformity of the Rx to the target was evaluated using a ratio of Rx to target volume (PITV). Heterogeneity was determined using a ratio of maximum dose to Rx dose. Falloff was scored using CGIg: the difference of effective radii of spheres equal to half and full Rx volumes. Results: All plans met RTOG SRS criteria for conformity and heterogeneity. The use of collimator rotation improved conformity by 3.2% on average, the mean PITV was 1.7±0.1 for C0 plans and 1.6±0.1 for CR. Mean heterogeneity was 1.25±0.0 for both C0 and CR. The mean CGIg was 75.9±16.4 for C0 plans and 74.4±17.0 for CR; with a mean dose falloff degradation of 2.5% by CR. Conclusion: Clinically acceptable SRT plans for spherical targets were created using jaws-only collimation with static fields. The addition of sweeping collimator rotation improves conformity at the expense of gradient. This technique can expand the availability of SRT to patients especially to those who cannot travel to a facility with a dedicated stereotactic radiosurgery machine.« less

Hospital delivery volume, severe obstetrical morbidity, and failure to rescue.

PubMed

Friedman, Alexander M; Ananth, Cande V; Huang, Yongmei; D'Alton, Mary E; Wright, Jason D

2016-12-01

In the setting of persistently high risk for maternal death and severe obstetric morbidity, little is known about the relationship between hospital delivery volume and maternal outcomes. The objectives of this analysis were (1) to determine maternal risk for severe morbidity during delivery hospitalizations by hospital delivery volume in the United States and (2) to characterize, by hospital volume, the risk for death in the setting of severe obstetric morbidity, a concept known as failure to rescue. This cohort study evaluated 50,433,539 delivery hospitalizations across the United States from 1998-2010. The main outcome measures were (1) severe morbidity that was defined as a composite of any 1 of 15 diagnoses that are representative of acute organ injury and critical illness and (2) failure to rescue that was defined as death in the setting of severe morbidity. The prevalence of severe morbidity rose from 471.2-751.5 cases per 100,000 deliveries from 1998-2010, which was an increase of 59.5%. Failure to rescue was highest in 1998 (1.5%), decreased to 0.6% in 2007, and rose to 0.9% in 2010. In models that were adjusted for comorbid risk and hospital factors, both low and high annualized delivery volume were associated with increased risk for failure to rescue and severe morbidity. However, the relative importance of hospital volume for both outcomes compared with other factors was relatively small. Although low-and high-delivery volume are associated with increased risk for both failure to rescue and severe maternal morbidity, other factors, in particular characteristics of individual centers, may be more important in the determination of outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

Adaptive Nonlinear RF Cancellation for Improved Isolation in Simultaneous Transmit–Receive Systems

NASA Astrophysics Data System (ADS)

Kiayani, Adnan; Waheed, Muhammad Zeeshan; Anttila, Lauri; Abdelaziz, Mahmoud; Korpi, Dani; Syrjala, Ville; Kosunen, Marko; Stadius, Kari; Ryynanen, Jussi; Valkama, Mikko

2018-05-01

This paper proposes an active radio frequency (RF) cancellation solution to suppress the transmitter (TX) passband leakage signal in radio transceivers supporting simultaneous transmission and reception. The proposed technique is based on creating an opposite-phase baseband equivalent replica of the TX leakage signal in the transceiver digital front-end through adaptive nonlinear filtering of the known transmit data, to facilitate highly accurate cancellation under a nonlinear TX power amplifier (PA). The active RF cancellation is then accomplished by employing an auxiliary transmitter chain, to generate the actual RF cancellation signal, and combining it with the received signal at the receiver (RX) low noise amplifier (LNA) input. A closed-loop parameter learning approach, based on the decorrelation principle, is also developed to efficiently estimate the coefficients of the nonlinear cancellation filter in the presence of a nonlinear TX PA with memory, finite passive isolation, and a nonlinear RX LNA. The performance of the proposed cancellation technique is evaluated through comprehensive RF measurements adopting commercial LTE-Advanced transceiver hardware components. The results show that the proposed technique can provide an additional suppression of up to 54 dB for the TX passband leakage signal at the RX LNA input, even at considerably high transmit power levels and with wide transmission bandwidths. Such novel cancellation solution can therefore substantially improve the TX-RX isolation, hence reducing the requirements on passive isolation and RF component linearity, as well as increasing the efficiency and flexibility of the RF spectrum use in the emerging 5G radio networks.

The promises and challenges of the use of genomics in the prescription of exercise for hypertension: the 2013 update.

PubMed

Ash, Garrett I; Eicher, John D; Pescatello, Linda S

2013-05-01

Hypertension is a major global public health problem, resulting in over 7.6 million deaths per year (13.5% of the total), more than any other cardiovascular disease risk factor. Exercise decreases blood pressure (BP) 5-7 mmHg among those with hypertension. Thus, the American College of Sports Medicine recommends the exercise prescription (ExRx) of 30 min or more of moderate intensity, aerobic activity on most days of the week to lower BP. Yet, there is considerable individual variability in the BP response to exercise due to genetic and environmental factors that are poorly understood. We and others have shown there is a genetic component to the BP response to exercise accounting for a significant proportion of this variability. However, identification of specific genetic variants accounting for this variability is a significant challenge. This review describes new work on candidate gene and BP association studies. It also describes other important emerging work in genome wide association studies, next generation sequencing, epigenetics, and gene expression regulation, and how this work may have future relevance to ExRx for hypertension. The ultimate goal of our research is to use genetic information to personalize ExRx to optimize the effectiveness of exercise as a therapeutic modality for the prevention, treatment, and control of hypertension. Because of the complexities surrounding work in exercise genomics, the future use of genomics in ExRx for hypertension still remains a vision of the future rather than a reality of the present.

Use of a decision-analytic model to support the use of a new oral US contrast agent in patients with abdominal pain.

PubMed

Bree, R L; Arnold, R J; Pettit, K G; Kaniecki, D J; O'haeri, C; LaFrance, N D; Toaff, A L

2001-03-01

The authors performed this study to compare the cost and diagnostic abilities of ultrasound (US) performed with and without the use of an oral contrast material recently approved by the U.S. Food and Drug Administration. An interactive decision-analytic model was constructed to compare US performed with and without contrast material (SonoRx; Bracco Diagnostics) for the evaluation of patients with abdominal pain who were suspected of having pancreatic disease. The model considered all resources that might be used to evaluate a patient suspected of having pancreatic disease (eg, US, computed tomography [CT], endoscopic retrograde cholangiopancreatography, fine-needle aspiration biopsy, and open biopsy). The literature and an expert panel were the clinical data sources. Cost estimates were based on Medicare and non-Medicare reimbursements. The primary cost-effectiveness measure was the cost to achieve a diagnosis. SonoRx-enhanced US was less expensive than unenhanced US ($714 vs $808, respectively, with Medicare costs; $1,612 vs $1,878, respectively, with non-Medicare costs) and as effective (0.785 vs 0.782, respectively). SonoRx-enhanced US was more cost-effective than unenhanced US ($909 vs $1,034, respectively, with Medicare costs; $2,052 vs $2,401, respectively, with non-Medicare costs). This relationship was maintained throughout extensive sensitivity analyses. SonoRx-enhanced US is more cost-effective than unenhanced US, primarily because it avoids the need for CT. CT may be avoided owing to the higher probability of obtaining optimal US scans with oral contrast material.

Position and Orientation Insensitive Wireless Power Transmission for EnerCage-Homecage System.

PubMed

Jia, Yaoyao; Mirbozorgi, S Abdollah; Wang, Zheyuan; Hsu, Chia-Chun; Madsen, Teresa E; Rainnie, Donald; Ghovanloo, Maysam

2017-10-01

We have developed a new headstage architecture as part of a smart experimental arena, known as the EnerCage-HC2 system, which automatically delivers stimulation and collects behavioral data over extended periods with minimal small animal subject handling or personnel intervention in a standard rodent homecage. Equipped with a four-coil inductive link, the EnerCage-HC2 system wirelessly powers the receiver (Rx) headstage, irrespective of the subject's location or head orientation, eliminating the need for tethering or carrying bulky batteries. On the transmitter (Tx) side, a driver coil, five high-quality (Q) factor segmented resonators at different heights and orientations, and a closed-loop Tx power controller create a homogeneous electromagnetic (EM) field within the homecage 3-D space, and compensate for drops in power transfer efficiency (PTE) due to Rx misalignments. The headstage is equipped with four small slanted resonators, each covering a range of head orientations with respect to the Tx resonators, which direct the EM field toward the load coil at the bottom of the headstage. Moreover, data links based on Wi-Fi, UART, and Bluetooth low energy are utilized to enables remote communication and control of the Rx. The PTE varies within 23.6%-33.3% and 6.7%-10.1% at headstage heights of 8 and 20 cm, respectively, while continuously delivering >40 mW to the Rx electronics even at 90° rotation. As a proof of EnerCage-HC2 functionality in vivo, a previously documented on-demand electrical stimulation of the globus pallidus, eliciting consistent head rotation, is demonstrated in three freely behaving rats.

PET attenuation correction for rigid MR Tx/Rx coils from 176Lu background activity

NASA Astrophysics Data System (ADS)

Lerche, Christoph W.; Kaltsas, Theodoris; Caldeira, Liliana; Scheins, Jürgen; Rota Kops, Elena; Tellmann, Lutz; Pietrzyk, Uwe; Herzog, Hans; Shah, N. Jon

2018-02-01

One challenge for PET-MR hybrid imaging is the correction for attenuation of the 511 keV annihilation radiation by the required RF transmit and/or RF receive coils. Although there are strategies for building PET transparent Tx/Rx coils, such optimised coils still cause significant attenuation of the annihilation radiation leading to artefacts and biases in the reconstructed activity concentrations. We present a straightforward method to measure the attenuation of Tx/Rx coils in simultaneous MR-PET imaging based on the natural 176Lu background contained in the scintillator of the PET detector without the requirement of an external CT scanner or PET scanner with transmission source. The method was evaluated on a prototype 3T MR-BrainPET produced by Siemens Healthcare GmbH, both with phantom studies and with true emission images from patient/volunteer examinations. Furthermore, the count rate stability of the PET scanner and the x-ray properties of the Tx/Rx head coil were investigated. Even without energy extrapolation from the two dominant γ energies of 176Lu to 511 keV, the presented method for attenuation correction, based on the measurement of 176Lu background attenuation, shows slightly better performance than the coil attenuation correction currently used. The coil attenuation correction currently used is based on an external transmission scan with rotating 68Ge sources acquired on a Siemens ECAT HR  +  PET scanner. However, the main advantage of the presented approach is its straightforwardness and ready availability without the need for additional accessories.

Peculiar Velocity Constraints from Five-band SZ Effect Measurements toward RX J1347.5-1145 with MUSIC and Bolocam from the CSO

NASA Astrophysics Data System (ADS)

Sayers, Jack; Zemcov, Michael; Glenn, Jason; Golwala, Sunil R.; Maloney, Philip R.; Siegel, Seth R.; Wheeler, Jordan; Bockstiegel, Clint; Brugger, Spencer; Czakon, Nicole G.; Day, Peter K.; Downes, Thomas P.; Duan, Ran P.; Gao, Jiansong; Hollister, Matthew I.; Lam, Albert; LeDuc, Henry G.; Mazin, Benjamin A.; McHugh, Sean G.; Miller, David A.; Mroczkowski, Tony K.; Noroozian, Omid; Nguyen, Hien T.; Radford, Simon J. E.; Schlaerth, James A.; Vayonakis, Anastasios; Wilson, Philip R.; Zmuidzinas, Jonas

2016-04-01

We present Sunyaev-Zel’dovich (SZ) effect measurements from wide-field images toward the galaxy cluster RX J1347.5-1145 obtained from the Caltech Submillimeter Observatory with the Multiwavelength Submillimeter Inductance Camera at 147, 213, 281, and 337 GHz and with Bolocam at 140 GHz. As part of our analysis, we have used higher frequency data from Herschel-SPIRE and previously published lower frequency radio data to subtract the signal from the brightest dusty star-forming galaxies behind RX J1347.5-1145 and from the AGN in RX J1347.5-1145’s BCG. Using these five-band SZ effect images, combined with X-ray spectroscopic measurements of the temperature of the intra-cluster medium (ICM) from Chandra, we constrain the ICM optical depth to be {τ }{{e}}={7.33}-0.97+0.96× {10}-3 and the ICM line of sight peculiar velocity to be {v}{pec}=-{1040}-840+870 km s-1. The errors for both quantities are limited by measurement noise rather than calibration uncertainties or astrophysical contamination, and significant improvements are possible with deeper observations. Our best-fit velocity is in good agreement with one previously published SZ effect analysis and in mild tension with the other, although some or all of that tension may be because that measurement samples a much smaller cluster volume. Furthermore, our best-fit optical depth implies a gas mass slightly larger than the Chandra-derived value, implying the cluster is elongated along the line of sight.

The role of P2X7 receptors in a rodent PCP-induced schizophrenia model

PubMed Central

Koványi, Bence; Csölle, Cecilia; Calovi, Stefano; Hanuska, Adrienn; Kató, Erzsébet; Köles, László; Bhattacharya, Anindya; Haller, József; Sperlágh, Beáta

2016-01-01

P2X7 receptors (P2X7Rs) are ligand-gated ion channels sensitive to extracellular ATP. Here we examined for the first time the role of P2X7R in an animal model of schizophrenia. Using the PCP induced schizophrenia model we show that both genetic deletion and pharmacological inhibition of P2X7Rs alleviate schizophrenia-like behavioral alterations. In P2rx7+/+ mice, PCP induced hyperlocomotion, stereotype behavior, ataxia and social withdrawal. In P2X7 receptor deficient mice (P2rx7−/−), the social interactions were increased, whereas the PCP induced hyperlocomotion and stereotype behavior were alleviated. The selective P2X7 receptor antagonist JNJ-47965567 partly replicated the effect of gene deficiency on PCP-induced behavioral changes and counteracted PCP-induced social withdrawal. We also show that PCP treatment upregulates and increases the functional responsiveness of P2X7Rs in the prefrontal cortex of young adult animals. The amplitude of NMDA evoked currents recorded from layer V pyramidal neurons of cortical slices were slightly decreased by both genetic deletion of P2rx7 and by JNJ-47965567. PCP induced alterations in mRNA expression encoding schizophrenia-related genes, such as NR2A, NR2B, neuregulin 1, NR1 and GABA α1 subunit were absent in the PFC of young adult P2rx7−/− animals. Our findings point to P2X7R as a potential therapeutic target in schizophrenia. PMID:27824163

Regulation of Nicotine Biosynthesis by an Endogenous Target Mimicry of MicroRNA in Tobacco.

PubMed

Li, Fangfang; Wang, Weidi; Zhao, Nan; Xiao, Bingguang; Cao, Peijian; Wu, Xingfu; Ye, Chuyu; Shen, Enhui; Qiu, Jie; Zhu, Qian-Hao; Xie, Jiahua; Zhou, Xueping; Fan, Longjiang

2015-10-01

The interaction between noncoding endogenous target mimicry (eTM) and its corresponding microRNA (miRNA) is a newly discovered regulatory mechanism and plays pivotal roles in various biological processes in plants. Tobacco (Nicotiana tabacum) is a model plant for studying secondary metabolite alkaloids, of which nicotine accounts for approximately 90%. In this work, we identified four unique tobacco-specific miRNAs that were predicted to target key genes of the nicotine biosynthesis and catabolism pathways and an eTM, novel tobacco miRNA (nta)-eTMX27, for nta-miRX27 that targets QUINOLINATE PHOSPHORIBOSYLTRANSFERASE2 (QPT2) encoding a quinolinate phosphoribosyltransferase. The expression level of nta-miRX27 was significantly down-regulated, while that of QPT2 and nta-eTMX27 was significantly up-regulated after topping, and consequently, nicotine content increased in the topping-treated plants. The topping-induced down-regulation of nta-miRX27 and up-regulation of QPT2 were only observed in plants with a functional nta-eTMX27 but not in transgenic plants containing an RNA interference construct targeting nta-eTMX27. Our results demonstrated that enhanced nicotine biosynthesis in the topping-treated tobacco plants is achieved by nta-eTMX27-mediated inhibition of the expression and functions of nta-miRX27. To our knowledge, this is the first report about regulation of secondary metabolite biosynthesis by an miRNA-eTM regulatory module in plants. © 2015 American Society of Plant Biologists. All Rights Reserved.

Polarizability of Rydberg atoms and the dominant long-range interactions

NASA Astrophysics Data System (ADS)

Hahn, Yukap

2000-10-01

The dominant long-range interaction of an alkali-metal atom with charged particles at low energies is given for large separation R by the dispersive potential W~=-αd/R4 in terms of the dipole polarizability αd. For atoms prepared initially in Rydberg states of quantum numbers (n, l), the potential assumes a more complicated form due to the complete or near degeneracy of the n manifold. Contributions to the polarizability are treated in two parts, (a) one for the nondegenerate states and (b) the other for the degenerate or near degenerate cases. It is shown that α~(b)d for case (b) is in general R dependent, and in the limit of complete degeneracy, diverges as R2. That is, for a small energy gap Δ between a pair of nearly degenerate states which are dipole coupled, the dispersion potential W(b)~=D/R2 for RRx, where D is the dipole moment, Rx=[2\\|D/Δ\\|]1/2, and α(b)d~=D2/Δ. They may also compete with a 1/R3 potential for Rydberg atoms with l>0. The total αd can be very large in magnitude for small Δ and even assume negative values, but the corresponding Rx also increases as Δ decreases. The validity region in R of the R-4 behavior of the potential recedes to larger R as the polarizability grows. A general formula for αd is given, taking into account the effects of fine-structure splitting, the Lamb shift, and quantum defects.

Clinician Use of a Palmtop Drug Reference Guide

PubMed Central

Rothschild, Jeffrey M.; Lee, Thomas H.; Bae, Taran; Bates, David W.

2002-01-01

Objective: Problems involving drug knowledge are one of the most common causes of serious medication errors. Although the information that clinicians need is often available somewhere, retrieving it expeditiously has been problematic. At the same time, clinicians are faced with an ever-expanding pharmacology knowledge base. Recently, point-of-care technology has become more widely available and more practical with the advent of handheld, or palmtop, computing. Therefore, the authors evaluated the clinical contribution of a drug database developed for the handheld computer. ePocrates Rx (formerly known as qRx; ePocrates, San Carlos, California) is a comprehensive drug information guide that is downloadable free from the Internet and designed for the Palm OS platform align="right". Design: A seven-day online survey of 3,000 randomly selected ePocrates Rx users was conducted during March 2000. Measurements: User technology experience, product evaluation and usage patterns, and the effects of the drug reference database on information-seeking behavior, practice efficiency, decision making, and patient care. Results: The survey response rate was 32 percent (n=946). Physicians reported that ePocrates Rx saves time during information retrieval, is easily incorporated into their usual workflow, and improves drug-related decision making. They also felt that it reduced the rate of preventable adverse drug events. Conclusions: Self-reported perceptions by responding clinicians endorse improved access to drug information and improved practice efficiency associated with the use of handheld devices. The clinical and practical value of using these devices in clinical settings will clearly grow further as wireless communication becomes more ubiquitous and as more applications become available. PMID:11971883

Investigating the Deflagration to Detonation Transition in LLM-105 and RX-55-DQ Using High Confinement as a Function of Density

NASA Astrophysics Data System (ADS)

Strickland, Shawn L.; Vandersall, Kevin S.; Dehaven, Martin R.

2017-06-01

The potential for deflagration-to-detonation transition (DDT) in LLM-105 and RX-55-DQ (94/6 LLM-105/Viton) has been investigated as a function of loading density using high confinement tubes. The high confinement arrangement uses a 76 mm outer diameter by 25 mm inner diameter mild steel tube 320 mm in length with 25 mm thick mild steel end caps ignited using a thermite igniter and was loaded with samples of varying densities. None of the experiments showed a transition to detonation over the entire length with non-violent burning or extinguishing of the burning observed. The hand packed RX-55-DQ molding powder or neat LLM-105 ( 1.1 g/cm3) burned nearly completely and vented non-violently by deforming or splitting the end caps. The RX-55-DQ was tested at higher densities with 1.35 g/cm3 resulting in a burning reaction on the 2nd attempt that fractured the end cap while the 1.85 g/cm3 resulted in the burning reaction extinguishing in the first 15 mm on the 2nd attempt. This work will outline the testing details, present the results, and compare them to the relatively high binder content HMX-based LX-04 (85% HMX and 15% Viton) and ultra-fine TATB results tested under similar confinement. This work performed under the auspices of the U.S. Department of Energy by Lawrence Livermore National Laboratory under Contract DE-AC52-07NA27344.

Term Coverage of Dietary Supplements Ingredients in Product Labels.

PubMed

Wang, Yefeng; Adam, Terrence J; Zhang, Rui

2016-01-01

As the clinical application and consumption of dietary supplements has grown, their side effects and possible interactions with prescribed medications has become a serious issue. Information extraction of dietary supplement related information is a critical need to support dietary supplement research. However, there currently is not an existing terminology for dietary supplements, placing a barrier for informatics research in this field. The terms related to dietary supplement ingredients should be collected and normalized before a terminology can be established to facilitate convenient search on safety information and control possible adverse effects of dietary supplements. In this study, the Dietary Supplement Label Database (DSLD) was chosen as the data source from which the ingredient information was extracted and normalized. The distribution based on the product type and the ingredient type of the dietary supplements were analyzed. The ingredient terms were then mapped to the existing terminologies, including UMLS, RxNorm and NDF-RT by using MetaMap and RxMix. The large gap between existing terminologies and ingredients were found: only 14.67%, 19.65%, and 12.88% of ingredient terms were covered by UMLS, RxNorm and NDF-RT, respectively.

Non-equilibrium dynamics due to moving deflagration front at RDX/HTPB interface

NASA Astrophysics Data System (ADS)

Chaudhuri, Santanu; Joshi, Kaushik; Lacevic, Naida

Reactive dissipative particle dynamics (DPD-RX), a promising tool in characterizing the sensitivity and performance of heterogeneous solid propellants like polymer bonded explosives (PSXs), requires further testing for non-equilibrium dynamics. It is important to understand detailed atomistic chemistry for developing coarse grain reactive models needed for the DPD-RX. In order to obtain insights into combustion chemistry of RDX/HTPB binder, we used reactive molecular dynamics (RMD) to obtain energy up-pumping and reaction mechanisms at RDX/HTPB interface when exposed to a self-sustaining deflagration front. Hot spots are ignited near and away from the heterogeneous interface using the thermal pulse. The results show that the hot spot near interface significantly delays the transition from ignition to deflagration. We will present the mechanical response and the combustion chemistry of HTPB when the propagating deflagration front hits the polymer binder. We will discuss our efforts to incorporate this RMD based chemistry into the DPD-RX which will enable us to perform such non-equilibrium dynamics simulations on large-length scale with microstructural heterogeneities. Funding from DTRA Grant Number HDTRA1-15-1-0034 is acknowledged.

Ship Detection in Optical Satellite Image Based on RX Method and PCAnet

NASA Astrophysics Data System (ADS)

Shao, Xiu; Li, Huali; Lin, Hui; Kang, Xudong; Lu, Ting

2017-12-01

In this paper, we present a novel method for ship detection in optical satellite image based on the ReedXiaoli (RX) method and the principal component analysis network (PCAnet). The proposed method consists of the following three steps. First, the spatially adjacent pixels in optical image are arranged into a vector, transforming the optical image into a 3D cube image. By taking this process, the contextual information of the spatially adjacent pixels can be integrated to magnify the discrimination between ship and background. Second, the RX anomaly detection method is adopted to preliminarily extract ship candidates from the produced 3D cube image. Finally, real ships are further confirmed among ship candidates by applying the PCAnet and the support vector machine (SVM). Specifically, the PCAnet is a simple deep learning network which is exploited to perform feature extraction, and the SVM is applied to achieve feature pooling and decision making. Experimental results demonstrate that our approach is effective in discriminating between ships and false alarms, and has a good ship detection performance.

Reactive oxygen species explicit dosimetry (ROSED) of a type 1 photosensitizer

NASA Astrophysics Data System (ADS)

Ong, Yi Hong; Kim, Michele M.; Huang, Zheng; Zhu, Timothy C.

2018-02-01

Type I photodynamic therapy (PDT) is based on the use of photochemical reactions mediated through an interaction between a tumor-selective photosensitizer, photoexcitation with a specific wavelength of light, and production of reactive oxygen species (ROS). The goal of this study is to develop a model to calculate reactive oxygen species concentration ([ROS]rx) after Tookad®-mediated vascular PDT. Mice with radiation-induced fibrosarcoma (RIF) tumors were treated with different light fluence and fluence rate conditions. Explicit measurements of photosensitizer drug concentration were made via diffuse reflective absorption spectrum using a contact probe before and after PDT. Blood flow and tissue oxygen concentration over time were measured during PDT as a mean to validate the photochemical parameters for the ROSED calculation. Cure index was computed from the rate of tumor regrowth after treatment and was compared against three calculated dose metrics: total light fluence, PDT dose, reacted [ROS]rx. The tumor growth study demonstrates that [ROS]rx serves as a better dosimetric quantity for predicting treatment outcome, as a clinically relevant tumor growth endpoint.

Interferometric observations of non-maser SiO emission from circumstellar envelopes of AGB stars - Acceleration regions and SiO depletion

NASA Technical Reports Server (NTRS)

Sahai, Raghvendra; Bieging, John H.

1993-01-01

High- and medium-resolution images of SiO J = 2-1(V = 0) from the circumstellar envelopes (CSEs) of three oxygen-rich stars, Chi Cyg, RX Boo, and IK Tau, were obtained. The SIO images were found to be roughly circular, implying that the CSEs are spherically symmetric on angular-size scales of about 3-9 arcsec. The observed angular half-maximum intensity source radius is nearly independent of the LSR velocity for all three CSEs. Chi Cyg and RX Boo are argued to be less than 450 pc distant, and have mass-loss rates larger than about 10 exp -6 solar mass/yr. In Chi Cyg and RX Boo, the line profiles at the peak of the brightness distribution are rounded, typical of optically-thick emission from a spherical envelope expanding with a constant velocity. In the IK Tau line profiles, an additional narrower central component is present, probably a result of emission from an inner circumstellar shell with a significantly smaller expansion velocity than the extended envelope.

Disparity of spectral behavior of RR Tel and RX Pup in the UV

NASA Astrophysics Data System (ADS)

Sanad, M. R.

2010-07-01

The main aim of this study is to use archival low-dispersion spectra from the International Ultraviolet Explorer (IUE) in an attempt to follow up the spectral behavior of two symbiotic Mira systems RR Tel and RX Pup of the period from 1978-1995 and 1979-1989 for two systems respectively. We concentrated on studying N IV 1486 Å intercombination line, coming from the emission nebulae ( Bryan and Kwok, 1991; Muerset et al., 1991; Murset and Nussbaumer, 1994), by calculating the line fluxes and line widths of N IV 1486 Å. We found that there is a disparity of spectral variability for these physical parameters at different times for both systems. For RR Tel, both line fluxes and line widths are increasing with the phase, while for RX Pup, both line fluxes and line widths are decreasing with the phase. There is a relation between the parameters of this emission line (line flux, line width) and phase, which we attribute to the variations of temperature of the emission nebulae at different times, as a result of the activity of the hot component.

Using pre-distorted PAM-4 signal and parallel resistance circuit to enhance the passive solar cell based visible light communication

NASA Astrophysics Data System (ADS)

Wang, Hao-Yu; Wu, Jhao-Ting; Chow, Chi-Wai; Liu, Yang; Yeh, Chien-Hung; Liao, Xin-Lan; Lin, Kun-Hsien; Wu, Wei-Liang; Chen, Yi-Yuan

2018-01-01

Using solar cell (or photovoltaic cell) for visible light communication (VLC) is attractive. Apart from acting as a VLC receiver (Rx), the solar cell can provide energy harvesting. This can be used in self-powered smart devices, particularly in the emerging ;Internet of Things (IoT); networks. Here, we propose and demonstrate for the first time using pre-distortion pulse-amplitude-modulation (PAM)-4 signal and parallel resistance circuit to enhance the transmission performance of solar cell Rx based VLC. Pre-distortion is a simple non-adaptive equalization technique that can significantly mitigate the slow charging and discharging of the solar cell. The equivalent circuit model of the solar cell and the operation of using parallel resistance to increase the bandwidth of the solar cell are discussed. By using the proposed schemes, the experimental results show that the data rate of the solar cell Rx based VLC can increase from 20 kbit/s to 1.25 Mbit/s (about 60 times) with the bit error-rate (BER) satisfying the 7% forward error correction (FEC) limit.

High validity of cardiomyopathy diagnoses in western Sweden (1989-2009).

PubMed

Basic, Carmen; Rosengren, Annika; Lindström, Sandra; Schaufelberger, Maria

2018-04-01

Hospital discharges with a diagnosis of cardiomyopathy have more than doubled in Sweden since 1987. We validated the cardiomyopathy diagnoses over this time period to investigate that the increase was real and not a result of improved recognition of the diagnosis and better diagnostic methods. Every fifth year from 1989 to 2009, records for all patients with a cardiomyopathy diagnosis were identified by searching the local registers in three hospitals in Västra Götaland, Sweden. The diagnoses were validated according to criteria defined by the European Society of Cardiology from 2008. The population comprised 611 cases with cardiomyopathy diagnoses [mean age 58.9 (SD 15.5) years, 68.2% male], divided into three major groups: dilated, hypertrophic, and other cardiomyopathies. Hypertrophic cardiomyopathy and hypertrophic obstructive cardiomyopathy were analysed as a group. Cardiomyopathies for which there were few cases, such as restrictive, arrhythmogenic right ventricular, left ventricular non-compaction, takotsubo, and peripartum cardiomyopathies, were analysed together and defined as 'other cardiomyopathies'. Relevant co-morbidities were registered. The use of echocardiography was 99.7%, of which 94.6% was complete echocardiography reports. The accuracy rates of the diagnoses dilated cardiomyopathy, hypertrophic cardiomyopathy, and other cardiomyopathies were 85.5%, 87.5%, and 100%, respectively, with no differences between the three hospitals or years studied; nor did the prevalence of co-morbidities differ. The accuracy rate of the cardiomyopathy diagnoses from in-hospital records from >600 patients in western Sweden during a 20 year period was 86.6%, with no significant trend over time, strengthening epidemiological findings that this is likely due to an actual increase in cardiomyopathy diagnoses rather than changes in coding practices. The use of echocardiography was high, and there was no significant difference in co-morbidities during the study period. The accuracy rate of the cardiomyopathy diagnoses during the 20 year period was high. The use of diagnostic tools did not increase under the study period, and once cardiomyopathy diagnoses were suspected, echocardiography was performed in almost all cases. In this study, the occurrence of cardiomyopathy was increasing over time without significant increase of co-morbidity, supporting that an actual increase of cardiomyopathy has occurred. © 2017 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.

High validity of cardiomyopathy diagnoses in western Sweden (1989–2009)

PubMed Central

Rosengren, Annika; Lindström, Sandra; Schaufelberger, Maria

2017-01-01

Abstract Aim Hospital discharges with a diagnosis of cardiomyopathy have more than doubled in Sweden since 1987. We validated the cardiomyopathy diagnoses over this time period to investigate that the increase was real and not a result of improved recognition of the diagnosis and better diagnostic methods. Methods and results Every fifth year from 1989 to 2009, records for all patients with a cardiomyopathy diagnosis were identified by searching the local registers in three hospitals in Västra Götaland, Sweden. The diagnoses were validated according to criteria defined by the European Society of Cardiology from 2008. The population comprised 611 cases with cardiomyopathy diagnoses [mean age 58.9 (SD 15.5) years, 68.2% male], divided into three major groups: dilated, hypertrophic, and other cardiomyopathies. Hypertrophic cardiomyopathy and hypertrophic obstructive cardiomyopathy were analysed as a group. Cardiomyopathies for which there were few cases, such as restrictive, arrhythmogenic right ventricular, left ventricular non‐compaction, takotsubo, and peripartum cardiomyopathies, were analysed together and defined as ‘other cardiomyopathies’. Relevant co‐morbidities were registered. The use of echocardiography was 99.7%, of which 94.6% was complete echocardiography reports. The accuracy rates of the diagnoses dilated cardiomyopathy, hypertrophic cardiomyopathy, and other cardiomyopathies were 85.5%, 87.5%, and 100%, respectively, with no differences between the three hospitals or years studied; nor did the prevalence of co‐morbidities differ. Conclusions The accuracy rate of the cardiomyopathy diagnoses from in‐hospital records from >600 patients in western Sweden during a 20 year period was 86.6%, with no significant trend over time, strengthening epidemiological findings that this is likely due to an actual increase in cardiomyopathy diagnoses rather than changes in coding practices. The use of echocardiography was high, and there was no significant difference in co‐morbidities during the study period. The accuracy rate of the cardiomyopathy diagnoses during the 20 year period was high. The use of diagnostic tools did not increase under the study period, and once cardiomyopathy diagnoses were suspected, echocardiography was performed in almost all cases. In this study, the occurrence of cardiomyopathy was increasing over time without significant increase of co‐morbidity, supporting that an actual increase of cardiomyopathy has occurred. PMID:29024504

Evaluation of an Evidence-Based Tobacco Treatment Curriculum for Psychiatry Residency Training Programs

PubMed Central

Prochaska, Judith J.; Fromont, Sebastien C.; Leek, Desiree; Hudmon, Karen Suchanek; Louie, Alan K.; Jacobs, Marc H.; Hall, Sharon M.

2009-01-01

Objective Smokers with mental illness and addictive disorders account for nearly one in two cigarettes sold in the United States and are at high risk for smoking-related deaths and disability. Psychiatry residency programs provide a unique arena for disseminating tobacco treatment guidelines, influencing professional norms, and increasing access to tobacco cessation services among smokers with mental illness. The current study evaluated the Rx for Change in Psychiatry curriculum, developed for psychiatry residency programs and focused on identifying and treating tobacco dependence among individuals with mental illness. Methods The 4-hour curriculum emphasized evidence-based, patient-oriented cessation treatments relevant for all tobacco users, including those not yet ready to quit. The curriculum was informed by comprehensive literature review, consultation with an expert advisory group, faculty interviews, and a focus group with psychiatry residents. This study reports on evaluation of the curriculum in 2005–2006, using a quasi-experimental design, with 55 residents in three psychiatry residency training programs in Northern California. Results The curriculum was associated with improvements in psychiatry residents’ knowledge, attitudes, confidence, and counseling behaviors for treating tobacco use among their patients, with initial changes from pre- to posttraining sustained at 3-months’ follow-up. Residents’ self-reported changes in treating patients’ tobacco use were substantiated through systematic chart review. Conclusion The evidence-based Rx for Change in Psychiatry curriculum is offered as a model tobacco treatment curriculum that can be implemented in psychiatry residency training programs and disseminated widely, thereby effectively reaching a vulnerable and costly population of smokers. PMID:19190293

TransitionRx: Impact of community pharmacy postdischarge medication therapy management on hospital readmission rate.

PubMed

Luder, Heidi R; Frede, Stacey M; Kirby, James A; Epplen, Kelly; Cavanaugh, Teresa; Martin-Boone, Jill E; Conrad, Wayne F; Kuhlmann, Diane; Heaton, Pamela C

2015-01-01

To determine if a community pharmacy-based transition of care (TOC) program that included the full scope of medication therapy management (MTM) services (TransitionRx) decreased hospital readmissions, resolved medication-related problems, and increased patient satisfaction. Prospective, quasi-experimental study. Nine Kroger Pharmacies located in Western Cincinnati. Patients older than 18 years of age and discharged from two local hospitals with a diagnosis of congestive heart failure, chronic obstructive pulmonary disease, or pneumonia. Patients were recruited from two local hospitals and referred to the community pharmacy for MTM services with the pharmacist within 1 week of discharge. Pharmacists reconciled the patients' medications, identified drug therapy problems, recommended changes to therapy, and provided self-management education. At 30 days after discharge, research personnel conducted telephone surveys, using a previously validated survey instrument, to assess hospital readmissions and patient satisfaction. Pharmacist interventions and medication-related problems were documented. A total of 90 patients completed the study. Of these, 20% of patients in the usual care group were admitted to the hospital within 30 days compared with 6.9% of patients in the intervention group (P = 0.019). In the 30 patients who received MTM services from the pharmacist, 210 interventions were made. The overall mean patient satisfaction with the TOC process was not significantly different between patients who were seen by the pharmacist and those who were not seen by the pharmacist. Community pharmacies successfully collaborated with hospitals to develop a referral process for TOC interventions. Patients who received MTM services from the pharmacist experienced significantly fewer readmissions than patients who received usual care.

Markers of Successful Extubation in Extremely Preterm Infants, and Morbidity After Failed Extubation

PubMed Central

Chawla, Sanjay; Natarajan, Girija; Shankaran, Seetha; Carper, Benjamin; Brion, Luc P.; Keszler, Martin; Carlo, Waldemar A.; Ambalavanan, Namasivayam; Gantz, Marie G.; Das, Abhik; Finer, Neil; Goldberg, Ronald N.; Cotten, C. Michael; Higgins, Rosemary D.

2017-01-01

Objectives To identify variables associated with successful elective extubation, and to determine neonatal morbidities associated with extubation failure in extremely preterm neonates. Study design This study was a secondary analysis of the National Institute of Child Health and Human Development Neonatal Research Network’s Surfactant, Positive Pressure, and Oxygenation Randomized Trial that included extremely preterm infants born at 240/7 to 276/7 weeks’ gestation. Patients were randomized either to a permissive ventilatory strategy (continuous positive airway pressure group) or intubation followed by early surfactant (surfactant group). There were prespecified intubation and extubation criteria. Extubation failure was defined as reintubation within 5 days of extubation. Results Of 1316 infants in the trial, 1071 were eligible; 926 infants had data available on extubation status; 538 were successful and 388 failed extubation. The rate of successful extubation was 50% (188/374) in the continuous positive airway pressure group and 63% (350/552) in the surfactant group. Successful extubation was associated with higher 5-minute Apgar score, and pH prior to extubation, lower peak fraction of inspired oxygen within the first 24 hours of age and prior to extubation, lower partial pressure of carbon dioxide prior to extubation, and non-small for gestational age status after adjustment for the randomization group assignment. Infants who failed extubation had higher adjusted rates of mortality (OR 2.89), bronchopulmonary dysplasia (OR 3.06), and death/bronchopulmonary dysplasia (OR 3.27). Conclusions Higher 5-minute Apgar score, and pH prior to extubation, lower peak fraction of inspired oxygen within first 24 hours of age, lower partial pressure of carbon dioxide and fraction of inspired oxygen prior to extubation, and nonsmall for gestational age status were associated with successful extubation. Failed extubation was associated with significantly higher likelihood of mortality and morbidities. Trial registration ClinicalTrials.gov: NCT00233324. PMID:28600154

Markers of Successful Extubation in Extremely Preterm Infants, and Morbidity After Failed Extubation.

PubMed

Chawla, Sanjay; Natarajan, Girija; Shankaran, Seetha; Carper, Benjamin; Brion, Luc P; Keszler, Martin; Carlo, Waldemar A; Ambalavanan, Namasivayam; Gantz, Marie G; Das, Abhik; Finer, Neil; Goldberg, Ronald N; Cotten, C Michael; Higgins, Rosemary D

2017-10-01

To identify variables associated with successful elective extubation, and to determine neonatal morbidities associated with extubation failure in extremely preterm neonates. This study was a secondary analysis of the National Institute of Child Health and Human Development Neonatal Research Network's Surfactant, Positive Pressure, and Oxygenation Randomized Trial that included extremely preterm infants born at 24 0/7 to 27 6/7 weeks' gestation. Patients were randomized either to a permissive ventilatory strategy (continuous positive airway pressure group) or intubation followed by early surfactant (surfactant group). There were prespecified intubation and extubation criteria. Extubation failure was defined as reintubation within 5 days of extubation. Of 1316 infants in the trial, 1071 were eligible; 926 infants had data available on extubation status; 538 were successful and 388 failed extubation. The rate of successful extubation was 50% (188/374) in the continuous positive airway pressure group and 63% (350/552) in the surfactant group. Successful extubation was associated with higher 5-minute Apgar score, and pH prior to extubation, lower peak fraction of inspired oxygen within the first 24 hours of age and prior to extubation, lower partial pressure of carbon dioxide prior to extubation, and non-small for gestational age status after adjustment for the randomization group assignment. Infants who failed extubation had higher adjusted rates of mortality (OR 2.89), bronchopulmonary dysplasia (OR 3.06), and death/ bronchopulmonary dysplasia (OR 3.27). Higher 5-minute Apgar score, and pH prior to extubation, lower peak fraction of inspired oxygen within first 24 hours of age, lower partial pressure of carbon dioxide and fraction of inspired oxygen prior to extubation, and nonsmall for gestational age status were associated with successful extubation. Failed extubation was associated with significantly higher likelihood of mortality and morbidities. ClinicalTrials.gov: NCT00233324. Copyright © 2017 Elsevier Inc. All rights reserved.

Safety and advantages of combined resection and microwave ablation in patients with bilobar hepatic malignancies.

PubMed

Philips, Prejesh; Scoggins, C R; Rostas, J K; McMasters, K M; Martin, R C

2017-02-01

The multimodality approach has significantly improved outcomes for hepatic malignancies. Microwave ablation is often used in isolation or succession, and seldom in combination with resection. Potential benefits and pitfalls from combined resection and ablation therapy in patients with complex and extensive bilobar hepatic disease have not been well defined. A review of the University of Louisville prospective Hepato-Pancreatico-Biliary Patients database was performed with multi-focal bilobar disease that underwent microwave ablation with resection or microwave only included. One hundred and eight were treated with microwave only (MWA, n = 108) or combined resection and ablation (CRA, n = 84) and were compared with similar disease-burden patients undergoing resection only (n = 84). The groups were comparable except that the MWA group was older (p = .02) and with higher co-morbidities (diabetes, hepatitis). The resection group had larger tumours (4 vs. 3.2 and 3 cm) but the CRA group had more numerous lesions (4 vs. 3 and 2, p = .002). Short-term outcomes including morbidity (47.6% vs. 43%, p = .0715) were similar between the CRA and resection only groups. Longer operative time (164 vs. 126 min, p = .003) and need for blood transfusion (p = .001) were independent predictors of complications. Survival analyses for colorectal metastasis patients (n = 158) demonstrated better overall survival (OS) (43.9 vs. 37.6 and 30.5 months, p = .035), disease-free survival (DFS) (38 vs. 26.6 and 16.9 months, p = .028) and local recurrence-free survival (LRFS) (55.4 vs. 17 and 22.9 months, p < .001) with resection only. The use of microwave ablation in addition to surgical resection did not significantly increase the morbidities or short-term outcomes. In combination with systemic and other local forms of therapy, combined resection and ablation is a safe and effective procedure.

[Experience of using bacteriophages and bitsillin-5 to reduce the incidence of respiratory diseases of bacterial ethiology in military personnel].

PubMed

Akimkin, V G; Kalmykov, A A; Aminev, R M; Polyakov, V S; Artebyakin, S V

2016-02-01

The authors defined epidemiological efficacy and safety of the use of bacteriophages(streptococcal, staphylococcal, piobakferiophage multipartial) and bitsillin-5 to reduce tonsillitis morbidityand other respiratory diseases with bacterial etiology in groups of servicemen during their formationagainst increase of seasonal morbidity. The results of the use of these preventive agents were evaluatedby a comparative analysis of this disease in experimental and control groups. In total 510 healthy conscriptswere involved into the study. The effectiveness of prophylactic use of bacteriophages and bitsillin-5, whichprovided a reduction in the incidence of respiratory infections of bacterial ethiology, tonsillitis, and otherrespiratory diseases is showed. Recommendations on the choice of drugsfor the prevention of these infections,methods and organization of their application in organized groups are given.

Coal liquefaction in an inorganic-organic medium. [DOE patent application

DOEpatents

Vermeulen, T.; Grens, E.A. II; Holten, R.R.

Improved process for liquefaction of coal by contacting pulverized coal in an inorganic-organic medium solvent system containing a ZnCl/sub 2/ catalyst, a polar solvent with the structure RX where X is one of the elements O, N, S, or P, and R is hydrogen or a lower hydrocarbon radical; the solvent system can contain a hydrogen donor solvent (and must when RX is water) which is immiscible in the ZnCl/sub 2/ and is a hydroaromatic hydrocarbon selected from tetralin, dihydrophenanthrene, dihydroanthracene or a hydrogenated coal derived hydroaromatic hydrocarbon distillate fraction.

Home Rx: The Health Benefits of Home Performance

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

Wilson, Jonathan; Jacobs, David; Reddy, Amanda

Evidence in a new, groundbreaking U.S. Department of Energy report, Home Rx: The Health Benefits of Home Performance, shows that home performance upgrades can improve the quality of a home’s indoor environment by reducing the prevalence of harmful indoor air pollutants and contaminants. Until recently, no systematic review of this evidence had been conducted, limiting full understanding of the link between home performance and health. This new report summarizes current knowledge and identifies research gaps. The design characteristics and results of each of the 40 studies considered in the report are summarized in a searchable matrix.

Recruitment of participants to a multiple sclerosis trial: The CombiRx experience

PubMed Central

Bhanushali, Minal J; Gustafson, Tarah; Powell, Steve; Conwit, Robin A; Wolinsky, Jerry S; Cutter, Gary R; Lublin, Fred; Cofield, Stacey S

2014-01-01

Background and Purpose: Participant recruitment is central to all clinical trials. Any delay in recruitment affects the completion and ultimate success of the trial. We report our experience with patient screening and randomization in CombiRx, which may inform the design of other trials. CombiRx was a multi-center, phase III, double-blind, randomized clinical trial comparing the combined use of interferon beta-1a and glatiramer acetate to either agent alone in patients with relapsing-remitting multiple sclerosis (RRMS). This trial was launched in January 2005 in 69 centers in the U.S. and Canada under a co-operative agreement with the National Institute of Neurological Disorders and Stroke (NINDS). The goal was to recruit 1000 patients over 1.5 years after a 6 month startup period. Instead, the investigators required 4.25 years to enroll 1008 patients. Methods: During this trial, we assessed the effectiveness of various recruitment strategies, utility of rescreening prior screen failures, and potential factors and strategies used in study conduct, research and infrastructure, all of which affected recruitment of participants and ultimately time to completion of CombiRx. We particularly were interested in the variability in time to site initiation between academic centers and private practice sites. Results: Physicians who were directly involved in the medical care of patients with RRMS were the primary source of patients recruited to CombiRx. A flexible study design that allowed for re-screening of the initial screen failures after a period of time was useful due to the relapsing/remitting course of the disease. Academic centers took longer to implement the trial than the private practice centers, but once sites were approved for enrollment, there was no important difference in the number of participants enrolled. Limitations: The CombiRx trial was conducted during a period when multiple new medications were being tested, thus affecting the pace of recruitment and limiting ability to generalize our experiences. However, the lessons we learned about process are relevant. Conclusion: Participants can be enrolled successfully in a clinical trial for RRMS, but factors affecting the time to achieve the requirements needed to start screening can be unpredictable and problematic. Prospective planning by the sponsors and investigators, use of central IRBs, master trial agreements and secure remote desktop access to the trial database may expedite trial implementation and participant recruitment. A good scientific research question with flexible study design and active involvement of the clinicians are important factors driving recruitment. Clinical trials can be implemented successfully both in private practices and at academic centers, a consideration when selecting sites. PMID:24686106

Establishing HZ43 A, Sirius B, and RX J185635-3754 as soft X-ray standards: a cross-calibration between the Chandra LETG+HRC-S, the EUVE spectrometer, and the ROSAT PSPC

NASA Astrophysics Data System (ADS)

Beuermann, K.; Burwitz, V.; Rauch, T.

2006-11-01

Context: .The absolute calibration of space-borne instruments in the soft X-ray regime rests strongly on model spectra of hot white dwarfs. Aims: .We analyze the Chandra LETG+HRC observations of the white dwarfs HZ43 A and Sirius B and of the neutron star RX J185635-3754 with the aim of resolving current uncertainties in the soft X-ray spectral fluxes and photospheric parameters of the three stars. We apply the derived photon spectra to a cross-calibration of the LETG+HRC-S with the short-wavelength EUVE spectrometer and the ROSAT PSPC. Methods: .We tie HZ43 A to the flux of RX J1856 in the 44-48 Å range and perform a simultaneous least squares fit to the LETG+HRC spectra of the three stars. This allows us to determine an internally consistent set of spectral energy distributions and an empirically derived wavelength-dependent correction to the LETG+HRC-S effective area. We employ NLTE model atmospheres calculated with TMAP for the white dwarfs and a two-blackbody model for RX J1856, tied to the respective optical fluxes. Results: .The two-blackbody model for RX J1856 features a hot spot on a cooler star and yields kT_spot=62.8±0.4 eV and kT_star=32.3±0.7 eV with a stellar angular radius as seen from infinity of 0.1371±0.0010 km pc-1. For HZ43 A, our fit yields T_eff = 51 126± 660 K and log g=7.90±0.080 (cgs) with anti-correlated errors (1-σ) which include not only the statistical but also the systematic uncertainties of the fit. HZ43AB displays a previously detected bremsstrahlung component with a temperature kT≃ 0.6 keV. For Sirius B, we find T_eff = 24 923± 115 K for fixed log g = 8.6. The calibration of the short-wavelength EUVE spectrometer differs from that of the LETG+HRC-S by 15± 7%. The ROSAT PSPC is found to be correctly calibrated within a few percent and reports of a major miscalibration are unfounded. Conclusions: .We have obtained improved parameters for RX J185635-3754, HZ43 A, and Sirius B which fit the observations from the optical to the soft X-ray regime. Our approach allows us to quote their absolute spectral fluxes at selected wavelengths which may aid the calibration of other space-borne instruments.

Chronic obstructive pulmonary disease and asthma-patient characteristics and health impairment.

PubMed

Pleasants, Roy A; Ohar, Jill A; Croft, Janet B; Liu, Yong; Kraft, Monica; Mannino, David M; Donohue, James F; Herrick, Harry L

2014-06-01

Abstract Background: Persons with chronic obstructive pulmonary disease (COPD) and/or asthma have great risk for morbidity. There has been sparse state-specific surveillance data to estimate the impact of COPD or COPD with concomitant asthma (overlap syndrome) on health-related impairment. The North Carolina (NC) Behavioral Risk Factor Surveillance System (BRFSS) was used to assess relationships between COPD and asthma with health impairment indicators. Five categories [COPD, current asthma, former asthma, overlap syndrome, and neither] were defined for 24,073 respondents. Associations of these categories with health impairments (physical or mental disability, use of special equipment, mental or physical distress) and with co-morbidities (diabetes, coronary heart disease, stroke, arthritis, and high blood pressure) were assessed. Fifteen percent of NC adults reported a COPD and/or asthma history. The overall age-adjusted prevalence of any self-reported COPD and current asthma were 5.6% and 7.6%, respectively; 2.4% reported both. In multivariable analyses, adults with overlap syndrome, current asthma only, and COPD only were twice as likely as those with neither disease to report health impairments (p < 0.05). Compared to those with neither disease, adults with overlap syndrome and COPD were more likely to have co-morbidities (p < 0.05). The prevalence of the five co-morbid conditions was highest in overlap syndrome; comparisons with the other groups were significant (p < 0.05) only for diabetes, stroke, and arthritis. The BRFSS demonstrates different levels of health impairment among persons with COPD, asthma, overlap syndrome, and those with neither disease. Persons reporting overlap syndrome had the most impairment and highest prevalence of co-morbidities.

Evaluation of a multi-herb supplement for erectile dysfunction: a randomized double-blind, placebo-controlled study.

PubMed

Shah, Gaurang R; Chaudhari, Manojkumar V; Patankar, Suresh B; Pensalwar, Shrikant V; Sabale, Vilas P; Sonawane, Navneet A

2012-09-15

Evidence is lacking for multi-ingredient herbal supplements claiming therapeutic effect in sexual dysfunction in men. We examined the safety and efficacy of VigRX Plus (VXP) - a proprietary polyherbal preparation for improving male sexual function, in a double blind, randomized placebo-controlled, parallel groups, multi-centre study. 78 men aged 25-50 years of age; suffering from mild to moderate erectile dysfunction (ED), participated in this study. Subjects were randomized to receive VXP or placebo at a dose of two capsules twice daily for 12 weeks. The international index of erectile function (IIEF) was the primary outcome measure of efficacy. Other efficacy measures were: Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS), Serum testosterone, Semen analysis, Investigator's Global assessment and Subjects' opinion. In subjects receiving VXP, the IIEF-Erectile Function (EF) scores improved significantly as compared to placebo. After 12 weeks of treatment, the mean (sd) IIEF-EF score at baseline increased from 16.08 (2.87) to 25.08 (4.56) in the VXP group versus 15.86 (3.24) to 16.47 (4.25) in the placebo group (P < 0.0001). Similar results were observed in each of the remaining four domains of the IIEF (orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction).There was a significant difference for VXP versus placebo comparison of mean (sd) EDITS scores of patients: 82.31(20.23) vs 36.78(22.53) and partners :(82.75(9.8) vs 18.50(9.44);P < 0.001. Thirty-five out of 39 (90%) subjects from the VXP group and one (3%) from the placebo group wished to continue with the treatment they received. Investigator's global assessment rated VXP therapy as very good to excellent in more than 50% patients and placebo therapy as fair to good in about 25% of patients. Incidence of side effects and subject's rating for tolerability of treatment was similar in both groups. VigRX Plus was well tolerated and more effective than placebo in improving sexual function in men. Clinical Trial Registry India, CTRI/2009/091/000099, 31-03-2009.

Defining Responses to Therapy and Study Outcomes in Clinical Trials of Invasive Fungal Diseases: Mycoses Study Group and European Organization for Research and Treatment of Cancer Consensus Criteria

PubMed Central

Segal, Brahm H.; Herbrecht, Raoul; Stevens, David A.; Ostrosky-Zeichner, Luis; Sobel, Jack; Viscoli, Claudio; Walsh, Thomas J.; Maertens, Johan; Patterson, Thomas F.; Perfect, John R.; Dupont, Bertrand; Wingard, John R.; Calandra, Thierry; Kauffman, Carol A.; Graybill, John R.; Baden, Lindsey R.; Pappas, Peter G.; Bennett, John E.; Kontoyiannis, Dimitrios P.; Cordonnier, Catherine; Viviani, Maria Anna; Bille, Jacques; Almyroudis, Nikolaos G.; Wheat, L. Joseph; Graninger, Wolfgang; Bow, Eric J.; Holland, Steven M.; Kullberg, Bart-Jan; Dismukes, William E.; De Pauw, Ben E.

2009-01-01

Invasive fungal diseases (IFDs) have become major causes of morbidity and mortality among highly immunocompromised patients. Authoritative consensus criteria to diagnose IFD have been useful in establishing eligibility criteria for antifungal trials. There is an important need for generation of consensus definitions of outcomes of IFD that will form a standard for evaluating treatment success and failure in clinical trials. Therefore, an expert international panel consisting of the Mycoses Study Group and the European Organization for Research and Treatment of Cancer was convened to propose guidelines for assessing treatment responses in clinical trials of IFDs and for defining study outcomes. Major fungal diseases that are discussed include invasive disease due to Candida species, Aspergillus species and other molds, Cryptococcus neoformans, Histoplasma capsulatum, and Coccidioides immitis. We also discuss potential pitfalls in assessing outcome, such as conflicting clinical, radiological, and/or mycological data and gaps in knowledge. PMID:18637757

[Morbidity and mortality rates in relation to the "surgeon factor" after duodenopancreatectomy].

PubMed

Targarona, Javier; Pando, Elizabeth; Garatea, Rafael; Vavoulis, Alexandra; Montoya, Eduardo

2007-10-01

The present study was designed to determine whether the surgeon factor has an independent effect on morbidity and mortality rates after duodenopancreatectomy. Between October 2002 and December 2006, we performed a study of 119 patients who underwent duodenopancreatectomy. The surgeons were divided into 3 groups according to the number of interventions they performed each year: a low volume group (three Whipple procedures per year), a medium volume group (four to 10 Whipple procedures per year) and a high volume group (> 10 Whipple procedures per year). The morbidity rate was higher in the low volume group (82%) than in the high volume group (35%). Length of hospital stay was clearly longer in the low and medium volume groups (27 days, and 21 days) than in the high volume group (17 days). Comparison of the results of the 3 groups revealed that the group performing three or less interventions per year (low volume) had the highest mortality rate (47%), while the group performing more than 10 interventions per year (high volume) had a very low mortality rate (4%). We found that the volume-to-surgeon ratio was inversely proportional to morbidity, length of hospital stay, return to oral intake, and mortality rates. Therefore, increasing surgical volume could improve morbidity and mortality rates.

Comparative Analysis of Gut Microbial Communities in Children under 5 Years Old with Diarrhea.

PubMed

Wen, Hongyu; Yin, Xin; Yuan, Zhenya; Wang, Xiuying; Su, Siting

2018-04-28

Diarrhea is a global disease with a high morbidity and mortality rate in children. In this study, 25 fecal samples were collected from children under 5 years old. Seven samples had been taken from healthy children without diarrhea and marked as the healthy control group; eight samples had been sampled from children with diarrhea caused by dyspepsia and defined as the non-infectious group; and ten samples had been taken from children with diarrhea induced by intestinal infections and identified as the infectious group. We detected the microbial communities of samples by using high-throughput sequencing of 16S rRNA genes. The proportion of aerobic and facultative anaerobic microbes in samples of the infectious group was much higher than in the non-infectious group. In addition, the relative abundance of Enterococcus in the healthy control group was significantly higher than in the non-infectious group and infectious group. This can be used as a potential diagnostic biomarker for diarrhea.

Design and Optimization of Ultrasonic Wireless Power Transmission Links for Millimeter-Sized Biomedical Implants.

PubMed

Meng, Miao; Kiani, Mehdi

2017-02-01

Ultrasound has been recently proposed as an alternative modality for efficient wireless power transmission (WPT) to biomedical implants with millimeter (mm) dimensions. This paper presents the theory and design methodology of ultrasonic WPT links that involve mm-sized receivers (Rx). For given load (R L ) and powering distance (d), the optimal geometries of transmitter (Tx) and Rx ultrasonic transducers, including their diameter and thickness, as well as the optimal operation frequency (f c ) are found through a recursive design procedure to maximize the power transmission efficiency (PTE). First, a range of realistic f c s is found based on the Rx thickness constrain. For a chosen f c within the range, the diameter and thickness of the Rx transducer are then swept together to maximize PTE. Then, the diameter and thickness of the Tx transducer are optimized to maximize PTE. Finally, this procedure is repeated for different f c s to find the optimal f c and its corresponding transducer geometries that maximize PTE. A design example of ultrasonic link has been presented and optimized for WPT to a 1 mm 3 implant, including a disk-shaped piezoelectric transducer on a silicon die. In simulations, a PTE of 2.11% at f c of 1.8 MHz was achieved for R L of 2.5 [Formula: see text] at [Formula: see text]. In order to validate our simulations, an ultrasonic link was optimized for a 1 mm 3 piezoelectric transducer mounted on a printed circuit board (PCB), which led to simulated and measured PTEs of 0.65% and 0.66% at f c of 1.1 MHz for R L of 2.5 [Formula: see text] at [Formula: see text], respectively.

Prostate-Specific Natural Health Products (Dietary Supplements) Radiosensitize Normal Prostate Cells

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

Hasan, Yasmin; Schoenherr, Diane; Martinez, Alvaro A.

Purpose: Prostate-specific health products (dietary supplements) are taken by cancer patients to alleviate the symptoms linked with poor prostate health. However, the effect of these agents on evidence-based radiotherapy practice is poorly understood. The present study aimed to determine whether dietary supplements radiosensitized normal prostate or prostate cancer cell lines. Methods and Materials: Three well-known prostate-specific dietary supplements were purchased from commercial sources available to patients (Trinovin, Provelex, and Prostate Rx). The cells used in the study included normal prostate lines (RWPE-1 and PWR-1E), prostate tumor lines (PC3, DU145, and LNCaP), and a normal nonprostate line (HaCaT). Supplement toxicity wasmore » assessed using cell proliferation assays [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide] and cellular radiosensitivity using conventional clonogenic assays (0.5-4Gy). Cell cycle kinetics were assessed using the bromodeoxyuridine/propidium iodide pulse-labeling technique, apoptosis by scoring caspase-3 activation, and DNA repair by assessing gammaH2AX. Results: The cell growth and radiosensitivity of the malignant PC3, DU145, and LNcaP cells were not affected by any of the dietary prostate supplements (Provelex [2mug/mL], Trinovin [10mug/mL], and Prostate Rx [50 mug/mL]). However, both Trinovin (10mug/mL) and Prostate Rx (6mug/mL) inhibited the growth rate of the normal prostate cell lines. Prostate Rx increased cellular radiosensitivity of RWPE-1 cells through the inhibition of DNA repair. Conclusion: The use of prostate-specific dietary supplements should be discouraged during radiotherapy owing to the preferential radiosensitization of normal prostate cells.« less

A Triple-Loop Inductive Power Transmission System for Biomedical Applications.

PubMed

Lee, Byunghun; Kiani, Mehdi; Ghovanloo, Maysam

2016-02-01

A triple-loop wireless power transmission (WPT) system equipped with closed-loop global power control, adaptive transmitter (Tx) resonance compensation (TRC), and automatic receiver (Rx) resonance tuning (ART) is presented. This system not only opposes coupling and load variations but also compensates for changes in the environment surrounding the inductive link to enhance power transfer efficiency (PTE) in applications such as implantable medical devices (IMDs). The Tx was built around a commercial off-the-shelf (COTS) radio-frequency identification (RFID) reader, operating at 13.56 MHz. A local Tx loop finds the optimal capacitance in parallel with the Tx coil by adjusting a varactor. A global power control loop maintains the received power at a desired level in the presence of changes in coupling distance, coil misalignments, and loading. Moreover, a local Rx loop is implemented inside a power management integrated circuit (PMIC) to avoid PTE degradation due to the Rx coil surrounding environment and process variations. The PMIC was fabricated in a 0.35- μm 4M2P standard CMOS process with 2.54 mm(2) active area. Measurement results show that the proposed triple-loop system improves the overall PTE by up to 10.5% and 4.7% compared to a similar open- and single closed-loop system, respectively, at nominal coil distance of 2 cm. The added TRC and ART loops contribute 2.3% and 1.4% to the overall PTE of 13.5%, respectively. This is the first WPT system to include three loops to dynamically compensate for environment and circuit variations and improve the overall power efficiency all the way from the driver output in Tx to the load in Rx.

Community pharmacist participation in a practice-based research network: a report from the Medication Safety Research Network of Indiana (Rx-SafeNet).

PubMed

Patel, Puja; Hemmeger, Heather; Kozak, Mary Ann; Gernant, Stephanie A; Snyder, Margie E

2015-01-01

To describe the experiences and opinions of pharmacists serving as site coordinators for the Medication Safety Research Network of Indiana (Rx-SafeNet). Retail chain, independent, and hospital/health system outpatient community pharmacies throughout Indiana, with a total of 127 pharmacy members represented by 26 site coordinators. Rx-SafeNet, a statewide practice-based research network (PBRN) formed in 2010 and administered by the Purdue University College of Pharmacy. Barriers and facilitators to participation in available research studies, confidence participating in research, and satisfaction with overall network communication. 22 of 26 site coordinators participated, resulting in an 85% response rate. Most (72.2%) of the respondents had received a doctor of pharmacy degree, and 13.6% had postgraduate year (PGY)1 residency training. The highest reported benefits of PBRN membership were an enhanced relationship with the Purdue University College of Pharmacy (81% agreed or strongly agreed) and enhanced professional development (80% agreed or strongly agreed). Time constraints were identified as the greatest potential barrier to network participation, reported by 62% of respondents. In addition, the majority (59%) of survey respondents identified no prior research experience. Last, respondents' confidence in performing research appeared to increase substantially after becoming network members, with 43% reporting a lack of confidence in engaging in research before joining the network compared with 90% reporting confidence after joining the network. In general, Rx-SafeNet site coordinators appeared to experience increased confidence in research engagement after joining the network. While respondents identified a number of benefits associated with network participation, concerns about potential time constraints remained a key barrier to participation. These findings will assist network leadership in identifying opportunities to positively increase member participation in the future.

The SN 393-SNR RX J1713.7-3946 (G347.3-0.5) Connection

NASA Astrophysics Data System (ADS)

Fesen, Robert A.; Kremer, Richard; Patnaude, Daniel; Milisavljevic, Dan

2012-02-01

Although the connection of the Chinese "guest" star of 393 AD with the Galactic supernova remnant RX J1713.7-3946 (G347.3-0.5) made by Wang et al. in 1997 is consistent with the remnant's relatively young properties and the guest star's projected position within the "tail" of the constellation Scorpius, there are difficulties with such an association. The brief Chinese texts concerning the 393 AD guest star make no comment about its apparent brightness, stating only that it disappeared after eight months. However, at the remnant's current estimated 1-1.3 kpc distance and A V ~= 3, its supernova (SN) should have been a visually bright object at maximum light (-3.5 to -5.0 mag) if MV = - 17 to -18 and would have remained visible for over a year. The peak brightness sime0 mag adopted by Wang et al. and others would require the RX J1713.7-3946 supernova to have been a very subluminous event similar to or fainter than SN 2005cs in M51. We also note problems connecting SN 393 with a European record in which the Roman poet Claudian describes a visually brilliant star in the heavens around 393 AD that could be readily seen even in midday. Although several authors have suggested this account may be a reference to the Chinese supernova of 393, Scorpius would not be visible near midday in March when the Chinese first reported the 393 guest star. We review both the Chinese and Roman accounts and calculate probable visual brightnesses for a range of SN subtypes and conclude that neither the Chinese nor the Roman descriptions are easily reconciled with an expected RX J1713.7-3946 supernova brightness and duration.

Utilizing mobile networks for the detection of clinically relevant interactions between chemotherapy regimens and complementary and alternative medicines.

PubMed

Yap, Kevin Yi-Lwern; See, Cheng Shang; Kuo, En Yi; Chui, Wai Keung; Chan, Alexandre

2012-02-01

Patients with cancer who use complementary and alternative medicines (CAMs) in conjunction with chemotherapy treatment are at risk of manifesting anticancer drug-CAM interactions (DCIs), which may lead to negative therapeutic outcomes. This article describes a novel iPhone application developed for the Mobile Internet, called OncoRx-MI, which identifies DCIs of single-agent and multiple-agent chemotherapy regimen (CReg) prescriptions. Drug-, CAM-, and DCI-related information was compiled from various hardcopy and softcopy sources, and published literature from PubMed. Overall management plans for the CRegs were then developed. The iPhone Web documents were constructed using Adobe software and programming scripts, and mounted onto a third-party server. DCI searches are based on CReg acronyms, and OncoRx-MI is designed to fit the iPhone screen configuration for improved usability. A small usability study was also carried out and the user feedback presented. OncoRx-MI is able to detect over 2700 interactions between 256 CRegs and 166 CAMs, making up a total of over 4400 DCI pairs. The CAMs are classified into seven categories based on their uses in supportive care, and non-cancer-related CAMs are also included. The majority of the DCIs are pharmacokinetic in nature (79%), involving the induction and inhibition of the cytochrome P450 isozymes and p-glycoprotein. Pharmacodynamic DCIs include hepatotoxicity (39%), altered corticosteroid efficacies (30%), and increased risks of hypoglycemia (4%), hypertensive crisis (2%), bleeding, and serotonin syndrome (1% each). OncoRx-MI is the first mobile application of its kind that allows searching of DCIs for CRegs through 3G networks, and is intended to improve pharmaceutical care of patients with cancer by assisting health care practitioners in managing CReg interactions in their clinical practices.

Evaluating standard terminologies for encoding allergy information.

PubMed

Goss, Foster R; Zhou, Li; Plasek, Joseph M; Broverman, Carol; Robinson, George; Middleton, Blackford; Rocha, Roberto A

2013-01-01

Allergy documentation and exchange are vital to ensuring patient safety. This study aims to analyze and compare various existing standard terminologies for representing allergy information. Five terminologies were identified, including the Systemized Nomenclature of Medical Clinical Terms (SNOMED CT), National Drug File-Reference Terminology (NDF-RT), Medication Dictionary for Regulatory Activities (MedDRA), Unique Ingredient Identifier (UNII), and RxNorm. A qualitative analysis was conducted to compare desirable characteristics of each terminology, including content coverage, concept orientation, formal definitions, multiple granularities, vocabulary structure, subset capability, and maintainability. A quantitative analysis was also performed to compare the content coverage of each terminology for (1) common food, drug, and environmental allergens and (2) descriptive concepts for common drug allergies, adverse reactions (AR), and no known allergies. Our qualitative results show that SNOMED CT fulfilled the greatest number of desirable characteristics, followed by NDF-RT, RxNorm, UNII, and MedDRA. Our quantitative results demonstrate that RxNorm had the highest concept coverage for representing drug allergens, followed by UNII, SNOMED CT, NDF-RT, and MedDRA. For food and environmental allergens, UNII demonstrated the highest concept coverage, followed by SNOMED CT. For representing descriptive allergy concepts and adverse reactions, SNOMED CT and NDF-RT showed the highest coverage. Only SNOMED CT was capable of representing unique concepts for encoding no known allergies. The proper terminology for encoding a patient's allergy is complex, as multiple elements need to be captured to form a fully structured clinical finding. Our results suggest that while gaps still exist, a combination of SNOMED CT and RxNorm can satisfy most criteria for encoding common allergies and provide sufficient content coverage.

Modulation of sibutramine-induced increases in extracellular noradrenaline concentration in rat frontal cortex and hypothalamus by α2-adrenoceptors

PubMed Central

Wortley, K E; Heal, D J; Stanford, S C

1999-01-01

The effects of sibutramine (0.25–10 mg kg−1 i.p.) on extracellular noradrenaline concentration in the frontal cortex and hypothalamus of freely-moving rats were investigated using microdialysis. The role of presynaptic α2-adrenoceptors in modulating the effects of sibutramine in these brain areas was also determined.Sibutramine induced an increase in extracellular noradrenaline concentration, the magnitude of which paralleled dose, in both brain areas. In the cortex, this increase was gradual and sustained, whereas in the hypothalamus it was more rapid and of shorter duration.In both the cortex and hypothalamus, pretreatment of rats with the α2-adrenoceptor antagonist RX821002 (3 mg kg−1 i.p.) potentiated increases in the accumulation of extracellular noradrenaline induced by sibutramine (10 mg kg−1 i.p.), by 7 and 10 fold respectively. RX821002 also reduced the latency of sibutramine to reach its maximum effect in the cortex, but not in the hypothalamus.Infusion of RX821002 (1 μM) via the probe increased the accumulation of extracellular noradrenaline induced by sibutramine (10 mg kg−1 i.p.) in both brain areas. In the hypothalamus, the effects of RX821002 on the accumulation of noradrenaline induced by sibutramine were 2 fold greater than those in the cortex.These findings support evidence that sibutramine inhibits the reuptake of noradrenaline in vivo, but that the accumulation of extracellular noradrenaline is limited by noradrenergic activation of presynaptic α2-adrenoceptors. Furthermore, the data suggest that terminal α2-adrenoceptors in the hypothalamus exert a greater inhibitory effect over the control of extracellular noradrenaline accumulation than do those in the cortex. PMID:10516646

Pneumococcal whole-cell vaccine: optimization of cell growth of unencapsulated Streptococcus pneumoniae in bioreactor using animal-free medium.

PubMed

Liberman, C; Takagi, M; Cabrera-Crespo, J; Sbrogio-Almeida, M E; Dias, W O; Leite, L C C; Gonçalves, V M

2008-11-01

The high cost of the available pneumococcal conjugated vaccines has been an obstacle in implementing vaccination programs for children in developing countries. As an alternative, Malley et al. proposed a vaccine consisting of inactivated whole-cells of unencapsulated S. pneumoniae, which provides serotype-independent protection and involves lower production costs. Although the pneumococcus has been extensively studied, little research has focused on its large-scale culture, thus implying a lack of knowledge of process parameters, which in turn are essential for its successful industrial production. The strain Rx1Al- eryR was originally cultured in Todd-Hewitt medium (THY), which is normally used for pneumococcus isolation, but is unsuitable for human vaccine preparations. The purposes of this study were to compare the strains Rx1Al- eryR and kanR, develop a new medium, and generate new data parameters for scaling-up the process. In static flasks, cell densities were higher for eryR than kanR. In contrast, the optical density (OD) of the former decreased immediately after reaching the stationary phase, and the OD of the latter remained stable. The strain Rx1Al- kanR was cultivated in bioreactors with medium based on either acid-hydrolyzed casein (AHC) or enzymatically hydrolyzed soybean meal (EHS). Biomass production in EHS was 2.5 times higher than in AHC, and about ten times higher than in THY. The process developed for growing the strain Rx1Al- kanR in pH-controlled bioreactors was shown to be satisfactory to this fastidious bacterium. The new culture conditions using this animal-free medium may allow the production of the pneumococcal whole-cell vaccine.

A co-culture system with an organotypic lung slice and an immortal alveolar macrophage cell line to quantify silica-induced inflammation.

PubMed

Hofmann, Falk; Bläsche, Robert; Kasper, Michael; Barth, Kathrin

2015-01-01

There is growing evidence that amorphous silica nanoparticles cause toxic effects on lung cells in vivo as well as in vitro and induce inflammatory processes. The phagocytosis of silica by alveolar macrophages potentiates these effects. To understand the underlying molecular mechanisms of silica toxicity, we applied a co-culture system including the immortal alveolar epithelial mouse cell line E10 and the macrophage cell line AMJ2-C11. In parallel we exposed precision-cut lung slices (lacking any blood cells as well as residual alveolar macrophages) of wild type and P2rx7-/- mice with or without AMJ2-C11 cells to silica nanoparticles. Exposure of E10 cells as well as slices of wild type mice resulted in an increase of typical alveolar epithelial type 1 cell proteins like T1α, caveolin-1 and -2 and PKC-β1, whereas the co-culture with AMJ2-C11 showed mostly a slightly lesser increase of these proteins. In P2rx7-/- mice most of these proteins were slightly decreased. ELISA analysis of the supernatant of wild type and P2rx7-/- mice precision-cut lung slices showed decreased amounts of IL-6 and TNF-α when incubated with nano-silica. Our findings indicate that alveolar macrophages influence the early inflammation of the lung and also that cell damaging reagents e.g. silica have a smaller impact on P2rx7-/- mice than on wild type mice. The co-culture system with an organotypic lung slice is a useful tool to study the role of alveolar macrophages during lung injury at the organoid level.

A Figure-of-Merit for Design and Optimization of Inductive Power Transmission Links for Millimeter-Sized Biomedical Implants.

PubMed

Ibrahim, Ahmed; Kiani, Mehdi

2016-12-01

Power transmission efficiency (PTE) has been the key parameter for wireless power transmission (WPT) to biomedical implants with millimeter (mm) dimensions. It has been suggested that for mm-sized implants increasing the power carrier frequency (f p ) of the WPT link to hundreds of MHz improves PTE. However, increasing f p significantly reduces the maximum allowable power that can be transmitted under the specific absorption rate (SAR) constraints. This paper presents a new figure-of-merit (FoM) and a design methodology for optimal WPT to mm-sized implants via inductive coupling by striking a balance between PTE and maximum delivered power under SAR constraints (P L,SAR ). First, the optimal mm-sized receiver (Rx) coil geometry is identified for a wide range of f p to maximize the Rx coil quality factor (Q). Secondly, the optimal transmitter (Tx) coil geometry and f p are found to maximize the proposed FoM under a low-loss Rx matched-load condition. Finally, proper Tx coil and tissue spacing is identified based on FoM at the optimal f p . We demonstrate that f p in order of tens of MHz still offer higher P L,SAR and FoM, which is key in applications that demand high power such as optogenetics. An inductive link to power a 1 mm 3 implant was designed based on our FoM and verified through full-wave electromagnetic field simulations and measurements using de-embedding method. In our measurements, an Rx coil with 1 mm diameter, located 10 mm inside the tissue, achieved PTE and P L,SAR of 1.4% and 2.2 mW at f p of 20 MHz, respectively.

Evaluating standard terminologies for encoding allergy information

PubMed Central

Goss, Foster R; Zhou, Li; Plasek, Joseph M; Broverman, Carol; Robinson, George; Middleton, Blackford; Rocha, Roberto A

2013-01-01

Objective Allergy documentation and exchange are vital to ensuring patient safety. This study aims to analyze and compare various existing standard terminologies for representing allergy information. Methods Five terminologies were identified, including the Systemized Nomenclature of Medical Clinical Terms (SNOMED CT), National Drug File–Reference Terminology (NDF-RT), Medication Dictionary for Regulatory Activities (MedDRA), Unique Ingredient Identifier (UNII), and RxNorm. A qualitative analysis was conducted to compare desirable characteristics of each terminology, including content coverage, concept orientation, formal definitions, multiple granularities, vocabulary structure, subset capability, and maintainability. A quantitative analysis was also performed to compare the content coverage of each terminology for (1) common food, drug, and environmental allergens and (2) descriptive concepts for common drug allergies, adverse reactions (AR), and no known allergies. Results Our qualitative results show that SNOMED CT fulfilled the greatest number of desirable characteristics, followed by NDF-RT, RxNorm, UNII, and MedDRA. Our quantitative results demonstrate that RxNorm had the highest concept coverage for representing drug allergens, followed by UNII, SNOMED CT, NDF-RT, and MedDRA. For food and environmental allergens, UNII demonstrated the highest concept coverage, followed by SNOMED CT. For representing descriptive allergy concepts and adverse reactions, SNOMED CT and NDF-RT showed the highest coverage. Only SNOMED CT was capable of representing unique concepts for encoding no known allergies. Conclusions The proper terminology for encoding a patient's allergy is complex, as multiple elements need to be captured to form a fully structured clinical finding. Our results suggest that while gaps still exist, a combination of SNOMED CT and RxNorm can satisfy most criteria for encoding common allergies and provide sufficient content coverage. PMID:23396542

The effects of house spraying with DDT or lambda-cyhalothrin against Anopheles arabiensis on measures of malarial morbidity in children in Tanzania.

PubMed

Mnzava, A E; Rwegoshora, R T; Tanner, M; Msuya, F H; Curtis, C F; Irare, S G

1993-08-01

The effects of house spraying of DDT and lambda-cyhalothrin against populations of Anopheles arabiensis were assessed in children aged between 1 and 10 years with regard to fever episodes and parasite prevalences. DDT and lambda-cyhalothrin treatment did not reduce the prevalence of malaria episodes as defined by fever (temperatures > or = 37.4 degrees C and/or fever reported) combined with high parasitaemia (> or = 100 parasites/200 leucocytes). However, the prevalence of malaria parasitaemia, of the episodes of fever with any level of malaria parasitaemia and of high parasitaemia alone were significantly reduced. Furthermore, the reduction in mean parasite densities was greater in children of the 1-2 years age group for both insecticides and also for children of 3-5 years age group with lambda-cyhalothrin. Measured and/or reported fever and high parasitaemia were correlated and the data indicated that most of the fevers in these children could be attributed to malaria. Using this criterion it is concluded that the population of An. arabiensis responded to both DDT and lambda-cyhalothrin house spraying which in turn also reduced malaria-related morbidity.

Retrospective Analysis Comparing Hollow Fiber and Silicone Membrane Oxygenators for Neonates on ECMO

PubMed Central

Mejak, Brian; Giacomuzzi, Carmen; Heller, Eileen; You, Xiaomang; Ungerleider, Ross; Shen, Irving

2007-01-01

Abstract: There is little information showing the use of microporous polypropylene hollow fiber oxygenators during extracorporeal life support (ECLS). Recent surveys have shown increasing use of these hollow fibers amongst ECLS centers in the United States. We performed a retrospective analysis comparing the Terumo BabyRx hollow fiber oxygenator to the Medtronic 800 silicone membrane oxygenator on 14 neonatal patients on extracorporeal membrane oxygenation (ECMO). The aim of this study was to investigate the similarities and differences when comparing pressure drops, prime volumes, oxygenator endurance, and gas transfer capabilities between the two groups. PMID:17672186

Recommendations for the classification of group A rotaviruses using all 11 genomic RNA segments.

PubMed

Matthijnssens, Jelle; Ciarlet, Max; Rahman, Mustafizur; Attoui, Houssam; Bányai, Krisztián; Estes, Mary K; Gentsch, Jon R; Iturriza-Gómara, Miren; Kirkwood, Carl D; Martella, Vito; Mertens, Peter P C; Nakagomi, Osamu; Patton, John T; Ruggeri, Franco M; Saif, Linda J; Santos, Norma; Steyer, Andrej; Taniguchi, Koki; Desselberger, Ulrich; Van Ranst, Marc

2008-01-01

Recently, a classification system was proposed for rotaviruses in which all the 11 genomic RNA segments are used (Matthijnssens et al. in J Virol 82:3204-3219, 2008). Based on nucleotide identity cut-off percentages, different genotypes were defined for each genome segment. A nomenclature for the comparison of complete rotavirus genomes was considered in which the notations Gx-P[x]-Ix-Rx-Cx-Mx-Ax-Nx-Tx-Ex-Hx are used for the VP7-VP4-VP6-VP1-VP2-VP3-NSP1-NSP2-NSP3-NSP4-NSP5/6 encoding genes, respectively. This classification system is an extension of the previously applied genotype-based system which made use of the rotavirus gene segments encoding VP4, VP7, VP6, and NSP4. In order to assign rotavirus strains to one of the established genotypes or a new genotype, a standard procedure is proposed in this report. As more human and animal rotavirus genomes will be completely sequenced, new genotypes for each of the 11 gene segments may be identified. A Rotavirus Classification Working Group (RCWG) including specialists in molecular virology, infectious diseases, epidemiology, and public health was formed, which can assist in the appropriate delineation of new genotypes, thus avoiding duplications and helping minimize errors. Scientists discovering a potentially new rotavirus genotype for any of the 11 gene segments are invited to send the novel sequence to the RCWG, where the sequence will be analyzed, and a new nomenclature will be advised as appropriate. The RCWG will update the list of classified strains regularly and make this accessible on a website. Close collaboration with the Study Group Reoviridae of the International Committee on the Taxonomy of Viruses will be maintained.

Escherichia coli Sequence Type 131 H30 Is the Main Driver of Emerging Extended-Spectrum-β-Lactamase-Producing E. coli at a Tertiary Care Center.

PubMed

Johnson, James R; Johnston, Brian; Thuras, Paul; Launer, Bryn; Sokurenko, Evgeni V; Miller, Loren G

2016-01-01

The H 30 strain of Escherichia coli sequence type 131 (ST131- H 30) is a recently emerged, globally disseminated lineage associated with fluoroquinolone resistance and, via its H 30Rx subclone, the CTX-M-15 extended-spectrum beta-lactamase (ESBL). Here, we studied the clonal background and resistance characteristics of 109 consecutive recent E. coli clinical isolates (2015) and 41 historical ESBL-producing E. coli blood isolates (2004 to 2011) from a public tertiary care center in California with a rising prevalence of ESBL-producing E. coli isolates. Among the 2015 isolates, ST131, which was represented mainly by ST131- H 30, was the most common clonal lineage (23% overall). ST131- H 30 accounted for 47% (8/17) of ESBL-producing, 47% (14/30) of fluoroquinolone-resistant, and 33% (11/33) of multidrug-resistant isolates. ST131- H 30 also accounted for 53% (8/14) of dually fluoroquinolone-resistant, ESBL-producing isolates, with the remaining 47% comprised of diverse clonal groups that contributed a single isolate each. ST131- H 30Rx, with CTX-M-15, was the major ESBL producer (6/8) among ST131- H 30 isolates. ST131- H 30 and H 30Rx also dominated (46% and 37%, respectively) among the historical ESBL-producing isolates (2004 to 2011), without significant temporal shifts in relative prevalence. Thus, this medical center's recently emerging ESBL-producing E. coli strains, although multiclonal, are dominated by ST131- H 30 and H 30Rx, which are the only clonally expanded fluoroquinolone-resistant, ESBL-producing lineages. Measures to rapidly and effectively detect, treat, and control these highly successful lineages are needed. IMPORTANCE The ever-rising prevalence of resistance to first-line antibiotics among clinical Escherichia coli isolates leads to worse clinical outcomes and higher health care costs, thereby creating a need to discover its basis so that effective interventions can be developed. We found that the H 30 subset within E. coli sequence type 131 (ST131- H 30) is currently, and has been since at least 2004, the main E. coli lineage contributing to key resistance phenotypes-including extended-spectrum-beta-lactamase (ESBL) production, fluoroquinolone resistance, multidrug resistance, and dual ESBL production-plus-fluoroquinolone resistance-at a United States tertiary care center with a rising prevalence of ESBL-producing E. coli isolates. This identifies ST131- H 30 as a target for diagnostic tests and preventive measures designed to curb the emergence of multidrug-resistant E. coli isolates and/or to blunt its clinical impact.

Trends in the Prevalence of Morbid and Severe Obesity in Australian Children Aged 7-15 Years, 1985-2012

PubMed Central

Garnett, Sarah P.; Baur, Louise A.; Jones, Aimee M. D.; Hardy, Louise L.

2016-01-01

Objective Children with severe obesity have greater risk of adverse health outcomes. The purpose of this study was to assess trends in the prevalence of morbid and severe obesity in Australian children between 1985 and 2012. Methods Secondary analysis of four national Australian cross-sectional surveys of measured height/weight in 7–15 year olds: Australian Health and Fitness Survey 1985 (n = 8,486), National Nutrition Survey 1995 (n = 1,541), the National Children’s Nutrition and Physical Activity Survey 2007 (n = 2,585) and the National Health Survey 2012 (n = 2,940). International Obesity Taskforce cut-point was used for morbid obesity (equivalent to a BMI ≥35kg/m2 at age 18 years). Severe obesity class 2 was defined as BMI ≥120% and <140% of the 95th percentile of the CDC 2000 growth charts or a BMI ≥35 and <40, and severe obesity class 3 as BMI ≥140% of the 95th percentile or a BMI ≥40. Results Between 1985 and 2012 the prevalence of morbid obesity increased from 0.2% to 1.8%, class 2 severe obesity from 0.3% to 2.0%, and class 3 from 0.1% to 0.5%. Children with morbid obesity represented 11.3% of children with obesity in 1985 and increased to 22.5% in 2012 (P = 0.005). Children with severe obesity represented 19.3% of children with obesity in 1985 and increased to 32.0% in 2012 (P = 0.016). The greatest increase was observed between 1995 and 2007. The proportion of children who were classified as morbidly or severely obese was not significantly different between 2007 and 2012, nor was it significantly different between age and sex groups. Conclusion Prevalence of morbid and severe obesity among children is low, but has significantly increased between 1985 and 2012. In contrast to overweight and obese children, children with morbid obesity require tertiary intervention. Failure to treat these children will have significant implications for the individual child and community. PMID:27171503

Future Research Directions in Asthma. An NHLBI Working Group Report.

PubMed

Levy, Bruce D; Noel, Patricia J; Freemer, Michelle M; Cloutier, Michelle M; Georas, Steve N; Jarjour, Nizar N; Ober, Carole; Woodruff, Prescott G; Barnes, Kathleen C; Bender, Bruce G; Camargo, Carlos A; Chupp, Geoff L; Denlinger, Loren C; Fahy, John V; Fitzpatrick, Anne M; Fuhlbrigge, Anne; Gaston, Ben M; Hartert, Tina V; Kolls, Jay K; Lynch, Susan V; Moore, Wendy C; Morgan, Wayne J; Nadeau, Kari C; Ownby, Dennis R; Solway, Julian; Szefler, Stanley J; Wenzel, Sally E; Wright, Rosalind J; Smith, Robert A; Erzurum, Serpil C

2015-12-01

Asthma is a common chronic disease without cure. Our understanding of asthma onset, pathobiology, classification, and management has evolved substantially over the past decade; however, significant asthma-related morbidity and excess healthcare use and costs persist. To address this important clinical condition, the NHLBI convened a group of extramural investigators for an Asthma Research Strategic Planning workshop on September 18-19, 2014, to accelerate discoveries and their translation to patients. The workshop focused on (1) in utero and early-life origins of asthma, (2) the use of phenotypes and endotypes to classify disease, (3) defining disease modification, (4) disease management, and (5) implementation research. This report summarizes the workshop and produces recommendations to guide future research in asthma.

Future Research Directions in Asthma. An NHLBI Working Group Report

PubMed Central

Levy, Bruce D.; Freemer, Michelle M.; Cloutier, Michelle M.; Georas, Steve N.; Jarjour, Nizar N.; Ober, Carole; Woodruff, Prescott G.; Barnes, Kathleen C.; Bender, Bruce G.; Camargo, Carlos A.; Chupp, Geoff L.; Denlinger, Loren C.; Fahy, John V.; Fitzpatrick, Anne M.; Fuhlbrigge, Anne; Gaston, Ben M.; Hartert, Tina V.; Kolls, Jay K.; Lynch, Susan V.; Moore, Wendy C.; Morgan, Wayne J.; Nadeau, Kari C.; Ownby, Dennis R.; Solway, Julian; Szefler, Stanley J.; Wenzel, Sally E.; Wright, Rosalind J.; Smith, Robert A.; Erzurum, Serpil C.

2015-01-01

Asthma is a common chronic disease without cure. Our understanding of asthma onset, pathobiology, classification, and management has evolved substantially over the past decade; however, significant asthma-related morbidity and excess healthcare use and costs persist. To address this important clinical condition, the NHLBI convened a group of extramural investigators for an Asthma Research Strategic Planning workshop on September 18–19, 2014, to accelerate discoveries and their translation to patients. The workshop focused on (1) in utero and early-life origins of asthma, (2) the use of phenotypes and endotypes to classify disease, (3) defining disease modification, (4) disease management, and (5) implementation research. This report summarizes the workshop and produces recommendations to guide future research in asthma. PMID:26305520

Use of Symbols in Labeling. Final rule.

PubMed

2016-06-15

The Food and Drug Administration (FDA or the Agency) is issuing this final rule revising its medical device and certain biological product labeling regulations to explicitly allow for the optional inclusion of graphical representations of information, or symbols, in labeling (including labels) without adjacent explanatory text (referred to in this document as "stand-alone symbols") if certain requirements are met. The final rule also specifies that the use of symbols, accompanied by adjacent explanatory text continues to be permitted. FDA is also revising its prescription device labeling regulations to allow the use of the symbol statement "Rx only" or "[rx] only" in the labeling for prescription devices.

Post-processing for improving hyperspectral anomaly detection accuracy

NASA Astrophysics Data System (ADS)

Wu, Jee-Cheng; Jiang, Chi-Ming; Huang, Chen-Liang

2015-10-01

Anomaly detection is an important topic in the exploitation of hyperspectral data. Based on the Reed-Xiaoli (RX) detector and a morphology operator, this research proposes a novel technique for improving the accuracy of hyperspectral anomaly detection. Firstly, the RX-based detector is used to process a given input scene. Then, a post-processing scheme using morphology operator is employed to detect those pixels around high-scoring anomaly pixels. Tests were conducted using two real hyperspectral images with ground truth information and the results based on receiver operating characteristic curves, illustrated that the proposed method reduced the false alarm rates of the RXbased detector.

Differential Weighting in Multi-Attribute Utility Measurement: When it Should Not and When it does make a Difference

DTIC Science & Technology

1976-08-01

of the motoring public. "The design should balance and optimize characteristics serving environmental, safety, and conservation goals " (McDonald...59 9,738 165 Datsun 610 58 4,766 82 Buick Century 55 5,558 101 Mazda RX4 54 5,207 96 Volkswagen Rabbit 54 4,353 81 AMC Matador 53 4,837 91 Toyota...53 Ford Maverick 8 92 4,229 46 ANMC Hornet 6 94 4,127 44 A’X Pacer 95 4,569 48 Audi Fox 96 5,678 59 Mazda RX4 96 5,207 54 Toyota Corona MIK II 98

Grain Propellant Optimization Using Real Code Genetic Algorithm (RCGA)

NASA Astrophysics Data System (ADS)

Farizi, Muhammad Farraz Al; Oktovianus Bura, Romie; Fajar Junjunan, Soleh; Jihad, Bagus H.

2018-04-01

Grain propellant design is important in rocket motor design. The total impulse and ISP of the rocket motor is influenced by the grain propellant design. One way to get a grain propellant shape that generates the maximum total impulse value is to use the Real Code Genetic Algorithm (RCGA) method. In this paper RCGA is applied to star grain Rx-450. To find burn area of propellant used analytical method. While the combustion chamber pressures are sought with zero-dimensional equations. The optimization result can reach the desired target and increase the total impulse value by 3.3% from the initial design of Rx-450.

Pedemis: a portable electromagnetic induction sensor with integrated positioning

NASA Astrophysics Data System (ADS)

Barrowes, Benjamin E.; Shubitidze, Fridon; Grzegorczyk, Tomasz M.; Fernández, Pablo; O'Neill, Kevin

2012-06-01

Pedemis (PortablE Decoupled Electromagnetic Induction Sensor) is a time-domain handheld electromagnetic induction (EMI) instrument with the intended purpose of improving the detection and classification of UneXploded Ordnance (UXO). Pedemis sports nine coplanar transmitters (the Tx assembly) and nine triaxial receivers held in a fixed geometry with respect to each other (the Rx assembly) but with that Rx assembly physically decoupled from the Tx assembly allowing flexible data acquisition modes and deployment options. The data acquisition (DAQ) electronics consists of the National Instruments (NI) cRIO platform which is much lighter and more energy efficient that prior DAQ platforms. Pedemis has successfully acquired initial data, and inversion of the data acquired during these initial tests has yielded satisfactory polarizabilities of a spherical target. In addition, precise positioning of the Rx assembly has been achieved via position inversion algorithms based solely on the data acquired from the receivers during the "on-time" of the primary field. Pedemis has been designed to be a flexible yet user friendly EMI instrument that can survey, detect and classify targets in a one pass solution. In this paper, the Pedemis instrument is introduced along with its operation protocols, initial data results, and current status.

Shock simulations of a single-site coarse-grain RDX model using the dissipative particle dynamics method with reactivity

NASA Astrophysics Data System (ADS)

Sellers, Michael S.; Lísal, Martin; Schweigert, Igor; Larentzos, James P.; Brennan, John K.

2017-01-01

In discrete particle simulations, when an atomistic model is coarse-grained, a tradeoff is made: a boost in computational speed for a reduction in accuracy. The Dissipative Particle Dynamics (DPD) methods help to recover lost accuracy of the viscous and thermal properties, while giving back a relatively small amount of computational speed. Since its initial development for polymers, one of the most notable extensions of DPD has been the introduction of chemical reactivity, called DPD-RX. In 2007, Maillet, Soulard, and Stoltz introduced implicit chemical reactivity in DPD through the concept of particle reactors and simulated the decomposition of liquid nitromethane. We present an extended and generalized version of the DPD-RX method, and have applied it to solid hexahydro-1,3,5-trinitro-1,3,5-triazine (RDX). Demonstration simulations of reacting RDX are performed under shock conditions using a recently developed single-site coarse-grain model and a reduced RDX decomposition mechanism. A description of the methods used to simulate RDX and its transition to hot product gases within DPD-RX is presented. Additionally, we discuss several examples of the effect of shock speed and microstructure on the corresponding material chemistry.

Ultra-high field MRI for primate imaging using the travelling-wave concept.

PubMed

Mallow, Johannes; Herrmann, Tim; Kim, Kyoung-Nam; Stadler, Joerg; Mylius, Judith; Brosch, Michael; Bernarding, Johannes

2013-08-01

Ultra-high field (UHF) neuroimaging is usually conducted with volume transmit (Tx) and phased array receive (Rx) coils, both tightly enclosing the object. The travelling-wave (TW) concept allows a remote excitation offering more flexible experimental setups. To investigate the feasibility of primate MRI in horizontal UHF MRI, we first compared the distribution of the electromagnetic fields in an oil phantom and then verified the concept with an in vivo experiment. In the phantom experiments an in-house circularly polarized hybrid birdcage coil and a self-developed patch antenna were used for Tx and an eight-element phased array antenna for Rx. B1+ fields were calculated and measured for both approaches. For in vivo experiments the Rx part was replaced with an optimized three-element phased array head coil. The SAR was calculated using field simulation. In the phantom the field distribution was homogenous in a central volume of interest of about 10 cm diameter. The TW concept showed a slightly better homogeneity. Examination of a female crab-eating macaque led to homogeneous high-contrast images with a good delineation of anatomical details. The TW concept opens up a new approach for MRI of medium-sized animals in horizontal UHF scanners.

Cost-effective parallel optical interconnection module based on fully passive-alignment process

NASA Astrophysics Data System (ADS)

Son, Dong Hoon; Heo, Young Soon; Park, Hyoung-Jun; Kang, Hyun Seo; Kim, Sung Chang

2017-11-01

In optical interconnection technology, high-speed and large data transitions with low error rate and cost reduction are key issues for the upcoming 8K media era. The researchers present notable types of optical manufacturing structures of a four-channel parallel optical module by fully passive alignment, which are able to reduce manufacturing time and cost. Each of the components, such as vertical-cavity surface laser/positive-intrinsic negative-photodiode array, microlens array, fiber array, and receiver (RX)/transmitter (TX) integrated circuit, is integrated successfully using flip-chip bonding, die bonding, and passive alignment with a microscope. Clear eye diagrams are obtained by 25.78-Gb/s (for TX) and 25.7-Gb/s (for RX) nonreturn-to-zero signals of pseudorandom binary sequence with a pattern length of 231 to 1. The measured responsivity and minimum sensitivity of the RX are about 0.5 A/W and ≤-6.5 dBm at a bit error rate (BER) of 10-12, respectively. The optical power margin at a BER of 10-12 is 7.5 dB, and cross talk by the adjacent channel is ≤1 dB.

An Investigation on Ground Electrodes of Capacitive Coupling Human Body Communication.

PubMed

Mao, Jingna; Yang, Huazhong; Zhao, Bo

2017-08-01

Utilizing the body surface as the signal transmission medium, capacitive coupling human body communication (CC-HBC) can achieve a much higher energy efficiency than conventional wireless communications in future wireless body area network (WBAN) applications. Under the CC-HBC scheme, the body surface serves as the forward signal path, whereas the backward path is formed by the capacitive coupling between the ground electrodes (GEs) of transmitter (TX) and receiver (RX). So the type of communication benefits from a low forward loss, while the backward loss depending on the GE coupling strength dominates the total transmission loss. However, none of the previous works have shown a complete research on the effects of GEs. In this paper, all kinds of GE effects on CC-HBC are investigated by both finite element method (FEM) analysis and human body measurement. We set the TX GE and RX GE at different heights, separation distances, and dimensions to study the corresponding influence on the overall signal transmission path loss. In addition, we also investigate the effects of GEs with different shapes and different TX-to-RX relative angles. Based on all the investigations, an analytical model is derived to evaluate the GE related variations of channel loss in CC-HBC.

Evaluation of a closed loop inductive power transmission system on an awake behaving animal subject.

PubMed

Kiani, Mehdi; Kwon, Ki Yong; Zhang, Fei; Oweiss, Karim; Ghovanloo, Maysam

2011-01-01

This paper presents in vivo experimental results for a closed loop wireless power transmission system to implantable devices on an awake behaving animal subject. In this system, wireless power transmission takes place across an inductive link, controlled by a commercial off-the-shelf (COTS) radio frequency identification (RFID) transceiver (TRF7960) operating at 13.56 MHz. Induced voltage on the implantable secondary coil is rectified, digitized by a 10-bit analog to digital converter, and transmitted back to the primary via back telemetry. Transmitter (Tx) and receiver (Rx) circuitry were mounted on the back of an adult rat with a nominal distance of ~7 mm between their coils. Our experiments showed that the closed loop system was able to maintain the Rx supply voltage at the designated 3.8 V despite changes in the coils' relative distance and alignment due to animal movements. The Tx power consumption changed between 410 ~ 560 mW in order to deliver 27 mW to the receiver. The open loop system, on the other hand, showed undesired changes in the Rx supply voltage while the Tx power consumption was constant at 660 mW.

Deep H.E.S.S. observations of the supernova remnant RX J0852.0-4622

NASA Astrophysics Data System (ADS)

Sushch, Iurii; Paz Arribas, Manuel; Komin, Nukri; Schwanke, Ullrich

2016-06-01

The largest TeV source, RX J0852.0-4622 (Vela Jr.), is one of the few supernova remnants (SNRs) with well resolved shell-like morphology at very-high-energy (VHE; E>100 GeV) gamma-rays. Strong non-thermal emission across the electromagnetic spectrum from radio to VHE gamma-rays, young age and proximity of the remnant makes it one of the prime objects for the study of particle acceleration aiming to test the paradigm of SNRs being sources of Galactic cosmic rays. Here we present deep H.E.S.S. observations of RX J0852.0-4622 with roughly doubled exposure comparing to previously published results. Improved statistics together with new analysis techniques result in a firm determination of the cut-off in the gamma-ray spectrum and allow the spatially resolved spectroscopy studies. A smooth connection of the H.E.S.S. spectrum to the spectrum at GeV energies as reported by Fermi/LAT provides an exciting opportunity to recover the present-time parent particle population in both leptonic and hadronic scenarios directly from the gamma-ray data alone. These new observations provide us a deeper insight and better understanding of the physical processes in SNRs.

The burden of clostridium difficile infection: estimates of the incidence of CDI from U.S. Administrative databases.

PubMed

Olsen, Margaret A; Young-Xu, Yinong; Stwalley, Dustin; Kelly, Ciarán P; Gerding, Dale N; Saeed, Mohammed J; Mahé, Cedric; Dubberke, Erik R

2016-04-22

Many administrative data sources are available to study the epidemiology of infectious diseases, including Clostridium difficile infection (CDI), but few publications have compared CDI event rates across databases using similar methodology. We used comparable methods with multiple administrative databases to compare the incidence of CDI in older and younger persons in the United States. We performed a retrospective study using three longitudinal data sources (Medicare, OptumInsight LabRx, and Healthcare Cost and Utilization Project State Inpatient Database (SID)), and two hospital encounter-level data sources (Nationwide Inpatient Sample (NIS) and Premier Perspective database) to identify CDI in adults aged 18 and older with calculation of CDI incidence rates/100,000 person-years of observation (pyo) and CDI categorization (onset and association). The incidence of CDI ranged from 66/100,000 in persons under 65 years (LabRx), 383/100,000 in elderly persons (SID), and 677/100,000 in elderly persons (Medicare). Ninety percent of CDI episodes in the LabRx population were characterized as community-onset compared to 41 % in the Medicare population. The majority of CDI episodes in the Medicare and LabRx databases were identified based on only a CDI diagnosis, whereas almost ¾ of encounters coded for CDI in the Premier hospital data were confirmed with a positive test result plus treatment with metronidazole or oral vancomycin. Using only the Medicare inpatient data to calculate encounter-level CDI events resulted in 553 CDI events/100,000 persons, virtually the same as the encounter proportion calculated using the NIS (544/100,000 persons). We found that the incidence of CDI was 35 % higher in the Medicare data and fewer episodes were attributed to hospital acquisition when all medical claims were used to identify CDI, compared to only inpatient data lacking information on diagnosis and treatment in the outpatient setting. The incidence of CDI was 10-fold lower and the proportion of community-onset CDI was much higher in the privately insured younger LabRx population compared to the elderly Medicare population. The methods we developed to identify incident CDI can be used by other investigators to study the incidence of other infectious diseases and adverse events using large generalizable administrative datasets.

Explicit macroscopic singlet oxygen modeling for benzoporphyrin derivative monoacid ring A (BPD)-mediated photodynamic therapy.

PubMed

Kim, Michele M; Penjweini, Rozhin; Liang, Xing; Zhu, Timothy C

2016-11-01

Photodynamic therapy (PDT) is an effective non-ionizing treatment modality that is currently being used for various malignant and non-malignant diseases. In type II PDT with photosensitizers such as benzoporphyrin monoacid ring A (BPD), cell death is based on the creation of singlet oxygen ( 1 O 2 ). With a previously proposed empirical five-parameter macroscopic model, the threshold dose of singlet oxygen ([ 1 O 2 ] rx,sh ]) to cause tissue necrosis in tumors treated with PDT was determined along with a range of the magnitude of the relevant photochemical parameters: the photochemical oxygen consumption rate per light fluence rate and photosensitizer concentration (ξ), the probability ratio of 1 O 2 to react with ground state photosensitizer compared to a cellular target (σ), the ratio of the monomolecular decay rate of the triplet state photosensitizer (β), the low photosensitizer concentration correction factor (δ), and the macroscopic maximum oxygen supply rate (g). Mice bearing radiation-induced fibrosarcoma (RIF) tumors were treated interstitially with a linear light source at 690nm with total energy released per unit length of 22.5-135J/cm and source power per unit length of 12-150mW/cm to induce different radii of necrosis. A fitting algorithm was developed to determine the photochemical parameters by minimizing the error function involving the range between the calculated reacted singlet oxygen ([ 1 O 2 ] rx ) at necrosis radius and the [ 1 O 2 ] rx,sh . [ 1 O 2 ] rx was calculated based on explicit dosimetry of the light fluence distribution, the tissue optical properties, and the BPD concentration. The initial ground state oxygen concentration ([ 3 O 2 ] 0 ) was set to be 40μM in this study. The photochemical parameters were found to be ξ=(55±40)×10 -3 cm 2 mW -1 s -1 , σ=(1.8±3)×10 -5 μM -1 , and g=1.7±0.7μMs -1 . We have taken the literature values for δ=33μM, and β=11.9μM. [ 1 O 2 ] rx has shown promise to be a more effective dosimetry quantity for predicting necrosis than either light dose or PDT dose, where the latter is simplistically a temporal integral of the products of the photosensitizer concentration and light fluence rate. Copyright © 2016 Elsevier B.V. All rights reserved.

Integrating historical clinical and financial data for pharmacological research.

PubMed

Deshmukh, Vikrant G; Sower, N Brett; Hunter, Cheri Y; Mitchell, Joyce A

2011-11-18

Retrospective research requires longitudinal data, and repositories derived from electronic health records (EHR) can be sources of such data. With Health Information Technology for Economic and Clinical Health (HITECH) Act meaningful use provisions, many institutions are expected to adopt EHRs, but may be left with large amounts of financial and historical clinical data, which can differ significantly from data obtained from newer systems, due to lack or inconsistent use of controlled medical terminologies (CMT) in older systems. We examined different approaches for semantic enrichment of financial data with CMT, and integration of clinical data from disparate historical and current sources for research. Snapshots of financial data from 1999, 2004 and 2009 were mapped automatically to the current inpatient pharmacy catalog, and enriched with RxNorm. Administrative metadata from financial and dispensing systems, RxNorm and two commercial pharmacy vocabularies were used to integrate data from current and historical inpatient pharmacy modules, and the outpatient EHR. Data integration approaches were compared using percentages of automated matches, and effects on cohort size of a retrospective study. During 1999-2009, 71.52%-90.08% of items in use from the financial catalog were enriched using RxNorm; 64.95%-70.37% of items in use from the historical inpatient system were integrated using RxNorm, 85.96%-91.67% using a commercial vocabulary, 87.19%-94.23% using financial metadata, and 77.20%-94.68% using dispensing metadata. During 1999-2009, 48.01%-30.72% of items in use from the outpatient catalog were integrated using RxNorm, and 79.27%-48.60% using a commercial vocabulary. In a cohort of 16304 inpatients obtained from clinical systems, 4172 (25.58%) were found exclusively through integration of historical clinical data, while 15978 (98%) could be identified using semantically enriched financial data. Data integration using metadata from financial/dispensing systems and pharmacy vocabularies were comparable. Given the current state of EHR adoption, semantic enrichment of financial data and integration of historical clinical data would allow the repurposing of these data for research. With the push for HITECH meaningful use, institutions that are transitioning to newer EHRs will be able to use their older financial and clinical data for research using these methods.

Integrating historical clinical and financial data for pharmacological research

PubMed Central

2011-01-01

Background Retrospective research requires longitudinal data, and repositories derived from electronic health records (EHR) can be sources of such data. With Health Information Technology for Economic and Clinical Health (HITECH) Act meaningful use provisions, many institutions are expected to adopt EHRs, but may be left with large amounts of financial and historical clinical data, which can differ significantly from data obtained from newer systems, due to lack or inconsistent use of controlled medical terminologies (CMT) in older systems. We examined different approaches for semantic enrichment of financial data with CMT, and integration of clinical data from disparate historical and current sources for research. Methods Snapshots of financial data from 1999, 2004 and 2009 were mapped automatically to the current inpatient pharmacy catalog, and enriched with RxNorm. Administrative metadata from financial and dispensing systems, RxNorm and two commercial pharmacy vocabularies were used to integrate data from current and historical inpatient pharmacy modules, and the outpatient EHR. Data integration approaches were compared using percentages of automated matches, and effects on cohort size of a retrospective study. Results During 1999-2009, 71.52%-90.08% of items in use from the financial catalog were enriched using RxNorm; 64.95%-70.37% of items in use from the historical inpatient system were integrated using RxNorm, 85.96%-91.67% using a commercial vocabulary, 87.19%-94.23% using financial metadata, and 77.20%-94.68% using dispensing metadata. During 1999-2009, 48.01%-30.72% of items in use from the outpatient catalog were integrated using RxNorm, and 79.27%-48.60% using a commercial vocabulary. In a cohort of 16304 inpatients obtained from clinical systems, 4172 (25.58%) were found exclusively through integration of historical clinical data, while 15978 (98%) could be identified using semantically enriched financial data. Conclusions Data integration using metadata from financial/dispensing systems and pharmacy vocabularies were comparable. Given the current state of EHR adoption, semantic enrichment of financial data and integration of historical clinical data would allow the repurposing of these data for research. With the push for HITECH meaningful use, institutions that are transitioning to newer EHRs will be able to use their older financial and clinical data for research using these methods. PMID:22099213

The effect on social welfare of a switch of second-generation antihistamines from prescription to over-the-counter status: a microeconomic analysis.

PubMed

Shih, Ya-Chen Tina; Prasad, Manishi; Luce, Bryan R

2002-04-01

The US Food and Drug Administration (FDA) recently held a meeting to determine whether the status of second-generation antihistamines (SGAs) should be switched from prescription (Rx) to over-the-counter (OTC) status. This article provides a conceptual microeconomic framework for addressing issues regarding the impact of such a switch on social welfare. A review of the economic literature on Rx-to-OTC switches was conducted. Relevant articles published in English between 1990 and 2001 were identified through searches of ABI Info, EconLit, PsychInfo, MEDLINE, CANCERLIT, AIDSLINE, and HealthStar, as well as a general Internet search for statements in the press or on the FDA Web site. The search terms used were Rx, prescription, OTC, over-the-counter, second-generation antihistamines, nonsedating antihistamines, first-generation antihistamines, and sedating antihistamines. Microeconomic models focusing on consumer surplus were employed to determine the potential price response and social-welfare implications of a switch of SGAs to OTC status. Unlike the agents involved in previous Rx-to-OTC switches, SGAs are still under patent protection. Economic theory suggests that a firm that is protected by a patent will price aggressively. The market for OTC SGAs is likely to be more elastic due to a lack of insurance coverage for OTC products; hence, drug manufacturers would be likely to charge a lower price if SGAs were sold OTC. However, a lower price does not necessarily guarantee an improvement in social welfare; the net impact is determined by whether the increase in consumer surplus outweighs the deadweight loss (losses of consumer and producer surplus not transferred to other parties). Additionally, the assumption of a price reduction would be called into question if there were inequalities in marginal costs between the Rx and OTC markets. In this situation, the postswitch price might increase or not be reduced significantly. It is uncertain whether granting OTC status to SGAs would be cost saving to society, particularly as these drugs are patent protected. The social-welfare implications of such a switch would depend heavily on pricing strategies and consumer behavior. Further analyses are needed to determine how both factors influence social welfare; only then can the costs and benefits of a switch be understood completely.

Surface differential rotation and prominences of the Lupus post T Tauri star RX J1508.6-4423

NASA Astrophysics Data System (ADS)

Donati, J.-F.; Mengel, M.; Carter, B. D.; Marsden, S.; Collier Cameron, A.; Wichmann, R.

2000-08-01

We present in this paper a spectroscopic monitoring of the Lupus post T Tauri star RX J1508.6-4423 carried out at two closely separated epochs (1998 May 06 and 10) with the UCL Echelle Spectrograph on the 3.9-m Anglo-Australian Telescope. Applying least-squares convolution and maximum entropy image reconstruction techniques to our sets of spectra, we demonstrate that this star features on its surface a large cool polar cap with several appendages extending to lower latitudes, as well as one spot close to the equator. The images reconstructed at both epochs are in good overall agreement, except for a photospheric shear that we interpret in terms of latitudinal differential rotation. Given the spot distribution at the epoch of our observations, differential rotation could only be investigated between latitudes 15° and 60°. We find in particular that the observed differential rotation is compatible with a solar-like law (i.e., with rotation rate decreasing towards high latitudes proportionally to sin2l, where l denotes the latitude) in this particular latitude range. Assuming that such a law can be extrapolated to all latitudes, we find that the equator of RX J1508.6-4423 does one more rotational cycle than the pole every 50+/-10d, implying a photospheric shear 2 to 3 times stronger than that of the Sun. We also discover that the Hα emission profile of RX J1508.6-4423 is most of the time double-peaked and strongly modulated with the rotation period of the star. We interpret this rotationally modulated emission as being caused by a dense and complex prominence system, the circumstellar distribution of which is obtained through maximum entropy Doppler tomography. These maps show in particular that prominences form a complete and inhomogeneous ring around the star, precisely at the corotation radius. We use the total Hα and Hβ emission flux to estimate that the mass of the whole prominence system is about 1020g. From our observation that the whole cloud system surrounding the star is regenerated in less than 4d, we conclude that the braking time-scale of RX J1508.6-4423 is shorter than 1Gyr, and that prominence expulsion is thus likely to contribute significantly to the rotational spindown of young low-mass stars.

Tracking Genomic Cancer Evolution for Precision Medicine: The Lung TRACERx Study

PubMed Central

Jamal-Hanjani, Mariam; Hackshaw, Alan; Ngai, Yenting; Shaw, Jacqueline; Dive, Caroline; Quezada, Sergio; Middleton, Gary; de Bruin, Elza; Le Quesne, John; Shafi, Seema; Falzon, Mary; Horswell, Stuart; Blackhall, Fiona; Khan, Iftekhar; Janes, Sam; Nicolson, Marianne; Lawrence, David; Forster, Martin; Fennell, Dean; Lee, Siow-Ming; Lester, Jason; Kerr, Keith; Muller, Salli; Iles, Natasha; Smith, Sean; Murugaesu, Nirupa; Mitter, Richard; Salm, Max; Stuart, Aengus; Matthews, Nik; Adams, Haydn; Ahmad, Tanya; Attanoos, Richard; Bennett, Jonathan; Birkbak, Nicolai Juul; Booton, Richard; Brady, Ged; Buchan, Keith; Capitano, Arrigo; Chetty, Mahendran; Cobbold, Mark; Crosbie, Philip; Davies, Helen; Denison, Alan; Djearman, Madhav; Goldman, Jacki; Haswell, Tom; Joseph, Leena; Kornaszewska, Malgorzata; Krebs, Matthew; Langman, Gerald; MacKenzie, Mairead; Millar, Joy; Morgan, Bruno; Naidu, Babu; Nonaka, Daisuke; Peggs, Karl; Pritchard, Catrin; Remmen, Hardy; Rowan, Andrew; Shah, Rajesh; Smith, Elaine; Summers, Yvonne; Taylor, Magali; Veeriah, Selvaraju; Waller, David; Wilcox, Ben; Wilcox, Maggie; Woolhouse, Ian; McGranahan, Nicholas; Swanton, Charles

2014-01-01

The importance of intratumour genetic and functional heterogeneity is increasingly recognised as a driver of cancer progression and survival outcome. Understanding how tumour clonal heterogeneity impacts upon therapeutic outcome, however, is still an area of unmet clinical and scientific need. TRACERx (TRAcking non-small cell lung Cancer Evolution through therapy [Rx]), a prospective study of patients with primary non-small cell lung cancer (NSCLC), aims to define the evolutionary trajectories of lung cancer in both space and time through multiregion and longitudinal tumour sampling and genetic analysis. By following cancers from diagnosis to relapse, tracking the evolutionary trajectories of tumours in relation to therapeutic interventions, and determining the impact of clonal heterogeneity on clinical outcomes, TRACERx may help to identify novel therapeutic targets for NSCLC and may also serve as a model applicable to other cancer types. PMID:25003521

Discriminability of Personality Profiles in Isolated and Co-Morbid Marijuana and Nicotine Users

PubMed Central

Ketcherside, Ariel; Jeon-Slaughter, Haekyung; Baine, Jessica L.; Filbey, Francesca M

2016-01-01

Specific personality traits have been linked with substance use disorders (SUDs), genetic mechanisms, and brain systems. Thus, determining the specificity of personality traits to types of SUD can advance the field towards defining SUD endophenotypes as well as understanding the brain systems involved for the development of novel treatments. Disentangling these factors is particularly important in highly co-morbid SUDs, such as marijuana and nicotine use, so treatment can occur effectively for both. This study evaluated personality traits that distinguish isolated and co-morbid use of marijuana and nicotine. To that end, we collected the NEO Five Factor Inventory in participants who used marijuana-only (n=59), nicotine-only (n=27), both marijuana and nicotine (n=28), and in non-using controls (n=28). We used factor analyses to identify personality profiles, which are linear combinations of the five NEO Factors. We then conducted Receiver Operating Characteristics (ROC) curve analysis to test accuracy of the personality factors in discriminating isolated and co-morbid marijuana and nicotine users from each other. ROC curve analysis distinguished the four groups based on their NEO personality patterns. Results showed that NEO Factor 2 (openness, extraversion, agreeableness) discriminated marijuana and marijuana + nicotine users from controls and nicotine-only users with high predictability. Additional ANOVA results showed that the openness dimension discriminated marijuana users from nicotine users. These findings suggest that personality dimensions distinguish marijuana users from nicotine users and should be considered in prevention strategies. PMID:27086256

Psoriasis and psychiatric morbidity: a profile from a tertiary care centre of eastern India.

PubMed

Sarkar, Somenath; Sarkar, Arnab; Saha, Revanta; Sarkar, Tanusree

2014-01-01

Psoriasis has an impact on psychology of the patients. There is a dearth of studies regarding this field in eastern India. The primary objective of this study is to evaluate the psychiatric morbidity in psoriasis and secondary objective is to assess the morbidity in all eight dimensions of psychosocial and physical aspects, i.e. cognitive, social, discomfort, limitations, depression, fear, embarrassment and anger. Institutional based case control study. Forty-eight patients of psoriasis and equal number of healthy controls were included in the study. Self-reporting questionnaire-24 (SRQ-24) and skindex (A 61-item survey questionnaire) were used to assess the psychiatric morbidity in both groups. "MedCalc version 10.2.0.0" (by Acacialaan 22, B-8400, Ostend, Belgium) was used as statistical software. Chi-square test was used as a test of significance. The SRQ assessed psychiatric morbidity in the study group was 62.5%, compared with 18.5% in the control group. This difference was statistically significant (P < 0.001). Guttate psoriasis had maximum association with psychiatric morbidity (100%), followed by plaque type (63.6%) and palmoplantar type (42.8%). According to the skindex, the most common psychiatric morbidity in psoriasis patients was anger (58.3%), followed by discomfort (52.08%), social problem (52.08%), cognitive impairment (50%), embarrassment (50%), physical limitation (47.91%), fear (47.91%) and depression (43.75%). The skindex observed psychiatric morbidity among the case and control group was statistically significant for all the parameters (P < 0.0001). Psoriasis has a high degree of psychiatric morbidity and the extent of this co-morbidity is even greater than hitherto thought of.

A Meta-Analysis of the Effect of Preoperative Biliary Stenting on Patients With Obstructive Jaundice

PubMed Central

Sun, Chengyi; Yan, Guirong; Li, Zhiming; Tzeng, Chi-Meng

2014-01-01

Abstract The goal of this study was to systematically review the effects of biliary stenting on postoperative morbidity and mortality of patients with obstructive jaundice. PubMed, Embase, Cochrane Library, and other relevant databases were searched by computer and manually for published and unpublished studies on the impact of preoperative biliary drainage on patients with obstructive jaundice from 2000 to the present day. Two investigators independently selected the studies according to the inclusion and exclusion criteria, extracted the data, and assessed the quality of the selected studies. Meta-analysis was performed to compare postoperative morbidity and mortality of patients between the drainage and nondrainage groups. Compared with the nondrainage group, the overall mortality, overall morbidity, infectious morbidity, incidence of wound infection, intra-abdominal abscess, pancreatic fistulas, bile leak, and delayed gastric emptying in the drainage group were not significantly different. Compared with the nondrainage group, the drainage group had a drainage time of <4 weeks with an increased overall morbidity by 7% to 23%; however, the overall morbidity of the drainage group with a drainage time >4 weeks was not significantly different. Compared with the nondrainage group, the overall mortality of the drainage group using metal stents and plastic stents as internal drainage devices was reduced by 0.5% to 6%, whereas that of the drainage group using plastic stent devices was not significantly different. In summary, preoperative drainage should be applied selectively. The drainage time should be >4 weeks, and metal stents should be used for internal drainage. PMID:25474436

In vivo (31) P MRS assessment of intracellular NAD metabolites and NAD(+) /NADH redox state in human brain at 4 T.

PubMed

Lu, Ming; Zhu, Xiao-Hong; Chen, Wei

2016-07-01

NAD(+) and NADH play key roles in cellular respiration. Intracellular redox state defined by the NAD(+) /NADH ratio (RX) reflects the cellular metabolic and physiopathological status. By taking advantage of high/ultrahigh magnetic field strengths, we have recently established a novel in vivo (31) P MRS-based NAD assay for noninvasive and quantitative measurements of intracellular NAD concentrations and redox state in animal and human brains at 16.4 T, 9.4 T and 7 T. To explore its potential for clinical application, in this study we investigated the feasibility of assessing the NAD metabolism and redox state in human brain at a lower field of 4 T by incorporating the (1) H-decoupling technique with the in vivo (31) P NAD assay. The use of (1) H decoupling significantly narrowed the linewidths of NAD and α-ATP resonances, resulting in higher sensitivity and better spectral resolution as compared with the (1) H-coupled (31) P spectrum. These improvements made it possible to reliably quantify cerebral NAD concentrations and RX, consistent with previously reported results obtained from similar age human subjects at 7 T. In summary, this work demonstrates the capability and utility of the (1) H-decoupled (31) P MRS-based NAD assay at lower field strength; thus, it opens new opportunities for studying intracellular NAD metabolism and redox state in human brain at clinical settings. This conclusion is supported by the simulation results, indicating that similar performance and reliability as observed at 4T can be achieved at 3 T with the same signal-to-noise ratio. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Intraoperative transfusion of 1 U to 2 U packed red blood cells is associated with increased 30-day mortality, surgical-site infection, pneumonia, and sepsis in general surgery patients.

PubMed

Bernard, Andrew C; Davenport, Daniel L; Chang, Phillip K; Vaughan, Taylor B; Zwischenberger, Joseph B

2009-05-01

Transfusion of packed red blood cells (PRBCs) increases morbidity and mortality in select surgical specialty patients. The impact of low-volume, leukoreduced RBC transfusion on general surgery patients is less well understood. The American College of Surgeons National Surgical Quality Improvement Program participant use file was queried for general surgery patients recorded in 2005 to 2006 (n = 125,223). Thirty-day morbidity (21 uniformly defined complications) and mortality, demographic, preoperative, and intraoperative risk variables were obtained. Infectious complications and composite morbidity and mortality were stratified across intraoperative PRBCs units received. Multivariable logistic regression was used to assess influence of transfusion on outcomes, while adjusting for transfusion propensity, procedure type, wound class, operative duration, and 30+ patient risk factors. After adjustment for transfusion propensity, procedure group, wound class, operative duration, and all other important risk variables, 1 U PRBCs significantly (p < 0.05) increased risk of 30-day mortality (odds ratio [OR] = 1.32), composite morbidity (OR = 1.23), pneumonia (OR = 1.24), and sepsis/shock (OR = 1.29). Transfusion of 2 U additionally increased risk for these outcomes (OR = 1.38, 1.40, 1.25, 1.53, respectively; p

[Organization of occupational therapeutic service, dynamics and structure of occupational morbidity in Krasnoyarsk area].

PubMed

Tereshchenko, Iu A; Zakharinskaia, O N

2010-01-01

The authors present organizational and functional structure of occupational therapeutic service in Krasnoyarsk area, major functional divisions of the territorial occupational therapeutic center and their activities. The article covers analysis of changes in levels and structure of occupational morbidity, defines main ways to optimize occupational therapeutic service for the territorial workers.

Signature motif-guided identification of receptors for peptide hormones essential for root meristem growth.

PubMed

Song, Wen; Liu, Li; Wang, Jizong; Wu, Zhen; Zhang, Heqiao; Tang, Jiao; Lin, Guangzhong; Wang, Yichuan; Wen, Xing; Li, Wenyang; Han, Zhifu; Guo, Hongwei; Chai, Jijie

2016-06-01

Peptide-mediated cell-to-cell signaling has crucial roles in coordination and definition of cellular functions in plants. Peptide-receptor matching is important for understanding the mechanisms underlying peptide-mediated signaling. Here we report the structure-guided identification of root meristem growth factor (RGF) receptors important for plant development. An assay based on a signature ligand recognition motif (Arg-x-Arg) conserved in a subfamily of leucine-rich repeat receptor kinases (LRR-RKs) identified the functionally uncharacterized LRR-RK At4g26540 as a receptor of RGF1 (RGFR1). We further solved the crystal structure of RGF1 in complex with the LRR domain of RGFR1 at a resolution of 2.6 Å, which reveals that the Arg-x-Gly-Gly (RxGG) motif is responsible for specific recognition of the sulfate group of RGF1 by RGFR1. Based on the RxGG motif, we identified additional four RGFRs. Participation of the five RGFRs in RGF-induced signaling is supported by biochemical and genetic data. We also offer evidence showing that SERKs function as co-receptors for RGFs. Taken together, our study identifies RGF receptors and co-receptors that can link RGF signals with their downstream components and provides a proof of principle for structure-based matching of LRR-RKs with their peptide ligands.

Are there socioeconomic differences in responses to a commonly used self report measure of chronic illness?

PubMed

Macintyre, Sally; Der, Geoff; Norrie, John

2005-12-01

Single questions on self-reported morbidity are commonly used in social or health surveys. It has been suggested that these may underestimate socioeconomic gradients in health because more disadvantaged social groups may have higher thresholds for defining illness. Method Face-to-face interviews by research nurses with community-based respondents in the West of Scotland, using a specially designed suite of prompts following up on responses to the UK General Household Survey (GHS) long-standing illness question. Participants were 858 respondents born in the early 1930s and 852 respondents born in the early 1950s (mean age at interview 59 and 40, respectively) classified by occupational social class and area deprivation. Adjusted for age and sex, the Relative Index of Inequality (RII) for reporting any condition in response to the GHS question was 2.14 (95% CIs 1.49-3.08) for social class and 2.01 (1.41-2.87) for Depcat. Among those not reporting any conditions to the GHS question, the RII for reporting conditions to any further prompts was 1.54 (0.87-2.70) for social class and 0.86 (0.50-1.46) for Depcat. The RIIs for reporting any condition after the initial question and all prompts were 2.16 (1.40-3.33) for social class and 1.50 (0.98-2.29) for Depcat. Across a range of conditions defined as more serious, and conditions classified by different ICD categories, socioeconomic status (SES) gradients after the initial question and all prompts were similar to, or less steep than, those produced by the GHS question alone. These data do not support the hypothesis that poorer social groups are more stoical and more likely to need detailed prompting in order to elicit morbidity. Nor do they support the hypothesis that SES gradients in morbidity are underestimated by using the GHS question rather than more detailed questioning. This suggests that responses to this type of question can be used in epidemiology and health needs assessment without major socioeconomic bias.

Falls-Related Drug Use and Risk of Falls Among Older Adults: A Study in a US Medicare Population.

PubMed

Musich, Shirley; Wang, Shaohung S; Ruiz, Joann; Hawkins, Kevin; Wicker, Ellen

2017-07-01

Approximately one-third of community-dwelling older adults fall each year, and approximately 10% have falls requiring medical services. Among other factors, research studies have linked certain medications with an increased risk of falls. The aim of this study was to examine the risk of falls relative to use patterns among new and continuing falls-related drug (FRD) users. A 10% random sample, insured in AARP ® Medicare Supplement and AARP Medicare Part D Rx plans, was utilized to define new and continuing FRD users. New users had a 12-month pre-period without FRD use, whereas continuing users had at least one FRD in the pre-period. Both groups had 12-month follow-up after initiating or continuing FRD use. Characteristics associated with the risk of falls for new and continuing users were determined using multivariate logistic regression models. Among insureds, 44% used at least one of the FRD classes. Of these, 29% were new users (N = 35,340) and 71% were continuing users (N = 121,488). Fall rates for the two subgroups were similar at 7 and 8%, respectively. Characteristics associated with the risk of falls were previous injurious fall, use of two or more classes of FRDs, older age, poorer health, and being female. New users were at higher risk than continuing users. New users of FRDs were at highest risk of falls, and continuing users were at increased risk, especially with higher numbers of FRD classes. Both groups could benefit from falls awareness and prevention programs.

Polymorphisms of alpha-actinin-3 and ciliary neurotrophic factor in national-level Italian athletes.

PubMed

Persi, A; Maltese, P E; Bertelli, M; Cecchin, S; Ciaghi, M; Guarnieri, M C; Agnello, L; Maggioni, M A; Merati, G; Veicsteinas, A

2013-06-01

The R577X polymorphism of the alpha-actinin-3 (ACTN3) gene and the IVS1-6G>A polymorphism of the ciliary neurotrophic factor (CNTF) gene have been associated with a favourable muscle phenotype (more muscle fibres with high glycolytic activity), reduced predisposition for congenital dystrophy and resistance to sarcopenia in old age. The aim of this study was to look for evidence of selective pressure towards genotypes favourable for strong muscle activity in a sample of national-level Italian athletes. We analysed two stop codon polymorphisms in the DNA of 50 Italian athletes, specialised in power or endurance sports, and compared their genotypic distribution with those of a population of 50 controls. In a representative sub-group of athletes (N.=42) we then compared the genetic data with anaerobic threshold, assessed by an incremental exercise test up to exhaustion. The athlete group showed an allelic distribution of ACTN3 (R/R:64%, R/X:16%, X/X:20%) and CNTF (G/G:72%, G/A:26%, A/A:2%), significantly imbalanced towards alleles R/R and G/G, respectively, compared to controls (ACTN3=R/R:40% R/X:22% X/X:38% and CNTF=G/G:52%, G/A:24%, A/A:24%) (p=0.0024 and p=0.0001, respectively). Only the ACTN3 577X/X polymorphism showed a significant association with the anaerobic threshold of athletes (F-ratio= 4.037; p=0.025). Factorial ANOVA demonstrated a non significant interaction between favourable allelic patterns of ACTN3 and CNTF genes on aerobic performance in the athlete group. The relationship found between favourable muscle phenotype and this genetic profile may have interesting implications in sport performance and training, athlete selection and different clinical activities, such as physical rehabilitation and modifying phenotypes associated with neuromuscular diseases.

A prospective study of morbidity patterns in a petroleum refinery and chemical plant.

PubMed Central

Tsai, S P; Dowd, C M; Cowles, S R; Ross, C E

1992-01-01

This study examined the morbidity experience from 1981 to 1988 of a prospective cohort of 3422 refinery and petrochemical plant employees from the Shell Deer Park manufacturing complex. The morbidity data for this study, which include all illness and absence records in excess of five days, were extracted from the morbidity section of the Shell health surveillance system. Standardised morbidity ratios (SMRs) of disease prevalence in this cohort were calculated using an internal comparison group of all manufacturing employees of the Shell Oil Company. Among production employees, the overall morbidity was statistically significantly higher (SMR = 109) than that of the comparison group. Illness due to hypertension (SMR = 144), haemorrhoids (SMR = 149), diseases of the nervous system (SMR = 120), respiratory system (SMR = 108), and digestive system (SMR = 117) were also raised for this group. The increased risk due to these medical conditions does not appear to be associated with occupational factors. Lymphatic and haematopoietic tissue neoplasms were raised (SMR = 124), but were based on only four cases. PMID:1637713

Open-book pelvic fractures with perineal open wounds: a significant morbid combination.

PubMed

Duchesne, Juan C; Bharmal, Husain M; Dini, Arash A; Islam, Tareq; Schmieg, Robert E; Simmons, Jon D; Wahl, Georgia M; Davis, John A; Krause, Peter; McSwain, Norman E

2009-12-01

Open-book pelvic fractures (OBPF) with concomitant intra-abdominal injuries carry a high morbidity and mortality; the significance of associated perineal open wound (OBPF-POW) has not been defined. We hypothesize that the presence of perineal open wounds increases morbidity, mortality, and concomitant use of hospital resources. Patients diagnosed with OBPF over a 5-year period at a Level I trauma center were identified by trauma registry review, and were retrospectively reviewed under an Institutional Review Board-approved protocol. Patients with OBPF without a perineal open wound were compared with those with OBPF-POW. Data collected included patient demographics, injury details, management, and outcomes. A total of 1,635 patients with blunt pelvic fractures were identified, of which 177 (10.8%) had OBPF. OBPF-POW (36/177) significantly increased the use of angioembolization, occurrence of sepsis, pelvic sepsis, ARDS, and multi-organ system failure. Patients with OBPF-POW had an increase of 13 days in length of hospitalization compared with the OBPF group (P < 0.001), with cost of $120,647.30 and $62,952.72 respectively (P < 0.001). Perineal open wounds complicate open-book pelvic fractures with significant increase in hospital resource utilization. Aggressive multidisciplinary evaluation and management is appropriate to detect and prevent complications.

The spectral expansion of the elasticity random field

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

Malyarenko, Anatoliy; Ostoja-Starzewski, Martin

2014-12-10

We consider a deformable body that occupies a region D in the plane. In our model, the body’s elasticity tensor H(x) is the restriction to D of a second-order mean-square continuous random field. Under translation, the expected value and the correlation tensor of the field H(x) do not change. Under action of an arbitrary element k of the orthogonal group O(2), they transform according to the reducible orthogonal representation k ⟼ S{sup 2}(S{sup 2}(k)) of the above group. We find the spectral expansion of the correlation tensor R(x) of the elasticity field as well as the expansion of the fieldmore » itself in terms of stochastic integrals with respect to a family of orthogonal scattered random measures.« less

Laparoscopic transperitoneal adrenalectomy in morbidly obese patients is not associated with worse short-term outcomes.

PubMed

Pędziwiatr, Michał; Major, Piotr; Pisarska, Magdalena; Natkaniec, Michał; Godlewska, Magdalena; Przęczek, Krzysztof; Dworak, Jadwiga; Dembiński, Marcin; Zub-Pokrowiecka, Anna; Budzyński, Andrzej

2017-01-01

To evaluate the impact of obesity and morbid obesity on short-term outcomes after laparoscopic adrenalectomy. The study included 520 consecutive patients undergoing laparoscopic adrenalectomy for adrenal tumor. The entire study group was divided depending on the body mass index: group 1 (normal weight), <25 kg/m 2 ; group 2 (overweight), 25-30 kg/m 2 ; and group 3 (obese) 30-40 kg/m 2 . Additionally, group 4 (morbidly obese) was distinguished. Study end-points were: operative time, intraoperative blood loss, total length of hospital stay, morbidity rate and 30-day readmission rate. The mean operative times were 88.8, 94.7, 93.5, and 99.9 min in groups 1, 2, 3 and 4, respectively (P = 0.1444). Complications were comparable between groups (12.8% vs 8.8% vs 8.2% vs 11.5%, P = 0.5295). The mean intraoperative blood loss was 66.8 versus 78.3 versus 60.7 versus 92.4, P = 0.1399. There were no differences in conversion rate between groups. Obesity has no influence on short-term outcomes of laparoscopic transperitoneal adrenalectomy. This procedure is feasible regardless of the body mass index. Therefore, it can be offered to all patient groups including those morbidly obese individuals in whose case preoperative weight loss seems unnecessary. © 2016 The Japanese Urological Association.

The effect of anesthetic technique on postoperative outcomes in hip fracture repair.

PubMed

O'Hara, D A; Duff, A; Berlin, J A; Poses, R M; Lawrence, V A; Huber, E C; Noveck, H; Strom, B L; Carson, J L

2000-04-01

The impact of anesthetic choice on postoperative mortality and morbidity has not been determined with certainty. The authors evaluated the effect of type of anesthesia on postoperative mortality and morbidity in a retrospective cohort study of consecutive hip fracture patients, aged 60 yr or older, who underwent surgical repair at 20 US hospitals between 1983 and 1993. The primary outcome was defined as death within 30 days of the operative procedure. The secondary outcomes were postoperative 7-day mortality, postoperative myocardial infarction, postoperative pneumonia, postoperative congestive heart failure, and postoperative change in mental status. Numerous comorbid conditions were controlled for individually and by several comorbidity indices using logistic regression. General anesthesia was used in 6,206 patients (65.8%) and regional anesthesia in 3,219 patients (3,078 spinal anesthesia and 141 epidural anesthesia). The 30-day mortality rate in the general anesthesia group was 4.4%, compared with 5.4% in the regional anesthesia group (unadjusted odds ratio = 0.80; 95% confidence interval = 0.66-0.97). However, the adjusted odds ratio for general anesthesia increased to 1.08 (0.84-1.38). The adjusted odds ratios for general anesthesia versus regional anesthesia for the 7-day mortality was 0.90 (0.59-1.39) and for postoperative morbidity outcomes were as follows: myocardial infarction: adjusted odds ratio = 1.17 (0.80-1.70); congestive heart failure: adjusted odds ratio = 1.04 (0.80-1.36); pneumonia: adjusted odds ratio = 1.21 (0.87-1.68); postoperative change in mental status: adjusted odds ratio = 1.08 (0.95-1.22). The authors were unable to demonstrate that regional anesthesia was associated with better outcome than was general anesthesia in this large observational study of elderly patients with hip fracture. These results suggest that the type of anesthesia used should depend on factors other than any associated risks of mortality or morbidity.

Impact of perioperative symbiotic therapy on infectious morbidity after Hpb Surgery in jaundiced patients: a randomized controlled trial.

PubMed

Russolillo, N; Ferrero, A; Vigano', L; Langella, S; Briozzo, A; Ferlini, M; Migliardi, M; Capussotti, L

2014-09-01

This study aimed at evaluating whether the administration of symbiotic therapy in jaundiced patients could reduce their postoperative infectious complications. The study was conducted between November 2008 and February 2011. Jaundiced patients scheduled for elective extrahepatic bile duct resection without liver cirrhosis, intestinal malabsorption or intolerance to symbiotic therapy were randomly assigned to receive [Group A] or not [Group B] symbiotics perioperatively. The primary endpoint was the infectious morbidity rate. Forty patients were included in the analysis (20 in each group). The patients in Group B presented a higher overall morbidity (70 vs 50%) and infectious morbidity rate (50 vs 25%), but the differences were not significant. Eleven patients in Group A (Group ndA) and 13 in Group B (Group ndB) did not receive preoperative biliary drainage. The results of the two groups were comparable. Infectious complications were higher in Group B [5 (34%) vs 0, p = 0.030], while the prevalence of natural killer (NK) cells was higher in Group ndA the day before surgery (17% ± 5.1 vs 10% ± 5.3, p < 0.01) and on post-operative day (POD) 7 (13.1% ± 4.1 vs 7.7% ± 3.4, p < 0.01). The rates of lymph node colonization were similar. The symbiotic therapy failed to reduce the rate of infectious morbidity in jaundiced patients. Further studies investigating the place of symbiotic in no-drainage patients are required.

The VLT Unravels the Nature of the Fastest Binary Star

NASA Astrophysics Data System (ADS)

2002-03-01

Two Hot White Dwarfs Perform a Tight Dance Summary Observations with ESO's Very Large Telescope (VLT) in Chile and the Italian Telescopio Nazionale Galileo (TNG) on the Canary Islands during the past two years have enabled an international group of astronomers [1] to unravel the true nature of an exceptional binary stellar system. This system, designated RX J0806.3+1527 , was first discovered as an X-ray source of variable brightness - once every five minutes, it "switches off" for a short moment. The new observations have shown beyond doubt that this period reflects the orbital motion of two "white dwarf" stars that revolve around each other at a distance of only 80,000 km . Each of the stars is about as large as the Earth and this is the shortest orbital period known for any binary stellar system. The VLT spectrum displays lines of ionized helium, indicating that the presence of an exceedingly hot area on one of the stars - a "hot spot" with a temperature of approx. 250,000 degrees. The system is currently in a rarely seen, transitory evolutionary state . PR Photo 10a/02 : U- and R-band images of RX J0806.3+1527. PR Photo 10b/02 : Spectrum of RX J0806.3+1527 An amazing stellar binary system ESO PR Photo 10a/02 ESO PR Photo 10a/02 [Preview - JPEG: 800 x 400 pix - 440k] [Normal - JPEG: 1600 x 800 pix - 1.1M] Caption : PR Photo 10a/02 shows U and R filter images of the sky field around RX J0806.3+1527 (at centre of circle), obtained with the FORS2 multi-mode instrument on VLT KUEYEN. The object is brightest at the shorter wavelength (U-band) - reflecting its very high temperature. Technical information about the photo is available below. One year is the time it takes the Earth to move once around the Sun, our central star. This may seem quite fast when measured on the scale of the Universe, but this is a snail's motion compared to the the speed of two recently discovered stars. They revolve around each other 100,000 times faster; one full revolution takes only 321 seconds , or a little more than 5 minutes! It is the shortest period ever observed in a binary stellar system . This is the surprising conclusion reached by an international team of astronomers led by GianLuca Israel of the Astronomical Observatory of Rome [1], and based on detailed observations of the faint light from these two stars with some of the world's most advanced telescopes. The record-holding binary stellar system bears the prosaic name RX J0806.3+1527 and it is located north of the celestial equator in the constellation Cancer (The Crab). The scientists also find that the two partners in this hectic dance are most likely a dying white dwarf star , trapped in the strong gravitational grip of another, somewhat heavier star of the same exotic type. The two Earth-size stars are separated by only 80,000 kilometers , a little more than twice the altitude of the TV-broadcasting satellites in orbit around the Earth, or just one fifth of the distance to the Moon. The orbital motion is very fast indeed - over 1,000 km/sec, and the lighter star apparently always turns the same hemisphere towards its companion, just as the Moon in its orbit around Earth. Thus, that star also makes one full turn around its axis in only 5 minutes, i.e. its "day" is exactly as long as its "year". The discovery of RX J0806.3+1527 The visible light emitted by this unusual system is very faint, but it radiates comparatively strong X-rays. It was due to this emission that it was first detected as a celestial X-ray source of unknown origin by the German ROSAT space observatory in 1994. Later it was found to be a periodically variable source [2]. Once every 5 minutes, the X-ray radiation disappears for a couple of minutes. It was recently studied in greater detail by the NASA Chandra observatory. The position of the X-ray source in the sky was localised with sufficient accuracy to reveal a very faint visible-light emitting object in the same direction, over one million times weaker than the faintest star that can be seen by unaided eye (V-magnitude 21.1). Follow-up observations were carried out with several world class telescopes, including the ESO Very Large Telescope (VLT) at the Paranal Observatory in Chile, and also the Telescopio Nazionale Galileo (TNG) , the Italian 4-m class observatory at the Roche de Muchachos Observatory on La Palma in the Canary Islands. The nature of RX J0806.3+1527 ESO PR Photo 10b/02 ESO PR Photo 10b/02 [Preview - JPEG: 756 x 400 pix - 168] [Normal - JPEG: 1512 x 800 pix - 368k] Caption : PR Photo 10b/02 shows the spectrum of RX J0806.3+1527, obtained with the FORS1 multi-mode instrument on VLT ANTU. Many emission lines of ionized helium (He II) and some of doubly ionized carbon (C III) and nitrogen (N III) are seen. They testify to the very high surface temperature of the stars in this system. Technical information about the photo is available below. The observations in visible light also showed the same effect: RX J0806.3+1527 was getting dimmer once every 5 minutes, while no other periodic modulation was seen. By observing the spectrum of this faint object with the FORS1 multi-mode instrument on the 8.2-m VLT ANTU telescope, the astronomers were able to determine the composition of RX J0806.3+1527 . It was found to contain large amounts of helium ; this is unlike most other stars, which are mainly made up of hydrogen. "At the outset, we thought that this was just another of the usual binary systems that emit X-rays", says Gianluca Israel . "None of us could imagine the real nature of this object. We finally solved the puzzle by eliminating all other possibilities one by one, while we kept collecting more data. As the famous detective said: when you have eliminated the impossible, whatever remains, however improbable, must be the truth!". Current theory predicts that the two stars, which are bound together by gravity in this tight system, produce X rays when one of them acts as a giant "vacuum cleaner", drawing gas off its companion. That star has already lost a significant fraction of its mass during this process. The incoming matter impacts at high speed on the surface of the other star and the corresponding area - a "hot spot" - is heated to some 250,000 °C, whereby X rays are emitted. This radiation disappears for a short time during each orbital revolution when this area is on the far side of the accreting star, as seen from the Earth. A very rare class of stars Our Sun is a normal star of comparatively low mass and it will eventually develop into a white dwarf star. Contrary to the violent demise of heavier stars in a glorious supernova explosion, this is a comparatively "quiet" process during which the star slowly cools while losing energy. It shrinks until it finally becomes as small as the Earth. The Sun is a single star. However when a solar-like star is a member of a binary system, the evolution of its component stars is more complicated. During an initial phase, one star continues to move along an orbit that is actually inside the outer, very tenuous atmospheric layers of its companion. Then the system rids itself of this matter and develops into a binary system with two orbiting white dwarf stars, like RX J0806.3+1527 . Systems in which the orbital period is very short (less than 1 hour) are referred to as AM Canis Venaticorum (AM CVn) systems , after first known binary star of this rare class. It is likely that such systems, after having reached a minimum orbital period of a few minutes, then begin to evolve towards longer orbital periods. This indicates that RX J0806.3+1527 is now at the very beginning of the "AM CVn phase". Gravitational waves With its extremely short orbital period, RX J0806.3+1527 is also a prime candidate for the detection of the elusive gravitational waves , predicted by Einstein's General Theory of Relativity. They have never been measured directly, but their existence has been revealed indirectly in binary neutron star systems. A planned gravitational wave space experiment, the European Space Agency's Laser Interferometer Space Antenna (LISA) that will be launched in about 10 years' time, will be sufficiently sensitive to be able to reveal this radiation from RX J0806.3+1527 with a high degree of confidence. Such an observational feat would open an entirely new window on the universe. More information The results described in this Press Release were announced in IAU Circular 7835 and will shortly appear in print in the European research journal Astronomy & Astrophysics Letters ("RX J0806.3+1527: a double degenerate binary with the shortest known orbital period (321 s)" by G.L. Israel and co-authors), cf. astro-ph/0203043. The 5-min optical modulation was detected independently by another group led by G. Ramsay, cf. astro-ph/0203053. Note [1]: The team consists of GianLuca Israel and Luigi Stella at the Astronomical Observatory of Rome (Italy), Stefano Covino and Sergio Campana at the Astronomical Observatory of Brera (Milan, Italy), Wolfgang Hummel, Gianni Marconi and Gero Rupprecht at the European Southern Observatory, Immo Appenzeller and Otmar Stahl at the University of Heidelberg (Germany), Wolfgang Gassler and Karl-Heinz Mantel at the University of Munich (Germany), Christopher Mauche at the Lawrence Livermore National Laboratory (USA), Ulisse Munari at the Astronomical Observatory of Padua (Italy), Ignacio Negueruela at the Astronomical Observatory of Strasbourg (France), Harald Nicklas at the University of Göttingen (Germany), and Richard Smart at the Astronomical Observatory of Turin (Italy). [2]: See the research article by Israel et al. (1999, Astronomy &A, Vol. 349, p. L1). Contact GianLuca Israel Osservatorio Astronomico di Roma Italy Tel.: +39 06 9428 6437 email: gianluca@ulysses.mporzio.astro.it Technical information about the photos PR Photo 10a/02 is reproduced from FORS1-exposures, obtained in November 1999 in the U- and R-bands, and both lasting 300 sec. The field measures 2.0 x 1.5 arcmin 2. PR Photo 10b/02 is based on an 18000 sec spectral exposure with FORS1 on VLT ANTU in January 2001.

Rx for H20

ERIC Educational Resources Information Center

Yapijakis, Costas

1978-01-01

Drinking water disinfectants are discussed. Disinfectants are chlorine, chlorine dioxide, ozone, potassium permanganate, iodine, bromine, hydrogen peroxide; silver, acids and bases, ultraviolet radiation. (MR)

Sleuthing the Isolated Compact Stars

NASA Astrophysics Data System (ADS)

Drake, J. J.

2004-08-01

In the early 1990's, isolated thermally-emitting neutron stars accreting from the interstellar medium were predicted to show up in their thousands in the ROSAT soft X-ray all-sky survey. The glut of sources would provide unprecedented opportunities for probing the equation of state of ultra-dense matter. Only seven objects have been firmly identified to date. The reasons for this discrepency are discussed and recent high resolution X-ray spectroscopic observations of these objects are described. Spectra of the brightest of the isolated neutron star candidates, RX J1856.5-3754, continue to present interpretational difficulties for current neutron star model atmospheres and alternative models are briefly discussed. RX J1856.5-3754 remains a valid quark star candidate.

Mid-Infrared Long-Baseline Interferometry of the Symbiotic Mira Star RX Pup with the VLTI/MIDI Instrument

NASA Astrophysics Data System (ADS)

Driebe, T.; Hofmann, K.-H.; Ohnaka, K.; Schertl, D.; Weigelt, G.; Wittkowski, M.

We present mid-infrared long-baseline interferometric observations of the symbiotic Mira star RX Pup obtained with the VLTI/MIDI instrument in prism mode within the framework of the Science Demonstration Time (SDT) program in Feb. 2004. Four visibility measurements have been carried out using the unit telescopes UT2 and UT3, with projected baseline lengths ranging from 34.7 to 46.5 m.As we show by means of radiative transfer modelin with the code DUSTY [3], the wavelength dependence of the visibility and the N-band spectrum measured with MIDI can be interpreted as thesignature of a circumstellar dust shell which is dominated by silicate dust.

Addition of a 5/cm Spectral Resolution Band Model Option to LOWTRAN5.

DTIC Science & Technology

1980-10-01

THETA-PHI CEO 880 SALP -RX*SPHI CEO 890 IF (SPHIl.GT.1 .E-10) DS-(RE+2)*SIN(BET*CA)ISPHI CEO 900 BETA-BETA+BET CEO 910 PSI-BETA+PHI-ANGLE CEO 920 PHI...9,I+1 )/EH(9,I) CEO 1250 SPHI-SPHI*RX/RN CEO 1260 IF (SALP.CE .RN) SFRI- SALP CEO 1270 -J75 CONTINUE CEO 1280 GO TO 190 CEO 1290 C HORIZONTAL PATH CEO...ABS(X2-NM).CT.1.OE-5) ALP-ASfI( SALP )/CA CEO 2120 IET-ALP-THET CEO 2130 17 (SPEI...-10) DS-(RE+X2)*SIN(BET*Ch)/SBI CEO 2140 THETAmI 80. 0-TE CEO 2150

Social phobia and quality of life in morbidly obese patients before and after bariatric surgery.

PubMed

Mirijello, Antonio; D'Angelo, Cristina; Iaconelli, Amerigo; Capristo, Esmeralda; Ferrulli, Anna; Leccesi, Laura; Cossari, Anthony; Landolfi, Raffaele; Addolorato, Giovanni

2015-07-01

Morbidly obesity is characterized by physical and psychological comorbidities which are associated with reduced quality of life. Bariatric surgery has been linked to a reduction of psychopathology other than to a reduction of weight and improvement in physical functioning. Aim of the present study was to compare psychological features of two groups of morbidly obese patients, before and after bariatric surgery, assessing social phobia and quality of life. A total of 46 morbidly obese patients were enrolled in the study. Of them, 20 were waiting for bilio-pancreatic diversion (group A), while 26 had already undergone surgical procedure (group B). Psychometric evaluation assessed social phobia, fear for the body-shape and quality of life, using appropriate psychometric tests. The percentage of patients showing social phobia was significantly higher compared to a sample of healthy controls (p=0.004), both in group A (p=0.003) and in group B (p=0.029). No differences in percentage of patients affected by social phobia were found between groups. A significantly higher percentage of patients affected by distress about the body (p<0.0001) was found in group A with respect to group B. A reduction of quality of life was found in both groups. The present study shows a high prevalence of social phobia in a population of morbidly obese patients, both before and after surgery. A general reduction of quality of life was also observed, with a partial improvement after surgery. Future studies are needed to clarify the relationship between social phobia and quality of life in surgically-treated morbidly obese patients. Copyright © 2015 Elsevier B.V. All rights reserved.

Levels and potential health risks of mercury in prescription, non-prescription medicines and dietary supplements in Poland.

PubMed

Kowalski, Artur; Frankowski, Marcin

2015-10-01

Determination of mercury is important in the case of pharmaceuticals for which the European Union regulations have not defined the maximum permissible concentration of this metal. The aim of the study was to determine the levels of mercury in the following groups of drugs (n = 119): analgesics, diuretics, cardiacs, antihypertensives, anti-influenza, antibiotics, anti-allergics, tranquilizers, antibacterials and in dietary supplements (n = 33) available on the Polish market. Mercury was analyzed using cold vapor atomic fluorescence spectrometry CV-AFS. Its content in the samples varied in the range of 0.9-476.1 ng g(-1). Higher mercury concentrations were reported for prescription drugs (Rx): 0.9-476.1 ng g(-1) (median: 7.4 ng g(-1)), lower--for non-prescription medicines (OTC): 1.2-45.8 ng g(-1) (median: 6.0 ng g(-1)). In the analyzed dietary supplements the concentrations were: 0.9-16.7 ng g(-1) (median: 5.9 ng g(-1)). On the basis of the information contained in the leaflet accompanying the medicine, a daily dose of mercury taken into the body with an analyzed medicament was estimated and the health risk posed by using such medicines was assessed. The study indicates that it is justified to carry out measurements of mercury in pharmaceuticals due to its high, potentially harmful. Copyright © 2015 Elsevier Inc. All rights reserved.

External apical root resorption concurrent with orthodontic forces: the genetic influence.

PubMed

Nieto-Nieto, Nuria; Solano, Jose Enrique; Yañez-Vico, Rosa

2017-05-01

Root resorption is a pathological process of multifactorial origin related to the permanent loss of dental root structure in response to a mechanical, inflammatory, autoimmune or infectious stimulus. External apical root resorption (EARR) is a frequent clinical complication secondary to orthodontic tooth movement; apart from variables related to treatment, environmental factors and/or interindividual genetic variations can confer susceptibility or resistance to its occurrence. In this context, genetic predisposition has been described as an etiological factor, together with mechanical factors derived from orthodontic treatment. In recent years, international research groups have determined the degree of influence of some genetic biomarkers in defining increased/reduced susceptibility to postorthodontic EARR. The influences of the IL1 gene cluster (IL1B, IL1A, IL1RN, IL6), P2RX7, CASP1, OPG (TNFRSF11B), RANK (TNFRSF11A), Osteopontin (OPN), TNFα, the vitamin D receptor (TaqI), TNSALP and IRAK1 have been analyzed. The objective of the present review study was to compile and analyze the latest information about the genetic background predisposing to EARR during orthodontic treatment. Genetics-based studies along with other basic science research in the field might help to clarify the exact nature of EARR, the influence of genetic inheritance and possibly lead to the prevention or even eradication of this phenomenon during orthodontic treatment.

The Mystery of the Lonely Neutron Star

NASA Astrophysics Data System (ADS)

2000-09-01

The VLT Reveals Bowshock Nebula around RX J1856.5-3754 Deep inside the Milky Way, an old and lonely neutron star plows its way through interstellar space. Known as RX J1856.5-3754 , it measures only ~ 20 km across. Although it is unusually hot for its age, about 700,000 °C, earlier observations did not reveal any activity at all, contrary to all other neutron stars known so far. In order to better understand this extreme type of object, a detailed study of RX J1856.5-3754 was undertaken by Marten van Kerkwijk (Institute of Astronomy of the University of Utrecht, The Netherlands) and Shri Kulkarni (California Institute of Technology, Pasadena, California, USA). To the astronomers' delight and surprise, images and spectra obtained with the ESO Very Large Telescope (VLT) now show a small nearby cone-shaped ("bowshock") nebula. It shines in the light from hydrogen atoms and is obviously a product of some kind of interaction with this strange star. Neutron stars - remnants of supernova explosions Neutron stars are among the most extreme objects in the Universe. They are formed when a massive star dies in a "supernova explosion" . During this dramatic event, the core of the star suddenly collapses under its own weight and the outer parts are violently ejected into surrounding space. One of the best known examples is the Crab Nebula in the constellation Taurus (The Bull). It is the gaseous remnant of a star that exploded in the year 1054 and also left behind a pulsar , i.e., a rotating neutron star [1]. A supernova explosion is a very complex event that is still not well understood. Nor is the structure of a neutron star known in any detail. It depends on the extreme properties of matter that has been compressed to incredibly high densities, far beyond the reach of physics experiments on Earth [2]. The ultimate fate of a neutron star is also unclear. From the observed rates of supernova explosions in other galaxies, it appears that several hundred million neutron stars must have formed in our own galaxy, the Milky Way. However, most of these are now invisible, having since long cooled down and become completely inactive while fading out of sight. An unsual neutron star - RX J1856.5-3754 Some years ago, the X-ray source RX J1856.5-3754 was found by the German ROSAT X-ray satellite observatory. Later observations with the Hubble Space Telescope (cf. STScI-PR97-32 ) detected extremely faint optical emission from this source and conclusively proved that it is an isolated neutron star [3]. There is no sign of the associated supernova remnant and it must therefore be at least 100,000 years "old". Most interestingly, and unlike younger isolated neutron stars or neutron stars in binary stellar systems, RX J1856.5-3754 does not show any sign of activity whatsoever, such as variability or pulsations. As a unique member of its class, RX J1856.5-3754 quickly became the centre of great interest among astronomers. It apparently presented the first, very welcome opportunity to perform detailed studies of the structure of a neutron star, without the disturbing influence of ill-understood activity. One particular question arose immediately. The emission of X-rays indicates a very high temperature of RX J1856.5-3754 . However, from the moment of their violent birth, neutron stars are thought to lose energy and to cool down continuously. But then, how can an old neutron star like this one be so hot? One possible explanation is that some interstellar material, gas and/or dust grains, is being captured by its strong gravitational field. Such particles would fall freely towards the surface of the neutron star and arrive there with about half the speed of light. Since the kinetic energy of these particles is proportionate to the second power of the velocity, even small amounts of matter would deposit much energy upon impact, thereby heating the neutron star. The spectrum of RX J1856.5-3754 The new VLT study by van Kerkwijk and Kulkarni of RX J1856.5-3754 was first aimed at taking optical spectra, in order to study its structure. The astronomers hoped to find in its spectrum some "signatures", i.e., emission or absorption lines and/or bands, that might provide information about the physical conditions on its surface. While the chances for this were admittedly rather slim, a detection of such spectral features would be a real break-through in the study of neutron stars. If present in the spectrum, they could for instance be used to measure directly the immense strength of the gravitational field on the surface, expected to be about 10 12 times stronger than that on the surface of the Earth. Moreover, it might be possible to determine the gravitational redshift , a relativistic effect whereby the light quanta (photons) that are emitted from the surface lose about 20% of their energy as they escape from the neutron star. Their wavelength is consequently red-shifted by that amount. The spectral observations were difficult, first of all because of the extreme faintness of RX J1856.5-3754 . But even though an excellent spectrum was obtained with the multi-mode FORS1 instrument at VLT ANTU, it was indeed quite featureless and no spectral features were seen. Surprises from RX J1856.5-3754 Nevertheless, as it often happens in astronomy, these observations did bring surprises. The first was that the neutron star had obviously moved on the sky since the HST had observed it in 1997. From positional measurements and the assumed distance, approx. 200 light-years, RX J1856.5-3754 was found to be moving with a velocity of about 100 km/s [4]. However, at such a high speed, it is hard to imagine how it would be able to catch much interstellar matter, whose infall might heat the surface as described above. The puzzle was deepening! Another surprise was that the spectra showed very faint emission from the neighbourhood of the neutron star. The measured wavelengths identified these emission lines as H-alpha and H-beta , two of the so-called Balmer lines that originate in hydrogen atoms. Most likely, the strong radiation from the very hot surface of the neutron star is ionizing hydrogen atoms (separating them in a proton and an electron) in the surroundings, a process that also takes place near very hot, normal stars. The observed emission is then produced when, at a later time, the protons and electrons again (re)combine into hydrogen atoms. Interestingly, a simple estimate of the hydrogen density near the neutron star that is needed to produce the observed glow indicates the presence of about one hundred hydrogen atoms per cubic centimetre. This is no less than one hundred times the usual density in the interstellar medium. So maybe the surface of RX J1856.5-3754 could still be heated by infalling hydrogen atoms? VLT images of the RX J1856.5-3754 region With the inferred hydrogen density near the neutron star, about one thousand years on the average will elapse between the moment of ionization by the passing neutron star and the subsequent re-unification of a proton with an electron to form a hydrogen atom. During this time, however, the fast-moving neutron star will have covered a substantial distance. For this reason, it is expected that much of the hydrogen emission will not be seen very close to the neutron star, but rather along its "recent" trajectory in space. ESO PR Photo 23a/00 ESO PR Photo 23a/00 [Preview - JPEG: 400 x 474 pix - 192k] [Normal - JPEG: 800 x 948 pix - 622k] [Full-Res - JPEG: 1975 x 2340 pix - 2.2Mb] ESO PR Photo 23b/00 ESO PR Photo 23b/00 [Preview - JPEG: 400 x 472 pix - 184k] [Normal - JPEG: 800 x 944 pix - 424k] Caption : False-colour composite photo of the sky field with the lonely neutron star RX J1856.5-3754 and the related cone-shaped nebula. It is based on a series of exposures obtained with the multi-mode FORS2 instrument at VLT KUEYEN through three different optical filters: R (29 exposures of 136 sec each; ~1.1 hrs total; here rendered as green); H-alpha (19; 1020 sec; ~5.5 hrs; red); and B (10; 138 sec; ~0.4 hrs; blue). The seeing was good to excellent during the exposures (0.66 arcsec on average). The trails of some moving objects, most likely asteroids in the solar system, are seen in the field with intermittent blue, green and red colours. The large field ( PR Photo 23a/00 ) measures 6.6 x 6.7 arcmin 2 , with 0.2 arcsec/pixel. For clarity, a smaller area around the neutron star and the cone ("bowshock") nebula has been enlarged in PR Photo 23b/00 . The object is at the centre of the circle and the neutron star is indicated with an arrow; the field measures 80 x 80 arcsec 2. North is to the lower right and East is upper right. The motion of the neutron star as seen on the sky (see the text) is towards East, exactly in the direction indicated by the nebula. In order to test these ideas, additional observing time was granted on the VLT to obtain very "deep", direct images that would attempt to map the hydrogen glow. They were carried out by ESO staff astronomers at Paranal in "service mode". Exposures lasting more than five hours in total were taken through a narrow optical filter that isolates the H-alpha hydrogen emission. In addition, shorter exposures were taken through B(lue) and R(ed) filters. The exposures have been combined into the false-colour PR Photos 23a-b/00 . Legions of stars are seen in the photos. This is partly because of the extraordinary light sensitivity of the VLT, and partly because a star-forming region is located in this direction. Stars like our Sun appear whitish, relatively cool stars emit little blue light and appear more reddish, while hot stars appear blue. The photos clearly show a lot of diffuse light, especially in the lower left area. This is most likely starlight reflected off interstellar dust grains. The cone-shaped nebula near RX J1856.5-3754 A small area, just a little above and to the right of the centre of PR Photo 23a/00 , has been enlarged in PR Photo 23b/00 . It shows a small, cone-shaped nebula never seen before - this is the emission from hydrogen atoms near the neutron star RX J1856.5-3754 . The star itself is the very faint, blue object very close to the top of the cone. The shape of the cone is like that of a "bowshock" from a ship, plowing through water. Similarly shaped cones have been found around fast-moving radio pulsars and massive stars, cf. e.g., ESO PR 01/97. However, for those objects, the bowshock forms because of a strong outflow of particles from the star or the pulsar (a "stellar wind"), that collides with the interstellar matter. Because of this analogy, one may think that a "wind" also blows from RX J1856.5-3754 . However, for this a new hypothesis would have to be invoked. An alternative, perhaps more plausible possibility is that when the surrounding hydrogen atoms are ionized, the resulting electrons and protons acquire substantial velocities, heating the interstellar gas near the passing neutron star. The heated gas expands and pushes aside the surrounding cooler gas. In the end, this process may lead to a geometrical shape similar to that caused by a stellar wind. Whither RX J1856.5-3754? At present, it is still uncertain whether the observed density of the surrounding interstellar matter is sufficient to heat RX J1856.5-3754 to the observed temperature. However, it is possible that sometimes in the past the neutron star managed to collect more matter during its travel through interstellar space, was heated, and is now slowly cooling down. In another million years or so, it will become undetectable, until it happens to pass through another dense interstellar region. And so on... Notes [1]: Images of the Crab Nebula and its pulsar from VLT KUEYEN and FORS2 are available in ESO PR 17/99. [2]: In fact, a neutron star is like one big atom with a diameter of 10-20 kilometres, and weighing about as much as the Sun. The mean density is an unimaginable 10 15 g/cm 3. Thus, a pinhead of neutron star material (1 millimetre across) weighs almost 1 million tons, or about as much as the largest oil carrier ever built, fully loaded. [3]: The apparent visual magnitude of RX J1856.5-3754 is 25.6, or nearly 100 million times fainter than what can be perceived with the unaided eye in a dark sky. [4]: The motion of RX J1856.5-3754 was also found by Frederick M. Walter (Stony Brook, New York, USA), who also determined the distance, cf. the corresponding research article that is now available on the web.

Sociodemographic status and self-reported BMI-related morbidity in Koreans.

PubMed

Lee, Kayoung

2010-03-01

This study examined whether the relationship between body mass index (BMI) and the morbidity of chronic diseases differs by marital status, education, and income level. From a nationally representative sample of 5,526 adults from the third Korean National Health and Nutrition Examination Survey (2005), data regarding measured height and weight to classify BMI category (< 23, 23-24.9, > or = 25), self-reported sociodemographics (marital status, education, income, age, sex, and residence area), health behaviors (smoking, alcohol use, exercise, sleep, stress perception, and depression), and morbidity from at least one chronic disease were collected. Education, income, and marital status were significantly associated with morbidity regardless of adjustment for BMI and health behaviors. After adjusting for BMI, other sociodemographic factors, and health behaviors, the odds ratio (95% confidence interval) of morbidity was 2.9 (2.4-3.7) for those in the married group and 2.9 (2.1-4.0) for those in the separated/divorced/widowed group, 2.0 (1.6-2.5) for those in the lowest education group, and 1.3 (1.2-1.6) for those in the lowest income group. When the BMI category and sociodemographic factors were combined, the odds ratios were elevated for those in the combination group with higher BMI and lower sociodemographic position. Korean subjects who were married, in the lowest education group, or in the lowest income level had a higher risk of morbidity in relation to BMI.

Performance of a Medipix3RX spectroscopic pixel detector with a high resistivity gallium arsenide sensor.

PubMed

Hamann, Elias; Koenig, Thomas; Zuber, Marcus; Cecilia, Angelica; Tyazhev, Anton; Tolbanov, Oleg; Procz, Simon; Fauler, Alex; Baumbach, Tilo; Fiederle, Michael

2015-03-01

High resistivity gallium arsenide is considered a suitable sensor material for spectroscopic X-ray imaging detectors. These sensors typically have thicknesses between a few hundred μm and 1 mm to ensure a high photon detection efficiency. However, for small pixel sizes down to several tens of μm, an effect called charge sharing reduces a detector's spectroscopic performance. The recently developed Medipix3RX readout chip overcomes this limitation by implementing a charge summing circuit, which allows the reconstruction of the full energy information of a photon interaction in a single pixel. In this work, we present the characterization of the first Medipix3RX detector assembly with a 500 μm thick high resistivity, chromium compensated gallium arsenide sensor. We analyze its properties and demonstrate the functionality of the charge summing mode by means of energy response functions recorded at a synchrotron. Furthermore, the imaging properties of the detector, in terms of its modulation transfer functions and signal-to-noise ratios, are investigated. After more than one decade of attempts to establish gallium arsenide as a sensor material for photon counting detectors, our results represent a breakthrough in obtaining detector-grade material. The sensor we introduce is therefore suitable for high resolution X-ray imaging applications.

ORBITAL SOLUTIONS FOR TWO YOUNG, LOW-MASS SPECTROSCOPIC BINARIES IN OPHIUCHUS

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

Rosero, V.; Prato, L.; Wasserman, L. H.

2011-01-15

We report the orbital parameters for ROXR1 14 and RX J1622.7-2325Nw, two young, low-mass, and double-lined spectroscopic binaries recently discovered in the Ophiuchus star-forming region. Accurate orbital solutions were determined from over a dozen high-resolution spectra taken with the Keck II and Gemini South telescopes. These objects are T Tauri stars with mass ratios close to unity and periods of {approx}5 and {approx}3 days, respectively. In particular, RX J1622.7-2325Nw shows a non-circularized orbit with an eccentricity of 0.30, higher than any other short-period pre-main-sequence (PMS) spectroscopic binary known to date. We speculate that the orbit of RX J1622.7-2325Nw has notmore » yet circularized because of the perturbing action of a {approx}1'' companion, itself a close visual pair. A comparison of known young spectroscopic binaries (SBs) and main-sequence (MS) SBs in the eccentricity-period plane shows an indistinguishable distribution of the two populations, implying that orbital circularization occurs in the first 1 Myr of a star's lifetime. With the results presented in this paper we increase by {approx}4% the small sample of PMS spectroscopic binary stars with known orbital elements.« less

Prospects for Cherenkov Telescope Array Observations of the Young Supernova Remnant RX J1713.7-3946

NASA Astrophysics Data System (ADS)

Acero, F.; Aloisio, R.; Amans, J.; Amato, E.; Antonelli, L. A.; Aramo, C.; Armstrong, T.; Arqueros, F.; Asano, K.; Ashley, M.; Backes, M.; Balazs, C.; Balzer, A.; Bamba, A.; Barkov, M.; Barrio, J. A.; Benbow, W.; Bernlöhr, K.; Beshley, V.; Bigongiari, C.; Biland, A.; Bilinsky, A.; Bissaldi, E.; Biteau, J.; Blanch, O.; Blasi, P.; Blazek, J.; Boisson, C.; Bonanno, G.; Bonardi, A.; Bonavolontà, C.; Bonnoli, G.; Braiding, C.; Brau-Nogué, S.; Bregeon, J.; Brown, A. M.; Bugaev, V.; Bulgarelli, A.; Bulik, T.; Burton, M.; Burtovoi, A.; Busetto, G.; Böttcher, M.; Cameron, R.; Capalbi, M.; Caproni, A.; Caraveo, P.; Carosi, R.; Cascone, E.; Cerruti, M.; Chaty, S.; Chen, A.; Chen, X.; Chernyakova, M.; Chikawa, M.; Chudoba, J.; Cohen-Tanugi, J.; Colafrancesco, S.; Conforti, V.; Contreras, J. L.; Costa, A.; Cotter, G.; Covino, S.; Covone, G.; Cumani, P.; Cusumano, G.; D'Ammando, F.; D'Urso, D.; Daniel, M.; Dazzi, F.; De Angelis, A.; De Cesare, G.; De Franco, A.; De Frondat, F.; de Gouveia Dal Pino, E. M.; De Lisio, C.; de los Reyes Lopez, R.; De Lotto, B.; de Naurois, M.; De Palma, F.; Del Santo, M.; Delgado, C.; della Volpe, D.; Di Girolamo, T.; Di Giulio, C.; Di Pierro, F.; Di Venere, L.; Doro, M.; Dournaux, J.; Dumas, D.; Dwarkadas, V.; Díaz, C.; Ebr, J.; Egberts, K.; Einecke, S.; Elsässer, D.; Eschbach, S.; Falceta-Goncalves, D.; Fasola, G.; Fedorova, E.; Fernández-Barral, A.; Ferrand, G.; Fesquet, M.; Fiandrini, E.; Fiasson, A.; Filipovíc, M. D.; Fioretti, V.; Font, L.; Fontaine, G.; Franco, F. J.; Freixas Coromina, L.; Fujita, Y.; Fukui, Y.; Funk, S.; Förster, A.; Gadola, A.; Garcia López, R.; Garczarczyk, M.; Giglietto, N.; Giordano, F.; Giuliani, A.; Glicenstein, J.; Gnatyk, R.; Goldoni, P.; Grabarczyk, T.; Graciani, R.; Graham, J.; Grandi, P.; Granot, J.; Green, A. J.; Griffiths, S.; Gunji, S.; Hakobyan, H.; Hara, S.; Hassan, T.; Hayashida, M.; Heller, M.; Helo, J. C.; Hinton, J.; Hnatyk, B.; Huet, J.; Huetten, M.; Humensky, T. B.; Hussein, M.; Hörandel, J.; Ikeno, Y.; Inada, T.; Inome, Y.; Inoue, S.; Inoue, T.; Inoue, Y.; Ioka, K.; Iori, M.; Jacquemier, J.; Janecek, P.; Jankowsky, D.; Jung, I.; Kaaret, P.; Katagiri, H.; Kimeswenger, S.; Kimura, S.; Knödlseder, J.; Koch, B.; Kocot, J.; Kohri, K.; Komin, N.; Konno, Y.; Kosack, K.; Koyama, S.; Kraus, M.; Kubo, H.; Kukec Mezek, G.; Kushida, J.; La Palombara, N.; Lalik, K.; Lamanna, G.; Landt, H.; Lapington, J.; Laporte, P.; Lee, S.; Lees, J.; Lefaucheur, J.; Lenain, J.-P.; Leto, G.; Lindfors, E.; Lohse, T.; Lombardi, S.; Longo, F.; Lopez, M.; Lucarelli, F.; Luque-Escamilla, P. L.; López-Coto, R.; Maccarone, M. C.; Maier, G.; Malaguti, G.; Mandat, D.; Maneva, G.; Mangano, S.; Marcowith, A.; Martí, J.; Martínez, M.; Martínez, G.; Masuda, S.; Maurin, G.; Maxted, N.; Melioli, C.; Mineo, T.; Mirabal, N.; Mizuno, T.; Moderski, R.; Mohammed, M.; Montaruli, T.; Moralejo, A.; Mori, K.; Morlino, G.; Morselli, A.; Moulin, E.; Mukherjee, R.; Mundell, C.; Muraishi, H.; Murase, K.; Nagataki, S.; Nagayoshi, T.; Naito, T.; Nakajima, D.; Nakamori, T.; Nemmen, R.; Niemiec, J.; Nieto, D.; Nievas-Rosillo, M.; Nikołajuk, M.; Nishijima, K.; Noda, K.; Nogues, L.; Nosek, D.; Novosyadlyj, B.; Nozaki, S.; Ohira, Y.; Ohishi, M.; Ohm, S.; Okumura, A.; Ong, R. A.; Orito, R.; Orlati, A.; Ostrowski, M.; Oya, I.; Padovani, M.; Palacio, J.; Palatka, M.; Paredes, J. M.; Pavy, S.; Pe'er, A.; Persic, M.; Petrucci, P.; Petruk, O.; Pisarski, A.; Pohl, M.; Porcelli, A.; Prandini, E.; Prast, J.; Principe, G.; Prouza, M.; Pueschel, E.; Pühlhofer, G.; Quirrenbach, A.; Rameez, M.; Reimer, O.; Renaud, M.; Ribó, M.; Rico, J.; Rizi, V.; Rodriguez, J.; Rodriguez Fernandez, G.; Rodríguez Vázquez, J. J.; Romano, P.; Romeo, G.; Rosado, J.; Rousselle, J.; Rowell, G.; Rudak, B.; Sadeh, I.; Safi-Harb, S.; Saito, T.; Sakaki, N.; Sanchez, D.; Sangiorgi, P.; Sano, H.; Santander, M.; Sarkar, S.; Sawada, M.; Schioppa, E. J.; Schoorlemmer, H.; Schovanek, P.; Schussler, F.; Sergijenko, O.; Servillat, M.; Shalchi, A.; Shellard, R. C.; Siejkowski, H.; Sillanpää, A.; Simone, D.; Sliusar, V.; Sol, H.; Stanič, S.; Starling, R.; Stawarz, Ł.; Stefanik, S.; Stephan, M.; Stolarczyk, T.; Szanecki, M.; Szepieniec, T.; Tagliaferri, G.; Tajima, H.; Takahashi, M.; Takeda, J.; Tanaka, M.; Tanaka, S.; Tejedor, L. A.; Telezhinsky, I.; Temnikov, P.; Terada, Y.; Tescaro, D.; Teshima, M.; Testa, V.; Thoudam, S.; Tokanai, F.; Torres, D. F.; Torresi, E.; Tosti, G.; Townsley, C.; Travnicek, P.; Trichard, C.; Trifoglio, M.; Tsujimoto, S.; Vagelli, V.; Vallania, P.; Valore, L.; van Driel, W.; van Eldik, C.; Vandenbroucke, J.; Vassiliev, V.; Vecchi, M.; Vercellone, S.; Vergani, S.; Vigorito, C.; Vorobiov, S.; Vrastil, M.; Vázquez Acosta, M. L.; Wagner, S. J.; Wagner, R.; Wakely, S. P.; Walter, R.; Ward, J. E.; Watson, J. J.; Weinstein, A.; White, M.; White, R.; Wierzcholska, A.; Wilcox, P.; Williams, D. A.; Wischnewski, R.; Wojcik, P.; Yamamoto, T.; Yamamoto, H.; Yamazaki, R.; Yanagita, S.; Yang, L.; Yoshida, T.; Yoshida, M.; Yoshiike, S.; Yoshikoshi, T.; Zacharias, M.; Zampieri, L.; Zanin, R.; Zavrtanik, M.; Zavrtanik, D.; Zdziarski, A.; Zech, A.; Zechlin, H.; Zhdanov, V.; Ziegler, A.; Zorn, J.

2017-05-01

We perform simulations for future Cherenkov Telescope Array (CTA) observations of RX J1713.7-3946, a young supernova remnant (SNR) and one of the brightest sources ever discovered in very high energy (VHE) gamma rays. Special attention is paid to exploring possible spatial (anti)correlations of gamma rays with emission at other wavelengths, in particular X-rays and CO/H I emission. We present a series of simulated images of RX J1713.7-3946 for CTA based on a set of observationally motivated models for the gamma-ray emission. In these models, VHE gamma rays produced by high-energy electrons are assumed to trace the nonthermal X-ray emission observed by XMM-Newton, whereas those originating from relativistic protons delineate the local gas distributions. The local atomic and molecular gas distributions are deduced by the NANTEN team from CO and H I observations. Our primary goal is to show how one can distinguish the emission mechanism(s) of the gamma rays (I.e., hadronic versus leptonic, or a mixture of the two) through information provided by their spatial distribution, spectra, and time variation. This work is the first attempt to quantitatively evaluate the capabilities of CTA to achieve various proposed scientific goals by observing this important cosmic particle accelerator.

Fe II fluorescence and anomalous C IV doublet intensities in symbiotic novae

NASA Technical Reports Server (NTRS)

Michalitsianos, A. G.; Kafatos, M.; Meier, S. R.

1992-01-01

The variation of absolute intensities of Bowen-excited Fe II emission in the symbiotic stars RR Tel, RX Pup, and AG Peg is examined. The C IV doublet intensity ratios in RR Tel were not anomalous between 1979 and 1989, and the ratio had typical values within the optically thin range. The intensity of individual Fe II Bowen-excited lines is correlated with the C IV 1548.2 A flux, suggesting the presence of a foreground Fe II region in which fluorescent-excited material responds to flux variations of C IV 1548.2 A. In RX Pup the combined fluxes of Fe II Bowen-pumped lines can account for an appreciable fraction of the flux deficit in the C IV 1548.2 A line when the C IV doublet ratio is less than the optically thick limit of unity. The Fe II Bowen lines in RX Pup exhibit a velocity range from 0 to 80 km/s, where several strong Fe II emission lines correspond to deep absorption structure in the C IV 1548.2 A line profile. In AG Peg and C IV 1548.2 A flux deficit cannot be explained by Fe II fluorescent absorption alone when the C IV doublet ratio anomaly is at an extreme.

Study of Morbidity Profile of a Rural Population in Tamil Nadu

PubMed Central

Ganeshkumar, P.; Katta, Ajitha

2015-01-01

Objective: To identify the reported morbidity profile of people according to age, gender and organ system affected using International Classification of Diseases (ICD) coding, in a demographically defined area in Tamil Nadu in order to identify their health care needs and to plan appropriate interventions strategies. Materials and Methods: This is a-cross sectional study using a convenience sample of 12308 persons sceened from the 41 panchayat units of the Kattankulathur block, comprising 90 villages with a population of about 2,00,890, over a period of one year. Diagnosis made were coded using ICD 10 version and data collected was analysed by appropriate statistical methods to explain the distribution of morbidity profile among the study population. Result: Out of total, 38.1% screened were males and 61.9% were females. Underfives were 5.3%, school going children 43.3%, adults 39.2% and elderly 12.3%. Majority had illness affecting respiratory system (20%), ‘symptoms and signs’ (19%), musculo-skeletal system (16.1%) and digestive system(11.9%). ‘Symptoms and signs’ classification, is a group of conditions which is of nonspecific diseases, signs, symptoms, abnormal findings and complaints, apart from the system specific conditions diagnosed properly and not elsewhere classified, More males were affeced with respiratory, digestive and illnesses with ‘symptoms and signs’ while more women were affected with musculo-skeletal problems. Only 9.7 % of patients reported with non-communicable diseases. Among them, 55 % women and 42.3 % men had osteoarthritis and 15.7 % women and 21.3 % men had cataract. About 15.8 % women and 18.1 % men had hypertension and other heart diseases while 9.7 % women and 8.4 % men had diabetes and 10.0 % men and 3.9 % women had chronic respiratory diseases. Conclusion: School going children and adults have higher levels of morbidity when compared to elderly and under five children. More females reported with illness but morbidity was found to be higher among males. The burden of illness increased with age. Acute ailments were responsible for high morbidity among children, while chronic ailments caused high morbidity among the elderly. PMID:25859470

Gastric Fluid Volume Change After Oral Rehydration Solution Intake in Morbidly Obese and Normal Controls: A Magnetic Resonance Imaging-Based Analysis.

PubMed

Shiraishi, Toshie; Kurosaki, Dai; Nakamura, Mitsuyo; Yazaki, Taiji; Kobinata, Satomi; Seki, Yosuke; Kasama, Kazunori; Taniguchi, Hideki

2017-04-01

Although preoperative fluid intake 2 hours before anesthesia is generally considered safe, there are concerns about delayed gastric emptying in obese subjects. In this study, the gastric fluid volume (GFV) change in morbidly obese subjects was investigated after ingesting an oral rehydration solution (ORS) and then compared with that in nonobese subjects. GFV change over time after the ingestion of 500 mL of ORS containing 2.5% carbohydrate (OS-1) was measured in 10 morbidly obese subjects (body mass index [BMI], >35) scheduled for bariatric surgery and 10 nonobese (BMI, 19-24) using magnetic resonance imaging. After 9 hours of fasting, magnetic resonance imaging scans were performed at preingestion, 0 min (just after ingestion), and every 30 minutes up to 120 minutes. GFV values were compared between morbidly obese and control groups and also between preingestion and postingestion time points. The morbidly obese group had a significantly higher body weight and BMI than the control group (mean body weight and BMI in morbidly obese, 129.6 kg and 46.3 kg/m, respectively; control, 59.5 kg and 21.6 kg/m, respectively). GFV was significantly higher in the morbidly obese subjects compared with the control group at preingestion (73 ± 30.8 mL vs 31 ± 19.9 mL, P = .001) and at 0 minutes after ingestion (561 ± 30.8 mL vs 486 ± 42.8 mL; P < .001). GFV declined rapidly in both groups and reached fasting baseline levels by 120 minutes (morbidly obese, 50 ± 29.5 mL; control, 30 ± 11.6 mL). A significant correlation was observed between preingestion residual GFV and body weight (r = .66; P = .001). Morbidly obese subjects have a higher residual gastric volume after 9 hours of fasting compared with subjects with a normal BMI. However, no differences were observed in gastric emptying after ORS ingestion in the 2 populations, and GFVs reached baseline within 2 hours after ORS ingestion. Further studies are required to confirm whether the preoperative fasting and fluid management that are recommended for nonobese patients could also be applied to morbidly obese patients.

A study of morbidity pattern among iron and steel workers from an industry in central India.

PubMed

Biswas, Manish J; Koparkar, Anil R; Joshi, Mohan P; Hajare, Shilpa T; Kasturwar, Nandakishor B

2014-01-01

Iron is the world's most commonly used metal and can usually be found with other elements in the form of steel. In this era of machines, it is the inevitable part in production of various materials like eyeglass frames, jet aircraft, the space shuttle, automobiles, and surgical instruments. Occupational factors make an important contribution to the global burden of disease, but the reliable data on occupational disease are much more difficult to obtain. Hence, the current study was carried out to find out the morbidity pattern among iron and steel workers. A cross-sectional study. was carried out after obtaining permission from Institutional Ethics Committee in an iron and steel factory. Worker's detailed information regarding profile was taken in pretested questionnaire format after obtaining the informed written consent and explaining the purpose of study. Workers were also interviewed regarding their years of job, job satisfaction, usage of protective devices, and history of injuries during work. Worker's detailed general and systemic examination was conducted. The overall prevalence of morbidities among the workers was 60%. It was observed that commonest morbidity in the workers was lumbago (musculoskeletal pain), that is, 33.25%which was more in Group B (49.73%) than Group A (18.78%), followed by occupational dermatitis (27%) which more common in Group A (33.33%) than Group B (19.79%). It was seen that occupation-related morbidities were more prevalent in Group A, i.e. Exposed group (P < 0.001). It was observed that occupation-related morbidities were more common in exposed group (EG) than that of nonexposed group (NEG) and the difference was found to be statistically significant (P < 0.001).

High beat-to-beat blood pressure variability in atrial fibrillation compared to sinus rhythm.

PubMed

Olbers, Joakim; Gille, Adam; Ljungman, Petter; Rosenqvist, Mårten; Östergren, Jan; Witt, Nils

2018-02-07

Atrial fibrillation (AF) is associated with an increased risk for cardiovascular morbidity and mortality, not entirely explained by thromboembolism. The underlying mechanisms for this association are largely unknown. Similarly, high blood pressure (BP) increases the risk for cardiovascular events. Despite this the interplay between AF and BP is insufficiently studied. The purpose of this study was to examine and quantify the beat-to-beat blood pressure variability in patients with AF in comparison to a control group of patients with sinus rhythm. We studied 33 patients - 21 in atrial fibrillation and 12 in sinus rhythm - undergoing routine coronary angiography. Invasive blood pressure was recorded at three locations: radial artery, brachial artery and ascending aorta. Blood pressure variability, defined as average beat-to-beat blood pressure difference, was calculated for systolic and diastolic blood pressure at each site. We observed a significant difference (p < .001) in systolic and diastolic blood pressure variability between the atrial fibrillation and sinus rhythm groups at all locations. Systolic blood pressure variability roughly doubled in the atrial fibrillation group compared to the sinus rhythm group (4.9 and 2.4 mmHg respectively). Diastolic beat-to-beat blood pressure variability was approximately 6 times as high in the atrial fibrillation group compared to the sinus rhythm group (7.5 and 1.2 mmHg respectively). No significant difference in blood pressure variability was seen between measurement locations. Beat-to-beat blood pressure variability in patients with atrial fibrillation was substantially higher than in patients with sinus rhythm. Hemodynamic effects of this beat-to-beat variation in blood pressure may negatively affect vascular structure and function, which may contribute to the increased cardiovascular morbidity and mortality seen in patients with atrial fibrillation.

Extensive Household Outbreak of Urinary Tract Infection and Intestinal Colonization due to Extended-Spectrum β-Lactamase-Producing Escherichia coli Sequence Type 131.

PubMed

Madigan, Theresa; Johnson, James R; Clabots, Connie; Johnston, Brian D; Porter, Stephen B; Slater, Billie S; Banerjee, Ritu

2015-07-01

Reasons for the successful global dissemination of multidrug-resistant Escherichia coli sequence type 131 (ST131) are undefined, but may include enhanced transmissibility or ability to colonize the intestine compared with other strains. We identified a household in which 2 young children had urinary tract infection (UTI) caused by an extended-spectrum β-lactamase (ESBL)-producing, multidrug-resistant ST131 E. coli strain. We assessed the prevalence of ST131 intestinal colonization among the 7 household members (6 humans, 1 dog). Fecal samples, collected 3 times over a 19-week period, were cultured selectively for E. coli. Isolates were characterized using clone-specific polymerase chain reaction to detect ST131 and its ESBL-associated H30Rx subclone, pulsed-field gel electrophoresis, extended virulence genotyping, and antimicrobial susceptibility testing. In total, 8 different E. coli pulsotypes (strains) were identified. The index patient's urine isolate represented ST131-H30Rx strain 903. This was the most widely shared and persistent strain in the household, colonizing 5 individuals at each sampling. In contrast, the 7 non-ST131 strains were each found in only 1 or 2 household members at a time, with variable persistence. The ST131 strain was the only strain with both extensive virulence and antimicrobial resistance profiles. An ESBL-producing ST131-H30Rx strain caused UTI in 2 siblings, plus asymptomatic intestinal colonization in multiple other household members, and was the household's most extensively detected and persistent fecal E. coli strain. Efficient transmission and intestinal colonization may contribute to the epidemiologic success of the H30Rx subclone of E. coli ST131. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

H.E.S.S. observations of RX J1713.7-3946 with improved angular and spectral resolution: Evidence for gamma-ray emission extending beyond the X-ray emitting shell

NASA Astrophysics Data System (ADS)

H. E. S. S. Collaboration; Abdalla, H.; Abramowski, A.; Aharonian, F.; Benkhali, F. Ait; Akhperjanian, A. G.; Andersson, T.; Angüner, E. O.; Arrieta, M.; Aubert, P.; Backes, M.; Balzer, A.; Barnard, M.; Becherini, Y.; Tjus, J. Becker; Berge, D.; Bernhard, S.; Bernlöhr, K.; Blackwell, R.; Böttcher, M.; Boisson, C.; Bolmont, J.; Bordas, P.; Bregeon, J.; Brun, F.; Brun, P.; Bryan, M.; Bulik, T.; Capasso, M.; Carr, J.; Casanova, S.; Cerruti, M.; Chakraborty, N.; Chalme-Calvet, R.; Chaves, R. C. G.; Chen, A.; Chevalier, J.; Chrétien, M.; Colafrancesco, S.; Cologna, G.; Condon, B.; Conrad, J.; Cui, Y.; Davids, I. D.; Decock, J.; Degrange, B.; Deil, C.; Devin, J.; deWilt, P.; Dirson, L.; Djannati-Ataï, A.; Domainko, W.; Donath, A.; Drury, L. O.'C.; Dubus, G.; Dutson, K.; Dyks, J.; Edwards, T.; Egberts, K.; Eger, P.; Ernenwein, J.-P.; Eschbach, S.; Farnier, C.; Fegan, S.; Fernandes, M. V.; Fiasson, A.; Fontaine, G.; Förster, A.; Fukuyama, T.; Funk, S.; Füßling, M.; Gabici, S.; Gajdus, M.; Gallant, Y. A.; Garrigoux, T.; Giavitto, G.; Giebels, B.; Glicenstein, J. F.; Gottschall, D.; Goyal, A.; Grondin, M.-H.; Hadasch, D.; Hahn, J.; Haupt, M.; Hawkes, J.; Heinzelmann, G.; Henri, G.; Hermann, G.; Hervet, O.; Hinton, J. A.; Hofmann, W.; Hoischen, C.; Holler, M.; Horns, D.; Ivascenko, A.; Jacholkowska, A.; Jamrozy, M.; Janiak, M.; Jankowsky, D.; Jankowsky, F.; Jingo, M.; Jogler, T.; Jouvin, L.; Jung-Richardt, I.; Kastendieck, M. A.; Katarzyński, K.; Katz, U.; Kerszberg, D.; Khélifi, B.; Kieffer, M.; King, J.; Klepser, S.; Klochkov, D.; Kluźniak, W.; Kolitzus, D.; Komin, Nu.; Kosack, K.; Krakau, S.; Kraus, M.; Krayzel, F.; Krüger, P. P.; Laffon, H.; Lamanna, G.; Lau, J.; Lees, J.-P.; Lefaucheur, J.; Lefranc, V.; Lemière, A.; Lemoine-Goumard, M.; Lenain, J.-P.; Leser, E.; Lohse, T.; Lorentz, M.; Liu, R.; López-Coto, R.; Lypova, I.; Marandon, V.; Marcowith, A.; Mariaud, C.; Marx, R.; Maurin, G.; Maxted, N.; Mayer, M.; Meintjes, P. J.; Meyer, M.; Mitchell, A. M. W.; Moderski, R.; Mohamed, M.; Mohrmann, L.; Morå, K.; Moulin, E.; Murach, T.; Naurois, M. de; Niederwanger, F.; Niemiec, J.; Oakes, L.; O'Brien, P.; Odaka, H.; Öttl, S.; Ohm, S.; Ostrowski, M.; Oya, I.; Padovani, M.; Panter, M.; Parsons, R. D.; Pekeur, N. W.; Pelletier, G.; Perennes, C.; Petrucci, P.-O.; Peyaud, B.; Piel, Q.; Pita, S.; Poon, H.; Prokhorov, D.; Prokoph, H.; Pühlhofer, G.; Punch, M.; Quirrenbach, A.; Raab, S.; Reimer, A.; Reimer, O.; Renaud, M.; los Reyes, R. de; Rieger, F.; Romoli, C.; Rosier-Lees, S.; Rowell, G.; Rudak, B.; Rulten, C. B.; Sahakian, V.; Salek, D.; Sanchez, D. A.; Santangelo, A.; Sasaki, M.; Schlickeiser, R.; Schüssler, F.; Schulz, A.; Schwanke, U.; Schwemmer, S.; Settimo, M.; Seyffert, A. S.; Shafi, N.; Shilon, I.; Simoni, R.; Sol, H.; Spanier, F.; Spengler, G.; Spies, F.; Stawarz, Ł.; Steenkamp, R.; Stegmann, C.; Stinzing, F.; Stycz, K.; Sushch, I.; Takahashi, T.; Tavernet, J.-P.; Tavernier, T.; Taylor, A. M.; Terrier, R.; Tibaldo, L.; Tiziani, D.; Tluczykont, M.; Trichard, C.; Tuffs, R.; Uchiyama, Y.; van der Walt, D. J.; Eldik, C. van; Rensburg, C. van; Soelen, B. van; Vasileiadis, G.; Veh, J.; Venter, C.; Viana, A.; Vincent, P.; Vink, J.; Voisin, F.; Völk, H. J.; Volpe, F.; Vuillaume, T.; Wadiasingh, Z.; Wagner, S. J.; Wagner, P.; Wagner, R. M.; White, R.; Wierzcholska, A.; Willmann, P.; Wörnlein, A.; Wouters, D.; Yang, R.; Zabalza, V.; Zaborov, D.; Zacharias, M.; Zdziarski, A. A.; Zech, A.; Zefi, F.; Ziegler, A.; Żywucka, N.

2018-04-01

Supernova remnants exhibit shock fronts (shells) that can accelerate charged particles up to very high energies. In the past decade, measurements of a handful of shell-type supernova remnants in very high-energy gamma rays have provided unique insights into the acceleration process. Among those objects, RX J1713.7-3946 (also known as G347.3-0.5) has the largest surface brightness, allowing us in the past to perform the most comprehensive study of morphology and spatially resolved spectra of any such very high-energy gamma-ray source. Here we present extensive new H.E.S.S. measurements of RX J1713.7-3946, almost doubling the observation time compared to our previous publication. Combined with new improved analysis tools, the previous sensitivity is more than doubled. The H.E.S.S. angular resolution of 0.048° (0.036° above 2 TeV) is unprecedented in gamma-ray astronomy and probes physical scales of 0.8 (0.6) parsec at the remnant's location. The new H.E.S.S. image of RX J1713.7-3946 allows us to reveal clear morphological differences between X-rays and gamma rays. In particular, for the outer edge of the brightest shell region, we find the first ever indication for particles in the process of leaving the acceleration shock region. By studying the broadband energy spectrum, we furthermore extract properties of the parent particle populations, providing new input to the discussion of the leptonic or hadronic nature of the gamma-ray emission mechanism. All images (FITS files) are available at the CDS via anonymous ftp to http://cdsarc.u-strasbg.fr (http://130.79.128.5) or via http://cdsarc.u-strasbg.fr/viz-bin/qcat?J/A+A/612/A6

An alternative clinical routine for subjective refraction based on power vectors with trial frames.

PubMed

María Revert, Antonia; Conversa, Maria Amparo; Albarrán Diego, César; Micó, Vicente

2017-01-01

Subjective refraction determines the final point of refractive error assessment in most clinical environments and its foundations have remained unchanged for decades. The purpose of this paper is to compare the results obtained when monocular subjective refraction is assessed in trial frames by a new clinical procedure based on a pure power vector interpretation with conventional clinical refraction procedures. An alternative clinical routine is described that uses power vector interpretation with implementation in trial frames. Refractive error is determined in terms of: (i) the spherical equivalent (M component), and (ii) a pair of Jackson Crossed Cylinder lenses oriented at 0°/90° (J 0 component) and 45°/135° (J 45 component) for determination of astigmatism. This vector subjective refraction result (VR) is compared separately for right and left eyes of 25 subjects (mean age, 35 ± 4 years) against conventional sphero-cylindrical subjective refraction (RX) using a phoropter. The VR procedure was applied with both conventional tumbling E optotypes (VR1) and modified optotypes with oblique orientation (VR2). Bland-Altman plots and intra-class correlation coefficient showed good agreement between VR, and RX (with coefficient values above 0.82) and anova showed no significant differences in any of the power vector components between RX and VR. VR1 and VR2 procedure results were similar (p ≥ 0.77). The proposed routine determines the three components of refractive error in power vector notation [M, J 0 , J 45 ], with a refraction time similar to the one used in conventional subjective procedures. The proposed routine could be helpful for inexperienced clinicians and for experienced clinicians in those cases where it is difficult to get a valid starting point for conventional RX (irregular corneas, media opacities, etc.) and for refractive situations/places with inadequate refractive facilities/equipment. © 2016 The Authors Ophthalmic & Physiological Optics © 2016 The College of Optometrists.

Fermi Large Area Telescope observations of the supernova remnant HESS J1731-347

NASA Astrophysics Data System (ADS)

Yang, Rui-zhi; Zhang, Xiao; Yuan, Qiang; Liu, Siming

2014-07-01

Context. HESS J1731-347 has been identified as one of the few TeV-bright shell-type supernova remnants (SNRs). These remnants are dominated by nonthermal emission, and the nature of TeV emission has been continuously debated for nearly a decade. Aims: We carry out the detailed modeling of the radio to γ-ray spectrum of HESS J1731-347 to constrain the magnetic field and energetic particles sources, which we compare with those of the other TeV-bright shell-type SNRs explored before. Methods: Four years of data from Fermi Large Area Telescope (LAT) observations for regions around this remnant are analyzed, leading to no detection correlated with the source discovered in the TeV band. The Markov chain Monte Carlo method is used to constrain parameters of one-zone models for the overall emission spectrum. Results: Based on the 99.9% upper limits of fluxes in the GeV range, one-zone hadronic models with an energetic proton spectral slope greater than 1.8 can be ruled out, which favors a leptonic origin for the γ-ray emission, making this remnant a sibling of the brightest TeV SNR RX J1713.7-3946, the Vela Junior SNR RX J0852.0-4622, and RCW 86. The best-fit leptonic model has an electron spectral slope of 1.8 and a magnetic field of ~30 μG, which is at least a factor of 2 higher than those of RX J1713.7-3946 and RX J0852.0-4622, posing a challenge to the distance estimate and/or the energy equipartition between energetic electrons and the magnetic field of this source. A measurement of the shock speed will address this challenge and has implications on the magnetic field evolution and electron acceleration driven by shocks of SNRs.

THE SN 393-SNR RX J1713.7-3946 (G347.3-0.5) CONNECTION

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

Fesen, Robert A.; Milisavljevic, Dan; Kremer, Richard

Although the connection of the Chinese 'guest' star of 393 AD with the Galactic supernova remnant RX J1713.7-3946 (G347.3-0.5) made by Wang et al. in 1997 is consistent with the remnant's relatively young properties and the guest star's projected position within the 'tail' of the constellation Scorpius, there are difficulties with such an association. The brief Chinese texts concerning the 393 AD guest star make no comment about its apparent brightness, stating only that it disappeared after eight months. However, at the remnant's current estimated 1-1.3 kpc distance and A{sub V} {approx_equal} 3, its supernova (SN) should have been amore » visually bright object at maximum light (-3.5 to -5.0 mag) if M{sub V} = - 17 to -18 and would have remained visible for over a year. The peak brightness {approx_equal}0 mag adopted by Wang et al. and others would require the RX J1713.7-3946 supernova to have been a very subluminous event similar to or fainter than SN 2005cs in M51. We also note problems connecting SN 393 with a European record in which the Roman poet Claudian describes a visually brilliant star in the heavens around 393 AD that could be readily seen even in midday. Although several authors have suggested this account may be a reference to the Chinese supernova of 393, Scorpius would not be visible near midday in March when the Chinese first reported the 393 guest star. We review both the Chinese and Roman accounts and calculate probable visual brightnesses for a range of SN subtypes and conclude that neither the Chinese nor the Roman descriptions are easily reconciled with an expected RX J1713.7-3946 supernova brightness and duration.« less

An improved methodology for investigating the parameters influencing migration resistance of abdominal aortic stent-grafts.

PubMed

Corbett, Timothy J; Callanan, Anthony; O'Donnell, Michael R; McGloughlin, Tim M

2010-02-01

To develop an improved methodology for investigating the parameters influencing stent-graft migration, with particular focus on the limitations of existing methods. A physiological silicone rubber abdominal aortic aneurysm (AAA) model for fixation studies was manufactured based on an idealized AAA geometry: the model had a 24-mm neck, a 50-mm aneurysm, 12-mm-diameter legs, a 60 degrees bifurcation angle, and 2-mm-thick walls. The models were authenticated in neck fixation experiments. The displacement force required to migrate stent-grafts in physiological pulsatile flow was tested dynamically in water at 37 degrees C. A commercially available longitudinally rigid stent-graft (AneuRx) and a homemade device with little longitudinal rigidity were studied in a number of different configurations to investigate the effect of neck fixation length and systolic pressure on displacement force. The AneuRx (6.95+/-0.49 to 8.52+/-0.5 N) performed significantly better than the homemade device (2.57+/-0.11 to 4.62+/-0.25 N) in pulsatile flow. The opposite was true in the neck fixation tests because the longitudinal stiffness of the AneuRx was not accounted for. Increasing pressure or decreasing fixation length compromised the fixation of the homemade device. This relationship was not as clear for the AneuRx because decreasing proximal fixation resulted in an increase in iliac fixation, which could assist fixation in this device. Assessing the migration resistance of stent-grafts based solely on proximal fixation discriminates against devices that are longitudinally stiff. Current in vivo models may give inaccurate displacement forces due to the high degree of oversizing in these studies. A novel in vitro approach, accounting for longitudinal rigidity and realistic graft oversizing, was developed to determine the resistance of aortic stent-grafts to migration in the period immediately after device implantation.

Alcohol-Induced Molecular Dysregulation in Human Embryonic Stem Cell-Derived Neural Precursor Cells

PubMed Central

Kim, Yi Young; Roubal, Ivan; Lee, Youn Soo; Kim, Jin Seok; Hoang, Michael; Mathiyakom, Nathan; Kim, Yong

2016-01-01

Adverse effect of alcohol on neural function has been well documented. Especially, the teratogenic effect of alcohol on neurodevelopment during embryogenesis has been demonstrated in various models, which could be a pathologic basis for fetal alcohol spectrum disorders (FASDs). While the developmental defects from alcohol abuse during gestation have been described, the specific mechanisms by which alcohol mediates these injuries have yet to be determined. Recent studies have shown that alcohol has significant effect on molecular and cellular regulatory mechanisms in embryonic stem cell (ESC) differentiation including genes involved in neural development. To test our hypothesis that alcohol induces molecular alterations during neural differentiation we have derived neural precursor cells from pluripotent human ESCs in the presence or absence of ethanol treatment. Genome-wide transcriptomic profiling identified molecular alterations induced by ethanol exposure during neural differentiation of hESCs into neural rosettes and neural precursor cell populations. The Database for Annotation, Visualization and Integrated Discovery (DAVID) functional analysis on significantly altered genes showed potential ethanol’s effect on JAK-STAT signaling pathway, neuroactive ligand-receptor interaction, Toll-like receptor (TLR) signaling pathway, cytokine-cytokine receptor interaction and regulation of autophagy. We have further quantitatively verified ethanol-induced alterations of selected candidate genes. Among verified genes we further examined the expression of P2RX3, which is associated with nociception, a peripheral pain response. We found ethanol significantly reduced the level of P2RX3 in undifferentiated hESCs, but induced the level of P2RX3 mRNA and protein in hESC-derived NPCs. Our result suggests ethanol-induced dysregulation of P2RX3 along with alterations in molecules involved in neural activity such as neuroactive ligand-receptor interaction may be a molecular event associated with alcohol-related peripheral neuropathy of an enhanced nociceptive response. PMID:27682028

ACE I/D and ACTN3 R/X polymorphisms as potential factors in modulating exercise-related phenotypes in older women in response to a muscle power training stimuli.

PubMed

Pereira, Ana; Costa, Aldo M; Izquierdo, Mikel; Silva, António J; Bastos, Estela; Marques, Mário C

2013-10-01

Genetic variation of the human ACE I/D and ACTN3 R577X polymorphisms subsequent to 12 weeks of high-speed power training on maximal strength (1RM) of the arm and leg muscles, muscle power performance (counter-movement jump), and functional capacity (sit-to-stand test) was examined in older Caucasian women [n = 139; mean age 65.5 (8.2) years; 67.0 (10.0) kg and 1.57 (0.06) m]. Chelex 100 was used for DNA extraction, and genotype was determined by PCR-RFLP methods. Muscular strength, power, and functional testing were conducted at baseline (T1) and after 12 weeks (T2) of high-speed power training. At baseline, the ACE I/D and ACTN3 R/X polymorphisms were not associated with muscle function or muscularity phenotypes in older Caucasian women. After the 12-week high-speed training program, subjects significantly increased their muscular and functional capacity performance (p < 0.05). For both polymorphisms, significant genotype-training interaction (p < 0.05) was found in all muscular performance indices, except for 1RM leg extension in the ACE I/D (p = 0.187). Analyses of the combined effects between genotypes showed significant differences in all parameters (p < 0.05) in response to high-speed power training between the power (ACTN3 RR + RX & ACE DD) versus "non-power" muscularity-oriented genotypes (ACTN3 XX & ACE II + ID)]. Our data suggest that the ACE and ACTN3 genotypes (single or combined) exert a significant influence in the muscle phenotypes of older Caucasian women in response to high-speed power training. Thus, the ACE I/D and ACTN3 R/X polymorphisms are likely factors in modulating exercise-related phenotypes in older women, particularly in response to a resistance training stimuli.

Spot Weight Adaptation for Moving Target in Spot Scanning Proton Therapy.

PubMed

Morel, Paul; Wu, Xiaodong; Blin, Guillaume; Vialette, Stéphane; Flynn, Ryan; Hyer, Daniel; Wang, Dongxu

2015-01-01

This study describes a real-time spot weight adaptation method in spot-scanning proton therapy for moving target or moving patient, so that the resultant dose distribution closely matches the planned dose distribution. The method proposed in this study adapts the weight (MU) of the delivering pencil beam to that of the target spot; it will actually hit during patient/target motion. The target spot that a certain delivering pencil beam may hit relies on patient monitoring and/or motion modeling using four-dimensional (4D) CT. After the adapted delivery, the required total weight [Monitor Unit (MU)] for this target spot is then subtracted from the planned value. With continuous patient motion and continuous spot scanning, the planned doses to all target spots will eventually be all fulfilled. In a proof-of-principle test, a lung case was presented with realistic temporal and motion parameters; the resultant dose distribution using spot weight adaptation was compared to that without using this method. The impact of the real-time patient/target position tracking or prediction was also investigated. For moderate motion (i.e., mean amplitude 0.5 cm), D95% to the planning target volume (PTV) was only 81.5% of the prescription (RX) dose; with spot weight adaptation PTV D95% achieves 97.7% RX. For large motion amplitude (i.e., 1.5 cm), without spot weight adaptation PTV D95% is only 42.9% of RX; with spot weight adaptation, PTV D95% achieves 97.7% RX. Larger errors in patient/target position tracking or prediction led to worse final target coverage; an error of 3 mm or smaller in patient/target position tracking is preferred. The proposed spot weight adaptation method was able to deliver the planned dose distribution and maintain target coverage when patient motion was involved. The successful implementation of this method would rely on accurate monitoring or prediction of patient/target motion.

Toward a normalized clinical drug knowledge base in China-applying the RxNorm model to Chinese clinical drugs.

PubMed

Wang, Li; Zhang, Yaoyun; Jiang, Min; Wang, Jingqi; Dong, Jiancheng; Liu, Yun; Tao, Cui; Jiang, Guoqian; Zhou, Yi; Xu, Hua

2018-07-01

In recent years, electronic health record systems have been widely implemented in China, making clinical data available electronically. However, little effort has been devoted to making drug information exchangeable among these systems. This study aimed to build a Normalized Chinese Clinical Drug (NCCD) knowledge base, by applying and extending the information model of RxNorm to Chinese clinical drugs. Chinese drugs were collected from 4 major resources-China Food and Drug Administration, China Health Insurance Systems, Hospital Pharmacy Systems, and China Pharmacopoeia-for integration and normalization in NCCD. Chemical drugs were normalized using the information model in RxNorm without much change. Chinese patent drugs (i.e., Chinese herbal extracts), however, were represented using an expanded RxNorm model to incorporate the unique characteristics of these drugs. A hybrid approach combining automated natural language processing technologies and manual review by domain experts was then applied to drug attribute extraction, normalization, and further generation of drug names at different specification levels. Lastly, we reported the statistics of NCCD, as well as the evaluation results using several sets of randomly selected Chinese drugs. The current version of NCCD contains 16 976 chemical drugs and 2663 Chinese patent medicines, resulting in 19 639 clinical drugs, 250 267 unique concepts, and 2 602 760 relations. By manual review of 1700 chemical drugs and 250 Chinese patent drugs randomly selected from NCCD (about 10%), we showed that the hybrid approach could achieve an accuracy of 98.60% for drug name extraction and normalization. Using a collection of 500 chemical drugs and 500 Chinese patent drugs from other resources, we showed that NCCD achieved coverages of 97.0% and 90.0% for chemical drugs and Chinese patent drugs, respectively. Evaluation results demonstrated the potential to improve interoperability across various electronic drug systems in China.

SU-F-P-61: Does It Matter Not to Use Optimization Points at the Apex for Vaginal Cylinder HDR Brachytherapy Planning?

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

Kim, Y

2016-06-15

Purpose: To test the impact of the use of apex optimization points for new vaginal cylinder (VC) applicators. Methods: New “ClickFit” single channel VC applicators (Varian) that have a different top thicknesses but the same diameters as the old VC applicators (2.3 cm diameter, 2.6 cm, 3.0 cm, and 3.5 cm) were compared using phantom studies. Old VC applicator plans without apex optimization points were also compared to the plans with the optimization points. The apex doses were monitored at 5 mm depth doses (8 points) where a prescription dose (Rx) of 6Gy was prescribed. VC surface doses (8 points)more » were also analyzed. Results: The new VC applicator plans without apex optimization points presented significantly lower 5mm depth doses than Rx (on average −31 ± 7%, p <0.00001) due to their thicker VC tops (3.4 ± 1.1 mm thicker with the range of 1.2 to 4.4 mm) than the old VC applicators. Old VC applicator plans also showed a statistically significant reduction (p <0.00001) due to Ir-192 source anisotropic effect at the apex region but the % reduction over Rx was only −7 ± 9%. However, by adding apex optimization points to the new VC applicator plans, the plans improved 5 mm depth doses (−7 ± 9% over Rx) that were not statistically different from old VC plans (p = 0.923), along with apex VC surface doses (−22 ± 10% over old VC versus −46 ± 7% without using apex optimization points). Conclusion: The use of apex optimization points are important in order to avoid significant additional cold doses (−24 ± 2%) at the prescription depth (5 mm) of apex, especially for the new VC applicators that have thicker tops.« less

Endometrial cancer in elderly women: Which disease, which surgical management? A systematic review of the literature.

PubMed

Bourgin, C; Saidani, M; Poupon, C; Cauchois, A; Foucher, F; Leveque, J; Lavoue, V

2016-02-01

Endometrial cancer primarily affects elderly women. The aim of the present literature review is to define the population of elderly women with this disease and to define the characteristics of this cancer in elderly people as well as its surgical treatment. A systematic review of the English-language literature of the last 20 years indexed in the PubMed database. Endometrial cancer is more aggressive in elderly women. However, surgical staging performed in elderly patients is often not concomitant with the disease's aggressiveness in this group. Mini-invasive surgery is performed less often, for no obvious reason. Of note, oncogeriatric evaluation was not usually ruled out to determine the most appropriate surgical modality. Studies are needed to evaluate surgical management of endometrial cancer in elderly women, notably with the aid of oncogeriatric scores to predict surgical morbidity. Copyright © 2015 Elsevier Ltd. All rights reserved.

Discriminability of personality profiles in isolated and Co-morbid marijuana and nicotine users.

PubMed

Ketcherside, Ariel; Jeon-Slaughter, Haekyung; Baine, Jessica L; Filbey, Francesca M

2016-04-30

Specific personality traits have been linked with substance use disorders (SUDs), genetic mechanisms, and brain systems. Thus, determining the specificity of personality traits to types of SUD can advance the field towards defining SUD endophenotypes as well as understanding the brain systems involved for the development of novel treatments. Disentangling these factors is particularly important in highly co morbid SUDs, such as marijuana and nicotine use, so treatment can occur effectively for both. This study evaluated personality traits that distinguish isolated and co-morbid use of marijuana and nicotine. To that end, we collected the NEO Five Factor Inventory in participants who used marijuana-only (n=59), nicotine-only (n=27), both marijuana and nicotine (n=28), and in non-using controls (n=28). We used factor analyses to identify personality profiles, which are linear combinations of the five NEO Factors. We then conducted Receiver Operating Characteristics (ROC) curve analysis to test accuracy of the personality factors in discriminating isolated and co-morbid marijuana and nicotine users from each other. ROC curve analysis distinguished the four groups based on their NEO personality patterns. Results showed that NEO Factor 2 (openness, extraversion, agreeableness) discriminated marijuana and marijuana+nicotine users from controls and nicotine-only users with high predictability. Additional ANOVA results showed that the openness dimension discriminated marijuana users from nicotine users. These findings suggest that personality dimensions distinguish marijuana users from nicotine users and should be considered in prevention strategies. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

The PER (Preoperative Esophagectomy Risk) Score: A Simple Risk Score to Predict Short-Term and Long-Term Outcome in Patients with Surgically Treated Esophageal Cancer.

PubMed

Reeh, Matthias; Metze, Johannes; Uzunoglu, Faik G; Nentwich, Michael; Ghadban, Tarik; Wellner, Ullrich; Bockhorn, Maximilian; Kluge, Stefan; Izbicki, Jakob R; Vashist, Yogesh K

2016-02-01

Esophageal resection in patients with esophageal cancer (EC) is still associated with high mortality and morbidity rates. We aimed to develop a simple preoperative risk score for the prediction of short-term and long-term outcomes for patients with EC treated by esophageal resection. In total, 498 patients suffering from esophageal carcinoma, who underwent esophageal resection, were included in this retrospective cohort study. Three preoperative esophagectomy risk (PER) groups were defined based on preoperative functional evaluation of different organ systems by validated tools (revised cardiac risk index, model for end-stage liver disease score, and pulmonary function test). Clinicopathological parameters, morbidity, and mortality as well as disease-free survival (DFS) and overall survival (OS) were correlated to the PER score. The PER score significantly predicted the short-term outcome of patients with EC who underwent esophageal resection. PER 2 and PER 3 patients had at least double the risk of morbidity and mortality compared to PER 1 patients. Furthermore, a higher PER score was associated with shorter DFS (P < 0.001) and OS (P < 0.001). The PER score was identified as an independent predictor of tumor recurrence (hazard ratio [HR] 2.1; P < 0.001) and OS (HR 2.2; P < 0.001). The PER score allows preoperative objective allocation of patients with EC into different risk categories for morbidity, mortality, and long-term outcomes. Thus, multicenter studies are needed for independent validation of the PER score.

Surgical management and perioperative morbidity of patients with primary borderline ovarian tumor (BOT).

PubMed

Trillsch, Fabian; Ruetzel, Jan David; Herwig, Uwe; Doerste, Ulrike; Woelber, Linn; Grimm, Donata; Choschzick, Matthias; Jaenicke, Fritz; Mahner, Sven

2013-07-09

Surgery is the cornerstone for clinical management of patients with borderline ovarian tumors (BOT). As these patients have an excellent overall prognosis, perioperative morbidity is the critical point for decision making when the treatment strategy is developed and the primary surgical approach is defined. Clinical and surgical parameters of patients undergoing surgery for primary BOT at our institutions between 1993 and 2008 were analyzed with regard to perioperative morbidity depending on the surgical approach (laparotomy vs. laparoscopy). A total of 105 patients were analyzed (44 with primary laparoscopy [42%], 61 with primary laparotomy [58%]). Complete surgical staging was achieved in 33 patients at primary surgical approach (31.4%) frequently leading to formal indication of re-staging procedures. Tumor rupture was significantly more frequent during laparoscopy compared to laparotomy (29.5% vs. 13.1%, p = 0.038) but no other intraoperative complications were seen in laparoscopic surgery in contrast to 7 of 61 laparotomies (0% vs. 11.5%, p = 0.020). Postoperative complication rates were similar in both groups (19.7% vs. 18.2%, p = 0.848). Irrespective of the surgical approach, surgical management of BOT has acceptable rates of perioperative complications and morbidity. Choice of initial surgical approach can therefore be made independent of complication-concerns. As the recently published large retrospective AGO ROBOT study observed similar oncologic outcome for both approaches, laparoscopy can be considered for staging of patients with BOT if this appears feasible. An algorithm for the surgical management of BOT patients has been developed.

Contracting for intensive care services.

PubMed

Dorman, S

1996-01-01

Purchasers will increasingly expect clinical services in the NHS internal market to provide objective measures of their benefits and cost effectiveness in order to maintain or develop current funding levels. There is limited scientific evidence to demonstrate the clinical effectiveness of intensive care services in terms of mortality/morbidity. Intensive care is a high-cost service and studies of cost-effectiveness need to take account of case-mix variations, differences in admission and discharge policies, and other differences between units. Decisions over development or rationalisation of intensive care services should be based on proper outcome studies of well defined patient groups. The purchasing function itself requires development in order to support effective contracting.

Nicotine dependence, use of illegal drugs and psychiatric morbidity.

PubMed

Martínez-Ortega, José María; Jurado, Dolores; Martínez-González, Miguel Angel; Gurpegui, Manuel

2006-09-01

The purpose of this study was to examine the association of smoking and nicotine dependence with psychiatric morbidity, controlling for the potential confounding effect of smoking on the relationship between the use of other substances and psychiatric morbidity. A sample of 290 adults were interviewed at a primary health centre (patients, 58%; patients' relatives, 34%; staff, 8%) to inquire about their tobacco, caffeine, alcohol, and illegal drug consumption. Psychiatric morbidity, defined by a score >6 on the General Health Questionnaire (GHQ-28), showed a strong direct association with nicotine dependence. The use of illegal drugs, but not of alcohol, was also strongly associated with psychiatric morbidity, after controlling for smoking. Both smoking and high nicotine dependence were also associated with use of caffeine, alcohol, cannabis and cocaine. High nicotine dependence may be considered as an expression of individual psychopathologic vulnerability. Tobacco may have a central facilitating role in the use of caffeine, alcohol, and illegal drug.

[Prevalence and potential predictors of morbidity among Hungarian female physicians].

PubMed

Gyorffy, Zsuzsa; Adám, Szilvia; Kopp, Mária

2009-07-01

We explored the general health status of physicians in Hungary using a nationwide sample. Based on international and Hungarian literature, we hypothesised that the prevalence of psychiatric and somatic morbidity is higher among female physicians in Hungary compared to the normative population. The objective of our cross-sectional research was to study the morbidity of Hungarian female physicians as well as to analyse background factors. Data for this national study were collected from 408 female physicians. 818 white collar workers from a representative survey (Hungarostudy 2002) served as controls. The prevalence of chronic somatic morbidity and reproduction disorders among female physicians was significantly higher than that in the control group. The female physicians have more chronic diseases, and the somatic morbidity have been appeared earlier. Correlation analyses confirmed a significant relationship: the chronic morbidity associated with injurious to health, sleep disorders and higher levels of work-family conflict. We found that the prevalence of chronic somatic morbidity among female physicians was significantly higher than that in the respective control groups. The higher prevalence of somatic and mental morbidity of Hungarian female physicians has important consequences. This may influence health care systems and thus might lead increased morbidity and mortality of Hungarian population.

Topological anomaly detection performance with multispectral polarimetric imagery

NASA Astrophysics Data System (ADS)

Gartley, M. G.; Basener, W.,

2009-05-01

Polarimetric imaging has demonstrated utility for increasing contrast of manmade targets above natural background clutter. Manual detection of manmade targets in multispectral polarimetric imagery can be challenging and a subjective process for large datasets. Analyst exploitation may be improved utilizing conventional anomaly detection algorithms such as RX. In this paper we examine the performance of a relatively new approach to anomaly detection, which leverages topology theory, applied to spectral polarimetric imagery. Detection results for manmade targets embedded in a complex natural background will be presented for both the RX and Topological Anomaly Detection (TAD) approaches. We will also present detailed results examining detection sensitivities relative to: (1) the number of spectral bands, (2) utilization of Stoke's images versus intensity images, and (3) airborne versus spaceborne measurements.

Validation of the grown-ups with congenital heart disease score.

PubMed

Hörer, Jürgen; Roussin, Régine; LeBret, Emanuel; Ly, Mohamed; Abdullah, Jarrah; Marzullo, Rafaella; Pabst von Ohain, Jelena; Belli, Emre

2018-06-01

Adults with congenital heart disease in need of heart surgery frequently present with significant comorbidity. Furthermore, additional technical difficulties often related to redo operations increase the risk for postoperative mortality and morbidity. Hence, next to the type of the procedure, additional procedure-dependent and procedure-independent factors have to be considered for risk evaluation. The recently proposed grown-ups with congenital heart disease (GUCH) mortality and morbidity scores account for these additional risk factors. We sought to validate their predictive power in a large population operated in a single centre. Data of all consecutive patients aged 18 years or more, who underwent surgery for congenital heart disease between 2005 and 2016, were collected. Mortality was defined as hospital mortality or mortality within 30 days following surgery. Morbidity was defined as occurrence of one or more of the following complications: renal failure requiring dialysis, neurologic deficit persisting at discharge, atrioventricular block requiring permanent pacemaker implantation, mechanical circulatory support, phrenic nerve injury and unplanned reoperation. The discriminatory power of the GUCH scores was assessed using the area under the receiver operating characteristics curve (c-index, including 95% CI). Eight hundred and twenty-four operations were evaluated. Additional procedure-dependent and procedure-independent factors, as defined in the GUCH scores, were present in 165 patients (20.0%) and 544 patients (66.0%), respectively. Hospital mortality and morbidity was 3.4% and 10.0%, respectively. C-index for GUCH mortality score was 0.809 (0.742-0.877). C-index for GUCH morbidity score was 0.676 (0.619-0.734). We could confirm the good predictive power of the GUCH mortality score for postoperative mortality in a large population of adults with congenital heart disease. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Morbidities and hospital resource use during the first 3 years of life among very preterm infants.

PubMed

Korvenranta, Emmi; Lehtonen, Liisa; Peltola, Mikko; Häkkinen, Unto; Andersson, Sture; Gissler, Mika; Hallman, Mikko; Leipälä, Jaana; Rautava, Liisi; Tammela, Outi; Linna, Miika

2009-07-01

The objective of this study was to determine how the use of hospital resources during the first 3 years of life was associated with prematurity-related morbidity in very preterm infants (gestational age of <32 weeks or birth weight of <1501 g). The study was a retrospective, national register study including all very preterm infants born alive in Finland between 2000 and 2003 (N = 2148). Infants who died before the age of 3 years (n = 264) or who had missing register data (n = 88) were excluded from the study. The relationship between 6 morbidity groups and the need for hospital care during the first 3 years of life was studied by using a negative binomial model. A total of 66.2% of the infants did not have any of the morbidities studied. Infants who were subsequently diagnosed as having cerebral palsy (6.1% of the study group), later obstructive airway disease (20.0%), hearing loss (2.5%), visual disturbances or blindness (3.8%), or other ophthalmologic problems (13.4%) had initial hospital stays that were a mean of 7, 8, 12, 17, and 3 days longer, respectively, than those for infants without these conditions. All morbidity groups were associated with increased numbers of hospital visits during either the second or third year of life, compared with infants without these morbidities. The need for hospitalizations and outpatient hospital care decreased with postnatal age for infants with later morbidities and for infants without later morbidities. Most very preterm infants born in Finland survived without severe morbidities and required relatively little hospital care after the initial discharge. However, those with later morbidities had a long initial length of stay and more readmissions and outpatient visits during the 3-year follow-up period.

Self-Harm Thoughts Postpartum as a Marker for Long-Term Morbidity.

PubMed

Iliadis, Stavros I; Skalkidou, Alkistis; Ranstrand, Hanna; Georgakis, Marios K; Axfors, Cathrine; Papadopoulos, Fotios C

2018-01-01

Postpartum depression predisposes to maternal affective and somatic disorders. It is important to identify which women are at an increased risk of subsequent morbidity and would benefit from an intensified follow-up. Self-harm thoughts (SHTs), with or without other depressive symptomatology, might have prognostic value for maternal health beyond the postpartum period. This study is to investigate the somatic and psychiatric morbidity of postpartum women with SHTs, with or without other depressive symptoms, over a 7-year follow-up period. The subjects for this study are derived from a population-based Swedish cohort of women who gave birth at Uppsala University Hospital (May 2006-June 2007) and who answered the Edinburgh Postnatal Depression Scale (EPDS) at 5 days, 6 weeks, and 6 months postpartum. Three groups were included: women reporting SHTs (SHT group, n  = 107) on item 10 of the EPDS; women reporting depressive symptoms, i.e., EPDS ≥ 12 at 6 weeks and/or 6 months postpartum, without SHTs (DEP group, n  = 94); and randomly selected controls screening negatively for postpartum depression (CTL group, n  = 104). The number of diagnostic codes for somatic and psychiatric morbidity according to the International Statistical Classification of Diseases and Related Health Problems system, and the number of medical interventions were retrieved from medical records over 7 years following childbirth and were used as the outcome measures, together with any prescription of antidepressants and sick leave during the follow-up. The SHT group had the highest psychiatric morbidity of all groups and more somatic morbidity than controls. Affective disorders were more common in the SHT and the DEP groups compared with controls, as well as antidepressant prescriptions and sick leave. One-fifth of women with SHTs did not screen positive for depressive symptoms; nevertheless, they had more somatic and psychiatric morbidity than the control group. Women reporting thoughts of self-harm in the postpartum period are at an increased risk of somatic and psychiatric morbidity during a follow-up of 7 years after delivery, and this increased risk may not be fully attributed to depressive symptoms. Results underline the importance of screening for self-harm symptoms postpartum and point to a need for individualized follow-up.

The role of disease management in the treatment and prevention of obesity with associated comorbidities.

PubMed

May, Jeanette; Buckman, Ellen

2007-06-01

Nearly two thirds of the US population is overweight or obese and those numbers are climbing. Many organizations are beginning to recognize overweight and obesity as severe health threats and to acknowledge that treatment can serve as an important first step in addressing this epidemic. Through its Obesity with Co-morbidities Initiative, the Disease Management Association of America (DMAA) seeks to raise awareness and improve understanding of the role disease management (DM) can play in the treatment and management of obesity with comorbidities. Among the objectives of the Obesity with Co-morbidities Initiative was to develop standard definitions of obesity and obesity with comorbidities and to conduct qualitative research among key DM stakeholders. The first project undertaken and completed by the Obesity with Associated Co-morbidities Steering Committee and work group was to define the term "obesity" for consistent usage within the DM community for the purposes of population-based interventions. As part of this initiative, DMAA partnered with Synovate, a global market research firm, to conduct focus groups and in-depth interviews in order to collect qualitative data on attitudes and practices related to obesity treatment and coverage among key industry stakeholders, including health plans, disease management organizations, employers, and the business community. The findings indicated that obesity was widely recognized as a serious issue, but there remained varying opinions regarding responsibility, health and productivity costs, coverage, and best treatment methods among the participants. DMAA will continue this initiative through 2007 and will continue to develop a knowledge base of obesity guidelines and management practices, create valuable tools and resources including an online resource center, and facilitate partnerships with other organizations involved in the management and prevention of obesity.

Defining Young in the Context of Prostate Cancer

PubMed Central

Lowe, Anthony; Hyde, Melissa K.; Zajdlewicz, Leah; Gardiner, Robert A.; Sandoe, David; Dunn, Jeff

2015-01-01

The experience of prostate cancer is for most men a major life stress with the psychological burden of this disease falling more heavily on those who are younger. Despite this, being young as it applies to prostate cancer is not yet clearly defined with varied chronological approaches applied. However, men’s responses to health crises are closely bound to life course and masculinities from which social roles emerge. This paper applied qualitative methodology (structured focus groups and semistructured interviews with expert informants) using interpretative phenomenological analysis to define what it means to be young and have prostate cancer. Structured focus groups were held with 26 consumer advisors (men diagnosed with prostate cancer who provide support to other men with prostate cancer or raise community awareness) and health professionals. As well, 15 men diagnosed with prostate cancer and in their 40s, 50s, or 60s participated in semi-structured interviews. Participants discussed the attributes that describe a young man with prostate cancer and the experience of being young and diagnosed with prostate cancer. Chronological definitions of a young man were absent or inconsistent. Masculine constructions of what it means to be a young man and life course characteristics appear more relevant to defining young as it applies to prostate cancer compared with chronological age. These findings have implications for better understanding the morbidities associated with this illness, and in designing interventions that are oriented to life course and helping young men reconstruct their identities after prostate cancer. PMID:24780936

Morbidity and Mortality Conferences: A Narrative Review of Strategies to Prioritize Quality Improvement.

PubMed

Giesbrecht, Vanessa; Au, Selena

2016-11-01

The morbidity and mortality conference (MMC) provides a valuable opportunity to review patient care processes and safety concerns, aligning with a growing quality improvement (QI) mandate. Yet the structure, processes, and aims of many MMCs are often ill-defined. This review summarizes strategies employed by medical, surgical, and critical care departments in the development of patient safety-centered MMCs. A structured narrative review of literature was conducted using combinations of the search terms "morbidity and mortality conference(s)," "morbidity and mortality meetings," or "morbidity and mortality round(s)." The titles and abstracts of 250 returned articles were screened; 76 articles were reviewed in full, with 32 meeting the full inclusion criteria. The literature review elicited a number of methods used by medical, surgical, and critical care MMCs to emphasize QI and patient safety outcomes. A list of actionable changes made in each article was compiled. Five themes common to QI-centered MMCs were identified: (1) defining the role of the MMC, (2) involving stakeholders, (3) detecting and selecting appropriate cases for presentation, (4) structuring goal-directed discussion, and (5) forming recommendations and assigning follow-up. Innovative methods to pair adverse event screening with MMCs were superior to nonstructured voluntary reporting and case selection for overall morbidity detection. Structured case review, discussion, and follow-up were more likely to lead to implementing systems-based change, and interdisciplinary MMCs were associated with a greater likelihood of forming an action item. The modern patient safety-centered MMC shares common themes of practices that can be adopted by institutions looking to create a venue for analysis of care processes, a platform to launch QI initiatives, and a culture of safety. Copyright 2016 The Joint Commission.

The impact of operative time on complications after plastic surgery: a multivariate regression analysis of 1753 cases.

PubMed

Hardy, Krista L; Davis, Kathryn E; Constantine, Ryan S; Chen, Mo; Hein, Rachel; Jewell, James L; Dirisala, Karunakar; Lysikowski, Jerzy; Reed, Gary; Kenkel, Jeffrey M

2014-05-01

Little evidence within plastic surgery literature supports the precept that longer operative times lead to greater morbidity. The authors investigate surgery duration as a determinant of morbidity, with the goal of defining a clinically relevant time for increased risk. A retrospective chart review was conducted of patients who underwent a broad range of complex plastic surgical procedures (n = 1801 procedures) at UT Southwestern Medical Center in Dallas, Texas, from January 1, 2008 to January 31, 2012. Adjusting for possible confounders, multivariate logistic regression assessed surgery duration as an independent predictor of morbidity. To define a cutoff for increased risk, incidence of complications was compared among quintiles of surgery duration. Stratification by type of surgery controlled for procedural complexity. A total of 1753 cases were included in multivariate analyses with an overall complication rate of 27.8%. Most operations were combined (75.8%), averaging 4.9 concurrent procedures. Each hour increase in surgery duration was associated with a 21% rise in odds of morbidity (P < .0001). Compared with the first quintile of operative time (<2.0 hours), there was no change in complications until after 3.1 hours of surgery (odds ratio, 1.6; P = .017), with progressively greater odds increases of 3.1 times after 4.5 hours (P < .0001) and 4.7 times after 6.8 hours (P < .0001). When stratified by type of surgery, longer operations continued to be associated with greater morbidity. Surgery duration is an independent predictor of complications, with a significantly increased risk above 3 hours. Although procedural complexity undoubtedly affects morbidity, operative time should factor into surgical decision making.

Severe morbidity after antiretroviral (ART) initiation: active surveillance in HIV care programs, the IeDEA West Africa collaboration.

PubMed

Abo, Yao; Zannou Djimon, Marcel; Messou, Eugène; Balestre, Eric; Kouakou, Martial; Akakpo, Jocelyn; Ahouada, Carin; de Rekeneire, Nathalie; Dabis, François; Lewden, Charlotte; Minga, Albert

2015-04-09

The causes of severe morbidity in health facilities implementing Antiretroviral Treatment (ART) programmes are poorly documented in sub-Saharan Africa. We aimed to describe severe morbidity among HIV-infected patients after ART initiation, based on data from an active surveillance system established within a network of specialized care facilities in West African cities. Within the International epidemiological Database to Evaluate AIDS (IeDEA)--West Africa collaboration, we conducted a prospective, multicenter data collection that involved two facilities in Abidjan, Côte d'Ivoire and one in Cotonou, Benin. Among HIV-infected adults receiving ART, events were recorded using a standardized form. A simple case-definition of severe morbidity (death, hospitalization, fever>38°5C, Karnofsky index<70%) was used at any patient contact point. Then a physician confirmed and classified the event as WHO stage 3 or 4 according to the WHO clinical classification or as degree 3 or 4 of the ANRS scale. From December 2009 to December 2011, 978 adults (71% women, median age 39 years) presented with 1449 severe events. The main diagnoses were: non-AIDS-defining infections (33%), AIDS-defining illnesses (33%), suspected adverse drug reactions (7%), other illnesses (4%) and syndromic diagnoses (16%). The most common specific diagnoses were: malaria (25%), pneumonia (13%) and tuberculosis (8%). The diagnoses were reported as syndromic in one out of five events recorded during this study. This study highlights the ongoing importance of conventional infectious diseases among severe morbid events occurring in patients on ART in ambulatory HIV care facilities in West Africa. Meanwhile, additional studies are needed due to the undiagnosed aspect of severe morbidity in substantial proportion.

A Study of Morbidity Pattern in Street Sweepers: A Cross-sectional Study.

PubMed

Sabde, Yogesh D; Zodpey, Sanjay P

2008-10-01

Street sweepers play an important role in maintaining the health and hygiene within the cities. This job exposes the street sweepers to a variety of risk factors such as dust, toxins and diesel exhaust pollution, which make them vulnerable to develop certain occupational diseases. Therefore, it was thought necessary to study the morbidity profile in this occupational group. To study the prevalence of morbidities among street sweepers and comparison group. A cross-sectional study with a comparison group. Nagpur Municipal Corporation, Nagpur. THE STUDY INCLUDED TWO GROUPS: (1) A study group comprising 273 street sweepers. (2) A comparison group comprising 142 class IV workers working in the office buildings of Nagpur Municipal Corporation, Nagpur. A pretested proforma was used to record the necessary information such as clinical history, sociodemographic factors, findings of clinical examination and investigations performed. THE IMPORTANT MORBIDITIES DETECTED AMONG STREET SWEEPERS WERE THE FOLLOWING: anemia (20.5%), hypertension (9.5%), upper respiratory tract infections (URTI) (7.3%) and chronic bronchitis (5.9%). In the comparison group, important morbidities detected were the following: anemia (20.4%), hypertension (11.3%), hyperacidity (9.9%), URTI (7.0%) and refractive error (7.0%). Chronic bronchitis was detected in two subjects (1.4%) of the comparison group. The prevalence of chronic bronchitis was significantly high among street sweepers than that of subjects of the comparison group. Therefore, it is recommended that further studies with a larger sample size be undertaken to identify the factors responsible for higher prevalence of chronic bronchitis among the street sweepers.

Protocol for diaphragm pacing in patients with respiratory muscle weakness due to motor neurone disease (DiPALS): a randomised controlled trial

PubMed Central

2012-01-01

Background Motor neurone disease (MND) is a devastating illness which leads to muscle weakness and death, usually within 2-3 years of symptom onset. Respiratory insufficiency is a common cause of morbidity, particularly in later stages of MND and respiratory complications are the leading cause of mortality in MND patients. Non Invasive Ventilation (NIV) is the current standard therapy to manage respiratory insufficiency. Some MND patients however do not tolerate NIV due to a number of issues including mask interface problems and claustrophobia. In those that do tolerate NIV, eventually respiratory muscle weakness will progress to a point at which intermittent/overnight NIV is ineffective. The NeuRx RA/4 Diaphragm Pacing System was originally developed for patients with respiratory insufficiency and diaphragm paralysis secondary to stable high spinal cord injuries. The DiPALS study will assess the effect of diaphragm pacing (DP) when used to treat patients with MND and respiratory insufficiency. Method/Design 108 patients will be recruited to the study at 5 sites in the UK. Patients will be randomised to either receive NIV (current standard care) or receive DP in addition to NIV. Study participants will be required to complete outcome measures at 5 follow up time points (2, 3, 6, 9 and 12 months) plus an additional surgery and 1 week post operative visit for those in the DP group. 12 patients (and their carers) from the DP group will also be asked to complete 2 qualitative interviews. Discussion The primary objective of this trial will be to evaluate the effect of Diaphragm Pacing (DP) on survival over the study duration in patients with MND with respiratory muscle weakness. The project is funded by the National Institute for Health Research, Health Technology Assessment (HTA) Programme (project number 09/55/33) and the Motor Neurone Disease Association and the Henry Smith Charity. Trial Registration: Current controlled trials ISRCTN53817913. The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the HTA programme, NIHR, NHS or the Department of Health. PMID:22897892

The modified Misgav-Ladach versus the Pfannenstiel-Kerr technique for cesarean section: a randomized trial.

PubMed

Xavier, Pedro; Ayres-De-Campos, Diogo; Reynolds, Ana; Guimarães, Mariana; Costa-Santos, Cristina; Patrício, Belmiro

2005-09-01

Modifications to the classic cesarean section technique described by Pfannenstiel and Kerr have been proposed in the last few years. The objective of this trial was to compare intraoperative and short-term postoperative outcomes between the Pfannenstiel-Kerr and the modified Misgav-Ladach (MML) techniques for cesarean section. This prospective randomized trial involved 162 patients undergoing transverse lower uterine segment cesarean section. Patients were allocated to one of the two arms: 88 to the MML technique and 74 to the Pfannenstiel-Kerr technique. Main outcome measures were defined as the duration of surgery, analgesic requirements, and bowel restitution by the second postoperative day. Additional outcomes evaluated were febrile morbidity, postoperative antibiotic use, postpartum endometritis, and wound complications. Student's t, Mann-Whitney, and Chi-square tests were used for statistical analysis of the results, and a p < 0.05 was considered as the probability level reflecting significant differences. No differences between groups were noted in the incidence of analgesic requirements, bowel restitution by the second postoperative day, febrile morbidity, antibiotic requirements, endometritis, or wound complications. The MML technique took on average 12 min less to complete (p = 0.001). The MML technique is faster to perform and similar in terms of febrile morbidity, time to bowel restitution, or need for postoperative medications. It is likely to be more cost-effective.

Morbidity and Mortality in Small for Gestational Age Infants at 22 to 29 Weeks' Gestation.

PubMed

Boghossian, Nansi S; Geraci, Marco; Edwards, Erika M; Horbar, Jeffrey D

2018-02-01

To identify the relative risks of mortality and morbidities for small for gestational age (SGA) infants in comparison with non-SGA infants born at 22 to 29 weeks' gestation. Data were collected (2006-2014) on 156 587 infants from 852 US centers participating in the Vermont Oxford Network. We defined SGA as sex-specific birth weight <10th centile for gestational age (GA) in days. Binomial generalized additive models with a thin plate spline term on GA by SGA were used to calculate the adjusted relative risks and 95% confidence intervals for outcomes by GA. Compared with non-SGA infants, the risk of patent ductus arteriosus decreased for SGA infants in early GA and then increased in later GA. SGA infants were also at increased risks of mortality, respiratory distress syndrome, necrotizing enterocolitis, late-onset sepsis, severe retinopathy of prematurity, and chronic lung disease. These risks of adverse outcomes, however, were not homogeneous across the GA range. Early-onset sepsis was not different between the 2 groups for the majority of GAs, although severe intraventricular hemorrhage was decreased among SGA infants for only gestational week 24 through week 25. SGA was associated with additional risks to mortality and morbidities, but the risks differed across the GA range. Copyright © 2018 by the American Academy of Pediatrics.

Severe delayed cutaneous and systemic reactions to drugs: a global perspective on the science and art of current practice

PubMed Central

Peter, Jonathan Grant; Lehloenya, Rannakoe; Dlamini, Sipho; Risma, Kimberly; White, Katie D.; Konvinse, Katherine C.; Phillips, Elizabeth J.

2017-01-01

The majority of immune-mediated adverse drug reactions (IM-ADRs) involve the skin, and many have additional systemic features. Severe cutaneous adverse drug reactions (SCAR) are an uncommon, potentially life-threatening and challenging sub-group of IM-ADRs with diverse clinical phenotypes, mechanisms and offending drugs. T-cell mediated immunopathology is central to these severe delayed reactions, but effector cells and cytokines differ by clinical phenotype. Strong HLA-gene associations have been elucidated for specific drug-SCAR IM-ADRs such as Stevens-Johnson Syndrome/toxic epidermal necrolysis (SJS/TEN); although the mechanisms by which carriage of a specific HLA allele is necessary but not sufficient for the development of many IM-ADRs is still being defined. SCAR management is complicated by substantial short and long-term morbidity/ mortality and the potential need to treat ongoing co-morbid disease with related medications. Multidisciplinary specialist teams at experienced units should care for patients. In the setting of SCAR, patient outcomes as well as preventive,diagnostic, treatment and management approaches are often not generalizable, but rather context specific, driven by population HLA-genetics, the pharmacology and genetic risk factors of the implicated drug, severity of underlying co-morbid disease necessitating ongoing treatments, and cost considerations. In this review, we update the basic and clinical science of SCAR diagnosis and management. PMID:28483310

PSYCHIATRIC MORBIDITY AND PERSONALITY PROFILE IN DIVORCE SEEKING COUPLES

PubMed Central

Batra, Lalit; Gautam, Shiv

1995-01-01

To what extent psychiatric morbidity and personality factors contribute to marital disharmony and decision to divorce is still an unanswered question in Indian setting. This study was undertaken with aims to find out (1) the prevalence of psychiatric morbidity in persons seeking divorce; (2) the prevalence of psychiatric morbidity in persons who had good marital adjustment; (3) the nature of psychiatric morbidity observed in these subjects, and (4) the personality profile of these subjects. Fifty randomly selected divorce seeking couples (n=100) from the matrimonial court of Jaipur City and thirty couples with good marital adjustment (n=60) selected from the community were studied. Probable psychiatric cases identified by administering GHQ (Hindi version) were diagnosed according to ICD-10 and personality profile of all cases was studied by using 16 PF. High psychiatric morbidity (50%) was found among divorce seeking couples in comparison to control group (13%). There was a high prevalence of neurone disorders (22%) and mood disorders (16%) in experimental group. Schizophrenia and related disorders (10%) and substance abuse disorder (2%) were seen only in the experimental group. Specific personality factors related to divorce seeking individuals and persons with stable marriage have been identified. The implications of this study are highlighted. PMID:21743746

Prevalence and clinical characteristics of obsessive-compulsive disorder and obsessive compulsive symptoms in Afrikaner schizophrenia and schizoaffective disorder patients.

PubMed

Seedat, F; Roos, J L; Pretorius, H W; Karayiorgou, M; Nel, B

2007-11-01

There is evidence of variation in the prevalence of co-morbid obsessive-compulsive disorder in schizophrenia amongst ethnic groups. This study evaluated the lifetime prevalence and clinical characteristics of obsessive-compulsive disorder (OCD)/ obsessive-compulsive symptoms (OCS) in Afrikaner schizophrenic and schizoaffective disorder patients. An ongoing genetic study of schizophrenia is currently being conducted on the Afrikaner founder population. In this cohort of 400 subjects from the original genetic study, we identified 53 subjects with schizophrenia or schizoaffective disorder and co-morbid OCD/OCS (study group). They were matched for gender and age of onset of illness with 59 subjects who do not have OCD/OCS (control group). The diagnostic instrument used in this cohort is the Diagnostic Interview for Genetic Studies (DIGS) version 2, which has been translated into Afrikaans. In addition to the DIGS, information for the relevant clinical characteristics reported in this study was also drawn from a detailed narrative chronological summary report and clinical files. A checklist was completed. The prevalence of co-morbid OCD/OCS amongst 400 subjects with schizophrenia or schizoaffective disorder was 13.2% [n=53] of which 40 were male and 13 female patients. The prevalence of OCD was 10.7% and OCS was 2.5%. Contamination obsessions [n=17] were the most common type of obsession reported, followed by religious obsessions [n=8]. The most prevalent compulsions were repetitive rituals [n=32] followed by checking behaviour [n=22]. Onset of psychotic symptoms was found to be insidious in 86.8% of the study group compared to 24.6% of the control group (p<0.0001). Second-generation antipsychotic use was found to be statistically more prevalent in the study group (77.4%), compared to the control group (45.8%) (p=0.0008). 73% of the study group experienced depressive symptoms compared to 50.8% of the control group. Both groups were found to have a similar incidence of suicidal thoughts and suicide attempts. Substance abuse amongst the control group was significantly higher (35.9%) compared to the study group (19.2%) (p <0.05). Cannabis was most commonly abused in both groups, followed by alcohol. The prevalence rate of 13.2% of co-morbid OCD/OCS in Afrikaner schizophrenia and schizoaffective disorder patients differs from findings in other ethnic groups, suggesting the possible role of genetic and cultural factors in the prevalence of co-morbid OCD/OCS. Second-generation antipsychotic use amongst schizophrenia and schizoaffective disorder patients with co-morbid OCD/OCS was found to be significantly higher than in those without co-morbid OCD/OCS. Clinical characteristics of Afrikaner schizophrenics and schizoaffective disorder patients with and without co-morbid OCD/OCS are the same, both groups were associated with significant psychopathology and a poor prognosis.

A randomized trial of a community-based approach to dyslipidemia management: Pharmacist prescribing to achieve cholesterol targets (RxACT Study).

PubMed

Tsuyuki, Ross T; Rosenthal, Meagen; Pearson, Glen J

2016-09-01

Dyslipidemia is an important risk factor for cardiovascular disease but is suboptimally managed. Pharmacists are accessible primary care professionals and with expanded scopes of practice (including prescribing), could identify and manage patients with dyslipidemia. We sought to evaluate the effect of pharmacist prescribing of dyslipidemia medications on the proportion of participants achieving target LDL-cholesterol (LDL-c) levels. We conducted a randomized controlled trial in 14 community pharmacies in Alberta, Canada. We enrolled adults with uncontrolled dyslipidemia as defined by the 2009 Canadian Dyslipidemia Guidelines. Intervention was pharmacist-directed dyslipidemia care, including assessment of cardiovascular risk, review of LDL-c, prescribing of medications, health behaviour interventions and follow-up every 6 weeks for 6 months. Usual care patients received their lipid results and a pamphlet on cardiovascular disease and usual care from their physician and pharmacist. Primary outcome was the proportion of participants achieving their target LDL-c (<2 mmol/L or ≥50% reduction) at 6 months between groups. We enrolled 99 patients with a mean (SD) age of 63 (13) years, 49% male and baseline LDL-c of 3.37 mmol/L (0.98). Proportion of patients achieving LDL-c target was 43% intervention versus 18% control ( p = 0.007). Adjusted odds of achieving target LDL-c were 3.3 times higher for the intervention group ( p = 0.031), who also achieved greater reduction in LDL-c (1.12 mmol/L, SE = 0.112) versus control (0.42 mmol/L, SE = 0.109), for an adjusted mean difference of 0.546 mmol/L (SE = 0.157), p < 0.001. Pharmacist prescribing resulted in >3-fold more patients achieving target LDL-c levels. This could have major public health implications.

The RxLR effector Avh241 from Phytophthora sojae requires plasma membrane localization to induce plant cell death.

PubMed

Yu, Xiaoli; Tang, Junli; Wang, Qunqing; Ye, Wenwu; Tao, Kai; Duan, Shuyi; Lu, Chenchen; Yang, Xinyu; Dong, Suomeng; Zheng, Xiaobo; Wang, Yuanchao

2012-10-01

• The Phytophthora sojae genome encodes hundreds of RxLR effectors predicted to manipulate various plant defense responses, but the molecular mechanisms involved are largely unknown. Here we have characterized in detail the P. sojae RxLR effector Avh241. • To determine the function and localization of Avh241, we transiently expressed it on different plants. Silencing of Avh241 in P. sojae, we determined its virulence during infection. Through the assay of promoting infection by Phytophthora capsici to Nicotiana benthamiana, we further confirmed this virulence role. • Avh241 induced cell death in several different plants and localized to the plant plasma membrane. An N-terminal motif within Avh241 was important for membrane localization and cell death-inducing activity. Two mitogen-activated protein kinases, NbMEK2 and NbWIPK, were required for the cell death triggered by Avh241 in N. benthamiana. Avh241 was important for the pathogen's full virulence on soybean. Avh241 could also promote infection by P. capsici and the membrane localization motif was not required to promote infection. • This work suggests that Avh241 interacts with the plant immune system via at least two different mechanisms, one recognized by plants dependent on subcellular localization and one promoting infection independent on membrane localization. © 2012 The Authors. New Phytologist © 2012 New Phytologist Trust.

Disconnection of Cobe SMARxT tubing from the venous outlet of the Terumo Capiox SX25RX oxygenator during cardiopulmonary bypass.

PubMed

Ottens, Jane; Baker, Robert A; Sanderson, Andrew J; Newland, Richard F

2010-06-01

The use of surface modified, biocompatible tubing in cardiopulmonary bypass has been reported to decrease the inflammatory responses caused by blood contact with the non endothelial surface of poly vinyl chloride (PVC) tubing. The combination of advances in biocompatible tubing and increased affordability resulted in a change to our cardiopulmonary bypass circuit, with the Terumo Capiox SX25 oxygenator and Cobe PVC tubing being replaced with a Terumo Capiox SX25RX (with X coating) and Cobe SMARxT tubing. Prior to the introduction of the coated oxygenator, no connection problems had been evident. One unrelated disconnection involving coated tubing was reported in June 2005 to the Australian and New Zealand College of Perfusionists Perfusion Incident Reporting System. At this time we revised all of our set up protocols and the recommended actions from manufacturers. We further report three separate incidents of pump boot disconnection from the venous reservoir outlet of the oxygenator during bypass (that occurred within a 13-month period), and an outline of immediate and prospective evaluation of the probable cause. We propose that SMARxT 3/8" x 3/32" tubing should not be used on the venous outlet connector of Terumo Capiox SX25RX oxygenators. It appears as though the design of the outlet combined with the properties of SMARxT tubing may contribute to the disconnection.

Understanding the Reactive Adsorption of H 2S and CO 2 in Sodium-Exchanged Zeolites

DOE PAGES

Fetisov, Evgenii O.; Shah, Mansi S; Knight, Christopher; ...

2018-02-19

Purifying sour natural gas streams containing hydrogen sulfide and carbon dioxide has been a long-standing environmental and economic challenge. In the presence of cation-exchanged zeolites, these two acid gases can react to form carbonyl sulfide and water (H 2S+CO 2H 2O+COS), but this reaction is rarely accounted for. In this work, we carry out reactive first-principles Monte Carlo (RxFPMC) simulations for mixtures of H 2S and CO 2 in all-silica and Na-exchanged forms of zeolite beta to understand the governing principles driving the enhanced conversion. The RxFPMC simulations show that the presence of Na + cations can change the equilibriummore » constant by several orders of magnitude compared to the gas phase or in all-silica beta. The shift in the reaction equilibrium is caused by very strong interactions of H 2O with Na + that reduce the reaction enthalpy by about 20 kJmol -1. The simulations also demonstrate that the siting of Al atoms in the framework plays an important role. Lastly, the RxFPMC method presented here is applicable to any chemical conversion in any confined environment, where strong interactions of guest molecules with the host framework and high activation energies limit the use of other computational approaches to study reaction equilibria.« less

Prospects for Cherenkov Telescope Array Observations of the Young Supernova Remnant RX J1713.7−3946

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

Acero, F.; Aloisio, R.; Amato, E.

We perform simulations for future Cherenkov Telescope Array (CTA) observations of RX J1713.7−3946, a young supernova remnant (SNR) and one of the brightest sources ever discovered in very high energy (VHE) gamma rays. Special attention is paid to exploring possible spatial (anti)correlations of gamma rays with emission at other wavelengths, in particular X-rays and CO/H i emission. We present a series of simulated images of RX J1713.7−3946 for CTA based on a set of observationally motivated models for the gamma-ray emission. In these models, VHE gamma rays produced by high-energy electrons are assumed to trace the nonthermal X-ray emission observedmore » by XMM-Newton , whereas those originating from relativistic protons delineate the local gas distributions. The local atomic and molecular gas distributions are deduced by the NANTEN team from CO and H i observations. Our primary goal is to show how one can distinguish the emission mechanism(s) of the gamma rays (i.e., hadronic versus leptonic, or a mixture of the two) through information provided by their spatial distribution, spectra, and time variation. This work is the first attempt to quantitatively evaluate the capabilities of CTA to achieve various proposed scientific goals by observing this important cosmic particle accelerator.« less

Prospects for Cherenkov Telescope Array Observations of the Young Supernova Remnant RX J1713.7–3946

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

Acero, F.; Aloisio, R.; Amans, J.

Here, we perform simulations for future Cherenkov Telescope Array (CTA) observations of RX J1713.7–3946, a young supernova remnant (SNR) and one of the brightest sources ever discovered in very high energy (VHE) gamma rays. Special attention is paid to exploring possible spatial (anti)correlations of gamma rays with emission at other wavelengths, in particular X-rays and CO/H i emission. We present a series of simulated images of RX J1713.7–3946 for CTA based on a set of observationally motivated models for the gamma-ray emission. In these models, VHE gamma rays produced by high-energy electrons are assumed to trace the nonthermal X-ray emissionmore » observed by XMM-Newton, whereas those originating from relativistic protons delineate the local gas distributions. The local atomic and molecular gas distributions are deduced by the NANTEN team from CO and H i observations. Our primary goal is to show how one can distinguish the emission mechanism(s) of the gamma rays (i.e., hadronic versus leptonic, or a mixture of the two) through information provided by their spatial distribution, spectra, and time variation. This work is the first attempt to quantitatively evaluate the capabilities of CTA to achieve various proposed scientific goals by observing this important cosmic particle accelerator.« less

ACTN3 R577X polymorphism and performance phenotypes in young Chinese male soldiers.

PubMed

Shang, Xuya; Zhang, Fu; Zhang, Li; Huang, Changlin

2012-01-01

Alpha-actinin-3 (ACTN3) is absent in 18% of healthy Caucasian individuals owing to homozygosity for a premature stop codon (X) at amino acid 577 (rs1815739). Previous studies have shown a strong association between ACTN3 genotype and human athletic performance. In a study of 452 young Chinese male soldiers, we examined the distribution of ACTN3 genotypes and alleles and analysed the association between ACTN3 genotypes and athletic performance. We found that the frequencies of the ACTN3 R577X genotype (RR 39.8%, RX 43.4%, and XX 16.8%) and R577X allele (R 61.5%, X 38.5%) in young Chinese males were not significantly different from those in Caucasians. We only observed a significant association (P = 0.025) between ACTN3 R577X genotypes and grip strength. Participants with the XX genotype displayed significantly lower handgrip strength than individuals with the RR genotype (P = 0.021), but the difference between XX and RX means (P = 0.258) and that between RR and RX means (P = 0.42) was not significant. We did not observe a strong association between the ACTN3 R577X genotypes and sprint phenotypes or endurance phenotypes. In conclusion, our results indicate that the ACTN3 R577X polymorphism is most strongly associated with grip strength in young Chinese male soldiers.

Personal digital assistant-based drug information sources: potential to improve medication safety.

PubMed

Galt, Kimberly A; Rule, Ann M; Houghton, Bruce; Young, Daniel O; Remington, Gina

2005-04-01

This study compared the potential for personal digital assistant (PDA)-based drug information sources to minimize potential medication errors dependent on accurate and complete drug information at the point of care. A quality and safety framework for drug information resources was developed to evaluate 11 PDA-based drug information sources. Three drug information sources met the criteria of the framework: Eprocrates Rx Pro, Lexi-Drugs, and mobileMICROMEDEX. Medication error types related to drug information at the point of care were then determined. Forty-seven questions were developed to test the potential of the sources to prevent these error types. Pharmacists and physician experts from Creighton University created these questions based on the most common types of questions asked by primary care providers. Three physicians evaluated the drug information sources, rating the source for each question: 1=no information available, 2=some information available, or 3 = adequate amount of information available. The mean ratings for the drug information sources were: 2.0 (Eprocrates Rx Pro), 2.5 (Lexi-Drugs), and 2.03 (mobileMICROMEDEX). Lexi-Drugs was significantly better (mobileMICROMEDEX t test; P=0.05; Eprocrates Rx Pro t test; P=0.01). Lexi-Drugs was found to be the most specific and complete PDA resource available to optimize medication safety by reducing potential errors associated with drug information. No resource was sufficient to address the patient safety information needs for all cases.