The utility of caesarean myomectomy as a safe procedure: a retrospective analysis of 21 cases with review of literature.

PubMed

Kumar R, Ramesh; Patil, Manjula; Sa, Shruthi

2014-09-01

Myomectomy at the time of caesarean delivery has been discouraged because of the risk of intractable haemorrhage and increased postoperative morbidity. The aim of this study is to determine the safety and feasibility of caesarean myomectomy. A retrospective case control study done between June 2012 to May 2013 in a tertiary care teaching hospital in Karnataka, India which included 21 pregnant women with uterine fibroids who underwent myomectomy during caesarean section and were compared with 42 matched controls without uterine fibroids who had caesarean section alone during the same period. Primary outcome measures studied were incidence of haemorrhage and need for blood transfusion. Secondary outcome measures were duration of operation, length of hospital stay, postpartum fever and wound infection. Statistical analysis is done using IBMSPSS 20.0 software and students t-test. For calculation of incidence of haemorrhage Fisher's exact test is used. Mean age of the 21 cases was 31.81yrs and 47.62% were primigravida. Total 37 fibroids were removed. Subserosal were 30 cases(81.08%) while 1(2.07%) was submucous. 21(56.76%)fibroids were situated in fundal region and 3(8.11%) were in lower segment. Mean change in the haemoglobin from preoperative to postoperative period in the cases was 1.3gm/dl(±1.155mg/dl) and control was 1.05% (±.854mg/dl). Two of the cases(9.52%) required blood transfusion compared to none in control. None in either group required hysterectomy. Mean duration of surgery was 68.57min (±15.012min)and 51.55min (±9.595min) for controls which is statistically significant. This study shows that myomectomy during caesarean section is a safe procedure and is not associated with major intraoperative and postoperative complications.

[Clinical evaluation of propess for induction of term pregnancy].

PubMed

Gai, Ming-ying; Zhang, Jian-ping; Li, Yang; Han, Hong-jing; Yang, Jian-qiu; Wang, Shan-mi; Su, Qi-feng; Wu, Lian-fang

2003-04-01

To explore the efficacy and safety of continuously released prostaglandin E(2) (PGE(2)) suppository-propess used for induction of term pregnancy. A multicenter, prospective, case control clinical study was carried out, propess was used in 100 cases as study group, the suppository without PGE(2) was used in 49 cases as control group. The cervical maturity (by Bishop scoring), the time to labor starting, membrane rupture and delivery, the application of oxytocin, ceserean section rate, fetal and neonatal condition were compared between 2 groups after inserting of the suppository. At the same time, side effects caused by propess were investigated. Bishop score was increased >or= 2 points in 93% cases, >or= 3 points in 87% cases in study group, whereas only 4% cases whose Bishop score increased >or= 2 points in control group. The time to labor starting, membrane rupture, and delivery was shortened obviously in study group than that in control group after inserting suppository. The application of oxytocin was much less in study group, cesarean section rate was reduced in study group (32% vs 61%). There was no significant difference between 2 groups in fetal and neonatal conditions. The overstimulation of uterine contraction and mild gastrointestinal tract reaction occurred in 3 cases and 2 cases respectively in study groups. Propess can be used for induction of term pregnancy effectively and safely.

Dietary habits after myocardial infarction - results from a cross-sectional study.

PubMed

Wallström, P; Mattisson, I; Tydén, P; Berglund, G; Janzon, L

2005-04-01

Comparing habitual nutrient intakes in persons with a history of acute myocardial infarction (AMI), and age-matched controls. Design. Cross-sectional study. Subjects. Men and women (525 cases and 1890 matched controls), aged 47-73 years, of the population-based Malmö Diet and Cancer cohort. Nutrient intakes were assessed by a validated modified diet history method. Body fatness was assessed by bioimpedance analysis. Case ascertainment was provided by national and regional registries. Men and women were analysed separately. Median time since AMI was 5.5 years in men and 3.8 years in women. Cases reported lower energy intakes (EIs) than controls, despite having similar basal metabolic rates. After adjustment for total EI, both male and female cases had lower fat intake and higher intake of several micronutrients, such as ascorbic acid, folate, and vitamin E, than controls, the difference being largest in men. Most of the cases reporting dietary change quoted 'disease' as their main reason for change. They had lower EI and lower energy-adjusted intake of fat than other cases. Survivors of AMI reported dietary habits more in line with current recommendations, particularly those who afterwards reported having changed their dietary habits. The possible bias introduced by social desirability is discussed.

Stall Flutter Control of a Smart Blade Section Undergoing Asymmetric Limit Oscillations

DOE PAGES

Li, Nailu; Balas, Mark J.; Nikoueeyan, Pourya; ...

2016-01-01

Stall flutter is an aeroelastic phenomenon resulting in unwanted oscillatory loads on the blade, such as wind turbine blade, helicopter rotor blade, and other flexible wing blades. While the stall flutter and related aeroelastic control have been studied theoretically and experimentally, microtab control of asymmetric limit cycle oscillations (LCOs) in stall flutter cases has not been generally investigated. This paper presents an aeroservoelastic model to study the microtab control of the blade section undergoing moderate stall flutter and deep stall flutter separately. The effects of different dynamic stall conditions and the consequent asymmetric LCOs for both stall cases are simulatedmore » and analyzed. Then, for the design of the stall flutter controller, the potential sensor signal for the stall flutter, the microtab control capability of the stall flutter, and the control algorithm for the stall flutter are studied. Lastly, the improvement and the superiority of the proposed adaptive stall flutter controller are shown by comparison with a simple stall flutter controller.« less

The Misconception of Case-Control Studies in the Plastic Surgery Literature: A Literature Audit.

PubMed

Hatchell, Alexandra C; Farrokhyar, Forough; Choi, Matthew

2017-06-01

Case-control study designs are commonly used. However, many published case-control studies are not true case-controls and are in fact mislabeled. The purpose of this study was to identify all case-control studies published in the top three plastic surgery journals over the past 10 years, assess which were truly case-control studies, clarify the actual design of the articles, and address common misconceptions. MEDLINE, Embase, and Web of Science databases were searched for case-control studies in the three highest-impact factor plastic surgery journals (2005 to 2015). Two independent reviewers screened the resulting titles, abstracts, and methods, if applicable, to identify articles labeled as case-control studies. These articles were appraised and classified as true case-control studies or non-case-control studies. The authors found 28 articles labeled as case-control studies. However, only six of these articles (21 percent) were truly case-control designs. Of the 22 incorrectly labeled studies, one (5 percent) was a randomized controlled trial, three (14 percent) were nonrandomized trials, two (9 percent) were prospective comparative cohort designs, 14 (64 percent) were retrospective comparative cohort designs, and two (9 percent) were cross-sectional designs. The mislabeling was worse in recent years, despite increases in evidence-based medicine awareness. The majority of published case-control studies are not in fact case-control studies. This misunderstanding is worsening with time. Most of these studies are actually comparative cohort designs. However, some studies are truly clinical trials and thus a higher level of evidence than originally proposed.

Successful use of balloon tamponade in the management of postpartum hemorrhage in a case of bicornuate uterus.

PubMed

Khan, Erum Saleem; Basharat, Ayesha

2018-01-01

Worldwide 50%-70% of all cases of maternal morbidity have been attributed to postpartum hemorrhage. This report discusses a case of bicornuate uterus in a term pregnancy. The delivery was by cesarean section, which was followed by massive postpartum hemorrhage, managed successfully with balloon tamponade. This is the second reported case of successful management of post partum hemorrhage in a bicornuate uterus with balloon tamponade. A 22-year-old primigravida at 39 weeks of gestational age presented with vaginal leaking of clear fluid. Cesarean section was done due to meconium stained liquor in early labor; with an incidental finding of bicornuate uterus followed by massive postpartum hemorrhage managed successfully with balloon tamponade. The use of uterine balloon tamponade as an effective method to control postpartum hemorrhage has been studied extensively, but use in cases of hemorrhage associated with uterine malformations has not been reported much in literature. Use of uterine balloon tamponade in case of uterine malformations has been highlighted in our case as an effective non-surgical method to control hemorrhage.

75 FR 67632 - Defense Federal Acquisition Regulation Supplement; Prohibition on Interrogation of Detainees by...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-03

... implement section 1038 of the National Defense Authorization Act for Fiscal Year 2010 (Pub. L. 111-84). Section 1038 prohibits contractor personnel from interrogating detainees under the control of the...-0310. Please cite DFARS Case 2010-D027. SUPPLEMENTARY INFORMATION: I. Background Section 1038 of the...

Computational Test Cases for a Clipped Delta Wing with Pitching and Trailing-Edge Control Surface Oscillations

NASA Technical Reports Server (NTRS)

Bennett, Robert M.; Walker, Charlotte E.

1999-01-01

Computational test cases have been selected from the data set for a clipped delta wing with a six-percent-thick circular-arc airfoil section that was tested in the NASA Langley Transonic Dynamics Tunnel. The test cases include parametric variation of static angle of attack, pitching oscillation frequency, trailing-edge control surface oscillation frequency, and Mach numbers from subsonic to low supersonic values. Tables and plots of the measured pressures are presented for each case. This report provides an early release of test cases that have been proposed for a document that supplements the cases presented in AGARD Report 702.

7 CFR 275.13 - Review of negative cases.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 4 2011-01-01 2011-01-01 false Review of negative cases. 275.13 Section 275.13... AGRICULTURE FOOD STAMP AND FOOD DISTRIBUTION PROGRAM PERFORMANCE REPORTING SYSTEM Quality Control (QC) Reviews § 275.13 Review of negative cases. (a) General. A sample of actions to deny applications, or suspend or...

22 CFR 46.7 - Instructions from the Administrator required in certain cases.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Instructions from the Administrator required in certain cases. 46.7 Section 46.7 Foreign Relations DEPARTMENT OF STATE VISAS CONTROL OF ALIENS DEPARTING FROM THE UNITED STATES § 46.7 Instructions from the Administrator required in certain cases. In the...

22 CFR 46.7 - Instructions from the Administrator required in certain cases.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Instructions from the Administrator required in certain cases. 46.7 Section 46.7 Foreign Relations DEPARTMENT OF STATE VISAS CONTROL OF ALIENS DEPARTING FROM THE UNITED STATES § 46.7 Instructions from the Administrator required in certain cases. In the...

22 CFR 46.7 - Instructions from the Administrator required in certain cases.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Instructions from the Administrator required in certain cases. 46.7 Section 46.7 Foreign Relations DEPARTMENT OF STATE VISAS CONTROL OF ALIENS DEPARTING FROM THE UNITED STATES § 46.7 Instructions from the Administrator required in certain cases. In the...

22 CFR 46.7 - Instructions from the Administrator required in certain cases.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Instructions from the Administrator required in certain cases. 46.7 Section 46.7 Foreign Relations DEPARTMENT OF STATE VISAS CONTROL OF ALIENS DEPARTING FROM THE UNITED STATES § 46.7 Instructions from the Administrator required in certain cases. In the...

Urinary Estrogen Metabolites, Active and Sedentary Behaviors, and Breast Cancer Risk

Cancer.gov

A cross-sectional study of approximately 600 postmenopausal controls in the Breast Cancer Case-Control Study in Poland to assess urinary estrogen metabolites in relation to accelerometer-based measures of active and sedentary behaviors

Improvements To Progressive Wave Tube Performance Through Closed-Loop Control

NASA Technical Reports Server (NTRS)

Rizzi, Stephen A.

2000-01-01

This report documents recent improvements to the acoustic and thermal control systems of the Thermal Acoustic Fatigue Apparatus (TAFA), a progressive wave tube test facility at the NASA Langley Research Center, Hampton, Virginia. A brief summary of past acoustic performance is given first to serve as a basis for comparison with the new performance data using a multiple-input, closed-loop, narrow-band controller. Performance data in the form of test section acoustic power spectral densities and coherence are presented in three of six facility configurations for a variety of input spectra. Tested spectra include uniform, two cases of pink noise, three cases of narrow-band random, a simulated launch payload bay environment for an expendable launch vehicle, and a simulated external acoustic load for the aft section of a reusable launch vehicle. In addition, a new closed-loop temperature controller and thermocouple data acquisition system are described.

Application of fuzzy logic-neural network based reinforcement learning to proximity and docking operations: Translational controller results

NASA Technical Reports Server (NTRS)

Jani, Yashvant

1992-01-01

The reinforcement learning techniques developed at Ames Research Center are being applied to proximity and docking operations using the Shuttle and Solar Maximum Mission (SMM) satellite simulation. In utilizing these fuzzy learning techniques, we also use the Approximate Reasoning based Intelligent Control (ARIC) architecture, and so we use two terms interchangeable to imply the same. This activity is carried out in the Software Technology Laboratory utilizing the Orbital Operations Simulator (OOS). This report is the deliverable D3 in our project activity and provides the test results of the fuzzy learning translational controller. This report is organized in six sections. Based on our experience and analysis with the attitude controller, we have modified the basic configuration of the reinforcement learning algorithm in ARIC as described in section 2. The shuttle translational controller and its implementation in fuzzy learning architecture is described in section 3. Two test cases that we have performed are described in section 4. Our results and conclusions are discussed in section 5, and section 6 provides future plans and summary for the project.

Delivery after external cephalic version, is there an increased rate of cesarian section?

PubMed

Lago Leal, Victor; Pradillo Aramendi, Tamara; Nicolas Montero, Estefania; Ocaña Martínez, Vanesa; Del Barrio Fernández, Pablo; Martínez-Cortés, Luis

2016-04-01

The aim of this study was to compare the obstetric outcomes after successful external cephalic version (cases) with a group of pregnant women with a spontaneous cephalic fetal position at delivery (controls). Retrospective review of the cohort of study was performed at the University Hospital of Getafe (Madrid, Spain) between January 2012 and January 2013. 1516 patients (48 cases; 1468 controls). We compared the type of delivery in pregnant women after ECV performed successfully (cases) with spontaneous cephalic presentations (controls). Pregnancies with vaginal delivery contraindicated, elective cesarean section (CS) justified by maternal disease, multiple pregnancies, or pregnancies below 37 weeks were excluded. Maternal age, BMI, parity, gestational age at delivery, and onset of labor (spontaneous or induced) were controlled. Prevalence of CS and operative delivery in both groups. Women who underwent a successful ECV had a significantly higher CS rate compared with the women of the control group (12/48 [25%] vs. 202/1468 [13.76%]; P=0.028). There was no difference in the rate of operative delivery (6/48 [12.5%] vs. 177/1468 [12.05%] P=0.92). Deliveries following a successful ECV are associated with an increased CS rate compared with deliveries of fetuses with spontaneous cephalic presentations.

Frozen Section Evaluation of Margin Status in Primary Squamous Cell Carcinomas of the Head and Neck: A Correlation Study of Frozen Section and Final Diagnoses.

PubMed

Layfield, Eleanor M; Schmidt, Robert L; Esebua, Magda; Layfield, Lester J

2018-06-01

Frozen section is routinely used for intraoperative margin evaluation in carcinomas of the head and neck. We studied a series of frozen sections performed for margin status of head and neck tumors to determine diagnostic accuracy. All frozen sections for margin control of squamous carcinomas of the head and neck were studied from a 66 month period. Frozen and permanent section diagnoses were classified as negative or malignant. Correlation of diagnoses was performed to determine accuracy. One thousand seven hundred and ninety-six pairs of frozen section and corresponding permanent section diagnoses were obtained. Discordances were found in 55 (3.1%) pairs. In 35 pairs (1.9%), frozen section was reported as benign, but permanent sections disclosed carcinoma. In 21 cases, the discrepancy was due to sampling and in the remaining cases it was an interpretive error. In 20 cases (1.1%), frozen section was malignant, but the permanent section was interpreted as negative. Frozen section is an accurate method for evaluation of operative margins for head and neck carcinomas with concordance between frozen and permanent results of 97%. Most errors are false negative results with the majority of these being due to sampling issues.

Antepartum transabdominal amnioinfusion.

PubMed

Chhabra, S; Dargan, R; Nasare, M

2007-05-01

To determine the usefulness of antepartum transabdominal amnioinfusion (APTA) in reducing perinatal morbidity and mortality due to oligohydramnios. In this case-control study of 100 pregnant women with oligohydramnios, 50 received APTA and 50 were treated conservatively. These controls were matched for age, parity, and pregnancy duration with the case patients. There was a mean 4.02-cm increase in amniotic fluid index (AFI) after amnioinfusion. Only 18% of case patients required cesarean sections vs. 46% of controls. The perinatal mortality rate was 18% among controls and 4% among case patients, and the difference was significant. Antepartum amnioinfusion is a useful procedure to reduce complications resulting from decreased intra-amniotic volume. It is especially useful in preterm pregnancies, where the procedure allows for a better perinatal outcome by prolonging the duration of pregnancy.

EIA model documentation: World oil refining logistics demand model,``WORLD`` reference manual. Version 1.1

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

Not Available

1994-04-11

This manual is intended primarily for use as a reference by analysts applying the WORLD model to regional studies. It also provides overview information on WORLD features of potential interest to managers and analysts. Broadly, the manual covers WORLD model features in progressively increasing detail. Section 2 provides an overview of the WORLD model, how it has evolved, what its design goals are, what it produces, and where it can be taken with further enhancements. Section 3 reviews model management covering data sources, managing over-optimization, calibration and seasonality, check-points for case construction and common errors. Section 4 describes in detailmore » the WORLD system, including: data and program systems in overview; details of mainframe and PC program control and files;model generation, size management, debugging and error analysis; use with different optimizers; and reporting and results analysis. Section 5 provides a detailed description of every WORLD model data table, covering model controls, case and technology data. Section 6 goes into the details of WORLD matrix structure. It provides an overview, describes how regional definitions are controlled and defines the naming conventions for-all model rows, columns, right-hand sides, and bounds. It also includes a discussion of the formulation of product blending and specifications in WORLD. Several Appendices supplement the main sections.« less

What puts them at risk? A cross-sectional case-control survey of demographic profile and sexual behavior of patients with sexually transmitted infections at a tertiary care center in North India.

PubMed

Raj, Rama; Gupta, Vishal; Pathak, Mona; Sreenivas, Vishnubhatla; Sood, Seema; Singh, Sarman; Verma, Kaushal K; Khanna, Neena; Das, Bimal K; Gupta, Somesh

2017-01-01

Sexually transmitted infections (STIs) are a major public health problem in developing nations. Identification of risk factors can help in formulating effective strategies against them. The present study was conducted in a tertiary care hospital in North India over 1 year to identify the risk factors associated with STIs. A questionnaire-based cross-sectional case-control survey was conducted where participants answered questions on demographic details, sexual behavior, and awareness of STIs. Cases were patients with STIs whereas controls were randomly selected from healthy individuals accompanying patients with nonvenereal complaints attending our hospital. There were 106 cases and 64 controls. STI patients had sexual debut 2 years before controls. A higher proportion of STI cases had lower education, multiple sexual partners, lived separately from their partner, had nonregular partners, had protected sex in the last month, had sex under influence of alcohol/illicit drugs, sex in unstructured settings, and engaged in transactional sex, in comparison to controls ( P < 0.05). More cases were aware of the symptoms/preventive measures of STIs ( P < 0.001). On multivariate analysis, multiple sexual partners, sex under influence of alcohol/illicit drugs with nonregular partner, protected sex in the last month, and knowledge of preventive measures were found to be statistically associated with STIs ( P < 0.05). Our study identifies risk-behavior patterns in patients with STIs, which should be modified to reduce the burden of these diseases. Increasing the knowledge about STIs in these patients can translate into more common condom usage that lends support for strengthening sexual health programs at grass-root levels. The small size of the study population could have led to decreased power of the study to detect differences between cases and controls. The external validity of our results needs to be tested in different population groups involving larger sample sizes.

Generalized Landauer equation: Absorption-controlled diffusion processes

NASA Astrophysics Data System (ADS)

Godoy, Salvador; García-Colín, L. S.; Micenmacher, Victor

1999-05-01

The exact expression of the one-dimensional Boltzmann multiple-scattering coefficients, for the passage of particles through a slab of a given material, is obtained in terms of the single-scattering cross section of the material, including absorption. The remarkable feature of the result is that for multiple scattering in a metal, free from absorption, one recovers the well-known Landauer result for conduction electrons. In the case of particles, such as neutrons, moving through a weak absorbing media, Landuer's formula is modified due to the absorption cross section. For photons, in a strong absorbing media, one recovers the Lambert-Beer equation. In this latter case one may therefore speak of absorption-controlled diffusive processes.

32 CFR 635.21 - USACRC control numbers.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 4 2010-07-01 2010-07-01 true USACRC control numbers. 635.21 Section 635.21 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW ENFORCEMENT AND CRIMINAL INVESTIGATIONS LAW ENFORCEMENT REPORTING Offense Reporting § 635.21 USACRC control numbers. (a) Case numbers to support reporting...

14 CFR 121.279 - Control of engine rotation.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Control of engine rotation. 121.279 Section... REQUIREMENTS: DOMESTIC, FLAG, AND SUPPLEMENTAL OPERATIONS Special Airworthiness Requirements § 121.279 Control... case of turbine engine installations, a means of stopping the rotation need be provided only if the...

27 CFR 478.54 - Change of control.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 27 Alcohol, Tobacco Products and Firearms 3 2010-04-01 2010-04-01 false Change of control. 478.54 Section 478.54 Alcohol, Tobacco Products, and Firearms BUREAU OF ALCOHOL, TOBACCO, FIREARMS, AND....54 Change of control. In the case of a corporation or association holding a license under this part...

Mechanical properties of the trapezius during scapular elevation in people with chronic whiplash associated disorders--A case-control ultrasound speckle tracking analysis.

PubMed

Landén Ludvigsson, Maria; Peterson, Gunnel; Jull, Gwendolen; Trygg, Johan; Peolsson, Anneli

2016-02-01

Approximately 50% of people with Whiplash Associated Disorders (WAD) report longstanding symptoms. The upper trapezius is commonly painful yet its mechanical properties are not fully understood. This study examined the deformation of different depths of the upper trapezius muscle during a scapular elevation task (shoulder shrugging) before and following loaded arm abduction. A cross-sectional case-control study of 36 people (26 female and 10 male, mean age 38 (SD 11)) with chronic WAD and 36 controls, matched for age and gender. Real-time ultrasound recordings of upper trapezius were taken during both scapular elevation tasks. Post-process speckle tracking analysis was undertaken of three different sections of the upper trapezius muscle (superficial, middle, deep). The WAD group had lower deformation of the superficial section of the upper trapezius compared to the control group in both concentric and eccentric phases of scapular elevation (p < 0.05) especially before the loaded arm abduction. After arm abduction, the deformation of the trapezius was reduced in both groups but only significantly in the WAD-group (p = 0.03). Within-group analysis revealed that the control group least engaged the deep section of upper trapezius during the task (p < 0.01). This study, measuring mechanical deformation of the upper trapezius during a scapular elevation task indicates that persons with WAD may display different patterns in engagement of the muscle sections than those in the control group. Further research is needed to replicate and understand the reasons for and implications of this possible change in motor strategy within upper trapezius. Clinical Trials.gov, Number: NCT01547624. Copyright © 2015 Elsevier Ltd. All rights reserved.

Application of fuzzy logic-neural network based reinforcement learning to proximity and docking operations: Attitude control results

NASA Technical Reports Server (NTRS)

Jani, Yashvant

1992-01-01

As part of the RICIS activity, the reinforcement learning techniques developed at Ames Research Center are being applied to proximity and docking operations using the Shuttle and Solar Max satellite simulation. This activity is carried out in the software technology laboratory utilizing the Orbital Operations Simulator (OOS). This report is deliverable D2 Altitude Control Results and provides the status of the project after four months of activities and outlines the future plans. In section 2 we describe the Fuzzy-Learner system for the attitude control functions. In section 3, we provide the description of test cases and results in a chronological order. In section 4, we have summarized our results and conclusions. Our future plans and recommendations are provided in section 5.

27 CFR 1.42 - Change in ownership, management, or control of business.

Code of Federal Regulations, 2011 CFR

2011-04-01

... ownership, management, or control of business. In the event of any change in the ownership, management, or..., management, or control of business. 1.42 Section 1.42 Alcohol, Tobacco Products and Firearms ALCOHOL AND..., management, or control of such business, or in the case of a corporation, the names and addresses of such new...

A large Legionnaires' disease outbreak in Pamplona, Spain: early detection, rapid control and no case fatality

PubMed Central

CASTILLA, J.; BARRICARTE, A.; ALDAZ, J.; GARCÍA CENOZ, M.; FERRER, T.; PELAZ, C.; PINEDA, S.; BALADRÓN, B.; MARTÍN, I.; GOÑI, B.; ARATAJO, P.; CHAMORRO, J.; LAMEIRO, F.; TORROBA, L.; DORRONSORO, I.; MARTÍNEZ-ARTOLA, V.; ESPARZA, M. J.; GASTAMINZA, M. A.; FRAILE, P.; ALDAZ, P.

2008-01-01

SUMMARY An outbreak of Legionnaire's disease was detected in Pamplona, Spain, on 1 June 2006. Patients with pneumonia were tested to detect Legionella pneumophila antigen in urine (Binax Now; Binax Inc., Scarborough, ME, USA), and all 146 confirmed cases were interviewed. The outbreak was related to district 2 (22 012 inhabitants), where 45% of the cases lived and 50% had visited; 5% lived in neighbouring districts. The highest incidence was found in the resident population of district 2 (3/1000 inhabitants), section 2 (14/1000). All 31 cooling towers of district 2 were analysed. L. pneumophila antigen (Binax Now) was detected in four towers, which were closed on 2 June. Only the strain isolated in a tower situated in section 2 of district 2 matched all five clinical isolates, as assessed by mAb and two genotyping methods, AFLP and PFGE. Eight days after closing the towers, new cases ceased appearing. Early detection and rapid coordinated medical and environmental actions permitted immediate control of the outbreak and probably contributed to the null case fatality. PMID:17662166

A large Legionnaires' disease outbreak in Pamplona, Spain: early detection, rapid control and no case fatality.

PubMed

Castilla, J; Barricarte, A; Aldaz, J; García Cenoz, M; Ferrer, T; Pelaz, C; Pineda, S; Baladrón, B; Martín, I; Goñi, B; Aratajo, P; Chamorro, J; Lameiro, F; Torroba, L; Dorronsoro, I; Martínez-Artola, V; Esparza, M J; Gastaminza, M A; Fraile, P; Aldaz, P

2008-06-01

An outbreak of Legionnaire's disease was detected in Pamplona, Spain, on 1 June 2006. Patients with pneumonia were tested to detect Legionella pneumophila antigen in urine (Binax Now; Binax Inc., Scarborough, ME, USA), and all 146 confirmed cases were interviewed. The outbreak was related to district 2 (22 012 inhabitants), where 45% of the cases lived and 50% had visited; 5% lived in neighbouring districts. The highest incidence was found in the resident population of district 2 (3/1000 inhabitants), section 2 (14/1000). All 31 cooling towers of district 2 were analysed. L. pneumophila antigen (Binax Now) was detected in four towers, which were closed on 2 June. Only the strain isolated in a tower situated in section 2 of district 2 matched all five clinical isolates, as assessed by mAb and two genotyping methods, AFLP and PFGE. Eight days after closing the towers, new cases ceased appearing. Early detection and rapid coordinated medical and environmental actions permitted immediate control of the outbreak and probably contributed to the null case fatality.

Bodies with noncircular cross sections and bank-to-turn missiles

NASA Technical Reports Server (NTRS)

Jackson, C. M., Jr.; Sawyer, W. C.

1992-01-01

A development status evaluation is presented for the aerodynamics of missile configurations with noncircular cross-sections and bank-to-turn maneuvering systems, giving attention to cases with elliptical and square cross-sections, as well as bodies with variable cross-sections. The assessment of bank-to-turn missile performance notes inherent stability/control problems. A summary and index are provided for aerodynamic data on monoplanar configurations, including those which incorporate airbreathing propulsion systems.

Persistent measles virus infection of the intestine: confirmation by immunogold electron microscopy.

PubMed Central

Lewin, J; Dhillon, A P; Sim, R; Mazure, G; Pounder, R E; Wakefield, A J

1995-01-01

This study sought to investigate persistent measles virus infection of the intestine: a novel protocol for immunogold electron microscopy was developed using a polyclonal anti-measles nucleoprotein antibody on reprocessed, formalin fixed paraffin wax embedded tissue sections. Antibody binding was detected using both immunoperoxidase and light microscopy on tissue sections, and 10 nm gold conjugated secondary antibody and electron microscopy on ultrathin sections. The techniques were validated using both measles infected vero cells and human tissues with established measles infection: these included brain affected by subacute sclerosing panencephalitis and acute measles appendicitis. The technique was applied subsequently to six untreated cases of granulomatous Crohn's disease, and two cases of ileocaecal tuberculosis, a granulomatous control. Mumps primary antibody--applied to both mumps infected vero cells, and measles infected vero cells and tissues studied by immunoperoxidase, and measles antibody on mumps infected cells studied by immunoperoxidase and immunogold--were used as specificity controls: the primary antibodies identified their respective target antigen and there was no antibody cross reactivity. Measles virus nucleocapsids labelled with gold conjugated antibody in both infected cells and tissues, including foci of granulomatous inflammation in five of six cases of Crohn's disease: in the fifth case, the granuloma could not be identified in ultrathin section. In one of the tuberculosis cases, a low level of signal was noted while the second case was negative. Labelling adopted a characteristic pattern in all infected tissues, strengthening the specificity of these findings. This study provides the first direct confirmation of persistent measles virus infection of the intestine. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 PMID:7737565

Certification of highly complex safety-related systems.

PubMed

Reinert, D; Schaefer, M

1999-01-01

The BIA has now 15 years of experience with the certification of complex electronic systems for safety-related applications in the machinery sector. Using the example of machining centres this presentation will show the systematic procedure for verifying and validating control systems using Application Specific Integrated Circuits (ASICs) and microcomputers for safety functions. One section will describe the control structure of machining centres with control systems using "integrated safety." A diverse redundant architecture combined with crossmonitoring and forced dynamization is explained. In the main section the steps of the systematic certification procedure are explained showing some results of the certification of drilling machines. Specification reviews, design reviews with test case specification, statistical analysis, and walk-throughs are the analytical measures in the testing process. Systematic tests based on the test case specification, Electro Magnetic Interference (EMI), and environmental testing, and site acceptance tests on the machines are the testing measures for validation. A complex software driven system is always undergoing modification. Most of the changes are not safety-relevant but this has to be proven. A systematic procedure for certifying software modifications is presented in the last section of the paper.

22 CFR 46.4 - Procedure in case of alien prevented from departing from the United States.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Procedure in case of alien prevented from departing from the United States. 46.4 Section 46.4 Foreign Relations DEPARTMENT OF STATE VISAS CONTROL OF ALIENS DEPARTING FROM THE UNITED STATES § 46.4 Procedure in case of alien prevented from departing from...

22 CFR 46.4 - Procedure in case of alien prevented from departing from the United States.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Procedure in case of alien prevented from departing from the United States. 46.4 Section 46.4 Foreign Relations DEPARTMENT OF STATE VISAS CONTROL OF ALIENS DEPARTING FROM THE UNITED STATES § 46.4 Procedure in case of alien prevented from departing from...

22 CFR 46.4 - Procedure in case of alien prevented from departing from the United States.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Procedure in case of alien prevented from departing from the United States. 46.4 Section 46.4 Foreign Relations DEPARTMENT OF STATE VISAS CONTROL OF ALIENS DEPARTING FROM THE UNITED STATES § 46.4 Procedure in case of alien prevented from departing from...

22 CFR 46.4 - Procedure in case of alien prevented from departing from the United States.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Procedure in case of alien prevented from departing from the United States. 46.4 Section 46.4 Foreign Relations DEPARTMENT OF STATE VISAS CONTROL OF ALIENS DEPARTING FROM THE UNITED STATES § 46.4 Procedure in case of alien prevented from departing from...

Incidence, risk factors and perinatal outcomes for placenta accreta in Australia and New Zealand: a case-control study.

PubMed

Farquhar, Cynthia M; Li, Zhuoyang; Lensen, Sarah; McLintock, Claire; Pollock, Wendy; Peek, Michael J; Ellwood, David; Knight, Marian; Homer, Caroline Se; Vaughan, Geraldine; Wang, Alex; Sullivan, Elizabeth

2017-10-05

Estimate the incidence of placenta accreta and describe risk factors, clinical practice and perinatal outcomes. Case-control study. Sites in Australia and New Zealand with at least 50 births per year. Cases were women giving birth (≥20 weeks or fetus ≥400 g) who were diagnosed with placenta accreta by antenatal imaging, at operation or by pathology specimens between 2010 and 2012. Controls were two births immediately prior to a case. A total of 295 cases were included and 570 controls. Data were collected using the Australasian Maternity Outcomes Surveillance System. Incidence, risk factors (eg, prior caesarean section (CS), maternal age) and clinical outcomes of placenta accreta (eg CS, hysterectomy and death). The incidence of placenta accreta was 44.2/100 000 women giving birth (95% CI 39.4 to 49.5); however, this may overestimated due to the case definition used. In primiparous women, an increased odds of placenta accreta was observed in older women (adjusted OR (AOR) women≥40 vs <30: 19.1, 95% CI 4.6 to 80.3) and current multiple birth (AOR: 6.1, 95% CI 1.1 to 34.1). In multiparous women, independent risk factors were prior CS (AOR ≥2 prior sections vs 0: 13.8, 95% CI 7.4 to 26.1) and current placenta praevia (AOR: 36.3, 95% CI 14.0 to 93.7). There were two maternal deaths (case fatality rate 0.7%).Women with placenta accreta were more likely to have a caesarean section (AOR: 4.6, 95% CI 2.7 to 7.6) to be admitted to the intensive care unit (ICU)/high dependency unit (AOR: 46.1, 95% CI 22.3 to 95.4) and to have a hysterectomy (AOR: 209.0, 95% CI 19.9 to 875.0). Babies born to women with placenta accreta were more likely to be preterm, be admitted to neonatal ICU and require resuscitation. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Mast cells and angiogenesis in wound healing.

PubMed

Gaber, Mohamed A; Seliet, Iman A; Ehsan, Nermin A; Megahed, Mohamed A

2014-02-01

To investigate the role of mast cells and vascular endothelial growth factor (VEGF) as a mediator of angiogenesis to promote wound healing in surgical and pathological scars. The study was carried out on 40 patients who presented with active scar lesions. They were subdivided into 4 groups. They included granulation tissue (10 cases), surgical scar (10 cases), hypertrophic scar (10 cases), and keloid scar (10 cases). Also 10 healthy volunteers of the same age and sex were selected as a control group. Skin biopsies were taken from the patients and the control group. Skin biopsies from clinically assessed studied groups were processed for routine histology and embedded in paraffin. Four sections were prepared from each paraffin block. The first section was stained with hematoxylin and eosin for histological evaluation. The second and third sections were processed for immunostaining of mast cells that contain chymase (MCCs) and mast cells that contain tryptase (MCTs). The fourth section was processed for immunostaining of VEGF. MCCs exhibited mild expression in normal tissue, granulation tissue, and surgical, hypertrophic and keloid scars. MCTs exhibited mild expression in normal tissue, granulation tissue and keloid, whereas moderate expression was exhibited in hypertrophic and surgical scars. VEGF expression was absent in normal tissue, mild in keloid, surgical and hypertrophic scars, and moderate in keloids and granulation tissue. Mast cell expression variation among different scar types signals the pathological evolution of the lesion, and hence may guide the need for therapeutic intervention.

Active case finding of tuberculosis: historical perspective and future prospects

PubMed Central

Golub, J. E.; Mohan, C. I.; Comstock, G. W.; Chaisson, R. E.

2015-01-01

SUMMARY Despite a history of remarkable scientific achievements in microbiology and therapeutics, tuberculosis (TB) continues to pose an extraordinary threat to human health. Case finding and treatment of TB disease are the principal means of controlling transmission and reducing incidence. This review presents a historical perspective of active case finding (ACF) of TB, detailing case detection strategies that have been used over the last century. This review is divided into the following sections: mass radiography, house-to-house surveys, out-patient case detection, enhanced case finding, high-risk populations and cost-effectiveness. The report concludes with a discussion and recommendations for future case finding strategies. Understanding the strengths and weaknesses of these methods will help inform and shape ACF as a TB control policy in the twenty-first century. PMID:16333924

Caesarean section and asthma in Malaysian children: a case-control study.

PubMed

Nathan, Anna Marie; de Bruyne, Jessie; Khalid, Farah; Arumugam, Kulantheran

2012-09-01

Birth cohort studies in some countries have shown a link between caesarean section and asthma. To determine if there is an association between asthma and delivery via caesarean section in Malaysian children. This is a case-control study involving 156 children aged 3-15 years old, in a tertiary hospital in Kuala Lumpur, Malaysia. Seventy-eight children with a confirmed diagnosis of asthma and seventy-eight age-matched controls (no history of asthma or wheezing) were enrolled. Demographic data including mode of delivery and family history of allergic disorders was obtained. Total serum immunoglobulin E (IgE) was measured and skin prick tests (SPT) to 6 common aeroallergens were performed. The median age of the patients was 8 years old. One hundred and three (66%) children were delivered via normal vaginal delivery, 8 (5.1%) via assisted vaginal delivery and 45 children (28.9%) via caesarean section. Delivery via caesarean section was not significantly associated with asthma (OR = 1.21 [95% CI 0.60-2.41], p = 0.596). Children delivered via caesarean section did not have higher IgE levels nor were they more sensitized to aeroallergens. Multiple logistic regression showed that asthma was significantly associated with a positive family history of atopy (OR = 13.8 [95% CI 5.96, 32.1], p < 0.001). Introduction of semi-solid food after 6 months old had a protective effect against asthma (OR = 0.97 [95% CI 0.94, 0.99], p = 0.034). Childhood asthma in Malaysian children was not associated with delivery by caesarean section.

Transrectal Near-Infrared Optical Tomography for Prostate Imaging

DTIC Science & Technology

2011-03-01

when the experimental measurements are grouped with the FEM and the MC for examining the analytic predictions. Section 5 examines the analytic...as well as other experimental limitations, but the error was controlled to be within 0:9mm for the case-azi and 0:5mm for the case- longi...be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number

An Investigation of Chaotic Kolmogorov Flows

DTIC Science & Technology

1990-08-01

plane for the Poincare sections used later. The choice of the constant D controls apparent positioning of the hyperplane in the phase...discovered in large scale structure regime. Features of the diverse cases are displayed in terms of the temporal power spectrum, Poincare sections and...examine in some detail the behavior of the flow and its transition states for a range of the bifurcation parameter Re. We use Poincare sections to

Risk factors and outcomes of carbapenem-resistant Acinetobacter baumannii ventilator-associated pneumonia in the neonate: A case-case-control study.

PubMed

Thatrimontrichai, Anucha; Techato, Chirabat; Dissaneevate, Supaporn; Janjindamai, Waricha; Maneenil, Gunlawadee; Kritsaneepaiboon, Supika; Tanaanantarak, Pattama

2016-07-01

Carbapenem-resistant and susceptible Acinetobacter baumannii (CRAB and CSAB) have emerged as serious threats among critically ill neonates. We aimed to identify the risks and outcomes for CRAB and CSAB ventilator-associated pneumonia (VAP) compared with a control group. We performed a retrospective and case-case-control study in a neonatal intensive care unit between 2009 and 2014. The numbers of patients in the CRAB VAP, CSAB VAP, and control groups were 63, 13, and 25, respectively. The mean gestational ages and median birthweights of CRAB VAP, CSAB VAP, and control groups were 33.2, 35.0, and 32.6 weeks and 1800, 2230, and 2245 g, respectively. By multivariate analysis, infants who had a birthweight of 1000-1499 g (P = 0.04), cesarean section (P = 0.01), history of cephalosporin use (P = 0.02), and surfactant replacement (P = 0.01) in CRAB VAP were significantly higher than in the control group. Inborn infant (P = 0.01), reintubation (P = 0.04), and umbilical artery catheterization (P = 0.04) in the CRAB VAP group were significantly more than in the CSAB VAP group. The crude mortality rates (CMRs) of CRAB VAP and CSAB VAP were 15.9% and 7.7%, respectively. By univariate analysis, the CMR, septic shock, and bronchopulmonary dysplasia in CRAB VAP were higher than in the control group. There are very high mortality and short-term morbidity rates in CRAB VAP. Surfactant replacement therapy, fewer cesarean sections, and the reduced use of cephalosporin in very preterm infants may reduce CRAB VAP. Copyright © 2016 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

24 CFR 51.105 - Exceptions.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 24 Housing and Urban Development 1 2012-04-01 2012-04-01 false Exceptions. 51.105 Section 51.105... ENVIRONMENTAL CRITERIA AND STANDARDS Noise Abatement and Control § 51.105 Exceptions. (a) Flexibility for non... acceptability standard of 65 decibels, the Acceptable Zone may be shifted to Ldn 70 on a case-by-case basis if...

24 CFR 51.105 - Exceptions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 1 2011-04-01 2011-04-01 false Exceptions. 51.105 Section 51.105... ENVIRONMENTAL CRITERIA AND STANDARDS Noise Abatement and Control § 51.105 Exceptions. (a) Flexibility for non... acceptability standard of 65 decibels, the Acceptable Zone may be shifted to Ldn 70 on a case-by-case basis if...

24 CFR 51.105 - Exceptions.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 24 Housing and Urban Development 1 2014-04-01 2014-04-01 false Exceptions. 51.105 Section 51.105... ENVIRONMENTAL CRITERIA AND STANDARDS Noise Abatement and Control § 51.105 Exceptions. (a) Flexibility for non... acceptability standard of 65 decibels, the Acceptable Zone may be shifted to Ldn 70 on a case-by-case basis if...

24 CFR 51.105 - Exceptions.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 24 Housing and Urban Development 1 2013-04-01 2013-04-01 false Exceptions. 51.105 Section 51.105... ENVIRONMENTAL CRITERIA AND STANDARDS Noise Abatement and Control § 51.105 Exceptions. (a) Flexibility for non... acceptability standard of 65 decibels, the Acceptable Zone may be shifted to Ldn 70 on a case-by-case basis if...

24 CFR 51.105 - Exceptions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Exceptions. 51.105 Section 51.105... ENVIRONMENTAL CRITERIA AND STANDARDS Noise Abatement and Control § 51.105 Exceptions. (a) Flexibility for non... acceptability standard of 65 decibels, the Acceptable Zone may be shifted to Ldn 70 on a case-by-case basis if...

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

Coronado-Gonzalez, Jose Antonio; Razo, Luz Maria del; Garcia-Vargas, Gonzalo

Inorganic arsenic exposure in drinking water has been recently related to diabetes mellitus. To evaluate this relationship the authors conducted in 2003, a case-control study in an arseniasis-endemic region from Coahuila, a northern state of Mexico with a high incidence of diabetes. The present analysis includes 200 cases and 200 controls. Cases were obtained from a previous cross-sectional study conducted in that region. Diagnosis of diabetes was established following the American Diabetes Association criteria, with two fasting glucose values {>=}126 mg/100 ml ({>=}7.0 mmol/l) or a history of diabetes treated with insulin or oral hypoglycemic agents. The next subject studied,more » subsequent to the identification of a case in the cross-sectional study was taken as control. Inorganic arsenic exposure was measured through total arsenic concentrations in urine, measured by hydride-generation atomic absorption spectrophotometry. Subjects with intermediate total arsenic concentration in urine (63.5-104 {mu}g/g creatinine) had two-fold higher risk of having diabetes (odds ratio=2.16; 95% confidence interval: 1.23, 3.79), but the risk was almost three times greater in subjects with higher concentrations of total arsenic in urine (odds ratio=2.84; 95% confidence interval: 1.64, 4.92). This data provides additional evidence that inorganic arsenic exposure may be diabetogenic.« less

Maternal and neonatal copeptin levels at cesarean section and vaginal delivery.

PubMed

Foda, Ashraf A; Abdel Aal, Ibrahim A

2012-12-01

The objective of the study was to measure the copeptin levels in maternal serum and umbilical cord serum at cesarean section and vaginal delivery in normotensive pregnancy and pre-eclamptic women. This was a prospective study at Mansoura University Hospital, Egypt. Ninety cases were included. They were divided into six groups: (1) normal pregnancy near term, as a control group, (2) primiparas who had vaginal delivery, (3) primiparas who had vaginal delivery and mild preeclampsia, (4) elective repeat cesarean section, (5) intrapartum cesarean section for indications other than fetal distress, and (6) intrapartum cesarean section for fetal distress. Serum copeptin concentrations were quantified with an enzyme-linked immunosorbent assay (ELISA). Mean, standard deviation, and paired t-test were used to test for significant change in quantitative data. The vaginal delivery groups had higher levels of maternal serum copeptin than the elective cesarean section group (P<0.01). Higher maternal serum copeptin levels were found in cases with pre-eclampsia as compared with the normotensive cases. The maternal copeptin levels during intrapartum cesarean section were higher than that during elective repeat cesarean section. There was a significant correlation between maternal copeptin levels and the duration of the first stage. In the presence of fetal distress, umbilical cord serum copeptin levels were significantly higher than other groups. Vaginal delivery can be very painful and stressful, and is accompanied by a marked increase of maternal serum copeptin. Increased maternal levels of serum copeptin were found in cases with pre-eclampsia as compared with the normotensive cases, and it may be helpful in assessing the disease. Intrauterine fetal distress is a strong stimulus to the release of copeptin into the fetal circulation. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Does temproray bilateral balloon occlusion of the common iliac arteries reduce the need for intra-operative blood transfusion in cases of placenta accretism?

PubMed

Al-Hadethi, Sinan; Fernando, Shane; Hughes, Simon; Thakorlal, Ajay; Seruga, Adam; Scurry, Bonnie

2017-06-01

Bilateral balloon occlusion has been employed as a prophylactic measure in cases of placenta accretism prior to caesarean section with the aim of reducing blood loss and its associated morbidity/mortality. There is however no clear consensus on its efficacy in the current literature. The objective of this study was to assess the efficacy of bilateral balloon occlusion of the common iliac arteries (CIA) in reducing intra-operative morbidity in cases of placenta accretism. The databases of the pathology department and radiology interventional suite were reviewed over a nine year period. Fifty-two cases of confirmed placental accretism who underwent caesarean section with or without hysterectomy were identified and divided into two groups. Twenty-five cases had temporary occlusion of the common iliac arteries (CIA) during delivery and these were considered the study group. The reminder 27 cases did not have temporary occlusion of the CIA and were considered the control group. The two groups were compared based on gravidity, age group, post-operative haemoglobin, drop in haemoglobin, estimated blood loss (EBL), transfusion requirement and the histopathological sub-types of placenta accretism. There was no statistically difference between the study and the control groups regarding EBL, post-operative haemoglobin drop, transfusion requirement or in the placenta accretism histopathological subtype. Two cases in the study group had acute thromboembolic complications. Both groups had a single patient requiring a massive intra-operative transfusion. Our study was not able to detect a significant difference in blood loss or blood product requirement between patients who underwent CIA balloon in the setting of caesarean section for placenta accreta. This remains a challenging scenario requiring a multidisciplinary approach. © 2016 The Royal Australian and New Zealand College of Radiologists.

The obstetric performance of United Kingdom asylum seekers from Somalia: a case-control study and literature review.

PubMed

Yoong, W; Kolhe, S; Karoshi, Mahantesh; Ullah, M; Nauta, M

2005-01-01

Little published research exists regarding obstetric performance of immigrant women in the United Kingdom. The aim of this study was to evaluate the obstetric performance and fetal outcomes of Somalian women who received prenatal care and requested to deliver at a teaching hospital in North London. This is a case-control study in which consecutive Somalian women were identified as index cases and the subsequent British-born Caucasian women listed in the delivery book served as controls. 69 index and 69 control cases were analyzed. Fifty-five percent of the Somalian women spoke little or no English. Half (50%) had undergone circumcision, the majority being type I WHO classification of female genital circumcision, which did not require significant surgical intervention prior to labor; 13% had cesarean sections, 13% instrumental vaginal deliveries, and 74% had vaginal deliveries. The Somalian women had higher parity (2.35 vs. 1.18) and were more likely to be grand multiparous (9/69 vs. 1/69) compared to controls. Epidural use was less frequent in Somalian women, but otherwise there were no significant differences between the two groups with regard to maternal age, rates of induction of labor, cesarean sections, duration of labor, premature deliveries, instrumental deliveries, and birth weights. The demographic characteristics of the Somalian female population appear to exert minimal effect on obstetric and fetal outcomes. This may be due to the increased vigilance exercised by health professionals as well as to the fact that recent arrivals are from more urban and westernized areas in Somalia.

Genotoxic Evaluation of Mexican Welders Occupationally Exposed to Welding-Fumes Using the Micronucleus Test on Exfoliated Oral Mucosa Cells: A Cross-Sectional, Case-Control Study.

PubMed

Jara-Ettinger, Ana Cecilia; López-Tavera, Juan Carlos; Zavala-Cerna, María Guadalupe; Torres-Bugarín, Olivia

2015-01-01

An estimated 800,000 people worldwide are occupationally exposed to welding-fumes. Previous studies show that the exposure to such fumes is associated with damage to genetic material and increased cancer risk. In this study, we evaluate the genotoxic effect of welding-fumes using the Micronucleus Test on oral mucosa cells of Mexican welders. We conducted a cross-sectional, matched case-control study of n = 66 (33 exposed welders, and 33 healthy controls). Buccal mucosa smears were collected and stained with acridine orange, observed under 100x optical amplification with a fluorescence lamp, and a single-blinded observer counted the number of micronuclei and other nuclear abnormalities per 2,000 observed cells. We compared the frequencies of micronuclei and other nuclear abnormalities, and fitted generalised linear models to investigate the interactions between nuclear abnormalities and the exposure to welding-fumes, while controlling for smoking and age. Binucleated cells and condensed-chromatin cells showed statistically significant differences between cases and controls. The frequency of micronuclei and the rest of nuclear abnormalities (lobed-nuclei, pyknosis, karyolysis, and karyorrhexis) did not differ significantly between the groups. After adjusting for smoking, the regression results showed that the occurrence of binucleated cells could be predicted by the exposure to welding-fumes plus the presence of tobacco consumption; for the condensed-chromatin cells, our model showed that the exposure to welding-fumes is the only reliable predictor. Our findings suggest that Mexican welders who are occupationally exposed to welding-fumes have increased counts of binucleated and condensed-chromatin cells. Nevertheless, the frequencies of micronuclei and the rest of nuclear abnormalities did not differ between cases and controls. Further studies should shed more light on this subject.

Viruses and interstitial cystitis: adenovirus genomes cannot be demonstrated in urinary bladder biopsies.

PubMed

Hukkanen, V; Haarala, M; Nurmi, M; Klemi, P; Kiilholma, P

1996-01-01

Microbes may be involved in the pathogenesis of interstitial cystitis (IC). Adenoviruses and BK virus (BKV) can infect epithelial cells in urinary bladder and they are causative agents for hemorrhagic cystitis. We therefore studied the presence of adenovirus and BKV genomes in urinary bladder tissue specimens of patients with IC using polymerase chain reaction (PCR) and in situ hybridization (ISH). Controls were specimens from cases with transitional cell carcinoma of the bladder. Nucleic acids were extracted from paraffin sections of the bladder tissue for PCR. Primers detecting all adenovirus types were used. In situ hybridization was carried out for the paraffin sections using digoxigenin-labeled DNA probes for adenovirus and BKV. The adenovirus DNA PCR was able to detect one to two infected cells/specimen. All the seven IC cases studied and six controls were negative for adenovirus DNA by PCR and ISH. The ISH test for BKV genomes was also considered negative in IC cases and controls. The specimens which were negative in PCR tests yielded a signal with beta-globin primers, thus being amplifiable. We conclude that adenovirus and BKV do not play a major pathogenetic role in interstitial cystitis.

Risk factors for asthma and allergy associated with urban migration: background and methodology of a cross-sectional study in Afro-Ecuadorian school children in Northeastern Ecuador (Esmeraldas-SCAALA Study).

PubMed

Cooper, Philip J; Chico, Martha E; Vaca, Maritza G; Rodriguez, Alejandro; Alcântara-Neves, Neuza M; Genser, Bernd; de Carvalho, Lain Pontes; Stein, Renato T; Cruz, Alvaro A; Rodrigues, Laura C; Barreto, Mauricio L

2006-09-13

Asthma and allergic diseases are becoming increasingly frequent in children in urban centres of Latin America although the prevalence of allergic disease is still low in rural areas. Understanding better why the prevalence of asthma is greater in urban migrant populations and the role of risk factors such as life style and environmental exposures, may be key to understand what is behind this trend. The Esmeraldas-SCAALA (Social Changes, Asthma and Allergy in Latin America) study consists of cross-sectional and nested case-control studies of school children in rural and urban areas of Esmeraldas Province in Ecuador. The cross-sectional study will investigate risk factors for atopy and allergic disease in rural and migrant urban Afro-Ecuadorian school children and the nested case-control study will examine environmental, biologic and social risk factors for asthma among asthma cases and non-asthmatic controls from the cross-sectional study. Data will be collected through standardised questionnaires, skin prick testing to relevant aeroallergen extracts, stool examinations for parasites, blood sampling (for measurement of IgE, interleukins and other immunological parameters), anthropometric measurements for assessment of nutritional status, exercise testing for assessment of exercise-induced bronchospasm and dust sampling for measurement of household endotoxin and allergen levels. The information will be used to identify the factors associated with an increased risk of asthma and allergies in migrant and urbanizing populations, to improve the understanding of the causes of the increase in asthma prevalence and to identify potentially modifiable factors to inform the design of prevention programmes to reduce the risk of allergy in urban populations in Latin America.

Risk factors for asthma and allergy associated with urban migration: background and methodology of a cross-sectional study in Afro-Ecuadorian school children in Northeastern Ecuador (Esmeraldas-SCAALA Study)

PubMed Central

Cooper, Philip J; Chico, Martha E; Vaca, Maritza G; Rodriguez, Alejandro; Alcântara-Neves, Neuza M; Genser, Bernd; de Carvalho, Lain Pontes; Stein, Renato T; Cruz, Alvaro A; Rodrigues, Laura C; Barreto, Mauricio L

2006-01-01

Background Asthma and allergic diseases are becoming increasingly frequent in children in urban centres of Latin America although the prevalence of allergic disease is still low in rural areas. Understanding better why the prevalence of asthma is greater in urban migrant populations and the role of risk factors such as life style and environmental exposures, may be key to understand what is behind this trend. Methods/design The Esmeraldas-SCAALA (Social Changes, Asthma and Allergy in Latin America) study consists of cross-sectional and nested case-control studies of school children in rural and urban areas of Esmeraldas Province in Ecuador. The cross-sectional study will investigate risk factors for atopy and allergic disease in rural and migrant urban Afro-Ecuadorian school children and the nested case-control study will examine environmental, biologic and social risk factors for asthma among asthma cases and non-asthmatic controls from the cross-sectional study. Data will be collected through standardised questionnaires, skin prick testing to relevant aeroallergen extracts, stool examinations for parasites, blood sampling (for measurement of IgE, interleukins and other immunological parameters), anthropometric measurements for assessment of nutritional status, exercise testing for assessment of exercise-induced bronchospasm and dust sampling for measurement of household endotoxin and allergen levels. Discussion The information will be used to identify the factors associated with an increased risk of asthma and allergies in migrant and urbanizing populations, to improve the understanding of the causes of the increase in asthma prevalence and to identify potentially modifiable factors to inform the design of prevention programmes to reduce the risk of allergy in urban populations in Latin America. PMID:16970809

Red Cell Distribution Width and Serum BNP Level Correlation in Diabetic Patients with Cardiac Failure: A Cross - Sectional Study.

PubMed

A R, Subhashree

2014-06-01

Red cell distribution width (RDW) is a red cell measurement given by fully automated hematology analyzers. It is a measure of heterogeneity in the size of circulating erythrocytes. Studies have shown that it is a prognostic marker in non - anemic diabetic patients with symptomatic cardiovascular disease but its correlation with cardiac failure in diabetics has not been studied so far. Moreover, studies have also shown that a higher RDW may reflect an underlying inflammatory state. Since Diabetes is a pro inflammatory state there is a possibility that it might have an influence on the RDW values even when there is no cardiac failure, but research data on this aspect is lacking. B-type natriuretic peptide (BNP) is a proven marker for cardiac failure whose values are comparable with echo cardio graphic findings in assessing the left ventricular dysfunction. This study aimed to find out the correlation between RDW% and serum BNP levels in Diabetics with heart failure (cases) when compared to those without failure (controls). Further, we compared the RDW % values of the cases with controls. Settings and Design : The study was approved by institutional ethical and research committee. A cross-sectional study was conducted with patients attending the Diabetes clinic of a tertiary care hospital in Chennai, India, during the period of October to December 2013. Hundred known cases of type II Diabetes mellitus attending Diabetes centre of the Hospital, with clinical and Echo cardio graphic features of cardiac failure were included as cases. Hundred age and gender matched diabetics with negative history of cardiovascular disease and with normal Echo cardio graphic features were included as controls. Informed consent was obtained from all the cases and controls. Demographic data and clinical history were gathered from all the cases and controls by using a standardized self - administered questionnaire. Biochemical and hematological parameters which included Fasting and Postprandial blood sugar, Glycosylated hemoglobin, Complete Blood count including RDW and serum BNP were performed for all the cases and controls. RESULTS were tabulated and analysed using SPSS 20.0 version A statistically significant correlation (p<.001) was found between Red cell Distribution Width % and Serum B type Natriuretic Peptide values in the cases. Further, RDW% showed a statistically significant difference between cases and controls. RDW% can be used as a screening parameter to identify cardiac failure in Diabetic patients similar to non-diabetic cardiac failure. RDW% values are significantly higher in cases of Diabetes with failure in comparison to uncomplicated Diabetes.

The Role of Hemispheral Asymmetry and Regional Activity of Quantitative EEG in Children with Stuttering

ERIC Educational Resources Information Center

Ozge, Aynur; Toros, Fevziye; Comelekoglu, Ulku

2004-01-01

We investigated the role of delayed cerebral maturation, hemisphere asymmetry and regional differences in children with stuttering and healthy controls during resting state and hyperventilation, using conventional EEG techniques and quantitative EEG (QEEG) analysis. This cross-sectional case control study included 26 children with stuttering and…

40 CFR Appendix F to Part 112 - Facility-Specific Response Plan

Code of Federal Regulations, 2012 CFR

2012-07-01

... Prevention, Control, and Countermeasures (SPCC) Plan as required by 40 CFR 112.3. In these cases, owners or... sections for the non-transportation-related and transportation-related components, as described in § 112.20... of measure Response Action Actions Taken to Correct, Control or Mitigate Incident: Impact Number of...

40 CFR Appendix F to Part 112 - Facility-Specific Response Plan

Code of Federal Regulations, 2013 CFR

2013-07-01

... Prevention, Control, and Countermeasures (SPCC) Plan as required by 40 CFR 112.3. In these cases, owners or... sections for the non-transportation-related and transportation-related components, as described in § 112.20... of measure Response Action Actions Taken to Correct, Control or Mitigate Incident: Impact Number of...

PLA2G7 genotype, Lp-PLA2 activity and coronary heart disease risk in 10,494 cases and 15,624 controls of European ancestry

PubMed Central

Casas, Juan P.; Ninio, Ewa; Panayiotou, Andrie; Palmen, Jutta; Cooper, Jackie A; Ricketts, Sally L; Sofat, Reecha; Nicolaides, Andrew N; Corsetti, James P; Fowkes, F Gerry R; Tzoulaki, Ioanna; Kumari, Meena; Brunner, Eric J; Kivimaki, Mika; Marmot, Michael G; Hoffmann, Michael M; Winkler, Karl; März, Winfred; Ye, Shu; Stirnadel, Heide A; MBBChir, Kay-Tee Khaw; Humphries, Steve E; Sandhu, Manjinder S; Hingorani, Aroon D; Talmud, Philippa J

2012-01-01

Background Higher Lp-PLA2 activity is associated with increased risk of coronary heart disease (CHD), making Lp-PLA2 a potential therapeutic target. PLA2G7 variants associated with Lp-PLA2 activity could evaluate whether this relationship is causal. Methods and Results A meta-analysis including a total of 12 studies (5 prospective, 4 case-control, 1 case-only and 2 cross-sectional, n=26,118) was undertaken to examine the association of: (i) LpPLA2 activity vs. cardiovascular biomarkers and risk factors and CHD events (two prospective studies; n=4884); ii) PLA2G7 SNPs and Lp-PLA2 activity (3 prospective, 2 case-control, 2 cross-sectional studies; up to n=6094); and iii) PLA2G7 SNPs and angiographic coronary artery disease (2 case-control, 1 case-only study; n=4971 cases) and CHD events (5 prospective, 2 case-control studies; n=5523). Lp-PLA2 activity correlated with several CHD risk markers. Hazard ratio for CHD events top vs. bottom quartile of Lp-PLA2 activity was 1.61 (95%CI: 1.31, 1.99) and 1.17 (95%CI: 0.91, 1.51) after adjustment for baseline traits. Of seven SNPs, rs1051931 (A379V) showed the strongest association with Lp-PLA2 activity, VV subjects having 7.2% higher activity than AAs. Genotype was not associated with risk markers, angiographic coronary disease (OR 1.03 (95%CI 0.80, 1.32), or CHD events (OR 0.98 (95%CI 0.82, 1.17). Conclusions Unlike Lp-PLA2 activity, PLA2G7 variants associated with modest effects on Lp-PLA2 activity were not associated with cardiovascular risk markers, coronary atheroma or CHD. Larger association studies, identification of SNPs with larger effects, or randomised trials of specific Lp-PLA2 inhibitors are needed to confirm/refute a contributory role for Lp-PLA2 in CHD. PMID:20479152

26 CFR 1.960-1 - Foreign tax credit with respect to taxes paid on earnings and profits of controlled foreign...

Code of Federal Regulations, 2010 CFR

2010-04-01

...-, second-, or third-tier corporation's earnings and profits. Section 1.960-2 prescribes rules for applying section 902 to dividends paid by a third-, second-, or first-tier corporation from earnings and profits...) Second-tier corporation. In the case of amounts included in the gross income of the taxpayer under...

26 CFR 1.382-8 - Controlled groups.

Code of Federal Regulations, 2012 CFR

2012-04-01

... described in section 382(h)(6)(B). (c) Computation of value. For purposes of computing the limitation under... (h)(2)(i) of this section in the case of a foreign component member) to restore value to another... consolidated group, a loss group, or loss subgroup (as those terms are defined in §§ 1.1502-1(h) and 1.1502-91...

26 CFR 1.382-8 - Controlled groups.

Code of Federal Regulations, 2013 CFR

2013-04-01

... described in section 382(h)(6)(B). (c) Computation of value. For purposes of computing the limitation under... (h)(2)(i) of this section in the case of a foreign component member) to restore value to another... consolidated group, a loss group, or loss subgroup (as those terms are defined in §§ 1.1502-1(h) and 1.1502-91...

UK case control study of brain tumours in children, teenagers and young adults: a pilot study.

PubMed

Feltbower, Richard G; Fleming, Sarah J; Picton, Susan V; Alston, Robert D; Morgan, Diana; Achilles, Janice; McKinney, Patricia A; Birch, Jillian M

2014-01-08

Tumours of the central nervous system are the second most common group of childhood cancers in 0-14 year olds (24% of total cancers) and represent a major diagnostic group in 15-24 year olds. The pilot case-control study aimed to establish methodologies for a future comprehensive aetiological investigation among children and young adults. Eligible cases were newly diagnosed with an intracranial tumour of neuroepithelial tissue aged 0-24 years. The pilot recruited patients through Leeds and Manchester Principal Treatment Centres. Controls were drawn from general practice lists. Controls were frequency matched by age and gender. We interviewed 49 cases and 78 controls comprising 85% of the target sample size. Response rates were 52% for cases and 32% for controls. Completion of the questionnaire was successful, with a very small proportion of missing data being reported (5-10%). The age distribution of cases and controls was similar with around three-quarters of interviewed subjects aged 0-14. Half of cases and almost two-thirds of controls reported using a mobile phone with the majority starting between 10-14 years of age. Prevalence of breastfeeding was lower in cases than controls (Odds Ratio 0.4; 95% CI 0.2-1.2), whilst cases were more likely to be delivered by caesarean section (OR 1.6; 95% CI 0.6-4.4). Cases were significantly more likely to have a birthweight > 3.5 kg compared to controls. Cases were also more likely to come from a family with 3 or more siblings than controls (OR 3.0; 95% CI 0.7-13.6). The majority of participants (>80%) were in favour of taking either blood or saliva to aid molecular epidemiological research. Successful methods were established for identifying and recruiting a high proportion of case subjects, exploiting strong links with the clinical teams at the treatment centres. Control procedures proved more difficult to implement. However, working closely with national clinical and professional research networks will enable improved control identification and recruitment, with good prospects for collecting biological samples in the future.

Uric acid and serum antioxidant capacity: a reaction to atherosclerosis?

PubMed

Nieto, F J; Iribarren, C; Gross, M D; Comstock, G W; Cutler, R G

2000-01-01

the evidence of a potential beneficial role of antioxidants in preventing atherosclerotic disease is not entirely consistent. to assess the longitudinal association of serum total antioxidant capacity and serum antioxidants with the presence of subclinical carotid atherosclerosis. Prospective case-control study nested within an historical cohort. Cases were 150 individuals with elevated carotid intimal-medial thickness measured by B-mode ultrasound at the first two examinations of the Atherosclerosis Risk in Communities Study (1987-92). Controls were 150 age-gender-matched individuals with low carotid intimal-medial thickness. Serum antioxidant vitamins, uric acid, and serum total antioxidant capacity were measured in frozen serum samples collected from the same individuals in 1974 (13-15 years prior to the determination of case-control status). Compared to controls, atherosclerosis cases had significantly higher levels of serum total antioxidant capacity in 1974 than controls. This difference was almost entirely explained by increased serum concentration of uric acid in cases. In contrast with cross-sectional results, uric acid serum concentration in 1974, was significantly higher in cases than in controls, even after adjusting for the main cardiovascular risk factors. Cases had significantly lower levels of alpha-carotene in the 1974 sera than controls, but no other differences in serum antioxidant vitamin concentrations were observed. The higher serum uric acid concentration seemed associated with elevated total serum antioxidant capacity among individuals with atherosclerosis. This finding is consistent with experimental evidence suggesting that hyperuricemia may be a compensatory mechanism to counteract oxidative damage related to atherosclerosis and aging in humans.

Blood Harmane (1-methyl-9h-pyrido[3,4-b]indole) Concentrations in Essential Tremor: Repeat Observation in Cases and Controls in New York

PubMed Central

Louis, Elan D.; Jiang, Wendy; Gerbin, Marina; Viner, Amanda S.; Factor-Litvak, Pam; Zheng, Wei

2012-01-01

Essential tremor (ET) is a widespread late-life neurological disease. Genetic and environmental factors are likely to play important etiological roles. Harmane (1-methyl-9H-pyrido[3,4-b]indole) is a potent tremor-producing neurotoxin. Previously, elevated blood harmane concentrations were demonstrated in ET cases compared to controls, but these observations were all been cross-sectional, assessing each subject at only one time point. Thus, no one has ever repeat-assayed blood harmane in the same subjects twice. Whether the observed case-control difference persists at a second time point, years later, is unknown. The current goal was to re-assess a sample of our ET cases and controls to determine whether blood harmane concentration remained elevated in ET at a second time point. Blood harmane concentrations were quantified by a well-established high performance liquid chromatography method in 63 ET cases and 70 controls. A mean of approximately 6 years elapsed between the initial and this subsequent blood harmane determination. The mean log blood harmane concentration was significantly higher in cases than controls (0.30 ± 0.61 g−10/ml vs. 0.08 ± 0.55 g−10/ml), and the median value in cases was double that of controls: 0.22 g−10/ml vs. 0.11 g−10/ml. The log blood harmane concentration was highest in cases with a family history of ET. Blood harmane concentration was elevated in ET cases compared to controls when re-assessed at a second time point several years later, indicating what seems to be a stable association between this environmental toxin and ET. PMID:22757671

Blood harmane (1-methyl-9H-pyrido[3,4-b]indole) concentrations in essential tremor: repeat observation in cases and controls in New York.

PubMed

Louis, Elan D; Jiang, Wendy; Gerbin, Marina; Viner, Amanda S; Factor-Litvak, Pam; Zheng, Wei

2012-01-01

Essential tremor (ET) is a widespread late-life neurological disease. Genetic and environmental factors are likely to play important etiological roles. Harmane (1-methyl-9H-pyrido[3,4-b]indole) is a potent tremor-producing neurotoxin. Previously, elevated blood harmane concentrations were demonstrated in ET cases compared to controls, but these observations have all been cross-sectional, assessing each subject at only one time point. Thus, no one has ever repeat-assayed blood harmane in the same subjects twice. Whether the observed case-control difference persists at a second time point, years later, is unknown. The current goal was to reassess a sample of our ET cases and controls to determine whether blood harmane concentration remained elevated in ET at a second time point. Blood harmane concentrations were quantified by a well-established high-performance liquid chromatography method in 63 ET cases and 70 controls. A mean of approximately 6 yr elapsed between the initial and this subsequent blood harmane determination. The mean log blood harmane concentration was significantly higher in cases than controls (0.30 ± 0.61 g(-10)/ml versus 0.08 ± 0.55 g(-10)/ml), and the median value in cases was double that of controls: 0.22 g(-10)/ml versus 0.11 g(-10)/ml. The log blood harmane concentration was highest in cases with a family history of ET. Blood harmane concentration was elevated in ET cases compared to controls when reassessed at a second time point several years later, indicating what seems to be a stable association between this environmental toxin and ET.

Benefits of using intrathecal buprenorphine.

PubMed

Rabiee, Seyed Mozaffar; Alijanpour, Ebrahim; Jabbari, Ali; Rostami, Sara

2014-01-01

General anesthesia draws attention to the most commonly used modalities for post cesarean delivery pain relief in systemic administration of opioids, while the administration of small dose of intrathecal opioid during spinal anesthesia can be a possible alternative. The aim of this study was to evaluate the effects of buprenorphine on cesarean section prescribed intrathecally. This double blind randomized clinical trial study was conducted in patients for cesarean section under spinal anesthesia. The patients were randomly divided into case and control groups. Case group (208 patients) received 65-70 mg of 5% lidocaine plus 0.2 ml of buprenorphine while the same amount of 5% lidocaine diluted with 0.2 ml of normal saline was given to 234 cases in the control group. Hemodynamic changes and neonatal APGAR scores (Appearance, Pulse, Grimace, Activity, Respiration) were recorded. Pain score was recorded according to the visual analog scale. This study was registered in the Iranian Registry of clinical Trials; IRCT2013022112552N1. The mean age of case and control groups was 24.4±5.38 and 26.84±5.42 years, respectively. Systolic blood pressure was not significantly different until the 45th minute but diastolic blood pressure showed a significant difference at the 15th and the 60th minutes (P<0.001). Heart rate changes were significantly different between cases and controls at the initial 5th, 15th and after 60th minutes (P<0.001). Pain-free period was significantly different between two groups (1.25 h versus 18.73 h) (P<0.001). The results show that prescription of intratechal buprenorphine prolongs the duration of analgesia without any significant considerable side effects.

Post-stroke bacteriuria among stroke patients attending a physiotherapy clinic in Ghana: a cross-sectional study

PubMed Central

Donkor, Eric S; Akumwena, Amos; Amoo, Philip K; Owolabi, Mayowa O; Aspelund, Thor; Gudnason, Vilmundur

2016-01-01

Background Infections are known to be a major complication of stroke patients. In this study, we evaluated the risk of community-acquired bacteriuria among stroke patients, the associated factors, and the causative organisms. Methods This was a cross-sectional study involving 70 stroke patients and 83 age- and sex-matched, apparently healthy controls. Urine specimens were collected from all the study subjects and were analyzed by standard microbiological methods. Demographic and clinical information was also collected from the study subjects. For stroke patients, the information collected also included stroke parameters, such as stroke duration, frequency, and subtype. Results Bacteriuria was significantly higher among stroke patients (24.3%, n=17) than among the control group (7.2%, n=6), with a relative risk of 3.36 (confidence interval [CI], 1.40–8.01, P=0.006). Among the control group, all six bacteriuria cases were asymptomatic, whereas the 17 stroke bacteriuria cases comprised 15 cases of asymptomatic bacteriuria and two cases of symptomatic bacteriuria. Female sex (OR, 3.40; CI, 1.12–10.30; P=0.03) and presence of stroke (OR, 0.24; CI, 0.08–0.70; P=0.009) were significantly associated with bacteriuria. The etiology of bacteriuria was similar in both study groups, and coagulase-negative Staphylococcus spp. were the most predominant organisms isolated from both stroke patients (12.9%) and the control group (2.4%). Conclusion Stroke patients in the study region have a significantly higher risk of community-acquired bacteriuria, which in most cases is asymptomatic. Community-acquired bacteriuria in stroke patients appears to have little or no relationship with clinical parameters of stroke such as stroke subtype, duration and frequency. PMID:27051289

Incidence, risk factors and perinatal outcomes for placenta accreta in Australia and New Zealand: a case–control study

PubMed Central

Farquhar, Cynthia M; Li, Zhuoyang; McLintock, Claire; Pollock, Wendy; Peek, Michael J; Ellwood, David; Knight, Marian; Vaughan, Geraldine; Wang, Alex; Sullivan, Elizabeth

2017-01-01

Objective Estimate the incidence of placenta accreta and describe risk factors, clinical practice and perinatal outcomes. Design Case–control study. Setting Sites in Australia and New Zealand with at least 50 births per year. Participants Cases were women giving birth (≥20 weeks or fetus ≥400 g) who were diagnosed with placenta accreta by antenatal imaging, at operation or by pathology specimens between 2010 and 2012. Controls were two births immediately prior to a case. A total of 295 cases were included and 570 controls. Methods Data were collected using the Australasian Maternity Outcomes Surveillance System. Primary and secondary outcome measures Incidence, risk factors (eg, prior caesarean section (CS), maternal age) and clinical outcomes of placenta accreta (eg CS, hysterectomy and death). Results The incidence of placenta accreta was 44.2/100 000 women giving birth (95% CI 39.4 to 49.5); however, this may overestimated due to the case definition used. In primiparous women, an increased odds of placenta accreta was observed in older women (adjusted OR (AOR) women≥40 vs <30: 19.1, 95% CI 4.6 to 80.3) and current multiple birth (AOR: 6.1, 95% CI 1.1 to 34.1). In multiparous women, independent risk factors were prior CS (AOR ≥2 prior sections vs 0: 13.8, 95% CI 7.4 to 26.1) and current placenta praevia (AOR: 36.3, 95% CI 14.0 to 93.7). There were two maternal deaths (case fatality rate 0.7%). Women with placenta accreta were more likely to have a caesarean section (AOR: 4.6, 95% CI 2.7 to 7.6) to be admitted to the intensive care unit (ICU)/high dependency unit (AOR: 46.1, 95% CI 22.3 to 95.4) and to have a hysterectomy (AOR: 209.0, 95% CI 19.9 to 875.0). Babies born to women with placenta accreta were more likely to be preterm, be admitted to neonatal ICU and require resuscitation. PMID:28982832

Complete embedding and close step-sectioning of radical prostatectomy specimens both increase detection of extra-prostatic extension, and correlate with increased disease-free survival by stage of prostate cancer patients.

PubMed

Desai, A; Wu, H; Sun, L; Sesterhenn, I A; Mostofi, F K; McLeod, D; Amling, C; Kusuda, L; Lance, R; Herring, J; Foley, J; Baldwin, D; Bishoff, J T; Soderdahl, D; Moul, J W

2002-01-01

The objectives of this work were to evaluate the efficacy of controlled close step-sectioned and whole-mounted radical prostatectomy specimen processing in prediction of clinical outcome as compared to the traditional processing techniques. Two-hundred and forty nine radical prostatectomy (RP) specimens were whole-mounted and close step-sectioned at caliper-measured 2.2-2.3 mm intervals. A group of 682 radical prostatectomy specimens were partially sampled as control. The RPs were performed during 1993-1999 with a mean follow-up of 29.3 months, pretreatment PSA of 0.1-40, and biopsy Gleason sums of 5-8. Disease-free survival based on biochemical or clinical recurrence and secondary intervention were computed using a Kaplan-Meier analysis. There were no significant differences in age at diagnosis, age at surgery, PSA at diagnosis, or biopsy Gleason between the two groups (P<0.05). Compared with the non-close step-sectioned group, the close step-sectioned group showed higher detection rates of extra-prostatic extension (215 (34.1%) vs, 128 (55.4%), P<0.01), and seminal vesicle invasion (50 (7.6%) vs 35 (14.7%), P<0.01). The close step-sectioned group correlated with greater 3-y disease-free survival in organ-confined (P<0.01) and specimen-confined (P<0.01) cases, over the non-uniform group. The close step-sectioned group showed significantly higher disease-free survival for cases with seminal vesicle invasion (P=0.046). No significant difference in disease-free survival was found for the positive margin group (P=0.39) between the close step-sectioned and non-uniform groups. The close step-sectioned technique correlates with increased disease-free survival rates for organ and specimen confined cases, possibly due to higher detection rates of extra-prostatic extension and seminal vesicle invasion. Close step-sectioning provides better assurance of organ-confined disease, resulting in enhanced prediction of outcome by pathological (TNM) stage.

No evidence for Helicobacter pylori in oral lichen planus.

PubMed

Hulimavu, Shwetha R; Mohanty, Leeky; Tondikulam, Narayan V; Shenoy, Sadhana; Jamadar, Saleha; Bhadranna, Abhishek

2014-09-01

Oral lichen planus is a T-cell-mediated mucosal disease of unknown etiology. Numerous predisposing factors have been put forward in the etiology of this disease. This includes stress, drugs, genetic susceptibility, certain viruses, and bacterial infections. Recently, there have been studies published on possible role of Helicobacter pylori infection in pathogenesis of mucocutaneous diseases including oral lichen planus (OLP). The aim of this study was to detect immunohistochemically the presence of Helicobacter pylori in oral lichen planus. Paraffin-embedded tissue blocks of 50 cases of OLP and 10 cases of normal buccal mucosal biopsies and 6 endoscopic biopsies of patients with peptic ulcer (control group) were sectioned and stained by hematoxylin and eosin. Serial sections of same were stained immunohistochemically using Anti-Helicobacter pylori antibody and observed under microscope for presence or absence of Helicobacter pylori. Except for the control group, none of the cases of OLP and normal buccal mucosal biopsies showed positivity for Helicobacter pylori. As we did not detect the presence of Helicobacter pylori in any of the OLP cases, we question the role of these organisms in the pathogenesis of OLP planus if any. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Successful vaginal birth after caesarean section in patient with Ehler-Danlos syndrome type 2.

PubMed

Maraj, Hemant; Mohajer, Michelle; Bhattacharjee, Deepannita

2011-12-01

We present the case of a 31-year-old woman with Ehler-Danlos syndrome (EDS) type 2. She had a previous caesarean section and went on to have an uncomplicated vaginal birth in her last pregnancy. To our knowledge, this is the first case of a successful vaginal birth after caesarean section in a patient with EDS. EDS is a multisystem disorder involving a genetic defect in collagen and connective-tissue synthesis and structure. It is a heterogeneous group of 11 different inherited disorders. Obstetric complications in these patients include miscarriages, stillbirths, premature rupture of the membranes, preterm labour, uterine prolapse, uterine rupture and severe postpartum haemorrhage. There has been much controversy over the appropriate mode of delivery. Abdominal deliveries are complicated by delayed wound healing and increased perioperative blood loss. Vaginal deliveries may be complicated by tissue friability causing extensive perineal tears, pelvic floor and bladder lesions. Our case highlights that in specific, controlled situations it is possible to have a vaginal delivery even after previous caesarean section in patients with EDS.

Successful vaginal birth after caesarean section in patient with Ehler-Danlos syndrome type 2

PubMed Central

Maraj, Hemant; Mohajer, Michelle; Bhattacharjee, Deepannita

2011-01-01

We present the case of a 31-year-old woman with Ehler-Danlos syndrome (EDS) type 2. She had a previous caesarean section and went on to have an uncomplicated vaginal birth in her last pregnancy. To our knowledge, this is the first case of a successful vaginal birth after caesarean section in a patient with EDS. EDS is a multisystem disorder involving a genetic defect in collagen and connective-tissue synthesis and structure. It is a heterogeneous group of 11 different inherited disorders. Obstetric complications in these patients include miscarriages, stillbirths, premature rupture of the membranes, preterm labour, uterine prolapse, uterine rupture and severe postpartum haemorrhage. There has been much controversy over the appropriate mode of delivery. Abdominal deliveries are complicated by delayed wound healing and increased perioperative blood loss. Vaginal deliveries may be complicated by tissue friability causing extensive perineal tears, pelvic floor and bladder lesions. Our case highlights that in specific, controlled situations it is possible to have a vaginal delivery even after previous caesarean section in patients with EDS. PMID:27579117

Structural Design and Analysis of the Upper Pressure Shell Section of a Composite Crew Module

NASA Technical Reports Server (NTRS)

Sleight, David W.; Paddock, David; Jeans, Jim W.; Hudeck, John D.

2008-01-01

This paper presents the results of the structural design and analysis of the upper pressure shell section of a carbon composite demonstration structure for the Composite Crew Module (CCM) Project. The project is managed by the NASA Engineering and Safety Center with participants from eight NASA Centers, the Air Force Research Laboratory, and multiple aerospace contractors including ATK/Swales, Northrop Grumman, Lockheed Martin, Collier Research Corporation, Genesis Engineering, and Janicki Industries. The paper discusses details of the upper pressure shell section design of the CCM and presents the structural analysis results using the HyperSizer structural sizing software and the MSC Nastran finite element analysis software. The HyperSizer results showed that the controlling load case driving most of the sizing in the upper pressure shell section was the internal pressure load case. The regions around the cutouts were controlled by internal pressure and the main parachute load cases. The global finite element analysis results showed that the majority of the elements of the CCM had a positive margin of safety with the exception of a few hot spots around the cutouts. These hot spots are currently being investigated with a more detailed analysis. Local finite element models of the Low Impact Docking System (LIDS) interface ring and the forward bay gussets with greater mesh fidelity were created for local sizing and analysis. The sizing of the LIDS interface ring was driven by the drogue parachute loads, Trans-Lunar Insertion (TLI) loads, and internal pressure. The drogue parachute loads controlled the sizing of the gusset cap on the drogue gusset and TLI loads controlled the sizing of the other five gusset caps. The main parachute loads controlled the sizing of the lower ends of the gusset caps on the main parachute fittings. The results showed that the gusset web/pressure shell and gusset web/gusset cap interfaces bonded using Pi-preform joints had local hot spots in the Pi-preform termination regions. These regions require a detailed three-dimensional analysis, which is currently being performed, to accurately address the load distribution near the Pi-preform termination in the upper and lower gusset caps.

A multi-site evaluation of innovative approaches to increase tuberculosis case notification: summary results.

PubMed

Creswell, Jacob; Sahu, Suvanand; Blok, Lucie; Bakker, Mirjam I; Stevens, Robert; Ditiu, Lucica

2014-01-01

Globally, TB notifications have stagnated since 2007, and sputum smear positive notifications have been declining despite policies to improve case detection. We evaluate results of 28 interventions focused on improving TB case detection. We measured additional sputum smear positive cases treated, defined as the intervention area's increase in case notification during the project compared to the previous year. Projects were encouraged to select control areas and collect historical notification data. We used time series negative binomial regression for over-dispersed cross-sectional data accounting for fixed and random effects to test the individual projects' effects on TB notification while controlling for trend and control populations. Twenty-eight projects, 19 with control populations, completed at least four quarters of case finding activities, covering a population of 89.2 million. Among all projects sputum smear positive (SS+) TB notifications increased 24.9% and annualized notification rates increased from 69.1 to 86.2/100,000 (p = 0.0209) during interventions. Among the 19 projects with control populations, SS+TB case notifications increased 36.9% increase while in the control populations a 3.6% decrease was observed. Fourteen (74%) of the 19 projects' SS+TB notification rates in intervention areas increased from the baseline to intervention period when controlling for historical trends and notifications in control areas. Interventions were associated with large increases in TB notifications across many settings, using an array of interventions. Many people with TB are not reached using current approaches. Different methods and interventions tailored to local realities are urgently needed.

Lack of Correlation between Metallic Elements Analyzed in Hair by ICP-MS and Autism

ERIC Educational Resources Information Center

De Palma, Giuseppe; Catalani, Simona; Franco, Anna; Brighenti, Maurizio; Apostoli, Pietro

2012-01-01

A cross-sectional case-control study was carried out to evaluate the concentrations of metallic elements in the hair of 44 children with diagnosis of autism and 61 age-balanced controls. Unadjusted comparisons showed higher concentrations of molybdenum, lithium and selenium in autistic children. Logistic regression analysis confirmed the role of…

45 CFR 2526.30 - How do convictions for the possession or sale of controlled substances affect an education award...

Code of Federal Regulations, 2013 CFR

2013-10-01

... trafficking of controlled substances; (F) Length of time between offenses; (G) Employment history; (H) Service... this section has successfully completed a legitimate drug rehabilitation program, or in the case of a first conviction that the individual has enrolled in a legitimate drug rehabilitation program, the...

45 CFR 2526.30 - How do convictions for the possession or sale of controlled substances affect an education award...

Code of Federal Regulations, 2011 CFR

2011-10-01

... trafficking of controlled substances; (F) Length of time between offenses; (G) Employment history; (H) Service... this section has successfully completed a legitimate drug rehabilitation program, or in the case of a first conviction that the individual has enrolled in a legitimate drug rehabilitation program, the...

Formal Leadership of Department Chairpersons with a Broadening Span of Control in Restructured Community Colleges: A Multi-Case Study

ERIC Educational Resources Information Center

Fattig, Teri L.

2013-01-01

Community college department chairpersons have experienced a broadening span of control due to the restructuring tactics of community colleges and the approaches utilized in order to cope with decreased budgets and increased enrollments. Many community colleges used strategies which involved flattening the middle management section of the…

45 CFR 2526.30 - How do convictions for the possession or sale of controlled substances affect an education award...

Code of Federal Regulations, 2010 CFR

2010-10-01

... trafficking of controlled substances; (F) Length of time between offenses; (G) Employment history; (H) Service... this section has successfully completed a legitimate drug rehabilitation program, or in the case of a first conviction that the individual has enrolled in a legitimate drug rehabilitation program, the...

Coordination in Distributed Intelligent Systems Applications

DTIC Science & Technology

2009-12-13

working in the area of Distributed Artificial Intelligence (DAI) unanimously endorses the idea that coordination - a fundamental paradigm - represents a...using the distributed artificial intelligence paradigm. Section 4 discusses the healthcare applications. On the other hand, Section 5 describes...coordination mechanisms should be used is in the control of swarms of UA Vs (unmanned aerial vehicles). The UAVs are considered in this case as highly mobile

Real-Time Meteorological Battlespace Characterization in Support of Sea Power 21

DTIC Science & Technology

2011-02-04

32  5.3  LESSONS LEARNED ....................................................................................... 44  6.  FUTURE WORK...problem with the SWR alignment, which is sometimes re- set during SWR maintenance (see Section 6 ‘Lessons Learned ’ for a case in point). Fig...ground clutter present (discussed in Section 6 ‘Lessons Learned ’), along with the lowest-tilt, quality controlled velocity. Bottom panel shows the

[Confirmed Dengue, Chikungunya and Zika Cases during the Period 2014 to 2016 in Barcelona, Spain].

PubMed

González, Roser; Camprubí, Esteve; Fernández, Lidia; Millet, Joan Pau; Peracho, Víctor; Gorrindo, Pilar; Avellanés, Ingrid; Romero, Arancha; Caylà, Joan A

2017-03-07

Arbovirus infections are a group of diseases whose incidence is increasing and that entail an important problem for public health. The aim of this study was to describe detected cases of arbovirosis in Barcelona, and surveillance and control actions performed in order to reduce the risk of transmission. Descriptive cross-sectional study of confirmed dengue, chikungunya and Zika cases in Barcelona during 2014-2016 (1st trimester). Suspected cases detected in the city were notified to the Epidemiology Department of the Barcelona Public Health Agency, where an epidemiological survey is undertaken and, if appropriate, Urban Pests Surveillance and Control Department is contacted. They perform an entomological inspection and implement control and monitoring actions. We collected sociodemographical, epidemiological, clinical and entomological variables. In 2014, 50 chikungunya and 20 dengue cases were detected; 25 entomological inspections were carried out in residences and 38 in the street. In 2015, 47 chikungunya, 51 dengue and 2 Zika cases were detected; 27 inspections were carried out in residences and 80 in the street. In 2016, 17 chikungunya, 52 dengue and 48 Zika cases were detected; 50 inspections were carried out in residences and 103 in the street. No autochtonous case was detected. We observed an increasing incidence of arbovirosis cases during the 3-year study period. There was a progressive intensification of vector surveillance and control actions (inspections, sample collection…).

Epidemiology of autistic disorder in Bahrain: prevalence and obstetric and familial characteristics.

PubMed

Al-Ansari, A M; Ahmed, M M

2013-09-01

European and North American studies show that the prevalence of autistic disorder is inccreasing. This study was performed to identify the prevalence of autistic disorder in Bahrain, and determine some of the demographic and family characteristics. Using a case-control design, 100 children who received a diagnosis of autistic disorder according to DSM-IV-TR during the period 2000-2010 were selected. An equal numberofcontrols who had received a diagnosis of nocturnal enuresis and no psychopathology were selected, matched for sex and age group. The prevalence of autistic disorder was estimated as 4.3 per 10,000 population, with a male:female sex ratio of 4:1. Significantly more cases than controls were delivered by caesarean section and had mothers who suffered prenatal complications. The prevalence estimate in Bahrain is comparable to previous reports using similar methods. Obstetric complications and caesarean section delivery may be associated with autistic disorder.

A life threatening uterine inversion and massive post partum hemorrhage caused by placenta accrete during Caesarean section in a primigravida: a case report

PubMed Central

2009-01-01

Background A 32-year-old Caucasian primigravida was admitted for elective Caesarean Section at 36 weeks and 6 days with the diagnosis of preeclampsia. Case presentation Traction of the umbilical cord after delivery of a healthy baby resulted in uterine inversion. The placenta was found to be densely adherent to the posterior uterine wall. Piecemeal excision of the placenta as close as possible to the uterine lining was then performed. Conclusion In this way we were able to control a massive post partum hemorrhage and preserve the fertility of the patient. PMID:19210798

Indoor dampness and molds and development of adult-onset asthma: a population-based incident case-control study.

PubMed Central

Jaakkola, Maritta S; Nordman, Henrik; Piipari, Ritva; Uitti, Jukka; Laitinen, Jukka; Karjalainen, Antti; Hahtola, Paula; Jaakkola, Jouni J K

2002-01-01

Previous cross-sectional and prevalent case-control studies have suggested increased risk of asthma in adults related to dampness problems and molds in homes. We conducted a population-based incident case-control study to assess the effects of indoor dampness problems and molds at work and at home on development of asthma in adults. We recruited systematically all new cases of asthma during a 2.5-year study period (1997-2000) and randomly selected controls from a source population consisting of adults 21-63 years old living in the Pirkanmaa Hospital district, South Finland. The clinically diagnosed case series consisted of 521 adults with newly diagnosed asthma and the control series of 932 controls, after we excluded 76 (7.5%) controls with a history of asthma. In logistic regression analysis adjusting for confounders, the risk of asthma was related to the presence of visible mold and/or mold odor in the workplace (odds ratio, 1.54; 95% confidence interval, 1.01-2.32) but not to water damage or damp stains alone. We estimated the fraction of asthma attributable to workplace mold exposure to be 35.1% (95% confidence interval, 1.0-56.9%) among the exposed. Present results provide new evidence of the relation between workplace exposure to indoor molds and adult-onset asthma. PMID:12003761

Fibrinogen Demonstration in Oral Lichen Planus: An Immunofluorescence Study on Archival Tissues.

PubMed

Shirol, Pallavi D; Naik, Veena; Kale, Alka

2015-10-01

Lichen planus is a premalignant condition with minimal diagnostic aids. This study is an attempt to use paraffin embedded sections of lichen planus with immunofluorescein stain and to evaluate the immunofluorescent sections to establish pattern of fibrinogen deposition. Thirty-five paraffin embedded sections of old and new cases of oral lichen planus (study group) and five normal oral mucosa (control group) were chosen. Two sections of each (H & E) case were taken, one was stained with hematoxylin and eosin and another with fluorescein isothiocynate conjugate (FITC) polyclonal rabbit antibody against fibrinogen. Fluorescent findings were examined with a fluorescent microscope. A high statistical significant correlation was found in respect to fluorescence positivity, intensity of fluorescence and distribution of fluorescence each with p < 0.0001 and fluorescence at blood vessel walls (p = 0.0003). This study suggested that paraffin embedded sections can be successfully used in direct immunofluorescence staining in routine set up where only formalin fixed tissues are received. Paraffin embedded sections can be successfully used in direct immunofluorescence staining when only formalin fixed tissues are received.

Abnormal folate metabolism as a risk factor for first-trimester spontaneous abortion.

PubMed

Hoffman, Michael L; Scoccia, Bert; Kurczynski, Thaddeus W; Shulman, Lee P; Gao, Weihua

2008-03-01

To assess the potential role of folic acid in early pregnancy loss by measuring homocysteine (hcy) levels in healthy, pregnant women who present with a current first-trimester miscarriage. This was a cross-sectional analysis comprising 13 patients aged 18-31 years old who had a scheduled dilatation and curettage for a first-trimester miscarriage. The controls were 15 patients of similar maternal age presenting for a first-trimester prenatal care visit. Following completion of a 21-item, structured questionnaire, patients were excluded from the study if they had any known risk factors for a first-trimester miscarriage. The remaining patients provided blood samples for measurement of homocysteine and red blood cell folate. Cases and controls were compared using a standard 2-sample t test. In order to detect a clinically relevant 2.3 micromol/L difference in homocysteine levels, 11 cases and 8 controls were needed. The mean hcy level in cases (5.8 umolmol/L) vs. controls (5.7 micromol/L) was not significantly different (p = 0.83), and all individual values fell within the normal range expected in pregnant women. Red blood cell folate levels (cases=586 ng/mL, controls=611 ng/mL) were also not significantly different (p = 0.72), and no cases of folate deficiency were detected. Maternal age (cases=26, controls=25) and gestational age (cases = 8.8 weeks, controls = 8.4 weeks) were similar between the 2 groups. In this community-based pilot study, abnormal folate metabolism was not an apparent risk factor for spontaneous first-trimester pregnancy loss.

[Application of lower abdominal aorta balloon occlusion technique by ultrasound guiding during caesarean section in patients with pernicious placenta previa].

PubMed

Wei, L C; Gong, G Y; Chen, J H; Hou, P Y; Li, Q Y; Zheng, Z Y; Su, Y M; Zheng, Y; Luo, C Z; Zhang, K; Xu, T F; Ye, Y H; Lan, Y J; Wei, X M

2018-03-27

Objective: To discuss the feasibility, effect and safety of lower abdominal aorta balloon occlusion technique by ultrasound guiding during caesarean section in patients with pernicious placenta previa. Methods: The clinical data of 40 patients with pernicious placenta previa complicated with placenta accreta from January 2015 to August 2017 in Liuzhou workers hospital were analyzed retrospectively. The study group included 20 cases, which were operated in the way of cesarean section combined lower abdominal aorta balloon occlusion technique by ultrasound guiding, while the control group also included 20 cases, which were operated in the way of the conventional cesarean section without balloon occlusion technique. The bleeding amount, blood transfusion volume, operative total time, hysterectomy and complications of the two groups were compared. Results: The bleeding amount and blood transfusion volume in study group were(850±100)ml and (400±50)ml, which were lower than that of the control group[(2 500±230)ml and (1 500±100)ml], the difference was statistically significant( t =35.624, 16.523, all P <0.05). In addition, the hysterectomy rate in study group was 5%, which was lower than that in the control group(30%), the difference was statistically significant(χ 2 =8.672, P <0.05). And the total time of operation was (2.0±0.5)h in the study group, which was shorter than that in the control group[(3.5±0.4)h]. The difference was statistically significant( t =11.362, P <0.05). No postoperative complications took place in the study group.The blood pressure, heart rate and blood oxygen fluctuated significantly, and the postoperative renal function was significantly reduced in the control group. Conclusions: The lower abdominal aorta balloon occlusion technique by ultrasound guiding during a caesarean section in patients with pernicious placenta previa can effectively control the bleeding during operation, and preserve reproductive function to the utmost degree.Therefore, the technique is safe, feasible, convenient and cheaper, and worthy of being widely applied in clinic.

Development and validation of a protocol for optimizing the use of paraffin blocks in molecular epidemiological studies: The example from the HPV-AHEAD study.

PubMed

Mena, Marisa; Lloveras, Belen; Tous, Sara; Bogers, Johannes; Maffini, Fausto; Gangane, Nitin; Kumar, Rekha Vijay; Somanathan, Thara; Lucas, Eric; Anantharaman, Devasena; Gheit, Tarik; Castellsagué, Xavier; Pawlita, Michael; de Sanjosé, Silvia; Alemany, Laia; Tommasino, Massimo

2017-01-01

Worldwide use of formalin-fixed paraffin-embedded blocks (FFPE) is extensive in diagnosis and research. Yet, there is a lack of optimized/standardized protocols to process the blocks and verify the quality and presence of the targeted tissue. In the context of an international study on head and neck cancer (HNC)-HPV-AHEAD, a standardized protocol for optimizing the use of FFPEs in molecular epidemiology was developed and validated. First, a protocol for sectioning the FFPE was developed to prevent cross-contamination and distributed between participating centers. Before processing blocks, all sectioning centers underwent a quality control to guarantee a satisfactory training process. The first and last sections of the FFPEs were used for histopathological assessment. A consensus histopathology evaluation form was developed by an international panel of pathologists and evaluated for four indicators in a pilot analysis in order to validate it: 1) presence/type of tumor tissue, 2) identification of other tissue components that could affect the molecular diagnosis and 3) quality of the tissue. No HPV DNA was found in sections from empty FFPE generated in any histology laboratories of HPV-AHEAD consortium and all centers passed quality assurance for processing after quality control. The pilot analysis to validate the histopathology form included 355 HNC cases. The form was filled by six pathologists and each case was randomly assigned to two of them. Most samples (86%) were considered satisfactory. Presence of >50% of invasive carcinoma was observed in all sections of 66% of cases. Substantial necrosis (>50%) was present in <2% of samples. The concordance for the indicators targeted to validate the histopathology form was very high (kappa > 0.85) between first and last sections and fair to high between pathologists (kappa/pabak 0.21-0.72). The protocol allowed to correctly process without signs of contamination all FFPE of the study. The histopathology evaluation of the cases assured the presence of the targeted tissue, identified the presence of other tissues that could disturb the molecular diagnosis and allowed the assessment of tissue quality.

Structured, Graphical Analysis of C2 Teams and their Technologies

DTIC Science & Technology

2011-01-01

Two Fratricide Cases Revisited. Paper presented at the 15th International Command and Control Reserach and Technology Symposium (ICCRTS), June 22-24...network-enabled ADF. The paper is thus organized in three sections. The first section introduces the graphics for analyzing the formation and use...summarize, Colored Petri Nets center on networks in which tokens are created, moved, copied, or destroyed (Figure 1). An ellipse denotes a space for

Advanced Containment System

DOEpatents

Kostelnik, Kevin M.; Kawamura, Hideki; Richardson, John G.; Noda, Masaru

2005-02-08

An advanced containment system for containing buried waste and associated leachate. The advanced containment system comprises a plurality of casing sections with each casing section interlocked to an adjacent casing section. Each casing section includes a complementary interlocking structure that interlocks with the complementary interlocking structure on an adjacent casing section. A barrier filler substantially fills the casing sections and may substantially fill the spaces of the complementary interlocking structure to form a substantially impermeable barrier. Some of the casing sections may include sensors so that the casing sections and the zone of interest may be remotely monitored after the casing sections are emplaced in the ground.

Aircraft Digital Input Controlled Hydraulic Actuation and Control System.

DTIC Science & Technology

1981-03-01

the individual pistons in each motor which act against its rotating swash plate to drive...single piston during each of two equal rotations of the output shaft. In the high-displacement case, the swash plate is assumed to move through an angle...for their assistance in conducting laboratory tests of the digital electrohydraulic actuation system. Vii TABLE OF CONTENTS Section Page I

Detection of microinvasion in vulvar and cervical intraepithelial neoplasia using double immunostaining for cytokeratin and basement membrane components.

PubMed

Rush, Demaretta; Hyjek, Elizabeth; Baergen, Rebecca N; Ellenson, Lora H; Pirog, Edyta C

2005-06-01

Identification of early invasion in vulvar intraepithelial neoplasia 3 (VIN 3) and cervical intraepithelial neoplasia 3 (CIN 3) may be difficult with the use of routine hematoxylin-eosin staining. Presence of obscuring inflammation and tangential tissue sectioning are the most common diagnostic pitfalls. To examine the utility of double immunostaining for cytokeratin-collagen IV or cytokeratin-laminin in the detection of early invasion in VIN 3 and CIN 3. The study group consisted of 10 cases of "VIN 3, suspicious for invasion" and 10 cases of "CIN 3, suspicious for invasion." The negative control group consisted of VIN 3 (n = 15) and CIN 3 (n = 10). The positive control group consisted of cases of invasive vulvar carcinoma (n = 11) and invasive cervical carcinoma (n = 25). All cases were double immunostained for cytokeratin and collagen IV and, in a separate reaction, for cytokeratin and laminin. The continuity of the basement membrane and the presence of stromal invasion were assessed in the stained sections. The staining for collagen IV and laminin yielded identical results. A well-defined, continuous basement membrane was visualized in all cases of VIN 3 and CIN 3. A discontinuous or absent basement membrane was observed around the malignant cells on the invasive tumor front in all cases of vulvar and cervical carcinoma. In 2 of 10 cases of VIN 3, suspicious for invasion and in 4 of 10 cases of CIN 3, suspicious for invasion definitive foci of microinvasion were identified with the use of double immunostaining. A well-defined, continuous basement membrane was present in the remaining cases "suspicious for invasion." Double immunostaining for cytokeratin- collagen IV or cytokeratin-laminin is useful for evaluation of early invasion in equivocal cases of VIN 3 and CIN 3.

Prediction of Gut Wall Integrity Loss in Viral Gastroenteritis by Non-Invasive Marker

PubMed Central

Elnady, Hala G.; Sherif, Lobna S.; Saleh, Maysa T.; El-Alameey, Inas R.; Youssef, Mai M.; El Shafie, Amal I.; Helwa, Iman; Raouf, Haiam Abdel; EL-Taweel, Ahmed N.

2015-01-01

BACKGROUND: Intestinal fatty acid binding proteins (I-FABPs) are mainly expressed in the intestinal villi, which are the initial site of destruction in viral gastroenteritis. AIM: This study was designed to assess serum I-FABPs as a predictor of gut wall integrity loss in viral gastroenteritis. PATIENTS AND METHODS: This case-control cross-sectional study was conducted on 93 cases of acute viral gastroenteritis. Twenty-eight healthy children matching in age were recruited as control group. Serum I-FABPs were measured using ELISA technique. Viral detection and typing were done by PCR for adenovirus, and by Reverse transcriptase PCR for rotavirus, astrovirus and norovirus. RESULTS: Serum I-FABPs level was significantly higher in the cases compared to the controls and was also higher in the 46 rotavirus gastroenteritis cases compared to other viral gastroenteritis cases. Serum I- FABPs level was significantly higher in severely dehydrated cases as compared to mildly dehydrated ones (P=0.037). CONCLUSION: Serum I-FABPs could be used as an early and sensitive predictor marker of gut wall integrity loss in children with viral gastroenteritis and its level can indicate case severity. PMID:27275194

An integrated strategy for aircraft/airport noise abatement: A legal-institutional control act section 7 to the noise control act of 1972 and proposals based thereon

NASA Technical Reports Server (NTRS)

Mayo, L. H.

1975-01-01

The development of the aircraft noise control structure since the Griggs case of 1962 was examined. The Noise Control Act of 1972 is described which undertook to establish the legal-institutional framework within which an adequate aircraft/airport noise abatement program might be initiated with concern for full recognition of all the beneficial and detrimental consequences of air transportation and appropriate distribution of benefits and costs.

Cesarean section without medical indication and risk of childhood asthma, and attenuation by breastfeeding.

PubMed

Chu, Shuyuan; Chen, Qian; Chen, Yan; Bao, Yixiao; Wu, Min; Zhang, Jun

2017-01-01

Previous studies suggest that caesarean section (CS) may increase the risk of asthma in children, but none of them could preclude potential confounding effects of underlying medical indications for CS. We aim to assess the association between CS itself (without medical indications) and risk of childhood asthma. We conducted a hospital-based case-control study on childhood asthma with 573 cases and 812 controls in Shanghai. Unconditional logistic regression models in SAS were employed to control for potential confounders. Our study found that CS without medical indication was significantly associated with elevated asthma risk (adjusted OR = 1.58 [95% CI 1.17-2.13]). However, this risk was attenuated in children fed by exclusive breastfeeding in the first six months after birth (adjusted OR = 1.39 [95% CI 0.92-2.10]). In contrast, the risk was more prominent in children with non-exclusive breastfeeding or bottle feeding (adjusted OR = 1.91 [95% CI 1.22-2.99]). CS without medical indication was associated with an increased risk of childhood asthma. Exclusive breastfeeding in infancy may attenuate this risk.

[Significance of amnioinfusion and amniotic fluid exchange under continuous internal fetal heart rate monitoring for management of fetal distress during labor].

PubMed

Zhao, S; Ai, L; Zhang, H

2000-01-01

To discuss the significance of amnioinfusion and amniotic fluid exchange under continuous internal fetal heart rate (FHR) monitoring for management of fetal distress during labor. 136 cases with frequent variable deceleration (VD) and meconium stained amniotic fluid during labor were divided into two groups: the study group (68 cases) and the control group (68 cases). The former were treated by amnioinfusion and amniotic fluid exchange, while oxygen inhalation, change of body position, and intravenous infusion for the control group. In the study group, VD disappeared or relieved in 62 cases obviously, and the efficacy rate reached 91.2% (62/68). 48 cases with II degree meconium stained amniotic fluid were treated by amniotic fluid exchange, amniotic fluid became clear or turned to I degree stained in 39 cases. In the control group, VD relieved in 20 cases, the efficacy rate was 19.4%, significantly lower than that of the study group (P < 0.01). In the study group, cesarean section rate was 14.7% neonatal asphyxia 7.4% while they were 47.1% and 48.5% in the control group respectively (P < 0.01; P < 0.01). Neonatal pneumonia caused by meconium aspiration occurred in 13 cases, meconium aspiration syndrome (MAS) 8 cases, with 5 newborns died in the control group, while there was no neonatal death in the study group. There was no significant difference on puerperal morbidity between the 2 groups (P > 0.05). Amnioinfusion and AF exchange during labor are one of the effective treatment methods for fetal distress and prevention for MAS.

Cross-sectional study of the association of abomasal displacement or volvulus with serum electrolyte and mineral concentrations in dairy cows.

PubMed Central

Delgado-Lecaroz, R; Warnick, L D; Guard, C L; Smith, M C; Barry, D A

2000-01-01

The objective of this study was to evaluate serum mineral and electrolyte concentrations at the time of on-farm diagnosis of left displaced abomasum, right displaced abomasum, or abomasal volvulus in dairy cows. Data were collected from 104 affected cows and 96 control cows matched with cases, based on herd, parity, and stage of lactation. Cows with abomasal displacement or volvulus had significantly lower calcium, phosphorous, magnesium, potassium, and chloride concentrations and increased anion gap at the time of diagnosis compared with control cows from the same herds. The percentages of cases and controls with total serum calcium concentrations below the lower limit of the laboratory reference range (2.08 mmol/L [8.3 mg/dL]) were 70% and 23%, respectively. Based on the large percentage of cases with hypocalcemia, administering calcium salts at the time of treatment of field cases of abomasal displacement or volvulus may be beneficial. PMID:10769767

Skeletal Maturation and Mineralisation of Children with Moderate to Severe Spastic Quadriplegia.

PubMed

Sharawat, Indar Kumar; Sitaraman, Sadasivan

2016-06-01

Diminished bone mineral density and delayed skeletal maturation are common in children with spastic quadriplegia. The purpose of our study was to evaluate the Bone Mineral Density (BMD) of children with moderate to severe spastic quadriplegia and its relationship with other variables like nutrition and growth. This was a hospital based, cross- sectional, case-control study. Forty-two (28 males, 14 females) children with spastic quadriplegia and 42 (24 males, 18 females) healthy children were included in the study. BMD of cases and control were measured by Dual Energy X-ray Absorptiometry (DEXA). Radiographs of left hand and wrist of cases and controls were taken and bone age was determined. BMD values of upper extremity, lower extremity, thoraco-lumbar spine and pelvis in cases were lower than those of controls (p <0.0001). In children with non severe malnutrition, 75% of the cases had lower bone age than chronological age, whereas all cases with severe malnutrition had lower bone age than chronological age. Step wise regression analysis showed that nutritional status independently contributed to lower BMD values but the BMD values did not correlate significantly with the use of anticonvulsant drugs and presence of physical therapy. Decreased BMD and delayed bone age is prevalent in children with spastic quadriplegia and nutritional status is an important contributing factor.

Combining dynamic and static robotic telepathology: a report on 184 consecutive cases of frozen sections, histology and cytology.

PubMed

Della Mea, V; Cataldi, P; Pertoldi, B; Beltrami, C A

2000-01-01

The aim of this paper is to describe the experiments carried out to evaluate the diagnostic efficacy of a dynamic-robotic telepathology system for the delivery of pathology services to distant hospitals. The system provides static/dynamic features and the remote control of a robotized microscope over 4 ISDN lines. For evaluation purposes, 184 consecutive cases of frozen sections (60), gastrointestinal pathology (64), and urinary cytology (60) have been diagnosed at a distance using the system, and the telediagnosis obtained in this way has been compared with the traditional microscopic diagnosis. Diagnostic agreement ranged from 90% in urinary cytology to 100% in frozen sections. The results obtained suggest that such a system can be considered a useful tool for supporting the pathology practice in isolated hospitals.

Genotoxic Evaluation of Mexican Welders Occupationally Exposed to Welding-Fumes Using the Micronucleus Test on Exfoliated Oral Mucosa Cells: A Cross-Sectional, Case-Control Study

PubMed Central

Jara-Ettinger, Ana Cecilia; López-Tavera, Juan Carlos; Zavala-Cerna, María Guadalupe; Torres-Bugarín, Olivia

2015-01-01

Background An estimated 800,000 people worldwide are occupationally exposed to welding-fumes. Previous studies show that the exposure to such fumes is associated with damage to genetic material and increased cancer risk. In this study, we evaluate the genotoxic effect of welding-fumes using the Micronucleus Test on oral mucosa cells of Mexican welders. Material and Methods We conducted a cross-sectional, matched case-control study of n = 66 (33 exposed welders, and 33 healthy controls). Buccal mucosa smears were collected and stained with acridine orange, observed under 100x optical amplification with a fluorescence lamp, and a single-blinded observer counted the number of micronuclei and other nuclear abnormalities per 2,000 observed cells. We compared the frequencies of micronuclei and other nuclear abnormalities, and fitted generalised linear models to investigate the interactions between nuclear abnormalities and the exposure to welding-fumes, while controlling for smoking and age. Results Binucleated cells and condensed-chromatin cells showed statistically significant differences between cases and controls. The frequency of micronuclei and the rest of nuclear abnormalities (lobed-nuclei, pyknosis, karyolysis, and karyorrhexis) did not differ significantly between the groups. After adjusting for smoking, the regression results showed that the occurrence of binucleated cells could be predicted by the exposure to welding-fumes plus the presence of tobacco consumption; for the condensed-chromatin cells, our model showed that the exposure to welding-fumes is the only reliable predictor. Conclusions Our findings suggest that Mexican welders who are occupationally exposed to welding-fumes have increased counts of binucleated and condensed-chromatin cells. Nevertheless, the frequencies of micronuclei and the rest of nuclear abnormalities did not differ between cases and controls. Further studies should shed more light on this subject. PMID:26244938

Impact of Abdominal Adipose Depots and Race on Risk for Colorectal Cancer: A Case-Control Study

PubMed Central

Gomez-Perez, Sandra L; Chaudhry, Vivek; Mar, Winnie; Patel, Bimal; Fantuzzi, Giamila; Freels, Sally; Braunschweig, Carol

2017-01-01

Visceral (VAT) but not subcutaneous adipose tissue (SAT) is associated with obesity-related diseases including colorectal cancer (CRC). Superficial SAT (SSAT) and deep SAT (DSAT), components of SAT, also appear to independently influence disease risk. These abdominal adipose tissues (AAT) are not extensively studied in connection with CRC and have not been explored in the United States (US) despite known racial variations in body composition. We conducted a case-control study that compared associations between AAT with CRC risk and race of AA and NHW males with incident CRC matched by age, BMI and race (N=158, 79/group). Cross-sectional computed tomography (CT) images were used for assessment of AAT. Overall cases and controls had similar VAT areas (140±192 vs 149±152 cm2, p-value=0.93), however cases had lower SSAT than controls (88±39 vs 112±65 cm2, p<0.01). Among controls, AA had significantly lower VAT (114±168 vs 180±167, p<0.01) than NHW. Conditional logistic regression revealed AA males with greater SSAT had lower odds for CRC (OR: 0.24, 95%CI 0.07–0.85). Our findings indicate VAT does vary between cases and controls by race, however this variation is not a risk factor for CRC. The negative association between CRC and SSAT in AA men warrants further investigation. PMID:28323443

Office of Workers’ Compensation Programs (OWCP). Data Codebook. Version 1.0

DTIC Science & Technology

1993-12-01

Section 4. OWCP Data Codebook 4.1 Codebook Description ........................... 5 4.2 Codebook Column WHading Defnitions ............... 5 4.3 Data...OWCP (EARLY-REF) First character: variable. It was originally used T = Test group case between 1987 and 1990 in a C = Control group case study done...Nondestructive testing 4255 Fuel distribution system mechanic 3707 Metalizing 4301 Miscellaneous pliable materials work 3708 Metal process working 4351

Magnetic Resonance Imaging and Anatomical Correlation of Human Temporal Lobe Landmarks, in 3D Euclidean Space: A Study of Control and Alzheimer's Disease Subjects.

PubMed

Delgado-González, José-Carlos; Florensa-Vila, José; Mansilla-Legorburo, Francisco; Insausti, Ricardo; Artacho-Pérula, Emilio

2017-01-01

The medial temporal lobe (MTL), and in particular the hippocampal formation, is essential in the processing and consolidation of declarative memory. The 3D environment of the anatomical structures contained in the MTL is an important issue. Our aim was to explore the spatial relationship of the anatomical structures of the MTL and changes in aging and/or Alzheimer's disease (AD). MTL anatomical landmarks are identified and registered to create a 3D network. The brain network is quantitatively described as a plane, rostrocaudally-oriented, and presenting Euclidean/real distances. Correspondence between 1.5T RM, 3T RM, and histological sections were assessed to determine the most important recognizable changes in AD, based on statistical significance. In both 1.5T and 3T RM images and histology, inter-rater reliability was high. Sex and hemisphere had no influence on network pattern. Minor changes were found in relation to aging. Distances from the temporal pole to the dentate gyrus showed the most significant differences when comparing control and AD groups. The best discriminative distance between control and AD cases was found in the temporal pole/dentate gyrus rostrocaudal length in histological sections. Moreover, more distances between landmarks were required to obtain 100% discrimination between control (divided into <65 years or >65 years) and AD cases. Changes in the distance between MTL anatomical landmarks can successfully be detected by using measurements of 3D network patterns in control and AD cases.

High-Risk HPV, Biomarkers, and Outcome in Matched Cohorts of Head and Neck Cancer Patients Positive and Negative for HIV.

PubMed

Walline, Heather M; Carey, Thomas E; Goudsmit, Christine M; Bellile, Emily L; D'Souza, Gypsyamber; Peterson, Lisa A; McHugh, Jonathan B; Pai, Sara I; Lee, J Jack; Shin, Dong M; Ferris, Robert L

2017-02-01

In this study, high-risk HPV (hrHPV) incidence, prognostic biomarkers, and outcome were assessed in HIV-positive (case) and HIV-negative (control) patients with head and neck squamous cell cancer (HNSCC). HIV-positive cases were matched to controls by tumor site, sex, and age at cancer diagnosis. A tissue microarray (TMA) was constructed and DNA isolated from tumor tissue. MultiPlex-PCR MassArray, L1-PCR, and in situ hybridization were used to assess hrHPV. TMA sections were stained for p16ink4a, TP53, RB, CCND1, EGFR, and scored for intensity and proportion of positive tumor cells. The HNSCC cohort included 41 HIV-positive cases and 41 HIV-negative controls. Tumors from 11 of 40 (28%) cases, and 10 of 41 (24%) controls contained hrHPV. p16 expression, indicative of E7 oncogene activity, was present in 10 of 11 HPV-positive cases and 7 of 10 HPV-positive controls. Low p16 and high TP53 expression in some HPV-positive tumors suggested HPV-independent tumorigenesis. Survival did not differ in cases and controls. RB expression was significantly associated with poor survival (P = 0.01). High TP53 expression exhibited a trend for poorer survival (P = 0.12), but among cases, association with poor survival reached statistical significance (P = 0.04). The proportion of HPV-positive tumors was similar, but the heterogeneity of HPV types was higher in the HIV-positive cases than in HIV-negative controls. High RB expression predicted poor survival, and high TP53 expression was associated with poorer survival in the HIV-positive cases but not HIV-negative controls. HIV infection did not increase risk of death from HNSCC, and HPV-positive tumors continued to be associated with a significantly improved survival, independent of HIV status. Mol Cancer Res; 15(2); 179-88. ©2016 AACR. ©2016 American Association for Cancer Research.

Oxidative stress and frailty: A systematic review and synthesis of the best evidence.

PubMed

Soysal, Pinar; Isik, Ahmet Turan; Carvalho, Andre F; Fernandes, Brisa S; Solmi, Marco; Schofield, Patricia; Veronese, Nicola; Stubbs, Brendon

2017-05-01

Oxidative stress (OS) is associated with accelerated aging. Previous studies have suggested a possible relationship between OS and frailty but this association remains unclear. We conducted a systematic review to investigate potential interactions between OS and frailty. A systematic literature search of original reports providing data on 'OS and antioxidant' parameters and frailty was carried out across major electronic databases from inception until May 2016. Cross-sectional/case control and longitudinal studies reporting data on the association between frailty and anti-oxidants-OS biomarkers were considered for inclusion. Results were summarized with a synthesis based on the best evidence. From 1856 hits, 8 studies (cross-sectional/case control) were included (N=6349; mean age of 75±12years; 56.4% females). Overall, there were 588 (=9.3%) frail, 3036 pre-frail (=47.8%), 40 (=0.6%) pre-frail/robust, and 2685 (=42.3%) robust subjects. Six cross-sectional/case control studies demonstrated that frailty was associated with an increase in peripheral OS biomarkers, including lipoprotein phospholipase A2 (1 study), isoprostanes (2 studies), malonaldehyde (2 studies), 8-hydroxy-20-deoxyguanosine (2 studies), derivate of reactive oxygen metabolites (2 studies), oxidized glutathione/glutathione (1 study), 4-hydroxy-2,3-nonenal (1 study), and protein carbonylation levels (1 study). In addition, preliminary evidence points to lower anti-oxidant parameters (vitamin C, E, α-tocopherol, biological anti-oxidant potential, total thiol levels) in frailty. Frailty and pre-frailty appear to be associated with higher OS and possibly lower anti-oxidant parameters. However, due to the cross-sectional design, it is not possible to disentangle the directionality of the relationships observed. Thus, future high-quality and in particular longitudinal research is required to confirm or refute these relationships and to further elucidate pathophysiological mechanisms. Copyright © 2017 Elsevier B.V. All rights reserved.

Is DSM-IV bereavement exclusion for major depressive episode relevant to severity and pattern of symptoms? A case-control, cross-sectional study.

PubMed

Corruble, Emmanuelle; Chouinard, Virginie-Anne; Letierce, Alexia; Gorwood, Philip A P M; Chouinard, Guy

2009-08-01

To assess the DSM-IV major depressive episode (MDE) bereavement exclusion criterion by comparing severity and pattern of symptoms in bereavement-excluded individuals satisfying all other DSM-IV MDE criteria to these same variables in MDE controls. A case-control, cross-sectional study of self-referred individuals seeking treatment for depressive symptoms was conducted. A total of 17,988 subjects met DSM-IV MDE symptom criteria. Of these, 1,521 individuals (8.5%) met all MDE criteria except the bereavement exclusion. They were matched by age, gender, marital status, and educational level with 1,521 MDE controls. Among the MDE controls, 292 had a recent bereavement and 1,229 did not. Severity of depression was measured by the number of MDE symptoms and the Montgomery-Asberg Depression Rating Scale (MADRS) score. Symptom cues of the bereavement-exclusion criterion were analyzed. The study was conducted between September 2003 and May 2004. Bereavement-excluded subjects were more severely depressed than MDE controls without bereavement and similar to MDE controls with bereavement. Two symptom cues, suicidal ideation and worthlessness, and the majority of other depressive symptoms were more pronounced in bereavement-excluded individuals than in MDE controls. Symptom cues of the DSM-IV MDE bereavement exclusion criterion should be modified since they could result in patients failing to be correctly diagnosed and treated. ©Copyright 2009 Physicians Postgraduate Press, Inc.

Shock Generation and Control Using DBD Plasma Actuators

NASA Technical Reports Server (NTRS)

Patel, Mehul P.; Cain, Alan B.; Nelson, Christopher C.; Corke, Thomas C.; Matlis, Eric H.

2012-01-01

This report is the final report of a NASA Phase I SBIR contract, with some revisions to remove company proprietary data. The Shock Boundary Layer Interaction (SBLI) phenomena in a supersonic inlet involve mutual interaction of oblique shocks with boundary layers, forcing the boundary layer to separate from the inlet wall. To improve the inlet efficiency, it is desired to prevent or delay shock-induced boundary layer separation. In this effort, Innovative Technology Applications Company (ITAC), LLC and the University of Notre Dame (UND) jointly investigated the use of dielectric-barrier-discharge (DBD) plasma actuators for control of SBLI in a supersonic inlet. The research investigated the potential for DBD plasma actuators to suppress flow separation caused by a shock in a turbulent boundary layer. The research involved both numerical and experimental investigations of plasma flow control for a few different SBLI configurations: (a) a 12 wedge flow test case at Mach 1.5 (numerical and experimental), (b) an impinging shock test case at Mach 1.5 using an airfoil as a shock generator (numerical and experimental), and (c) a Mach 2.0 nozzle flow case in a simulated 15 X 15 cm wind tunnel with a shock generator (numerical). Numerical studies were performed for all three test cases to examine the feasibility of plasma flow control concepts. These results were used to guide the wind tunnel experiments conducted on the Mach 1.5 12 degree wedge flow (case a) and the Mach 1.5 impinging shock test case (case b) which were at similar flow conditions as the corresponding numerical studies to obtain experimental evidence of plasma control effects for SBLI control. The experiments also generated data that were used in validating the numerical studies for the baseline cases (without plasma actuators). The experiments were conducted in a Mach 1.5 test section in the University of Notre Dame Hessert Laboratory. The simulation results from cases a and b indicated that multiple spanwise actuators in series and at a voltage of 75 kVp-p could fully suppress the flow separation downstream of the shock. The simulation results from case c showed that the streamwise plasma actuators are highly effective in creating pairs of counter-rotating vortices, much like the mechanical vortex generators, and could also potentially have beneficial effects for SBLI control. However, to achieve these effects, the positioning and the quantity of the DBD actuators used must be optimized. The wind tunnel experiments mapped the baseline flow with good agreement to the numerical simulations. The experimental results were conducted with spanwise actuators for cases a and b, but were limited by the inability to generate a sufficiently high voltage due to arcing in the wind-tunnel test-section. The static pressure in the tunnel was lower than the static pressure in an inlet at flight conditions, promoting arching and degrading the actuator performance.

Association between periodontitis and ischemic stroke: a systematic review and meta-analysis.

PubMed

Leira, Yago; Seoane, Juan; Blanco, Miguel; Rodríguez-Yáñez, Manuel; Takkouche, Bahi; Blanco, Juan; Castillo, José

2017-01-01

Several observational studies have suggested an association between periodontitis and cerebral ischemia. This meta-analysis aimed to investigate whether this link exists, and if so, the degree to which it is significant. The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guideline for systematic review was used. The search strategy included using electronic databases and hand searching works published up to March 2015. MEDLINE via PubMed, EMBASE, Proceedings Web of Science and Current Contents Connect were searched by two independent reviewers. Case-control, cross-sectional or cohort studies including patients with measures of periodontitis and ischemic stroke were eligible to be included in the analysis. Quality assessments of selected studies were performed. From a total of 414 titles and abstracts, 57 potentially relevant full text papers were identified. After inclusion criteria were applied, 8 studies were included in the present systematic review (5 case-control and 3 cohort studies). Although it was not the intention, cross-sectional studies were excluded due to eligibility criteria were not accomplished. Therefore, meta-analyses were conducted with data retrieved from the 8 studies included. These meta-analyses showed statistically significant association between periodontitis and ischemic stroke in both cohort pooled relative risks at 2.52 (1.77-3.58), and case-control studies pooled relative risks at 3.04 (1.10-8.43). In conclusion, the present meta-analysis demonstrated an association between periodontitis and ischemic stroke. However, well-designed prospective studies should be carried out to provide robust evidence of the link between both diseases. In regards to ischemic stroke subtypes, further case-control studies should be carried out to investigate whether there is any association between the different subtypes of cerebral infarcts and periodontitis.

Dientamoeba fragilis colonization is not associated with gastrointestinal symptoms in children at primary care level.

PubMed

Holtman, Gea A; Kranenberg, Justin J; Blanker, Marco H; Ott, Alewijn; Lisman-van Leeuwen, Yvonne; Berger, Marjolein Y

2017-02-01

Dientamoeba fragilis is commonly identified in children in primary care and is suspected to cause gastrointestinal disease. To determine the association between D. fragilis colonization and gastrointestinal symptoms in children. We performed a cross-sectional study with children who presented in primary care with gastrointestinal symptoms. The associations between D. fragilis colonization and specific symptoms were explored by means of logistic regression analyses. Asymptomatic siblings of these cases were invited as control subjects for a case-control analysis, where we explored the association between D. fragilis and gastrointestinal symptoms with conditional logistic regression analysis. In the cross-sectional study, 107 children were included. Their median age was 9 years (interquartile range = 6-12) and 38 (35.5%) were boys. Colonization of D. fragilis was present in 59 children (55.1%). The absence of D. fragilis was associated with soft to watery stool [odds ratio (OR) = 0.29; 95% confidence interval (CI) = 0.10-0.85], chronic diarrhoea (OR = 0.42; 95% CI = 0.18-0.97) and fatigue (OR = 0.45; 95% CI = 0.20-0.99). The case-control analyses included 44 children in each group. Dientamoeba fragilis colonization was not observed more often in cases than in controls after adjustment for age and sex (OR = 1.02; 95% CI = 0.28-3.65). Dientamoeba fragilis is a common parasite in children with and without gastrointestinal symptoms. The anomalous finding of the association between the absence of D. fragilis with soft to watery stools, chronic diarrhoea and fatigue are inexplicable. Our study suggests that D. fragilis colonization does not increase the risk for gastrointestinal symptoms. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Case-control studies in neurosurgery.

PubMed

Nesvick, Cody L; Thompson, Clinton J; Boop, Frederick A; Klimo, Paul

2014-08-01

Observational studies, such as cohort and case-control studies, are valuable instruments in evidence-based medicine. Case-control studies, in particular, are becoming increasingly popular in the neurosurgical literature due to their low cost and relative ease of execution; however, no one has yet systematically assessed these types of studies for quality in methodology and reporting. The authors performed a literature search using PubMed/MEDLINE to identify all studies that explicitly identified themselves as "case-control" and were published in the JNS Publishing Group journals (Journal of Neurosurgery, Journal of Neurosurgery: Pediatrics, Journal of Neurosurgery: Spine, and Neurosurgical Focus) or Neurosurgery. Each paper was evaluated for 22 descriptive variables and then categorized as having either met or missed the basic definition of a case-control study. All studies that evaluated risk factors for a well-defined outcome were considered true case-control studies. The authors sought to identify key features or phrases that were or were not predictive of a true case-control study. Those papers that satisfied the definition were further evaluated using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist. The search detected 67 papers that met the inclusion criteria, of which 32 (48%) represented true case-control studies. The frequency of true case-control studies has not changed with time. Use of odds ratios (ORs) and logistic regression (LR) analysis were strong positive predictors of true case-control studies (for odds ratios, OR 15.33 and 95% CI 4.52-51.97; for logistic regression analysis, OR 8.77 and 95% CI 2.69-28.56). Conversely, negative predictors included focus on a procedure/intervention (OR 0.35, 95% CI 0.13-0.998) and use of the word "outcome" in the Results section (OR 0.23, 95% CI 0.082-0.65). After exclusion of nested case-control studies, the negative correlation between focus on a procedure/intervention and true case-control studies was strengthened (OR 0.053, 95% CI 0.0064-0.44). There was a trend toward a negative association between the use of survival analysis or Kaplan-Meier curves and true case-control studies (OR 0.13, 95% CI 0.015-1.12). True case-control studies were no more likely than their counterparts to use a potential study design "expert" (OR 1.50, 95% CI 0.57-3.95). The overall average STROBE score was 72% (range 50-86%). Examples of reporting deficiencies were reporting of bias (28%), missing data (55%), and funding (44%). The results of this analysis show that the majority of studies in the neurosurgical literature that identify themselves as "case-control" studies are, in fact, labeled incorrectly. Positive and negative predictors were identified. The authors provide several recommendations that may reverse the incorrect and inappropriate use of the term "case-control" and improve the quality of design and reporting of true case-control studies in neurosurgery.

Prevalence of bullying victimisation amongst first-episode psychosis patients and unaffected controls

PubMed Central

Trotta, Antonella; Di Forti, Marta; Mondelli, Valeria; Dazzan, Paola; Pariante, Carmine; David, Anthony; Mulè, Alice; Ferraro, Laura; Formica, Ivan; Murray, Robin M.; Fisher, Helen L.

2013-01-01

Background Despite increasing evidence suggesting that childhood maltreatment is significantly associated with psychosis, the specific role of bullying in the onset of psychotic disorders is still unclear. This study aimed to examine whether bullying was more prevalent amongst individuals presenting to services for the first time with a psychotic disorder than in unaffected community controls. Methods Data on exposure to bullying, psychotic symptoms, cannabis use and history of conduct disorder were collected cross-sectionally from 222 first-presentation psychosis cases and 215 geographically-matched controls. Bullying victimisation was assessed retrospectively as part of the Brief Life Events schedule. Logistic regression was used to examine associations between exposure to bullying and case-control status, while controlling for potential confounders. Results Psychosis cases were approximately twice as likely to report bullying victimisation when compared to controls. No significant interactions between bullying and either gender or cannabis use were found. Controls reporting being a victim of bullying were approximately twice as likely to also report at least one psychosis-like symptom. Conclusions Our results extend previous research by suggesting that bullying victimisation may contribute to vulnerability to develop a psychotic disorder in some individuals. PMID:23891482

Caffeine intake from coffee or tea and cognitive disorders: a meta-analysis of observational studies.

PubMed

Kim, Young-Seok; Kwak, Sang Mi; Myung, Seung-Kwon

2015-01-01

Observational epidemiological studies such as cross-sectional, case-control, and cohort studies have reported inconsistent findings regarding the association between caffeine intake from coffee or tea and the risk of cognitive disorders such as dementia, Alzheimer's disease, cognitive impairment, and cognitive decline. We searched PubMed and EMBASE in September 2014. Three evaluators independently extracted and reviewed articles, based on predetermined selection criteria. Out of 293 articles identified through the search and bibliographies of relevant articles, 20 epidemiological studies from 19 articles, which involved 31,479 participants (8,398 in six cross-sectional studies, 4,601 in five case-control studies, and 19,918 in nine cohort studies), were included in the final analysis. The pooled odds ratio (OR) or relative risk (RR) of caffeine intake from coffee or tea for cognitive disorders (dementia, Alzheimer's disease, cognitive impairment, and cognitive decline) was 0.82 (95% confidence interval [CI], 0.67-1.01, I² = 63.2%) in a random-effects meta-analysis. In the subgroup meta-analysis by caffeine sources, the summary OR or RR of coffee intake was 0.83 (95% CI, 0.70-0.98; I² = 44.8%). However, in the subgroup meta-analysis by study design, the summary estimates (RR or OR) of coffee intake for cognitive disorders were 0.70 (95% CI, 0.50-0.98; I² = 42.0%) for cross-sectional studies, 0.82 (95% CI, 0.55-1.24; I² = 33.4%) for case-control studies, and 0.90 (95% CI, 0.59-1.36; I² = 60.0%) for cohort studies. This meta-analysis found that caffeine intake from coffee or tea was not associated with the risk of cognitive disorders.

Risk Factors of Congenital Heart Diseases: A Case-Control Study inNorthwest Iran.

PubMed

Naghavi-Behzad, Mohammad; Alizadeh, Mahasti; Azami, Saber; Foroughifar, Shirin; Ghasempour-Dabbaghi, Khazar; Karzad, Nazila; Ahadi, Hamid-Reza; Naghavi-Behzad, Ali

2013-01-01

Congenital heart diseases are of immense importance and also a high prevalence. Contributing factors to developing these defects have not been abundantly studied. Therefore, the current study was conducted aiming at determining the effective factors on Congenital Heart Disease (CHD) in newborn infants of Northwest Iran. A case-control study was carried out in North-West of Iran from 2002 to 2012 and a total of 473 infants entered the study. Required data were obtained through check lists completed by the information of hospital records and interview with mothers of 267 newborn infants with CHD together with medical records of mothers as the case group, and 206 medical records of healthy infants at the same period all together with those of their mothers as the control group. The obtained data were statistically analyzed using descriptive statistical methods, T-test, Spearman's correlation coefficient, and Multi-variable Logistic Regression Model (OR with 95% CI), using SPSS.19. In the present study, P value less than 0.05 was considered statistically significant. Based on the results of univariable analyses, the number of previous cesarean sections, past medical history of diseases, gestational age (GA), fetal weight at birth, diastolic blood pressure, fetal heart rate, pulse rate, fetal hemoglobin and hematocrit levels, and fetal head circumference at birth have significant relationship with incidence of congenital abnormalities (P<0.05). Family history, past cesarean sections history, past medical history and GA had significant relationship with CHD incidence. Based on the results of present study, in order to control and reduce the cases of CHD, it is crucial to make proper decisions and implement policies for reducing cesarean cases, lowering consanguineous marriages, providing proper pre-marriage counseling, prompt treatment of mothers' illnesses, improving pregnancy health care and mothers' health status for the purpose of better well-being of newborn infants.

Experimental Studies of Low-Pressure Turbine Flows and Flow Control. Streamwise Pressure Profiles and Velocity Profiles

NASA Technical Reports Server (NTRS)

Volino, Ralph

2012-01-01

This report summarizes research performed in support of the NASA Glenn Research Center (GRC) Low-Pressure Turbine (LPT) Flow Physics Program. The work was performed experimentally at the U.S. Naval Academy faculties. The geometry corresponded to "Pak B" LPT airfoil. The test section simulated LPT flow in a passage. Three experimental studies were performed: (a) Boundary layer measurements for ten baseline cases under high and low freestream turbulence conditions at five Reynolds numbers of 25,000, 50,000, 100,000, 200,000, and 300,000, based on passage exit velocity and suction surface wetted length; (b) Passive flow control studies with three thicknesses of two-dimensional bars, and two heights of three-dimensional circular cylinders with different spanwise separations, at same flow conditions as the 10 baseline cases; (c) Active flow control with oscillating synthetic (zero net mass flow) vortex generator jets, for one case with low freestream turbulence and a low Reynolds number of 25,000. The Passive flow control was successful at controlling the separation problem at low Reynolds numbers, with varying degrees of success from case to case and varying levels of impact at higher Reynolds numbers. The active flow control successfully eliminated the large separation problem for the low Reynolds number case. Very detailed data was acquired using hot-wire anemometry, including single and two velocity components, integral boundary layer quantities, turbulence statistics and spectra, turbulent shear stresses and their spectra, and intermittency, documenting transition, separation and reattachment. Models were constructed to correlate the results. The report includes a summary of the work performed and reprints of the publications describing the various studies.This report summarizes research performed in support of the NASA Glenn Research Center (GRC) Low-Pressure Turbine (LPT) Flow Physics Program. The work was performed experimentally at the U.S. Naval Academy faculties. The geometry corresponded to "Pak B" LPT airfoil. The test section simulated LPT flow in a passage. Three experimental studies were performed: (a) Boundary layer measurements for ten baseline cases under high and low freestream turbulence conditions at five Reynolds numbers of 25,000, 50,000, 100,000, 200,000, and 300,000, based on passage exit velocity and suction surface wetted length; (b) Passive flow control studies with three thicknesses of two-dimensional bars, and two heights of three-dimensional circular cylinders with different spanwise separations, at same flow conditions as the 10 baseline cases; (c) Active flow control with oscillating synthetic (zero net mass flow) vortex generator jets, for one case with low freestream turbulence and a low Reynolds number of 25,000. The Passive flow control was successful at controlling the separation problem at low Reynolds numbers, with varying degrees of success from case to case and varying levels of impact at higher Reynolds numbers. The active flow control successfully eliminated the large separation problem for the low Reynolds number case. Very detailed data was acquired using hot-wire anemometry, including single and two velocity components, integral boundary layer quantities, turbulence statistics and spectra, turbulent shear stresses and their spectra, and intermittency, documenting transition, separation and reattachment. Models were constructed to correlate the results. The report includes a summary of the work performed and reprints of the publications describing the various studies. The folders in this supplement contain processed data in ASCII format. Streamwise pressure profiles and velocity profiles are included. The velocity profiles were acquired using single sensor and cross sensor hot-wire probes which were traversed from the wall to the freestream at various streamwise locations. In some of the flow control cases (3D Trips and Jets) profiles were acquired at multiple spanwise locations.

26 CFR 1.482-9T - Methods to determine taxable income in connection with a controlled services transaction...

Code of Federal Regulations, 2010 CFR

2010-04-01

... covered by § 1.482-7T. In the case of such an arrangement, consideration of the principles, methods..., including an unspecified method, under this section, as appropriately adjusted in light of the differences...

10 CFR 70.55 - Inspections.

Code of Federal Regulations, 2011 CFR

2011-01-01

... the case of fuel cycle facilities where nuclear reactor fuel is fabricated or processed each licensee... 10 Energy 2 2011-01-01 2011-01-01 false Inspections. 70.55 Section 70.55 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) DOMESTIC LICENSING OF SPECIAL NUCLEAR MATERIAL Special Nuclear Material Control...

10 CFR 70.55 - Inspections.

Code of Federal Regulations, 2012 CFR

2012-01-01

... the case of fuel cycle facilities where nuclear reactor fuel is fabricated or processed each licensee... 10 Energy 2 2012-01-01 2012-01-01 false Inspections. 70.55 Section 70.55 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) DOMESTIC LICENSING OF SPECIAL NUCLEAR MATERIAL Special Nuclear Material Control...

10 CFR 70.55 - Inspections.

Code of Federal Regulations, 2013 CFR

2013-01-01

... the case of fuel cycle facilities where nuclear reactor fuel is fabricated or processed each licensee... 10 Energy 2 2013-01-01 2013-01-01 false Inspections. 70.55 Section 70.55 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) DOMESTIC LICENSING OF SPECIAL NUCLEAR MATERIAL Special Nuclear Material Control...

10 CFR 70.55 - Inspections.

Code of Federal Regulations, 2010 CFR

2010-01-01

... the case of fuel cycle facilities where nuclear reactor fuel is fabricated or processed each licensee... 10 Energy 2 2010-01-01 2010-01-01 false Inspections. 70.55 Section 70.55 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) DOMESTIC LICENSING OF SPECIAL NUCLEAR MATERIAL Special Nuclear Material Control...

10 CFR 70.55 - Inspections.

Code of Federal Regulations, 2014 CFR

2014-01-01

... the case of fuel cycle facilities where nuclear reactor fuel is fabricated or processed each licensee... 10 Energy 2 2014-01-01 2014-01-01 false Inspections. 70.55 Section 70.55 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) DOMESTIC LICENSING OF SPECIAL NUCLEAR MATERIAL Special Nuclear Material Control...

A Testing Framework for Critical Space SW

NASA Astrophysics Data System (ADS)

Fernandez, Ignacio; Di Cerbo, Antonio; Dehnhardt, Erik; Massimo, Tipaldi; Brünjes, Bernhard

2015-09-01

This paper describes a testing framework for critical space SW named Technical Specification Validation Framework (TSVF). It provides a powerful and flexible means and can be used throughout the SW test activities (test case specification & implementation, test execution and test artifacts analysis). In particular, tests can be run in an automated and/or step-by-step mode. The TSVF framework is currently used for the validation of the Satellite Control Software (SCSW), which runs on the Meteosat Third Generation (MTG) satellite on-board computer. The main purpose of the SCSW is to control the spacecraft along with its various subsystems (AOCS, Payload, Electrical Power, Telemetry Tracking & Command, etc.) in a way that guarantees a high degree of flexibility and autonomy. The TSVF framework serves the challenging needs of the SCSW project, where a plan-driven approach has been combined with an agile process in order to produce preliminary SW versions (with a reduced scope of implemented functionality) in order to fulfill the stakeholders needs ([1]). The paper has been organised as follows. Section 2 gives an overview of the TSVF architecture and interfaces versus the test bench along with the technology used for its implementation. Section 3 describes the key elements of the XML based language for the test case implementation. Section 4 highlights all the benefits compared to conventional test environments requiring a manual test script development, whereas section 5 concludes the paper.

The National Biological Information Infrastructure: Coming of age

USGS Publications Warehouse

Cotter, G.; Frame, M.; Sepic, R.; Zolly, L.

2000-01-01

Coordinated by the US Geological Survey, the National Biological Information Infrastructure (NBII) is a Web-based system that provides increased access to data and information on the nation's biological resources. The NBII can be viewed from a variety of perspectives. This article - an individual case study and not a broad survey with extensive references to the literature - addresses the structure of the NBII related to thematic sections, infrastructure sections and place-based sections, and other topics such as the Integrated Taxonomic Information System (one of our more innovative tools) and the development of our controlled vocabulary.

Development of ATC for High Speed and High Density Commuter Line

NASA Astrophysics Data System (ADS)

Okutani, Tamio; Nakamura, Nobuyuki; Araki, Hisato; Irie, Shouji; Osa, Hiroki; Sano, Minoru; Ikeda, Keigo; Ozawa, Hiroyuki

A new ATC (Automatic Train Control) system has been developed with solutions to realize short train headway by assured braking utilizing digital data transmission via rails; the digital data for the ATP (Automatic Train Protection) function; and to achieve EMC features for both AC and DC sections. The DC section is of the unprecedented DC traction power supply system utilizing IGBT PWM converter at all DC substations. Within the AC section, train traction force is controlled by PWM converter/inverters. The carrier frequencies of the digital data signals and chopping frequency of PWM traction power converters on-board are decided via spectral analysis of noise up to degraded mode cases of equipment. Developed system was equipped to the Tukuba Express Line, new commuter line of Tokyo metropolitan area, and opened since Aug. 2005.

H. pylori seroprevalence and risk of diabetes: An ancillary case-control study nested in the diabetes prevention program.

PubMed

Alzahrani, Saud; Nelson, Jason; Moss, Steven F; Paulus, Jessica K; Knowler, William C; Pittas, Anastassios G

2017-10-01

To determine the association between H. pylori infection and risk of incident diabetes in adults at high risk for diabetes who participated in the Diabetes Prevention Program (DPP) study. In a nested case-control study conducted among 421 adults with newly diagnosed diabetes and 421 matched controls, we examined the association between serological status of H. pylori at baseline and risk of incident diabetes over a mean follow-up period of 2.6years. Using data from the baseline visit of the DPP, we also examined the cross-sectional association between presence of H. pylori antibodies and insulin sensitivity, insulin secretion and the disposition index-like measure after a 75-g oral glucose tolerance test (OGTT). At baseline, H. pylori antibodies were present in 40% of participants who developed diabetes and 39% of controls. After adjusting for matching factors, there was no association between exposure to H. pylori and incident diabetes (odds ratio [OR] of 1.04 (95% CI, 0.77 to 1.40). In cross-sectional analyses, H. pylori status was not significantly associated with insulin sensitivity and disposition index-like measure from OGTT. In adults at high risk for diabetes, H. pylori seropositivity was not associated with risk of developing diabetes. Copyright © 2017 Elsevier Inc. All rights reserved.

Experimental Studies of Low-Pressure Turbine Flows and Flow Control

NASA Technical Reports Server (NTRS)

Volino, Ralph J.

2012-01-01

This report summarizes research performed in support of the NASA Glenn Research Center (GRC) Low-Pressure Turbine (LPT) Flow Physics Program. The work was performed experimentally at the U.S. Naval Academy faculties. The geometry corresponded to "Pak B" LPT airfoil. The test section simulated LPT flow in a passage. Three experimental studies were performed: (a) Boundary layer measurements for ten baseline cases under high and low freestream turbulence conditions at five Reynolds numbers of 25,000, 50,000, 100,000, 200,000, and 300,000, based on passage exit velocity and suction surface wetted length; (b) Passive flow control studies with three thicknesses of two-dimensional bars, and two heights of three-dimensional circular cylinders with different spanwise separations, at same flow conditions as the 10 baseline cases; (c) Active flow control with oscillating synthetic (zero net mass flow) vortex generator jets, for one case with low freestream turbulence and a low Reynolds number of 25,000. The Passive flow control was successful at controlling the separation problem at low Reynolds numbers, with varying degrees of success from case to case and varying levels of impact at higher Reynolds numbers. The active flow control successfully eliminated the large separation problem for the low Reynolds number case. Very detailed data was acquired using hot-wire anemometry, including single and two velocity components, integral boundary layer quantities, turbulence statistics and spectra, turbulent shear stresses and their spectra, and intermittency, documenting transition, separation and reattachment. Models were constructed to correlate the results. The report includes a summary of the work performed and reprints of the publications describing the various studies.

Reporting of euthanasia in medical practice in Flanders, Belgium: cross sectional analysis of reported and unreported cases

PubMed Central

Bilsen, Johan; Cohen, Joachim; Rurup, Mette L; Mortier, Freddy; Deliens, Luc

2010-01-01

Objectives To estimate the rate of reporting of euthanasia cases to the Federal Control and Evaluation Committee and to compare the characteristics of reported and unreported cases of euthanasia. Design Cross sectional analysis. Setting Flanders, Belgium. Participants A stratified at random sample was drawn of people who died between 1 June 2007 and 30 November 2007. The certifying physician of each death was sent a questionnaire on end of life decision making in the death concerned. Main outcome measures The rate of euthanasia cases reported to the Federal Control and Evaluation Committee; physicians’ reasons for not reporting cases of euthanasia; the relation between reporting and non-reporting and the characteristics of the physician and patient; the time by which life was shortened according to the physician; the labelling of the end of life decision by the physician involved; and differences in characteristics of due care between reported and unreported euthanasia cases. Results The survey response rate was 58.4% (3623/6202 eligible cases). The estimated total number of cases of euthanasia in Flanders in 2007 was 1040 (95% CI 970 to 1109), thus the incidence of euthanasia was estimated as 1.9% of all deaths (95% CI 1.6% to 2.3%). Approximately half (549/1040 (52.8%, 95% CI 43.9% to 60.5%)) of all estimated cases of euthanasia were reported to the Federal Control and Evaluation Committee. Physicians who perceived their case as euthanasia reported it in 93.1% (67/72) of cases. Cases of euthanasia were reported less often when the time by which life was shortened was less than one week compared with when the perceived life shortening was greater (37.3% v 74.1%; P<0.001). Unreported cases were generally dealt with less carefully than reported cases: a written request for euthanasia was more often absent (87.7% v 17.6% verbal request only; P<0.001), other physicians and caregivers specialised in palliative care were consulted less often (54.6% v 97.5%; 33.0% v 63.9%; P<0.001 for both), the life ending act was more often performed with opioids or sedatives (92.1% v 4.4%; P<0.001), and the drugs were more often administered by a nurse (41.3% v 0.0%; P<0.001). Conclusions One out of two euthanasia cases is reported to the Federal Control and Evaluation Committee. Most non-reporting physicians do not perceive their act as euthanasia. Countries debating legalisation of euthanasia should simultaneously consider developing a policy facilitating the due care and reporting obligations of physicians. PMID:20923842

Skeletal Maturation and Mineralisation of Children with Moderate to Severe Spastic Quadriplegia

PubMed Central

Sitaraman, Sadasivan

2016-01-01

Introduction Diminished bone mineral density and delayed skeletal maturation are common in children with spastic quadriplegia. Aim The purpose of our study was to evaluate the Bone Mineral Density (BMD) of children with moderate to severe spastic quadriplegia and its relationship with other variables like nutrition and growth. Materials and Methods This was a hospital based, cross- sectional, case-control study. Forty-two (28 males, 14 females) children with spastic quadriplegia and 42 (24 males, 18 females) healthy children were included in the study. BMD of cases and control were measured by Dual Energy X-ray Absorptiometry (DEXA). Radiographs of left hand and wrist of cases and controls were taken and bone age was determined. Results BMD values of upper extremity, lower extremity, thoraco-lumbar spine and pelvis in cases were lower than those of controls (p <0.0001). In children with non severe malnutrition, 75% of the cases had lower bone age than chronological age, whereas all cases with severe malnutrition had lower bone age than chronological age. Step wise regression analysis showed that nutritional status independently contributed to lower BMD values but the BMD values did not correlate significantly with the use of anticonvulsant drugs and presence of physical therapy. Conclusion Decreased BMD and delayed bone age is prevalent in children with spastic quadriplegia and nutritional status is an important contributing factor. PMID:27504366

Increased Use of Community Medicine Distributors and Rational Use of Drugs in Children Less than Five Years of Age in Uganda Caused by Integrated Community Case Management of Fever

PubMed Central

Kalyango, Joan N.; Lindstrand, Ann; Rutebemberwa, Elizeus; Ssali, Sarah; Kadobera, Daniel; Karamagi, Charles; Peterson, Stefan; Alfven, Tobias

2012-01-01

We compared use of community medicine distributors (CMDs) and drug use under integrated community case management and home-based management strategies in children 6–59 months of age in eastern Uganda. A cross-sectional study with 1,095 children was nested in a cluster randomized trial with integrated community case management (CMDs treating malaria and pneumonia) as the intervention and home-based management (CMDs treating only malaria) as the control. Care-seeking from CMDs was higher in intervention areas (31%) than in control areas (22%; P = 0.01). Prompt and appropriate treatment of malaria was higher in intervention areas (18%) than in control areas (12%; P = 0.03) and among CMD users (37%) than other health providers (9%). The mean number of drugs among CMD users compared with other health providers was 1.6 versus 2.4 in intervention areas and 1.4 versus 2.3 in control areas. Use of CMDs was low. However, integrated community case management of childhood illnesses increased use of CMDs and rational drug use. PMID:23136276

Risk factors for chronic periodontitis in Sri Lankan adults: a population based case-control study.

PubMed

Wellapuli, Nimali; Ekanayake, Lilani

2017-09-07

To determine risk factors for chronic periodontitis in 30-60 year olds in Sri Lanka. Cases and controls for this population based unmatched case-control study were identified from a broader cross-sectional study which was conducted to determine the prevalence of chronic periodontitis in 30-60 year old adults in Colombo district Sri Lanka. The study included 694 cases and 706 controls. Data were collected by means of a pre-tested interviewer administered questionnaire to obtain information about socio-demographic and behavioural factors, a physical examination to record anthropometric measurements and an oral examination. Being a male, a Muslim, belonging to the 45-60 year old age group, having less than 12 years of education, using the finger to clean teeth, current smoking, current betel quid chewing, self-reported diabetes and hypertension emerged as risk factors for chronic periodontitis. Several socio-demographic and behavioural factors as well as co-morbid conditions emerged as independent risk factors for chronic periodontits in this population. The findings could be used for planning programmes to reduce the burden of chronic periodontits in Colombo district Sri Lanka.

Immunohistochemical and Biochemical Expression Patterns of TTF-1, RAGE, GLUT-1 and SOX2 in HCV-Associated Hepatocellular Carcinomas

PubMed Central

Aboushousha, Tarek; Mamdouh, Samah; Hamdy, Hussam; Helal, Noha; Khorshed, Fatma; Safwat, Gehan; Seleem, Mohamed

2018-01-01

Objective: To investigate the expression of TTF-1, RAGE, GLUT1 and SOX2 in HCV-associated HCCs and in surrounding non-tumorous liver tissue. Material and Methods: Tissue material from partial hepatectomy cases for HCC along with corresponding serum samples and 30 control serum samples from healthy volunteers were studied. Biopsies were classified into: non-tumor hepatic tissue (36 sections); HCC (33 sections) and liver cell dysplasia (LCD) (15 sections). All cases were positive for HCV. Immunohistochemistry (IHC), gene extraction and quantitative real-time reverse-transcription assays (qRT-PCR) were applied. Results: By IHC, LCD and HCC showed significantly high percentages of positive cases with all markers. SOX2 showed significant increase with higher HCC grades, while RAGE demonstrated an inverse relation and GLUT-1 and TTF-1 lacked any correlation. In nontumorous-HCV tissue, we found significantly high TTF-1, low RAGE and negative SOX2 expression. RAGE, GLUT-1 and SOX2 show non-significant elevation positivity in high grade HCV compared to low grade lesions. TTF-1, RAGE and SOX2 exhibited low expression in cirrhosis compared to fibrosis. Biochemical studies on serum and tissue extracts revealed significant down-regulation of RAGE, GLUT-1 and SOX2 genes, as well as significant up-regulation of the TTF-1 gene in HCC cases compared to controls. All studied genes show significant correlation with HCC grade. In non-tumor tissue, only TTF-1 gene expression had a significant correlation with the fibrosis score. Conclusion: Higher expression of TTF-1, RAGE, GLUT-1 and SOX2 in HCC and dysplasia compared to non-tumor tissues indicates up-regulation of these markers as early events during the development of HCV-associated HCC. PMID:29373917

Immunohistochemical and Biochemical Expression Patterns of TTF-1, RAGE, GLUT-1 and SOX2 in HCV-Associated Hepatocellular Carcinomas

PubMed

Aboushousha, Tarek; Mamdouh, Samah; Hamdy, Hussam; Helal, Noha; Khorshed, Fatma; Safwat, Gehan; Seleem, Mohamed

2018-01-27

Objective: To investigate the expression of TTF-1, RAGE, GLUT1 and SOX2 in HCV-associated HCCs and in surrounding non-tumorous liver tissue. Material and Methods: Tissue material from partial hepatectomy cases for HCC along with corresponding serum samples and 30 control serum samples from healthy volunteers were studied. Biopsies were classified into: non-tumor hepatic tissue (36 sections); HCC (33 sections) and liver cell dysplasia (LCD) (15 sections). All cases were positive for HCV. Immunohistochemistry (IHC), gene extraction and quantitative real-time reverse-transcription assays (qRT-PCR) were applied. Results: By IHC, LCD and HCC showed significantly high percentages of positive cases with all markers. SOX2 showed significant increase with higher HCC grades, while RAGE demonstrated an inverse relation and GLUT-1 and TTF-1 lacked any correlation. In nontumorous-HCV tissue, we found significantly high TTF-1, low RAGE and negative SOX2 expression. RAGE, GLUT-1 and SOX2 show non-significant elevation positivity in high grade HCV compared to low grade lesions. TTF-1, RAGE and SOX2 exhibited low expression in cirrhosis compared to fibrosis. Biochemical studies on serum and tissue extracts revealed significant down-regulation of RAGE, GLUT-1 and SOX2 genes, as well as significant up-regulation of the TTF-1 gene in HCC cases compared to controls. All studied genes show significant correlation with HCC grade. In non-tumor tissue, only TTF-1 gene expression had a significant correlation with the fibrosis score. Conclusion: Higher expression of TTF-1, RAGE, GLUT-1 and SOX2 in HCC and dysplasia compared to non-tumor tissues indicates up-regulation of these markers as early events during the development of HCV-associated HCC. Creative Commons Attribution License

40 CFR 146.8 - Mechanical integrity.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 22 2010-07-01 2010-07-01 false Mechanical integrity. 146.8 Section...) UNDERGROUND INJECTION CONTROL PROGRAM: CRITERIA AND STANDARDS General Provisions § 146.8 Mechanical integrity. (a) An injection well has mechanical integrity if: (1) There is no significant leak in the casing...

10 CFR 74.81 - Inspections.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 2 2010-01-01 2010-01-01 false Inspections. 74.81 Section 74.81 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) MATERIAL CONTROL AND ACCOUNTING OF SPECIAL NUCLEAR MATERIAL Enforcement § 74.81..., import, export, or transfer of special nuclear material. (c)(1) In the case of fuel cycle facilities...

Association of circulating total bilirubin with the metabolic syndrome and type 2 diabetes: A systematic review and meta-analysis of observational evidence.

PubMed

Nano, J; Muka, T; Cepeda, M; Voortman, T; Dhana, K; Brahimaj, A; Dehghan, A; Franco, O H

2016-12-01

Emerging evidence suggests that bilirubin levels might be associated with the metabolic syndrome (MetS) and type 2 diabetes (T2D), although the nature of the association remains unclear. This systematic review and meta-analysis investigated the relationship between total plasma bilirubin and the risk of MetS and T2D. Relevant studies were identified using five databases (Embase, Medline [Ovid], Web of Science, PubMed, Cochrane Central and Google Scholar), with the last search done on 21 October 2015. Study references were checked and authors contacted to identify additional studies. Randomized controlled trials, and cohort, case-control and cross-sectional studies of adults examining the association between blood bilirubin levels and MetS and T2D were included, irrespective of language and date of publication. Abstract and full-text selection was done by two independent reviewers, with a third reviewer available in case of disagreement. Data were extracted by two independent reviewers using a predesigned data collection form. MetS and T2D. Summary estimates were obtained by random-effects meta-analysis. Of the 2313 searched references, 16 observational studies (11 cross-sectional, two prospective, one that was both cross-sectional and prospective, two retrospective and one national survey) met our inclusion criteria. Overall, data were available for 175,911 non-overlapping participants, including 7414 MetS cases and 9406 T2D cases. In the meta-analysis of seven cross-sectional studies, the pooled odds ratio (95% confidence interval) for MetS in a comparison of extreme tertiles of serum bilirubin levels was 0.70 (95% CI: 0.62, 0.78), whereas no significant association was found for the pooled estimated relative risk between two prospective studies (0.57, 95% CI: 0.11, 2.94). The corresponding estimate was 0.77 (95% CI: 0.67, 0.87) for T2D from four cross-sectional studies. The available evidence, mainly from cross-sectional studies, supports an inverse association of bilirubin levels with adverse metabolic outcomes. Large-scale prospective studies are now needed to establish whether bilirubin levels may be useful in the prevention of MetS and T2D. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Full hoop casing for midframe of industrial gas turbine engine

DOEpatents

Myers, Gerald A.; Charron, Richard C.

2015-12-01

A can annular industrial gas turbine engine, including: a single-piece rotor shaft spanning a compressor section (82), a combustion section (84), a turbine section (86); and a combustion section casing (10) having a section (28) configured as a full hoop. When the combustion section casing is detached from the engine and moved to a maintenance position to allow access to an interior of the engine, a positioning jig (98) is used to support the compressor section casing (83) and turbine section casing (87).

Caesarean section rate and cost control effectiveness of case payment reform in the new cooperative medical scheme for delivery: evidence from Xi County, China.

PubMed

Liu, Shuang; Wang, Jing; Zhang, Liang; Zhang, Xiang

2018-03-09

In China, increases in both the caesarean section (CS) rates and delivery costs have raised questions regarding the reform of the medical insurance payment system. Case payment is useful for regulating the behaviour of health providers and for controlling the CS rates and excessive increases in medical expenses. New Cooperative Medical Scheme (NCMS) agencies in Xi County in Henan Province piloted a case payment reform (CPR) in delivery for inpatients. We aimed to observe the changes in the CS rates, compare the changes in delivery-related variables, and identify variables related to delivery costs before and after the CPR in Xi County. Overall, 28,314 cases were selected from the Xi County NCMS agency from 2009 to 2010 and from 2014 to 2015. One-way ANOVA and chi-square tests were used to compare the distributions of CS and vaginal delivery (VD) before and after the CPR under different indicators. We applied multivariate linear regressions for the total medical cost of the VD and CS groups and total samples to identify the relationships between medical expenses and variables. The CS rates in Xi County increased from 26.1% to 32.5% after the CPR. The length of stay (LOS), total medical cost, and proportion of county hospitals increased in the CS and VD groups after the CPR, which had significant differences. The total medical cost in the CS and VD groups as well as the total samples was significantly influenced by inpatient age, LOS, and hospital type, and had a significant correlation with the CPR in the VD group and the total samples. The CPR might fail to control the growth of unreasonable medical expenses and regulate the behaviour of providers, which possibly resulted from the unreasonable compensation standard of case payments, prolonged LOS, and the increasing proportion of county hospitals. The NCMS should modify the case payment standard of delivery to inhibit providers' motivation to render CS services. The LOS should be controlled by implementing clinical guidelines, and a reference system should be established to guide patients in choosing reasonable hospitals.

Depletion of catecholaminergic neurons of the rostral ventrolateral medulla in multiple systems atrophy with autonomic failure

NASA Technical Reports Server (NTRS)

Benarroch, E. E.; Smithson, I. L.; Low, P. A.; Parisi, J. E.

1998-01-01

The ventrolateral portion of the intermediate reticular formation of the medulla (ventrolateral medulla, VLM), including the C1/A1 groups of catecholaminergic neurons, is thought to be involved in control of sympathetic cardiovascular outflow, cardiorespiratory interactions, and reflex control of vasopressin release. As all these functions are affected in patients with multiple systems atrophy (MSA) with autonomic failure, we sought to test the hypothesis that catecholaminergic (tyrosine hydroxylase [TH]-positive) neurons of the VLM are depleted in these patients. Medullas were obtained at autopsy from 4 patients with MSA with prominent autonomic failure and 5 patients with no neurological disease. Patients with MSA had laboratory evidence of severe adrenergic sudomotor and cardiovagal failure. Tissue was immersion fixed in 2% paraformaldehyde at 4 degrees C for 24 hours and cut into 1-cm blocks in the coronal plane from throughout the medulla. Serial 50-microm sections were collected and one section every 300 microm was stained for TH. There was a pronounced depletion of TH neurons in the rostral VLM in all cases of MSA. There was also significant reduction of TH neurons in the caudal VLM in 3 MSA patients compared with 3 control subjects. In 2 MSA cases and in 2 control subjects, the thoracic spinal cord was available for study. There was also depletion of TH fibers and sympathetic preganglionic neurons (SPNs) in the 2 MSA cases examined. Thus, depletion of catecholaminergic neurons in the VLM may provide a substrate for some of the autonomic and endocrine manifestations of MSA.

Peer Teaching to Foster Learning in Physiology.

PubMed

Srivastava, Tripti K; Waghmare, Lalitbhushan S; Mishra, Ved Prakash; Rawekar, Alka T; Quazi, Nazli; Jagzape, Arunita T

2015-08-01

Peer teaching is an effective tool to promote learning and retention of knowledge. By preparing to teach, students are encouraged to construct their own learning program, so that they can explain effectively to fellow learners. Peer teaching is introduced in present study to foster learning and pedagogical skills amongst first year medical under-graduates in physiology with a Hypothesis that teaching is linked to learning on part of the teacher. Non-randomized, Interventional study, with mixed methods design. Cases experienced peer teaching whereas controls underwent tutorials for four consecutive classes. Quantitative Evaluation was done through pre/post test score analysis for Class average normalized gain and tests of significance, difference in average score in surprise class test after one month and percentage of responses in closed ended items of feedback questionnaire. Qualitative Evaluation was done through categorization of open ended items and coding of reflective statements. The average pre and post test score was statistically significant within cases (p = 0.01) and controls (p = 0.023). The average post test scores was more for cases though not statistically significant. The class average normalized gain (g) for Tutorials was 49% and for peer teaching 53%. Surprise test had average scoring of 36 marks (out of 50) for controls and 41 marks for cases. Analysed section wise, the average score was better for Long answer question (LAQ) in cases. Section wise analysis suggested that through peer teaching, retention was better for descriptive answers as LAQ has better average score in cases. Feedback responses were predominantly positive for efficacy of peer teaching as a learning method. The reflective statements were sorted into reflection in action, reflection on action, claiming evidence, describing experience, and recognizing discrepancies. Teaching can stimulate further learning as it involves interplay of three processes: metacognitive awareness; deliberate practice, and self-explanation. Coupled with immediate feedback and reflective exercises, learning can be measurably enhanced along with improved teaching skills.

Peer Teaching to Foster Learning in Physiology

PubMed Central

Srivastava, Tripti K; Waghmare, Lalitbhushan S.; Mishra, Ved Prakash; Rawekar, Alka T; Quazi, Nazli; Jagzape, Arunita T

2015-01-01

Introduction Peer teaching is an effective tool to promote learning and retention of knowledge. By preparing to teach, students are encouraged to construct their own learning program, so that they can explain effectively to fellow learners. Peer teaching is introduced in present study to foster learning and pedagogical skills amongst first year medical under-graduates in physiology with a Hypothesis that teaching is linked to learning on part of the teacher. Materials and Methods Non-randomized, Interventional study, with mixed methods design. Cases experienced peer teaching whereas controls underwent tutorials for four consecutive classes. Quantitative Evaluation was done through pre/post test score analysis for Class average normalized gain and tests of significance, difference in average score in surprise class test after one month and percentage of responses in closed ended items of feedback questionnaire. Qualitative Evaluation was done through categorization of open ended items and coding of reflective statements. Results The average pre and post test score was statistically significant within cases (p = 0.01) and controls (p = 0.023). The average post test scores was more for cases though not statistically significant. The class average normalized gain (g) for Tutorials was 49% and for peer teaching 53%. Surprise test had average scoring of 36 marks (out of 50) for controls and 41 marks for cases. Analysed section wise, the average score was better for Long answer question (LAQ) in cases. Section wise analysis suggested that through peer teaching, retention was better for descriptive answers as LAQ has better average score in cases. Feedback responses were predominantly positive for efficacy of peer teaching as a learning method. The reflective statements were sorted into reflection in action, reflection on action, claiming evidence, describing experience, and recognizing discrepancies. Conclusion Teaching can stimulate further learning as it involves interplay of three processes: metacognitive awareness; deliberate practice, and self-explanation. Coupled with immediate feedback and reflective exercises, learning can be measurably enhanced along with improved teaching skills. PMID:26435969

A New Approach for Identifying Patients with Undiagnosed Chronic Obstructive Pulmonary Disease

PubMed Central

Mannino, David; Leidy, Nancy Kline; Malley, Karen G.; Bacci, Elizabeth D.; Barr, R. Graham; Bowler, Russ P.; Han, MeiLan K.; Houfek, Julia F.; Make, Barry; Meldrum, Catherine A.; Rennard, Stephen; Thomashow, Byron; Walsh, John; Yawn, Barbara P.

2017-01-01

Rationale: Chronic obstructive pulmonary disease (COPD) is often unrecognized and untreated. Objectives: To develop a method for identifying undiagnosed COPD requiring treatment with currently available therapies (FEV1 <60% predicted and/or exacerbation risk). Methods: We conducted a multisite, cross-sectional, case-control study in U.S. pulmonary and primary care clinics that recruited subjects from primary care settings. Cases were patients with COPD and at least one exacerbation in the past year or FEV1 less than 60% of predicted without exacerbation in the past year. Control subjects were persons with no COPD or with mild COPD (FEV1 ≥60% predicted, no exacerbation in the past year). In random forests analyses, we identified the smallest set of questions plus peak expiratory flow (PEF) with optimal sensitivity (SN) and specificity (SP). Measurements and Main Results: PEF and spirometry were recorded in 186 cases and 160 control subjects. The mean (SD) age of the sample population was 62.7 (10.1) years; 55% were female; 86% were white; and 16% had never smoked. The mean FEV1 percent predicted for cases was 42.5% (14.2%); for control subjects, it was 82.5% (15.7%). A five-item questionnaire, CAPTURE (COPD Assessment in Primary Care to Identify Undiagnosed Respiratory Disease and Exacerbation Risk), was used to assess exposure, breathing problems, tiring easily, and acute respiratory illnesses. CAPTURE exhibited an SN of 95.7% and an SP of 44.4% for differentiating cases from all control subjects, and an SN of 95.7% and an SP of 67.8% for differentiating cases from no-COPD control subjects. The PEF (males, <350 L/min; females, <250 L/min) SN and SP were 88.0% and 77.5%, respectively, for differentiating cases from all control subjects, and they were 88.0% and 90.8%, respectively, for distinguishing cases from no-COPD control subjects. The CAPTURE plus PEF exhibited improved SN and SP for all cases versus all control subjects (89.7% and 78.1%, respectively) and for all cases versus no-COPD control subjects (89.7% and 93.1%, respectively). Conclusions: CAPTURE with PEF can identify patients with COPD who would benefit from currently available therapy and require further diagnostic evaluation. Clinical trial registered with clinicaltrials.gov (NCT01880177). PMID:27783539

Intrauterine Inflated Foley's Catheter Balloon in the Management of Abnormally Invasive Placenta Previa: A Case-Control Study.

PubMed

Thabet, Mahmoud; Abdelhafez, Mohamed Sayed; Fyala, Emad Ahmed

2018-06-01

To describe the use of intrauterine inflated Foley's catheter balloon for control of postpartum hemorrhage (PPH) during cesarean section (CS) in cases of abnormally invasive placenta previa aiming to preserve the uterus. Retrospective case-control study of the data of women who underwent elective CS on abnormally adherent placenta previa was carried out. Women in whom inflated Foley's catheter balloon was used for control of PPH during CS ( n  = 40) were compared with a control group of women who underwent elective CS by the same technique but without use of intrauterine catheter balloon ( n  = 38). Use of intrauterine inflated Foley's catheter balloon significantly reduced the estimated amount of blood loss ( P  = 0.008), amounts of crystalloids, colloids and packed red blood cells transfusion ( P  = 0.025, 0.017 and 0.022, respectively), and the need for bilateral internal iliac artery (IIA) ligation ( P  = 0.016). No significant difference was observed between both groups regarding the use of massive transfusion protocol, performing cesarean hysterectomy, relaparotomy, and admission to the intensive care unit. Application of an intrauterine inflated Foley's catheter balloon during CS in cases of morbidly adherent placenta previa helps to control PPH with preservation of the uterus and decreases the need for the invasive IIA ligation.

33 CFR 26.03 - Radiotelephone required.

Code of Federal Regulations, 2011 CFR

2011-07-01

... on board capable of operation from its navigational bridge, or in the case of a dredge, from its main control station, and capable of transmitting and receiving on the frequency or frequencies within the 156... section must be carried on board the described vessels, dredges, and floating plants upon the navigable...

33 CFR 26.03 - Radiotelephone required.

Code of Federal Regulations, 2010 CFR

2010-07-01

... on board capable of operation from its navigational bridge, or in the case of a dredge, from its main control station, and capable of transmitting and receiving on the frequency or frequencies within the 156... section must be carried on board the described vessels, dredges, and floating plants upon the navigable...

10 CFR 1016.38 - Suspension or revocation of access authorization.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false Suspension or revocation of access authorization. 1016.38 Section 1016.38 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) SAFEGUARDING OF RESTRICTED DATA Control of Information § 1016.38 Suspension or revocation of access authorization. In any case where the...

10 CFR 1016.38 - Suspension or revocation of access authorization.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Suspension or revocation of access authorization. 1016.38 Section 1016.38 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) SAFEGUARDING OF RESTRICTED DATA Control of Information § 1016.38 Suspension or revocation of access authorization. In any case where the...

26 CFR 1.952-1 - Subpart F income defined.

Code of Federal Regulations, 2010 CFR

2010-04-01

... such year from the insurance of United States risks (determined in accordance with the provisions of... of United States risks in the case of certain controlled foreign corporations described in section.... While CFC's general limitation post-1986 undistributed earnings for 1999 are 0 ((100u) opening balance...

Electrical Safety: Safety and Health for Electrical Trades. Student Manual.

ERIC Educational Resources Information Center

Fowler, Thaddeus W.; Miles, Karen K.

This document is designed to teach learners in secondary and postsecondary electrical trades courses to recognize, evaluate, and control hazards associated with electrical work, The manual's eight sections each include some or all of the following components: instructional text; definitions; case studies illustrating key safety considerations;…

40 CFR 230.77 - Other actions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 24 2010-07-01 2010-07-01 false Other actions. 230.77 Section 230.77...) GUIDELINES FOR SPECIFICATION OF DISPOSAL SITES FOR DREDGED OR FILL MATERIAL Actions To Minimize Adverse Effects § 230.77 Other actions. (a) In the case of fills, controlling runoff and other discharges from...

40 CFR 230.77 - Other actions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 25 2011-07-01 2011-07-01 false Other actions. 230.77 Section 230.77...) GUIDELINES FOR SPECIFICATION OF DISPOSAL SITES FOR DREDGED OR FILL MATERIAL Actions To Minimize Adverse Effects § 230.77 Other actions. (a) In the case of fills, controlling runoff and other discharges from...

Association of hypoglycemia, hypocalcemia and hypomagnesemia in neonates with perinatal asphyxia.

PubMed

Saha, D; Ali, M A; Haque, M A; Ahmed, M S; Sutradhar, P K; Latif, T; Sarkar, D; Husain, F

2015-04-01

The clinical evidence of neurological menifestations associated with asphyxia is described as hypoxic ischaemic encephalopathy (HIE). A variety of metabolic problems are present in asphyxiated newborns including hypoglycemia, hypocalcemia, hypomagnesemia and others metabolic abnormalities. Some of these biochemical disturbances may trigger seizure or potentiate further brain damage. This cross sectional case-control study was done in Mymensingh Medical College Hospital, to identify the association of hypoglycemia, hypocalcemia, hypomagnesemia in neonates with perinatal asphyxia. Study period was six months. Sample size was 60. Among total sample 30 term asphyxiated newborns of <24 hours age were case and equal number term healthy newborns <24 hours age were control. The main clinical presentations were delayed cry after birth along with respiratory distress, convulsion and absence of cry in asphyxiated newborns. Major physical findings were cyanosis, convulsion and tachypnoea in asphyxiated group. The mean value of serum calcium level was significantly lower in asphyxiated newborns (7.37 ± 0.10mg/dl) than control value (8.04±0.09mg/dl). Hypocalcemia was found among 23.33% babies in case group. On the contrary, hypocalcemia was found in single baby among control group. The mean value of serum magnesium was significantly lower in asphyxiated newborns (1.83 ± 0.04mg/dl) than control value (1.96 ± 0.05mg/dl). Hypomagnesemia was found among 3(10%) newborns but none was found among control group. Hypoglycemia was found in 7(23.33%) cases though the mean value of blood glucose was higher in case group (5.72 ± 0.62mmol/l) than control group (4.87 ± 0.15mmol/l) difference was not statistically significant. Combined hypoglycemia, hypocalcemia and hypomagnesemia were found in 1(3.33%) case; combined hypoglycemia and hypocalcemia were found in 2(6.67%) cases; and combined hypocalcemia and hypomagnesemia were found in 1(3.33%) case. During the study period, 3(10.0%) cases were expired but no death occurred among control group. This study shows isolated or combined hypoglycemia, hypocalcemia, hypomagnesemia are frequently found in newborns with perinatal asphyxia. So, it is necessary to monitor blood glucose, serum calcium and also serum magnesium among asphyxiated newborns for proper management.

Acute pulmonary emphysema in death by hanging: a morphometric digital study.

PubMed

Castiglioni, Claudia; Baumann, Pia; Fracasso, Tony

2016-09-01

Acute pulmonary emphysema (APE) has been described in cases of mechanical asphyxia such as ligature or manual strangulation but not in cases of hanging. In this study, we wanted to verify by morphometric digital analysis of lung tissue whether APE occurs in death by hanging.We investigated 16 cases of hanging (eight complete, eight incomplete), 10 cases of freshwater drowning (positive control group), and 10 cases of acute external bleeding (negative control group). Tissue sections were obtained from each pulmonary lobe. For each slide, five fields were randomly selected. The area of every alveolar space was measured by image analysis software. The mean alveolar area (MAA) was calculated for each group.In incomplete hanging, MAA was significantly higher than that observed in complete hanging and similar to the one observed in freshwater drowning.APE in cases of incomplete hanging can be considered as a sign of vitality. The high number of conditions that can cause alveolar distension (that were excluded in this study) limits the applicability of this vital sign in the routine forensic practice.

Sanitation of wallboard colonized with Stachybotrys chartarum.

PubMed

Price, D L; Ahearn, D G

1999-07-01

Sections (8 cm2) of unused, nonsterile gypsum wallboard (dry wall) were inoculated with varying densities (10(4) to approximately 10(8)/ml) of conidia from 14- to 21-day cultures of Stachybotrys chartarum grown on cellulose agar. The sections were permitted to air dry and were placed into vessels with 86% or 92% RH and incubated at 22-25 degrees C for up to 12 weeks. The moisture content of the dryboard increased from near 10% to over 35%. Selected sections with confluent surface growth, mainly of S. chartarum, were obtained within 3 weeks. Sections were cleaned with a quaternary or quaternary and chlorine dioxide or a concentrated oxygen-saline solution and treated, in some cases, with a preservative system and returned to humidity vessels. Reemergence of S. chartarum from inoculated and treated surfaces occurred within 5 weeks only with sections treated with the quaternary alone. Other fungi, mostly species of Aspergillus, Chaetomium and Penicillium, slowly colonized (between 9-12 weeks) at least some areas of most treated surfaces and most uninoculated control surfaces. Stachybotrys chartarum was also found on several sections of uninoculated controls. Sections treated with a quaternary/acrylic and placed in a dynamic challenging chamber remained visually free of colonized fungi for over 90 days. These studies indicate that control samples of uninstalled wallboard, available from local distributors, can contain a baseline bioburden, including S. chartarum, that will colonize surfaces under high humidity conditions. Sanitation and preservation treatment of the wallboard can markedly delay regrowth of these fungi, particularly of S. chartarum.

High altitude haemofiltration.

PubMed

Stevens, P E; Bloodworth, L L; Rainford, D J

1986-05-24

Evacuating people in acute renal failure by air is difficult because the hazards of fluid overload and anaemia are potentiated by altitude. In two such patients continuous arteriovenous haemofiltration was used to control their fluid problems during aeromedical evacuation. In the first case, a patient with renal failure and blast lung, haemofiltration was performed at 500 ml/h over a four hour journey; in the second, a woman with severe pre-eclamptic toxaemia who developed acute renal failure after caesarean section, haemofiltration was performed at 200 ml/h over a 14 hour flight. Both patients recovered fully. In these two cases haemofiltration permitted control of the intravascular volume during aeromedical evacuation. The technique represents a major advance in the safe transfer of casualties.

Ground control failures. A pictorial view of case studies

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

Peng, S.S.

2007-07-01

The book shows, in pictorial views, many forms and/or stages of types of failures in mines, for instance, cutter, roof falls, and cribs. In each case, the year of occurrence is stated in the beginning so that the environment or technological background under which it occurred are reflected. The narrative than begins with the mining and geological conditions, followed by a description of the ground control problems and recommended solutions and results, if any. The sections cover failure of pillars, roof falls, longwall, roof bolting, multiple-seam mining, floor heave, longwall, flooding and weathering of coal, old workings, and shortwall andmore » thin-seam plow longwall.« less

The need to scale up HIV indicator condition-guided testing for early case-finding: a case-control study in primary care.

PubMed

Joore, Ivo K; Twisk, Denise E; Vanrolleghem, Ann M; de Ridder, Maria; Geerlings, Suzanne E; van Bergen, Jan E A M; van den Broek, Ingrid V

2016-11-17

European guidelines recommend offering an HIV test to individuals who display HIV indicator conditions (ICs). We aimed to investigate the incidence of ICs in primary care reported in medical records prior to HIV diagnosis. We did a cross-sectional search in an electronic general practice database using a matched case-control design to identify which predefined ICs registered by Dutch GPs were most associated with an HIV-positive status prior to the time of diagnosis. We included 224 HIV cases diagnosed from 2009 to 2013, which were matched with 2,193 controls. Almost two thirds (n = 136, 60.7%) of cases were diagnosed with one or more ICs in the period up to five years prior to the index date compared to 18.7% (n = 411) of controls. Cases were more likely to have an IC than controls: in the one year prior to the index date, the odds ratio (OR) for at least one condition was 11.7 (95% CI: 8.3 to 16.4). No significant differences were seen in the strength of the association between HIV diagnosis and ICs when comparing genders, age groups or urbanisation levels. There is no indication that subgroups require a different testing strategy. Our study shows that there are opportunities for IC-guided testing in primary care. We recommend that IC-guided testing be more integrated in GPs' future guidelines and that education strategies be used to facilitate its implementation in daily practice.

Explaining worker strain and learning: how important are emotional job demands?

PubMed

Taris, Toon W; Schreurs, Paul J G

2009-05-01

This study examined the added value of emotional job demands in explaining worker well-being, relative to the effects of task characteristics, such as quantitative job demands, job control, and coworker support. Emotional job demands were expected to account for an additional proportion of the variance in well-being. Cross-sectional data were obtained from 11,361 female Dutch home care employees. Hierarchical stepwise regression analysis demonstrated that low control, low support and high quantitative demands were generally associated with lower well-being (as measured in terms of emotional exhaustion, dedication, professional accomplishment and learning). Moreover, high emotional demands were in three out of four cases significantly associated with adverse well-being, in these cases accounting for an additional 1-6% of the variance in the outcome variables. In three out of eight cases the main effects of emotional demands on well-being were qualified by support and control, such that high control and high support either buffered the adverse effects of high emotional demands on well-being or increased the positive effects thereof. All in all, high emotional demands are as important a risk factor for worker well-being as well-established concepts like low job control and high quantitative job demands.

Are obesity and body fat distribution associated with low back pain in women? A population-based study of 1128 Spanish twins.

PubMed

Dario, Amabile B; Ferreira, Manuela L; Refshauge, Kathryn; Sánchez-Romera, Juan F; Luque-Suarez, Alejandro; Hopper, John L; Ordoñana, Juan R; Ferreira, Paulo H

2016-04-01

To investigate the relationship between different measures of obesity and chronic low back pain (LBP) using a within-pair twin case-control design that adjusts for genetics and early shared environment. A cross-sectional association between lifetime prevalence of chronic LBP and different measures of obesity (body mass index-BMI; percent body fat; waist circumference; waist-hip ratio) was investigated in 1128 female twins in three stages: (i) total sample analysis; (ii) within-pair case-control analysis for monozygotic (MZ) and dizygotic (DZ) twins together; (iii) within-pair case-control analysis separated by DZ and MZ. Odds ratios (OR) and 95% confidence intervals (CI) were calculated. BMI (OR 1.12; 95% CI 1.02-1.26) and percent body fat (OR 1.15; 95% CI 1.01-1.32) were weakly associated with lifetime prevalence of chronic LBP in the total sample analysis but were absent when shared environment and genetic factors were adjusted for using the within-pair case-control analysis. Greater waist-hip ratios were associated with smaller prevalence estimates of chronic LBP in the within-pair case-control analysis with both MZ and DZ twins (OR 0.67; 95% CI 0.47-0.94). However, this association did not remain after the full adjustment for genetic factors in the MZ within-pair case-control analysis. BMI, percent of fat mass and greater depositions of fat and mass around the hips are associated with increases in chronic LBP prevalence in women but these associations are small and appear to be confounded by the effects of genetics and early shared environment. Therefore, our results do not support a causal direct relationship between obesity and chronic LBP.

Comparison of CFD simulations to non-rotating MEXICO blades experiment in the LTT wind tunnel of TUDelft

NASA Astrophysics Data System (ADS)

Zhang, Ye; van Zuijlen, Alexander; van Bussel, Gerard

2014-06-01

In this paper, three dimensional flow over non-rotating MEXICO blades is simulated by CFD methods. The numerical results are compared with the latest MEXICO wind turbine blades measurements obtained in the low speed low turbulence (LTT) wind tunnel of Delft University of Technology. This study aims to validate CFD codes by using these experimental data measured in well controlled conditions. In order to avoid use of wind tunnel corrections, both the blades and the wind tunnel test section are modelled in the simulations. The ability of Menter's k - ω shear stress transport (SST) turbulence model is investigated at both attached flow and massively separated flow cases. Steady state Reynolds averaged Navier Stokes (RANS) equations are solved in these computations. The pressure distribution at three measured sections are compared under the conditions of different inflow velocities and a range of angles of attack. The comparison shows that at attached flow condition, good agreement can be obtained for all three airfoil sections. Even with massively separated flow, still fairly good pressure distribution comparison can be found for the DU and NACA airfoil sections, although the RISØ section shows poor comparison. At the near stall case, considerable deviations exists on the forward half part of the upper surface for all three sections.

A 26-year review of emergency peripartum hysterectomy in a tertiary teaching hospital in Kuwait - years 1983-2011.

PubMed

Chibber, Rachana; Al-Hijji, Jassim; Fouda, Mohamed; Al-Saleh, Eyad; Al-Adwani, Abdul Razzak; Mohammed, Asiya Tasneem

2012-01-01

To identify the risk factors and study the incidence, indications and complications of emergency peripartum hysterectomy (EPH). This was a retrospective case-control study. The cases consisted of all women who underwent EPH between January 1983 and January 2011. Two controls per case were randomly selected from the remaining deliveries by using a random number table. Case records were retrieved from the medical records. Among 150,993 deliveries, there were 59 EPHs (cases), giving a rate of 0.390 per 1,000. Of the 59 cases, only 56 were analysed because 3 files were unavailable. These women were older (mean age 36 ± 5.7 vs. 22 ± 5.3 years, p < 0.01) and had delivered more than 1 child (p = 0.02). Thirty-seven (66%) cases had had previous caesarean sections (CSs) and the number of CSs in this group was greater than in the controls (21%, p < 0.01). More index cases had a history of atonic postpartum haemorrhage (46 vs. 4%, p < 0.001) and placenta praevia (34 vs. 4%, p < 0.01). More cases than controls were delivered by CS (73 vs. 29%; p = 0.003). The leading indications for EPH were haemorrhage due to uterine atony and placenta praevia. Independent risk factors were older age, multiparity, history of one or more CSs and placenta praevia. There were 2 maternal deaths from coagulopathy following massive obstetric haemorrhage. The main complications of EPH were febrile morbidity: 12 (21%), wound infection: 8 (14%) and bladder or ureteric injury: 8 (14%). CSs, especially repeat CSs in women with placenta praevia and persistent uterine atony, significantly increased the risks of peripartum hysterectomy. Copyright © 2011 S. Karger AG, Basel.

No association between level of vitamin D and chronic low back pain in Swedish primary care: a cross-sectional case-control study.

PubMed

Thörneby, Andreas; Nordeman, Lena Margareta; Johanson, Else Hellebö

2016-06-01

Assessment of vitamin D levels and deficiency status in individuals with chronic low back pain (CLBP) in a Swedish general population, compared with controls matched for sex and age. Cross-sectional case-control study. Primary care, southern Sweden. Participants (n = 44) with self-reported low back pain for at least 3 months and individually sex- and age-matched controls without a chronic pain condition (n = 44), recruited from the general population by random letter of invitation. Association between vitamin D level and CLBP when adjusting for possible confounders in a multivariate forward conditional logistic regression model. Mean S-25-hydroxyvitamin D levels were 81 and 80 nmol/L in the CLBP and control group, respectively. The prevalence of vitamin D deficiency was low and similar in the CLBP group and the control group. Vitamin D level was not associated with CLBP when potential confounders were taken into account. No difference in vitamin D levels between participants with CLBP and matched controls could be demonstrated in the present sample. Assessment of vitamin D level and deficiency status may be of questionable value in the management of CLBP in primary care settings at similar latitudes, unless there are additional risk factors for deficiency or specific indicators of osteomalacia. Key points Vitamin D deficiency is common and reported in many chronic pain conditions, including chronic low back pain (CLBP), but evidence for an association and causality is insufficient. • The present study found no association between vitamin D levels and CLBP in a case-control sample of 44 + 44 individuals from the Swedish general population. • Prevalence of vitamin D deficiency was low and comparable in individuals with CLBP and controls without chronic pain, matched for sex and age. • Assessment of vitamin D status, for the purpose of finding and treating an underlying cause of pain, may be of limited value in the management of CLBP in primary care settings at similar latitudes.

Acromegaly and aging: a comparative cross-sectional study.

PubMed

Hatipoglu, Esra; Yuruyen, Mehmet; Keskin, Ela; Yavuzer, Hakan; Niyazoglu, Mutlu; Doventas, Alper; Erdincler, Deniz Suna; Beger, Tanju; Kadioglu, Pinar; Gundogdu, Sadi

2015-02-01

Cognitive and functional geriatric assessment may change in acromegaly. Herein we aimed to determine at which points geriatric assessment of the cases with acromegaly differs from that of general elderly population. In this comparative cross-sectional study, a total of 30 cases with acromegaly (controlled n = 14, uncontrolled n = 16) and 30 gender and body-mass index-matched cases without acromegaly (control group, CG) above 60 years old were included. Cognitive functions were evaluated on the basis of the mini-mental state exam (MMSE). Affective status was determined using the geriatric depression scale. Activities of daily living (ADL) were ranked according to the Barthel index while instrumental activities of daily living (IADL) were graded on the basis of the Lawton scale. Nutritional status was evaluated using the mini-nutritional assessment (MNA). Body composition was measured through bioimpedance analysis. Functional mobility was determined using the Timed Up and Go test (TUG) and muscle strength with the handgrip strength test. Scores on the MMSE were significantly lower in the elderly cases with acromegaly than in the cases without acromegaly (p < 0.001). Dementia was more frequent in the acromegaly group than in the CG (p = 0.04). Total MNA scores were significantly lower in cases with acromegaly than in the CG (p = 0.006). More subjects in the acromegaly group (33%) were at greater risk of malnutrition than in the CG (3%) (p = 0.003). There was greater moderate functional impairment based on Barthel ADL in the acromegaly group than in the CG (p = 0.04). Acromegaly may impair cognitive functions, functional mobility and instrumental daily living activities in the geriatric population. With acromegaly, the risk of malnutrition may also increase. Copyright © 2014 Elsevier Ltd. All rights reserved.

Disturbed eating behavior and eating disorders in preteen and early teenage girls with type 1 diabetes: a case-controlled study.

PubMed

Colton, Patricia; Olmsted, Marion; Daneman, Denis; Rydall, Anne; Rodin, Gary

2004-07-01

To compare the prevalence of eating disturbances in preteen and early teenage girls with type 1 diabetes to their nondiabetic peers. A cross-sectional, case-controlled study of 101 girls with type 1 diabetes, ages 9-14 years, and 303 age-matched, female nondiabetic control subjects was conducted. Participants completed a Children's Eating Disorder Examination interview. Socioeconomic status, BMI, and diabetes-related variables were assessed. Groups were compared using chi(2) analyses. Binge eating; the use of intense, excessive exercise for weight control; the combination of two disturbed eating-related behaviors; and subthreshold eating disorders were all more common in girls with type 1 diabetes. Metabolic control was not related to eating behavior in this study population. Eating disturbances, though mostly mild, were significantly more common in preteen and early teenage girls with type 1 diabetes. Screening and prevention programs for this high-risk group should begin in the preteen years.

[Arterial hypertension and control in Brazzaville (Congo): role of ambulatory blood pressure monitoring (ABPM)].

PubMed

Ikama, M S; Nsitou, B M; Makani, J; Nkalla-Lambi, M; Passi-Louamba, C

2015-04-01

To evaluate the rate control in the hypertensive patients and to identify the predictive factors of non-control. It was about a cross-sectional study with prospective collection of data over a period of 36 months. It has been held in Brazzaville, and included a consecutive series of 620 hypertensive patients known and treated for at least 6 weeks, having profited from an ambulatory blood pressure monitoring (ABPM) with therapeutic aiming. We used the TONOPORT V and the software Cardiosoft 6.51 of GE Health Care, respectively for the recording and the data analysis. The threshold fixed on the average of 24-hour was BP<130/80 mmHg, and the patients divided into two groups according to whether they were or not controlled. They were 352 men (56.8%) and 268 women (43.2%), old on average of 53.8 ± 9.7 years (ranges: 29 and 89 years). The standard of living of the patients was average in 330 cases (53.2%), weak in 132 cases (21.3%), and high in 71 cases (11.5%). The other associated risk factors were sedentariness in 275 cases (44.4%), overweight/obesity in 134 cases (21.6%), dyslipidemia in 121 cases (19.5%), diabetes mellitus in 90 cases (14.5%), and tobacco addiction in 25 cases (4%). The hypertension, old of 5.8 ± 5.7 years on average, was controlled among 215 patients (34.7%). The 24- hour BP average was 139 ± 14 mmHg for the SBP and 88.2 ± 10.2 mmHg for the DBP. The awake and asleep BP averages were respectively 141 ± 14 mmHg and 133 ± 16.2 mmHg for the SBP, 90.5 ± 10.5 and 81.2 ± 11.1 mmHg for the DBP. The antihypertensive protocol used was a monotherapy in 130 cases (21%), bitherapy in 287 cases (46.3%), tritherapy in 154 cases (24.8%), quadritherapy or more in 27 cases (4.3%). Prevalence of non-dipping was 43%. Age and male gender were the significant predictors of poor control. The rate control of hypertension in our study population remains low. Its improvement passes by the education of the hypertensive patients and the improvement of their living conditions. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

A compendium of controlled diffusion blades generated by an automated inverse design procedure

NASA Technical Reports Server (NTRS)

Sanz, Jose M.

1989-01-01

A set of sample cases was produced to test an automated design procedure developed at the NASA Lewis Research Center for the design of controlled diffusion blades. The range of application of the automated design procedure is documented. The results presented include characteristic compressor and turbine blade sections produced with the automated design code as well as various other airfoils produced with the base design method prior to the incorporation of the automated procedure.

Protecting Files Hosted on Virtual Machines With Out-of-Guest Access Control

DTIC Science & Technology

2017-12-01

analyzes the design and methodology of the implemented mechanism, while Chapter 4 explains the test methodology, test cases, and performance testing ...SACL, we verify that the user or group accessing the file has sufficient permissions. If that is correct, the callback function returns control to...ferify. In the first section, we validate our design of ferify. Next, we explain the tests we performed to verify that ferify has the results we expected

Bayesian analysis of stage-fall-discharge rating curves and their uncertainties

NASA Astrophysics Data System (ADS)

Mansanarez, V.; Le Coz, J.; Renard, B.; Lang, M.; Pierrefeu, G.; Vauchel, P.

2016-09-01

Stage-fall-discharge (SFD) rating curves are traditionally used to compute streamflow records at sites where the energy slope of the flow is variable due to variable backwater effects. We introduce a model with hydraulically interpretable parameters for estimating SFD rating curves and their uncertainties. Conventional power functions for channel and section controls are used. The transition to a backwater-affected channel control is computed based on a continuity condition, solved either analytically or numerically. The practical use of the method is demonstrated with two real twin-gauge stations, the Rhône River at Valence, France, and the Guthusbekken stream at station 0003ṡ0033, Norway. Those stations are typical of a channel control and a section control, respectively, when backwater-unaffected conditions apply. The performance of the method is investigated through sensitivity analysis to prior information on controls and to observations (i.e., available gaugings) for the station of Valence. These analyses suggest that precisely identifying SFD rating curves requires adapted gauging strategy and/or informative priors. The Madeira River, one of the largest tributaries of the Amazon, provides a challenging case typical of large, flat, tropical river networks where bed roughness can also be variable in addition to slope. In this case, the difference in staff gauge reference levels must be estimated as another uncertain parameter of the SFD model. The proposed Bayesian method is a valuable alternative solution to the graphical and empirical techniques still proposed in hydrometry guidance and standards.

School Openness, Parent Participation and Satisfaction: An Exploration of Causal Models.

ERIC Educational Resources Information Center

Spivak, Harriet

This case study in policy research was prompted by: (1) concern about a methodological issue: how useful are cross-sectional, non-experimental data for answering policy questions?--and, (2) interest in some policy issues raised by the school decentralization/community control controversies and participatory reforms of the 1960s--are participatory…

40 CFR 112.12 - Spill Prevention, Control, and Countermeasure Plan requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... drainage system or facility effluent treatment system, except where facility systems are designed to...), (iii), and (iv) of this section. (3) Design facility drainage systems from undiked areas with a... engineer facility drainage systems to prevent a discharge as described in § 112.1(b) in case there is an...

10 CFR Appendix D to Part 52 - Design Certification Rule for the AP1000 Design

Code of Federal Regulations, 2014 CFR

2014-01-01

... under 10 CFR 50.90. (1) Maximum fuel rod average burn-up. (2) Fuel principal design requirements. (3... Cases. (3) Design Summary of Critical Sections. (4) American Concrete Institute (ACI) 318, ACI 349... control system, except burn-up limit. (8) Motor-operated and power-operated valves. (9) Instrumentation...

10 CFR Appendix D to Part 52 - Design Certification Rule for the AP1000 Design

Code of Federal Regulations, 2012 CFR

2012-01-01

... under 10 CFR 50.90. (1) Maximum fuel rod average burn-up. (2) Fuel principal design requirements. (3... Cases. (3) Design Summary of Critical Sections. (4) American Concrete Institute (ACI) 318, ACI 349... control system, except burn-up limit. (8) Motor-operated and power-operated valves. (9) Instrumentation...

10 CFR Appendix D to Part 52 - Design Certification Rule for the AP1000 Design

Code of Federal Regulations, 2013 CFR

2013-01-01

... under 10 CFR 50.90. (1) Maximum fuel rod average burn-up. (2) Fuel principal design requirements. (3... Cases. (3) Design Summary of Critical Sections. (4) American Concrete Institute (ACI) 318, ACI 349... control system, except burn-up limit. (8) Motor-operated and power-operated valves. (9) Instrumentation...

Asthma and Attention-Deficit/Hyperactivity Disorder: A Nationwide Population-Based Prospective Cohort Study

ERIC Educational Resources Information Center

Chen, Mu-Hong; Su, Tung-Ping; Chen, Ying-Sheue; Hsu, Ju-Wei; Huang, Kai-Lin; Chang, Wen-Han; Chen, Tzeng-Ji; Bai, Ya-Mei

2013-01-01

Background: Previous cross-sectional studies have suggested an association between asthma and attention-deficit/hyperactivity disorder (ADHD), but the temporal relationship was not determined. Using a nationwide population-based prospective case-control cohort study (1:4, age-/gender-matched), we hypothesized that asthma in infanthood or early…

Sampling from living organisms: section 3 in Sampling and experiments with biofilms in the environment: chapter 6

USGS Publications Warehouse

Kellogg, Christina A.

2014-01-01

Living organisms, unlike inanimate surfaces, seem to exert some control over their surface microbiota, in many cases maintaining conserved, species-specific microbial communities. Microbial ecologists seek to characterize and identify these microbes to understand the roles they are playing in the larger organism's biology.

[Incidence and risk factors for acute gastroenteritis among pilgrims following the French way to Santiago de Compostela (Spain) in summer 2008].

PubMed

Duran, Jaume Giménez; Fernández, Miguel Angel Luque; Urrego, Johana Rodríguez; Gil, Cristina Linares; Vargas, Luis Alberto Bonilla; Savulescu, Camelia; Clerger, Guerrier; Martínez-Lamas, Lucia; Pousa, Anxela; Donado, Juan de Mata; Herrera, Dionisio; Martínez, María Victoria

2010-01-01

To determine the incidence of acute gastroenteritis in pilgrims on St. James' Way, as well as associated risk factors and microbiological characteristics. Two studies were designed simultaneously: a cross-sectional study through self-completed questionnaires among pilgrims reaching Santiago, and a case-control study of pilgrims traveling along the Way. Multivariate analysis was performed using logistic regression. In the cross-sectional study, the incidence rate was 23.5 episodes of acute gastroenteritis/10³ pilgrims-day (95% CI: 18.9-2.4/10³. In the case-control study, the major risk factors were age <20 years (OR=4.72; 95% CI: 2.16-10.28), traveling in groups (three or more) (OR=1.49; 95% CI: 0.98-2.28), and drinking unbottled water (OR=2.09; 95% CI: 0.91-4.82). The most frequent etiologic agent was norovirus (56%). Age less than 20 years, traveling in groups and drinking unbottled water were important risk factors for acute gastroenteritis. Copyright © 2010 SESPAS. Published by Elsevier Espana. All rights reserved.

Randomised controlled trial of effect of terbutaline before elective caesarean section on postnatal respiration and glucose homeostasis

PubMed Central

Eisler, G.; Hjertberg, R.; Lagercrantz, H.

1999-01-01

AIM—To determine if terbutaline given to mothers before elective caesarean section facilitates neonatal respiration and metabolism.
METHODS—A randomised controlled trial of 25 full term infants delivered by elective caesarean section was conducted. The mothers received a continuous infusion of terbutaline or saline 120-0 minutes before birth. Umbilical artery blood was collected at birth and analysed for blood gases and catecholamines. The lung function of each infant was assessed two hours after birth, and blood pressure, heart rate, blood glucose and body temperature were monitored until 24 hours of age.
RESULTS—The infants of the treated mothers (n=13) had significantly higher dynamic lung compliance (p<0.001), lower airway resistance (p<0.001), and respiratory frequency than control infants (n=12). Blood glucose and adrenaline concentrations were significantly higher in the treated group (p=0.0014 and p<0.01). None of these infants had any clinical respiratory difficulties; there were two cases of transient tachypnoea in the control group. No negative side effects due to the terbutaline treatment were seen among the infants. The mothers felt no discomfort caused by the terbutaline infusion, although they bled more during surgery (p=0.03).
CONCLUSION—Stimulation of the β adrenoceptors in utero with terbutaline infusion to the mothers promotes neonatal respiratory and metabolic adaptation after elective caesarean section.

 PMID:10325782

The diversity of the effects of sulfur mustard gas inhalation on respiratory system 10 years after a single, heavy exposure: analysis of 197 cases.

PubMed

Emad, A; Rezaian, G R

1997-09-01

To find out the late pulmonary sequelae of sulfur mustard gas inhalation in 197 veterans, 10 years after their exposure. Cross-sectional clinical study. University hospital. One hundred ninety-seven veterans with a single, heavy exposure to sulfur mustard gas in 1986 and 86 nonexposed veterans as their control group. Pulmonary function tests, carbon monoxide diffusion capacity, bronchoscopy, and high-resolution CT of the chest were performed in all patients. Transbronchial lung biopsy was done in 24 suspected cases of pulmonary fibrosis. Asthma was diagnosed in 21 (10.65%), chronic bronchitis in 116 (58.88%), bronchiectasis in 17 (8.62%), airway narrowing due to searing or granulation tissue in 19 (9.64%), and pulmonary fibrosis in 24 (12.18%) cases. None of these were found among the control group except for a single case of chronic bronchitis. Although the respiratory symptoms of an acute sulfur mustard gas inhalation are usually transient and nonspecific, it can lead to the development of a series of chronic destructive pulmonary sequelae in such cases.

An outbreak of adult measles by nosocomial transmission in a high vaccination coverage community.

PubMed

Wang, Fen-juan; Sun, Xiang-jue; Wang, Fu-liang; Jiang, Long-fang; Xu, Er-ping; Guo, Jian-feng

2014-09-01

The aims of this study were to determine the mechanism of an outbreak of measles in adults and to provide scientific measures for putting forward a measles elimination program. We performed a cross-sectional investigation during the measles outbreak to identify a possible communication link. From November 1, 2011 to January 26, 2012, the town reported 11 cases of measles in total. The case study identified an obvious propagation chain, which showed ordered and intimate exposure between cases. Hospital exposure 1-2 weeks before infection with measles was the main cause of the measles outbreak. We must be fully aware of the possibility of nosocomial infection in an outbreak of measles; controlling nosocomial infections is a vital step in the prevention and control of the propagation of measles. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

29 CFR 102.94 - Expeditious processing of section 10(j) cases.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 2 2010-07-01 2010-07-01 false Expeditious processing of section 10(j) cases. 102.94..., SERIES 8 Procedure in Cases Under Section 10(j), (l), and (m) of the Act § 102.94 Expeditious processing of section 10(j) cases. (a) Whenever temporary relief or a restraining order pursuant to section 10(j...

Glucose-6-phosphate dehydrogenase deficiency and the risk of malaria: A meta-analysis and trial sequential analysis

NASA Astrophysics Data System (ADS)

Sun, Fengmei; Zhang, Juan; Pu, Yuepu

2017-10-01

This study is designed to perform a meta-analysis and trial sequential analysis (TSA) to investigate whether people with G6PD deficiency suffered less malarial infection. We searched from PubMed, Science Direct, Springer Link, CNKI, and Wan Fang databases for case-control study, cohort study or cross section study until April 2017. TSA was used to determine the state of evidence and calculate the required sample size. Eight case-control studies and five cross-sectional studies (30,683participants) were included in this meta-analysis. Compared with normal control group, we found significant protection from severe malaria (OR 0.644, 95% CI [0.493-0.842]; P=0.001) among people with decreasing G6PD activity. People with variations of G6PD gene at nucleotide 202(G6PD A-) were also found to be associated with resistance on severe malaria pooled (OR 0.851, 95% CI [0.779-0.930]; P =0.0001). Sex-stratified test suggested that protection of severe malaria is conferred to both G6PD A-males and heterozygous females (with a single copy of the variant). In conclusion, our study found a significant protection from severe malaria among G6PD deficient people compared to the

[Postpartum hemorrhage and pregnancy induced hypertension during emergency lower segment cesarean section: dexmedetomidine to our rescue].

PubMed

Hariharan, Uma

Dexmedetomidine is a highly selective α-2 agonist which has recently revolutionized our anesthesia and intensive care practice. An obstetric patient presented for emergency cesarean delivery under general anesthesia, with pre-eclampsia and postpartum hemorrhage. In carefully selected cases with refractory hypertension and postpartum hemorrhage, dexmedetomidine can be used for improving overall patient outcome. It was beneficial in controlling both the blood pressure and uterine bleeding during cesarean section in our patient. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

[The Joel-Cohen (Misgav Ladach) method--a new surgical technic for cesarean section and gynecological laparotomy].

PubMed

Katsulov, A; Nedialkov, K; Koleva, Zh; Iankov, M; Tashkov, B; Iotov, T; Kirov, K; Genov, M; Rusinov, P; Doncheva, Zh; Grŭncharov, I

2000-01-01

The authors make a review on this problem for first time in Bulgarian literature and for the first time by us operated with the Misgav Ladach method--cesarean section. The authors describe 50 cases wit Ladach method and as control 20 with Pfannenstiel. The authors establish shorter duration of the operation-Si] and 56.3 min. respective in benefit for Misgav method; the babies were extracted at 5.5 and 12.3 min. respect. The mothers with Misgav had better prognosis at the time of dehospitalization.

Amphetamine-type stimulants and HIV infection among men who have sex with men: implications on HIV research and prevention from a systematic review and meta-analysis

PubMed Central

Thu Vu, Nga Thi; Maher, Lisa; Zablotska, Iryna

2015-01-01

Introduction HIV infections and the use of amphetamine-type stimulants (ATS) among men who have sex with men (MSM) have been increasing internationally, but the role of ATS use as a co-factor for HIV infection remains unclear. We aimed to summarize the association between ATS use and HIV infection among MSM. Methods We conducted a systematic search of MEDLINE, EMBASE, GLOBAL HEALTH and PsycINFO for relevant English, peer-reviewed articles of quantitative studies published between 1980 and 25 April 2013. Pooled estimates of the association – prevalence rate ratios (PRR, cross-sectional studies), odds ratio (OR, case-control studies) and hazard ratio (HR, longitudinal studies), with 95% Confidence Intervals (CI) – were calculated using random-effects models stratified by study design and ATS group (meth/amphetamines vs. ecstasy). We assessed the existence of publication bias in funnel plots and checked for sources of heterogeneity using meta-regression and subgroup analysis. Results We identified 6710 article titles, screened 1716 abstracts and reviewed 267 full text articles. A total of 35 publications were eligible for data abstraction and meta-analysis, resulting in 56 records of ATS use. Most studies (31/35) were conducted in high-income countries. Published studies used different research designs, samples and measures of ATS use. The pooled association between meth/amphetamine use and HIV infection was statistically significant in all three designs (PRR=1.86; 95% CI: 1.57–2.17; OR=2.73; 95% CI: 2.16–3.46 and HR=3.43; 95% CI: 2.98–3.95, respectively, for cross-sectional, case-control and longitudinal studies). Ecstasy use was not associated with HIV infection in cross-sectional studies (PRR=1.15; 95% CI: 0.88–1.49; OR=3.04; 95% CI: 1.29–7.18 and HR=2.48; 95% CI: 1.42–4.35, respectively, for cross-sectional, case-control and longitudinal studies). Results in cross-sectional studies were highly heterogeneous due to issues with ATS measurement and different sampling frames. Conclusions While meth/amphetamine use was significantly associated with HIV infection among MSM in high-income countries in all study designs, evidence of the role of ecstasy in HIV infection was lacking in cross-sectional studies. Cross-sectional study design, measurement approaches and source populations may also be important modifiers of the strength and the direction of associations. Event-specific measure of individual drug is required to establish temporal relationship between ATS use and HIV infection. HIV prevention programmes targeting MSM should consider including interventions designed to address meth/amphetamine use. PMID:25609214

[The clinico-epidemiological characteristics of cholera patients in Mexico City].

PubMed

Vilchis-Guizar, A E; Uribe-Márquez, S; Pérez-Sánchez, P L

1999-01-01

To compare the clinical and epidemiological characteristics of cholera patients and patients with diarrhea of different etiology (controls), treated at Mexican Institute of Social Security medical units in northeast Mexico City, from 1995 to 1998. Cross-sectional analytical study design. Data were collected using the official form "Immediate Notification of Cholera Cases" that each medical unit reports to the Coordination of Community Health. Statistical analysis consisted of comparisons of means and proportions between both groups. In 4,952 notifications, there were 588 cholera cases and 4,364 controls. The age range of cases was 39 to 51 years and 54% were females. During 1995 and 1997 (years with higher proportion of cases) patients with cholera had a greater frequency of watery evacuations than controls (97% vs. 73%), "rice water" appearance (31% vs. 13%), vomiting (72% vs. 63%), muscular spasms (49% vs. 26%), dehydration (83% vs. 71%), hypovolemic shock (10% vs. 1%) and death (0.85% vs. 0.25%). These differences were statistically significant. Cholera presents a biannual cyclic behavior; greater frequencies are associated with greater severity and complications. It is necessary to increase epidemiologic surveillance and medical efforts for opportune diagnosis and treatment.

Non-Autoimmune Subclinical and Overt Hypothyroidism in Idiopathic Steroid-resistant Nephrotic Syndrome in Children.

PubMed

Marimuthu, Vidhya; Krishnamurthy, Sriram; Rajappa, Medha

2017-11-15

To evaluate the frequency of non-autoimmune subclinical and overt hypothyroidism in children with idiopathic steroid-resistant nephrotic syndrome (SRNS). This cross-sectional study recruited 30 children (age 1-18 y) with idiopathic SRNS; and 30 healthy controls. Serum T3, T4 and TSH were performed in cases as well as controls. Anti-thyroid peroxidase and anti-thyroglobulin antibody tests were performed in all cases. Non-autoimmune subclinical or overt hypothyroidism was detected in 10 out of 30 children with idiopathic SRNS; 2 had overt hypothyroidism, while 8 patients had subclinical hypothyroidism. Children with SRNS had a mean (SD) TSH value 4.55 (4.64) mIU/L that was higher as compared to controls (1.88 (1.04) mIU/L) (P<0.01). Focal segmental glomerulosclerosis (FSGS) was the commonest histopathological condition, seen in 13 (43.3%). Children with overt hypothyroidism (2 cases) and grade III subclinical hypothyroidism (1 case) were subsequently started on levothyroxine therapy. The prevalence of subclinical and overt hypothyroidism seems to be high in idiopathic SRNS, with almost one-third of children having overt or subclinical non-autoimmune hypothyroidism.

Evaluation of synaptophysin as an immunohistochemical marker for equine grass sickness.

PubMed

Waggett, B E; McGorum, B C; Shaw, D J; Pirie, R S; MacIntyre, N; Wernery, U; Milne, E M

2010-05-01

It has been proposed that synaptophysin, an abundant integral membrane protein of synaptic vesicles, is an immunohistochemical marker for degenerating neurons in equine grass sickness (GS). In the present study, a statistically generated decision tree based on assessment of synaptophysin-immunolabelled ileal sections facilitated correct differentiation of all 20 cases of GS and 24 cases of non-GS disease (comprising eight horses with colic, six with neuroparalytic botulism and 10 controls). This technique also facilitated correct diagnosis of GS in all three cases that had been erroneously classified as having non-GS disease based on conventional interpretation of haematoxylin and eosin-stained cryostat sections of ileal surgical biopsies. Further prospective studies involving larger numbers of horses are required to fully validate this decision tree. In contrast to GS, botulism did not alter ileal neuron density or synaptophysin labelling, indicating that different mechanisms cause neuronal damage and/or dysfunction in GS and botulism. Copyright 2009 Elsevier Ltd. All rights reserved.

Evidence-Based Advances in Reptile Medicine.

PubMed

Mitchell, Mark A; Perry, Sean M

2017-09-01

Evidence-based medicine allows veterinarians to practice high-quality medicine, because the basis for all decision making is quantitative, objective, and reproducible. Case reports and case series are limited in their scope and application. Cross-sectional studies, likewise, cannot provide answers to specific variable testing with a temporal application. It is essential for the reptile specialty to expand into case-control studies, cohort studies, and experimental/intervention studies. Unfortunately, much of the reptile literature remains limited to descriptive studies. This article reviews current evidence-based topics in reptile medicine and shares how everyone practicing in the field can contribute to improving this specialty. Copyright © 2017 Elsevier Inc. All rights reserved.

Bridging glycated hemoglobin with quality of life and health state; a randomized case-control study among type 2 diabetes patients.

PubMed

Gillani, Syed Wasif; Ansari, Irfan Altaf; Zaghloul, Hisham A; Abdul, Mohi Iqbal Mohammad; Sulaiman, Syed Azhar Syed; Baig, Mirza R

2018-01-01

The aim of this study was to explore the predictors of QOL and health state and examine the relationship with glycemic control among type 2 diabetes mellitus (T2DM) patients. A randomized cross-sectional case-control study was conducted among n = 600 T2DM patients of Malaysia. Study population was distributed into three groups as: controls: patients with HbA1c ≤ 7 (n = 199), cases arm 1: with HbA1c 7-7.9 (n = 204) and cases arm 2 (n = 197): with HbA1c ≥ 8 consecutively last 3 times. Participants with diabetes history > 10 years exhibits higher mean QOL score among all the three groups. In contrast mean health status score significantly ( p  < 0.001) reduced with the exposure duration of diabetes both within and intergroup assessment that participants with poor glycemic control (arm 2) had significantly higher mean QOL score with knowledge and self-care dimensions as compared to others, however mean health state scores were significantly ( p  < 0.001) lower in all assessment dimensions as compared to controls. The F test of significance showed that demographic and clinical parameters were strong predictors of QOL, whereas self-care activities, comorbidities, ability of positive management and BMI were significant predictors to health state for consistent glycemic control (controls) as compared to poor glycemic control (arm 2) participants. This study suggested that poor glycemic index reported low self-care behavior, increase barriers to daily living activities and poor ability to manage diabetes positively, which cause poor QOL and decrease health state.

A two-dimensional adaptive-wall test section with ventilated walls in the Ames 2- by 2-foot transonic wind tunnel

NASA Technical Reports Server (NTRS)

Schairer, Edward T.; Lee, George; Mcdevitt, T. Kevin

1989-01-01

The first tests conducted in the adaptive-wall test section of the Ames Research Center's 2- by 2-Foot Transonic Wind Tunnel are described. A procedure was demonstrated for reducing wall interference in transonic flow past a two-dimensional airfoil by actively controlling flow through the slotted walls of the test section. Flow through the walls was controlled by adjusting pressures in compartments of plenums above and below the test section. Wall interference was assessed by measuring (with a laser velocimeter) velocity distributions along a contour surrounding the model, and then checking those measurements for their compatibility with free-air far-field boundary conditions. Plenum pressures for minimum wall interference were determined from empirical influence coefficients. An NACA 0012 airfoil was tested at angles of attach of 0 and 2, and at Mach numbers between 0.70 and 0.85. In all cases the wall-setting procedure greatly reduced wall interference. Wall interference, however, was never completely eliminated, primarily because the effect of plenum pressure changes on the velocities along the contour could not be accurately predicted.

Potential energy savings with exterior shades in large office buildings and the impact of discomfort glare

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

Hoffmann, Sabine; Lee, Eleanor

Exterior shades are highly efficient for reducing solar load in commercial buildings. Their impact on net energy use depends on the annual energy balance of heating, cooling, fan and lighting energy. This paper discusses the overall energy use intensity of various external shading systems for a prototypical large office building split into the different types of energy use and for different orientations and window sizes. Lighting energy was calculated for a constant lighting power as well as for dimmed lighting fixtures (daylighting control). In Section 3, slat angles and solar cut-off angles were varied for fixed exterior slat shading systems.more » While the most light-blocking shades performed best for the case without daylighting controls, the optimum cut-off angle with daylighting controls was found to be 30 deg for the office building prototype used in Chicago and Houston. For large window-to-wall (WWR) ratios, window related annual energy use could be reduced by at least 70 % without daylighting control and by a minimum of 86 % with daylighting control in average over all orientations. The occurrence of discomfort glare was is considered in Section 4 of the paper, which looks at the performance of commercially available exterior shading systems when an interior shade is used in addition to the exterior shade during hours when occupants would experience discomfort glare. Glare control impacts overall energy use intensity significantly for exterior shades with high transmittance, especially when daylighting controls are used. In these cases, exterior shades are only beneficial for window-to-wall areas ≥ 45% in the hot Houston climate. For smaller windows and in a heating/cooling climate like Chicago, exterior shades can increase energy consumption« less

[Gastroesophageal reflux and sleep position of infants. A survey conducted in France by 493 pediatricians].

PubMed

Bellaïche, M; Bargaoui, K; Jung, C; Maigret, P; Clerson, P

2017-01-01

The supine sleeping position with the head higher than the legs has no impact on regurgitations in infants. Inclined ventral decubitus decreases regurgitations but is associated with an increased risk of sudden infant death syndrome (SIDS). The LUNE study aimed to evaluate the impact of regurgitations on the choice of sleeping position by pediatricians and parents. Cross-sectional case-control study (ratio 1:1) conducted in France in 2013. A representative sample of pediatricians recruited 3-week to 4-month-old breast- or formula-fed infants. Cases and controls were defined by the presence or absence of regurgitations. Collected data included Vandenplas codification for regurgitations (VD, range 0-6), associated symptoms, and variations in sleeping position since maternity hospital discharge. A total of 1347 cases and 1346 controls were recruited by 493 pediatricians. Regurgitations were evaluated at VD1 (minor, 22 % of cases), VD2 (mild, 47 % of cases), or VD≥3 (moderate to severe, 31 % of cases). At the maternity hospital, the supine position was recommended to 96 % of parents for SIDS prevention. Since discharge, parents asked questions about the relationship between sleeping position and regurgitations (79 % of infants with GER versus 45 % of controls). The sleeping position was modified at least once since maternity discharge (42 % of infants with GER versus 35 % of controls). At inclusion, 86 % of infants with GER and 86 % of controls were sleeping on their back. Fifty-one percent of infants with GER and 28 % of controls slept in an inclined position. Pediatricians repeated the prescription of dorsal decubitus for 91 % of infants with GER and recommended an inclined position in 70 %. Regurgitations had no impact on supine sleeping position. The inclined supine sleeping position was more frequent in infants with regurgitations with pediatricians' assent, which is not in agreement with evidence-based medicine. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

SimSup's Loop: A Control Theory Approach to Spacecraft Operator Training

NASA Technical Reports Server (NTRS)

Owens, Brandon Dewain; Crocker, Alan R.

2015-01-01

Immersive simulation is a staple of training for many complex system operators, including astronauts and ground operators of spacecraft. However, while much has been written about simulators, simulation facilities, and operator certification programs, the topic of how one develops simulation scenarios to train a spacecraft operator is relatively understated in the literature. In this paper, an approach is presented for using control theory as the basis for developing the immersive simulation scenarios for a spacecraft operator training program. The operator is effectively modeled as a high level controller of lower level hardware and software control loops that affect a select set of system state variables. Simulation scenarios are derived from a STAMP-based hazard analysis of the operator's high and low level control loops. The immersive simulation aspect of the overall training program is characterized by selecting a set of scenarios that expose the operator to the various inadequate control actions that stem from control flaws and inadequate control executions in the different sections of the typical control loop. Results from the application of this approach to the Lunar Atmosphere and Dust Environment Explorer (LADEE) mission are provided through an analysis of the simulation scenarios used for operator training and the actual anomalies that occurred during the mission. The simulation scenarios and inflight anomalies are mapped to specific control flaws and inadequate control executions in the different sections of the typical control loop to illustrate the characteristics of anomalies arising from the different sections of the typical control loop (and why it is important for operators to have exposure to these characteristics). Additionally, similarities between the simulation scenarios and inflight anomalies are highlighted to make the case that the simulation scenarios prepared the operators for the mission.

Is gamma-glutamyl transpeptidase a biomarker for oxidative stress in periodontitis?

PubMed Central

Sreeram, Meenakshi; Suryakar, Adinath Narayan; Dani, Nitin Hemchandra

2015-01-01

Context: Periodontal disease and oxidative stress (OS) are part of a vicious cycle with each causing a deleterious effect on the other causing changes in the levels of antioxidants, and enzymes of antioxidant defense. Biomarkers and methods used for measuring OS are very expensive. Aims: To see how gamma-glutamyltransferase (GGT) fares, as a biomarker for OS in periodontits along with other routinely used biomarkers. Design: A cross-sectional study involving 300 people of which 150 were cases and 150 were controls. Setting: Candidates enrolled were patients visiting the OPD of MGV's Dental College and Hospital, Nasik, India between January 2011 and December 2012. Materials and Methods: Serum samples of patients with periodontitis, and controls were analyzed for malondialdehyde, superoxide dismutase (SOD), glutathione peroxidase (GPx), uric acid, and GGT. Statistical Analysis Used: Analysis was performed using Student's t test. P <0.05 were considered to be significant. Results: Malondialdehyde values were found to be significantly higher cases, while SOD, GPx and uric acid levels were found to be lower than controls. GGT levels were significantly higher in cases as compared to controls. Conclusions: GGT may be used as a cheap, quick, easy and precise marker for measuring OS. PMID:26015663

Thrombolysis with intravenous recombinant tissue plasminogen activator during early postpartum period: a review of the literature.

PubMed

Akazawa, Munetoshi; Nishida, Makoto

2017-05-01

Thromboembolic events are one of the leading causes of maternal death during the postpartum period. Postpartum thrombolytic therapy with recombinant tissue plasminogen activator (rt-PA) is controversial because the treatment may lead to massive bleeding. Data centralization may be beneficial for analyzing the safety and effectiveness of systemic thrombolysis during the early postpartum period. We performed a computerized MEDLINE and EMBASE search. We collected data for 13 cases of systemic thrombolytic therapy during the early postpartum period, when limiting the early postpartum period to 48 hours after delivery. Blood transfusion was necessary in all cases except for one (12/13; 92%). In seven cases (7/13; 54%), a large amount of blood was required for transfusion. Subsequent laparotomy to control bleeding was required in five cases (5/13; 38%), including three cases of hysterectomy and two cases of hematoma removal, all of which involved cesarean delivery. In cases of transvaginal delivery, there was no report of laparotomy. The occurrence of severe bleeding was high in relation to cesarean section, compared with vaginal deliveries. Using rt-PA in relation to cesarean section might be worth avoiding. However, the paucity of data in the literature makes it difficult to assess the ultimate outcomes and safety of this treatment. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

Alcohol Intake and Risk of Thyroid Cancer: A Meta-Analysis of Observational Studies.

PubMed

Hong, Seung-Hee; Myung, Seung-Kwon; Kim, Hyeon Suk

2017-04-01

The purpose of this study was to assess whether alcohol intake is associated with the risk of thyroid cancer by a meta-analysis of observational studies. We searched PubMed and EMBASE in June of 2015 to locate eligible studies. We included observational studies such as cross-sectional studies, case-control studies, and cohort studies reporting odd ratios (ORs) or relative risk (RRs) with 95% confidence intervals (CIs). We included 33 observational studies with two cross-sectional studies, 20 case-controls studies, and 11 cohort studies, which involved a total of 7,725 thyroid cancer patients and 3,113,679 participants without thyroid cancer in the final analysis. In the fixed-effect model meta-analysis of all 33 studies, we found that alcohol intake was consistently associated with a decreased risk of thyroid cancer (OR or RR, 0.74; 95% CI, 0.67 to 0.83; I 2 =38.6%). In the subgroup meta-analysis by type of study, alcohol intake also decreased the risk of thyroid cancer in both case-control studies (OR, 0.77; 95% CI, 0.65 to 0.92; I 2 =29.5%; n=20) and cohort studies (RR, 0.70; 95% CI, 0.60 to 0.82; I 2 =0%; n=11). Moreover, subgroup meta-analyses by type of thyroid cancer, gender, amount of alcohol consumed, and methodological quality of study showed that alcohol intake was significantly associated with a decreased risk of thyroid cancer. The current meta-analysis of observational studies found that, unlike most of other types of cancer, alcohol intake decreased the risk of thyroid cancer.

Intrapartum amnioinfusion in meconium-stained liquor: a case-control study.

PubMed

Bansal, Neeta; Gupta, Vineeta; Nanda, Anuja; Chaudhary, Priyanka; Tandon, Archna; Behl, Neelima

2013-06-01

The aim of this study was to investigate perinatal outcome and the rate of cesarean section (CS) following intrapartum amnioinfusion in women with meconium-stained amniotic fluid (MSAF). A total of 100 women at term in labor with meconium were randomized to infuse transcervical intrapartum amnioinfusion with saline (50) and routine obstetrical care (50). Perinatal outcome and obstetric outcome were recorded and analyzed in both groups by means of Chi-square test. The CS rate due to fetal distress was 40.0 % in the control group and 20.0 % in the study group. The difference was statistically significant (P < 0.01). Respiratory distress of the neonate was significantly less common in the study group than in the control group (4.0 % vs. 12 %; P = 0.0349). Amnioinfusion in cases of meconium-stained liquor significantly improved neonatal outcome and CS rate without increasing any maternal and fetal complications.

27 CFR 70.802 - Rules for disclosure of certain specified matters.

Code of Federal Regulations, 2010 CFR

2010-04-01

... any case arising under Chapter 32 (relating to firearms and ammunition excise taxes) and Subtitle E..., or in connection with property seized under Title I of the Gun Control Act of 1968 (18 U.S.C... 20220, shall furnish information as to the issuance, pursuant to section 105(e) of the Federal Alcohol...

46 CFR 78.47-38 - Valves and closing appliances.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 3 2010-10-01 2010-10-01 false Valves and closing appliances. 78.47-38 Section 78.47-38... Fire and Emergency Equipment, Etc. § 78.47-38 Valves and closing appliances. (a) All valves and closing appliances, or other mechanisms which may be required to be operated for damage control purposes in case of...

40 CFR 1068.250 - What are the provisions for extending compliance deadlines for small businesses under hardship?

Code of Federal Regulations, 2010 CFR

2010-07-01

..., technical, and economic steps to comply. (i) In the case of importers of engines/equipment produced by other... ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR POLLUTION CONTROLS GENERAL COMPLIANCE PROVISIONS FOR ENGINE... describing the steps you have taken to comply under paragraph (c)(1) of this section, include at least the...

Factors Contributing to a School's Decision to Apply for the California Instructional School Garden Program

ERIC Educational Resources Information Center

Hazzard, Eric L.; Moreno, Elizabeth; Beall, Deborah L.; Zidenberg-Cherr, Sheri

2012-01-01

Objective: To compare the applicant schools (AS) to non-applicant schools (NAS) residing in the same school districts for the California Instructional School Garden Program and identify barriers to the application process. Methods: A case-control, cross-sectional study design was used to compare resources and school environments. Pearson…

10 CFR Appendix D to Part 52 - Design Certification Rule for the AP1000 Design

Code of Federal Regulations, 2011 CFR

2011-01-01

... amendment under 10 CFR 50.90. (1) Maximum fuel rod average burn-up. (2) Fuel principal design requirements... Case-284. (3) Design Summary of Critical Sections. (4) American Concrete Institute (ACI) 318, ACI 349... control system, except burn-up limit. (8) Motor-operated and power-operated valves. (9) Instrumentation...

10 CFR Appendix D to Part 52 - Design Certification Rule for the AP1000 Design

Code of Federal Regulations, 2010 CFR

2010-01-01

... amendment under 10 CFR 50.90. (1) Maximum fuel rod average burn-up. (2) Fuel principal design requirements... Case-284. (3) Design Summary of Critical Sections. (4) American Concrete Institute (ACI) 318, ACI 349... control system, except burn-up limit. (8) Motor-operated and power-operated valves. (9) Instrumentation...

Changes in serum biochemical factors associated with opium addiction after addiction desertion.

PubMed

Afarinesh, Mohammad Reza; Haghpanah, Tahereh; Divsalar, Kouros; Dehyadegary, Elham; Shaikh-Aleslami, Azar; Mahmoodi, Majid

2014-01-01

The long time use of opium has some effects on serums biochemical factors, the determination of this variation is a new approach in understanding off addiction and relive of drug abuser health. Hence in this study, these indicators in person who were withdrawing of opium have been studied. In this cross-sectional study bloods biochemical factors such as fasting blood sugar (FBS), sodium (Na), calcium (Ca), uric acid (UA), blood urea nitrogen (BUN), creatinine, cholesterol, total protein, and fibrinogen in three groups serum were studied: (1) Who had been permanent opium users more than 2 years (case). (2) Dependent person who has taken one month addiction withdrawal course (control). (3) A healthy group that had been demographically similar to the other groups. According to these study findings, FBS serum level in the case group is lower than control group. Serum level of Na, creatinine, and blood triglyceride (TG) in case study are higher than group control. Concentration of potassium, Ca, UA, BUN, cholesterol, total serum protein, fibrinogen, and thrombin time in case study and group control showed no significant difference. Also, in withdrawing case serum level of Na, Ca, UA, BUN, creatinine, and TG significantly increase and thrombin time decrease. According to this study not only the longtime use of opium but also opium with drawerin opium dependent people can change their serum biochemical factors. So recognition, treatment, and prevention of this change could be a new step in improving of health and condition of patients.

Serum levels of C-reactive protein in adolescents with periodontitis.

PubMed

López, Rodrigo; Baelum, Vibeke; Hedegaard, Chris Juul; Bendtzen, Klaus

2011-04-01

The results of several cross-sectional studies suggested a relationship between periodontitis and higher serum levels of C-reactive protein (CRP). Most of these studies were restricted to adult study groups with severe periodontal inflammation, and the potential effects of confounding factors were frequently overlooked. A case-referent study comprised of 87 adolescent cases who presented with clinical attachment loss ≥3 mm recorded in ≥2 of 16 teeth and 73 controls who did not fulfill these criteria was nested in a fully enumerated adolescent population. Venous blood samples were obtained, and CRP levels were quantified, using a high-sensitive bead-based flow cytometric assay. The Mann-Whitney U test was used to assess overall differences between groups. The median serum CRP values for cases and controls were 64 ng/ml (interquartile range: 27 to 234 ng/ml) and 55 ng/ml (31 to 183 ng/ml), respectively (P = 0.8). Serum levels of CRP were not significantly higher among subjects with periodontitis than among controls. However, a statistically significant positive association between percentages of sites with bleeding on probing and log-transformed CRP values was observed.

A three-dimensional soft tissue analysis of Class III malocclusion: a case-controlled cross-sectional study.

PubMed

Johal, Ama; Chaggar, Amrit; Zou, Li Fong

2018-03-01

The present study used the optical surface laser scanning technique to compare the facial features of patients aged 8-18 years presenting with Class I and Class III incisor relationship in a case-control design. Subjects with a Class III incisor relationship, aged 8-18 years, were age and gender matched with Class I control and underwent a 3-dimensional (3-D) optical surface scan of the facial soft tissues. Landmark analysis revealed Class III subjects displayed greater mean dimensions compared to the control group most notably between the ages of 8-10 and 17-18 years in both males and females, in respect of antero-posterior (P = 0.01) and vertical (P = 0.006) facial dimensions. Surface-based analysis, revealed the greatest difference in the lower facial region, followed by the mid-face, whilst the upper face remained fairly consistent. Significant detectable differences were found in the surface facial features of developing Class III subjects.

Arterial hemorrhage from cesarean scar: a rare cause of recurring massive uterine bleeding and successful surgical management.

PubMed

Wang, Chun-Feng; Hu, Min

2015-02-01

Abnormal uterine bleeding and other gynecologic complications associated with a previous cesarean section scar are only recently being identified and described. Herein we report a rare case of a woman with recurring massive uterine bleeding after 2 cesarean sections. Curettage and hormone therapy were unsuccessfully used in an attempt to control the bleeding. After she was transferred to our hospital, she had another episode of vaginal bleeding that was successfully managed with oxytocin and hemostatic. Diagnostic hysteroscopy performed under anesthesia revealed an abnormal transected artery in the cesarean section scar with a thrombus visible. In the treatment at the beginning of laparoscopic management, we adopted temporary bilateral uterine artery occlusion with titanium clips to prevent massive hemorrhage. Secondly, with the aid of hysteroscopy, the bleeding site was opened, and then the cesarean scar was wedge resected and stitched interruptedly with 1-0 absorbable sutures. The postoperative recovery was uneventful. It would seem that the worldwide use of cesarean section delivery may contribute to the risk of gynecologic disturbances including some unrecognized and complex conditions as seen in this case. Copyright © 2015 AAGL. Published by Elsevier Inc. All rights reserved.

Comparison of driven and simulated "free" stall flutter in a wind tunnel

NASA Astrophysics Data System (ADS)

Culler, Ethan; Farnsworth, John; Fagley, Casey; Seidel, Jurgen

2016-11-01

Stall flutter and dynamic stall have received a significant amount of attention over the years. To experimentally study this problem, the body undergoing stall flutter is typically driven at a characteristic, single frequency sinusoid with a prescribed pitching amplitude and mean angle of attack offset. This approach allows for testing with repeatable kinematics, however it effectively decouples the structural motion from the aerodynamic forcing. Recent results suggest that this driven approach could misrepresent the forcing observed in a "free" stall flutter scenario. Specifically, a dynamically pitched rigid NACA 0018 wing section was tested in the wind tunnel under two modes of operation: (1) Cyber-Physical where "free" stall flutter was physically simulated through a custom motor-control system modeling a torsional spring and (2) Direct Motor-Driven Dynamic Pitch at a single frequency sinusoid representative of the cyber-physical motion. The time-resolved pitch angle and moment were directly measured and compared for each case. It was found that small deviations in the pitch angle trajectory between these two operational cases generate significantly different aerodynamic pitching moments on the wing section, with the pitching moments nearly 180o out of phase in some cases. This work is supported by the Air Force Office of Scientific Research through the Flow Interactions and Control Program and by the National Defense Science and Engineering Graduate Fellowship Program.

Prevalence of Pulmonary Tuberculosis among Prison Inmates in Ethiopia, a Cross-Sectional Study

PubMed Central

Ali, Solomon; Haileamlak, Abraham; Wieser, Andreas; Pritsch, Michael; Heinrich, Norbert; Loscher, Thomas; Hoelscher, Michael; Rachow, Andrea

2015-01-01

Setting Tuberculosis (TB) is one of the major health problems in prisons. Objective This study was done to assess the prevalence and determinants of active tuberculosis in Ethiopian prisons. Design A cross-sectional study was conducted from January 2013 to December 2013 in 13 zonal prisons. All incarcerated inmates underwent TB symptom screening according to WHO criteria. From identified TB-suspects two sputum samples were analyzed using smear microscopy and solid culture. A standardized questionnaire assessing TB risk factors was completed for each TB suspect. Results 765 (4.9%) TB suspects were identified among 15,495 inmates. 51 suspects were already on anti-TB treatment (6.67%) and 20 (2.8%) new culture-confirmed TB cases were identified in the study, resulting in an overall TB prevalence of 458.1/100,000 (95%CI: 350-560/100,000). Risk factors for active TB were alcohol consumption, contact with a TB case before incarceration and no window in prison cell. HIV prevalence was not different between TB suspects and active TB cases. Further, the TB burden in prisons increased with advancing distance from the capital Addis Ababa. Conclusions The overall TB prevalence in Ethiopian prisons was high and extremely variable among different prisons. TB risk factors related to conditions of prison facilities and the impact of implemented TB control measures need to be further studied in order to improve TB control among inmates. PMID:26641654

[Caesarean section with vacuum extraction of the head].

PubMed

Dimitrov, A; Pavlova, E; Krŭsteva, K; Nikolov, A

2008-01-01

The aim of the study is to investigate the benefits and the limits in using the soft cup vacuum extractor on the fetal scalp during the caesarean section. The prospective study includes 19 cases of caesarean sections (group A), with vacuum assisted delivery using the soft cup vacuum extractor on the fetal scalp (diameter 6 cm) and 25 cases (group B) of caesarean sections with usual, manual extraction of the head assisted by fundal compression. All of the patients had undergone a planned caesarean section on term in absence of uterine activity and preserved amniotic membranes. Our results doesn't show differences in the Apgar score on the first and 5-th minute in the newborns of the two groups. The duration of the scalp traction was significantly shorter (30 +/- 4 sec) in comparison to the classical manual extraction (53 +/- 21 sec). The mean duration for applying the vacuum cup was 10 sec and 25 sec for tractions. The total blood loose and total duration of the caesarean sections were shorter than in the control group. The applied traction with the vacuum cup was sufficient for head extraction and there was no need for additional fundal compression. In conclusion we consider that the extraction of the fetal head in high position in caesarean section with vacuum extractor is an easy, non traumatic and rapid method which can put away the need of rough and prolonged fundal compression and its consequences.

Development of a State Machine Sequencer for the Keck Interferometer: Evolution, Development and Lessons Learned using a CASE Tool Approach

NASA Technical Reports Server (NTRS)

Rede, Leonard J.; Booth, Andrew; Hsieh, Jonathon; Summer, Kellee

2004-01-01

This paper presents a discussion of the evolution of a sequencer from a simple EPICS (Experimental Physics and Industrial Control System) based sequencer into a complex implementation designed utilizing UML (Unified Modeling Language) methodologies and a CASE (Computer Aided Software Engineering) tool approach. The main purpose of the sequencer (called the IF Sequencer) is to provide overall control of the Keck Interferometer to enable science operations be carried out by a single operator (and/or observer). The interferometer links the two 10m telescopes of the W. M. Keck Observatory at Mauna Kea, Hawaii. The IF Sequencer is a high-level, multi-threaded, Hare1 finite state machine, software program designed to orchestrate several lower-level hardware and software hard real time subsystems that must perform their work in a specific and sequential order. The sequencing need not be done in hard real-time. Each state machine thread commands either a high-speed real-time multiple mode embedded controller via CORB A, or slower controllers via EPICS Channel Access interfaces. The overall operation of the system is simplified by the automation. The UML is discussed and our use of it to implement the sequencer is presented. The decision to use the Rhapsody product as our CASE tool is explained and reflected upon. Most importantly, a section on lessons learned is presented and the difficulty of integrating CASE tool automatically generated C++ code into a large control system consisting of multiple infrastructures is presented.

Development of a state machine sequencer for the Keck Interferometer: evolution, development, and lessons learned using a CASE tool approach

NASA Astrophysics Data System (ADS)

Reder, Leonard J.; Booth, Andrew; Hsieh, Jonathan; Summers, Kellee R.

2004-09-01

This paper presents a discussion of the evolution of a sequencer from a simple Experimental Physics and Industrial Control System (EPICS) based sequencer into a complex implementation designed utilizing UML (Unified Modeling Language) methodologies and a Computer Aided Software Engineering (CASE) tool approach. The main purpose of the Interferometer Sequencer (called the IF Sequencer) is to provide overall control of the Keck Interferometer to enable science operations to be carried out by a single operator (and/or observer). The interferometer links the two 10m telescopes of the W. M. Keck Observatory at Mauna Kea, Hawaii. The IF Sequencer is a high-level, multi-threaded, Harel finite state machine software program designed to orchestrate several lower-level hardware and software hard real-time subsystems that must perform their work in a specific and sequential order. The sequencing need not be done in hard real-time. Each state machine thread commands either a high-speed real-time multiple mode embedded controller via CORBA, or slower controllers via EPICS Channel Access interfaces. The overall operation of the system is simplified by the automation. The UML is discussed and our use of it to implement the sequencer is presented. The decision to use the Rhapsody product as our CASE tool is explained and reflected upon. Most importantly, a section on lessons learned is presented and the difficulty of integrating CASE tool automatically generated C++ code into a large control system consisting of multiple infrastructures is presented.

Higher prevalence of wheezing and lower FEV1 and FVC percent predicted in adults with sickle cell anaemia: A cross-sectional study.

PubMed

Musa, Baba M; Galadanci, Najibah A; Rodeghier, Mark; Debaun, Michael R

2017-02-01

Respiratory symptoms including wheezing are common in adults with sickle cell anaemia (SCA), even in the absence of asthma. However, the prevalence of spirometry changes and respiratory symptoms in adults with SCA is unknown. Using a cross-sectional study design, we tested the hypothesis that adults with SCA (cases) would have higher rates of lower airway obstruction and wheezing than those without SCA (controls) using the American Thoracic Society Division of Lung Diseases' questionnaire. Patients were adults with SCA aged between 18 and 65 years. Controls were consecutive unselected individuals without SCA who presented to an outpatient general medicine clinic. We enrolled 150 adults with SCA and 287 consecutive controls without SCA. The median age was 23.0 and 27.0 years for adults with and without SCA, respectively. Cases were more likely to report cough without a cold (35.0% vs 18.6%, P < 0.001), lower forced expiratory volume in 1 s (FEV 1 ) % predicted (70.1% vs 82.1%, P = 0.001) and lower forced vital capacity (FVC) % predicted (67.4% vs 74.9%, P = 0.001) than controls. In the multivariable model, wheezing was significantly associated with SCA status (OR = 1.69, 95% CI = 1.08-2.65, P = 0.024). Similarly, FEV 1 % predicted was significantly associated with SCA status and wheezing (P = 0.001 for both). Adults with SCA experience a higher rate of wheezing and impaired respiratory functions compared with controls from the same region. © 2016 Asian Pacific Society of Respirology.

Ongoing pregnancies in patients with unexplained recurrent pregnancy loss: adverse obstetric outcomes.

PubMed

Cozzolino, Mauro; Rizzello, Francesca; Riviello, Chiara; Romanelli, Chiara; Coccia Elisabetta, Maria

2018-05-25

To investigate the incidence of adverse pregnancy outcomes in couples with an unexplained Recurrent Pregnancy Loss (RPL) history, a retrospective cohort study was conducted between 2014 and 2015. The study group (A) included couples with an unexplained RPL, and the control group (B) was composed of couples who attended the Low-Risk Antenatal Unit during the same period. On the other hand, 53 couples were included in the study group (A) and on the other hand, 65 in the control group (B). Women with previous unexplained recurrent pregnancies loss had a significantly increased risk of gestational diabetes with 12 cases (22.6%) in the study group and 3 cases (4.6%) in the control (OR: 6.048; 95% CI: 1.607-22.762; p = 0.007). A slight increase in the risk of preterm delivery and hepatic cholestasis was observed in the study group (6 cases, 11.3%, in study group and 1 case, 1.5% in the controls (OR: 8.170; 95% CI: 0.951-70.158; p = 0.0555). Women with a history of RPL delivered more frequently by caesarean section (OR: 3.252; 95% CI: 1.460-7.241; p = 0.0039). Women with a history of RPL were at an increased risk for adverse pregnancy outcomes, mainly gestational diabetes. Therefore, a closer surveillance during the antenatal period is recommended in this group of patients.

Relationship between C-Reactive Protein Level and Diabetic Retinopathy: A Systematic Review and Meta-Analysis

PubMed Central

Chen, Song; Duan, Hongtao; Kong, Jiahui; Li, Zedong

2015-01-01

Objectives To date, the relationship between C-reactive protein (CRP) level and diabetic retinopathy (DR) remains controversial. Therefore, a systematic review and meta-analysis was used to reveal the potential relationship between CRP level and DR. Methods A systematic search of PubMed, Embase.com, and Web of Science was performed to identify all comparative studies that compared the CRP level of two groups (case group and control group). We defined that diabetic patients without retinopathy and /or matched healthy persons constituted the control group, and patients with DR were the case group. Results Two cross sectional studies and twenty case control studies including a total of 3679 participants were identified. After pooling the data from all 22 studies, obvious heterogeneity existed between the studies, so a subgroup analysis and sensitivity analysis were performed. Removing the sensitivity studies, the blood CRP levels in the case group were observed to be higher than those in the control group [SMD = 0.22, 95% confidence interval (CI), 0.11–0.34], and the blood CRP levels in the proliferative diabetic retinopathy (PDR) group were also higher than those in the non-proliferative diabetic retinopathy (NPDR) group [SMD = 0.50, 95% CI, 0.30–0.70]. Conclusions The results from this current meta-analysis indicate that the CRP level might be used as a biomarker to determine the severity of DR. PMID:26636823

Association between resilience and posttraumatic stress disorder among Brazilian victims of urban violence: a cross-sectional case-control study.

PubMed

Teche, Stefania Pigatto; Barros, Alcina Juliana Soares; Rosa, Regis Goulart; Guimarães, Luciano Pinto; Cordini, Kariny Larissa; Goi, Julia Domingues; Hauck, Simone; Freitas, Lucia Helena

2017-01-01

This study investigated the association between resilience and posttraumatic stress disorder (PTSD) among Brazilian victims of urban violence. It also compared defense mechanisms, parental bonding, and childhood trauma between those who developed PTSD and those who did not. This cross-sectional case-control study included 66 adult subjects exposed to recent urban violence in southern Brazil - 33 with PTSD and 33 healthy controls matched by sex and age - who were administered the Resilience Scale, Defense Style Questionnaire, Parental Bonding Instrument, and Childhood Trauma Questionnaire. The statistical tests used were the McNemar test for categorical variables, the Wilcoxon signed-rank test for continuous asymmetric variables, and the paired Student t-test for continuous symmetric variables. The PTSD group showed lower total Resilience Scale scores compared with controls (128.4±20.7 vs. 145.8±13.1, respectively; p = 0.01), along with a lower ability to solve situations and lower personal values that give meaning to life (p = 0.019). They also had lower rates of mature defense mechanisms (p < 0.001) and higher rates of emotional (p = 0.001) and physical (p = 0.003) abuse during childhood. Lower levels of resilience, especially the ability to solve situations and having personal values that give meaning to life, immature defense mechanisms, and emotional and physical abuse in childhood are associated with PTSD in adult Brazilian victims of urban violence.

Development of large intestinal attaching and effacing lesions in pigs in association with the feeding of a particular diet.

PubMed Central

Neef, N A; McOrist, S; Lysons, R J; Bland, A P; Miller, B G

1994-01-01

Hysterotomy-derived piglets were kept in gnotobiotic isolators and artificially colonized at 7 days of age with an adult bovine enteric microflora. At 3 weeks of age, the pigs were transferred to conventional experimental accommodation and weaned, either onto a solid diet that had been associated with field cases of typhlocolitis in pigs or onto a solid control diet. At necropsy at 5 weeks of age, groups of pigs fed the diet associated with field cases of typhlocolitis were found to have developed typhlocolitis. This was absent from the groups fed the control diet. The typhlocolitis was characterized by attaching and effacing lesions typical of those described following experimental inoculation of various species with enteropathogenic Escherichia coli. A nonverocytotoxic, eae probe-positive E. coli serotype O116 was isolated from pigs on the colitis-associated diet but not from any of the pigs on the control diet. Coliform bacteria attached to the colonic lesions reacted with polyclonal antiserum to E. coli O116 in an immunoperoxidase assay of histological sections of affected tissue. No reaction with this antiserum was observed in corresponding tissue sections taken from pigs on the control diet. No colon lesions were observed in germfree pigs fed either of the diets. It is postulated that proliferation and possibly expression of pathogenicity of the attaching and effacing E. coli responsible for the lesions are strongly influenced by diet. Images PMID:7927691

Development of large intestinal attaching and effacing lesions in pigs in association with the feeding of a particular diet.

PubMed

Neef, N A; McOrist, S; Lysons, R J; Bland, A P; Miller, B G

1994-10-01

Hysterotomy-derived piglets were kept in gnotobiotic isolators and artificially colonized at 7 days of age with an adult bovine enteric microflora. At 3 weeks of age, the pigs were transferred to conventional experimental accommodation and weaned, either onto a solid diet that had been associated with field cases of typhlocolitis in pigs or onto a solid control diet. At necropsy at 5 weeks of age, groups of pigs fed the diet associated with field cases of typhlocolitis were found to have developed typhlocolitis. This was absent from the groups fed the control diet. The typhlocolitis was characterized by attaching and effacing lesions typical of those described following experimental inoculation of various species with enteropathogenic Escherichia coli. A nonverocytotoxic, eae probe-positive E. coli serotype O116 was isolated from pigs on the colitis-associated diet but not from any of the pigs on the control diet. Coliform bacteria attached to the colonic lesions reacted with polyclonal antiserum to E. coli O116 in an immunoperoxidase assay of histological sections of affected tissue. No reaction with this antiserum was observed in corresponding tissue sections taken from pigs on the control diet. No colon lesions were observed in germfree pigs fed either of the diets. It is postulated that proliferation and possibly expression of pathogenicity of the attaching and effacing E. coli responsible for the lesions are strongly influenced by diet.

Test Cases for the Benchmark Active Controls: Spoiler and Control Surface Oscillations and Flutter

NASA Technical Reports Server (NTRS)

Bennett, Robert M.; Scott, Robert C.; Wieseman, Carol D.

2000-01-01

As a portion of the Benchmark Models Program at NASA Langley, a simple generic model was developed for active controls research and was called BACT for Benchmark Active Controls Technology model. This model was based on the previously-tested Benchmark Models rectangular wing with the NACA 0012 airfoil section that was mounted on the Pitch and Plunge Apparatus (PAPA) for flutter testing. The BACT model had an upper surface spoiler, a lower surface spoiler, and a trailing edge control surface for use in flutter suppression and dynamic response excitation. Previous experience with flutter suppression indicated a need for measured control surface aerodynamics for accurate control law design. Three different types of flutter instability boundaries had also been determined for the NACA 0012/PAPA model, a classical flutter boundary, a transonic stall flutter boundary at angle of attack, and a plunge instability near M = 0.9. Therefore an extensive set of steady and control surface oscillation data was generated spanning the range of the three types of instabilities. This information was subsequently used to design control laws to suppress each flutter instability. There have been three tests of the BACT model. The objective of the first test, TDT Test 485, was to generate a data set of steady and unsteady control surface effectiveness data, and to determine the open loop dynamic characteristics of the control systems including the actuators. Unsteady pressures, loads, and transfer functions were measured. The other two tests, TDT Test 502 and TDT Test 5 18, were primarily oriented towards active controls research, but some data supplementary to the first test were obtained. Dynamic response of the flexible system to control surface excitation and open loop flutter characteristics were determined during Test 502. Loads were not measured during the last two tests. During these tests, a database of over 3000 data sets was obtained. A reasonably extensive subset of the data sets from the first two tests have been chosen for Test Cases for computational comparisons concentrating on static conditions and cases with harmonically oscillating control surfaces. Several flutter Test Cases from both tests have also been included. Some aerodynamic comparisons with the BACT data have been made using computational fluid dynamics codes at the Navier-Stokes level (and in the accompanying chapter SC). Some mechanical and active control studies have been presented. In this report several Test Cases are selected to illustrate trends for a variety of different conditions with emphasis on transonic flow effects. Cases for static angles of attack, static trailing-edge and upper-surface spoiler deflections are included for a range of conditions near those for the oscillation cases. Cases for trailing-edge control and upper-surface spoiler oscillations for a range of Mach numbers, angle of attack, and static control deflections are included. Cases for all three types of flutter instability are selected. In addition some cases are included for dynamic response measurements during forced oscillations of the controls on the flexible mount. An overview of the model and tests is given, and the standard formulary for these data is listed. Some sample data and sample results of calculations are presented. Only the static pressures and the first harmonic real and imaginary parts of the pressures are included in the data for the Test Cases, but digitized time histories have been archived. The data for the Test Cases are also available as separate electronic files.

Association of tobacco use and other determinants with pregnancy outcomes: a multicentre hospital-based case-control study in Karachi, Pakistan.

PubMed

Rozi, Shafquat; Butt, Zahid Ahmad; Zahid, Nida; Wasim, Saba; Shafique, Kashif

2016-09-20

The study aimed to identify the effects of maternal tobacco consumption during pregnancy and other factors on birth outcomes and obstetric complications in Karachi, Pakistan. A multicentre hospital-based case-control study. Four leading maternity hospitals of Karachi. A random sample of 1275 women coming to the gynaecology and obstetric department of selected hospitals for delivery was interviewed within 48 hours of delivery from wards. Cases were women with adverse birth outcomes and obstetric complications, while controls were women who had normal uncomplicated delivery. Adverse birth outcomes (preterm delivery, low birth weight, stillbirth, low Apgar score) and obstetric complications (antepartum haemorrhage, caesarean section, etc). Final multiple logistic regression analysis revealed that with every 1 year increase in age the odds of being a case was 1.03 times as compared with being a control. Tobacco use (adjusted OR (aOR): 2.24; 95% CI 1.56 to 3.23), having no slits in the kitchen (proxy indicator for indoor air pollution) (aOR=1.90; 95% CI 1.05 to 3.43), gravidity (aOR=0.83; 95% CI 0.73 to 0.93), non-booked hospital cases (aOR=1.87; 95% CI 1.38 to 2.74), history of stillbirth (aOR=4.06; 95% CI 2.36 to 6.97), miscarriages (aOR=1.91; 95% CI 1.27 to 2.85) and preterm delivery (aOR=6.04; 95% CI 2.52 to 14.48) were significantly associated with being a case as compared with control. This study suggests that women who had adverse pregnancy outcomes were more likely to have exposure to tobacco, previous history of adverse birth outcomes and were non-booked cases. Engagement of stakeholders in tobacco control for providing health education, incorporating tobacco use in women in the tobacco control policy and designing interventions for tobacco use cessation is warranted. Prenatal care and health education might help in preventing such adverse events. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Comparison of standing postural control and gait parameters in people with and without chronic low back pain: a cross-sectional case-control study.

PubMed

MacRae, Catharine Siân; Critchley, Duncan; Lewis, Jeremy S; Shortland, Adam

2018-01-01

Differences in postural control and gait have been identified between people with and without chronic low back pain (CLBP); however, many previous studies present data from small samples, or have used methodologies with questionable reliability. This study, employing robust methodology, hypothesised that there would be a difference in postural control, and spatiotemporal parameters of gait in people with CLBP compared with asymptomatic individuals. This cross-sectional case-control study age-matched and gender-matched 16 CLBP and 16 asymptomatic participants. Participants were assessed barefoot (1) standing, over three 40 s trials, under four posture challenging conditions (2) during gait. Primary outcome was postural stability (assessed by root mean squared error of centre of pressure (CoP) displacement (CoP RMSEAP ) and mean CoP velocity (CoP VELAP ), both in the anteroposterior direction); gait outcomes were hip range of movement and peak moments, walking speed, cadence and stride length, assessed using force plates and a motion analysis system. There were no differences between groups in CoP RMSEAP (P=0.26), or CoP VELAP (P=0.60) for any standing condition. During gait, no differences were observed between groups for spatiotemporal parameters, maximum, minimum and total ranges of hip movement, or peak hip flexor or extensor moments in the sagittal plane. In contrast to previous research, this study suggests that people with mild to moderate CLBP present with similar standing postural control, and parameters of gait to asymptomatic individuals. Treatments directed at influencing postural stability (eg, standing on a wobble board) or specific parameters of gait may be an unnecessary addition to a treatment programme.

[Factors associated with road accidents in the city of Lubumbashi].

PubMed

Kandolo, Simon Ilunga; Matungulu, Charles Matungulu; Mukanya, Pascal Kimba; Umba, Irène Kabange; Kabamba, Julie Ndayi; Numbi, Oscar Luboya; Ilunga, Benjamin Kabyla; Kaj, Françoise Malonga; Lubaba, Célestin Banza; Ngongo, Ghislain Mashini

2014-01-01

We conducted a retrospective non-comparative cross-sectional study in Lubumbashi on factors associated with road accidents. To contribute to the reduction of morbidity and mortality related to road accidents based on a better understanding of this phenomenon in the city of Lubumbashi, to assess the frequency and the growth of road accidents in the city of Lubumbashi and to determine the factors predisposing to these accidents. This non-controlled retrospective cross-sectional descriptive study covered the period from 1st January to 31st December 2008, and included all cases of vehicles registered by the police department after an accident. A total of 1,915 road traffic were reported, mostly caused by public transport vehicles (59%) driven by young adult males (89% of cases) with a mean age of 28 years. The main cause was speeding combined with other factors (34% of cases). The majority of these accidents occurred in the city of Lubumbashi (52.9% of cases) between 6:00 a.m. and 6:00 p.m. (74% of cases). Transit vehicles were exposed to a greater risk of road accidents (59%). There is an urgent need for accurate information on the rules of the road for drivers and road users to reduce the mortality and morbidity due to road accidents.

A breath test for malignant mesothelioma using an electronic nose.

PubMed

Chapman, Eleanor A; Thomas, Paul S; Stone, Emily; Lewis, Craig; Yates, Deborah H

2012-08-01

Malignant mesothelioma (MM) is a rare tumour which is difficult to diagnose in its early stages. Earlier detection of MM could potentially improve survival. Exhaled breath sampling of volatile organic compounds (VOCs) using a carbon polymer array (CPA) electronic nose recognises specific breath profiles characteristic of different diseases, and can distinguish between patients with lung cancer and controls. With MM, the potential confounding effect of other asbestos-related diseases (ARDs) needs to be considered. We hypothesised that as CPA electronic nose would distinguish patients with MM, patients with benign ARDs, and controls with high sensitivity and specificity. 20 MM, 18 ARD and 42 control subjects participated in a cross-sectional, case-control study. Breath samples were analysed using the Cyranose 320 (Smiths Detection, Pasadena, CA, USA), using canonical discriminant analysis and principal component reduction. 10 MM subjects created the training set. Smell prints from 10 new MM patients were distinguished from control subjects with an accuracy of 95%. Patients with MM, ARDs and control subjects were correctly identified in 88% of cases. Exhaled breath VOC profiling can accurately distinguish between patients with MM, ARDs and controls using a CPA electronic nose. This could eventually translate into a screening tool for high-risk populations.

Celiac Disease in Children with Moderate-to-Severe Iron-deficiency Anemia.

PubMed

Narang, Manish; Natarajan, Ravikumar; Shah, Dheeraj; Puri, Amarender Singh; Manchanda, Vikas; Kotru, Mrinalini

2018-01-15

To evaluate the proportion of children with moderate to severe iron-deficiency anemia who have associated celiac disease. This cross-sectional analytical study was conducted among children aged 1 to 12 years of age with moderate-to-severe iron deficiency anemia and control children without anemia. Serum IgA-tissue trans-glutaminase levels were assessed in both cases and controls. All children with positive celiac serology underwent upper gastrointestinal endoscopy and duodenal biopsy; biopsy finding of Marsh grade 3 was considered positive for celiac disease. There were 152 anemic children and 152 controls with mean (SD) hemoglobinof 7.7 (1.8) and 12.2 (0.74) g/dL, respectively. 16 (10.5%) cases and 3 (2%) control patients had positive serology for celiac disease [OR (95% CI) 5.33 (1.52-18.67), P=0.007]. Six (3.9%) children with iron-deficiency anemia and none of the controls had biopsy features diagnostic of celiac disease. In the Northern Indian tertiary-care hospital outpatient setting, Celiac disease was associated with 4% of children presenting with moderate-to-severe anemia.

Numerical chromosomal aberrations in Hodgkin's disease detected by in situ hybridisation on routine paraffin sections.

PubMed Central

Pringle, J H; Shaw, J A; Gillies, A; Lauder, I

1997-01-01

AIMS: To visualise directly numerical chromosomal aberrations and polyploidy in both Hodgkin and Reed Sternberg (HRS) cells and background cells from cases of Hodgkin's disease using in situ hybridisation. METHODS: Non-isotopic DNA in situ hybridisation was applied to interphase cell nuclei of Hodgkin's disease within routine paraffin embedded tissue sections. Two a satellite DNA probes, specific for chromosomes 3 and 12, were used to evaluate the feasibility of this approach. Double labelling with immunocytochemical detection of the CD30 antigen was used to identify HRS cells. Cytogenetic normal diploid and triploid placental tissue served as controls. RESULTS: The eight cases of Hodgkin's disease investigated displayed frequent polysomy, while the majority of background cells showed disomy signals. CONCLUSIONS: Numerical chromosomal aberrations were detected in HRS cells from eight cases of Hodgkin's disease by in situ hybridisation. These data show that in Hodgkin's disease HRS cells frequently display polyploidy compared with background cells and are, therefore, probably the only neoplastic component in this disease. Correlations between polysomy and tumour type or grade could not be made from these data owing to the limited number of cases examined and to problems with interpreting data from truncated nuclei. Images PMID:9306933

Perinatal factors and the risk of bipolar disorder in Finland.

PubMed

Chudal, Roshan; Sourander, Andre; Polo-Kantola, Päivi; Hinkka-Yli-Salomäki, Susanna; Lehti, Venla; Sucksdorff, Dan; Gissler, Mika; Brown, Alan S

2014-02-01

Complications during the perinatal period have been associated with neurodevelopmental disorders like schizophrenia and autism. However, similar studies on bipolar disorder (BPD) have been limited and the findings are inconsistent. The aim of this study was to examine the association between perinatal risk factors and BPD. This nested case-control study, based on the Finnish Prenatal Study of Bipolar Disorders (FIPS-B), identified 724 cases and 1419 matched controls from population based registers. Conditional logistic regression was used to examine the associations between perinatal factors and BPD adjusting for potential confounding due to maternal age, psychiatric history and educational level, place of birth, number of previous births and maternal smoking during pregnancy. Children delivered by planned cesarean section had a 2.5-fold increased risk of BPD (95% CI: 1.32-4.78, P<0.01). No association was seen between other examined perinatal risk factors and BPD. The limitations of this study include: the restriction in the sample to treated cases of BPD in the population, and usage of hospital based clinical diagnosis for case ascertainment. In addition, in spite of the large sample size, there was low power to detect associations for certain exposures including the lowest birth weight category and pre-term birth. Birth by planned cesarean section was associated with risk of BPD, but most other perinatal risk factors examined in this study were not associated with BPD. Larger studies with greater statistical power to detect less common exposures and studies utilizing prospective biomarker-based exposures are necessary in the future. © 2013 Published by Elsevier B.V.

A life threatening uterine inversion and massive post partum hemorrhage caused by placenta accrete during Caesarean section in a primigravida: a case report.

PubMed

Tsivos, Dimitris; Malik, Fozia; Arambage, Kirana; Hagan, Philip; Lee, Cheng

2009-02-12

A 32-year-old Caucasian primigravida was admitted for elective Caesarean Section at 36 weeks and 6 days with the diagnosis of preeclampsia. Traction of the umbilical cord after delivery of a healthy baby resulted in uterine inversion. The placenta was found to be densely adherent to the posterior uterine wall. Piecemeal excision of the placenta as close as possible to the uterine lining was then performed. In this way we were able to control a massive post partum hemorrhage and preserve the fertility of the patient.

29 CFR 102.97 - Expeditious processing of section 10(l) and (m) cases in successive stages.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 2 2010-07-01 2010-07-01 false Expeditious processing of section 10(l) and (m) cases in... RULES AND REGULATIONS, SERIES 8 Procedure in Cases Under Section 10(j), (l), and (m) of the Act § 102.97 Expeditious processing of section 10(l) and (m) cases in successive stages. (a) Any complaint issued pursuant...

29 CFR 102.97 - Expeditious processing of section 10(l) and (m) cases in successive stages.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 2 2011-07-01 2011-07-01 false Expeditious processing of section 10(l) and (m) cases in... RULES AND REGULATIONS, SERIES 8 Procedure in Cases Under Section 10(j), (l), and (m) of the Act § 102.97 Expeditious processing of section 10(l) and (m) cases in successive stages. (a) Any complaint issued pursuant...

A clinicopathological review of 34 cases of inflammatory breast disease showing an association between corynebacteria infection and granulomatous mastitis.

PubMed

Taylor, Graeme B; Paviour, Sue D; Musaad, Sahar; Jones, Wayne O; Holland, David J

2003-04-01

Granulomatous mastitis is a rare condition of unknown aetiology. The great majority of cases has not been associated with bacterial pathogens if women with mammary tuberculosis are excluded. We noted that some women in Auckland with a histological diagnosis of granulomatous mastitis had both microbiological and histological evidence of corynebacteria infection and aimed to study this further. Thirty-four women were reviewed who presented with inflammatory breast disease and had microbiological specimens from which corynebacteria were isolated and/or histological specimens containing coryneform bacteria. These 34 cases were compared with 28 controls with similar histology but no evidence of corynebacteria infection. Twenty-seven (79%) of the cases and 21 (75%) of the controls had histological and/or cytological evidence of suppurative granulomas. Fourteen of the 34 cases also had Gram-positive bacilli (GPB), recognisable as coryneform bacteria, in histological sections. In all cases the bacilli were confined to empty spaces, consistent with dissolved lipid, and were surrounded by neutrophils and, frequently, suppurative granulomas. Corynebacterium species were isolated from 52 of 116 microbiological specimens taken from the 34 cases. Forty of these 52 cultures were pure. Twenty-four of the cultures were further classified biochemically and using 16S rRNA gene sequencing. Twenty of the 24 were lipophilic Corynebacterium species and 14 were identified as Corynebacterium kroppenstedtii. The cases were more likely to present with fever or neutrophilia and more often formed sinuses than the controls but other clinical features were similar. Maori and Pacific Islanders accounted for 77% of the women across both groups. We suggest granulomatous mastitis can be associated with corynebacteria infection, particularly infection by C. kroppenstedtii. The significance of this finding, which has previously been described in only a single case report, is discussed.

Canine noninflammatory alopecia: a comprehensive evaluation of common and distinguishing histological characteristics.

PubMed

Müntener, Tabitha; Schuepbach-Regula, Gertraud; Frank, Linda; Rüfenacht, Silvia; Welle, Monika M

2012-06-01

Noninflammatory alopecia is a frequent problem in dogs, and the pathogenesis is still unclear. The objective of this study was a comparative histological description of skin biopsies from dogs with different alopecic disorders and control dogs matched for coat type, season and disease duration. Twenty-one cases of alopecia X in plush-coated dogs, 12 cases of recurrent flank alopecia, three cases of hyperestrogenism, 15 cases of hyperadrenocorticism, 12 cases of hypothyroidism and 12 cases of primary alopecic disorders of unknown cause were evaluated. The controls were biopsies from 38 dogs of different coat types. We evaluated five serial sections of each biopsy histologically and immunohistologically to compare the histological findings within the disease groups and with the control. All the dogs with hair cycle disorders had a significant increase in the number of hairless hair follicles, which we assigned to kenogen. In addition, dogs with alopecia X had the lowest percentage of anagen follicles and the highest percentage of telogen follicles. The marked increase in kenogen follicles is a strong indication that the induction of the new anagen phase is impaired in hair cycle disorders. The findings in dogs with alopecia X further suggest that premature catagen is also involved in the pathogenesis. Further work to investigate the stem cell compartment and possible initiating factors for the different cycle phases is required to elucidate the exact pathogenesis. © 2012 The Authors. Veterinary Dermatology. © 2012 ESVD and ACVD.

The PD-1/PD-L1 axis may be aberrantly activated in occupational cholangiocarcinoma.

PubMed

Sato, Yasunori; Kinoshita, Masahiko; Takemura, Shigekazu; Tanaka, Shogo; Hamano, Genya; Nakamori, Shoji; Fujikawa, Masahiro; Sugawara, Yasuhiko; Yamamoto, Takatsugu; Arimoto, Akira; Yamamura, Minako; Sasaki, Motoko; Harada, Kenichi; Nakanuma, Yasuni; Kubo, Shoji

2017-03-01

An outbreak of cholangiocarcinoma in a printing company was reported in Japan, and these cases were regarded as an occupational disease (occupational cholangiocarcinoma). This study examined the expression status of programmed death-1 (PD-1) and programmed death-ligand 1 (PD-L1) in occupational cholangiocarcinoma. Immunostaining of PD-1, PD-L1, CD3, CD8, and CD163 was performed using tissue sections of occupational cholangiocarcinoma (n = 10), and the results were compared with those of control cases consisting of intrahepatic (n = 23) and extrahepatic (n = 45) cholangiocarcinoma. Carcinoma cells expressed PD-L1 in all cases of occupational cholangiocarcinoma, whereas the detection of PD-L1 expression in cholangiocarcinoma cells was limited to a low number of cases (less than 10%) in the control subjects. In cases of occupational cholangiocarcinoma, occasional PD-L1 expression was also noted in precancerous/preinvasive lesions such as biliary intraepithelial neoplasia and intraductal papillary neoplasm of the bile duct. Additionally, tumor-associated macrophages and tumor-infiltrating T cells expressed PD-L1 and PD-1, respectively. The number of PD-L1-positive mononuclear cells, PD-1-positive lymphocytes, and CD8-positive lymphocytes infiltrating within the tumor was significantly higher in occupational cholangiocarcinoma compared with that in control cases. These results indicate that immune escape via the PD-1/PD-L1 axis may be occurring in occupational cholangiocarcinoma. © 2017 Japanese Society of Pathology and John Wiley & Sons Australia, Ltd.

45 CFR 260.74 - How do existing welfare reform waivers affect the application of the Federal time-limit provisions?

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 2 2014-10-01 2012-10-01 true How do existing welfare reform waivers affect the application of the Federal time-limit provisions? 260.74 Section 260.74 Public Welfare Regulations Relating to... assistance to adults; and (ii) If applicable, experimental and control group cases not otherwise exempted...

45 CFR 260.74 - How do existing welfare reform waivers affect the application of the Federal time-limit provisions?

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 2 2013-10-01 2012-10-01 true How do existing welfare reform waivers affect the application of the Federal time-limit provisions? 260.74 Section 260.74 Public Welfare Regulations Relating to... assistance to adults; and (ii) If applicable, experimental and control group cases not otherwise exempted...

45 CFR 260.73 - How do existing welfare reform waivers affect the participation rates and work rules?

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 2 2013-10-01 2012-10-01 true How do existing welfare reform waivers affect the participation rates and work rules? 260.73 Section 260.73 Public Welfare Regulations Relating to Public Welfare..., experimental and control cases not otherwise exempted, in calculating the rate; (ii) Defining work activities...

45 CFR 260.73 - How do existing welfare reform waivers affect the participation rates and work rules?

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 2 2014-10-01 2012-10-01 true How do existing welfare reform waivers affect the participation rates and work rules? 260.73 Section 260.73 Public Welfare Regulations Relating to Public Welfare..., experimental and control cases not otherwise exempted, in calculating the rate; (ii) Defining work activities...

Relationship between Early Familial Influences and Personality Traits in Relation to Career Success Outcomes of African American Women

ERIC Educational Resources Information Center

Gardner, Keeba G.

2010-01-01

This study will examine the relationship between career success outcomes of African American women and early familial factors, as well as personality traits. Using a cross-sectional case-control design. the study will use participants who self-identified as African American with two African American parents. They will be randomly selected from a…

Estimating the Occurrence of Child Maltreatment and Risk-Factor Effects: Benefits of a Mixed-Design Strategy in Epidemiologic Research.

ERIC Educational Resources Information Center

Bertolli, Jeanne; And Others

1995-01-01

This article discusses methodologic limitations of four observational study designs (ecologic, case-control, cross-sectional, and cohort) that dominate the child abuse and neglect literature and identifies key features of an "ideal" study of child maltreatment. It proposes a new mixed-design strategy, which improves ability to identify child…

Reduced Haematopoietic Output in Automobile Mechanics and Sprayers with Chronic Exposure to Petrochemicals: A Case-Control Study in Cape Coast, Ghana.

PubMed

Adu, Patrick; Pobee, Richard; Awuah, Aaron; Asiamah, Paul B; Amoani, Festus; Gyabaa, Sampson

2018-01-01

Automobile mechanics and sprayers are at a higher risk of exposure to hazardous chemicals such as polycyclic aromatic hydrocarbons and heavy metals which may cause adverse health outcomes. This study aimed to use reticulocyte count as an indirect measure of the haematological output in automobile mechanics and sprayers in the Cape Coast Metropolis, Ghana. This cross-sectional study recruited 130 participants: 90 cases (57 automobile mechanics and 33 automobile sprayers) and 40 controls (nonautomobile workers). Venous blood samples were drawn from the participants and examined for full blood count and absolute reticulocyte count. Semi-structured questionnaire was used to collect demographic and occupational safety information from participants. 75.6% of cases had never received occupational safety training. Whereas 35.1% of automobile mechanics routinely siphoned fuel, 36.4% of automobile sprayers never used nose masks in the discharge of their duties. Controls had significantly higher WBC counts compared to mechanics ( p = 0.0001; 5.04 ± 1.7 versus 3.81 ± 1.1), or sprayers ( p = 0.0004; 5.04 ± 1.7 versus 3.74 ± 0.9). Lymphocyte, monocyte, and platelet counts were also significantly higher in controls compared to cases. Whereas RBC counts were significantly higher in controls compared to automobile mechanics (4.85 versus 4.66; p = 0.034), haemoglobin levels were significantly higher in automobile sprayers compared to controls (15.13 versus 14.1 g/dl; p = 0.0126). Absolute reticulocyte count was significantly higher in controls compared to cases [ p < 0.0001; (56.88 ± 32.14) × 10 9 /L (controls) versus (25.31 ± 15.75) × 10 9 /L (sprayers) or (33.27 ± 24.42) × 10 9 /L (mechanics)]. Among the cases however, only RBC counts were significantly lower in automobile mechanics compared to automobile sprayers ( p = 0.0088; 4.66 ± 0.4 versus 4.85 ± 0.5). It was evident that both automobile mechanics and sprayers had significantly reduced haematopoietic output. Occupational safety training is not given priority and must be addressed.

Reduced Haematopoietic Output in Automobile Mechanics and Sprayers with Chronic Exposure to Petrochemicals: A Case-Control Study in Cape Coast, Ghana

PubMed Central

Pobee, Richard; Awuah, Aaron; Asiamah, Paul B.; Amoani, Festus; Gyabaa, Sampson

2018-01-01

Background Automobile mechanics and sprayers are at a higher risk of exposure to hazardous chemicals such as polycyclic aromatic hydrocarbons and heavy metals which may cause adverse health outcomes. This study aimed to use reticulocyte count as an indirect measure of the haematological output in automobile mechanics and sprayers in the Cape Coast Metropolis, Ghana. Method This cross-sectional study recruited 130 participants: 90 cases (57 automobile mechanics and 33 automobile sprayers) and 40 controls (nonautomobile workers). Venous blood samples were drawn from the participants and examined for full blood count and absolute reticulocyte count. Semi-structured questionnaire was used to collect demographic and occupational safety information from participants. Results 75.6% of cases had never received occupational safety training. Whereas 35.1% of automobile mechanics routinely siphoned fuel, 36.4% of automobile sprayers never used nose masks in the discharge of their duties. Controls had significantly higher WBC counts compared to mechanics (p = 0.0001; 5.04 ± 1.7 versus 3.81 ± 1.1), or sprayers (p = 0.0004; 5.04 ± 1.7 versus 3.74 ± 0.9). Lymphocyte, monocyte, and platelet counts were also significantly higher in controls compared to cases. Whereas RBC counts were significantly higher in controls compared to automobile mechanics (4.85 versus 4.66; p = 0.034), haemoglobin levels were significantly higher in automobile sprayers compared to controls (15.13 versus 14.1 g/dl; p = 0.0126). Absolute reticulocyte count was significantly higher in controls compared to cases [p < 0.0001; (56.88 ± 32.14) × 109/L (controls) versus (25.31 ± 15.75) × 109/L (sprayers) or (33.27 ± 24.42) × 109/L (mechanics)]. Among the cases however, only RBC counts were significantly lower in automobile mechanics compared to automobile sprayers (p = 0.0088; 4.66 ± 0.4 versus 4.85 ± 0.5). Conclusion It was evident that both automobile mechanics and sprayers had significantly reduced haematopoietic output. Occupational safety training is not given priority and must be addressed. PMID:29780424

Birth characteristics of women with Marfan syndrome, obstetric and neonatal outcomes of their pregnancies-A nationwide cohort and case-control study.

PubMed

Kernell, Kristina; Sydsjö, Gunilla; Bladh, Marie; Josefsson, Ann

2017-08-01

The aim was to investigate birth characteristics, obstetric and neonatal outcomes of the first childbirth in women with Marfan syndrome by use of Swedish national registers since pregnancy-related outcomes in women with Marfan syndrome have only been sparsely investigated. In this national population-based cohort study and matched case-control study of Swedish women born 1973-1993, women with Marfan syndrome (n=273) were compared to women without the condition (n=1 017 265). The study population was followed until 2013. A total of 364 553 mother-firstborn-offspring pairs were analyzed. Sixty-one women with Marfan syndrome became mothers. Women with Marfan syndrome were also compared to 543 healthy controls. Women with Marfan syndrome were more often born preterm (p<0.001), small-for-gestational age (p<0.001), and delivered by cesarean section (p=0.001). Women with Marfan syndrome had no increased risk of giving birth by cesarean section (p=0.079). No increased neonatal risks in their children were found. Women with Marfan syndrome were less likely to give birth than those without (p<0.001). There were no maternal deaths. Women with Marfan syndrome were more likely to be born preterm, SGA and by cesarean section. These increased risks of preterm birth and SGA babies were not found in connection with their own first childbirth. Pregnancies with known fetal Marfan syndrome have to be carefully monitored. The results are important for obstetricians giving preconception counseling and treating women with Marfan syndrome. Further studies are needed to evaluate risks during pregnancy and long-term effects of pregnancy on the cardiovascular status of women with Marfan syndrome. Copyright © 2017 Elsevier B.V. All rights reserved.

Lung function in type 2 diabetes: the Normative Aging Study.

PubMed

Litonjua, Augusto A; Lazarus, Ross; Sparrow, David; Demolles, Debbie; Weiss, Scott T

2005-12-01

Cross-sectional studies have noted that subjects with diabetes have lower lung function than non-diabetic subjects. We conducted this analysis to determine whether diabetic subjects have different rates of lung function change compared with non-diabetic subjects. We conducted a nested case-control analysis in 352 men who developed diabetes and 352 non-diabetic subjects in a longitudinal observational study of aging in men. We assessed lung function among cases and controls at three time points: Time0, prior to meeting the definition of diabetes; Time1, the point when the definition of diabetes was met; and Time2, the most recent follow-up exam. Cases had lower forced expiratory volume in 1s (FEV1) and forced vital capacity (FVC) at all time points, even with adjustment for age, height, weight, and smoking. In multiple linear regression models adjusting for relevant covariates, there were no differences in rates of FEV1 or FVC change over time between cases and controls. Men who are predisposed to develop diabetes have decreased lung function many years prior to the diagnosis, compared with men who do not develop diabetes. This decrement in lung function remains after the development of diabetes. We postulate that mechanisms involved in the insulin resistant state contribute to the diminished lung function observed in our subjects.

Epidemiological characteristics of measles from 2000 to 2014: Results of a measles catch-up vaccination campaign in Xianyang, China.

PubMed

Zhang, Rong-Qiang; Li, Hong-Bing; Li, Feng-Ying; Han, Li-Xin; Xiong, Yong-Min

This study was a cross-sectional case-control study aimed at (1) identifying risk factors contributing to the measles epidemic and (2) evaluating the impacts of measles-containing vaccines (MCVs), with the goal of providing evidence-based recommendations for measles elimination strategies in China. Data on measles cases from 2000 to 2014 were obtained from a passive surveillance system at the Center for Diseases Prevention and Control in Xianyang. The effectiveness of MCVs was evaluated in 357 patients with a vaccination history and 503 healthy randomly selected controls. Patient data were subjected to multivariable logistic regression modeling. From 2005 to 2014, the average incidence of measles in Xianyang was 5.42 cases per 100,000 people. The second MCV dose was highly protective in 8-month-old infants. MCVs in general have been highly protective in 8-month-old infants. Multivariable logistic regression modeling indicated that age (≥2 years vs. <2years), MCV dose 2 vaccination, and MV vaccination were each independently associated with measles case status. In conclusions: A MCV should be administered on time to all age-eligible children, reproductive-age women, and migrant populations, to maximize herd immunity to measles. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Overview of clinical research design.

PubMed

Hartung, Daniel M; Touchette, Daniel

2009-02-15

Basic concepts and terminology of clinical research design are presented for new clinical investigators. Clinical research, research involving human subjects, can be described as either observational or experimental. The findings of all clinical research can be threatened by issues of bias and confounding. Biases are systematic errors in how study subjects are selected or measured, which result in false inferences. Confounding is a distortion in findings that is attributable to mixing variable effects. Uncontrolled observation research is generally more prone to bias and confounding than experimental research. Observational research includes designs such as the cohort study, case-control study, and cross-sectional study, while experimental research typically involves a randomized controlled trial (RCT). The cohort study, which includes the RCT, defines subject allocation on the basis of exposure interest (e.g., drug, disease-management program) and follows the patients to assess the outcomes. The case-control study uses the primary outcome of interest (e.g., adverse event) to define subject allocation, and different exposures are assessed in a retrospective manner. Cross-sectional research evaluates both exposure and outcome concurrently. Each of these design methods possesses different strengths and weaknesses in answering research questions, as well as underlying many study subtypes. While experimental research is the strongest method for establishing causality, it can be difficult to accomplish under many scenarios. Observational clinical research offers many design alternatives that may be appropriate if planned and executed carefully.

Maternal sepsis: a Scottish population-based case-control study.

PubMed

Acosta, C D; Bhattacharya, S; Tuffnell, D; Kurinczuk, J J; Knight, M

2012-03-01

To describe the risk of maternal sepsis associated with obesity and other understudied risk factors such as operative vaginal delivery. Population-based, case-control study. North NHS region of Scotland. All cases of pregnant, intrapartum and postpartum women with International Classification of Disease-9 codes for sepsis or severe sepsis recorded in the Aberdeen Maternal and Neonatal Databank (AMND) from 1986 to 2009. Four controls per case selected from the AMND were frequency matched on year-of-delivery. Cases and controls were compared; significant variables from univariable regression were adjusted in a multivariable logistic regression model. Dependent variables were uncomplicated sepsis or severe ('near-miss') sepsis. Independent variables were demographic, medical and clinical delivery characteristics. Unadjusted and adjusted odds ratios (OR) with 95% confidence intervals (95% CI) are reported. Controlling for mode of delivery and demographic and clinical factors, obese women had twice the odds of uncomplicated sepsis (OR 2.12; 95% CI 1.14-3.89) compared with women of normal weight. Age <25 years (OR 5.15; 95% CI 2.43-10.90) and operative vaginal delivery (OR 2.20; 95% CI 1.02-4.87) were also significant predictors of sepsis. Known risk factors for maternal sepsis were also significant in this study (OR for uncomplicated and severe sepsis respectively): multiparity (OR 6.29, 12.04), anaemia (OR 3.43, 18.49), labour induction (OR 3.92 severe only), caesarean section (OR 3.23, 13.35), and preterm birth (OR 2.46 uncomplicated only). Obesity, operative vaginal delivery and age <25 years are significant risk factors for sepsis and should be considered in clinical obstetric care. © 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.

Factors associated with severe occupational injuries at mining company in Zimbabwe, 2010: a cross-sectional study.

PubMed

Chimamise, Chipo; Gombe, Notion Tafara; Tshimanga, Mufuta; Chadambuka, Addmore; Shambira, Gerald; Chimusoro, Anderson

2013-01-01

Injury rate among mining workers in Zimbabwe was 789/1000 workers in 2008. The proportion of severe occupational injuries increased from 18% in 2008 to 37% in 2009. We investigated factors associated with severe injuries at the mine. An unmatched 1:1 case-control study was carried out at the mine, a case was any worker who suffered severe occupational injury at the mine and was treated at the mine or district hospital from January 2008 to April 2010, a control was any worker who did not suffer occupational injury during same period. We randomly selected 156 cases and 156 controls and used interviewer administered questionnaires to collect data from participants. Majority of cases, 155(99.4%) and of controls 142(91%) were male, 127(81.4%) of cases and 48(30.8%) of controls worked underground. Majority (73.1%) of severe occupational injuries occurred during night shift. Underground temperatures reached 500C. Factors independently associated with getting severe occupational injuries included working underground (AOR=10.55; CI 5.97-18.65), having targets per shift (AOR=12.60; CI 3.46-45.84), inadequate PPE (AOR=3.65 CI 1.34-9.89) and working more than 8 hours per shift (AOR=8.65 CI 2.99-25.02). Having targets exerts pressure to perform on workers. Prolonged working periods decrease workers' attention and concentration resulting in increased risk to severe injuries as workers become exhausted, lose focus and alertness. Underground work environment had environmental hazards so managers to install adequate ventilation and provide adequate PPE. Management agreed to standardize shifts to eight hours and workers in some departments have been supplied with adequate PPE.

Effect of Primary Elective Cesarean Delivery on Placenta Accreta: A Case-Control Study.

PubMed

Shi, Xiao-Ming; Wang, Yan; Zhang, Yan; Wei, Yuan; Chen, Lian; Zhao, Yang-Yu

2018-03-20

Cesarean section (CS) is an independent risk factor for placenta accreta. Some researchers think that the timing of primary cesarean delivery is associated with placenta accreta in subsequent pregnancies. The aim of this study was to investigate the risk of placenta accreta following primary CS without labor, also called primary elective CS, in a pregnancy complicated with placenta previa. A retrospective, single-center, case-control study was conducted at Peking University Third Hospital. Relevant clinical data of singleton pregnancies between January 2010 and September 2017 were recorded. The case group included women with placenta accreta who had placenta previa and one previous CS. Control group included women with one previous CS that was complicated with placenta previa. Maternal age, body mass index, gestational age, fetal birth weight, gravity, parity, induced abortion, the rate of women received assisted reproductive technology, other uterine surgery, and primary elective CS were analyzed between the two groups. The rate of primary elective CS (90.1% vs. 69.9%, P < 0.001) was higher, and maternal age was younger (32.7 ± 4.7 years vs. 34.6 ± 4.0 years, P < 0.001) in case group, compared with control group. Case group also had higher gravity and induced abortions compared with the control group (both P < 0.05). Primary CS without labor was associated with significantly increased risk of placenta accreta in a subsequent pregnancy complicated with placenta previa (odds ratio: 3.32; 95% confidential interval: 1.68-6.58). Women with a primary elective CS without labor have a higher chance of developing an accreta in a subsequent pregnancy that is complicated with placenta previa.

Effect of Primary Elective Cesarean Delivery on Placenta Accreta: A Case-Control Study

PubMed Central

Shi, Xiao-Ming; Wang, Yan; Zhang, Yan; Wei, Yuan; Chen, Lian; Zhao, Yang-Yu

2018-01-01

Background: Cesarean section (CS) is an independent risk factor for placenta accreta. Some researchers think that the timing of primary cesarean delivery is associated with placenta accreta in subsequent pregnancies. The aim of this study was to investigate the risk of placenta accreta following primary CS without labor, also called primary elective CS, in a pregnancy complicated with placenta previa. Methods: A retrospective, single-center, case-control study was conducted at Peking University Third Hospital. Relevant clinical data of singleton pregnancies between January 2010 and September 2017 were recorded. The case group included women with placenta accreta who had placenta previa and one previous CS. Control group included women with one previous CS that was complicated with placenta previa. Maternal age, body mass index, gestational age, fetal birth weight, gravity, parity, induced abortion, the rate of women received assisted reproductive technology, other uterine surgery, and primary elective CS were analyzed between the two groups. Results: The rate of primary elective CS (90.1% vs. 69.9%, P < 0.001) was higher, and maternal age was younger (32.7 ± 4.7 years vs. 34.6 ± 4.0 years, P < 0.001) in case group, compared with control group. Case group also had higher gravity and induced abortions compared with the control group (both P < 0.05). Primary CS without labor was associated with significantly increased risk of placenta accreta in a subsequent pregnancy complicated with placenta previa (odds ratio: 3.32; 95% confidential interval: 1.68–6.58). Conclusion: Women with a primary elective CS without labor have a higher chance of developing an accreta in a subsequent pregnancy that is complicated with placenta previa. PMID:29521289

Factors associated with severe occupational injuries at mining company in Zimbabwe, 2010: a cross-sectional study

PubMed Central

Chimamise, Chipo; Gombe, Notion Tafara; Tshimanga, Mufuta; Chadambuka, Addmore; Shambira, Gerald; Chimusoro, Anderson

2013-01-01

Introduction Injury rate among mining workers in Zimbabwe was 789/1000 workers in 2008. The proportion of severe occupational injuries increased from 18% in 2008 to 37% in 2009. We investigated factors associated with severe injuries at the mine. Methods An unmatched 1:1 case-control study was carried out at the mine, a case was any worker who suffered severe occupational injury at the mine and was treated at the mine or district hospital from January 2008 to April 2010, a control was any worker who did not suffer occupational injury during same period. We randomly selected 156 cases and 156 controls and used interviewer administered questionnaires to collect data from participants. Results Majority of cases, 155(99.4%) and of controls 142(91%) were male, 127(81.4%) of cases and 48(30.8%) of controls worked underground. Majority (73.1%) of severe occupational injuries occurred during night shift. Underground temperatures reached 500C. Factors independently associated with getting severe occupational injuries included working underground (AOR = 10.55; CI 5.97-18.65), having targets per shift (AOR = 12.60; CI 3.46-45.84), inadequate PPE (AOR= 3.65 CI 1.34-9.89) and working more than 8 hours per shift (AOR = 8.65 CI 2.99-25.02). Conclusion Having targets exerts pressure to perform on workers. Prolonged working periods decrease workers’ attention and concentration resulting in increased risk to severe injuries as workers become exhausted, lose focus and alertness. Underground work environment had environmental hazards so managers to install adequate ventilation and provide adequate PPE. Management agreed to standardize shifts to eight hours and workers in some departments have been supplied with adequate PPE. PMID:23504270

Insulin sensitivity and β-cell function in normoglycemic offspring of individuals with type 2 diabetes mellitus: Impact of line of inheritance.

PubMed

Praveen, Edavan P; Sahoo, Jayaprakash; Khurana, Madan L; Kulshreshtha, Bindu; Khadgawat, Rajesh; Gupta, Nandita; Dwivedi, Sada Nand; Kumar, Guresh; Prabhakaran, Dorairaj; Ammini, Ariachery C

2012-01-01

The aim was to study the effect of family history of type 2 diabetes mellitus (T2DM) on insulin sensitivity and β-cell function in normoglycemic offspring. Offspring of T2DM patients (cases) and individuals without family history of T2DM (controls) were the subjects for this cross-sectional study. All participants underwent 75 g OGTT and samples were collected for plasma insulin, C-peptide, and proinsulin at 0, 30, 60, and 120 minutes. A total of 271 cases (age 22 ± 10 years; 53% males) and 259 controls (28 ± 10 years, 66% males) were enrolled for the study. BMI, plasma insulin, C-peptide, proinsulin, HOMA-IR, and insulinogenic index (0-120) were significantly higher and whole-body insulin sensitivity (WBISI) and disposition index (0-120) [DI 120] were lower in cases compared to controls. After adjusting for BMI, proinsulin at 120 minutes, area under the curve (AUC) of proinsulin (during OGTT) and AUC proinsulin/AUC C-peptide were significantly higher in cases. Cases were subdivided into four groups according to inheritance pattern; paternal DM (PDM), maternal DM (MDM), grandparental DM (GPDM), and both parents DM (BPDM). The magnitude of differences varied with relationship (greater when both parents and grandparents were affected). Mean HOMA-IR was higher by 127% and 50% and DI 120 was lower by 33% and 18% (adjusted for age and gender) in the BPDM and GPDM groups respectively compared to controls. We observed higher BMI, plasma insulin, C-peptide, and proinsulin and lower insulin sensitivity and β-cell compensation in normoglycemic offspring of T2DM subjects compared to controls. Differences were greater when both parents and grandparents had T2DM.

Utility of additional tissue sections in dermatopathology: diagnostic, clinical and financial implications.

PubMed

Stuart, Lauren N; Rodriguez, Adrianna S; Gardner, Jerad M; Foster, Toby E; MacKelfresh, Jamie; Parker, Douglas C; Chen, Suephy C; Stoff, Benjamin K

2014-02-01

As histopathologic assessment is subject to sampling error, some institutions 'preorder' deeper sections on some or all cases (hereafter referred to as prospective deeper sections), while others order additional sections only when needed (hereafter referred to as retrospective deeper sections). We investigated how often additional sections changed a diagnosis and/or clinical management. Given the recent decrease in reimbursement for CPT-code 88305, we also considered the financial implications of ordering additional sections. Cases (n = 204) were assigned a preliminary diagnosis, based on review of the initial slide, and a final diagnosis, after reviewing additional sections. Cases with discordant diagnoses were assessed by two dermatologists, who indicated whether the change in diagnosis altered clinical management. Expenses were estimated for three scenarios: (a) no additional sections, (b) prospective deeper sections and (c) retrospective deeper sections. Diagnoses were modified in 9% of cases, which changed clinical management in 56% of these cases. Lesions obtained by punch-biopsy and inflammatory lesions were disproportionately overrepresented amongst cases with changed diagnoses (p < 0.001, p = 0.12, respectively). The cost of prospective deeper sections and retrospective deeper sections represented a 56% and 115% increase over base costs, respectively. Labor costs, particularly the cost of dermatopathologist evaluation, were the most significant cost-drivers. While additional sections improve diagnostic accuracy, they delay turn-around-time and increase expenditures. In our practice, prospective deeper sections are cost effective, however, this may vary by institution. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

14 CFR 302.213 - Procedures in foreign air carrier permit cases.

Code of Federal Regulations, 2010 CFR

2010-01-01

... cases. 302.213 Section 302.213 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF... Applications § 302.213 Procedures in foreign air carrier permit cases. (a) Applicability. This section applies to cases involving foreign air carrier permits under section 41302 of the Statute, including...

14 CFR 302.213 - Procedures in foreign air carrier permit cases.

Code of Federal Regulations, 2011 CFR

2011-01-01

... cases. 302.213 Section 302.213 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF... Applications § 302.213 Procedures in foreign air carrier permit cases. (a) Applicability. This section applies to cases involving foreign air carrier permits under section 41302 of the Statute, including...

Environmental, maternal, and reproductive risk factors for childhood acute lymphoblastic leukemia in Egypt: a case-control study.

PubMed

Ezzat, Sameera; Rashed, Wafaa M; Salem, Sherin; Dorak, M Tevfik; El-Daly, Mai; Abdel-Hamid, Mohamed; Sidhom, Iman; El-Hadad, Alaa; Loffredo, Christopher

2016-08-20

Acute lymphocytic leukemia (ALL) is the most common pediatric cancer. The exact cause is not known in most cases, but past epidemiological research has suggested a number of potential risk factors. This study evaluated associations between environmental and parental factors and the risk for ALL in Egyptian children to gain insight into risk factors in this developing country. We conducted a case-control design from May 2009 to February 2012. Cases were recruited from Children's Cancer Hospital, Egypt (CCHE). Healthy controls were randomly selected from the general population to frequency-match the cumulative group of cases by sex, age groups (<1; 1 - 5; >5 - 10; >10 years) and region of residence (Cairo metropolitan region, Nile Delta region (North), and Upper Egypt (South)). Mothers provided answers to an administered questionnaire about their environmental exposures and health history including those of the father. Odds ratios (ORs) and 95 % confidence intervals (CI) were calculated using logistic regression with adjustment for covariates. Two hundred ninety nine ALL cases and 351 population-based controls frequency-matched for age group, gender and location were recruited. The risk of ALL was increased with the mother's use of medications for ovulation induction (ORadj = 2.5, 95 % CI =1.2 -5.1) and to a lesser extend with her age (ORadj = 1.8, 95 % CI = 1.1 - 2.8, for mothers ≥ 30 years old). Delivering the child by Cesarean section, was also associated with increased risk (ORadj = 2.01, 95 % CI =1.24-2.81). In Egypt, the risk for childhood ALL appears to be associated with older maternal age, and certain maternal reproductive factors.

Online NASTRAN documentation

NASA Technical Reports Server (NTRS)

Turner, Horace Q.; Harper, David F.

1991-01-01

The distribution of NASTRAN User Manual information has been difficult because of the delay in printing and difficulty in identification of all the users. This has caused many users not to have the current information for the release of NASTRAN that could be available to them. The User Manual updates have been supplied with the NASTRAN Releases, but distribution within organizations was not coordinated with access to releases. The Executive Control, Case Control, and Bulk Data sections are supplied in machine readable format with the 91 Release of NASTRAN. This information is supplied on the release tapes in ASCII format, and a FORTRAN program to access this information is supplied on the release tapes. This will allow each user to have immediate access to User Manual level documentation with the release. The sections on utilities, plotting, and substructures are expected to be prepared for the 92 Release.

Sickle cell disease and venous thromboembolism in pregnancy and the puerperium.

PubMed

Noubouossie, Denis; Key, Nigel S

2015-02-01

Recent data strongly suggest an increased risk of venous thromboembolism in subjects with sickle cell disease and to a lesser extent, sickle cell trait. However, most studies have been retrospective, case-control or cross-sectional based on data obtained from administrative databases. More data from adequately powered prospective studies that include matched controls are needed to definitely establish the link between venous thromboembolism during pregnancy and sickle hemoglobin disorders. Similarly, there remains a need for properly designed randomized control trials to establish the safety of various hormonal contraceptive methods in women with sickle cell disorders. © 2015 Elsevier Ltd. All rights reserved.

Building capacity to address tobacco-related disparities among American Indian and Hispanic/Latino communities: conceptual and systemic considerations.

PubMed

Báezconde-Garbanati, Lourdes; Beebe, Laura A; Pérez-Stable, Eliseo J

2007-10-01

To discuss systemic and conceptual issues that surround capacity building for tobacco control in traditionally underserved communities, by presenting two case studies, one in an American Indian community and another in a Hispanic/Latino community. Key informant interviews, cross-sectional surveys and case study methods were used to create community-specific conceptual frameworks for building capacity for tobacco control. These models of capacity building serve as the backdrop for the development of the two case studies. SETTING, PARTICIPANTS, MEASUREMENTS: Interview and survey participants were identified through convenience and snowball sampling, using a community-based participatory process in an American Indian community in Oklahoma and among the Hispanic/Latino Tobacco Education Partnership (H/LTEP) organizations in California. Using qualitative and quantitative methods, two case studies were created based on the results of interviews with key informants in each of the respective communities, outcomes of efforts to build capacity in tobacco control are presented. The extent to which American Indian and Hispanic/Latino communities have the capacity to address effectively the disproportionate burden of tobacco abuse is contingent upon the presence of leadership, collaboration, programs, distribution of funds and resources, development of policies and an underlying understanding of community strengths, history, values and participation. Common characteristics emerge from the case studies that help bridge differences in definition and measurement across both populations and programs. The conceptual frameworks for capacity building presented provide insight that enhances the ability of priority populations to engage in tobacco control strategies using culturally and language appropriate interventions.

Changes in Serum Biochemical Factors Associated with Opium Addiction after Addiction Desertion

PubMed Central

Afarinesh, Mohammad Reza; Haghpanah, Tahereh; Divsalar, Kouros; Dehyadegary, Elham; Shaikh-Aleslami, Azar; Mahmoodi, Majid

2014-01-01

Background The long time use of opium has some effects on serums biochemical factors, the determination of this variation is a new approach in understanding off addiction and relive of drug abuser health. Hence in this study, these indicators in person who were withdrawing of opium have been studied. Methods In this cross-sectional study bloods biochemical factors such as fasting blood sugar (FBS), sodium (Na), calcium (Ca), uric acid (UA), blood urea nitrogen (BUN), creatinine, cholesterol, total protein, and fibrinogen in three groups serum were studied: (1) Who had been permanent opium users more than 2 years (case). (2) Dependent person who has taken one month addiction withdrawal course (control). (3) A healthy group that had been demographically similar to the other groups. Findings According to these study findings, FBS serum level in the case group is lower than control group. Serum level of Na, creatinine, and blood triglyceride (TG) in case study are higher than group control. Concentration of potassium, Ca, UA, BUN, cholesterol, total serum protein, fibrinogen, and thrombin time in case study and group control showed no significant difference. Also, in withdrawing case serum level of Na, Ca, UA, BUN, creatinine, and TG significantly increase and thrombin time decrease. Conclusion According to this study not only the longtime use of opium but also opium with drawerin opium dependent people can change their serum biochemical factors. So recognition, treatment, and prevention of this change could be a new step in improving of health and condition of patients. PMID:25984281

Condenser microbiofouling control handbook. Final report

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

Rice, J.K.; Garey, J.; Mussalli, Y.G.

1993-10-01

This handbook is a unified source of information to support the decisions that must be made to control microbiofouling. It is organized to help power plant engineers and operators (1) understand the causes of biofouling and how this knowledge can be used to develop an effective cleaning process, (2) move through the regulatory maze to find the regulations applicable to their own plant, (3) monitor biofouling, including on-line, off-line, direct, and indirect methods, (4) calculate the economic penalties for biofouling, (5) evaluate various chemical control methods in terms of system design and operation, biocontrol agents, specific restrictive environmental regulations, chemicalmore » application methods, and safety and exposure for workers, (6) evaluate mechanical cleaning methods, both on-line and off-line. Worksheets and examples are provided in many sections to guide operators to a more solid understanding of their problems and possible solutions. The handbook contains 46 figures, 28 tables, several case studies, and a complete index to aid the user in selecting appropriate sections of the handbook to read or review.« less

[Maternal and perinatal outcomes in Bolivian pregnant women in the city of São Paulo: a cross-sectional case-control study].

PubMed

Sass, Nelson; de Figueredo Junior, Alcides Rocha; Siqueira, José Martins; da Silva, Fabio Roberto Oliveira; Sato, Jussara Leiko; Nakamura, Mary Uchiyama; de Sousa, Eduardo

2010-08-01

to evaluate the characteristics regarding care of Bolivian pregnant women and their outcomes in Hospital Municipal Vereador José Storopolli. a cross-sectional retrospective case-control study comparing two groups of pregnant women from 2003 to 2007. The Study Group included 312 Bolivian pregnant women and the Control Group, 314 Brazilian women. The groups were compared with respect to demographic variables, the presence of maternal complications and perinatal outcomes. Statistical analysis was performed by χ2 test and, when necessary, by applying Yates' correction. compared to Brazilian mothers, a smaller number of Bolivian women received prenatal care (16.4 versus 5.1%, p<0.001) and among those that did, the percentage of those who had less than five visits was higher (50 versus 19.3%, p<0.001). Compared to the Brazilian group, the Bolivian group had fewer unwed mothers (12.1 versus 25.4%, p<0.001) and a lower number of nulliparous women (34.1 versus 43.6%, p=0.017). Congenital syphilis had a higher incidence in the Bolivian group (2.9 versus 0.5%, p<0.05), as well as a higher number of newborns classified as large for gestational age (14.6 versus 5.8%, p <0.001). the failure to attend prenatal care or its completion with an inadequate number of consultations, and the higher number of cases of congenital syphilis observed among the Bolivian women show the great vulnerability of this ethnic minority group to health problems. Consequently, it is necessary a strategic planning of the sectors responsible for coordinating assistance in our country, in order to reduce this disparity, either through socio-economic improvements or by the implementation of health care tailored to the needs of this group.

Report of ejections in the Spanish Air Force, 1979-1995: an epidemiological and comparative study.

PubMed

Moreno Vázquez, J M; Durán Tejeda, M R; García Alcón, J L

1999-07-01

Ejection seats have saved many lives with more than 80% of pilots having survived an ejection. Nevertheless, ejection injuries are seen in all modern air forces. An epidemiological study has been carried out on the 48 ejections made by the Spanish Air Force (SpAF) from 1979-1995. From data facilitated by the Flight Safety Section of the SpAF Staff, by the Flight Safety Section of Squadrons, and from personal reports of pilots who survived ejections a form was created. Relationships between data concerning aeronautical parameters, pilot data and injuries have been found, and a comparative study was made between these results and data shown by air forces of other countries. Of 48 pilots who ejected, 7 died, 25 had severe injuries, 11 had minor injuries and 5 had no injuries. The reason for the ejections included 35 cases of technical failure, and 13 cases of human error. Of 43 surviving pilots, 23 were injured only at the egress phase, 1 1 only at landing, and 9 cases at both moments. None of the five pilots who ejected outside the ejection envelope were able to adopt the correct position. However, of 43 pilots who ejected within the envelope, 19 were seated in good position. Of 13 pilots who maintained control of the airplane, 9 were able to adopt a correct position. Of 35 pilots who effected the ejection without control of the aircraft, 25 were not able to achieve a correct seated position. The pilot position in the ejection seat, plane control, ejection inside the envelope, the pilot's training in how to assume the necessary body position at both egress and landing phases are determining factors for successful ejections.

Alcohol Intake and Risk of Thyroid Cancer: A Meta-Analysis of Observational Studies

PubMed Central

Hong, Seung-Hee; Myung, Seung-Kwon; Kim, Hyeon Suk

2017-01-01

Purpose The purpose of this study was to assess whether alcohol intake is associated with the risk of thyroid cancer by a meta-analysis of observational studies. Materials and Methods We searched PubMed and EMBASE in June of 2015 to locate eligible studies. We included observational studies such as cross-sectional studies, case-control studies, and cohort studies reporting odd ratios (ORs) or relative risk (RRs) with 95% confidence intervals (CIs). Results We included 33 observational studies with two cross-sectional studies, 20 case-controls studies, and 11 cohort studies, which involved a total of 7,725 thyroid cancer patients and 3,113,679 participants without thyroid cancer in the final analysis. In the fixed-effect model meta-analysis of all 33 studies, we found that alcohol intake was consistently associated with a decreased risk of thyroid cancer (OR or RR, 0.74; 95% CI, 0.67 to 0.83; I2=38.6%). In the subgroup meta-analysis by type of study, alcohol intake also decreased the risk of thyroid cancer in both case-control studies (OR, 0.77; 95% CI, 0.65 to 0.92; I2=29.5%; n=20) and cohort studies (RR, 0.70; 95% CI, 0.60 to 0.82; I2=0%; n=11). Moreover, subgroup meta-analyses by type of thyroid cancer, gender, amount of alcohol consumed, and methodological quality of study showed that alcohol intake was significantly associated with a decreased risk of thyroid cancer. Conclusion The current meta-analysis of observational studies found that, unlike most of other types of cancer, alcohol intake decreased the risk of thyroid cancer. PMID:27456949

Behaviour of wrapped cold-formed steel columns under different loading conditions

NASA Astrophysics Data System (ADS)

Baabu, B. Hari; Sreenath, S.

2017-07-01

The use of Cold Formed Steel (CFS) sections as structural members is widely accepted because of its light nature. However, the load carrying capacity of these sections will be less compared to hot rolled sections. This study is meant to analyze the possibility of strengthening cold formed members by wrapping it with Glass Fiber Reinforced Polymer (GFRP) laminates. Light gauge steel columns of cross sectional dimensions 100mm x 50mm x 3.15mm were taken for this study. The effective length of the section is about 750mm. A total of 8 specimens including the control specimen is tested under axial and eccentric loading. The columns were tested keeping both ends hinged. For both loading cases the buckling behaviour, ultimate load carrying capacity and load-deflection characteristics of the CFS columns were analyzed. The GFRP laminates were wrapped on columns in three different ways such that wrapping the outer surface of web and flange throughout the length of specimen, wrapping the outer surface of web alone throughout the length of specimen and wrapping the outer surface of web and flange for the upper half length of the specimen where the buckling is expected. For both loading cases, the results indicated that the column with wrapping at the outer surface of web and flange throughout the length of specimen provides better strength for it.

Suicide risk among individuals with sleep disturbances in Japan: a case-control psychological autopsy study.

PubMed

Kodaka, Manami; Matsumoto, Toshihiko; Katsumata, Yotaro; Akazawa, Masato; Tachimori, Hisateru; Kawakami, Norito; Eguchi, Nozomi; Shirakawa, Norihito; Takeshima, Tadashi

2014-04-01

This case-control psychological autopsy study aimed to explore a relationship between sleep disturbances and suicide among Japanese, as well as determine the importance and usability of screening for sleep disturbances in suicide prevention. A semi-structured interview was conducted with the close family members of 49 adult suicide completers and 145 gender-, age-, and residential municipality-matched living controls. The survey included sections on demographics, sleep disturbances, and mental disorders. Conditional logistic regression analyses were performed to compare sleep disturbance prevalence between the two groups. A significantly higher prevalence of sleep disturbances was found among the suicide group (75.5%) compared to the controls (11.0%) (odds ratio [OR]=21.6, p<0.001). The association remained significant after adjusting for mental disorders (OR=12.7, p<0.001). The population attributable risk percent of suicide associated with sleep disturbances and mental disorders was estimated to be 56.4% and 35.3%, respectively. The study confirmed that sleep disturbances are an important risk factor of suicide, independent of mental disorders. Sleep disturbances accounted for a greater proportion of suicide cases than did mental disorders in the Japanese population given the higher prevalence, and could thus be considered an important target in suicide prevention in Japan. Copyright © 2014 Elsevier B.V. All rights reserved.

29 CFR 102.95 - Priority of cases pursuant to section 10(l) and (m) of the Act.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 2 2011-07-01 2011-07-01 false Priority of cases pursuant to section 10(l) and (m) of the... AND REGULATIONS, SERIES 8 Procedure in Cases Under Section 10(j), (l), and (m) of the Act § 102.95 Priority of cases pursuant to section 10(l) and (m) of the Act. (a) Whenever a charge is filed alleging the...

29 CFR 102.95 - Priority of cases pursuant to section 10(l) and (m) of the Act.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 2 2010-07-01 2010-07-01 false Priority of cases pursuant to section 10(l) and (m) of the... AND REGULATIONS, SERIES 8 Procedure in Cases Under Section 10(j), (l), and (m) of the Act § 102.95 Priority of cases pursuant to section 10(l) and (m) of the Act. (a) Whenever a charge is filed alleging the...

Interleukin (IL)-8 immunoreactivity of injured axons and surrounding oligodendrocytes in traumatic head injury.

PubMed

Hayashi, Takahito; Ago, Kazutoshi; Nakamae, Takuma; Higo, Eri; Ogata, Mamoru

2016-06-01

Interleukin (IL)-8 has been suggested to be a positive regulator of myelination in the central nervous system, in addition to its principal role as a chemokine for neutrophils. Immunostaining for beta-amyloid precursor protein (AβPP) is an effective tool for detecting traumatic axonal injury, although AβPP immunoreactivity can also indicate axonal injury due to hypoxic causes. In this study, we examined IL-8 and AβPP immunoreactivity in sections of corpus callosum obtained from deceased patients with blunt head injury and from equivalent control tissue. AβPP immunoreactivity was detected in injured axons, such as axonal bulbs and varicose axons, in 24 of 44 head injury cases. These AβPP immunoreactive cases had survived for more than 3h. The AβPP immunostaining pattern can be classified into two types: traumatic (Pattern 1) and non-traumatic (Pattern 2) axonal injuries, which we described previously [Hayashi et al. Int. J. Legal Med. 129 (2015) 1085-1090]. Three of 44 control cases also showed AβPP immunoreactive injured axons as Pattern 2. In contrast, IL-8 immunoreactivity was detected in 7 AβPP immunoreactive and in 2 non-AβPP immunoreactive head injury cases, but was not detected in any of the 44 control cases, including the 3 AβPP immunoreactive control cases. The IL-8 immunoreactive cases had survived from 3 to 24 days, whereas those cases who survived less than 3 days (n=29) and who survived 90 days (n=1) were not IL-8 immunoreactive. Moreover, IL-8 was detected as Pattern 1 axons only. In addition, double immunofluorescence analysis showed that IL-8 is expressed by oligodendrocytes surrounding injured axons. In conclusion, our results suggest that immunohistochemical detection of IL-8 may be useful as a complementary diagnostic marker of traumatic axonal injury. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies.

PubMed

von Elm, Erik; Altman, Douglas G; Egger, Matthias; Pocock, Stuart J; Gøtzsche, Peter C; Vandenbroucke, Jan P

2014-12-01

Much biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalisability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Initiative developed recommendations on what should be included in an accurate and complete report of an observational study. We defined the scope of the recommendations to cover three main study designs: cohort, case-control, and cross-sectional studies. We convened a 2-day workshop in September 2004, with methodologists, researchers, and journal editors to draft a checklist of items. This list was subsequently revised during several meetings of the coordinating group and in e-mail discussions with the larger group of STROBE contributors, taking into account empirical evidence and methodological considerations. The workshop and the subsequent iterative process of consultation and revision resulted in a checklist of 22 items (the STROBE Statement) that relate to the title, abstract, introduction, methods, results, and discussion sections of articles. 18 items are common to all three study designs and four are specific for cohort, case-control, or cross-sectional studies. A detailed Explanation and Elaboration document is published separately and is freely available on the Web sites of PLoS Medicine, Annals of Internal Medicine, and Epidemiology. We hope that the STROBE Statement will contribute to improving the quality of reporting of observational studies. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Maternal and fetal alternative complement pathway activation in early severe preeclampsia.

PubMed

Hoffman, M Camille; Rumer, Kristen K; Kramer, Anita; Lynch, Anne M; Winn, Virginia D

2014-01-01

We sought to determine whether alternative complement activation fragment Bb (Bb) levels are elevated in the maternal, fetal, and placental blood in cases of severe preeclampsia (PE) compared with normotensive controls. This was a cross-sectional study of women admitted at ≥24 weeks gestation with or without severe PE. Maternal plasma was collected at the time of enrollment. Umbilical venous cord and intervillous space blood were collected at delivery. Plasma Bb levels were assessed using ELISA. Bb levels were compared between cases and controls. Median Bb levels were higher in the maternal plasma of severe PE subjects (n = 24) than in controls (n = 20), 1.45 ± 1.03 versus 0.65 ± 0.23 μg/mL, P < 0.001. In umbilical venous plasma, Bb levels were higher in severe PE subjects (n = 15) compared with controls (n = 15), 2.48 ± 1.40 versus 1.01 ± 0.57 μg/mL, P = 0.01. Activation fragment Bb is increased in the maternal and umbilical venous blood of cases of severe PE when compared with normotensive controls. These data provide support for alternative complement pathway involvement in the pathogenesis of severe PE and demonstrate that alternative complement activation occurs not only in the maternal but also in the fetal compartment. © 2013 John Wiley & Sons Ltd.

What is healthy work for women and men? - A case-control study of gender- and sector-specific effects of psycho-social working conditions on long-term sickness absence.

PubMed

Lidwall, Ulrik; Marklund, Staffan

2006-01-01

The aim of the study was to investigate the relevance of the demand-control model and social support in predicting long-term sickness absence (LTSA). Identifying gender- and sector- (private vs. public) specific patterns was in focus. The study uses a cross-sectional design with a case and a control group. The cases are a sample of 2 327 long-term sick listed (>60 days) and the controls are a Swedish population-based sample of 2 063. Data on sickness absence were retrieved from the Swedish national social insurance registers. Data on health, working and living conditions were gathered through a self-administered questionnaire. The results show that employed women have a notably higher risk for LTSA than employed men. High-strain jobs increase the odds for LTSA among both women and men. Active jobs were also associated with LTSA among women. The study confirms the demand-control model (job strain hypothesis) and social support and their associations with LTSA. However, the job strain hypothesis is more evident in the private sector. Active jobs with high psychological demands and high decision latitude seem to be problematic for many women, especially in the private sector. Thus, the active learning hypothesis receives no support for women in the Swedish working population in general.

Effect of a culture-based screening algorithm on tuberculosis incidence in immigrants and refugees bound for the United States: a population-based cross-sectional study.

PubMed

Liu, Yecai; Posey, Drew L; Cetron, Martin S; Painter, John A

2015-03-17

Before 2007, immigrants and refugees bound for the United States were screened for tuberculosis (TB) by a smear-based algorithm that could not diagnose smear-negative/culture-positive TB. In 2007, the Centers for Disease Control and Prevention implemented a culture-based algorithm. To evaluate the effect of the culture-based algorithm on preventing the importation of TB to the United States by immigrants and refugees from foreign countries. Population-based, cross-sectional study. Panel physician sites for overseas medical examination. Immigrants and refugees with TB. Comparison of the increase of smear-negative/culture-positive TB cases diagnosed overseas among immigrants and refugees by the culture-based algorithm with the decline of reported cases among foreign-born persons within 1 year after arrival in the United States from 2007 to 2012. Of the 3 212 421 arrivals of immigrants and refugees from 2007 to 2012, a total of 1 650 961 (51.4%) were screened by the smear-based algorithm and 1 561 460 (48.6%) were screened by the culture-based algorithm. Among the 4032 TB cases diagnosed by the culture-based algorithm, 2195 (54.4%) were smear-negative/culture-positive. Before implementation (2002 to 2006), the annual number of reported cases among foreign-born persons within 1 year after arrival was relatively constant (range, 1424 to 1626 cases; mean, 1504 cases) but decreased from 1511 to 940 cases during implementation (2007 to 2012). During the same period, the annual number of smear-negative/culture-positive TB cases diagnosed overseas among immigrants and refugees bound for the United States by the culture-based algorithm increased from 4 to 629. This analysis did not control for the decline in new arrivals of nonimmigrant visitors to the United States and the decrease of incidence of TB in their countries of origin. Implementation of the culture-based algorithm may have substantially reduced the incidence of TB among newly arrived, foreign-born persons in the United States. None.

Factors associated with severe maternal morbidity in Kelantan, Malaysia: A comparative cross-sectional study.

PubMed

Norhayati, Mohd Noor; Nik Hazlina, Nik Hussain; Aniza, Abd Aziz; Sulaiman, Zaharah

2016-07-26

Knowledge on the factors associated with severe maternal morbidity enables a better understanding of the problem and serves as a foundation for the development of an effective preventive strategy. However, various definitions of severe maternal morbidity have been applied, leading to inconsistencies between studies. The objective of this study was to identify the sociodemographic characteristics, medical and gynaecological history, past and present obstetric performance and the provision of health care services as associated factors for severe maternal morbidity in Kelantan, Malaysia. A comparative cross-sectional study was conducted in two tertiary referral hospitals in 2014. Postpartum women with severe morbidity and without severe morbidity who fulfilled the inclusion and exclusion criteria were eligible as cases and controls, respectively. The study population included all postpartum women regardless of their age. Pregnancy at less than 22 weeks of gestation, more than 42 days after the termination of pregnancy and non-Malaysian citizens were excluded. Consecutive sampling was applied for the selection of cases and for each case identified, one unmatched control from the same hospital was selected using computer-based simple random sampling. Simple and multiple logistic regressions were performed using Stata Intercooled version 11.0. A total of 23,422 pregnant women were admitted to these hospitals in 2014 and 395 women with severe maternal morbidity were identified, of which 353 were eligible as cases. An age of 35 or more years old [Adj. OR (95 % CI): 2.6 (1.67, 4.07)], women with past pregnancy complications [Adj. OR (95 % CI): 1.7 (1.00, 2.79)], underwent caesarean section deliveries [Adj. OR (95 % CI): 6.8 (4.68, 10.01)], preterm delivery [Adj. OR (95 % CI): 3.4 (1.87, 6.32)] and referral to tertiary centres [Adj. OR (95 % CI): 2.7 (1.87, 3.97)] were significant associated factors for severe maternal morbidity. Our study suggests the enhanced screening and monitoring of women of advanced maternal age, women with past pregnancy complications, those who underwent caesarean section deliveries, those who delivered preterm and the mothers referred to tertiary centres as they are at increased risk of severe maternal morbidity. Identifying these factors may contribute to specific and targeted strategies aimed at tackling the issues related to maternal morbidity.

Progress on Shape Memory Alloy Actuator Development for Active Clearance Control

NASA Technical Reports Server (NTRS)

DeCastro, Jonathan; Melcher, Kevin; Noebe, Ronald

2006-01-01

Results of a numerical analysis evaluating the feasibility of high-temperature shape memory alloys (HTSMA) for active clearance control actuation in the high-pressure turbine section of a modern turbofan engine has been conducted. The prototype actuator concept considered here consists of parallel HTSMA wires attached to the shroud that is located on the exterior of the turbine case. A transient model of an HTSMA actuator was used to evaluate active clearance control at various operating points in a test bed aircraft engine simulation. For the engine under consideration, each actuator must be designed to counteract loads from 380 to 2000 lbf and displace at least 0.033 in. Design results show that an actuator comprised of 10 wires 2 in. in length is adequate for control at critical engine operating points and still exhibit acceptable failsafe operability and cycle life. A proportional-integral-derivative (PID) controller with integrator windup protection was implemented to control clearance amidst engine transients during a normal mission. Simulation results show that the control system exhibits minimal variability in clearance control performance across the operating envelope. The final actuator design is sufficiently small to fit within the limited space outside the high-pressure turbine case and is shown to consume only small amounts of bleed air to adequately regulate temperature.

Public health case studies in diabetes prevention and control: innovation, partnerships, and funding.

PubMed

Davis, Mary V; Cannon, Margaret M; Reese, April; Lovette, Beth; Porterfield, Deborah S

2011-01-01

In 2006, we conducted case studies of 4 North Carolina local health departments (LHDs) that scored highly on an index of diabetes prevention and control performance, to explore characteristics that may serve as barriers or facilitators of diabetes prevention and control services. Case studies involving in-depth interviews were conducted at 4 LHDs. Sites were selected on the basis of 2 variables, known external funding for diabetes services and population size, that were associated with performance in diabetes prevention and control in a 2005 survey of all North Carolina LHDs. Fourteen interviews (individual and group) were conducted among 17 participants from the 4 LHDs. The main outcome measures were LHD characteristics that facilitate or hinder the performance of diabetes programs and services. Interviews revealed that all 4 high-performing LHDs had received some sort of funding from a source external to the LHD. Case study participants indicated that barriers to additional service delivery included low socioeconomic status of the population and lack of financial resources. Having a diabetes self-management education program that was recognized by the American Diabetes Association appeared to be a facilitator of diabetes services provision. Other facilitators were leadership and staff commitment, which appeared to facilitate the leveraging of partnerships and funding opportunities, leading to enhanced service delivery. The small number of LHDs participating in the study and the cross-sectional study design were limitations. Leadership, staff commitment, partnership leveraging, and funding appear to be associated with LHD performance in diabetes prevention and control services. These factors should be further studied in future public health systems and services research.

Arteriolosclerosis that affects multiple brain regions is linked to hippocampal sclerosis of ageing.

PubMed

Neltner, Janna H; Abner, Erin L; Baker, Steven; Schmitt, Frederick A; Kryscio, Richard J; Jicha, Gregory A; Smith, Charles D; Hammack, Eleanor; Kukull, Walter A; Brenowitz, Willa D; Van Eldik, Linda J; Nelson, Peter T

2014-01-01

Hippocampal sclerosis of ageing is a prevalent brain disease that afflicts older persons and has been linked with cerebrovascular pathology. Arteriolosclerosis is a subtype of cerebrovascular pathology characterized by concentrically thickened arterioles. Here we report data from multiple large autopsy series (University of Kentucky Alzheimer's Disease Centre, Nun Study, and National Alzheimer's Coordinating Centre) showing a specific association between hippocampal sclerosis of ageing pathology and arteriolosclerosis. The present analyses incorporate 226 cases of autopsy-proven hippocampal sclerosis of ageing and 1792 controls. Case-control comparisons were performed including digital pathological assessments for detailed analyses of blood vessel morphology. We found no evidence of associations between hippocampal sclerosis of ageing pathology and lacunar infarcts, large infarcts, Circle of Willis atherosclerosis, or cerebral amyloid angiopathy. Individuals with hippocampal sclerosis of ageing pathology did not show increased rates of clinically documented hypertension, diabetes, or other cardiac risk factors. The correlation between arteriolosclerosis and hippocampal sclerosis of ageing pathology was strong in multiple brain regions outside of the hippocampus. For example, the presence of arteriolosclerosis in the frontal cortex (Brodmann area 9) was strongly associated with hippocampal sclerosis of ageing pathology (P < 0.001). This enables informative evaluation of anatomical regions outside of the hippocampus. To assess the morphology of brain microvasculature far more rigorously than what is possible using semi-quantitative pathological scoring, we applied digital pathological (Aperio ScanScope) methods on a subsample of frontal cortex sections from hippocampal sclerosis of ageing (n = 15) and control (n = 42) cases. Following technical studies to optimize immunostaining methods for small blood vessel visualization, our analyses focused on sections immunostained for smooth muscle actin (a marker of arterioles) and CD34 (an endothelial marker), with separate analyses on grey and white matter. A total of 43 834 smooth muscle actin-positive vascular profiles and 603 798 CD34-positive vascular profiles were evaluated. In frontal cortex of cases with hippocampal sclerosis of ageing, smooth muscle actin-immunoreactive arterioles had thicker walls (P < 0.05), larger perimeters (P < 0.03), and larger vessel areas (P < 0.03) than controls. Unlike the arterioles, CD34-immunoreactive capillaries had dimensions that were unchanged in cases with hippocampal sclerosis of ageing versus controls. Arteriolosclerosis appears specific to hippocampal sclerosis of ageing brains, because brains with Alzheimer's disease pathology did not show the same morphological alterations. We conclude that there may be a pathogenetic change in aged human brain arterioles that impacts multiple brain areas and contributes to hippocampal sclerosis of ageing.

Experimental Evaluation of Verification and Validation Tools on Martian Rover Software

NASA Technical Reports Server (NTRS)

Brat, Guillaume; Giannakopoulou, Dimitra; Goldberg, Allen; Havelund, Klaus; Lowry, Mike; Pasareanu, Corina; Venet, Arnaud; Visser, Willem

2003-01-01

To achieve its science objectives in deep space exploration, NASA has a need for science platform vehicles to autonomously make control decisions in a time frame that excludes intervention from Earth-based controllers. Round-trip light-time is one significant factor motivating autonomy capability, another factor is the need to reduce ground support operations cost. An unsolved problem potentially impeding the adoption of autonomy capability is the verification and validation of such software systems, which exhibit far more behaviors (and hence distinct execution paths in the software) than is typical in current deepspace platforms. Hence the need for a study to benchmark advanced Verification and Validation (V&V) tools on representative autonomy software. The objective of the study was to access the maturity of different technologies, to provide data indicative of potential synergies between them, and to identify gaps in the technologies with respect to the challenge of autonomy V&V. The study consisted of two parts: first, a set of relatively independent case studies of different tools on the same autonomy code, second a carefully controlled experiment with human participants on a subset of these technologies. This paper describes the second part of the study. Overall, nearly four hundred hours of data on human use of three different advanced V&V tools were accumulated, with a control group that used conventional testing methods. The experiment simulated four independent V&V teams debugging three successive versions of an executive controller for a Martian Rover. Defects were carefully seeded into the three versions based on a profile of defects from CVS logs that occurred in the actual development of the executive controller. The rest of the document is structured a s follows. In section 2 and 3, we respectively describe the tools used in the study and the rover software that was analyzed. In section 4 the methodology for the experiment is described; this includes the code preparation, seeding of defects, participant training and experimental setup. Next we give a qualitative overview of how the experiment went from the point of view of each technology; model checking (section 5), static analysis (section 6), runtime analysis (section 7) and testing (section 8). The find section gives some preliminary quantitative results on how the tools compared.

Individual hippocampal subfield assessment indicates that matrix macromolecules and gliosis are key elements for the increased T2 relaxation time seen in temporal lobe epilepsy.

PubMed

Peixoto-Santos, Jose Eduardo; Kandratavicius, Ludmyla; Velasco, Tonicarlo Rodrigues; Assirati, Joao Alberto; Carlotti, Carlos Gilberto; Scandiuzzi, Renata Caldo; Salmon, Carlos Ernesto Garrido; Santos, Antonio Carlos Dos; Leite, Joao Pereira

2017-01-01

Increased T2 relaxation time is often seen in temporal lobe epilepsy (TLE) with hippocampal sclerosis. Water content directly affects the effective T2 in a voxel. Our aim was to evaluate the relation between T2 values and two molecules associated with brain water homeostasis aquaporin 4 (AQP4) and chondroitin sulfate proteoglycan (CSPG), as well as cellular populations in the hippocampal region of patients with TLE. Hippocampal T2 imaging and diffusion tensor imaging (DTI) were obtained from 42 drug-resistant patients with TLE and 20 healthy volunteers (radiologic controls, RCs). A similar protocol (ex vivo) was applied to hippocampal sections from the same TLE cases and 14 autopsy control hippocampi (histologic and radiologic controls, HRCs), and each hippocampal subfield was evaluated. Hippocampal sections from TLE cases and HRC controls were submitted to immunohistochemistry for neurons (neuron nuclei [NeuN]), reactive astrocytes (glial fibrillary acidic protein [GFAP]), activated microglia (human leukocyte antigen-D-related [HLA-DR]), polarized AQP4, and CSPG. Patients with TLE had higher in vivo and ex vivo hippocampal T2 relaxation time. Hippocampi from epilepsy cases had lower neuron density, higher gliosis, decreased AQP4 polarization, and increased CSPG immunoreactive area. In vivo relaxation correlated with astrogliosis in the subiculum and extracellular CSPG in the hilus. Ex vivo T2 relaxation time correlated with astrogliosis in the hilus, CA4, and subiculum, and with microgliosis in CA1. The difference between in vivo and ex vivo relaxation ratio correlated with mean diffusivity and with the immunopositive area for CSPG in the hilus. Our data indicate that astrogliosis, microgliosis, and CSPG expression correlate with the increased T2 relaxation time seen in the hippocampi of patients with TLE. Wiley Periodicals, Inc. © 2016 International League Against Epilepsy.

Obstetric performance of ethnic Kosovo Albanian asylum seekers in London: a case-control study.

PubMed

Yoong, W; Wagley, A; Fong, C; Chukwuma, C; Nauta, M

2004-08-01

The most recent Confidential Enquiry into Maternal Deaths expressed concern that mortality in women from non-English-speaking ethnic groups was twice that of native-born women. There are very few published data on the obstetric performance of Kosovo Albanian refugees who have relocated to the United Kingdom and the aim of this study was to compare the obstetric performances of Kosovo Albanian women currently residing in the United Kingdom with their British-born Caucasian counterparts. Sixty-one index and 61 control cases were analysed; 63% of the Kosovo Albanian women spoke little or no English and 50% were on income support. Of the study group, 9.8% had caesarean sections, 8.2% had instrumental vaginal deliveries and 82% achieved normal deliveries. The Kosovo Albanian women were statistically younger and had shorter duration of labour compared to controls (P < 0.05, unpaired t-test). Epidural use was significantly lower in Kosovan women (P < 0.05, chi2 test). The rates of induction of labour (IOL), caesarean section, instrumental deliveries, premature delivery and low birth weight < 2.5 kg were not statistically different (P > 0.05 in all cases, chi2 test) between the two groups. This is the first study to examine the obstetric outcomes of Kosovo Albanian women who have resettled in a western European country. Most Kosovo Albanian refugees living in the United Kingdom are not socio-economic migrants but displaced due to civil unrest and many had reasonable socio-economic status prior to resettlement. The similarity in obstetric and fetal outcomes between the study and control groups could be attributed to the 'healthy immigrant effect', where immigrant groups appear to have better outcomes due to family support and relatively lower intake of alcohol and nicotine. It also suggests that obstetricians may be heeding the recommendations from recent Confidential Enquiry into Maternal Deaths, which highlight the need for increased vigilance in women from ethnic minorities.

Database structure for the Laser Accident and Incident Registry (LAIR)

NASA Astrophysics Data System (ADS)

Ness, James W.; Hoxie, Stephen W.; Zwick, Harry; Stuck, Bruce E.; Lund, David J.; Schmeisser, Elmar T.

1997-05-01

The ubiquity of laser radiation in military, medical, entertainment, telecommunications and research industries and the significant risk, of eye injury from this radiation are firmly established. While important advances have been made in understanding laser bioeffects using animal analogues and clinical data, the relationships among patient characteristics, exposure conditions, severity of the resulting injury, and visual function are fragmented, complex and varied. Although accident cases are minimized through laser safety regulations and control procedures, accumulated accident case information by the laser eye injury evaluation center warranted the development of a laser accident and incident registry. The registry includes clinical data for validating and refining hypotheses on injury and recovery mechanisms; a means for analyzing mechanisms unique to human injury; and a means for identifying future areas of investigation. The relational database supports three major sections: (1) the physics section defines exposure circumstances, (2) the clinical/ophthalmologic section includes fundus and scanning laser ophthalmoscope images, and (3) the visual functions section contains specialized visual function exam results. Tools are available for subject-matter experts to estimate parameters like total intraocular energy, ophthalmic lesion grade, and exposure probability. The database is research oriented to provide a means for generating empirical relationships to identify symptoms for definitive diagnosis and treatment of laser induced eye injuries.

Potential risk factors associated with human alveolar echinococcosis: Systematic review and meta-analysis.

PubMed

Conraths, Franz J; Probst, Carolina; Possenti, Alessia; Boufana, Belgees; Saulle, Rosella; La Torre, Giuseppe; Busani, Luca; Casulli, Adriano

2017-07-01

Human alveolar echinococcosis (AE) is a severe zoonotic disease caused by the metacestode stage of Echinococcus multilocularis. AE is commonly associated with a long incubation period that may last for more than ten years. The objective of this systematic literature review was to identify and summarize the current knowledge on statistically relevant potential risk factors (PRFs) associated with AE in humans. Six bibliographic databases were searched, generating a total of 1,009 publications. Following the removal of duplicate records and the exclusion of papers that failed to meet the criteria of a previously agreed a priori protocol, 23 publications were retained; however, 6 of these did not contain data in a format that allowed their inclusion in the meta-analysis. The remaining 17 publications (6 case-control and 11 cross-sectional studies) were meta-analysed to investigate associations between AE and PRFs. Pooled odds ratios (OR) were used as a measure of effect and separately analysed for case-control and cross-sectional studies. In the case-control studies, the following PRFs for human AE showed higher odds of outcome: "dog ownership", "cat ownership", "have a kitchen garden", "occupation: farmer", "haymaking in meadows not adjacent to water", "went to forests for vocational reasons", "chewed grass" and "hunting / handling foxes". In the cross-sectional studies, the following PRFs showed higher odds of outcome: "dog ownership", "play with dogs", "gender: female", "age over 20 years", "ethnic group: Tibetan", "low income", "source of drinking water other than well or tap", "occupation: herding" and "low education". Our meta-analysis confirmed that the chance of AE transmission through ingestion of food and water contaminated with E. multilocularis eggs exists, but showed also that food- and water-borne PRFs do not significantly increase the risk of infection. This systematic review analysed international peer-reviewed articles that have over the years contributed to our current understanding of the epidemiology of human AE. The identification of potential risk factors may help researchers and decision makers improve surveillance and/or preventive measures that aim at decreasing human infection with E. multilocularis. More primary studies are needed to confirm potential risk factors and their role in the epidemiology of human AE.

Safety of ceftriaxone in paediatrics: a systematic review protocol.

PubMed

Zeng, Linan; Choonara, Imti; Zhang, Lingli; Xue, Song; Chen, Zhe; He, Miaomiao

2017-08-21

Ceftriaxone is widely used in children in the treatment of sepsis. However, concerns have been raised about the safety of ceftriaxone, especially in young children. The aim of this review is to systematically evaluate the safety of ceftriaxone in children of all age groups. MEDLINE, PubMed, Cochrane Central Register of Controlled Trials, EMBASE, CINAHL, International Pharmaceutical Abstracts and adverse drug reaction (ADR) monitoring systems will be systematically searched for randomised controlled trials (RCTs), cohort studies, case-control studies, cross-sectional studies, case series and case reports evaluating the safety of ceftriaxone in children. The Cochrane risk of bias tool, Newcastle-Ottawa and quality assessment tools developed by the National Institutes of Health will be used for quality assessment. Meta-analysis of the incidence of ADRs from RCTs and prospective studies will be done. Subgroup analyses will be performed for age and dosage regimen. Formal ethical approval is not required as no primary data are collected. This systematic review will be disseminated through a peer-reviewed publication and at conference meetings. CRD42017055428. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Expression of CDK6 in Oral Squamous Cell Carcinomas

PubMed

Andisheh-Tadbir, Azadeh; Ashraf, Mohammad Javad; Jeiroodi, Naghmeh

2018-04-25

Background: CDK6 is the key factor in regulation of the cell cycle and essential for passage into the G1 phase. It also plays an important role in the development of various tumors. In this cross-sectional study expression of the CDK6 protein in oral squamous cell carcinoma (OSCC) and healthy oral mucosa of controls was assessed to determine relations with malignant transformation and clinicopathologic factors. Method: A total of 60 samples, 45 from OSCCs and 15 from healthy tissue, underwent immunohistochemistry for CDK6. Nuclear and cytoplasmic staining of keratinocytes was considered as positive and the percentages of positive cells were calculated. Results: Expression of CDK6 was detected in 55.6% of OSCC samples (25 cases) and 13.3% of controls (2 cases), the difference being significant. Mean percentage of CDK6 stained cells was 24.2±29.3 in the OSCC cases and 4.33±2.1 in the control group, again statistically significant. No relationship was detected between CDK6 expression and clinicopathologic factors. Conclusion: Overexpression of CDK6 observed in OSCC points to a role for this protein in oral carcinogenesis. Creative Commons Attribution License

Cranial pole nephrectomy in the pig model: anatomic analysis of arterial injuries in tridimensional endocasts.

PubMed

Pereira-Sampaio, Marco A; Henry, Robert W; Favorito, Luciano A; Sampaio, Francisco J B

2012-06-01

To assess the intrarenal arteries injuries after cranial pole nephrectomy in a pig model to compare these findings with those in humans. Polyester resin was injected through the ureter and the renal artery to make three-dimensional casts of 61 pig kidneys. The cranial pole of the kidneys was sectioned at four different sites before the solidification of the resin, and the casts were examined for arterial damage. Section performed through the hilus (15 kidneys): The cranial division of the renal artery was sectioned in two (13.33%) cases, the ventral branch of the cranial division of the renal artery was sectioned in 13 (86.7%) cases, and the dorsal branch of the cranial division of the renal artery was sectioned in 11 (73.34%) cases. Section at 0.5 cm cranial to the hilus (16 kidneys): The cranial division of the renal artery was sectioned in 1 (6.25%) case, the ventral branch of the cranial division of the renal artery was sectioned in 14 (87.5%) cases, and the dorsal branch of the cranial division of the renal artery was sectioned in 13 (81.25%) cases. Section at 1.0 cm cranial to the hilus (15 kidneys): The ventral branch of the cranial division of the renal artery was sectioned in five (33.33%) cases, and the dorsal branch of the cranial division of the renal artery was injured in five (33.33%) cases. Section at 1.5 cm cranial to the hilus (15 kidneys): No lesions were found in the main arteries, only in the interlobular branches. As previously demonstrated in humans, sections at 1.0 cm or more cranially to the hilus in pigs also showed a significant decrease in damage to the major intrarenal arteries. Therefore, as regards arterial damage, the pig kidney is a useful model for partial nephrectomy in the cranial (upper) pole.

Two different immunostaining patterns of beta-amyloid precursor protein (APP) may distinguish traumatic from nontraumatic axonal injury.

PubMed

Hayashi, Takahito; Ago, Kazutoshi; Nakamae, Takuma; Higo, Eri; Ogata, Mamoru

2015-09-01

Immunostaining for beta-amyloid precursor protein (APP) is recognized as an effective tool for detecting traumatic axonal injury, but it also detects axonal injury due to ischemic or other metabolic causes. Previously, we reported two different patterns of APP staining: labeled axons oriented along with white matter bundles (pattern 1) and labeled axons scattered irregularly (pattern 2) (Hayashi et al. (Leg Med (Tokyo) 11:S171-173, 2009). In this study, we investigated whether these two patterns are consistent with patterns of trauma and hypoxic brain damage, respectively. Sections of the corpus callosum from 44 cases of blunt head injury and equivalent control tissue were immunostained for APP. APP was detected in injured axons such as axonal bulbs and varicose axons in 24 of the 44 cases of head injuries that also survived for three or more hours after injury. In 21 of the 24 APP-positive cases, pattern 1 alone was observed in 14 cases, pattern 2 alone was not observed in any cases, and both patterns 1 and 2 were detected in 7 cases. APP-labeled injured axons were detected in 3 of the 44 control cases, all of which were pattern 2. These results suggest that pattern 1 indicates traumatic axonal injury, while pattern 2 results from hypoxic insult. These patterns may be useful to differentiate between traumatic and nontraumatic axonal injuries.

Association between parental myopia and the risk of myopia in a child

PubMed Central

ZHANG, XIAOYU; QU, XINHUA; ZHOU, XINGTAO

2015-01-01

The association between parental myopia and a child's risk of developing the condition is not well understood. Therefore, the present study conducted a meta-analysis of the results of observational studies in order to investigate the association between myopia in parents and their child's risk of developing the condition. The current study systematically examined the databases MEDLINE, Embase and Ovid for relevant studies. Two reviewers independently evaluated the data and extracted the odds ratios (ORs) and 95% confidence intervals (CIs) from the suitable studies. Heterogeneity, publication bias and subgroup analyses were performed. The present meta-analysis included 31,677 participants from 16 studies with 8,393 cases of myopia (six prospective cohort, eight cross-sectional and two case-control studies). The OR of giving birth to a child with myopia, according to the prospective cohort, cross-sectional and case-control studies, was 1.53 (95% CI, 1.21–1.85), 1.96 (95% CI, 1.53–2.39), and 2.13 (95% CI, 1.79–2.46), respectively, when one parent had myopia, and 2.10 (95% CI, 1.42–2.77), 2.96 (95% CI, 2.21–3.71), and 2.13 (95% CI, 1.79–2.46), respectively, when two parents had myopia. The current study identified a significant positive association between parental myopia and a child's risk of developing myopia. Children of two parents with myopia had a higher risk of developing myopia compared to those with one myopic parent. PMID:26136998

Non-obstetrical indications for cesarean section: a state-of-the-art review.

PubMed

Venturella, Roberta; Quaresima, Paola; Micieli, Mariella; Rania, Erika; Palumbo, Annarita; Visconti, Federica; Zullo, Fulvio; Di Carlo, Costantino

2018-07-01

To propose an evidence-based review on the most frequent indications for Cesarean section (CS) given by specialists in disciplines other than Obstetrics and Gynecology, with the aim of increasing consciousness about the available data in the literature and the guidelines recommendations about topics that are not frequently managed by obstetricians and gynecologists. We analyzed hospital discharge data regarding deliveries occurred in a 10-year study period in our department to obtain the prevalence and the list of the most recurrent non-obstetrical indications for CS. A search was performed in PubMed, the Cochrane Library, SCOPUS, Web of Science and Ovid MEDLINE and only studies published in English from 1950 to 2017 were included. For indications for which no systematic reviews existed, we included the best available evidence, including guidelines of non-obstetrics scientific societies or organizations, RCTs, non-randomized controlled clinical trials, case-control studies, cohort studies, and case series. The rising rate of CS registered in the recent years is not justified by reduction in maternal--fetal risk or perinatal outcomes and often reflects inappropriate clinical behaviour and a wrong tendency that assimilates CS as a defensive practice. In a relevant percentage of cases, the indication to CS is given by specialists in other disciplines, even when specific guidelines do not give clear recommendation about the route of delivery. To refuse non-obstetrical indications for CS, when scientific support is lacking, could be a useful and safe strategy to further reduce the rate of unnecessary CS.

Psoriasis and cardiometabolic traits: modest association but distinct genetic architectures

PubMed Central

Koch, Manja; Baurecht, Hansjörg; Ried, Janina S.; Rodriguez, Elke; Schlesinger, Sabrina; Volks, Natalie; Gieger, Christian; Rückert, Ina-Maria; Heinrich, Luise; Willenborg, Christina; Smith, Catherine; Peters, Annette; Thorand, Barbara; Koenig, Wolfgang; Lamina, Claudia; Jansen, Henning; Kronenberg, Florian; Seissler, Jochen; Thiery, Joachim; Rathmann, Wolfgang; Schunkert, Heribert; Erdmann, Jeanette; Barker, Jonathan; Nair, Rajan P; Tsoi, Lam C; Elder, James T; Mrowietz, Ulrich; Weichenthal, Michael; Mucha, Sören; Schreiber, Stefan; Franke, Andre; Schmitt, Jochen; Lieb, Wolfgang; Weidinger, Stephan

2015-01-01

Psoriasis has been linked to cardiometabolic diseases, but epidemiological findings are inconsistent. We investigated the association between psoriasis and cardiometabolic outcomes in a German cross-sectional study (n=4.185) and a prospective cohort of German Health Insurance beneficiaries (n=1.811.098). A potential genetic overlap was explored using genome-wide data from >22.000 coronary artery disease (CAD) and >4.000 psoriasis cases, and with a dense genotyping study of cardiometabolic risk loci on 927 psoriasis cases and 3.717 controls. Controlling for major confounders, in the cross-sectional analysis psoriasis was significantly associated with type 2 diabetes (T2D, adjusted odd’s ratio OR=2.36; 95% confidence interval CI=1.26–4.41) and myocardial infarction (MI, OR=2.26, 95% CI=1.03–4.96). In the longitudinal study, psoriasis slightly increased the risk for incident T2D (adjusted relative risk RR=1.11; 95%CI=1.08–1.14) and MI (RR=1.14; 95%CI=1.06–1.22), with highest risk increments in systemically treated psoriasis, which accounted for 11 and 17 excess cases of T2D and MI per 10,000 person-years. Except for weak signals from within the MHC, there was no evidence for genetic risk loci shared between psoriasis and cardiometabolic traits. Our findings suggest that psoriasis, in particular severe psoriasis, increases risk for T2D and MI, and that the genetic architecture of psoriasis and cardiometabolic traits is largely distinct. PMID:25599394

Levator Muscle Enlargement in Thyroid Eye Disease-Related Upper Eyelid Retraction.

PubMed

Davies, Michael J; Dolman, Peter J

To identify levator palpebrae superioris enlargement in thyroid eye disease (TED)-related upper eyelid retraction (ULR). Retrospective case-control. Subjects included 50 consecutive patients with unilateral thyroid eye disease-related ULR ≥ 2 mm and no previous eyelid surgery. The contralateral side was used as control. Clinical information was recorded from charts. CT scans were assessed by investigators blinded to the clinical data. A prediction of retracted side was made based on CT scan appearance and on basis of measured levator palpebrae superioris cross-sectional area at 2 defined points. Statistical analysis determined correlation between levator palpebrae superioris size and presence of ULR. The study was approved by the institutional ethics committee. Side with ULR predicted from CT scan review in over 85% of cases. Mean cross-sectional area of levator palpebrae superioris on retracted side was significantly larger than nonretracted side at 2 separate sites. Levator palpebrae superioris area was larger on retracted side compared with nonretracted side in over 85% of subjects. More than 30% of subjects had no enlargement of other extraocular muscles. Only 6% of patients had enlargement of the ipsilateral inferior rectus muscle. Levator palpebrae superioris enlargement from inflammation or scar is a factor in thyroid eye disease-related ULR. Upper eyelid retraction can be predicted from CT scan appearance in over 85% of cases. Ipsilateral inferior rectus enlargement is rare. Levator palpebrae superioris is the most commonly targeted muscle in thyroid eye disease.

A systematic review and meta-analyses on C-reactive protein in relation to periodontitis.

PubMed

Paraskevas, Spiros; Huizinga, John D; Loos, Bruno G

2008-04-01

Elevated plasma C-reactive protein (CRP) is regarded as a risk predictor for cardiovascular diseases. This systematic review explored the robustness of observations that CRP is elevated in periodontitis. Similarly, the effect of periodontal therapy on CRP levels was investigated. Selection of publications was based on: (1) cross-sectional (case-control) studies; (2) longitudinal (treatment) studies; (3) high-sensitivity CRP measurement; (4) median and/or mean (+/-SD) values presented; and (5) subjects with no systemic disorders. Screening of the initially 448 identified studies and reference checking resulted in 18 suitable papers. The majority of the studies showed that CRP levels are higher in patients than in controls. Often, studies showed that patients had CRP levels >2.1 mg/l. A meta-analysis of 10 cross-sectional studies showed that the weighted mean difference (WMD) of CRP between patients and controls was 1.56 mg/l (p<0.00001). Evidence from available treatment studies (n=6) showed lower levels of CRP after periodontal therapy. Eligible treatment studies in a meta-analysis demonstrated a WMD of reductions of CRP after therapy of 0.50 mg/L (95% CI 0.08-0.93) (p=0.02). There is strong evidence from cross-sectional studies that plasma CRP in periodontitis is elevated compared with controls. There is modest evidence on the effect of periodontal therapy in lowering the levels of CRP.

Reynolds-Averaged Navier-Stokes Simulation of a 2D Circulation Control Wind Tunnel Experiment

NASA Technical Reports Server (NTRS)

Allan, Brian G.; Jones, Greg; Lin, John C.

2011-01-01

Numerical simulations are performed using a Reynolds-averaged Navier-Stokes (RANS) flow solver for a circulation control airfoil. 2D and 3D simulation results are compared to a circulation control wind tunnel test conducted at the NASA Langley Basic Aerodynamics Research Tunnel (BART). The RANS simulations are compared to a low blowing case with a jet momentum coefficient, C(sub u), of 0:047 and a higher blowing case of 0.115. Three dimensional simulations of the model and tunnel walls show wall effects on the lift and airfoil surface pressures. These wall effects include a 4% decrease of the midspan sectional lift for the C(sub u) 0.115 blowing condition. Simulations comparing the performance of the Spalart Allmaras (SA) and Shear Stress Transport (SST) turbulence models are also made, showing the SST model compares best to the experimental data. A Rotational/Curvature Correction (RCC) to the turbulence model is also evaluated demonstrating an improvement in the CFD predictions.

Contaminated drinking water in one town manifesting as an outbreak of cryptosporidiosis in another.

PubMed

McAnulty, J M; Keene, W E; Leland, D; Hoesly, F; Hinds, B; Stevens, G; Fleming, D W

2000-08-01

In early 1992 we identified an outbreak of cryptosporidiosis in Oregon and sought to identify and control its source. We used a series of studies to identify risk factors for illness: (i) a case-control study among employees of a long-term-care facility (LTCF); (ii) a matched case-control study of the general community; (iii) a cohort study of wedding attendees; and (iv) a cross-sectional survey of the general community. Drinking Talent water was associated with illness in the LTCF (OR = 22.7, 95 % CI = 2.7-1009.0), and in the community (matched OR = 9.5, 95% CI 2.3-84.1). Drinking Talent water was associated with illness only among non-Talent residents who attended the wedding (P < 0.001) and in the community (RR = 6.5, 95 % CI 3.3-12.9). The outbreak was caused by contaminated municipal water from Talent in the absence of a discernible outbreak among Talent residents, suggesting persons exposed to contaminated water may develop immunity to cryptosporidiosis.

Generic health/safety/environment cases

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

Kelland, A.N.; Primrose, M.; Pickles, J.C.

1996-12-31

A desire to implement HSE Management Systems including HSE Cases in all Shell companies operations prompted the development of a relational data base software package (THESIS) to provide a structured way of preparing an HSE Case. The software includes features which facilitate the management of {open_quotes}Keeping the Case Alive{close_quotes}, enabling the dissemination of tasks and hazard information to the workplace. During the software development it was recognized that a significant reduction could be made in the resources which would be required to prepare an HSE Case for each and every operation by the building of {open_quotes}Generic HSE Cases{close_quotes} addressing specificmore » activities which were repeated across the Company`s operations. This was recognized to be particularly valid for the smaller Single String Venture type of operations. The activities selected for the initial Generic HSE Case development include Land Drilling Operations, Land Seismic Acquisition, and Land Transport. To establish the Generic HSE Case, the THESIS data base is populated with data for a generic operation, identifying all the hazards and activities associated with that operation including all the associated controls, with established formats for the textual sections. In effect, the Generic Case defines the standards required for that type of operation. To generate an operation specific HSE Case, the Generic Case thereafter requires to be modified/adapted so that it represents the actual situation in the operation which it defines. This process includes itemization of all the operation specific details, and may involve the inclusion/deletion of any additional/existing activities or hazards together with their associated controls.« less

Estimating the Counterfactual Impact of Conservation Programs on Land Cover Outcomes: The Role of Matching and Panel Regression Techniques

PubMed Central

Jones, Kelly W.; Lewis, David J.

2015-01-01

Deforestation and conversion of native habitats continues to be the leading driver of biodiversity and ecosystem service loss. A number of conservation policies and programs are implemented—from protected areas to payments for ecosystem services (PES)—to deter these losses. Currently, empirical evidence on whether these approaches stop or slow land cover change is lacking, but there is increasing interest in conducting rigorous, counterfactual impact evaluations, especially for many new conservation approaches, such as PES and REDD, which emphasize additionality. In addition, several new, globally available and free high-resolution remote sensing datasets have increased the ease of carrying out an impact evaluation on land cover change outcomes. While the number of conservation evaluations utilizing ‘matching’ to construct a valid control group is increasing, the majority of these studies use simple differences in means or linear cross-sectional regression to estimate the impact of the conservation program using this matched sample, with relatively few utilizing fixed effects panel methods—an alternative estimation method that relies on temporal variation in the data. In this paper we compare the advantages and limitations of (1) matching to construct the control group combined with differences in means and cross-sectional regression, which control for observable forms of bias in program evaluation, to (2) fixed effects panel methods, which control for observable and time-invariant unobservable forms of bias, with and without matching to create the control group. We then use these four approaches to estimate forest cover outcomes for two conservation programs: a PES program in Northeastern Ecuador and strict protected areas in European Russia. In the Russia case we find statistically significant differences across estimators—due to the presence of unobservable bias—that lead to differences in conclusions about effectiveness. The Ecuador case illustrates that if time-invariant unobservables are not present, matching combined with differences in means or cross-sectional regression leads to similar estimates of program effectiveness as matching combined with fixed effects panel regression. These results highlight the importance of considering observable and unobservable forms of bias and the methodological assumptions across estimators when designing an impact evaluation of conservation programs. PMID:26501964

Estimating the Counterfactual Impact of Conservation Programs on Land Cover Outcomes: The Role of Matching and Panel Regression Techniques.

PubMed

Jones, Kelly W; Lewis, David J

2015-01-01

Deforestation and conversion of native habitats continues to be the leading driver of biodiversity and ecosystem service loss. A number of conservation policies and programs are implemented--from protected areas to payments for ecosystem services (PES)--to deter these losses. Currently, empirical evidence on whether these approaches stop or slow land cover change is lacking, but there is increasing interest in conducting rigorous, counterfactual impact evaluations, especially for many new conservation approaches, such as PES and REDD, which emphasize additionality. In addition, several new, globally available and free high-resolution remote sensing datasets have increased the ease of carrying out an impact evaluation on land cover change outcomes. While the number of conservation evaluations utilizing 'matching' to construct a valid control group is increasing, the majority of these studies use simple differences in means or linear cross-sectional regression to estimate the impact of the conservation program using this matched sample, with relatively few utilizing fixed effects panel methods--an alternative estimation method that relies on temporal variation in the data. In this paper we compare the advantages and limitations of (1) matching to construct the control group combined with differences in means and cross-sectional regression, which control for observable forms of bias in program evaluation, to (2) fixed effects panel methods, which control for observable and time-invariant unobservable forms of bias, with and without matching to create the control group. We then use these four approaches to estimate forest cover outcomes for two conservation programs: a PES program in Northeastern Ecuador and strict protected areas in European Russia. In the Russia case we find statistically significant differences across estimators--due to the presence of unobservable bias--that lead to differences in conclusions about effectiveness. The Ecuador case illustrates that if time-invariant unobservables are not present, matching combined with differences in means or cross-sectional regression leads to similar estimates of program effectiveness as matching combined with fixed effects panel regression. These results highlight the importance of considering observable and unobservable forms of bias and the methodological assumptions across estimators when designing an impact evaluation of conservation programs.

Effectiveness of Vascular Markers (Immunohistochemical Stains) in Soft Tissue Sarcomas.

PubMed

Naeem, Namra; Mushtaq, Sajid; Akhter, Noreen; Hussain, Mudassar; Hassan, Usman

2018-05-01

To ascertain the effectiveness of IHC markers of vascular origin like CD31, CD34, FLI1 and ERG in vascular soft tissue sarcomas including angiosarcomas, Kaposi sarcomas, epithelioid hemangioendothelioma and a non-vascular soft tissue sarcoma (Epithelioid sarcoma). Descriptive study. Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, from 2011 to 2017. Diagnosed cases of angiosarcomas (n=48), epithelioid hemangioendothelioma (n=9), Kaposi sarcoma (n=9) and epithelioid sarcoma (n=20) were selected. Immunohistochemical staining as performed on formalin fixed paraffin embedded sections. The sections were stained for the following markers: CD34 (VENTANA clone Q Bend 10), CD31 (Leica clone 1 A 10), FLI1 (CELL MARQUE clone MRQ-1) and ERG (CELL MARQUE clone EP111). A complete panel of CD34, CD31 and ERG was applied on 8/48 cases of angiosarcomas with triple positivity in 6 cases. Eight cases showed positivity for only CD31 and ERG and 2 cases showed positivity for only ERG. A complete panel of CD34, CD31 and ERG was applied on 3/9 cases of epithelioid hemangioendothelioma with positivity for all markers in 2 cases. Combined positivity for ERG and CD34 was seen in 2 cases and on 4 cases only CD31 immunohistochemical was solely applied with 100% positivity. FLI1 was not applied on any case. Among 9 cases of Kaposi sarcoma, ERG, CD34 and CD31 in combination were applied on only 1 case with triple positivity. Remaining cases show positivity for either CD34, CD31 or FLI1. Majority of cases of epithelioid sarcomas were diagnosed on the basis of cytokeratin and CD34 positivity with loss of INI1. The other vascular markers showed negativity in all cases. Among these four markers, ERG immunohistochemical stain is highly effective for endothelial differentiation due to its specific nuclear staining pattern in normal blood vessel endothelial cells (internal control) as well as neoplastic cells of vascular tumors and lack of background staining.

The impact of mode of delivery on outcomes in patients with perianal Crohn's disease

PubMed Central

Cheng, Alice G; Oxford, Emily C; Sauk, Jenny; Nguyen, Deanna D; Yajnik, Vijay; Friedman, Sonia; Ananthakrishnan, Ashwin N

2014-01-01

Introduction Crohn's disease (CD) often affects women during the reproductive years. While several studies have examined the impact of pregnancy on luminal disease, limited literature exists in those with perianal CD. Decision regarding mode of delivery is a unique challenge in such patients due to concerns regarding the effect of pelvic floor trauma during delivery on pre-existing perianal involvement. Methods We performed a retrospective chart review of CD patients with established perianal disease undergoing either vaginal delivery or Caesarean section (C-section) at our institutions. We examined the occurrence of symptomatic perianal disease flares within 5 years after delivery in such women compared to non-pregnant CD controls. We also compared the occurrence of such flares between the two modes of delivery in women with established perianal CD. Results We identified 61 pregnant CD patients with established perianal disease (11 vaginal delivery, 50 via C-section) and 61 non-pregnant CD controls with perianal disease. One-third of the C-sections were primarily for obstetric indications. Six of the vaginal deliveries were complicated. Approximately 36% of cases had a symptomatic perianal flare within 1 year after delivery. This was similar across both modes of delivery (p=0.53), and similar to non-pregnant CD patients. There was no difference in the rates of perianal surgical intervention or luminal disease flares in our population based on mode of delivery, or between pregnant CD patients and non-pregnant CD controls. Conclusion We observed no difference in risk of symptomatic perianal flares in patients with established perianal CD delivering vaginally or via C-section. PMID:24918322

Recurrent Vulvovaginal Candidiasis: Could It Be Related to Cell-Mediated Immunity Defect in Response to Candida Antigen?

PubMed Central

Talaei, Zahra; Sheikhbahaei, Saba; Ostadi, Vajihe; Ganjalikhani Hakemi, Mazdak; Meidani, Mohsen; Naghshineh, Elham; Yaran, Majid; Naeini, Alireza Emami; Sherkat, Roya

2017-01-01

Background Recurrent vulvovaginal candidiasis (RVVC) is a common cause of morbidity affecting millions of women worldwide. Patients with RVVC are thought to have an underlying immunologic defect. This study has been established to evaluate cell-mediated immunity defect in response to candida antigen in RVVC cases. Materials and Methods Our cross-sectional study was performed in 3 groups of RVVC patients (cases), healthy individuals (control I) and known cases of chronic mucocutaneous candidiasis (CMC) (control II). Patients who met the inclusion criteria of RVVC were selected consecutively and were allocated in the case group. Peripheral blood mononuclear cells were isolated and labeled with CFSE and proliferation rate was measured in exposure to candida antigen via flow cytometry. Results T lymphocyte proliferation in response to candida was significantly lower in RVVC cases (n=24) and CMC patients (n=7) compared to healthy individuals (n=20, P<0.001), but no statistically significant difference was seen between cases and control II group (P>0.05). Family history of primary immunodeficiency diseases (PID) differed significantly among groups (P=0.01), RVVC patients has family history of PID more than control I (29.2 vs. 0%, P=0.008) but not statistically different from CMC patients (29.2 vs. 42.9%, P>0.05). Prevalence of atopy was greater in RVVC cases compared to healthy individuals (41.3 vs. 15%, P=0.054). Lymphoproliferative activity and vaginal symptoms were significantly different among RVVC cases with and without allergy (P=0.01, P=0.02). Conclusion Our findings revealed that T cells do not actively proliferate in response to Candida antigen in some RVVC cases. So it is concluded that patients with cell-mediated immunity defect are more susceptible to recurrent fungal infections of vulva and vagina. Nonetheless, some other cases of RVVC showed normal function of T cells. Further evaluations showed that these patients suffer from atopy. It is hypothesized that higher frequency of VVC in patients with history of atopy might be due to allergic response in mucocutaneous membranes rather than a functional impairment in immune system components. PMID:28868834

Generation of surface plasmons with compact devices

NASA Astrophysics Data System (ADS)

Baron, A.; Lalanne, P.; Gan, C. H.; Hugonin, J. P.

2013-03-01

We review the properties of the generation of surface plasmons by subwavelength isolated slits in metal films and by small ensembles of slits. After an introduction, in Section 2, we recall the theoretical modal formalism that allows us to calculate the generation efficiency of SPP from the total field scattered by an indentation on a metal film. We also rapidly discuss the main results known of the SPP generation efficiency by subwavelength tiny slits or grooves. In Section 3, we consider the special case of wavelength-large slits that support two propagative modes and that allow us to dynamically control the direction of generated surface plasmons. In Section 4, we conclude by describing a compact and efficient device capable of launching SPPs in a single direction with a normally incident beam.

Epidemiology of Organophosphate Poisoning in the Tshwane District of South Africa.

PubMed

Razwiedani, L L; Rautenbach, Pgd

2017-01-01

Organophosphate poisoning is a major public health problem in South Africa. Individuals get exposed to organophosphate in both the domestic and industrial spheres. A cross-sectional study was conducted using retrospective, secondary data of organophosphate poisoning cases over a 3-year period, reported at the Tshwane District surveillance office. Data were analysed using Microsoft Excel, and Epi Info version 7 was used for descriptive statistics. A total of 207 cases were reported with ages ranging from 10 months to 59 years. Most of the cases were men (58.9%). Intentional poisoning accounted for 51% of cases. Unintentional poisoning accounted for 21.7% of cases, and 26.5% of cases had unknown circumstances of poisoning. A significant number (50.2%) of intentional poisonings were suicide related. Nonsuicidal cases accounted for 47.4% of cases, and deliberate unlawful poisoning accounted for 2.4% of cases. The mortality rate for the whole group was 3.4%. Improvement in data collection on organophosphate poisoning is essential to properly measure the burden of the problem. More effective regulatory controls for pesticide use are needed in South Africa.

Has the DOTS Strategy Improved Case Finding or Treatment Success? An Empirical Assessment

PubMed Central

Obermeyer, Ziad; Abbott-Klafter, Jesse; Murray, Christopher J. L.

2008-01-01

Background Nearly fifteen years after the start of WHO's DOTS strategy, tuberculosis remains a major global health problem. Given the lack of empirical evidence that DOTS reduces tuberculosis burden, considerable debate has arisen about its place in the future of global tuberculosis control efforts. An independent evaluation of DOTS, one of the most widely-implemented and longest-running interventions in global health, is a prerequisite for meaningful improvements to tuberculosis control efforts, including WHO's new Stop TB Strategy. We investigate the impact of the expansion of the DOTS strategy on tuberculosis case finding and treatment success, using only empirical data. Methods and Findings We study the effect of DOTS using time-series cross-sectional methods. We first estimate the impact of DOTS expansion on case detection, using reported case notification data and controlling for other determinants of change in notifications, including HIV prevalence, GDP, and country-specific effects. We then estimate the effect of DOTS expansion on treatment success. DOTS programme variables had no statistically significant impact on case detection in a wide range of models and specifications. DOTS population coverage had a significant effect on overall treatment success rates, such that countries with full DOTS coverage benefit from at least an 18% increase in treatment success (95% CI: 5–31%). Conclusions The DOTS technical package improved overall treatment success. By contrast, DOTS expansion had no effect on case detection. This finding is less optimistic than previous analyses. Better epidemiological and programme data would facilitate future monitoring and evaluation efforts. PMID:18320042

Performance of Optimized Actuator and Sensor Arrays in an Active Noise Control System

NASA Technical Reports Server (NTRS)

Palumbo, D. L.; Padula, S. L.; Lyle, K. H.; Cline, J. H.; Cabell, R. H.

1996-01-01

Experiments have been conducted in NASA Langley's Acoustics and Dynamics Laboratory to determine the effectiveness of optimized actuator/sensor architectures and controller algorithms for active control of harmonic interior noise. Tests were conducted in a large scale fuselage model - a composite cylinder which simulates a commuter class aircraft fuselage with three sections of trim panel and a floor. Using an optimization technique based on the component transfer functions, combinations of 4 out of 8 piezoceramic actuators and 8 out of 462 microphone locations were evaluated against predicted performance. A combinatorial optimization technique called tabu search was employed to select the optimum transducer arrays. Three test frequencies represent the cases of a strong acoustic and strong structural response, a weak acoustic and strong structural response and a strong acoustic and weak structural response. Noise reduction was obtained using a Time Averaged/Gradient Descent (TAGD) controller. Results indicate that the optimization technique successfully predicted best and worst case performance. An enhancement of the TAGD control algorithm was also evaluated. The principal components of the actuator/sensor transfer functions were used in the PC-TAGD controller. The principal components are shown to be independent of each other while providing control as effective as the standard TAGD.

Fiber-type susceptibility to eccentric contraction-induced damage of hindlimb-unloaded rat AL muscles

NASA Technical Reports Server (NTRS)

Vijayan, K.; Thompson, J. L.; Norenberg, K. M.; Fitts, R. H.; Riley, D. A.

2001-01-01

Slow oxidative (SO) fibers of the adductor longus (AL) were predominantly damaged during voluntary reloading of hindlimb unloaded (HU) rats and appeared explainable by preferential SO fiber recruitment. The present study assessed damage after eliminating the variable of voluntary recruitment by tetanically activating all fibers in situ through the motor nerve while applying eccentric (lengthening) or isometric contractions. Muscles were aldehyde fixed and resin embedded, and semithin sections were cut. Sarcomere lesions were quantified in toluidine blue-stained sections. Fibers were typed in serial sections immunostained with antifast myosin and antitotal myosin (which highlights slow fibers). Both isometric and eccentric paradigms caused fatigue. Lesions occurred only in eccentrically contracted control and HU muscles. Fatigue did not cause lesions. HU increased damage because lesioned- fiber percentages within fiber types and lesion sizes were greater than control. Fast oxidative glycolytic (FOG) fibers were predominantly damaged. In no case did damaged SO fibers predominate. Thus, when FOG, SO, and hybrid fibers are actively lengthened in chronically unloaded muscle, FOG fibers are intrinsically more susceptible to damage than SO fibers. Damaged hybrid-fiber proportions ranged between these extremes.

[Present and prospects of telepathology].

PubMed

Takahashi, M; Mernyei, M; Shibuya, C; Toshima, S

1999-01-01

Nearly ten years have passed since telepathology was introduced and real-time pathology consultations were conducted. Long distance consultations in pathology, cytology, computed tomography and magnetic resonance imaging, which are referred to as telemedicine, clearly enhance the level of medical care in remote hospitals where no full-time specialists are employed. To transmit intraoperative frozen section images, we developed a unique hybrid system "Hi-SPEED". The imaging view through the CCD camera is controlled by a camera controller that provides NTSC composite video output for low resolution motion pictures and high resolution digital output for final interpretation on computer display. The results of intraoperative frozen section diagnosis between the Gihoku General Hospital 410 km from SRL showed a sensitivity of 97.6% for 82 cases of breast carcinoma and a false positive rate of 1.2%. This system can be used for second opinions as well as for consultations between cytologists and cytotechnologists.

A Comprehensive Prediction Model of Hydraulic Extended-Reach Limit Considering the Allowable Range of Drilling Fluid Flow Rate in Horizontal Drilling.

PubMed

Li, Xin; Gao, Deli; Chen, Xuyue

2017-06-08

Hydraulic extended-reach limit (HERL) model of horizontal extended-reach well (ERW) can predict the maximum measured depth (MMD) of the horizontal ERW. The HERL refers to the well's MMD when drilling fluid cannot be normally circulated by drilling pump. Previous model analyzed the following two constraint conditions, drilling pump rated pressure and rated power. However, effects of the allowable range of drilling fluid flow rate (Q min  ≤ Q ≤ Q max ) were not considered. In this study, three cases of HERL model are proposed according to the relationship between allowable range of drilling fluid flow rate and rated flow rate of drilling pump (Q r ). A horizontal ERW is analyzed to predict its HERL, especially its horizontal-section limit (L h ). Results show that when Q min  ≤ Q r  ≤ Q max (Case I), L h depends both on horizontal-section limit based on rated pump pressure (L h1 ) and horizontal-section limit based on rated pump power (L h2 ); when Q min  < Q max  < Q r (Case II), L h is exclusively controlled by L h1 ; while L h is only determined by L h2 when Q r  < Q min  < Q max (Case III). Furthermore, L h1 first increases and then decreases with the increase in drilling fluid flow rate, while L h2 keeps decreasing as the drilling fluid flow rate increases. The comprehensive model provides a more accurate prediction on HERL.

ADAPTIVE CLEARANCE CONTROL SYSTEMS FOR TURBINE ENGINES

NASA Technical Reports Server (NTRS)

Blackwell, Keith M.

2004-01-01

The Controls and Dynamics Technology Branch at NASA Glenn Research Center primarily deals in developing controls, dynamic models, and health management technologies for air and space propulsion systems. During the summer of 2004 I was granted the privilege of working alongside professionals who were developing an active clearance control system for commercial jet engines. Clearance, the gap between the turbine blade tip and the encompassing shroud, increases as a result of wear mechanisms and rubbing of the turbine blades on shroud. Increases in clearance cause larger specific fuel consumption (SFC) and loss of efficient air flow. This occurs because, as clearances increase, the engine must run hotter and bum more fuel to achieve the same thrust. In order to maintain efficiency, reduce fuel bum, and reduce exhaust gas temperature (EGT), the clearance must be accurately controlled to gap sizes no greater than a few hundredths of an inch. To address this problem, NASA Glenn researchers have developed a basic control system with actuators and sensors on each section of the shroud. Instead of having a large uniform metal casing, there would be sections of the shroud with individual sensors attached internally that would move slightly to reform and maintain clearance. The proposed method would ultimately save the airline industry millions of dollars.

Influence of the 2009 financial crisis on detection of advanced pulmonary tuberculosis in Osaka city, Japan: a cross-sectional study.

PubMed

Danno, Katsura; Komukai, Jun; Yoshida, Hideki; Matsumoto, Kenji; Koda, Shinichi; Terakawa, Kazuhiko; Iso, Hiroyasu

2013-01-01

To investigate the association between the economic recession and the detection of advanced cases of pulmonary tuberculosis in Osaka city from 2007 to 2009. A repeated cross-sectional study. Osaka city has been the highest tuberculosis burden area in Japan. After the previous global financial crisis, the unemployment rate in Osaka prefecture has deteriorated from 5.3% in 2008 to 6.6% in 2009. During the study period, 3406 pulmonary tuberculosis cases were enrolled: 2530 males and 876 females; 1546 elderly cases (65 years and above) and 1860 young cases (under 65 years); 417 homeless cases and 2989 non-homeless cases. Patients' information included the sex, age, registry, health insurances, places of detection, sputum smear test results, patients' delay, doctors' delay and the grade of chest x-ray findings. They were statistically analysed between 2007 and 2008, two years before and just before the financial crisis, and between 2008 and 2009, just before and after the financial crisis. The total numbers of pulmonary tuberculosis cases were 1172 in 2007, 1083 in 2008 and 1151 in 2009. In health examinations for non-homeless people, higher number of cases in 2009 were sputum smear positive, had respiratory symptoms and showed advanced disease in chest x-rays than those in 2008, with a longer patients' delay. On the contrary, in health examination for homeless people, fewer cases of advanced pulmonary tuberculosis were found in 2009 than in 2008, with a shorter patients' delay. In clinical examinations, there was no trend towards a difference between non-homeless and homeless people. Although homeless people might be protected by public assistance, tuberculosis prevention and control need to be reinforced for the non-homeless population after the financial crisis.

Social phobia and other psychiatric problems in children with strabismus.

PubMed

Cumurcu, Tongabay; Cumurcu, Birgul Elbozan; Ozcan, Ozlem; Demirel, Soner; Duz, Cem; Porgalı, Esra; Doganay, Selim

2011-06-01

To investigate the rate of social phobia, anxiety, depression, and other psychiatric problems in children with strabismus. Prospective, cross-sectional, case-control study. Forty-two children with strabismus and 47 control subjects 8-13 years of age were enrolled in this study. After the ophthalmologist's examination, all cases were assessed by a psychiatrist based on the structured interview technique of Schedule for Affective Disorders and Schizophrenia for School-Aged Children-Present and Lifetime Version (Kiddie-SADS-PL). The Screen for Child Anxiety Related Emotional Disorders (SCARED) was administered to each subject to evaluate social phobia. All participants completed the Children's Depression Inventory (CDI). Age as well as sex and income were comparable between the strabismus patients and control groups. Social phobia was diagnosed in 8 (19.04%) of the 42 strabismic children and in 1 (2.12%) of the control subjects. The CDI and SCARED (total score, social phobia, separation anxiety) scores of strabismus patients were significantly higher than the control group (p = 0.001, p = 0.004, p = 0.0001, p = 0.05, respectively). A relationship between strabismus in children and social phobia, depression, and anxiety on a symptom basis was underlined by our data. Copyright © 2011. Published by Elsevier Inc.

Pragmatic communication is impaired in Parkinson disease.

PubMed

Hall, Deborah; Ouyang, Bichun; Lonnquist, Eryn; Newcombe, Jill

2011-05-01

The purpose of this study was to determine whether severity of disease, cognitive function, age, gender, or amount of social interaction were associated with pragmatic dysfunction in Parkinson disease. No studies have previously been done to investigate variables that may be associated with pragmatic dysfunction in Parkinson disease. A case-control study was conducted with 17 Parkinson disease patients and 17 convenience controls. Each Parkinson disease patient and a control were interviewed, and their pragmatic skills were evaluated using a scale of pragmatic communication skills. Correlation analysis was used to determine what factors were associated with pragmatic dysfunction in the Parkinson disease patients. Cases scored lower on the pragmatic scale with a mean of 29.7 compared with 38.9 in the controls (p < .001) out of 40 possible points. The score on the scale of pragmatic communication skills had moderate to strong correlations with the MMSE (r = .81, p = .002), Unified Parkinson's Disease Rating Scale score (r = -.71, p = .002), and duration of disease (r = -.53, p = .03). These results show that Parkinson disease patients have impaired pragmatic function compared with controls on both verbal and nonverbal sections, and this impairment correlates with mental state, duration, and severity of disease.

Manual Of The Judge Advocate General (Jagman)

DTIC Science & Technology

2004-03-15

1114, MCM, and section 0155. ( 2 ) Companion cases tried separately. In court- martial cases where the separate trial of a companion case is...under escort in cases of deliv- ery in accordance with section 0613) to a naval or Marine Corps activity as set forth in the agreement; ( 2 ) the...command not permit service, see section 0616e. ( 2 ) Out-of-state process. In those cases where the process is to be served by authority of a

Formation and Control of Fluidic Species

NASA Technical Reports Server (NTRS)

Link, Darren Roy (Inventor); Marquez-Sanchez, Manuel (Inventor); Cheng, Zhengdong (Inventor); Weitz, David A. (Inventor)

2015-01-01

This invention generally relates to systems and methods for the formation and/or control of fluidic species, and articles produced by such systems and methods. In some cases, the invention involves unique fluid channels, systems, controls, and/or restrictions, and combinations thereof. In certain embodiments, the invention allows fluidic streams (which can be continuous or discontinuous, i.e., droplets) to be formed and/or combined, at a variety of scales, including microfluidic scales. In one set of embodiments, a fluidic stream may be produced from a channel, where a cross-sectional dimension of the fluidic stream is smaller than that of the channel, for example, through the use of structural elements, other fluids, and/or applied external fields, etc. In some cases, a Taylor cone may be produced. In another set of embodiments, a fluidic stream may be manipulated in some fashion, for example, to create tubes (which may be hollow or solid), droplets, nested tubes or droplets, arrays of tubes or droplets, meshes of tubes, etc. In some cases, droplets produced using certain embodiments of the invention may be charged or substantially charged, which may allow their further manipulation, for instance, using applied external fields. Non-limiting examples of such manipulations include producing charged droplets, coalescing droplets (especially at the microscale), synchronizing droplet formation, aligning molecules within the droplet, etc. In some cases, the droplets and/or the fluidic streams may include colloids, cells, therapeutic agents, and the like.

Chronic coffee consumption and respiratory disease: A systematic review.

PubMed

Alfaro, Tiago M; Monteiro, Rita A; Cunha, Rodrigo A; Cordeiro, Carlos Robalo

2018-03-01

The widespread consumption of coffee means that any biological effects from its use can lead to significant public health consequences. Chronic pulmonary diseases are extremely prevalent and responsible for one of every six deaths on a global level. Major medical databases for studies reporting on the effects of coffee or caffeine consumption on a wide range of non-malignant respiratory outcomes, including incidence, prevalence, evolution or severity of respiratory disease in adults were searched. Studies on lung function and respiratory mortality were also considered. Fifteen studies, including seven cohort, six cross-sectional, one case control and one randomized control trial were found. Coffee consumption was generally associated with a reduction in prevalence of asthma. The association of coffee with natural honey was an effective treatment for persistent post-infectious cough. One case-control study found higher risk of chronic obstructive pulmonary disease (COPD) with coffee consumption. No association was found with the evolution of COPD or sarcoidosis. Coffee was associated with a reduction in respiratory mortality, and one study found improved lung function in coffee consumers. Smoking was a significant confounder in most studies. Coffee consumption was associated with some positive effects on the respiratory system. There was however limited available evidence, mostly from cross sectional and retrospective studies. The only prospective cohort studies were those reporting on respiratory mortality. These results suggest that coffee consumption may be a part of a healthy lifestyle leading to reduced respiratory morbidity. © 2017 John Wiley & Sons Ltd.

Health-related quality of life among long-term rectal cancer survivors with an ostomy: manifestations by sex.

PubMed

Krouse, Robert S; Herrinton, Lisa J; Grant, Marcia; Wendel, Christopher S; Green, Sylvan B; Mohler, M Jane; Baldwin, Carol M; McMullen, Carmit K; Rawl, Susan M; Matayoshi, Eric; Coons, Stephen Joel; Hornbrook, Mark C

2009-10-01

Intestinal stomas can pose significant challenges for long-term (> or = 5 years) rectal cancer (RC) survivors. Specifying common challenges and sociodemographic or clinical differences will further the development of tailored interventions to improve health-related quality of life (HRQOL). This was a matched cross-sectional study of long-term RC survivors conducted in three Kaiser Permanente regions. The mailed questionnaire included the modified City of Hope Quality of Life-Ostomy (mCOH-QOL-Ostomy) and Medical Outcomes Study 36-Item Short-Form Health Survey, version 2 (SF-36v2). Groups surveyed were permanent ostomates (cases) and those who did not require an ostomy (controls). RC survivors were matched on sex, age, and time since diagnosis. Comparisons between groups used regression analysis with adjustment for age, comorbidity score, history of radiation therapy, income, and work status. Response rate was 54% (491 of 909). Cases and controls had similar demographic characteristics. On the basis of the mCOH-QOL-Ostomy, both male and female cases had significantly worse social well-being compared with controls, while only female cases reported significantly worse overall HRQOL and psychological well-being. For younger females (< age 75 years), ostomy had a greater impact on physical well-being compared with older females. Based on the SF-36v2, statistically significant and meaningful differences between female cases and controls were observed for seven of the eight scales and on the physical and mental component summary scores. Men and women report a different profile of challenges, suggesting the need for targeted or sex-specific interventions to improve HRQOL in this population. This may include focus on physical HRQOL for female ostomy survivors younger than age 75.

Health-Related Quality of Life Among Long-Term Rectal Cancer Survivors With an Ostomy: Manifestations by Sex

PubMed Central

Krouse, Robert S.; Herrinton, Lisa J.; Grant, Marcia; Wendel, Christopher S.; Green, Sylvan B.; Mohler, M. Jane; Baldwin, Carol M.; McMullen, Carmit K.; Rawl, Susan M.; Matayoshi, Eric; Coons, Stephen Joel; Hornbrook, Mark C.

2009-01-01

Purpose Intestinal stomas can pose significant challenges for long-term (≥ 5 years) rectal cancer (RC) survivors. Specifying common challenges and sociodemographic or clinical differences will further the development of tailored interventions to improve health-related quality of life (HRQOL). Patients and Methods This was a matched cross-sectional study of long-term RC survivors conducted in three Kaiser Permanente regions. The mailed questionnaire included the modified City of Hope Quality of Life-Ostomy (mCOH-QOL-Ostomy) and Medical Outcomes Study 36-Item Short-Form Health Survey, version 2 (SF-36v2). Groups surveyed were permanent ostomates (cases) and those who did not require an ostomy (controls). RC survivors were matched on sex, age, and time since diagnosis. Comparisons between groups used regression analysis with adjustment for age, comorbidity score, history of radiation therapy, income, and work status. Results Response rate was 54% (491 of 909). Cases and controls had similar demographic characteristics. On the basis of the mCOH-QOL-Ostomy, both male and female cases had significantly worse social well-being compared with controls, while only female cases reported significantly worse overall HRQOL and psychological well-being. For younger females (< age 75 years), ostomy had a greater impact on physical well-being compared with older females. Based on the SF-36v2, statistically significant and meaningful differences between female cases and controls were observed for seven of the eight scales and on the physical and mental component summary scores. Conclusion Men and women report a different profile of challenges, suggesting the need for targeted or sex-specific interventions to improve HRQOL in this population. This may include focus on physical HRQOL for female ostomy survivors younger than age 75. PMID:19720920

Isolated diastolic hypertension associated risk factors among Chinese in Anhui Province, China.

PubMed

Wang, Yanchun; Xing, Fengjun; Liu, Rongjuan; Liu, Li; Zhu, Yu; Wen, Yufeng; Sun, Wenjie; Song, Ziwei

2015-04-22

To explore potential risk factors of isolated diastolic hypertension (IDH) among young and middle-aged Chinese. A community-based cross-sectional study was conducted among 338 subjects, aged 25 years and above, using random sampling technique. There were 68 cases of IDH, 46 cases of isolated systolic hypertension (ISH), 89 cases of systolic and diastolic hypertension (SDH), and 135 of subjects with normal blood pressure. Cases and controls were matched on sex by frequency matching. Demographic characteristics, blood pressure and other relevant information were collected. Compared with controls, patients with IDH and ISH had significant higher level of triglyceride, high density lipoprotein, blood glucose and body mass index (BMI) (p < 0.05); while patients with SDH had significantly higher level of total cholesterol, triglyceride, glucose and BMI (p < 0.05). Linear mixed effects model showed that drinking tea, family history of hypertension (FHH), higher blood glucose, triglyceride and low density lipoprotein were related with elevated diastolic blood pressure (DBP) (p < 0.01); HFH, blood glucose, creatinine and BMI have positive effect on systolic blood pressure (SBP) (p < 0.05). Drinking tea, FHH, high levels of triglyceride, high density lipoprotein, blood glucose and BMI are associated with IDH among young and middle-aged Chinese.

Cross-border-assisted reproduction: a qualitative account of UK travellers' experiences.

PubMed

Hudson, Nicky; Culley, Lorraine; Blyth, Eric; Norton, Wendy; Pacey, Allan; Rapport, Frances

2016-06-01

Surveys on patients' experiences of cross-border fertility treatment have reported a range of positive and challenging features. However, the number of such studies is limited, and there is no detailed qualitative account of the experiences of UK patients who travel overseas for fertility treatment. The present study used a cross-sectional, qualitative design and in-depth interviews. Fifty-one participants (41 women and 10 men, representing 41 treatment 'cases') participated in semi-structured interviews. The experiences reported were broadly positive with a large proportion of participants (39 cases, 95%) citing a favourable overall experience with only two cases (5%) reporting a more negative experience. Thematic analysis revealed 6 major categories and 20 sub-categories, which described the positive and challenging aspects of cross-border fertility travel. The positive aspects were represented by the categories: 'access', 'control' and 'care and respect'. The more challenging aspects were categorized as 'logistics and coordination of care', 'uncertainty' and 'cultural dissonance'. The study confirms findings from others that despite some challenges, there is a relatively high level of patient satisfaction with cross-border treatment with participants able to extend the boundaries of their fertility-seeking trajectories and in some cases, regain a sense of control over their treatment.

Tea consumption may decrease the risk of osteoporosis: an updated meta-analysis of observational studies.

PubMed

Guo, Ming; Qu, Hua; Xu, Lin; Shi, Da-Zhuo

2017-06-01

Several epidemiological investigations have evaluated the correlation between tea consumption and risk of osteoporosis, but the results are inconsistent. Therefore, we conducted an updated meta-analysis of observational studies to assess this association. We searched for all relevant studies including cohort, cross-sectional, and case-control studies published from database inception to July 15, 2016, using MEDLINE EMBASE, and Cochrane Library. Polled odds ratios (ORs) were calculated using the random-effect model. Fourteen articles (16 studies) that examined 138523 patients were included in this meta-analysis. Seven studies concerning bone mineral density (BMD) showed an increase in BMD with tea consumption, including 4 cross-sectional studies (OR, 0.04, 95% confidence interval [CI], 0.01-0.08) and 3 cohort studies (OR, 0.01; 95% CI, 0.01-0.01). The remaining 9 studies concerning fracture, including 6 case-control studies and 3 cohort studies, showed no association between tea consumption and osteoporotic fracture (OR, 0.86; 95% CI, 0.74-1.01). This updated meta-analysis demonstrates that tea consumption could increase BMD, but the association with osteoporotic fracture requires further investigation. Together, the results highlight the need for future, high-quality-designed clinical trials on tea consumption and osteoporosis. Copyright © 2017 Elsevier Inc. All rights reserved.

Persian adaptation of a questionnaire of environmental risk factors in multiple sclerosis (EnvIMS-Q).

PubMed

Sahraian, Mohammad Ali; Naghshineh, Hoda; Shati, Mohsen; Jahromi, Soodeh Razeghi; Rezaei, Niloofar

2016-11-01

It seems that gene-environment interaction play most important role in Multiple Sclerosis development. Increasing the incidence and prevalence of MS during the recent decades in the low prevalence area such as Iran is explained better by environment factors. Environmental Risk Factors in Multiple Sclerosis (the 'EnvIMS-Q') is a 6-page self-administered questionnaire for case control studies. the objectives of study are validation and adaptation of the EnvIMS-Q' then development of a Persian version for case control studies in Persian population. This questionnaire translated literally and in culturally relevant form, then content validation process was done by three groups' experts. According to giving rating to each item, each section and the whole instrument, we calculated their content validation indexes and also added some new questions and a new section to EnvIMS-Q. Finally, we analyzed repeatability of the answers within a 4 weeks interval. Relevancy and clarity indexes of all items were more than 80%. Scale relevancy index equaled 99% and scale clarity index equaled 97%. Repeatability of most items was acceptable. the use of standardized validated questionnaires will assist the researchers to perform local studies on the role of environmental factors on the basis of reliable data. Copyright © 2016 Elsevier B.V. All rights reserved.

Cost-Effectiveness Analysis of Three Leprosy Case Detection Methods in Northern Nigeria

PubMed Central

Ezenduka, Charles; Post, Erik; John, Steven; Suraj, Abdulkarim; Namadi, Abdulahi; Onwujekwe, Obinna

2012-01-01

Background Despite several leprosy control measures in Nigeria, child proportion and disability grade 2 cases remain high while new cases have not significantly reduced, suggesting continuous spread of the disease. Hence, there is the need to review detection methods to enhance identification of early cases for effective control and prevention of permanent disability. This study evaluated the cost-effectiveness of three leprosy case detection methods in Northern Nigeria to identify the most cost-effective approach for detection of leprosy. Methods A cross-sectional study was carried out to evaluate the additional benefits of using several case detection methods in addition to routine practice in two north-eastern states of Nigeria. Primary and secondary data were collected from routine practice records and the Nigerian Tuberculosis and Leprosy Control Programme of 2009. The methods evaluated were Rapid Village Survey (RVS), Household Contact Examination (HCE) and Traditional Healers incentive method (TH). Effectiveness was measured as number of new leprosy cases detected and cost-effectiveness was expressed as cost per case detected. Costs were measured from both providers' and patients' perspectives. Additional costs and effects of each method were estimated by comparing each method against routine practise and expressed as incremental cost-effectiveness ratio (ICER). All costs were converted to the U.S. dollar at the 2010 exchange rate. Univariate sensitivity analysis was used to evaluate uncertainties around the ICER. Results The ICER for HCE was $142 per additional case detected at all contact levels and it was the most cost-effective method. At ICER of $194 per additional case detected, THs method detected more cases at a lower cost than the RVS, which was not cost-effective at $313 per additional case detected. Sensitivity analysis showed that varying the proportion of shared costs and subsistent wage for valuing unpaid time did not significantly change the results. Conclusion Complementing routine practice with household contact examination is the most cost-effective approach to identify new leprosy cases and we recommend that, depending on acceptability and feasibility, this intervention is introduced for improved case detection in Northern Nigeria. PMID:23029580

Uncomplicated Caesarean section: is prolonged hospital stay necessary?

PubMed

Fasubaa, O B; Ogunniyi, S O; Dare, F O; Isawumi, A I; Ezechi, O C; Orji, E O

2000-08-01

Caesarean section among the Yoruba of western Nigerian is surrounded by a lot of fears, miseries, aversion, guilt and misconceptions for reasons varying from the desire by women to have a natural vaginal birth, fear of surgery, morbidity and deaths from the operation and prolonged hospital stay. To examine issues of reduced hospital stay following Caesarean section with a view of making the operation more acceptable and proffering solution to some of the problems faced by women when Caesarean section is indicated. A prospective case control study. Wesley Guild Hospital, Ilesha, Nigeria from 1st July, 1997 to 30th June, 1998. One hundred consecutive patients who had uncomplicated Caesarean section, randomised into two groups of short (three days) and prolonged (seven to eight days) hospital stay respectively. Observations of patients in both groups were made by an independent observer on day seven post-operation and the main outcomes measured included: wound infection rates, ability to maintain erect posture, mood changes, neonatal sepsis rate, immunisation rate of the neonates and average hospital bills. The findings revealed that wound infection rates of six per cent and ten per cent among the short and prolonged hospitalised patients respectively are not significantly different. Patients with short stay have better erect posture, lower incidence of depressive mood, lower neonatal sepsis rate, lower hospital bill and are more satisfied with early home discharge. Embracing the concept of early home discharge after Caesarean section in uncomplicated cases may remove some of the psychological upsets and economical impediments associated with the operation and make the operation more acceptable.

Calculation of two dimensional vortex/surface interference using panel methods

NASA Technical Reports Server (NTRS)

Maskew, B.

1980-01-01

The application of panel methods to the calculation of vortex/surface interference characteristics in two dimensional flow was studied over a range of situations starting with the simple case of a vortex above a plane and proceeding to the case of vortex separation from a prescribed point on a thick section. Low order and high order panel methods were examined, but the main factor influencing the accuracy of the solution was the distance between control stations in relation to the height of the vortex above the surface. Improvements over the basic solutions were demonstrated using a technique based on subpanels and an applied doublet distribution.

[Adolescent pregnancy: epidemiological perspectives].

PubMed

1985-01-01

A specialized obstetrical section for single adolescent mothers was created at a University of Chile hospital to test the hypothesis that adequate and appropriate medical care could improve the outcome for adolescent mothers and their infants. The team consisted of an obstetrician-gynecologist, a pediatrician, a psychologist, a midwife, a nurse, a social worker, and a nurse's aide. A nutritionist and a psychiatrist were later added. Between November 1981-March 1985, 610 pregnancies were followed and 490 deliveries were attended. The psychosocial characteristics of the 1st 300 adolescents were studied, the obstetrical and preinatal outcomes of the 1st 200 deliveries were compared with those of 200 deliveries of adolescents not participating in the prenatal program but delivering at the same hospital, and a 2nd control group of 100 single primaparas was used to compare maternal morbidity and mortality and neonatal pathology. 11.6% were aged 11-14, 32.7% were 15-16, 30.3% were 17, and the remainder were 18 or 19. 5% of the fathers were under 15, 33.3% were 15-19, and the rest were 20 or above. The father's age and other characteristics were unknown in 6 pregnancies resulting from rape. 1.3% of the mothers had no education, 67% had some basic education, and 31.7% had a middle level or higher. Of the adolescent mothers and the fathers respectively, 50.3% and 23.0% were students, 17.0% and 26.3% had stable employment, 32.7% and 12.0% had no economic activity, and 32.0% of fathers were subemployed. Only 35.7% of the adolescents mothers lived in stable family environments. 94.7% of the adolescents had negative attitudes on learning of their pregnancies, but 79.7% had positive attitudes when they began receiving prenatal care. 89.7% of the 213 legitimate adolescent mothers but only 64.4% of the 87 illegitimate mothers had positive attitudes toward their pregnancies at the end of the prenatal period. Cases were younger than either group of controls, with 27.0% of cases and 58.9% and 64% of controls aged 18-19. 58.1% of the 1st control group was married. 67.5% of cases but 53% of controls had some form of maternal morbidity, with morbidity more frequent at lower ages. The frequency of spontaneous deliveries increased with age for both cases and controls. Controls had more low Apgar scores of 1-4, especially at the youngest maternal ages. There was no difference between cases and controls in proportions of newborns weighing under 2500 g, but more babies of cases weighed 3501 g or more. The frequency of congenital malformations was slightly greater among cases, especially those under 15, but respiratory difficulties and asphyxia were less frequent in cases. Neonatal morbidity and mortality rates were significantly lower among cases. Overall maternal factors during pregnancy did not differ greatly between cases and controls, but among cases there was better secondary prevention due to early diagnosis of maternal morbidity, and the outcome for infants of study subjects was better than for those of controls.

HYPERTHYROIDISM AND HYPERPROLACTINEMIA: IS THERE ANY ASSOCIATION?

PubMed

Sanjari, Mojgan; Safi, Zohreh; Tahroodi, Khatereh Mohammadi

2016-12-01

To compare the serum prolactin level in hyperthyroid and normal control females. Hyperthyroidism is a common disease. Although a direct association has been demonstrated between hypothyroidism and increased prolactin levels, this association has not been established for hyperthyroidism. Cross-sectional study in cases and control groups. Control subjects were chosen from those participating in the Kerman Coronary Artery Disease Risk Factors study. To select the cases, all women referred to the laboratories of Kerman with a thyroid-stimulating hormone (TSH) level ≤0.5 mIU/L who met the inclusion criteria were entered in the study. A total of 231 women aged 15 to 50 years were enrolled. The case group included 71 hyperthyroid women, and the control group included 160 women with normal thyroid function matched by age. The mean (SD) serum level of prolactin was 16.56 (0.97) ng/mL (95% confidence interval [CI], 15.41 ng/mL to 15.71 ng/mL) in the controls and 23.07 (1.49) ng/mL (95% CI, 22.7 ng/mL to 23.4 ng/mL) in the case subjects. Hyperprolactinemia was more common in the hyperthyroid group (16.5 [0.97] ng/mL versus 23.07 [1.49] ng/mL; P<.001). The prolactin level decreased with age. Hyperthyroidism and estradiol increased the prolactin level. After adjusting for age and estradiol, hyperthyroidism increased the serum prolactin level (P<.001). The results of this study revealed that hyperprolactinemia is more frequent in hyperthyroid females. Serum prolactin level can be increased in hyperthyroidism. PRL = prolactin T4 = thyroxine TRH = thyrotropin-releasing hormone TSH = thyroid-stimulating hormone.

Association between β2-adrenoceptor (ADRB2) haplotypes and insulin resistance in PCOS.

PubMed

Tellechea, Mariana L; Muzzio, Damián O; Iglesias Molli, Andrea E; Belli, Susana H; Graffigna, Mabel N; Levalle, Oscar A; Frechtel, Gustavo D; Cerrone, Gloria E

2013-04-01

The aim of this study was to explore β2-adrenoceptor (ADRB2) haplotype associations with phenotypes and quantitative traits related to insulin resistance (IR) and the metabolic syndrome (MS) in a polycystic ovary syndrome (PCOS) population. A secondary purpose was to assess the association between ADRB2 haplotype and PCOS. Genetic polymorphism analysis. Cross-sectional case-control association study. Medical University Hospital and research laboratory. One hundred and sixty-five unrelated women with PCOS and 116 unrelated women without PCOS (control sample). Clinical and biochemical measurements, and ADRB2 genotyping in PCOS patients and control subjects. ADRB2 haplotypes (comprising rs1042711, rs1801704, rs1042713 and rs1042714 in that order), genotyping and statistical analysis to evaluate associations with continuous variables and traits related to IR and MS in a PCOS population. Associations between ADRB2 haplotypes and PCOS were also assessed. We observed an age-adjusted association between ADRB2 haplotype CCGG and lower insulin (P = 0·018) and HOMA (P = 0·008) in the PCOS sample. Interestingly, the expected differences in surrogate measures of IR between cases and controls were not significant in CCGG/CCGG carriers. In the case-control study, genotype CCGG/CCGG was associated with a 14% decrease in PCOS risk (P = 0·043), taking into account confounding variables. Haplotype I (CCGG) has a protective role for IR and MS in PCOS. © 2012 Blackwell Publishing Ltd.

Visualization of flow separation and control by vortex generators on an single flap in landing configuration

NASA Astrophysics Data System (ADS)

Součková, Natálie; Kuklová, Jana; Popelka, Lukáš; Matějka, Milan

2012-04-01

This paper focuses on a suppression of the flow separation, which occurs on a deflected flap, by means of vortex generators (VG's). An airfoil NACA 63A421 with a simple flap and vane-type vortex generators were used. The investigation was carried out by using experimental and numerical methods. The data from the numerical simulation of the flapped airfoil without VG's control were used for the vortex generator design. Two sizes, two different shapes and various spacing of the vortex generators were tested. The flow past the airfoil was visualized through three methods, namely tuft filaments technique, oil and thermo camera visualization. The experiments were performed in closed circuit wind tunnels with closed and open test sections. The lift curves for both cases without and with vortex generators were acquired for a lift coefficient improvement determination. The improvement was achieved for several cases by means all of the applied methods.

Bacterial infection in deep paraspinal muscles in a parturient following epidural analgesia.

PubMed

Yang, Ying-Wei; Chen, Wei-Ting; Chen, Jui-Yuan; Lee, She-Chin; Chang, Yi; Wen, Yeong-Ray

2011-06-01

We report a case of paraspinal muscle infection shortly after epidural analgesia for labor pain in a nulliparous parturient who was subjected to emergent Cesarean section because of fetal distress. Epidural morphine was administered for 3 days for postoperative pain control. She began to have constant lower back pain on postpartum Day 4. Magnetic resonance image study revealed a broad area of subcutaneous edema with a continuum along the catheter trajectory deep to the paraspinal muscles. An injection-related bacterial infection was suspected; the patient was treated with intravenous antibiotics and was soon cured uncomplicatedly. Epidural analgesia is effective to control labor pain and, in general, it is safe. However, the sequelae of complicated infection may be underestimated. We herein report a case complicated by iatrogenic infection, discuss the causes, and give suggestions for prevention. Copyright © 2011. Published by Elsevier B.V.

Labor Dystocia and the Risk of Uterine Rupture in Women with Prior Cesarean.

PubMed

Vachon-Marceau, Chantale; Demers, Suzanne; Goyet, Martine; Gauthier, Robert; Roberge, Stéphanie; Chaillet, Nils; Laroche, Jasmin; Bujold, Emmanuel

2016-05-01

Objective The objective of this study was to evaluate the association between labor dystocia and uterine rupture. Methods We performed a secondary analysis of a multicenter case-control study that included women with single, prior, low-transverse cesarean section who experienced complete uterine rupture during a trial of labor (TOL). For each case, three women who underwent a TOL without uterine rupture were selected as controls. Data were collected on cervical dilatations from admission to delivery. We evaluated the relationship between uterine rupture and labor dystocia according to several criteria, including the World Health Organization's (WHO's) partogram. Results Data were available for 90 cases and 260 controls. Compared with the controls, uterine rupture was associated with less cervical dilatation on admission, slower cervical dilatation in the first stage of labor and longer second stage of labor (all with p < 0.05). Performing cesarean when the labor curve crossed the ACTION line of WHO's partogram or when the second stage was greater than 2 hours could have (1) prevented up to 56% of uterine rupture and (2) reduced the duration of labor in 57% of women with failed TOL. Conclusion Labor dystocia is a significant risk factor for uterine rupture. Labor progression should be assessed regularly in women with prior cesarean. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

System-Level Design of a Shape Memory Alloy Actuator for Active Clearance Control in the High-Pressure Turbine

NASA Technical Reports Server (NTRS)

DeCastro, Jonathan A.; Melcher, Kevin J.; Noebe, Ronald D.

2005-01-01

This paper describes results of a numerical analysis evaluating the feasibility of high-temperature shape memory alloys (HTSMA) for active clearance control actuation in the high-pressure turbine section of a modern turbofan engine. The prototype actuator concept considered here consists of parallel HTSMA wires attached to the shroud that is located on the exterior of the turbine case. A transient model of an HTSMA actuator was used to evaluate active clearance control at various operating points in a test bed aircraft engine simulation. For the engine under consideration, each actuator must be designed to counteract loads from 380 to 2000 lbf and displace at least 0.033 inches. Design results show that an actuator comprised of 10 wires 2 inches in length is adequate for control at critical engine operating points and still exhibits acceptable failsafe operability and cycle life. A proportional-integral-derivative (PID) controller with integrator windup protection was implemented to control clearance amidst engine transients during a normal mission. Simulation results show that the control system exhibits minimal variability in clearance control performance across the operating envelope. The final actuator design is sufficiently small to fit within the limited space outside the high-pressure turbine case and is shown to consume only small amounts of bleed air to adequately regulate temperature.

Engine Icing Modeling and Simulation (Part 2): Performance Simulation of Engine Rollback Phenomena

NASA Technical Reports Server (NTRS)

May, Ryan D.; Guo, Ten-Huei; Veres, Joseph P.; Jorgenson, Philip C. E.

2011-01-01

Ice buildup in the compressor section of a commercial aircraft gas turbine engine can cause a number of engine failures. One of these failure modes is known as engine rollback: an uncommanded decrease in thrust accompanied by a decrease in fan speed and an increase in turbine temperature. This paper describes the development of a model which simulates the system level impact of engine icing using the Commercial Modular Aero-Propulsion System Simulation 40k (C-MAPSS40k). When an ice blockage is added to C-MAPSS40k, the control system responds in a manner similar to that of an actual engine, and, in cases with severe blockage, an engine rollback is observed. Using this capability to simulate engine rollback, a proof-of-concept detection scheme is developed and tested using only typical engine sensors. This paper concludes that the engine control system s limit protection is the proximate cause of iced engine rollback and that the controller can detect the buildup of ice particles in the compressor section. This work serves as a feasibility study for continued research into the detection and mitigation of engine rollback using the propulsion control system.

Nosocomial tuberculosis prevention in Portuguese hospitals: a cross-sectional evaluation.

PubMed

Sousa, M; Gomes, M; Gaio, A R; Duarte, R

2017-08-01

Measures to control tuberculous infection are crucial to prevent nosocomial transmission and protect health care workers (HCWs). In Portugal, the extent of implementation of tuberculosis (TB) control measures in hospitals is not known. To determine the current implementation of preventive measures for tuberculous infection at administrative, environmental and personal levels in Portuguese hospitals. A cross-sectional evaluation was performed using two anonymous questionnaires: one sent to all the hospital infection control (IC) committees and the other sent to all pulmonologists and physicians specialising in infectious disease. Fourteen IC committees and 72 physicians responded. According to the IC committees, 92% of hospitals had a written TB control plan, but only 37% of the physicians said there was always/almost always a fast track for diagnosing suspected pulmonary TB cases. The majority of the hospitals had an isolation policy (85%) and these patients were always/almost always admitted in separate rooms, according to 70% of physicians. Both HCWs and TB patients used respiratory protection equipment (92%). These findings indicate that the most basic TB IC measures had been undertaken, but some TB IC measures were not fully implemented at all hospitals. An institutional effort should be made to solve this problem and strengthen TB prevention activities.

Lack of association between human herpesvirus and vestibular schwannoma: analysis of 121 cases.

PubMed

Bhimrao, Sanjiv K; Maguire, John; Garnis, Cathie; Tang, Patrick; Lea, Jane; Akagami, Ryojo; Westerberg, Brian D

2015-03-01

To assess for the presence of human herpesvirus (HHV) using immunohistochemical and polymerase chain reaction (PCR) assay in surgically excised vestibular schwannoma (VS) samples. Cross-sectional study. A retrospective laboratory-based study of tumors from patients with vestibular schwannoma. Tissue microarrays (TMAs) representing sporadic and NF2-associated VS from 121 patients, as well as appropriate positive and negative controls, were studied. TMA sections were immunostained using antibodies directed against HHV-1, HHV-2, HHV-3, HHV-4, HHV-5, and HHV-8. PCR was used for the detection of all 8 known human herpesviruses. There was no detectable HHV (HHV-1, HHV-2, HHV-3, HHV-4, HHV-5, HHV-8) by immunohistochemistry in any of the 121 cases of sporadic and NF2 cases analyzed. These data were further validated by DNA sequence analyses using PCR in a subset of the VS samples, all of which were found to be negative for all HHV. The data offer no support for an association between HHV and the development of sporadic or NF2-associated VS in humans. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

[Application of acupoint massage in postpartum hypogalactia in puerpera].

PubMed

Zhu, Yunfei; Liu, Yuling; Quan, Xiaoming

2018-01-12

To evaluate the effects of acupoint massage for postpartum hypogalactia in puerpera. A total of 60 puerpera of cesarean section were randomized into an observation group and a control group, 30 cases in each one. In the observation group, 2 cases were dropped out. Finally, there were 28 cases in the observation group and 30 cases in the control group. In the control group, the routine nursing after operation in obstetrics department was given, guiding maternal breastfeeding and postpartum health education. In the observation group, on the basis of the treatment as the control group, the corresponding acupoints were selected from the breast related meridians for massage. Acupoint massage was given since the 3rd day after operation, 8:00 am to 9:00 am, once a day, 1 min at one acupoint, continuously for 5 days. The lactation volume, breast filling, galactostasis and milk viscosity were compared in the parturient of the two groups. The clinical therapeutic effects were compared between the two groups. From the 1st to the 2nd days, the differences were not significant in lactation volume, breast filling and galactostasis score between the two groups (all P >0.05). From the 3rd to 5th days, the lactation volume, breast filling and galactostasis score in the observation group were all lower than those in the control group (all P <0.01). The difference in milk viscosity was not significant in the first 4 days between the two groups (all P >0.05). On the 5th day, the score of milk viscosity in the observation group was lower than that in the control group ( P <0.01). The cured rate was 64.3% (18/28) in the observation group, which was better than 13.3% (4/30) in the control group ( P <0.05). Massage at the acupoints from the breast related meridians effectively promotes the lactation secretion in puerpera of postpartum hypogalactia and alleviates breast distention.

Malformations detected by abdominal ultrasound in children with congenital heart disease.

PubMed

Rosa, Rosana Cardoso Manique; Rosa, Rafael Fabiano Machado; Flores, José Antônio Monteiro; Golendziner, Eliete; Oliveira, Ceres Andréia Vieira de; Varella-Garcia, Marileila; Paskulin, Giorgio Adriano; Zen, Paulo Ricardo Gazzola

2012-12-01

Extracardiac malformations may be present in patients with congenital heart disease (CHD), bringing greater risk of comorbidity and mortality. Verify frequency and types of abdominal abnormalities detected in children with and without CHD through abdominal ultrasound (AUS), compare the patients in relation to their dysmorphic/cytogenetic findings and perform an estimative of the cost-effectiveness of the screening through AUS. We conducted a cross-sectional study with a control cohort. The cases consisted of patients with CHD admitted for the first time in a pediatric intensive care unit; the controls consisted of children without CHD who underwent AUS at the hospital shortly thereafter a case. All patients with CHD underwent AUS, high-resolution karyotype and fluorescence in situ hybridization (FISH) for microdeletion 22q11.2. AUS identified clinically significant abnormalities in 12.2% of the cases and 5.2% of controls (p= 0.009), with a power of significance of 76.6%. Most malformations with clinical significance were renal anomalies (10.4% in cases and 4.9% in controls; p= 0.034). In Brazil, the cost of an AUS examination for the Unified Health System is US$ 21. Since clinically significant abnormalities were observed in one in every 8.2 CHD patients, the cost to identify an affected child was calculated as approximately US$ 176. Patients with CHD present a significant frequency of abdominal abnormalities detected by AUS, an inexpensive and noninvasive diagnostic method with good sensitivity. The cost of screening for these defects is considerably lower than the cost to treat the complications of late diagnoses of abdominal malformations such as renal disease.

Fostering Entrepreneurship through Business Incubation: The Role and Prospects of Postsecondary Vocational-Technical Education. Report 2: Case Studies.

ERIC Educational Resources Information Center

Hernandez-Gantes, Victor M.; And Others

This report presents nine case studies featuring efforts to foster community development through business incubation and entrepreneurial programs at two-year colleges. A background section discusses case description, and organization and format of case studies. The second section describes the case study design. Each case study is introduced with…

Hydrocarbon exposure may cause glomerulonephritis and worsen renal function: evidence based on Hill's criteria for causality.

PubMed

Ravnskov, U

2000-08-01

Many observational and experimental studies point to hydrocarbon exposure as an important pathogenic factor in glomerulonephritis. The findings have made little impact on current concepts and patient care, possibly because the hypothesis of a direct causal effect of the exposure and the hypothesis that the exposure worsens renal function have not been considered separately. This review examines these two hypotheses using Hill's criteria for causality. The results from 14 cross-sectional, 18 case-control studies, two cohort studies, 15 experiments on laboratory animals and two on human beings together with many case reports satisfy all but one of Hill's criteria for both hypotheses. Of particular importance is the finding in the case-control and follow-up studies of an association between degree of exposure and stage of renal disease, and an inverse association between degree of exposure and renal function, indicating that the most important effect of hydrocarbon exposure is its effect on renal function. End-stage renal failure may be preventable in many patients with glomerulonephritis provided a possible exposure to toxic chemicals is discontinued.

Plasma levels of interlukin-4 and Interferon-γ in patients with chronic or healed cutaneous leishmaniasis

PubMed Central

Taheri, Ahmad Reza; Mashayekhi Goyonlo, Vahid; Nahidi, Yalda; Moheghi, Nasrin; Tavakkol Afshari, Jalil

2014-01-01

Objective(s): In this study, the serum level of interferon-γ (IFN- γ) and interlukin-4 (IL-4) was evaluated as a marker of Th1 and Th2 immune response that influence the clinical course of cutaneous leishmaniasis . Materials and Methods: This cross-sectional study was conducted on 44 cases of cutaneous leishmaniasis (21 cases with healed lesions and 23 cases with chronic non-healing lesions. Thirty-two non-infected persons living in the area were considered as controls. Serum levels of IFN- γ and IL-4 were determined using ELISA, and the results along with clinical data were analyzed using SPSS 11.5. Results: Serum IFN-γ level was not significantly different between various patient groups and control (P=0.27), but the serum level of IL-4 in patient groups was higher than in healthy subjects, and it was higher in patients with non-healed chronic cutaneous leishmaniasis than those with healed lesions (P<0.01). Conclusion: Serum IL-4 level is a good marker for evaluation of the clinical course of cutaneous leishmaniasis. PMID:24847425

Application of Layered Perforation Profile Control Technique to Low Permeable Reservoir

NASA Astrophysics Data System (ADS)

Wei, Sun

2018-01-01

it is difficult to satisfy the demand of profile control of complex well section and multi-layer reservoir by adopting the conventional profile control technology, therefore, a research is conducted on adjusting the injection production profile with layered perforating parameters optimization. i.e. in the case of coproduction for multi-layer, water absorption of each layer is adjusted by adjusting the perforating parameters, thus to balance the injection production profile of the whole well section, and ultimately enhance the oil displacement efficiency of water flooding. By applying the relationship between oil-water phase percolation theory/perforating damage and capacity, a mathematic model of adjusting the injection production profile with layered perforating parameters optimization, besides, perforating parameters optimization software is programmed. Different types of optimization design work are carried out according to different geological conditions and construction purposes by using the perforating optimization design software; furthermore, an application test is done for low permeable reservoir, and the water injection profile tends to be balanced significantly after perforation with optimized parameters, thereby getting a good application effect on site.

Evaluation of margins in head and neck squamous cell carcinoma from the surgeon's perspective.

PubMed

Baumeister, Philipp; Baumüller, Konstantin; Harréus, Ulrich; Reiter, Maximilian; Welz, Christian

2018-05-01

The surgeon's evaluation of resection status based on frozen section analysis during operation and pathological examination of resected specimens often differ. For this study, we recapitulated the surgeon's perspective during an operation, accordingly classified the evaluation of margins by the surgeon, and analyzed its impact on the outcome compared with the pathological results. This was a retrospective analysis. As data sources, paper-based and digital patient files, as well as the Munich Cancer Registry database were used. Three hundred ninety-six cases were included in this analysis. Only the evaluation of margins by the surgeon influenced local control, and the pathological results influenced disease-free survival (DFS). Surprisingly, margins of >5 mm of normal tissue to cancer growth led to local control and overall survival (OS) significantly worse than 1 to 5-mm resections. The evaluation of margins by the surgeon is of significant importance for local control and OS. It is largely based on frozen section analysis, which, therefore, should be used whenever possible. © 2018 Wiley Periodicals, Inc.

Successful external cephalic version is an independent factor for caesarean section during trial of labor - a matched controlled study.

PubMed

Boujenah, J; Fleury, C; Bonneau, C; Pharisien, I; Tigaizin, A; Carbillon, L

2017-12-01

To assess the mode of delivery and Caesarean Section (CS) rate after successful External Cephalic Version (ECV). A matched case-control study. Data were gathered from a tertiary care university hospital register from 1996-2015. All pregnant women who delivered after successful External Cephalic Version (ECV). Among 643 women who attempted ECV, we identified 198 with successful ECVs and compared them with the next two women who presented for labor management with spontaneous cephalic presentation, matching for delivery date, maternal age, parity, body mass index, and delivery history using univariate and stepwise logistic regression. The main outcome measure was the risk of caesarean. The caesarean section rate was higher after successful ECV (respectively 20.7% versus 7.07%, P<0.05). Caesarean section for abnormal fetal head position (forehead, bregma, face) was higher after successful ECV (28.6% versus 0%). After adjustment for matching and confounding variables (variation of the caesarean section rate over the study period, gestational maternal complications, antepartum fetal complications, term of delivery, induction of labor, oxytocin use for dystocia, neonatal cephalic perimeter), a successful ECV increased the risk of caesarean section (adjusted OR 3.17, 95% CI 1.86-5.46). By stratifying on week, a trend for increased risk for caesarean section was observed at the week after ECV and at post term (28.6% before 37+6, 14.8% at 38+0-38+6, 13.8% at 39+0-39+6, 14.2% at 40+0-40+6 and 33.3% beyond 41+0 weeks' gestation, P=0.06). Women who have a successful ECV are at increased risk of caesarean section compared with women who experience spontaneous cephalic presentation. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

A Cluster of Group A Streptococcal Infections in a Skilled Nursing Facility-the Potential Role of Healthcare Worker Presenteeism.

PubMed

Kobayashi, Miwako; Lyman, Meghan M; Francois Watkins, Louise K; Toews, Karrie-Ann; Bullard, Leon; Radcliffe, Rachel A; Beall, Bernard; Langley, Gayle; Beneden, Chris Van; Stone, Nimalie D

2016-12-01

To determine the extent of a group A streptococcus (GAS) cluster (2 residents with invasive GAS (invasive case-patients), 2 carriers) caused by a single strain (T antigen type 2 and M protein gene subtype 2.0 (T2, emm 2.0)), evaluate factors contributing to transmission, and provide recommendations for disease control. Cross-sectional analysis and retrospective review. Skilled nursing facility (SNF). SNF residents and staff. The initial cluster was identified through laboratory notification and screening of SNF residents with wounds. Laboratory and SNF administrative records were subsequently reviewed to identify additional residents with GAS, oropharyngeal and wound (if present) swabs were collected from SNF staff and residents to examine GAS colonization, staff were surveyed to assess infection control practices and risk factors for GAS colonization, epidemiologic links between case-patients and persons colonized with GAS were determined, and facility infection control practices were assessed. No additional invasive case-patients were identified. Oropharyngeal swabs obtained from all 167 SNF residents were negative; one wound swab grew GAS that was the same as the outbreak strain (T2, emm 2.0). The outbreak strain was not identified in any of the 162 staff members. One of six staff members diagnosed with GAS pharyngitis worked while ill and had direct contact with invasive case-patients within a few weeks before their onset of symptoms. Additional minor breaches in infection control were noted. Sick healthcare workers may have introduced GAS into the SNF, with propagation by infection control lapses. "Presenteeism," or working while ill, may introduce and transmit GAS to vulnerable in SNF populations. Identification of an invasive GAS case-patient should trigger a prompt response by facilities to prevent further transmission and workplace culture, and policies should be in place to discourage presenteeism in healthcare settings. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Infection prevention and control practice for Crimean-Congo hemorrhagic fever-A multi-center cross-sectional survey in Eurasia.

PubMed

Fletcher, Tom E; Gulzhan, Abuova; Ahmeti, Salih; Al-Abri, Seif S; Asik, Zahide; Atilla, Aynur; Beeching, Nick J; Bilek, Heval; Bozkurt, Ilkay; Christova, Iva; Duygu, Fazilet; Esen, Saban; Khanna, Arjun; Kader, Çiğdem; Mardani, Masoud; Mahmood, Faisal; Mamuchishvili, Nana; Pshenichnaya, Natalia; Sunbul, Mustafa; Yalcin, Tuğba Y; Leblebicioglu, Hakan

2017-01-01

Crimean Congo Hemorrhagic Fever (CCHF) is a life threatening acute viral infection that presents significant risk of nosocomial transmission to healthcare workers. Evaluation of CCHF infection prevention and control (IP&C) practices in healthcare facilities that routinely manage CCHF cases in Eurasia. A cross-sectional CCHF IP&C survey was designed and distributed to CCHF centers in 10 endemic Eurasian countries in 2016. Twenty-three responses were received from centers in Turkey, Pakistan, Russia, Georgia, Kosovo, Bulgaria, Oman, Iran, India and Kazakhstan. All units had dedicated isolation rooms for CCHF, with cohorting of confirmed cases in 15/23 centers and cohorting of suspect and confirmed cases in 9/23 centers. There was adequate personal protective equipment (PPE) in 22/23 facilities, with 21/23 facilities reporting routine use of PPE for CCHF patients. Adequate staffing levels to provide care reported in 14/23 locations. All centers reported having a high risk CCHFV nosocomial exposure in last five years, with 5 centers reporting more than 5 exposures. Education was provided annually in most centers (13/23), with additional training requested in PPE use (11/23), PPE donning/doffing (12/23), environmental disinfection (12/23) and waste management (14/23). Staff and patient safety must be improved and healthcare associated CCHF exposure and transmission eliminated. Improvements are recommended in isolation capacity in healthcare facilities, use of PPE and maintenance of adequate staffing levels. We recommend further audit of IP&C practice at individual units in endemic areas, as part of national quality assurance programs.

Infection prevention and control practice for Crimean-Congo hemorrhagic fever—A multi-center cross-sectional survey in Eurasia

PubMed Central

Gulzhan, Abuova; Ahmeti, Salih; Al-Abri, Seif S.; Asik, Zahide; Atilla, Aynur; Beeching, Nick J.; Bilek, Heval; Bozkurt, Ilkay; Christova, Iva; Duygu, Fazilet; Esen, Saban; Khanna, Arjun; Kader, Çiğdem; Mardani, Masoud; Mahmood, Faisal; Mamuchishvili, Nana; Pshenichnaya, Natalia; Sunbul, Mustafa; Yalcin, Tuğba Y.; Leblebicioglu, Hakan

2017-01-01

Background Crimean Congo Hemorrhagic Fever (CCHF) is a life threatening acute viral infection that presents significant risk of nosocomial transmission to healthcare workers. Aim Evaluation of CCHF infection prevention and control (IP&C) practices in healthcare facilities that routinely manage CCHF cases in Eurasia. Methods A cross-sectional CCHF IP&C survey was designed and distributed to CCHF centers in 10 endemic Eurasian countries in 2016. Results Twenty-three responses were received from centers in Turkey, Pakistan, Russia, Georgia, Kosovo, Bulgaria, Oman, Iran, India and Kazakhstan. All units had dedicated isolation rooms for CCHF, with cohorting of confirmed cases in 15/23 centers and cohorting of suspect and confirmed cases in 9/23 centers. There was adequate personal protective equipment (PPE) in 22/23 facilities, with 21/23 facilities reporting routine use of PPE for CCHF patients. Adequate staffing levels to provide care reported in 14/23 locations. All centers reported having a high risk CCHFV nosocomial exposure in last five years, with 5 centers reporting more than 5 exposures. Education was provided annually in most centers (13/23), with additional training requested in PPE use (11/23), PPE donning/doffing (12/23), environmental disinfection (12/23) and waste management (14/23). Conclusions Staff and patient safety must be improved and healthcare associated CCHF exposure and transmission eliminated. Improvements are recommended in isolation capacity in healthcare facilities, use of PPE and maintenance of adequate staffing levels. We recommend further audit of IP&C practice at individual units in endemic areas, as part of national quality assurance programs. PMID:28886039

Anamneses-Based Internet Information Supply: Can a Combination of an Expert System and Meta-Search Engine Help Consumers find the Health Information they Require?

PubMed Central

Honekamp, Wilfried; Ostermann, Herwig

2010-01-01

An increasing number of people search for health information online. During the last 10 years various researchers have determined the requirements for an ideal consumer health information system. The aim of this study was to figure out, whether medical laymen can find a more accurate diagnosis for a given anamnesis via the developed prototype health information system than via ordinary internet search. In a randomized controlled trial, the prototype information system was evaluated by the assessment of two sample cases. Participants had to determine the diagnosis of a patient with a headache via information found searching the web. A patient’s history sheet and a computer with internet access were provided to the participants and they were guided through the study by an especially designed study website. The intervention group used the prototype information system; the control group used common search engines and portals. The numbers of correct diagnoses in each group were compared. A total of 140 (60/80) participants took part in two study sections. In the first case, which determined a common diagnosis, both groups did equally well. In the second section, which determined a less common and more complex case, the intervention group did significantly better (P=0.031) due to the tailored information supply. Using medical expert systems in combination with a portal searching meta-search engine represents a feasible strategy to provide reliable patient-tailored information and can ultimately contribute to patient safety with respect to information found via the internet. PMID:20502597

3D Numerical Simulation versus Experimental Assessment of Pressure Pulsations Using a Passive Method for Swirling Flow Control in Conical Diffusers of Hydraulic Turbines

NASA Astrophysics Data System (ADS)

TANASA, C.; MUNTEAN, S.; CIOCAN, T.; SUSAN-RESIGA, R. F.

2016-11-01

The hydraulic turbines operated at partial discharge (especially hydraulic turbines with fixed blades, i.e. Francis turbine), developing a swirling flow in the conical diffuser of draft tube. As a result, the helical vortex breakdown, also known in the literature as “precessing vortex rope” is developed. A passive method to mitigate the pressure pulsations associated to the vortex rope in the draft tube cone of hydraulic turbines is presented in this paper. The method involves the development of a progressive and controlled throttling (shutter), of the flow cross section at the bottom of the conical diffuser. The adjustable cross section is made on the basis of the shutter-opening of circular diaphragms, while maintaining in all positions the circular cross-sectional shape, centred on the axis of the turbine. The stagnant region and the pressure pulsations associated to the vortex rope are mitigated when it is controlled with the turbine operating regime. Consequently, the severe flow deceleration and corresponding central stagnant are diminished with an efficient mitigation of the precessing helical vortex. Four cases (one without diaphragm and three with diaphragm), are numerically and experimentally investigated, respectively. The present paper focuses on a 3D turbulent swirling flow simulation in order to evaluate the control method. Numerical results are compared against measured pressure recovery coefficient and Fourier spectra. The results prove the vortex rope mitigation and its associated pressure pulsations when employing the diaphragm.

Immunoperoxidase staining for identification of Aspergillus species in routinely processed tissue sections.

PubMed Central

Verweij, P E; Smedts, F; Poot, T; Bult, P; Hoogkamp-Korstanje, J A; Meis, J F

1996-01-01

AIMS: To evaluate the performance of an immunoperoxidase stain using the monoclonal antibody EB-A1 to detect Aspergillus species in formalin fixed, paraffin wax embedded tissue. METHODS: The monoclonal antibody EB-A1 directed against galactomannan was used to detect Aspergillus species in 23 patients with suspected or confirmed invasive aspergillosis. Immunostaining was performed on formalin fixed, paraffin wax embedded tissue using the streptavidin-biotin method and compared with conventional haematoxylin and eosin, periodic acid-Schiff, and Gomori-Grocott stains. Results of immunostaining were semiquantitatively analysed with regard to both intensity of staining and number of positively staining micro-organisms. Tissue sections from 16 patients with confirmed invasive mycoses due to Candida species, Apophysomyces elegans, Rhizopus oryzae, Pseudallescheria boydii and Histoplasma capsulatum were used as controls. RESULTS: In 19 (83%) of 23 cases invasive aspergillosis was confirmed by both histological examination and culture (18 Aspergillus fumigatus and one A flavus). Immunoperoxidase stains were positive in 17 (89%) of 19 cases including one case of disseminated infection due to A flavus. Furthermore, the immunoperoxidase stain was positive in a culture negative tissue section with histological evidence of mycelial development, indicating the presence of Aspergillus species. Some cross-reactivity was observed with the highly related fungus P boydii, although the number of mycelial elements that stained was low. CONCLUSIONS: Immunoperoxidase staining using the monoclonal antibody EB-A1 performs well on routinely processed tissue sections and permits detection and generic identification of Aspergillus species, although it was no better than conventional histopathology in identifying the presence of an infection. An additional advantage is that the immunostain may help to provide an aetiological diagnosis when cultures remain negative. Images PMID:8943743

On turbulent friction in straight ducts with complex cross-section: the wall law and the hydraulic diameter

NASA Astrophysics Data System (ADS)

Pirozzoli, Sergio

2018-07-01

We develop predictive formulas for friction resistance in ducts with complex cross-sectional shape based on the use of the log law and neglect of wall shear stress nonuniformities. The traditional hydraulic diameter naturally emerges from the analysis as the controlling length scale for common duct shapes as triangles and regular polygons. The analysis also suggests that a new effective diameter should be used in more general cases, yielding corrections of a few percent to friction estimates based on the traditional hydraulic diameter. Fair but consistent predictive improvement is shown for duct geometries of practical relevance, including rectangular and annular ducts, and circular rod bundles.

Relationships of dissociative disorders and personality traits in opium addicts on methadone treatment.

PubMed

Ghafarinezhad, Alireza; Rajabizadeh, Ghodratollah; Shahriari, Vahid

2013-01-01

Drug abuse is a major public health problem. Some believe that when dissociation fails to defend against emotional, physical, or sexual trauma, the person will find relief from unpleasant thoughts and emotions in opium use. On the other hand, personality disorders are considered as important predictors of treatment outcomes in drug abusers. Due to lack of adequate research in this regard, we evaluated dissociative disorders and personality traits of opium addicts on methadone treatment. This cross-sectional analytic study included 111 non-psychotic subjects on methadone treatment (case group) and 69 non-addicts (control group). After recording demographic characteristics, Dissociative Experiences Scale (DES) and Millon Multiaxial Inventory III were applied to assess dissociative symptoms and clinical personality patterns of all participants. Dissociative symptoms were significantly more common in the case group than in the control group (P = 0.044). While hysterionic personality disorder was more frequent in the control group (P = 0.008), sadistic, antisocial, and schizotypal personality disorders were significantly more common in the case group (P = 0.008, 0.002, and 0.023, respectively). We found relations between history of drug dependence, dissociative symptoms, and personality disorders. Therefore, the mentioned disorders need to be kept in mind while planning addiction treatment modalities and identifying high risk groups.

The Role of Malaria Microscopy Training and Refresher Training Courses in Malaria Control Program in Iran during 2001 - 2011.

PubMed

Nateghpour, M; Edrissian, Ghh; Raeisi, A; Motevalli-Haghi, A; Farivar, L; Mohseni, Gh; Rahimi-Froushani, A

2012-01-01

Malaria is still one of the most important infectious diseases in the world. The disease also is a public health problem in south and southeast of Iran. This study programmed to show the correlation between regular malaria microscopy training and refresher training courses and control of malaria in Iran. Three types of training courses were conducted in this programme including; five - day, ten - day and bimonthly training courses. Each of the training courses contained theoretical and practical sections and training impact was evaluated by practical examination and multiple-choice quizzes through pre and post tests. Distribution pattern of the participants in the training and refresher training courses showed that the most participants were from Sistan & Baluchistan and Hormozgan provinces where malaria is endemic and most cases of the infection come out from these malarious areas. A total of 695 identified individuals were participated in the training courses. A significant conversely correlation was found between conducting malaria microscopy training courses and annual malaria cases in Iran. Conducting a suitable programme for malaria microscopy training and refresher training plays an important role in the control of malaria in endemic areas. Obviously, the decrease of malaria cases in Iran has been achieved due to some activities that malaria diagnosis training was one of them.

Making medical decisions in dependence of genetic background: estimation of the utility of DNA testing in clinical, pharmaco-epidemiological or genetic studies.

PubMed

Nguyen, Thuy Trang; Schäfer, Helmut; Timmesfeld, Nina

2013-05-01

An index measuring the utility of testing a DNA marker before deciding between two alternative treatments is proposed which can be estimated from pharmaco-epidemiological case-control or cohort studies. In the case-control design, external estimates of the prevalence of the disease and of the frequency of the genetic risk variant are required for estimating the utility index. Formulas for point and interval estimates are derived. Empirical coverage probabilities of the confidence intervals were estimated under different scenarios of disease prevalence, prevalence of drug use, and population frequency of the genetic variant. To illustrate our method, we re-analyse pharmaco-epidemiological case-control data on oral contraceptive intake and venous thrombosis in carriers and non-carriers of the factor V Leiden mutation. We also re-analyse cross-sectional data from the Framingham study on a gene-diet interaction between an APOA2 polymorphism and high saturated fat intake on obesity. We conclude that the utility index may be helpful to evaluate and appraise the potential clinical and public health relevance of gene-environment interaction effects detected in genomic and candidate gene association studies and may be a valuable decision support for designing prospective studies on the clinical utility. © 2013 Wiley Periodicals, Inc.

Bone mineral density in children with idiopathic nephrotic syndrome.

PubMed

El-Mashad, Ghada Mohamed; El-Hawy, Mahmoud Ahmed; El-Hefnawy, Sally Mohamed; Mohamed, Sanaa Mansour

To assess bone mineral density (BMD) in children with idiopathic nephrotic syndrome (NS) and normal glomerular filtration rate (GFR). Cross-sectional case-control study carried out on 50 children: 25 cases of NS (16 steroid-sensitive [SSNS] and nine steroid-resistant [SRNS] under follow up in the pediatric nephrology unit of Menoufia University Hospital, which is tertiary care center, were compared to 25 healthy controls with matched age and sex. All of the participants were subjected to complete history taking, thorough clinical examination, laboratory investigations (serum creatinine, blood urea nitrogen [BUN], phosphorus [P], total and ionized calcium [Ca], parathyroid hormone [PTH], and alkaline phosphatase [ALP]). Bone mineral density was measured at the lumbar spinal region (L2-L4) in patients group using dual-energy X-ray absorptiometry (DXA). Total and ionized Ca were significantly lower while, serum P, ALP, and PTH were higher in SSNS and SRNS cases than the controls. Osteopenia was documented by DXA scan in 11 patients (44%) and osteoporosis in two patients (8%). Fracture risk was mild in six (24%), moderate in two (8%), and marked in three (12%) of patients. Bone mineralization was negatively affected by steroid treatment in children with NS. Copyright © 2016 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

An Architecture for Cooperative Localization in Underwater Acoustic Networks

DTIC Science & Technology

2015-10-24

range. (b) Independent navigation and control system onboard Iver AUVs . The cooperative localization process is highlighted in red. Figure 1: Block...Iver2 AUVs (Fig. 3) and a topside ship. While we make spe- cific notes about this three vehicle network, the architecture is vehicle independent. 3.1...Single vehicle subsystem Each vehicle executes several processes including sensor drivers, a pose estimator (Section 2), and, in the case of the AUVs

Relevant Obstetric Factors for Cerebral Palsy: From the Nationwide Obstetric Compensation System in Japan

PubMed Central

Hasegawa, Junichi; Toyokawa, Satoshi; Ikenoue, Tsuyomu; Asano, Yuri; Satoh, Shoji; Ikeda, Tomoaki; Ichizuka, Kiyotake; Tamiya, Nanako; Nakai, Akihito; Fujimori, Keiya; Maeda, Tsugio; Masuzaki, Hideaki; Suzuki, Hideaki; Ueda, Shigeru

2016-01-01

Objective The aim of this study was to identify the relevant obstetric factors for cerebral palsy (CP) after 33 weeks’ gestation in Japan. Study design This retrospective case cohort study (1:100 cases and controls) used a Japanese national CP registry. Obstetric characteristics and clinical course were compared between CP cases in the Japan Obstetric Compensation System for Cerebral Palsy database and controls in the perinatal database of the Japan Society of Obstetrics and Gynecology born as live singleton infants between 2009 and 2011 with a birth weight ≥ 2,000 g and gestation ≥ 33 weeks. Results One hundred and seventy-five CP cases and 17,475 controls were assessed. Major relevant single factors for CP were placental abnormalities (31%), umbilical cord abnormalities (15%), maternal complications (10%), and neonatal complications (1%). A multivariate regression model demonstrated that obstetric variables associated with CP were acute delivery due to non-reassuring fetal status (relative risk [RR]: 37.182, 95% confidence interval [CI]: 20.028–69.032), uterine rupture (RR: 24.770, 95% CI: 6.006–102.160), placental abruption (RR: 20.891, 95% CI: 11.817–36.934), and preterm labor (RR: 3.153, 95% CI: 2.024–4.911), whereas protective factors were head presentation (RR: 0.199, 95% CI: 0.088–0.450) and elective cesarean section (RR: 0.236, 95% CI: 0.067–0.828). Conclusion CP after 33 weeks’ gestation in the recently reported cases in Japan was strongly associated with acute delivery due to non-reassuring fetal status, uterine rupture, and placental abruption. PMID:26821386

The utility of the Kohlman Evaluation of Living Skills test is associated with substantiated cases of elder self-neglect.

PubMed

Pickens, Sabrina; Naik, Aanand D; Burnett, Jason; Kelly, P A; Gleason, Mary; Dyer, Carmel B

2007-03-01

Self-neglect is the most prevalent finding among cases reported to Adult Protective Services (APS) and is characterized by an inability to meet one's own basic needs. The Kohlman evaluation of living skills (KELS) has been validated in geriatric populations to assess performance with both instrumental and basic activities of daily living and as an assessment tool for the capacity to live independently; therefore, the purpose of this analysis was to compare the scores of the KELS between substantiated cases of self-neglect and matched community-dwelling elders. This is a cross-sectional pilot study of 50 adults aged 65 years and older who were recruited from APS as documented cases of self-neglect and 50 control participants recruited from Harris County Hospital District outpatient clinics. Control participants were matched for age, race, gender, and ZIP code. A geriatric nurse practitioner (NP)-led team administered a comprehensive geriatric assessment in homes of all study participants. The assessment included the KELS and mini-mental state examination (MMSE) tests. Chi-square analyses were used to determine if cases of self-neglect were significantly more likely to fail the KELS test than matched controls. The analyses revealed that self-neglectors were significantly more likely to fail the KELS than non-self-neglectors (50% vs. 30%, p = .025). When stratified by MMSE scores, self-neglectors with intact cognitive function remained significantly more likely to fail the KELS compared to matched, cognitively intact controls (45% vs. 17%, p = .013). Abnormal results using an in-home KELS test were significantly associated with substantiated cases of self-neglect. There is currently no gold-standard measure for identifying capacity with self-care behaviors among cases of self-neglect. As a result, self-neglect may remain unidentified in many clinical settings. The KELS provides clinicians with an objective measure of an individual's capacity and performance with everyday life-supporting tasks and thus, provides information that can help NPs identify elders at risk for self-neglect. These findings suggest that the KELS test has significant utility as part of a comprehensive geriatric assessment to aid clinicians in suspected cases of self-neglect.

The Wall Interference of a Wind Tunnel of Elliptic Cross Section

NASA Technical Reports Server (NTRS)

Tani, Itiro; Sanuki, Matao

1944-01-01

The wall interference is obtained for a wind tunnel of elliptic section for the two cases of closed and open working sections. The approximate and exact methods used gave results in practically good agreement. Corresponding to the result given by Glauert for the case of the closed rectangular section, the interference is found to be a minimum for a ratio of minor to major axis of 1:square root of 6 This, however, is true only for the case where the span of the airfoil is small in comparison with the width of the tunnel. For a longer airfoil the favorable ellipse is flatter. In the case of the open working section the circular shape gives the minimum interference.

Ram-Jet off Design Performances

NASA Astrophysics Data System (ADS)

Andriani, Roberto; Ghezzi, Umberto

2002-01-01

In this work it is intended to study the off-design performances of a ram jet engine. To this purpouse it has been analyzed in a first time the behaviour of an ideal engine, that means to not consider the losses in the various components, or, under a thermodynamic point of view, to consider the fluid transformation through the air intake and exhaust nozzle, remembering that in a ram jet there are not rotating components as compressor and turbine, isentropic. Referring to the ram-jet scheme of fig.1. we can say, neglecting the fuel introduced, that the air mass flow rate throughout the engine is constant. If we consider the two control sections 4 and 8, respectively the throat section of the converging-diverging supersonic inlet and the throat section of the discharge nozzle, the condition of constant mass flow leads to the relation: m4 =f (M 4 ) m8 = m 4 = m8 We can imaging that the throat section # 4 is always choked for any value of the flight Mach number M0. This means that the throat section 4 is adjusted at any value of M0 so that the flow Mach number in 4 is equal to unity. In this it follows: R. Andriani, U. Ghezzi1 Since in an ideal case T t8 The relation [1] allows to determine the T8 temperature, that represent the maximum cycle temperature, for different operating conditions, as flight Mach number and altitude. We then have two cases: the first is A8 (nozzle throat section) fixed, and the second is A8 variable. In the first case the maximum temperature T8 is univocally determined by the operating condition. In the second case A8 can be varied so to maintain T8 at a chosen value. The graphic of fig.2 shows the first case. In particular it has been considered as design point an altitude of 15000 meters and a flight Mach number equal to 2. In this condition it has been evaluated the section A8 for unity mass flow rate. At the same altitude, varying the flight Mach number, with the section A4 always choked, the graphic shows the variation of the maximum cycle temperature according to the equation *. We notice as the temperature raises to unacceptable levels as we accelerate from the design point. For instance we can see as if we move to flight Mach number 2.2 the maximum temperature raises from 1800 Kelvin degrees (design point) to more than 2900 [K], a value practically unreachable. This shows as the ramjet with fixed discharge nozzle allows very little variation of the operating conditions around the design point. If we consider instead the possibility to vary the nozzle section A8 we can imagine to adjust it so to maintain constant the temperature T8, according to the relation *. The graphics of fig.3 show the area variation required to the section A8 to maintain constant the temperature T8 at the same altitude for different values of the flight Mach number. Considering a circular section, on the same R. Andriani, U. Ghezzi2 picture is reported the corresponding variation of the diameter. On the Y-axis it is reported the ratio between the entity (section and diameter) at the considered condition and at the design point. For the case of A8 section variable it has also been evaluated the behavior of the specific fuel consumption, the mass flow rate and the thrust. In fig.4 they are reported the behavior TSFC and Fuel/air ratio at different flight Mach numbers, and the ratio between them and the design value. In fig .5 it is reported the ratio between the thrust and mass flow rate at different flight conditions and their value at design point. R. Andriani, U. Ghezzi3

Case Citations 1991. Eleventh Series.

ERIC Educational Resources Information Center

Sharp, Linda A., Ed.

Case citations from five legal areas--college students, liability on campus, sport law, employment, and employment discrimination--are presented in this document. Each section offers brief summaries of cases and concludes with a table of cases. The first section on college students examines litigation involving student finances, disciplinary…

Probing the mechanism for Deep Submarine Groundwater Discharge using a Case Study in the Levant Basin (Achziv Canyon)

NASA Astrophysics Data System (ADS)

Paldor, A.; Aharonov, E.; Katz, O.

2017-12-01

Deep Submarine Groundwater Discharge (DSGD) is a ubiquitous and highly significant phenomenon, yet it remains poorly understood. Here we use numerical modeling (FEFLOW) to investigate a case study of DSGD offshore northern Israel, aiming to unravel the main features and mechanics of steady-state DSGD: the hydrology that enables its formation, the controls on rates and salinity of seepage, and the residence time of fluid underground. In addition, we investigate the geometry of the fresh-salt water interface within the seeping offshore aquifer. The first part of this work constructs a large scale (70 km) geologic cross-section of our case-study region. The mapping suggests outcropping of confined aquifer strata (Upper Cenomanian Judea Group) on the continental shelf break, 5-15 km offshore. The second part consists of hydrological simulations of DSGD from a confined aquifer similar to the case-study aquifer. The main findings are thus: steady-state DSGD from a confined aquifer occurs far offshore even under moderate heads. It is accompanied by a circulation cell that forms around an intrinsic freshwater-seawater interface. Circulation consists of seawater entering the confined aquifer at the exposed section offshore, mixing with terrestrial groundwater within the aquifer, and seeping saline water out the upper part of the exposed section. In addition, the simulated confined aquifer displays a very flat fresh-salt water interface extending far offshore, as observed in natural offshore aquifers. Preliminary results of a hydrographic survey in the area of study suggest a low-salinity anomaly close to the seafloor, implying seepage of brines in that area, as expected from the model. These new insights have potentially important implications for coastal hydrology, seawater chemistry, biogeochemistry, and submarine slope instability.

Building research capacity in Botswana: a randomized trial comparing training methodologies in the Botswana ethics training initiative.

PubMed

Barchi, Francis H; Kasimatis-Singleton, Megan; Kasule, Mary; Khulumani, Pilate; Merz, Jon F

2013-02-01

Little empirical data are available on the extent to which capacity-building programs in research ethics prepare trainees to apply ethical reasoning skills to the design, conduct, or review of research. A randomized controlled trial was conducted in Botswana in 2010 to assess the effectiveness of a case-based intervention using email to augment in-person seminars. University faculty and current and prospective IRB/REC members took part in a semester-long training program in research ethics. Participants attended two 2-day seminars and were assigned at random to one of two on-line arms of the trial. Participants in both arms completed on-line international modules from the Collaborative Institutional Training Initiative. Between seminars, intervention-arm participants were also emailed a weekly case to analyze in response to set questions; responses and individualized faculty feedback were exchanged via email. Tests assessing ethics knowledge were administered at the start of each seminar. The post-test included an additional section in which participants were asked to identify the ethical issues highlighted in five case studies from a list of multiple-choice responses. Results were analyzed using regression and ANOVA. Of the 71 participants (36 control, 35 intervention) enrolled at the first seminar, 41 (57.7%) attended the second seminar (19 control, 22 intervention). In the intervention arm, 19 (54.3%) participants fully completed and 8 (22.9%) partially completed all six weekly cases. The mean score was higher on the post-test (30.3/40) than on the pre-test (28.0/40), and individual post- and pre-test scores were highly correlated (r = 0.65, p < 0.0001). Group assignment alone did not have an effect on test scores (p > 0.84), but intervention-arm subjects who completed all assigned cases answered an average of 3.2 more questions correctly on the post-test than others, controlling for pre-test scores (p = 0.003). Completion of the case-based intervention improved respondents' test scores, with those who completed all six email cases scoring roughly 10% better than those who failed to complete this task and those in the control arm. There was only suggestive evidence that intensive case work improved ethical issue identification, although there was limited ability to assess this outcome due to a high drop-out rate.

Building research capacity in Botswana: a randomized trial comparing training methodologies in the Botswana ethics training initiative

PubMed Central

2013-01-01

Background Little empirical data are available on the extent to which capacity-building programs in research ethics prepare trainees to apply ethical reasoning skills to the design, conduct, or review of research. A randomized controlled trial was conducted in Botswana in 2010 to assess the effectiveness of a case-based intervention using email to augment in-person seminars. Methods University faculty and current and prospective IRB/REC members took part in a semester-long training program in research ethics. Participants attended two 2-day seminars and were assigned at random to one of two on-line arms of the trial. Participants in both arms completed on-line international modules from the Collaborative Institutional Training Initiative. Between seminars, intervention-arm participants were also emailed a weekly case to analyze in response to set questions; responses and individualized faculty feedback were exchanged via email. Tests assessing ethics knowledge were administered at the start of each seminar. The post-test included an additional section in which participants were asked to identify the ethical issues highlighted in five case studies from a list of multiple-choice responses. Results were analyzed using regression and ANOVA. Results Of the 71 participants (36 control, 35 intervention) enrolled at the first seminar, 41 (57.7%) attended the second seminar (19 control, 22 intervention). In the intervention arm, 19 (54.3%) participants fully completed and 8 (22.9%) partially completed all six weekly cases. The mean score was higher on the post-test (30.3/40) than on the pre-test (28.0/40), and individual post- and pre-test scores were highly correlated (r = 0.65, p < 0.0001). Group assignment alone did not have an effect on test scores (p > 0.84), but intervention-arm subjects who completed all assigned cases answered an average of 3.2 more questions correctly on the post-test than others, controlling for pre-test scores (p = 0.003). Conclusions Completion of the case-based intervention improved respondents’ test scores, with those who completed all six email cases scoring roughly 10% better than those who failed to complete this task and those in the control arm. There was only suggestive evidence that intensive case work improved ethical issue identification, although there was limited ability to assess this outcome due to a high drop-out rate. PMID:23368699

Central nervous system lesions: correlation of intraoperative and final diagnoses, six year experience at a referral centre in a developing country, Pakistan.

PubMed

Ud Din, Nasir; Memon, Aisha; Idress, Romana; Ahmad, Zubair; Hasan, Sheema

2011-01-01

Intraoperative consultation of CNS lesions provides accurate diagnosis to neurosurgeons. Some lesions, however, may cause diagnostic difficulty. In this study accuracy of intraoperative consultations of CNS lesions and discrepancies in diagnosis and deferrals were analysed. All CNS cases from May 1, 2004 to September 20, 2010 in which intraoperative frozen section had been performed, and which were reported in the Section of Histopathology, Aga Khan University Hospital, Karachi Pakistan were retrieved. The diagnoses given on FS were compared with the final diagnosis given on permanent sections (and additional material if received), as indicated in the frozen section and final pathology report. During the study period, 171 CNS cases were received for intraoperative consultation. In all cases, cryostat sections (FS) plus cytology smears were prepared. The ages of the patients ranged from 03 to 77 years. 106 were males and 65 were females. Out of these 171 cases, 160 cases (94.1 %) were concordant, 10 cases (5.8 %) were discrepant, and one case was deferred until permanent sections. The diagnostic accuracy of frozen section was 88.9%. The sensitivity and specificity were 94.8% and 87.5% respectively. The positive predictive value was 98.6% and negative predictive value was 63.6%. All our cases in which intraoperative consultation was requested were sent for primary diagnosis. Adequacy per se was not a criterion for sending cases for intraoperative consultation. Our results show a reasonably high percentage of accuracy in the intraoperative diagnosis of CNS lesions. However, there are limitations and some lesions pose a diagnostic challenge. There is a need to improve our own diagnostic skills and establish better communication with neurosurgeons.

Arteriolosclerosis that affects multiple brain regions is linked to hippocampal sclerosis of ageing

PubMed Central

Neltner, Janna H.; Abner, Erin L.; Baker, Steven; Schmitt, Frederick A.; Kryscio, Richard J.; Jicha, Gregory A.; Smith, Charles D.; Hammack, Eleanor; Kukull, Walter A.; Brenowitz, Willa D.; Van Eldik, Linda J.

2014-01-01

Hippocampal sclerosis of ageing is a prevalent brain disease that afflicts older persons and has been linked with cerebrovascular pathology. Arteriolosclerosis is a subtype of cerebrovascular pathology characterized by concentrically thickened arterioles. Here we report data from multiple large autopsy series (University of Kentucky Alzheimer’s Disease Centre, Nun Study, and National Alzheimer’s Coordinating Centre) showing a specific association between hippocampal sclerosis of ageing pathology and arteriolosclerosis. The present analyses incorporate 226 cases of autopsy-proven hippocampal sclerosis of ageing and 1792 controls. Case–control comparisons were performed including digital pathological assessments for detailed analyses of blood vessel morphology. We found no evidence of associations between hippocampal sclerosis of ageing pathology and lacunar infarcts, large infarcts, Circle of Willis atherosclerosis, or cerebral amyloid angiopathy. Individuals with hippocampal sclerosis of ageing pathology did not show increased rates of clinically documented hypertension, diabetes, or other cardiac risk factors. The correlation between arteriolosclerosis and hippocampal sclerosis of ageing pathology was strong in multiple brain regions outside of the hippocampus. For example, the presence of arteriolosclerosis in the frontal cortex (Brodmann area 9) was strongly associated with hippocampal sclerosis of ageing pathology (P < 0.001). This enables informative evaluation of anatomical regions outside of the hippocampus. To assess the morphology of brain microvasculature far more rigorously than what is possible using semi-quantitative pathological scoring, we applied digital pathological (Aperio ScanScope) methods on a subsample of frontal cortex sections from hippocampal sclerosis of ageing (n = 15) and control (n = 42) cases. Following technical studies to optimize immunostaining methods for small blood vessel visualization, our analyses focused on sections immunostained for smooth muscle actin (a marker of arterioles) and CD34 (an endothelial marker), with separate analyses on grey and white matter. A total of 43 834 smooth muscle actin-positive vascular profiles and 603 798 CD34-positive vascular profiles were evaluated. In frontal cortex of cases with hippocampal sclerosis of ageing, smooth muscle actin-immunoreactive arterioles had thicker walls (P < 0.05), larger perimeters (P < 0.03), and larger vessel areas (P < 0.03) than controls. Unlike the arterioles, CD34-immunoreactive capillaries had dimensions that were unchanged in cases with hippocampal sclerosis of ageing versus controls. Arteriolosclerosis appears specific to hippocampal sclerosis of ageing brains, because brains with Alzheimer’s disease pathology did not show the same morphological alterations. We conclude that there may be a pathogenetic change in aged human brain arterioles that impacts multiple brain areas and contributes to hippocampal sclerosis of ageing. PMID:24271328

Decision-case mix model for analyzing variation in cesarean rates.

PubMed

Eldenburg, L; Waller, W S

2001-01-01

This article contributes a decision-case mix model for analyzing variation in c-section rates. Like recent contributions to the literature, the model systematically takes into account the effect of case mix. Going beyond past research, the model highlights differences in physician decision making in response to obstetric factors. Distinguishing the effects of physician decision making and case mix is important in understanding why c-section rates vary and in developing programs to effect change in physician behavior. The model was applied to a sample of deliveries at a hospital where physicians exhibited considerable variation in their c-section rates. Comparing groups with a low versus high rate, the authors' general conclusion is that the difference in physician decision tendencies (to perform a c-section), in response to specific obstetric factors, is at least as important as case mix in explaining variation in c-section rates. The exact effects of decision making versus case mix depend on how the model application defines the obstetric condition of interest and on the weighting of deliveries by their estimated "risk of Cesarean." The general conclusion is supported by an additional analysis that uses the model's elements to predict individual physicians' annual c-section rates.

Prevalence of dental attrition in in vitro fertilization children of West Bengal.

PubMed

Kar, Sudipta; Sarkar, Subrata; Mukherjee, Ananya

2014-01-01

Dental attrition is one of the problems affecting the tooth structure. It may affect both in vitro fertilization (IVF) and spontaneously conceived children. This study was aimed to evaluate and to compare the prevalence of dental attrition in deciduous dentition of IVF and spontaneously conceived children. In a cross-sectional case control study dental attrition status of 3-5 years old children were assessed. The case group consisted of term, singleton babies who were the outcome of IVF in the studied area in 2009. The control group consisted of term, first child, singleton and spontaneously conceived 3-5 years old children who were also resident of the studied area. A sample of 153 IVF and 153 spontaneously conceived children was examined according to Hansson and Nilner classification. Statistical analysis was carried out using Chi-square tests (χ(2) ) or Z test. No statistically significant difference found in studied (IVF children) and control group (spontaneously conceived children). IVF children are considered same as spontaneously conceived children when studied in relation to dental attrition status.

Muscarinic agonists for the treatment of cognition in schizophrenia.

PubMed

Sellin, Angela K; Shad, Mujeeb; Tamminga, Carol

2008-11-01

It is widely accepted that cholinergic activity at muscarinic receptors is required to maintain cognitive functions, including learning and memory. Memory domains are especially impaired in schizophrenia, which may explain difficulties in psychosocial rehabilitation of individuals with this illness. However, little is known about the mechanism of this impairment. To understand our current knowledge, we reviewed the literature since 1990 via a PubMed search for the terms "muscarinic", "schizophrenia", "cognition", "memory", "learning", and "agonist" in combination. We found 89 basic science/laboratory studies, case reports/series, case-control studies, cross-sectional studies, standardized controlled animal trials, standardized controlled human trials, and reviews. Although further research is required to fully understand the neuropharmacology of the cholinergic system in cognitive function in schizophrenia, we have examined the data currently available. In general, these data suggest that agonist activity at acetylcholine muscarinic type 1 (M1) receptors would enhance memory and learning in schizophrenia. We present an overview of likely side effects of muscarinic agonists. We outline the anticholinergic activity of several available antipsychotics and review the available M1 muscarinic agonists.

Pegasus delivers SLS engine section

NASA Image and Video Library

2017-03-03

NASA engineers install test hardware for the agency's new heavy lift rocket, the Space Launch System, into a newly constructed 50-foot structural test stand at NASA's Marshall Space Flight Center. In the stand, hydraulic cylinders will be electronically controlled to push, pull, twist and bend the test article with millions of pounds of force. Engineers will record and analyze over 3,000 channels of data for each test case to verify the capabilities of the engine section and validate that the design and analysis models accurately predict the amount of loads the core stage can withstand during launch and ascent. The engine section, recently delivered via NASA's barge Pegasus from NASA's Michoud Assembly Facility, is the first of four core stage structural test articles scheduled to be delivered to Marshall for testing. The engine section, located at the bottom of SLS's massive core stage, will house the rocket's four RS-25 engines and be an attachment point for the two solid rocket boosters.

Pegasus delivers SLS engine section

NASA Image and Video Library

2017-05-18

NASA engineers install test hardware for the agency's new heavy lift rocket, the Space Launch System, into a newly constructed 50-foot structural test stand at NASA's Marshall Space Flight Center. In the stand, hydraulic cylinders will be electronically controlled to push, pull, twist and bend the test article with millions of pounds of force. Engineers will record and analyze over 3,000 channels of data for each test case to verify the capabilities of the engine section and validate that the design and analysis models accurately predict the amount of loads the core stage can withstand during launch and ascent. The engine section, recently delivered via NASA's barge Pegasus from NASA's Michoud Assembly Facility, is the first of four core stage structural test articles scheduled to be delivered to Marshall for testing. The engine section, located at the bottom of SLS's massive core stage, will house the rocket's four RS-25 engines and be an attachment point for the two solid rocket boosters.

On the derivation of flow rating curves in data-scarce environments

NASA Astrophysics Data System (ADS)

Manfreda, Salvatore

2018-07-01

River monitoring is a critical issue for hydrological modelling that relies strongly on the use of flow rating curves (FRCs). In most cases, these functions are derived by least-squares fitting which usually leads to good performance indices, even when based on a limited range of data that especially lack high flow observations. In this context, cross-section geometry is a controlling factor which is not fully exploited in classical approaches. In fact, river discharge is obtained as the product of two factors: 1) the area of the wetted cross-section and 2) the cross-sectionally averaged velocity. Both factors can be expressed as a function of the river stage, defining a viable alternative in the derivation of FRCs. This makes it possible to exploit information about cross-section geometry limiting, at least partially, the uncertainty in the extrapolation of discharge at higher flow values. Numerical analyses and field data confirm the reliability of the proposed procedure for the derivation of FRCs.

Imported Zika Virus in a European City: How to Prevent Local Transmission?

PubMed

Millet, Joan-Pau; Montalvo, Tomàs; Bueno-Marí, Ruben; Romero-Tamarit, Arancha; Prats-Uribe, Albert; Fernández, Lidia; Camprubí, Esteve; Del Baño, Lucía; Peracho, Victor; Figuerola, Jordi; Sulleiro, Elena; Martínez, Miguel J; Caylà, Joan A

2017-01-01

Background: On February 1st 2016 the WHO declared the Zika Virus (ZIKV) infection a worldwide public health emergency because of its rapid expansion and severe complications, such as Guillain-Barré Syndrome or microcephaly in newborn. The huge amount of people traveling to endemic areas and the presence of Aedes albopictus in Barcelona increase the risk of autochtonous transmission. The objective of this study was to describe the first ZIKV cases diagnosed in our city and to analyze the surveillance, prevention, and control measures implemented to avoid autochthonous transmission. Methods: An observational cross-sectional population-based study in Barcelona, Spain was performed.An analysis of the socio-demographic, epidemiological, clinical characteristics, and mosquito control activities of the ZIKV cases detected between January 1st and December 2016 was carried out using a specific ZIKV epidemiological survey of the Barcelona Public Health Agency. Results: A total of 118 notifications of possible ZIKV infections were received, and 44 corresponded to confirmed cases in Barcelona residents.Amongst these, the median age was 35 years and 57% were women. All cases were imported, 48% were Spanish-born and 52% foreign-born. Dominican Republic was the most visited country amongst foreign-born patients and Nicaragua amongst Spanish-born. The most frequent symptoms were exanthema, fever, and arthralgia. Among the 24 diagnosed women, 6 (25%) were pregnant. There was one case of microcephaly outside Barcelona city. Entomological inspections were done at the homes of 19 cases (43.2% of the total) and in 34 (77.3%) public spaces. Vector activity was found in one case of the 44 confirmed cases, and 134 surveillance and vector control were carried out associated to imported ZIKV cases. In all cases prevention measures were recommended to avoid mosquito bites on infected cases. Conclusion: Epidemiological and entomological surveillance are essential for the prevention of autochthonous transmission of arbovirosis that may have a great impact on Public Health.The good coordination between epidemiologists, entomologists, microbiologists, and clinicians is a priority in a touristic city with an intense relationship with endemic countries to minimize the risk of local transmission by competent vectors.

Imported Zika Virus in a European City: How to Prevent Local Transmission?

PubMed Central

Millet, Joan-Pau; Montalvo, Tomàs; Bueno-Marí, Ruben; Romero-Tamarit, Arancha; Prats-Uribe, Albert; Fernández, Lidia; Camprubí, Esteve; del Baño, Lucía; Peracho, Victor; Figuerola, Jordi; Sulleiro, Elena; Martínez, Miguel J.; Caylà, Joan A.; Álamo-Junquera, Dolores

2017-01-01

Background: On February 1st 2016 the WHO declared the Zika Virus (ZIKV) infection a worldwide public health emergency because of its rapid expansion and severe complications, such as Guillain-Barré Syndrome or microcephaly in newborn. The huge amount of people traveling to endemic areas and the presence of Aedes albopictus in Barcelona increase the risk of autochtonous transmission. The objective of this study was to describe the first ZIKV cases diagnosed in our city and to analyze the surveillance, prevention, and control measures implemented to avoid autochthonous transmission. Methods: An observational cross-sectional population-based study in Barcelona, Spain was performed.An analysis of the socio-demographic, epidemiological, clinical characteristics, and mosquito control activities of the ZIKV cases detected between January 1st and December 2016 was carried out using a specific ZIKV epidemiological survey of the Barcelona Public Health Agency. Results: A total of 118 notifications of possible ZIKV infections were received, and 44 corresponded to confirmed cases in Barcelona residents.Amongst these, the median age was 35 years and 57% were women. All cases were imported, 48% were Spanish-born and 52% foreign-born. Dominican Republic was the most visited country amongst foreign-born patients and Nicaragua amongst Spanish-born. The most frequent symptoms were exanthema, fever, and arthralgia. Among the 24 diagnosed women, 6 (25%) were pregnant. There was one case of microcephaly outside Barcelona city. Entomological inspections were done at the homes of 19 cases (43.2% of the total) and in 34 (77.3%) public spaces. Vector activity was found in one case of the 44 confirmed cases, and 134 surveillance and vector control were carried out associated to imported ZIKV cases. In all cases prevention measures were recommended to avoid mosquito bites on infected cases. Conclusion: Epidemiological and entomological surveillance are essential for the prevention of autochthonous transmission of arbovirosis that may have a great impact on Public Health.The good coordination between epidemiologists, entomologists, microbiologists, and clinicians is a priority in a touristic city with an intense relationship with endemic countries to minimize the risk of local transmission by competent vectors. PMID:28769893

Quantitative Sensory Testing and Current Perception Threshold Testing in Patients With Chronic Pain Following Lower Extremity Fracture.

PubMed

Griffioen, Mari A; Greenspan, Joel D; Johantgen, Meg; Von Rueden, Kathryn; O'Toole, Robert V; Dorsey, Susan G; Renn, Cynthia L

2018-01-01

Chronic pain is a significant problem for patients with lower extremity injuries. While pain hypersensitivity has been identified in many chronic pain conditions, it is not known whether patients with chronic pain following lower extremity fracture report pain hypersensitivity in the injured leg. To quantify and compare peripheral somatosensory function and sensory nerve activation thresholds in persons with chronic pain following lower extremity fractures with a cohort of persons with no history of lower extremity fractures. This was a cross-sectional study where quantitative sensory testing and current perception threshold testing were conducted on the injured and noninjured legs of cases and both legs of controls. A total of 14 cases and 28 controls participated in the study. Mean time since injury at the time of testing for cases was 22.3 (standard deviation = 12.1) months. The warmth detection threshold ( p = .024) and nerve activation thresholds at 2,000 Hz ( p < .001) and 250 Hz ( p = .002), respectively, were significantly higher in cases compared to controls. This study suggests that patients with chronic pain following lower extremity fractures may experience hypoesthesia in the injured leg, which contrasts with the finding of hyperesthesia previously observed in other chronic pain conditions but is in accord with patients with nerve injuries and surgeries. This is the first study to examine peripheral sensory nerve function at the site of injury in patients with chronic pain following lower extremity fractures using quantitative sensory testing and current perception threshold testing.

Molecular Histopathology Using Gold Nanorods and Optical Coherence Tomography

PubMed Central

Prabhulkar, Shradha; Matthews, Jared; Rawal, Siddarth; Awdeh, Richard M.

2013-01-01

Purpose. To examine the novel application of a commercially available optical coherence tomography (OCT) system toward molecular histopathology using gold nanorod (GNR) linked antibodies as a functionalized contrast agent to evaluate ocular surface squamous neoplasia (OSSN). Methods. GNRs were synthesized and covalently attached to anti–glucose transporter-1 (GLUT-1) antibodies via carbodiimide chemistry. Three specimens from each of three distinct categories of human conjunctival tissue were selected for analysis, including conjunctiva without epithelial atypia (controls); conjunctival intraepithelial neoplasia, carcinoma in situ (CIS); and conjunctival squamous cell carcinoma (SCC). Tissue sections were incubated initially with GNR tagged anti–GLUT-1 antibodies and then with a fluorescent-tagged secondary antibody. Immunofluorescence and OCT imaging of the tissue was performed and the results were correlated to the light microscopic findings on traditional hemotoxyin and eosin stained sections. Results. No binding of the functionalized GNRs was observed within the epithelium of three normal conjunctiva controls. While immunofluorescence disclosed variable binding of the functionalized GNRs to atypical epithelial cells in all six cases of OSSN, the enhancement of the OCT signal in three cases of CIS was insufficient to distinguish these specimens from normal controls. In two of three cases of SCC, binding of functionalized GNRs was sufficient to produce an increased scattering effect on OCT in areas correlating to atypical epithelial cells which stained intensely on immunofluorescence imaging. Binding of functionalized GNRs was sufficient to produce an increased scattering effect on OCT in areas correlating to regions of erythrocytes and hemorrhage which stained intensely on immunofluorescence imaging within all nine tested samples. Conclusions. We have demonstrated the use of OCT for molecular histopathology using functionalized gold nanorods in the setting of OSSN. Our results suggest a threshold concentration of functionalized GNRs within tissue is required to achieve a detectable enhancement in scattering of the OCT signal. PMID:23307958

Dental caries experience and periodontal treatment needs of children with autistic spectrum disorder.

PubMed

Fakroon, S; Arheiam, A; Omar, S

2015-04-01

To assess dental caries experience and periodontal treatment needs among Libyan children diagnosed with autistic spectrum disorder (ASD). A cross-sectional, comparative case-control study was used, in which dental caries experience of 50 children with ASD was compared with that of 50 controls. The children with ASD were recruited from Benghazi Centre of Children with ASD, Libya. Controls were recruited from school children and matched for age, gender and socioeconomic status. DMFT, dmft for dental caries experience and CPITN for periodontal treatment needs were calculated according to WHO criteria by a calibrated examiner. Scores for DMFT as well as CPITN indices were compared using bivariate analysis. The data analysed for this study comprised observations from a group of children (cases = 50) diagnosed with ASD matched with healthy children (controls = 50). Consequently, each group consisted of 40 males and 10 females aged between 3 and 14 years (mean 7.29 ± 3.11). The ASD children showed significantly lower means for DMFT and dmft teeth as well as higher periodontal treatment needs (p > 0.05). Children with ASD were found to be more likely caries-free and have lower DMFT scores and higher unmet periodontal treatment needs than did the unaffected control children.

Emotion, Engagement, and Case Studies

ERIC Educational Resources Information Center

Herreid, Clyde Freeman; Terry, David R.; Lemons, Paula; Armstrong, Norris; Brickman, Peggy; Ribbens, Eric

2014-01-01

Three college faculty taught large general biology classes using case studies and personal response systems (clickers). Each instructor taught the same eight cases in two different sections, except the questions within the cases differed. In one section the questions were lower order (LO) factual inquiries, and in the other they were largely…

14 CFR 399.62 - Target dates in hearing cases.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Target dates in hearing cases. 399.62... Target dates in hearing cases. (a) Applicability. This section applies to initial and recommended.... (b) Issuance of target dates. In cases to which this section applies, the Board or the administrative...

14 CFR 399.62 - Target dates in hearing cases.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false Target dates in hearing cases. 399.62... Target dates in hearing cases. (a) Applicability. This section applies to initial and recommended.... (b) Issuance of target dates. In cases to which this section applies, the Board or the administrative...

14 CFR 399.62 - Target dates in hearing cases.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 4 2013-01-01 2013-01-01 false Target dates in hearing cases. 399.62... Target dates in hearing cases. (a) Applicability. This section applies to initial and recommended.... (b) Issuance of target dates. In cases to which this section applies, the Board or the administrative...

14 CFR 399.62 - Target dates in hearing cases.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 4 2014-01-01 2014-01-01 false Target dates in hearing cases. 399.62... Target dates in hearing cases. (a) Applicability. This section applies to initial and recommended.... (b) Issuance of target dates. In cases to which this section applies, the Board or the administrative...

14 CFR 399.62 - Target dates in hearing cases.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 4 2012-01-01 2012-01-01 false Target dates in hearing cases. 399.62... Target dates in hearing cases. (a) Applicability. This section applies to initial and recommended.... (b) Issuance of target dates. In cases to which this section applies, the Board or the administrative...

Potential risk factors associated with human alveolar echinococcosis: Systematic review and meta-analysis

PubMed Central

Probst, Carolina; Possenti, Alessia; Boufana, Belgees; Saulle, Rosella; La Torre, Giuseppe; Busani, Luca; Casulli, Adriano

2017-01-01

Background Human alveolar echinococcosis (AE) is a severe zoonotic disease caused by the metacestode stage of Echinococcus multilocularis. AE is commonly associated with a long incubation period that may last for more than ten years. The objective of this systematic literature review was to identify and summarize the current knowledge on statistically relevant potential risk factors (PRFs) associated with AE in humans. Methodology/Principal findings Six bibliographic databases were searched, generating a total of 1,009 publications. Following the removal of duplicate records and the exclusion of papers that failed to meet the criteria of a previously agreed a priori protocol, 23 publications were retained; however, 6 of these did not contain data in a format that allowed their inclusion in the meta-analysis. The remaining 17 publications (6 case-control and 11 cross-sectional studies) were meta-analysed to investigate associations between AE and PRFs. Pooled odds ratios (OR) were used as a measure of effect and separately analysed for case-control and cross-sectional studies. In the case-control studies, the following PRFs for human AE showed higher odds of outcome: “dog ownership”, “cat ownership”, “have a kitchen garden”, “occupation: farmer”, “haymaking in meadows not adjacent to water”, “went to forests for vocational reasons”, “chewed grass” and “hunting / handling foxes”. In the cross-sectional studies, the following PRFs showed higher odds of outcome: “dog ownership”, “play with dogs”, “gender: female”, “age over 20 years”, “ethnic group: Tibetan”, “low income”, “source of drinking water other than well or tap”, “occupation: herding” and “low education”. Our meta-analysis confirmed that the chance of AE transmission through ingestion of food and water contaminated with E. multilocularis eggs exists, but showed also that food- and water-borne PRFs do not significantly increase the risk of infection. Conclusions/significance This systematic review analysed international peer-reviewed articles that have over the years contributed to our current understanding of the epidemiology of human AE. The identification of potential risk factors may help researchers and decision makers improve surveillance and/or preventive measures that aim at decreasing human infection with E. multilocularis. More primary studies are needed to confirm potential risk factors and their role in the epidemiology of human AE. PMID:28715408

Higher body mass index is associated with plantar fasciopathy/'plantar fasciitis': systematic review and meta-analysis of various clinical and imaging risk factors.

PubMed

van Leeuwen, K D B; Rogers, J; Winzenberg, T; van Middelkoop, M

2016-08-01

What (risk) factors are associated with plantar fasciopathy (PF)? Systematic review with meta-analyses. Patients with PF. All factors described in prospective, case-control or cross-sectional observational studies. 51 included studies (1 prospective, 46 case-control and 4 cross-sectional studies) evaluated a total of 104 variables. Pooling was possible for 12 variables. Higher body mass index (BMI) (BMI>27, OR 3.7 (95% CI 2.93 to 5.62)) in patients with PF was the only significant clinical association, and its effect was the strongest in the non-athletic subgroup. In people with PF compared to controls, pooled imaging data demonstrated a significantly thicker, hypoechogenic plantar fascia with increased vascular signal and perifascial fluid collection. In addition, people with PF were more likely to have a thicker loaded and unloaded heel fat pat, and bone findings, including a subcalcaneal spur and increased Tc-99 uptake. No significant difference was found in the extension of the first metatarsophalangeal joint. We found a consistent clinical association between higher BMI and plantar fasciopathy. This association may differ between athletic and non-athletic subgroups. While consistent evidence supports a range of bone and soft tissue abnormalities, there is lack of evidence for the dogma of clinical and mechanical measures of foot and ankle function. Clinicians can use this information in shared decision-making. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

DPT Student Perceptions of the Physical Therapist Assistant's Role: Effect of Collaborative Case-Based Learning Compared to Traditional Content Delivery and Clinical Experience.

PubMed

Colgrove, Yvonne M; VanHoose, Lisa D

2017-01-01

Doctor of physical therapy (DPT) student learning about role delineation of physical therapist assistants (PTAs) is essential to ethical and legal practice. Survey assessment of three DPT student cohorts compared collaborative interprofessional case-based learning with PTA students to traditional curriculum delivery strategies. Control cohorts were assessed one time. The intervention group was assessed pre-intervention, immediately post-intervention, and after completing a full-time clinical experience. The case-based learning covered 46% of survey content, allowing for the assessment of content-specific material and potential learning through collaboration. Following the educational intervention, the intervention group improved significantly in areas inside and outside the case-based study content, outscoring both control groups on 25-34% of the survey items. Following the clinical experience, the intervention group declined answer accuracy for patient evaluation and treatment implementation, suggesting unlearning. Improvement in the administrative section was observed after the clinical experience. Perceptions of the tasks within the PTA role were diminished while tasks outside the scope of practice appeared clarified following the clinical experience. While case-based collaborative intraprofessional learning proves effective in student learning about the PTA role, changes following the clinical experience raise questions about the influence of the clinical environment on learning and the practical application of recently learned knowledge.

Are Ultrasonographic Measures of Cervical Flexor Muscles Correlated With Flexion Endurance in Chronic Neck Pain and Asymptomatic Participants?

PubMed

Ghamkhar, Leila; Kahlaee, Amir Hossein

2017-12-01

This study compared the relationship between some clinical factors and the size of neck flexors in participants with or without chronic neck pain. In this case-control study, the correlation between flexor endurance capacity as well as thickness, cross-section area, and shape ratio of longus colli/capitis and sternocleidomastoid muscles were examined in 30 patients with chronic neck pain and 30 asymptomatic participants. The patients showed lower flexor endurance (P = 0.02), smaller thickness (P = 0.03), and cross-section area (P < 0.01) of longus colli as compared with controls. Longus capitis and sternocleidomastoid size were not different between the two groups. The flexor endurance showed a negative correlation with longus colli shape ratio (r = -0.38, P = 0.03) and a positive correlation with longus capitis cross-section area (r = 0.38, P = 0.03) in the patients with chronic neck pain. In the control group, flexor endurance was negatively correlated with longus colli shape ratio (r = -0.45, P = 0.01) but positively correlated with longus capitis thickness (r = 0.45, P = 0.01) and cross-section area (r = 0.38, P = 0.03). Neck disability and pain intensity indices were not significantly correlated with either flexor muscles endurance or size. The ultrasonographic measures of the deep neck flexor muscles and the flexor endurance test, being associated with each other, could successfully differentiate patients with chronic neck pain from asymptomatic participants. However, the endurance test scores were not correlated with self-reported disability or pain intensity indices.

Operational effectiveness and quality assurance mechanisms with stochastic demand of blood supply: blood bank case study.

PubMed

Smith, Alan D

2011-01-01

A general overview of various blood products operational effectiveness and related strategies that can be utilised by service providers (in particular, healthcare providers) is presented in the present study. In terms of the massive volumes of blood products, the North American blood centres collect more than eight million units of whole blood, which represents appropriately 50% of the US and Quebec, Canada?s volunteer donor blood supply. A case study of the quality inspection and inventory control concerns of the Central Blood Bank, located in the metropolitan area of Pittsburgh, PA, is presented. Initially, brief introduction to its general operating environment is followed by sections describing its general situation, quality-service initiatives, and followed by a fairly detailed discussion of the practical applications of lessons learned from the case study.

Histology and immunohistochemistry of severe inflammatory bowel disease versus lymphoma in the ferret (Mustela putorius furo).

PubMed

Watson, Megan K; Cazzini, Paola; Mayer, Joerg; Gottdenker, Nicole; Reavill, Drury; Parry, Nicola; Fox, James G; Sakamoto, Kaori

2016-05-01

Inflammatory bowel disease (IBD) is a common disorder of ferrets (Mustela putorius furo) that may progress to lymphoma. Although routine histology is used to distinguish between these diseases, misclassifications may occur. Immunohistochemistry (IHC) is commonly used to distinguish between IBD and lymphoma in small animals. The objective of our study was to determine the agreement in the diagnosis reached solely using hematoxylin and eosin (HE)-stained, full-thickness sections versus using a combination of HE and IHC. Enteric sections from 44 ferrets previously diagnosed with IBD or intestinal lymphoma and 3 control ferrets were analyzed by pathologists with expertise in ferrets. A pathologist blinded to the original diagnosis assessed the same HE-stained sections. Analysis was then repeated using HE sections in parallel with sections stained using antibodies against CD3 and CD79a. No significant difference was found between the original HE diagnosis and the HE diagnosis reached by the blinded pathologist (p = 0.91) or between the blinded pathologist's HE versus HE with IHC diagnosis (p = 0.16). In the 2 cases where disagreement was present, IHC was pivotal in reaching a final diagnosis. There was no significant age (p = 0.29) difference between diagnoses; however, significantly more male ferrets were affected with IBD than females (p = 0.004). Immunophenotype of the lymphoma was not correlated with predilection for location in the intestinal wall (p = 0.44). Results suggest that although IHC is not necessary to distinguish IBD from intestinal lymphoma in ferrets, it can be useful a definitive diagnosis in cases of severe IBD. © 2016 The Author(s).

Separate physical tests of lower extremities and postural control are associated with cognitive impairment. Results from the general population study Good Aging in Skåne (GÅS-SNAC)

PubMed Central

Bramell-Risberg, Eva; Jarnlo, Gun-Britt; Elmståhl, Sölve

2012-01-01

Purpose To investigate whether separate physical tests of the lower extremities, that assess movement speed and postural control, were associated with cognitive impairment in older community-dwelling subjects. Subjects and methods In this population-based, cross-sectional, cohort study, the following items were assessed: walking speed, walking 2 × 15 m, Timed Up and Go (TUG) at self-selected and fast speeds, one-leg standing, and performance in step- and five chair-stand tests. The study comprised 2115 subjects, aged 60–93 years, with values adjusted for demographics, health-related factors, and comorbidity. Global cognitive function was assessed using the Mini-Mental State Examination (MMSE), and cognitive impairment was defined by the three-word delayed recall task of the MMSE. Subjects who scored 0/3 on the three-word delayed recall task were defined as cases (n = 328), those who scored 1/3 were defined as intermediates (n = 457), and the others as controls (n = 1330). Results Physical tests performed rapidly were significantly associated with cognitive impairment; this was the case in increased time of five chair stands (P = 0.009, odds ratio [OR] = 1.03), TUG (P < 0.001, OR = 1.11) and walking 2 × 15 m (P < 0.001, OR = 1.05). Inability to stand on one leg for 10 seconds was associated with increased risk of being a case (P < 0.001, OR = 1.78), compared to those able to stand for 30 seconds or longer. More steps during the step test (P < 0.001, OR = 0.95) and higher fast walking speed (P < 0.001, OR = 0.51) were associated with lower risk of being a case. Conclusion Slower movements and reduced postural control were related to an increased risk of being cognitively impaired. All tests that were performed rapidly were able to separate cases from controls. These findings suggest that physical tests that are related to lower extremity and postural control, emphasizing velocity, might be useful in investigating relationships between physical and cognitive function; furthermore, they can be used to complement cognitive impairment diagnoses. PMID:22807629

Isolated Diastolic Hypertension Associated Risk Factors among Chinese in Anhui Province, China

PubMed Central

Wang, Yanchun; Xing, Fengjun; Liu, Rongjuan; Liu, Li; Zhu, Yu; Wen, Yufeng; Sun, Wenjie; Song, Ziwei

2015-01-01

Objective: To explore potential risk factors of isolated diastolic hypertension (IDH) among young and middle-aged Chinese. Methods: A community-based cross-sectional study was conducted among 338 subjects, aged 25 years and above, using random sampling technique. There were 68 cases of IDH, 46 cases of isolated systolic hypertension (ISH), 89 cases of systolic and diastolic hypertension (SDH), and 135 of subjects with normal blood pressure. Cases and controls were matched on sex by frequency matching. Demographic characteristics, blood pressure and other relevant information were collected.Results: Compared with controls, patients with IDH and ISH had significant higher level of triglyceride, high density lipoprotein, blood glucose and body mass index (BMI) (p < 0.05); while patients with SDH had significantly higher level of total cholesterol, triglyceride, glucose and BMI (p < 0.05). Linear mixed effects model showed that drinking tea, family history of hypertension (FHH), higher blood glucose, triglyceride and low density lipoprotein were related with elevated diastolic blood pressure (DBP) (p < 0.01); HFH, blood glucose, creatinine and BMI have positive effect on systolic blood pressure (SBP) (p < 0.05). Conclusions: Drinking tea, FHH, high levels of triglyceride, high density lipoprotein, blood glucose and BMI are associated with IDH among young and middle-aged Chinese. PMID:25913184

Contact screening and chemoprophylaxis in India's Revised Tuberculosis Control Programme: a situational analysis.

PubMed

Banu Rekha, V V; Jagarajamma, K; Wares, F; Chandrasekaran, V; Swaminathan, S

2009-12-01

India's Revised National Tuberculosis Control Programme (RNTCP) recommends screening of all household contacts of smear-positive pulmonary tuberculosis (PTB) cases for tuberculosis (TB) disease, and 6-month isoniazid preventive therapy (IPT) for asymptomatic children aged <6 years. To assess the implementation of child contact screening and IPT administration under the RNTCP. A cross-sectional study conducted in four randomly selected TB units (TUs), two in an urban (Chennai City) and two in a rural (Vellore District) area of Tamil Nadu, South India, from July to September 2008. The study involved the perusal of TB treatment cards of source cases (new or retreatment smear-positive PTB patients started on treatment), interview of source cases and focus group discussions (FGDs) among health care workers. Interviews of 253 PTB patients revealed that of 220 contacts aged <14 years, only 31 (14%) had been screened for TB, and that of 84 household children aged <6 years, only 16 (19%) had been initiated on IPT. The treatment cards of source cases lacked documentation of contact details. FGDs revealed greater TB awareness among urban health care workers, but a lack of detailed knowledge about procedures. Provision for documentation using a separate IPT card and focused training may help improve the implementation of contact screening and IPT.

The contribution of community health workers to the control of Buruli ulcer in the Ngoantet area, Cameroon.

PubMed

Vouking, Marius Zambou; Takougang, Innocent; Mbam, Léonard Mbam; Mbuagbaw, Lawrence; Tadenfok, Carine Nouboudem; Tamo, Claire Violette

2013-01-01

Buruli ulcer (BU) is a skin disease caused by Mycobacterium ulcerans. It is the third most common mycobacterial infection after tuberculosis and leprosy. Community Health Workers (CHWs) hold the potential to support patients and their families at the community level. We conducted a cross-sectional descriptive study to assess the participation of CHWs in the early diagnosis and treatment of BU in Ngoantet, Cameroon. The CHWs performance was measured using: the number of cases referred to the Ngoantet Health Centre, the percentage of accomplished referrals, the percentage of cases referred by CHWs confirmed by the staff of Ngoantet Health Centre. Data was analyzed using Epi-info version 3.4.1. and Microsoft Office Excel 2003. The study focused on 51 CHWs in the Ngoantet health area. The referral rate was 95.0%. Most of the suspicious cases (91.5%) referred were confirmed by health workers. Most CHWs (78.4%) declared that they had identified at least one presumptive case of BU infection. We conclude that the CHWs can play a key role in scaling up BU control activities using a referral system. This study confirms the role of home visits and inspections in the early detection and treatment of BU.

Relationship of obstructive sleep apnea syndrome with the 5-HT2A receptor gene in Brazilian patients.

PubMed

de Carvalho, Thiago Bittencourt Ottoni; Suman, Marcela; Molina, Fernando Drimel; Piatto, Vânia Belintani; Maniglia, José Victor

2013-03-01

Serotonin (5-HT) regulates a variety of visceral and physiological functions, including sleep. Polymorphisms in the 5-HT2A receptor gene can alter its transcription, affecting the number of receptors in the serotoninergic system, contributing to obstructive sleep apnea syndrome (OSAS). The aim of this study was to determine the prevalence of the 102T-C and -1438G-A polymorphisms in the 5-HTR2A gene in Brazilian patients with and without OSAS. A cross-sectional study performed at the Otorhinolaryngology and Sleep Disorder Out Clinics, São José do Rio Preto Medical School, FAMERP. One hundred patients were examined as index cases and 100 persons as controls, of both genders to both groups. DNA was extracted from peripheral blood leukocytes, and the sites that encompassed both polymorphisms were amplified by PCR-RFLP. There was a significant prevalence of the male gender in index cases compared with the control group gender (p < 0.0001). There was no significant genotypic difference in the 102T-C polymorphism between the case and control groups (p = 1.000). The AA genotype of the -1438G-A polymorphism was more prevalent in the patients with OSAS compared with the controls (OR, 2.3; CI 95% 1.20-4.38; p = 0.01). There was no difference in the prevalence of the 102T-C polymorphism between patients with OSAS and the control group. Serotoninergic system dysfunction appeared to be related to OSAS. The -1438G-A polymorphism and OSAS are related in this studied Brazilian population.

Novel sensors to enable closed-loop active clearance control in gas turbine engines

NASA Astrophysics Data System (ADS)

Geisheimer, Jonathan; Holst, Tom

2014-06-01

Active clearance control within the turbine section of gas turbine engines presents and opportunity within aerospace and industrial applications to improve operating efficiencies and the life of downstream components. Open loop clearance control is currently employed during the development of all new large core aerospace engines; however, the ability to measure the gap between the blades and the case and close down the clearance further presents as opportunity to gain even greater efficiencies. The turbine area is one of the harshest environments for long term placement of a sensor in addition to the extreme accuracy requirements required to enable closed loop clearance control. This paper gives an overview of the challenges of clearance measurements within the turbine as well as discusses the latest developments of a microwave sensor designed for this application.

A curvilinear, anisotropic, p-version, brick finite element based on geometric entities

NASA Technical Reports Server (NTRS)

Hinnant, Howard E.

1992-01-01

A 'brick' solid finite element is presently developed on the basis of the p-version analysis, and used to demonstrate the FEM concept of 'geometric entities'. This method eliminates interelement discontinuities between low- and high-order elements, allowing very fine control over the shape-function order in various parts of the model. Attention is given to the illustrative cases of a one-element model of an elliptic pipe, and a square cross-section cantilevered beam.

LAREDO: LAunching, REndezvous and DOcking Simulation Tool

DTIC Science & Technology

2006-08-01

the Clohessy - Wiltshire equation for small eccentricities and relative distances, as shown in Eq. (12). z 2 y x 2 azz ax2y ay2x3x +−= +−= ++= ω ω...ωω && &&& &&& (12) In case of circular orbits, the LAREDO tool orbital maneuvers are all based on the Clohessy - Wiltshire equations4, where the set...Elliptical maneuvers guidance and control The Clohessy - Wiltshire equations described in the above section cannot be applied when the orbits have a

Does orthodontic treatment before the age of 18 years improve oral health-related quality of life? A systematic review and meta-analysis.

PubMed

Javidi, Hanieh; Vettore, Mario; Benson, Philip E

2017-04-01

Orthodontics aims to improve oral health-related quality of life (OHRQoL). In this systematic review, we examined the evidence for changes in OHRQoL after orthodontic treatment for patients treated before they were 18 years old. The participants were patients aged less than 18 years. The interventions were nonorthognathic and cleft orthodontic treatment. The comparisons were before and after orthodontic treatment, or nonorthodontic control. The outcomes were validated measures of OHRQoL. The study designs were randomized controlled trials, controlled clinical trials, prospective cohort studies, and cross-sectional or case-control studies. Multiple electronic databases were searched, with no language restrictions; authors were contacted, and reference lists screened. The Newcastle-Ottawa scale was used for quality assessments. Screening, data extraction, and quality assessments were performed by 2 investigators independently. We found 1590 articles and included 13 studies (9 cohort, 3 cross sectional, and 1 case control), with 6 in the meta-analyses. All were judged of low or moderate quality. A moderate improvement in OHRQoL was observed before and after orthodontic treatment (n = 243 participants; standardized mean difference, -0.75; 95% CI, -1.15 to -0.36) particularly in the dimensions of emotional well-being (n = 213 participants; standardized mean difference, -0.61; 95% CI, -0.80 to -0.41) and social well-being (n = 213 participants; standardized mean difference, -0.62; 95% CI, -0.82 to -0.43). Orthodontic treatment during childhood or adolescence leads to moderate improvements in the emotional and social well-being dimensions of OHRQoL, although the evidence is of low and moderate quality. More high quality, longitudinal, prospective studies are needed. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Protein crystal growth in low gravity

NASA Technical Reports Server (NTRS)

Feigelson, Robert S.

1993-01-01

This Final Technical Report for NASA Grant NAG8-774 covers the period from April 27, 1989 through December 31, 1992. It covers five main topics: fluid flow studies, the influence of growth conditions on the morphology of isocitrate lyase crystals, control of nucleation, the growth of lysozyme by the temperature gradient method and graphoepitaxy of protein crystals. The section on fluid flow discusses the limits of detectability in the Schlieren imaging of fluid flows around protein crystals. The isocitrate lyase study compares crystals grown terrestrially under a variety of conditions with those grown in space. The controlling factor governing the morphology of the crystals is the supersaturation. The lack of flow in the interface between the drop and the atmosphere in microgravity causes protein precipitation in the boundary layer and a lowering of the supersaturation in the drop. This lowered supersaturation leads to improved crystal morphology. Preliminary experiments with lysozyme indicated that localized temperature gradients could be used to nucleate crystals in a controlled manner. An apparatus (thermonucleator) was designed to study the controlled nucleation of protein crystals. This apparatus has been used to nucleate crystals of materials with both normal (ice-water, Rochelle salt and lysozyme) and retrograde (horse serum albumin and alpha chymotrypsinogen A) solubility. These studies have lead to the design of an new apparatus that small and more compatible with use in microgravity. Lysozyme crystals were grown by transporting nutrient from a source (lysozyme powder) to the crystal in a temperature gradient. The influence of path length and cross section on the growth rate was demonstrated. This technique can be combined with the thermonucleator to control both nucleation and growth. Graphoepitaxy utilizes a patterned substrate to orient growing crystals. In this study, silicon substrates with 10 micron grooves were used to grow crystals of catalase, lysozyme and canavalin. In all cases, the crystals grew oriented to the substrate. The supersaturation needed for nucleation and growth was lower on the patterned substrates. In some cases, isolated, large crystals were grown.

TREM2 R47H variant and risk of essential tremor: A cross-sectional international multicenter study

PubMed Central

Ortega-Cubero, Sara; Lorenzo-Betancor, Oswaldo; Lorenzo, Elena; Agúndez, José A.G.; Jiménez-Jiménez, Félix J.; Ross, Owen A.; Wurster, Isabel; Mielke, Carina; Lin, Juei-Jueng; Coria, Francisco; Clarimon, Jordi; Ezquerra, Mario; Brighina, Laura; Annesi, Grazia; Alonso-Navarro, Hortensia; García-Martin, Elena; Gironell, Alex; Marti, Maria J.; Yueh, Kuo-Chu; Wszolek, Zbigniew K.; Sharma, Manu; Berg, Daniela; Krüger, Rejko; Pastor, Maria A.; Pastor, Pau

2015-01-01

Introduction Essential tremor (ET) is the most frequent movement disorder in adults. Its pathophysiology is not clearly understood, however there is growing evidence showing common etiologic factors with other neurodegenerative disorders such as Alzheimer’s and Parkinson’s diseases (AD, PD). Recently, a rare p.R47H substitution (rs75932628) in the TREM2 protein (triggering receptor expressed on myeloid cells 2; OMIM: *605086) has been proposed as a risk factor for AD, PD and amyotrophic lateral sclerosis (ALS). The objective of the study was to determine whether TREM2 p.R47H allele is also a risk factor for developing ET. Methods This was a cross-sectional multicenter international study. An initial case-control cohort from Spain (n = 456 ET, n = 2715 controls) was genotyped. In a replication phase, a case-control series (n = 897 ET, n = 1449 controls) from different populations (Italy, Germany, North-America and Taiwan) was studied. Owed to the rarity of the variant, published results on p.R47H allele frequency from 14777 healthy controls from European, North American or Chinese descent were additionally considered. The main outcome measure was p.R47H (rs75932628) allelic frequency. Results There was a significant association between TREM2 p.R47H variant and ET in the Spanish cohort (odds ratio [OR], 5.97; 95% CI, 1.203–29.626; p = 0.042), but it was not replicated in other populations. Conclusions These results argue in favor of population-specific differences in the allelic distribution and suggest that p.R47H (rs75932628) variant may contribute to the susceptibility of ET in Spanish population. However, taking into account the very low frequency of p.R47H, further confirmatory analyses of larger ET series are needed. PMID:25585992

TREM2 R47H variant and risk of essential tremor: a cross-sectional international multicenter study.

PubMed

Ortega-Cubero, Sara; Lorenzo-Betancor, Oswaldo; Lorenzo, Elena; Agúndez, José A G; Jiménez-Jiménez, Félix J; Ross, Owen A; Wurster, Isabel; Mielke, Carina; Lin, Juei-Jueng; Coria, Francisco; Clarimon, Jordi; Ezquerra, Mario; Brighina, Laura; Annesi, Grazia; Alonso-Navarro, Hortensia; García-Martin, Elena; Gironell, Alex; Marti, Maria J; Yueh, Kuo-Chu; Wszolek, Zbigniew K; Sharma, Manu; Berg, Daniela; Krüger, Rejko; Pastor, Maria A; Pastor, Pau

2015-03-01

Essential tremor (ET) is the most frequent movement disorder in adults. Its pathophysiology is not clearly understood, however there is growing evidence showing common etiologic factors with other neurodegenerative disorders such as Alzheimer's and Parkinson's diseases (AD, PD). Recently, a rare p.R47H substitution (rs75932628) in the TREM2 protein (triggering receptor expressed on myeloid cells 2; OMIM: *605086) has been proposed as a risk factor for AD, PD and amyotrophic lateral sclerosis (ALS). The objective of the study was to determine whether TREM2 p.R47H allele is also a risk factor for developing ET. This was a cross-sectional multicenter international study. An initial case-control cohort from Spain (n = 456 ET, n = 2715 controls) was genotyped. In a replication phase, a case-control series (n = 897 ET, n = 1449 controls) from different populations (Italy, Germany, North-America and Taiwan) was studied. Owed to the rarity of the variant, published results on p.R47H allele frequency from 14777 healthy controls from European, North American or Chinese descent were additionally considered. The main outcome measure was p.R47H (rs75932628) allelic frequency. There was a significant association between TREM2 p.R47H variant and ET in the Spanish cohort (odds ratio [OR], 5.97; 95% CI, 1.203-29.626; p = 0.042), but it was not replicated in other populations. These results argue in favor of population-specific differences in the allelic distribution and suggest that p.R47H (rs75932628) variant may contribute to the susceptibility of ET in Spanish population. However, taking into account the very low frequency of p.R47H, further confirmatory analyses of larger ET series are needed. Copyright © 2014 Elsevier Ltd. All rights reserved.

Challenges of Maintaining Good Clinical Laboratory Practices in Low-Resource Settings:  A Health Program Evaluation Framework Case Study From East Africa.

PubMed

Zhang, Helen L; Omondi, Michael W; Musyoka, Augustine M; Afwamba, Isaac A; Swai, Remigi P; Karia, Francis P; Muiruri, Charles; Reddy, Elizabeth A; Crump, John A; Rubach, Matthew P

2016-08-01

Using a clinical research laboratory as a case study, we sought to characterize barriers to maintaining Good Clinical Laboratory Practice (GCLP) services in a developing world setting. Using a US Centers for Disease Control and Prevention framework for program evaluation in public health, we performed an evaluation of the Kilimanjaro Christian Medical Centre-Duke University Health Collaboration clinical research laboratory sections of the Kilimanjaro Clinical Research Institute in Moshi, Tanzania. Laboratory records from November 2012 through October 2014 were reviewed for this analysis. During the 2-year period of study, seven instrument malfunctions suspended testing required for open clinical trials. A median (range) of 9 (1-55) days elapsed between instrument malfunction and biomedical engineer service. Sixteen (76.1%) of 21 suppliers of reagents, controls, and consumables were based outside Tanzania. Test throughput among laboratory sections used a median (range) of 0.6% (0.2%-2.7%) of instrument capacity. Five (55.6%) of nine laboratory technologists left their posts over 2 years. These findings demonstrate that GCLP laboratory service provision in this setting is hampered by delays in biomedical engineer support, delays and extra costs in commodity procurement, low testing throughput, and high personnel turnover. © American Society for Clinical Pathology, 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Vitamin D levels and risk for periodontal disease: A systematic review.

PubMed

Pinto, J P N S; Goergen, J; Muniz, F W M G; Haas, A N

2018-06-01

To evaluate the existing evidence supporting or refuting the following questions: (i) Do patients with lower vitamin D levels have higher risk for periodontal disease? (ii) Are periodontal treatment outcomes improved by the adjuvant supplementation of vitamin D or by elevated serum vitamin D levels? MEDLINE, SCOPUS, EMBASE and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched up to September 2017. Studies were included if they had measured serum vitamin D levels or vitamin D intake and any periodontal parameter. Overall, 27 studies were included (13 cross-sectional studies, 6 case-control studies, 5 cohort studies, 2 randomized clinical trials and 1 case series study). Sixty-five percent of the cross-sectional studies reported significant associations between low vitamin D levels and poor periodontal parameters. None of the observational longitudinal studies found that periodontal disease progression could be attributed to lower vitamin D levels. No interventional studies that evaluated the use of vitamin D supplementation as a solely adjuvant to periodontal treatment was found. No meta-analysis was performed due to high variability across studies. The data to support or refute the association between vitamin D levels and periodontal disease are inconclusive at the moment. More rigorously designed longitudinal studies with standardized definitions of periodontal disease and vitamin D are necessary. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Depression, anxiety and self-care behaviours of young adults with Type 2 diabetes: results from the International Diabetes Management and Impact for Long-term Empowerment and Success (MILES) Study.

PubMed

Browne, J L; Nefs, G; Pouwer, F; Speight, J

2015-01-01

Young adults with Type 2 diabetes have higher physical morbidity and mortality than other diabetes sub-groups, but differences in psychosocial outcomes have not yet been investigated. We sought to compare depression and anxiety symptoms and self-care behaviours of young adults with Type 2 diabetes with two matched control groups. Using cross-sectional survey data from the Australian and Dutch Diabetes Management and Impact for Long-term Empowerment and Success (MILES) studies, we matched 93 young adults (aged 18-39 years) with Type 2 diabetes (case group) with: (i) 93 older adults ( ≥ 40 years) with Type 2 diabetes (Type 2 diabetes control group; matched on country, gender, education, diabetes duration and insulin use) and (ii) 93 young adults with Type 1 diabetes (Type 1 diabetes control group; matched on country, gender, age and education). Groups were compared with regard to depression symptoms (nine-item Patient Health Questionnaire), anxiety symptoms (seven-item Generalised Anxiety Disorder questionnaire) and frequency of selected self-care behaviours (single item per behaviour). Participants in the case group had higher depression scores (Cohen's d = 0.40) and were more likely to have clinically meaningful depressive symptoms (Cramer's V = 0.23) than those in the Type 2 diabetes control group. Participants in the case group had statistically equivalent depression scores to the Type 1 diabetes control group. The groups did not differ in anxiety scores. Those in the case group were less likely than both control groups to take insulin as recommended (Cramer's V = 0.24-0.34), but there were no significant differences between the groups in oral medication-taking. The case group were less likely than the Type 2 diabetes control group to eat healthily (Cramer's V = 0.16), and less likely than the Type 1 diabetes control group to be physically active (Cramer's V = 0.15). Our results suggest that Type 2 diabetes is as challenging as Type 1 diabetes for young adults and more so than for older adults. Young adults with Type 2 diabetes may require more intensive psychological and self-care support than their older counterparts. © 2014 The Authors. Diabetic Medicine © 2014 Diabetes UK.

Pipe crawler with extendable legs

DOEpatents

Zollinger, William T.

1992-01-01

A pipe crawler for moving through a pipe in inchworm fashion having front and rear leg assemblies separated by air cylinders to increase and decrease the spacing between assemblies. Each leg of the four legs of an assembly is moved between a wall-engaging, extended position and a retracted position by a separate air cylinder. The air cylinders of the leg assemblies are preferably arranged in pairs of oppositely directed cylinders with no pair lying in the same axial plane as another pair. Therefore, the cylinders can be as long a leg assembly is wide and the crawler can crawl through sections of pipes where the diameter is twice that of other sections. The crawler carries a valving system, a manifold to distribute air supplied by a single umbilical air hose to the various air cylinders in a sequence controlled electrically by a controller. The crawler also utilizes a rolling mechanism, casters in this case, to reduce friction between the crawler and pipe wall thereby further extending the range of the pipe crawler.

Pipe crawler with extendable legs

DOEpatents

Zollinger, W.T.

1992-06-16

A pipe crawler for moving through a pipe in inchworm fashion having front and rear leg assemblies separated by air cylinders to increase and decrease the spacing between assemblies. Each leg of the four legs of an assembly is moved between a wall-engaging, extended position and a retracted position by a separate air cylinder. The air cylinders of the leg assemblies are preferably arranged in pairs of oppositely directed cylinders with no pair lying in the same axial plane as another pair. Therefore, the cylinders can be as long as a leg assembly is wide and the crawler can crawl through sections of pipes where the diameter is twice that of other sections. The crawler carries a valving system, a manifold to distribute air supplied by a single umbilical air hose to the various air cylinders in a sequence controlled electrically by a controller. The crawler also utilizes a rolling mechanism, casters in this case, to reduce friction between the crawler and pipe wall thereby further extending the range of the pipe crawler. 8 figs.

Relationship satisfaction in women: a longitudinal case-control study about the role of breast cancer, personal assertiveness, and partners' relationship-focused coping.

PubMed

Hinnen, Chris; Hagedoorn, Mariët; Ranchor, Adelita V; Sanderman, Robbert

2008-11-01

The aim of this study was to investigate whether a breast cancer diagnosis, personal assertiveness (i.e. frequency of assertive behaviour and tension associated with this behaviour), and partners' relationship-focused coping (i.e. active engagement and protective buffering) were sources of variation in patients' relationship satisfaction, cross-sectionally and over time. This longitudinal case-control study assessed the two dimensions of personal assertiveness and relationship satisfaction in both women with cancer (N=72) and comparison controls (N=62). In addition, patients completed a measure assessing their partners' active engagement and protective buffering. Cases (i.e. women with breast cancer) were not found to report more relationship problems than controls. Women with breast cancer who tended not to express their concerns and feelings and who experienced much tension when they did, reported relatively low marital satisfaction. Moreover, partners' protective buffering was associated with less relationship satisfaction in especially more assertive (i.e. high frequency of assertive behaviour and low tension) women with cancer, while active engagement was associated with more relationship satisfaction, regardless of the women's personal assertiveness. The results of the present study indicate that a breast cancer diagnosis by itself may not be a risk factor for relationship problems. However, in the context of an illness such as cancer, personal assertiveness, and a partner's relationship-focused coping strategies do seem to play a role in maintaining a satisfactory relationship with one's partner.

Impact of Off-road Vehicles (ORVs) on Ghost Crabs of Sandy Beaches with Traffic Restrictions: A Case Study of Sodwana Bay, South Africa

NASA Astrophysics Data System (ADS)

Lucrezi, Serena; Saayman, Melville; van der Merwe, Peet

2014-03-01

Off-road vehicles (ORVs) are popular in coastal recreation, although they have negative impacts on sandy shores. In South Africa, ORVs are banned from most coastal areas, while some areas are designated for restricted ORV use, providing an opportunity to assess whether ORV traffic restrictions translate into biological returns. In Sodwana Bay, the impact of ORVs on ghost crab populations was investigated. During Easter 2012, ghost crab burrows were counted on beach sections open and closed to traffic. Burrow density in the Impact section was less than a third that of the Reference section, and by the end of the study burrow size in the Impact section was half that of the Reference section. ORV traffic caused a shift in burrow distribution to the Lower beach. However, differences in burrow densities between sections were 14 times smaller than differences obtained at a time when ORV use in Sodwana Bay was not controlled. While confirming the well-established detrimental effects of ORV use on sandy beach ecosystems, results demonstrated that traffic restrictions on beaches measurably minimize impacts to the fauna, thus translating into clear-cut biological returns.

The association between harm avoidance personality traits and self-reported concussion history in South African rugby union players.

PubMed

Mc Fie, Sarah; Abrahams, Shameemah; Patricios, Jon; Suter, Jason; Posthumus, Michael; September, Alison V

2018-01-01

Personality traits have been proposed to affect the risk of sports concussion, but evidence is limited. Cloninger's Tridimensional Personality Questionnaire (TPQ) measures novelty seeking, harm avoidance (HA), and reward dependence traits. The aim of this study was to investigate the relationship between TPQ scores and concussion history in rugby union players. Cross-sectional study. Rugby players from high schools, senior amateur clubs, and professional teams provided a self-reported concussion history and completed the TPQ. Participants reporting no previous concussions formed the control group, while participants reporting concussion formed the case group. A one-way analysis of covariance, with age as a covariate, was used to examine the differences in TPQ scores between groups. Of the 309 participants, 54% reported a minimum of one concussion (junior: 47%; amateur: 52%; professional: 72%). HA scores were significantly higher in junior players without a history of concussion compared to cases (p=0.006). Specifically, the junior control group had higher "anticipatory worry" (p=0.009) and "fear of uncertainty" (p=0.008). In contrast, the professional control group had lower HA scores than cases (p=0.009), while the amateur cohort displayed no differences between control and case groups. This study identified a novel association between HA and concussion in rugby players, adding evidence to the role of personality in a multifactorial risk-model of concussion. The findings suggest that lower HA may lead to increased dangerous play in youth rugby, influencing concussion susceptibility. Contrasting associations in the professional cohort suggest further research is required to understand the role of personality in concussion. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Childhood acute respiratory infections and household environment in an Eastern Indonesian urban setting.

PubMed

Shibata, Tomoyuki; Wilson, James L; Watson, Lindsey M; LeDuc, Alyse; Meng, Can; Ansariadi; La Ane, Ruslan; Manyullei, Syamsuar; Maidin, Alimin

2014-11-25

This pilot study evaluated the potential effect of household environmental factors such as income, maternal characteristics, and indoor air pollution on children's respiratory status in an Eastern Indonesian community. Household data were collected from cross-sectional (n = 461 participants) and preliminary childhood case-control surveys (pneumonia cases = 31 diagnosed within three months at a local health clinic; controls = 30). Particulate matter (PM2.5 and PM10) was measured in living rooms, kitchens, children's bedrooms, and outside areas in close proximity once during the case-control household interviews (55 homes) and once per hour from 6 a.m. to midnight in 11 homes. The household survey showed that children were 1.98 times (p = 0.02) more likely to have coughing symptoms indicating respiratory infection, if mothers were not the primary caregivers. More children exhibited coughing if they were not exclusively breastfed (OR = 2.18; p = 0.06) or there was a possibility that their mothers were exposed to environmental tobacco smoke during pregnancy (OR = 2.05; p = 0.08). This study suggests that household incomes and mother's education have an indirect effect on childhood pneumonia and respiratory illness. The concentrations of PM2.5 and PM10 ranged from 0.5 to 35.7 µg/m3 and 7.7 to 575.7 µg/m3, respectively, based on grab samples. PM was significantly different between the case and control groups (p < 0.01). The study also suggests that ambient air may dilute indoor pollution, but also introduces pollution into the home from the community environment. Effective intervention programs need to be developed that consider multiple direct and indirect risk factors to protect children.

Childhood Acute Respiratory Infections and Household Environment in an Eastern Indonesian Urban Setting

PubMed Central

Shibata, Tomoyuki; Wilson, James L.; Watson, Lindsey M.; LeDuc, Alyse; Meng, Can; Ansariadi; La Ane, Ruslan; Manyullei, Syamsuar; Maidin, Alimin

2014-01-01

This pilot study evaluated the potential effect of household environmental factors such as income, maternal characteristics, and indoor air pollution on children’s respiratory status in an Eastern Indonesian community. Household data were collected from cross-sectional (n = 461 participants) and preliminary childhood case-control surveys (pneumonia cases = 31 diagnosed within three months at a local health clinic; controls = 30). Particulate matter (PM2.5 and PM10) was measured in living rooms, kitchens, children’s bedrooms, and outside areas in close proximity once during the case-control household interviews (55 homes) and once per hour from 6 a.m. to midnight in 11 homes. The household survey showed that children were 1.98 times (p = 0.02) more likely to have coughing symptoms indicating respiratory infection, if mothers were not the primary caregivers. More children exhibited coughing if they were not exclusively breastfed (OR = 2.18; p = 0.06) or there was a possibility that their mothers were exposed to environmental tobacco smoke during pregnancy (OR = 2.05; p = 0.08). This study suggests that household incomes and mother’s education have an indirect effect on childhood pneumonia and respiratory illness. The concentrations of PM2.5 and PM10 ranged from 0.5 to 35.7 µg/m3 and 7.7 to 575.7 µg/m3, respectively, based on grab samples. PM was significantly different between the case and control groups (p < 0.01). The study also suggests that ambient air may dilute indoor pollution, but also introduces pollution into the home from the community environment. Effective intervention programs need to be developed that consider multiple direct and indirect risk factors to protect children. PMID:25429685

Nutrition knowledge, food label use, and food intake patterns among Latinas with and without type 2 diabetes.

PubMed

Fitzgerald, Nurgül; Damio, Grace; Segura-Pérez, Sofia; Pérez-Escamilla, Rafael

2008-06-01

To examine the associations of nutrition knowledge, food label use, and food intake patterns among Latinas with and without diagnosed diabetes. This was a case-control study. A convenience sample of 201 (100 cases with diagnosed type 2 diabetes, 101 controls without diagnosed diabetes) nonpregnant, nonbreastfeeding Latinas without severe health conditions, aged 35 to 60 years were interviewed by bicultural interviewers. Diverse community-based recruitment methods were used. Independent samples t test, Mann-Whitney U, and chi(2) tests, and multivariate logistic regression were performed. Food labels self-efficacy and stage of change, and average nutrition knowledge scores were similar between cases and controls (P>0.05). Within the diabetes group, nutrition knowledge was greater among those who had seen a registered dietitian or a diabetes educator (P=0.020). Cases reported consuming artificially sweetened desserts and beverages more frequently than controls (P<0.001). Pooled sample cross-sectional analyses showed that nutrition knowledge was positively related to food label use, which in turn was related to a more healthful food intake pattern (P<0.05). After adjusting for likely confounders, socioeconomic status (SES) was positively related to nutrition knowledge (P=0.001) and intakes of fruits, vegetables, and meats (P

[Quality control in the follow-up of pulmonary tuberculosis contacts in Camagüey, Cuba (2008-2011)].

PubMed

Dair, Roberto; Torres, Etelivar; Rodríguez, Odalys; Cruz, Ramona; Hernández, Lizzie

2014-02-19

Tuberculosis is currently a health problem in the municipality of Camagüey. To assess compliance of guidelines issued by the National Program for the Control of Tuberculosis for the follow-up of contacts of positive cases of pulmonary tuberculosis in the municipality of Camagüey, Cuba. Descriptive cross-sectional design. 1,242 contacts resulting from 39 reported cases of tuberculosis during the study period were included in the municipality of Camagüey between 2008 and 2011. Epidemiological surveys and records of reported cases were reviewed. The results were processed and analyzed in SPSS 17.0 statistical software and subsequently presented in tables and graphs. The results were summarized by percentages. The “follow-up form for contacts of pulmonary tuberculosis” was used as main guideline, which was created by experts of the Investigation and Monitoring of Tuberculosis, Acute Respiratory Infections, and Leprosy Workshop of Tropical Medicine Institute Pedro Kourí. Contacts that had an initial examination and four checkups had 96.2% of acceptability. Contacts that had fewer than four checkups showed less than 10% acceptability (3.3%). All contacts were assessed from the outset and were treated, in accordance with program guidelines. We found adequate compliance of National Program for the Control of the Tuberculosis guidelines for follow-up of contacts of positive cases of pulmonary tuberculosis. Compliance is greater in younger age groups and in the actively employed (25 to 54 years). This evaluation contributed to identify existing weaknesses in follow-up, such as low interest of this population to undergo appropriate testing in the National Program of Control of Tuberculosis.

Attention deficit hyperactivity disorder increases the risk of having abnormal eating behaviours in obese adults.

PubMed

Docet, M F; Larrañaga, A; Pérez Méndez, L F; García-Mayor, R V

2012-06-01

To determine the rate of abnormal eating behaviours in obese adult patients with attention deficit hyperactivity disorder (ADHD) in comparison with obese adult patients without ADHD. This case-control study includes: obese adult patients defined by a body mass index (BMI) ≥30 kg/m², screening positive in the adult ADHD self-report scale-V1.1. (ASRS-V1.1), attending the Nutrition Section, as cases; and obese adult patients screening negative, as controls. Weight, height and BMI were determined in all the participants. The rate of abnormal eating behaviours was determined using an eating pattern questionnaire. Forty-five out of 51 (88.2%) cases vs 127 out of 179 (70.9%) controls had abnormal eating behaviours (p=0.01). Eating between-meal snacks was found in 39 (76.5%) cases vs 107 (59.8%) controls (p=0.03), going on binge eating episodes in 28 (54.9%) vs 42 (23.5%) (p=0.00), waking up at night to eat in 11 (21.6%) vs 16 (8.9%) (p=0.01), eating large amounts of food in 13 (25.5%) vs 38 (21.2%) (p=0.52), and eating in secret in 11 (21.6%) vs 16 (8.9%) (p=0.01), respectively. This is the first study that determines the rate of these abnormal eating behaviours in obese adult patients with ADHD in comparison with obese adult patients without ADHD. A high rate of abnormal eating behaviours was observed in obese patients with ADHD. Our results suggest that ADHD is a risk factor for the development of these abnormal eating behaviours, which may be contributing factors of obesity and the unsuccessful treatment of obese patients.

A comparison of digitized frozen section and smear preparations for intraoperative neurotelepathology.

PubMed

Gould, Peter V; Saikali, Stephan

2012-01-01

Intraoperative consultations in neuropathology are often assessed by smear preparations rather than by frozen sections. Both techniques are standard practice for light microscopic examination on site, but there is little data comparing these techniques in a telepathology setting. Thirty cases of brain tumours submitted for intraoperative consultation at our institution between July and December 2010 were identified in which both frozen section and tissue smear preparations were available for digitization at 20× magnification. Slides were digitized using a Hamamatsu Nanozoomer 2.0 HT whole slide scanner, and resulting digital images were visualized at 1680 × 1050 pixel resolution with NDP. view software. The original intraoperative diagnosis was concordant with the sign out diagnosis in 29/30 cases; one tumeur was initially interpreted as a high grade glioma but proved to be a lymphoma at sign out. Digitized frozen section slides were sufficient for diagnosis at 10× magnification in 27/30 cases. Digitized tissue smears were sufficient for diagnosis at 10× magnification in 28/30 cases. In two cases tumour was present on the tissue smear but not the frozen section (one case of recurrent astrocytoma, one case of meningeal carcinomatosis). In one case of lymphoma, tumour was present on frozen section only. These discrepancies were attributed to tissue sampling rather than image quality. Examination of digitized slides at higher magnfication (20×) permitted confirmation of mitoses and Rosenthal fibers on tissue smear preparations, but did not change the primary diagnosis. Intra-slide variations in tissue thickness on smear preparations led to variable loss of focus in digitized images, but did not affect image quality in thinner areas of the smear or impede diagnosis. Digitized tissue smears are suitable for intraoperative neurotelepathology and provide comparable information to digitized frozen sections at medium power magnification.

Perceptions of malaria control and prevention in an era of climate change: a cross-sectional survey among CDC staff in China.

PubMed

Tong, Michael Xiaoliang; Hansen, Alana; Hanson-Easey, Scott; Cameron, Scott; Xiang, Jianjun; Liu, Qiyong; Liu, Xiaobo; Sun, Yehuan; Weinstein, Philip; Han, Gil-Soo; Williams, Craig; Bi, Peng

2017-03-31

Though there was the significant decrease in the incidence of malaria in central and southwest China during the 1980s and 1990s, there has been a re-emergence of malaria since 2000. A cross-sectional survey was conducted amongst the staff of eleven Centers for Disease Control and Prevention (CDC) in China to gauge their perceptions regarding the impacts of climate change on malaria transmission and its control and prevention. Descriptive analysis was performed to study CDC staff's knowledge, attitudes, perceptions and suggestions for malaria control in the face of climate change. A majority (79.8%) of CDC staff were concerned about climate change and 79.7% believed the weather was becoming warmer. Most participants (90.3%) indicated climate change had a negative effect on population health, 92.6 and 86.8% considered that increasing temperatures and precipitation would influence the transmission of vector-borne diseases including malaria. About half (50.9%) of the surveyed staff indicated malaria had re-emerged in recent years, and some outbreaks were occurring in new geographic areas. The main reasons for such re-emergence were perceived to be: mosquitoes in high-density, numerous imported cases, climate change, poor environmental conditions, internal migrant populations, and lack of health awareness. This study found most CDC staff endorsed the statement that climate change had a negative impact on infectious disease transmission. Malaria had re-emerged in some areas of China, and most of the staff believed that this can be managed. However, high densities of mosquitoes and the continuous increase in imported cases of malaria in local areas, together with environmental changes are bringing about critical challenges to malaria control in China. This study contributes to an understanding of climate change related perceptions of malaria control and prevention amongst CDC staff. It may help to formulate in-house training guidelines, community health promotion programmes and policies to improve the capacity of malaria control and prevention in the face of climate change in China.

How State-Funded Home Care Programs Respond to Changes in Medicare Home Health Care: Resource Allocation Decisions on the Front Line

PubMed Central

Corazzini, Kirsten

2003-01-01

Objective To examine how case managers in a state-funded home care program allocate home care services in response to information about a client's Medicare home health care status, with particular attention to the influence of work environment. Data Sources/Study Setting Primary data collected on 355 case managers and 26 agency directors employed in June 1999 by 26 of the 27 regional agencies administering the Massachusetts Home Care Program for low-income elders. Study Design Data were collected in a cross-sectional survey study design. A case manager survey included measures of work environment, demographics, and factorial survey vignette clients (N=2,054), for which case managers assessed service eligibility levels. An agency director survey included measures of management practices. Data Collection/Extraction Methods Hierarchical linear models estimated the effects of work environment on the relationship between client receipt of Medicare home health care and care plan levels while controlling for case-mix differences in agencies' clients. Principal Findings Case managers did not supplement extant Medicare home health services, but did allocate more generous service plans to clients who have had Medicare home health care services recently terminated. This finding persisted when controlling for case mix and did not vary by work environment. Work environment affected overall care plan levels. Conclusions Study findings indicate systematic patterns of frontline resource allocation shaping the relationships among community-based long-term care payment sources. Further, results illustrate how nonuniform implementation of upper-level initiatives may be partially attributed to work environment characteristics. PMID:14596390

Influence of the 2009 financial crisis on detection of advanced pulmonary tuberculosis in Osaka city, Japan: a cross-sectional study

PubMed Central

Danno, Katsura; Komukai, Jun; Yoshida, Hideki; Matsumoto, Kenji; Koda, Shinichi; Terakawa, Kazuhiko; Iso, Hiroyasu

2013-01-01

Objective To investigate the association between the economic recession and the detection of advanced cases of pulmonary tuberculosis in Osaka city from 2007 to 2009. Design A repeated cross-sectional study. Setting Osaka city has been the highest tuberculosis burden area in Japan. After the previous global financial crisis, the unemployment rate in Osaka prefecture has deteriorated from 5.3% in 2008 to 6.6% in 2009. Participants During the study period, 3406 pulmonary tuberculosis cases were enrolled: 2530 males and 876 females; 1546 elderly cases (65 years and above) and 1860 young cases (under 65 years); 417 homeless cases and 2989 non-homeless cases. Outcome measures Patients’ information included the sex, age, registry, health insurances, places of detection, sputum smear test results, patients’ delay, doctors’ delay and the grade of chest x-ray findings. They were statistically analysed between 2007 and 2008, two years before and just before the financial crisis, and between 2008 and 2009, just before and after the financial crisis. Results The total numbers of pulmonary tuberculosis cases were 1172 in 2007, 1083 in 2008 and 1151 in 2009. In health examinations for non-homeless people, higher number of cases in 2009 were sputum smear positive, had respiratory symptoms and showed advanced disease in chest x-rays than those in 2008, with a longer patients’ delay. On the contrary, in health examination for homeless people, fewer cases of advanced pulmonary tuberculosis were found in 2009 than in 2008, with a shorter patients’ delay. In clinical examinations, there was no trend towards a difference between non-homeless and homeless people. Conclusions Although homeless people might be protected by public assistance, tuberculosis prevention and control need to be reinforced for the non-homeless population after the financial crisis. PMID:23558729

A morphometric and histological study of placental malaria shows significant changes to villous architecture in both Plasmodium falciparum and Plasmodium vivax infection

PubMed Central

2014-01-01

Background Malaria in pregnancy remains a major health problem. Placental malaria infection may cause pathophysiological changes in pregnancy and result in morphological changes to placental villi. Quantitative histomorphological image analysis of placental biopsies was performed to compare placental villous architecture between active or treated placental malaria cases and controls. Methods A total of 67 placentas were studied from three clinical groups: control patients who did not have malaria (n = 27), active (n = 14) and treated (n=26) malaria cases, including both Plasmodium falciparum and Plasmodium vivax infections. Image analysis of histological placental sections was performed using ImageJ software to measure the number and size (area) of terminal villi, perimeter measurement per villus and total perimeter per unit area, and number of capillaries per villus (vascularity). Histological features of placental malaria were scored and these results were correlated with malaria status and clinical outcomes. Results Villous size correlated with vascularity (p <0.0001) but was inversely correlated with observed villi per unit area, (p = 0.0001). Significantly greater villous area and vascularity was observed in UK controls. Indices of histological malaria infection were significantly greater in active versus treated malaria cases. Active placental malaria cases showed significantly smaller villous area (p <0.0084), vascularity (p <0.0139) and perimeter (p <0.0006) than treated malaria cases or controls, but significantly more villi per unit area (p <0.0001). Villous size in treated malaria cases was significantly larger than active placental malaria cases (p <0.001) and similar to controls. There was a significant relationship between villous number and anaemia at the time of infection (p <0.0034), but not placental weight, birth weight or gestational age at delivery. No differences were found between histology or villous morphology comparing infections with P. falciparum or P. vivax. Conclusions These results imply that villous size, perimeter and vascularity are acutely decreased during active placental malaria, decreasing the surface area available for gas exchange per villus. However the increased number of villi per unit area offsets this change and persists after treatment. Histopathological and villous architectural changes may be reversed by early detection and appropriate anti-malarial treatment. PMID:24386908

[Usefullness of Beta-blocker for Hemodynamic Changes Induced by Uterotonic Drug in a Patient with Hypertrophic Obstructive Cardiomyopathy Undergoing Elective Cesarean Section].

PubMed

Tsukano, Yuri; Sugita, Michiko; Ikuta, Yoshihiro; Yamamoto, Tatsuo

2015-06-01

Combined spinal-epidural anesthesia (CSEA) was given to a 27-year-old woman with hypertrophic obstructive cardiomyopathy (HOCM) for a selective cesarean section. After the injection of uterotonic drug via uterine muscle and a vein after delivery, the patient developed dyspnea, tachycardia, ST-change on elecrocardiogram and hypotension. It is important in HOCM patients to control heart rate and left ventricular contractile force. We started to infuse beta-blocker (landiolol, 10 μg x kg(-1) x min(-1)) and improved these symptoms of the patient. This case demonstrates that CSEA is safe for HOCM patients and beta-blocker is effective to improve hemodynamic changes induced by uterotonic drug in these patients.

[Iliac artery occlusion balloons for suspected placenta accreta during cesarean section].

PubMed

Burgos Frías, N; Gredilla, E; Guasch, E; Gilsanz, F

2014-02-01

Massive obstetric hemorrhage still remains a major cause of maternal mortality and morbidity. The risk factors associated with this pathology must be identified in order to schedule the appropriate delivery with the necessary resources. A case is presented of an iliac artery occlusion with intravascular balloons for suspected placenta accreta during cesarean section. The perioperative treatment, as well as an analysis of the treatment options is described, along with their advantages and disadvantages, from the use of postpartum hemorrhage protocols, blood transfusion and procoagulant factors, and other maneuvers to control bleeding, until the hysterectomy. Copyright © 2012 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España. All rights reserved.

Relationships between pediatric obesity and maternal emotional states and attitudes.

PubMed

Akay, Aynur Pekcanlar; Ozturk, Yesim; Avcil, Sibel Nur; Kavurma, Canem; Tufan, Evren

2015-01-01

The goal of this study was to investigate depression and anxiety levels of mothers whose child (7-11 years) and adolescent (12-18 years) offspring had obesity, as well as those mothers' attitudes toward their children and their family relationships. This is a cross-sectional, case-control study of 100 dyads. All mothers completed the Beck Depression Inventory, the State-Trait Anxiety Inventory, the Parental Attitude Research Instrument, and the Family Assessment Device. Maternal state anxiety in the group with obesity was significantly higher than controls (p = 0.03). As measured by Family Assessment Device, affective involvement (p = 0.05) and behavior control (p = 0.00) scores were significantly higher for those with obesity. Obesity and adolescence have independent effects on maternal state anxiety; affective involvement domain of family function is affected by both obesity and its interaction with adolescence, while behavior control domain is singularly affected by obesity. Our results may demonstrate that, for the mothers of children who have obesity, this condition may have an adverse effect on their lives and their family relationships. Pediatric obesity and developmental stage of offspring may have different effects on maternally reported psychometric variables. Cross-sectional design may hinder causal explanations. Further studies with longitudinal designs are needed. © The Author(s) 2015.

Obstetricians' attitudes, subjective norms, perceived controls, and intentions on antibiotic prophylaxis in caesarean section.

PubMed

Liabsuetrakul, Tippawan; Chongsuvivatwong, Virasakdi; Lumbiganon, Pisake; Lindmark, Gunilla

2003-11-01

Over 10% of current births in all countries of the world are delivered by caesarean section. Single-dose ampicillin or cefazolin administered after cord clamping has been proven to be effective for the prevention of post-caesarean infections as indicated in many randomised trials and reviews in the Cochrane Library. This study aimed to determine three determinants of behavioural intention using the theory of planned behaviour: attitudes, subjective norms, and perceived controls. Intentions were examined for five aspects of the use of antibiotic prophylaxis, namely whether or not antibiotics were used, used in all caesarean sections, after rather than before cord clamping, whether ampicillin/cefazolin or broader-spectrum antibiotics were used, and whether single or multiple doses were given. Fifty obstetricians selected from university, regional, and general hospitals in southern Thailand, were surveyed using a questionnaire and in-depth interview. Their intentions to use a single dose and to use in all cases were low, and this was related to negative attitudes and reference groups who did not approve of the single dose. The negative attitude was based on scepticism concerning the applicability of well-equipped trials from the developed world and fear of consequences of post-caesarean infections. Norms carried over from residency training had more long-term influence in their practice than newer information from books or journals. Perceived external controls on their practice were less predictive of intentions. Intentions were only partly predictive of behaviour. Changing attitudes, introducing evidence-based information into residency training and strengthening control systems in the hospital are essential to improve intentions.

Smoking and the risk of diabetic nephropathy in patients with type 1 and type 2 diabetes: a meta-analysis of observational studies.

PubMed

Jiang, Ning; Huang, Feng; Zhang, Xiurong

2017-11-03

Conflicting evidence exists for observational studies on whether tobacco smoking is a risk factor for diabetic nephropathy (DN) in patients with type 1 (T1DM) and type 2 diabetes mellitus (T2DM). In this meta-analysis, we aimed to assess the effects of tobacco smoking on the development of DN. We searched MEDLINE and EMBASE databases from their inception to March 31 st , 2017 for cross-sectional, case-control, and prospective cohort studies. We screened reference lists of retrieved articles. Summary relative risks (SRRs) and 95% confidence intervals (CIs) were calculated using a random-effects model. A total of nineteen observational studies (1 case-control, 8 cross-sectional and 10 prospective cohort studies) were identified, involving more than 78,000 participants and a total of 17,832 DN cases. Compared with never-smokers, there was an augmented SRR (95% CI) of DN in ever-smokers in patients with T1DM (1.31 [1.06-1.62]; P = 0.006) and T2DM (1.44 [1.24-1.67]; P < 0.001), respectively. In patients with T1DM, the SRR (95% CI) was 1.25 (0.86-1.83) for microalbuminuria only, 1.27 (1.10-1.48) for macroalbuminuria only, and 1.06 (0.97-1.15) for end-stage renal disease (ESRD). In patients with T2DM, the SRR (95% CI) associated with ever smoking was 1.46 (0.94-2.26) for microalbuminuria only, 1.72 (1.04-2.84) for macroalbuminuria only, and 1.10 (0.36-3.33) for ESRD. Our meta-analysis suggests evidence for cigarette smoking as an independent risk factor for the development of DN in patients with both T1DM and T2DM.

Brain cortical structural differences between non-central nervous system cancer patients treated with and without chemotherapy compared to non-cancer controls: a cross-sectional pilot MRI study using clinically indicated scans

NASA Astrophysics Data System (ADS)

Shiroishi, Mark S.; Gupta, Vikash; Bigjahan, Bavrina; Cen, Steven Y.; Rashid, Faisal; Hwang, Darryl H.; Lerner, Alexander; Boyko, Orest B.; Liu, Chia-Shang Jason; Law, Meng; Thompson, Paul M.; Jahanshad, Neda

2017-11-01

Background: Increases in cancer survival have made understanding the basis of cancer-related cognitive impairment (CRCI) more important. CRCI neuroimaging studies have traditionally used dedicated research brain MRIs in breast cancer survivors with small sample sizes; little is known about other non-CNS cancers. However, there is a wealth of unused data from clinically-indicated MRIs that could be used to study CRCI. Objective: Evaluate brain cortical structural differences in those with non-CNS cancers using clinically-indicated MRIs. Design: Cross-sectional Patients: Adult non-CNS cancer and non-cancer control (C) patients who underwent clinically-indicated MRIs. Methods: Brain cortical surface area and thickness were measured using 3D T1-weighted images. An age-adjusted linear regression model was used and the Benjamini and Hochberg false discovery rate (FDR) corrected for multiple comparisons. Group comparisons were: cancer cases with chemotherapy (Ch+), cancer cases without chemotherapy (Ch-) and subgroup of lung cancer cases with and without chemotherapy vs C. Results: Sixty-four subjects were analyzed: 22 Ch+, 23 Ch- and 19 C patients. Subgroup analysis of 16 LCa was also performed. Statistically significant decreases in either cortical surface area or thickness were found in multiple ROIs primarily within the frontal and temporal lobes for all comparisons. Limitations: Several limitations were apparent including a small sample size that precluded adjustment for other covariates. Conclusions: Our preliminary results suggest that various types of non-CNS cancers, both with and without chemotherapy, may result in brain structural abnormalities. Also, there is a wealth of untapped clinical MRIs that could be used for future CRCI studies.

Evaluating the Role of Immunological Cells (Tissue Eosinophils and Mast Cells) in Progression of Oral Squamous Cell Carcinoma.

PubMed

Saxena, S; Singh, A; Singh, P; Sundaragiri, K S; Sankhla, B; Bhargava, A

2018-04-01

Mast cells and eosinophils are increased in oral squamous cell carcinoma. The significance of such an association has been variably thought to be either a potential diagnostic tool for stromal invasion or as a prognostic indicator. The aim of the study was to study the mast cells and eosinophils between normal oral mucosa, leukoplakia and oral squamous cell carcinoma and to study the significance of mast cells in the progression of the lesion. A retrospective study was done on archival tissue received from January 2015 to December 2015, in the Department of Oral Pathology, RUHS College of Dental Sciences, Jaipur, Rajasthan, India. Seventy (70) cases were studied (30 cases each of leukoplakia and carcinoma and 10 cases of control group), sections were stained with toluidine blue solution to reveal mast cells. Eosinophils were studied in Haematoxylin & Eosin stained sections. Mast cell density significantly increased from: normal mucosa to oral leukoplakia to carcinoma, suggesting a role of the mast cells in the development of these lesions. The higher eosinophil counts in carcinoma group compared to dysplasia group proved that they might have a role in stromal invasion. The assessment of these could become, in the future, useful for therapeutic approaches in this subset of the patient.

Nuclear reactor control column

DOEpatents

Bachovchin, Dennis M.

1982-01-01

The nuclear reactor control column comprises a column disposed within the nuclear reactor core having a variable cross-section hollow channel and containing balls whose vertical location is determined by the flow of the reactor coolant through the column. The control column is divided into three basic sections wherein each of the sections has a different cross-sectional area. The uppermost section of the control column has the greatest cross-sectional area, the intermediate section of the control column has the smallest cross-sectional area, and the lowermost section of the control column has the intermediate cross-sectional area. In this manner, the area of the uppermost section can be established such that when the reactor coolant is flowing under normal conditions therethrough, the absorber balls will be lifted and suspended in a fluidized bed manner in the upper section. However, when the reactor coolant flow falls below a predetermined value, the absorber balls will fall through the intermediate section and into the lowermost section, thereby reducing the reactivity of the reactor core and shutting down the reactor.

Effect of Free Stream Turbulence on the Performance of a Marine Hydrokinetic Turbine

NASA Astrophysics Data System (ADS)

Vinod, Ashwin; Banerjee, Arindam

2015-11-01

The effects of controlled and elevated levels of free stream turbulence on the performance characteristics of a three bladed, constant chord, untwisted marine hydrokinetic turbine is tested experimentally. Controlled homogeneous free stream turbulence levels ranging from 3% to ~20% are achieved by employing an active grid turbulence generator that is placed at the entrance of the water channel test section and is equipped with motor controlled winglet shafts. In addition to free stream turbulence, various (turbine) operating conditions such as the free stream velocity and rotational speed are varied. A comparison of performance characteristics that includes the mean and standard deviations of the power coefficient (CP) , and thrust coefficient (CT) will be presented and compared to the case of a laminar free stream with FST levels <1%.

The Publication Rate of Abstracts Presented at the 2003 Urological Brazilian Meeting

PubMed Central

Oliveira, Leonardo Resende Sousa; Figueiredo, André Avarese; Choi, Mauro; Ferrarez, Carlos Eduardo Prata Fernandes; Bastos, Andre Netto; Netto, Jose Murillo Bastos

2009-01-01

OBJECTIVE: To determine the publication rate of orally-presented abstracts from the 2003 Urological Brazilian Meeting, as well as the factors determining this publication rate. MATERIALS AND METHODS: The publication rate of the 313 orally-presented abstracts at the 2003 Urological Brazilian Meeting was evaluated by scanning the Lilacs, Scielo and Medline databases. The time between presentation and publication, the state and country of the abstract, the research methodology (cross-sectional, case-control, retrospective case series, prospective case series or clinical trial), whether drugs were utilized and the topic of the study were all characterized. RESULTS: Thirty-nine percent of the abstracts were published after a median time of 14 months (range: 1 to 51 months). There were high publication rates for cross-sectional abstracts (75%), drug utilization studies (51.3%), clinical trials (50%) and prospective case series’ (48.1%). However, there was only a moderate statistical trend towards a higher publication rate in the prospective case series (p=0.07), while the retrospective case series’ showed statistically lower publication rates than the other groups (33.7%, p=0.04). Abstracts on laparoscopic surgery had the highest publication rate (61.9%, p=0.03) compared to others topics. In 57% of the unpublished abstracts, there was no interest in or attempt to publish, and rejection was responsible for the lack of publication of only 4% of the abstracts. CONCLUSION: The publication rate of the orally-presented abstracts from the 2003 Urological Brazilian Meeting was comparable to that of international congresses. The subsequent publication of presented abstracts and the selection of prospective studies with stronger evidence should be encouraged and may improve the scientific quality of the meeting. PMID:19488593

Validation of a TFE3 break-apart FISH assay for Xp11.2 translocation renal cell carcinomas.

PubMed

Mosquera, Juan-Miguel; Dal Cin, Paola; Mertz, Kirsten D; Perner, Sven; Davis, Ian J; Fisher, David E; Rubin, Mark A; Hirsch, Michelle S

2011-09-01

Renal cell carcinomas (RCCs) with an Xp11.2 translocation predominantly affect young patients, and can present at an advanced stage. However, more cases in older patients and incidentally detected cancers at earlier stages are also being identified. As the histology of Xp11.2 RCCs overlaps with clear cell and papillary RCCs, it is not infrequent that Xp11.2 RCCs are overlooked and misdiagnosed. The objective of this study was to validate the use of fluorescence in-situ hybridization (FISH) for identifying Xp11.2 RCCs. One hundred fifty-eight consecutive, unselected renal tumors were evaluated in tissue microarrays, including 109 clear cell RCCs, 20 papillary RCCs, 3 RCCs with mixed papillary and clear cell features, 1 Xp11.2 translocation RCC, 8 chromophobe RCCs, 10 oncocytomas, and 7 angiomyolipomas. FISH evaluation was performed blinded to karyotype data, available in about two-thirds of cases. Furthermore, conventional sections of 4 Xp11.2 RCCs, 4 RCCs with mixed papillary and clear cell features, and 4 cases of alveolar soft part sarcoma (the latter for control purposes) were also assessed by FISH. Break-apart signals were homogeneously identified throughout tumor cells in 2 cases from the tissue microarrays including 1 known Xp11.2 RCC and 1 misdiagnosed Xp11.2 RCC. All conventional sections from the Xp11.2 RCC and alveolar soft part sarcoma cases were positive for the TFE3 rearrangement by FISH. All remaining cases were negative. Our study shows the clinical application of FISH in formalin-fixed, paraffin-embedded tissue for detection of Xp11.2 translocation RCCs and other tumors with this genetic aberration.

Detecting paroxysmal coughing from pertussis cases using voice recognition technology.

PubMed

Parker, Danny; Picone, Joseph; Harati, Amir; Lu, Shuang; Jenkyns, Marion H; Polgreen, Philip M

2013-01-01

Pertussis is highly contagious; thus, prompt identification of cases is essential to control outbreaks. Clinicians experienced with the disease can easily identify classic cases, where patients have bursts of rapid coughing followed by gasps, and a characteristic whooping sound. However, many clinicians have never seen a case, and thus may miss initial cases during an outbreak. The purpose of this project was to use voice-recognition software to distinguish pertussis coughs from croup and other coughs. We collected a series of recordings representing pertussis, croup and miscellaneous coughing by children. We manually categorized coughs as either pertussis or non-pertussis, and extracted features for each category. We used Mel-frequency cepstral coefficients (MFCC), a sampling rate of 16 KHz, a frame Duration of 25 msec, and a frame rate of 10 msec. The coughs were filtered. Each cough was divided into 3 sections of proportion 3-4-3. The average of the 13 MFCCs for each section was computed and made into a 39-element feature vector used for the classification. We used the following machine learning algorithms: Neural Networks, K-Nearest Neighbor (KNN), and a 200 tree Random Forest (RF). Data were reserved for cross-validation of the KNN and RF. The Neural Network was trained 100 times, and the averaged results are presented. After categorization, we had 16 examples of non-pertussis coughs and 31 examples of pertussis coughs. Over 90% of all pertussis coughs were properly classified as pertussis. The error rates were: Type I errors of 7%, 12%, and 25% and Type II errors of 8%, 0%, and 0%, using the Neural Network, Random Forest, and KNN, respectively. Our results suggest that we can build a robust classifier to assist clinicians and the public to help identify pertussis cases in children presenting with typical symptoms.

Differential Expression of c-fos Proto-Oncogene in Normal Oral Mucosa versus Squamous Cell Carcinoma

PubMed Central

Krishna, Akhilesh; Bhatt, Madan Lal Brahma; Singh, Vineeta; Singh, Shraddha; Gangwar, Pravin Kumar; Singh, Uma Shankar; Kumar, Vijay; Mehrotra, Divya

2018-01-01

Background: The c-Fos nuclear protein dimerizes with Jun family proteins to form the transcription factor AP-1 complex which participates in signal transduction and regulation of normal cellular processes. In tumorigenesis, c-Fos promotes invasive growth through down-regulation of tumor suppressor genes but its role in oral carcinogenesis is not clear. Objectives: This study concerned c-fos gene expression in normal and malignant tissues of the oral cavity, with attention to associations between expression status and clinico-pathological profiles of OSCC patients. Method: A total of 65 histopathologically confirmed OSCC tissue samples were included in case group along with an equal number of age and sex-matched normal tissue samples of oral cavity for the control group. c-Fos protein and m-RNA expressions were analyzed using immunohistochemistry and qRT-PCR, respectively. Results: A significant low expression of c-Fos protein was observed in OSCC cases than normal control subjects (p= <0.001). The mean percent positivity of c-Fos protein in cases vs. controls was 24.91± 2.7 vs. 49.68± 2.2 (p= <0.001). Most OSCC tissue samples showed weak or moderate c-Fos expression whereas 53.8% of normal tissue sections presented with strong immunostaining. Moreover, the relative m-RNA expression for the c-fos gene was significantly decreased in case group (0.93± 0.48) as compared to the control group (1.22± 0.87). Majority of c-Fos positive cases were diagnosed with well developed tumor. The mean percent positivity of c-Fos protein was significantly lower in higher grade tumor as compared with normal oral mucosa (p= < 0.001). Conclusion: The present study suggested that the c-fos gene is downregulated in oral carcinomas. The disparity of c-Fos protein levels in different pathological grades of tumor and normal oral tissue samples may indicate that loss of c-Fos expression is related with the progression of OSCC. PMID:29582647

[The practice of special observation in adults in the German-speaking part of Switzerland - a descriptive cross-sectional study].

PubMed

Lienhardt, Andrea; Rabenschlag, Franziska; Panfil, Eva-Maria

2018-06-08

The practice of special observation in adults in the German-speaking part of Switzerland - a descriptive cross-sectional study Abstract. Psychiatric Special Observation (PSO) is an intervention often used by nurses to prevent service users of harming themselves or to protect others. The intervention ranges between control and therapy and is resource intensive. Despite the widespread use of PSO, there is still no data on the practice of the intervention in Switzerland. What is the current practice of PSO in adults in psychiatric hospitals in the German-speaking part of Switzerland? Descriptive cross-sectional study. Nurses from inpatient psychiatric services in the German-speaking part of Switzerland completed a questionnaire based on a concept analysis of PSO. 538 questionnaires were analysed. PSO was more often conducted intermittent than as constant observation. In more than one out of four cases, suicidality reasoned as a cause for prescription. Nurses generally used standardized instruments to assess the risk of harming oneself or others. The duration of PSO lasted eight hours or more in three out of four cases. In every fifth case, there was no validation of the need of the intervention taking place during one shift. Nurses have a neutral attitude towards the intervention and are experiencing no or weak negative feelings during performance of PSO. The results suggest that there is an inconsistent performance of PSO in Switzerland as well as in other countries. The validation of the need of the intervention is insufficient. To facilitate PSO as a justified performance, the preparation of an interprofessional guideline is recommended.

Effects of delivery on maternal & neonatal irisin levels in normal and preeclamptic pregnant women.

PubMed

Foda, Ashraf A; Foda, Engy A

2017-10-01

The aim of this work was to measure the irisin levels in maternal and umbilical cord serums at cesarean section and vaginal delivery. This is a case-control study conducted at the Obstetric Department of the Mansoura University Hospital, Mansoura University, Egypt. The 150 nulliparous cases were divided into three groups. Serum irisin concentrations were assayed by enzyme-linked immunosorbent assay (ELISA) method. Unpaired t-test and correlation were done by using the Statistical Package for Social Scientists (SPSS). The maternal irisin levels in cases with mild preeclampsia were found to be significantly lower than that of the normal cases. In cases with mild preeclampsia, the maternal irisin levels early in labor for vaginal deliveries were significantly higher than that during cesarean section. The maternal irisin levels after vaginal deliveries were significantly higher than the levels early in labor. The maternal serum irisin was a significantly correlated with the duration of the first stage. The umbilical cord serum irisin levels were significantly correlated with the neonatal weight and with the duration of the first stage of labor. Labor is a strong stimulus to the release of irisin into the maternal and fetal circulations. Neonatal serum irisin levels are positively correlated with the birth weight and with the duration of the first stage. The neonatal birth weight and the duration of the first stage of labor are positively correlated with the umbilical cord serum irisin levels. Copyright © 2017 International Society for the Study of Hypertension in Pregnancy. Published by Elsevier B.V. All rights reserved.

CD147 overexpression may serve as a promising diagnostic and prognostic marker for gastric cancer: evidence from original research and literature.

PubMed

Hu, Chenghao; Dong, Xiaoxia; Wu, Junbo; Xiao, Feifan; Shang, Jun; Liu, Liang; Yang, Yuan; Luo, Dongmei; Li, Qiuting; Song, Qian; Yang, Jingcheng; Zhang, Chengdong; Shen, Li; Luo, Zhiguo

2017-05-09

Gastric cancer (GC) is one of the most common malignancies worldwide. The expression of CD147 protein is associated with GC. However, the clinical role of CD147 in GC has not been investigated extensively. Hence, we focused on studying the association between the expression of CD147 and clinicopathological features of GC patients in this study. Firstly, sixteen publications (1752 cases and 391 controls) and one from our own original research (143 cases) were included in the meta-analysis to obtain a more precise estimation of the diagnostic value of CD147. The results showed that expression rate of CD147 in the GC group is higher than that in control group. Moreover, gender, TNM stage, lymph node metastasis, and depth of invasion are all associated with CD147. Further, sections of gastric tissue from 143 cases underwent immunohistochemical staining for evaluation of CD147 protein expression. Our retrospective analysis demonstrated CD147 protein expression was significantly associated with clinical N stage, and tumor stage. Meanwhile, it can also serve as an independent prognosis biomarker. In conclusion, our results support the role of CD147 as a good indicator of diagnosis and prognosis.

Factors associated with Allergic Rhinitis in Colombian subpopulations aged 1 to 17 and 18 to 59.

PubMed

Peñaranda, Augusto; Garcia, Elizabeth; Barragán, Ana M; Rondón, Martín A; Pérez, Adriana; Rojas, María X; Caraballo, Luis; Dennis, Rodolfo J

2016-03-01

Several studies have shown variations in the prevalence of allergic rhinitis (AR) around the world, and different potential predisposing factors. More studies are needed on risk factors, specifically in developing countries. This study explored the association of several factors and AR among urban residents in six cities of Colombia. A cross-sectional study and a nested case-control study were carried out between 2009 and 2010 involving two Colombian subpopulations: children/adolescents and adults. Cases were affirmative respondents to "In the past 12 months, have you (or your child) had a problem with sneezing or a running or blocked nose, when you (or your child) did not have a cold or the flu?" "Controls" were subjects who never had been diagnosed with asthma, AR or atopic eczema by a physician, and whom did not report any symptoms in the past twelve months. Weighted logistic regression was used to assess the association of different factors with case/control status. Factors associated with AR in children/adolescents were family history of AR, acetaminophen consumption and high socioeconomic status. Among adults, family history of asthma, AR and atopic eczema, and cetaminophen consumption were associated with AR. Consumption of cereals among children/adolescents and eating eggs among adults showed protective associations. Our findings suggest the presence of previously unknown cultural, environmental and family factors associated with the presence of AR in Colombia.

Unmet refractive need and its determinants in Shahroud, Iran.

PubMed

Emamian, Mohammad Hassan; Zeraati, Hojjat; Majdzadeh, Reza; Shariati, Mohammad; Hashemi, Hassan; Fotouhi, Akbar

2012-08-01

Uncorrected refractive error plays a significant role in poor vision and blindness, and its correction is the most cost-effective intervention in eye care. In this study, we report the status of the unmet refractive need and the role of economic inequality in determining the level of this need in Shahroud, Iran. This cross-sectional nested case-control study was performed on 5,190 individuals aged 40-64 years. Cases and controls were individuals with uncorrected visual acuity worse than 0.3 LogMAR in the better eye who showed at least 0.2 LogMAR improvement after correction. Cases were individuals whose presenting vision was worse than 0.3 in the better eye but improved by at least 0.2 LogMAR after correction. Controls were individuals in whom the difference between the presenting and corrected vision was less than 0.2 LogMAR. The prevalence of the unmet need was 5.7 % and it was more prevalent in women (6.5 %) than in men (4.6 %) (p = 0.003). There was a gap of 19.6 % between the two groups of high and low economic status. The Oaxaca-Blinder decomposition method revealed that differences in the education level of the two groups accounted for half of this gap. Spectacle usage is better in Iran than in some other developing countries; however, in this study, about 40 % of those who required spectacles did not have them.

Surgical infection in a videolaparoscopic cholecystectomy when using peracetic acid for the sterilization of instruments.

PubMed

de Melo, Edluza Maria Viana Bezerra; Leão, Cristiano de Souza; Andreto, Luciana Marques; de Mello, Maria Júlia Gonçalves

2013-01-01

To determine the frequency of surgical site infection in patients undergoing laparoscopic cholecystectomy with instruments sterilized by peracetic acid. We conducted a retrospective, cohort, descriptive, cross-sectional study. Peracetic acid has been used for sterilization following the protocol recommended by the manufacturer. We observed the criteria and indicators of process and structure for preventing surgical site infection pre and intraoperatively. For epidemiological surveillance, outpatient visits were scheduled for the 15th and between the 30th and 45th days after discharge. Among the 247 patients, there were two cases of surgical site infection (0.8%). One patient was readmitted to systemic antibiotic therapy and percutaneous puncture; in the other the infection was superficial and followed at the clinic. Ethical issues prevent the conduction of a prospective study because of peracetic acid have been banned for the sterilization of instruments that penetrate organs and cavities. Nevertheless, these results encourage prospective case-control studies comparing its use (historical control) with ethylene oxide sterilization.

Determining the status quo of infection prevention and control standards in the hospitals of iran: a case study in 23 hospitals.

PubMed

Shojaee, Jalil; Moosazadeh, Mahmood

2014-02-01

Applying Prevention and Control of Infection (PCI) standards in hospitals reduces probable risks to patients, staff and visitors; it also increases efficiency, and ultimately improves productivity of hospitals. The current study aimed to determine the status quo of international standards of PCI in hospitals located in the north of Iran. This cross-sectional study was conducted in 23 hospitals. Data collection tool was a questionnaire with confirmed validity and reliability. . In this regard, 260 managers, section supervisors and infection control nurses participated in the study according to census basis. SPSS software version 16 was employed to analyze the data through descriptive and analytical statistics. Among the studied hospitals, 18 hospitals were public. Hospitals enjoyed 77.2% of leadership and programming, 80.8% of focus of programs, 67.4% of isolating methods, 88.2% of hand health and protection techniques, 78.8% of improving patient's safety and quality, 90.3% of training personnel, and 78.7% of the average status quo of PCI standards. This study revealed that PCI standards were significantly observed in the studied hospitals and that there were necessary conditions for full deployment of nosocomial infection surveillance.

Fibromyalgia as a cause of uncontrolled asthma: a case-control multicenter study.

PubMed

Martinez-Moragon, Eva; Plaza, Vicente; Torres, Isabel; Rosado, Ana; Urrutia, Isabel; Casas, Xavier; Hinojosa, Belen; Blanco-Aparicio, Marina; Delgado, Julio; Quirce, Santiago; Sabadell, Carles; Cebollero, Pilar; Muñoz-Fernández, Ana

2017-12-01

Fibromyalgia can affect the control of asthma when both diseases are present in a single patient. To characterize asthma in patients with concomitant fibromyalgia to assess whether fibromyalgia is an independent factor of asthma severity that influences poor asthma control. We also evaluated how dyspnea is perceived by patients in order to demonstrate that alterations in the perception of airway obstruction may be responsible for poor asthma control. This was a cross-sectional case-control multicenter study, in which 56 patients in the asthma and fibromyalgia group were matched to 36 asthmatics by sex, approximate age, and asthma severity level. All patients were women. Study variables included the Asthma Control Test (ACT), the Mini Asthma Quality of Life Questionnaire (MiniAQLQ), the Nijmegen hyperventilation syndrome questionnaire, the Hospital Anxiety and Depression Scale, and perception of dyspnea after acute bronchoconstriction. Although patients in both study groups showed similar asthma severity and use of anti-asthmatic drugs, patients in the asthma and fibromyalgia group showed lower scores on the ACT and MiniAQLQ questionnaires, and higher scores of anxiety and depression as well as hyperventilation compared to asthma patients without fibromyalgia. All these differences were statistically significant. Fibromyalgia in patients with asthma influences poor control of the respiratory disease and is associated with altered perception of dyspnea, hyperventilation syndrome, high prevalence of depression and anxiety, and impaired quality of life. Fibromyalgia may be considered a risk factor for uncontrolled asthma in patients suffering from asthma and fibromyalgia concomitantly.

Effect of cavitation on flow structure of a tip vortex

NASA Astrophysics Data System (ADS)

Matthieu, Dreyer; Reclari, Martino; Farhat, Mohamed

2013-11-01

Tip vortices, which may develop in axial turbines and marine propellers, are often associated with the occurrence of cavitation because of the low pressure in their core. Although this issue has received a great deal of attention, it is still unclear how the phase transition affects the flow structure of such a vortex. In the present work, we investigate the change of the vortex structure due to cavitation incipience. The measurement of the velocity field is performed in the case of a tip vortex generated by an elliptical hydrofoil placed in the test section of EPFL high speed cavitation tunnel. To this end, a 3D stereo PIV is used with fluorescent seeding particles. A cost effective method is developed to produce in-house fluorescent seeding material, based on polyamide particles and Rhodamine-B dye. The amount of cavitation in the vortex core is controlled by the inlet pressure in the test section, starting with the non-cavitating case. We present an extensive analysis of the vorticity distribution, the vortex intensity and core size for various cavitation developments. This research is supported by CCEM and swisselectric research.

Allele Imbalance or Loss of Heterozygosity, in Normal Appearing Breast Epithelium as a Novel Biomarker to Predict Future Breast Cancer

DTIC Science & Technology

2011-07-10

benign biopsy, had no atypia on the benign biopsy, and had no family history of breast cancer. For each breast cancer case, she selected one control...biopsies lacked atypia , and who had no fa mily history of breast cancer. 10-μ sections were cut from paraffin blocks and TDLUs were removed by laser...TITLE: Allele Imbalance or loss of heterozygosity, in normal- appearing breast epithelium as a novel biomarker to predict future breast cancer

Continuing Experiments on the Receptivity of Transient Disturbances to Surface Roughness and Freestream Turbulence

DTIC Science & Technology

2008-09-28

rotating the spindle of the angle controller with a precision of 0.2°. The multiple-hotwire holder is designed to carry four hotwires. One hotwire is a...section and a maximum operating speed of 25 m/s. The tunnel’s design follows the recommendations of Reshotko et al. (1997) for flow quality. Operating at...This sting assembly includes a shaft that rotates in a streamlined casing and allows angular calibration of slanted hotwires. Outside the test

Isocitrate dehydrogenase 1 R132H mutation is not detected in angiocentric glioma.

PubMed

Raghunathan, Aditya; Olar, Adriana; Vogel, Hannes; Parker, John R; Coventry, Susan C; Debski, Robert; Albarracin, Constance T; Aldape, Kenneth D; Cahill, Daniel P; Powell, Suzanne Z; Fuller, Gregory N

2012-08-01

Mutations of isocitrate dehydrogenase-1 gene (IDH1), most commonly resulting in replacement of arginine at position 132 by histidine (R132H), have been described in World Health Organization grade II and III diffuse gliomas and secondary glioblastoma. Immunohistochemistry using a mouse monoclonal antibody has a high specificity and sensitivity for detecting IDH1 R132H mutant protein in sections from formalin-fixed, paraffin-embedded tissue. Angiocentric glioma (AG), a unique neoplasm with mixed phenotypic features of diffuse glioma and ependymoma, has recently been codified as a grade I neoplasm in the 2007 World Health Organization classification of central nervous system tumors. The present study was designed to evaluate IDH1 R132H protein in AG. Three cases of AG were collected, and the diagnoses were confirmed. Expression of mutant IDH1 R132H protein was determined by immunohistochemistry on representative formalin-fixed, paraffin-embedded sections using the antihuman mouse monoclonal antibody IDH1 R132H (Dianova, Hamburg, Germany). Known IDH1 mutation-positive and IDH1 wild-type cases of grade II to IV glioma served as positive and negative controls. All 3 patients were male, aged 3, 5, and 15 years, with intra-axial tumors in the right posterior parietal-occipital lobe, right frontal lobe, and left frontal lobe, respectively. All 3 cases showed characteristic morphologic features of AG, including a monomorphous population of slender bipolar cells that diffusely infiltrated cortical parenchyma and ensheathed cortical blood vessels radially and longitudinally. All 3 cases were negative for the presence of IDH1 R132H mutant protein (0/3). All control cases showed appropriate reactivity. IDH1 R132H mutation has been described as a common molecular signature of grade II and III diffuse gliomas and secondary glioblastoma; however, AG, which exhibits some features of diffuse glioma, has not been evaluated. The absence of mutant IDH1 R132H protein expression in AG may help further distinguish this unique neoplasm from diffuse glioma. Copyright © 2012 Elsevier Inc. All rights reserved.

Method for isolating two aquifers in a single borehole

DOEpatents

Burklund, P.W.

1984-01-20

A method for isolating and individually instrumenting separate aquifers within a single borehole is disclosed. A borehole is first drilled from the ground surface, through an upper aquifer, and into a separating confining bed. A casing, having upper and lower sections separated by a coupling collar, is lowered into the borehole. The borehole is grouted in the vicinity of the lower section of the casing. A borehole is then drilled through the grout plug and into a lower aquifer. After the lower aquifer is instrumented, the borehole is grouted back into the lower portion of the casing. Then the upper section of the casing is unscrewed via the coupling collar and removed from the borehole. Finally, instrumentation is added to the upper aquifer and the borehole is appropriately grouted. The coupling collar is designed to have upper right-hand screw threads and lower left-hand screw thread, whereby the sections of the casing can be readily separated.

Method for isolating two aquifers in a single borehole

DOEpatents

Burklund, Patrick W.

1985-10-22

A method for isolating and individually instrumenting separate aquifers within a single borehole. A borehole is first drilled from the ground surface, through an upper aquifer, and into a separating confining bed. A casing, having upper and lower sections separated by a coupling collar, is lowered into the borehole. The borehole is grouted in the vicinity of the lower section of the casing. A borehole is then drilled through the grout plug and into a lower aquifer. After the lower aquifer is instrumented, the borehole is grouted back into the lower portion of the casing. Then the upper section of the casing is unscrewed via the coupling collar and removed from the borehole. Finally, instrumentation is added to the upper aquifer and the borehole is appropriately grouted. The coupling collar is designed to have upper right-hand screw threads and lower left-hand screw thread, whereby the sections of the casing can be readily separated.

Microtunneling systems and methods of use

DOEpatents

Richardson, John G.; Kostelnik, Kevin M.; Nickelson, Reva A.; Sloan, Paul A.

2006-07-04

A tunneling system including a tunneling apparatus including a cutting structure for forming a borehole and at least one linkage section for transmitting a force generally toward the cutting structure is disclosed. A method of disposing a casing string within a subterranean formation by applying a force generally to the trailing end of the tunneling apparatus, generally toward the leading end thereof, but without transmitting the entire force through the entire casing string is also disclosed. At least one linkage section extending within but not in contact with at least one casing section of the casing string may transmit the force. Also, a force limiting member may limit a force applied to the casing string.

Racial and ethnic differences in the risk of postpartum venous thromboembolism: a population-based, case-control study.

PubMed

Blondon, M; Harrington, L B; Righini, M; Boehlen, F; Bounameaux, H; Smith, N L

2014-12-01

Venous thromboembolism (VTE) is a major contributor of maternal morbidity and mortality. Whether maternal race/ethnicity is associated with the risk of postpartum VTE remains unclear. We conducted a population-based, case-control study in Washington State, from 1987 through 2011. Cases comprised all women with selected International Classification of Diseases, Ninth Edition, Clinical Modification codes for hospitalized VTE within 3 months post-delivery. Controls were randomly selected postpartum women who did not experience a VTE. Characteristics of women and their deliveries were abstracted from birth certificates. Using logistic regression models, we compared the risk of postpartum VTE in black, Asian, and Hispanic women with that in non-Hispanic white women, after adjustment for maternal characteristics (age, body mass index, parity, education), pregnancy complications, and delivery methods. Our study comprised 688 cases and 10 246 controls. Among controls, the mean age and body mass index were 27.5 years and 26.3 kg m(-2) , respectively. Compared with white women, black and Asian women had a greater and lower risk of postpartum VTE (adjusted odds ratio [OR] 1.50, 95% confidence interval [CI] 1.10-2.04 and OR 0.67, 95%CI 0.48-0.94, respectively). A lower risk was present in Hispanic women (adjusted OR 0.80, 95% CI 0.61-1.06) but was not statistically significant. In subgroup analyses, we observed an increased risk for black compared with white women among women who delivered via cesarean section (OR 2.03, 95% CI 1.34-3.07) but not among vaginal deliveries (OR 1.03, 95% CI 0.61-1.74). Maternal race/ethnicity is associated with the risk of postpartum VTE, independently of other risk factors, and should be considered when assessing the use of thromboprophylaxis after delivery. © 2014 International Society on Thrombosis and Haemostasis.

Comparison of MRI-assessed body fat content between lean women with polycystic ovary syndrome (PCOS) and matched controls: less visceral fat with PCOS.

PubMed

Dolfing, Jacoba G; Stassen, Chrit M; van Haard, Paul M M; Wolffenbuttel, Bruce H R; Schweitzer, Dave H

2011-06-01

BACKGROUND Polycystic ovary syndrome (PCOS) is a heterogeneous disorder. However, PCOS has a strong resemblance to the metabolic syndrome, including preponderance of visceral fat deposition. The aim of this study is to compare fat distribution between lean women with PCOS and controls matched for body composition but with regular menstrual cycles and proven fertility. METHODS In this prospective cross-sectional study in a fertility outpatient clinic, 10 Caucasian women with PCOS and 10 controls, all with a BMI between 19 and 25 kg/m(2), were included. Fasting glucose, insulin and C-peptide concentrations, homeostasis model assessment (HOMA), hormonal levels and bioelectrical impedance analysis (BIA) variables were assessed and fat content and ovarian volume determinations were obtained with magnetic resonance imaging (MRI). Multiple axial cross-sections were calculated. RESULTS The age of the PCOS and control groups were [mean (SD)] 28.2 years (2.6) versus 33.7 years (2.3) P < 0.0001, respectively, and both groups were matched for BMI: 21.6 kg/m(2) (1.1) versus 21.8 kg/m(2) (2.1) (ns), fasting glucose, insulin, C-peptide, HOMA-insulin resistance (IR) levels and BIA parameters. PCOS cases had higher ovarian volumes and less visceral fat compared with controls. CONCLUSIONS Lean women with PCOS have higher MRI-determined ovarian volumes and less visceral fat content when compared with control women.

Research and Teaching: Eight Is Not Enough--The Level of Questioning and Its Impact on Learning in Clicker Cases

ERIC Educational Resources Information Center

Terry, David R.; Lemons, Paula; Armstrong, Norris; Brickman, Peggy; Ribbens, Eric; Herreid, Clyde Freeman

2016-01-01

Three college faculty taught large general biology classes using case studies and personal response systems (clickers). Each instructor taught the same eight cases in two different sections, except the questions within the cases differed. In one section the questions were lower order (LO) factual inquiries, and in the other they were largely…

27 CFR 70.164 - Surrender of property subject to levy in the case of life insurance and endowment contracts.

Code of Federal Regulations, 2010 CFR

2010-04-01

... the case of life insurance and endowment contracts. (a) In general. This section provides special rules relating to the surrender of property subject to levy in the case of life insurance and endowment... subject to levy in the case of life insurance and endowment contracts. 70.164 Section 70.164 Alcohol...

49 CFR 511.26 - Settlement.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 6 2010-10-01 2010-10-01 false Settlement. 511.26 Section 511.26 Transportation...; Summary Judgment; Settlement § 511.26 Settlement. (a) Applicability. This section applies only to cases of..., 89 Stat. 911 (15 U.S.C. section 2007(3)). Settlement in other cases may be made only in accordance...

Index of Federal Regulations and Court Cases on the Implementation of Section 504 of the Rehabilitation Act of 1973.

ERIC Educational Resources Information Center

California State and Consumer Services Agency, Sacramento. Office of Statewide Compliance Coordination.

This index is divided into two sections: an Index on Federal Regulations and an Abstracts section of Court Cases and Administrative Decisions. Section 1 provides a topic index and comparison of contents and coverage of 16 federal departments with regulations established as of August 1981. Presented in tabular form, this index shows major topics…

[Epilepsy and pregnancy].

PubMed

Delmis, J; Drazancić, A; Tkalcević, T; Ivanisević, M

1991-01-01

A total of 132 women with epilepsy were confined in the period from 1978-1989. Their pregnancies and outcomes were analysed. The special aim was to find out if the anticonvulsive therapy has any correlation with the occurrence of fetal malformations in the studied group of women. In 43.9% of pregnant women with epilepsy, methyl-phenobarbitone as an anticonvulsive drug was administered, while carbamazepine was applied in 13.6% cases. A combination of phenytoin and phenobarbitone was prescribed in 18.9% of cases. Primidone was the drug of choice in 8% cases and 5.3% of patients were treated with various combinations of anticonvulsive drugs. Hyperemesis, threatened spontaneous abortion and premature labor complicated significantly more pregnancies in patients with epilepsy than on controls. Pregnancies from the studied group were terminated by the cesarean section in significantly more cases (11.2%) than in the control group (5.4%). Newborns from mothers with epilepsy had a statistically lower birthweight (3173 +/- 575 g) than those born from healthy mothers (3376 +/- 510g). Fifteen newborns or 11.2% were born with congenital malformations, while among the control group of newborns only two were malformed. It is noticed that the newborns from mothers treated with phenitoin and phenobarbitone had dysmorphic anomalies of the face more frequently. The drugs mentioned above interfere with the metabolism of K vitamin and as a result of this interreaction, mothers and newborns can suffer from coagulation disorders. In conclusion it is important to mention that no anticonvulsant drug seems to be absolutely safe when used during pregnancy since each of them has a teratogenic effect on the fetus.

Modeling the transmission dynamics and control of rabies in China.

PubMed

Ruan, Shigui

2017-04-01

Human rabies was first recorded in ancient China in about 556 BC and is still one of the major public-health problems in China. From 1950 to 2015, 130,494 human rabies cases were reported in Mainland China with an average of 1977 cases per year. It is estimated that 95% of these human rabies cases are due to dog bites. The purpose of this article is to provide a review about the models, results, and simulations that we have obtained recently on studying the transmission of rabies in China. We first construct a basic susceptible, exposed, infectious, and recovered (SEIR) type model for the spread of rabies virus among dogs and from dogs to humans and use the model to simulate the human rabies data in China from 1996 to 2010. Then we modify the basic model by including both domestic and stray dogs and apply the model to simulate the human rabies data from Guangdong Province, China. To study the seasonality of rabies, in Section 4 we further propose a SEIR model with periodic transmission rates and employ the model to simulate the monthly data of human rabies cases reported by the Chinese Ministry of Health from January 2004 to December 2010. To understand the spatial spread of rabies, in Section 5 we add diffusion to the dog population in the basic SEIR model to obtain a reaction-diffusion equation model and determine the minimum wave speed connecting the disease-free equilibrium to the endemic equilibrium. Finally, in order to investigate how the movement of dogs affects the geographically inter-provincial spread of rabies in Mainland China, in Section 6 we propose a multi-patch model to describe the transmission dynamics of rabies between dogs and humans and use the two-patch submodel to investigate the rabies virus clades lineages and to simulate the human rabies data from Guizhou and Guangxi, Hebei and Fujian, and Sichuan and Shaanxi, respectively. Some discussions are provided in Section 7. Copyright © 2017 Elsevier Inc. All rights reserved.

Peculiarities of section topograms for the multiple diffraction of X rays

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

Kohn, V. G., E-mail: kohnvict@yandex.ru; Smirnova, I. A.

The distortion of interference fringes on the section topograms of single crystal due to the multiple diffraction of X rays has been investigated. The cases of the 220 and 400 reflections in a silicon crystal in the form of a plate with a surface oriented normally to the [001] direction are considered both theoretically and experimentally. The same section topogram exhibits five cases of multiple diffraction at small azimuthal angles for the 400 reflection and MoK{sub α} radiation, while the topogram for the 220 reflection demonstrates two cases of multiple diffraction. All these cases correspond to different combinations of reciprocalmore » lattice vectors. Exact theoretical calculations of section topograms for the aforementioned cases of multiple diffraction have been performed for the first time. The section topograms exhibit two different distortion regions. The distortions in the central region of the structure are fairly complex and depend strongly on the azimuthal angle. In the tails of the multiple diffraction region, there is a shift of two-beam interference fringes, which can be observed even with a laboratory X-ray source.« less

Ethnic differences in risk factors for ischemic stroke: a European case-control study.

PubMed

Hajat, Cother; Tilling, Kate; Stewart, Judy A; Lemic-Stojcevic, Nada; Wolfe, Charles D A

2004-07-01

The aim is to estimate the relative risk and population attributable risk (PAR) of risk factors for ischemic stroke by ethnic group. In this case-control study, cases of first ischemic stroke were taken from the South London Stroke Register and controls from a cross-sectional prevalence survey covering the same area. PAR was determined for each risk factor by ethnic group. Multivariable analysis was used to examine the association between risk factors and ischemic stroke across all ethnic groups. 664 cases and 716 controls aged 45 to 74 years were included, with ethnicity of white 78%:42%, black Caribbean 16%:43%, and black African 6%:15%, respectively. For the white group, high PAR was found for ischemic heart disease (IHD) on ECG (56% [95% CI, 49% to 62%]), obesity (49% [95% CI, 40% to 56%]), hypertension (HT) (38% [95% CI, 29% to 46%]), smoking (31% [95% CI, 19% to 41%]), transient ischemic attack (TIA) (23% [95% CI, 19% to 27%]), and atrial fibrillation (AF) (16% [95% CI, 10% to 21%]). In the black Caribbean compared with the white group, PAR was higher for HT (46% [95% CI, 21% to 63%]) and diabetes mellitus (DM) (29% [95% CI, 14% to 42%]), and lower for current smoking (18% [95% CI, 1% to 32%]) and AF (10% [95% CI, 0% to 18%]). In the black African group HT had a higher PAR (59% [95% CI, 91% to 82%]) than the other groups. PAR for AF (11% [95% CI, -11% to 29%]), obesity (30% [95% CI, -20% to 60%]), and DM (4% [95% CI, -25% to 26%]) was low compared with the other groups. In multivariable analysis, risk factors associated with ischemic stroke included TIA, AF, IHD on ECG, smoking, excess alcohol, obesity, HT, and DM. In the first European case-control study examining risk factors for ischemic stroke in black Caribbean and African populations, some differences were demonstrated in the impact of risk factors between these groups. It may be important to address such differences when developing stroke preventative strategies.

Intra-operative fluid warming in elective caesarean section: a blinded randomised controlled trial.

PubMed

Woolnough, M; Allam, J; Hemingway, C; Cox, M; Yentis, S M

2009-10-01

We assessed the effect of warming intravenous fluids during elective caesarean section under combined spinal-epidural anaesthesia in a blinded, randomised controlled trial. Seventy-five women having elective caesarean section were randomly assigned to receive all intravenous fluids at room temperature, or heated in a cabinet set at 45 degrees C or via a Hotline fluid warmer (Smiths Medical International Ltd, Watford, Herts, UK). After 10 mL/kg crystalloid preload, combined spinal-epidural anaesthesia was performed. Core and ambient temperatures, thermal comfort and shivering were measured every 15 min thereafter. The primary outcome was the temperature at 60 min. Temperature decreased in all groups. Although the temperature decrease at 60 min was similar in the heated cabinet and Hotline groups, the room temperature group exhibited a greater decrease [difference 0.4 degrees C (95% CI 0.2-0.6 degrees C); P=0.015]. More women felt cold in the room temperature group (8: 32%) than in the heated cabinet set (3: 12%) and Hotline (1: 4%) groups (P=0.02), but the incidence of shivering was similar: 11 (44%), 9 (36%) and 7 (28%) respectively. Apgar scores and neonatal cord gases were similar. Warming intravenous fluids mitigates the decrease in maternal temperature during elective caesarean section under combined spinal-epidural anaesthesia and improves thermal comfort, but does not affect shivering. Intravenous fluids should be warmed routinely in elective caesarean section, especially for cases of expected long duration, but the use of pre-warmed fluids is as efficient and cheaper than using a Hotline fluid warmer.

Obstetric and perinatal health outcomes related to schizophrenia: A national register-based follow-up study among Finnish women born between 1965 and 1980 and their offspring.

PubMed

Simoila, Laura; Isometsä, Erkki; Gissler, Mika; Suvisaari, Jaana; Halmesmäki, Erja; Lindberg, Nina

2018-05-04

This national register-based study assesses obstetric and perinatal health outcomes in women with schizophrenia and their offspring. Using the Care Register for Health Care, we identified Finnish women who were born in 1965- 1980 and diagnosed with schizophrenia. For each case, five age- and place-of-birth- matched controls were obtained from the Central Population Register of Finland. They were followed from the day when the disorder was diagnosed in specialized health-care (the index day) until 31.12.2013. Information related to births was obtained from the Medical Birth Register and the Register of Congenital Malformations. We focused on singleton pregnancies that led to a delivery after the index day. We restricted the analysis of deliveries in controls to those that occurred after the index day of the case. Maternal age, marital status, smoking status, sex of the newborn, and parity were used as covariates in adjusted models. We identified 1162 singleton births among women with schizophrenia and 4683 among controls. Schizophrenic women had a 1.4-fold increased risk of induction of labor, delivery by cesarean section, and delivery by elective cesarean section. Regarding offspring, the risk of premature birth and the risk of low Apgar score at 1 min (<7) were 1.6-fold, of resuscitation 2.5-fold, and of neonatal monitoring 2.1-fold higher. Schizophrenia associates with some specific delivery methods, but delivery complications are rare and their prevalence does not differ from that observed among community women. Maternal schizophrenia associates with some negative perinatal health outcomes of the offspring. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Toxocara spp. infection and risk of childhood asthma: A systematic review and meta-analysis.

PubMed

Aghaei, Shima; Riahi, Seyed Mohammad; Rostami, Ali; Mohammadzadeh, Iraj; Javanian, Mostafa; Tohidi, Ehsan; Foroutan, Masoud; Esmaeili Dooki, Mohammadreza

2018-06-01

Asthma is one of the most common chronic respiratory disease worldwide, with a negative impact on quality of life and socio-economic status of patients. There are some evidences to suggest that Toxocara infection is a neglected risk factor for childhood asthma. We performed a systematic review and meta-analysis to further understanding of this relationship. Five databases include PubMed, Science Direct, Scopus, Web of Science (ISI), and Google scholar were searched (up to October 2017) to identify the relevant studies. We used random-effects meta-analysis model to estimate the pooled odds ratio (OR) and 95% confidence intervals (CI). Heterogeneity was assessed with the Q-test and I 2 statistic. A total of 17 studies including 11 studies with case-control design (1139 patients and 1023 controls) and six studies with cross-sectional design (a total of 5469 participants, 872 asthmatics, and 4597 non-asthmatics children) met the eligibility criteria. An increased risk for asthma was observed in children with Toxocara infection seropositivity (OR, 1.91; 95% CI, 1.47-2.47). In sub-group analysis, the pooled ORs were (OR, 2.13; 95% CI, 1.43-3.15) and (OR, 1.73; 95% CI, 1.23-2.44) for case-control and cross-sectional studies, respectively. Moreover, considering to specific IgE seropositivity, a pooled OR of 2.36 (95% CI, 0.93-5.98) was observed. In conclusion, this meta-analysis revealed that children infected with Toxocara spp. are more likely to have asthma compared to non-infected children. More studies (especially longitudinal studies) are needed to further investigate the impact of Toxocara spp. infection on the onset or development of asthma. Copyright © 2018 Elsevier B.V. All rights reserved.

Improvement of perinatal outcome in diabetic pregnant women.

PubMed

Szilagyi, A; Szabo, I

2001-01-01

Obstetrical and perinatal outcomes in newborns of diabetic pregnant women depend on metabolic control and fetal surveillance during pregnancy. The effects of fetal surveillance on perinatal mortality and morbidity was analyzed in diabetic pregnant women with appropriate glucose control in our regional center for diabetes and pregnancy. 480 deliveries complicated by frank or gestational diabetes occurred in our Department in the period of 1988-1999. Perinatal mortality and morbidity, prevalence of premature deliveries, methods of fetal surveillance, options for respiratory distress syndrome (RDS) profilaxis, cesarean section rate, timing of delivery and its indications and occurrence of malformations have been analyzed. It was found that malformation rate and perinatal mortality may be reduced to even lower level than that of in healthy pregnant women by appropriate glucose control and by using the latest methods of intrauterine fetal surveillance including cardiotocography (non stress test and oxytocin challenge test), doppler fetal artery velocimetry and fetal pulse oximetry. Timing of delivery was needed in 35% of the cases with IDDM and 15% of gestational diabetes due to chronic placental insufficiency. If labour induction was needed before the 38 weeks, amniocentesis was performed to test fetal lung maturity. Direct fetal glucocorticoid administration was used to enhance fetal lung maturation in 14 cases. C-section rate was slightly higher than that of in non diabetic pregnant women. Our perinatal morbidity data (macrosomia, hyperbilirubinemia, hypoglycemia, injuries, infections) are comparable with the data from the literature. Although perinatal mortality with the help of thorough fetal surveillance is even better in diabetic pregnant women than in non diabetic patients, future eye should be focused on factors affecting perinatal morbidity, because it is still higher than in newborns of healthy mothers.

Immunohistochemical characterization of neoplastic cells of breast origin.

PubMed

Noriega, Mariadelasmercedes; Paesani, Fernando; Perazzo, Florencia; Lago, Néstor; Krupitzki, Hugo; Nieto, Silvana; Garcia, Alejandro; Avagnina, Alejandra; Elsner, Boris; Denninghoff, Valeria Cecilia

2012-06-22

After skin cancer, breast cancer is the most common malignancy in women. Tumors of unknown origin account for 5-15% of malignant neoplasms, with 1.5% being breast cancer. An immunohistochemical panel with conventional and newer markers, such as mammaglobin, was selected for the detection of neoplastic cells of breast origin. The specific objectives are: 1) to determine the sensitivity and specificity of the panel, with a special emphasis on the inclusion of the mammaglobin marker, and 2) to compare immunohistochemistry performed on whole tissue sections and on tissue micro-array. Twenty-nine metastatic breast tumors were included and assumed as tumors of unknown origin. Other 48 biopsies of diverse tissues were selected and assumed as negative controls. Tissue Micro-Array was performed. Immunohistochemistry for mammaglobin, gross cystic disease fluid protein-15, estrogen receptor, progesterone receptor and cytokeratin 7 was done. Mammaglobin positive staining was observed in 10/29 cases, in 13/29 cases for gross cystic disease fluid protein-15, in 20/29 cases for estrogen receptor, in 9/29 cases for progesterone receptor, and in 25/29 cases for cytokeratin 7. Among the negative controls, mammaglobin was positive in 2/48, and gross cystic disease fluid protein-15 in 4/48. The inclusion of MAG antibody in the immunohistochemical panel for the detection of tumors of unknown origin contributed to the detection of metastasis of breast cancer. The diagnostic strategy with the highest positive predictive value (88%) included hormone receptors and mammaglobin in serial manner.

Translabyrinthine vestibular neurectomy and simultaneous cochlear implant for Ménière's disease.

PubMed

Canzi, Pietro; Manfrin, Marco; Perotti, Marco; Aprile, Federico; Quaglieri, Silvia; Rebecchi, Elisabetta; Locatelli, Giulia; Benazzo, Marco

2017-01-01

Surgical management of Ménière's disease (MD) is recommended in case of medical and intratympanic treatment failures. Translabyrinthine vestibular nerve section has been considered the gold standard for denervation procedures in order to control vertigo attacks, although at the cost of sacrificing residual hearing. To the best of our knowledge, no work has been published with regard to a group of patients submitted to translabyrinthine vestibular neurectomy and simultaneous cochlear implant for MD. The aim of the present study was to assess the effectiveness of translabyrinthine vestibular nerve section and simultaneous cochlear implant in a prospective study. All adult patients (over 18 years of age) with a diagnosis of intractable unilateral definite MD and useless residual hearing function were enrolled after medical and intratympanic treatment failures. Pre- and postoperative otoneurological evaluation concerned: frequency of vertigo attacks, head impulse test and caloric testing, pure tone average and speech perception audiometry in quiet conditions, tinnitus handicap inventory test, functional level scale and rate of vertigo control, dizziness handicap inventory test, and MD patient-oriented severity index. At least 6 months of follow-up were needed to be enrolled in the study. Four patients were included in the study. Translabyrinthine vestibular nerve section and simultaneous cochlear implant seemed to considerably improve the disabling effects of MD, achieving a good control of vestibular symptoms (mean pre/postoperative vertigo attacks per month: 16.5/0), resolving hearing loss (mean pre/postoperative pure tone average in the affected ear: 86.2/32.5 dB), improving the tinnitus (mean pre/postoperative tinnitus handicap inventory test: 77.2/6), and finally increasing the overall quality-of-life parameters. In our preliminary report, translabyrinthine vestibular nerve section and simultaneous cochlear implant showed encouraging results in order to definitively control both vestibular and cochlear symptoms during the same therapeutic procedure.

Influence Assessment of Multiple Large-sized Reservoirs on Flooding in the Huai River Watershed, China

NASA Astrophysics Data System (ADS)

Wan, X. Y.

2017-12-01

The extensive constructions of reservoirs change the hydrologic characteristics of the associated watersheds, which obviously increases the complexity of watershed flood control decisions. By evaluating the impacts of the multi-reservoir system on the flood hydrograph, it becomes possible to improve the effectiveness of the flood control decisions. In this paper we compare the non-reservoir flood hydrograph with the actual observed flood hydrograph using the Lutaizi upstream of Huai river in East China as a representative case, where 20 large-scale/large-sized reservoirs have been built. Based on the total impact of the multi-reservoir system, a novel strategy, namely reservoir successively added (RSA) method, is presented to evaluate the contribution of each reservoir to the total impact. According each reservoir contribution, the "highly effective" reservoirs for watershed flood control are identified via hierarchical clustering. Moreover, we estimate further the degree of impact of the reservoir current operation rules on the flood hydrograph on the base of the impact of dams themselves. As a result, we find that the RSA method provides a useful method for analysis of multi-reservoir systems by partitioning the contribution of each reservoir to the total impacts on the flooding at the downstream section. For all the historical large floods examined, the multi-reservoir system in the Huai river watershed has a significant impact on flooding at the downstream Lutaizi section, on average reducing the flood volume and peak discharge by 13.92 × 108 m3 and 18.7% respectively. It is more informative to evaluate the maximum impact of each reservoir (on flooding at the downstream section) than to examine the average impact. Each reservoir has a different impact on the flood hydrograph at the Lutaizi section. In particular, the Meishan, Xianghongdian, Suyahu, Nanwan, Nianyushan and Foziling reservoirs exert a strong influence on the flood hydrograph, and are therefore important for flood control on the Huai river. Under the current operation rules, the volume and peak discharge of flooding at the Lutaizi section are reduced by 13.69 × 108m3 and 1429 m3/s respectively, accounting for 98% and 80.5% of the real reduction respectively.

A series of forensic toxicology and drug seizure cases involving illicit fentanyl alone and in combination with heroin, cocaine or heroin and cocaine.

PubMed

Marinetti, Laureen J; Ehlers, Brooke J

2014-10-01

The Montgomery County Coroner's Office Toxicology Section and the Miami Valley Regional Crime Lab (MVRCL) Drug Chemistry Section have been receiving case work in drug seizures, death cases and human performance cases involving products marketed as heroin or as illicit fentanyl. Upon analysis by the Drug Chemistry Section, these products were found to contain various drug(s) including illicit fentanyl only, illicit fentanyl and heroin, illicit fentanyl and cocaine and illicit fentanyl, heroin and cocaine. Both the Chemistry and Toxicology Sections began seeing these combinations starting in late October 2013. The percentage of the combinations encountered by the MVRCL as well as the physical appearance of the product, and the results of presumptive screening tests will be discussed. The demographics of the users and the results of toxicology and autopsy findings on the decedents will also be discussed. According to regional drug task force undercover agents, there is evidence that some of the products are being sold as illicit fentanyl and not just as a heroin product. Also, there is no evidence to support that the fentanyl source is being diverted from pharmaceutical grade fentanyl. The chemistry section currently has over 109 confirmed cases, and the toxicology section currently has 81 confirmed drug deaths, 8 driving under the influence of drugs and 1 suicidal hanging. Both sections are continuing to see these cases at the present time. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Evaluate fundamental approaches to longwall dust control. Phase III report

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

Babbitt, C.; Bartlett, P.; Kelly, J.

1984-03-31

The overall objective of the contract is to evaluate the effectiveness of available dust control technology for double-drum shearer longwall sections in a coordinated, systematic program at a few longwall test sections and to make the results available to the entire coal mining industry. This program is investigating nine different dust control techniques. These nine subprograms encompass a broad range of dust control measures ranging from administrative controls to new hardware. They span not only presently employed methods but also those recently adopted in the United States and those proposed for the future. This report documents the Phase III effortmore » on each of the subprograms. For clarity, the report is divided in sections by subprogram as follows: Section 2, Subprogram A - passive barriers/spray air movers for dust control; Section 3, Subprogram B - practical aspects of deep cutting; Section 4, Subprogram C - stage loader dust control; Section 5, Subprogram D - longwall automation technology; Section 6, Subprogram E - longwall application of ventilation curtains; Section 7, Subprogram F - reversed drum rotation; Section 8, Subprogram G - reduction of shield generated dust; Section 9, Subprogram H - air canopies for longwalls; and Section 10, Subprogram I - mining practices. 43 figures, 11 tables.« less

Maternal plasma levels of interleukin-6, C-reactive protein, vitamins C, E and A, 8-isoprostane and oxidative status in women with preterm premature rupture of membranes.

PubMed

Ilhan, Nevin; Celik, Ebru; Kumbak, Banu

2015-02-01

Preterm premature rupture of membranes (PPROM) is associated with significant maternal and perinatal morbidity. This study examined maternal oxidative stress in PPROM. This was a prospective cross-sectional study conducted in a university hospital. A total of 72 pregnant women were recruited into two groups, those with PPROM (38 cases) and those without PPROM (34 controls) matched for gestational age. Plasma interleukin-6, C-reactive protein, vitamins C, E and A, 8-isoprostane, total oxidant status (TOS) and antioxidant status (TAS) were determined for all study participants and the data were compared between the PPROM and control groups. Both case and control groups were comparably matched in age, parity, gestational age and smoking status. There was a significant association between low 8-isoprostane, low vitamin C and high total oxidant status and the occurrence of PPROM (p < 0.001). Plasma vitamin C and 8-isoprostane levels were lower and TOS higher in women with PPROM. Further research is needed to identify robust biological markers for the prevention and also prognosis of PPROM.

Prevalence of dental attrition in in vitro fertilization children of West Bengal

PubMed Central

Kar, Sudipta; Sarkar, Subrata; Mukherjee, Ananya

2014-01-01

CONTEXT: Dental attrition is one of the problems affecting the tooth structure. It may affect both in vitro fertilization (IVF) and spontaneously conceived children. AIMS: This study was aimed to evaluate and to compare the prevalence of dental attrition in deciduous dentition of IVF and spontaneously conceived children. SETTINGS AND DESIGN: In a cross-sectional case control study dental attrition status of 3-5 years old children were assessed. The case group consisted of term, singleton babies who were the outcome of IVF in the studied area in 2009. SUBJECTS AND METHODS: The control group consisted of term, first child, singleton and spontaneously conceived 3-5 years old children who were also resident of the studied area. A sample of 153 IVF and 153 spontaneously conceived children was examined according to Hansson and Nilner classification. STATISTICAL ANALYSIS USED: Statistical analysis was carried out using Chi-square tests (χ2 ) or Z test. RESULTS: No statistically significant difference found in studied (IVF children) and control group (spontaneously conceived children). CONCLUSIONS: IVF children are considered same as spontaneously conceived children when studied in relation to dental attrition status. PMID:24829529

[Accesibility and use of spirometry in primary care centers in Catalonia].

PubMed

Llauger, M Antònia; Rosas, Alba; Burgos, Felip; Torrente, Elena; Tresserras, Ricard; Escarrabill, Joan

2014-01-01

Examine the accessibility and use of forced spirometry (FS) in public primary care facilities centers in Catalonia. Cross-sectional study using a survey. Three hundred sixty-six Primary Care Teams (PCT) in Catalonia. Third quarter of 2010. Survey with information on spirometers, training, interpretation and quality control, and the priority that the quality of spirometry had for the team. Indicators FS/100 inhabitants/year, FS/month/PCT; FS/month/10,000 inhabitants. Response rate: 75%. 97.5% of PCT had spirometer and made an average of 2.01 spirometries/100 inhabitants (34.68 spirometry/PCT/month). 83% have trained professionals.>50% centers perform formal training but no information is available on the quality. 70% performed some sort of calibration. Interpretation was made by the family physician in 87.3% of cases. In 68% of cases not performed any quality control of exploration. 2/3 typed data manually into the computerized medical record.>50% recognized a high priority strategies for improving the quality. Despite the accessibility of EF efforts should be made to standardize training, increasing the number of scans test and promote systematic quality control. Copyright © 2013 Elsevier España, S.L. All rights reserved.

A Modular Approach to Model Oscillating Control Surfaces Using Navier Stokes Equations

NASA Technical Reports Server (NTRS)

Guruswamy, Guru P.; Lee, Henry

2014-01-01

The use of active controls for rotorcraft is becoming more important for modern aerospace configurations. Efforts to reduce the vibrations of helicopter blades with use of active-controls are in progress. Modeling oscillating control surfaces using the linear aerodynamics theory is well established. However, higher-fidelity methods are needed to account for nonlinear effects, such as those that occur in transonic flow. The aeroelastic responses of a wing with an oscillating control surface, computed using the transonic small perturbation (TSP) theory, have been shown to cause important transonic flow effects such as a reversal of control surface effectiveness that occurs as the shock wave crosses the hinge line. In order to account for flow complexities such as blade-vortex interactions of rotor blades higher-fidelity methods based on the Navier-Stokes equations are used. Reference 6 presents a procedure that uses the Navier-Stokes equations with moving-sheared grids and demonstrates up to 8 degrees of control-surface amplitude, using a single grid. Later, this procedure was extended to accommodate larger amplitudes, based on sliding grid zones. The sheared grid method implemented in EulerlNavier-Stokes-based aeroelastic code ENS AERO was successfully applied to active control design by industry. Recently there are several papers that present results for oscillating control surface using Reynolds Averaged Navier-Stokes (RANS) equations. References 9 and 10 report 2-D cases by filling gaps with overset grids. Reference 9 compares integrated forces with the experiment at low oscillating frequencies whereas Ref. 10 reports parametric studies but with no validation. Reference II reports results for a 3D case by modeling the gap region with a deformed grid and compares force results with the experiment only at the mid-span of flap. In Ref. II grid is deformed to match the control surface deflections at the section where the measurements are made. However, there is no indication in Ref. II that the gaps are explicitly modeled as in Ref. 6. Computations using overset grids are reported in Ref. 12 for a case by adding moving control surface to an existing blade but with no validation either with an experiment or another computation.

A Rare Case of Transvesical Cesarean Section

PubMed Central

Juneja, Sunil Kumar; Tandon, Pooja; Kochhar, Bakul; Singh, Harman Deep; Sharma, Bhanupriya

2017-01-01

Cesarean section, also commonly known as C-section, is a surgical procedure in which incision is made through a mother's abdomen and uterus to deliver one or more babies. According to urgency, they are classified either as elective or emergency. According to technique, they have been classified as classical, lower uterine segment and cesarean hysterectomy. Intentional transvesical cesarean though not a routinely practiced technique is used for delivery in women born with imperforate anus, ectopic intravaginal urethra, vaginal and urethral strictures, and bladder adherent completely over the uterus. Since such cases are very rare, we are reporting one such case of transvesical cesarean section. PMID:28904925

Sleep disturbance in psoriasis - a case-controlled study.

PubMed

Jensen, P; Zachariae, C; Skov, L; Zachariae, R

2018-04-28

Sleep is essential for daytime functioning and health. Given the physical symptoms of psoriasis, a higher prevalence of sleep disorders could be expected. So far, the studies examining sleep disturbance in psoriasis have been of less-than-optimal methodological quality and with mixed results. We aimed to: 1) examine the prevalence of sleep disturbance in patients with plaque psoriasis compared to controls, 2) evaluate associations with health-related quality of life (HRQoL), and 3) examine possible disease-related predictors of disturbed sleep. We used a cross-sectional, case-controlled design. Participants included 179 consecutively recruited patients with plaque psoriasis and 105 controls. Measures included psoriasis severity (Psoriasis Area and Severity index [PASI]); HRQoL (Dermatology Life Quality Index [DLQI]); insomnia severity (Insomnia Severity Index [ISI]); sleep quality (Pittsburgh Sleep Quality Index [PSQI]); stress (Perceived Stress Scale [PSS]); Itch (Itch Severity Scale [ISS]); and depressive symptoms (Beck Depression Inventory [BDI]). Analyses included group comparisons and regression analyses to identify predictors of sleep disturbance. Twenty-five per cent of patients with psoriasis reported clinical insomnia (ISI > 15), compared with 10.5% of controls. In all, 53.9% of patients with psoriasis were poor sleepers (PSQI > 5), compared with 21.9% of controls. Itch was statistically significantly associated with all sleep-related outcomes. A higher proportion of patients with psoriasis suffer from poor sleep than controls from the general population. Itch was the main predictor of impaired sleep. Improved control of psoriasis with decreased itch may improve sleep disturbance in psoriasis. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Adaptive Control of Linear Modal Systems Using Residual Mode Filters and a Simple Disturbance Estimator

NASA Technical Reports Server (NTRS)

Balas, Mark; Frost, Susan

2012-01-01

Flexible structures containing a large number of modes can benefit from adaptive control techniques which are well suited to applications that have unknown modeling parameters and poorly known operating conditions. In this paper, we focus on a direct adaptive control approach that has been extended to handle adaptive rejection of persistent disturbances. We extend our adaptive control theory to accommodate troublesome modal subsystems of a plant that might inhibit the adaptive controller. In some cases the plant does not satisfy the requirements of Almost Strict Positive Realness. Instead, there maybe be a modal subsystem that inhibits this property. This section will present new results for our adaptive control theory. We will modify the adaptive controller with a Residual Mode Filter (RMF) to compensate for the troublesome modal subsystem, or the Q modes. Here we present the theory for adaptive controllers modified by RMFs, with attention to the issue of disturbances propagating through the Q modes. We apply the theoretical results to a flexible structure example to illustrate the behavior with and without the residual mode filter.

The impact of primary open-angle glaucoma: Quality of life in Indian patients.

PubMed

Kumar, Suresh; Ichhpujani, Parul; Singh, Roopali; Thakur, Sahil; Sharma, Madhu; Nagpal, Nimisha

2018-03-01

Glaucoma significantly affects the quality of life (QoL) of a patient. Despite the huge number of glaucoma patients in India, not many, QoL studies have been carried out. The purpose of the present study was to evaluate the QoL in Indian patients with varying severity of glaucoma. This was a hospital-based, cross-sectional, analytical study of 180 patients. The QoL was assessed using orally administered QoL instruments comprising of two glaucoma-specific instruments; Glaucoma Quality of Life-15 (GQL-15) and Viswanathan 10 instrument, and 1 vision-specific instrument; National Eye Institute Visual Function Questionnaire-25 (NEIVFQ25). Using NEIVFQ25, the difference between mean QoL scores among cases (88.34 ± 4.53) and controls (95.32 ± 5.76) was statistically significant. In GQL-15, there was a statistically significant difference between mean scores of cases (22.58 ± 5.23) and controls (16.52 ± 1.24). The difference in mean scores with Viswanathan 10 instrument in cases (7.92 ± 0.54) and controls (9.475 ± 0.505) was also statistically significant. QoL scores also showed moderate correlation with mean deviation, pattern standard deviation, and vertical cup-disc ratio. In our study, all the three instruments showed decrease in QoL in glaucoma patients compared to controls. With the increase in severity of glaucoma, corresponding decrease in QoL was observed. It is important for ophthalmologists to understand about the QoL in glaucoma patients so as to have a more holistic approach to patients and for effective delivery of treatment.

Frozen section analysis of margins for head and neck tumor resections: reduction of sampling errors with a third histologic level.

PubMed

Olson, Stephen M; Hussaini, Mohammad; Lewis, James S

2011-05-01

Frozen section analysis is an essential tool for assessing margins intra-operatively to assure complete resection. Many institutions evaluate surgical defect edge tissue provided by the surgeon after the main lesion has been removed. With the increasing use of transoral laser microsurgery, this method is becoming even more prevalent. We sought to evaluate error rates at our large academic institution and to see if sampling errors could be reduced by the simple method change of taking an additional third section on these specimens. All head and neck tumor resection cases from January 2005 through August 2008 with margins evaluated by frozen section were identified by database search. These cases were analyzed by cutting two levels during frozen section and a third permanent section later. All resection cases from August 2008 through July 2009 were identified as well. These were analyzed by cutting three levels during frozen section (the third a 'much deeper' level) and a fourth permanent section later. Error rates for both of these periods were determined. Errors were separated into sampling and interpretation types. There were 4976 total frozen section specimens from 848 patients. The overall error rate was 2.4% for all frozen sections where just two levels were evaluated and was 2.5% when three levels were evaluated (P=0.67). The sampling error rate was 1.6% for two-level sectioning and 1.2% for three-level sectioning (P=0.42). However, when considering only the frozen section cases where tumor was ultimately identified (either at the time of frozen section or on permanent sections) the sampling error rate for two-level sectioning was 15.3 versus 7.4% for three-level sectioning. This difference was statistically significant (P=0.006). Cutting a single additional 'deeper' level at the time of frozen section identifies more tumor-bearing specimens and may reduce the number of sampling errors.

Maternal syphilis and accomplishing sexual partner treatment: still a huge gap.

PubMed

Dallé, Jessica; Baumgarten, Vanessa Z; Ramos, Mauro C; Jimenez, Mirela F; Acosta, Lisiane; Bumaguin, Daniela B; Antonello, Vicente S

2017-08-01

Congenital syphilis (CS) is a preventable epidemic disease for which control is hindered by socioeconomic and health system issues. Inadequately treated maternal syphilis (MaS) commonly has serious adverse obstetric outcomes. This study - which is a cross-sectional study in a Brazilian large urban public Mother and Child hospital, making use of secondary data - evaluated the occurrence of treatment of sexual partners (SP) among women with MaS. The results showed that 771 MaS cases were identified from 2007 to 2014. No information on SP treatment was available in 570 (73.9%) cases. Of the 201 cases presenting information, 25 (12.4%) SP were treated. Out of 164 women having six or more prenatal visits, 25 (15.2%) SP received treatment. Data analyzed biennially have shown a growing trend of cases without collected information, ranging from 27.2% in 2007-2008 to 87.5% in 2013-2014. No linear trend in proportions of treated SP (maximum 7.4% SP treated) was found. Thus, in this study, it has been concluded that the proportion of SP adequately treated was consistently low, and the quality of information deteriorated during the studied period. Prenatal care per se, as provided, was not effective in delivering adequate treatment of SP. Creative integrated services with SP active participation are greatly needed if CS is to be controlled.

High Prevalence of Restless Legs Syndrome among Patients with Fibromyalgia: A Controlled Cross-Sectional Study

PubMed Central

Viola-Saltzman, Mari; Watson, Nathaniel F.; Bogart, Andy; Goldberg, Jack; Buchwald, Dedra

2010-01-01

Study Objectives: To investigate the prevalence of restless legs syndrome (RLS) in fibromyalgia (FM) and determine the presence and amount of sleep disruption in FM patients with RLS. RLS and FM have been associated in uncontrolled studies using a variety of RLS definitions. We explored this relationship using a cross-sectional study design. Methods: FM cases that met the American College of Rheumatology diagnostic criteria were recruited through an academic referral clinic and advertising. Pain- and fatigue-free controls were recruited from the Seattle metropolitan area. We enrolled 172 FM patients (mean age 50 years, 93% female) and 63 pain- and fatigue-free controls (mean age 41 years, 56% female). RLS was ascertained by a self-administered validated diagnostic interview. Results: The age- and gender-adjusted prevalence of RLS was higher in the FM group than the control group (33.0%; 95% CI: 25.9, 40.1 vs. 3.1%; 95% CI: 0.0, 7.4; p = 0.001). Likewise, the FM group was more likely to report RLS (OR = 11.7; 95% CI: 2.6, 53.0), even after adjusting for age and gender. The mean Pittsburgh Sleep Quality Index score was higher among FM patients with RLS than those without (11.8 vs. 9.9; p = 0.01) but subjective limb pain measures did not differ between these 2 groups. Conclusions: There is a higher prevalence and odds of RLS in those with FM compared to controls. Clinicians should routinely query FM patients regarding RLS symptoms because treatment of RLS can potentially improve sleep and quality of life in these patients. Citation: Viola-Saltzman M; Watson NF; Bogart A; Goldberg J; Buchwald D. High prevalence of restless legs syndrome among patients with fibromyalgia: a controlled cross-sectional study. J Clin Sleep Med 2010;6(5):423-427. PMID:20957840

Multimodal Perception and Multicriterion Control of Nested Systems. 1; Coordination of Postural Control and Vehicular Control

NASA Technical Reports Server (NTRS)

Riccio, Gary E.; McDonald, P. Vernon

1998-01-01

The purpose of this report is to identify the essential characteristics of goal-directed whole-body motion. The report is organized into three major sections (Sections 2, 3, and 4). Section 2 reviews general themes from ecological psychology and control-systems engineering that are relevant to the perception and control of whole-body motion. These themes provide an organizational framework for analyzing the complex and interrelated phenomena that are the defining characteristics of whole-body motion. Section 3 of this report applies the organization framework from the first section to the problem of perception and control of aircraft motion. This is a familiar problem in control-systems engineering and ecological psychology. Section 4 examines an essential but generally neglected aspect of vehicular control: coordination of postural control and vehicular control. To facilitate presentation of this new idea, postural control and its coordination with vehicular control are analyzed in terms of conceptual categories that are familiar in the analysis of vehicular control.

Case-controlled clinical and histopathological study of conjunctivochalasis.

PubMed

Francis, I C; Chan, D G; Kim, P; Wilcsek, G; Filipic, M; Yong, J; Coroneo, M T

2005-03-01

Conjunctivochalasis, a secondary cause of the watery eye, is frequently seen in the older age group as an elevation of the bulbar conjunctiva lying along the lateral or central lower lid margin. A prospective, interventional, case-controlled clinical and histopathological study was conducted. The relevant features of 18 patients (29 eyes) who had their conjunctivochalasis resected as part of the surgical management of their watery eye syndrome were examined. In the control group, tissue was obtained from an age matched series of 24 normal subjects undergoing routine cataract surgery. 24 controls (24 specimens) and 18 patients (29 specimens) had conjunctival strip biopsies, taken from the usual lid margin level bulbar conjunctiva in line with the inferior limbus (controls), and the clinically apparent conjunctivochalasis (patients). These were submitted for histological study. 23 of 24 control sections demonstrated normal conjunctival variation. Four of 29 patient specimens demonstrated a chronic non-granulomatous conjunctivitis, while three eyes of the patient group (two patients) demonstrated features of elastosis. Of the four patients who had the inflammatory infiltrates, three had functional nasolacrimal duct obstructions (FNLDOs) and one had a primary acquired nasolacrimal duct obstruction (PANDO). Of the two patients who had elastosis, one had an FNLDO and the other had normal lacrimal drainage and was Jones 1 positive. Six of 18 patients--that is, seven of 29 specimens of conjunctivochalasis demonstrated signs of elastosis or of chronic non-granulomatous inflammation. Clinically, patients had a spectrum of aetiologies of their watery eye syndrome.

Variation of froude number with discharge for large-gradient steams

USGS Publications Warehouse

Wahl, Kenneth L.; ,

1993-01-01

Under chemical-control conditions, the Froude number (f) for a cross-section can be approximated as a function of the ratio R2/ 3/d 1/2 , where R is the hydraulic radius and d is the average depth. For cross sections where the ratio increases with increasing depth, F can also increase with depth Current-meter measurement data for 433 streamflow gaging stations in Colorado were reviewed, and 62 stations were identified at which F increases with depth of flow. Data for four streamflow gaging stations are presented. In some cases, F approaches 1 as the discharge approaches the magnitude of the median annual peak discharge. The data also indicate that few actual current meter measurement have been made at the large discharges where velocities can be supercritical.

Socio-Economic and Cultural Determinants of Human African Trypanosomiasis at the Kenya – Uganda Transboundary

PubMed Central

Rutto, Jane Jemeli; Osano, Odipo; Thuranira, Elias Gitonga; Kurgat, Richard Kiptum; Odenyo, Victor Agab Omondi

2013-01-01

Background Kenya and Uganda have reported different Human African Trypanosomiasis incidences in the past more than three decades, with the latter recording more cases. This cross-sectional study assessed the demographic characteristics, tsetse and trypanosomiasis control practices, socio-economic and cultural risk factors influencing Trypanosoma brucei rhodesiense (T.b.r.) infection in Teso and Busia Districts, Western Kenya and Tororo and Busia Districts, Southeast Uganda. A conceptual framework was postulated to explain interactions of various socio-economic, cultural and tsetse control factors that predispose individuals and populations to HAT. Methods A cross-sectional household survey was conducted between April and October 2008. Four administrative districts reporting T.b.r and lying adjacent to each other at the international boundary of Kenya and Uganda were purposely selected. Household data collection was carried out in two villages that had experienced HAT and one other village that had no reported HAT case from 1977 to 2008 in each district. A structured questionnaire was administered to 384 randomly selected household heads or their representatives in each country. The percent of respondents giving a specific answer was reported. Secondary data was also obtained on socio-economic and political issues in both countries. Results Inadequate knowledge on the disease cycle and intervention measures contributed considerable barriers to HAT, and more so in Uganda than in Kenya. Gender-associated socio-cultural practices greatly predisposed individuals to HAT. Pesticides-based crop husbandry in the 1970's reportedly reduced vector population while vegetation of coffee and banana's and livestock husbandry directly increased occurrence of HAT. Livestock husbandry practices in the villages were strong predictors of HAT incidence. The residents in Kenya (6.7%) applied chemoprophylaxis and chemotherapeutic controls against trypanosomiasis to a larger extent than Uganda (2.1%). Conclusion Knowledge on tsetse and its control methods, culture, farming practice, demographic and socio-economic variables explained occurrence of HAT better than landscape features. PMID:23638206

Nonlinear aeroelastic analysis, flight dynamics, and control of a complete aircraft

NASA Astrophysics Data System (ADS)

Patil, Mayuresh Jayawant

The focus of this research was to analyze a high-aspect-ratio wing aircraft flying at low subsonic speeds. Such aircraft are designed for high-altitude, long-endurance missions. Due to the high flexibility and associated wing deformation, accurate prediction of aircraft response requires use of nonlinear theories. Also strong interactions between flight dynamics and aeroelasticity are expected. To analyze such aircraft one needs to have an analysis tool which includes the various couplings and interactions. A theoretical basis has been established for a consistent analysis which takes into account, (i) material anisotropy, (ii) geometrical nonlinearities of the structure, (iii) rigid-body motions, (iv) unsteady flow behavior, and (v) dynamic stall. The airplane structure is modeled as a set of rigidly attached beams. Each of the beams is modeled using the geometrically exact mixed variational formulation, thus taking into account geometrical nonlinearities arising due to large displacements and rotations. The cross-sectional stiffnesses are obtained using an asymptotically exact analysis, which can model arbitrary cross sections and material properties. An aerodynamic model, consisting of a unified lift model, a consistent combination of finite-state inflow model and a modified ONERA dynamic stall model, is coupled to the structural system to determine the equations of motion. The results obtained indicate the necessity of including nonlinear effects in aeroelastic analysis. Structural geometric nonlinearities result in drastic changes in aeroelastic characteristics, especially in case of high-aspect-ratio wings. The nonlinear stall effect is the dominant factor in limiting the amplitude of oscillation for most wings. The limit cycle oscillation (LCO) phenomenon is also investigated. Post-flutter and pre-flutter LCOs are possible depending on the disturbance mode and amplitude. Finally, static output feedback (SOF) controllers are designed for flutter suppression and gust alleviation. SOF controllers are very simple and thus easy to implement. For the case considered, SOF controllers with proper choice of sensors give results comparable to full state feedback (linear quadratic regulator) designs.

Environmental risk factors for women with polycystic ovary syndrome in china: a population-based case-control study.

PubMed

Zhang, J; Liu, X F; Liu, Y; Xu, L Z; Zhou, L L; Tang, L L; Zhuang, J; Li, T T; Guo, W Q; Hu, R; Qiu, D S; Han, D W

2014-01-01

Polycystic ovary syndrome (PCOS) is a common reproductive endocrinology disease with heterogeneous phenotype. Environmental factors are thought to be involved in the development of PCOS. The present study aimed to explore the potential environmental risk factors of PCOS. A cross-sectional study and stratified population-based case-control study were carried out. Pre-designed questionnaires were prepared, including questions about medication history, contact history of endocrine disruptors (EDs), environment and habituation. Fasting blood was collected for measurement of sex hormone, glucose and insulin. Matched logistic regression analysis was used to find the potential independent risk factor of PCOS. One thousand eight hundred fifty-four participants (aged 12-44 years) were analyzed in the cross-sectional investigation. One hundred sixty-nine PCOS patients and 338 matched controls were compared. PCOS patients were more frequent than controls in eating plastic-packaged food (p=0.001), contacting pesticide (p=0.021), eating fruit with pericarp (p=0.001), living beside a garbage heap (p=0.001), working at an acid plant (p=0.028), taking Chinese patent drugs (p=0.001), smoking (p=0.028) and drinking alcohol (p=0.001). However, PCOS patients were less likely to use kitchen ventilators (p=0.002), eat canned food (p=0.049), contact decorated materials, use skin care products (p=0.01) and cosmetics (p=0.027). No difference was found in taking antiepileptic drugs (p=0.93). Eating plastic-packaged food (p=0.001, OR=44.449), eating fruit with pericarp (p=0.03, OR=5.7) and drinking alcohol (p=0.001, OR=29.632) were found to be the independent risk factors for PCOS. The existence of an association between EDs and PCOS was proved. Plastic-packaged food, fruit with pericarp and drinking alcohol should be avoided as possible as we can. However, the causal relationships among these factors and PCOS should be proved by further research.