COMCAN: a computer program for common cause analysis

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

Burdick, G.R.; Marshall, N.H.; Wilson, J.R.

1976-05-01

The computer program, COMCAN, searches the fault tree minimal cut sets for shared susceptibility to various secondary events (common causes) and common links between components. In the case of common causes, a location check may also be performed by COMCAN to determine whether barriers to the common cause exist between components. The program can locate common manufacturers of components having events in the same minimal cut set. A relative ranking scheme for secondary event susceptibility is included in the program.

AxiaLIF system: minimally invasive device for presacral lumbar interbody spinal fusion

PubMed Central

Rapp, Steven M; Miller, Larry E; Block, Jon E

2011-01-01

Lumbar fusion is commonly performed to alleviate chronic low back and leg pain secondary to disc degeneration, spondylolisthesis with or without concomitant lumbar spinal stenosis, or chronic lumbar instability. However, the risk of iatrogenic injury during traditional anterior, posterior, and transforaminal open fusion surgery is significant. The axial lumbar interbody fusion (AxiaLIF) system is a minimally invasive fusion device that accesses the lumbar (L4–S1) intervertebral disc spaces via a reproducible presacral approach that avoids critical neurovascular and musculoligamentous structures. Since the AxiaLIF system received marketing clearance from the US Food and Drug Administration in 2004, clinical studies of this device have reported high fusion rates without implant subsidence, significant improvements in pain and function, and low complication rates. This paper describes the design and approach of this lumbar fusion system, details the indications for use, and summarizes the clinical experience with the AxiaLIF system to date. PMID:22915939

AxiaLIF system: minimally invasive device for presacral lumbar interbody spinal fusion.

PubMed

Rapp, Steven M; Miller, Larry E; Block, Jon E

2011-01-01

Lumbar fusion is commonly performed to alleviate chronic low back and leg pain secondary to disc degeneration, spondylolisthesis with or without concomitant lumbar spinal stenosis, or chronic lumbar instability. However, the risk of iatrogenic injury during traditional anterior, posterior, and transforaminal open fusion surgery is significant. The axial lumbar interbody fusion (AxiaLIF) system is a minimally invasive fusion device that accesses the lumbar (L4-S1) intervertebral disc spaces via a reproducible presacral approach that avoids critical neurovascular and musculoligamentous structures. Since the AxiaLIF system received marketing clearance from the US Food and Drug Administration in 2004, clinical studies of this device have reported high fusion rates without implant subsidence, significant improvements in pain and function, and low complication rates. This paper describes the design and approach of this lumbar fusion system, details the indications for use, and summarizes the clinical experience with the AxiaLIF system to date.

Targeted temperature management in survivors of cardiac arrest.

PubMed

Ferreira Da Silva, Ivan Rocha; Frontera, Jennifer Ann

2013-11-01

Mild therapeutic hypothermia (MTH) results in a significant decrease in mortality and improvement of neurologic outcomes in cardiac arrest (CA) survivors. Cardiologists and intensivists must be acquainted with the indications and technique because MTH is the only proven neuroprotective therapy for CA survivors. CA involves reinstituting meaningful cardiac activity and minimizing secondary neurologic injuries. This article focuses on MTH as the main strategy for post-CA care. Copyright © 2013 Elsevier Inc. All rights reserved.

Changes in Educational Practices: A Multiple Case Study Investigating Faculty Implemented Changes in Educational Practices Designed to Meet the Academic Needs of the Contemporary Student at a Southwestern Community College

ERIC Educational Resources Information Center

Tompkins, David K.

2017-01-01

For the past few decades, the trend of first generation low-economic status community college students, considerably comprised of immigrants, has continued to grow at a significant rate (Connell, 2008; Ray, 2013; Kim & Diaz, 2013c; Kim, 2014). Community colleges are encountering challenges that were previously viewed as minimal or secondary to…

Membrane technology for sustainable treated wastewater reuse: agricultural, environmental and hydrological considerations.

PubMed

Oron, Gideon; Gillerman, Leonid; Bick, Amos; Manor, Yossi; Buriakovsky, Nisan; Hagin, Joseph

2008-01-01

Field experiments were conducted in agricultural fields in which secondary wastewater of the City of Arad (Israel) is reused for irrigation. For sustainable agricultural production and safe groundwater recharge the secondary effluent is further polished by a combined two-stage membrane pilot system. The pilot membrane system consists of two main in row stages: Ultrafiltration (UF) and Reverse Osmosis (RO). The UF stage is efficient in the removal of the pathogens and suspended organic matter while the successive RO stage provides safe removal of the dissolved solids (salinity). Effluents of various qualities were applied for agricultural irrigation along with continuous monitoring of the membrane system performance. Best agricultural yields were obtained when applying effluent having minimal content of dissolved solids (after the RO stage) as compared with secondary effluent without any further treatment and extended storage. In regions with shallow groundwater reduced soil salinity in the upper productive layers, maintained by extra membrane treatment, will guarantee minimal dissolved solids migration to the aquifers and minimize salinisation processes. (c) IWA Publishing 2008.

Reading Preparation of Secondary ELA Teachers: A U.S. Survey of State Licensure Requirements

ERIC Educational Resources Information Center

Lovette, Gail E.

2013-01-01

Secondary teacher preparation in reading in the U.S. has received minimal attention from the research community despite the almost universal implementation of the Common Core State Standards. In response, numerous publications have demanded that secondary teachers be fully prepared to support the needs of struggling readers, especially ELA…

COMCAN; COMCAN2A; system safety common cause analysis. [IBM360; CDC CYBER176,175; FORTRAN IV (30%) and BAL (70%) (IBM360), FORTRAN IV (97%) and COMPASS (3%) (CDC CYBER176)

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

Burdick, G.R.; Wilson, J.R.

COMCAN2A and COMCAN are designed to analyze complex systems such as nuclear plants for common causes of failure. A common cause event, or common mode failure, is a secondary cause that could contribute to the failure of more than one component and violates the assumption of independence. Analysis of such events is an integral part of system reliability and safety analysis. A significant common cause event is a secondary cause common to all basic events in one or more minimal cut sets. Minimal cut sets containing events from components sharing a common location or a common link are called commonmore » cause candidates. Components share a common location if no barrier insulates any one of them from the secondary cause. A common link is a dependency among components which cannot be removed by a physical barrier (e.g., a common energy source or common maintenance instructions).IBM360;CDC CYBER176,175; FORTRAN IV (30%) and BAL (70%) (IBM360), FORTRAN IV (97%) and COMPASS (3%) (CDC CYBER176).; OS/360 (IBM360) and NOS/BE 1.4 (CDC CYBER176), NOS 1.3 (CDC CYBER175); 140K bytes of memory for COMCAN and 242K (octal) words of memory for COMCAN2A.« less

Horizontal Slide Creates Less Cervical Motion When Centering an Injured Patient on a Spine Board.

PubMed

DuBose, Dewayne N; Zdziarski, Laura Ann; Scott, Nicole; Conrad, Bryan; Long, Allyson; Rechtine, Glenn R; Prasarn, Mark L; Horodyski, MaryBeth

2016-05-01

A patient with a suspected cervical spine injury may be at risk for secondary neurologic injury when initially placed and repositioned to the center of the spine board. We sought to determine which centering adjustment best limits cervical spine movement and minimizes the chance for secondary injury. Using five lightly embalmed cadaveric specimens with a created global instability at C5-C6, motion sensors were anchored to the anterior surface of the vertebral bodies. Three repositioning methods were used to center the cadavers on the spine board: horizontal slide, diagonal slide, and V-adjustment. An electromagnetic tracking device measured angular (degrees) and translation (millimeters) motions at the C5-C6 level during each of the three centering adjustments. The dependent variables were angular motion (flexion-extension, axial rotation, lateral flexion) and translational displacement (anteroposterior, axial, and medial-lateral). The nonuniform condition produced significantly less flexion-extension than the uniform condition (p = 0.048). The horizontal slide adjustment produced less cervical flexion-extension (p = 0.015), lateral bending (p = 0.003), and axial rotation (p = 0.034) than the V-adjustment. Similarly, translation was significantly less with the horizontal adjustment than with the V-adjustment; medial-lateral (p = 0.017), axial (p < 0.001), and anteroposterior (p = 0.006). Of the three adjustments, our team found that horizontal slide was also easier to complete than the other methods. The horizontal slide best limited cervical spine motion and may be the most helpful for minimizing secondary injury based on the study findings. Copyright © 2016 Elsevier Inc. All rights reserved.

Secondary Startup Neutron Sources as a Source of Tritium in a Pressurized Water Reactor (PWR) Reactor Coolant System (RCS)

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

Shaver, Mark W.; Lanning, Donald D.

2010-02-01

The hypothesis of this paper is that the Zircaloy clad fuel source is minimal and that secondary startup neutron sources are the significant contributors of the tritium in the RCS that was previously assigned to release from fuel. Currently there are large uncertainties in the attribution of tritium in a Pressurized Water Reactor (PWR) Reactor Coolant System (RCS). The measured amount of tritium in the coolant cannot be separated out empirically into its individual sources. Therefore, to quantify individual contributors, all sources of tritium in the RCS of a PWR must be understood theoretically and verified by the sum ofmore » the individual components equaling the measured values.« less

Identification of primary and secondary UBA footprints on the surface of ubiquitin in cell-mimicking crowded solution.

PubMed

Munari, Francesca; Bortot, Andrea; Zanzoni, Serena; D'Onofrio, Mariapina; Fushman, David; Assfalg, Michael

2017-04-01

Despite significant advancements in our understanding of ubiquitin-mediated signaling, the influence of the intracellular environment on the formation of transient ubiquitin-partner complexes remains poorly explored. In our work, we introduce macromolecular crowding as a first level of complexity toward the imitation of a cellular environment in the study of such interactions. Using NMR spectroscopy, we find that the stereospecific complex of ubiquitin and the ubiquitin-associated domain (UBA) is minimally perturbed by the crowding agent Ficoll. However, in addition to the primary canonical recognition patch on ubiquitin, secondary patches are identified, indicating that in cell-mimicking crowded solution, UBA contacts ubiquitin at multiple sites. © 2017 Federation of European Biochemical Societies.

Minimally invasive fixation of type B and C interprosthetic femoral fractures.

PubMed

Ehlinger, M; Czekaj, J; Adam, P; Brinkert, D; Ducrot, G; Bonnomet, F

2013-09-01

Interprosthetic femoral fractures are rare and raise unresolved treatment issues such as the length of the fixation material that best prevents secondary fractures. Awareness of the advantages of locked-plate fixation via a minimally invasive approach remains limited, despite the potential of this method for improving success rates. Femur-spanning (from the trochanters to the condyles) locked-plate fixation via a minimally invasive approach provides high healing rates with no secondary fractures. From January 2004 to May 2011, all eight patients seen for interprosthetic fractures were treated with minimally invasive locked-plate fixation. Mean time since hip arthroplasty was 47.5 months and mean time since knee arthroplasty was 72.6 months. There were 12 standard primary prostheses and four revision prostheses; 11 prostheses were cemented and a single prosthesis showed femoral loosening. Classification about the hip prostheses was Vancouver B in one patient and Vancouver C in seven patients; about the knee prosthesis, the fracture was SoFCOT B in three patients and SOFCOT C in five patients, and a single fracture was SoFCOT D. Minimally invasive locking-plate fixation was performed in all eight patients, with installation on a traction table in seven patients. Healing was obtained in all eight patients, after a mean of 14 weeks (range, 12-16 weeks). One patient had malalignment with more than 5° of varus. There were no general or infectious complications. One patient died, 32 months after surgery. The mean Parker-Palmer mobility score decreased from 6.2 pre-operatively to 2.5 at last follow-up. Early construct failure after 3 weeks in one patient required surgical revision. There was no change in implant fixation at last follow-up. No secondary fractures were recorded. In patients with type B or C interprosthetic fractures, femur-spanning fixation not only avoids complications related to altered bone stock and presence of prosthetic material, but also decreases the risk of secondary fractures by eliminating stress riser zones. The minimally invasive option enhances healing by preserving the fracture haematoma. Thus, healing was obtained consistently in our patients, with no secondary fractures, although the construct failed in one patient. Level IV. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

The minimally invasive approach to the symptomatic isthmocele - what does the literature say? A step-by-step primer on laparoscopic isthmocele - excision and repair.

PubMed

Sipahi, Sevgi; Sasaki, Kirsten; Miller, Charles E

2017-08-01

The purpose of this review is to understand the minimally invasive approach to the excision and repair of an isthmocele. Previous small trials and case reports have shown that the minimally invasive approach by hysteroscopy and/or laparoscopy can cure symptoms of a uterine isthmocele, including abnormal bleeding, pelvic pain and secondary infertility. A recent larger prospective study has been published that evaluates outcomes of minimally invasive isthmocele repair. Smaller studies and individual case reports echo the positive results of this larger trial. The cesarean section scar defect, also known as an isthmocele, has become an important diagnosis for women who present with abnormal uterine bleeding, pelvic pain and secondary infertility. It is important for providers to be aware of the effective surgical treatment options for the symptomatic isthmocele. A minimally invasive approach, whether it be laparoscopic or hysteroscopic, has proven to be a safe and effective option in reducing symptoms and improving fertility. VIDEO ABSTRACT: http://links.lww.com/COOG/A37.

Communication interventions for minimally verbal children with autism: a sequential multiple assignment randomized trial.

PubMed

Kasari, Connie; Kaiser, Ann; Goods, Kelly; Nietfeld, Jennifer; Mathy, Pamela; Landa, Rebecca; Murphy, Susan; Almirall, Daniel

2014-06-01

This study tested the effect of beginning treatment with a speech-generating device (SGD) in the context of a blended, adaptive treatment design for improving spontaneous, communicative utterances in school-aged, minimally verbal children with autism. A total of 61 minimally verbal children with autism, aged 5 to 8 years, were randomized to a blended developmental/behavioral intervention (JASP+EMT) with or without the augmentation of a SGD for 6 months with a 3-month follow-up. The intervention consisted of 2 stages. In stage 1, all children received 2 sessions per week for 3 months. Stage 2 intervention was adapted (by increased sessions or adding the SGD) based on the child's early response. The primary outcome was the total number of spontaneous communicative utterances; secondary measures were the total number of novel words and total comments from a natural language sample. Primary aim results found improvements in spontaneous communicative utterances, novel words, and comments that all favored the blended behavioral intervention that began by including an SGD (JASP+EMT+SGD) as opposed to spoken words alone (JASP+EMT). Secondary aim results suggest that the adaptive intervention beginning with JASP+EMT+SGD and intensifying JASP+EMT+SGD for children who were slow responders led to better posttreatment outcomes. Minimally verbal school-aged children can make significant and rapid gains in spoken spontaneous language with a novel, blended intervention that focuses on joint engagement and play skills and incorporates an SGD. Future studies should further explore the tailoring design used in this study to better understand children's response to treatment. Clinical trial registration information-Developmental and Augmented Intervention for Facilitating Expressive Language (CCNIA); http://clinicaltrials.gov/; NCT01013545. Copyright © 2014 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Epidural analgesia versus intravenous patient-controlled analgesia following minimally invasive pectus excavatum repair: a systematic review and meta-analysis

PubMed Central

Stroud, Andrea M.; Tulanont, Darena D.; Coates, Thomasena E.; Goodney, Philip P.; Croitoru, Daniel P.

2017-01-01

Background/Purpose The minimally invasive pectus excavatum repair (MIPER) is a painful procedure. The ideal approach to postoperative analgesia is debated. We performed a systematic review and meta-analysis to assess the efficacy and safety of epidural analgesia compared to intravenous Patient Controlled Analgesia (PCA) following MIPER. Methods We searched MEDLINE (1946–2012) and the Cochrane Library (inception–2012) for randomized controlled trials (RCT) and cohort studies comparing epidural analgesia to PCA for postoperative pain management in children following MIPER. We calculated weighted mean differences (WMD) for numeric pain scores and summarized secondary outcomes qualitatively. Results Of 699 studies, 3 RCTs and 3 retrospective cohorts met inclusion criteria. Compared to PCA, mean pain scores were modestly lower with epidural immediately (WMD −1.04, 95% CI −2.11 to 0.03, p = 0.06), 12 hours (WMD −1.12; 95% CI −1.61 to −0.62, p < 0.001), 24 hours (WMD −0.51, 95%CI −1.05 to 0.02, p = 0.06), and 48 hours (WMD −0.85, 95% CI −1.62 to −0.07, p = 0.03) after surgery. We found no statistically significant differences between secondary outcomes. Conclusions Epidural analgesia may provide superior pain control but was comparable with PCA for secondary outcomes. Better designed studies are needed. Currently the analgesic technique should be based on patient preference and institutional resources. PMID:24851774

The incidence of secondary vertebral fracture of vertebral augmentation techniques versus conservative treatment for painful osteoporotic vertebral fractures: a systematic review and meta-analysis.

PubMed

Song, Dawei; Meng, Bin; Gan, Minfeng; Niu, Junjie; Li, Shiyan; Chen, Hao; Yuan, Chenxi; Yang, Huilin

2015-08-01

Percutaneous vertebroplasty (PVP) and balloon kyphoplasty (BKP) are minimally invasive and effective vertebral augmentation techniques for managing osteoporotic vertebral compression fractures (OVCFs). Recent meta-analyses have compared the incidence of secondary vertebral fractures between patients treated with vertebral augmentation techniques or conservative treatment; however, the inclusions were not thorough and rigorous enough, and the effects of each technique on the incidence of secondary vertebral fractures remain unclear. To perform an updated systematic review and meta-analysis of the studies with more rigorous inclusion criteria on the effects of vertebral augmentation techniques and conservative treatment for OVCF on the incidence of secondary vertebral fractures. PubMed, MEDLINE, EMBASE, SpringerLink, Web of Science, and the Cochrane Library database were searched for relevant original articles comparing the incidence of secondary vertebral fractures between vertebral augmentation techniques and conservative treatment for patients with OVCFs. Randomized controlled trials (RCTs) and prospective non-randomized controlled trials (NRCTs) were identified. The methodological qualities of the studies were evaluated, relevant data were extracted and recorded, and an appropriate meta-analysis was conducted. A total of 13 articles were included. The pooled results from included studies showed no statistically significant differences in the incidence of secondary vertebral fractures between patients treated with vertebral augmentation techniques and conservative treatment. Subgroup analysis comparing different study designs, durations of symptoms, follow-up times, races of patients, and techniques were conducted, and no significant differences in the incidence of secondary fractures were identified (P > 0.05). No obvious publication bias was detected by either Begg's test (P = 0.360 > 0.05) or Egger's test (P = 0.373 > 0.05). Despite current thinking in the field that vertebral augmentation procedures may increase the incidence of secondary fractures, we found no differences in the incidence of secondary fractures between vertebral augmentation techniques and conservative treatment for patients with OVCFs. © The Foundation Acta Radiologica 2014.

The impact of inducing germination of Bacillus anthracis and Bacillus thuringiensis spores on potential secondary decontamination strategies.

PubMed

Omotade, T O; Bernhards, R C; Klimko, C P; Matthews, M E; Hill, A J; Hunter, M S; Webster, W M; Bozue, J A; Welkos, S L; Cote, C K

2014-12-01

Decontamination and remediation of a site contaminated by the accidental or intentional release of fully virulent Bacillus anthracis spores are difficult, costly and potentially damaging to the environment. Development of novel decontamination strategies that have minimal environmental impacts remains a high priority. Although ungerminated spores are amongst the most resilient organisms known, once exposed to germinants, the germinating spores, in some cases, become susceptible to antimicrobial environments. We evaluated the concept that once germinated, B. anthracis spores would be less hazardous and significantly easier to remediate than ungerminated dormant spores. Through in vitro germination and sensitivity assays, we demonstrated that upon germination, B. anthracis Ames spores and Bacillus thuringiensis Al Hakam spores (serving as a surrogate for B. anthracis) become susceptible to environmental stressors. The majority of these germinated B. anthracis and B. thuringiensis spores were nonviable after exposure to a defined minimal germination-inducing solution for prolonged periods of time. Additionally, we examined the impact of potential secondary disinfectant strategies including bleach, hydrogen peroxide, formaldehyde and artificial UV-A, UV-B and UV-C radiation, employed after a 60-min germination-induction step. Each secondary disinfectant employs a unique mechanism of killing; as a result, germination-induction strategies are better suited for some secondary disinfectants than others. These results provide evidence that the deployment of an optimal combination strategy of germination-induction/secondary disinfection may be a promising aspect of wide-area decontamination following a B. anthracis contamination event. By inducing spores to germinate, our data confirm that the resulting cells exhibit sensitivities that can be leveraged when paired with certain decontamination measures. This increased susceptibility could be exploited to devise more efficient and safe decontamination measures and may obviate the need for more stringent methods that are currently in place. Published 2014. This article is a U.S. Government work and is in the public domain in the USA.

Minimally invasive surgery for intracerebral haemorrhage.

PubMed

Barnes, Benjamin; Hanley, Daniel F; Carhuapoma, Juan R

2014-04-01

Spontaneous intracerebral haemorrhage (ICH) imposes a significant health and economic burden on society. Despite this, ICH remains the only stroke subtype without a definitive treatment. Without a clearly identified and effective treatment for spontaneous ICH, clinical practice varies greatly from aggressive surgery to supportive care alone. This review will discuss the current modalities of treatments for ICH including preliminary experience and investigative efforts to advance the care of these patients. Open surgery (craniotomy), prothrombotic agents and other therapeutic interventions have failed to significantly improve the outcome of these stroke victims. Recently, the Surgical Trial in Intracerebral Haemorrhage (STICH) II assessed the surgical management of patients with superficial intraparenchymal haematomas with negative results. MISTIE II and other trials of minimally invasive surgery (MIS) have shown promise for improving patient outcomes and a phase III trial started in late 2013. ICH lacks a definitive primary treatment as well as a therapy targeting surrounding perihematomal oedema and associated secondary damage. An ongoing phase III trial using MIS techniques shows promise for providing treatment for these patients.

Cheap carbon and biodiversity co-benefits from forest regeneration in a hotspot of endemism

NASA Astrophysics Data System (ADS)

Gilroy, James J.; Woodcock, Paul; Edwards, Felicity A.; Wheeler, Charlotte; Baptiste, Brigitte L. G.; Medina Uribe, Claudia A.; Haugaasen, Torbjørn; Edwards, David P.

2014-06-01

Climate change and biodiversity loss can be addressed simultaneously by well-planned conservation policies, but this requires information on the alignment of co-benefits under different management actions. One option is to allow forests to naturally regenerate on marginal agricultural land: a key question is whether this approach will deliver environmental co-benefits in an economically viable manner. Here we report on a survey of carbon stocks, biodiversity and economic values from one of the world's most endemic-rich and threatened ecosystems: the western Andes of Colombia. We show that naturally regenerating secondary forests accumulate significant carbon stocks within 30 years, and support biodiverse communities including many species at risk of extinction. Cattle farming, the principal land use in the region, provides minimal economic returns to local communities, making forest regeneration a viable option despite weak global carbon markets. Efforts to promote natural forest regeneration in the tropical Andes could therefore provide globally significant carbon and biodiversity co-benefits at minimal cost.

Complex networks repair strategies: Dynamic models

NASA Astrophysics Data System (ADS)

Fu, Chaoqi; Wang, Ying; Gao, Yangjun; Wang, Xiaoyang

2017-09-01

Network repair strategies are tactical methods that restore the efficiency of damaged networks; however, unreasonable repair strategies not only waste resources, they are also ineffective for network recovery. Most extant research on network repair focuses on static networks, but results and findings on static networks cannot be applied to evolutionary dynamic networks because, in dynamic models, complex network repair has completely different characteristics. For instance, repaired nodes face more severe challenges, and require strategic repair methods in order to have a significant effect. In this study, we propose the Shell Repair Strategy (SRS) to minimize the risk of secondary node failures due to the cascading effect. Our proposed method includes the identification of a set of vital nodes that have a significant impact on network repair and defense. Our identification of these vital nodes reduces the number of switching nodes that face the risk of secondary failures during the dynamic repair process. This is positively correlated with the size of the average degree 〈 k 〉 and enhances network invulnerability.

Evidence-Based Integrated Environmental Solutions For Secondary Lead Smelters: Pollution Prevention And Waste Minimization Technologies And Practices

EPA Science Inventory

An evidence-based methodology was adopted in this research to establish strategies to increase lead recovery and recycling via a systematic review and critical appraisal of the published literature. In particular, the research examines pollution prevention and waste minimization...

Comparison of characteristics of chronic kidney diseases between Tibet plateau and plain areas

PubMed Central

Zhou, Yan; Deng, Yong-Ming; Li, Chuan; Gong, Yun-Bing; Mao, Zhi-Guo; Wu, Jun; Li, Su-Zhi; Liu, Zhi-Hong; Tang, Zheng

2014-01-01

Background: The purpose of the current study was to investigate the pathological characteristics of chronic kidney diseases in the Tibet plateau and the plain. Methods: 77 cases from the Tibet plateau and 154 cases from the plain of renal biopsied patients with chronic kidney diseases were compared in a randomized, and parallel controlled manner. Pathological characteristics were defined according to the standards of WHO and associated classifications. Results: The ration of sex was shown that most of patients in the plateau region were female, whereas those in the plain were male. The characteristics of pathological types were shown that the patients in the plateau region were primarily minimal change disease, but IgA nephropathy was rare; meanwhile, the proportional lupus nephritis (LN) ratio of the secondary glomerulonephritis in the plateau region was significantly lower than those in the plain region. Conclusions: The current data demonstrated that the most common kidney disease in the Tibet Plateau region is still the primary glomerulonephritis as the same as those in the plain region. However, the primary glomerular disease in the plateau region is minimal change disease, and the most common clinical manifestations are the nephrotic syndrome. The IgA nephropathy in the plain is the most frequent disease. In terms of the secondary renal diseases, Henoch-Schnolein purpura nephritis are dominated in the plateau region, whereas LN-based diseases are frequently found in the plain. There is a statistical significance existed between those two groups. PMID:25337266

Intravesical instillation of Formalin for hemorrhagic cystitis secondary to radiation for gynecologic malignancies

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

Behnam, K.; Patil, U.B.; Mariano, E.

Our experience with the use of Formalin instillation in intractable gross hematuria secondary to radiation cystitis in patients with gynecological malignancies is reported. This study indicates coagulative effect of low concentration of Formalin with minimal side effects as a method to control hemorrhage.

The Reading Skills of Home Economics: Problems and Selected References.

ERIC Educational Resources Information Center

Cranney, A. Garr; And Others

Since most secondary school reading textbooks give home economics only minimal attention, this paper identifies selected information sources in home economics reading skills and in home economics for high school reading specialists. The first portion of the paper discusses eight principle problems that home economics poses for secondary school…

Quadrupole mass spectrometer driver with higher signal levels

NASA Technical Reports Server (NTRS)

Chutjian, Ara (Inventor); Aalami, Dean (Inventor); Darrach, Murray (Inventor); Orient, Otto (Inventor)

2003-01-01

Driving a quadrapole mass spectrometer includes obtaining an air core transformer with a primary and a secondary, matching the secondary to the mass spectrometer, and driving the primary based on first and second voltage levels. Driving of the primary is via an isolating stage that minimizes low level drive signal coupling.

Biochemical trade-offs: evidence for ecologically linked secondary metabolism of the sponge Oscarella balibaloi.

PubMed

Ivanisevic, Julijana; Thomas, Olivier P; Pedel, Laura; Pénez, Nicolas; Ereskovsky, Alexander V; Culioli, Gérald; Pérez, Thierry

2011-01-01

Secondary metabolite production is assumed to be costly and therefore the resource allocation to their production should be optimized with respect to primary biological functions such as growth or reproduction. Sponges are known to produce a great diversity of secondary metabolites with powerful biological activities that may explain their domination in some hard substrate communities both in terms of diversity and biomass. Oscarella balibaloi (Homoscleromorpha) is a recently described, highly dynamic species, which often overgrows other sessile marine invertebrates. Bioactivity measurements (standardized Microtox assay) and metabolic fingerprints were used as indicators of the baseline variations of the O. balibaloi secondary metabolism, and related to the sponge reproductive effort over two years. The bioactivity showed a significant seasonal variation with the lowest values at the end of spring and in early summer followed by the highest bioactivity in the late summer and autumn. An effect of the seawater temperature was detected, with a significantly higher bioactivity in warm conditions. There was also a tendency of a higher bioactivity when O. balibaloi was found overgrowing other sponge species. Metabolic fingerprints revealed the existence of three principal metabolic phenotypes: phenotype 1 exhibited by a majority of low bioactive, female individuals, whereas phenotypes 2 and 3 correspond to a majority of highly bioactive, non-reproductive individuals. The bioactivity was negatively correlated to the reproductive effort, minimal bioactivities coinciding with the period of embryogenesis and larval development. Our results fit the Optimal Defense Theory with an investment in the reproduction mainly shaping the secondary metabolism variability, and a less pronounced influence of other biotic (species interaction) and abiotic (temperature) factors.

Intraoperative Secondary Insults During Orthopedic Surgery in Traumatic Brain Injury.

PubMed

Algarra, Nelson N; Lele, Abhijit V; Prathep, Sumidtra; Souter, Michael J; Vavilala, Monica S; Qiu, Qian; Sharma, Deepak

2017-07-01

Secondary insults worsen outcomes after traumatic brain injury (TBI). However, data on intraoperative secondary insults are sparse. The primary aim of this study was to examine the prevalence of intraoperative secondary insults during orthopedic surgery after moderate-severe TBI. We also examined the impact of intraoperative secondary insults on postoperative head computed tomographic scan, intracranial pressure (ICP), and escalation of care within 24 hours of surgery. We reviewed medical records of TBI patients 18 years and above with Glasgow Coma Scale score <13 who underwent single orthopedic surgery within 2 weeks of TBI. Secondary insults examined were: systemic hypotension (systolic blood pressure<90 mm Hg), intracranial hypertension (ICP>20 mm Hg), cerebral hypotension (cerebral perfusion pressure<50 mm Hg), hypercarbia (end-tidal CO2>40 mm Hg), hypocarbia (end-tidal CO2<30 mm Hg in absence of intracranial hypertension), hyperglycemia (glucose>200 mg/dL), hypoglycemia (glucose<60 mg/dL), and hyperthermia (temperature >38°C). A total of 78 patients (41 [18 to 81] y, 68% male) met the inclusion criteria. The most common intraoperative secondary insults were systemic hypotension (60%), intracranial hypertension and cerebral hypotension (50% and 45%, respectively, in patients with ICP monitoring), hypercarbia (32%), and hypocarbia (29%). Intraoperative secondary insults were associated with worsening of head computed tomography, postoperative decrease of Glasgow Coma Scale score by ≥2, and escalation of care. After Bonferroni correction, association between cerebral hypotension and postoperative escalation of care remained significant (P<0.001). Intraoperative secondary insults were common during orthopedic surgery in patients with TBI and were associated with postoperative escalation of care. Strategies to minimize intraoperative secondary insults are needed.

Anti-lysophosphatidic acid antibodies improve traumatic brain injury outcomes

PubMed Central

2014-01-01

Background Lysophosphatidic acid (LPA) is a bioactive phospholipid with a potentially causative role in neurotrauma. Blocking LPA signaling with the LPA-directed monoclonal antibody B3/Lpathomab is neuroprotective in the mouse spinal cord following injury. Findings Here we investigated the use of this agent in treatment of secondary brain damage consequent to traumatic brain injury (TBI). LPA was elevated in cerebrospinal fluid (CSF) of patients with TBI compared to controls. LPA levels were also elevated in a mouse controlled cortical impact (CCI) model of TBI and B3 significantly reduced lesion volume by both histological and MRI assessments. Diminished tissue damage coincided with lower brain IL-6 levels and improvement in functional outcomes. Conclusions This study presents a novel therapeutic approach for the treatment of TBI by blocking extracellular LPA signaling to minimize secondary brain damage and neurological dysfunction. PMID:24576351

Effect of timed secondary-air injection on automotive emissions

NASA Technical Reports Server (NTRS)

Coffin, K. P.

1973-01-01

A single cylinder of an automotive V-8 engine was fitted with an electronically timed system for the pulsed injection of secondary air. A straight-tube exhaust minimized any mixing other than that produced by secondary-air pulsing. The device was operated over a range of engine loads and speeds. Effects attributable to secondary-air pulsing were found, but emission levels were generally no better than using the engine's own injection system. Under nontypical fast-idle, no-load conditions, emission levels were reduced by roughly a factor of 2.

Alternating-polarity operation for complete regeneration of electrochemical deionization system

DOEpatents

Tran, Tri D.; Lenz, David J.

2002-01-01

An electrically regeneratable battery of electrochemical cells for capacitive deionization (including electrochemical purification) and regeneration of electrodes is operated at alternate polarities during consecutive cycles. By polarizing the cells, ions are removed from the electrolyte and are held in the electric double layers formed at the carbon aerogel surfaces of the electrodes. As the electrodes of each cell of the battery are saturated with the removed ions, the battery is regenerated electrically at a reversed polarity from that during the deionization step of the cycle, thus significantly minimizing secondary wastes.

Numerical simulations on active shielding methods comparison and wrapped angle optimization for gradient coil design in MRI with enhanced shielding effect

NASA Astrophysics Data System (ADS)

Wang, Yaohui; Xin, Xuegang; Guo, Lei; Chen, Zhifeng; Liu, Feng

2018-05-01

The switching of a gradient coil current in magnetic resonance imaging will induce an eddy current in the surrounding conducting structures while the secondary magnetic field produced by the eddy current is harmful for the imaging. To minimize the eddy current effects, the stray field shielding in the gradient coil design is usually realized by minimizing the magnetic fields on the cryostat surface or the secondary magnetic fields over the imaging region. In this work, we explicitly compared these two active shielding design methods. Both the stray field and eddy current on the cryostat inner surface were quantitatively discussed by setting the stray field constraint with an ultra-low maximum intensity of 2 G and setting the secondary field constraint with an extreme small shielding ratio of 0.000 001. The investigation revealed that the secondary magnetic field control strategy can produce coils with a better performance. However, the former (minimizing the magnetic fields) is preferable when designing a gradient coil with an ultra-low eddy current that can also strictly control the stray field leakage at the edge of the cryostat inner surface. A wrapped-edge gradient coil design scheme was then optimized for a more effective control of the stray fields. The numerical simulation on the wrapped-edge coil design shows that the optimized wrapping angles for the x and z coils in terms of our coil dimensions are 40° and 90°, respectively.

The Impact of Dysphonic Voices on Healthy Listeners: Listener Reaction Times, Speech Intelligibility, and Listener Comprehension.

PubMed

Evitts, Paul M; Starmer, Heather; Teets, Kristine; Montgomery, Christen; Calhoun, Lauren; Schulze, Allison; MacKenzie, Jenna; Adams, Lauren

2016-11-01

There is currently minimal information on the impact of dysphonia secondary to phonotrauma on listeners. Considering the high incidence of voice disorders with professional voice users, it is important to understand the impact of a dysphonic voice on their audiences. Ninety-one healthy listeners (39 men, 52 women; mean age = 23.62 years) were presented with speech stimuli from 5 healthy speakers and 5 speakers diagnosed with dysphonia secondary to phonotrauma. Dependent variables included processing speed (reaction time [RT] ratio), speech intelligibility, and listener comprehension. Voice quality ratings were also obtained for all speakers by 3 expert listeners. Statistical results showed significant differences between RT ratio and number of speech intelligibility errors between healthy and dysphonic voices. There was not a significant difference in listener comprehension errors. Multiple regression analyses showed that voice quality ratings from the Consensus Assessment Perceptual Evaluation of Voice (Kempster, Gerratt, Verdolini Abbott, Barkmeier-Kraemer, & Hillman, 2009) were able to predict RT ratio and speech intelligibility but not listener comprehension. Results of the study suggest that although listeners require more time to process and have more intelligibility errors when presented with speech stimuli from speakers with dysphonia secondary to phonotrauma, listener comprehension may not be affected.

Minimally Invasive Extracorporeal Circulation Circuit Is Not Inferior to Off-Pump Coronary Artery Bypass Grafting: Meta-Analysis Using the Bayesian Method.

PubMed

Winkler, Bernhard; Heinisch, Paul P; Gahl, Brigitta; Aghlmandi, Soheila; Jenni, Hans Jörg; Carrel, Thierry P

2017-01-01

The pathophysiologic side effects of cardiopulmonary bypass have already been identified. Minimally invasive extracorporeal circulation technologies (MiECT) and off-pump coronary artery bypass graft surgery (OPCABG) aim to reduce these problems. This meta-analysis provides a comparison of MiECT and OPCABG in randomized and observational studies. A fully probabilistic, Bayesian approach of primary and secondary endpoints was conducted. MiECT does not give inferior results when compared with OPCABG. However, there is a trend to borderline significantly higher blood loss in this group in randomized controlled trials. The question whether MiECT is equivalent to OPCABG can be answered with the affirmative, but long-term follow-up data are needed to detect any advantage over time. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

A review on use of botulinum toxin for intractable lacrimal drainage disorders.

PubMed

Singh, Swati; Ali, Mohammad Javed; Paulsen, Friedrich

2017-08-01

To review the published literature on botulinum toxin (BTX) for epiphora secondary to refractory lacrimal drainage disorders. The authors performed a Pub Med search of all articles published in English on BTX injection into lacrimal gland for epiphora secondary to lacrimal drainage disorders. Relevant cross-references were obtained from the resultant studies. Data reviewed included demographics, indications, dose of BTX, number of injections, transconjunctival or transcutaneous route, outcomes and complications. Animal experiments of BTX into lacrimal gland were included and analyzed separately. Botulinum toxin injection into lacrimal gland, in animal studies, has shown to reduce the tear volume significantly lasting for approximately a month without any histological changes. The major indications have been refractory canalicular obstructions and functional epiphora. The commonly used dose was 2.5 U. Outcomes in the few studies published are encouraging with transient ptosis being the most common complication. Botulinum toxin into the lacrimal gland is a minimally invasive alternative in cases of refractory epiphora secondary to lacrimal drainage disorders. In these subsets of patients, the reported concentrations, dosage and outcome measures are variable and need larger studies for standardization.

Randomized, double-blinded, placebo-controlled trial comparing two multimodal opioid-minimizing pain management regimens following transsphenoidal surgery.

PubMed

Shepherd, Deborah M; Jahnke, Heidi; White, William L; Little, Andrew S

2018-02-01

OBJECTIVE Pain control is an important clinical consideration and quality-of-care metric. No studies have examined postoperative pain control following transsphenoidal surgery for pituitary lesions. The study goals were to 1) report postoperative pain scores following transsphenoidal surgery, 2) determine if multimodal opioid-minimizing pain regimens yielded satisfactory postoperative pain control, and 3) determine if intravenous (IV) ibuprofen improved postoperative pain scores and reduced opioid use compared with placebo. METHODS This study was a single-center, randomized, double-blinded, placebo-controlled intervention trial involving adult patients with planned transsphenoidal surgery for pituitary tumors randomized into 2 groups. Group 1 patients were treated with scheduled IV ibuprofen, scheduled oral acetaminophen, and rescue opioids. Group 2 patients were treated with IV placebo, scheduled oral acetaminophen, and rescue opioids. The primary end point was patient pain scores (visual analog scale [VAS], rated 0-10) for 48 hours after surgery. The secondary end point was opioid use as estimated by oral morphine equivalents (OMEs). RESULTS Of 136 patients screened, 62 were enrolled (28 in Group 1, 34 in Group 2). The study was terminated early because the primary and secondary end points were reached. Baseline characteristics between groups were well matched except for age (Group 1, 59.3 ± 14.4 years; Group 2, 49.8 ± 16.2 years; p = 0.02). Mean VAS pain scores were significantly different, with a 43% reduction in Group 1 (1.7 ± 2.2) compared with Group 2 (3.0 ± 2.8; p < 0.0001). Opioid use was significantly different, with a 58% reduction in Group 1 (26.3 ± 28.7 mg OME) compared with Group 2 (62.5 ± 63.8 mg OME; p < 0.0001). CONCLUSIONS Multimodal opioid-minimizing pain-management protocols resulted in acceptable pain control following transsphenoidal surgery. IV ibuprofen resulted in significantly improved pain scores and significantly decreased opioid use compared with placebo. Postoperative multimodal pain management, including a nonsteroidal antiinflammatory medication, should be considered after surgery to improve patient comfort and to limit opioid use. Clinical trial registration no.: NCT02351700 (clinicaltrials.gov) ■ CLASSIFICATION OF EVIDENCE Type of question: therapeutic; study design: randomized, controlled trial; evidence: Class III.

Should Proof Be Minimal? Ms T's Evaluation of Secondary School Students' Proofs

ERIC Educational Resources Information Center

Tsamir, Pessia; Tirosh, Dina; Dreyfus, Tommy; Barkai, Ruthi; Tabach, Michal

2009-01-01

Calls for reform in mathematics education around the world state that proofs should be part of school mathematics at all levels. Turning these calls into a reality falls on teachers' shoulders. This paper focuses on one secondary school teacher's reactions to students' suggested proofs and justifications in elementary number theory. To determine…

Comparison of Low-Thrust Control Laws for Application in Planetocentric Space

NASA Technical Reports Server (NTRS)

Falck, Robert D.; Sjauw, Waldy K.; Smith, David A.

2014-01-01

Recent interest at NASA for the application of solar electric propulsion for the transfer of significant payloads in cislunar space has led to the development of high-fidelity simulations of such missions. With such transfers involving transfer times on the order of months, simulation time can be significant. In the past, the examination of such missions typically began with the use of lower-fidelity trajectory optimization tools such as SEPSPOT to develop and tune guidance laws which delivered optimal or near- optimal trajectories, where optimal is generally defined as minimizing propellant expenditure or time of flight. The transfer of these solutions to a high-fidelity simulation is typically an iterative process whereby the initial solution may nearly, but not precisely, meet mission objectives. Further tuning of the guidance algorithm is typically necessary when accounting for high-fidelity perturbations such as those due to more detailed gravity models, secondary-body effects, solar radiation pressure, etc. While trajectory optimization is a useful method for determining optimal performance metrics, algorithms which deliver nearly optimal performance with minimal tuning are an attractive alternative.

[Injuries of the cervical spine in patients with ankylosing spondylitis].

PubMed

Vaverka, M; Hrabálek, L

2001-01-01

A brittle and rigid, osteoporotic and injury prone "bamboo" spine which develops as a result of transformation of the normal spine in the final stage of Bekhterev's disease contains normal neural elements. Unstable fractures occur frequently even after a minimal injury and the morbidity and mortality is significantly higher than in the group of routine injuries of the cervical, spine, in particular as a result of pulmonary complications. Diagnosis of the fracture based on simple X-ray pictures is difficult, CT examination is essential. The authors present an account on their experience with three patients. They draw attention to problems of skeletal traction when the spinal axis is altered by disease and to risks associated with semiconservative treatment. The authors therefore recommend traction with a minimal load and with subsequent early decompression and stabilization by a combined anterior and posterior approach in a single session. By this approach secondary affection of neural structures in unstable fractures can be prevented, and early rehabilitation with verticalization without restriction of respiratory excursions by an orthesis then significantly reduces the risk of pulmonary complications.

Unexpected role of activated carbon in promoting transformation of secondary amines to N-nitrosamines.

PubMed

Padhye, Lokesh; Wang, Pei; Karanfil, Tanju; Huang, Ching-Hua

2010-06-01

Activated carbon (AC) is the most common solid phase extraction material used for analysis of nitrosamines in water. It is also widely used for the removal of organics in water treatment and as a catalyst or catalyst support in some industrial applications. In this study, it was discovered that AC materials can catalyze transformation of secondary amines to yield trace levels of N-nitrosamines under ambient aerobic conditions. All 11 commercial ACs tested in the study formed nitrosamines from secondary amines. Among the different ACs, the N-nitrosodimethylamine (NDMA) yield at pH 7.5 ranged from 0.001% to 0.01% of initial amount of aqueous dimethylamine (DMA) concentration, but at 0.05-0.29% of the amount of adsorbed DMA by AC. Nitrosamine yield increased with higher pH and for higher molecular weight secondary amines, probably because of increased adsorption of amines. Presence of oxygen was a critical factor in the transformation of secondary amines, since ACs with adsorbed secondary amines dried under air for longer period of time exhibited significantly higher nitrosamine yields. The AC-catalyzed nitrosamine formation was also observed in surface water and wastewater effluent samples. Properties of AC play an important role in the nitrosamine yields. Preliminary evaluation indicated that nitrosamine formation was higher on reduced than oxidized AC surfaces. Overall, the study results show that selecting ACs and reaction conditions are important to minimize analytical errors and undesirable formation associated with nitrosamines in water samples.

Do children overestimate the extent of smoking among their peers? A feasibility study of the social norms approach to prevent smoking.

PubMed

Elsey, Helen; Owiredu, Elizabeth; Thomson, Heather; Mann, Gemma; Mehta, Rashesh; Siddiqi, Kamran

2015-02-01

Social norms approaches (SNA) are based on the premise that we frequently overestimate risk behaviours among our peers. By conducting campaigns to reduce these misperceptions, SNAs aim to reduce risk behaviours. This study examines the extent to which 12 to 13year old pupils overestimate smoking among their peers and explores the appropriateness of using SNA in secondary schools to prevent smoking uptake. The extent of overestimation of smoking among peers was assessed through an on-line SNA questionnaire in five schools (n=595). Based on questionnaire results, pupils developed SNA campaigns in each school. Qualitative methods of focus groups (7), interviews (7) and observation were used to explore in-depth, from the perspective of staff and pupils, the appropriateness and feasibility of the SNA to prevent smoking uptake in secondary schools. A quarter of pupils, 25.9% (95% CI 25.6% to 26.1%) believed that most of their peers smoked, however, only 3% (95% CI 2.8% to 3.3%) reported that they actually did; a difference of 22.9% (95% CI 19.1% to 26.6%). Self-reported smoking was not significantly different between schools (X(2)=8.7 p=0.064), however, perceptions of year group smoking was significantly different across schools (X(2)=63.9 p<0.001). Qualitative analysis identified full school engagement, minimal teacher time requirements, pupils' belief in questionnaire results and understanding wider context, as key in optimising implementation. This study shows significant misperception between self-reported and perceived smoking among peers in secondary schools, thus supporting a key premise of social norms theory. Implementing SNAs and studying effects is feasible within secondary schools. Copyright © 2014 Elsevier Ltd. All rights reserved.

Photodynamic treatment of a secondary vasoproliferative tumour associated with sector retinitis pigmentosa and Usher syndrome type I.

PubMed

Osman, Saatci A; Aylin, Yaman; Arikan, Gul; Celikel, Harika

2007-03-01

Vasoproliferative tumours may be primary or secondary and present with severe exudation leading to marked visual loss. We describe a 47-year-old man with unilateral secondary vasoproliferative tumour associated with sector retinitis pigmentosa and Usher I syndrome who was successfully treated with a single session of photodynamic treatment. Standard treatment protocol was used except that the treatment duration was doubled. A year after the treatment, the angioma-like tumour vanished and exudation was dramatically reduced. Photodynamic therapy seems to be a minimally invasive and safe technique in eyes with secondary vasoproliferative tumours.

Biochemical Trade-Offs: Evidence for Ecologically Linked Secondary Metabolism of the Sponge Oscarella balibaloi

PubMed Central

Ivanisevic, Julijana; Thomas, Olivier P.; Pedel, Laura; Pénez, Nicolas; Ereskovsky, Alexander V.; Culioli, Gérald; Pérez, Thierry

2011-01-01

Secondary metabolite production is assumed to be costly and therefore the resource allocation to their production should be optimized with respect to primary biological functions such as growth or reproduction. Sponges are known to produce a great diversity of secondary metabolites with powerful biological activities that may explain their domination in some hard substrate communities both in terms of diversity and biomass. Oscarella balibaloi (Homoscleromorpha) is a recently described, highly dynamic species, which often overgrows other sessile marine invertebrates. Bioactivity measurements (standardized Microtox assay) and metabolic fingerprints were used as indicators of the baseline variations of the O. balibaloi secondary metabolism, and related to the sponge reproductive effort over two years. The bioactivity showed a significant seasonal variation with the lowest values at the end of spring and in early summer followed by the highest bioactivity in the late summer and autumn. An effect of the seawater temperature was detected, with a significantly higher bioactivity in warm conditions. There was also a tendency of a higher bioactivity when O. balibaloi was found overgrowing other sponge species. Metabolic fingerprints revealed the existence of three principal metabolic phenotypes: phenotype 1 exhibited by a majority of low bioactive, female individuals, whereas phenotypes 2 and 3 correspond to a majority of highly bioactive, non-reproductive individuals. The bioactivity was negatively correlated to the reproductive effort, minimal bioactivities coinciding with the period of embryogenesis and larval development. Our results fit the Optimal Defense Theory with an investment in the reproduction mainly shaping the secondary metabolism variability, and a less pronounced influence of other biotic (species interaction) and abiotic (temperature) factors. PMID:22132209

Recovery of polyhydroxyalkanoates from municipal secondary wastewater sludge.

PubMed

Kumar, Manish; Ghosh, Pooja; Khosla, Khushboo; Thakur, Indu Shekhar

2018-05-01

In the current study, the feasibility of utilizing municipal secondary wastewater sludge for Polyhydroxyalkanoate (PHA) extraction was improved by optimization of various parameters (temperature, duration and concentration of sludge solids). Optimized process parameters resulted in PHA recovery of 0.605 g, significantly higher than un-optimized conditions. The characterization of PHA was carried out by GC-MS, FT-IR and NMR ( 1 H and 13 C) spectroscopy. The PHA profile was found to be dominated by mcl PHA (58%) along with other diverse PHA. The results of the present study show rich diversity of PHA extracted from a raw material which is readily available at minimal cost. In conclusion, exploring the potential of wastes for production of bioplastics not only reduces the cost of bioplastic production, but also provides a sustainable means for waste management. Copyright © 2018 Elsevier Ltd. All rights reserved.

Optimal secondary source position in exterior spherical acoustical holophony

NASA Astrophysics Data System (ADS)

Pasqual, A. M.; Martin, V.

2012-02-01

Exterior spherical acoustical holophony is a branch of spatial audio reproduction that deals with the rendering of a given free-field radiation pattern (the primary field) by using a compact spherical loudspeaker array (the secondary source). More precisely, the primary field is known on a spherical surface surrounding the primary and secondary sources and, since the acoustic fields are described in spherical coordinates, they are naturally subjected to spherical harmonic analysis. Besides, the inverse problem of deriving optimal driving signals from a known primary field is ill-posed because the secondary source cannot radiate high-order spherical harmonics efficiently, especially in the low-frequency range. As a consequence, a standard least-squares solution will overload the transducers if the primary field contains such harmonics. Here, this is avoided by discarding the strongly decaying spherical waves, which are identified through inspection of the radiation efficiency curves of the secondary source. However, such an unavoidable regularization procedure increases the least-squares error, which also depends on the position of the secondary source. This paper deals with the above-mentioned questions in the context of far-field directivity reproduction at low and medium frequencies. In particular, an optimal secondary source position is sought, which leads to the lowest reproduction error in the least-squares sense without overloading the transducers. In order to address this issue, a regularization quality factor is introduced to evaluate the amount of regularization required. It is shown that the optimal position improves significantly the holophonic reconstruction and maximizes the regularization quality factor (minimizes the amount of regularization), which is the main general contribution of this paper. Therefore, this factor can also be used as a cost function to obtain the optimal secondary source position.

Assessing the trend in sustainable remediation: A questionnaire survey of remediation professionals in various countries.

PubMed

Hou, Deyi; Guthrie, Peter; Rigby, Mark

2016-12-15

Over the past decade, sustainable remediation has grown from an emerging concept into a widely accepted new institutional norm. Scholar literature increased exponentially from nearly none in late 1990s to over 400 publications per year in 2014. The present study used a questionnaire survey conducted in 2012 and 2014 to assess the global trend in the awareness and practice of sustainable remediation. A total of 373 responses were received from survey participants located in 22 countries. The survey found that the US and the UK similarly had the highest level of awareness and adoption rate of sustainable remediation. Asia and other developing countries had much lower awareness levels and/or adoption rates. For all regions, the adoption rates were significantly lower than awareness levels, indicating a large gap between awareness and practice. One specific example is regarding minimizing greenhouse gas emission, which is a focal point in sustainable remediation literature, but with very low adoption rate according to this survey. This study also found that the adoption rates of a few sustainable remediation considerations, such as "minimizing local scale secondary impact", "minimizing national to global scale secondary impact", and "bringing prosperity to disadvantaged community", had decreased between 2012 and 2014. On the other hand, the survey also suggests the remediation community has rendered more expertise, training, and resources in sustainable remediation between 2012 and 2014. The mixed results suggest that in order to enhance sustainable remediation adoption, it is imperative to employ continued effort to enhance the understanding of sustainable remediation by practitioners and to link self-interest and public interest with sustainable remediation considerations. Copyright © 2016 Elsevier Ltd. All rights reserved.

Quantitative investigation of physical factors contributing to gold nanoparticle-mediated proton dose enhancement.

PubMed

Cho, Jongmin; Gonzalez-Lepera, Carlos; Manohar, Nivedh; Kerr, Matthew; Krishnan, Sunil; Cho, Sang Hyun

2016-03-21

Some investigators have shown tumor cell killing enhancement in vitro and tumor regression in mice associated with the loading of gold nanoparticles (GNPs) before proton treatments. Several Monte Carlo (MC) investigations have also demonstrated GNP-mediated proton dose enhancement. However, further studies need to be done to quantify the individual physical factors that contribute to the dose enhancement or cell-kill enhancement (or radiosensitization). Thus, the current study investigated the contributions of particle-induced x-ray emission (PIXE), particle-induced gamma-ray emission (PIGE), Auger and secondary electrons, and activation products towards the total dose enhancement. Specifically, GNP-mediated dose enhancement was measured using strips of radiochromic film that were inserted into vials of cylindrical GNPs, i.e. gold nanorods (GNRs), dispersed in a saline solution (0.3 mg of GNRs/g or 0.03% of GNRs by weight), as well as vials containing water only, before proton irradiation. MC simulations were also performed with the tool for particle simulation code using the film measurement setup. Additionally, a high-purity germanium detector system was used to measure the photon spectrum originating from activation products created from the interaction of protons and spherical GNPs present in a saline solution (20 mg of GNPs/g or 2% of GNPs by weight). The dose enhancement due to PIXE/PIGE recorded on the films in the GNR-loaded saline solution was less than the experimental uncertainty of the film dosimetry (<2%). MC simulations showed highly localized dose enhancement (up to a factor 17) in the immediate vicinity (<100 nm) of GNRs, compared with hypothetical water nanorods (WNRs), mostly due to GNR-originated Auger/secondary electrons; however, the average dose enhancement over the entire GNR-loaded vial was found to be minimal (0.1%). The dose enhancement due to the activation products from GNPs was minimal (<0.1%) as well. In conclusion, under the currently investigated conditions that are considered clinically relevant, PIXE, PIGE, and activation products contribute minimally to GNP/GNR-mediated proton dose enhancement, whereas Auger/secondary electrons contribute significantly but only at short distances (<100 nm) from GNPs/GNRs.

Predicting the host range of Nystalea ebalea: secondary plant chemistry and host selection by a surrogate biological control agent of Schinus terebinthifolia

USDA-ARS?s Scientific Manuscript database

The safety of weed biological control depends upon the selection and utilization of the target weed by the agent while causing minimal harm to non-target species. Selection of weed species by biological control agents is determined by the presence of behavioral cues, generally host secondary plant c...

A Comparison of Dietary Practices at or En Route to School between Elementary and Secondary School Students in Vancouver, Canada.

PubMed

Velazquez, Cayley E; Black, Jennifer L; Billette, Jean-Michel; Ahmadi, Naseam; Chapman, Gwen E

2015-08-01

There is evidence that dietary quality declines as children age in North America, but few studies have explored whether food environment exposures in secondary schools as opposed to elementary schools are associated with changes in students' school-day food choices. This study examined differences in dietary practices (at or en route to and/or from school) between students in their last years of elementary school (grades 5 to 7) and first year of secondary school (grade 8) in Vancouver, Canada, controlling for sociodemographic characteristics and school-level socioeconomic status. Demographic characteristics and dietary data were collected through a cross-sectional survey (n=950 from 26 schools) and combined with school-level socioeconomic data derived from the 2006 Canadian Census. Multilevel logistic regression analyses indicated that secondary school students were significantly more likely to report daily consumption of fast foods (odds ratio=1.92; 95% CI 1.18 to 3.12) and minimally nutritious packaged snacks (eg, candy or chocolate bars) (odds ratio=1.60; 95% CI 1.05 to 2.45), and to report regular purchases from off-campus retailers (odds ratio=1.63; 95% CI 1.10 to 2.42). Gender, food insecurity, lower acculturation to Canada, and access to more weekly spending money were associated with nutritionally poor practices. Students attending schools drawing from lower-income neighborhoods were also significantly more likely to consume fast foods and packaged snacks daily. The majority of students sampled did not report consuming healthy foods, such as fruit and vegetables, daily at or en route to and/or from school. Intake of fruit, vegetables, and low-fat milk did not differ significantly between elementary and secondary school students. Findings suggest that research and intervention strategies should address modifiable school-level exposures and policies to improve dietary practices for both elementary and secondary school-aged youth, while at the same time addressing sociocultural factors associated with eating behavior. Copyright © 2015 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Minimal differences in prevalence and spectrum of organic disease at upper gastrointestinal endoscopy between selected secondary care patients with symptoms of gastro-oesophageal reflux or dyspepsia.

PubMed

Irvine, Andrew J; Pinto-Sanchez, Maria Ines; Bercik, Premysl; Moayyedi, Paul; Ford, Alexander C

2017-04-01

Gastro-oesophageal reflux and dyspepsia are felt to be separate upper gastrointestinal (GI) conditions. We aimed to measure the degree of overlap between them, and assess whether endoscopic findings differed. Demographic, symptom, upper GI endoscopy and histology data were collected from consecutive adults in secondary care. Patients were categorised according to whether they reported gastro-oesophageal reflux alone, dyspepsia alone or both, and patient demographics and endoscopic findings were compared. Of 1167 patients, 97 (8.3%) had gastro-oesophageal reflux alone, 571 (48.9%) dyspepsia alone, and 499 (42.8%) overlap. Patients with overlap symptoms were more likely to smoke, compared with those with gastro-oesophageal reflux alone, or dyspepsia alone (p = .009), but there were no other differences. Patients with gastro-oesophageal reflux alone or overlap had a higher prevalence of erosive oesophagitis (18.6% and 15.4% respectively, p < .001), but this was still the commonest diagnosis among those with dyspepsia alone (7.2%). No significant differences were seen in prevalence of other endoscopic findings. Gastro-oesophageal reflux and dyspepsia symptoms commonly overlap. There were minimal differences in demographics or spectrum of underlying organic disease between various symptom groups, suggesting that restrictive classifications according to predominant symptom may not be clinically useful.

Mini-Membrane Evaporator for Contingency Spacesuit Cooling

NASA Technical Reports Server (NTRS)

Makinen, Janice V.; Bue, Grant C.; Campbell, Colin; Petty, Brian; Craft, Jesse; Lynch, William; Wilkes, Robert; Vogel, Matthew

2015-01-01

The next-generation Advanced Extravehicular Mobility Unit (AEMU) Portable Life Support System (PLSS) is integrating a number of new technologies to improve reliability and functionality. One of these improvements is the development of the Auxiliary Cooling Loop (ACL) for contingency crewmember cooling. The ACL is a completely redundant, independent cooling system that consists of a small evaporative cooler--the Mini Membrane Evaporator (Mini-ME), independent pump, independent feedwater assembly and independent Liquid Cooling Garment (LCG). The Mini-ME utilizes the same hollow fiber technology featured in the full-sized AEMU PLSS cooling device, the Spacesuit Water Membrane Evaporator (SWME), but Mini-ME occupies only approximately 25% of the volume of SWME, thereby providing only the necessary crewmember cooling in a contingency situation. The ACL provides a number of benefits when compared with the current EMU PLSS contingency cooling technology, which relies upon a Secondary Oxygen Vessel; contingency crewmember cooling can be provided for a longer period of time, more contingency situations can be accounted for, no reliance on a Secondary Oxygen Vessel (SOV) for contingency cooling--thereby allowing a reduction in SOV size and pressure, and the ACL can be recharged-allowing the AEMU PLSS to be reused, even after a contingency event. The first iteration of Mini-ME was developed and tested in-house. Mini-ME is currently packaged in AEMU PLSS 2.0, where it is being tested in environments and situations that are representative of potential future Extravehicular Activities (EVA's). The second iteration of Mini-ME, known as Mini-ME2, is currently being developed to offer more heat rejection capability. The development of this contingency evaporative cooling system will contribute to a more robust and comprehensive AEMU PLSS.

Minimally invasive soft tissue release of foot and ankle contracture secondary to stroke.

PubMed

Boffeli, Troy J; Collier, Rachel C

2014-01-01

Lower extremity contracture associated with stroke commonly results in a nonreducible, spastic equinovarus deformity of the foot and ankle. Rigid contracture deformity leads to gait instability, pain, bracing difficulties, and ulcerations. The classic surgical approach for stroke-related contracture of the foot and ankle has been combinations of tendon lengthening, tendon transfer, osteotomy, and joint fusion procedures. Recovery after traditional foot and ankle reconstructive surgery requires a period of non-weightbearing that is not typically practical for these patients. Little focus has been given in published studies on minimally invasive soft tissue release of contracture. We present the case of a 61-year-old female with an equinovarus foot contracture deformity secondary to stroke. The patient underwent Achilles tendon lengthening, posterior tibial tendon Z lengthening, and digital flexor tenotomy of each toe with immediate weightbearing in a walking boot, followed by transition to an ankle-foot orthosis. The surgical principles and technique tips are presented to demonstrate our minimally invasive approach to release of foot and ankle contracture secondary to stroke. The main goal of this approach is to improve foot and ankle alignment for ease of bracing, which, in turn, will improve gait, reduce the risk of falls, decrease pain, and avoid the development of pressure sores. Copyright © 2014 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

[Toxic nephropathy secondary to occupational exposure to metallic mercury].

PubMed

Voitzuk, Ana; Greco, Vanina; Caputo, Daniel; Alvarez, Estela

2014-01-01

Toxic nephrophaties secondary to occupational exposure to metals have been widely studied, including membranous nephropathy by mercury, which is rare. Occupational poisoning by mercury is frequent, neurological symptoms are the main form of clinical presentation. Secondary renal involvement in chronic exposure to metallic mercury can cause glomerular disease by deposit of immune-complexes. Membranous glomerulopathy and minimal change disease are the most frequently reported forms. Here we describe the case of a patient with occupational exposure to metallic mercury, where nephrotic syndrome due to membranous glomerulonephritis responded favorably to both chelation and immunosuppressive therapy.

Secondary Radial Nerve Palsy after Minimally Invasive Plate Osteosynthesis of a Distal Humeral Shaft Fracture

PubMed Central

Bichsel, Ursina; Nyffeler, Richard Walter

2015-01-01

Minimally invasive plate osteosynthesis is a widely used procedure for the treatment of fractures of the femur and the tibia. For a short time it is also used for the treatment of humeral shaft fractures. Among other advantages, the ambassadors of this technique emphasize the lower risk of nerve injuries when compared to open reduction and internal fixation. We report the case of secondary radial nerve palsy caused by percutaneous fixation of a plate above the antecubital fold. The nerve did not recover and the patient needed a tendon transfer to regain active extension of the fingers. This case points to the importance of adequate exposure of the bone and plate if a humeral shaft fracture extends far distally. PMID:26558125

Hydrogen-bonded turns in proteins: The case for a recount

PubMed Central

Panasik, Nick; Fleming, Patrick J.; Rose, George D.

2005-01-01

β-Turns are sites at which proteins change their overall chain direction, and they occur with high frequency in globular proteins. The Protein Data Bank has many instances of conformations that resemble β-turns but lack the characteristic N–H(i) → O=C(i − 3) hydrogen bond of an authentic β-turn. Here, we identify potential hydrogen-bonded β-turns in the coil library, a Web-accessible database utility comprised of all residues not in repetitive secondary structure, neither α-helix nor β-sheet (http://www.roselab.jhu.edu/coil). In particular, candidate turns were identified as four-residue segments satisfying highly relaxed geometric criteria but lacking a strictly defined hydrogen bond. Such candidates were then subjected to a minimization protocol to determine whether slight changes in torsion angles are sufficient to shift the conformation into reference-quality geometry without deviating significantly from the original structure. This approach of applying constrained minimization to known structures reveals a substantial population of previously unidentified, stringently defined, hydrogen-bonded β-turns. In particular, 33% of coil library residues were classified as β-turns prior to minimization. After minimization, 45% of such residues could be classified as β-turns, with another 8% in 310 helixes (which closely resemble type III β-turns). Of the remaining coil library residues, 37% have backbone dihedral angles in left-handed polyproline II structure. PMID:16251367

Hydrogen-bonded turns in proteins: the case for a recount.

PubMed

Panasik, Nick; Fleming, Patrick J; Rose, George D

2005-11-01

Beta-turns are sites at which proteins change their overall chain direction, and they occur with high frequency in globular proteins. The Protein Data Bank has many instances of conformations that resemble beta-turns but lack the characteristic N-H(i) --> O=C(i - 3) hydrogen bond of an authentic beta-turn. Here, we identify potential hydrogen-bonded beta-turns in the coil library, a Web-accessible database utility comprised of all residues not in repetitive secondary structure, neither alpha-helix nor beta-sheet (http://www.roselab.jhu.edu/coil). In particular, candidate turns were identified as four-residue segments satisfying highly relaxed geometric criteria but lacking a strictly defined hydrogen bond. Such candidates were then subjected to a minimization protocol to determine whether slight changes in torsion angles are sufficient to shift the conformation into reference-quality geometry without deviating significantly from the original structure. This approach of applying constrained minimization to known structures reveals a substantial population of previously unidentified, stringently defined, hydrogen-bonded beta-turns. In particular, 33% of coil library residues were classified as beta-turns prior to minimization. After minimization, 45% of such residues could be classified as beta-turns, with another 8% in 3(10) helixes (which closely resemble type III beta-turns). Of the remaining coil library residues, 37% have backbone dihedral angles in left-handed polyproline II structure.

Highly efficient secondary dewatering of dewatered sewage sludge using low boiling point solvents.

PubMed

He, Chao; Chena, Chia-Lung; Xu, Zhirong; Wang, Jing-Yuan

2014-01-01

Secondary dewatering of dewatered sludge is imperative to make conventional drying and incineration of sludge more economically feasible. In this study, a secondary dewatering of dewatered sludge with selected solvents (i.e. acetone and ethanol) followed by vacuum filtration and nature drying was investigated to achieve in-depth dewatering. After the entire secondary dewatering process, the sludge was shown to be odourless and the organic matter content was greatly retained. Increased mean particle size of sludge after solvent contact improved solid-liquid separation. With an acetone/sludge ratio of 3:1 (mL:g) in solvent contact and subsequent nature drying at ambient temperature after 24 h, the moisture content of sludge can be reduced to a level less than 20%. It is found that the polysaccharides were mainly precipitated by acetone, whereas the release ratios of protein and DNA were increased significantly as the added acetone volumes were elevated. During nature drying, accumulated evaporation rates of the sludge after solvent contact were 5-6 times higher than original dewatered sludge. Furthermore, sludge after acetone contact had better nature drying performance than ethanol. The two-stage dewatering involves solvent contact dewatering and solvent enhanced evaporation dewatering. Through selecting an appropriate solvent/sludge ratio as well as economical solvents and minimizing the solvent loss in a closed-pilot system, this dewatering process can be competitive in industrial applications. Therefore, this solvent-aided secondary dewatering is an energy-saving technology for effective in-depth dewatering of dewatered sludge and subsequent sludge utilization.

Method of minimizing the effects of parasitic currents

DOEpatents

Chi, Michael C.; Carr, Peter

1983-02-01

A method of minimizing the effect of parasitic currents in secondary batteries having a plurality of cells connected electrically in series and a common electrolyte in communication with the cells is described. Specifically, the parasitic currents flowing through the battery cause a cell imbalance over the charge/discharge cycle. This cell imbalance is minimized by first separating the cells of the battery into two equal groups. Then the battery is charged with the two groups of cells connected electrically in series, and subsequently discharged with the two groups of cells reconnected electrically in series in an inverted sequence.

ANTIDEPRESSANTS ARE NOT OVER-PRESCRIBED FOR MILD DEPRESSION

PubMed Central

Simon, Gregory E; Rossom, Rebecca C; Beck, Arne; Waitzfelder, Beth E; Coleman, Karen J; Stewart, Christine; Operskalski, Belinda; Penfold, Robert B; Shortreed, Susan M

2016-01-01

Objective Evaluate over-prescribing of antidepressant medication for minimal or mild depression. Method Electronic records data from four large healthcare systems identified outpatients aged 18 or older starting a new episode of antidepressant treatment with an ICD9 diagnosis of depressive disorder (296.2, 296.3, 311, or 300.4). PHQ9 depression severity scores at time of treatment initiation were used to examine the distribution of baseline severity and the association between baseline severity and patients' demographic and clinical characteristics. Results Of 19,751 adults beginning treatment in 2011, baseline PHQ9 scores were available for 7051. In those with a baseline score, 85% reported moderate or severe symptoms (PHQ9 score 10 or more), 12% reported mild symptoms (PHQ score 5 to 9), and 3% reported minimal symptoms (PHQ9 score less than 5). The proportion reporting minimal or mild symptoms when starting treatment increased with age, ranging from 11% in those under age 30 to 26% in those aged 65 and older. The proportion with minimal or mild symptoms was also moderately higher among patients living in wealthier neighborhoods and those treated by psychiatrists. Nevertheless, across all subgroups defined by sex, race/ethnicity, prescriber specialty, and treatment history, the proportions with minimal or mild symptoms did not exceed 18%. Secondary analyses, including weighting and subgroup analyses, found no evidence that estimates of baseline severity were biased by missing PHQ9 scores. Conclusions In these health systems, prescribing of antidepressant medication for minimal or mild depression is much less common than suggested by previous reports. Given that this practice may sometimes be clinically appropriate, our findings indicate that over-prescribing of antidepressants for mild depression is not a significant public health concern. PMID:26580702

The possibility of biomasses and coal co-firing in the Czech Republic

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

Juchelkova, D.

1998-07-01

The present state of the environment in the Czech Republic is influenced by many factors and one of them is the quality of fuel used in energetic sources. The greatest share is created by coal, burned with a low capacity, big power station blocks without a significant effort to reduce the emission of pollutants. It is possible to use other provisions for improving the environment: (1) primary--changing the burning fuel, the minimization of pollutant formation resulting in a burning process, the reconstruction of a significant part of burning equipment, and others; (2) or secondary--trapping pollutants. Changing the fuel must bemore » done, however, with minimization of outgoing pollutants. It should not burden surroundings with other undesirable influences and must provide the necessary output. One of the possibilities which is getting attention in the world today is the burning of biomasses. This solution itself has great investment cost (the necessity to build special burning equipment), but an attempt to burn suitable forms of biomass together with coal directly in the existing burning equipment has been discovered as a possible solution to this problem.« less

A methodology for improving the spatial framework for secondary education: An example from trinidad and tobago

NASA Astrophysics Data System (ADS)

London, Norrel A.

1992-03-01

Following a period of massive quantitative increases in education provision in the 1970's and 1980's, many Third World nations now find it difficult to provide additional school places to improve their present system of education provision. Strapped by financial constraints on the one hand, and on the other by pressing demands for efficient and effective services, developing nations have been encouraged to adopt judicious and careful spatial planning as a way out of the present dilemma. The paper uses a technical model to demonstrate how Trinidad and Tobago may reduce the problem of a lengthy journey-to-school, currently faced by many secondary school students. Paradoxically, this results from the Government's efforts to expand the system of secondary education during the past two decades. Using an index of distance travelled between home and school, the paper evaluates the geographic location of eight schools that have been proposed for construction by Trinidad and Tobago, and recommends alternative locations that would more effectively and more quickly achieve the Government's objective of minimizing home-to-school distances now travelled by secondary students. The rank order in which the proposed eight schools ought to be built, so as to achieve distance minimization with incremental addition of each new facility is also suggested.

Gallbladder Nonvisualization in Cholecystectomy: A Factor for Conversion.

PubMed

Slack, Daniel R; Grisby, Shaunda; Dike, Uzoamaka Kimberly; Kohli, Harjeet

2018-01-01

Many risk factors have been identified in minimally invasive cholecystectomies that lead to higher complications and conversion rates. No study that we encountered looked at nonvisualization of the gallbladder (GB) during surgery as a risk factor. We hypothesized that nonvisualization was associated with an increased risk of complications and could be an early intraoperative identifier of a higher risk procedure. Recognizing this could allow surgeons to be aware of potential risks and to be more likely to convert to open for the safety of the patient. We looked at minimally invasive cholecystectomies performed at our institution from January 2015 through April 2016 and had the performing resident fill out a survey after the surgery. Outcomes were conversion rates, intraoperative complications, and blood loss and were analyzed via Pearson χ 2 test or Mann-Whitney U test. The primary outcome showed a conversion rate of 37% in nonvisualized GBs versus 0% in visualized ( P = .001). Secondary outcomes showed significant differences in GB perforations (74% vs 13%, P = .001), omental vessel bleeding (16% vs. 0%, P = .005), and EBL (46 mL vs 29 mL, P = .001). Intraoperative nonvisualization of the GB after adequate positioning caused significantly increased risk of intraoperative complications and conversion. This knowledge could be useful during intraoperative assessment, to decide whether a case should be continued as a minimally invasive procedure or converted early to help reduce risk to the patient. Further randomized controlled studies should be performed to further demonstrate the value of this assessment.

Investigation of α-MnO 2 Tunneled Structures as Model Cation Hosts for Energy Storage

DOE PAGES

Housel, Lisa M.; Wang, Lei; Abraham, Alyson; ...

2018-02-19

Future advances in energy storage systems rely on identification of appropriate target materials and deliberate synthesis of the target materials with control of their physiochemical properties in order to disentangling the contributions of distinct properties to the functional electrochemistry. Furthermore, this goal demands systematic inquiry using model materials that provide the opportunity for significant synthetic versatility and control. Ideally, a material family that enables direct manipulation of characteristics including composition, defects and crystallite size while remaining within the defined structural framework would be necessary. Accomplishing this through direct synthetic methods is desirable to minimize the complicating effects of secondary processing.

Investigation of α-MnO 2 Tunneled Structures as Model Cation Hosts for Energy Storage

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

Housel, Lisa M.; Wang, Lei; Abraham, Alyson

Future advances in energy storage systems rely on identification of appropriate target materials and deliberate synthesis of the target materials with control of their physiochemical properties in order to disentangling the contributions of distinct properties to the functional electrochemistry. Furthermore, this goal demands systematic inquiry using model materials that provide the opportunity for significant synthetic versatility and control. Ideally, a material family that enables direct manipulation of characteristics including composition, defects and crystallite size while remaining within the defined structural framework would be necessary. Accomplishing this through direct synthetic methods is desirable to minimize the complicating effects of secondary processing.

Web-Beagle: a web server for the alignment of RNA secondary structures.

PubMed

Mattei, Eugenio; Pietrosanto, Marco; Ferrè, Fabrizio; Helmer-Citterich, Manuela

2015-07-01

Web-Beagle (http://beagle.bio.uniroma2.it) is a web server for the pairwise global or local alignment of RNA secondary structures. The server exploits a new encoding for RNA secondary structure and a substitution matrix of RNA structural elements to perform RNA structural alignments. The web server allows the user to compute up to 10 000 alignments in a single run, taking as input sets of RNA sequences and structures or primary sequences alone. In the latter case, the server computes the secondary structure prediction for the RNAs on-the-fly using RNAfold (free energy minimization). The user can also compare a set of input RNAs to one of five pre-compiled RNA datasets including lncRNAs and 3' UTRs. All types of comparison produce in output the pairwise alignments along with structural similarity and statistical significance measures for each resulting alignment. A graphical color-coded representation of the alignments allows the user to easily identify structural similarities between RNAs. Web-Beagle can be used for finding structurally related regions in two or more RNAs, for the identification of homologous regions or for functional annotation. Benchmark tests show that Web-Beagle has lower computational complexity, running time and better performances than other available methods. © The Author(s) 2015. Published by Oxford University Press on behalf of Nucleic Acids Research.

Sequence and structure determinants of Drosophila Hsp70 mRNA translation: 5'UTR secondary structure specifically inhibits heat shock protein mRNA translation.

PubMed Central

Hess, M A; Duncan, R F

1996-01-01

Preferential translation of Drosophila heat shock protein 70 (Hsp70) mRNA requires only the 5'-untranslated region (5'-UTR). The sequence of this region suggests that it has relatively little secondary structure, which may facilitate efficient protein synthesis initiation. To determine whether minimal 5'-UTR secondary structure is required for preferential translation during heat shock, the effect of introducing stem-loops into the Hsp70 mRNA 5'-UTR was measured. Stem-loops of -11 kcal/mol abolished translation during heat shock, but did not reduce translation in non-heat shocked cells. A -22 kcal/mol stem-loop was required to comparably inhibit translation during growth at normal temperatures. To investigate whether specific sequence elements are also required for efficient preferential translation, deletion and mutation analyses were conducted in a truncated Hsp70 5'-UTR containing only the cap-proximal and AUG-proximal segments. Linker-scanner mutations in the cap-proximal segment (+1 to +37) did not impair translation. Re-ordering the segments reduced mRNA translational efficiency by 50%. Deleting the AUG-proximal segment severely inhibited translation. A 5-extension of the full-length leader specifically impaired heat shock translation. These results indicate that heat shock reduces the capacity to unwind 5-UTR secondary structure, allowing only mRNAs with minimal 5'-UTR secondary structure to be efficiently translated. A function for specific sequences is also suggested. PMID:8710519

Elicitation of anti-viral cytotoxic T lymphocytes with purified viral and H-2 antigens.

PubMed

Hale, A H; Ruebush, M J; Harris, D T

1980-07-01

The minimal molecular requirements for elicitation of secondary anti-Sendai virus CTL were investigated. The hemagglutinin-neuraminidase (HN) glycoprotein of Sendai virus and the H-2Kk glycoprotein of YAC tumor cells were purified and incorporated into phospholipid vesicles. These unilamellar liposomes were then tested for the ability to elicit H-2 restricted secondary anti-Sendai virus CTL. The results indicate that these well-defined vesicles were capable of eliciting secondary anti-Sendai virus CTL which lysed only target cells possessing the H-2Kk haplotype and modified with inactivated Sendai virus.

Mini-Membrane Evaporator for Contingency Spacesuit Cooling

NASA Technical Reports Server (NTRS)

Makinen, Janice V.; Bue, Grant C.; Campbell, Colin; Craft, Jesse; Lynch, William; Wilkes, Robert; Vogel, Matthew

2014-01-01

The next-generation Advanced Extravehicular Mobility Unit (AEMU) Portable Life Support System (PLSS) is integrating a number of new technologies to improve reliability and functionality. One of these improvements is the development of the Auxiliary Cooling Loop (ACL) for contingency crewmember cooling. The ACL is a completely redundant, independent cooling system that consists of a small evaporative cooler--the Mini Membrane Evaporator (Mini-ME), independent pump, independent feedwater assembly and independent Liquid Cooling Garment (LCG). The Mini-ME utilizes the same hollow fiber technology featured in the full-sized AEMU PLSS cooling device, the Spacesuit Water Membrane Evaporator (SWME), but Mini-ME occupies only 25% of the volume of SWME, thereby providing only the necessary crewmember cooling in a contingency situation. The ACL provides a number of benefits when compared with the current EMU PLSS contingency cooling technology, which relies upon a Secondary Oxygen Vessel; contingency crewmember cooling can be provided for a longer period of time, more contingency situations can be accounted for, no reliance on a Secondary Oxygen Vessel (SOV) for contingency cooling--thereby allowing a reduction in SOV size and pressure, and the ACL can be recharged-allowing the AEMU PLSS to be reused, even after a contingency event. The first iteration of Mini-ME was developed and tested in-house. Mini-ME is currently packaged in AEMU PLSS 2.0, where it is being tested in environments and situations that are representative of potential future Extravehicular Activities (EVA's). The second iteration of Mini-ME, known as Mini- ME2, is currently being developed to offer more heat rejection capability. The development of this contingency evaporative cooling system will contribute to a more robust and comprehensive AEMU PLSS.

Burn Wound Infections

PubMed Central

Church, Deirdre; Elsayed, Sameer; Reid, Owen; Winston, Brent; Lindsay, Robert

2006-01-01

Burns are one of the most common and devastating forms of trauma. Patients with serious thermal injury require immediate specialized care in order to minimize morbidity and mortality. Significant thermal injuries induce a state of immunosuppression that predisposes burn patients to infectious complications. A current summary of the classifications of burn wound infections, including their diagnosis, treatment, and prevention, is given. Early excision of the eschar has substantially decreased the incidence of invasive burn wound infection and secondary sepsis, but most deaths in severely burn-injured patients are still due to burn wound sepsis or complications due to inhalation injury. Burn patients are also at risk for developing sepsis secondary to pneumonia, catheter-related infections, and suppurative thrombophlebitis. The introduction of silver-impregnated devices (e.g., central lines and Foley urinary catheters) may reduce the incidence of nosocomial infections due to prolonged placement of these devices. Improved outcomes for severely burned patients have been attributed to medical advances in fluid resuscitation, nutritional support, pulmonary and burn wound care, and infection control practices. PMID:16614255

Heavy equipment maintenance wastes and environmental management in the mining industry.

PubMed

Guerin, Turlough F

2002-10-01

Maintenance wastes, if not managed properly, represent significant environmental issues for mining operations. Petroleum hydrocarbon liquid wastes were studied at an Australian site and a review of the literature and technology vendors was carried out to identify oil/water separation technologies. Treatment technologies and practices for managing oily wastewater, used across the broader mining industry in the Asia-Pacific region, were also identified. Key findings from the study were: (1) primary treatment is required to remove grease oil contamination and to protect secondary oily wastewater treatment systems from being overloaded; (2) selection of an effective secondary treatment system is dependent on influent oil droplet size and concentration, suspended solids concentration, flow rates (and their variability), environmental conditions, maintenance schedules and effectiveness, treatment targets and costs; and (3) oily wastewater treatment systems, based on mechanical separation, are favoured over those that are chemically based, as they simplify operational requirements. Source reduction, through housekeeping, equipment and reagent modifications, and segregation and/or consolidation of hydrocarbon waste streams, minimizes treatment costs, safety and environmental impact.

Measuring and improving performance in incident management.

DOT National Transportation Integrated Search

2010-03-01

Traffic incidents account for about 25 percent of traffic congestion and delay. Clearing incidents rapidly is crucial in : minimizing congestion, reducing secondary crashes and improving safety for both emergency responders and : travelers. Especiall...

Beneficiation of Compression Debarked Wood Chips

Treesearch

James A. Mattson

1974-01-01

Presents the results of a preliminary study of secondary beneficiation of compression debarked chips to reduce residual bark to acceptable amounts. Ballmilling is a feasible method of reducing residual bark and minimizing wood loss.

Worst-Case Cooperative Jamming for Secure Communications in CIoT Networks.

PubMed

Li, Zhen; Jing, Tao; Ma, Liran; Huo, Yan; Qian, Jin

2016-03-07

The Internet of Things (IoT) is a significant branch of the ongoing advances in the Internet and mobile communications. The use of a large number of IoT devices makes the spectrum scarcity problem even more serious. The usable spectrum resources are almost entirely occupied, and thus, the increasing radio access demands of IoT devices cannot be met. To tackle this problem, the Cognitive Internet of Things (CIoT) has been proposed. In a CIoT network, secondary users, i.e., sensors and actuators, can access the licensed spectrum bands provided by licensed primary users (such as telephones). Security is a major concern in CIoT networks. However, the traditional encryption method at upper layers (such as symmetric cryptography and asymmetric cryptography) may be compromised in CIoT networks, since these types of networks are heterogeneous. In this paper, we address the security issue in spectrum-leasing-based CIoT networks using physical layer methods. Considering that the CIoT networks are cooperative networks, we propose to employ cooperative jamming to achieve secrecy transmission. In the cooperative jamming scheme, a certain secondary user is employed as the helper to harvest energy transmitted by the source and then uses the harvested energy to generate an artificial noise that jams the eavesdropper without interfering with the legitimate receivers. The goal is to minimize the signal to interference plus noise ratio (SINR) at the eavesdropper subject to the quality of service (QoS) constraints of the primary traffic and the secondary traffic. We formulate the considered minimization problem into a two-stage robust optimization problem based on the worst-case Channel State Information of the Eavesdropper. By using semi-definite programming (SDP), the optimal solutions of the transmit covariance matrices can be obtained. Moreover, in order to build an incentive mechanism for the secondary users, we propose an auction framework based on the cooperative jamming scheme. The proposed auction framework jointly formulates the helper selection and the corresponding energy allocation problems under the constraint of the eavesdropper's SINR. By adopting the Vickrey auction, truthfulness and individual rationality can be guaranteed. Simulation results demonstrate the good performance of the cooperative jamming scheme and the auction framework.

Relationships between symptomatology and SES-related factors in hyperkinetic/MBD boys.

PubMed

Paternite, C E; Loney, J; Langhorne, J E

1976-04-01

Relationships among symptomatology, socioeconomic status, and parenting styles were examined for 113 hyperkinetic/minimal brain dysfunction boys from intact families. Primary symptoms (e.g. hyperactivity) did not vary as a function of SES, but SES-related differences emerged for secondary symptoms (e.g., aggressive behavior, self-esteem deficits) and for parenting variables. Parenting variables were found to be better predictors of secondary symptoms than was SES. Implications for further research are offered.

Safety of vitrectomy for floaters.

PubMed

Tan, H Stevie; Mura, Marco; Lesnik Oberstein, Sarit Y; Bijl, Heico M

2011-06-01

To assess the risks of vitrectomy for the removal of primary and secondary vitreous opacities. Retrospective, nonrandomized, interventional case series. We reviewed the results of 116 consecutive cases of vitrectomy for vitreous floaters. Eighty-six cases were primary and 30 cases were secondary floaters. Main outcome measures were the incidence of iatrogenic retinal breaks and postoperative rhegmatogenous retinal detachments. We found iatrogenic retinal breaks in 16.4% of operations. There was no statistically significant difference in risk between cases of primary and secondary floaters. Intraoperative posterior vitreous detachment induction was found to increase significantly the risk of breaks. Retinal detachment occurred in 3 cases (2.5%), all after operations for primary floaters. One case of complicated retinal detachment ended with a low visual acuity of hand movements. Cataract occurred in 50% of phakic cases. Transient postoperative hypotony was found after 5.2% of our operations, and transient postoperative high intraocular pressure was encountered in 7.8%. An intraoperative choroidal hemorrhage occurred in 1 case, which resolved spontaneously. The mean visual acuity improved from 0.20 to 0.13 logarithm of the minimal angle of resolution units. The risk profile of vitrectomy for floaters is comparable with that of vitrectomy for other elective indications. Retinal breaks are a common finding during surgery and treatment of these breaks is crucial for the prevention of postoperative retinal detachment. Patients considering surgery for floaters should be informed specifically about the risks involved. Copyright © 2011 Elsevier Inc. All rights reserved.

Evaluation of the Potential for Secondary Kill for Ingested Insecticides in the Common Bed Bug (Hemiptera: Cimicidae).

PubMed

Matos, Yvonne K; Sierras, Angela; Schal, Coby

2017-06-01

Baits are a preferred method of urban pest management. Baits enable more targeted insecticide applications with a fraction of the active ingredient used in residual sprays. Bait translocation by foragers, and consequent secondary kill of nonforagers, enhances bait effectiveness in social insects, and in other group-living species like German cockroaches (Blattella germanica L.). We investigated the potential for secondary kill in bed bugs (Cimex lectularius L.), another gregarious species, using a liquid bait. We first investigated whether blood-fed adults enhance nymph survivorship within aggregations by increasing the local relative humidity (RH) and providing fecal nutrients. Higher RH (50% and 95%) resulted in greater survivorship of first instars compared with 0% RH. Therefore, in subsequent experiments, we controlled RH to decouple its effect on nymph survivorship from effects of fecal nutrients. The presence of fed or unfed adults did not increase unfed first instar survivorship, suggesting that if nymphs ingested feces, its nutritional benefits were minimal. Nymph survivorship was unaffected by the presence of adult males fed fipronil or clothianidin, suggesting that unlike in cockroaches, highly effective insecticides might not be effective as secondary kill toxicants in bed bugs. To directly compare secondary kill in first-instar bed bugs and B. germanica, we exposed both to insecticide-laden adult B. germanica feces. Whereas first-instar B. germanica died in the presence of insecticide-laden feces, bed bugs did not. We, therefore, conclude that secondary kill with neuroactive insecticides will likely not be a significant factor in bed bug population suppression. © The Authors 2017. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Comparative evaluation of pressure generated on a simulated maxillary oral analog by impression materials in custom trays of different spacer designs: An in vitro study.

PubMed

Chopra, Sakshi; Gupta, Narendra Kumar; Tandan, Amrit; Dwivedi, Ravi; Gupta, Swati; Agarwal, Garima

2016-01-01

Literature reveals that masticatory load on denture bearing tissues through complete dentures should be maximum on primary stress bearing areas and least on relief area in accordance with the histology of underlying tissues. A study to validate the existing beliefs was planned to compare the pressure on mucosa using selective pressure technique and minimal pressure technique, with the incorporation of two different impression materials utilizing the pressure sensors during secondary impression procedure. The study was performed using a maxillary analog. Three pressure sensors were imbedded in the oral analog, one in the mid palatine area and the other two in the right and left ridge crest. Custom trays of two different configurations were fabricated. The two impression materials tested were light body and zinc oxide eugenol. A total of 40 impressions were made. A constant weight of 1 kg was placed, and the pressure was recorded as initial and end pressures. A significant difference in the pressure produced using different impression materials was found (P < 0.001). Light body vinyl polysiloxane produced significantly lesser pressure than zinc oxide eugenol impression materials. The presence of relief did affect the magnitude of pressure at various locations. All impression materials produced pressure during maxillary edentulous impression making. Tray modification is an important factor in changing the amount of pressure produced. The impression materials used also had a significant role to play on the pressures acting on the tissues during impression procedure. Light body VPS impression material may be recommended to achieve minimal pressure on the denture bearing tissues in both selective as well as minimal pressure techniques.

Surgical outcomes of robotic-assisted surgical staging for endometrial cancer are equivalent to traditional laparoscopic staging at a minimally invasive surgical center

PubMed Central

Cardenas-Goicoechea, Joel; Adams, Sarah; Bhat, Suneel B.; Randall, Thomas C.

2010-01-01

Objective To compare peri- and post-operative complications and outcomes of robotic-assisted surgical staging with traditional laparoscopic surgical staging for women with endometrial cancer. Methods A retrospective chart review of cases of women undergoing minimally invasive total hysterectomy and pelvic and para-aortic lymphadenectomy by a robotic-assisted approach or traditional laparoscopic approach was conducted. Major intraoperative complications, including vascular injury, enterotomy, cystotomy, or conversion to laparotomy, were measured. Secondary outcomes including operative time, blood loss, transfusion rate, number of lymph nodes retrieved, and the length of hospitalization were also measured. Results 275 cases were identified–102 patients with robotic-assisted staging and 173 patients with traditional laparoscopic staging. There was no significant difference in the rate of major complications between groups (p=0.13). The mean operative time was longer in cases of robotic-assisted staging (237 min vs. 178 min, p<0.0001); however, blood loss was significantly lower (109 ml vs. 187 ml, p<0.0001). The mean number of lymph nodes retrieved were similar between groups (p=0.32). There were no significant differences in the time to discharge, re-admission, or re-operation rates between the two groups. Conclusion Robotic-assisted surgery is an acceptable alternative to laparoscopy for minimally invasive staging of endometrial cancer. In addition to the improved ease of operation, visualization, and range of motion of the robotic instruments, robotic surgery results in a lower mean blood loss, although longer operative time. More data are needed to determine if the rates of urinary tract injuries and other surgical complications can be reduced with the use of robotic surgery. PMID:20144471

A population-based study comparing laparoscopic and robotic outcomes in colorectal surgery.

PubMed

Tam, Michael S; Kaoutzanis, Christodoulos; Mullard, Andrew J; Regenbogen, Scott E; Franz, Michael G; Hendren, Samantha; Krapohl, Greta; Vandewarker, James F; Lampman, Richard M; Cleary, Robert K

2016-02-01

Current data addressing the role of robotic surgery for the management of colorectal disease are primarily from single-institution and case-matched comparative studies as well as administrative database analyses. The purpose of this study was to compare minimally invasive surgery outcomes using a large regional protocol-driven database devoted to surgical quality, improvement in patient outcomes, and cost-effectiveness. This is a retrospective cohort study from the prospectively collected Michigan Surgical Quality Collaborative registry designed to compare outcomes of patients who underwent elective laparoscopic, hand-assisted laparoscopic, and robotic colon and rectal operations between July 1, 2012 and October 7, 2014. We adjusted for differences in baseline covariates between cases with different surgical approaches using propensity score quintiles modeled on patient demographics, general health factors, diagnosis, and preoperative co-morbidities. The primary outcomes were conversion rates and hospital length of stay. Secondary outcomes included operative time, and postoperative morbidity and mortality. A total of 2735 minimally invasive colorectal operations met inclusion criteria. Conversion rates were lower with robotic as compared to laparoscopic operations, and this was statistically significant for rectal resections (colon 9.0 vs. 16.9%, p < 0.06; rectum 7.8 vs. 21.2%, p < 0.001). The adjusted length of stay for robotic colon operations (4.00 days, 95% CI 3.63-4.40) was significantly shorter compared to laparoscopic (4.41 days, 95% CI 4.17-4.66; p = 0.04) and hand-assisted laparoscopic cases (4.44 days, 95% CI 4.13-4.78; p = 0.008). There were no significant differences in overall postoperative complications among groups. When compared to conventional laparoscopy, the robotic platform is associated with significantly fewer conversions to open for rectal operations, and significantly shorter length of hospital stay for colon operations, without increasing overall postoperative morbidity. These findings and the recent upgrades in minimally invasive technology warrant continued evaluation of the role of the robotic platform in colorectal surgery.

Secondary health conditions and spinal cord injury: an uphill battle in the journey of care.

PubMed

Guilcher, Sara J T; Craven, B Cathy; Lemieux-Charles, Louise; Casciaro, Tiziana; McColl, Mary Ann; Jaglal, Susan B

2013-06-01

To understand the journey of care in the prevention and management of secondary health conditions (SHCs) following spinal cord injury (SCI). This was a case study design with 'Ontario' as the case. The Network Episode Model was used as the conceptual framework. Data sources included in depth interviews with persons with SCI, care providers, and policy and decision makers. Document analysis was also conducted on relevant materials and policies. Key informants were selected by purposeful sampling as well as snowball sampling to provide maximum variation. Data analysis was an iterative process and involved descriptive and interpretive analyses. A coding structure was developed based on the conceptual framework which allowed for free nodes when emerging ideas or themes were identified. Twenty-eight individuals were interviewed (14 persons with SCI and 14 persons representing care providers, community advocacy organization representatives, system service delivery administrators and policy-makers). A major over-arching domain that emerged from the data was the concept of 'fighting'. Eleven themes were identified: at the micro-individual level: (i) social isolation and system abandonment, (ii) funding and equitable care, (iii) bounded freedom and self-management; at the meso care provider level: (iv) gender and caregiving strain, (v) help versus disempowerment, (vi) holistic care-thinking outside the box, (vii) poor communication and coordination of care; and at the macro health system level: (viii) fight for access and availability, (ix) models of care tensions, (x) private versus public tensions and (xi) rigid rules and policies. Findings suggest that the journey is challenging and a persistent uphill struggle for persons with SCI, care providers, and community-based advocates. If we are to make significant gains in minimizing the incidence and severity of SHCs, we need to tailor efforts at the health system level. • Secondary health conditions are problematic for individuals with a spinal cord injury (SCI). • This study aimed to understand the journey of care in the prevention and management of secondary health conditions (SHCs) following SCI. • Findings suggest that the journey is challenging and a persistent uphill struggle for persons with SCI, care providers, and community-based advocates. • All stakeholders involved recognized the disparities in access to care and resources that exist within the system. We recommend that if we are to make significant gains in minimizing the incidence and severity of SHCs, we need to tailor efforts at the health system level.

Secondary-electron-emission losses in multistage depressed collectors and traveling-wave-tube efficiency improvements with carbon collector electrode surfaces

NASA Technical Reports Server (NTRS)

Ramins, P.; Ebihara, B. T.

1986-01-01

Secondary-electron-emission losses in multistage depressed collectors (MDC's) and their effects on overall traveling-wave-tube (TWT) efficiency were investigated. Two representative TWT's and several computer-modeled MDC's were used. The experimental techniques provide the measurement of both the TWT overall and the collector efficiencies. The TWT-MDC performance was optimized and measured over a wide range of operating conditions, with geometrically identical collectors, which utilized different electrode surface materials. Comparisons of the performance of copper electrodes to that of various forms of carbon, including pyrolytic and iisotropic graphites, were stressed. The results indicate that: (1) a significant improvement in the TWT overall efficiency was obtained in all cases by the use of carbon, rather than copper electrodes, and (2) that the extent of this efficiency enhancement depended on the characteristics of the TWT, the TWT operating point, the MDC design, and collector voltages. Ion textured graphite was found to be particularly effective in minimizing the secondary-electron-emission losses. Experimental and analytical results, however, indicate that it is at least as important to provide a maximum amount of electrostatic suppression of secondary electrons by proper MDC design. Such suppression, which is obtained by ensuring that a substantial suppressing electric field exists over the regions of the electrodes where most of the current is incident, was found to be very effective. Experimental results indicate that, with proper MDC design and the use of electrode surfaces with low secondary-electron yield, degradation of the collector efficiency can be limited to a few percent.

Collagen induced arthritis increases secondary metastasis in MMTV-PyV MT mouse model of mammary cancer.

PubMed

Roy, Lopamudra Das; Ghosh, Sriparna; Pathangey, Latha B; Tinder, Teresa L; Gruber, Helen E; Mukherjee, Pinku

2011-08-22

Several studies have demonstrated that sites of chronic inflammation are often associated with the establishment and growth of various malignancies. A common inflammatory condition in humans is autoimmune arthritis (AA). Although AA and cancer are different diseases, many of the underlying processes that contribute to the disorders of the joints and connective tissue that characterize AA also affect cancer progression and metastasis. Systemically, AA can lead to cellular infiltration and inflammation of the lungs. Several studies have reported statistically significant risk ratios between AA and breast cancer. Despite this knowledge being available, there has been minimal research linking breast cancer, arthritis, and metastasis associated with breast cancer. Notably both diseases are extremely prevalent in older post-menopausal women. To establish the novel link between arthritis induced inflammation and secondary metastasis associated with breast cancer, PyV MT mice that spontaneously develop mammary gland carcinoma were injected with Type II collagen (CII) to induce arthritis at 9 and 18 weeks of age for pre-metastatic and metastatic condition. The sites of secondary metastasis and the associated inflammatory microenvironment were evaluated. A significant increase in breast cancer-associated secondary metastasis to the lungs and bones was observed in the arthritic versus the non-arthritic PyV MT mice along with an increase in primary tumor burden. We report significant increases in the levels of interstitial cellular infiltrates and pro-inflammatory cytokines such as interleukin-17 (IL-17), interleukin-6 (IL-6), Pro- Matrix metallopeptidase 9 (Pro-MMP9), insulin like growth factor-II (GF-II) and macrophage colony stimulating factor (M-CSF) in the arthritic lung and bone milieu as well as in the circulation. These pro-inflammatory cytokines along with the inflammatory microenvironment may be the underlying factors facilitating tumor progression and metastasis in arthritic PyV MT mice. This was further substantiated by treatment with celecoxib, an anti-inflammatory drug + αIL-17 antibody that significantly reduced the secondary metastasis to lung and bone. The data generated not only reveal the underlying mechanism of high susceptibility to bone and lung metastasis in an arthritic condition but our combination therapies may lead to treatment modalities that will be capable of reducing tumor burden, and preventing relapse and metastasis in arthritic patients with breast cancer.

Collagen induced arthritis increases secondary metastasis in MMTV-PyV MT mouse model of mammary cancer

PubMed Central

2011-01-01

Background Several studies have demonstrated that sites of chronic inflammation are often associated with the establishment and growth of various malignancies. A common inflammatory condition in humans is autoimmune arthritis (AA). Although AA and cancer are different diseases, many of the underlying processes that contribute to the disorders of the joints and connective tissue that characterize AA also affect cancer progression and metastasis. Systemically, AA can lead to cellular infiltration and inflammation of the lungs. Several studies have reported statistically significant risk ratios between AA and breast cancer. Despite this knowledge being available, there has been minimal research linking breast cancer, arthritis, and metastasis associated with breast cancer. Notably both diseases are extremely prevalent in older post-menopausal women. Methods To establish the novel link between arthritis induced inflammation and secondary metastasis associated with breast cancer, PyV MT mice that spontaneously develop mammary gland carcinoma were injected with Type II collagen (CII) to induce arthritis at 9 and 18 weeks of age for pre-metastatic and metastatic condition. The sites of secondary metastasis and the associated inflammatory microenvironment were evaluated. Results A significant increase in breast cancer-associated secondary metastasis to the lungs and bones was observed in the arthritic versus the non-arthritic PyV MT mice along with an increase in primary tumor burden. We report significant increases in the levels of interstitial cellular infiltrates and pro-inflammatory cytokines such as interleukin-17 (IL-17), interleukin-6 (IL-6), Pro- Matrix metallopeptidase 9 (Pro-MMP9), insulin like growth factor-II (GF-II) and macrophage colony stimulating factor (M-CSF) in the arthritic lung and bone milieu as well as in the circulation. These pro-inflammatory cytokines along with the inflammatory microenvironment may be the underlying factors facilitating tumor progression and metastasis in arthritic PyV MT mice. This was further substantiated by treatment with celecoxib, an anti-inflammatory drug + αIL-17 antibody that significantly reduced the secondary metastasis to lung and bone. Conclusions The data generated not only reveal the underlying mechanism of high susceptibility to bone and lung metastasis in an arthritic condition but our combination therapies may lead to treatment modalities that will be capable of reducing tumor burden, and preventing relapse and metastasis in arthritic patients with breast cancer. PMID:21859454

Minimal invasive treatments for liver malignancies.

PubMed

Orsi, Franco; Varano, Gianluca

2015-11-01

Minimal invasive therapies have proved useful in the management of primary and secondary hepatic malignancies. The most relevant aspects of all these therapies are their minimal toxicity profiles and highly effective tumor responses without affecting the normal hepatic parenchyma. These unique characteristics coupled with their minimally invasive nature provide an attractive therapeutic option for patients who previously may have had few alternatives. Combination of these therapies might extend indications to bring curative treatment to a wider selected population. The results of various ongoing combination trials of intraarterial therapies with targeted therapies are awaited to further improve survival in this patient group. This review focuses on the application of ablative and intra-arterial therapies in the management of hepatocellular carcinoma and hepatic colorectal metastasis. Copyright © 2015 Elsevier B.V. All rights reserved.

An Overview of Randomization and Minimization Programs for Randomized Clinical Trials

PubMed Central

Saghaei, Mahmoud

2011-01-01

Randomization is an essential component of sound clinical trials, which prevents selection biases and helps in blinding the allocations. Randomization is a process by which subsequent subjects are enrolled into trial groups only by chance, which essentially eliminates selection biases. A serious consequence of randomization is severe imbalance among the treatment groups with respect to some prognostic factors, which invalidate the trial results or necessitate complex and usually unreliable secondary analysis to eradicate the source of imbalances. Minimization on the other hand tends to allocate in such a way as to minimize the differences among groups, with respect to prognostic factors. Pure minimization is therefore completely deterministic, that is, one can predict the allocation of the next subject by knowing the factor levels of a previously enrolled subject and having the properties of the next subject. To eliminate the predictability of randomization, it is necessary to include some elements of randomness in the minimization algorithms. In this article brief descriptions of randomization and minimization are presented followed by introducing selected randomization and minimization programs. PMID:22606659

Decision Making in Concurrent Multitasking: Do People Adapt to Task Interference?

PubMed Central

Nijboer, Menno; Taatgen, Niels A.; Brands, Annelies; Borst, Jelmer P.; van Rijn, Hedderik

2013-01-01

While multitasking has received a great deal of attention from researchers, we still know little about how well people adapt their behavior to multitasking demands. In three experiments, participants were presented with a multicolumn subtraction task, which required working memory in half of the trials. This primary task had to be combined with a secondary task requiring either working memory or visual attention, resulting in different types of interference. Before each trial, participants were asked to choose which secondary task they wanted to perform concurrently with the primary task. We predicted that if people seek to maximize performance or minimize effort required to perform the dual task, they choose task combinations that minimize interference. While performance data showed that the predicted optimal task combinations indeed resulted in minimal interference between tasks, the preferential choice data showed that a third of participants did not show any adaptation, and for the remainder it took a considerable number of trials before the optimal task combinations were chosen consistently. On the basis of these results we argue that, while in principle people are able to adapt their behavior according to multitasking demands, selection of the most efficient combination of strategies is not an automatic process. PMID:24244527

Time-dependent radiation dose estimations during interplanetary space flights

NASA Astrophysics Data System (ADS)

Dobynde, M. I.; Shprits, Y.; Drozdov, A.

2015-12-01

Time-dependent radiation dose estimations during interplanetary space flights 1,2Dobynde M.I., 2,3Drozdov A.Y., 2,4Shprits Y.Y.1Skolkovo institute of science and technology, Moscow, Russia 2University of California Los Angeles, Los Angeles, USA 3Lomonosov Moscow State University Skobeltsyn Institute of Nuclear Physics, Moscow, Russia4Massachusetts Institute of Technology, Cambridge, USASpace radiation is the main restriction for long-term interplanetary space missions. It induces degradation of external components and propagates inside providing damage to internal environment. Space radiation particles and induced secondary particle showers can lead to variety of damage to astronauts in short- and long- term perspective. Contribution of two main sources of space radiation- Sun and out-of-heliosphere space varies in time in opposite phase due to the solar activity state. Currently the only habituated mission is the international interplanetary station that flights on the low Earth orbit. Besides station shell astronauts are protected with the Earth magnetosphere- a natural shield that prevents significant damage for all humanity. Current progress in space exploration tends to lead humanity out of magnetosphere bounds. With the current study we make estimations of spacecraft parameters and astronauts damage for long-term interplanetary flights. Applying time dependent model of GCR spectra and data on SEP spectra we show the time dependence of the radiation in a human phantom inside the shielding capsule. We pay attention to the shielding capsule design, looking for an optimal geometry parameters and materials. Different types of particles affect differently on the human providing more or less harm to the tissues. Incident particles provide a large amount of secondary particles while propagating through the shielding capsule. We make an attempt to find an optimal combination of shielding capsule parameters, namely material and thickness, that will effectively decrease the incident particle energy, at the same time minimizing flow of secondary induced particles and minimizing most harmful particle types flows.

Preparative electrophoresis with on-column optical fiber monitoring and direct elution into a minimized volume.

PubMed

Jackson, George W; Willson, Richard

2005-11-01

A "column-format" preparative electrophoresis device which obviates the need for gel extraction or secondary electro-elution steps is described. Separated biomolecules are continuously detected and eluted directly into a minimal volume of free solution for subsequent use. An optical fiber allows the species of interest to be detected just prior to elution from the gel column, and a small collection volume is created by addition of an ion-exchange membrane near the end of the column.

Modern management of salivary calculi.

PubMed

McGurk, M; Escudier, M P; Brown, J E

2005-01-01

The aim was to investigate the results of a minimally invasive approach to the management of salivary calculi. Four hundred and fifty-five salivary calculi (323 submandibular and 132 parotid) were treated using extracorporeal shock-wave lithotripsy (ECSWL), fluoroscopically guided basket retrieval or intraoral stone removal under general anaesthesia. The techniques were used either alone or in combination. ECSWL achieved complete success (stone and symptom free) in 87 (39.4 percent) of 221 patients (84 of 218 primary and all of three secondary procedures; 43 of 131 submandibular, 44 of 90 parotid). Basket retrieval cured 124 (74.7 percent) of 166 patients (103 of 136 primary and 21 of 30 secondary procedures; 80 of 109 submandibular, 44 of 57 parotid). Intraoral surgical removal was successful in a further 137 (95.8 percent) of 143 patients with submandibular stones (99 of 101 primary, 36 of 38 secondary and two of four tertiary procedures). The overall success rate for the three techniques was 348 (76.5 percent) of 455. A minimally invasive approach to the management of salivary calculi is to be encouraged. All three techniques described have low morbidity and afford the possibility of retaining a functional gland.

Energy distributions exhibited during thermal runaway of commercial lithium ion batteries used for human spaceflight applications

NASA Astrophysics Data System (ADS)

Yayathi, Sandeep; Walker, William; Doughty, Daniel; Ardebili, Haleh

2016-10-01

Lithium ion (Li-ion) batteries provide low mass and energy dense solutions necessary for space exploration, but thermal related safety concerns impede the utilization of Li-ion technology for human applications. Experimental characterization of thermal runaway energy release with accelerated rate calorimetry supports safer thermal management systems. 'Standard' accelerated rate calorimetry setup provides means to measure the addition of energy exhibited through the body of a Li-ion cell. This study considers the total energy generated during thermal runaway as distributions between cell body and hot gases via inclusion of a unique secondary enclosure inside the calorimeter; this closed system not only contains the cell body and gaseous species, but also captures energy release associated with rapid heat transfer to the system unobserved by measurements taken on the cell body. Experiments include Boston Power Swing 5300, Samsung 18650-26F and MoliCel 18650-J Li-ion cells at varied states-of-charge. An inverse relationship between state-of-charge and onset temperature is observed. Energy contained in the cell body and gaseous species are successfully characterized; gaseous energy is minimal. Significant additional energy is measured with the heating of the secondary enclosure. Improved calorimeter apparatus including a secondary enclosure provides essential capability to measuring total energy release distributions during thermal runaway.

A Novel Minimally Invasive Wireless Technology for Neuromodulation via Percutaneous Intercostal Nerve Stimulation for Post-Herpetic Neuralgia: A Case Report with Short-Term Follow-up.

PubMed

Billet, Bart; Wynendaele, Roel; Vanquathem, Niek E

2018-03-01

Peripheral nerve stimulation of primary afferent neurons provides control of localized chronic pain. This technique applies permanent electrical stimulation at the target area via a minimally invasive, subcutaneous placement of an electrode. To assess the analgesic effects of minimally invasive wireless neuromodulation in the treatment of chronic intractable pain secondary to post-herpetic neuralgia. A 78-year-old man presented with severe intractable post-herpetic neuralgic pain. He was known to have non-Hodgkin's lymphoma under remission following treatment with chemotherapy and stem cell transplantation, twice. He also developed steroid-induced diabetes mellitus during this treatment. In view of his compromised immune status, he was deemed a suitable candidate for our minimally invasive neuromodulation technology. Two subcutaneous electrodes were placed on the right-hand side of the trunk, 10 cm medial and parallel to the spinous process at the level of T7-T8 under fluoroscopic guidance along the T7 intercostal nerve. The external transmitter was worn with a belt over a single layer of clothing and used to transmit power to the stimulator. The entire procedure required only a small incision for the introduction of the electrode placement. After an uneventful procedure, the pain score decreased from 8 to 3, with a reduction in pain medication. The EuroQol Five Dimensions Questionnaire scores were 0.102 before the trial, 0.630 at 1 month, and 0.576 at 3 months. Subcutaneous placement of electrodes with our minimally invasive technique and wireless neuromodulation technology was safe and effective. Significant improvements in pain relief ensued, and no further adverse events had been reported at the end of 3 months' follow-up. © 2017 World Institute of Pain.

Placebo effects in trials evaluating 12 selected minimally invasive interventions: a systematic review and meta-analysis

PubMed Central

Holtedahl, Robin; Brox, Jens Ivar; Tjomsland, Ole

2015-01-01

Objectives To analyse the impact of placebo effects on outcome in trials of selected minimally invasive procedures and to assess reported adverse events in both trial arms. Design A systematic review and meta-analysis. Data sources and study selection We searched MEDLINE and Cochrane library to identify systematic reviews of musculoskeletal, neurological and cardiac conditions published between January 2009 and January 2014 comparing selected minimally invasive with placebo (sham) procedures. We searched MEDLINE for additional randomised controlled trials published between January 2000 and January 2014. Data synthesis Effect sizes (ES) in the active and placebo arms in the trials’ primary and pooled secondary end points were calculated. Linear regression was used to analyse the association between end points in the active and sham groups. Reported adverse events in both trial arms were registered. Results We included 21 trials involving 2519 adult participants. For primary end points, there was a large clinical effect (ES≥0.8) after active treatment in 12 trials and after sham procedures in 11 trials. For secondary end points, 7 and 5 trials showed a large clinical effect. Three trials showed a moderate difference in ES between active treatment and sham on primary end points (ES ≥0.5) but no trials reported a large difference. No trials showed large or moderate differences in ES on pooled secondary end points. Regression analysis of end points in active treatment and sham arms estimated an R2 of 0.78 for primary and 0.84 for secondary end points. Adverse events after sham were in most cases minor and of short duration. Conclusions The generally small differences in ES between active treatment and sham suggest that non-specific mechanisms, including placebo, are major predictors of the observed effects. Adverse events related to sham procedures were mainly minor and short-lived. Ethical arguments frequently raised against sham-controlled trials were generally not substantiated. PMID:25636794

Antioxidants Potential of the Filamentous Fungi (Mucor circinelloides)

PubMed Central

Hussain, Syed Ammar; Yang, Junhuan; Ijaz, Muhammad Umair; Liu, Qing; Song, Yuanda

2017-01-01

Three important strains of Mucor circinelloides grown in complete and minimal media for specified period (72 h, 120 h and 168 h) under submerged fermentation conditions were investigated for their potential antioxidants/secondary metabolite production. All mycelial extracts demonstrated effective antioxidant activities in terms of β-carotene/linoleic acid bleaching, radical scavenging, reduction of metal ions and chelating abilities against ferrous ions. Different extraction methods and solvent systems affected the recovery yield and antioxidant activities of the extracts significantly (p ≤ 0.05). Ethanolic extracts were found to be rich source of antioxidant components and subsequently more effective in antioxidant properties. Fermentation period and media used also significantly affected (p ≤ 0.05) the antioxidant production and the resulting antioxidant properties. The (ethanolic) extracts of all the strains from late exponential growth phase (120 h) showed highest antioxidant production with topmost reducing, chelating and radical scavenging capabilities. Strain MC277.49 was found to be the highest producer of antioxidants followed by MC108.16 and WJ11. Phenolic compounds were detected significantly in higher (p ≤ 0.05) amount succeeded by the condensed tannins and flavonoids. Total phenol content of each extract was attributed to overall antioxidant capacity. Submerged fermentation with nutritional stress conditions were found to be excellent way of producing surplus amount of natural antioxidants/secondary metabolites with their vast potential commercial application in food and pharmaceutical industries. PMID:28991177

Antioxidants Potential of the Filamentous Fungi (Mucor circinelloides).

PubMed

Hameed, Ahsan; Hussain, Syed Ammar; Yang, Junhuan; Ijaz, Muhammad Umair; Liu, Qing; Suleria, Hafiz Ansar Rasul; Song, Yuanda

2017-10-07

Three important strains of Mucor circinelloides grown in complete and minimal media for specified period (72 h, 120 h and 168 h) under submerged fermentation conditions were investigated for their potential antioxidants/secondary metabolite production. All mycelial extracts demonstrated effective antioxidant activities in terms of β-carotene/linoleic acid bleaching, radical scavenging, reduction of metal ions and chelating abilities against ferrous ions. Different extraction methods and solvent systems affected the recovery yield and antioxidant activities of the extracts significantly ( p ≤ 0.05). Ethanolic extracts were found to be rich source of antioxidant components and subsequently more effective in antioxidant properties. Fermentation period and media used also significantly affected ( p ≤ 0.05) the antioxidant production and the resulting antioxidant properties. The (ethanolic) extracts of all the strains from late exponential growth phase (120 h) showed highest antioxidant production with topmost reducing, chelating and radical scavenging capabilities. Strain MC277.49 was found to be the highest producer of antioxidants followed by MC108.16 and WJ11. Phenolic compounds were detected significantly in higher ( p ≤ 0.05) amount succeeded by the condensed tannins and flavonoids. Total phenol content of each extract was attributed to overall antioxidant capacity. Submerged fermentation with nutritional stress conditions were found to be excellent way of producing surplus amount of natural antioxidants/secondary metabolites with their vast potential commercial application in food and pharmaceutical industries.

Can Cognitive Behavioral Therapy for Insomnia also treat fatigue, pain, and mood symptoms in individuals with traumatic brain injury? - A multiple case report.

PubMed

Lu, William; Krellman, Jason W; Dijkers, Marcel P

2016-01-01

Individuals with traumatic brain injury (TBI) often develop sleep disorders post-injury. The most common one is insomnia, which can exacerbate other post-injury symptoms, including fatigue, impaired cognition, depression, anxiety, and pain. Cognitive Behavioral Therapy for Insomnia (CBT-I) is a manualized treatment that effectively treats insomnia with secondary effects on cognition, mood, and pain in various populations. This paper reviews the use of CBT-I for three participants with TBI of different severities. Pre- and post-treatment assessments of insomnia, fatigue, depression, anxiety, and pain were conducted. Mood was further assessed at follow-up. Minimal clinically important difference (MCID) scores derived from the research literature were used to establish clinically meaningful symptom improvement on self-report questionnaires. The reduction in insomnia severity scores for all three participants were not large enough to be considered a clinically significant improvement following CBT-I, although trends toward improvement were observed. However, all participants showed clinically significant reductions in anxiety at post-treatment; the effects persisted for 2 participants at follow-up. Reductions in depression symptoms were observed for 2 participants at post-treatment, and treatment effects persisted for 1 participant at follow-up. One participant endorsed clinically significant improvements in fatigue and pain severity. We conclude that CBT-I may provide secondary benefits for symptoms commonly experienced by individuals with TBI, especially mood disturbances.

Citrate-Coated Silver Nanoparticles Growth-Independently Inhibit Aflatoxin Synthesis in Aspergillus parasiticus.

PubMed

Mitra, Chandrani; Gummadidala, Phani M; Afshinnia, Kamelia; Merrifield, Ruth C; Baalousha, Mohammed; Lead, Jamie R; Chanda, Anindya

2017-07-18

Manufactured silver nanoparticles (Ag NPs) have long been used as antimicrobials. However, little is known about how these NPs affect fungal cell functions. While multiple previous studies reveal that Ag NPs inhibit secondary metabolite syntheses in several mycotoxin producing filamentous fungi, these effects are associated with growth repression and hence need sublethal to lethal NP doses, which besides stopping fungal growth, can potentially accumulate in the environment. Here we demonstrate that citrate-coated Ag NPs of size 20 nm, when applied at a selected nonlethal dose, can result in a >2 fold inhibition of biosynthesis of the carcinogenic mycotoxin and secondary metabolite, aflatoxin B 1 in the filamentous fungus and an important plant pathogen, Aspergillus parasiticus, without inhibiting fungal growth. We also show that the observed inhibition was not due to Ag ions, but was specifically associated with the mycelial uptake of Ag NPs. The NP exposure resulted in a significant decrease in transcript levels of five aflatoxin genes and at least two key global regulators of secondary metabolism, laeA and veA, with a concomitant reduction of total reactive oxygen species (ROS). Finally, the depletion of Ag NPs in the growth medium allowed the fungus to regain completely its ability of aflatoxin biosynthesis. Our results therefore demonstrate the feasibility of Ag NPs to inhibit fungal secondary metabolism at nonlethal concentrations, hence providing a novel starting point for discovery of custom designed engineered nanoparticles that can efficiently prevent mycotoxins with minimal risk to health and environment.

A High-Efficiency Refractive Secondary Solar Concentrator for High Temperature Solar Thermal Applications

NASA Technical Reports Server (NTRS)

Piszczor, Michael F., Jr.; Macosko, Robert P.

2000-01-01

A refractive secondary solar concentrator is a non-imaging optical device that accepts focused solar energy from a primary concentrator and redirects that light, by means of refraction and total internal reflection (TIR) into a cavity where the solar energy is used for power and/or propulsion applications. This concept offers a variety of advantages compared to typical reflective secondary concentrators (or the use of no secondary at all): higher optical efficiency, minimal secondary cooling requirements, a smaller cavity aperture, a reduction of outgassing from the cavity and flux tailoring of the solar energy within the heat receiver. During the past 2 years, NASA Lewis has been aggressively developing this concept in support of the NASA Marshall Shooting Star Flight Experiment. This paper provides a brief overview of the advantages and technical challenges associated with the development of a refractive secondary concentrator and the fabrication of a working unit in support of the flight demonstration program.

Evaluation of hemodynamic and regional tissue perfusion effects of minimized extracorporeal circulation (MECC).

PubMed

Bauer, Adrian; Diez, Claudius; Schubel, Jens; El-Shouki, Nagi; Metz, Dietrich; Eberle, T; Hausmann, Harald

2010-03-01

Minimized extracorporeal circulation (MECC, Maquet, Cardiopulmonary AG, Hirrlingen, Germany) is an established procedure to perform coronary revascularization. Studies showed positive effects of MECC compared to conventional cardiopulmonary bypass (CCPB) procedures in terms of transfusion requirements, less inflammation reactions, and neurological impairments. Recent retrospective studies showed higher mean arterial pressure (MAP) and a lower frequency of vasoactive drug use. We addressed this issue in this study. The hypothesis was to find a higher MAP during coronary bypass grafting surgery in patients treated with MECC systems. We performed a prospective, controlled, randomized trial with 40 patients either assigned to MECC (n = 18) or CCPB (n = 22) undergoing coronary bypass grafting. Primary endpoints were the perioperative course of mean arterial pressure, and the consumption of norepinephrine. Secondary endpoints were the regional cerebral and renal oxygen saturation (rSO2) as an indicator of area perfusion and the course of hematocrit. Clinical and demographic characteristics did not significantly differ between both groups. Thirty-day mortality was 0%. At four of five time points during extracorporeal circulation (ECC) MAP values were significantly higher in the MECC group compared to CCPB patients (after starting the ECC 60 +/- 11 mmHg vs. 49 +/- 10 mmHg, p = .002). MECC patients received significantly less norepinephrine (MECC 22.5 +/- 35 microg vs. CCPB 60.5 +/- 75 microg, p = .045). The rSO2 measured at right and left forehead and the renal area was similar for both groups during ECC and significantly higher at CCPB group 1 and 4 hours after termination of CPB. Minimized extracorporeal circulation provides a higher mean arterial pressure during ECC and we found a lower consumption of vasoactive drugs in the MECC group. There was a decrease in regional tissue saturation at 1 and 4 hours post bypass in the MECC group possibly due to increased systemic inflammation and extravascular fluid shift in the CCPB group.

Evaluation of Hemodynamic and Regional Tissue Perfusion Effects of Minimized Extracorporeal Circulation (MECC®)

PubMed Central

Bauer, Adrian; Diez, Claudius; Schubel, Jens; El-Shouki, Nagi; Metz, Dietrich; Eberle, T.; Hausmann, Harald

2010-01-01

Abstract: Minimized extracorporeal circulation (MECC®, Maquet, Cardiopulmonary AG, Hirrlingen, Germany) is an established procedure to perform coronary revascularization. Studies showed positive effects of MECC compared to conventional cardiopulmonary bypass (CCPB) procedures in terms of transfusion requirements, less inflammation reactions, and neurological impairments. Recent retrospective studies showed higher mean arterial pressure (MAP) and a lower frequency of vasoactive drug use. We addressed this issue in this study. The hypothesis was to find a higher MAP during coronary bypass grafting surgery in patients treated with MECC systems. We performed a prospective, controlled, randomized trial with 40 patients either assigned to MECC (n = 18) or CCPB (n = 22) undergoing coronary bypass grafting. Primary endpoints were the perioperative course of mean arterial pressure, and the consumption of norepinephrine. Secondary endpoints were the regional cerebral and renal oxygen saturation (rSO2) as an indicator of area perfusion and the course of hematocrit. Clinical and demographic characteristics did not significantly differ between both groups. Thirty-day mortality was 0%. At four of five time points during extracorporeal circulation (ECC) MAP values were significantly higher in the MECC group compared to CCPB patients (after starting the ECC 60 ± 11 mmHg vs. 49 ± 10 mmHg, p = .002). MECC patients received significantly less norepinephrine (MECC 22.5 ± 35 μg vs. CCPB 60.5 ± 75 μg, p = .045). The rSO2 measured at right and left forehead and the renal area was similar for both groups during ECC and significantly higher at CCPB group 1 and 4 hours after termination of CPB. Minimized extracorporeal circulation provides a higher mean arterial pressure during ECC and we found a lower consumption of vasoactive drugs in the MECC group. There was a decrease in regional tissue saturation at 1 and 4 hours post bypass in the MECC group possibly due to increased systemic inflammation and extravascular fluid shift in the CCPB group. PMID:20437789

Recombinant versus highly-purified, urinary follicle-stimulating hormone (r-FSH vs. HP-uFSH) in ovulation induction: a prospective, randomized study with cost-minimization analysis.

PubMed

Revelli, Alberto; Poso, Francesca; Gennarelli, Gianluca; Moffa, Federica; Grassi, Giuseppina; Massobrio, Marco

2006-07-18

Both recombinant FSH (r-FSH) and highly-purified, urinary FSH (HP-uFSH) are frequently used in ovulation induction associated with timed sexual intercourse. Their effectiveness is reported to be similar, and therefore the costs of treatment represent a major issue to be considered. Although several studies about costs in IVF have been published, data obtained in low-technology infertility treatments are still scarce. Two hundred and sixty infertile women (184 with unexplained infertility, 76 with CC-resistant polycystic ovary syndrome) at their first treatment cycle were randomized and included in the study. Ovulation induction was accomplished by daily administration of rFSH or HP-uFSH according to a low-dose, step-up regimen aimed to obtain a monofollicular ovulation. A bi- or tri-follicular ovulation was anyway accepted, whereas hCG was withdrawn and the cycle cancelled when more than three follicles greater than or equal to 18 mm diameter were seen at ultrasound. The primary outcome measure was the cost of therapy per delivered baby, estimated according to a cost-minimization analysis. Secondary outcomes were the following: monofollicular ovulation rate, total FSH dose, cycle cancellation rate, length of the follicular phase, number of developing follicles (>12 mm diameter), endometrial thickness at hCG, incidence of twinning and ovarian hyperstimulation syndrome, delivery rate. The overall FSH dose needed to achieve ovulation was significantly lower with r-FSH, whereas all the other studied variables did not significantly differ with either treatments. However, a trend toward a higher delivery rate with r-FSH was observed in the whole group and also when results were considered subgrouping patients according to the indication to treatment. Considering the significantly lower number of vials/patient and the slight (although non-significant) increase in the delivery rate with r-FSH, the cost-minimization analysis showed a 9.4% reduction in the overall therapy cost per born baby in favor of r-FSH.

Insights into the phylogenetic positions of photosynthetic bacteria obtained from 5S rRNA and 16S rRNA sequence data

NASA Technical Reports Server (NTRS)

Fox, G. E.

1985-01-01

Comparisons of complete 16S ribosomal ribonucleic acid (rRNA) sequences established that the secondary structure of these molecules is highly conserved. Earlier work with 5S rRNA secondary structure revealed that when structural conservation exists the alignment of sequences is straightforward. The constancy of structure implies minimal functional change. Under these conditions a uniform evolutionary rate can be expected so that conditions are favorable for phylogenetic tree construction.

Comparison of 3 Minimally Invasive Methods for Distal Tibia Fractures.

PubMed

Fang, Jun-Hao; Wu, Yao-Sen; Guo, Xiao-Shan; Sun, Liao-Jun

2016-07-01

This study compared the results of external fixation combined with limited open reduction and internal fixation (EF + LORIF), minimally invasive percutaneous plate osteosynthesis (MIPPO), and intramedullary nailing (IMN) for distal tibia fractures. A total of 84 patients with distal tibia shaft fractures were randomized to operative stabilization using EF + LORIF (28 cases), MIPPO (28 cases), or IMN (28 cases). The 3 groups were comparable with respect to patient demographics. Data were collected on operative time and radiation time, union time, complications, time of recovery to work, secondary operations, and measured joint function using the American Orthopaedic Foot and Ankle Society (AOFAS) score. There was no significant difference in time to union, incidence of union status, time of recovery to work, and AOFAS scores among the 3 groups (P>.05). Mean operative time and radiation time in the MIPPO group were longer than those in the IMN or EF + LORIF groups (P<.05). Wound complications after MIPPO were more common compared with IMN or EF + LORIF (P<.05). Anterior knee pain occurred frequently after IMN (32.1%), and irritation symptoms were encountered more frequently after MIPPO (46.4%). Although EF + LORIF was associated with fewer secondary procedures vs MIPPO or IMN, it was related with more pin-tract infections (14.3%). Findings indicated that EF + LORIF, MIPPO, and IMN all achieved similar good functional results. However, EF + LORIF had some advantages over MIPPO and IMN in reducing operative and radiation times, postoperative complications, and reoperation rate. [Orthopedics. 2016; 39(4):e627-e633.]. Copyright 2016, SLACK Incorporated.

Treatment of bunion deformity in the athlete.

PubMed

Baxter, D E

1994-01-01

Bunions occur in athletes. Often, the bunion is compensated and has a congruous joint, needing minimal treatment. If the bunion rapidly progresses, the sesamoids sublux, and the joint becomes incongruous; surgery becomes necessary. Surgery for decompensated bunions and secondary problems is discussed.

Secondary plastic closure of gastroschisis is associated with a lower incidence of mechanical ventilation.

PubMed

Dariel, Anne; Poocharoen, Wannisa; de Silva, Nicole; Pleasants, Hazel; Gerstle, Justin Ted

2015-02-01

Nonsurgical closure after primary silo placement, secondary plastic closure (SPC), has been used as an alternative to secondary surgical closure (SSC) in gastroschisis. The benefits described were closure without formal surgical procedure, cosmetic aspect, and minimization of intra-abdominal pressures. This study compared requirements for mechanical ventilation and general anesthesia, nutritional care, and outcomes between SPC and SSC. We included patients with primary staged-silo reduction with a 1-year minimum follow-up. SPC was performed at bedside with sedation using a nonadherent dressing. SSC was performed in operating room under general anesthesia using standard surgical techniques. This retrospective study included 64 patients, 23 SPC and 41 SSC. The characteristics of the two groups were comparable. Mechanical ventilation was used for 15 SPC and 41 SSC (p=0.0001) with a comparable median duration (5.5 and 6.0 days, not significant [NS]). General anesthesia was required for 9 SPC and 41 SSC (p<0.0001). Complications included one SPC and six SSC with necrotizing enterocolitis, zero SPC and four SSC with intestinal atresia, two SPC and four SSC with small bowel obstruction, zero SPC and one SSC with abdominal compartment syndrome resulting in a short bowel syndrome (NS). Median duration of parenteral nutrition (30 and 27 days), time to first feeds (14 and 14 days), time at or above minimal enteral feeding (22 and 17 days), time to full feeds (31 and 28 days), length of stay (LOS) in neonatal intensive care unit (24 and 23.5 days) and overall hospital LOS (37 and 36 days) were not statistically different between SPC and SSC patients without complications, respectively. These data were comparable for SPC and SSC patients with complications. Five SPC and six SSC developed an umbilical hernia (NS); two patients in each group required a surgical repair (NS). Plastic closure of gastroschisis after primary silo reduction is simple, safe, reproducible, and associated with a significant lower incidence of mechanical ventilation. Nutritional management and length of hospital stay were similar to conventional surgical closure for patients. Plastic closure allows nonoperative management without general anesthesia at patient's bedside, in comparison with surgical closure that must be performed under general anesthesia in the operating room. Plastic closure does not appear to be associated with more umbilical hernias in this retrospective study. Georg Thieme Verlag KG Stuttgart · New York.

A technical case report on use of tubular retractors for anterior cervical spine surgery.

PubMed

Kulkarni, Arvind G; Patel, Ankit; Ankith, N V

2017-12-19

The authors put-forth this technical report to establish the feasibility of performing an anterior cervical corpectomy and fusion (ACCF) and a two-level anterior cervical discectomy and fusion (ACDF) using a minimally invasive approach with tubular retractors. First case: cervical spondylotic myelopathy secondary to a large postero-inferiorly migrated disc treated with corpectomy and reconstruction with a mesh cage and locking plate. Second case: cervical disc herniation with radiculopathy treated with a two-level ACDF. Both cases were operated with minimally invasive approach with tubular retractor using a single incision. Technical aspects and clinical outcomes have been reported. No intra or post-operative complications were encountered. Intra-operative blood loss was negligible. The patients had a cosmetic scar on healing. Standard procedure of placement of tubular retractors is sufficient for adequate surgical exposure with minimal invasiveness. Minimally invasive approach to anterior cervical spine with tubular retractors is feasible. This is the first report on use of minimally invasive approach for ACCF and two-level ACDF.

Vascular disruption and blood–brain barrier dysfunction in intracerebral hemorrhage

PubMed Central

2014-01-01

This article reviews current knowledge of the mechanisms underlying the initial hemorrhage and secondary blood–brain barrier (BBB) dysfunction in primary spontaneous intracerebral hemorrhage (ICH) in adults. Multiple etiologies are associated with ICH, for example, hypertension, Alzheimer’s disease, vascular malformations and coagulopathies (genetic or drug-induced). After the initial bleed, there can be continued bleeding over the first 24 hours, so-called hematoma expansion, which is associated with adverse outcomes. A number of clinical trials are focused on trying to limit such expansion. Significant progress has been made on the causes of BBB dysfunction after ICH at the molecular and cell signaling level. Blood components (e.g. thrombin, hemoglobin, iron) and the inflammatory response to those components play a large role in ICH-induced BBB dysfunction. There are current clinical trials of minimally invasive hematoma removal and iron chelation which may limit such dysfunction. Understanding the mechanisms underlying the initial hemorrhage and secondary BBB dysfunction in ICH is vital for developing methods to prevent and treat this devastating form of stroke. PMID:25120903

MiDAS ENCORE: Randomized Controlled Clinical Trial Report of 6-Month Results.

PubMed

Staats, Peter S; Benyamin, Ramsin M

2016-02-01

Patients suffering from neurogenic claudication due to lumbar spinal stenosis (LSS) often experience moderate to severe pain and significant functional disability. Neurogenic claudication results from progressive degenerative changes in the spine, and most often affects the elderly. Both the MILD® procedure and epidural steroid injections (ESIs) offer interventional pain treatment options for LSS patients experiencing neurogenic claudication refractory to more conservative therapies. MILD provides an alternative to ESIs via minimally invasive lumbar decompression. Prospective, multi-center, randomized controlled clinical trial. Twenty-six US interventional pain management centers. To compare patient outcomes following treatment with either MILD (treatment group) or ESIs (active control group) in LSS patients with neurogenic claudication and verified ligamentum flavum hypertrophy. This prospective, multi-center, randomized controlled clinical trial includes 2 study arms with a 1-to-1 randomization ratio. A total of 302 patients were enrolled, with 149 randomized to MILD and 153 to the active control. Six-month follow-up has been completed and is presented in this report. In addition, one year follow-up will be conducted for patients in both study arms, and supplementary 2 year outcome data will be collected for patients in the MILD group only. Outcomes are assessed using the Oswestry Disability Index (ODI), numeric pain rating scale (NPRS) and Zurich Claudication Questionnaire (ZCQ). Primary efficacy is the proportion of ODI responders, tested for statistical superiority of the MILD group versus the active control group. ODI responders are defined as patients achieving the validated Minimal Important Change (MIC) of =10 point improvement in ODI from baseline to follow-up. Similarly, secondary efficacy includes proportion of NPRS and ZCQ responders using validated MIC thresholds. Primary safety is the incidence of device or procedure-related adverse events in each group. At 6 months, all primary and secondary efficacy results provided statistically significant evidence that MILD is superior to the active control. For primary efficacy, the proportion of ODI responders in the MILD group (62.2%) was statistically significantly higher than for the epidural steroid group (35.7%) (P < 0.001). Further, all secondary efficacy parameters demonstrated statistical superiority of MILD versus the active control. The primary safety endpoint was achieved, demonstrating that there is no difference in safety between MILD and ESIs (P = 1.00). Limitations include lack of patient blinding due to considerable differences in treatment protocols, and a potentially higher non-responder rate for both groups versus standard-of-care due to study restrictions on adjunctive pain therapies. Six month follow-up data from this trial demonstrate that the MILD procedure is statistically superior to epidural steroids, a known active treatment for LSS patients with neurogenic claudication and verified central stenosis due to ligamentum flavum hypertrophy. The results of all primary and secondary efficacy outcome measures achieved statistically superior outcomes in the MILD group versus ESIs. Further, there were no statistically significant differences in the safety profile between study groups. This prospective, multi-center, randomized controlled clinical trial provides strong evidence of the effectiveness of MILD versus epidural steroids in this patient population. NCT02093520.

Shape Memory Silk Protein Sponges for Minimally Invasive Tissue Regeneration.

PubMed

Brown, Joseph E; Moreau, Jodie E; Berman, Alison M; McSherry, Heather J; Coburn, Jeannine M; Schmidt, Daniel F; Kaplan, David L

2017-01-01

Porous silk protein scaffolds are designed to display shape memory characteristics and volumetric recovery following compression. Two strategies are utilized to realize shape recovery: addition of hygroscopic plasticizers like glycerol, and tyrosine modifications with hydrophilic sulfonic acid chemistries. Silk sponges are evaluated for recovery following 80% compressive strain, total porosity, pore size distribution, secondary structure development, in vivo volume retention, cell infiltration, and inflammatory responses. Glycerol-modified sponges recover up to 98.3% of their original dimensions following compression, while sulfonic acid/glycerol modified sponges swell in water up to 71 times their compressed volume, well in excess of their original size. Longer silk extraction times (lower silk molecular weights) and higher glycerol concentrations yielded greater flexibility and shape fidelity, with no loss in modulus following compression. Sponges are over 95% porous, with secondary structure analysis indicating glycerol-induced β-sheet physical crosslinking. Tyrosine modifications with sulfonic acid interfere with β-sheet formation. Glycerol-modified sponges exhibit improved rates of cellular infiltration at subcutaneous implant sites with minimal immune response in mice. They also degrade more rapidly than unmodified sponges, a result posited to be cell-mediated. Overall, this work suggests that silk sponges may be useful for minimally invasive deployment in soft tissue augmentation procedures. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Novel diffuse optics system for continuous tissue viability monitoring: extended recovery in vivo testing in a porcine flap model

NASA Astrophysics Data System (ADS)

Lee, Seung Yup; Pakela, Julia M.; Hedrick, Taylor L.; Vishwanath, Karthik; Helton, Michael C.; Chung, Yooree; Kolodziejski, Noah J.; Stapels, Christopher J.; McAdams, Daniel R.; Fernandez, Daniel E.; Christian, James F.; O'Reilly, Jameson; Farkas, Dana; Ward, Brent B.; Feinberg, Stephen E.; Mycek, Mary-Ann

2017-02-01

In reconstructive surgery, tissue perfusion/vessel patency is critical to the success of microvascular free tissue flaps. Early detection of flap failure secondary to compromise of vascular perfusion would significantly increase the chances of flap salvage. We have developed a compact, clinically-compatible monitoring system to enable automated, minimally-invasive, continuous, and quantitative assessment of flap viability/perfusion. We tested the system's continuous monitoring capability during extended non-recovery surgery using an in vivo porcine free flap model. Initial results indicated that the system could assess flap viability/perfusion in a quantitative and continuous manner. With proven performance, the compact form constructed with cost-effective components would make this system suitable for clinical translation.

Bevacizumab Therapy and Multimodal Ultra-widefield Imaging in Immunogammopathy Maculopathy Secondary to Waldenstrom’s Macroglobulinemia

PubMed Central

Xu, Lucy T.; Courtney, Robert J.; Ehlers, Justis P

2015-01-01

Waldenstrom’s macroglobulinemia (WM) is associated with retinal findings of hyperviscosity such as venous dilation, and findings of immunogammopathy maculopathy such as serous macular detachment. The report describes a case of bilateral serous macular detachment with intraretinal schisis-like fluid in a patient with WM. Enhanced depth imaging OCT revealed a thickened choroid with hyper-reflective accumulations in the RPE layer. The ultra-widefield fundus autofluorescence demonstrated a central area of hyperautofluorescence corresponding to the area of serous macular detachment. Ultra-widefield fluorescein angiography was characteristically silent. Intravitreal bevacizumab therapy resulted in significant reduction in intraretinal fluid, but minimal change in subretinal fluid. Long-term follow-up demonstrated alterations in retinal architecture and improved serous detachments. PMID:25707055

Action seniors! - secondary falls prevention in community-dwelling senior fallers: study protocol for a randomized controlled trial.

PubMed

Liu-Ambrose, Teresa; Davis, Jennifer C; Hsu, Chun Liang; Gomez, Caitlin; Vertes, Kelly; Marra, Carlo; Brasher, Penelope M; Dao, Elizabeth; Khan, Karim M; Cook, Wendy; Donaldson, Meghan G; Rhodes, Ryan; Dian, Larry

2015-04-10

Falls are a 'geriatric giant' and are the third leading cause of chronic disability worldwide. About 30% of community-dwellers over the age of 65 experience one or more falls every year leading to significant risk for hospitalization, institutionalization, and even death. As the proportion of older adults increases, falls will place an increasing demand and cost on the health care system. Exercise can effectively and efficiently reduce falls. Specifically, the Otago Exercise Program has demonstrated benefit and cost-effectiveness for the primary prevention of falls in four randomized trials of community-dwelling seniors. Although evidence is mounting, few studies have evaluated exercise for secondary falls prevention (that is, preventing falls among those with a significant history of falls). Hence, we propose a randomized controlled trial powered for falls that will, for the first time, assess the efficacy and efficiency of the Otago Exercise Program for secondary falls prevention. A randomized controlled trial among 344 community-dwelling seniors aged 70 years and older who attend a falls prevention clinic to assess the efficacy and the cost-effectiveness of a 12-month Otago Exercise Program intervention as a secondary falls prevention strategy. Participants randomized to the control group will continue to behave as they did prior to study enrolment. The economic evaluation will examine the incremental costs and benefits generated by using the Otago Exercise Program intervention versus the control. The burden of falls is significant. The challenge is to make a difference - to discover effective, ideally cost-effective, interventions that prevent injurious falls that can be readily translated to the population. Our proposal is very practical - the exercise program requires minimal equipment, the physical therapist expertise is widely available, and seniors in Canada and elsewhere have adopted the program and complied with it. Our innovation includes applying the intervention to a targeted high-risk population, aiming to provide the best value for money. Given society's limited financial resources and the known and increasing burden of falls, there is an urgent need to test this feasible intervention which would be eminently ready for roll out. ClinicalTrials.gov Protocol Registration System: NCT01029171; registered 7 December 2009.

PM2.5 soluble brown-carbon measured in contrasting urban and rural environments

NASA Astrophysics Data System (ADS)

Weber, R.; Zhang, X.

2011-12-01

An instrument was developed to continuously measure the light absorption spectra and carbon mass of soluble PM2.5 components by coupling a particle-into-liquid sampler (PILS), UV-VIS (200-800nm) spectrophotometer with long-path absorption cell and total organic carbon (TOC) analyzer. The analytical system has also been used to measure brown carbon in aqueous extracts from integrated filters. Measurements have been conducted at a number of locations, including urban sites in Los Angeles, Atlanta and smaller urban and rural locations in the southeastern US. At all locations a characteristic brown carbon absorption spectra was observed, where soluble chromophores produce an increasing absorption with decreasing wavelength, starting from mid-visible and extending into the near UV. Incomplete combustion from biomass and fossil fuel burning and secondary processes have been identified as sources of soluble brown carbon. During summer when biomass burning impacts were minimal, mass absorption efficiencies calculated relative to ambient particle water-soluble organic carbon (WSOC) were highest in Los Angeles and correlated with the daily production of secondary organic aerosol. Nitro-aromatics were identified as a component of the brown carbon. In contrast, the Atlanta secondary aerosol was significantly less light-absorbing, and unlike Los Angeles the diurnal trend in brown carbon largely tracked primary sources. Absorption Angstrom exponents varied between 3 and 7 with fresh Los Angeles secondary organic aerosol associated with smaller exponents, indicting greater absorption into the visible spectrum. The southeastern US regional/rural brown carbon was the least absorbing per WSOC mass in the UV and with largest Angstrom exponents (7) the least absorbing at higher wavelengths. A correlation between the regional brown carbon and fine particle oxalate suggested an aqueous phase heterogeneous source for these chromophores. Compared to pure black carbon, brown carbon was optically significant at low wavelengths (365 nm) and most important in rural regions due to low black carbon concentrations.

A fast and robust iterative algorithm for prediction of RNA pseudoknotted secondary structures

PubMed Central

2014-01-01

Background Improving accuracy and efficiency of computational methods that predict pseudoknotted RNA secondary structures is an ongoing challenge. Existing methods based on free energy minimization tend to be very slow and are limited in the types of pseudoknots that they can predict. Incorporating known structural information can improve prediction accuracy; however, there are not many methods for prediction of pseudoknotted structures that can incorporate structural information as input. There is even less understanding of the relative robustness of these methods with respect to partial information. Results We present a new method, Iterative HFold, for pseudoknotted RNA secondary structure prediction. Iterative HFold takes as input a pseudoknot-free structure, and produces a possibly pseudoknotted structure whose energy is at least as low as that of any (density-2) pseudoknotted structure containing the input structure. Iterative HFold leverages strengths of earlier methods, namely the fast running time of HFold, a method that is based on the hierarchical folding hypothesis, and the energy parameters of HotKnots V2.0. Our experimental evaluation on a large data set shows that Iterative HFold is robust with respect to partial information, with average accuracy on pseudoknotted structures steadily increasing from roughly 54% to 79% as the user provides up to 40% of the input structure. Iterative HFold is much faster than HotKnots V2.0, while having comparable accuracy. Iterative HFold also has significantly better accuracy than IPknot on our HK-PK and IP-pk168 data sets. Conclusions Iterative HFold is a robust method for prediction of pseudoknotted RNA secondary structures, whose accuracy with more than 5% information about true pseudoknot-free structures is better than that of IPknot, and with about 35% information about true pseudoknot-free structures compares well with that of HotKnots V2.0 while being significantly faster. Iterative HFold and all data used in this work are freely available at http://www.cs.ubc.ca/~hjabbari/software.php. PMID:24884954

Combination Chemotherapy in Treating Young Patients With Down Syndrome and Acute Myeloid Leukemia or Myelodysplastic Syndromes

ClinicalTrials.gov

2017-07-10

Childhood Acute Basophilic Leukemia; Childhood Acute Eosinophilic Leukemia; Childhood Acute Erythroleukemia (M6); Childhood Acute Megakaryocytic Leukemia (M7); Childhood Acute Minimally Differentiated Myeloid Leukemia (M0); Childhood Acute Monoblastic Leukemia (M5a); Childhood Acute Monocytic Leukemia (M5b); Childhood Acute Myeloblastic Leukemia With Maturation (M2); Childhood Acute Myeloblastic Leukemia Without Maturation (M1); Childhood Acute Myelomonocytic Leukemia (M4); Childhood Myelodysplastic Syndromes; de Novo Myelodysplastic Syndromes; Secondary Acute Myeloid Leukemia; Secondary Myelodysplastic Syndromes; Untreated Childhood Acute Myeloid Leukemia and Other Myeloid Malignancies

Coronagraph for astronomical imaging and spectrophotometry

NASA Technical Reports Server (NTRS)

Vilas, Faith; Smith, Bradford A.

1987-01-01

A coronagraph designed to minimize scattered light in astronomical observations caused by the structure of the primary mirror, secondary mirror, and secondary support structure of a Cassegrainian telescope is described. Direct (1:1) and reducing (2.7:1) imaging of astronomical fields are possible. High-quality images are produced. The coronagraph can be used with either a two-dimensional charge-coupled device or photographic film camera. The addition of transmission dispersing optics converts the coronagraph into a low-resolution spectrograph. The instrument is modular and portable for transport to different observatories.

Zearalenone occurrence in surface waters in Central Illinois, USA

USDA-ARS?s Scientific Manuscript database

Exposure to environmental estrogens can occur through a variety of routes. Most obvious is through consumption of contaminated foods or minimally processed commodities such as cereal grains. There are also less obvious routes, including through inhalation, from drinking water, and from secondary or ...

Total Marrow and Lymphoid Irradiation, Fludarabine, and Melphalan Before Donor Stem Cell Transplant in Treating Participants With High-Risk Acute Leukemia or Myelodysplastic Syndrome

ClinicalTrials.gov

2018-06-01

Acute Lymphoblastic Leukemia; Acute Lymphoblastic Leukemia in Remission; Acute Myeloid Leukemia; Acute Myeloid Leukemia in Remission; Hematopoietic Cell Transplantation Recipient; Minimal Residual Disease; Myelodysplastic Syndrome; Secondary Acute Myeloid Leukemia

Working with the Disadvantaged Student in Vocational Education.

ERIC Educational Resources Information Center

DeKalb SERVE Satellite Center, Stone Mountain, GA.

This handbook provides vocational educators at the secondary and postsecondary levels with approaches for working with minimally disadvantaged students enrolled in their regular programs. Chapter 1 focuses on the disadvantaged student and considers such problems as perceptual difficulties, resistance to authority, parental influence, insecurity…

A 35-year-old pregnant woman presenting with sudden cardiac arrest secondary to peripartum cardiomyopathy.

PubMed

Nelson, Matthew; Moorhead, Amy; Yost, Dana; Whorton, Adrian

2012-01-01

We present a case of successful resuscitation from cardiac arrest after 25 minutes of ventricular fibrillation (VF) secondary to peripartum cardiomyopathy. This case highlights a rare disease, but also, more importantly, the successful use of the five links of survival: early access to 9-1-1, early cardiopulmonary resuscitation (CPR), early defibrillation, early advanced life support, and postresuscitative care. We also demonstrate the importance of high-quality resuscitation practices in order to achieve a successful outcome. Manual compressions can be performed at a guidelines-compliant rate. With training, users are able to achieve high compression fractions. Pre/post shock delays can be minimized to further increase compression fraction. Nationally, CPR interruptions are often long. We recommend closer attention to uninterrupted 2-minute cycles of CPR, minimizing delays in CPR through training, and a focus on a closely choreographed approach. User review of transthoracic impedance feedback data should play a vital role in a cardiac arrest quality-improvement program.

Using SHRP 2 naturalistic driving data to assess drivers' speed choice while being engaged in different secondary tasks.

PubMed

Schneidereit, Tina; Petzoldt, Tibor; Keinath, Andreas; Krems, Josef F

2017-09-01

The engagement in secondary tasks while driving has been found to result in considerable impairments of driving performance. Texting has especially been suspected to be associated with an increased crash risk. At the same time, there is evidence that drivers use various self-regulating strategies to compensate for the increased demands caused by secondary task engagement. One of the findings reported from multiple studies is a reduction in driving speed. However, most of these studies are of experimental nature and do not let the drivers decide for themselves to (not) engage in the secondary task, and therefore, eliminate other strategies of self-regulation (e.g., postponing the task). The goal of the present analysis was to investigate if secondary task engagement results in speed adjustment also under naturalistic conditions. Our analysis relied on data of the SHRP 2 naturalistic driving study. To minimize the influence of potentially confounding factors on drivers' speed choice, we focused on episodes of free flow driving on interstates/highways. Driving speed was analyzed before, during, and after texting, smoking, eating, and adjusting/monitoring radio or climate control; in a total of 403 episodes. Data show some indication for speed adjustment for texting, especially when driving with high speed. However, the effect sizes were small and behavioral patterns varied considerably between drivers. The engagement in the other tasks did not influence drivers' speed behavior significantly. While drivers might indeed reduce speed slightly to accommodate for secondary task engagement, other forms of adaptation (e.g., strategic decisions) might play a more important role in a natural driving environment. The use of naturalistic driving data to study drivers' self-regulatory behavior at an operational level has proven to be promising. Still, in order to obtain a comprehensive understanding about drivers' self-regulatory behavior, a mixed-method approach is required. Copyright © 2017 National Safety Council and Elsevier Ltd. All rights reserved.

Pronounced Structural and Functional Damage in Early Adult Pediatric-Onset Multiple Sclerosis with No or Minimal Clinical Disability.

PubMed

Giorgio, Antonio; Zhang, Jian; Stromillo, Maria Laura; Rossi, Francesca; Battaglini, Marco; Nichelli, Lucia; Mortilla, Marzia; Portaccio, Emilio; Hakiki, Bahia; Amato, Maria Pia; De Stefano, Nicola

2017-01-01

Pediatric-onset multiple sclerosis (POMS) may represent a model of vulnerability to damage occurring during a period of active maturation of the human brain. Whereas adaptive mechanisms seem to take place in the POMS brain in the short-medium term, natural history studies have shown that these patients reach irreversible disability, despite slower progression, at a significantly younger age than adult-onset MS (AOMS) patients. We tested for the first time whether significant brain alterations already occurred in POMS patients in their early adulthood and with no or minimal disability ( n  = 15) in comparison with age- and disability-matched AOMS patients ( n  = 14) and to normal controls (NC, n  = 20). We used a multimodal MRI approach by modeling, using FSL, voxelwise measures of microstructural integrity of white matter tracts and gray matter volumes with those of intra- and internetwork functional connectivity (FC) (analysis of variance, p  ≤ 0.01, corrected for multiple comparisons across space). POMS patients showed, when compared with both NC and AOMS patients, altered measures of diffusion tensor imaging (reduced fractional anisotropy and/or increased diffusivities) and higher probability of lesion occurrence in a clinically eloquent region for physical disability such as the posterior corona radiata. In addition, POMS patients showed, compared with the other two groups, reduced long-range FC, assessed from resting functional MRI, between default mode network and secondary visual network, whose interaction subserves important cognitive functions such as spatial attention and visual learning. Overall, this pattern of structural damage and brain connectivity disruption in early adult POMS patients with no or minimal clinical disability might explain their unfavorable clinical outcome in the long term.

Pediatric Hodgkin lymphoma: biomarkers, drugs, and clinical trials for translational science and medicine.

PubMed

Nagpal, Poonam; Akl, Mohamed R; Ayoub, Nehad M; Tomiyama, Tatsunari; Cousins, Tasheka; Tai, Betty; Carroll, Nicole; Nyrenda, Themba; Bhattacharyya, Pritish; Harris, Michael B; Goy, Andre; Pecora, Andrew; Suh, K Stephen

2016-10-11

Hodgkin lymphoma (HL) is a lymphoid malignancy that is typically derived from germinal-center B cells. EBV infection, mutations in NF-κB pathway genes, and genetic susceptibility are known risk factors for developing HL. CD30 and NF-κB have been identified as potential biomarkers in pediatric HL patients, and these molecules may represent therapeutic targets. Although current risk adapted and response based treatment approaches yield overall survival rates of >95%, treatment of relapse or refractory patients remains challenging. Targeted HL therapy with the antibody-drug conjugate Brentuximab vedotin (Bv) has proven to be superior to conventional salvage chemotherapy and clinical trials are being conducted to incorporate Bv into frontline therapy that substitutes Bv for alkylating agents to minimize secondary malignancies. The appearance of secondary malignancies has been a concern in pediatric HL, as these patients are at highest risk among all childhood cancer survivors. The risk of developing secondary leukemia following childhood HL treatment is 10.4 to 174.8 times greater than the risk in the general pediatric population and the prognosis is significantly poorer than the other hematological malignancies with a mortality rate of nearly 100%. Therefore, identifying clinically valuable biomarkers is of utmost importance to stratify and select patients who may or may not need intensive regimens to maintain optimal balance between maximal survival rates and averting late effects. Here we discuss epidemiology, risk factors, staging, molecular and genetic prognostic biomarkers, treatment for low and high-risk patients, and the late occurrence of secondary malignancies in pediatric HL.

Improved Model for Predicting the Free Energy Contribution of Dinucleotide Bulges to RNA Duplex Stability.

PubMed

Tomcho, Jeremy C; Tillman, Magdalena R; Znosko, Brent M

2015-09-01

Predicting the secondary structure of RNA is an intermediate in predicting RNA three-dimensional structure. Commonly, determining RNA secondary structure from sequence uses free energy minimization and nearest neighbor parameters. Current algorithms utilize a sequence-independent model to predict free energy contributions of dinucleotide bulges. To determine if a sequence-dependent model would be more accurate, short RNA duplexes containing dinucleotide bulges with different sequences and nearest neighbor combinations were optically melted to derive thermodynamic parameters. These data suggested energy contributions of dinucleotide bulges were sequence-dependent, and a sequence-dependent model was derived. This model assigns free energy penalties based on the identity of nucleotides in the bulge (3.06 kcal/mol for two purines, 2.93 kcal/mol for two pyrimidines, 2.71 kcal/mol for 5'-purine-pyrimidine-3', and 2.41 kcal/mol for 5'-pyrimidine-purine-3'). The predictive model also includes a 0.45 kcal/mol penalty for an A-U pair adjacent to the bulge and a -0.28 kcal/mol bonus for a G-U pair adjacent to the bulge. The new sequence-dependent model results in predicted values within, on average, 0.17 kcal/mol of experimental values, a significant improvement over the sequence-independent model. This model and new experimental values can be incorporated into algorithms that predict RNA stability and secondary structure from sequence.

Barks Essential Oil, Secondary Metabolites and Biological Activities of Four Organs of Tunisian Calligonum azel Maire.

PubMed

Bannour, Marwa; Aouadhi, Chedia; Khalfaoui, Houssem; Aschi-Smiti, Samira; Khadhri, Ayda

2016-11-01

This study is the first to investigate the chemical composition of barks essential oil (EO), secondary metabolites and biological activities of the MeOH and infusions extracts of seeds, leaves, barks and roots of Calligonum azel Maire (Polygonaceae) harvested from Tunisian desert. The gas chromatography/mass spectrometry (GC/MS) results showed the presence of fifty-four compounds in barks EO. The major components were: viridiflorol (14.6%), α-eudesmol (8.65%), trans-caryophyllene (6.72%), elemol (6.63%), β-eudesmol (6.21%). The obtained results showed that C. azel is a very rich plant in secondary metabolites. High contents in polyphenols, flavonoids and tannins were observed in both extracts of all studied organs. Significant differences were found between both extracts of the four organs. Thus, polyphenols and tannins were more abundant in leaves infusion extract, while, flavonoids showed a high level in barks extract. The antioxidant activity data demonstrated that all extracts showed strong antioxidant and radical scavenging activities. The MeOH extracts presented potential for antibacterial and antifungal activities against all tested microorganisms. The inhibition zones diameters and minimal inhibitrice concentration values were in the range of 9 - 15 mm and 2.5 - 20 μg/ml, respectively. This study demonstrated that C. azel can be regarded as an excellent plant source for natural antimicrobial agents. © 2016 Wiley-VHCA AG, Zurich, Switzerland.

Drug delivery, cell-based therapies, and tissue engineering approaches for spinal cord injury.

PubMed

Kabu, Shushi; Gao, Yue; Kwon, Brian K; Labhasetwar, Vinod

2015-12-10

Spinal cord injury (SCI) results in devastating neurological and pathological consequences, causing major dysfunction to the motor, sensory, and autonomic systems. The primary traumatic injury to the spinal cord triggers a cascade of acute and chronic degenerative events, leading to further secondary injury. Many therapeutic strategies have been developed to potentially intervene in these progressive neurodegenerative events and minimize secondary damage to the spinal cord. Additionally, significant efforts have been directed toward regenerative therapies that may facilitate neuronal repair and establish connectivity across the injury site. Despite the promise that these approaches have shown in preclinical animal models of SCI, challenges with respect to successful clinical translation still remain. The factors that could have contributed to failure include important biologic and physiologic differences between the preclinical models and the human condition, study designs that do not mirror clinical reality, discrepancies in dosing and the timing of therapeutic interventions, and dose-limiting toxicity. With a better understanding of the pathobiology of events following acute SCI, developing integrated approaches aimed at preventing secondary damage and also facilitating neuroregenerative recovery is possible and hopefully will lead to effective treatments for this devastating injury. The focus of this review is to highlight the progress that has been made in drug therapies and delivery systems, and also cell-based and tissue engineering approaches for SCI. Copyright © 2015 Elsevier B.V. All rights reserved.

Neutralizing antibodies to botulinum neurotoxin type A in aesthetic medicine: five case reports

PubMed Central

Torres, Sebastian; Hamilton, Mark; Sanches, Elena; Starovatova, Polina; Gubanova, Elena; Reshetnikova, Tatiana

2014-01-01

Botulinum neurotoxin injections are a valuable treatment modality for many therapeutic indications as well as in the aesthetic field for facial rejuvenation. As successful treatment requires repeated injections over a long period of time, secondary resistance to botulinum toxin preparations after repeated injections is an ongoing concern. We report five case studies in which neutralizing antibodies to botulinum toxin type A developed after injection for aesthetic use and resulted in secondary treatment failure. These results add to the growing number of reports in the literature for secondary treatment failure associated with high titers of neutralizing antibodies in the aesthetic field. Clinicians should be aware of this risk and implement injection protocols that minimize resistance development. PMID:24379687

Effects of stimulation parameters and electrode location on thresholds for epidural stimulation of cat motor cortex

NASA Astrophysics Data System (ADS)

Wongsarnpigoon, Amorn; Grill, Warren M.

2011-12-01

Epidural electrical stimulation (ECS) of the motor cortex is a developing therapy for neurological disorders. Both placement and programming of ECS systems may affect the therapeutic outcome, but the treatment parameters that will maximize therapeutic outcomes and minimize side effects are not known. We delivered ECS to the motor cortex of anesthetized cats and investigated the effects of electrode placement and stimulation parameters on thresholds for evoking motor responses in the contralateral forelimb. Thresholds were inversely related to stimulation frequency and the number of pulses per stimulus train. Thresholds were lower over the forelimb representation in motor cortex (primary site) than surrounding sites (secondary sites), and thresholds at sites <4 mm away from the primary site were significantly lower than at sites >4 mm away. Electrode location and montage influenced the effects of polarity on thresholds: monopolar anodic and cathodic thresholds were not significantly different over the primary site, cathodic thresholds were significantly lower than anodic thresholds over secondary sites and bipolar thresholds were significantly lower with the anode over the primary site than with the cathode over the primary site. A majority of bipolar thresholds were either between or equal to the respective monopolar thresholds, but several bipolar thresholds were greater than or less than the monopolar thresholds of both the anode and cathode. During bipolar stimulation, thresholds were influenced by both electric field superposition and indirect, synaptically mediated interactions. These results demonstrate the influence of stimulation parameters and electrode location during cortical stimulation, and these effects should be considered during the programming of systems for therapeutic cortical stimulation.

Off-pump compared to minimal extracorporeal circulation surgery in coronary artery bypass grafting.

PubMed

Reuthebuch, Oliver; Koechlin, Luca; Gahl, Brigitta; Matt, Peter; Schurr, Ulrich; Grapow, Martin; Eckstein, Friedrich

2014-01-01

Coronary artery bypass grafting (CABG) using extracorporeal circulation (ECC) is still the gold standard. However, alternative techniques have been developed to avoid ECC and its potential adverse effects. These encompass minimal extracorporeal circulation (MECC) or off-pump coronary artery bypass grafting (OPCAB). However, the prevailing potential benefits when comparing MECC and OPCABG are not yet clearly established. In this retrospective study we investigated the potential benefits of MECC and OPCABG in 697 patients undergoing CABG. Of these, 555 patients had been operated with MECC and 142 off-pump. The primary endpoint was Troponin T level as an indicator for myocardial damage. Study groups were not significantly different in general. However, patients undergoing OPCABG were significantly older (65.01 years ± 9.5 vs. 69.39 years ± 9.5; p value <0.001) with a higher Logistic EuroSCORE I (4.92% ± 6.5 vs. 5.88% ± 6.8; p value = 0.017). Operating off pump significantly reduced the need for intra-operative blood products (0.7% vs. 8.6%; p-value <0.001) and the length of stay in the intensive care unit (ICU) (2.04 days ± 2.63 vs. 2.76 days ± 2.79; p value <0.001). Regarding other blood values a significant difference could not be found in the adjusted calculations. The combined secondary endpoint, major cardiac or cerebrovascular events (MACCE), was equal in both groups as well. Coronary artery bypass grafting using MECC or OPCABG are two comparable techniques with advantages for OPCABG regarding the reduced need for intra-operative blood products and shorter length of stay in the ICU. However serological values and combined endpoint MACCE did not differ significantly in both groups.

Dissociating word stem completion and cued recall as a function of divided attention at retrieval.

PubMed

Clarke, A J Benjamin; Butler, Laurie T

2008-10-01

The aim of this study was to investigate the widely held, but largely untested, view that implicit memory (repetition priming) reflects an automatic form of retrieval. Specifically, in Experiment 1 we explored whether a secondary task (syllable monitoring), performed during retrieval, would disrupt performance on explicit (cued recall) and implicit (stem completion) memory tasks equally. Surprisingly, despite substantial memory and secondary costs to cued recall when performed with a syllable-monitoring task, the same manipulation had no effect on stem completion priming or on secondary task performance. In Experiment 2 we demonstrated that even when using a particularly demanding version of the stem completion task that incurred secondary task costs, the corresponding disruption to implicit memory performance was minimal. Collectively, the results are consistent with the view that implicit memory retrieval requires little or no processing capacity and is not seemingly susceptible to the effects of dividing attention at retrieval.

Does daily tobacco smoking affect outcomes after microdecompression for degenerative central lumbar spinal stenosis? - A multicenter observational registry-based study.

PubMed

Gulati, Sasha; Nordseth, Trond; Nerland, Ulf S; Gulati, Michel; Weber, Clemens; Giannadakis, Charalampis; Nygaard, Øystein P; Solberg, Tore K; Solheim, Ole; Jakola, Asgeir S

2015-07-01

There are limited scientific data on the impact of smoking on patient-reported outcomes following minimally invasive spine surgery. The aim of this multicenter observational study was to examine the relationship between daily smoking and patient-reported outcome at 1 year using the Oswestry Disability Index (ODI) after microdecompression for single- and two-level central lumbar spinal stenosis (LSS). Secondary outcomes were the length of hospital stays, perioperative and postoperative complications. Data were collected through the Norwegian Registry for Spine Surgery (NORspine). A total of 825 patients were included (619 nonsmokers and 206 smokers). For the whole patient population there was a significant difference between preoperative ODI and ODI at 1 year (17.3 points, 95% CI 15.93-18.67, p < 0.001). There was a significant difference in ODI change at 1 year between nonsmokers and smokers (4.2 points, 95% CI 0.98-7.34, p = 0.010). At 1 year 69.6% of nonsmokers had achieved a minimal clinically important difference (≥10 points ODI improvement) compared to 60.8% of smokers (p = 0.008). There was no difference between nonsmokers and smokers in the overall complication rate (11.6% vs. 9.2%, p = 0.34). There was no difference between nonsmokers and smokers in length of hospital stays for either single-level (2.3 vs. 2.2 days, p = 0.99) or two-level (3.1 vs. 2.3 days, p = 0.175) microdecompression. Smoking was identified as a negative predictor for ODI change in a multiple regression analysis (p = 0.001) CONCLUSIONS: Nonsmokers experienced a significantly larger improvement at 1 year following microdecompression for LSS compared to smokers. Smokers were less likely to achieve a minimal clinically important difference. However, it should be emphasized that considerable improvement also was found among smokers.

Effectiveness and Cost-effectiveness of Opportunistic Screening and Stepped-care Interventions for Older Alcohol Users in Primary Care.

PubMed

Coulton, Simon; Bland, Martin; Crosby, Helen; Dale, Veronica; Drummond, Colin; Godfrey, Christine; Kaner, Eileen; Sweetman, Jennifer; McGovern, Ruth; Newbury-Birch, Dorothy; Parrott, Steve; Tober, Gillian; Watson, Judith; Wu, Qi

2017-11-01

To compare the clinical effectiveness and cost-effectiveness of a stepped-care intervention versus a minimal intervention for the treatment of older hazardous alcohol users in primary care. Multi-centre, pragmatic RCT, set in Primary Care in UK. Patients aged ≥ 55 years scoring ≥ 8 on the Alcohol Use Disorders Identification Test were allocated either to 5-min of brief advice or to 'Stepped Care': an initial 20-min of behavioural change counselling, with Step 2 being three sessions of Motivational Enhancement Therapy and Step 3 referral to local alcohol services (progression between each Step being determined by outcomes 1 month after each Step). Outcome measures included average drinks per day, AUDIT-C, alcohol-related problems using the Drinking Problems Index, health-related quality of life using the Short Form 12, costs measured from a NHS/Personal Social Care perspective and estimated health gains in quality adjusted life-years measured assessed EQ-5D. Both groups reduced alcohol consumption at 12 months but the difference between groups was small and not significant. No significant differences were observed between the groups on secondary outcomes. In economic terms stepped care was less costly and more effective than the minimal intervention. Stepped care does not confer an advantage over a minimal intervention in terms of reduction in alcohol use for older hazardous alcohol users in primary care. However, stepped care has a greater probability of being more cost-effective. Current controlled trials ISRCTN52557360. A stepped care approach was compared with brief intervention for older at-risk drinkers attending primary care. While consumption reduced in both groups over 12 months there was no significant difference between the groups. An economic analysis indicated the stepped care which had a greater probability of being more cost-effective than brief intervention. © The Author 2017. Medical Council on Alcohol and Oxford University Press. All rights reserved.

Minimal instructions improve the performance of laypersons in the use of semiautomatic and automatic external defibrillators

PubMed Central

Beckers, Stefan; Fries, Michael; Bickenbach, Johannes; Derwall, Matthias; Kuhlen, Ralf; Rossaint, Rolf

2005-01-01

Introduction There is evidence that use of automated external defibrillators (AEDs) by laypersons improves rates of survival from cardiac arrest, but there is no consensus on the optimal content and duration of training for this purpose. In this study we examined the use of semiautomatic or automatic AEDs by laypersons who had received no training (intuitive use) and the effects of minimal general theoretical instructions on their performance. Methods In a mock cardiac arrest scenario, 236 first year medical students who had not previously attended any preclinical courses were evaluated in their first study week, before and after receiving prespecified instructions (15 min) once. The primary end-point was the time to first shock for each time point; secondary end-points were correct electrode pad positioning, safety of the procedure and the subjective feelings of the students. Results The mean time to shock for both AED types was 81.2 ± 19.2 s (range 45–178 s). Correct pad placement was observed in 85.6% and adequate safety in 94.1%. The time to shock after instruction decreased significantly to 56.8 ± 9.9 s (range 35–95 s; P ≤ 0.01), with correct electrode placement in 92.8% and adequate safety in 97%. The students were significantly quicker at both evaluations using the semiautomatic device than with the automatic AED (first evaluation: 77.5 ± 20.5 s versus 85.2 ± 17 s, P ≤ 0.01; second evaluation: 55 ± 10.3 s versus 59.6 ± 9.6 s, P ≤ 0.01). Conclusion Untrained laypersons can use semiautomatic and automatic AEDs sufficiently quickly and without instruction. After one use and minimal instructions, improvements in practical performance were significant. All tested laypersons were able to deliver the first shock in under 1 min. PMID:15774042

Computers in Physical Education.

ERIC Educational Resources Information Center

Sydow, James Armin

Although computers have potential applications in the elementary and secondary physical education curriculum, current usage is minimal when compared to other disciplines. However, present trends indicate a substantial growth in the use of the computer in a supportive role in assisting the teacher in the management of instructional activities.…

Correction of Retrograde Ejaculation in Patients with Diabetes Mellitus Using Endourethral Collagen Injection: Preliminary Results.

PubMed

Kurbatov, Dmitry; Russo, Giorgio Ivan; Galstyan, G R; Rozhivanov, Roman; Lepetukhin, Alexander; Dubsky, Sergey; Shwartz, Y G; Cimino, Sebastiano; Morgia, Giuseppe; Sansalone, Salvatore

2015-11-01

Diabetic neuropathy secondary to diabetes mellitus type 1 (DM1) is responsible for retrograde ejaculation (RE) in 5-18% of cases. Medical treatment of RE is based either on increasing the sympathetic tone of the bladder or on decreasing the parasympathetic activity. However, the onset of side effects and the lack of response should be considered. The aim of this study was to analyze long-term outcome of endourethral injection of volume-forming material (VFM) of collagen type 2 into bladder neck submucosa in patients with RE secondary to DM1. Twenty-four patients with complete RE refractory to imipramine and DM1 were included in the study. Patients were single-blinded randomized according to a computer-generated random sequence with a 1:1 ratio in two treatment groups, namely group A (endourethral collage type 2 injection) and group B (endourethral saline water injection). New technique includes an endoscopic injection of VFM such as collagen (Correcting MIT®, Ltd. minimally invasive technologies, Moscow, Russia) into bladder neck submucosa. Primary endpoint of the study was the reduction of semen antegrade volume (mL). Secondary endpoints were considered as the changes of antegrade count (millions/mL), antegrade total motility (%), antegrade progressive motility (%), State-Trait Anxiety Inventory, Beck Depression Questionnaire and International Index of Erectile Function (IIEF-5). Pregnancy rate was calculated in each group. Twenty-three patients completed the study. In group A, significant differences from baseline to 12 months were observed relative to antegrade volume (mL) (mean difference: 0.71, P < 0.05), antegrade count (millions/mL) (mean difference: 45.6, P < 0.05), antegrade total motility (%) (mean difference: 15.4, P < 0.05) and antegrade progressive motility (%) (mean difference: 8.4, P < 0.05). In group A, we observed significant differences in terms State-Trait Anxiety Inventory (mean difference: -20.5, P < 0.05) and Beck Depression Inventory (mean difference: -8.4, P < 0.05) with significant differences compared with group B. We observed significant improvements in group A vs. group B when considering primary and secondary endpoints of the study, but not for the IIEF-5. Correction of RE in DM1 patients could be achieved with endourethral injection of collagen type 2. © 2015 International Society for Sexual Medicine.

The predominant circular form of avocado sunblotch viroid accumulates in planta as a free RNA adopting a rod-shaped secondary structure unprotected by tightly bound host proteins.

PubMed

López-Carrasco, Amparo; Flores, Ricardo

2017-07-01

Avocado sunblotch viroid (ASBVd), the type member of the family Avsunviroidae, replicates and accumulates in chloroplasts. Whether this minimal non-protein-coding circular RNA of 246-250 nt exists in vivo as a free nucleic acid or closely associated with host proteins remains unknown. To tackle this issue, the secondary structures of the monomeric circular (mc) (+) and (-) strands of ASBVd have been examined in silico by searching those of minimal free energy, and in vitro at single-nucleotide resolution by selective 2'-hydroxyl acylation analysed by primer extension (SHAPE). Both approaches resulted in predominant rod-like secondary structures without tertiary interactions, with the mc (+) RNA being more compact than its (-) counterpart as revealed by non-denaturing polyacryamide gel electrophoresis. Moreover, in vivo SHAPE showed that the mc ASBVd (+) form accumulates in avocado leaves as a free RNA adopting a similar rod-shaped conformation unprotected by tightly bound host proteins. Hence, the mc ASBVd (+) RNA behaves in planta like the previously studied mc (+) RNA of potato spindle tuber viroid, the type member of nuclear viroids (family Pospiviroidae), indicating that two different viroids replicating and accumulating in distinct subcellular compartments, have converged into a common structural solution. Circularity and compact secondary structures confer to these RNAs, and probably to all viroids, the intrinsic stability needed to survive in their natural habitats. However, in vivo SHAPE has not revealed the (possibly transient or loose) interactions of the mc ASBVd (+) RNA with two host proteins observed previously by UV irradiation of infected avocado leaves.

Evaluating holistic environmental consequences of brownfield management options using consequential life cycle assessment for different perspectives.

PubMed

Lesage, Pascal; Deschênes, Louise; Samson, Réjean

2007-08-01

Brownfields are abandoned, idled, or underused sites whose reuse necessitates some sort of intervention. These sites are largely urban and are frequently contaminated. Brownfield management options can be associated with three types of environmental consequences: those resulting from changes in the site's environmental quality (primary impacts); those resulting from the actual intervention stage (secondary impacts); and, if the vocation of the site changes, those resulting from effects on regional land use (tertiary impacts). Different stakeholders and decision-making contexts will place a different importance on each of these types of impacts. This article proposes a framework for comparing brownfield management options in regard to these three types of environmental impacts and for interpreting these results from different perspectives. The assessment framework is based on consequential life cycle assessment (LCA), which is shown to provide environmental information on the three types of impacts. The results for a case study are presented, where a "rehabilitation" option allowing residential redevelopment is compared to an "exposure minimization" option not resulting in the site being reused. Calculated primary and tertiary impacts are favorable to the rehabilitation option, whereas secondary impacts are favorable to the exposure minimization option. A ternary diagram presents the favorable option for different stereotypical perspectives. Tertiary impacts are much greater than secondary impacts, and consequently all perspectives that consider tertiary impacts favor rehabilitation. The perspective that considers primary and secondary impacts receives conflicting information. The ternary diagram, showing results for all perspectives, could possibly be useful for consensus-building among stakeholders.

Analysis of 4931 renal biopsy data in central China from 1994 to 2014.

PubMed

Xu, Xiu; Ning, Yong; Shang, Weifeng; Li, Menglan; Ku, Ming; Li, Qing; Li, Yueqiang; Dai, Wei; Shao, Jufang; Zeng, Rui; Han, Min; He, Xiaofeng; Yao, Ying; Lv, Yongman; Liu, Xiaocheng; Ge, Shuwang; Xu, Gang

2016-08-01

The purpose of this study is to investigate the changing spectrum and clinicopathologic correlation of biopsy-proven renal diseases in central China. We retrospectively analyzed data of 4931 patients who underwent renal biopsy in ten hospitals between September 1994 and December 2014. Among them, 81.55% were primary glomerular diseases (GD), and 13.02% were secondary GD. IgA nephropathy (IgAN) was the most common primary GD (43.45%), followed by focal glomerulonephritis (16.79%), mesangial proliferative glomerulonephritis (MsPGN, 14.35%), and membranous nephropathy (MN, 13.28%). IgAN was leading primary GD in patients under 60 years old, while MN was the leading one over 60 years old. The most frequent secondary GD was lupus nephritis (LN) (47.35%). The prevalence of IgAN, MN and minimal change disease was found to increase significantly (p < 0.001, p < 0.001, and p < 0.01, respectively), while that of MsPGN, membranoproliferative glomerulonephritis and LN decreased significantly (p < 0.001, p < 0.001, and p < 0.05, respectively). The main indication for renal biopsy was proteinuria and hematuria (49.03%), followed by nephrotic syndrome (NS, 20.36%). IgAN was the most common cause in patients with proteinuria and hematuria, chronic-progressive kidney injury, hematuria and acute kidney injury; and MN was the leading cause of NS. Primary GD remained the predominant renal disease in central China. IgAN and LN were the most prevalent histopathologic lesions of primary and secondary GD, respectively. The spectrum of biopsy-proven renal disease had a great change in the past two decades. Proteinuria and hematuria was the main indication for renal biopsy.

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

Lindquist, N.; Hay, M.E.

Marine larvae are consumed by a wide variety of generalist fishes and particle-feeding invertebrates, but larvae of any particular species probably constitute a small and variable portion of the diet for these consumers. Because virtually all consumers can ingest small quantities of noxious compounds with minimal detrimental effects, it is uncertain that toxic chemicals in larvae could be consumed in quantities sufficient to select for predator recognition and avoidance. Despite this, chemically defended larvae do occur. We show that, at low doses, secondary metabolites (the didemnins) from adults and larvae of the Caribbean tunicate Trididenmum solidum induced vomiting in fish,more » resulting in rapid learned aversion to the dedemnin-defended food. The particle-feeding anemone Aiptasia pallida did not learn to avoid the chemically defended food. When anemones ingested the chemical equivalent of 15 larvae/d, representing <2% of the mass of their total daily diet, the didemnins in the {open_quotes}larvae{close_quotes} significantly reduced: (1) growth of adults by 82%, (2) combined growth of adults and daughter clones by 76%, (3) production of daughter clones by 44%, and (4) average mass of individual daughter clones by 41%. At higher water temperatures, anemones cloned more rapidly. Significant differences in the number of daughter clones produced between treatment and control anemones occurred after only 4 d at seawater temperatures of 27{degrees}-29{degrees}C vs. 32 d at seawater temperatures of 18{degrees}-21{degrees}C. Consumption of even very small quantities of secondary metabolites can decrease consumer fitness substantially and select for predators that recognize and avoid chemically defended larvae, as do many consumers that co-occur with Trididemnum solidum larvae. This is the first rigorous demonstration that consumption of marine secondary metabolites can decrease consumer fitness when ingested at ecologically realistic doses. 59 refs., 5 figs., 3 tabs.« less

Comparative evaluation of the effectiveness of the implantation in the lateral part of the mandible between short tissue level (TE) and bone level (BL) implant systems.

PubMed

Hadzik, Jakub; Botzenhart, Ute; Krawiec, Maciej; Gedrange, Tomasz; Heinemann, Friedhelm; Vegh, Andras; Dominiak, Marzena

2017-09-01

Short dental implants can be an alternative method of treatment to a vertical bone augmentation procedure at sites of reduced alveolar height. However, for successful treatment, an implant system that causes a minimal marginal bone loss (MBL) should be taken into consideration. The aim of the study has been to evaluate implantation effectiveness for bone level and tissue level short implants provided in lateral aspects of partially edentulous mandible and limited alveolar ridge height. The MBL and primary as well as secondary implant stability were determined in the study. Patients were randomly divided into two groups according to the method of treatment provided. Sixteen short Bone Level Implants (OsseoSpeed TX, Astra tech) and 16 short Tissue Level Implants (RN SLActive ® , Straumann) were successfully placed in the edentulous part of the mandible. The determination of the marginal bone level was based on radiographic evaluation after 12 and 36 weeks. Implant stability was measured immediately after insertion and after 12 weeks. The marginal bone level of Bone Level Implants was significantly lower compared to Tissue Level Implants. Furthermore, the Bone Level Implants had greater primary and secondary stability in comparison with Tissue Level Implants (Primary: 77.8 ISQ versus 66.5 ISQ; Secondary: 78.9 ISQ versus 73.9 ISQ, respectively). Since short Bone Level Implants showed a significantly decreased MBL 12 and 36 weeks after implantation as well as better results for the primary stability compared to Tissue Level Implants, they should preferentially be used for this mentioned indication. Copyright © 2017 Elsevier GmbH. All rights reserved.

Instructional strategies in science classrooms of specialized secondary schools for the gifted

NASA Astrophysics Data System (ADS)

Poland, Donna Lorraine

This study examined the extent to which science teachers in Academic Year Governor's Schools were adhering to the national standards for suggested science instruction and providing an appropriate learning environment for gifted learners. The study asked 13 directors, 54 instructors of advanced science courses, and 1190 students of advanced science courses in 13 Academic Year Governor's Schools in Virginia to respond to researcher-developed surveys and to participate in classroom observations. The surveys and classroom observations collected demographic data as well as instructors' and students' perceptions of the use of various instructional strategies related to national science reform and gifted education recommendations. Chi-square analyses were used to ascertain significant differences between instructors' and students' perceptions. Findings indicated that instructors of advanced science classes in secondary schools for the gifted are implementing nationally recognized gifted education and science education instructional strategies with less frequency than desired. Both students and instructors concur that these strategies are being implemented in the classroom setting, and both concur as to the frequency with which the implementation occurs. There was no significant difference between instructors' and students' perceptions of the frequency of implementation of instructional strategies. Unfortunately, there was not a single strategy that students and teachers felt was being implemented on a weekly or daily basis across 90% of the sampled classrooms. Staff development in gifted education was found to be minimal as an ongoing practice. While this study offers some insights into the frequency of strategy usage, the study needs more classroom observations to support findings; an area of needed future research. While this study was conducted at the secondary level, research into instructional practices at the middle school and elementary school gifted science classroom settings would be appropriate and warranted.

Effect of training and lifting equipment for preventing back pain in lifting and handling: systematic review

PubMed Central

2008-01-01

Objectives To determine whether advice and training on working techniques and lifting equipment prevent back pain in jobs that involve heavy lifting. Data sources Medline, Embase, CENTRAL, Cochrane Back Group’s specialised register, CINAHL, Nioshtic, CISdoc, Science Citation Index, and PsychLIT were searched up to September-November 2005. Review methods The primary search focused on randomised controlled trials and the secondary search on cohort studies with a concurrent control group. Interventions aimed to modify techniques for lifting and handling heavy objects or patients and including measurements for back pain, consequent disability, or sick leave as the main outcome were considered for the review. Two authors independently assessed eligibility of the studies and methodological quality of those included. For data synthesis, we summarised the results of studies comparing similar interventions. We used odds ratios and effect sizes to combine the results in a meta-analysis. Finally, we compared the conclusions of the primary and secondary analyses. Results Six randomised trials and five cohort studies met the inclusion criteria. Two randomised trials and all cohort studies were labelled as high quality. Eight studies looked at lifting and moving patients, and three studies were conducted among baggage handlers or postal workers. Those in control groups received no intervention or minimal training, physical exercise, or use of back belts. None of the comparisons in randomised trials (17 720 participants) yielded significant differences. In the secondary analysis, none of the cohort studies (772 participants) had significant results, which supports the results of the randomised trials. Conclusions There is no evidence to support use of advice or training in working techniques with or without lifting equipment for preventing back pain or consequent disability. The findings challenge current widespread practice of advising workers on correct lifting technique. PMID:18244957

Prostate Artery Embolization (PAE) in the Management of Refractory Hematuria of Prostatic Origin Secondary to Iatrogenic Urological Trauma: A Safe and Effective Technique.

PubMed

Kably, Isaam; Pereira, Keith; Chong, William; Bhatia, Shivank

2016-02-01

Incidence of refractory hematuria of prostatic origin (RHPO) is extremely rare, with an iatrogenic etiology even rarer. When conservative methods fail to control bleeding, more invasive surgical methods are needed. In this article we describe our experience with prostatic artery embolization (PAE) as a minimally invasive alternative treatment option in patients with RHPO secondary to iatrogenic urologic trauma. Three patients presented with RHPO. The etiologies were transurethral resection of prostate surgery, Foley catheter removal with a supratherapeutic international normalized ratio and self-traumatic Foley catheter removal respectively. Stepwise management with conservative and medical methods failed to control bleeding. Under local anesthesia and moderate sedation, bilateral PAE was performed via a right common femoral artery access and using cone beam computed tomography. An embolic mixture containing 300-500 um Embosphere® Microspheres (Biosphere Medical, Rockland, MA) was injected under fluoroscopic guidance until stasis was achieved. PAE using the described technique was a technical and clinical success in all three patients. Hematuria resolved within a period of 24 hours. There were no intra- or periprocedural complications. PAE offers a reasonable option in treatment of RHPO, regardless of the cause and may be attempted prior to surgical techniques or sometimes in conjunction. Being minimally invasive and performed under local anesthesia, PAE is especially useful when excessive bleeding prevents adequate visualization of a bleeding source during cystoscopy and in the elderly age group with several comorbidities. An added advantage is the prostatic parenchymal ischemia leading to significant prostate volume reduction and alleviation of the obstructive symptoms. Copyright © 2016 Elsevier Inc. All rights reserved.

Pulsatile dry cupping in chronic low back pain - a randomized three-armed controlled clinical trial.

PubMed

Teut, M; Ullmann, A; Ortiz, M; Rotter, G; Binting, S; Cree, M; Lotz, F; Roll, S; Brinkhaus, B

2018-04-02

We aimed to investigate the effectiveness of two different forms of dry pulsatile cupping in patients with chronic low back pain (cLBP) compared to medication on demand only in a three-armed randomized trial. 110 cLBP patients were randomized to regular pulsatile cupping with 8 treatments plus paracetamol on demand (n = 37), minimal cupping with 8 treatments plus paracetamol on demand (n = 36) or the control group with paracetamol on demand only (n = 37). Primary outcome was the pain intensity on a visual analogue scale (VAS, 0-100 mm) after 4 weeks, secondary outcome parameter included VAS pain intensity after 12 weeks, back function as measured with the 'Funktionsfragebogen Hannover Rücken' (FFbH-R) and health related quality of life questionnaire Short form 36 (SF-36) after 4 and 12 weeks. The mean baseline-adjusted VAS after 4 weeks was 34.9 mm (95% CI: 28.7; 41.2) for pulsatile cupping, 40.4 (34.2; 46.7) for minimal cupping and 56.1 (49.8; 62.4) for control group, resulting in statistically significant differences between pulsatile cupping vs. control (21.2 (12.2; 30.1); p < 0.001) and minimal cupping vs. control (15.7 (6.9; 24.4); p = 0.001). After 12 weeks, mean adjusted VAS difference between pulsatile cupping vs. control was 15.1 ((3.1; 27.1); p = 0.014), and between minimal cupping vs. control 11.5 ((- 0.44; 23.4); p = 0.059). Differences of VAS between pulsatile cupping and minimal cupping showed no significant differences after 4 or 12 weeks. Pulsatile cupping was also better (- 5.8 (- 11.5;-0.1); p = 0.045) compared to control for back function after 4 weeks, but not after 12 weeks (- 5.4 (- 11.7;0.8); p = 0.088), pulsatile cupping also showed better improvements on SF-36 physical component scale compared to control at 4 and 12 weeks (- 5.6 (- 9.3;-2.0); p = 0.003; - 6.1 (- 9.9;-2.4); p = 0.002). For back function and quality of life minimal cupping group was not statistically different to control after 4 and 12 weeks. Paracetamol intake did not differ between the groups (cupping vs. control (7.3 (- 0.4;15.0); p = 0.063); minimal cupping vs. control (6.3 (- 2.0;14.5); p = 0.133). Both forms of cupping were effective in cLBP without showing significant differences in direct comparison after four weeks, only pulsatile cupping showed effects compared to control after 12 weeks. The study was registered at ClinicalTrials.gov (identifier: NCT02090686 ).

A System of Movement and Motor Skill Challenges for Children

ERIC Educational Resources Information Center

Hill, Grant M.; Turner, Bud

2012-01-01

Given increasing childhood inactivity and obesity, and minimal time for quality physical education in elementary and secondary schools, it is essential that children are motivated and held accountable for independent motor and movement skill practice. The Movement and Motor Skill Challenge System provides a comprehensive set of stimulating,…

Trade Education Syllabus in Graphics Industries Occupations.

ERIC Educational Resources Information Center

New York State Education Dept., Albany. Bureau of Occupational Education Curriculum Development.

This syllabus provides occupational education teachers in secondary schools with a guide for developing a course in trade graphics which meets the minimal requirements that an acceptable two-year program in New York State must provide. The content is presented in six sections, and each one includes terminal objectives and suggestions for…

Minimization of the Effects of Secondary Reactions on Turbine Film Cooling in a Fuel Rich Environment

DTIC Science & Technology

2014-06-02

the instrumentation block ..................................... 57 Table 4.1: Flame Length Results...91 Table 4.2: Five Row Flame Lengths , Blowing Ratio Sweep .......................................... 123 Table...4.3: Five Row Flame Lengths , Equivalence Ratio Sweep .................................... 124 Table 4.4: Five Row - Wall Absorption Parameter

Prostate artery embolization: a new, minimally invasive treatment for lower urinary tract symptoms secondary to prostate enlargement

PubMed Central

Maclean, Drew; Maher, Ben; Modi, Sachin; Harris, Mark; Dyer, Jonathan; Somani, Bhaskar; Hacking, Nigel; Bryant, Timothy

2017-01-01

Prostate artery embolization (PAE) is emerging as a safe and efficacious treatment which approaches benign prostatic obstruction (BPO) from a unique perspective. This brings with it distinct advantages and solutions, which we discuss along with cost, evidence, complications and disadvantages. PMID:29662545

Neighborhood Environment and Adherence to a Walking Intervention in African American Women

ERIC Educational Resources Information Center

Zenk, Shannon N.; Wilbur, JoEllen; Wang, Edward; McDevitt, Judith; Oh, April; Block, Richard; McNeil, Sue; Savar, Nina

2009-01-01

This secondary analysis examined relationships between the environment and adherence to a walking intervention among 252 urban and suburban, midlife African American women. Participants received an enhanced or minimal behavioral intervention. Walking adherence was measured as the percentage of prescribed walks completed. Objective measures of the…

[Mentor High School Reading Program.

ERIC Educational Resources Information Center

Mentor Exempted Village School District, OH.

This program, begun in 1968 and included in "Effective Reading Programs...," serves about 2,800 students in grades 10-12. A secondary reading skills chart was developed, behavioral objectives were written, and minimal-competency tests in both reading and sriting were prepared. During the school year, all skills listed on the chart are…

Students' Reading Images in Kinematics: The Case of Real-Time Graphs.

ERIC Educational Resources Information Center

Testa, Italo; Monroy, Gabriella; Sassi, Elena

2002-01-01

Describes a study in which secondary school students were called upon to read and interpret documents containing images of real-time kinematics graphs specially designed to address common learning problems and minimize iconic difficulties. Makes suggestions regarding the acquisition of some specific capabilities that are needed to avoid…

Missouri Secondary Science Safety Manual.

ERIC Educational Resources Information Center

Lemons, Judith L.

The purpose of this safety manual is to provide a resource to help manage and minimize potential risks in science classrooms where students spend up to 60% of instructional time engaged in hands-on activities. This manual contains information on standards, legal aspects, and responsibilities for science safety; general laboratory safety for…

Rock ramp design guidelines

USGS Publications Warehouse

Mooney, David M.; Holmquist-Johnson, Christopher L.; Broderick, Susan

2007-01-01

Rock ramps or roughened channels consist of steep reaches stabilized by large immobile material (riprap). Primary objectives for rock ramps include: Create adequate head for diversionMaintain fish passage during low-flow conditionsMaintain hydraulic conveyance during high-flow conditionsSecondary objectives for rock ramp design include:Emulate natural systemsMinimize costsThe rock ramp consists of a low-flow channel designed to maintain biologically adequate depth and velocity conditions during periods of small discharges. The remainder of the ramp is designed to withstand and pass large flows with minimal structural damage. The following chapters outline a process for designing rock ramps.

TRANSFORMER

DOEpatents

Baker, W.R.

1959-08-25

Transformers of a type adapted for use with extreme high power vacuum tubes where current requirements may be of the order of 2,000 to 200,000 amperes are described. The transformer casing has the form of a re-entrant section being extended through an opening in one end of the cylinder to form a coaxial terminal arrangement. A toroidal multi-turn primary winding is disposed within the casing in coaxial relationship therein. In a second embodiment, means are provided for forming the casing as a multi-turn secondary. The transformer is characterized by minimized resistance heating, minimized external magnetic flux, and an economical construction.

DNASynth: a software application to optimization of artificial gene synthesis

NASA Astrophysics Data System (ADS)

Muczyński, Jan; Nowak, Robert M.

2017-08-01

DNASynth is a client-server software application in which the client runs in a web browser. The aim of this program is to support and optimize process of artificial gene synthesizing using Ligase Chain Reaction. Thanks to LCR it is possible to obtain DNA strand coding defined by user peptide. The DNA sequence is calculated by optimization algorithm that consider optimal codon usage, minimal energy of secondary structures and minimal number of required LCR. Additionally absence of sequences characteristic for defined by user set of restriction enzymes is guaranteed. The presented software was tested on synthetic and real data.

ANTIBODY FORMATION BY TRANSPLANTED BONE MARROW, SPLEEN, LYMPH NODE AND THYMUS CELLS IN IRRADIATED RECIPIENTS

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

Stoner, R.D.; Bond, V.P.

1963-01-14

Immunological competence of immunized mouse bone marrow, spleen, lymph node, and thymus cells was demonstrated when specific recall tetanus antitoxin responses were elicited after transfer of these cells to isologous irradiated mice or rats. Lesser amounts of antibody were obtained as the genetic strain distance was increased between the relation of donor and host in the parental to F/sub 1/ and in the homologous combination within the same species. It was not possible in the heterologous situation to elicit significant amounts of antibody from rat bone marrow and other lymphoid cells following their transplantation into irradiated mice. Minimal but notmore » significant antibody responses were elicited from cells obtained from immunized rat spleen and thymus tissue. In a few experiments, it was possible to elicit antibody formation from a buffy coat suspension of circulating white cells following their transfer to irradiated recipients. Isologous nonimmunized bone marrow did not stimulate or hasten recovery of the ability to eiicit secondary antibody responses in previously immunized irradiated mice. The capacity to elicit primary antibody responses to tetanus toxoid was depressed in parental-bone-marrow-protected F/sub 1/ mice when these chimeras exhibited varying degrees of secondary disease. The depression of primary antibody responses in irradiated F/sub 1/ mice given parental bone marrow provides evidence for a donor mediated immunological depression of antibody synthesis by host-lymphoid tissues. (auth)« less

Use of milrinone to treat cardiac dysfunction in infants with pulmonary hypertension secondary to congenital diaphragmatic hernia: a review of six patients.

PubMed

Patel, Neil

2012-01-01

Pulmonary hypertension and secondary cardiac dysfunction are important contributors of morbidity and mortality in infants with congenital diaphragmatic hernia (CDH). Milrinone, a phosphodiesterase-3 inhibitor, may be useful in this setting for its combined actions as a pulmonary vasodilator and to improve systolic and diastolic function. This study aimed to assess the effects of milrinone on cardiac function and pulmonary artery pressure in infants with CDH. A retrospective review of echocardiograms performed on infants with CDH who received milrinone was performed. Tissue Doppler imaging velocities were used to assess systolic and diastolic function. Pulmonary artery pressure was assessed from the pattern and velocity of ductal shunting. Six infants with CDH and severe pulmonary hypertension were identified. Systolic and diastolic myocardial velocities were reduced in the right ventricle (RV) and interventricular septum (IVS) at baseline. In the 72 h after commencement of milrinone, there was a significant increase in early diastolic myocardial velocities in the RV, accompanied by increasing systolic velocities in the RV and IVS. Oxygenation index was significantly reduced, blood pressure unchanged, and ductal shunt velocity minimally altered over the same time period. Milrinone use was associated with an improvement in systolic and diastolic function in the RV, corresponding to an improvement in clinical status. Copyright © 2012 S. Karger AG, Basel.

Polycyclic aromatic hydrocarbon and particulate emissions from two-stage combustion of polystyrene: the effect of the primary furnace temperature.

PubMed

Wang, J; Levendis, Y A; Richter, H; Howard, J B; Carlson, J

2001-09-01

A study is presented on laboratory-scale combustion of polystyrene (PS) to identify staged-combustion conditions that minimize emissions. Batch combustion of shredded PS was conducted in fixed beds placed in a bench-scale electrically heated horizontal muffle furnace. In most cases, combustion of the samples occurred by forming gaseous diffusion flames in atmospheric pressure air. The combustion effluent was mixed with additional air, and it was channeled to a second muffle furnace (afterburner) placed in series. Further reactions took place in the secondary furnace at a residence time of 0.7 s. The gas temperature of the primary furnace was varied in the range of 500-1,000 degrees C, while that of the secondary furnace was kept fixed at 1,000 degrees C. Sampling for CO, CO2, O2, soot, and unburned hydrocarbon emissions (volatile and semivolatile, by GC-MS) was performed at the exits of the two furnaces. Results showed that the temperature of the primary furnace, where PS gasifies, is of paramount importance to the formation and subsequent emissions of organic species and soot. Atthe lowesttemperatures explored, mostly styrene oligomers were identified at the outlet of the primary furnace, but they did not survive the treatment in the secondary furnace. The formation and emission of polycyclic aromatic hydrocarbons (PAH) and soot were suppressed. As the temperature in the first furnace was raised, increasing amounts of a wide range of both unsubstituted and substituted PAH containing up to at least seven condensed aromatic rings were detected. A similar trend was observed for total particulate yields. The secondary furnace treatment reduced the yields of total PAH, but it had an ambiguous effect on individual species. While most low molecular mass PAH were reduced in the secondary furnace, concentrations of some larger PAH increased under certain conditions. Thus, care in the selection of operating conditions of both the primary furnace (gasifier/ burner) and the secondary furnace (afterburner) must be exercised to minimize the emission of hazardous pollutants. The emissions of soot were also reduced in the afterburner but not drastically. This indicates that soot is indeed resistant to oxidation; thus, it would be best to avoid its formation in the first place. An oxidative pyrolysis temperature of PS in the vicinity of 600 degrees C appears to accomplish exactly that. An additional afterburner treatment at a sufficiently high temperature (1,000 degrees C) may be a suitable setting for minimization of most pollutants. To obtain deeper understanding of chemical processes, the experimental results were qualitatively compared with preliminary predictions of a detailed kinetic model that describes formation and destruction pathways of chemical species including most PAH observed in the present work. The modeling was performed forthe secondary furnace assuming plug-flow conditions therein. The experimentally determined chemical composition at the outlet of the primary furnace was part of the input parameters of the model calculation.

Effects of functional taping compared with sham taping and minimal intervention on pain intensity and static postural control for patients with non-specific chronic low back pain: a randomised clinical trial protocol.

PubMed

Jassi, F J; Del Antônio, T; Moraes, R; George, S Z; Chaves, T C

2017-06-01

To investigate the immediate and 1-month effects of functional taping to lumbar spine for pain intensity and postural control in patients with chronic non-specific low back pain. Randomised clinical trial. One hundred and twenty participants aged 18 to 50 years. Participants will be allocated at random to receive one of three interventions: functional star-shape taping for 7 days, sham functional taping for 7 days or minimal intervention, one session. The primary outcomes will be pain intensity and postural control. Four measurements of static posturography will be conducted: pre-intervention, immediately after application of the tape, 7 days post-intervention (after removal of the tape) and 1-month follow-up. The secondary outcomes will be low-back-pain-related disability, global perceived effect of treatment and fear avoidance beliefs. Primary and secondary outcomes will be assessed on three occasions: pre-intervention, 7 days post-intervention and at 1-month follow-up. All statistical analyses will be conducted following intention-to-treat principles, and the treatment effects will be calculated using linear mixed models. The results of this study will determine the effects of functional taping on pain intensity and postural control compared with sham taping and minimal intervention. NCT02546466. Copyright © 2016 Chartered Society of Physiotherapy. All rights reserved.

Germanium photodetectors fabricated on 300 mm silicon wafers for near-infrared focal plane arrays

NASA Astrophysics Data System (ADS)

Zeller, John W.; Rouse, Caitlin; Efstathiadis, Harry; Dhar, Nibir K.; Wijewarnasuriya, Priyalal; Sood, Ashok K.

2017-09-01

SiGe p-i-n photodetectors have been fabricated on 300 mm (12") diameter silicon (Si) wafers utilizing high throughput, large-area complementary metal-oxide semiconductor (CMOS) technologies. These Ge photodetectors are designed to operate in room temperature environments without cooling, and thus have potential size and cost advantages over conventional cooled infrared detectors. The two-step fabrication process for the p-i-n photodetector devices, designed to minimize the formation of defects and threading dislocations, involves low temperature epitaxial growth of a thin p+ (boron) Ge seed/buffer layer, followed by higher temperature deposition of a thicker Ge intrinsic layer. Scanning electron microscopy (SEM) and transmission electron microscopy (TEM) demonstrated uniform layer compositions with well defined layer interfaces and reduced dislocation density. Time-of-flight secondary ion mass spectroscopy (TOF-SIMS) was likewise employed to analyze the doping levels of the p+ and n+ layers. Current-voltage (I-V) measurements demonstrated that these SiGe photodetectors, when exposed to incident visible-NIR radiation, exhibited dark currents down below 1 μA and significant enhancement in photocurrent at -1 V. The zero-bias photocurrent was also relatively high, showing a minimal drop compared to that at -1 V bias.

A semi-active damper in vertical secondary suspension for the comfort increase in passenger trains

NASA Astrophysics Data System (ADS)

Ripamonti, Francesco; Chiarabaglio, Andrea; Resta, Ferruccio

2017-04-01

Passive oil dampers for railway vehicles present a damping and stiffness characteristics, which depend from excitation history. This behaviour is not acceptable for many high-performance applications. A mechatronic approach, able to continuously adjust the damping coefficient according to the operation requirements, represents a very attractive and smart solution. In this paper, a control strategy for semi-active dampers of train vertical secondary suspensions is presented. The controller aims at assuring the maximum available damping at low frequencies, while at high frequencies minimizes the force transmitted to the carbody that excites the bending modes.

The effect of process parameters on Twin Wire Arc spray pattern shape

DOE PAGES

Hall, Aaron Christopher; McCloskey, James Francis; Horner, Allison Lynne

2015-04-20

A design of experiments approach was used to describe process parameter—spray pattern relationships in the Twin Wire Arc process using zinc feed stock in a TAFA 8835 (Praxair, Concord, NH, USA) spray torch. Specifically, the effects of arc current, primary atomizing gas pressure, and secondary atomizing gas pressure on spray pattern size, spray pattern flatness, spray pattern eccentricity, and coating deposition rate were investigated. Process relationships were investigated with the intent of maximizing or minimizing each coating property. It was determined that spray pattern area was most affected by primary gas pressure and secondary gas pressure. Pattern eccentricity was mostmore » affected by secondary gas pressure. Pattern flatness was most affected by primary gas pressure. Lastly, coating deposition rate was most affected by arc current.« less

The effect of process parameters on Twin Wire Arc spray pattern shape

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

Hall, Aaron Christopher; McCloskey, James Francis; Horner, Allison Lynne

A design of experiments approach was used to describe process parameter—spray pattern relationships in the Twin Wire Arc process using zinc feed stock in a TAFA 8835 (Praxair, Concord, NH, USA) spray torch. Specifically, the effects of arc current, primary atomizing gas pressure, and secondary atomizing gas pressure on spray pattern size, spray pattern flatness, spray pattern eccentricity, and coating deposition rate were investigated. Process relationships were investigated with the intent of maximizing or minimizing each coating property. It was determined that spray pattern area was most affected by primary gas pressure and secondary gas pressure. Pattern eccentricity was mostmore » affected by secondary gas pressure. Pattern flatness was most affected by primary gas pressure. Lastly, coating deposition rate was most affected by arc current.« less

Recombinant versus highly-purified, urinary follicle-stimulating hormone (r-FSH vs. HP-uFSH) in ovulation induction: a prospective, randomized study with cost-minimization analysis

PubMed Central

Revelli, Alberto; Poso, Francesca; Gennarelli, Gianluca; Moffa, Federica; Grassi, Giuseppina; Massobrio, Marco

2006-01-01

Background Both recombinant FSH (r-FSH) and highly-purified, urinary FSH (HP-uFSH) are frequently used in ovulation induction associated with timed sexual intercourse. Their effectiveness is reported to be similar, and therefore the costs of treatment represent a major issue to be considered. Although several studies about costs in IVF have been published, data obtained in low-technology infertility treatments are still scarce. Methods Two hundred and sixty infertile women (184 with unexplained infertility, 76 with CC-resistant polycystic ovary syndrome) at their first treatment cycle were randomized and included in the study. Ovulation induction was accomplished by daily administration of rFSH or HP-uFSH according to a low-dose, step-up regimen aimed to obtain a monofollicular ovulation. A bi- or tri-follicular ovulation was anyway accepted, whereas hCG was withdrawn and the cycle cancelled when more than three follicles greater than or equal to 18 mm diameter were seen at ultrasound. The primary outcome measure was the cost of therapy per delivered baby, estimated according to a cost-minimization analysis. Secondary outcomes were the following: monofollicular ovulation rate, total FSH dose, cycle cancellation rate, length of the follicular phase, number of developing follicles (>12 mm diameter), endometrial thickness at hCG, incidence of twinning and ovarian hyperstimulation syndrome, delivery rate. Results The overall FSH dose needed to achieve ovulation was significantly lower with r-FSH, whereas all the other studied variables did not significantly differ with either treatments. However, a trend toward a higher delivery rate with r-FSH was observed in the whole group and also when results were considered subgrouping patients according to the indication to treatment. Conclusion Considering the significantly lower number of vials/patient and the slight (although non-significant) increase in the delivery rate with r-FSH, the cost-minimization analysis showed a 9.4% reduction in the overall therapy cost per born baby in favor of r-FSH. PMID:16848893

Controlling the leakage of liquid bismuth cathode elements in ceramic crucibles used for the electrowinning process in pyroprocessing

NASA Astrophysics Data System (ADS)

Kim, Dae-Young; Hwang, Il-Soon; Lee, Jong-Hyeon

2016-09-01

Pyroprocessing has shown promise as an alternative to wet processing for the recycling of transuranics with a high proliferation resistance. However, a critical issue for pyroprocessing is the ceramic crucibles used in the electrowinning process. These ceramic crucibles are frequently damaged by thermal stress, which results in significant volumes of crucible waste that must be properly disposed. Transuranic waste (TRU) elements intrude throughout the pores of a damaged crucible. The volume of generated radioactive waste is a concern when dealing with nuclear power plants and decontamination issues. In this study, laser treatment and sintering were performed on the crucibles to minimize the TRU elements trapped within. Secondary ion mass spectroscopy was used to measure the intrusion depth of Li in the surface-treated ceramics.

Time estimation as a secondary task to measure workload. [attention sharing effect on operator performance

NASA Technical Reports Server (NTRS)

Hart, S. G.

1975-01-01

Variation in the length of time productions and verbal estimates of duration was investigated to determine the influence of concurrent activity on operator time perception. The length of 10-, 20-, and 30-sec intervals produced while performing six different compensatory tracking tasks was significantly longer, 23% on the average, than those produced while performing no other task. Verbal estimates of session duration, taken at the end of each of 27 experimental sessions, reflected a parallel increase in subjective underestimation of the passage of time as the difficulty of the task performed increased. These data suggest that estimates of duration made while performing a manual control task provide stable and sensitive measures of the workload imposed by the primary task, with minimal interference.

Eye-related pain induced by visually demanding computer work.

PubMed

Thorud, Hanne-Mari Schiøtz; Helland, Magne; Aarås, Arne; Kvikstad, Tor Martin; Lindberg, Lars Göran; Horgen, Gunnar

2012-04-01

Eye strain during visually demanding computer work may include glare and increased squinting. The latter may be related to elevated tension in the orbicularis oculi muscle and development of muscle pain. The aim of the study was to investigate the development of discomfort symptoms in relation to muscle activity and muscle blood flow in the orbicularis oculi muscle during computer work with visual strain. A group of healthy young adults with normal vision was randomly selected. Eye-related symptoms were recorded during a 2-h working session on a laptop. The participants were exposed to visual stressors such as glare and small font. Muscle load and blood flow were measured by electromyography and photoplethysmography, respectively. During 2 h of visually demanding computer work, there was a significant increase in the following symptoms: eye-related pain and tiredness, blurred vision, itchiness, gritty eyes, photophobia, dry eyes, and tearing eyes. Muscle load in orbicularis oculi was significantly increased above baseline and stable at 1 to 1.5% maximal voluntary contraction during the working sessions. Orbicularis oculi muscle blood flow increased significantly during the first part of the working sessions before returning to baseline. There were significant positive correlations between eye-related tiredness and orbicularis oculi muscle load and eye-related pain and muscle blood flow. Subjects who developed eye-related pain showed elevated orbicularis oculi muscle blood flow during computer work, but no differences in muscle load, compared with subjects with minimal pain symptoms. Eyestrain during visually demanding computer work is related to the orbicularis oculi muscle. Muscle pain development during demanding, low-force exercise is associated with increased muscle blood flow, possible secondary to different muscle activity pattern, and/or increased mental stress level in subjects experiencing pain compared with subjects with minimal pain.

Gondola for High Altitude Planetary Science (GHAPS) Telescope Secondary Mirror Positioning Hexapod Issues and Alternatives

NASA Technical Reports Server (NTRS)

Wells, Mark

2017-01-01

Active positioning of the GHAPS secondary telescope mirror is desired to correct for rigid body deflections due to temperature variations and gravity sag in the telescope structure that may impact optical performance. The current design concept for the secondary mirror mount uses a Commercial-Off -the-Shelf hexapod for mirror positioning and fine adjustment. The Hexapod specification states that motions as small as 0.1 microns along the optical axis and 2 microns perpendicular to the optical axis will cause optical aberrations that will require correction by repositioning the secondary mirror. In addition, the secondary mirror mount and positioning system must survive a 15g shock of parachute opening and landing during the instrument recovery operation. The secondary mirror positioning system must operate at a minimum specified temperature of -50 C. The telescope operates in the IR and the secondary mirror mount and positioning device is in the metering path between the primary and secondary mirrors. I2R losses in positioning system actuator devices, which may cause heating of the positioning system and secondary mirror, must be minimized due to the previously mentioned alignment sensitivity and the viewing spectrum of interest. The GHAPs project was cancelled on June 30, 2017. The purpose of this study is to address some of the issues identified with the hexapod secondary mirror positioning system and identify alternative approaches. This information may be used if the project is re-started at a later date.

Characterization of the functional role of nucleotides within the URE2 IRES element and the requirements for eIF2A-mediated repression.

PubMed

Reineke, Lucas C; Merrick, William C

2009-12-01

Cap-independent initiation of translation is thought to promote protein synthesis on some mRNAs during times when cap-dependent initiation is down-regulated. However, the mechanism of cap-independent initiation is poorly understood. We have previously reported the secondary structure within the yeast minimal URE2 IRES element. In this study, we sought to investigate the mechanism of internal initiation in yeast by assessing the functional role of nucleotides within the minimal URE2 IRES element, and delineating the cis-sequences that modulate levels of internal initiation using a monocistronic reporter vector. Furthermore, we compared the eIF2A sensitivity of the URE2 IRES element with some of the invasive growth IRES elements using DeltaeIF2A yeast. We found that the stability of the stem-loop structure within the minimal URE2 IRES element is not a critical determinant of optimal IRES activity, and the downstream sequences that modulate URE2 IRES-mediated translation can be defined to discrete regions within the URE2 coding region. Repression of internal initiation on the URE2 minimal IRES element by eIF2A is not dependent on the stability of the secondary structure within the URE2 IRES element. Our data also indicate that eIF2A-mediated repression is not specific to the URE2 IRES element, as both the GIC1 and PAB1 IRES elements are repressed by eIF2A. These data provide valuable insights into the mRNA requirements for internal initiation in yeast, and insights into the mechanism of eIF2A-mediated suppression.

Responsiveness, minimal detectable change, and minimal clinically important difference of the Nottingham Extended Activities of Daily Living Scale in patients with improved performance after stroke rehabilitation.

PubMed

Wu, Ching-yi; Chuang, Li-ling; Lin, Keh-chung; Lee, Shin-da; Hong, Wei-hsien

2011-08-01

To determine the responsiveness, minimal detectable change (MDC), and minimal clinically important differences (MCIDs) of the Nottingham Extended Activities of Daily Living (NEADL) scale and to assess percentages of patients' change scores exceeding the MDC and MCID after stroke rehabilitation. Secondary analyses of patients who received stroke rehabilitation therapy. Medical centers. Patients with stroke (N=78). Secondary analyses of patients who received 1 of 4 rehabilitation interventions. Responsiveness (standardized response mean [SRM]), 90% confidence that a change score at this threshold or higher is true and reliable rather than measurement error (MDC(90)), and MCID on the NEADL score and percentages of patients exceeding the MDC(90) and MCID. The SRM of the total NEADL scale was 1.3. The MDC(90) value for the total NEADL scale was 4.9, whereas minima and maxima of the MCID for total NEADL score were 2.4 and 6.1 points, respectively. Percentages of patients exceeding the MDC(90) and MCID of the total NEADL score were 50.0%, 73.1%, and 32.1%, respectively. The NEADL is a responsive instrument relevant for measuring change in instrumental activities of daily living after stroke rehabilitation. A patient's change score has to reach 4.9 points on the total to indicate a true change. The mean change score of a stroke group on the total NEADL scale should achieve 6.1 points to be regarded as clinically important. Our findings are based on patients with improved NEADL performance after they received specific interventions. Future research with larger sample sizes is warranted to validate these estimates. Copyright © 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Lifetime Alcohol Use & Cognitive Performance in Older Adults

PubMed Central

Kalapatapu, Raj K.; Ventura, Maria I.; Barnes, Deborah E.

2016-01-01

Background Substance use is an important clinical issue in the older adult population. As older adults are susceptible to cognitive disorders, the intersection of the fields of substance use and cognitive neuroscience is an active area of research. Prior studies of alcohol use and cognitive performance are mixed, and inconsistencies may be due to under- or over-adjustment for confounders. Aim This manuscript adds to this literature by conducting a secondary analysis of self-reported lifetime history of alcohol use and cognitive performance in older adults (n = 133). We hypothesized that current alcohol users would have poorer cognitive performance compared to never/minimal and former alcohol users. Methods Older adult participants were classified into never/minimal alcohol users, former alcohol users, and current alcohol users. A neurocognitive battery included a global cognitive measure and individual measures of attention, memory, fluency, and executive function. A directed acyclic graph (DAG)-based approach was used to select variables to be included in the multiple linear regression models. Results Though unadjusted analyses showed some significant associations between alcohol use and cognitive performance, all associations between alcohol use and cognitive performance were eliminated after adjusting for age, education, sex, race and smoking pack years. Alcohol drink years were not significantly associated with cognitive performance among current and former alcohol users. Discussion These results suggest that lifetime alcohol use is not significantly associated with cognitive performance in older adults after adjustment for key confounders. Inconsistencies in prior studies may be due to uncontrolled confounding and/or unnecessary adjustment of mediators and/or colliders. PMID:27719514

National proficiency-gain curves for minimally invasive gastrointestinal cancer surgery.

PubMed

Mackenzie, H; Markar, S R; Askari, A; Ni, M; Faiz, O; Hanna, G B

2016-01-01

Minimal access surgery for gastrointestinal cancer has short-term benefits but is associated with a proficiency-gain curve. The aim of this study was to define national proficiency-gain curves for minimal access colorectal and oesophagogastric surgery, and to determine the impact on clinical outcomes. All adult patients undergoing minimal access oesophageal, colonic and rectal surgery between 2002 and 2012 were identified from the Hospital Episode Statistics database. Proficiency-gain curves were created using risk-adjusted cumulative sum analysis. Change points were identified, and bootstrapping was performed with 1000 iterations to identify a confidence level. The primary outcome was 30-day mortality; secondary outcomes were 90-day mortality, reintervention, conversion and length of hospital stay. Some 1696, 15 008 and 16 701 minimal access oesophageal, rectal and colonic cancer resections were performed during the study period. The change point in the proficiency-gain curve for 30-day mortality for oesophageal, rectal and colonic surgery was 19 (confidence level 98·4 per cent), 20 (99·2 per cent) and three (99·5 per cent) procedures; the mortality rate fell from 4·0 to 2·0 per cent (relative risk reduction (RRR) 0·50, P = 0·033), from 2·1 to 1·2 per cent (RRR 0·43, P < 0·001) and from 2·4 to 1·8 per cent (RRR 0·25, P = 0·058) respectively. The change point in the proficiency-gain curve for reintervention in oesophageal, rectal and colonic resection was 19 (98·1 per cent), 32 (99·5 per cent) and 26 (99·2 per cent) procedures respectively. There were also significant proficiency-gain curves for 90-day mortality, conversion and length of stay. The introduction of minimal access gastrointestinal cancer surgery has been associated with a proficiency-gain curve for mortality and major morbidity at a national level. Unnecessary patient harm should be avoided by appropriate training and monitoring of new surgical techniques. © 2015 BJS Society Ltd Published by John Wiley & Sons Ltd.

Vasoactive drugs and the gut: is there anything new?

PubMed

Woolsey, Cheryl A; Coopersmith, Craig M

2006-04-01

Systemic changes in blood pressure and cardiac output induced by pressors and inotropes do not always correlate to improvements in regional perfusion. Since the gut is often referred to as the 'motor' of the systemic inflammatory response syndrome, the impact of vasoactive agents on splanchnic perfusion has theoretical importance. This review will highlight recent studies examining secondary effects of vasoactive agents on intestinal perfusion, metabolism, and barrier function. Norepinephrine has minimal impact on mesenteric blood flow although the combination of norepinephrine and dobutamine increases splanchnic blood flow in sepsis. Dopamine also increases mesenteric blood flow although this may be associated with negative hepatic energy balance at high does. Vasopressin and epinephrine both have negative effects on splanchnic blood flow. Newer inodilators levosimendan and olprinone preferentially improve mesenteric perfusion in animal models. Secondary effects of norepinephrine and dopamine on splanchnic perfusion are minor compared with their systemic effects. While vasopressin usage is increasing in the intensive care unit, caution should be used because of its adverse effects on gut perfusion. Experimental agents for the treatment of heart failure have beneficial gut-specific effects although the clinical significance of this is currently limited by their availability.

Electromagnetic interference-aware transmission scheduling and power control for dynamic wireless access in hospital environments.

PubMed

Phunchongharn, Phond; Hossain, Ekram; Camorlinga, Sergio

2011-11-01

We study the multiple access problem for e-Health applications (referred to as secondary users) coexisting with medical devices (referred to as primary or protected users) in a hospital environment. In particular, we focus on transmission scheduling and power control of secondary users in multiple spatial reuse time-division multiple access (STDMA) networks. The objective is to maximize the spectrum utilization of secondary users and minimize their power consumption subject to the electromagnetic interference (EMI) constraints for active and passive medical devices and minimum throughput guarantee for secondary users. The multiple access problem is formulated as a dual objective optimization problem which is shown to be NP-complete. We propose a joint scheduling and power control algorithm based on a greedy approach to solve the problem with much lower computational complexity. To this end, an enhanced greedy algorithm is proposed to improve the performance of the greedy algorithm by finding the optimal sequence of secondary users for scheduling. Using extensive simulations, the tradeoff in performance in terms of spectrum utilization, energy consumption, and computational complexity is evaluated for both the algorithms.

Secondary and tertiary preventions of thyroid disease.

PubMed

Azizi, Fereidoun; Mehran, Ladan; Hosseinpanah, Farhad; Delshad, Hossein; Amouzegar, Atieh

2018-05-01

Secondary and tertiary preventions are concerned with the recognition of the disease process in a very early stage and delay in progression to complete disease and minimization of complications and the impact of illness. All articles related to secondary and tertiary prevention of thyroid diseases were reviewed. Using related key words, articles published between 2001 and 2015 were evaluated, categorized, and analyzed. In secondary prevention, congenital hypothyroidism and subclinical hypo and hyperthyroidism are equally important. Routine screening of patients with multinodular goiter by either ultrasonography or calcitonin is a controversial issue, while calcitonin assessments in medullary cancer and RET in family members are recommended. Screening of thyroid disease in pregnancy is limited to those with risk factors. Views regarding the importance of thyroid autoimmunity in secondary prevention are also presented. In tertiary prevention, prescribing excessive doses of levothyroxine, in the elderly in particular and appropriate care of all patients to avoid progression and complications are the key issues. Optimization of management of thyroid diseases requires timely screening, prevention of progression to more sever disease, optimal medical care, and avoidance of iatrogenic conditions.

Nanostructure Secondary-Mirror Apodizing Mask for Transmitter Signal Suppression in a Duplex Telescope

NASA Technical Reports Server (NTRS)

Hagopian, John; Livas, Jeffrey; Shiri, Shahram; Getty, Stephanie; Tveekrem, June; Butler, James

2012-01-01

A document discusses a nanostructure apodizing mask, made of multi-walled carbon nanotubes, that is applied to the centers (or in and around the holes) of the secondary mirrors of telescopes that are used to interferometrically measure the strain of space-time in response to gravitational waves. The shape of this ultra-black mask can be adjusted to provide a smooth transition to the clear aperture of the secondary mirror to minimize diffracted light. Carbon nanotubes grown on silicon are a viable telescope mirror substrate, and can absorb significantly more light than other black treatments. The hemispherical reflectance of multi-walled carbon nanotubes grown at GSFC is approximately 3 to 10 times better than a standard aerospace paint used for stray light control. At the LISA (Laser Interferometer Space Antenna) wavelength of 1 micron, the advantage over paint is a factor of 10. Primarily, in the center of the secondary mirror (in the region of central obscuration, where no received light is lost) a black mask is applied to absorb transmitted light that could be reflected back into the receiver. In the LISA telescope, this is in the center couple of millimeters. The shape of this absorber is critical to suppress diffraction at the edge. By using the correct shape, the stray light can be reduced by approximately 10 to the 9 orders of magnitude versus no center mask. The effect of the nanotubes has been simulated in a stray-light model. The effect of the apodizing mask has been simulated in a near-field diffraction model. Specifications are geometry-dependent, but the baseline design for the LISA telescope has been modeled as well. The coatings are somewhat fragile, but work is continuing to enhance adhesion.

Ear diseases among secondary school students in Xi'an, China: the role of portable audio device use, insomnia and academic stress.

PubMed

Chen, Yang; Li, Xu; Xu, Zhan; Li, Zonghua; Zhang, Pengzhi; He, Ya; Wang, Fangyuan; Qiu, Jianhua

2011-06-08

Hearing impairment negatively impacts students' development of academic, language and social skills. Even minimal unilateral hearing loss can hinder educational performance. We investigated the prevalence of ear diseases among secondary school students in the city of Xi'an, China in order to provide a foundation for evidence-based hearing healthcare. A stratified random sampling survey was conducted in 29 secondary schools. Demographics and medical histories were collected, and otologic examinations were performed. Questionnaires were administered to assess insomnia, academic stress and use of portable audio devices. Logistic regression analysis was used to identify factors associated with hearing impairment, and the association of sensorineural hearing loss with insomnia, academic stress and the use of portable audio devices was analyzed with the chi-square test. The percentage of students with some form of ear disease was 3.32%. External ear disease, middle ear disease and sensorineural hearing loss occurred in 1.21%, 0.64% and 1.47% of the students, respectively. Boys had a relatively higher prevalence of ear disease than girls. According to our survey, the prevalence of sensorineural hearing loss increased significantly among the students with insomnia and extended use of portable audio devices, but not among those with elevated levels of academic stress. Hearing aids and surgical treatment were needed in 1.47% and 0.89% of the students, respectively. There is a high prevalence of ear disease among secondary school students, and this should be given more attention. Insomnia and the excessive use of portable audio devices may be related to adolescent sensorineural hearing loss. It is important to establish and comply with an evidence-based preventive strategy.

Fully porous 3D printed titanium femoral stem to reduce stress-shielding following total hip arthroplasty.

PubMed

Arabnejad, Sajad; Johnston, Burnett; Tanzer, Michael; Pasini, Damiano

2017-08-01

Current hip replacement femoral implants are made of fully solid materials which all have stiffness considerably higher than that of bone. This mechanical mismatch can cause significant bone resorption secondary to stress shielding, which can lead to serious complications such as peri-prosthetic fracture during or after revision surgery. In this work, a high strength fully porous material with tunable mechanical properties is introduced for use in hip replacement design. The implant macro geometry is based off of a short stem taper-wedge implant compatible with minimally invasive hip replacement surgery. The implant micro-architecture is fine-tuned to locally mimic bone tissue properties which results in minimum bone resorption secondary to stress shielding. We present a systematic approach for the design of a 3D printed fully porous hip implant that encompasses the whole activity spectrum of implant development, from concept generation, multiscale mechanics of porous materials, material architecture tailoring, to additive manufacturing, and performance assessment via in vitro experiments in composite femurs. We show that the fully porous implant with an optimized material micro-structure can reduce the amount of bone loss secondary to stress shielding by 75% compared to a fully solid implant. This result also agrees with those of the in vitro quasi-physiological experimental model and the corresponding finite element model for both the optimized fully porous and fully solid implant. These studies demonstrate the merit and the potential of tuning material architecture to achieve a substantial reduction of bone resorption secondary to stress shielding. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1774-1783, 2017. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

Spatial variability in secondary metabolites of the indo-pacific sponge Stylissa massa.

PubMed

Rohde, Sven; Gochfeld, Deborah J; Ankisetty, Sridevi; Avula, Bharathi; Schupp, Peter J; Slattery, Marc

2012-05-01

Chemical diversity represents a measure of selective pressures acting on genotypic variability. In order to understand patterns of chemical ecology and biodiversity in the environment, it is necessary to enhance our knowledge of chemical diversity within and among species. Many sponges produce variable levels of secondary metabolites in response to diverse biotic and abiotic environmental factors. This study evaluated intra-specific variability in secondary metabolites in the common Indo-Pacific sponge Stylissa massa over various geographic scales, from local to ocean basin. Several major metabolites were quantified in extracts from sponges collected in American Samoa, Pohnpei, Saipan, and at several sites and depths in Guam. Concentrations of several of these metabolites varied geographically across the Pacific basin, with American Samoa and Pohnpei exhibiting the greatest differences, and Guam and Saipan more similar to each other. There were also significant differences in concentrations among different sites and depths within Guam. The crude extract of S. massa exhibited feeding deterrence against the omnivorous pufferfish Canthigaster solandri at natural concentrations, however, none of the isolated compounds was deterrent at the maximum natural concentrations observed, nor were mixtures of these compounds, thus emphasizing the need for bioassay-guided isolation to characterize specific chemical defenses. Antibacterial activity against a panel of ecologically relevant pathogens was minimal. Depth transplants, predator exclusion, and UV protection experiments were performed, but although temporal variability in compound concentrations was observed, there was no evidence that secondary metabolite concentration in S. massa was induced by any of these factors. Although the reasons behind the variability observed in the chemical constituents of S. massa are still in question, all sponges are not created equal from a chemical standpoint, and these studies provide further insights into patterns of chemical diversity within S. massa.

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

Friberg, Ari T.; Visser, Taco D.; Wolf, Emil

A reciprocity inequality is derived, involving the effective size of a planar, secondary, Gaussian Schell-model source and the effective angular spread of the beam that the source generates. The analysis is shown to imply that a fully spatially coherent source of that class (which generates the lowest-order Hermite-Gaussian laser mode) has certain minimal properties. (c) 2000 Optical Society of America.

Understanding by Design: Mentored Implementation of Backward Design Methodology at the University Level

ERIC Educational Resources Information Center

Michael, Nancy A.; Libarkin, Julie C.

2016-01-01

Unless sought out by the individual, University and College faculty typically receive minimal, if any, pedagogical training as part of their career development. This perspectives essay first introduces pedagogical training for instructors in higher education by comparing it to the training required for primary and secondary school educators. Using…

40 CFR 63.11148 - What are the standards and compliance requirements for existing sources using batch copper...

Code of Federal Regulations, 2013 CFR

2013-07-01

... acid plant prior to discharge to the atmosphere. (iv) For each secondary capture system that is used to... practicable, maintain and operate any affected source, including associated air pollution control equipment, in a manner consistent with good air pollution control practice for minimizing emissions...

40 CFR 63.11148 - What are the standards and compliance requirements for existing sources using batch copper...

Code of Federal Regulations, 2014 CFR

2014-07-01

... acid plant prior to discharge to the atmosphere. (iv) For each secondary capture system that is used to... practicable, maintain and operate any affected source, including associated air pollution control equipment, in a manner consistent with good air pollution control practice for minimizing emissions...

40 CFR 63.11148 - What are the standards and compliance requirements for existing sources using batch copper...

Code of Federal Regulations, 2011 CFR

2011-07-01

... acid plant prior to discharge to the atmosphere. (iv) For each secondary capture system that is used to... practicable, maintain and operate any affected source, including associated air pollution control equipment, in a manner consistent with good air pollution control practice for minimizing emissions...

40 CFR 63.11148 - What are the standards and compliance requirements for existing sources using batch copper...

Code of Federal Regulations, 2010 CFR

2010-07-01

... acid plant prior to discharge to the atmosphere. (iv) For each secondary capture system that is used to... practicable, maintain and operate any affected source, including associated air pollution control equipment, in a manner consistent with good air pollution control practice for minimizing emissions...

40 CFR 63.11148 - What are the standards and compliance requirements for existing sources using batch copper...

Code of Federal Regulations, 2012 CFR

2012-07-01

... acid plant prior to discharge to the atmosphere. (iv) For each secondary capture system that is used to... practicable, maintain and operate any affected source, including associated air pollution control equipment, in a manner consistent with good air pollution control practice for minimizing emissions...

78 FR 8705 - Approval and Promulgation of Air Quality Implementation Plans; States of Minnesota and Michigan...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-06

... pollutants can lead to secondary environmental problems, as well as increased energy consumption. The Band... companies had demonstrated that burner designs that lower flame temperature can reduce NO X formation in... temperature, which is the opposite strategy needed for minimizing PIC (i.e., increasing combustion temperature...

77 FR 555 - National Emissions Standards for Hazardous Air Pollutants From Secondary Lead Smelting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-05

..., stack, storage, or fugitive emissions point; and/or are design, equipment, work practice, or operational... procedures designed to minimize emissions of THC for each start-up and shutdown scenario anticipated for all... designed and maintained can sometimes fail and that such failure can sometimes cause an exceedance of the...

An Ecologist Is Born: An Integrated Experiential Learning Activity

ERIC Educational Resources Information Center

Behrendt, Marc; Behrendt, Barbara

2012-01-01

Language arts and mathematics are high priority content areas in early grades. Science is often a secondary concern, even though students appear to have minimal knowledge or interest in their local ecology. This article describes a year-long project integrating science and technology with language arts. Students researched and wrote about local…

Basics of Sterile Compounding: Manipulating Peptides and Proteins.

PubMed

Akers, Michael J

2017-01-01

Biopharmaceuticals contain primary and secondary structure, which offer few problems. It is the tertiary structure that causes problems, resulting in both physical and chemical stability issues. The thrust of this article is to share briefly what can be done to minimize these problems. Copyright© by International Journal of Pharmaceutical Compounding, Inc.

Human Odometry Verifies the Symmetry Perspective on Bipedal Gaits

ERIC Educational Resources Information Center

Turvey, M. T.; Harrison, Steven J.; Frank, Till D.; Carello, Claudia

2012-01-01

Bipedal gaits have been classified on the basis of the group symmetry of the minimal network of identical differential equations (alias "cells") required to model them. Primary gaits are characterized by dihedral symmetry, whereas secondary gaits are characterized by a lower, cyclic symmetry. This fact was used in a test of human…

Integrated least-cost lumber grade-mix solver

Treesearch

U. Buehlmann; R. Buck; R.E. Thomas

2011-01-01

Hardwood lumber costs account for up to 70 percent of the total product costs of U.S. secondary wood products producers. Reducing these costs is difficult and often requires substantial capital investments. However, lumber-purchasing costs can be minimized by buying the least-cost lumber grade-mix that satisfies a company's component needs. Price differentials...

Creating a Winning Game Plan. The Secondary Teacher's Playbook.

ERIC Educational Resources Information Center

Gose, Michael D.

This book offers strategies for high school teachers that provide tools for creating, repairing, and tweaking all the discernible components of teaching. The book is organized to move from context to teaching to discipline to thriving in teaching. The book includes tips on how to minimize discipline problems with effective curriculum and sound…

Drug-induced liver injury secondary to testosterone prohormone dietary supplement use.

PubMed

Hoedebecke, Kyle; Rerucha, Caitlyn; Maxwell, Kimberly; Butler, Jason

2013-01-01

Dietary supplementation has become progressively more prevalent, with over half of the American population reporting use of various products. An increased incidence of supplement use has been reported in the military especially within Special Operations Forces (SOF) where training regimens rival those of elite athletes. Federal regulations regarding dietary supplements are minimal, allowing for general advertisement to the public without emphasis on the potentially harmful side effects. Subsequent medical care for these negative effects causes financial burden on the military in addition to the unit?s loss of an Operator and potential mission compromise. This report reviews a case of an Operator diagnosed with drug-induced liver injury secondary to a testosterone prohormone supplement called Post Cycle II. Clinical situations like this emphasize the necessity that SOF Operators and clinicians be aware of the risks and benefits of these minimally studied substances. Providers should also be aware of the Human Performance Resource Center for Health Information and Natural Medicines Comprehensive Database supplement safety ratings as well as the Food and Drug Administration?s MedWatch and Natural Medicines WATCH, to which adverse reactions should be reported. 2013.

[Therapy concepts for diffuse peritonitis: When laparoscopic lavage and when open abdomen?].

PubMed

Güsgen, C; Schwab, R; Willms, A

2016-01-01

Secondary diffuse peritonitis still has a high morbidity and mortality even now; therefore, the various strategies and options for the different surgical therapies are undergoing an evidence-based review. Laparoscopic lavage without resection of the focus of sepsis for example is a profoundly different approach in the treatment of diffuse peritonitis from the damage control-based strategy of surgery with initial laparostomy and deferred anastomosis. The evidential data for minimally invasive therapy are comparatively well-reviewed for appendicitis, cholecystitis and ulcerated perforation of the stomach and duodenum. In contrast, the evidence for laparoscopy and minimally invasive surgery with lavage and deferred anastomosis or damage control in secondary peritonitis has improved but is still low and cannot yet be clearly recommended. This article presents an overview of the currently available therapeutic methods for diffuse peritonitis and a critical consideration of the evidence-based data. The key recommendation is that the decision to use a surgical procedure based on the currently available data depends more on the severity of the abdominal sepsis, the duration, the age of the patient and comorbidities than on the individual technique.

Polarized atomic orbitals for self-consistent field electronic structure calculations

NASA Astrophysics Data System (ADS)

Lee, Michael S.; Head-Gordon, Martin

1997-12-01

We present a new self-consistent field approach which, given a large "secondary" basis set of atomic orbitals, variationally optimizes molecular orbitals in terms of a small "primary" basis set of distorted atomic orbitals, which are simultaneously optimized. If the primary basis is taken as a minimal basis, the resulting functions are termed polarized atomic orbitals (PAO's) because they are valence (or core) atomic orbitals which have distorted or polarized in an optimal way for their molecular environment. The PAO's derive their flexibility from the fact that they are formed from atom-centered linear-combinations of the larger set of secondary atomic orbitals. The variational conditions satisfied by PAO's are defined, and an iterative method for performing a PAO-SCF calculation is introduced. We compare the PAO-SCF approach against full SCF calculations for the energies, dipoles, and molecular geometries of various molecules. The PAO's are potentially useful for studying large systems that are currently intractable with larger than minimal basis sets, as well as offering potential interpretative benefits relative to calculations in extended basis sets.

Spectrum Access In Cognitive Radio Using a Two-Stage Reinforcement Learning Approach

NASA Astrophysics Data System (ADS)

Raj, Vishnu; Dias, Irene; Tholeti, Thulasi; Kalyani, Sheetal

2018-02-01

With the advent of the 5th generation of wireless standards and an increasing demand for higher throughput, methods to improve the spectral efficiency of wireless systems have become very important. In the context of cognitive radio, a substantial increase in throughput is possible if the secondary user can make smart decisions regarding which channel to sense and when or how often to sense. Here, we propose an algorithm to not only select a channel for data transmission but also to predict how long the channel will remain unoccupied so that the time spent on channel sensing can be minimized. Our algorithm learns in two stages - a reinforcement learning approach for channel selection and a Bayesian approach to determine the optimal duration for which sensing can be skipped. Comparisons with other learning methods are provided through extensive simulations. We show that the number of sensing is minimized with negligible increase in primary interference; this implies that lesser energy is spent by the secondary user in sensing and also higher throughput is achieved by saving on sensing.

Aluminum/hydrocarbon gel propellants: An experimental and theoretical investigation of secondary atomization and predicted rocket engine performance

NASA Astrophysics Data System (ADS)

Mueller, Donn Christopher

1997-12-01

Experimental and theoretical investigations of aluminum/hydrocarbon gel propellant secondary atomization and its potential effects on rocket engine performance were conducted. In the experimental efforts, a dilute, polydisperse, gel droplet spray was injected into the postflame region of a burner and droplet size distributions was measured as a function of position above the burner using a laser-based sizing/velocimetry technique. The sizing/velocimetry technique was developed to measure droplets in the 10-125 mum size range and avoids size-biased detection through the use of a uniformly illuminated probe volume. The technique was used to determine particle size distributions and velocities at various axial locations above the burner for JP-10, and 50 and 60 wt% aluminum gels. Droplet shell formation models were applied to aluminum/hydrocarbon gels to examine particle size and mass loading effects on the minimum droplet diameter that will permit secondary atomization. This diameter was predicted to be 38.1 and 34.7 mum for the 50 and 60 wt% gels, which is somewhat greater than the experimentally measured 30 and 25 mum diameters. In the theoretical efforts, three models were developed and an existing rocket code was exercised to gain insights into secondary atomization. The first model was designed to predict gel droplet properties and shell stresses after rigid shell formation, while the second, a one-dimensional gel spray combustion model was created to quantify the secondary atomization process. Experimental and numerical comparisons verify that secondary atomization occurs in 10-125 mum diameter particles although an exact model could not be derived. The third model, a one-dimensional gel-fueled rocket combustion chamber, was developed to evaluate secondary atomization effects on various engine performance parameters. Results show that only modest secondary atomization may be required to reduce propellant burnout distance and radiation losses. A solid propellant engine code was employed to estimate nozzle two-phase flow losses and engine performance for upper-stage and booster missions (3-6% and 2-3%, respectively). Given these losses and other difficulties, metallized gel propellants may be impractical in high-expansion ratio engines. Although uncertainties remain, it appears that performance gains will be minimal in gross-weight limited missions, but that significant gains may arise in volume-limited missions.

Recovery of metal values from copper slag and reuse of residual secondary slag.

PubMed

Sarfo, Prince; Das, Avimanyu; Wyss, Gary; Young, Courtney

2017-12-01

Resource and environmental factors have become major forces in mining and metallurgy sectors driving research for sustainability purposes. The concept of zero-waste processing has been gaining ground readily. The scant availability of high quality raw materials has forced the researchers to shift their focus to recycling while the exceedingly stringent environmental regulations have forced researchers to explore new frontiers of minimizing/eliminating waste generation. The present work is aimed at addressing both aspects by employing recycling to generate wealth from copper slag and producing utilizable materials at the same time thus restoring the ecosystem. Copper slag was characterized and processed. The pyro-metallurgical processing prospects to generate utilizable materials were arrived at through rigorous thermodynamic analysis. Carbothermal reduction at elevated temperature (near 1440°C) helped recover a majority of the metal values (e.g., Fe, Cu and Mo) into the iron-rich alloy product which can be a feed material for steel making. On the other hand, the non-metallic residue, the secondary slag, can be used in the glass and ceramic industries. Reduction time and temperature and carbon content were shown to be the most important process variables for the reaction which were optimized to identify the most favored operating regime that maximizes the metal recovery and simultaneously maximizes the hardness of the secondary slag and minimizes its density, the two major criteria for the secondary slag product to be utilizable. The flux addition level was shown to have relatively less impact on the process performance if these are maintained at an adequate level. The work established that the copper slag, a waste material, can be successfully processed to generate reusable products through pyrometallurgical processing. Copyright © 2017 Elsevier Ltd. All rights reserved.

Comparative Effectiveness and Economic Evaluations of Open Versus Minimally Invasive Posterior or Transforaminal Lumbar Interbody Fusion: A Systematic Review.

PubMed

Goldstein, Christina L; Phillips, Frank M; Rampersaud, Y Raja

2016-04-01

Systematic review of randomized and nonrandomized comparative studies. To summarize the literature examining comparative effectiveness and economic evaluation of minimally invasive versus open transforaminal/posterior lumbar interbody fusion (T/PLIF). Minimally invasive approaches to lumbar fusion have been proposed as an alternative to open surgery to decrease patient morbidity and improve clinical and patient-reported outcomes, with the possibility of secondary cost-savings. The comparative clinical and economic effectiveness of minimally invasive versus open T/PLIF remains largely undetermined. A systematic review of Medline, EMBASE, Web of Science, and Cochrane from database inception to September 2015 inclusive was performed. Reference lists were manually searched. Studies comparing MIS to open T/PLIF for degenerative lumbar conditions, including at least 10 patients in each arm and reporting at least one clinical, perioperative, radiographic, adverse event, or economic outcome, were included. Between database inception and October 2015, 45 studies meeting inclusion criteria were identified with 3472 subjects undergoing MIS fusion and 5925 having an open procedure. There were no significant differences in operative time between the two groups, whereas patients undergoing MIS fusion consistently demonstrated less blood loss (16.1-88.7%) and shorter hospital stays (15.0-64.0% shorter). There was no difference in variably reported VAS, ODI, SF-36, SF-12, or EQ-5D scores between the two techniques at intermediate to long-term follow-up (12-60 months). Complication rates and fusion rates were also equivalent between the two groups. Economic studies demonstrate cost-savings in favor of MIS fusion ranging from 2.5 to 49.3%. Limited quality comparative observational cohort and randomized controlled studies of MIS versus open T/PLIF consistently demonstrate improved perioperative outcomes including operative time, estimated blood loss, and length of stay with no significant difference in patient-reported outcomes or complication rates between the two groups at final follow-up. Increasing economic data suggest both direct and indirect cost-savings in favor of MIS fusion. N/A.

Plasma Inter-Particle and Particle-Wall Interactions

NASA Astrophysics Data System (ADS)

Patino, Marlene Idy

An improved understanding of plasma inter-particle and particle-wall interactions is critical to the advancement of plasma devices used for space electric propulsion, fusion, high-power communications, and next-generation energy systems. Two interactions of particular importance are (1) ion-atom collisions in the plasma bulk and (2) secondary electron emission from plasma-facing materials. For ion-atom collisions, interactions between fast ions and slow atoms are commonly dominated by charge-exchange and momentum-exchange collisions that are important to understanding the performance and behavior of many plasma devices. To investigate this behavior, this work developed a simple, well-characterized experiment that accurately measures the effects of high energy xenon ions incident on a background of xenon neutral atoms. By comparing these results to both analytical and computational models of ion-atom interactions, we discovered the importance of (1) accurately treating the differential cross-sections for momentum-exchange and charge-exchange collisions over all neutral background pressures, and (2) commonly overlooked interactions, including ion-induced electron emission and neutral-neutral ionization collisions, at high pressures. Data provide vital information on the angular scattering distributions of charge-exchange and momentum-exchange ions at 1.5 keV relevant for ion thrusters, and serve as canonical data for validation of plasma models. This work also investigates electron-induced secondary electron emission behavior relevant to materials commonly considered for plasma thrusters, fusion systems, and many other plasma devices. For such applications, secondary electron emission can alter the sheath potential, which can significantly affect device performance and life. Secondary electron emission properties were measured for materials that are critical to the efficient operation of many plasma devices, including: graphite (for tokamaks, ion thrusters, and traveling wave tubes), lithium (for tokamak walls), tungsten (the most promising material for future tokamaks such as ITER), and nickel (for plasma-enhanced chemistry). Measurements were made for incident electron energies up to 1.5 keV and angles between 0 and 78°. The most significant results from these measurements are as follows: (1) first-ever measurements of naturally-forming tungsten fuzz show a more than 40% reduction in secondary electron emission and an independence on incidence angle; (2) original measurements of lithium oxide show a 2x and 6x increase in secondary electron emission for 17% and 100% oxidation; and (3) unique measurements of Ni(110) single crystal show extrema in secondary electron emission when incidence angle is varied and an up to 36% increase at 0° over polycrystalline nickel. Each of these results are important discoveries for improving plasma devices. For example, from (1), the growth of tungsten fuzz in tokamaks is desirable for minimizing adverse secondary electron emission effects. From (2), the opposite is true for tokamaks with lithium coatings which are oxidized by typical residual gases. From (3), secondary electron emission from Ni(110) catalysts in plasma-enhanced chemistry may facilitate further reactions.

Inequalities in the use of secondary prevention of cardiovascular disease by socioeconomic status: evidence from the PURE observational study.

PubMed

Murphy, Adrianna; Palafox, Benjamin; O'Donnell, Owen; Stuckler, David; Perel, Pablo; AlHabib, Khalid F; Avezum, Alvaro; Bai, Xiulin; Chifamba, Jephat; Chow, Clara K; Corsi, Daniel J; Dagenais, Gilles R; Dans, Antonio L; Diaz, Rafael; Erbakan, Ayse N; Ismail, Noorhassim; Iqbal, Romaina; Kelishadi, Roya; Khatib, Rasha; Lanas, Fernando; Lear, Scott A; Li, Wei; Liu, Jia; Lopez-Jaramillo, Patricio; Mohan, Viswanathan; Monsef, Nahed; Mony, Prem K; Puoane, Thandi; Rangarajan, Sumathy; Rosengren, Annika; Schutte, Aletta E; Sintaha, Mariz; Teo, Koon K; Wielgosz, Andreas; Yeates, Karen; Yin, Lu; Yusoff, Khalid; Zatońska, Katarzyna; Yusuf, Salim; McKee, Martin

2018-03-01

There is little evidence on the use of secondary prevention medicines for cardiovascular disease by socioeconomic groups in countries at different levels of economic development. We assessed use of antiplatelet, cholesterol, and blood-pressure-lowering drugs in 8492 individuals with self-reported cardiovascular disease from 21 countries enrolled in the Prospective Urban Rural Epidemiology (PURE) study. Defining one or more drugs as a minimal level of secondary prevention, wealth-related inequality was measured using the Wagstaff concentration index, scaled from -1 (pro-poor) to 1 (pro-rich), standardised by age and sex. Correlations between inequalities and national health-related indicators were estimated. The proportion of patients with cardiovascular disease on three medications ranged from 0% in South Africa (95% CI 0-1·7), Tanzania (0-3·6), and Zimbabwe (0-5·1), to 49·3% in Canada (44·4-54·3). Proportions receiving at least one drug varied from 2·0% (95% CI 0·5-6·9) in Tanzania to 91·4% (86·6-94·6) in Sweden. There was significant (p<0·05) pro-rich inequality in Saudi Arabia, China, Colombia, India, Pakistan, and Zimbabwe. Pro-poor distributions were observed in Sweden, Brazil, Chile, Poland, and the occupied Palestinian territory. The strongest predictors of inequality were public expenditure on health and overall use of secondary prevention medicines. Use of medication for secondary prevention of cardiovascular disease is alarmingly low. In many countries with the lowest use, pro-rich inequality is greatest. Policies associated with an equal or pro-poor distribution include free medications and community health programmes to support adherence to medications. Full funding sources listed at the end of the paper (see Acknowledgments). Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0. license. Published by Elsevier Ltd.. All rights reserved.

Ab initio study of chain branching reactions involving second generation products in hydrocarbon combustion mechanisms.

PubMed

Davis, Alexander C; Francisco, Joseph S

2012-01-28

sec-Alkyl radicals are key reactive intermediates in the hydrocarbon combustion and atmospheric decomposition mechanisms that are formed by the abstraction of hydrogen from an alkane, or as a second generation product of n-alkyl H-migrations, C-C bond scissions in branched alkyl radicals, or the bimolecular reaction between olefins and n-alkyl radicals. Since alkanes and branched alkanes, which the sec-alkyl radicals are derived from, make up roughly 40-50% of traditional fuels an understanding of their chemistry is essential to improving combustion systems. The present work investigates all H-migration reactions initiated from an sec-alkyl radical that involve the movement of a secondary hydrogen, for the 2-butyl through 4-octyl radicals, using the CBS-Q, G2, and G4 composite methods. The resulting thermodynamic and kinetic parameters are compared to similar reactions in n-alkyl radicals in order to determine underlying trends. Particular attention is paid to the effect of cis/trans and 1,3-diaxial interactions on activation energies and rate coefficients. When combined with our previous work on n-alkyl radical H-migrations, a complete picture of H-migrations in unbranched alkyl radicals is obtained. This full data set suggests that the directionality of the remaining branched chains has a minimal effect on the rate coefficients for all but the largest viable transition states, which is in stark contrast to the differences predicted by the structurally similar dimethylcycloalkanes. In fact the initial location of the secondary radical site has a greater effect on the rate than does the directionality of the remaining alkyl chains. The activation energies for secondary to secondary reactions are much closer to those of the secondary to primary H-migrations. However, the rate coefficients are found to be closer to the corresponding primary to primary reaction values. A significant ramification of these results is that there will be multiple viable reaction pathways for these reactions instead of only one dominant pathway as previously believed.

Effects of an ozone-generating air purifier on indoor secondary particles in three residential dwellings.

PubMed

Hubbard, H F; Coleman, B K; Sarwar, G; Corsi, R L

2005-12-01

The use of indoor ozone generators as air purifiers has steadily increased over the past decade. Many ozone generators are marketed to consumers for their ability to eliminate odors and microbial agents and to improve health. In addition to the harmful effects of ozone, recent studies have shown that heterogeneous and homogeneous reactions between ozone and some unsaturated hydrocarbons can be an important source of indoor secondary pollutants, including free radicals, carbonyls, carboxylic acids, and fine particles. Experiments were conducted in one apartment and two detached single-family dwellings in Austin, TX, to assess the effects of an ozone generator on indoor secondary organic aerosol concentrations in actual residential settings. Ozone was generated using a commercial ozone generator marketed as an air purifier, and particle measurements were recorded before, during, and after the release of terpenes from a pine oil-based cleaning product. Particle number concentration, ozone concentration, and air exchange rate were measured during each experiment. Particle number and mass concentrations increased when both terpenes and ozone were present at elevated levels. Experimental results indicate that ozone generators in the presence of terpene sources facilitate the growth of indoor fine particles in residential indoor atmospheres. Human exposure to secondary organic particles can be reduced by minimizing the intentional release of ozone, particularly in the presence of terpene sources. Past studies have shown that ozone-initiated indoor chemistry can lead to elevated concentrations of fine particulate matter, but have generally been completed in controlled laboratory environments and office buildings. We explored the effects of an explicit ozone generator marketed as an air purifier on the formation of secondary organic aerosol mass in actual residential indoor settings. Results indicate significant increases in number and mass concentrations for particles <0.7 microns in diameter, particularly when an ozone generator is used in the presence of a terpene source such as a pine oil-based cleaner. These results add evidence to the potentially harmful effects of ozone generation in residential environments.

Muon and Gamma Bundles tracing Up-going Tau Neutrino Astronomy

NASA Astrophysics Data System (ADS)

Fargion, D.; de Santis, M.; de Sanctis Lucentini, P. G.; Grossi, M.

2004-11-01

Up-going and Horizontal Tau Air-Showers, UpTaus and HorTaus, may trace Ultra High Energy Neutrino Tau Earth Skimming at the edge of the horizons. Their secondaries (μ± and γ bundles with e± pair flashes) might trace their nature over UHECR secondaries in horizontal showers. Indeed the atmosphere act as a perfect amplifier as well as a filter for showers: down-ward and horizontal μ bundles may still be originated by far Ultra High Energy Cosmic Rays skimming the terrestrial atmosphere but their rich gamma component will be exponentially suppressed. At large zenith angles after crossing a large slant depth (Xmax > 3 × 103 g cm-2) the number of μ± and secondary γ's (produced by the e± pair from μ decay in flight) is comparable. On the other hand, up-ward muon bundles from UpTaus and HorTaus may arise within a young shower with a larger gamma-muon ratio (˜ 102), leaving its characteristic imprint. We estimate the UpTaus and HorTaus rate from the Earth and we evaluate the consequent event rate of μ±, e± and γ bundles. We show that such events even for minimal GZK neutrino fluxes could be detected by scintillator arrays placed on mountains at 1 -5 km and pointing to the horizon. The required array areas are within tens-hundreds of square meters. An optimal structure is an array of crown-like twin detectors facing the horizons. We argue that such detectors will be able to detect both muonic bundles at a minimal average flux of 10-11 cm-2 s-1 sr-1 and electromagnetic particles (γ, e±) at 3 × 10-9 cm-2 s-1 sr-1, a few times each year, even for the minimal GZK ν flux.

LATTICES FOR HIGH-POWER PROTON BEAM ACCELERATION AND SECONDARY BEAM COLLECTION AND COOLING.

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

WANG, S.; WEI, J.; BROWN, K.

2006-06-23

Rapid cycling synchrotrons are used to accelerate high-intensity proton beams to energies of tens of GeV for secondary beam production. After primary beam collision with a target, the secondary beam can be collected, cooled, accelerated or decelerated by ancillary synchrotrons for various applications. In this paper, we first present a lattice for the main synchrotron. This lattice has: (a) flexible momentum compaction to avoid transition and to facilitate RF gymnastics (b) long straight sections for low-loss injection, extraction, and high-efficiency collimation (c) dispersion-free straights to avoid longitudinal-transverse coupling, and (d) momentum cleaning at locations of large dispersion with missing dipoles.more » Then, we present a lattice for a cooler ring for the secondary beam. The momentum compaction across half of this ring is near zero, while for the other half it is normal. Thus, bad mixing is minimized while good mixing is maintained for stochastic beam cooling.« less

Feedlot Euthanasia and Necropsy.

PubMed

Griffin, Dee

2015-11-01

Timely euthanasia of feeder cattle can minimize suffering of cattle that have little hope of recovery or pain abatement. Euthanasia techniques are described, including primary and secondary steps to ensure humane death. Considerations are discussed to ensure rendered product from euthanized cattle will be safe. A necropsy technique that is time efficient and thorough is outlined. An important aspect is minimizing the number of detached body organs, thereby making it easier to remove the necropsied animal. A necropsy data collection system is discussed that uses check-boxes to record findings. A link to a database that can be downloaded is included. Copyright © 2015 Elsevier Inc. All rights reserved.

Malignant arrhythmia as the first manifestation of Wolff-Parkinson-White syndrome: a case with minimal preexcitation on electrocardiography.

PubMed

Gungor, B; Alper, A T

2013-09-01

Wolff-Parkinson-White (WPW) syndrome is defined as the presence of an accessory atrioventricular pathway which is manifested as delta waves and short PR interval on electrocardiography (ECG). However, some WPW cases do not have typical findings on ECG and may remain undiagnosed unless palpitations occur. Sudden cardiac death may be the first manifestation of WPW and develops mostly secondary to degeneration of atrial fibrillation into ventricular fibrillation. In this report, we present a case of undiagnosed WPW with minimal preexcitation on ECG and who suffered an episode of malignant arrhythmia as the first manifestation of the disease.

Neither pre-operative education or a minimally invasive procedure have any influence on the recovery time after total hip replacement.

PubMed

Biau, David Jean; Porcher, Raphael; Roren, Alexandra; Babinet, Antoine; Rosencher, Nadia; Chevret, Sylvie; Poiraudeau, Serge; Anract, Philippe

2015-08-01

The purpose of this study was to evaluate pre-operative education versus no education and mini-invasive surgery versus standard surgery to reach complete independence. We conducted a four-arm randomized controlled trial of 209 patients. The primary outcome criterion was the time to reach complete functional independence. Secondary outcomes included the operative time, the estimated total blood loss, the pain level, the dose of morphine, and the time to discharge. There was no significant effect of either education (HR: 1.1; P = 0.77) or mini-invasive surgery (HR: 1.0; 95 %; P = 0.96) on the time to reach complete independence. The mini-invasive surgery group significantly reduced the total estimated blood loss (P = 0.0035) and decreased the dose of morphine necessary for titration in the recovery (P = 0.035). Neither pre-operative education nor mini-invasive surgery reduces the time to reach complete functional independence. Mini-invasive surgery significantly reduces blood loss and the need for morphine consumption.

Pediatric Digital Necrosis Secondary to Dressing Application: A Case Series.

PubMed

Bjorklund, Kim A; Rice, Dahlia M; Amalfi, Ashley N

2018-04-01

Pediatric digital necrosis resulting in revision amputation is a devastating outcome following digital dressing application. We report a series of 4 pediatric patients (age: 21 months-11 years) who presented for surgical consultation related to digital ischemia and irreversible necrosis following the application of Coban digital dressings. A review of the literature demonstrated that such injuries had not previously been described. In our case series, Coban dressing was utilized as a deterrent for thumb sucking, fingertip tuft fractures with nail bed lacerations, and a phalanx fracture secondary to crush injury. All 4 children suffered digital necrosis secondary to Coban dressings and ultimately required revision amputation. We discuss risks factors, application practices, and strategies to minimize complications with digital dressings in the pediatric population with the intent of creating awareness among hand surgeons to help promote safe practices and improve patient outcomes.

Combined radioguided parathyroidectomy and intravenous vitamin D therapy for the treatment of uraemic hyperparathyroidism.

PubMed

Oyama, Yuko; Kazama, J James; Maruyama, Hiroki; Narita, Ichiei; Kanbayashi, Chizuko; Koyama, Yu; Omori, Tsukasa; Hatakeyama, Katsuyoshi; Gejyo, Fumitake

2003-06-01

Therapy combining radioguided parathyroidectomy (PTx) followed by intravenous maxacalcitol was given to a 50-year-old Japanese man referred for treatment of uraemic secondary hyperparathyroidism. After laboratory and radiological examinations, the patient underwent uncomplicated, successful surgery, but glands that had not been detected radiologically before the procedure became apparent with a scintillation counter immediately after the removal of the swollen gland. To prevent relapse of secondary hyperparathyroidism in the remaining glands, 10 microg of maxacalcitol was injected intravenously after each dialysis session. Following a minimally invasive radioisotope-guided PTx, the potential risk of relapse in the remaining glands has to be considered and intensive medical therapy should be instituted immediately after the operation. Further study needs to elucidate whether this treatment strategy can improve the long-term prognosis of patients with secondary hyperparathyroidism

Minimal spanning tree algorithm for γ-ray source detection in sparse photon images: cluster parameters and selection strategies

DOE PAGES

Campana, R.; Bernieri, E.; Massaro, E.; ...

2013-05-22

We present that the minimal spanning tree (MST) algorithm is a graph-theoretical cluster-finding method. We previously applied it to γ-ray bidimensional images, showing that it is quite sensitive in finding faint sources. Possible sources are associated with the regions where the photon arrival directions clusterize. MST selects clusters starting from a particular “tree” connecting all the point of the image and performing a cut based on the angular distance between photons, with a number of events higher than a given threshold. In this paper, we show how a further filtering, based on some parameters linked to the cluster properties, canmore » be applied to reduce spurious detections. We find that the most efficient parameter for this secondary selection is the magnitudeM of a cluster, defined as the product of its number of events by its clustering degree. We test the sensitivity of the method by means of simulated and real Fermi-Large Area Telescope (LAT) fields. Our results show that √M is strongly correlated with other statistical significance parameters, derived from a wavelet based algorithm and maximum likelihood (ML) analysis, and that it can be used as a good estimator of statistical significance of MST detections. Finally, we apply the method to a 2-year LAT image at energies higher than 3 GeV, and we show the presence of new clusters, likely associated with BL Lac objects.« less

Introduction of laparoscopic sacral colpopexy to a fellowship training program.

PubMed

Kantartzis, Kelly; Sutkin, Gary; Winger, Dan; Wang, Li; Shepherd, Jonathan

2013-11-01

Minimally invasive sacral colpopexy has increased over the past decade, with many senior physicians adopting this new skill set. However, skill acquisition at an academic institution in the presence of postgraduate learners is not well described. This manuscript outlines the introduction of laparoscopic sacral colpopexy to an academic urogynecology service that was not performing minimally invasive sacral colpopexies, and it also defines a surgical learning curve. The first 180 laparoscopic sacral colpopexies done by four attending urogynecologists from January 2009 to December 2011 were retrospectively analyzed. The primary outcome was operative time. Secondary outcomes included conversion to laparotomy, estimated blood loss, and intra- and postoperative complications. Linear regression was used to analyze trends in operative times. Fisher's exact test compared surgical complications and counts of categorical variables. Mean total operative time was 250 ± 52 min (range 146-452) with hysterectomy and 222 ± 45 (range 146-353) for sacral colpopexy alone. When compared with the first ten cases performed by each surgeon, operative times in subsequent groups decreased significantly, with a 6-16.3% reduction in overall times. There was no significant difference in the rate of overall complications regardless of the number of prior procedures performed (p = 0.262). Introduction of laparoscopic sacral colpopexy in a training program is safe and efficient. Reduction in operative time is similar to published learning curves in teaching and nonteaching settings. Introducing this technique does not add additional surgical risk as these skills are acquired.

The use of adhesion barrier film as an alternative to omental wrap in open ureterolysis.

PubMed

Hartman, Robert J; Helfand, Brian T; Lin, William W

2013-12-01

Retroperitoneal fibrosis (RPF) is a rarely occurring disease process characterized by the development of fibrous plaques that encase retroperitoneal organs and major vessels. The most common sequelae is obstructive uropathy secondary to ureteral compression. Ureterolysis with intraperitoneal transposition and omental wrapping has historically been a popularized means to relieve ureteral obstruction. We present the case of a 47-year-old man with bilateral hydronephrosis secondary to RPF. Due to insufficient length of omentum, we report the first documented use of SurgiWrap to wrap the ureters to minimize the future possibility of recurrent/continued fibrosis, compression, and ureteral obstruction.

A Prospective Randomized Study on Operative Treatment for Simple Distal Tibial Fractures-Minimally Invasive Plate Osteosynthesis Versus Minimal Open Reduction and Internal Fixation.

PubMed

Kim, Ji Wan; Kim, Hyun Uk; Oh, Chang-Wug; Kim, Joon-Woo; Park, Ki Chul

2018-01-01

To compare the radiologic and clinical results of minimally invasive plate osteosynthesis (MIPO) and minimal open reduction and internal fixation (ORIF) for simple distal tibial fractures. Randomized prospective study. Three level 1 trauma centers. Fifty-eight patients with simple and distal tibial fractures were randomized into a MIPO group (treatment with MIPO; n = 29) or a minimal group (treatment with minimal ORIF; n = 29). These numbers were designed to define the rate of soft tissue complication; therefore, validation of superiority in union time or determination of differences in rates of delayed union was limited in this study. Simple distal tibial fractures treated with MIPO or minimal ORIF. The clinical outcome measurements included operative time, radiation exposure time, and soft tissue complications. To evaluate a patient's function, the American Orthopedic Foot and Ankle Society ankle score (AOFAS) was used. Radiologic measurements included fracture alignment, delayed union, and union time. All patients acquired bone union without any secondary intervention. The mean union time was 17.4 weeks and 16.3 weeks in the MIPO and minimal groups, respectively. There was 1 case of delayed union and 1 case of superficial infection in each group. The radiation exposure time was shorter in the minimal group than in the MIPO group. Coronal angulation showed a difference between both groups. The American Orthopedic Foot and Ankle Society ankle scores were 86.0 and 86.7 in the MIPO and minimal groups, respectively. Minimal ORIF resulted in similar outcomes, with no increased rate of soft tissue problems compared to MIPO. Both MIPO and minimal ORIF have high union rates and good functional outcomes for simple distal tibial fractures. Minimal ORIF did not result in increased rates of infection and wound dehiscence. Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.

Low-rank matrix decomposition and spatio-temporal sparse recovery for STAP radar

DOE PAGES

Sen, Satyabrata

2015-08-04

We develop space-time adaptive processing (STAP) methods by leveraging the advantages of sparse signal processing techniques in order to detect a slowly-moving target. We observe that the inherent sparse characteristics of a STAP problem can be formulated as the low-rankness of clutter covariance matrix when compared to the total adaptive degrees-of-freedom, and also as the sparse interference spectrum on the spatio-temporal domain. By exploiting these sparse properties, we propose two approaches for estimating the interference covariance matrix. In the first approach, we consider a constrained matrix rank minimization problem (RMP) to decompose the sample covariance matrix into a low-rank positivemore » semidefinite and a diagonal matrix. The solution of RMP is obtained by applying the trace minimization technique and the singular value decomposition with matrix shrinkage operator. Our second approach deals with the atomic norm minimization problem to recover the clutter response-vector that has a sparse support on the spatio-temporal plane. We use convex relaxation based standard sparse-recovery techniques to find the solutions. With extensive numerical examples, we demonstrate the performances of proposed STAP approaches with respect to both the ideal and practical scenarios, involving Doppler-ambiguous clutter ridges, spatial and temporal decorrelation effects. As a result, the low-rank matrix decomposition based solution requires secondary measurements as many as twice the clutter rank to attain a near-ideal STAP performance; whereas the spatio-temporal sparsity based approach needs a considerably small number of secondary data.« less

Potato Barrels, Animal Traps, Birth Control and Unicorns: Re-Visioning Teaching and Learning in English Classes.

ERIC Educational Resources Information Center

Allen, Janet S.

1997-01-01

A teacher describes her initiation into secondary school English literature instruction, adoption of the whole-language approach before it had a name, and development of a curriculum with limited resources and minimal guidance. The author finds many classrooms still struggling with conventional instruction, and argues that the whole-language…

Linking Measures of Quality and Success at Community Colleges to Individual Goals and Customer Needs. NAVE Design Papers.

ERIC Educational Resources Information Center

Rosenfeld, Stuart A.

Two-year institutions of higher education have, in many ways, been anomalies in America's educational enterprise. Vocational education studies and assessments completed in 1981, 1989, and 1994 have all treated postsecondary vocational education primarily as more advanced versions of secondary programs and minimized the differences. Compared to…

School Leadership Challenges along Kenya's Borabu-Sotik Border

ERIC Educational Resources Information Center

Abaya, Joel

2016-01-01

This article is based on a qualitative multi-case study carried out in southwestern Kenya along the border areas of Nyanza and Rift Valley province. The purpose of the research was to examine the challenges public secondary school principals faced in their leadership roles and suggest efforts they might adopt to minimize the effects of these…

Can Email Prompting Minimize the Decrease in Wintertime Physical Activity Levels?

ERIC Educational Resources Information Center

Liguori, Gary; Mozumdar, Arupendra

2007-01-01

The primary purpose of this study is to evaluate the effectiveness of using email prompts to attenuate the decrease of physical activity in adults during a winter season. In addition, the secondary purposes were (1) to evaluate the effectiveness of email prompts at increasing motivation towards physical activity and (2) to evaluate the awareness…

Classroom Management and Loss of Time at the Lesson Start: A Preliminary Study

ERIC Educational Resources Information Center

Saloviita, Timo

2013-01-01

Lesson starts are transitional events which may cause management problems for teachers. In this study 131 lesson starts of equally many teachers were observed in primary and secondary schools in Finland. The results indicated that, in general, the problems were minimal. However, for various reasons lesson starts were delayed by an average of about…

Influence of Culture on Secondary School Students' Understanding of Statistics: A Fijian Perspective

ERIC Educational Resources Information Center

Sharma, Sashi

2014-01-01

Although we use statistical notions daily in making decisions, research in statistics education has focused mostly on formal statistics. Further, everyday culture may influence informal ideas of statistics. Yet, there appears to be minimal literature that deals with the educational implications of the role of culture. This paper will discuss the…

The Role of Green Chemistry Activities in Fostering Secondary School Students' Understanding of Acid-Base Concepts and Argumentation Skills

ERIC Educational Resources Information Center

Karpudewan, Mageswary; Roth, Wolff Michael; Sinniah, Devananthini

2016-01-01

In a world where environmental degradation is taking on alarming levels, understanding, and acting to minimize, the individual environmental impact is an important goal for many science educators. In this study, a green chemistry curriculum--combining chemistry experiments with everyday, environmentally friendly substances with a student-centered…

Walkway Length Determination for Steady State Walking in Young and Older Adults

ERIC Educational Resources Information Center

Macfarlane, Pamela A.; Looney, Marilyn A.

2008-01-01

The primary purpose of this study was to determine acceleration (AC) and deceleration (DC) distances that would accommodate young and older adults walking at their preferred and fast speeds. A secondary purpose was to determine the minimal walkway length needed to record six steady state (SS) steps (three full gait cycles) for younger and older…

Minimally invasive palliative resection of lumbar epidural metastasis.

PubMed

Yew, Andrew; Kimball, Jon; Pezeshkian, Patrick; Lu, Daniel C

2013-07-01

Spinal metastatic lesions are the most common tumors encountered by spinal surgeons. As with procedures for degenerative disease, minimally invsive surgery techniques have been applied to minimize muscle and soft tissue destruction in procedures for tumor resection. Here, we present a 23-year-old female with radiculopathy and foot drop secondary to nerve root compression by epidural metastases from Ewing's sarcoma. This patient had a history of previous resection and instrumentation as well as multiple rounds of chemotherapy and radiation that failed to control her disease. The patient presented with three weeks of radicular pain and foot drop that was continuing to worsen at the time of her operation. The decision was therefore made to perform a palliative resection and decompression for relief of her progressive symptoms. In this video, we demonstrate a palliative tumor debulking and nerve root decompression utilizing an MIS approach. The video can be found here: http://youtu.be/tq4kbvKTebI.

Oral misoprostol versus oxytocin in the management of the third stage of labour.

PubMed

Parsons, Steven M; Walley, Robert L; Crane, Joan M G; Matthews, Kay; Hutchens, Donna

2006-01-01

To compare the effects of oral misoprostol 800 mug with intramuscular oxytocin 10 IU in routine management of the third stage of labour. This randomized controlled trial was performed in a rural district hospital in Ghana, West Africa, and enrolled women in labour with anticipated vaginal delivery and no known medical contraindication to prostaglandin administration. Women were randomized to receive oral misoprostol 800 mug or intramuscular oxytocin 10 IU. Blood samples were taken to determine hemoglobin concentration before delivery and at 12 hours post partum. Treatment was administered at delivery of the anterior shoulder. The primary outcome was the change in hemoglobin concentration from before to after delivery. Secondary outcomes included other measures of blood loss and presumed medication side effects. In total, 450 women were enrolled in the study. Their baseline characteristics were similar. There was no significant difference between the groups in the change in hemoglobin concentration (misoprostol 1.07 g/dL and oxytocin 1.00 g/dL). The only significant secondary outcomes were shivering (80.7% with misoprostol vs. 3.6% with oxytocin) and pyrexia (11.4% with misoprostol, none with oxytocin). Routine use of oral misoprostol 800 microg appears to be as effective as 10 IU parenteral oxytocin in minimizing blood loss during the third stage of labour, as determined by change in hemoglobin concentration. Misoprostol appears to be a safe, inexpensive, and effective uterotonic for use in rural and remote areas, where intravenous oxytocin may be unavailable.

Secondary Circulation Asymmetry in a Meandering, Partially Stratified Estuary

NASA Astrophysics Data System (ADS)

Pein, J.; Valle-Levinson, A.; Stanev, E. V.

2018-03-01

Numerical model experiments are used to study the effects of multiple channel bends on estuarine dynamics and, in particular, on secondary flows. These effects are demonstrated by comparing experiments with two different idealized trumpet-shaped estuaries, one straight and another one with a ˜8 km meandering section in the middle of the estuary. Meanders complicate the flow field by introducing secondary processes. For instance, meanders increase turbulence and associated mixing locally within the water column, as well as outside the meandering portion. Furthermore, meanders transform up to 30% of the along-channel momentum into secondary circulation. Production of turbulence and secondary currents is different at flood and ebb tidal phases. At flood, meanders lead to unstable stratification and increased turbulence. At ebb, the flow develops a helical pattern and adjusts to the channel curvature with minimal decrease in density stability. The secondary circulation asymmetry is caused by an interplay between the across-channel baroclinic pressure gradient force and the centrifugal force. During ebb both forces enhance each other, whereas they oppose during flood. As a consequence of this interaction between baroclinic forcing and curving morphology, ebb flows and horizontal buoyancy fluxes increase relative to flood. The enhanced ebb dominance shifts a density front toward the mouth of the estuary, thus reducing salt intrusion.

Secondary environmental impacts of remedial alternatives for sediment contaminated with hydrophobic organic contaminants.

PubMed

Choi, Yongju; Thompson, Jay M; Lin, Diana; Cho, Yeo-Myoung; Ismail, Niveen S; Hsieh, Ching-Hong; Luthy, Richard G

2016-03-05

This study evaluates secondary environmental impacts of various remedial alternatives for sediment contaminated with hydrophobic organic contaminants using life cycle assessment (LCA). Three alternatives including two conventional methods, dredge-and-fill and capping, and an innovative sediment treatment technique, in-situ activated carbon (AC) amendment, are compared for secondary environmental impacts by a case study for a site at Hunters Point Shipyard, San Francisco, CA. The LCA results show that capping generates substantially smaller impacts than dredge-and-fill and in-situ amendment using coal-based virgin AC. The secondary impacts from in-situ AC amendment can be reduced effectively by using recycled or wood-based virgin AC as production of these materials causes much smaller impacts than coal-based virgin AC. The secondary environmental impacts are highly sensitive to the dredged amount and the distance to a disposal site for dredging, the capping thickness and the distance to the cap materials for capping, and the AC dose for in-situ AC amendment. Based on the analysis, this study identifies strategies to minimize secondary impacts caused by different remediation activities: optimize the dredged amount, the capping thickness, or the AC dose by extensive site assessments, obtain source materials from local sites, and use recycled or bio-based AC. Copyright © 2015 Elsevier B.V. All rights reserved.

Secondary arterial hypertension: when, who, and how to screen?

PubMed

Rimoldi, Stefano F; Scherrer, Urs; Messerli, Franz H

2014-05-14

Secondary hypertension refers to arterial hypertension due to an identifiable cause and affects ∼5-10% of the general hypertensive population. Because secondary forms are rare and work up is time-consuming and expensive, only patients with clinical suspicion should be screened. In recent years, some new aspects gained importance regarding this screening. In particular, increasing evidence suggests that 24 h ambulatory blood pressure (BP) monitoring plays a central role in the work up of patients with suspected secondary hypertension. Moreover, obstructive sleep apnoea has been identified as one of the most frequent causes. Finally, the introduction of catheter-based renal denervation for the treatment of patients with resistant hypertension has dramatically increased the interest and the number of patients evaluated for renal artery stenosis. We review the clinical clues of the most common causes of secondary hypertension. Specific recommendations are given as to evaluation and treatment of various forms of secondary hypertension. Despite appropriate therapy or even removal of the secondary cause, BP rarely ever returns to normal with long-term follow-up. Such residue hypertension indicates either that some patients with secondary hypertension also have concomitant essential hypertension or that irreversible vascular remodelling has taken place. Thus, in patients with potentially reversible causes of hypertension, early detection and treatment are important to minimize/prevent irreversible changes in the vasculature and target organs. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2013. For permissions please email: journals.permissions@oup.com.

Comparative Effectiveness of Minimally Invasive Surgery and Conventional Approaches to Major or Challenging Hepatectomy

PubMed Central

Thornblade, Lucas W; Shi, Xu; Ruiz, Alex; Flum, David R; Park, James O

2017-01-01

Background The benefits of minimally invasive surgery (MIS) for low-risk or minor liver resection are well established. There is growing interest in MIS for major hepatectomy (MH) and other challenging resections, but there remain unanswered questions of safety that prevent broad adoption of this technique. Study Design Retrospective cohort study of patients undergoing hepatectomy at 65 hospitals participating in the NSQIP Hepatopancreatobiliary Collaborative in 2014. We assessed serious morbidity or mortality (SMM, including organ-space infection and organ failure). Secondary outcomes included transfusion, bile leak, liver failure, reoperation or intervention, and 30-day readmission. We also measured factors considered to make resection more challenging (large tumors, cirrhosis, ≥3 concurrent resections, prior neoadjuvant chemotherapy, or morbid obesity). Results 2819 patients underwent hepatectomy (age 58±14 years, 53% female; 25% MIS). After adjusting for clinical and operative factors, the odds of SMM (OR=0.57, 95%CI: 0.34–0.96, p=0.03) and reoperation or intervention (OR=0.52 (0.29–0.93), p=0.03) were significantly lower for patients undergoing MIS compared with open. In the MH group (n=1,015; 13% MIS), there was no difference in the odds of SMM after MIS (OR=0.37, (0.13–1.11), p=0.08) however MIS MH met criteria for non-inferiority. There were no differences in liver-specific complications or readmission between the groups. Odds of SMM were significantly lower following MIS among patients who had received neoadjuvant chemotherapy (OR 0.33 (0.15–0.70), p=0.004). Conclusion In this large study of minimally invasive major hepatectomy, we demonstrate safety outcomes that are equivalent or superior to conventional open surgery. While the decision to offer MIS may be influenced by factors not included in this evaluation, (e.g. surgeon experience and other patient factors), these findings support its current use in major hepatectomies. PMID:28163089

The hydration status of young female elite soccer players during an official tournament.

PubMed

Chapelle, Laurent; Tassignon, Bruno; Aerenhouts, Dirk; Mullie, Patrick; Clarys, Peter

2017-09-01

The hydration status of elite female soccer players is a concern, especially during high-volume training periods or tournaments. Furthermore, scientific literature on this topic is scarce to non-existent. Therefore, the primary aim of this study was to evaluate the hydration status in elite youth female soccer players during an official tournament. The secondary aim was to identify a possible relationship between pre-training hydration status and fluid intake. Eighteen players were followed during eight consecutive days. Urine specific gravity was used to assess hydration status. Body weight was monitored before and after every training and match, whilst individual fluid intake was only registered during training. The players were informed about their hydration status on day 5. On days 1 to 4, the percentage of players who were at least minimally hypohydrated ranged between 44% and 78%. On day 5 (rest day), all the players were at least minimally hypohydrated. After the information session on day 5, the relative number of euhydrated players increased to 89% on both day 6 (training day) and day 7 (match day). On the final day (rest day), all players were either minimally hypohydrated or hypohydrated. Furthermore, a moderate and significant negative correlation (r=-0.44; N.=54; P=0.01) was found between fluid intake during and USG value before the training sessions. The data illustrates that the hydration status of this population of elite youth female soccer players may be suboptimal and is of substantial concern on rest days during this tournament under temperate conditions. Receiving personal advice about rehydration seems to have a positive effect.

A study on acceptance of mobileschool at secondary schools in Malaysia: Urban vs rural

NASA Astrophysics Data System (ADS)

Hashim, Ahmad Sobri; Ahmad, Wan Fatimah Wan; Sarlan, Aliza

2017-10-01

Developing countries are in dilemma where sophisticated technologies are more advance as compared to the way their people think. In education, there have been many novel approaches and technologies were introduced. However, very minimal efforts were put to apply in our education. MobileSchool is a mobile learning (m-learning) management system, developed for administrative, teaching and learning processes at secondary schools in Malaysia. The paper presents the acceptance of MobileSchool between urban and rural secondary schools in Malaysia. Research framework was designed based on Technology Acceptance Model (TAM). The constructs of the framework include computer anxiety, self-efficacy, facilitating condition, technological complexity, perceived behavioral control, perceive ease of use, perceive usefulness, attitude and behavioral intention. Questionnaire was applied as research instrument which involved 373 students from four secondary schools (two schools in urban category and another two in rural category) in Perak. Inferential analyses using hypothesis and t-test, and descriptive analyses using mean and percentage were used to analyze the data. Results showed that there were no big difference (<20%) of all acceptance constructs between urban and rural secondary schools except computer anxiety.

An Experimental and Numerical Investigation of Endwall Aerodynamics and Heat Transfer in a Gas Turbine Nozzle Guide Vane with Slot Film Cooling

NASA Astrophysics Data System (ADS)

Alqefl, Mahmood Hasan

In many regions of the high-pressure gas turbine, film cooling flows are used to protect the turbine components from the combustor exit hot gases. Endwalls are challenging to cool because of the complex system of secondary flows that disturb surface film coolant coverage. The secondary flow vortices wash the film coolant from the surface into the mainstream significantly decreasing cooling effectiveness. In addition to being effected by secondary flow structures, film cooling flow can also affect these structures by virtue of their momentum exchange. In addition, many studies in the literature have shown that endwall contouring affects the strength of passage secondary flows. Therefore, to develop better endwall cooling schemes, a good understanding of passage aerodynamics and heat transfer as affected by interactions of film cooling flows with secondary flows is required. This experimental and computational study presents results from a linear, stationary, two-passage cascade representing the first stage nozzle guide vane of a high-pressure gas turbine with an axisymmetrically contoured endwall. The sources of film cooling flows are upstream combustor liner coolant and endwall slot film coolant injected immediately upstream of the cascade passage inlet. The operating conditions simulate combustor exit flow features, with a high Reynolds number of 390,000 and approach flow turbulence intensity of 11% with an integral length scale of 21% of the chord length. Measurements are performed with varying slot film cooling mass flow to mainstream flow rate ratios (MFR). Aerodynamic effects are documented with five-hole probe measurements at the exit plane. Heat transfer is documented through recovery temperature measurements with a thermocouple. General secondary flow features are observed. Total pressure loss measurements show that varying the slot film cooling MFR has some effects on passage loss. Velocity vectors and vorticity distributions show a very thin, yet intense, cross-pitch flow on the contoured endwall side. Endwall adiabatic effectiveness values and coolant distribution thermal fields show minimal effects of varying slot film coolant MFR. This suggests the dominant effects of combustor liner coolant. show dominant effects of combustor liner coolant on cooling the endwall. A coolant vorticity correlation presenting the advective mixing of the coolant due to secondary flow vorticity at the exit plane is also discussed.

Association Between Spousal Caregiver Well-Being and Care Recipient Healthcare Expenditures.

PubMed

Ankuda, Claire K; Maust, Donovan T; Kabeto, Mohammed U; McCammon, Ryan J; Langa, Kenneth M; Levine, Deborah A

2017-10-01

To measure the association between spousal depression, general health, fatigue and sleep, and future care recipient healthcare expenditures and emergency department (ED) use. Prospective cohort study. Health and Retirement Study. Home-dwelling spousal dyads in which one individual (care recipient) was aged 65 and older and had one or more activity of daily living or instrumental activity of daily living disabilities and was enrolled in Medicare Part B (N = 3,101). Caregiver sleep (Jenkins Sleep Scale), depressive symptoms (Center for Epidemiologic Studies Depression-8 Scale), and self-reported general health measures. Primary outcome was care recipient Medicare expenditures. Secondary outcome was care recipient ED use. Follow-up was 6 months. Caregiver depressive symptoms score and six of 17 caregiver well-being measures were prospectively associated with higher care recipient expenditures after minimal adjustment (P < .05). Higher care recipient expenditures remained significantly associated with caregiver fatigue (cost increase, $1,937, 95% confidence interval (CI) = $770-3,105) and caregiver sadness (cost increase, $1,323, 95% CI = $228-2,419) after full adjustment. Four of 17 caregiver well-being measures, including severe fatigue, were significantly associated with care recipient ED use after minimal adjustment (P < .05). Greater odds of care recipient ED use remained significantly associated with caregiver fatigue (odds ratio (OR) = 1.24, 95% CI = 1.01-1.52) and caregiver fair to poor health (OR = 1.23, 95% CI = 1.04-1.45) after full adjustment. Caregiver total sleep score was not associated with care recipient outcomes. Poor caregiver well-being, particularly severe fatigue, is independently and prospectively associated with higher care recipient Medicare expenditures and ED use. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

Impact of prior treatment and depth of response on survival in MM-003, a randomized phase 3 study comparing pomalidomide plus low-dose dexamethasone versus high-dose dexamethasone in relapsed/refractory multiple myeloma

PubMed Central

San Miguel, Jesus F.; Weisel, Katja C.; Song, Kevin W.; Delforge, Michel; Karlin, Lionel; Goldschmidt, Hartmut; Moreau, Philippe; Banos, Anne; Oriol, Albert; Garderet, Laurent; Cavo, Michele; Ivanova, Valentina; Alegre, Adrian; Martinez-Lopez, Joaquin; Chen, Christine; Renner, Christoph; Bahlis, Nizar Jacques; Yu, Xin; Teasdale, Terri; Sternas, Lars; Jacques, Christian; Zaki, Mohamed H.; Dimopoulos, Meletios A.

2015-01-01

Pomalidomide is a distinct oral IMiD® immunomodulatory agent with direct antimyeloma, stromal-support inhibitory, and immunomodulatory effects. The pivotal, multicenter, open-label, randomized phase 3 trial MM-003 compared pomalidomide + low-dose dexamethasone vs high-dose dexamethasone in 455 patients with refractory or relapsed and refractory multiple myeloma after failure of bortezomib and lenalidomide treatment. Initial results demonstrated significantly longer progression-free survival and overall survival with an acceptable tolerability profile for pomalidomide + low-dose dexamethasone vs high-dose dexamethasone. This secondary analysis describes patient outcomes by treatment history and depth of response. Pomalidomide + low-dose dexamethasone significantly prolonged progression-free survival and favored overall survival vs high-dose dexamethasone for all subgroups analyzed, regardless of prior treatments or refractory status. Both univariate and multivariate analyses showed that no variable relating to either the number (≤ or > 3) or type of prior treatment was a significant predictor of progression-free survival or overall survival. No cross-resistance with prior lenalidomide or thalidomide treatment was observed. Patients achieving a minimal response or better to pomalidomide + low-dose dexamethasone treatment experienced a survival benefit, which was even higher in those achieving at least a partial response (17.2 and 19.9 months, respectively, as compared with 7.5 months for patients with less than minimal response). These data suggest that pomalidomide + low-dose dexamethasone should be considered a standard of care in patients with refractory or relapsed and refractory multiple myeloma regardless of prior treatment. ClinicalTrials.gov: NCT01311687; EudraCT: 2010-019820-30. PMID:26160879

Trans-oral resection of large parapharyngeal space tumours.

PubMed

Hussain, A; Ah-See, K W; Shakeel, M

2014-03-01

The aim of this study is to describe minimally invasive trans-oral approach for resection of parapharyngeal space (PPS) tumours and to demonstrate surgical technique, resection, repair and outcomes. Five cases were prospectively included in the study. The data collected include age, sex, site, size, pathology, radiological investigations, surgical excision, complications and outcomes. Three females and two male patients underwent trans-oral resection of PPS tumours sized 4-8 cm. The pathology included two deep lobe parotid tumours, one schwannoma, one hibernoma and one primary adenocarcinoma arising form the minor salivary gland. All tumours were resected completely without any technical difficulty. The healing was quick and by primary intention. Patients resumed oral feeding on recovery from general anaesthesia and did not require any significant analgesia beyond the first 2 days. Patient with adenocarcinoma received postoperative radiotherapy and remained disease-free during 4 years post-treatment. No recurrences were observed in patients with benign tumours. No neurovascular injury occurred during surgery and no secondary bleeding was observed. We have demonstrated successful and safe execution of trans-oral resection of large PPS tumours. There were no intra and post-operative complications and there has been no recurrence during the follow-up period. In our experience, it appears to be efficient, safe and minimally invasive compared to the established techniques.

49 CFR 195.246 - Installation of pipe in a ditch.

Code of Federal Regulations, 2011 CFR

2011-10-01

... in a ditch must be installed in a manner that minimizes the introduction of secondary stresses and... waters less than 15 feet deep, all offshore pipe in water at least 12 feet deep (3.7 meters) but not more than 200 feet deep (61 meters) deep as measured from the mean low water must be installed so that the...

49 CFR 195.246 - Installation of pipe in a ditch.

Code of Federal Regulations, 2010 CFR

2010-10-01

... in a ditch must be installed in a manner that minimizes the introduction of secondary stresses and... waters less than 15 feet deep, all offshore pipe in water at least 12 feet deep (3.7 meters) but not more than 200 feet deep (61 meters) deep as measured from the mean low water must be installed so that the...

Interventions Employed in Regular Education Settings for Secondary Students with High Functioning Autism: A Meta-Analysis

ERIC Educational Resources Information Center

McKeithan, Glennda Kashner

2016-01-01

An increase has occurred in the number of students identified as having high functioning autism (HFA), who are being served in the regular education setting with their non-disabled peers. Many of these students have difficulty with academic and social expectations in this setting, and a minimal amount of information is available to educators…

40 CFR 267.1103 - What additional design and operating standards apply if liquids will be in my containment building?

Code of Federal Regulations, 2014 CFR

2014-07-01

... minimize hydraulic head on the containment system at the earliest practicable time. (c) A secondary...) Constructed of a granular drainage material with a hydraulic conductivity of 1 × 10−2 cm/sec or more and a... containment building and of sufficient strength and thickness to prevent collapse under the pressure exerted...

40 CFR 267.1103 - What additional design and operating standards apply if liquids will be in my containment building?

Code of Federal Regulations, 2013 CFR

2013-07-01

... minimize hydraulic head on the containment system at the earliest practicable time. (c) A secondary...) Constructed of a granular drainage material with a hydraulic conductivity of 1 × 10−2 cm/sec or more and a... containment building and of sufficient strength and thickness to prevent collapse under the pressure exerted...

A Study of Criteria for the Evaluation of Secondary School Instrumentalists When Auditioning for Festival Bands. Final Report.

ERIC Educational Resources Information Center

Owen, Curtis D., Jr.

This study purposed to develop a means of evaluating student performance in auditions for festival bands which would minimize the inconsistencies of subjective judgment. Tape recordings of student auditions were played three times to judges. During the first audition, evaluators rated students on a continuum scale with numerical divisions, and…

Use of low temperature blowers for recirculation of hot gases

DOEpatents

Maru, H.C.; Forooque, M.

1982-08-19

An apparatus is described for maintaining motors at low operating temperatures during recirculation of hot gases in fuel cell operations and chemical processes such as fluidized bed coal gasification. The apparatus includes a means for separating the hot process gas from the motor using a secondary lower temperature gas, thereby minimizing the temperature increase of the motor and associated accessories.

Subtle Discourses on Equality in the Finnish Curricula of Upper Secondary Education: Reflections of the Imagined Society

ERIC Educational Resources Information Center

Lappalainen, Sirpa; Lahelma, Elina

2016-01-01

Assurance of citizens' social rights and minimization of social differences have been central tenets that have framed the educational policy of Finland and the other Nordic welfare states. Equality has been on the official agenda in educational politics and policies since the comprehensive school reforms of the 1960s and 1970s. However, the…

Transmission Models of Historical Ebola Outbreaks

PubMed Central

Drake, John M.; Bakach, Iurii; Just, Matthew R.; O’Regan, Suzanne M.; Gambhir, Manoj

2015-01-01

To guide the collection of data under emergent epidemic conditions, we reviewed compartmental models of historical Ebola outbreaks to determine their implications and limitations. We identified future modeling directions and propose that the minimal epidemiologic dataset for Ebola model construction comprises duration of incubation period and symptomatic period, distribution of secondary cases by infection setting, and compliance with intervention recommendations. PMID:26196358

Herpes zoster-induced acute urinary retention.

PubMed

Addison, Ben; Harvey, Martyn

2013-06-01

Urinary retention is a common acute presentation for men in their later decades. Potential contributing pathologies are numerous. We report an unusual case of acute urinary retention requiring catheterisation secondary to sacral herpes zoster reactivation (S2-4) in an 88-year-old man with minimal preceding obstructive symptoms. © 2013 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Paralytic ileus requiring hospitalization secondary to high-dose antipsychotic polypharmacy and benztropine.

PubMed

Kwiatkowski, Mercedes; Denka, Zachary D; White, Christopher C

2011-01-01

Ileus can result from the combined activity of antipsychotic and anticholinergic medications. Despite frequent use, case reports in the literature are sparse. We present a patient who developed a paralytic ileus requiring extended hospitalization. Providers should minimize antipsychotic and concurrent anticholinergic medications, consider prophylactic bowel regimens and monitor for constipation. Copyright © 2011 Elsevier Inc. All rights reserved.

The Effect of Concussion or Mild Traumatic Brain Injury on School Grades, National Examination Scores, and School Attendance: A Systematic Review.

PubMed

Rozbacher, Adrian; Selci, Erin; Leiter, Jeff; Ellis, Michael; Russell, Kelly

2017-07-15

Concussion often results in symptoms, including difficulty concentrating, focusing, and remembering, that are typically managed with cognitive and physical rest. Often, the school environment is not conducive to cognitive rest and may lead to worsening or prolonged symptoms that can contribute to impaired academic performance. The objective of the review was to identify and summarize literature concerning the effects of concussion or mild traumatic brain injury (mTBI) on academic outcomes. MEDLINE, Embase, Scopus, and CINAHL were searched until June 1, 2016. Studies must have been primary literature examining students enrolled in primary, secondary, or post-secondary education, have received a physician diagnosis of concussion or mTBI, and have post-injury academic outcomes assessed in numeric or alphabet grade/grade point average (GPA), school attendance records, or national examination scores. Data were extracted and checked by a second reviewer for accuracy and completeness. Nine studies were included. Among four studies that examined grades, one found a significant difference in pre- and post-grades only in the subject Afrikaans. Three examined national test scores and no significant differences were found between cases and controls. Four examined school absenteeism and found that students who developed post-concussion syndrome missed significantly more school days and took longer to return to school than students with extremity injuries. Although mTBI or concussion is associated with missed school, the results demonstrate minimal impact on school grades and national examination scores at a group level. Further research is needed to identify risk factors for impaired school functioning following mTBI and concussion in individual patients.

Pharmacological synergism of bee venom and melittin with antibiotics and plant secondary metabolites against multi-drug resistant microbial pathogens.

PubMed

Al-Ani, Issam; Zimmermann, Stefan; Reichling, Jürgen; Wink, Michael

2015-02-15

The goal of this study was to investigate the antimicrobial activity of bee venom and its main component, melittin, alone or in two-drug and three-drug combinations with antibiotics (vancomycin, oxacillin, and amikacin) or antimicrobial plant secondary metabolites (carvacrol, benzyl isothiocyanate, the alkaloids sanguinarine and berberine) against drug-sensitive and antibiotic-resistant microbial pathogens. The secondary metabolites were selected corresponding to the molecular targets to which they are directed, being different from those of melittin and the antibiotics. The minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) were evaluated by the standard broth microdilution method, while synergistic or additive interactions were assessed by checkerboard dilution and time-kill curve assays. Bee venom and melittin exhibited a broad spectrum of antibacterial activity against 51 strains of both Gram-positive and Gram-negative bacteria with strong anti-MRSA and anti-VRE activity (MIC values between 6 and 800 µg/ml). Moreover, bee venom and melittin showed significant antifungal activity (MIC values between 30 and 100 µg/ml). Carvacrol displayed bactericidal activity, while BITC exhibited bacteriostatic activity against all MRSA and VRE strains tested (reference strains and clinical isolates), both compounds showed a remarkable fungicidal activity with minimum fungicidal concentration (MFC) values between 30 and 200 µg/ml. The DNA intercalating alkaloid sanguinarine showed bactericidal activity against MRSA NCTC 10442 (MBC 20 µg/ml), while berberine exhibited bacteriostatic activity against MRSA NCTC 10442 (MIC 40 µg/ml). Checkerboard dilution tests mostly revealed synergism of two-drug combinations against all the tested microorganisms with FIC indexes between 0.24 and 0.50, except for rapidly growing mycobacteria in which combinations exerted an additive effect (FICI = 0.75-1). In time-kill assays all three-drug combinations exhibited a powerful bactericidal synergistic effect against MRSA NCTC 10442, VRE ATCC 51299, and E. coli ATCC 25922 with a reduction of more than 3log10 in the colony count after 24 h. Our findings suggest that bee venom and melittin synergistically enhanced the bactericidal effect of several antimicrobial agents when applied in combination especially when the drugs affect several and differing molecular targets. These results could lead to the development of novel or complementary antibacterial drugs against MDR pathogens. Copyright © 2015 Elsevier GmbH. All rights reserved.

A novel model of inflammatory pain in human skin involving topical application of sodium lauryl sulfate.

PubMed

Petersen, L J; Lyngholm, A M; Arendt-Nielsen, L

2010-09-01

Sodium lauryl sulfate (SLS) is a known irritant. It releases pro-inflammatory mediators considered pivotal in inflammatory pain. The sensory effects of SLS in the skin remain largely unexplored. In this study, SLS was evaluated for its effect on skin sensory functions. Eight healthy subjects were recruited for this study. Skin sites were randomized to topical SLS 0.25, 0.5, 1, 2% and vehicle for 24 h. Topical capsaicin 1% was applied for 30 min at 24 h after SLS application. Assessments included laser Doppler imaging of local vasodilation and flare reactions, rating of spontaneous pain, assessment of primary thermal and tactile hyperalgesia, and determination of secondary dynamic and static hyperalgesia. SLS induced significant and dose-dependent local inflammation and primary hyperalgesia to tactile and thermal stimulation at 24 h after application, with SLS 2% treatment eliciting results comparable to those observed following treatment with capsaicin 1%. SLS induced no spontaneous pain, small areas of flare, and minimal secondary hyperalgesia. The primary hyperalgesia vanished within 2-3 days, whereas the skin inflammation persisted and was only partly normalized by Day 6. SLS induces profound perturbations of skin sensory functions lasting 2-3 days. SLS-induced inflammation may be a useful model for studying the mechanisms of inflammatory pain.

Modeling the Secondary Drying Stage of Freeze Drying: Development and Validation of an Excel-Based Model.

PubMed

Sahni, Ekneet K; Pikal, Michael J

2017-03-01

Although several mathematical models of primary drying have been developed over the years, with significant impact on the efficiency of process design, models of secondary drying have been confined to highly complex models. The simple-to-use Excel-based model developed here is, in essence, a series of steady state calculations of heat and mass transfer in the 2 halves of the dry layer where drying time is divided into a large number of time steps, where in each time step steady state conditions prevail. Water desorption isotherm and mass transfer coefficient data are required. We use the Excel "Solver" to estimate the parameters that define the mass transfer coefficient by minimizing the deviations in water content between calculation and a calibration drying experiment. This tool allows the user to input the parameters specific to the product, process, container, and equipment. Temporal variations in average moisture contents and product temperatures are outputs and are compared with experiment. We observe good agreement between experiments and calculations, generally well within experimental error, for sucrose at various concentrations, temperatures, and ice nucleation temperatures. We conclude that this model can serve as an important process development tool for process design and manufacturing problem-solving. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Short-Term and Long-Term Effects of Orthopedic Biodegradable Implants

PubMed Central

Amini, Ami R.; Wallace, James S.; Nukavarapu, Syam P.

2012-01-01

Presently, orthopedic and oral/maxillofacial implants represent a combined $2.8 billion market, a figure expected to experience significant and continued growth. Although traditional permanent implants have been proved clinically efficacious, they are also associated with several drawbacks, including secondary revision and removal surgeries. Non-permanent, biodegradable implants offer a promising alternative for patients, as they provide temporary support and degrade at a rate matching tissue formation, and thus, eliminate the need for secondary surgeries. These implants have been in clinical use for nearly 25 years, competing directly with, or maybe even exceeding, the performance of permanent implants. The initial implantation of biodegradable materials, as with permanent materials, mounts an acute host inflammatory response. Over time, the implant degradation profile and possible degradation product toxicity mediate long-term biodegradable implant-induced inflammation. However, unlike permanent implants, this inflammation is likely to cease once the material disappears. Implant-mediated inflammation is a critical determinant for implant success. Thus, for the development of a proactive biodegradable implant that has the ability to promote optimal bone regeneration and minimal detrimental inflammation, a thorough understanding of short- and long-term inflammatory events is required. Here, we discuss an array of biodegradable orthopedic implants, their associated short- and long- term inflammatory effects, and methods to mediate these inflammatory events. PMID:22043969

Chronic pruritus in the absence of specific skin disease: an update on pathophysiology, diagnosis, and therapy.

PubMed

Cassano, Nicoletta; Tessari, Gianpaolo; Vena, Gino A; Girolomoni, Giampiero

2010-12-01

Chronic pruritus is a major and distressing symptom of many cutaneous and systemic diseases and can significantly impair the patient's quality of life. Pruritus perception is the final result of a complex network involving dedicated nerve pathways and brain areas, and an increasing number of peripheral and central mediators are thought to be involved. Itch is associated with most cutaneous disorders and, in these circumstances, its management overlaps with that of the skin disease. Itch can also occur without associated skin diseases or primary skin lesions, but only with nonspecific lesions secondary to rubbing or scratching. Chronic itch with no or minimal skin changes can be secondary to important diseases, such as neurologic disorders, chronic renal failure, cholestasis, systemic infections, malignancies, and endocrine disorders, and may also result from exposure to some drugs. The search for the cause of pruritus usually requires a meticulous step-by-step assessment involving careful history taking as well as clinical examination and laboratory investigations. Few evidence-based treatments for pruritus are available. Topical therapy, oral histamine H(1) receptor antagonists, and phototherapy with UV radiation can target pruritus elicitation in the skin, whereas antiepileptic drugs, opioid receptor antagonists, and antidepressants can block signal processing in the CNS.

Metal Dissipation and Inefficient Recycling Intensify Climate Forcing.

PubMed

Ciacci, Luca; Harper, E M; Nassar, N T; Reck, Barbara K; Graedel, T E

2016-10-07

In the metals industry, recycling is commonly included among the most viable options for climate change mitigation, because using secondary (recycled) instead of primary sources in metal production carries both the potential for significant energy savings and for greenhouse gas emissions reduction. Secondary metal production is, however, limited by the relative quantity of scrap available at end-of-life for two reasons: long product lifespans during use delay the availability of the material for reuse and recycling; and end-of-life recycling rates are low, a result of inefficient collection, separation, and processing. For a few metals, additional losses exist in the form of in-use dissipation. The sum of these lost material flows forms the theoretical maximum potential for future efficiency improvements. Based on a dynamic material flow analysis, we have evaluated these factors from an energy perspective for 50 metals and calculated the corresponding greenhouse gas emissions associated with the supply of lost material from primary sources that would otherwise be used to satisfy demand. A use-by-use examination demonstrates the potential emission gains associated with major application sectors. The results show that minimizing in-use dissipation and constraints to metal recycling have the potential to reduce greenhouse gas emissions from the metal industry by about 13-23%, corresponding to 1% of global anthropogenic greenhouse gas emissions.

The pinwheel pupil discovery: exoplanet science & improved processing with segmented telescopes

NASA Astrophysics Data System (ADS)

Breckinridge, James Bernard

2018-01-01

In this paper, we show that by using a “pinwheel” architecture for the segmented primary mirror and curved supports for the secondary mirror, we can achieve a near uniform diffraction background in ground and space large telescope systems needed for high SNR exoplanet science. Also, the point spread function will be nearly rotationally symmetric, enabling improved digital image reconstruction. Large (>4-m) aperture space telescopes are needed to characterize terrestrial exoplanets by direct imaging coronagraphy. Launch vehicle volume constrains these apertures are segmented and deployed in space to form a large mirror aperture that is masked by the gaps between the hexagonal segments and the shadows of the secondary support system. These gaps and shadows over the pupil result in an image plane point spread function that has bright spikes, which may mask or obscure exoplanets.These telescope artifact mask faint exoplanets, making it necessary for the spacecraft to make a roll about the boresight and integrate again to make sure no planets are missed. This increases integration time, and requires expensive space-craft resources to do bore-sight roll.Currently the LUVOIR and HabEx studies have several significant efforts to develop special purpose A/O technology and to place complex absorbing apodizers over their Hex pupils to shape the unwanted diffracted light. These strong apodizers absorb light, decreasing system transmittance and reducing SNR. Implementing curved pupil obscurations will eliminate the need for the highly absorbing apodizers and thus result in higher SNR.Quantitative analysis of diffraction patterns that use the pinwheel architecture are compared to straight hex-segment edges with a straight-line secondary shadow mask to show a gain of over a factor of 100 by reducing the background. For the first-time astronomers are able to control and minimize image plane diffraction background “noise”. This technology will enable 10-m segmented apertures to perform nearly the same as a 10-meter monolith filled aperture. The pinwheel pupil will enable a significant gain in exoplanet SNR.

Coordinated Isotopic and Mineral Characterization of Highly Fractionated 18O-Rich Silicates in the Queen Alexandra Range 99177 CR3 Chondrite

NASA Technical Reports Server (NTRS)

Nguyen, A. N.; Keller, L. P.; Messenger, S.; Rahman, Z.

2016-01-01

Carbonaceous chondrites contain a mixture of solar system condensates, pre-solar grains, and primitive organic matter. Each of these materials record conditions and processes in different regions of the solar nebula, on the meteorite parent body, and beyond the solar system. Oxygen isotopic studies of meteorite components can trace interactions of distinct oxygen isotopic reservoirs in the early solar system and secondary alteration processes. The O isotopic compositions of the earliest solar system condensates fall along a carbonaceous chondrite anhydrous mineral (CCAM) line of slope approximately 1 in a plot of delta 17O against delta 18O. This trend is attributed to mixing of material from 16O-poor and 16O-rich reservoirs. Secondary processing can induce mass-dependent fractionation of the O isotopes, shifting these compositions along a line of slope approximately 0.52. Substantial mass-dependent fractionation of O isotopes has been observed in secondary minerals in CAIs, calcite, and FUN inclusions. These fractionations were caused by significant thermal or aqueous alteration. We recently reported the identification of four silicate grains with extremely fractionated O isotopic ratios (delta 18O equals 37 - 55 per mille) in the minimally altered CR3 chondrite QUE 99177. TEM analysis of one grain indicates it is a nebular condensate that did not experience substantial alteration. The history of these grains is thus distinct from those of the aforementioned fractionated materials. To constrain the origin of the silicate grains, we conducted further Mg and Fe isotopic studies and TEM analyses of two grains.

Effect of L-ornithine 8-vasopressin on blood loss during liposuction.

PubMed

Lalinde, E; Sanz, J; Ballesteros, A; Elejabeitia, J; Mesa, F; Bazán, A; Paloma, V

1995-06-01

In this comparative study, we carried out liposuction on 20 patients randomly divided in two groups to find an alternative medication to epinephrine that would not result in secondary effects at the cardiovascular level but would offer a similar vasoconstricting capacity. Also, a variation of the wet technique is described that decreases blood loss secondary to liposuction. The area to undergo liposuction is infiltrated with a cannula of our own design. Epinephrine is not used as a vasoconstrictor but rather L-ornithine 8-vasopressin at a concentration of 0.01 IU/ml chilled saline. With this new technique, the amount of blood removed is minimal, even in the case of extraction of large volumes of fat.

Freeze-drying of tert-butyl alcohol/water cosolvent systems: effects of formulation and process variables on residual solvents.

PubMed

Wittaya-Areekul, S; Nail, S L

1998-04-01

The objective of this study was to identify significant formulation and processing variables affecting levels of tert-butyl alcohol (TBA) and isopropyl alcohol (IPA) in freeze-dried solids prepared from TBA/water cosolvent systems. The variables examined were the physical state of the solute (crystalline vs amorphous), initial TBA concentration, freezing rate, cake thickness, and the temperature and duration of secondary drying. Sucrose and glycine were used as models for noncrystallizing and crystallizing solutes, respectively. The TBA concentration above which eutectic crystallization takes place was determined by differential scanning calorimetry. Model formulations were subjected to extremes of freezing rate by either dipping in liquid nitrogen or by slowly freezing on the shelf of a freeze-dryer. Dynamics of solvent loss during secondary drying was determined by withdrawing samples as a function of time at different shelf temperatures using a thief system. On the basis of these studies, the most important determinant of residual TBA level is the physical state of the solute. Freeze-dried glycine contained very low levels of residual TBA (0.01-0.03%) regardless of freezing rate or initial TBA concentration. For freeze-dried sucrose, residual TBA levels were approximately 2 orders of magnitude higher and were significantly affected by initial TBA concentration and freezing rate. For the sucrose/TBA/water system, relatively low residual TBA levels were obtained when the initial TBA level was above the threshold concentration for eutectic crystallization of TBA, whereas samples freeze-dried from solutions containing TBA concentrations below this threshold contained significantly higher levels of TBA. Residual IPA levels increased continuously with initial concentration of TBA in the sucrose/TBA/water system. Formulations of sucrose/TBA/water which were frozen rapidly contained residual TBA levels which were approximately twice those measured in the same formulation after slow freezing and drying under the same conditions. For the sucrose/TBA/water system, the temperature and time of secondary drying had only minimal influence on residual TBA in the freeze-dried solid. At low initial TBA concentrations (2%), residual TBA increases with increased cake thickness, perhaps because of the influence of depth of fill on effective freezing rate.

Physical Therapy Considerations for Chronic Kidney Disease and Secondary Sarcopenia

PubMed Central

Hernandez, Haniel J.; Obamwonyi, Gideon; Harris-Love, Michael O.

2018-01-01

Chronic kidney disease (CKD) is a progressive condition that may negatively affect musculoskeletal health. These comorbidities may include malnutrition, osteoporosis, and decreased lean body mass. Secondary sarcopenia due to CKD may be associated with mobility limitations and elevated fall risk. Physical therapists are well-positioned among the health care team to screen for secondary sarcopenia in those with CKD and for the treatment of musculoskeletal comorbid conditions that may affect functional performance. Given the consequences of both low muscle mass and low bone mineral density, appropriate and timely physical therapy is important for fall risk assessment and intervention to minimize the susceptibility to bone fracture. While strength training has been studied less frequently than aerobic training for the management of secondary CKD conditions, evidence suggests that this patient population benefits from participation in strength training programs. However, the provision of a formal exercise prescription by a health care professional, along with formal implementation of an exercise program, may need to be more fully integrated into the standard plan of care for individuals with CKD. PMID:29376141

DNS of Laminar-Turbulent Transition in Swept-Wing Boundary Layers

NASA Technical Reports Server (NTRS)

Duan, L.; Choudhari, M.; Li, F.

2014-01-01

Direct numerical simulation (DNS) is performed to examine laminar to turbulent transition due to high-frequency secondary instability of stationary crossflow vortices in a subsonic swept-wing boundary layer for a realistic natural-laminar-flow airfoil configuration. The secondary instability is introduced via inflow forcing and the mode selected for forcing corresponds to the most amplified secondary instability mode that, in this case, derives a majority of its growth from energy production mechanisms associated with the wall-normal shear of the stationary basic state. An inlet boundary condition is carefully designed to allow for accurate injection of instability wave modes and minimize acoustic reflections at numerical boundaries. Nonlinear parabolized stability equation (PSE) predictions compare well with the DNS in terms of modal amplitudes and modal shape during the strongly nonlinear phase of the secondary instability mode. During the transition process, the skin friction coefficient rises rather rapidly and the wall-shear distribution shows a sawtooth pattern that is analogous to the previously documented surface flow visualizations of transition due to stationary crossflow instability. Fully turbulent features are observed in the downstream region of the flow.

Secondary Electron Emission From Solar Cell Coverslides And Its Effect On Absolute Vehicle Charging

NASA Astrophysics Data System (ADS)

Ferguson, Dale C.

2011-10-01

It has often been stated that earthed conductive solar cell coverslides are the best way to prevent electrostatic discharges on space solar arrays in GEO. While it is true that such coverslides will prevent differential charging on the solar arrays, it will be shown through NASCAP- 2k simulations that the secondary electron emission of such coverslides is very important for absolute vehicle charging. In particular, carbon nanotube coatings, due to the extremely low secondary electron emission from carbon, may exacerbate absolute vehicle charging. However, if they are earthed, because of their conductivity they may minimize differential charging and the possibility of arcing elsewhere on the spacecraft. Such results may also be true for insulative coverslides if spacecraft thermal blankets are made of materials with high secondary electron emission. Finally, photoemission from coverslides is investigated, with regard to anti-reflection coatings. Surfaces which reflect UV can have low photoemission, while those that absorb may have higher photoemission rates. Thus, anti-reflection coatings may lead to higher absolute spacecraft charging rates. NASCAP-2k simulations will be used to investigate these dependences for realistic spacecraft.

Elasto-optics in double-coated optical fibers induced by axial strain and hydrostatic pressure.

PubMed

Yang, Yu-Ching; Lee, Haw-Long; Chou, Huann-Ming

2002-04-01

Stresses, microbending loss, and refractive-index changes induced simultaneously by axial strain and hydrostatic pressure in double-coated optical fibers are analyzed. The lateral pressure and normal stresses in the optical fiber, primary coating, and secondary coating are derived. Also presented are the microbending loss and refractive-index changes in the glass fiber. The normal stresses are affected by axial strain, hydrostatic pressure, material properties, and thickness of the primary and secondary coatings. It is found that microbending loss decreases with increasing thickness, the Young's modulus, and the Poisson's ratio of the secondary coating but increases with the increasing Young's modulus and Poisson's ratio of the primary coating. Similarly, changes in refractive index in the glass fiber decrease with the increasing Young's modulus and Poisson's ratio of the secondary coating but increase with the increasing Young's modulus and Poisson's ratio of the primary coating. Therefore, to minimize microbending loss induced simultaneously by axial strain and hydrostatic pressure in the glass fiber, the polymeric coatings should be suitably selected. An optimal design procedure is also indicated.

SPITZER SECONDARY ECLIPSE DEPTHS WITH MULTIPLE INTRAPIXEL SENSITIVITY CORRECTION METHODS OBSERVATIONS OF WASP-13b, WASP-15b, WASP-16b, WASP-62b, AND HAT-P-22b

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

Kilpatrick, Brian M.; Tucker, Gregory S.; Lewis, Nikole K.

2017-01-01

We measure the 4.5 μ m thermal emission of five transiting hot Jupiters, WASP-13b, WASP-15b, WASP-16b, WASP-62b, and HAT-P-22b using channel 2 of the Infrared Array Camera (IRAC) on the Spitzer Space Telescope . Significant intrapixel sensitivity variations in Spitzer IRAC data require careful correction in order to achieve precision on the order of several hundred parts per million (ppm) for the measurement of exoplanet secondary eclipses. We determine eclipse depths by first correcting the raw data using three independent data reduction methods. The Pixel Gain Map (PMAP), Nearest Neighbors (NNBR), and Pixel Level Decorrelation (PLD) each correct for themore » intrapixel sensitivity effect in Spitzer photometric time-series observations. The results from each methodology are compared against each other to establish if they reach a statistically equivalent result in every case and to evaluate their ability to minimize uncertainty in the measurement. We find that all three methods produce reliable results. For every planet examined here NNBR and PLD produce results that are in statistical agreement. However, the PMAP method appears to produce results in slight disagreement in cases where the stellar centroid is not kept consistently on the most well characterized area of the detector. We evaluate the ability of each method to reduce the scatter in the residuals as well as in the correlated noise in the corrected data. The NNBR and PLD methods consistently minimize both white and red noise levels and should be considered reliable and consistent. The planets in this study span equilibrium temperatures from 1100 to 2000 K and have brightness temperatures that require either high albedo or efficient recirculation. However, it is possible that other processes such as clouds or disequilibrium chemistry may also be responsible for producing these brightness temperatures.« less

Spitzer Secondary Eclipse Depths with Multiple Intrapixel Sensitivity Correction Methods Observations of WASP-13b, WASP-15b, WASP-16b, WASP-62b, and HAT-P-22b

NASA Astrophysics Data System (ADS)

Kilpatrick, Brian M.; Lewis, Nikole K.; Kataria, Tiffany; Deming, Drake; Ingalls, James G.; Krick, Jessica E.; Tucker, Gregory S.

2017-01-01

We measure the 4.5 μm thermal emission of five transiting hot Jupiters, WASP-13b, WASP-15b, WASP-16b, WASP-62b, and HAT-P-22b using channel 2 of the Infrared Array Camera (IRAC) on the Spitzer Space Telescope. Significant intrapixel sensitivity variations in Spitzer IRAC data require careful correction in order to achieve precision on the order of several hundred parts per million (ppm) for the measurement of exoplanet secondary eclipses. We determine eclipse depths by first correcting the raw data using three independent data reduction methods. The Pixel Gain Map (PMAP), Nearest Neighbors (NNBR), and Pixel Level Decorrelation (PLD) each correct for the intrapixel sensitivity effect in Spitzer photometric time-series observations. The results from each methodology are compared against each other to establish if they reach a statistically equivalent result in every case and to evaluate their ability to minimize uncertainty in the measurement. We find that all three methods produce reliable results. For every planet examined here NNBR and PLD produce results that are in statistical agreement. However, the PMAP method appears to produce results in slight disagreement in cases where the stellar centroid is not kept consistently on the most well characterized area of the detector. We evaluate the ability of each method to reduce the scatter in the residuals as well as in the correlated noise in the corrected data. The NNBR and PLD methods consistently minimize both white and red noise levels and should be considered reliable and consistent. The planets in this study span equilibrium temperatures from 1100 to 2000 K and have brightness temperatures that require either high albedo or efficient recirculation. However, it is possible that other processes such as clouds or disequilibrium chemistry may also be responsible for producing these brightness temperatures.

Modular assembly for supporting, straining, and directing flow to a core in a nuclear reactor

DOEpatents

Pennell, William E.

1977-01-01

A reactor core support arrangement for supporting, straining, and providing fluid flow to the core and periphery of a nuclear reactor during normal operation. A plurality of removable inlet modular units are contained within permanent liners in the lower supporting plate of the reactor vessel lower internals. During normal operation (1) each inlet modular unit directs main coolant flow to a plurality of core assemblies, the latter being removably supported in receptacles in the upper portion of the modular unit and (2) each inlet modular unit may direct bypass flow to a low pressure annular region of the reactor vessel. Each inlet modular unit may include special fluid seals interposed between mating surfaces of the inlet modular units and the core assemblies and between the inlet modular units and the liners, to minimize leakage and achieve an hydraulic balance. Utilizing the hydraulic balance, the modular units are held in the liners and the assemblies are held in the modular unit receptacles by their own respective weight. Included as part of the permanent liners below the horizontal support plate are generally hexagonal axial debris barriers. The axial debris barriers collectively form a bottom boundary of a secondary high pressure plenum, the upper boundary of which is the bottom surface of the horizontal support plate. Peripheral liners include radial debris barriers which collectively form a barrier against debris entry radially. During normal operation primary coolant inlet openings in the liner, below the axial debris barriers, pass a large amount of coolant into the inlet modular units, and secondary coolant inlet openings in the portion of the liners within the secondary plenum pass a small amount of coolant into the inlet modular units. The secondary coolant inlet openings also provide alternative coolant inlet flow paths in the unlikely event of blockage of the primary inlet openings. The primary inlet openings have characteristics which limit the entry of debris and minimize the potential for debris entering the primary inlets blocking the secondary inlets from inside the modular unit.

Overcoming double-step CO2 adsorption and minimizing water co-adsorption in bulky diamine-appended variants of Mg2(dobpdc).

PubMed

Milner, Phillip J; Martell, Jeffrey D; Siegelman, Rebecca L; Gygi, David; Weston, Simon C; Long, Jeffrey R

2018-01-07

Alkyldiamine-functionalized variants of the metal-organic framework Mg 2 (dobpdc) (dobpdc 4- = 4,4'-dioxidobiphenyl-3,3'-dicarboxylate) are promising for CO 2 capture applications owing to their unique step-shaped CO 2 adsorption profiles resulting from the cooperative formation of ammonium carbamate chains. Primary , secondary (1°,2°) alkylethylenediamine-appended variants are of particular interest because of their low CO 2 step pressures (≤1 mbar at 40 °C), minimal adsorption/desorption hysteresis, and high thermal stability. Herein, we demonstrate that further increasing the size of the alkyl group on the secondary amine affords enhanced stability against diamine volatilization, but also leads to surprising two-step CO 2 adsorption/desorption profiles. This two-step behavior likely results from steric interactions between ammonium carbamate chains induced by the asymmetrical hexagonal pores of Mg 2 (dobpdc) and leads to decreased CO 2 working capacities and increased water co-adsorption under humid conditions. To minimize these unfavorable steric interactions, we targeted diamine-appended variants of the isoreticularly expanded framework Mg 2 (dotpdc) (dotpdc 4- = 4,4''-dioxido-[1,1':4',1''-terphenyl]-3,3''-dicarboxylate), reported here for the first time, and the previously reported isomeric framework Mg-IRMOF-74-II or Mg 2 (pc-dobpdc) (pc-dobpdc 4- = 3,3'-dioxidobiphenyl-4,4'-dicarboxylate, pc = para -carboxylate), which, in contrast to Mg 2 (dobpdc), possesses uniformally hexagonal pores. By minimizing the steric interactions between ammonium carbamate chains, these frameworks enable a single CO 2 adsorption/desorption step in all cases, as well as decreased water co-adsorption and increased stability to diamine loss. Functionalization of Mg 2 (pc-dobpdc) with large diamines such as N -( n -heptyl)ethylenediamine results in optimal adsorption behavior, highlighting the advantage of tuning both the pore shape and the diamine size for the development of new adsorbents for carbon capture applications.

Overcoming double-step CO 2 adsorption and minimizing water co-adsorption in bulky diamine-appended variants of Mg 2(dobpdc)

DOE PAGES

Milner, Phillip J.; Martell, Jeffrey D.; Siegelman, Rebecca L.; ...

2017-10-26

Alkyldiamine-functionalized variants of the metal–organic framework Mg 2(dobpdc) (dobpdc 4- = 4,4'-dioxidobiphenyl-3,3'-dicarboxylate) are promising for CO 2 capture applications owing to their unique step-shaped CO 2 adsorption profiles resulting from the cooperative formation of ammonium carbamate chains. Primary,secondary (1°,2°) alkylethylenediamine-appended variants are of particular interest because of their low CO 2 step pressures (≤1 mbar at 40 °C), minimal adsorption/desorption hysteresis, and high thermal stability. Herein, we demonstrate that further increasing the size of the alkyl group on the secondary amine affords enhanced stability against diamine volatilization, but also leads to surprising two-step CO 2 adsorption/desorption profiles. This two-step behaviormore » likely results from steric interactions between ammonium carbamate chains induced by the asymmetrical hexagonal pores of Mg 2(dobpdc) and leads to decreased CO 2 working capacities and increased water co-adsorption under humid conditions. To minimize these unfavorable steric interactions, we targeted diamine-appended variants of the isoreticularly expanded framework Mg 2(dotpdc) (dotpdc 4- = 4,4''-dioxido-[1,1':4',1''-terphenyl]-3,3''-dicarboxylate), reported here for the first time, and the previously reported isomeric framework Mg-IRMOF-74-II or Mg 2(pc-dobpdc) (pc-dobpdc 4- = 3,3'-dioxidobiphenyl-4,4'-dicarboxylate, pc = para-carboxylate), which, in contrast to Mg 2(dobpdc), possesses uniformally hexagonal pores. By minimizing the steric interactions between ammonium carbamate chains, these frameworks enable a single CO 2 adsorption/desorption step in all cases, as well as decreased water co-adsorption and increased stability to diamine loss. Functionalization of Mg 2(pc-dobpdc) with large diamines such as N-(n-heptyl)ethylenediamine results in optimal adsorption behavior, highlighting the advantage of tuning both the pore shape and the diamine size for the development of new adsorbents for carbon capture applications.« less

Clinical significance in nursing research: A discussion and descriptive analysis.

PubMed

Polit, Denise F

2017-08-01

It is widely understood that statistical significance should not be equated with clinical significance, but the topic of clinical significance has not received much attention in the nursing literature. By contrast, interest in conceptualizing and operationalizing clinical significance has been a "hot topic" in other health care fields for several decades. The major purpose of this paper is to briefly describe recent advances in defining and quantifying clinical significance. The overview covers both group-level indicators of clinical significance (e.g., effect size indexes), and individual-level benchmarks (e.g., the minimal important change index). A secondary purpose is to describe the extent to which developments in clinical significance have penetrated the nursing literature. A descriptive analysis of a sample of primary research articles published in three high-impact nursing research journals in 2016 was undertaken. A total of 362 articles were electronically searched for terms relating to statistical and clinical significance. Of the 362 articles, 261 were reports of quantitative studies, the vast majority of which (93%) included a formal evaluation of the statistical significance of the results. By contrast, the term "clinical significance" or related surrogate terms were found in only 33 papers, and most often the term was used informally, without explicit definition or assessment. Raising consciousness about clinical significance should be an important priority among nurse researchers. Several recommendations are offered to improve the visibility and salience of clinical significance in nursing science. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

Sommer, C. M., E-mail: christof.sommer@med.uni-heidelberg.de; Grenacher, L.; Stampfl, U.

The purpose of this study was to evaluate the impact of stent design on in-stent stenosis in rabbit iliac arteries. Four different types of stent were implanted in rabbit iliac arteries, being different in stent design (crown or wave) and strut thickness (50 or 100 {mu}m). Ten stents of each type were implanted. Each animal received one crown and one wave stent with the same strut thickness. Follow-up was either 12 weeks (n = 10 rabbits) or 24 weeks (n = 10 rabbits). Primary study end points were angiographic and microscopic in-stent stenosis. Secondary study end points were vessel injury,more » vascular inflammation, and stent endothelialization. Average stent diameter, relative stent overdilation, average and minimal luminal diameter, and relative average and maximum luminal loss were not significantly different. However, a trend to higher relative stent overdilation was recognized in crown stents compared to wave stents. A trend toward higher average and minimal luminal diameter and lower relative average and maximum luminal loss was recognized in crown stents compared to wave stents with a strut thickness of 100 {mu}m. Neointimal height, relative luminal area stenosis, injury score, inflammation score, and endothelialization score were not significantly different. However, a trend toward higher neointimal height was recognized in crown stents compared to wave stents with a strut thickness of 50 {mu}m and a follow-up of 24 weeks. In conclusion, in this study, crown stents seem to trigger neointima. However, the optimized radial force might equalize the theoretically higher tendency for restenosis in crown stents. In this context, also more favorable positive remodeling in crown stents could be important.« less

TFE3-Expressing Perivascular Epithelioid Cell Neoplasm (PEComa) of the Sella Turcica.

PubMed

Hyrcza, Martin D; Winer, Daniel A; Shago, Mary; Au, Karolyn; Zadeh, Gelareh; Asa, Sylvia L; Mete, Ozgur

2017-03-01

We report a primary central nervous system (CNS) perivascular epithelioid cell tumor (PEComa) in a middle-aged female patient. The tumor occurred in suprasellar location with secondary extension into the sella turcica. The patient presented with intracranial hemorrhage and an altered level of consciousness. The tumor had morphologic features matching those of other previously described TFE3-translocated PEComas, including epithelioid morphology, diffuse and strong nuclear immunoreactivity for TFE3, and minimal staining with myoid markers. The TFE3 break-apart FISH testing showed a slight splitting of one of the TFE3 signals in 49.5 % of nuclei. This case illustrates that PEComas should be added to the growing list of mesenchymal tumors that can be encountered in the CNS and specifically in the vicinity of the pituitary gland. The recognition of this entity is of significance given their underlying pathogenesis and possible management implications.

The pleiotropic effects of paricalcitol: Beyond bone-mineral metabolism.

PubMed

Egido, Jesús; Martínez-Castelao, Alberto; Bover, Jordi; Praga, Manuel; Torregrosa, José Vicente; Fernández-Giráldez, Elvira; Solozábal, Carlos

2016-01-01

Secondary hyperparathyroidism (SHPT) is a common complication in patients with chronic kidney disease (CKD) that is characterised by elevated parathyroid hormone (PTH) levels and a series of bone-mineral metabolism anomalies. In patients with SHPT, treatment with paricalcitol, a selective vitamin D receptor activator, has been shown to reduce PTH levels with minimal serum calcium and phosphorus variations. The classic effect of paricalcitol is that of a mediator in mineral and bone homeostasis. However, recent studies have suggested that the benefits of treatment with paricalcitol go beyond PTH reduction and, for instance, it has a positive effect on cardiovascular disease and survival. The objective of this study is to review the most significant studies on the so-called pleiotropic effects of paricalcitol treatment in patients with CKD. Copyright © 2015 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

The minimizing of fluorescence background in Raman optical activity and Raman spectra of human blood plasma.

PubMed

Tatarkovič, Michal; Synytsya, Alla; Šťovíčková, Lucie; Bunganič, Bohuš; Miškovičová, Michaela; Petruželka, Luboš; Setnička, Vladimír

2015-02-01

Raman optical activity (ROA) is inherently sensitive to the secondary structure of biomolecules, which makes it a method of interest for finding new approaches to clinical applications based on blood plasma analysis, for instance the diagnostics of several protein-misfolding diseases. Unfortunately, real blood plasma exhibits strong background fluorescence when excited at 532 nm; hence, measuring the ROA spectra appears to be impossible. Therefore, we established a suitable method using a combination of kinetic quenchers, filtering, photobleaching, and a mathematical correction of residual fluorescence. Our method reduced the background fluorescence approximately by 90%, which allowed speedup for each measurement by an average of 50%. In addition, the signal-to-noise ratio was significantly increased, while the baseline distortion remained low. We assume that our method is suitable for the investigation of human blood plasma by ROA and may lead to the development of a new tool for clinical diagnostics.

Second-order polynomial model to solve the least-cost lumber grade mix problem

Treesearch

Urs Buehlmann; Xiaoqiu Zuo; R. Edward Thomas

2010-01-01

Material costs when cutting solid wood parts from hardwood lumber for secondary wood products manufacturing account for 20 to 50 percent of final product cost. These costs can be minimized by proper selection of the lumber quality used. The lumber quality selection problem is referred to as the least-cost lumber grade mix problem in the industry. The objective of this...

iMAST FY2003 Annual Report

DTIC Science & Technology

2003-01-01

The approach being pursued, under this program structure, is to eliminate the use of physical surfaces on the component as datum. The use of physical...will eliminate /minimize fretting and low-cycle fatigue and the blade-disk interface. This optimum coating and/or coating process will be evaluated both...Utilizes MCLB infrastructure Avoids costs associated with existing APCS Biofiltration produces no secondary emissions Biofiltration is the most

Mobile Uninterruptible Power Supply

NASA Technical Reports Server (NTRS)

Mears, Robert L.

1990-01-01

Proposed mobile unit provides 20 kVA of uninterruptible power. Used with mobile secondary power-distribution centers to provide power to test equipment with minimal cabling, hazards, and obstacles. Wheeled close to test equipment and system being tested so only short cable connections needed. Quickly moved and set up in new location. Uninterruptible power supply intended for tests which data lost or equipment damaged during even transient power failure.

Soldier System Power Sources

DTIC Science & Technology

2006-12-31

dependence, and estimated mass of the stack. The model equations were derived from peer reviewed academic journals , internal studies, and texts on the subject...Liu, R. Dougal, E. Solodovnik, "VTB-Based Design of a Standalone Photovoltaic Power System", International Journal of Green Energy, Vol. 1, No. 3...Powered Battery Chargers 17 Exergy minimization 19 Use of secondary cells as temporary energy repositories 19 Design an automatic energy optimization

The Role of Urban Primary and Secondary Schools in Minimizing Disease Outbreak Caused by Environmental Contamination: A Case of Chinhoyi, Zimbabwe

ERIC Educational Resources Information Center

Mutungwe, Edlight; Tsvere, Maria; Dondo, Beauty; Munikwa, Simbarashe

2011-01-01

Waste management is a major challenge facing urban councils in Zimbabwe and Chinhoyi Municipality is no exception. Lack of resources and technical and administrative know-how is hindering proper waste management. Raw sewage and industrial waste flow into streams and rivers and uncollected rubbish bins and strewn litter is a common feature in the…

Translations on Eastern Europe. Political, Sociological, and Military Affairs, Number 1405

DTIC Science & Technology

1977-06-24

the field in which they have graduated. The higher military academies shall accept young people with completed secondary school education and a ...Army. Applicants for scholarships for the subjects listed above shall apply to the respective higher educational institutions; those with a minimal...military districts within 10 days following the announcement of competition results. The applications must include a curriculum vitae, medical

Promoting Writing in Mathematics: Prospective Teachers' Experiences and Perspectives on the Process of Writing When Doing Mathematics as Problem Solving

ERIC Educational Resources Information Center

Kuzle, Ana

2013-01-01

Despite a great deal of research on the benefits of writing in mathematics, writing plays a minimal role, if any, in secondary and tertiary mathematics education. In order for teachers to use writing in their classrooms, they themselves have to experience writing mathematics within the teacher education programme. The present paper reports on a…

Cerebral venous thrombosis and secondary polycythemia in a case of nephrotic syndrome.

PubMed

Nagaraju, Shankar Prasad; Bairy, Manohar; Attur, Ravindra Prabhu; Sambhaji, Charudutt Jayant

2016-03-01

Cerebral venous thrombosis (CVT) and polycythemia are considered as rare and life threatening complications of nephrotic syndrome. We report an unusual combination of both these complications in a case of nephrotic syndrome due to minimal change disease that was treated successfully. There was prompt and complete remission of nephrotic syndrome with steroid therapy, concurrent with complete resolution of polycythemia and CVT.

Secondary histiocytic sarcoma may cause apparent persistence or recurrence of minimal residual disease in childhood acute lymphoblastic leukemia.

PubMed

Alten, Julia; Klapper, Wolfram; Leuschner, Ivo; Eckert, Cornelia; Beier, Rita; Vallo, Elisabeth; Krause, Martin; Claviez, Alexander; Vieth, Simon; Bleckmann, Kirsten; Möricke, Anja; Schrappe, Martin; Cario, Gunnar

2015-09-01

Histiocytic sarcoma (HS) is a rare disease with poor prognosis which may develop subsequent to acute lymphoblastic leukemia (ALL). Here we report two children treated within the AIEOP-BFM ALL 2009 trial: one patient succumbed to fulminant hemophagocytic lymphohistiocytosis triggered by HS during ALL maintenance therapy, the other patient had a smoldering course of HS for over 2 years, and subsequently died after allogeneic stem cell transplantation. In both cases, HS and ALL were clonally related and apparent return of minimal residual disease (MRD) was detected by qPCR in bone marrow. Thus, HS should be considered in ALL when MRD appears to persist or reappear. © 2015 Wiley Periodicals, Inc.

Two in one: making electron and ion measurements using a single MCP in future top hat instruments.

NASA Astrophysics Data System (ADS)

Bedington, Robert; Saito, Yoshifumi

To allow for the reduced use of spacecraft resources in future missions, we are developing techniques to enable both electrons and ions to be measured in a single top hat instrument. Top hat energy analyser instruments typically analyse charged particles from a few eV to a few tens keV. They consist of an electrostatic, energy-analyser section and a detector. MCPs (micro-channel plates) are the most commonly used detectors, because of their high sensitivity and strong heritage in space instrumentation. To detect the lowest energies of charged particles, a pre-accelerating bias potential is applied to the front surface of the MCP, however this voltage cannot be altered quickly without drastically affecting the detector response. Any instrument that detects both electrons and ions, will therefore typically use two detectors (with fixed voltages)—one for electrons, one for ions, and will often use two separate energy analysers. Significant resource savings are available however if just a single MCP can be used. This can be achieved by having incoming ions (and optionally incoming electrons also) impact a secondary electron emitting material, and thus release secondary electrons to be detected by a positively biased (electron-detecting) MCP. Unlike MCPs, the electrostatic, energy-analyser sections are able to have their voltages cycled extremely rapidly, so that they can be made to sample electrons and then ions in quick succession with minimal design changes required. Two secondary electron conversion methods are being investigated: ultra-thin carbon foils, and dynodes. Using carbon foils in front of the MCPs, incoming ions can be detected by the secondary electrons they release, while incoming electrons pass straight through them. Using dynodes all incoming particles can be converted to secondary electrons before detection. The challenges include finding materials with uniform electron emission responses for the desired energies and particles, managing electric fields and scattered primary electrons. Experiments pertaining to this research will be discussed. These investigations are being pursued as prototype developments for the SCOPE mission for use on the EISA (Electron & Ion Spectrum Analyzer) instrument.

Methyl Jasmonate Regulates Antioxidant Defense and Suppresses Arsenic Uptake in Brassica napus L.

PubMed

Farooq, Muhammad A; Gill, Rafaqat A; Islam, Faisal; Ali, Basharat; Liu, Hongbo; Xu, Jianxiang; He, Shuiping; Zhou, Weijun

2016-01-01

Methyl jasmonate (MJ) is an important plant growth regulator, involved in plant defense against abiotic stresses, however, its possible function in response to metal stress is poorly understood. In the present study, the effect of MJ on physiological and biochemical changes of the plants exposed to arsenic (As) stress were investigated in two Brassica napus L. cultivars (ZS 758 - a black seed type, and Zheda 622 - a yellow seed type). The As treatment at 200 μM was more phytotoxic, however, its combined application with MJ resulted in significant increase in leaf chlorophyll fluorescence, biomass production and reduced malondialdehyde content compared with As stressed plants. The application of MJ minimized the oxidative stress, as revealed via a lower level of reactive oxygen species (ROS) synthesis (H2O2 and OH(-)) in leaves and the maintenance of high redox states of glutathione and ascorbate. Enhanced enzymatic activities and gene expression of important antioxidants (SOD, APX, CAT, POD), secondary metabolites (PAL, PPO, CAD) and induction of lypoxygenase gene suggest that MJ plays an effective role in the regulation of multiple transcriptional pathways which were involved in oxidative stress responses. The content of As was higher in yellow seeded plants (cv. Zheda 622) as compared to black seeded plants (ZS 758). The application of MJ significantly reduced the As content in leaves and roots of both cultivars. Findings of the present study reveal that MJ improves ROS scavenging through enhanced antioxidant defense system, secondary metabolite and reduced As contents in both the cultivars.

Methyl Jasmonate Regulates Antioxidant Defense and Suppresses Arsenic Uptake in Brassica napus L.

PubMed Central

Farooq, Muhammad A.; Gill, Rafaqat A.; Islam, Faisal; Ali, Basharat; Liu, Hongbo; Xu, Jianxiang; He, Shuiping; Zhou, Weijun

2016-01-01

Methyl jasmonate (MJ) is an important plant growth regulator, involved in plant defense against abiotic stresses, however, its possible function in response to metal stress is poorly understood. In the present study, the effect of MJ on physiological and biochemical changes of the plants exposed to arsenic (As) stress were investigated in two Brassica napus L. cultivars (ZS 758 – a black seed type, and Zheda 622 – a yellow seed type). The As treatment at 200 μM was more phytotoxic, however, its combined application with MJ resulted in significant increase in leaf chlorophyll fluorescence, biomass production and reduced malondialdehyde content compared with As stressed plants. The application of MJ minimized the oxidative stress, as revealed via a lower level of reactive oxygen species (ROS) synthesis (H2O2 and OH-) in leaves and the maintenance of high redox states of glutathione and ascorbate. Enhanced enzymatic activities and gene expression of important antioxidants (SOD, APX, CAT, POD), secondary metabolites (PAL, PPO, CAD) and induction of lypoxygenase gene suggest that MJ plays an effective role in the regulation of multiple transcriptional pathways which were involved in oxidative stress responses. The content of As was higher in yellow seeded plants (cv. Zheda 622) as compared to black seeded plants (ZS 758). The application of MJ significantly reduced the As content in leaves and roots of both cultivars. Findings of the present study reveal that MJ improves ROS scavenging through enhanced antioxidant defense system, secondary metabolite and reduced As contents in both the cultivars. PMID:27148299

Clinically significant response to zolpidem in disorders of consciousness secondary to anti-N-methyl-D-aspartate receptor encephalitis in a teenager: a case report.

PubMed

Appu, Merveen; Noetzel, Michael

2014-03-01

Anti-N-methyl-d-aspartate receptor encephalitis has been associated with a prolonged neuropsychiatric phase that may last for months to years. We report the case of a 16-year-old girl who was diagnosed with anti-N-methyl-d-aspartate receptor encephalitis resulting from left ovarian mature teratoma 2 weeks after presentation with psychosis. Following tumor removal and immunotherapy, recovery from a minimally conscious state was accelerated significantly by zolpidem that was used for her sleep disturbance. Our patient was discharged home 8 weeks after admission with marked improvement in her neurological function. Zolpidem has been reported to improve arousal in disorders of consciousness but there are no previous reports of its benefit among patients with anti-N-methyl-d-aspartate receptor encephalitis. Zolpidem would be a reasonable consideration as an adjunctive treatment in anti-N-methyl-d-aspartate receptor encephalitis after tumor removal and immunotherapy to accelerate recovery and rehabilitation. Copyright © 2014 Elsevier Inc. All rights reserved.

Centaur Test Bed (CTB) for Cryogenic Fluid Management

NASA Technical Reports Server (NTRS)

Sakla, Steven; Kutter, Bernard; Wall, John

2006-01-01

Future missions such as NASA s space exploration vision and DOD satellite servicing will require significant increases in the understanding and knowledge of space based cryogenic fluid management (CFM), including the transfer and storage of cryogenic fluids. Existing CFM capabilities are based on flight of upper stage cryogenic vehicles, scientific dewars, a few dedicated flight demonstrations and ground testing. This current capability is inadequate to support development of the CEV cryogenic propulsion system, other aspects of robust space exploration or the refueling of satellite cryo propulsion systems with reasonable risk. In addition, these technologies can provide significant performance increases for missions beyond low-earth orbit to enable manned missions to the Moon and beyond. The Centaur upper-stage vehicle can provide a low cost test platform for performing numerous flight demonstrations of the full breadth of required CFM technologies to support CEV development. These flight demonstrations can be performed as secondary mission objectives using excess LH2 and/or LO2 from the main vehicle propellant tanks following primary spacecraft separation at minimal cost and risk.

Household transmission of SARS, 2003

PubMed Central

Wilson-Clark, Samantha D.; Deeks, Shelley L.; Gournis, Effie; Hay, Karen; Bondy, Susan; Kennedy, Erin; Johnson, Ian; Rea, Elizabeth; Kuschak, Theodore; Green, Diane; Abbas, Zahid; Guarda, Brenda

2006-01-01

Background In the 2003 outbreak in Toronto (in Ontario, Canada) of severe acute respiratory syndrome (SARS), about 20% of cases resulted from household transmission. The purpose of our study was to determine characteristics associated with the transmission of SARS within households. Methods A retrospective cohort of SARS-affected households was studied to determine risk factors for household transmission. Questionnaires addressed characteristics of the index case, the household and behaviours among household members. Potential risk factors for secondary transmission of infection were assessed in regression models appropriate to the outcome (secondary cases) and nonindependence of household members. Results The 74 households that participated included 18 secondary cases and 158 uninfected household members in addition to the 74 index cases. The household secondary attack rate was 10.2% (95% confidence interval [CI] 6.7%–23.5%). There was a linear association between the time the index patient spent at home after symptom onset and the secondary attack rate. Infected health care workers who were index cases had lower rates of household transmission. Interpretation SARS transmission in households is complex and increases with the length of time an ill person spends at home. Risk of transmission was lower when the index case was a health care worker. Rapid case identification is the public health measure most useful in minimizing exposure in the home. PMID:17098951

Chemical kinetic model uncertainty minimization through laminar flame speed measurements

PubMed Central

Park, Okjoo; Veloo, Peter S.; Sheen, David A.; Tao, Yujie; Egolfopoulos, Fokion N.; Wang, Hai

2016-01-01

Laminar flame speed measurements were carried for mixture of air with eight C3-4 hydrocarbons (propene, propane, 1,3-butadiene, 1-butene, 2-butene, iso-butene, n-butane, and iso-butane) at the room temperature and ambient pressure. Along with C1-2 hydrocarbon data reported in a recent study, the entire dataset was used to demonstrate how laminar flame speed data can be utilized to explore and minimize the uncertainties in a reaction model for foundation fuels. The USC Mech II kinetic model was chosen as a case study. The method of uncertainty minimization using polynomial chaos expansions (MUM-PCE) (D.A. Sheen and H. Wang, Combust. Flame 2011, 158, 2358–2374) was employed to constrain the model uncertainty for laminar flame speed predictions. Results demonstrate that a reaction model constrained only by the laminar flame speed values of methane/air flames notably reduces the uncertainty in the predictions of the laminar flame speeds of C3 and C4 alkanes, because the key chemical pathways of all of these flames are similar to each other. The uncertainty in model predictions for flames of unsaturated C3-4 hydrocarbons remain significant without considering fuel specific laminar flames speeds in the constraining target data set, because the secondary rate controlling reaction steps are different from those in the saturated alkanes. It is shown that the constraints provided by the laminar flame speeds of the foundation fuels could reduce notably the uncertainties in the predictions of laminar flame speeds of C4 alcohol/air mixtures. Furthermore, it is demonstrated that an accurate prediction of the laminar flame speed of a particular C4 alcohol/air mixture is better achieved through measurements for key molecular intermediates formed during the pyrolysis and oxidation of the parent fuel. PMID:27890938

Chemical kinetic model uncertainty minimization through laminar flame speed measurements.

PubMed

Park, Okjoo; Veloo, Peter S; Sheen, David A; Tao, Yujie; Egolfopoulos, Fokion N; Wang, Hai

2016-10-01

Laminar flame speed measurements were carried for mixture of air with eight C 3-4 hydrocarbons (propene, propane, 1,3-butadiene, 1-butene, 2-butene, iso -butene, n -butane, and iso -butane) at the room temperature and ambient pressure. Along with C 1-2 hydrocarbon data reported in a recent study, the entire dataset was used to demonstrate how laminar flame speed data can be utilized to explore and minimize the uncertainties in a reaction model for foundation fuels. The USC Mech II kinetic model was chosen as a case study. The method of uncertainty minimization using polynomial chaos expansions (MUM-PCE) (D.A. Sheen and H. Wang, Combust. Flame 2011, 158, 2358-2374) was employed to constrain the model uncertainty for laminar flame speed predictions. Results demonstrate that a reaction model constrained only by the laminar flame speed values of methane/air flames notably reduces the uncertainty in the predictions of the laminar flame speeds of C 3 and C 4 alkanes, because the key chemical pathways of all of these flames are similar to each other. The uncertainty in model predictions for flames of unsaturated C 3-4 hydrocarbons remain significant without considering fuel specific laminar flames speeds in the constraining target data set, because the secondary rate controlling reaction steps are different from those in the saturated alkanes. It is shown that the constraints provided by the laminar flame speeds of the foundation fuels could reduce notably the uncertainties in the predictions of laminar flame speeds of C 4 alcohol/air mixtures. Furthermore, it is demonstrated that an accurate prediction of the laminar flame speed of a particular C 4 alcohol/air mixture is better achieved through measurements for key molecular intermediates formed during the pyrolysis and oxidation of the parent fuel.

Does intraoperative navigation improve the accuracy of pedicle screw placement in the apical region of dystrophic scoliosis secondary to neurofibromatosis type I: comparison between O-arm navigation and free-hand technique.

PubMed

Jin, Mengran; Liu, Zhen; Liu, Xingyong; Yan, Huang; Han, Xiao; Qiu, Yong; Zhu, Zezhang

2016-06-01

To assess the accuracy of O-arm-navigation-based pedicle screw insertion in dystrophic scoliosis secondary to NF-1 and compare it with free-hand pedicle screw insertion technique. 32 patients with dystrophic NF-1-associated scoliosis were divided into two groups. A total of 92 pedicle screws were implanted in apical region (two vertebrae above and below the apex each) in 13 patients using O-arm-based navigation (O-arm group), and 121 screws were implanted in 19 patients using free-hand technique (free-hand group). The postoperative CT images were reviewed and analyzed for pedicle violation. The screw penetration was divided into four grades: grade 0 (ideal placement), grade 1 (penetration <2 mm), grade 2 (penetration between 2 and 4 mm), and grade 3 (penetration >4 mm). The accuracy rate of pedicle screw placement (grade 0, 1) was significantly higher in the O-arm group (79 %, 73/92) compared to 67 % (81/121) of the free-hand group (P = 0.045). Meanwhile, a significantly lower prevalence of grade 2-3 perforation was observed in the O-arm group (21 vs. 33 %, P < 0.05), and the incidence of medial perforation was significantly minimized by using O-arm navigation compared to free-hand technique (2 vs. 15 %, P < 0.01). Moreover, the implant density in apical region was significantly elevated by using O-arm navigation (58 vs. 42 %, P < 0.001). We reported 79 % accuracy of O-arm-based pedicle screw placement in dystrophic NF-1-associated scoliosis. O-arm navigation system does facilitate pedicle screw insertion in dystrophic NF-1-associated scoliosis, demonstrating superiorities in the safety and accuracy of pedicle screw placement in comparison with free-hand technique.

Secondary Electron Emission Yields

NASA Technical Reports Server (NTRS)

Krainsky, I.; Lundin, W.; Gordon, W. L.; Hoffman, R. W.

1981-01-01

The secondary electron emission (SEE) characteristics for a variety of spacecraft materials were determined under UHV conditions using a commercial double pass CMA which permits sequential Auger electron electron spectroscopic analysis of the surface. The transparent conductive coating indium tin oxide (ITO) was examined on Kapton and borosilicate glass and indium oxide on FED Teflon. The total SEE coefficient ranges from 2.5 to 2.6 on as-received surfaces and from 1.5 to 1.6 on Ar(+) sputtered surfaces with 5 nm removed. A cylindrical sample carousel provides normal incidence of the primary beam as well as a multiple Faraday cup measurement of the approximately nA beam currents. Total and true secondary yields are obtained from target current measurements with biasing of the carousel. A primary beam pulsed mode to reduce electron beam dosage and minimize charging of insulating coatings was applied to Mg/F2 coated solar cell covers. Electron beam effects on ITO were found quite important at the current densities necessary to do Auger studies.

Characterization of high explosive particles using cluster secondary ion mass spectrometry.

PubMed

Gillen, Greg; Mahoney, Christine; Wight, Scott; Lareau, Richard

2006-01-01

The use of secondary ion mass spectrometry (SIMS) for the detection and spatially resolved analysis of individual high explosive particles is described. A C(8) (-) carbon cluster primary ion beam was used in a commercial SIMS instrument to analyze samples of high explosives dispersed as particles on silicon substrates. In comparison with monatomic primary ion bombardment, the carbon cluster primary ion beam was found to greatly enhance characteristic secondary ion signals from the explosive compounds while causing minimal beam-induced degradation. The resistance of these compounds to degradation under ion bombardment allows explosive particles to be analyzed under high primary ion dose bombardment (dynamic SIMS) conditions, facilitating the rapid acquisition of spatially resolved molecular information. The use of cluster SIMS combined with computer control of the sample stage position allows for the automated identification and counting of explosive particle distributions on silicon surfaces. This will be useful for characterizing the efficiency of transfer of particulates in trace explosive detection portal collectors and/or swipes utilized for ion mobility spectrometry applications.

Turbomachine Sealing and Secondary Flows. Part 1; Review of Sealing Performance, Customer, Engine Designer, and Research Issues

NASA Technical Reports Server (NTRS)

Hendricks, R. C.; Steinetz, B. M.; Braun, M. J.

2004-01-01

Although forces outside our control shape our industry, turbomachine sealing research, design, and customer agendas established in 1978 by Ludwig, Campbell, and Smith in terms of specific fuel consumption and performance remain as objectives today. Advances have been made because failures of the space shuttle main engine turbomachinery ushered in a new understanding of sealing in high-power-density systems. Further, it has been shown that changes in sealing, especially for high-pressure rotors, dramatically change the performance of the entire engine or turbomachine. Maintaining seal leakages and secondary flows within engine design specifications remains the most efficient and cost effective way to enhance performance and minimize maintenance costs. This three-part review summarizes experiences, ideas, successes, and failures by NASA and the U.S. aerospace industry in secondary flow management in advanced turbomachinery. Part 1 presents system sealing, part 2 system rotordynamics, and part 3 modeling, with some overlap of each part.

Evaluation of passive and active vibration control mechanisms in a microgravity environment

NASA Technical Reports Server (NTRS)

Ellison, J.; Ahmadi, G.; Grodsinsky, C.

1993-01-01

The behavior of equipment and their light secondary attachments in large space structures under orbital excitation is studied. The equipment is modeled as a shear beam and its secondary attachment is treated as a single-degree-of-freedom lumped mass system. Peak responses of the equipment and its secondary system for a variety of vibration control mechanisms are evaluated. A novel active friction control mechanism, by varying the normal force, is suggested. The device uses a magnetic field control to minimize the stick condition, thereby reducing the overall structural response. The results show that the use of the passive vibration control devices could reduce the peak equipment responses to a certain extent. However, major reduction of vibration levels could be achieved only by the use of active devices. Using active control of the interface normal force, the peak responses of the equipment and its attachment are reduced by a factor of 10 over the fixed-base equipment response.

Tube thoracostomy; chest tube implantation and follow up

PubMed Central

Kuhajda, Ivan; Zarogoulidis, Konstantinos; Kougioumtzi, Ioanna; Huang, Haidong; Li, Qiang; Dryllis, Georgios; Kioumis, Ioannis; Pitsiou, Georgia; Machairiotis, Nikolaos; Katsikogiannis, Nikolaos; Papaiwannou, Antonis; Lampaki, Sofia; Papaiwannou, Antonis; Zaric, Bojan; Branislav, Perin; Porpodis, Konstantinos

2014-01-01

Pneumothorax is an urgent medical situation that requires urgent treatment. We can divide this entity based on the etiology to primary and secondary. Chest tube implantation can be performed either in the upper chest wall or lower. Both thoracic surgeons and pulmonary physicians can place a chest tube with minimal invasive techniques. In our current work, we will demonstrate chest tube implantation to locations, methodology and tools. PMID:25337405

Growth response of Acacia koa trees to thinning, grass control, and phosphorus fertilization in a secondary forest in Hawai‘i

Treesearch

Paul G. Scowcroft; J.B. Friday; Travis Idol; Nicklos Dudley; Janis Haraguchi; Dean Meason

2007-01-01

Koa (Acacia koa A. Gray) is an endemic Hawaiian hardwood tree of high ecological, cultural and economic value. Despite its multiple values, research on the silviculture of koa has been minimal until recently because the preferred land-use was pasture for livestock, and logging was done mainly to facilitate and reduce the costs of conversion. This...

Performance Analysis on the Coexistence of Multiple Cognitive Radio Networks

DTIC Science & Technology

2015-05-28

the scarce spectrum resources. Cognitive radio is a key in minimizing the spectral congestion through its adaptability, where the radio parameters...static allocation of spectrum results in congestion in some parts of the spectrum and non use in some others, therefore, spectra utilization is...well as the secondary user (SU) activities in multiple CR networks. It is shown that the scheduler provided much needed gain during congestions . However

Detection of tanker defects with infrared thermography

NASA Technical Reports Server (NTRS)

Kantsios, A. G.

1980-01-01

Infrared scanning technique for finding defects in secondary barrier of liquid natural gas (LNG) tank has been successfully tested on ship under construction at Newport News Shipbuilding and Dry Dock Company. Technique determines defects with minimal expenditure of time and manpower. Tests could be repeated during life of tanker and make more complicated testing unnecessary. Tests also confirmed that tank did not have any major defects, and tank was certified.

Bioaugmentation for Aerobic Bioremediation of RDX Contaminated Groundwater

DTIC Science & Technology

2016-01-06

Subsequent higher concentration (15 to 24 mM) fructose additions during high carbon biostimulation in DW-1 and MW-28 resulted in a slight decrease in pH ...that has suitable transport properties and high RDX degradation rates for a given site may not be able to be developed; (2) the selected...phase; attached cells were not measured. Minimal secondary groundwater quality degradation pH , dissolved oxygen (O2), oxidation

Early Postoperative Results of Percutaneous Needle Fasciotomy in 451 Patients with Dupuytren Disease.

PubMed

Molenkamp, Sanne; Schouten, Tanneke A M; Broekstra, Dieuwke C; Werker, Paul M N; Moolenburgh, J Daniel

2017-06-01

Percutaneous needle fasciotomy is a minimally invasive treatment modality for Dupuytren disease. In this study, the authors analyzed the efficacy and complication rate of percutaneous needle fasciotomy using a statistical method that takes the multilevel structure of data, regarding multiple measurements from the same patient, into account. The data of 470 treated rays from 451 patients with Dupuytren disease that underwent percutaneous needle fasciotomy were analyzed retrospectively. The authors described the early postoperative results of percutaneous needle fasciotomy and applied linear mixed models to compare mean correction of passive extension deficit between joints and efficacy of primary versus secondary percutaneous needle fasciotomy. Mean preoperative passive extension deficits at the metacarpophalangeal, proximal interphalangeal, and distal interphalangeal joints were 37, 40, and 31 degrees, respectively. Mean preoperative total passive extension deficit was 54 degrees. Results were excellent, with a mean total passive extension deficit correction of 85 percent. Percutaneous needle fasciotomy was most effective for metacarpophalangeal joints and less effective for proximal interphalangeal and distal interphalangeal joints. Secondary percutaneous needle fasciotomy was as effective as primary percutaneous needle fasciotomy. Complications were rare and mostly minor. The results of this study confirm that percutaneous needle fasciotomy is an effective and safe treatment modality for patients with mild to moderate disease who prefer a minimally invasive procedure. Therapeutic, IV.

PCDD/F and dioxin-like PCB minimization: A 13-year experimental study along the flue gas cleaning system of a secondary aluminium refining plant.

PubMed

Collina, Elena; Bortolami, Michele; Franzoni, Francesco; Lasagni, Marina; Piccinelli, Elsa; Pitea, Demetrio

2017-08-01

A 13-years study shows that a careful design of the flue gas cleaning system of a full scale secondary aluminium refining plant results in a minimized and very stable emission of Polychlorinated Dibenzo-p-Dioxins (PCDD), Polychlorinated Dibenzo Furans (PCDF) and dioxin-like Polychlorinated Biphenyls (PCB). The value of equivalent toxicity of PCDD/F in the emission was definitely of an order of magnitude less than the regulation limit. In the initial flue gas cleaning system, the PCB mean fingerprint after the slow cooling of the flue gas was typical of de novo synthesis. Instead, in the presence of quenching, there was evidence that the fast cooling of flue gas prevented the PCB de novo synthesis. In fact, the PCB profile was similar to that in the air collected from the aspiration hoods for the quenching. The gas-phase and solid-phase partitioning of PCBs, before and after the fabric filters, highlights the predominant role of the vapor phase with respect to the total removal efficiency. The polycyclic aromatic hydrocarbons breakdown could be an additional de novo formation pathway even in industrial plants. Copyright © 2017 Elsevier Ltd. All rights reserved.

Minimally invasive corticotomy in orthodontics using a three-dimensional printed CAD/CAM surgical guide.

PubMed

Cassetta, M; Giansanti, M; Di Mambro, A; Calasso, S; Barbato, E

2016-09-01

The aim of this prospective study was to evaluate the effectiveness of an innovative, minimally invasive, flapless corticotomy procedure in orthodontics. The STROBE guidelines were followed. Ten patients with severe dental crowding and a class I molar relationship were selected to receive orthodontic treatment with clear aligners and corticotomy-facilitated orthodontics. The mean age of these patients was 21 years (range 17-28, standard deviation 6.08 years); the male to female ratio was 2:1. The main outcome was a reduction in the total treatment time to correct dental crowding. The secondary outcomes were periodontal index changes, the degree of root resorption, and patient perceptions of the method used, assessed using the short-form Oral Health Impact Profile (OHIP-14). The occurrence of early surgical complications or unexpected events was also recorded. All patients completed the treatment to correct dental crowding. The average treatment time was reduced by two-thirds. The procedure did not significantly modify the periodontal indices or oral health-related quality of life. No early surgical complications or unexpected events were observed. In short, the results indicate that this new procedure is safe and accelerates tooth movement without periodontal complications or discomfort. However, the efficacy of this procedure must be confirmed in controlled clinical trials. Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

When proteome meets genome: the alpha helix and the beta strand of proteins are eschewed by mRNA splice junctions and may define the minimal indivisible modules of protein architecture

PubMed Central

Barik, Sailen

2008-01-01

The significance of the intron-exon structure of genes is a mystery. As eukaryotic proteins are made up of modular functional domains, each exon was suspected to encode some form of module; however, the definition of a module remained vague. Comparison of pre-mRNA splice junctions with the three-dimensional architecture of its protein product from different eukaryotes revealed that the junctions were far less likely to occur inside the α-helices and β-strands of proteins than within the more flexible linker regions (‘turns’ and ‘loops’) connecting them. The splice junctions were equally distributed in the different types of linkers and throughout the linker sequence, although a slight preference for the central region of the linker was observed. The avoidance of the α-helix and the β-strand by splice junctions suggests the existence of a selection pressure against their disruption, perhaps underscoring the investment made by nature in building these intricate secondary structures. A corollary is that the helix and the strand are the smallest integral architectural units of a protein and represent the minimal modules in the evolution of protein structure. These results should find use in comparative genomics, designing of cloning strategies, and in the mutual verification of genome sequences with protein structures. PMID:15381847

When proteome meets genome: the alpha helix and the beta strand of proteins are eschewed by mRNA splice junctions and may define the minimal indivisible modules of protein architecture.

PubMed

Barik, Sailen

2004-09-01

The significance of the intron-exon structure of genes is a mystery. As eukaryotic proteins are made up of modular functional domains, each exon was suspected to encode some form of module; however, the definition of a module remained vague. Comparison of pre-mRNA splice junctions with the three-dimensional architecture of its protein product from different eukaryotes revealed that the junctions were far less likely to occur inside the alpha-helices and beta-strands of proteins than within the more flexible linker regions ('turns' and 'loops') connecting them. The splice junctions were equally distributed in the different types of linkers and throughout the linker sequence, although a slight preference for the central region of the linker was observed. The avoidance of the alpha-helix and the beta-strand by splice junctions suggests the existence of a selection pressure against their disruption, perhaps underscoring the investment made by nature in building these intricate secondary structures. A corollary is that the helix and the strand are the smallest integral architectural units of a protein and represent the minimal modules in the evolution of protein structure. These results should find use in comparative genomics, designing of cloning strategies, and in the mutual verification of genome sequences with protein structures.

Planck intermediate results: XLI. A map of lensing-induced B-modes

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

Ade, P. A. R.; Aghanim, N.; Ashdown, M.

The secondary cosmic microwave background (CMB) B-modes stem from the post-decoupling distortion of the polarization E-modes due to the gravitational lensing effect of large-scale structures. These lensing-induced B-modes constitute both a valuable probe of the dark matter distribution and an important contaminant for the extraction of the primary CMB B-modes from inflation. Planck provides accurate nearly all-sky measurements of both the polarization E-modes and the integrated mass distribution via the reconstruction of the CMB lensing potential. By combining these two data products, we have produced in this paper an all-sky template map of the lensing-induced B-modes using a real-space algorithmmore » that minimizes the impact of sky masks. The cross-correlation of this template with an observed (primordial and secondary) B-mode map can be used to measure the lensing B-mode power spectrum at multipoles up to 2000. In particular, when cross-correlating with the B-mode contribution directly derived from the Planck polarization maps, we obtain lensing-induced B-mode power spectrum measurement at a significance level of 12σ, which agrees with the theoretical expectation derived from the Planck best-fit Λ cold dark matter model. This unique nearly all-sky secondary B-mode template, which includes the lensing-induced information from intermediate to small (10 ≲ ℓ ≲ 1000) angular scales, is delivered as part of the Planck 2015 public data release. Finally, it will be particularly useful for experiments searching for primordial B-modes, such as BICEP2/Keck Array or LiteBIRD, since it will enable an estimate to be made of the lensing-induced contribution to the measured total CMB B-modes.« less

Direct and indirect effects of invasive plants on soil chemistry and ecosystem function.

PubMed

Weidenhamer, Jeffrey D; Callaway, Ragan M

2010-01-01

Invasive plants have a multitude of impacts on plant communities through their direct and indirect effects on soil chemistry and ecosystem function. For example, plants modify the soil environment through root exudates that affect soil structure, and mobilize and/or chelate nutrients. The long-term impact of litter and root exudates can modify soil nutrient pools, and there is evidence that invasive plant species may alter nutrient cycles differently from native species. The effects of plants on ecosystem biogeochemistry may be caused by differences in leaf tissue nutrient stoichiometry or secondary metabolites, although evidence for the importance of allelochemicals in driving these processes is lacking. Some invasive species may gain a competitive advantage through the release of compounds or combinations of compounds that are unique to the invaded community—the “novel weapons hypothesis.” Invasive plants also can exert profound impact on plant communities indirectly through the herbicides used to control them. Glyphosate, the most widely used herbicide in the world, often is used to help control invasive weeds, and generally is considered to have minimal environmental impacts. Most studies show little to no effect of glyphosate and other herbicides on soil microbial communities. However, herbicide applications can reduce or promote rhizobium nodulation and mycorrhiza formation. Herbicide drift can affect the growth of non-target plants, and glyphosate and other herbicides can impact significantly the secondary chemistry of plants at sublethal doses. In summary, the literature indicates that invasive species can alter the biogeochemistry of ecosystems, that secondary metabolites released by invasive species may play important roles in soil chemistry as well as plant-plant and plant-microbe interactions, and that the herbicides used to control invasive species can impact plant chemistry and ecosystems in ways that have yet to be fully explored.

Planck intermediate results. XLI. A map of lensing-induced B-modes

NASA Astrophysics Data System (ADS)

Planck Collaboration; Ade, P. A. R.; Aghanim, N.; Ashdown, M.; Aumont, J.; Baccigalupi, C.; Banday, A. J.; Barreiro, R. B.; Bartolo, N.; Basak, S.; Battaner, E.; Benabed, K.; Benoit-Lévy, A.; Bernard, J.-P.; Bersanelli, M.; Bielewicz, P.; Bock, J. J.; Bonaldi, A.; Bonavera, L.; Bond, J. R.; Borrill, J.; Bouchet, F. R.; Boulanger, F.; Burigana, C.; Butler, R. C.; Calabrese, E.; Cardoso, J.-F.; Catalano, A.; Chiang, H. C.; Christensen, P. R.; Clements, D. L.; Colombi, S.; Colombo, L. P. L.; Combet, C.; Crill, B. P.; Curto, A.; Cuttaia, F.; Danese, L.; Davis, R. J.; de Bernardis, P.; de Zotti, G.; Delabrouille, J.; Dickinson, C.; Diego, J. M.; Doré, O.; Ducout, A.; Dupac, X.; Elsner, F.; Enßlin, T. A.; Eriksen, H. K.; Finelli, F.; Forni, O.; Frailis, M.; Fraisse, A. A.; Franceschi, E.; Galeotta, S.; Galli, S.; Ganga, K.; Ghosh, T.; Giard, M.; Giraud-Héraud, Y.; Gjerløw, E.; González-Nuevo, J.; Górski, K. M.; Gruppuso, A.; Gudmundsson, J. E.; Harrison, D. L.; Hernández-Monteagudo, C.; Herranz, D.; Hildebrandt, S. R.; Hornstrup, A.; Hovest, W.; Hurier, G.; Jaffe, A. H.; Jones, W. C.; Keihänen, E.; Keskitalo, R.; Kisner, T. S.; Knoche, J.; Knox, L.; Kunz, M.; Kurki-Suonio, H.; Lagache, G.; Lähteenmäki, A.; Lamarre, J.-M.; Lasenby, A.; Lattanzi, M.; Leonardi, R.; Levrier, F.; Lilje, P. B.; Linden-Vørnle, M.; López-Caniego, M.; Lubin, P. M.; Macías-Pérez, J. F.; Maffei, B.; Maggio, G.; Maino, D.; Mandolesi, N.; Mangilli, A.; Maris, M.; Martin, P. G.; Martínez-González, E.; Masi, S.; Matarrese, S.; Meinhold, P. R.; Melchiorri, A.; Mennella, A.; Migliaccio, M.; Mitra, S.; Miville-Deschênes, M.-A.; Moneti, A.; Montier, L.; Morgante, G.; Mortlock, D.; Moss, A.; Munshi, D.; Murphy, J. A.; Naselsky, P.; Nati, F.; Natoli, P.; Netterfield, C. B.; Nørgaard-Nielsen, H. U.; Novikov, D.; Novikov, I.; Pagano, L.; Pajot, F.; Paoletti, D.; Pasian, F.; Patanchon, G.; Perdereau, O.; Perotto, L.; Pettorino, V.; Piacentini, F.; Piat, M.; Pierpaoli, E.; Pointecouteau, E.; Polenta, G.; Pratt, G. W.; Rachen, J. P.; Reinecke, M.; Remazeilles, M.; Renault, C.; Renzi, A.; Ristorcelli, I.; Rocha, G.; Rosset, C.; Rossetti, M.; Roudier, G.; Rubiño-Martín, J. A.; Rusholme, B.; Sandri, M.; Santos, D.; Savelainen, M.; Savini, G.; Scott, D.; Spencer, L. D.; Stolyarov, V.; Stompor, R.; Sudiwala, R.; Sunyaev, R.; Sutton, D.; Suur-Uski, A.-S.; Sygnet, J.-F.; Tauber, J. A.; Terenzi, L.; Toffolatti, L.; Tomasi, M.; Tristram, M.; Tucci, M.; Tuovinen, J.; Valenziano, L.; Valiviita, J.; Van Tent, B.; Vielva, P.; Villa, F.; Wade, L. A.; Wandelt, B. D.; Wehus, I. K.; Yvon, D.; Zacchei, A.; Zonca, A.

2016-12-01

The secondary cosmic microwave background (CMB) B-modes stem from the post-decoupling distortion of the polarization E-modes due to the gravitational lensing effect of large-scale structures. These lensing-induced B-modes constitute both a valuable probe of the dark matter distribution and an important contaminant for the extraction of the primary CMB B-modes from inflation. Planck provides accurate nearly all-sky measurements of both the polarization E-modes and the integrated mass distribution via the reconstruction of the CMB lensing potential. By combining these two data products, we have produced an all-sky template map of the lensing-induced B-modes using a real-space algorithm that minimizes the impact of sky masks. The cross-correlation of this template with an observed (primordial and secondary) B-mode map can be used to measure the lensing B-mode power spectrum at multipoles up to 2000. In particular, when cross-correlating with the B-mode contribution directly derived from the Planck polarization maps, we obtain lensing-induced B-mode power spectrum measurement at a significance level of 12σ, which agrees with the theoretical expectation derived from the Planck best-fit Λ cold dark matter model. This unique nearly all-sky secondary B-mode template, which includes the lensing-induced information from intermediate to small (10 ≲ ℓ ≲ 1000) angular scales, is delivered as part of the Planck 2015 public data release. It will be particularly useful for experiments searching for primordial B-modes, such as BICEP2/Keck Array or LiteBIRD, since it will enable an estimate to be made of the lensing-induced contribution to the measured total CMB B-modes.

The Impact Of Sports Activities On Quality Of Life Of Persons With A Spinal Cord Injury

PubMed Central

Eminović, Fadilj; Dopsaj, Milivoj; Pavlović, Dragan; Arsić, Sladjana; Otašević, Jadranka

2016-01-01

Abstract Objectives Studying the quality of life of people with a spinal cord injury is of great importance as it allows the monitoring of both functioning and adaptation to disability. The aim of this study was to determine the difference between persons with a spinal cord injury involved in sports activities and those not involved in sports activities in relation to their quality of life and the presence of secondary health conditions (pressure ulcers, urinary infections, muscle spasms, osteoporosis, pain, kidney problems-infections, calculosis and poor circulation). Methods The study included a total of 44 participants with spinal cord injury-paraplegia of both genders; 26 of them were athletes and 18 were not athletes. The athletes were training actively for the last two years, minimally 2-3 times per week. A specially designed questionnaire, medical documentation and the Spinal Cord Injury Quality of Life Questionnaire (SCI QL-23) were used for research purposes. Chi-square test was used to analyze the differences between the groups, while multiple analysis of variance (MANOVA) was used to determine the differences between the sets of variables. Results Among the participants, the athletes perceived higher quality of life than the non-athletes (male gender p<0.001 and female gender p<0.05). Regarding secondary health conditions, the athletes reported the presence of less pain (p=0.034) and a subjective feeling of better circulation (p=0.023). Conclusion The implementation of sports activities significantly improves quality of life in the population of people with spinal cord injury-paraplegia. However, sports activities only partially affect secondary health conditions. PMID:27284378

The pattern and time course of somatosensory changes in the human UVB sunburn model reveal the presence of peripheral and central sensitization.

PubMed

Gustorff, Burkhard; Sycha, Thomas; Lieba-Samal, Doris; Rolke, Roman; Treede, Rolf-Detlef; Magerl, Walter

2013-04-01

The ultraviolet B (UVB) sunburn model was characterized with a comprehensive battery of quantitative sensory testing (QST). Primary hyperalgesia in UVB-irradiated skin and secondary hyperalgesia in adjacent nonirradiated skin were studied in 22 healthy subjects 24h after irradiation with UVB at 3-fold minimal erythema dose of a skin area 5 cm in diameter at the thigh and compared to mirror-image contralateral control areas. The time course of hyperalgesia over 96 h was studied in a subgroup of 12 subjects. Within the sunburn area, cold hyperesthesia (P=.01), profound generalized hyperalgesia to heat (P<.001), cold (P<.05), pinprick and pressure (P<.001), and mild dynamic mechanical allodynia (P<.001) were present. The finding of cold hyperalgesia and cold hyperesthesia is new in this model. The sunburn was surrounded by large areas of pinprick hyperalgesia (mean±SEM, 218±32 cm(2)) and a small rim of dynamic mechanical allodynia but no other sensory changes. Although of smaller magnitude, secondary hyperalgesia and dynamic mechanical allodynia adjacent to the UVB-irradiated area were statistically highly significant. Primary and secondary hyperalgesia developed in parallel within hours, peaked after 24-32 h, and lasted for more than 96 h. These data reveal that the UVB sunburn model activates a broad spectrum of peripheral and central sensitization mechanisms and hence is a useful human surrogate model to be used as a screening tool for target engagement in phases 1 and 2a of drug development. Copyright © 2013 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

Planck intermediate results: XLI. A map of lensing-induced B-modes

DOE PAGES

Ade, P. A. R.; Aghanim, N.; Ashdown, M.; ...

2016-12-12

The secondary cosmic microwave background (CMB) B-modes stem from the post-decoupling distortion of the polarization E-modes due to the gravitational lensing effect of large-scale structures. These lensing-induced B-modes constitute both a valuable probe of the dark matter distribution and an important contaminant for the extraction of the primary CMB B-modes from inflation. Planck provides accurate nearly all-sky measurements of both the polarization E-modes and the integrated mass distribution via the reconstruction of the CMB lensing potential. By combining these two data products, we have produced in this paper an all-sky template map of the lensing-induced B-modes using a real-space algorithmmore » that minimizes the impact of sky masks. The cross-correlation of this template with an observed (primordial and secondary) B-mode map can be used to measure the lensing B-mode power spectrum at multipoles up to 2000. In particular, when cross-correlating with the B-mode contribution directly derived from the Planck polarization maps, we obtain lensing-induced B-mode power spectrum measurement at a significance level of 12σ, which agrees with the theoretical expectation derived from the Planck best-fit Λ cold dark matter model. This unique nearly all-sky secondary B-mode template, which includes the lensing-induced information from intermediate to small (10 ≲ ℓ ≲ 1000) angular scales, is delivered as part of the Planck 2015 public data release. Finally, it will be particularly useful for experiments searching for primordial B-modes, such as BICEP2/Keck Array or LiteBIRD, since it will enable an estimate to be made of the lensing-induced contribution to the measured total CMB B-modes.« less

Does contraceptive treatment in wildlife result in side effects? A review of quantitative and anecdotal evidence.

PubMed

Gray, Meeghan E; Cameron, Elissa Z

2010-01-01

The efficacy of contraceptive treatments has been extensively tested, and several formulations are effective at reducing fertility in a range of species. However, these formulations should minimally impact the behavior of individuals and populations before a contraceptive is used for population manipulation, but these effects have received less attention. Potential side effects have been identified theoretically and we reviewed published studies that have investigated side effects on behavior and physiology of individuals or population-level effects, which provided mixed results. Physiological side effects were most prevalent. Most studies reported a lack of secondary effects, but were usually based on qualitative data or anecdotes. A meta-analysis on quantitative studies of side effects showed that secondary effects consistently occur across all categories and all contraceptive types. This contrasts with the qualitative studies, suggesting that anecdotal reports are insufficient to investigate secondary impacts of contraceptive treatment. We conclude that more research is needed to address fundamental questions about secondary effects of contraceptive treatment and experiments are fundamental to conclusions. In addition, researchers are missing a vital opportunity to use contraceptives as an experimental tool to test the influence of reproduction, sex and fertility on the behavior of wildlife species.

Active room compensation for sound reinforcement using sound field separation techniques.

PubMed

Heuchel, Franz M; Fernandez-Grande, Efren; Agerkvist, Finn T; Shabalina, Elena

2018-03-01

This work investigates how the sound field created by a sound reinforcement system can be controlled at low frequencies. An indoor control method is proposed which actively absorbs the sound incident on a reflecting boundary using an array of secondary sources. The sound field is separated into incident and reflected components by a microphone array close to the secondary sources, enabling the minimization of reflected components by means of optimal signals for the secondary sources. The method is purely feed-forward and assumes constant room conditions. Three different sound field separation techniques for the modeling of the reflections are investigated based on plane wave decomposition, equivalent sources, and the Spatial Fourier transform. Simulations and an experimental validation are presented, showing that the control method performs similarly well at enhancing low frequency responses with the three sound separation techniques. Resonances in the entire room are reduced, although the microphone array and secondary sources are confined to a small region close to the reflecting wall. Unlike previous control methods based on the creation of a plane wave sound field, the investigated method works in arbitrary room geometries and primary source positions.

Percutaneous needle fasciotomy for recurrent Dupuytren disease.

PubMed

van Rijssen, Annet L; Werker, Paul M N

2012-09-01

Increasing options to treat Dupuytren disease include percutaneous needle fasciotomy (PNF), a minimally invasive technique that has proven to be effective for the treatment of primary disease. However, its effect on recurrent disease is not clear. We studied 30 patients with recurrent Dupuytren disease in 40 fingers, with a mean follow-up of 4.4 years. Primary outcome measures were total passive extension deficit reduction and interval to a second recurrence, defined as an increase of more than 30° compared with the result at the end of the previous treatment. We noted complications. Total passive extension reduction was 76%. Percutaneous needle fasciotomy was especially effective for the metacarpophalangeal joint, with an average reduction of 93%, whereas the average reduction in the proximal interphalangeal joint was 57%. A total of 50% of patients did not develop a secondary recurrence during follow-up. The other 50% did, and we treated recurrence within an average of 1.4 years after PNF. By means of PNF, we postponed tertiary treatment an average of 2.9 years starting from the initial treatment for Dupuytren disease. We successfully treated all secondary recurrences by limited fasciectomy, according to patients' wishes. We noted no major adverse effects. Percutaneous needle fasciotomy can be applied effectively for recurrent disease; 50% of patients remain free of recurrence for a mean of 4.4 years. If a secondary recurrence occurs, it does so relatively early after treatment. Patients must therefore be willing to accept this uncertainty in the context of the advantages of PNF, such as fast recovery, low complication rate, and minimal invasiveness. Copyright © 2012 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Reinforced cementoplasty using dedicated spindles in the management of unstable malignant lesions of the cervicotrochanteric region.

PubMed

Premat, Kévin; Clarençon, Frédéric; Bonaccorsi, Raphael; Degos, Vincent; Cormier, Évelyne; Chiras, Jacques

2017-09-01

In long bones, cementoplasty alone does not provide sufficient stability, which may cause secondary fractures. This study reviewed the safety and efficacy of reinforced cementoplasty (RC) (percutaneous internal fixation using dedicated spindles combined with cementoplasty) for unstable malignant lesions of the cervicotrochanteric region (CTR) of the proximal femur. Eighteen consecutive patients (nine women [50%] and nine men [50%]; mean age 55.1 ± 16.2 years; range 22-85) underwent RC for 19 unstable lesions of the CTR (16/19 [84.2%] bone metastases, 3/19 [15.8%] multiple myeloma lesions). All the patients were considered unsuitable for surgery. Clinical outcome was judged with a mean follow-up of 8.8 ± 7.2 months (range 1-27). The primary endpoints were occurrence of secondary fractures during the follow-up period and local pain relief measured by a visual analogue scale (VAS). No secondary fracture occurred. Mean VAS improved from 5.9 ± 3.1 (range 0-10) to 2.3 ± 2.4 (range 0-7) at 1 month (p = 0.001) to 1.6 ± 1.7 (range 0-5) at final follow-up (p = 0.0002). One symptomatic cement pulmonary embolism was recorded. RC is an original minimally invasive technique providing pain relief and effective bone stability for unstable malignant lesions of the cervicotrochanteric region in patients unsuitable for open surgery. • Reinforced cementoplasty (RC) combines intralesional spindling with cementoplasty. • RC provides effective bone stability and pain relief. • RC is a suitable minimally invasive option for patients in poor general condition.

The greening of pesticide-environment interactions: some personal observations.

PubMed

Casida, John E

2012-04-01

Pesticide-environment interactions are bidirectional. The environment alters pesticides by metabolism and photodegradation, and pesticides in turn change the environment through nontarget or secondary effects. Approximately 900 currently used commercial pesticides of widely diverse structures act by nearly a hundred mechanisms to control insects, weeds, and fungi, usually with minimal disruption of nature's equilibrium. Here I consider some aspects of the discovery, development, and use of ecofriendly or green pesticides (i.e., pesticides that are safe, effective, and biodegradable with minimal adverse secondary effects on the environment). Emphasis is given to research in my laboratory. The need for understanding and improving pesticide-environment interactions began with production of the first major insecticide approximately 150 years ago: The arsenical poison Paris Green was green in color but definitely not ecofriendly. Development and use of other pesticides has led to a variety of problems. Topics considered here include the need for high purity [e.g., hexachlorocyclohexane and polychloroborane isomers and 2,4,5-trichlorophenoxyacetic acid (2,4,5-T)], environmental degradation and the bioactivity of resulting photoproducts and metabolites, pesticide photochemistry (including the use of structural optimization, photostabilizers, and photosensitizers to achieve suitable persistence), the presence of multiple active ingredients in botanical insecticides, the need to consider compounds with common mechanisms of action, issues related to primary and secondary targets, and chemically induced or genetically modified changes in plant biochemistry. Many insecticides are bird, fish, and honeybee toxicants, whereas herbicides and fungicides pose fewer environmental problems. Six factors have contributed to the greening of pesticide-environment interactions: advances in pesticide chemistry and toxicology, banning of many chlorinated hydrocarbons, the development of new biochemical targets, increased reliance on genetically modified crops that reduce the amount and variety of pesticides applied, emphasis on biodegradability and environmental protection, and integrated pest- and pesticide-management systems.

Minimal Marking: A Success Story

ERIC Educational Resources Information Center

McNeilly, Anne

2014-01-01

The minimal-marking project conducted in Ryerson's School of Journalism throughout 2012 and early 2013 resulted in significantly higher grammar scores in two first-year classes of minimally marked university students when compared to two traditionally marked classes. The "minimal-marking" concept (Haswell, 1983), which requires…

Expert test results of the TPP-312A Boiler at the Zuev District Power Station during the combustion of the GSSh grade coal with adding the RA-GEN-F Anaklarid

NASA Astrophysics Data System (ADS)

Tupitsyn, S. P.; Sokolov, V. V.; Chebakova, G. F.; Kharchenko, A. V.; Chetverikov, A. N.

2014-03-01

The expert test results of the TPP-312 boiler no. 4 at the Zuev District Power Station (DPS) without supply and with the supply of the RA-GEN-F anaklarid to the boiler by means of its introduction in the approved dosing with the secondary air are presented. It is shown that the introduction of anaklarid positively affects the furnace process parameters during the combustion of grade GSSh coal. The possibility of the boiler operation at its minimal (490 t/h) and extremely minimal (440 t/h) steam output without supporting the flame by natural gas and the provision of the mode of liquid slag removal in the night drop of electrical loads.

Guidelines for the diagnosis, prevention and management of osteoporosis.

PubMed

Rossini, M; Adami, S; Bertoldo, F; Diacinti, D; Gatti, D; Giannini, S; Giusti, A; Malavolta, N; Minisola, S; Osella, G; Pedrazzoni, M; Sinigaglia, L; Viapiana, O; Isaia, G C

2016-06-23

Osteoporosis poses a significant public health issue. National Societies have developed Guidelines for the diagnosis and treatment of this disorder with an effort of adapting specific tools for risk assessment on the peculiar characteristics of a given population. The Italian Society for Osteoporosis, Mineral Metabolism and Bone Diseases (SIOMMMS) has recently revised the previously published Guidelines on the diagnosis, riskassessment, prevention and management of primary and secondary osteoporosis. The guidelines were first drafted by a working group and then approved by the board of SIOMMMS. Subsequently they received also the endorsement of other major Scientific Societies that deal with bone metabolic disease. These recommendations are based on systematic reviews of the best available evidence and explicit consideration of cost effectiveness. When minimal evidence is available, recommendations are based on leading experts' experience and opinion, and on good clinical practice. The osteoporosis prevention should be based on the elimination of specific risk factors. The use of drugs registered for the treatment of osteoporosis are recommended when the benefits overcome the risk, and this is the case only when the risk of fracture is rather high as measured with variables susceptible to pharmacological effect. DeFRA (FRAX® derived fracture risk assessment) is recognized as a useful tool for easily estimate the long-term fracture risk. Several secondary forms of osteoporosis require a specific diagnostic and therapeutic management.

Consequences of childhood reading difficulties and behaviour problems for educational achievement and employment in early adulthood.

PubMed

Smart, Diana; Youssef, George J; Sanson, Ann; Prior, Margot; Toumbourou, John W; Olsson, Craig A

2017-06-01

Reading difficulties (RDs) and behaviour problems (BPs) are two common childhood problems that have a high degree of stability and often negatively affect well-being in both the short and longer terms. The study aimed to shed light on the unique and joint consequences of these two childhood problems for educational and occupational outcomes in early adulthood. Data were drawn from a life-course longitudinal study of psychosocial development, the Australian Temperament Project. Parent and teacher reports and a standard reading test were used to define four groups of children at 7-8 years: RDs only; BPs only; both problems; and neither problem. These groups were followed forward to ascertain educational attainment and employment status at 19-20 and 23-24 years. Each childhood problem was a unique risk for poorer educational and occupational outcomes, with co-occurring problems significantly increasing the risk of poorer educational outcomes. Further analyses revealed that the effects of childhood BPs on occupational status were mediated by secondary school non-completion, but childhood RDs were not. The findings point to the importance of screening and early intervention to prevent or minimize the development of these two childhood problems, as well as continuing to support vulnerable children to increase their likelihood of secondary school completion. © 2017 The British Psychological Society.

Stochastic modelling suggests that an elevated superoxide anion - hydrogen peroxide ratio can drive extravascular phagocyte transmigration by lamellipodium formation.

PubMed

Kundu, Siddhartha

2016-10-21

Chemotaxis, integrates diverse intra- and inter-cellular molecular processes into a purposeful patho-physiological response; the operatic rules of which, remain speculative. Here, I surmise, that superoxide anion induced directional motility, in a responding cell, results from a quasi pathway between the stimulus, surrounding interstitium, and its biochemical repertoire. The epochal event in the mounting of an inflammatory response, is the extravascular transmigration of a phagocyte competent cell towards the site of injury, secondary to the development of a lamellipodium. This stochastic-to-markovian process conversion, is initiated by the cytosolic-ROS of the damaged cell, but is maintained by the inverse association of a de novo generated pool of self-sustaining superoxide anions and sub-critical hydrogen peroxide levels. Whilst, the exponential rise of O2(.-) is secondary to the focal accumulation of higher order lipid raft-Rac1/2-actin oligomers; O2(.-) mediated inactivation and redistribution of ECSOD, accounts for the minimal concentration of H2O2 that the phagocyte experiences. The net result of this reciprocal association between ROS/ RNS members, is the prolonged perturbation and remodeling of the cytoskeleton and plasma membrane, a prelude to chemotactic migration. The manuscript also describes the significance of stochastic modeling, in the testing of plausible molecular hypotheses of observable phenomena in complex biological systems. Copyright © 2016 Elsevier Ltd. All rights reserved.

Risk of secondary cancers in women with breast cancer and the influence of radiotherapy: A national cohort study in Taiwan.

PubMed

Lin, Cheng-Yao; Chen, Sih-Hao; Huang, Chien-Cheng; Weng, Shih-Feng; Lee, Song-Tay; Guo, How-Ran; Kuo, Shu-Chun; Su, Shih-Bin

2016-12-01

Breast cancer is the most common cancer in women worldwide; thus, the prolongation of survival, and the incidence and risk factors, including radiotherapy, for developing secondary malignancies are important. We compared the incidence of secondary and new primary cancers in women with breast cancer (CA) and well-matched for age, geographic region, and monthly income cancer-free controls (CA). The risk for secondary cancers with and without radiotherapy was also compared in CA women. We enrolled 2422 CA patients and CA 12,110 controls. In a 4-year follow-up, the secondary cancers risk was significant in the CA group (adjusted hazard ratio [AHR]: 1.59; 95% confidence interval [CI]: 1.17-2.18). Only the risk of uterine cancer was significant compared with the controls (AHR: 6.30; 95% CI: 2.28-17.38). CA patients and <50 years old had a higher risk for secondary cancers. Developing secondary cancers was significant in the first follow-up year (AHR: 1.51; 95% CI: 1.11-2.06). Radiotherapy had no significant effect on the CA group, but it was significant (P = 0.0298) in women ≥60 years old (elderly). We recommend monitoring secondary cancers in CA women, especially those <50 years old, and during the first year of follow-up. Radiotherapy should be used more carefully in elderly CA women.

Pre-Intensive Care Unit Cognitive Status, Subsequent Disability, and New Nursing Home Admission among Critically Ill Older Adults.

PubMed

Ferrante, Lauren E; Murphy, Terrence E; Gahbauer, Evelyne A; Leo-Summers, Linda S; Pisani, Margaret A; Gill, Thomas M

2018-05-01

Cognitive impairment is common among older adults, yet little is known about the association of pre-intensive care unit cognitive status with outcomes relevant to older adults maintaining independence after a critical illness. To evaluate whether pre-intensive care unit cognitive status is associated with post-intensive care unit disability, new nursing home admission, and mortality after a critical illness among older adults. In this prospective cohort study, 754 persons aged 70 years or more were monitored from March 1998 to December 2013 with monthly assessments of disability. Cognitive status was assessed every 18 months, using the Mini-Mental State Examination (range, 0-30), with scores classified as 28 or higher (cognitively intact), 24-27 (minimal impairment), and less than 24 (moderate impairment). The primary outcome was disability count (range, 0-13), assessed monthly over 6 months after an intensive care unit stay. The secondary outcomes were incident nursing home admission and time to death after intensive care unit admission. The analytic sample included 391 intensive care unit admissions. The mean age was 83.5 years. The prevalence of moderate impairment, minimal impairment, and intact cognition (the comparison group) was 17.3, 46.2, and 36.5%, respectively. In the multivariable analysis, moderate impairment was associated with nearly a 20% increase in disability over the 6-month follow-up period (adjusted relative risk, 1.19; 95% confidence interval, 1.04-1.36), and minimal impairment was associated with a 16% increase in post-intensive care unit disability (adjusted relative risk, 1.16; 95% confidence interval, 1.02-1.32). Moderate impairment was associated with more than double the likelihood of a new nursing home admission (adjusted odds ratio, 2.37; 95% confidence interval, 1.01-5.55). Survival differed significantly across the three cognitive groups (log-rank P = 0.002), but neither moderate impairment (adjusted hazard ratio, 1.19; 95% confidence interval, 0.65-2.19) nor minimal impairment (adjusted hazard ratio, 1.00; 95% confidence interval, 0.61-1.62) was significantly associated with mortality in the multivariable analysis. Among older adults, any impairment (even minimal) in pre-intensive care unit cognitive status was associated with an increase in post-intensive care unit disability over the 6 months after a critical illness; moderate cognitive impairment doubled the likelihood of a new nursing home admission. Pre-intensive care unit cognitive impairment was not associated with mortality from intensive care unit admission through 6 months of follow-up. Pre-intensive care unit cognitive status may provide prognostic information about the likelihood of older adults maintaining independence after a critical illness.

Characterization of freshly retrieved preantral follicles using a low-invasive, mechanical isolation method extended to different ruminant species.

PubMed

Langbeen, A; Jorssen, E P A; Fransen, E; Rodriguez, A P A; García, M Chong; Leroy, J L M R; Bols, P E J

2015-10-01

Due to the increased interest in preantral follicular physiology, non-invasive retrieval and morphological classification are crucial. Therefore, this study aimed: (1) to standardize a minimally invasive isolation protocol, applicable to three ruminant species; (2) to morphologically classify preantral follicles upon retrieval; and (3) to describe morphological features of freshly retrieved follicles compared with follicle characteristics using invasive methods. Bovine, caprine and ovine ovarian cortex strips were retrieved from slaughterhouse ovaries and dispersed. This suspension was filtered, centrifuged, re-suspended and transferred to a Petri dish, to which 0.025 mg/ml neutral red (NR) was added to assess the viability of the isolated follicles. Between 59 and 191 follicles per follicle class and per species were collected and classified by light microscopy, based on follicular cell morphology. Subsequently, follicle diameters were measured. The proposed isolation protocol was applicable to all three species and showed a significant, expected increase in diameter with developmental stage. With an average diameter of 37 ± 5 μm for primordial follicles, 47 ± 6.3 μm for primary follicles and 67.1 ± 13.1 μm for secondary follicles, no significant difference in diameter among the three species was observed. Bovine, caprine and ovine follicles (63, 59 and 50% respectively) were graded as viable upon retrieval. Using the same morphological characteristics as determined by invasive techniques [e.g. haematoxylin-eosin (HE) sections], cumulus cell morphology and follicle diameter could be used routinely to classify freshly retrieved follicles. Finally, we applied a mechanical, minimally invasive, follicle isolation protocol and extended it to three ruminant species, yielding viable preantral follicles without compromising further in vitro processing and allowing routine follicle characterization upon retrieval.

A Randomized Controlled Trial of Intranasal Ketamine in Major Depressive Disorder

PubMed Central

Lapidus, Kyle A.B.; Levitch, Cara F.; Perez, Andrew M.; Brallier, Jess W.; Parides, Michael K.; Soleimani, Laili; Feder, Adriana; Iosifescu, Dan V.; Charney, Dennis S.; Murrough, James W.

2014-01-01

Background The N-methyl-d-aspartate glutamate receptor antagonist ketamine, delivered via an intravenous route, has shown rapid antidepressant effects in patients with treatment-resistant depression. The current study was designed to test the safety, tolerability and efficacy of intranasal ketamine in patients with depression who had failed at least one prior antidepressant trial. Methods Twenty patients with major depression were randomized and 18 completed two treatment days with intranasal ketamine hydrochloride (50 mg) or saline solution in a randomized, double-blind, crossover study. The primary efficacy outcome measure was change in depression severity 24 hours following ketamine or placebo, measured using the Montgomery-Asberg Depression Rating Scale. Secondary outcomes included persistence of benefit, changes in self-reports of depression, changes in anxiety, and proportion of responders. Potential psychotomimetic, dissociative, hemodynamic, and general adverse effects associated with ketamine were also measured. Results Patients showed significant improvement in depressive symptoms at 24 hours following ketamine compared to placebo [t=4.39, p<0.001; estimated mean MADRS score difference of 7.6 ± 3.7 (95% CI: 3.9 – 11.3)]. Eight of 18 patients (44%) met response criteria 24 hours following ketamine administration, compared to 1 of 18 (6%) following placebo (p=0.033). Intranasal ketamine was well tolerated with minimal psychotomimetic or dissociative effects and was not associated with clinically significant changes in hemodynamic parameters. Conclusions This study provides the first controlled evidence for the rapid antidepressant effects of intranasal ketamine. Treatment was associated with minimal adverse effects. If replicated, these findings may lead to novel approaches to the pharmacologic treatment of patients with major depression. Trial Registration clinicaltrials.gov identifier NCT01304147 PMID:24821196

Responsiveness and Minimally Important Difference of the 6-Minute Stepper Test in Patients with Chronic Obstructive Pulmonary Disease.

PubMed

Pichon, Romain; Couturaud, Francis; Mialon, Philippe; Le Ber-Moy, Catherine; Péran, Loïc; Lochon, Chantal; Nowak, Emmanuel; Beaumont, Marc

2016-01-01

The validity and reproducibility of the 6-minute stepper test (6MST) have already been demonstrated in patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to evaluate the responsiveness of the 6MST to pulmonary rehabilitation (PR) in patients with COPD, to determine a minimal important difference (MID) for the 6MST, and to compare the 6MST and the 6-minute walk test (6MWT). Sixty-two patients with COPD were included in a prospective experimental study. Participants underwent a 3-week inpatient PR program. The primary outcome was the change in the number of steps during the 6MST measured before and after PR. The secondary outcome included the change in the 6-minute walking distance (6MWD) pulse oximetry, heart rate, dyspnea, and leg discomfort during the tests measured before and after PR. MID was determined by anchor-based and distribution approaches. After PR, we observed a significant increase in the number of steps during the 6MST (22.5 steps; 95% CI 13.8-31.3; p < 0.0001) and in the 6MWD (26.6 m; 95% CI 17.6-35.5; p < 0.0001). The 6MST and 6MWT were improved by 10.1 and 6.5%, respectively. The number of steps during the 6MST was significantly correlated with the 6MWD before (r = 0.72; p < 0.0001) and after PR (r = 0.66; p < 0.0001). MID was estimated to be around 20 steps. The 6MST appears to be as responsive as the 6MWT in assessing functional improvement during PR in patients with COPD. The 6MST is a low-cost assessment and requires limited space. © 2016 S. Karger AG, Basel.

Induction prednisone dosing for childhood nephrotic syndrome: how low should we go?

PubMed

Sibley, Matthew; Roshan, Abishek; Alshami, Alanoud; Catapang, Marisa; Jöbsis, Jasper J; Kwok, Trevor; Polderman, Nonnie; Sibley, Jennifer; Matsell, Douglas G; Mammen, Cherry

2018-05-22

Historically, children with nephrotic syndrome (NS) across British Columbia (BC), Canada have been cared for without formal standardization of induction prednisone dosing. We hypothesized that local historical practice variation in induction dosing was wide and that children treated with lower doses had worse relapsing outcomes. This retrospective cohort study included 92 NS patients from BC Children's Hospital (1990-2010). We excluded secondary causes of NS, age < 1 year at diagnosis, steroid resistance, and incomplete induction due to early relapse. We explored cumulative induction dose and defined dosing quartiles. Relapsing outcomes above and below each quartile threshold were compared including total relapses in 2 years, time to first relapse, and proportions developing frequently relapsing NS (FRNS) or starting a steroid-sparing agent (SSA). Cumulative prednisone was widely distributed with approximated median, 1st, and 3rd quartile doses of 2500, 2000, and 3000 mg/m 2 respectively. Doses ≤ 2000 mg/m 2 showed significantly higher relapses (4.2 vs 2.7), shorter time to first relapse (61 vs 175 days), and higher SSA use (36 vs 14%) compared to higher doses. Doses ≤ 2500 mg/m 2 also showed significantly more relapses (3.9 vs 2.2), quicker first relapse (79 vs 208 days), and higher FRNS (37 vs 17%) and SSA use (28 vs 11%). Relapsing outcomes lacked statistical difference in ≤ 3000 vs > 3000 mg/m 2 doses. Results strongly justify our development of a standardized, province-wide NS clinical pathway to reduce practice variation and minimize under-treatment. The lowest induction prednisone dosing threshold to minimize future relapsing risks is likely between 2000 and 2500 mg/m 2 . Further prospective studies are warranted.

Ultra-processed foods have the worst nutrient profile, yet they are the most available packaged products in a sample of New Zealand supermarkets.

PubMed

Luiten, Claire M; Steenhuis, Ingrid Hm; Eyles, Helen; Ni Mhurchu, Cliona; Waterlander, Wilma E

2016-02-01

To examine the availability of packaged food products in New Zealand supermarkets by level of industrial processing, nutrient profiling score (NPSC), price (energy, unit and serving costs) and brand variety. Secondary analysis of cross-sectional survey data on packaged supermarket food and non-alcoholic beverages. Products were classified according to level of industrial processing (minimally, culinary and ultra-processed) and their NPSC. Packaged foods available in four major supermarkets in Auckland, New Zealand. Packaged supermarket food products for the years 2011 and 2013. The majority (84% in 2011 and 83% in 2013) of packaged foods were classified as ultra-processed. A significant positive association was found between the level of industrial processing and NPSC, i.e., ultra-processed foods had a worse nutrient profile (NPSC=11.63) than culinary processed foods (NPSC=7.95), which in turn had a worse nutrient profile than minimally processed foods (NPSC=3.27), P<0.001. No clear associations were observed between the three price measures and level of processing. The study observed many variations of virtually the same product. The ten largest food manufacturers produced 35% of all packaged foods available. In New Zealand supermarkets, ultra-processed foods comprise the largest proportion of packaged foods and are less healthy than less processed foods. The lack of significant price difference between ultra- and less processed foods suggests ultra-processed foods might provide time-poor consumers with more value for money. These findings highlight the need to improve the supermarket food supply by reducing numbers of ultra-processed foods and by reformulating products to improve their nutritional profile.

What is a meaningful change in physical performance? Findings from a clinical trial in older adults (the LIFE-P study).

PubMed

Kwon, S; Perera, S; Pahor, M; Katula, J A; King, A C; Groessl, E J; Studenski, S A

2009-06-01

Performance measures provide important information, but the meaning of change in these measures is not well known. The purpose of this research is to 1) examine the effect of treatment assignment on the relationship between self-report and performance; 2) to estimate the magnitude of meaningful change in 400-meter walk time (400MWT), 4-meter gait speed (4MGS), and Short Physical Performance Battery (SPPB) and 3) to evaluate the effect of direction of change on estimates of magnitude. This is a secondary analysis of data from the LIFE-P study, a single blinded randomized clinical trial. Using change over one year, we applied distribution-based and anchor-based methods for self-reported mobility to estimate minimally important and substantial change in 400MWT, 4MGS and SPPB. Four university-based clinical research sites. Sedentary adults aged 70-89 whose SPPB scores were less than 10 and who were able to complete a 400MW at baseline (n=424). A structured exercise program versus health education. 400MWT, 4MGS, SPPB. Relationships between self-report and performance measures were consistent between treatment arms. Minimally significant change estimates were 400MWT: 20-30 seconds, 4MGS: 0.03-0.05m/s and SPPB: 0.3 - 0.8 points. Substantial changes were 400MWT: 50-60 seconds, 4MGS: 0.08m/s, SPPB: 0.4 - 1.5 points. Magnitudes of change for improvement and decline were not significantly different. The magnitude of clinically important change in physical performance measures is reasonably consistent using several analytic techniques and appears to be achievable in clinical trials of exercise. Due to limited power, the effect of direction of change on estimates of magnitude remains uncertain.

Consequences of Secondary Calibrations on Divergence Time Estimates.

PubMed

Schenk, John J

2016-01-01

Secondary calibrations (calibrations based on the results of previous molecular dating studies) are commonly applied in divergence time analyses in groups that lack fossil data; however, the consequences of applying secondary calibrations in a relaxed-clock approach are not fully understood. I tested whether applying the posterior estimate from a primary study as a prior distribution in a secondary study results in consistent age and uncertainty estimates. I compared age estimates from simulations with 100 randomly replicated secondary trees. On average, the 95% credible intervals of node ages for secondary estimates were significantly younger and narrower than primary estimates. The primary and secondary age estimates were significantly different in 97% of the replicates after Bonferroni corrections. Greater error in magnitude was associated with deeper than shallower nodes, but the opposite was found when standardized by median node age, and a significant positive relationship was determined between the number of tips/age of secondary trees and the total amount of error. When two secondary calibrated nodes were analyzed, estimates remained significantly different, and although the minimum and median estimates were associated with less error, maximum age estimates and credible interval widths had greater error. The shape of the prior also influenced error, in which applying a normal, rather than uniform, prior distribution resulted in greater error. Secondary calibrations, in summary, lead to a false impression of precision and the distribution of age estimates shift away from those that would be inferred by the primary analysis. These results suggest that secondary calibrations should not be applied as the only source of calibration in divergence time analyses that test time-dependent hypotheses until the additional error associated with secondary calibrations is more properly modeled to take into account increased uncertainty in age estimates.

Waste Minimization Program. Air Force Plant 4.

DTIC Science & Technology

1986-02-01

incinerator equipped with a secondary combustion chamber and venturi scrubber could serve AFP 4’s needs. As the wastes listed in Table 3-6 contain negligible... scrubber water treatment in the AFP 4eatment. waste treatment system. 2.3 ECONOMICS -Table 2-3 summarizes the projected economics of the recommendations for...control devices. These paint booths are equipped with water curtain air scrubbers which remove solids from the booth exhaust by providing - intimate

Sealing intersecting vane machines

DOEpatents

Martin, Jedd N.; Chomyszak, Stephen M.

2005-06-07

The invention provides a toroidal intersecting vane machine incorporating intersecting rotors to form primary and secondary chambers whose porting configurations minimize friction and maximize efficiency. Specifically, it is an object of the invention to provide a toroidal intersecting vane machine that greatly reduces the frictional losses through intersecting surfaces without the need for external gearing by modifying the width of one or both tracks at the point of intermeshing. The inventions described herein relate to these improvements.

Sealing intersecting vane machines

DOEpatents

Martin, Jedd N [Providence, RI; Chomyszak, Stephen M [Attleboro, MA

2007-06-05

The invention provides a toroidal intersecting vane machine incorporating intersecting rotors to form primary and secondary chambers whose porting configurations minimize friction and maximize efficiency. Specifically, it is an object of the invention to provide a toroidal intersecting vane machine that greatly reduces the frictional losses through intersecting surfaces without the need for external gearing by modifying the width of one or both tracks at the point of intermeshing. The inventions described herein relate to these improvements.

[Mobile CT at neurointensive sections--it is possible].

PubMed

Frost, Majbritt; Stenkær, Susanne; Kellenberger, Simone; Ehlers, Lars

2011-01-24

Intrahospital transportation can be complicated and hazardous. Mobile computerized tomography (CT) of the head performed at the neurointensive care unit is a new technique that minimizes the need for transportation of unstable patients. Even small changes in physiological parameters can be detrimental for these patients and cause secondary injury and thus affect their prognoses. The portable CT scanner in the neurointensive care unit holds great potential, but the high price level may limit its use.

Use of a biodegradable, oversized stent in a child with tracheomalacia secondary to vascular external compression.

PubMed

Di Dedda, Giovanni; Mirabile, Cristian

2017-01-01

We describe the implantation of an absorbable, custom-made stent of polydioxanone to treat tracheomalacia in a 5-month-old patient with extrinsic compression by a double aortic arch. The use of an absorbable, oversized stent treated the tracheal collapse caused by vascular compression, avoided removal procedures, and allowed the infant's growth. The use of an oversized stent prevented stent migration and gave minimal problems of granulation.

Genetically Modified T-cell Immunotherapy in Treating Patients With Relapsed/Refractory Acute Myeloid Leukemia and Persistent/Recurrent Blastic Plasmacytoid Dendritic Cell Neoplasm

ClinicalTrials.gov

2018-03-02

Adult Acute Myeloid Leukemia in Remission; Acute Biphenotypic Leukemia; Early Relapse of Acute Myeloid Leukemia; Late Relapse of Acute Myeloid Leukemia; Recurrent Adult Acute Myeloid Leukemia; Secondary Acute Myeloid Leukemia; Blastic Plasmacytoid Dendritic Cell Neoplasm; Acute Myeloid Leukemia; Adult Acute Lymphoblastic Leukemia; Interleukin-3 Receptor Subunit Alpha Positive; Minimal Residual Disease; Refractory Acute Myeloid Leukemia; Untreated Adult Acute Myeloid Leukemia

Apparatus and method for solar coal gasification

DOEpatents

Gregg, David W.

1980-01-01

Apparatus for using focused solar radiation to gasify coal and other carbonaceous materials. Incident solar radiation is focused from an array of heliostats onto a tower-mounted secondary mirror which redirects the focused solar radiation down through a window onto the surface of a vertically-moving bed of coal, or a fluidized bed of coal, contained within a gasification reactor. The reactor is designed to minimize contact between the window and solids in the reactor. Steam introduced into the gasification reactor reacts with the heated coal to produce gas consisting mainly of carbon monoxide and hydrogen, commonly called "synthesis gas", which can be converted to methane, methanol, gasoline, and other useful products. One of the novel features of the invention is the generation of process steam at the rear surface of the secondary mirror.

Apparatus for solar coal gasification

DOEpatents

Gregg, D.W.

Apparatus for using focused solar radiation to gasify coal and other carbonaceous materials is described. Incident solar radiation is focused from an array of heliostats onto a tower-mounted secondary mirror which redirects the focused solar radiation down through a window onto the surface of a vertically-moving bed of coal, or a fluidized bed of coal, contained within a gasification reactor. The reactor is designed to minimize contact between the window and solids in the reactor. Steam introduced into the gasification reactor reacts with the heated coal to produce gas consisting mainly of carbon monoxide and hydrogen, commonly called synthesis gas, which can be converted to methane, methanol, gasoline, and other useful products. One of the novel features of the invention is the generation of process steam at the rear surface of the secondary mirror.

RNA secondary structures of the bacteriophage phi6 packaging regions.

PubMed

Pirttimaa, M J; Bamford, D H

2000-06-01

Bacteriophage phi6 genome consists of three segments of double-stranded RNA. During maturation, single-stranded copies of these segments are packaged into preformed polymerase complex particles. Only phi6 RNA is packaged, and each particle contains only one copy of each segment. An in vitro packaging and replication assay has been developed for phi6, and the packaging signals (pac sites) have been mapped to the 5' ends of the RNA segments. In this study, we propose secondary structure models for the pac sites of phi6 single-stranded RNA segments. Our models accommodate data from structure-specific chemical modifications, free energy minimizations, and phylogenetic comparisons. Previously reported pac site deletion studies are also discussed. Each pac site possesses a unique architecture, that, however, contains common structural elements.

Acute Iliac Artery Rupture: Endovascular Treatment

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

Chatziioannou, A.; Mourikis, D.; Katsimilis, J.

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

A microprocessor-based position control system for a telescope secondary mirror

NASA Technical Reports Server (NTRS)

Lorell, K. R.; Barrows, W. F.; Clappier, R. R.; Lee, G. K.

1983-01-01

The pointing requirements for the Shuttle IR Telescope Facility (SIRTF), which consists of an 0.85-m cryogenically cooled IR telescope, call for an image stability of 0.25 arcsec. Attention is presently given to a microprocessor-based position control system developed for the control of the SIRTF secondary mirror, employing a special control law (to minimize energy dissipation), a precision capacitive position sensor, and a specially designed power amplifier/actuator combination. The microprocessor generates the command angular position and rate waveforms in order to maintain a 90 percent dwell time/10 percent transition time ratio independently of chop frequency or amplitude. Performance and test results of a prototype system designed for use with a demonstration model of the SIRTF focal plane fine guidance sensor are presented.

Reducing robotic prostatectomy costs by minimizing instrumentation.

PubMed

Delto, Joan C; Wayne, George; Yanes, Rafael; Nieder, Alan M; Bhandari, Akshay

2015-05-01

Since the introduction of robotic surgery for radical prostatectomy, the cost-benefit of this technology has been under scrutiny. While robotic surgery professes to offer multiple advantages, including reduced blood loss, reduced length of stay, and expedient recovery, the associated costs tend to be significantly higher, secondary to the fixed cost of the robot as well as the variable costs associated with instrumentation. This study provides a simple framework for the careful consideration of costs during the selection of equipment and materials. Two experienced robotic surgeons at our institution as well as several at other institutions were queried about their preferred instrument usage for robot-assisted prostatectomy. Costs of instruments and materials were obtained and clustered by type and price. A minimal set of instruments was identified and compared against alternative instrumentation. A retrospective review of 125 patients who underwent robotically assisted laparoscopic prostatectomy for prostate cancer at our institution was performed to compare estimated blood loss (EBL), operative times, and intraoperative complications for both surgeons. Our surgeons now conceptualize instrument costs as proportional changes to the cost of the baseline minimal combination. Robotic costs at our institution were reduced by eliminating an energy source like the Ligasure or vessel sealer, exploiting instrument versatility, and utilizing inexpensive tools such as Hem-o-lok clips. Such modifications reduced surgeon 1's cost of instrumentation to ∼40% less compared with surgeon 2 and up to 32% less than instrumentation used by surgeons at other institutions. Surgeon 1's combination may not be optimal for all robotic surgeons; however, it establishes a minimally viable toolbox for our institution through a rudimentary cost analysis. A similar analysis may aid others in better conceptualizing long-term costs not as nominal, often unwieldy prices, but as percent changes in spending. With regard to intraoperative outcomes, the use of a minimally viable toolbox did not result in increased EBL, operative time, or intraoperative complications. Simple changes to surgeon preference and creative utilization of instruments can eliminate 40% of costs incurred on robotic instruments alone. Moreover, EBL, operative times, and intraoperative complications are not compromised as a result of cost reduction. Our process of identifying such improvements is straightforward and may be replicated by other robotic surgeons. Further prospective multicenter trials should be initiated to assess other methods of cost reduction.

On the nonlinear stability of a high-speed, axisymmetric boundary layer

NASA Technical Reports Server (NTRS)

Pruett, C. David; Ng, Lian L.; Erlebacher, Gordon

1991-01-01

The stability of a high-speed, axisymmetric boundary layer is investigated using secondary instability theory and direct numerical simulation. Parametric studies based on the temporal secondary instability theory identify subharmonic secondary instability as a likely path to transition on a cylinder at Mach 4.5. The theoretical predictions are validated by direct numerical simulation at temporally-evolving primary and secondary disturbances in an axisymmetric boundary-layer flow. At small amplitudes of the secondary disturbance, predicted growth rates agree to several significant digits with values obtained from the spectrally-accurate solution of the compressible Navier-Stokes equations. Qualitative agreement persists to large amplitudes of the secondary disturbance. Moderate transverse curvature is shown to significantly affect the growth rate of axisymmetric second mode disturbances, the likely candidates of primary instability. The influence of curvature on secondary instability is largely indirect but most probably significant, through modulation of the primary disturbance amplitude. Subharmonic secondary instability is shown to be predominantly inviscid in nature, and to account for spikes in the Reynolds stress components at or near the critical layer.

Occupational Therapy Treatment to Improve Upper Extremity Function in Individuals with Early Systemic Sclerosis: A Pilot Study.

PubMed

Murphy, Susan L; Barber, Mary; Homer, Kristen; Dodge, Carole; Cutter, Gary; Khanna, Dinesh

2018-01-30

To determine feasibility and preliminary effects of an occupational therapy treatment to improve upper extremity (UE) function in patients with early systemic sclerosis (SSc) who have UE contractures. A one-arm pilot clinical rehabilitation trial was conducted at a university health system. Participants with SSc and ≥ 1 UE contracture (n = 21) participated in a total of 8 weekly in-person occupational therapy sessions. The therapy consisted of thermal modalities, tissue mobilization, and UE mobility. Between sessions, participants were instructed to complete UE home exercises. Feasibility was measured by percent enrollment and session attendance and duration. The primary outcome measure was the QuickDASH, secondary and exploratory outcomes included PROMIS physical function, objective UE measures, and skin thickening. Linear mixed models were performed to determine treatment effects on primary and secondary outcomes. Fifty percent (24/48) of potentially eligible participants were interested. Of those, 88% (21/24) enrolled; and nineteen out of 21 (91%) completed all sessions. The mean (SD) age was 47.9 years (± 16.1); 100% had diffuse SSc, and mean disease duration was 3.1 years. At 8 weeks, participants reported statistically significant improvement on QuickDASH and PROMIS physical function measures (p =.0012 and p = .004). Forty-seven and 53% percent of the sample achieved improvements that exceeded minimally important differences. In-person treatment sessions were feasible for individuals with SSc and demonstrated statistically significant and clinically meaningful improvements on UE and physical function. Future studies need to examine effects against a control condition and examine durability of treatment effects. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Hypothermia for Neuroprotection in Convulsive Status Epilepticus.

PubMed

Legriel, Stephane; Lemiale, Virginie; Schenck, Maleka; Chelly, Jonathan; Laurent, Virginie; Daviaud, Fabrice; Srairi, Mohamed; Hamdi, Aicha; Geri, Guillaume; Rossignol, Thomas; Hilly-Ginoux, Julia; Boisramé-Helms, Julie; Louart, Benjamin; Malissin, Isabelle; Mongardon, Nicolas; Planquette, Benjamin; Thirion, Marina; Merceron, Sybille; Canet, Emmanuel; Pico, Fernando; Tran-Dinh, Yves-Roger; Bedos, Jean-Pierre; Azoulay, Elie; Resche-Rigon, Matthieu; Cariou, Alain

2016-12-22

Convulsive status epilepticus often results in permanent neurologic impairment. We evaluated the effect of induced hypothermia on neurologic outcomes in patients with convulsive status epilepticus. In a multicenter trial, we randomly assigned 270 critically ill patients with convulsive status epilepticus who were receiving mechanical ventilation to hypothermia (32 to 34°C for 24 hours) in addition to standard care or to standard care alone; 268 patients were included in the analysis. The primary outcome was a good functional outcome at 90 days, defined as a Glasgow Outcome Scale (GOS) score of 5 (range, 1 to 5, with 1 representing death and 5 representing no or minimal neurologic deficit). The main secondary outcomes were mortality at 90 days, progression to electroencephalographically (EEG) confirmed status epilepticus, refractory status epilepticus on day 1, "super-refractory" status epilepticus (resistant to general anesthesia), and functional sequelae on day 90. A GOS score of 5 occurred in 67 of 138 patients (49%) in the hypothermia group and in 56 of 130 (43%) in the control group (adjusted common odds ratio, 1.22; 95% confidence interval [CI], 0.75 to 1.99; P=0.43). The rate of progression to EEG-confirmed status epilepticus on the first day was lower in the hypothermia group than in the control group (11% vs. 22%; odds ratio, 0.40; 95% CI, 0.20 to 0.79; P=0.009), but there were no significant differences between groups in the other secondary outcomes. Adverse events were more frequent in the hypothermia group than in the control group. In this trial, induced hypothermia added to standard care was not associated with significantly better 90-day outcomes than standard care alone in patients with convulsive status epilepticus. (Funded by the French Ministry of Health; HYBERNATUS ClinicalTrials.gov number, NCT01359332 .).

Identifying and managing the risks of medical ionizing radiation in endourology.

PubMed

Yecies, Todd; Averch, Timothy D; Semins, Michelle J

2018-02-01

The risks of exposure to medical ionizing radiation is of increasing concern both among medical professionals and the general public. Patients with nephrolithiasis are exposed to high levels of ionizing radiation through both diagnostic and therapeutic modalities. Endourologists who perform a high-volume of fluoroscopy guided procedures are also exposed to significant quantities of ionizing radiation. The combination of judicious use of radiation-based imaging modalities, application of new imaging techniques such as ultra-low dose computed tomography (CT) scan, and modifying use of current technology such as increasing ultrasound and pulsed fluoroscopy utilization offers the possibility of significantly reducing radiation exposure. We present a review of the literature regarding the risks of medical ionizing radiation to patients and surgeons as it pertains to the field of endourology and interventions that can be performed to limit this exposure. A review of the current state of the literature was performed using MEDLINE and PubMed. Interventions designed to limit patient and surgeon radiation exposure were identified and analyzed. Summaries of the data were compiled and synthesized in the body of the text. While no level 1 evidence exists demonstrating the risk of secondary malignancy with radiation exposure, the preponderance of evidence suggests a dose and age dependent increase in malignancy risk from ionizing radiation. Patients with nephrolithiasis were exposed to an average effective dose of 37mSv over a 2 year period. Multiple evidence-based interventions to limit patient and surgeon radiation exposure and associated risk were identified. Current evidence suggest an age and dose dependent risk of secondary malignancy from ionizing radiation. Urologists must act in accordance with ALARA principles to safely manage nephrolithiasis while minimizing radiation exposure.

Natural history of coexistent tricuspid regurgitation in patients with degenerative mitral valve disease: implications for future guidelines.

PubMed

Goldstone, Andrew B; Howard, Jessica L; Cohen, Jeffrey E; MacArthur, John W; Atluri, Pavan; Kirkpatrick, James N; Woo, Y Joseph

2014-12-01

The management of coexistent tricuspid regurgitation in patients with mitral regurgitation remains controversial. We sought to define the incidence and natural history of coexistent tricuspid regurgitation in patients undergoing isolated mitral surgery for degenerative mitral regurgitation, as well as the effect of late secondary tricuspid regurgitation on cardiovascular symptom burden and survival. To minimize confounding, analysis was limited to 495 consecutive patients who underwent isolated mitral surgery for degenerative mitral valve disease between 2002 and 2011. Patients with coexistent severe tricuspid regurgitation were excluded because such patients typically undergo concomitant tricuspid intervention. Grade 1 to 3 coexistent tricuspid regurgitation was present in 215 patients (43%) preoperatively. Actuarial freedom from grade 3 to 4 tricuspid regurgitation 1, 5, and 9 years after surgery was 100% ± 0%, 90% ± 2%, and 64% ± 7%, respectively. Older age (P < .001) and grade of preoperative tricuspid regurgitation (P = .006) independently predicted postoperative progression of tricuspid regurgitation on multivariable analysis. However, when limited to patients with mild or absent tricuspid regurgitation, indexed tricuspid annular diameter was the only significant risk factor for late tricuspid regurgitation (P = .04). New York Heart Association functional class and long-term survival did not worsen with development of late secondary tricuspid regurgitation (P = .4 and P = .6, respectively). However, right ventricular dysfunction was significantly more common in patients with more severe late tricuspid regurgitation (P = .007). Despite durable correction of degenerative mitral regurgitation, less than severe tricuspid regurgitation is likely to progress after surgery if uncorrected. Given the low incremental risk of tricuspid annuloplasty, a more aggressive strategy of concomitant tricuspid repair may be warranted. Copyright © 2014 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

Iron Is a Sensitive Biomarker for Inflammation in Multiple Sclerosis Lesions

PubMed Central

Mehta, Veela; Pei, Wei; Yang, Grant; Li, Suyang; Swamy, Eashwar; Boster, Aaron; Schmalbrock, Petra; Pitt, David

2013-01-01

MRI phase imaging in multiple sclerosis (MS) patients and in autopsy tissue have demonstrated the presence of iron depositions in white matter lesions. The accumulation of iron in some but not all lesions suggests a specific, potentially disease-relevant process, however; its pathophysiological significance remains unknown. Here, we explore the role of lesional iron in multiple sclerosis using multiple approaches: immunohistochemical examination of autoptic MS tissue, an in vitro model of iron-uptake in human cultured macrophages and ultra-highfield phase imaging of highly active and of secondary progressive MS patients. Using Perls' stain and immunohistochemistry, iron was detected in MS tissue sections predominantly in non-phagocytosing macrophages/microglia at the edge of established, demyelinated lesions. Moreover, iron-containing macrophages but not myelin-laden macrophages expressed markers of proinflammatory (M1) polarization. Similarly, in human macrophage cultures, iron was preferentially taken up by non-phagocytosing, M1-polarized macrophages and induced M1 (super) polarization. Iron uptake was minimal in myelin-laden macrophages and active myelin phagocytosis led to depletion of intracellular iron. Finally, we demonstrated in MS patients using GRE phase imaging with ultra-highfield MRI that phase hypointense lesions were significantly more prevalent in patients with active relapsing than with secondary progressive MS. Taken together, our data provide a basis to interpret iron-sensitive GRE phase imaging in MS patients: iron is present in non-phagocytosing, M1-polarized microglia/macrophages at the rim of chronic active white matter demyelinating lesions. Phase imaging may therefore visualize specific, chronic proinflammatory activity in established MS lesions and thus provide important clinical information on disease status and treatment efficacy in MS patients. PMID:23516409

The effect of a novel minimally invasive strategy for infected necrotizing pancreatitis.

PubMed

Tong, Zhihui; Shen, Xiao; Ke, Lu; Li, Gang; Zhou, Jing; Pan, Yiyuan; Li, Baiqiang; Yang, Dongliang; Li, Weiqin; Li, Jieshou

2017-11-01

Step-up approach consisting of multiple minimally invasive techniques has gradually become the mainstream for managing infected pancreatic necrosis (IPN). In the present study, we aimed to compare the safety and efficacy of a novel four-step approach and the conventional approach in managing IPN. According to the treatment strategy, consecutive patients fulfilling the inclusion criteria were put into two time intervals to conduct a before-and-after comparison: the conventional group (2010-2011) and the novel four-step group (2012-2013). The conventional group was essentially open necrosectomy for any patient who failed percutaneous drainage of infected necrosis. And the novel drainage approach consisted of four different steps including percutaneous drainage, negative pressure irrigation, endoscopic necrosectomy and open necrosectomy in sequence. The primary endpoint was major complications (new-onset organ failure, sepsis or local complications, etc.). Secondary endpoints included mortality during hospitalization, need of emergency surgery, duration of organ failure and sepsis, etc. Of the 229 recruited patients, 92 were treated with the conventional approach and the remaining 137 were managed with the novel four-step approach. New-onset major complications occurred in 72 patients (78.3%) in the two-step group and 75 patients (54.7%) in the four-step group (p < 0.001). For other important endpoints, although there was no statistical difference in mortality between the two groups (p = 0.403), significantly fewer patients in the four-step group required emergency surgery when compared with the conventional group [14.6% (20/137) vs. 45.6% (42/92), p < 0.001]. In addition, stratified analysis revealed that the four-step approach group presented significantly lower incidence of new-onset organ failure and other major complications in patients with the most severe type of AP. Comparing with the conventional approach, the novel four-step approach significantly reduced the rate of new-onset major complications and requirement of emergency operations in treating IPN, especially in those with the most severe type of acute pancreatitis.

Long-term clinical effects of ventricular pacing reduction with a changeover mode to minimize ventricular pacing in a general pacemaker population

PubMed Central

Stockburger, Martin; Boveda, Serge; Moreno, Javier; Da Costa, Antoine; Hatala, Robert; Brachmann, Johannes; Butter, Christian; Garcia Seara, Javier; Rolando, Mara; Defaye, Pascal

2015-01-01

Aim Right ventricular pacing (VP) has been hypothesized to increase the risk in heart failure (HF) and atrial fibrillation (AF). The ANSWER study evaluated, whether an AAI-DDD changeover mode to minimize VP (SafeR) improves outcome compared with DDD in a general dual-chamber pacemaker population. Methods and results ANSWER was a randomized controlled multicentre trial assessing SafeR vs. standard DDD in sinus node disease (SND) or AV block (AVB) patients. After a 1-month run-in period, they were randomized (1 : 1) and followed for 3 years. Pre-specified co-primary end-points were VP and the composite of hospitalization for HF, AF, or cardioversion. Pre-specified secondary end-points were cardiac death or HF hospitalizations and cardiovascular hospitalizations. ANSWER enrolled 650 patients (52.0% SND, 48% AVB) at 43 European centres and randomized in SafeR (n = 314) or DDD (n = 318). The SafeR mode showed a significant decrease in VP compared with DDD (11.5 vs. 93.6%, P < 0.0001 at 3 years). Deaths and syncope did not differ between randomization arms. No significant difference between groups [HR = 0.78; 95% CI (0.48–1.25); P = 0.30] was found in the time to event of the co-primary composite of hospitalization for HF, AF, or cardioversion, nor in the individual components. SafeR showed a 51% risk reduction (RR) in experiencing cardiac death or HF hospitalization [HR = 0.49; 95% CI (0.27–0.90); P = 0.02] and 30% RR in experiencing cardiovascular hospitalizations [HR = 0.70; 95% CI (0.49–1.00); P = 0.05]. Conclusion SafeR safely and significantly reduced VP in a general pacemaker population though had no effect on hospitalization for HF, AF, or cardioversion, when compared with DDD. PMID:25179761

Radiographical predictors for postoperative sagittal imbalance in patients with thoracolumbar kyphosis secondary to ankylosing spondylitis after lumbar pedicle subtraction osteotomy.

PubMed

Qian, Bang-ping; Jiang, Jun; Qiu, Yong; Wang, Bin; Yu, Yang; Zhu, Ze-zhang

2013-12-15

A retrospective radiographical study. To identify the radiographical predictors for sagittal imbalance in patients with thoracolumbar kyphosis secondary to ankylosing spondylitis (AS) after 1-level lumbar pedicle subtraction osteotomy (PSO). Few studies had correlated the preoperative sagittal parameters with postoperative sagittal alignments to determine the radiographical predictors for postoperative sagittal imbalance in patients with AS after 1-level lumbar PSO. Thirty-six patients with thoracolumbar kyphosis secondary to AS who underwent 1-level lumbar PSO were recruited with a minimal follow-up of 24 months (mean = 27.4 mo; range, 24-53 mo). Correlation analysis and subsequent stepwise multiple regression analysis were used to evaluate the correlations between preoperative parameters, including global kyphosis, local kyphosis, thoracic kyphosis, thoracolumbar Cobb angle, lumbar lordosis, pelvic incidence (PI), pelvic tilt, sacral slope, and sagittal vertical axis (SVA), as well as SVA at the last follow-up. All these patients were further divided into 2 groups according to the PI value (group A: PI >50°; group B: PI ≤50°). The correction outcomes were compared between these 2 groups. The preoperative SVA was not significantly different between group A and group B (157.6 mm vs. 124.5 mm; P> 0.05), and both groups had similar magnitudes of kyphosis corrections at the last follow-up (global kyphosis: 42.9° vs. 46.1°; local kyphosis: 42.7° vs. 40.5°; lumbar lordosis: 35.7° vs. 43.0°). However, group A patients had significantly larger SVA at the last follow-up (73.2 mm vs. 28.7 mm; P< 0.05) and a higher incidence of postoperative sagittal imbalance (77.8% vs. 25.9%; P< 0.05) than those in group B. The stepwise multiple regression analysis demonstrated that both preoperative SVA and PI were significant independent predictors of postoperative sagittal alignments, which explained 52.0% and 9.7% of the variability of SVA at the last follow-up, respectively. Patients with AS with either larger preoperative SVA or larger PI are more likely to experience failed sagittal realignments after 1-level lumbar PSO. For these patients, additional osteotomies may be recommended for satisfactory correction outcomes. 4.

Does Stepwise Voltage Ramping Protect the Kidney from Injury During Extracorporeal Shockwave Lithotripsy? Results of a Prospective Randomized Trial.

PubMed

Skuginna, Veronika; Nguyen, Daniel P; Seiler, Roland; Kiss, Bernhard; Thalmann, George N; Roth, Beat

2016-02-01

Renal damage is more frequent with new-generation lithotripters. However, animal studies suggest that voltage ramping minimizes the risk of complications following extracorporeal shock wave lithotripsy (SWL). In the clinical setting, the optimal voltage strategy remains unclear. To evaluate whether stepwise voltage ramping can protect the kidney from damage during SWL. A total of 418 patients with solitary or multiple unilateral kidney stones were randomized to receive SWL using a Modulith SLX-F2 lithotripter with either stepwise voltage ramping (n=213) or a fixed maximal voltage (n=205). SWL. The primary outcome was sonographic evidence of renal hematomas. Secondary outcomes included levels of urinary markers of renal damage, stone disintegration, stone-free rate, and rates of secondary interventions within 3 mo of SWL. Descriptive statistics were used to compare clinical outcomes between the two groups. A logistic regression model was generated to assess predictors of hematomas. Significantly fewer hematomas occurred in the ramping group(12/213, 5.6%) than in the fixed group (27/205, 13%; p=0.008). There was some evidence that the fixed group had higher urinary β2-microglobulin levels after SWL compared to the ramping group (p=0.06). Urinary microalbumin levels, stone disintegration, stone-free rate, and rates of secondary interventions did not significantly differ between the groups. The logistic regression model showed a significantly higher risk of renal hematomas in older patients (odds ratio [OR] 1.03, 95% confidence interval [CI] 1.00-1.05; p=0.04). Stepwise voltage ramping was associated with a lower risk of hematomas (OR 0.39, 95% CI 0.19-0.80; p=0.01). The study was limited by the use of ultrasound to detect hematomas. In this prospective randomized study, stepwise voltage ramping during SWL was associated with a lower risk of renal damage compared to a fixed maximal voltage without compromising treatment effectiveness. Lithotripsy is a noninvasive technique for urinary stone disintegration using ultrasonic energy. In this study, two voltage strategies are compared. The results show that a progressive increase in voltage during lithotripsy decreases the risk of renal hematomas while maintaining excellent outcomes. ISRCTN95762080. Copyright © 2015 European Association of Urology. Published by Elsevier B.V. All rights reserved.

[TECHNIQUES IN MITRAL VALVE REPAIR VIA A MINIMALLY INVASIVE APPROACH].

PubMed

Ito, Toshiaki

2016-03-01

In mitral valve repair via a minimally invasive approach, resection of the leaflet is technically demanding compared with that in the standard approach. For resection and suture repair of the posterior leaflet, premarking of incision lines is recommended for precise resection. As an alternative to resection and suture, the leaflet-folding technique is also recommended. For correction of prolapse of the anterior leaflet, neochordae placement with the loop technique is easy to perform. Premeasurement with transesophageal echocardiography or intraoperative measurement using a replica of artificial chordae is useful to determine the appropriate length of the loops. Fine-tuning of the length of neochordae is possible by adding a secondary fixation point on the leaflet if the loop is too long. If the loop is too short, a CV5 Gore-Tex suture can be passed through the loop and loosely tied several times to stack the knots, with subsequent fixation to the edge of the leaflet. Finally, skill in the mitral valve replacement technique is necessary as a back-up for surgeons who perform minimally invasive mitral valve repair.

Minimally invasive brow suspension for facial paralysis.

PubMed

Costantino, Peter D; Hiltzik, David H; Moche, Jason; Preminger, Aviva

2003-01-01

To report a new technique for unilateral brow suspension for facial paralysis that is minimally invasive, limits supraciliary scar formation, does not require specialized endoscopic equipment or expertise, and has proved to be equal to direct brow suspension in durability and symmetry. Retrospective survey of a case series of 23 patients between January 1997 and December 2000. Metropolitan tertiary care center. Patients with head and neck tumors and brow ptosis caused by facial nerve paralysis. The results of the procedure were determined using the following 3-tier rating system: outstanding (excellent elevation and symmetry); acceptable (good elevation and fair symmetry); and unacceptable (loss of elevation). The results were considered outstanding in 12 patients, acceptable in 9 patients, and unacceptable in only 1 patient. One patient developed a hematoma, and 1 patient required a secondary adjustment. The technique has proved to be superior to standard brow suspension procedures with regard to scar formation and equal with respect to facial symmetry and suspension. These results have caused us to abandon direct brow suspension and to use this minimally invasive method in all cases of brow ptosis due to facial paralysis.

Prediction of protein tertiary structure to low resolution: performance for a large and structurally diverse test set.

PubMed

Eyrich, V A; Standley, D M; Friesner, R A

1999-05-14

We report the tertiary structure predictions for 95 proteins ranging in size from 17 to 160 residues starting from known secondary structure. Predictions are obtained from global minimization of an empirical potential function followed by the application of a refined atomic overlap potential. The minimization strategy employed represents a variant of the Monte Carlo plus minimization scheme of Li and Scheraga applied to a reduced model of the protein chain. For all of the cases except beta-proteins larger than 75 residues, a native-like structure, usually 4-6 A root-mean-square deviation from the native, is located. For beta-proteins larger than 75 residues, the energy gap between native-like structures and the lowest energy structures produced in the simulation is large, so that low RMSD structures are not generated starting from an unfolded state. This is attributed to the lack of an explicit hydrogen bond term in the potential function, which we hypothesize is necessary to stabilize large assemblies of beta-strands. Copyright 1999 Academic Press.

Refractive Secondary Solar Concentrator Demonstrated High-Temperature Operation

NASA Technical Reports Server (NTRS)

Wong, Wayne A.

2002-01-01

Space applications that utilize solar thermal energy--such as electric power conversion systems, thermal propulsion systems, and furnaces--require highly efficient solar concentration systems. The NASA Glenn Research Center is developing the refractive secondary concentrator, which uses refraction and total internal reflection to efficiently concentrate and direct solar energy. When used in combination with advanced lightweight primary concentrators, such as inflatable thin films, the refractive secondary concentrator enables very high system concentration ratios and very high temperatures. Last year, Glenn successfully demonstrated a secondary concentrator throughput efficiency of 87 percent, with a projected efficiency of 93 percent using an antireflective coating. Building on this achievement, Glenn recently successfully demonstrated high-temperature operation of the secondary concentrator when it was used to heat a rhenium receiver to 2330 F. The high-temperature demonstration of the concentrator was conducted in Glenn's 68-ft long Tank 6 thermal vacuum facility equipped with a solar simulator. The facility has a rigid panel primary concentrator that was used to concentrate the light from the solar simulator onto the refractive secondary concentrator. NASA Marshall Space Flight Center provided a rhenium cavity, part of a solar thermal propulsion engine, to serve as the high-temperature receiver. The prototype refractive secondary concentrator, measuring 3.5 in. in diameter and 11.2 in. long, is made of single-crystal sapphire. A water-cooled splash shield absorbs spillage light outside of the 3.5-in. concentrator aperture. Multilayer foil insulation composed of tungsten, molybdenum, and niobium is used to minimize heat loss from the hightemperature receiver. A liquid-cooled canister calorimeter is used to measure the heat loss through the multilayer foil insulation.

Pain and efficacy rating of a microprocessor-controlled metered injection system for local anaesthesia in minor hand surgery.

PubMed

Nimigan, André S; Gan, Bing Siang

2011-01-01

Purpose. Little attention has been given to syringe design and local anaesthetic administration methods. A microprocessor-controlled anaesthetic delivery device has become available that may minimize discomfort during injection. The purpose of this study was to document the pain experience associated with the use of this system and to compare it with use of a conventional syringe. Methods. A prospective, randomized clinical trial was designed. 40 patients undergoing carpal tunnel release were block randomized according to sex into a two groups: a traditional syringe group and a microprocessor-controlled device group. The primary outcome measure was surgical pain and local anaesthetic administration pain. Secondary outcomes included volume of anaesthetic used and injection time. Results. Analysis showed that equivalent anaesthesia was achieved in the microprocessor-controlled group despite using a significantly lower volume of local anaesthetic (P = .0002). This same group, however, has significantly longer injection times (P < .0001). Pain during the injection process or during surgery was not different between the two groups. Conclusions. This RCT comparing traditional and microprocessor controlled methods of administering local anaesthetic showed similar levels of discomfort in both groups. While the microprocessor-controlled group used less volume, the total time for the administration was significantly greater.

Evaluation of the abuse potential of lorcaserin, a serotonin 2C (5-HT2C) receptor agonist, in recreational polydrug users.

PubMed

Shram, M J; Schoedel, K A; Bartlett, C; Shazer, R L; Anderson, C M; Sellers, E M

2011-05-01

Lorcaserin is a selective and potent serotonin 2C receptor subtype (5-HT(2C)) agonist under development for the treatment of obesity. This study assessed the drug's abuse potential on the basis of its pharmacological profile. For this purpose, a double-blind, double-dummy, placebo-controlled, randomized seven-way crossover study with single oral doses of lorcaserin (20, 40, and 60 mg), zolpidem (15 and 30 mg), ketamine (100 mg), and placebo was conducted in recreational polydrug users (N = 35). Subjective and objective measures were assessed up to 24 h after the dose. We found that zolpidem and ketamine had significantly higher peak scores relative to placebo on the primary measures as well as on most of the secondary measures. The subjective effects of a 20-mg dose of lorcaserin were similar to those of placebo, whereas supratherapeutic doses of lorcaserin were associated with significant levels of dislike by users as compared with placebo, zolpidem, and ketamine. Perceptual effects were minimal after administration of lorcaserin and significantly lower than after administration of either ketamine or zolpidem. The findings suggest that, at supratherapeutic doses, lorcaserin is associated with distinct, primarily negative, subjective effects and has low abuse potential.

Ingenol mebutate in low amounts for the treatment of actinic keratosis in Korean patients.

PubMed

Joe, Hyun Jae; Oh, Byung Ho

2017-01-01

Ingenol mebutate (IM), a novel agent for field therapy of actinic keratosis (AK), has a drawback of inducing local skin reactions (LSRs), which may cause discomfort in patients. To reduce the LSRs, we tried the application of IM in low amounts. The purpose of this study was to review Korean patients with AK being treated with IM and evaluate the LSRs and therapeutic outcomes of low amounts of IM. We retrospectively reviewed 47 patients with AK on the face. A total of 20 and 27 patients were treated by applying recommended amount of 18.8 mg/cm 2 and the lower amount of 10 mg/cm 2 , respectively. The mean composite LSR score for the low amount group (LAG; 12.18±3.29) was significantly lower than that for the recommended amount group (RAG; 15.45±2.70) ( P <0.01, independent sample t -test). The 2-month clearance rate calculated by the number of AKs before and after treatment in each patient was significantly higher for RAG (88.16%), compared with 75.56% for LAG ( P <0.001). Low amount of IM for the treatment of facial AK significantly reduced LSRs in Korean patients. Minimizing LSRs may allow for a secondary targeting treatment of IM for the residual lesions, depending on initial treatment outcomes.

Porcelain surface conditioning protocols and shear bond strength of orthodontic brackets.

PubMed

Lestrade, Ashley M; Ballard, Richard W; Xu, Xiaoming; Yu, Qingzhao; Kee, Edwin L; Armbruster, Paul C

2016-05-01

The objective of the present study was to determine which of six bonding protocols yielded a clinically acceptable shear bond strength (SBS) of metal orthodontic brackets to CAD/CAM lithium disilicate porcelain restorations. A secondary aim was to determine which bonding protocol produced the least surface damage at debond. Sixty lithium disilicate samples were fabricated to replicate the facial surface of a mandibular first molar using a CEREC CAD/CAM machine. The samples were split into six test groups, each of which received different mechanical/chemical pretreatment protocols to roughen the porcelain surface prior to bonding a molar orthodontic attachment. Shear bond strength testing was conducted using an Instron machine. The mean, maximum, minimal, and standard deviation SBS values for each sample group including an enamel control were calculated. A t-test was used to evaluate the statistical significance between the groups. No significant differences were found in SBS values, with the exception of surface roughening with a green stone prior to HFA and silane treatment. This protocol yielded slightly higher bond strength which was statistically significant. Chemical treatment alone with HFA/silane yielded SBS values within an acceptable clinical range to withstand forces applied by orthodontic treatment and potentially eliminates the need to mechanically roughen the ceramic surface.

An in vitro comparison of the effects of voluven (6% hydroxyethyl starch 130/0.4) and hespan (6% hydroxyethyl starch 670/0.75) on measures of blood coagulation in canine blood.

PubMed

Griego-Valles, Michelle; Buriko, Yekaterina; Prittie, Jennifer E; Fox, Philip R

2017-01-01

To assess primary and secondary hemostasis following in vitro dilution of canine whole blood (WB) with hydroxyethyl starch (HES) 130/0.4 and HES 670/0.75. In vitro experimental study. Private practice, teaching hospital. Twenty-five healthy dogs. Each dog underwent venipuncture and 18 mL of venous blood was sampled once. Collected blood was separated in 4 aliquots. Aliquot A served as baseline sample. The remaining tubes of WB were diluted with 0.9% saline, HES 670/0.75 and HES 130/0.4 at a ratio of 1:5.5. Dilutional effects were evaluated using prothrombin time (PT), activated partial thromboplastin time (aPTT), packed cell volume (PCV), thromboelastography (TEG), and platelet closure time (Ct), which was measured using a platelet function analyzer (PFA). Clot strength (ie, G value) was calculated from measured TEG values. Significant increases in PT (P < 0.05) and aPTT (P < 0.05) were documented following WB dilution with saline. Dilution of WB with HES 670/0.75 and HES 130/0.4 resulted in significant hypocoagulable changes in K, MA and G (P < 0.05) compared to baseline and saline. When comparing saline to HES 670/0.75, both R and K values were significantly increased (P < 0.05). K value was significantly increased (P < 0.05) when comparing baseline to HES 130/0.4 and HES 670/0.75. Ct (P < 0.05) was significantly prolonged after WB dilution with HES solutions but not after saline. Dilution of WB with HES 670/0.75 and HES 130/0.4 resulted in changes in primary and secondary hemostasis. Although there were small differences between saline and HES 670/0.75, no differences between HES solutions were evident in this small study. This may suggest there would be minimal increases in bleeding risk when either solution is administered to dogs at low doses. Clinical relevance of our findings requires further investigation. © Veterinary Emergency and Critical Care Society 2016.

Randomized trials are frequently fragmented in multiple secondary publications.

PubMed

Ebrahim, Shanil; Montoya, Luis; Kamal El Din, Mostafa; Sohani, Zahra N; Agarwal, Arnav; Bance, Sheena; Saquib, Juliann; Saquib, Nazmus; Ioannidis, John P A

2016-11-01

To assess the frequency and features of secondary publications of randomized controlled trials (RCTs). For 191 RCTs published in high-impact journals in 2009, we searched for secondary publications coauthored by at least one same author of the primary trial publication. We evaluated the probability of having secondary publications, characteristics of the primary trial publication that predict having secondary publications, types of secondary analyses conducted, and statistical significance of those analyses. Of 191 primary trials, 88 (46%) had a total of 475 secondary publications by 2/2014. Eight trials had >10 (up to 51) secondary publications each. In multivariable modeling, the risk of having subsequent secondary publications increased 1.32-fold (95% CI 1.05-1.68) per 10-fold increase in sample size, and 1.71-fold (95% CI 1.19-2.45) in the presence of a design article. In a sample of 197 secondary publications examined in depth, 193 tested different hypotheses than the primary publication. Of the 193, 43 tested differences between subgroups, 85 assessed predictive factors associated with an outcome of interest, 118 evaluated different outcomes than the original article, 71 had differences in eligibility criteria, and 21 assessed different durations of follow-up; 176 (91%) presented at least one analysis with statistically significant results. Approximately half of randomized trials in high-impact journals have secondary publications published with a few trials followed by numerous secondary publications. Almost all of these publications report some statistically significant results. Copyright © 2016 Elsevier Inc. All rights reserved.

Prevalence of Venous Thromboembolism in Patients With Secondary Polycythemia

PubMed Central

Nadeem, Omar; Gui, Jiang; Ornstein, Deborah L.

2013-01-01

To investigate an association between secondary polycythemia and venous thromboembolism (VTE) risk, we performed a case–control study to compare the prevalence of VTE in participants with secondary polycythemia due to chronic obstructive pulmonary disease (COPD; N = 86) to that in age- and sex-matched controls with COPD without secondary polycythemia (N = 86). Although there was a significant difference in mean hematocrit between cases and controls (53.5% vs 43.6%, respectively; P < .005), we identified no difference in the number of total or idiopathic VTE events in the 2 groups. Patients with VTE, however, had a significantly higher body mass index than patients without VTE. Our findings suggest that secondary polycythemia alone may not be a significant risk factor for VTE but that VTE risk in this population may be related to known risk factors such as obesity. The role of phlebotomy for VTE risk reduction secondary polycythemia is therefore questionable. PMID:23007895

Prevalence of venous thromboembolism in patients with secondary polycythemia.

PubMed

Nadeem, Omar; Gui, Jiang; Ornstein, Deborah L

2013-01-01

To investigate an association between secondary polycythemia and venous thromboembolism (VTE) risk, we performed a case-control study to compare the prevalence of VTE in participants with secondary polycythemia due to chronic obstructive pulmonary disease (COPD; N = 86) to that in age- and sex-matched controls with COPD without secondary polycythemia (N = 86). Although there was a significant difference in mean hematocrit between cases and controls (53.5% vs 43.6%, respectively; P < .005), we identified no difference in the number of total or idiopathic VTE events in the 2 groups. Patients with VTE, however, had a significantly higher body mass index than patients without VTE. Our findings suggest that secondary polycythemia alone may not be a significant risk factor for VTE but that VTE risk in this population may be related to known risk factors such as obesity. The role of phlebotomy for VTE risk reduction secondary polycythemia is therefore questionable.

30-kW SEP Spacecraft as Secondary Payloads for Low-Cost Deep Space Science Missions

NASA Technical Reports Server (NTRS)

Brophy, John R.; Larson, Tim

2013-01-01

The Solar Array System contracts awarded by NASA's Space Technology Mission Directorate are developing solar arrays in the 30 kW to 50 kW power range (beginning of life at 1 AU) that have significantly higher specific powers (W/kg) and much smaller stowed volumes than conventional rigid-panel arrays. The successful development of these solar array technologies has the potential to enable new types of solar electric propulsion (SEP) vehicles and missions. This paper describes a 30-kW electric propulsion vehicle built into an EELV Secondary Payload Adapter (ESPA) ring. The system uses an ESPA ring as the primary structure and packages two 15-kW Megaflex solar array wings, two 14-kW Hall thrusters, a hydrazine Reaction Control Subsystem (RCS), 220 kg of xenon, 26 kg of hydrazine, and an avionics module that contains all of the rest of the spacecraft bus functions and the instrument suite. Direct-drive is used to maximize the propulsion subsystem efficiency and minimize the resulting waste heat and required radiator area. This is critical for packaging a high-power spacecraft into a very small volume. The fully-margined system dry mass would be approximately 1120 kg. This is not a small dry mass for a Discovery-class spacecraft, for example, the Dawn spacecraft dry mass was only about 750 kg. But the Dawn electric propulsion subsystem could process a maximum input power of 2.5 kW, and this spacecraft would process 28 kW, an increase of more than a factor of ten. With direct-drive the specific impulse would be limited to about 2,000 s assuming a nominal solar array output voltage of 300 V. The resulting spacecraft would have a beginning of life acceleration that is more than an order of magnitude greater than the Dawn spacecraft. Since the spacecraft would be built into an ESPA ring it could be launched as a secondary payload to a geosynchronous transfer orbit significantly reducing the launch costs for a planetary spacecraft. The SEP system would perform the escape from Earth and then the heliocentric transfer to the science target.

40 CFR 63.1213 - How can the compliance date be extended to install pollution prevention or waste minimization...

Code of Federal Regulations, 2013 CFR

2013-07-01

... extended to install pollution prevention or waste minimization controls? 63.1213 Section 63.1213 Protection... extended to install pollution prevention or waste minimization controls? (a) Applicability. You may request... pollution prevention or waste minimization measures will significantly reduce the amount and/or toxicity of...

40 CFR 63.1213 - How can the compliance date be extended to install pollution prevention or waste minimization...

Code of Federal Regulations, 2014 CFR

2014-07-01

... extended to install pollution prevention or waste minimization controls? 63.1213 Section 63.1213 Protection... extended to install pollution prevention or waste minimization controls? (a) Applicability. You may request... pollution prevention or waste minimization measures will significantly reduce the amount and/or toxicity of...

Heel impact forces during barefoot versus minimally shod walking among Tarahumara subsistence farmers and urban Americans

PubMed Central

Koch, Elizabeth; Holowka, Nicholas B.; Lieberman, Daniel E.

2018-01-01

Despite substantial recent interest in walking barefoot and in minimal footwear, little is known about potential differences in walking biomechanics when unshod versus minimally shod. To test the hypothesis that heel impact forces are similar during barefoot and minimally shod walking, we analysed ground reaction forces recorded in both conditions with a pedography platform among indigenous subsistence farmers, the Tarahumara of Mexico, who habitually wear minimal sandals, as well as among urban Americans wearing commercially available minimal sandals. Among both the Tarahumara (n = 35) and Americans (n = 30), impact peaks generated in sandals had significantly (p < 0.05) higher force magnitudes, slower loading rates and larger vertical impulses than during barefoot walking. These kinetic differences were partly due to individuals' significantly greater effective mass when walking in sandals. Our results indicate that, in general, people tread more lightly when walking barefoot than in minimal footwear. Further research is needed to test if the variations in impact peaks generated by walking barefoot or in minimal shoes have consequences for musculoskeletal health. PMID:29657826

Does change in isolated lumbar extensor muscle function correlate with good clinical outcome? A secondary analysis of data on change in isolated lumbar extension strength, pain, and disability in chronic low back pain.

PubMed

Steele, James; Fisher, James; Perrin, Craig; Conway, Rebecca; Bruce-Low, Stewart; Smith, Dave

2018-01-12

Secondary analysis of data from studies utilising isolated lumbar extension exercise interventions for correlations among changes in isolated lumbar extension strength, pain, and disability. Studies reporting isolated lumbar extension strength changes were examined for inclusion criteria including: (1) participants with chronic low back pain, (2) intervention ≥ four weeks including isolated lumbar extension exercise, (3) outcome measures including isolated lumbar extension strength, pain (Visual Analogue Scale), and disability (Oswestry Disability Index). Six studies encompassing 281 participants were included. Correlations among change in isolated lumbar extension strength, pain, and disability. Participants were grouped as "met" or "not met" based on minimal clinically important changes and between groups comparisons conducted. Isolated lumbar extension strength and Visual Analogue Scale pooled analysis showed significant weak to moderate correlations (r = -0.391 to -0.539, all p < 0.001). Isolated lumbar extension strength and Oswestry Disability Index pooled analysis showed significant weak correlations (r = -0.349 to -0.470, all p < 0.001). For pain and disability, isolated lumbar extension strength changes were greater for those "met" compared with those "not met" (p < 0.001-0.008). Improvements in isolated lumbar extension strength may be related to positive and meaningful clinical outcomes. As many other performance outcomes and clinical outcomes are not related, isolated lumbar extension strength change may be a mechanism of action affecting symptom improvement. Implications for Rehabilitation Chronic low back pain is often associated with deconditioning of the lumbar extensor musculature. Isolated lumbar extension exercise has been shown to condition this musculature and also reduce pain and disability. This study shows significant correlations between increases in isolated lumbar extension strength and reductions in pain and disability. Strengthening of the lumbar extensor musculature could be considered an important target for exercise interventions.

Anterior Cervical Discectomy and Fusion Outcomes over 10 Years: A Prospective Study.

PubMed

Buttermann, Glenn R

2018-02-01

Prospective cohort study with >10-year follow-up. To assess the long-term, >10-year clinical outcomes of anterior cervical discectomy and fusion (ACDF) and to compare outcomes based on primary diagnosis of disc herniation, stenosis or advanced degenerative disc disease (DDD), number of levels treated, and preexisting adjacent level degeneration. ACDF is a proven treatment for patients with stenosis and disc herniation and results in significantly improved short- and intermediate-term outcomes. Motion preservation treatments may result in improved long-term outcomes but need to be compared to long-term ACDF outcomes reference. Patients who had disc herniation, stenosis, and DDD and underwent ACDF with or without decompression were prospectively enrolled and followed for a minimum of 10 years with outcome assessment at various intervals. All 159 consecutive patients had autogenous tricortical iliac crest bone graft and plate instrumentation used. Outcomes included visual analog scale for neck and arm pain. pain drawing, Oswestry Disability Index, and self-assessment of procedure success. Preoperative adjacent-level disc degeneration, pseudarthrosis, and secondary operations were analyzed. For all diagnostic groups, significant outcomes improvement was seen at all follow-up periods for all scales relative to preoperative scores. Outcomes were not related to age, gender, number of levels treated, and minimally to preexisting degeneration at the adjacent level. The use of narcotic pain medication decreased substantially. Neurological deficits almost all resolved. Patient self-reported success ranged from 85% to 95%. Over the long term, additional surgery for pseudarthrosis (10%) occurred in the early follow-up period, and for adjacent segment degeneration (21%), which occurred linearly during the >10-year follow-up period. ACDF leads to significantly improved outcomes for all primary diagnoses and was sustained for >10 years' follow-up. Secondary surgeries were performed for pseudarthrosis repair and for symptomatic adjacent-level degeneration. 2.

Efficient pairwise RNA structure prediction using probabilistic alignment constraints in Dynalign

PubMed Central

2007-01-01

Background Joint alignment and secondary structure prediction of two RNA sequences can significantly improve the accuracy of the structural predictions. Methods addressing this problem, however, are forced to employ constraints that reduce computation by restricting the alignments and/or structures (i.e. folds) that are permissible. In this paper, a new methodology is presented for the purpose of establishing alignment constraints based on nucleotide alignment and insertion posterior probabilities. Using a hidden Markov model, posterior probabilities of alignment and insertion are computed for all possible pairings of nucleotide positions from the two sequences. These alignment and insertion posterior probabilities are additively combined to obtain probabilities of co-incidence for nucleotide position pairs. A suitable alignment constraint is obtained by thresholding the co-incidence probabilities. The constraint is integrated with Dynalign, a free energy minimization algorithm for joint alignment and secondary structure prediction. The resulting method is benchmarked against the previous version of Dynalign and against other programs for pairwise RNA structure prediction. Results The proposed technique eliminates manual parameter selection in Dynalign and provides significant computational time savings in comparison to prior constraints in Dynalign while simultaneously providing a small improvement in the structural prediction accuracy. Savings are also realized in memory. In experiments over a 5S RNA dataset with average sequence length of approximately 120 nucleotides, the method reduces computation by a factor of 2. The method performs favorably in comparison to other programs for pairwise RNA structure prediction: yielding better accuracy, on average, and requiring significantly lesser computational resources. Conclusion Probabilistic analysis can be utilized in order to automate the determination of alignment constraints for pairwise RNA structure prediction methods in a principled fashion. These constraints can reduce the computational and memory requirements of these methods while maintaining or improving their accuracy of structural prediction. This extends the practical reach of these methods to longer length sequences. The revised Dynalign code is freely available for download. PMID:17445273

Time estimation as a secondary task to measure workload: Summary of research

NASA Technical Reports Server (NTRS)

Hart, S. G.; Mcpherson, D.; Loomis, L. L.

1978-01-01

Actively produced intervals of time were found to increase in length and variability, whereas retrospectively produced intervals decreased in length although they also increased in variability with the addition of a variety of flight-related tasks. If pilots counted aloud while making a production, however, the impact of concurrent activity was minimized, at least for the moderately demanding primary tasks that were selected. The effects of feedback on estimation accuracy and consistency were greatly enhanced if a counting or tapping production technique was used. This compares with the minimal effect that feedback had when no overt timekeeping technique was used. Actively made verbal estimates of sessions filled with different activities performed during the interval were increased. Retrospectively made verbal estimates, however, increased in length as the amount and complexity of activities performed during the interval were increased.

Peroneal Tendon Reconstruction and Coverage for Treatment of Septic Peroneal Tenosynovitis: A Devastating Complication of Lateral Ankle Ligament Reconstruction With a Tendon Allograft.

PubMed

Schade, Valerie L; Harsha, Wayne; Rodman, Caitlin; Roukis, Thomas S

2016-01-01

Septic peroneal tenosynovitis is a rare and significant challenge. A search of peer-reviewed published studies revealed only 5 case reports to guide treatment, none of which resulted in significant loss of both peroneal tendons necessitating reconstruction. No clear guidance is available regarding how to provide reliable reconstruction of both peroneal tendons after a significant loss secondary to septic tenosynovitis. In the present report, we describe the case of a young, active-duty soldier who underwent lateral ankle ligament reconstruction with a tendon allograft whose postoperative course was complicated by septic peroneal tenosynovitis resulting in significant loss of both peroneal tendons. Reconstruction was achieved in a staged fashion with the use of silicone rods and external fixation to maintain physiologic tension and preserve peroneal tendon function, followed by reconstruction of both peroneal tendons and the superior peroneal retinaculum with a tensor fascia lata autograft. Soft tissue coverage was obtained with an anterolateral thigh free tissue transfer and a split-thickness skin graft. The patient returned to full activity as an active-duty soldier with minimal pain and no instability of the right lower extremity. The muscle strength of both peroneal tendons remained at 5 of 5, and no objective findings of ankle instability were seen at 3.5 years postoperatively. Published by Elsevier Inc.

Therapeutic singing as an early intervention for swallowing in persons with Parkinson's disease.

PubMed

Stegemöller, E L; Hibbing, P; Radig, H; Wingate, J

2017-04-01

For persons with Parkinson's disease (PD), secondary motor symptoms such as swallow impairment impact the quality of life and are major contributors to mortality. There is a present need for therapeutic interventions aimed at improving swallow function during the early stages of PD. The purpose of this pilot study was to examine the effects of a group therapeutic singing intervention on swallowing in persons with PD with no significant dysphagia symptoms. Cohort study. University in the United States. Twenty-four participants with PD. Eight weeks of group therapeutic singing. Electromyography (EMG) was used to assess muscle activity associated with swallow pre and post the group singing intervention. Swallow quality of life (SWAL-QOL) and the Unified Parkinson's Disease Rating Scale (UPDRS) were also obtained pre- and post-intervention. Participants reported minimal difficulty with swallowing, yet results revealed a significant increase in EMG outcome measures, as well as significant improvement in UPDRS total and UPDRS motor scores. No significant differences were revealed for SWAL-QOL. Increases in EMG timing measures may suggest that group singing results in the prolongation of laryngeal elevation, protecting the airway from foreign material for longer periods of time during swallow. Combined with the improvement in UPDRS clinical measures, therapeutic singing may be an engaging early intervention strategy to address oropharyngeal dysphagia while also benefiting additional clinical symptoms of PD. Copyright © 2017 Elsevier Ltd. All rights reserved.

Minimally invasive surgery for esophageal motility disorders.

PubMed

Balaji, Nagammapudur S; Peters, Jeffrey H

2002-08-01

Laparoscopic Heller myotomy has emerged as an excellent primary treatment for patients with dysphagia secondary to achalasia. A laparoscopic rather than thoracoscopic approach has stood the test of time. An antireflux procedure combined with the myotomy is crucial to the maintenance of the antireflux barrier. Thoracoscopic long myotomy offers effective relief for spastic disorders of the esophagus. Endoscopic stapled diverticulotomy is a safe and effective procedure for Zenker's diverticulum and has potential advantages over the open approach.

Micro Autonomous Systems Research: A Methodology for Quantitative Technology Assessment and Prototyping of Unmanned Vehicles

DTIC Science & Technology

2014-06-06

Structure Flex Joints 6828 68% Power Primary: Lithium-Ion 7530 75% Secondary: Fuel Cells (miniature) 8843 88% Sensors IMU /LIDAR 7713 77...mission requirements taken into account; the payload included a LIDAR, sonar, and an IMU . Moreover, the focus moved to the integration of the entire...negligible for any pitch or roll angle less than 15 degrees. The small deflection assumption utilized instead seeks to minimize momentum generation. To

[Balloon osteoplasty as reduction technique in the treatment of tibial head fractures].

PubMed

Freude, T; Kraus, T M; Sandmann, G H

2015-10-01

Tibial plateau fractures requiring surgery are severe injuries of the lower extremities. Depending on the fracture pattern, the age of the patient, the range of activity and the bone quality there is a broad variation in adequate treatment.  This article reports on an innovative treatment concept to address split depression fractures (Schatzker type II) and depression fractures (Schatzker type III) of the tibial head using the balloon osteoplasty technique for fracture reduction. Using the balloon technique achieves a precise and safe fracture reduction. This internal osteoplasty combines a minimal invasive percutaneous approach with a gently rise of the depressed area and the associated protection of the stratum regenerativum below the articular cartilage surface. This article lights up the surgical procedure using the balloon technique in tibia depression fractures. Using the balloon technique a precise and safe fracture reduction can be achieved. This internal osteoplasty combines a minimally invasive percutaneous approach with a gentle raising of the depressed area and the associated protection of the regenerative layer below the articular cartilage surface. Fracture reduction by use of a tamper results in high peak forces over small areas, whereas by using the balloon the forces are distributed over a larger area causing less secondary stress to the cartilage tissue. This less invasive approach might help to achieve a better long-term outcome with decreased secondary osteoarthritis due to the precise and chondroprotective reduction technique.

A design strategy for the use of vortex generators to manage inlet-engine distortion using computational fluid dynamics

NASA Technical Reports Server (NTRS)

Anderson, Bernhard H.; Levy, Ralph

1991-01-01

A reduced Navier-Stokes solution technique was successfully used to design vortex generator installations for the purpose of minimizing engine face distortion by restructuring the development of secondary flow that is induced in typical 3-D curved inlet ducts. The results indicate that there exists an optimum axial location for this installation of corotating vortex generators, and within this configuration, there exists a maximum spacing between generator blades above which the engine face distortion increases rapidly. Installed vortex generator performance, as measured by engine face circumferential distortion descriptors, is sensitive to Reynolds number and thereby the generator scale, i.e., the ratio of generator blade height to local boundary layer thickness. Installations of corotating vortex generators work well in terms of minimizing engine face distortion within a limited range of generator scales. Hence, the design of vortex generator installations is a point design, and all other conditions are off design. In general, the loss levels associated with a properly designed vortex generator installation are very small; thus, they represent a very good method to manage engine face distortion. This study also showed that the vortex strength, generator scale, and secondary flow field structure have a complicated and interrelated influence over engine face distortion, over and above the influence of the initial arrangement of generators.

Assessment of minimally invasive surgical skills of pre-medical students: What can we learn from future learners?

PubMed

Borahay, Mostafa A; Jackson, Mary; Tapısız, Omer L; Lyons, Elizabeth; Patel, Pooja R; Nassar, Ramsey; Kılıç, Gökhan Sami

2014-01-01

Knowledge of baseline laparoscopic and robotic surgical skills of future learners is essential to develop teaching strategies that best fit them. The objectives of this study are to determine baseline laparoscopic and robotic skills of high school and college students and compare them to those of current obstetrics and gynecology residents. A cross-sectional (Class II-2) pilot study. Laparoscopic and robotic surgical skills of college and high (secondary) school students were evaluated using simulators and compared to those of obstetrics and gynecology residents. In addition, questionnaire data were collected regarding video game playing and computer use. A total of 17 students, both high school (n=9) and college (n=8), in addition to 11 residents, completed the study. Overall, students performed comparably to the residents in simple exercises (p>.05). However, students took significantly longer time to complete complex exercises (p=.001). Finally, students played video games significantly more than residents (p<.001). Future learners may have a different background skill set. This difference may be related to improved hand-eye coordination, possibly due to playing video games. The results of this pilot study should spur more research into surgical teaching strategies.

Clinical evaluation of a new collagen matrix (Mucograft prototype) to enhance the width of keratinized tissue in patients with fixed prosthetic restorations: a randomized prospective clinical trial.

PubMed

Sanz, Mariano; Lorenzo, Ramón; Aranda, Juan J; Martin, Conchita; Orsini, Marco

2009-10-01

The aim of this study was to test a new collagen matrix (CM) aimed to increase keratinized gingiva/mucosa when compared with the free connective tissue graft (CTG). This randomized longitudinal parallel controlled clinical trial studied 20 patients with at least one location with minimal keratinized tissue (

Efficacy of a new device to optimize positive pressure ventilation via face mask in edentulous patients: a randomized trial.

PubMed

Niño, Maria C; Pauwels, Andres; Raffan, Fernando; Arango, Enrique; Romero, David J; Benitez, Daniel

2017-04-01

Mask ventilation is routinely performed during anesthesia. Under some circumstances, it might be difficult to perform, such as in edentulous patients, due to inadequate mask seal. We developed a new device called NIPARA and studied its use For ventilation optimization in edentulous patients. This randomized controlled trial included edentulous adults who had no other predictors of difficult airway, scheduled to undergo general anesthesia. Patients were assigned either to the NIPARA device group or to the control group (oral airway only). The primary outcomes were peak inspiratory pressure and tidal volume values of the first 14 breaths. The secondary outcome was the incidence of complications. Data from 37 patients were collected during a one-year period (twenty in the NIPARA device group and 17 in the control group). The difference in mean PIP was not statistically significant. The tidal volume was 1.5 times greater in the NIPARA group than in the control group. One patient from the intervention group had minimal oral trauma. In the administration of face mask ventilation, NIPARA is an effective device that significantly improves the tidal volume administered in edentulous patients.

Do nurse-led skill training interventions affect informal caregivers' out-of-pocket expenditures?

PubMed

Van Houtven, Courtney Harold; Thorpe, Joshua M; Chestnutt, Deborah; Molloy, Margory; Boling, John C; Davis, Linda Lindsey

2013-02-01

This paper is a report of a study of the Assistance, Support, and Self-health Initiated through Skill Training (ASSIST) randomized control trial. The aim of this paper is to understand whether participating in ASSIST significantly changed the out-of-pocket (OOP) costs for family caregivers of Alzheimer's disease (AD) or Parkinson's disease (PD) patients. Secondary analysis of randomized control trial data, calculating average treatment effects of the intervention on OOP costs. Enrollment in the ASSIST trial occurred between 2002 and 2007 at 2 sites: Durham, North Carolina, and Birmingham, Alabama. We profile OOP costs for caregivers who participated in the ASSIST study and use 2-part expenditure models to examine the average treatment effect of the intervention on caregiver OOP expenditures. ASSIST-trained AD and PD caregivers reported monthly OOP expenditures that averaged $500-$600. The intervention increased the likelihood of caregivers spending any money OOP by 26 percentage points over usual care, but the intervention did not significantly increase overall OOP costs. The ASSIST intervention was effective and inexpensive to the caregiver in direct monetary outlays; thus, there are minimal unintended consequences of the trial on caregiver financial well-being.

Critical reappraisal of embryo quality as a predictive parameter for pregnancy outcome: a pilot study.

PubMed

Campo, R; Binda, M M; Van Kerkhoven, G; Frederickx, V; Serneels, A; Roziers, P; Lopes, A S; Gordts, S; Puttemans, P; Gordts, S

2010-01-01

Pilot study to analyse the efficacy and embryo morphology using a new human embryo culture medium (GM501) versus the conventional used medium (ISM1). Over a four-month period, all patients at the Leuven Institute of Fertility and Embryology (LIFE) were -randomly allocated to have their embryos cultured in either the standard sequential culture medium ISM1 (control) or in a new universal medium (GM501) (study group). Primary outcome parameters were clinical pregnancy and live birth rate. The secondary outcome parameter was the correlation of embryo fragmentation rate with pregnancy outcome. We did not observe any differences between the ISM1 control group and GM501 study group with regard to fertilization, pregnancy, implantation rates, ongoing pregnancy, and babies born. The number of embryos with a minimal fragmentation rate (less than 30%) was significantly higher in the GM501 study group. Although a significant higher embryo fragmentation rate was seen in In vitro culture of embryos in GM501, pregnancy outcome results were comparable to those of embryos cultured in ISM1. According to our results the value of embryo morphological criteria as a parameter for pregnancy outcome should be examined and discussed again.

Effects of nutrients on specific growth rate of bacterioplankton in oligotrophic lake water cultures

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

Coveney, M.F.; Wetzel, R.G.

The effects of organic and inorganic nutrient additions on the specific growth rates of bacterioplankton in oligotrophic lake water cultures were investigated. Lake water was first passed through 0.8-{mu}m-pore-size filters (prescreening) to remove bacterivores and to minimize confounding effects of algae. Specific growth rates were calculated from changes in both bacterial cell numbers and biovolumes over 36 h. Gross specific growth rates in unmanipulated control samples were estimated through separate measurements of grazing losses by use of penicillin. The addition of mixed organic substrates alone to prescreened water did not significantly increase bacterioplankton specific growth rates. The addition of inorganicmore » phosphorus alone significantly increased one or both specific growth rates in three of four experiments, and one experiment showed a secondary stimulation by organic substrates. The stimulatory effects of phosphorus addition were greatest concurrently with the highest alkaline phosphatase activity in the lake water. Because bacteria have been shown to dominate inorganic phosphorus uptake in other P-deficient systems, the demonstration that phosphorus, rather than organic carbon, can limit bacterioplankton growth suggests direct competition between phytoplankton and bacterioplankton for inorganic phosphorus.« less

The Impact of Laparoscopic Approaches on Short-term Outcomes in Patients Undergoing Liver Surgery for Metastatic Tumors.

PubMed

Karagkounis, Georgios; Seicean, Andreea; Berber, Eren

2015-06-01

To compare the perioperative outcomes associated with open and laparoscopic (LAP) surgical approaches for liver metastases. The American College of Surgeons National Surgical Quality Improvement Program database was used to identify all adult patients who underwent surgical therapy for metastatic liver tumors between 2006 and 2012 (N=7684). Patients who underwent >1 procedure were excluded. Logistic regression after matching on propensity scores was used to assess the association between surgical approaches and perioperative outcomes. A total of 4555 patients underwent open resection, 387 LAP resection, 297 open radiofrequency ablation (RFA), and 265 LAP RFA. In propensity-matched samples (over 95% of patients successfully matched), there was no significant difference between LAP resection and LAP RFA in perioperative complications and length of stay and both compared favorably with their open counterparts. Minimally invasive approaches for secondary hepatic malignancies were associated with improved postoperative morbidity and length of stay and should be preferred in appropriate patients.

Pressure-relieving properties of a intra-operative warming device.

PubMed

Baker, E A; Leaper, D J

2003-04-01

The primary objective of this study was to determine differences in interface pressure between four mattress combinations: a standard operating table mattress, a pressure-relieving gel pad and an under-patient warming device set at 38 degrees C (Pegasus Inditherm System) and at ambient temperature. The secondary objective was to determine whether the warming device remains stable in extreme surgical positions. Interface pressures obtained with all four combinations were measured in 10 healthy volunteers using force sensing array technology. The warming device demonstrated better or equivalent pressure relief when compared with the standard gel pad. There was no significant difference in subject position 'shift' between the mattress, the gel pad and the warming device for either the Trendelenberg or reverse Trendelenberg positions. Both pressure-relieving mattresses and warming reduce intra-operative pressure damage. A mattress with both properties may further reduce pressure damage postoperatively. The warming device used in this study appears stable--subject 'slippage' was minimal in extreme positions. Research needs to be conducted among real anaesthetised patients to support these conclusions.

Near-Earth Asteroid (NEA) Scout

NASA Technical Reports Server (NTRS)

McNutt, Leslie; Johnson, Les; Kahn, Peter; Castillo-Rogez, Julie; Frick, Andreas

2014-01-01

Near-Earth asteroids (NEAs) are the most easily accessible bodies in the solar system, and detections of NEAs are expected to grow exponentially in the near future, offering increasing target opportunities. As NASA continues to refine its plans to possibly explore these small worlds with human explorers, initial reconnaissance with comparatively inexpensive robotic precursors is necessary. Obtaining and analyzing relevant data about these bodies via robotic precursors before committing a crew to visit a NEA will significantly minimize crew and mission risk, as well as maximize exploration return potential. The Marshall Space Flight Center (MSFC) and Jet Propulsion Laboratory (JPL) are jointly examining a potential mission concept, tentatively called 'NEAScout,' utilizing a low-cost platform such as CubeSat in response to the current needs for affordable missions with exploration science value. The NEAScout mission concept would be treated as a secondary payload on the Space Launch System (SLS) Exploration Mission 1 (EM-1), the first planned flight of the SLS and the second un-crewed test flight of the Orion Multi-Purpose Crew Vehicle (MPCV).

Near-Earth Asteroid Scout

NASA Technical Reports Server (NTRS)

McNutt, Leslie; Johnson, Les; Clardy, Dennon; Castillo-Rogez, Julie; Frick, Andreas; Jones, Laura

2014-01-01

Near-Earth Asteroids (NEAs) are an easily accessible object in Earth's vicinity. Detections of NEAs are expected to grow in the near future, offering increasing target opportunities. As NASA continues to refine its plans to possibly explore these small worlds with human explorers, initial reconnaissance with comparatively inexpensive robotic precursors is necessary. Obtaining and analyzing relevant data about these bodies via robotic precursors before committing a crew to visit a NEA will significantly minimize crew and mission risk, as well as maximize exploration return potential. The Marshall Space Flight Center (MSFC) and Jet Propulsion Laboratory (JPL) are jointly examining a mission concept, tentatively called 'NEA Scout,' utilizing a low-cost CubeSats platform in response to the current needs for affordable missions with exploration science value. The NEA Scout mission concept would be a secondary payload on the Space Launch System (SLS) Exploration Mission 1 (EM-1), the first planned flight of the SLS and the second un-crewed test flight of the Orion Multi-Purpose Crew Vehicle (MPCV).

A histopathological study of bulbar conjunctival flaps occurring in 2 contact lens wearers.

PubMed

Markoulli, Maria; Francis, Ian C; Yong, Jim; Jalbert, Isabelle; Carnt, Nicole; Cole, Nerida; Papas, Eric

2011-09-01

To study the histopathology of paralimbal bulbar conjunctival flaps occurring secondary to soft contact lens wear. Slit-lamp biomicroscopy using sodium fluorescein, cobalt blue light, and a Wratten filter was used to observe the presence, location, and dimensions of bulbar conjunctival flaps presenting in a cohort of contact lens wearers. Two subjects who exhibited such flaps agreed to undergo conjunctival biopsy. Tissue samples, obtained from the region of the flap, and an adjacent unaffected area were processed by standard histopathological methods. In the first subject, analysis of the flap tissue showed even collagen distribution and overall normal histology. The flap of the second subject displayed a mild focal increase in collagen and mild degeneration of collagen, but no increase in elastic tissue. Conjunctival epithelium was normal in both cases. In these 2 subjects, conjunctival flap tissue either was normal or showed only minimal abnormality. There is insufficient evidence for significant pathological change on the time scale of this study.

Design Study for the Asteroid Redirect Vehicle (ARV) Composite Primary Bulkhead

NASA Technical Reports Server (NTRS)

Cressman, Thomas O.; Paddock, David A.

2017-01-01

A design study was undertaken of a carbon fiber primary bulkhead for a large solar electric propulsion (SEP) spacecraft. The bulkhead design, supporting up to 16 t of xenon propellant, progressed from one consisting of many simple parts with many complex joints, to one consisting of a few complex parts with a few simple joints. The unique capabilities of composites led to a topology that transitioned loads from bending to in-plane tension and shear, with low part count. This significantly improved bulkhead manufacturability, cost, and mass. The stiffness-driven structure utilized high-modulus M55J fiber unidirectional prepregs. A full-scale engineering demonstration unit (EDU) of the concept was used to demonstrate manufacturability of the concept. Actual labor data was obtained, which could be extrapolated to a full bulkhead. The effort demonstrated the practicality of using high-modulus fiber (HMF) composites for unique shape topologies that minimize mass and cost. The lessons are applicable to primary and secondary aerospace structures that are stiffness driven.

Bright and compact macromolecular probes for bioimaging applications

NASA Astrophysics Data System (ADS)

Thapaliya, Ek Raj; Zhang, Yang; Dhakal, Pravat; Brown, Adrienne S.; Wilson, James N.; Collins, Kevin M.; Raymo, Françisco M.

2018-02-01

Amphiphilic macromolecules with multiple borondipyrromethene (BODIPY) chromophores appended to a common poly(methacrylate) backbone were synthesized by the random co-polymerization of appropriate methacrylate monomers. The resulting polymers incorporate also hydrophilic oligo(ethylene glycol) and hydrophobic decyl side chains designed to impose aqueous solubility and insulate the chromophoric components from each other respectively. The presence of multiple chromophores translates into a significant enhancement in molar absorption coefficient, relative to a model BODIPY monomer. The effective insulation of the fluorophores minimizes interchromophoric interactions and mitigates depressive effects on the fluorescence quantum yield. The overall result is a 6-fold enhancement in brightness, relative to the model monomer. These macromolecular probes can be injected into live Caenorhabditis elegans to allow their visualization with a 4-fold increase in signal intensity, relative to the model system. Furthermore, they can be conjugated to secondary antibodies, under standard amide-coupling conditions, with negligible influence on the binding affinity of the biomoleucles to allow the implementation of immunolabeling protocols.

Marine envenomations.

PubMed

Berling, Ingrid; Isbister, Geoffrey

2015-01-01

Marine stings are common but most are minor and do not require medical intervention. Severe and systemic marine envenoming is uncommon, but includes box jellyfish stings, Irukandji syndrome, major stingray trauma and blue-ringed octopus envenoming. Almost all marine injuries are caused by jellyfish stings, and penetrating injuries from spiny fish, stingrays or sea urchins. This article describes the presentation and management of marine envenomations and injuries that may occur in Australia. First aid for jellyfish includes tentacle removal, application of vinegar for box jellyfish, and hot water immersion (45°C for 20 min) for bluebottle jellyfish stings. Basic life support is essential for severe marine envenomings that result in cardiac collapse or paralysis. Irukandji syndrome causes severe generalised pain, autonomic excess and minimal local pain, which may require large amounts of analgesia, and, uncommonly, myocardial depression and pulmonary oedema occur. Penetrating marine injuries can cause significant trauma depending on location of the injury. Large and unclean wounds may have delayed healing and secondary infection if not adequately irrigated, debrided and observed.

Decompression illness secondary to occupational diving: recommended management based current legistation and practice in Malaysia.

PubMed

Rozali, A; Khairuddin, H; Sherina, M S; Zin, B Mohd; Sulaiman, A

2008-06-01

Occupational divers are exposed to hazards which contribute to the risk of developing decompression illnesses (DCI). DCI consists of Type I decompression sickness (DCS), Type II DCS and arterial gas embolism (AGE), developed from formation of bubbles in the tissues or circulation as a result of inadequate elimination of inert gas (nitrogen) after a dive. In Malaysia, DCI is one of the significant contributions to mortality and permanent residual morbidity in diving accidents. This is a case of a diver who suffered from Type II DCS with neurological complications due to an occupational diving activity. This article mentions the clinical management of the case and makes several recommendations based on current legislations and practise implemented in Malaysia in order to educate medical and health practitioners on the current management of DCI from the occupational perspective. By following these recommendations, hopefully diving accidents mainly DCI and its sequalae among occupational divers can be minimized and prevented, while divers who become injured receive the proper compensation for their disabilities.

Secondary structure prediction and structure-specific sequence analysis of single-stranded DNA.

PubMed

Dong, F; Allawi, H T; Anderson, T; Neri, B P; Lyamichev, V I

2001-08-01

DNA sequence analysis by oligonucleotide binding is often affected by interference with the secondary structure of the target DNA. Here we describe an approach that improves DNA secondary structure prediction by combining enzymatic probing of DNA by structure-specific 5'-nucleases with an energy minimization algorithm that utilizes the 5'-nuclease cleavage sites as constraints. The method can identify structural differences between two DNA molecules caused by minor sequence variations such as a single nucleotide mutation. It also demonstrates the existence of long-range interactions between DNA regions separated by >300 nt and the formation of multiple alternative structures by a 244 nt DNA molecule. The differences in the secondary structure of DNA molecules revealed by 5'-nuclease probing were used to design structure-specific probes for mutation discrimination that target the regions of structural, rather than sequence, differences. We also demonstrate the performance of structure-specific 'bridge' probes complementary to non-contiguous regions of the target molecule. The structure-specific probes do not require the high stringency binding conditions necessary for methods based on mismatch formation and permit mutation detection at temperatures from 4 to 37 degrees C. Structure-specific sequence analysis is applied for mutation detection in the Mycobacterium tuberculosis katG gene and for genotyping of the hepatitis C virus.

Synthesis of robalzotan, ebalzotan, and rotigotine precursors via the stereoselective multienzymatic cascade reduction of α,β-unsaturated aldehydes.

PubMed

Brenna, Elisabetta; Gatti, Francesco G; Malpezzi, Luciana; Monti, Daniela; Parmeggiani, Fabio; Sacchetti, Alessandro

2013-05-17

A stereoselective synthesis of bicyclic primary or secondary amines, based on tetralin or chroman structural moieties, is reported. These amines are precursors of important active pharmaceutical ingredients such as rotigotine (Neupro), robalzotan, and ebalzotan. The key step is based on a multienzymatic reduction of an α,β-unsaturated aldehyde or ketone to give the saturated primary or secondary alcohol, in a high yield and with a high ee. The catalytic system consists of the combination of an ene-reductase (ER; i.e., OYE2 or OYE3 belonging to the Old Yellow Enzyme family) with an alcohol dehydrogenase (ADH), applying the in situ substrate feeding product removal technology. By this system the formation of the allylic alcohol side product and the racemization of the chirally unstable α-substituted aldehyde intermediate are minimized. The primary alcohols were elaborated via a Curtius rearrangement. The combination of OYE2 with a Prelog or an anti-Prelog ADH allowed the preparation of the secondary alcohols with ee > 99% and de > 87%. The absolute configuration of the primary amines was unambiguously assigned by comparison with authentic samples. The stereochemistry of secondary alcohols was assigned by X-ray crystal structure and NMR analysis of Mosher esters.

[Concentrations of alkaloids, cyanogenic glycosides, polyphenols and saponins in selected medicinal plants from Ecuador and their relationship with acute toxicity against Artemia salina].

PubMed

Jaramillo Jaramillo, Carmita; Jaramillo Espinoza, Anyi; D'Armas, Haydelba; Troccoli, Luis; Rojas de Astudillo, Luisa

2016-09-01

Alkaloids, polyphenols, cyanogenic glycosides and saponins are among the main chemical compounds synthesized by plants but not considered essential for their basic metabolism. These compounds have different functions in plants, and have been recognized with medicinal and pharmacological properties. In this research, concentrations of the mentioned secondary metabolites were determined in the medicinal plants Artemisia absinthium, Cnidoscolus aconitifolius, Parthenium hysterophorus, Piper carpunya and Taraxacum officinale, from Ecuador, and related with cytotoxic effects against Artemia salina. Alcoholic and aqueous extracts from leaves of these selected plants were prepared at different concentrations. To assess cytotoxicity of these extracts, different bioassays with A. salina were undertaken, and the mortality rates and LC50 were obtained. Besides, concentrations of alkaloids, cyanogenic glycosides, phenols, tannins and saponins were determined by spectrophotometric methods; this constituted the first report of quantification of secondary metabolites in the selected plants from Ecuador. T. officinale had the highest concentration of total phenols (22.30 ± 0.23 mg/g) and tannins (11.70 ± 0.10 mg/g), C. aconitifolius of cyanogenic glycosides (5.02 ± 0.37 µg/g) and P. hysterophorus of saponins (6.12 ± 0.02 mg/g). Tannins values obtained were not adverse to their consumption. Alcoholic and aqueous extracts of selected plants had hemolytic activity depending on the concentration of saponins. Although the values of cyanogenic glycosides were permissible, it was necessary to monitor the presence of this metabolite in plants to minimize health problems. LC50 values ranged from extremely toxic (3.37 µg/mL) to highly toxic (274.34 μg/mL), in P. carpunya and T. officinale, respectively. From correlation analysis, it was observed that increase values of alkaloids concentrations had highly significant (p<0.001) acute toxicity against A. salina, while at a higher polyphenol concentration the level of plants cytotoxicity decreased significantly (p<0.001). The results of principal component analysis showed that saponins apparently were in synergy with polyphenols to decrease cytotoxicity, but antagonize with alkaloids and cyanogenic glycosides, indicating that these secondary metabolites present variability in the mechanisms of action against A. salina, as cytotoxic compounds. These results also demonstrate that polyphenols and saponins can be lethal at low concentrations, demonstrating the potential of brine shrimp bioassay as a model to evaluate plant extracts containing low concentrations of chemical compounds with high polarities. The significant positive correlation between cytotoxicity and concentration of alkaloids confirmed by the bioassay of brine shrimp can be useful to identify promising sources of antitumor compounds, and to evaluate tolerable limits not affecting other benign cells. Contents of secondary metabolites found in the selected plants confer them great pharmacologic values.

Effects of footwear and strike type on running economy.

PubMed

Perl, Daniel P; Daoud, Adam I; Lieberman, Daniel E

2012-07-01

This study tests if running economy differs in minimal shoes versus standard running shoes with cushioned elevated heels and arch supports and in forefoot versus rearfoot strike gaits. We measured the cost of transport (mL O(2)·kg(-1)·m(-1)) in subjects who habitually run in minimal shoes or barefoot while they were running at 3.0 m·s(-1) on a treadmill during forefoot and rearfoot striking while wearing minimal and standard shoes, controlling for shoe mass and stride frequency. Force and kinematic data were collected when subjects were shod and barefoot to quantify differences in knee flexion, arch strain, plantar flexor force production, and Achilles tendon-triceps surae strain. After controlling for stride frequency and shoe mass, runners were 2.41% more economical in the minimal-shoe condition when forefoot striking and 3.32% more economical in the minimal-shoe condition when rearfoot striking (P < 0.05). In contrast, forefoot and rearfoot striking did not differ significantly in cost for either minimal- or standard-shoe running. Arch strain was not measured in the shod condition but was significantly greater during forefoot than rearfoot striking when barefoot. Plantar flexor force output was significantly higher in forefoot than in rearfoot striking and in barefoot than in shod running. Achilles tendon-triceps surae strain and knee flexion were also lower in barefoot than in standard-shoe running. Minimally shod runners are modestly but significantly more economical than traditionally shod runners regardless of strike type, after controlling for shoe mass and stride frequency. The likely cause of this difference is more elastic energy storage and release in the lower extremity during minimal-shoe running.

Potato suberin induces differentiation and secondary metabolism in the genus Streptomyces.

PubMed

Lerat, Sylvain; Forest, Martin; Lauzier, Annie; Grondin, Gilles; Lacelle, Serge; Beaulieu, Carole

2012-01-01

Bacteria of the genus Streptomyces are soil microorganisms with a saprophytic life cycle. Previous studies have revealed that the phytopathogenic agent S. scabiei undergoes metabolic and morphological modifications in the presence of suberin, a complex plant polymer. This paper investigates morphological changes induced by the presence of potato suberin in five species of the genus Streptomyces, with emphasis on S. scabiei. Streptomyces scabiei, S. acidiscabies, S. avermitilis, S. coelicolor and S. melanosporofaciens were grown both in the presence and absence of suberin. In all species tested, the presence of the plant polymer induced the production of aerial hyphae and enhanced resistance to mechanical lysis. The presence of suberin in liquid minimal medium also induced the synthesis of typical secondary metabolites in S. scabiei and S. acidiscabies (thaxtomin A), S. coelicolor (actinorhodin) and S. melanosporofaciens (geldanamycin). In S. scabiei, the presence of suberin modified the fatty acid composition of the bacterial membrane, which translated into higher membrane fluidity. Moreover, suberin also induced thickening of the bacterial cell wall. The present data indicate that suberin hastens cellular differentiation and triggers the onset of secondary metabolism in the genus Streptomyces.

Secondary structure in solution of two anti-HIV-1 hammerhead ribozymes as investigated by two-dimensional 1H 500 MHz NMR spectroscopy in water

NASA Technical Reports Server (NTRS)

Sarma, R. H.; Sarma, M. H.; Rein, R.; Shibata, M.; Setlik, R. S.; Ornstein, R. L.; Kazim, A. L.; Cairo, A.; Tomasi, T. B.

1995-01-01

Two hammerhead chimeric RNA/DNA ribozymes (HRz) were synthesized in pure form. Both were 30 nucleotides long, and the sequences were such that they could be targeted to cleave the HIV-1 gag RNA. Named HRz-W and HRz-M, the former had its invariable core region conserved, the latter had a uridine in the invariable region replaced by a guanine. Their secodary structures were determined by 2D NOESY 1H 500 MHz NMR spectroscopy in 90% water and 10% D2(0), following the imino protons. The data show that both HRz-M and HRz-W form identical secondary structures with stem regions consisting of continuous stacks of AT and GT pairs. An energy minimized computer model of this stem region is provided. The results suggest that the loss of catalytic activity that is known to result when an invariant core residue is replaced is not related to the secondary structure of the ribozymes in the absence of substrate.

Prospects for a Muon Spin Resonance Facility in the Fermilab MuCool Test Area

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

Johnstone, John A.; Johnstone, Carol

This paper investigates the feasibility of re-purposing the MuCool Test Area (MTA) beamline and experimental hall to support a Muon Spin Resonance (MuSR) facility, which would make it the only such facility in the US. This report reviews the basic muon production concepts studied and operationally implemented at TRIUMF, PSI, and RAL and their application in the context of the MTA facility. Two scenarios were determined feasible. One, an initial minimal-shielding and capital-cost investment stage with a single secondary muon beamline that utilizes an existing high- intensity beam absorber and, another, upgraded stage, that implements an optimized production target pile,more » a proximate high-intensity absorber, and optimized secondary muon lines. A unique approach is proposed which chops or strips a macropulse of H$^-$ beam into a micropulse substructure – a muon creation timing scheme – which allows Muon Spin Resonance experiments in a linac environment. With this timing scheme, and attention to target design and secondary beam collection, the MTA can host enabling and competitive Muon Spin Resonance experiments.« less

[A review on fundamental studies of secondary forest management].

PubMed

Zhu, Jiaojun

2002-12-01

Secondary forest is also called as natural secondary forest, which regenerates on native forest that has been disturbed by severe natural or anthropogenic disturbances. The structural and dynamic organizations, growth, productivity and stand environment of secondary forests are significantly different from those of natural and artificial forests. Such significant differences make secondary forests have their own special characteristics in forestry. Secondary forests are the main body of forests in China. Therefore, their management plays a very important role in the projects of natural forest conservation and the construction of ecological environment in China or in the world. Based on a wide range of literature collection on secondary forest research, the fundamental studies of secondary forest management were discussed. The major topics are as follows: 1) basic characteristics of secondary forest, 2) principles of secondary forest management, 3) types of secondary forest, 4) community structure and succession dynamics of secondary forest, including niches, biodiversity, succession and so on, 5) main ecological processes of secondary forest, including regeneration, forest soil and forest environment. Additionally, the research needs and tendency related to secondary forest in the future were also given, based on the analyses of the main results and the problems in current management of secondary forest. The review may be helpful to the research of secondary forest management, and to the projects of natural forest conservation in China.

Modular photovoltaic stand-alone systems: Phase 1

NASA Technical Reports Server (NTRS)

Naff, G. J.; Marshall, N. A.

1983-01-01

A family of modular stand-alone power systems that covered the range in power level from 1 kw to 14 kw was developed. Products within this family were required to be easily adaptable to different environments and applications, and were to be both reliable and cost effective. Additionally, true commonality in hardware was to be exploited, and unnecessary recurrence of design and development costs were to be minimized; thus improving hardware availability. Assurance of compatibility with large production runs, was also an underlying program goal. A secondary objective was to compile, evaluate, and determine the economic and technical status of available, and potentially available, technology options associated with the balance of systems (BOS) for stand-along photovoltaic (PV) power systems. The secondary objective not only directly supported the primary but additionally contributed to the definition and implementation of the BOS cost reduction plan.

Investigation of the radiation background in the interaction region of the medium-energy electron relativisitic heavy ion collider (MeRHIC)

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

Beebe-Wang,J.

There are three main sources of the radiation background in MeRHIC: forward synchrotron radiation generated upstream of the detector, the direct backward radiation caused by the photons hitting beampipe downstream of the detector, and the indirect secondary radiation caused by hard photons hitting vacuum systems, masks, collimators, absorbers or any other elements in the interaction region. In this paper, we first calculate the primary radiation distribution by employing electromagnetic theory. Then we obtain the direct backward scattering rate by applying the kinematic Born approximation deduced from scattering dynamics. The diffuse scattering cross section is calculated as a function of themore » surface properties of the MeRHIC vacuum system. Finally, the dominating physical processes and minimization of indirect secondary radiation is presented and discussed.« less

Motivation for DOC III: 64-bit digital optical computer

NASA Astrophysics Data System (ADS)

Guilfoyle, Peter S.

1991-09-01

OptiComp has focused on a digital optical logic family in order to capitalize on the inherent benefits of optical computing, which include (1) high FAN-IN and FAN-OUT, (2) low power consumption, (3) high noise margin, (4) high algorithmic efficiency using 'smart' interconnects, and (5) free-space leverage of gate interconnect bandwidth product. Other well-known secondary advantages of optical logic include zero capacitive loading of signals at a detector, zero cross-talk between signals, zero signal dispersion, and minimal clock skew (a few picoseconds or less in an imaging system). The primary focus of this paper is to demonstrate how each of the five advantages can be used to leverage other logic family performance such as GaAs; the secondary attributes are discussed only in the context of introducing the DOC III architecture.

Burnout, compassion fatigue, compassion satisfaction, and secondary traumatic stress in trauma nurses.

PubMed

Hinderer, Katherine A; VonRueden, Kathryn T; Friedmann, Erika; McQuillan, Karen A; Gilmore, Rebecca; Kramer, Betsy; Murray, Mary

2014-01-01

The relationship of burnout (BO), compassion fatigue (CF), compassion satisfaction (CS), and secondary traumatic stress (STS) to personal/environmental characteristics, coping mechanisms, and exposure to traumatic events was explored in 128 trauma nurses. Of this sample, 35.9% had scores consistent with BO, 27.3% reported CF, 7% reported STS, and 78.9% had high CS scores. High BO and high CF scores predicted STS. Common characteristics correlating with BO, CF, and STS were negative coworker relationships, use of medicinals, and higher number of hours worked per shift. High CS correlated with greater strength of supports, higher participation in exercise, use of meditation, and positive coworker relationships. Caring for trauma patients may lead to BO, CF, and STS; identifying predictors of these can inform the development of interventions to mitigate or minimize BO, CF, and STS in trauma nurses.

Minimized extracorporeal circulation in coronary artery bypass surgery is equivalent to standard extracorporeal circulation in patients with reduced left ventricular function.

PubMed

Puehler, T; Haneya, A; Philipp, A; Camboni, D; Hirt, S; Zink, W; Lehle, K; Rupprecht, L; Kobuch, R; Diez, C; Schmid, C

2010-06-01

Minimized extracorporeal circulation (MECC) is a promising alternative to standard extracorporeal circulation (ECC) and its use is increasing in routine coronary bypass surgery. We analyzed the clinical outcome of patients with reduced left ventricular function who underwent coronary artery bypass surgery with MECC or with standard ECC. From January 2003 to September 2008, 238 patients with a left ventricular function < 30 % underwent bypass surgery with ECC or MECC. The primary end point of our retrospective observational study was 30-day mortality. Secondary endpoints were the transfusion requirements, as well as intensive care and the in-hospital course. Demographic data, comorbidities and left ventricular function were similar in the study groups. MECC patients had a tendency towards a lower 30-day mortality rate, a better postoperative renal function and reduced ventilation times. Extracorporeal circulation time and postoperative high-dose inotropic support were significantly lower in the MECC group, while the stays in the intensive care unit and in hospital were comparable between the two groups. In our study, age in the ECC group, and previous infarction and New York Heart Association grade IV in the MECC group were preoperative risk factors associated with a higher mortality. Coronary bypass surgery using MECC is feasible and safe for patients with severely impaired left ventricular function. It is a promising alternative to ECC with a low mortality rate and a more favorable postoperative course.

A comparison of 2 cesarean section methods, modified Misgav-Ladach and Pfannenstiel-Kerr: A randomized controlled study.

PubMed

Şahin, Nur; Genc, Mine; Turan, Gülüzar Arzu; Kasap, Esin; Güçlü, Serkan

2018-03-13

The modified Misgav-Ladach method (MML) is a minimally invasive cesarean section procedure compared with the classic Pfannenstiel-Kerr (PK) method. The aim of the study was to compare the MML method and the PK method in terms of intraoperative and short-term postoperative outcomes. This prospective, randomized controlled trial involved 252 pregnant women scheduled for primary emergency or elective cesarean section between October, 2014 and July, 2015. The primary outcome measures were the duration of surgery, extraction time, Apgar score, blood loss, wound complications, and number of sutures used. Secondary outcome measures were the wound infection, time of bowel restitution, visual analogue scale (VAS) scores at 6 h and 24 h after the operation, limitations in movement, and analgesic requirements. At 6 weeks after surgery, the patients were evaluated regarding late complications. There was a significant reduction in total operating and extraction time in the MML group (p < 0.001). Limitations in movement were lower at 24 h after the MML operation, and less analgesic was required in the MML group. There was no difference between the 2 groups in terms of febrile morbidity or the duration of hospitalization. At 6 weeks after the operation, no complaints and no additional complications from the surgery were noted. The MML method is a minimally invasive cesarean section. In the future, as surgeons' experience increases, MML will likely be chosen more often than the classic PK method.

Resin transfer molding of textile preforms for aircraft structural applications

NASA Technical Reports Server (NTRS)

Hasko, Gregory H.; Dexter, H. Benson; Weideman, Mark H.

1992-01-01

The NASA LaRC is conducting and supporting research to develop cost-effective fabrication methods that are applicable to primary composite aircraft structures. One of the most promising fabrication methods that has evolved is resin transfer molding (RTM) of dry textile material forms. RTM has been used for many years for secondary structures, but has received increased emphasis because it is an excellent method for applying resin to damage-tolerant textile preforms at low cost. Textile preforms based on processes such as weaving, braiding, knitting, stitching, and combinations of these have been shown to offer significant improvements in damage tolerance compared to laminated tape composites. The use of low-cost resins combined with textile preforms could provide a major breakthrough in achieving cost-effective composite aircraft structures. RTM uses resin in its lowest cost form, and storage and spoilage costs are minimal. Near net shape textile preforms are expected to be cost-effective because automated machines can be used to produce the preforms, post-cure operations such as machining and fastening are minimized, and material scrap rate may be reduced in comparison with traditional prepreg molding. The purpose of this paper is to discuss experimental and analytical techniques that are under development at NASA Langley to aid the engineer in developing RTM processes for airframe structural elements. Included are experimental techniques to characterize preform and resin behavior and analytical methods that were developed to predict resin flow and cure kinetics.

Feline mitochondrial DNA sampling for forensic analysis: when enough is enough!

PubMed

Grahn, Robert A; Alhaddad, Hasan; Alves, Paulo C; Randi, Ettore; Waly, Nashwa E; Lyons, Leslie A

2015-05-01

Pet hair has a demonstrated value in resolving legal issues. Cat hair is chronically shed and it is difficult to leave a home with cats without some level of secondary transfer. The power of cat hair as an evidentiary resource may be underused because representative genetic databases are not available for exclusionary purposes. Mitochondrial control region databases are highly valuable for hair analyses and have been developed for the cat. In a representative worldwide data set, 83% of domestic cat mitotypes belong to one of twelve major types. Of the remaining 17%, 7.5% are unique within the published 1394 sample database. The current research evaluates the sample size necessary to establish a representative population for forensic comparison of the mitochondrial control region for the domestic cat. For most worldwide populations, randomly sampling 50 unrelated local individuals will achieve saturation at 95%. The 99% saturation is achieved by randomly sampling 60-170 cats, depending on the numbers of mitotypes available in the population at large. Likely due to the recent domestication of the cat and minimal localized population substructure, fewer cats are needed to meet mitochondria DNA control region database practical saturation than for humans or dogs. Coupled with the available worldwide feline control region database of nearly 1400 cats, minimal local sampling will be required to establish an appropriate comparative representative database and achieve significant exclusionary power. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Microincision, aspiration cutter-assisted multifocal iris biopsy for melanoma.

PubMed

Finger, Paul T; Milman, Tatyana

2017-01-19

To describe a minimally invasive method to create multifocal full-thickness surgical iridectomy biopsies. Seven patients suspected to have diffuse iris melanoma underwent multifocal surgical iridectomy biopsy through a single 1.0-mm clear corneal incision. A 25-G inked trocar was used to create one visible corneal portal, through which the anterior chamber was filled with sodium hyaluronate 1%. Then, a 25-G aspiration cutter probe was introduced through the corneal incision such that the aspiration portal was occluded by the iris biopsy sites. Then aspiration (600 mm Hg) cutting (300 cuts per minute) was used to create full- and partial-thickness surgical iridectomy biopsies at multiple locations. After each biopsy the probe was removed, and its contents aspirated into a separate 3-mL syringe (marked by clock hour location). The sodium hyaluronate 1% was removed and wound checked for leakage. Diagnostic specimens were obtained in all cases. Five were found to be diffuse iris melanomas and 2 were indeterminate iris melanocytic proliferations. No patients developed a secondary increase in intraocular pressure, hyphema, infection, cataract, or vision loss. No cases of intraocular tumor dissemination were observed. No patient complained of glare or monocular diplopia. Three of 7 corneal wounds were self-sealing. Multifocal surgical iridectomy biopsy can be minimally invasive and effective allowing for partial- and full-thickness iris biopsy. Use of a 25-G aspiration cutting probe allowed for small incision surgery, rapid rehabilitation, and no significant complications.

Interval from prostate biopsy to radical prostatectomy does not affect immediate operative outcomes for open or minimally invasive approach.

PubMed

Park, Bumsoo; Choo, Seol Ho; Jeon, Hwang Gyun; Jeong, Byong Chang; Seo, Seong Il; Jeon, Seong Soo; Lee, Hyun Moo; Choi, Han Yong

2014-12-01

Traditionally, urologists recommend an interval of at least 4 weeks after prostate biopsy before radical prostatectomy. The aim of our study was to evaluate whether the interval from prostate biopsy to radical prostatectomy affects immediate operative outcomes, with a focus on differences in surgical approach. The study population of 1,848 radical prostatectomy patients was divided into two groups according to the surgical approach: open or minimally invasive. Open group included perineal and retropubic approach, and minimally invasive group included laparoscopic and robotic approach. The cut-off of the biopsy-to-surgery interval was 4 weeks. Positive surgical margin status, operative time and estimated blood loss were evaluated as endpoint parameters. In the open group, there were significant differences in operative time and estimated blood loss between the <4-week and ≥4-week interval subgroups, but there was no difference in positive margin rate. In the minimally invasive group, there were no differences in the three outcome parameters between the two subgroups. Multivariate analysis revealed that the biopsy-to-surgery interval was not a significant factor affecting immediate operative outcomes in both open and minimally invasive groups, with the exception of the interval ≥4 weeks as a significant factor decreasing operative time in the minimally invasive group. In conclusion, performing open or minimally invasive radical prostatectomy within 4 weeks of prostate biopsy is feasible for both approaches, and is even beneficial for minimally invasive radical prostatectomy to reduce operative time.

Secondary instabilities of hypersonic stationary crossflow waves

NASA Astrophysics Data System (ADS)

Edelman, Joshua B.

A sharp, circular 7° half-angle cone was tested in the Boeing/AFOSR Mach-6 Quiet Tunnel at 6° angle of attack. Using a variety of roughness configurations, measurements were made using temperature-sensitive paint (TSP) and fast pressure sensors. High-frequency secondary instabilities of the stationary crossflow waves were detected near the aft end of the cone, from 110° to 163° from the windward ray. At least two frequency bands of the secondary instabilities were measured. The secondary instabilities have high coherence between upstream and downstream sensor pairs. In addition, the amplitudes of the instabilities increase with the addition of roughness elements near the nose of the cone. Two of the measured instabilities were captured over a range of axial Reynolds numbers of about 1 - 2 million, with amplitudes ranging from low to turbulent breakdown. For these instabilities, the wave speed and amplitude growth can be calculated. The wave speeds were all near the edge velocity. Measured growth before breakdown for the two instabilities are between e3 and e4 from background noise levels. The initial linear growth rates for the instabilities are near 50 /m. Simultaneous measurement of two frequency bands of the secondary instabilities was made during a single run. It was found that each mode was spatially confined within a small azimuthal region, and that the regions of peak amplitude for one mode correspond to regions of minimal amplitude for the other.

Left-liver hypertrophy after therapeutic right-liver radioembolization is substantial but less than after portal vein embolization.

PubMed

Garlipp, Benjamin; de Baere, Thierry; Damm, Robert; Irmscher, Romy; van Buskirk, Mark; Stübs, Patrick; Deschamps, Frederic; Meyer, Frank; Seidensticker, Ricarda; Mohnike, Konrad; Pech, Maciej; Amthauer, Holger; Lippert, Hans; Ricke, Jens; Seidensticker, Max

2014-05-01

In patients with liver malignancies potentially amenable to curative extended right hepatectomy but insufficient size of the future liver remnant (FLR), portal vein embolization (PVE) of the tumor-bearing liver is used to induce contralateral liver hypertrophy but leaves the tumor untreated. Radioembolization (RE) treats the tumor in the embolized lobe along with contralateral hypertrophy induction. We performed a matched-pair analysis to compare the capacity for hypertrophy induction of these two modalities. Patients with right-hepatic secondary liver malignancies with no or negligible left-hepatic tumor involvement who were treated by right-lobar PVE (n = 141) or RE (n = 35) at two centers were matched for criteria known to influence liver regeneration following PVE: 1) baseline FLR/Total liver volume ratio (<25 versus ≥ 25%); 2) prior platinum-containing systemic chemotherapy; 3) embolization of segments 5-8 versus 4-8; and 4) baseline platelet count (<200 versus ≥ 200 Gpt/L).The primary endpoint was relative change in FLR volume from baseline to follow-up. Twenty-six matched pairs were identified. FLR volume increase from baseline to follow-up (median 33 [24-56] days after PVE or 46 [27-79] days after RE) was significant in both groups but PVE produced significantly more FLR hypertrophy than RE (61.5 versus 29%, P < 0.001). Time between treatment and follow-up was not correlated with the degree of contralateral hypertrophy achieved in both groups. Although group differences in patient history and treatment setting were present and some bias cannot be excluded, this was minimized by the matched-pair design, as remaining group differences after matching were found to have no significant influence on contralateral hypertrophy development. PVE induces significantly more contralateral hypertrophy than RE with therapeutic (nonlobectomy) doses. However, contralateral hypertrophy induced by RE is substantial and RE minimizes the risk of tumor progression in the treated lobe, possibly making it a suitable modality for selected patients. © 2014 by the American Association for the Study of Liver Diseases.

The PARAGON stent study: a randomized trial of a new martensitic nitinol stent versus the Palmaz-Schatz stent for treatment of complex native coronary arterial lesions.

PubMed

Holmes, D R; Lansky, A; Kuntz, R; Bell, M R; Buchbinder, M; Fortuna, R; O'Shaughnessy, C D; Popma, J

2000-11-15

A new martensitic nitinol stent with improved flexibility and radiopacity was tested to evaluate whether these differences improve initial or long-term outcome. Patients who underwent percutaneous revascularization of a discrete native coronary lesion were randomly assigned to the new stent (PARAGON, n = 349) or to the first-generation Palmaz-Schatz (PS) stent (n = 339). The primary end point was target vessel failure at 6 months (a composite of cardiac or noncardiac death, any infarction in the distribution of the treated vessel, or clinically indicated target vessel revascularization). Secondary end points were, among others, device and procedural success and angiographic restenosis. Mean age was 62 years; diabetes was present in 21% of patients, prior bypass surgery in 6%, and recent infarction in 22% (p = NS for comparison between the 2 randomized arms). The PARAGON stent group had smaller reference vessels (2.97 vs 3.05 mm, p = 0.05), more prior restenosis (8.0% vs 4.5%, p = 0.07), and a longer average stent length (21.3 vs 19.4 mm, p < 0.05). Device success was significantly higher in the PARAGON arm (99.1% vs 94.3%, p < 0.05). Death and infarction at 6-month follow-up were infrequent in both groups. There was no significant difference in death (2.0% vs 1.2%, p = 0.546), but a higher rate of infarction for the PARAGON cohort (9.2% vs 4.7%, p = 0.025). Although target vessel failure (20.3% vs 12.4%, p = 0.005) and target lesion revascularization (12.0% vs 5.9%, p = 0.005) were higher in the PARAGON group, there was no significant difference in 6-month follow-up in in-stent minimal lumen diameter or in the rate of binary angiographic restenosis. Both PARAGON and PS stents are safe and associated with infrequent adverse events. The PARAGON stent can be delivered more frequently than the first-generation PS stent. Although there was no significant difference in in-stent minimal lumen diameter or the frequency of angiographic restenosis, clinical restenosis was more frequent in the PARAGON group.

The mediating role of secondary beliefs: enhancing the understanding of emotional responses and illness perceptions in arthritis.

PubMed

McCracken, James; Lindner, Helen; Sciacchitano, Laura

2008-01-01

Chronic illnesses are a significant issue across many health professional domains, becoming an increasing burden on limited and costly resources. The current study investigated the relationship between secondary beliefs and emotional responses, beyond the relationship accounted for by illness perceptions, using the framework of Rational Emotive Behavior Therapy. Sixty-five adults with arthritis participated in the questionnaire-based study. Multivariate analysis found that different emotional representations of the illness were significantly predicted by the individual's secondary belief, above and beyond that predicted by the cognitive representation of their illness alone. The study found that individuals who utilized an achievement secondary belief experienced feelings of worry, whereas individuals who used an approval orientation to understand their arthritis experienced emotions such as depression, being upset, anger, anxiety, and fear. No significant pattern emerged for individuals who used a comfort secondary belief to understand their arthritis. These findings are in line with the theory of secondary beliefs, as articulated by Rational Emotive Behavior Therapy.

The Importance of Three Physical Processes in a Minimal Three-Dimensional Tropical Cyclone Model.

NASA Astrophysics Data System (ADS)

Zhu, Hongyan; Smith, Roger K.

2002-06-01

The minimal three-dimensional tropical cyclone model developed by Zhu et al. is used to explore the role of shallow convection, precipitation-cooled downdrafts, and the vertical transport of momentum by deep convection on the dynamics of tropical cyclone intensification. The model is formulated in coordinates and has three vertical levels, one characterizing a shallow boundary layer, and the other two representing the upper and lower troposphere, respectively. It has three options for treating cumulus convection on the subgrid scale and a simple scheme for the explicit release of latent heat on the grid scale.In the model, as in reality, shallow convection transports air with low moist static energy from the lower troposphere to the boundary layer, stabilizing the atmosphere not only to itself, but also to deep convection. Also it moistens and cools the lower troposphere. For realistic parameter values, the stabilization in the vortex core region is the primary effect: it reduces the deep convective mass flux and therefore the rate of heating and drying in the troposphere. This reduced heating, together with the direct cooling of the lower troposphere by shallow convection, diminishes the buoyancy in the vortex core and thereby the vortex intensification rate.The effects of precipitation-cooled downdrafts depend on the closure scheme chosen for deep convection. In the two closures in which the deep cloud mass flux depends on the degree of convective instability, the downdrafts do not change the total mass flux of air that subsides into the boundary layer, but they carry air with a lower moist static energy into this layer than does subsidence outside downdrafts. As a result they decrease the rate of intensification during the early development stage. Nevertheless, by reducing the deep convective mass flux and the drying effect of compensating subsidence, they enable grid scale saturation, and therefore rapid intensification, to occur earlier than in calculations where they are excluded. In the closure in which the deep cloud mass flux depends on the mass convergence in the boundary layer, downdrafts reduce the gestation period and increase the intensification rate.Convective momentum transport as represented in the model weakens both the primary and secondary circulations of the vortex. However, it does not significantly reduce the maximum intensity attained after the period of rapid development. The weakening of the secondary circulation impedes vortex development and significantly prolongs the gestation period.Where possible the results are compared with those found in other studies.

Flight simulator evaluation of a novel flight instrument display to minimize the risks of spatial disorientation.

PubMed

Braithwaite, M G; Durnford, S J; Groh, S L; Jones, H D; Higdon, A A; Estrada, A; Alvarez, E A

1998-08-01

Spatial disorientation (SD) in flight remains a major source of attrition. Many SD accidents would occur regardless of the instrument display in use, since the aircrew are simply not looking at the instruments. However, there are a number of accidents which might be amenable to improved instrument displays. In an attempt to improve maintenance and reattainment of correct orientation with a reduced cognitive workload, a novel instrument display has been developed. This paper describes an assessment of the display in a UH-60 helicopter flight simulator. This study tested the hypothesis that during instrument flight and recovery from unusual attitudes, the novel display permits a more accurate maintenance and reestablishment of flight parameters than the standard flight instruments. There were 16 male aviators who flew a simulated instrument flight profile and recovery from unusual attitudes using both the standard flight instruments and the novel display. The two display formats were tested both with and without a secondary task. When compared with the standard instruments, both control of flight parameters and recovery from unusual attitudes were significantly improved when using the novel display. Analysis of the secondary task scores showed that cognitive workload was reduced when using the novel display compared with the standard instruments. Results from all aspects of the assessment indicated benefits of the new display. Future testing should be carried out during real flight, and the display should be further developed to be used in a head-up or helmet-mounted device.

Search for Gamma-Ray Emission from the Coma Cluster with Six Years of Fermi-LAT Data

NASA Technical Reports Server (NTRS)

Ackermann, M.; Ajello, M.; Albert, A.; Atwood, W. B.; Baldini, L.; Ballet, J.; Barbiellini, G.; Bastieri, D.; Bechtol, K.; Bellazzini, R.;

Interactions between SO2 oxidation and Secondary Organic Aerosol formation through Criegee intermediate chemistry

NASA Astrophysics Data System (ADS)

Chan, A. W. H.; Ye, J.; Abbatt, J.

2016-12-01

Ozonolysis of monoterpenes is an important source of atmospheric biogenic secondary organic aerosol (BSOA). While enhanced BSOA formation has been repeatedly observed under sulfate-rich conditions in both field studies and laboratory experiments, the underlying mechanisms remain poorly understood. In this work, the effect of SO2 on BSOA formation from monoterpene ozonolysis was investigated. The role of stabilized Criegee biradicals (sCIs) generated from alkene ozonolysis on SO2 oxidation was examined under different humidity conditions (<5% vs. 50%). Experiments were conducted in a 1 m3 Teflon chamber. BSOA was produced from ozonolysis of a-pinene or limonene. SO2 concentration was injected at various levels ranging from 30 to 100 ppb. In all experiments, cyclohexane was used as OH scavenger and added at sufficient amount to minimize the influence from OH + monoterpenes reaction. SOA samples were collected for composition analysis. Preliminary results show that BSOA from monoterpene ozonolysis is significantly enhanced in the presence of SO2 under dry conditions. SOA enhancement increases with increasing the concentration of SO2. However, the enhancement became negligible as the conditions became more humid. Control experiments show that SO2 is consumed at timescales consistent with oxidation by sCIs indicating that gaseous SO2 interacts directly with reactive intermediates during monoterpene ozonolysis. Organosulfate formation is probed by electrospray ionization-ion mobility time of flight mass spectrometer (ESI-IMS/TOF). The effect of SO2 on ozonolysis mechanism and chemical composition will be discussed.

Performance Modeling and Cost Analysis of a Pilot-Scale Reverse Osmosis Process for the Final Purification of Olive Mill Wastewater

PubMed Central

Ochando-Pulido, Javier Miguel; Hodaifa, Gassan; Victor-Ortega, Maria Dolores; Martinez-Ferez, Antonio

2013-01-01

A secondary treatment for olive mill wastewater coming from factories working with the two-phase olive oil production process (OMW-2) has been set-up on an industrial scale in an olive oil mill in the premises of Jaén (Spain). The secondary treatment comprises Fenton-like oxidation followed by flocculation-sedimentation and filtration through olive stones. In this work, performance modelization and preliminary cost analysis of a final reverse osmosis (RO) process was examined on pilot scale for ulterior purification of OMW-2 with the goal of closing the loop of the industrial production process. Reduction of concentration polarization on the RO membrane equal to 26.3% was provided upon increment of the turbulence over the membrane to values of Reynolds number equal to 2.6 × 104. Medium operating pressure (25 bar) should be chosen to achieve significant steady state permeate flux (21.1 L h−1 m−2) and minimize membrane fouling, ensuring less than 14.7% flux drop and up to 90% feed recovery. Under these conditions, irreversible fouling below 0.08 L h−2 m−2 bar−1 helped increase the longevity of the membrane and reduce the costs of the treatment. For 10 m3 day−1 OMW-2 on average, 47.4 m2 required membrane area and 0.87 € m−3 total costs for the RO process were estimated. PMID:24957058

A Study on the Performance and Electrochemistry of Bryophyllum pinnatum Leaf (BPL) Electrochemical Cell

NASA Astrophysics Data System (ADS)

Al Mamun, Mohammad; Khan, M. I.; Sarker, M. H.; Khan, K. A.

The study was carried out to investigate on an innovative invention, Pathor Kuchi Leaf (PKL) electrochemical cell, which is fueled with PKL sap of widely available plant called Bryophyllum pinnatum as an energy source for use in PKL battery to generate electricity. This battery, a primary source of electricity, has several order of magnitude longer shelf-lives than the traditional Galvanic cell battery, is still under investigation. In this regard, we have conducted some experiments using various instruments including Atomic Absorption Spectrophotometer (AAS), Ultra-Violet Visible spectrophotometer (UV-Vis), pH meter, Ampere-Volt-Ohm Meter etc. The AAS, UV-Vis and pH metric analysis data provided that the potential and current were produced as the Zn electrode itself acts as reductant while Cu2+and H+ ions are behaving as oxidant. The significant influence of secondary salt on current and potential leads to the dissociation of weak organic acids in PKL juice, and subsequent enrichment to the reactant ions by the secondary salt effects. However, the liquid junction potential was not as great as minimized with the opposite transference of organic acid anions and H + ions as their dissimilar ionic mobilities. Moreover, the large value of equilibrium constant (K) implies the big change in Gibbs free energy (ΔG), revealed the additional electrical work in presence of PKL sap. This easily fabricated high performance PKL battery can demonstrate an excellent promise during the off-peak across the country-side.

Search for gamma-ray emission from the Coma Cluster with six years of Fermi-LAT data

DOE PAGES

Ackermann, M.

2016-03-08

We present results from γ-ray observations of the Coma cluster incorporating 6 years of Fermi-LAT data and the newly released “Pass 8” event-level analysis. Our analysis of the region reveals low-significance residual structures within the virial radius of the cluster that are too faint for a detailed investigation with the current data. Using a likelihood approach that is free of assumptions on the spectral shape we derive upper limits on the γ-ray flux that is expected from energetic particle interactions in the cluster. We also consider a benchmark spatial and spectral template motivated by models in which the observed radiomore » halo is mostly emission by secondary electrons. In this case, the median expected and observed upper limits for the flux above 100MeV are 1.7 x 10 -9 ph cm -2 s -1 and 5.2 x 10 -9 ph cm -2 s -1 respectively (the latter corresponds to residual emission at the level of 1:8σ). These bounds are comparable to or higher than predicted levels of hadronic gamma-ray emission in cosmic-ray models with or without reacceleration of secondary electrons, although direct comparisons are sensitive to assumptions regarding the origin and propagation mode of cosmic rays and magnetic field properties. The minimal expected γ-ray flux from radio and star-forming galaxies within the Coma cluster is roughly an order of magnitude below the median sensitivity of our analysis.« less

Profiles of Motivated Self-Regulation in College Computer Science Courses: Differences in Major versus Required Non-Major Courses

NASA Astrophysics Data System (ADS)

Shell, Duane F.; Soh, Leen-Kiat

2013-12-01

The goal of the present study was to utilize a profiling approach to understand differences in motivation and strategic self-regulation among post-secondary STEM students in major versus required non-major computer science courses. Participants were 233 students from required introductory computer science courses (194 men; 35 women; 4 unknown) at a large Midwestern state university. Cluster analysis identified five profiles: (1) a strategic profile of a highly motivated by-any-means good strategy user; (2) a knowledge-building profile of an intrinsically motivated autonomous, mastery-oriented student; (3) a surface learning profile of a utility motivated minimally engaged student; (4) an apathetic profile of an amotivational disengaged student; and (5) a learned helpless profile of a motivated but unable to effectively self-regulate student. Among CS majors and students in courses in their major field, the strategic and knowledge-building profiles were the most prevalent. Among non-CS majors and students in required non-major courses, the learned helpless, surface learning, and apathetic profiles were the most prevalent. Students in the strategic and knowledge-building profiles had significantly higher retention of computational thinking knowledge than students in other profiles. Students in the apathetic and surface learning profiles saw little instrumentality of the course for their future academic and career objectives. Findings show that students in STEM fields taking required computer science courses exhibit the same constellation of motivated strategic self-regulation profiles found in other post-secondary and K-12 settings.

Pelvic Arterial Embolisation in a Trauma Patient with a Pre-Existing Aortobifemoral Graft

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

Abulaban, Osama; Hopkins, Jonathan; Willis, Andrew P.

2011-02-15

Pelvic fractures secondary to blunt trauma are associated with a significant mortality rate due to uncontrolled bleeding. Interventional radiology (IR) can play an important and central role in the management of such patients, offering definitive minimally invasive therapy and avoiding the need for high-risk surgery. Rapid access to whole-body computed tomography has been shown to improve survival in polytrauma patients and allows rapid diagnosis of vascular injury and assessment of suitability for endovascular therapy. IR can then target and treat the specific area of bleeding. Embolisation of bleeding pelvic arteries has been shown to be highly effective and should bemore » the treatment of choice in this situation. The branches of the internal iliac artery (IIA) are usually involved, and these arteries are accessed by way of IIA catheterisation after abdominal aortography. Occasionally these arteries cannot be accessed by way of this conventional route because of recent IIA ligation carried out surgically in an attempt to stop the bleeding or because (in the rare situation we describe here) these vessels are excluded secondary to previous aortoiliac repair. In this situation, knowledge of pelvic arterial collateral artery pathways is important because these will continue to supply pelvic structures whilst making access to deep pelvic branches challenging. We describe a rare case, which has not been previously reported in the literature, in which successful embolisation of a bleeding pelvic artery was carried out by way of the collateral artery pathways.« less

Secondary multidrug efflux pump mutants alter Escherichia coli biofilm growth in the presence of cationic antimicrobial compounds.

PubMed

Bay, Denice C; Stremick, Carol A; Slipski, Carmine J; Turner, Raymond J

2017-04-01

Escherichia coli possesses many secondary active multidrug resistance transporters (MDTs) that confer overlapping substrate resistance to a broad range of antimicrobials via proton and/or sodium motive force. It is uncertain whether redundant MDTs uniquely alter cell survival when cultures grow planktonically or as biofilms. In this study, the planktonic and biofilm growth and antimicrobial resistance of 13 E. coli K-12 single MDT gene deletion strains in minimal and rich media were determined. Antimicrobial tolerance to tetracycline, tobramycin and benzalkonium were also compared for each ΔMDT strain. Four E. coli MDT families were represented in this study: resistance nodulation and cell division members acrA, acrB, acrD, acrE, acrF and tolC; multidrug and toxin extruder mdtK; major facilitator superfamily emrA and emrB; and small multidrug resistance members emrE, sugE, mdtI and mdtJ. Deletions of multipartite efflux system genes acrB, acrE and tolC resulted in significant reductions in both planktonic and biofilm growth phenotypes and enhanced antimicrobial susceptibilities. The loss of remaining MDT genes produced similar or enhanced (acrD, acrE, emrA, emrB, mdtK, emrE and mdtJ) biofilm growth and antimicrobial resistance. ΔMDT strains with enhanced antimicrobial tolerance also enhanced biofilm biomass. These findings suggest that many redundant MDTs regulate biofilm formation and drug tolerance. Copyright © 2016 Institut Pasteur. Published by Elsevier Masson SAS. All rights reserved.

One year results of anti-VEGF treatment in pigment epithelial detachment secondary to macular degeneration.

PubMed

Yüksel, Harun; Türkcü, Fatih M; Sahin, Alparslan; Sahin, Muhammed; Cinar, Yasin; Cingü, Abdullah K; Ari, Seyhmus; Caça, Ihsan

2013-01-01

Pigment epithelial detachment (PED) may be seen in all stages of age-related macular degeneration (ARMD) and may lead to poor prognosis. In this study, we retrospectively examined the effect of anti-VEGF treatments in ARMD patients with vascularized PED. Medical records of 15 patients with PED secondary to ARMD were reviewed retrospectively. The diagnosis of PED was made with fundoscopy, fundus fluorescein angiography and optical coherence tomography. Patients were treated with intravitreal ranibizumab or/and bevacizumab and followed up for a minimum of one year. PED height and best corrected visual acuity (BCVA) was obtained before the first intravitreal anti-VEGF injection and again at the 1st, 3rd, 6th and 12th month after the injection. The mean baseline BCVA was 0.71 ± 0.48 logarithm of the minimal angle of resolution (logMAR) unit and the mean baseline PED height was 361 ± 153 µ. The mean injection count per eye was 3.9 ± 2.9. There was a significant reduce in mean PED height (247 ± 177 µ) also in 2 eyes PED completely resolved at the end of the follow up period. The mean BCVA at 12th month (0,69 ± 0,37) were not different from the baseline record. This retrospective case series showed that intravitreal anti-VEGF therapy preserved vision and reduced PED height in PED patients in a one-year follow-up period.

BILLIARDS: Baseline Instrumented Lithology Lander, Inspector and Asteroid Redirection Demonstration System

NASA Technical Reports Server (NTRS)

Marcus, Matthew; Sloane, Joshua; Ortiz, Oliver; Barbee, Brent

2015-01-01

BILLIARDS Baseline Instrumented Lithology Lander, Inspector, and Asteroid Redirection Demonstration System Proposed demonstration mission for Billiard-Ball concept Select asteroid pair with natural close approach to minimize cost and complexity Primary Objectives Rendezvous with a small (10m), near Earth (alpha) asteroid Maneuver the alpha asteroid to a collision with a 100m (beta) asteroid Produce a detectable deflection or disruption of the beta asteroid Secondary objectives Contribute knowledge of asteroid composition and characteristics Contribute knowledge of small-body formation Opportunity for international collaboration

Fineblanking, Diffusion Bonding, and Testing of Fluidic Laminates.

DTIC Science & Technology

1980-07-01

AD-AU69 347 TRITEC INC COLUMBIA ND F/$ 13/7 FINEBLANKING, DIFFUSION BONDING, AND TESTING OF FLUIDIC LAMINAT --ETCIU) JUL 80 L K PECAN OAAK21-79-C-0074...amplifier assembly. The effects of die roll and burrs can be minimized by secondary operations *such as abrasive machining , but this adds to the expense...clad material. Experience has shown that a clad thickness of 0.038 + 0.008 mm is required for the semi-solid diffusion bonding process. The composition

Solid handling valve

DOEpatents

Williams, William R.

1979-01-01

The present invention is directed to a solids handling valve for use in combination with lock hoppers utilized for conveying pulverized coal to a coal gasifier. The valve comprises a fluid-actuated flow control piston disposed within a housing and provided with a tapered primary seal having a recessed seat on the housing and a radially expandable fluid-actuated secondary seal. The valve seals are highly resistive to corrosion, erosion and abrasion by the solids, liquids, and gases associated with the gasification process so as to minimize valve failure.

Cervical necrotizing fasciitis as a complication of acute epiglottitis managed with minimally aggressive surgical intervention: Case report.

PubMed

Gollapalli, Rajesh Babu; Naiman, Ana Nusa; Merry, David

2015-07-01

Cervical necrotizing fasciitis secondary to epiglottitis is rare. The standard treatment of this severe condition has long been early and aggressive surgical debridement and adequate antimicrobial therapy. We report the case of an immunocompetent 59-year-old man who developed cervical necrotizing fasciitis as a complication of acute epiglottitis. We were able to successfully manage this patient with conservative surgical treatment (incision and drainage, in addition to antibiotic therapy) that did not involve aggressive debridement.

Robot-assisted "Santosh-Post Graduate Institute tubularized flap pyelovesicostomy" in a solitary functioning kidney with giant hydronephrosis: A minimally invasive salvage procedure.

PubMed

Kumar, Santosh; Singh, Shivanshu; Kumar, Navneet

2016-03-01

We describe a case of a solitary functioning kidney with giant hydronephrosis secondary to ureteropelvic junction obstruction in a young girl who underwent successful robot-assisted tubularized flap pyelovesicostomy. The aim of this report was to highlight the feasibility and efficacy of this technique in salvaging such renal moieties and to present a brief review of the surgical options available for the management of giant hydronephrosis.

Membrane bioreactors for the removal of anionic micropollutants from drinking water.

PubMed

Crespo, João G; Velizarov, Svetlozar; Reis, Maria A

2004-10-01

Biological treatment processes allow for the effective elimination of anionic micropollutants from drinking water. However, special technologies have to be implemented to eliminate the target pollutants without changing water quality, either by adding new pollutants or removing essential water components. Some innovative technologies that combine the use of membranes with the biological degradation of ionic micropollutants in order to minimize the secondary contamination of treated water include pressure-driven membrane bioreactors, gas-transfer membrane bioreactors and ion exchange membrane bioreactors.

Resilience-based optimal design of water distribution network

NASA Astrophysics Data System (ADS)

Suribabu, C. R.

2017-11-01

Optimal design of water distribution network is generally aimed to minimize the capital cost of the investments on tanks, pipes, pumps, and other appurtenances. Minimizing the cost of pipes is usually considered as a prime objective as its proportion in capital cost of the water distribution system project is very high. However, minimizing the capital cost of the pipeline alone may result in economical network configuration, but it may not be a promising solution in terms of resilience point of view. Resilience of the water distribution network has been considered as one of the popular surrogate measures to address ability of network to withstand failure scenarios. To improve the resiliency of the network, the pipe network optimization can be performed with two objectives, namely minimizing the capital cost as first objective and maximizing resilience measure of the configuration as secondary objective. In the present work, these two objectives are combined as single objective and optimization problem is solved by differential evolution technique. The paper illustrates the procedure for normalizing the objective functions having distinct metrics. Two of the existing resilience indices and power efficiency are considered for optimal design of water distribution network. The proposed normalized objective function is found to be efficient under weighted method of handling multi-objective water distribution design problem. The numerical results of the design indicate the importance of sizing pipe telescopically along shortest path of flow to have enhanced resiliency indices.

Minimally access versus conventional hydrocelectomy: a randomized trial.

PubMed

Saber, Aly

2015-01-01

To compare our previously published new minimally access hydrocelectomy versus Jaboulay's procedure regarding operative outcome and patient's satisfaction. A total of 124 adult patients were divided into two groups: A and B. Group A patients were subjected to conventional surgical hydrocelectomy (Jaboulay's procedure) and group B patients were subjected to the new minimal access hydrocelectomy. The primary endpoint of the study was recurrence defined as a clinically detectable characteristic swelling in the scrotum and diagnosed by the two surgeons and confirmed by ultrasound imaging study. The secondary endpoints were postoperative hematoma, wound sepsis and persistent edema and hardening. The mean operative time in group B was 15.1 ± 4.24 minutes and in group A was 32.5 ± 4.76 minutes (P ≤ 0.02). The mean time to return to work was 8.5 ± 2.1 (7-10) days in group B while in group A was 12.5 ± 3.53 (10-15) days (P=0.0001). The overall complication rate in group B was 12.88% and in group A was 37%. The parameters of the study were postoperative hematoma, degree of scrotal edema, wound infection, patients' satisfaction and recurrence. Hydrocelectomy is considered the gold standard technique for the treatment of hydrocele and the minimally access maneuvers provide the best operative outcomes regarding scrotal edema and hardening and patient's satisfaction when compared to conventional eversion-excision hydrocelectomies.

Sequential Metabolism of Secondary Alkyl Amines to Metabolic-Intermediate Complexes: Opposing Roles for the Secondary Hydroxylamine and Primary Amine Metabolites of Desipramine, (S)-Fluoxetine, and N-Desmethyldiltiazem

PubMed Central

Hanson, Kelsey L.; VandenBrink, Brooke M.; Babu, Kantipudi N.; Allen, Kyle E.; Nelson, Wendel L.

2010-01-01

Three secondary amines desipramine (DES), (S)-fluoxetine [(S)-FLX], and N-desmethyldiltiazem (MA) undergo N-hydroxylation to the corresponding secondary hydroxylamines [N-hydroxydesipramine, (S)-N-hydroxyfluoxetine, and N-hydroxy-N-desmethyldiltiazem] by cytochromes P450 2C11, 2C19, and 3A4, respectively. The expected primary amine products, N-desmethyldesipramine, (S)-norfluoxetine, and N,N-didesmethyldiltiazem, are also observed. The formation of metabolic-intermediate (MI) complexes from these substrates and metabolites was examined. In each example, the initial rates of MI complex accumulation followed the order secondary hydroxylamine > secondary amine ≫ primary amine, suggesting that the primary amine metabolites do not contribute to formation of MI complexes from these secondary amines. Furthermore, the primary amine metabolites, which accumulate in incubations of the secondary amines, inhibit MI complex formation. Mass balance studies provided estimates of the product ratios of N-dealkylation to N-hydroxylation. The ratios were 2.9 (DES-CYP2C11), 3.6 [(S)-FLX-CYP2C19], and 0.8 (MA-CYP3A4), indicating that secondary hydroxylamines are significant metabolites of the P450-mediated metabolism of secondary alkyl amines. Parallel studies with N-methyl-d3-desipramine and CYP2C11 demonstrated significant isotopically sensitive switching from N-demethylation to N-hydroxylation. These findings demonstrate that the major pathway to MI complex formation from these secondary amines arises from N-hydroxylation rather than N-dealkylation and that the primary amines are significant competitive inhibitors of MI complex formation. PMID:20200233

Sequential metabolism of secondary alkyl amines to metabolic-intermediate complexes: opposing roles for the secondary hydroxylamine and primary amine metabolites of desipramine, (s)-fluoxetine, and N-desmethyldiltiazem.

PubMed

Hanson, Kelsey L; VandenBrink, Brooke M; Babu, Kantipudi N; Allen, Kyle E; Nelson, Wendel L; Kunze, Kent L

2010-06-01

Three secondary amines desipramine (DES), (S)-fluoxetine [(S)-FLX], and N-desmethyldiltiazem (MA) undergo N-hydroxylation to the corresponding secondary hydroxylamines [N-hydroxydesipramine, (S)-N-hydroxyfluoxetine, and N-hydroxy-N-desmethyldiltiazem] by cytochromes P450 2C11, 2C19, and 3A4, respectively. The expected primary amine products, N-desmethyldesipramine, (S)-norfluoxetine, and N,N-didesmethyldiltiazem, are also observed. The formation of metabolic-intermediate (MI) complexes from these substrates and metabolites was examined. In each example, the initial rates of MI complex accumulation followed the order secondary hydroxylamine > secondary amine > primary amine, suggesting that the primary amine metabolites do not contribute to formation of MI complexes from these secondary amines. Furthermore, the primary amine metabolites, which accumulate in incubations of the secondary amines, inhibit MI complex formation. Mass balance studies provided estimates of the product ratios of N-dealkylation to N-hydroxylation. The ratios were 2.9 (DES-CYP2C11), 3.6 [(S)-FLX-CYP2C19], and 0.8 (MA-CYP3A4), indicating that secondary hydroxylamines are significant metabolites of the P450-mediated metabolism of secondary alkyl amines. Parallel studies with N-methyl-d(3)-desipramine and CYP2C11 demonstrated significant isotopically sensitive switching from N-demethylation to N-hydroxylation. These findings demonstrate that the major pathway to MI complex formation from these secondary amines arises from N-hydroxylation rather than N-dealkylation and that the primary amines are significant competitive inhibitors of MI complex formation.

An awake, minimally-invasive, fully-endoscopic surgical technique for treating lumbar radiculopathy secondary to heterotopic foraminal bone formation after a minimally invasive transforaminal lumbar interbody fusion with BMP: technical note

PubMed Central

2018-01-01

One complication associated with recombinant human bone morphogenetic protein (rhBMP-2) use in minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) is heterotopic bone growth at the neural foramen which results in the compression of neural structures. Here we present an awake, minimally invasive surgical approach for treating the radiculopathy that results from this excessive bone growth in the foramen. A 42-year-old male underwent a lumbar 4–sacral 1 MIS-TLIF by another surgeon. He did well in the initial postoperative period, but he began to note right leg pain and numbness in an L5 dermatomal pattern. The pain continued for 2 years despite interventional pain management, and he began to note left foot dorsiflexion weakness. An electromyography (EMG) showed a left L5 radiculopathy and a CT Lumbar spine demonstrated excessive bone growth in the right L4–5 neural foramen. The patient underwent an awake, endoscopic foraminotomy procedure utilizing a blunt tipped manual shaver drill system. The patient’s radicular symptoms improved immediately, and he remained asymptomatic at the 1 year follow up. Heterotopic foraminal bone growth is one potential complication of rhBMP-2 use in the MIS-TLIF procedure. The endoscopic procedure described here is a minimally invasive surgical option that can be performed in an awake patient and is suggested a unique salvage or rescue procedure to be considered for the treatment of this potential rhBMP-2 complication. PMID:29732437

Initial Results from the Miniature Imager for Neutral Ionospheric Atoms and Magnetospheric Electrons (MINI-ME) on the FASTSAT Spacecraft

NASA Technical Reports Server (NTRS)

Collier, Michael R.; Rowland, Douglas; Keller, John W.; Chornay, Dennis; Khazanov, George; Herrero, Federico; Moore, Thomas E.; Kujawski, Joseph; Casas, Joseph C.; Wilson, Gordon

2011-01-01

The MINI-ME instrument is a collaborative effort between NASA's Goddard Space Flight Center (GSFC) and the U.S. Naval Academy, funded solely through GSFC Internal Research and Development (IRAD) awards. It detects neutral atoms from about 10 eV to about 700 eV (in 30 energy steps) in its current operating configuration with an approximately 10 degree by 360 degree field-of-view, divided into six sectors. The instrument was delivered on August 3, 2009 to Marshall Space Flight Center (MSFC) for integration with the FASTSAT-HSV01 small spacecraft bus developed by MSFC and a commercial partner, one of six Space Experiment Review Board (SERB) experiments on FASTSAT and one of three GSFC instruments (PISA and TTI being the other two). The FASTSAT spacecraft was launched on November 21, 2010 from Kodiak, Alaska on a Minotaur IV as a secondary payload and inserted into a 650 km, 72 degree inclination orbit, very nearly circular. MINI-ME has been collecting science data, as spacecraft resources would permit, in "optimal science mode" since January 20, 2011. In this presentation, we report initial science results including the potential first observations of neutral molecular ionospheric outflow. At the time of this abstract, we have identified 15 possible molecular outflow events. All these events occur between about 65 and 82 degrees geomagnetic latitude and most map to the auroral oval. The MINI-ME results provide an excellent framework for interpretation of the MILENA data, two instruments almost identical to MINI-ME that will launch on the VISIONS suborbital mission

Initial Results from the Miniature Imager for Neutral Ionospheric atoms and Magnetospheric Electrons (MINI-ME) on the FASTSAT Spacecraft

NASA Astrophysics Data System (ADS)

Collier, M. R.; Rowland, D. E.; Keller, J. W.; Chornay, D. J.; Khazanov, G. V.; Herrero, F.; Moore, T. E.; Kujawski, J. T.; Casas, J. C.; Wilson, G. R.

2011-12-01

The MINI-ME instrument is a collaborative effort between NASA's Goddard Space Flight Center (GSFC) and the U.S. Naval Academy, funded solely through GSFC Internal Research and Development (IRAD) awards. It detects neutral atoms from about 10 eV to about 700 eV (in 30 energy steps) in its current operating configuration with an approximately 10 degree by 360 degree field-of-view, divided into six sectors. The instrument was delivered on August 3, 2009 to Marshall Space Flight Center (MSFC) for integration with the FASTSAT-HSV01 small spacecraft bus developed by MSFC and a commercial partner, one of six Space Experiments Review Board (SERB) experiments on FASTSAT and one of three GSFC instruments (PISA and TTI being the other two). The FASTSAT spacecraft was launched on November 21, 2010 from Kodiak, Alaska on a Minotaur IV as a secondary payload and inserted into a 650 km, 72 degree inclination orbit, very nearly circular. MINI-ME has been collecting science data, as spacecraft resources would permit, in "optimal science mode" since January 20, 2011. In this presentation, we report initial science results including the potential first observations of neutral molecular ionospheric outflow. At the time of this abstract, we have identified 15 possible molecular outflow events. All these events occur between about 65 and 82 degrees geomagnetic latitude and most map to the auroral oval. The MINI-ME results provide an excellent framework for interpretation of the MILENA data, two instruments almost identical to MINI-ME that will launch on the VISIONS suborbital mission (PI: Douglas Rowland).

Monophasic versus biphasic defibrillation for pediatric out-of-hospital cardiac arrest patients: a nationwide population-based study in Japan

PubMed Central

2012-01-01

Introduction Conventional monophasic defibrillators for out-of-hospital cardiac-arrest patients have been replaced with biphasic defibrillators. However, the advantage of biphasic over monophasic defibrillation for pediatric out-of-hospital cardiac-arrest patients remains unknown. This study aimed to compare the survival outcomes of pediatric out-of-hospital cardiac-arrest patients who underwent monophasic defibrillation with those who underwent biphasic defibrillation. Methods This prospective, nationwide, population-based observational study included pediatric out-of-hospital cardiac-arrest patients from January 1, 2005, to December 31, 2009. The primary outcome measure was survival at 1 month with minimal neurologic impairment. The secondary outcome measures were survival at 1 month and the return of spontaneous circulation before hospital arrival. Multivariable logistic regression analysis was performed to identify the independent association between defibrillator type (monophasic or biphasic) and outcomes. Results Among 5,628 pediatric out-of-hospital cardiac-arrest patients (1 through 17 years old), 430 who received defibrillation shock with monophasic or biphasic defibrillator were analyzed. The number of patients who received defibrillation shock with monophasic defibrillator was 127 (30%), and 303 (70%) received defibrillation shock with biphasic defibrillator. The survival rates at 1 month with minimal neurologic impairment were 17.5% and 24.4%, the survival rates at 1 month were 32.3% and 35.6%, and the rates of return of spontaneous circulation before hospital arrival were 24.4% and 27.4% in the monophasic and biphasic defibrillator groups, respectively. Hierarchic logistic regression analyses by using generalized estimation equations found no significant difference between the two groups in terms of 1-month survival with minimal neurologic impairment (odds ratio (OR), 1.57; 95% confidence interval (CI), 0.87 to 2.83; P = 0.14) and 1-month survival (OR, 1.38; 95% CI, 0.87 to 2.18; P = 0.17). Conclusions The present nationwide population-based observational study could not confirm an advantage of biphasic over monophasic defibrillators for pediatric OHCA patients. PMID:23148767

Chemical kinetic model uncertainty minimization through laminar flame speed measurements

DOE PAGES

Park, Okjoo; Veloo, Peter S.; Sheen, David A.; ...

2016-07-25

Laminar flame speed measurements were carried for mixture of air with eight C 3-4 hydrocarbons (propene, propane, 1,3-butadiene, 1-butene, 2-butene, iso-butene, n-butane, and iso-butane) at the room temperature and ambient pressure. Along with C 1-2 hydrocarbon data reported in a recent study, the entire dataset was used to demonstrate how laminar flame speed data can be utilized to explore and minimize the uncertainties in a reaction model for foundation fuels. The USC Mech II kinetic model was chosen as a case study. The method of uncertainty minimization using polynomial chaos expansions (MUM-PCE) (D.A. Sheen and H. Wang, Combust. Flame 2011,more » 158, 2358–2374) was employed to constrain the model uncertainty for laminar flame speed predictions. Results demonstrate that a reaction model constrained only by the laminar flame speed values of methane/air flames notably reduces the uncertainty in the predictions of the laminar flame speeds of C 3 and C 4 alkanes, because the key chemical pathways of all of these flames are similar to each other. The uncertainty in model predictions for flames of unsaturated C 3-4 hydrocarbons remain significant without considering fuel specific laminar flames speeds in the constraining target data set, because the secondary rate controlling reaction steps are different from those in the saturated alkanes. It is shown that the constraints provided by the laminar flame speeds of the foundation fuels could reduce notably the uncertainties in the predictions of laminar flame speeds of C 4 alcohol/air mixtures. Furthermore, it is demonstrated that an accurate prediction of the laminar flame speed of a particular C 4 alcohol/air mixture is better achieved through measurements for key molecular intermediates formed during the pyrolysis and oxidation of the parent fuel.« less

Chemical kinetic model uncertainty minimization through laminar flame speed measurements

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

Park, Okjoo; Veloo, Peter S.; Sheen, David A.

Laminar flame speed measurements were carried for mixture of air with eight C 3-4 hydrocarbons (propene, propane, 1,3-butadiene, 1-butene, 2-butene, iso-butene, n-butane, and iso-butane) at the room temperature and ambient pressure. Along with C 1-2 hydrocarbon data reported in a recent study, the entire dataset was used to demonstrate how laminar flame speed data can be utilized to explore and minimize the uncertainties in a reaction model for foundation fuels. The USC Mech II kinetic model was chosen as a case study. The method of uncertainty minimization using polynomial chaos expansions (MUM-PCE) (D.A. Sheen and H. Wang, Combust. Flame 2011,more » 158, 2358–2374) was employed to constrain the model uncertainty for laminar flame speed predictions. Results demonstrate that a reaction model constrained only by the laminar flame speed values of methane/air flames notably reduces the uncertainty in the predictions of the laminar flame speeds of C 3 and C 4 alkanes, because the key chemical pathways of all of these flames are similar to each other. The uncertainty in model predictions for flames of unsaturated C 3-4 hydrocarbons remain significant without considering fuel specific laminar flames speeds in the constraining target data set, because the secondary rate controlling reaction steps are different from those in the saturated alkanes. It is shown that the constraints provided by the laminar flame speeds of the foundation fuels could reduce notably the uncertainties in the predictions of laminar flame speeds of C 4 alcohol/air mixtures. Furthermore, it is demonstrated that an accurate prediction of the laminar flame speed of a particular C 4 alcohol/air mixture is better achieved through measurements for key molecular intermediates formed during the pyrolysis and oxidation of the parent fuel.« less

Gastric Ulceration and Bleeding with Hemodynamic Instability Caused by an Intragastric Balloon for Weight Loss.

PubMed

Reed, Larrite; Edriss, Hawa; Nugent, Kenneth

2018-06-01

Obesity in the United States is a medical crisis with many people attempting to lose weight with caloric restriction. Some patients choose minimally invasive weight loss solutions, such as intragastric balloon systems. These balloon systems were approved by the Federal Drug Administration (FDA) in 2015-2016 and have been considered safe, with minimal side effects. We report a patient with a two-day history of melena, abdominal pain, hypotension, and syncope which developed five months after placement of an intragastric balloon. Esophagogastroduodenoscopy with balloon removal revealed a small 8-mm gastric ulcer in the incisura. This gastric ulcer probably developed secondary to mechanical compression of the stomach mucosa by the gastric balloon which contained 900 mL of saline. The FDA is now investigating five deaths since 2016 associated with these second-generation balloons. Clinicians should be aware of these complications when evaluating patients with gastrointestinal complications, such as bleeding.

Dropout policies and trends for students with and without disabilities.

PubMed

Kemp, Suzanne E

2006-01-01

Students with and without disabilities are dropping out of school at an alarming rate. However, the precise extent of the problem remains elusive because individual schools, school districts, and state departments of education often use different definitional criteria and calculation methods. In addition, specific reasons why students drop out continues to be speculative and minimal research exists validating current dropout prevention programs for students with and without disabilities. This study examined methods secondary school principals used to calculate dropout rates, reasons they believed students dropped out of school, and what prevention programs were being used for students with and without disabilities. Results indicated that school districts used calculation methods that minimized dropout rates, students with and without disabilities dropped out for similar reasons, and few empirically validated prevention programs were being implemented. Implications for practice and directions for future research are discussed.

[Clinical study of aged patients with secondary benign paroxysmal positional vertigo].

PubMed

Zhu, Z J; Wei, L P; Xu, Z X; Xu, H J; Liu, Q; Luo, N

2017-09-07

Objective: To investigate the clinical features and evaluate the efficacy of manual reduction in treatment of age patients with secondary benign paroxysmal positional vertigo (s-BPPV). Methods: Thirty-two cases of aged patients ( the s-BPPV group: including 19 cases of female and 13 males, age from 60 to 86 years old)with secondary benign paroxysmal positional vertigo from Jul. 2013 to Sep. 2015 in our hospital were retrospectively analyzed. The results were compared with 121 patients( the primary group: including 82 cases of female and 39males, aged from 60 to 86 years old)with aged primary benign paroxysmal positional vertigo(p -BPPV). All the patients were followed up for 12 months. Statistical data analysis was carried out with SPSS 19.0. Results: 20.92%(32/153)of all the observed elderly patients with BPPV was the aged s-BPPV. The sex ratio and onset age had no significant difference between the two groups(χ(2)=0.79, P >0.05; t =0.37, P >0.05). The rate of two or more semicircular canal involvement in the secondary group(21.88%) was higher than that in primary group(6.61%)(χ(2)=6.67, P <0.05). Bilateral semicircular canals were involved in 5 of the 32 cases in secondary group(15.63%) and 4 of the 121 cases in aged primary group(3.31%), The difference was significant(χ(2)=6.94, P <0.05). The effective rate after first manual reduction was 57.50%(23/40)in secondary group and 82.31%(107/130)in primary group, the difference was significant(χ(2)=10.46, P <0.05). The total effective rate were 87.50%(35/40) after more than once manual reduction in secondary group and 91.54%(119/130) in primary group, the difference was not significant(χ(2)= 0.59, P >0.05). The numbers of circulation of the first successful manual reduction management were (3.9±1.3)times in secondary group and (2.1±1.1)times in primary group, the difference was significant( t =3.15, P <0.05). The recurrence rate was 37.50%(15/40) in the secondary group and 16.15%(21/130)in primary group after during follow-up for 12 months, the difference was statistically significant(χ(2)=8.35, P <0.05). Conclusions: It's shown that the aged patients with secondary BPPV is not rare in clinical practice, sudden deafness and head trauma are frequent more than other reasons. The aged patients with secondary BPPV are prone to injury in multi-semicircular and bilateral canal compared with the primary BPPV. The effective rate after first manual reduction of secondary BPPV is lower than primary BPPV, it's needed more circulation of first success in manual reduction management. The total effective rates are not significant in two groups and recurrence rate is relatively high in secondary group.

Understanding variations in secondary findings reporting practices across U.S. genome sequencing laboratories.

PubMed

Ackerman, Sara L; Koenig, Barbara A

2018-01-01

Increasingly used for clinical purposes, genome and exome sequencing can generate clinically relevant information that is not directly related to the reason for testing (incidental or secondary findings). Debates about the ethical implications of secondary findings were sparked by the American College of Medical Genetics (ACMG) 2013 policy statement, which recommended that laboratories report pathogenic alterations in 56 genes. Although wide variation in laboratories' secondary findings policies has been reported, little is known about its causes. We interviewed 18 laboratory directors and genetic counselors at 10 U.S. laboratories to investigate the motivations and interests shaping secondary findings reporting policies for clinical exome sequencing. Analysis of interview transcripts and laboratory documents was informed by sociological theories of standardization. Laboratories varied widely in terms of the types of secondary findings reported, consent-form language, and choices offered to patients. In explaining their adaptation of the ACMG report, our participants weighed genetic information's clinical, moral, professional, and commercial value in an attempt to maximize benefits for patients and families, minimize the costs of sequencing and analysis, adhere to professional norms, attract customers, and contend with the uncertain clinical implications of much of the genetic information generated. Nearly all laboratories in our study voluntarily adopted ACMG's recommendations, but their actual practices varied considerably and were informed by laboratory-specific judgments about clinical utility and patient benefit. Our findings offer a compelling example of standardization as a complex process that rarely leads simply to uniformity of practice. As laboratories take on a more prominent role in decisions about the return of genetic information, strategies are needed to inform patients, families, and clinicians about the differences between laboratories' practices and ensure that the consent process prompts a discussion of the value of additional genetic information for patients and their families.

Ecotoxicological studies with newly hatched larvae of Concholepas concholepas (Mollusca, Gastropoda): bioassay with secondary-treated kraft pulp mill effluents.

PubMed

Manríquez, Patricio H; Llanos-Rivera, Alejandra; Galaz, Sylvana; Camaño, Andrés

2013-12-01

The Chilean abalone or "loco" (Concholepas concholepas, Bruguière 1789) represent the most economically important marine recourse exploited from inner inshore Management and Exploitation Areas for Benthic Resources along the Chilean coast. In this study, newly-hatched larvae of C. concholepas were investigated as a potential model species for marine ecotoxicological studies. The study developed a behavioral standard protocol for assessing the impact that kraft pulp mill effluents after secondary treatment have on C. concholepas larvae. Under controlled laboratory conditions, newly-hatched larvae were exposed to a series of different concentrations of kraft pulp mill effluents with secondary treatment (Pinus spp. and Eucalyptus spp.), potassium dichromate as standard reference toxicant and effluent-free control conditions. Regardless of the type of effluent the results indicated that diluted kraft pulp effluent with secondary treatment had reduced effect on larval survival. Low larval survivals were only recorded when they were exposed to high concentrations of the reference toxicant. This suggests that C. concholepas larval bioassay is a simple method for monitoring the effects of kraft pulp mill effluents with secondary treatment discharged into the sea. The results indicated that dilution of ca. 1% of the effluent with an elemental chlorine free (ECF) secondary treatment is appropriate for achieving low larval mortalities, such as those obtained under control conditions with filtered seawater, and to minimize their impact on early ontogenetic stages of marine invertebrates such as newly-hatched larvae of C. concholepas. The methodological aspects of toxicological testing and behavioral responses described here with newly-hatched larvae of C. concholepas can be used to evaluate in the future the potential effects of other stressful conditions as other pollutants or changes in seawater pH associated with ocean acidification. © 2013 Elsevier Inc. All rights reserved.

The effect of advanced secondary municipal wastewater treatment on the molecular composition of dissolved organic matter.

PubMed

Maizel, Andrew C; Remucal, Christina K

2017-10-01

There is a growing interest in water reuse and in recovery of nutrients from wastewater. Because many advanced treatment processes are designed to remove organic matter, a better understanding of the composition of dissolved organic matter (DOM) in wastewater is needed. To that end, we assessed DOM in the Nine Springs Wastewater Treatment Plant in Madison, Wisconsin by UV-visible spectroscopy and Fourier transform-ion cyclotron resonance mass spectrometry. Samples were collected from the influent and effluent of two different secondary treatment processes and their respective secondary clarifiers, the UV disinfection unit, and an Ostara treatment system, which produces struvite via chemical precipitation. The optical properties reveal that DOM throughout the plant is relatively aliphatic and is low in molecular weight compared to DOM in freshwater systems. Furthermore, the DOM is rich in heteroatoms (e.g., N, S, P, and Cl) and its molecular formulas are present in the lipid-, protein-, carbohydrate-, and lignin-like regions of van Krevelen diagrams. Secondary treatment produces DOM that is more aromatic and more complex, as shown by the loss of highly saturated formulas and the increase in the number of CHO, CHON, and CHOP formulas. The two secondary treatment processes produce DOM with distinct molecular compositions, while the secondary clarifiers and UV disinfection unit result in minimal changes in DOM composition. The Ostara process decreases the molecular weight of DOM, but does not otherwise alter its composition. The optical properties agree with trends in the molecular composition of DOM within the main treatment train of the Nine Springs plant. Copyright © 2017 Elsevier Ltd. All rights reserved.

Radiation equivalent dose simulations for long-term interplanetary flights

NASA Astrophysics Data System (ADS)

Dobynde, M. I.; Drozdov, A.; Shprits, Y. Y.

2016-12-01

Cosmic particle radiation is a limiting factor for the human interplanetary flights. The unmanned flights inside heliosphere and human flights inside of magnetosphere tend to become a routine procedure, whereas there have been only few shot term human flights out of it (Apollo missions 1969-1972) with maximum duration less than a month. Long-term human flights set much higher requirements to the radiation shielding, primarily because of long exposition to cosmic radiation. Inside the helosphere there are two main sources of cosmic radiation: galactic cosmic rays (GCR) and soalr particle events (SPE). GCR come from the outside of heliosphere forming a background of overall radiation that affects the spacecraft. The intensity of GCR is varied according to solar activity, increasing with solar activity decrease and backward, with the modulation time (time between nearest maxima) of 11 yeas. SPE are shot term events, comparing to GCR modulation time, but particle fluxes are much more higher. The probability of SPE increases with the increase of solar activity. Time dependences of the intensity of these two components encourage looking for a time window of flight, when intensity and effect of GCR and SPE would be minimized. Combining GEANT4 Monte Carlo simulations with time dependent model of GCR spectra and data on SPE spectra we show the time dependence of the radiation dose in an anthropomorphic human phantom inside the shielding capsule. Different types of particles affect differently on the human providing more or less harm to the tissues. We use quality factors to recalculate absorbed dose into biological equivalent dose, which give more information about risks for astronaut's health. Incident particles provide a large amount of secondary particles while propagating through the shielding capsule. We try to find an optimal combination of shielding material and thickness, that will effectively decrease the incident particle energy, at the same time minimizing flow of secondary induced particles and minimizing most harmful particle types flows.

Screening and brief interventions for hazardous alcohol use in accident and emergency departments: a randomised controlled trial protocol

PubMed Central

Coulton, Simon; Perryman, Katherine; Bland, Martin; Cassidy, Paul; Crawford, Mike; Deluca, Paolo; Drummond, Colin; Gilvarry, Eilish; Godfrey, Christine; Heather, Nick; Kaner, Eileen; Myles, Judy; Newbury-Birch, Dorothy; Oyefeso, Adenekan; Parrott, Steve; Phillips, Tom; Shenker, Don; Shepherd, Jonathan

2009-01-01

Background There is a wealth of evidence regarding the detrimental impact of excessive alcohol consumption on the physical, psychological and social health of the population. There also exists a substantial evidence base for the efficacy of brief interventions aimed at reducing alcohol consumption across a range of healthcare settings. Primary research conducted in emergency departments has reinforced the current evidence regarding the potential effectiveness and cost-effectiveness. Within this body of evidence there is marked variation in the intensity of brief intervention delivered, from very minimal interventions to more intensive behavioural or lifestyle counselling approaches. Further the majority of primary research has been conducted in single centre and there is little evidence of the wider issues of generalisability and implementation of brief interventions across emergency departments. Methods/design The study design is a prospective pragmatic factorial cluster randomised controlled trial. Individual Emergency Departments (ED) (n = 9) are randomised with equal probability to a combination of screening tool (M-SASQ vs FAST vs SIPS-PAT) and an intervention (Minimal intervention vs Brief advice vs Brief lifestyle counselling). The primary hypothesis is that brief lifestyle counselling delivered by an Alcohol Health Worker (AHW) is more effective than Brief Advice or a minimal intervention delivered by ED staff. Secondary hypotheses address whether short screening instruments are more acceptable and as efficient as longer screening instruments and the cost-effectiveness of screening and brief interventions in ED. Individual participants will be followed up at 6 and 12 months after consent. The primary outcome measure is performance using a gold-standard screening test (AUDIT). Secondary outcomes include; quantity and frequency of alcohol consumed, alcohol-related problems, motivation to change, health related quality of life and service utilisation. Discussion This paper presents a protocol for a large multi-centre pragmatic factorial cluster randomised trial to evaluate the effectiveness and cost-effectiveness of screening and brief interventions for hazardous alcohol users attending emergency departments. Trial Registration ISRCTN 93681536 PMID:19575791

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

Milner, Phillip J.; Martell, Jeffrey D.; Siegelman, Rebecca L.

Alkyldiamine-functionalized variants of the metal–organic framework Mg 2(dobpdc) (dobpdc 4- = 4,4'-dioxidobiphenyl-3,3'-dicarboxylate) are promising for CO 2 capture applications owing to their unique step-shaped CO 2 adsorption profiles resulting from the cooperative formation of ammonium carbamate chains. Primary,secondary (1°,2°) alkylethylenediamine-appended variants are of particular interest because of their low CO 2 step pressures (≤1 mbar at 40 °C), minimal adsorption/desorption hysteresis, and high thermal stability. Herein, we demonstrate that further increasing the size of the alkyl group on the secondary amine affords enhanced stability against diamine volatilization, but also leads to surprising two-step CO 2 adsorption/desorption profiles. This two-step behaviormore » likely results from steric interactions between ammonium carbamate chains induced by the asymmetrical hexagonal pores of Mg 2(dobpdc) and leads to decreased CO 2 working capacities and increased water co-adsorption under humid conditions. To minimize these unfavorable steric interactions, we targeted diamine-appended variants of the isoreticularly expanded framework Mg 2(dotpdc) (dotpdc 4- = 4,4''-dioxido-[1,1':4',1''-terphenyl]-3,3''-dicarboxylate), reported here for the first time, and the previously reported isomeric framework Mg-IRMOF-74-II or Mg 2(pc-dobpdc) (pc-dobpdc 4- = 3,3'-dioxidobiphenyl-4,4'-dicarboxylate, pc = para-carboxylate), which, in contrast to Mg 2(dobpdc), possesses uniformally hexagonal pores. By minimizing the steric interactions between ammonium carbamate chains, these frameworks enable a single CO 2 adsorption/desorption step in all cases, as well as decreased water co-adsorption and increased stability to diamine loss. Functionalization of Mg 2(pc-dobpdc) with large diamines such as N-(n-heptyl)ethylenediamine results in optimal adsorption behavior, highlighting the advantage of tuning both the pore shape and the diamine size for the development of new adsorbents for carbon capture applications.« less

Thrust Augmented Nozzle for a Hybrid Rocket with a Helical Fuel Port

NASA Astrophysics Data System (ADS)

Marshall, Joel H.

A thrust augmented nozzle for hybrid rocket systems is investigated. The design lever-ages 3-D additive manufacturing to embed a helical fuel port into the thrust chamber of a hybrid rocket burning gaseous oxygen and ABS plastic as propellants. The helical port significantly increases how quickly the fuel burns, resulting in a fuel-rich exhaust exiting the nozzle. When a secondary gaseous oxygen flow is injected into the nozzle downstream of the throat, all of the remaining unburned fuel in the plume spontaneously ignites. This secondary reaction produces additional high pressure gases that are captured by the nozzle and significantly increases the motor's performance. Secondary injection and combustion allows a high expansion ratio (area of the nozzle exit divided by area of the throat) to be effective at low altitudes where there would normally be significantly flow separation and possibly an embedded shock wave due. The result is a 15 percent increase in produced thrust level with no loss in engine efficiency due to secondary injection. Core flow efficiency was increased significantly. Control tests performed using cylindrical fuel ports with secondary injection, and helical fuel ports without secondary injection did not exhibit this performance increase. Clearly, both the fuel-rich plume and secondary injection are essential features allowing the hybrid thrust augmentation to occur. Techniques for better design optimization are discussed.

HIV, other STD, and pregnancy prevention education in public secondary schools -- 45 states, 2008-2010.

PubMed

2012-04-06

In the United States, 46% of high school students have had sexual intercourse and potentially are at risk for human immunodeficiency virus (HIV) infection, other sexually transmitted diseases (STDs), and pregnancy. The National HIV/AIDS Strategy for the United States recommends educating young persons about HIV before they begin engaging in behaviors that place them at risk for HIV infection. The Community Preventive Services Task Force (CPSTF) also recommends risk reduction interventions to prevent HIV, other STDs, and pregnancy among adolescents. To estimate changes in the percentage of secondary schools that teach specific HIV, other STD, and pregnancy risk reduction topics, a key intervention consistent with those supported by the National HIV/AIDS Strategy and CPSTF, CDC analyzed 2008 and 2010 School Health Profiles data for public secondary schools in 45 states. This report summarizes the results of those analyses, which indicated that in 2010, compared with 2008, the percentage of secondary schools teaching 11 topics on HIV, other STD, and pregnancy prevention in a required course in grades 6, 7, or 8 was significantly lower in 11 states and significantly higher in none; the percentage of secondary schools teaching eight topics in a required course in grades 9, 10, 11, or 12 was significantly lower in one state and significantly higher in two states; and the percentage of secondary schools teaching three condom-related topics in a required course in grades 9, 10, 11, or 12 was significantly lower in eight states and significantly higher in three states. Secondary schools can increase efforts to teach all age-appropriate HIV, other STD, and pregnancy prevention topics to help reduce risk behaviors among students.

Open conversion during minimally invasive radical prostatectomy: impact on perioperative complications and predictors from national data.

PubMed

Sharma, Vidit; Meeks, Joshua J

2014-12-01

Despite the increased use of minimally invasive radical prostatectomy, open conversion may occur due to surgical complications, surgeon inexperience or failure to progress. We used nationally representative data to quantify the impact of open conversion compared to nonconverted minimally invasive radical prostatectomy and open radical prostatectomy, and identify predictors of open conversion. Years 2004 to 2010 of the Nationwide Inpatient Sample were queried for patients who underwent radical prostatectomy to analyze the association of open conversion during minimally invasive radical prostatectomy with Clavien complications. Multivariate regression models yielded significant predictors of open conversion. From 2004 to 2010, 134,398 (95% CI 111,509-157,287) minimally invasive radical prostatectomies were performed with a 1.8% (95% CI 1.4-2.1) open conversion rate, translating to 2,360 (95% CI 2,001-2,720) conversions. Open conversion cases had a longer length of stay (4.17 vs 1.71 days, p <0.001) and higher hospital charges ($51,049 vs $37,418, p <0.001) than nonconverted cases. Of open conversion cases 45.2% experienced a complication vs 7.2% and 12.9% of minimally invasive radical prostatectomy and open radical prostatectomy cases, respectively (p <0.001). After adjusting for age and comorbidities, open conversion was associated with significantly increased odds of a Clavien grade 1, 2, 3 and 4 complication compared to nonconverted minimally invasive radical prostatectomy and open radical prostatectomy (OR range 2.913 to 15.670, p <0.001). Significant multivariate predictors of open conversion were obesity (OR 1.916), adhesions (OR 3.060), anemia (OR 5.692) and surgeon volume for minimally invasive radical prostatectomy less than 25 cases per year (OR 7.376) (all p <0.01). Open conversion during minimally invasive radical prostatectomy is associated with a higher than expected increase in complications compared to open radical prostatectomy and minimally invasive radical prostatectomy after adjusting for age and comorbidities. External validation of predictors of open conversion may prove useful in minimizing open conversion during minimally invasive radical prostatectomy. Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

[Synthetic biology toward microbial secondary metabolites and pharmaceuticals].

PubMed

Wu, Lin-Zhuan; Hong, Bin

2013-02-01

Microbial secondary metabolites are one of the major sources of anti-bacterial, anti-fungal, antitumor, anti-virus and immunosuppressive agents for clinical use. Present challenges in microbial pharmaceutical development are the discovery of novel secondary metabolites with significant biological activities, improving the fermentation titers of industrial microbial strains, and production of natural product drugs by re-establishing their biosynthetic pathways in suitable microbial hosts. Synthetic biology, which is developed from systematic biology and metabolic engineering, provides a significant driving force for microbial pharmaceutical development. The review describes the major applications of synthetic biology in novel microbial secondary metabolite discovery, improved production of known secondary metabolites and the production of some natural drugs in genetically modified or reconstructed model microorganisms.

Pediatric extracorporeal shock wave lithotripsy: Predicting successful outcomes.

PubMed

McAdams, Sean; Shukla, Aseem R

2010-10-01

Extracorporeal shock wave lithotripsy (ESWL) is currently a first-line procedure of most upper urinary tract stones <2 cm of size because of established success rates, its minimal invasiveness and long-term safety with minimal complications. Given that alternative surgical and endourological options exist for the management of stone disease and that ESWL failure often results in the need for repeat ESWL or secondary procedures, it is highly desirable to identify variables predicting successful outcomes of ESWL in the pediatric population. Despite numerous reports and growing experience, few prospective studies and guidelines for pediatric ESWL have been completed. Variation in the methods by which study parameters are measured and reported can make it difficult to compare individual studies or make definitive recommendations. There is ongoing work and a need for continuing improvement of imaging protocols in children with renal colic, with a current focus on minimizing exposure to ionizing radiation, perhaps utilizing advancements in ultrasound and magnetic resonance imaging. This report provides a review of the current literature evaluating the patient attributes and stone factors that may be predictive of successful ESWL outcomes along with reviewing the role of pre-operative imaging and considerations for patient safety.

Impact of target mRNA structure on siRNA silencing efficiency: A large-scale study.

PubMed

Gredell, Joseph A; Berger, Angela K; Walton, S Patrick

2008-07-01

The selection of active siRNAs is generally based on identifying siRNAs with certain sequence and structural properties. However, the efficiency of RNA interference has also been shown to depend on the structure of the target mRNA, primarily through studies using exogenous transcripts with well-defined secondary structures in the vicinity of the target sequence. While these studies provide a means for examining the impact of target sequence and structure independently, the predicted secondary structures for these transcripts are often not reflective of structures that form in full-length, native mRNAs where interactions can occur between relatively remote segments of the mRNAs. Here, using a combination of experimental results and analysis of a large dataset, we demonstrate that the accessibility of certain local target structures on the mRNA is an important determinant in the gene silencing ability of siRNAs. siRNAs targeting the enhanced green fluorescent protein were chosen using a minimal siRNA selection algorithm followed by classification based on the predicted minimum free energy structures of the target transcripts. Transfection into HeLa and HepG2 cells revealed that siRNAs targeting regions of the mRNA predicted to have unpaired 5'- and 3'-ends resulted in greater gene silencing than regions predicted to have other types of secondary structure. These results were confirmed by analysis of gene silencing data from previously published siRNAs, which showed that mRNA target regions unpaired at either the 5'-end or 3'-end were silenced, on average, approximately 10% more strongly than target regions unpaired in the center or primarily paired throughout. We found this effect to be independent of the structure of the siRNA guide strand. Taken together, these results suggest minimal requirements for nucleation of hybridization between the siRNA guide strand and mRNA and that both mRNA and guide strand structure should be considered when choosing candidate siRNAs. (c) 2008 Wiley Periodicals, Inc.

The Greening of Pesticide–Environment Interactions: Some Personal Observations

PubMed Central

2012-01-01

Background: Pesticide–environment interactions are bidirectional. The environment alters pesticides by metabolism and photodegradation, and pesticides in turn change the environment through nontarget or secondary effects. Objectives: Approximately 900 currently used commercial pesticides of widely diverse structures act by nearly a hundred mechanisms to control insects, weeds, and fungi, usually with minimal disruption of nature’s equilibrium. Here I consider some aspects of the discovery, development, and use of ecofriendly or green pesticides (i.e., pesticides that are safe, effective, and biodegradable with minimal adverse secondary effects on the environment). Emphasis is given to research in my laboratory. Discussion: The need for understanding and improving pesticide–environment interactions began with production of the first major insecticide approximately 150 years ago: The arsenical poison Paris Green was green in color but definitely not ecofriendly. Development and use of other pesticides has led to a variety of problems. Topics considered here include the need for high purity [e.g., hexachlorocyclohexane and polychloroborane isomers and 2,4,5-trichlorophenoxyacetic acid (2,4,5-T)], environmental degradation and the bioactivity of resulting photoproducts and metabolites, pesticide photochemistry (including the use of structural optimization, photostabilizers, and photosensitizers to achieve suitable persistence), the presence of multiple active ingredients in botanical insecticides, the need to consider compounds with common mechanisms of action, issues related to primary and secondary targets, and chemically induced or genetically modified changes in plant biochemistry. Many insecticides are bird, fish, and honeybee toxicants, whereas herbicides and fungicides pose fewer environmental problems. Conclusion: Six factors have contributed to the greening of pesticide–environment interactions: advances in pesticide chemistry and toxicology, banning of many chlorinated hydrocarbons, the development of new biochemical targets, increased reliance on genetically modified crops that reduce the amount and variety of pesticides applied, emphasis on biodegradability and environmental protection, and integrated pest- and pesticide-management systems. PMID:22472325

Impact of target mRNA structure on siRNA silencing efficiency: a large-scale study

PubMed Central

Gredell, Joseph A.; Berger, Angela K.; Walton, S. Patrick

2009-01-01

The selection of active siRNAs is generally based on identifying siRNAs with certain sequence and structural properties. However, the efficiency of RNA interference has also been shown to depend on the structure of the target mRNA, primarily through studies using exogenous transcripts with well-defined secondary structures in the vicinity of the target sequence. While these studies provide a means for examining the impact of target sequence and structure independently, the predicted secondary structures for these transcripts are often not reflective of structures that form in full-length, native mRNAs where interactions can occur between relatively remote segments of the mRNAs. Here, using a combination of experimental results and analysis of a large dataset, we demonstrate that the accessibility of certain local target structures on the mRNA is an important determinant in the gene silencing ability of siRNAs. siRNAs targeting the enhanced green fluorescent protein were chosen using a minimal siRNA selection algorithm followed by classification based on the predicted minimum free energy structures of the target transcripts. Transfection into HeLa and HepG2 cells revealed that siRNAs targeting regions of the mRNA predicted to have unpaired 5’- and 3’-ends resulted in greater gene silencing than regions predicted to have other types of secondary structure. These results were confirmed by analysis of gene silencing data from previously published siRNAs, which showed that mRNA target regions unpaired at either the 5’-end or 3’-end were silenced, on average, ~10% more strongly than target regions unpaired in the center or primarily paired throughout. We found this effect to be independent of the structure of the siRNA guide strand. Taken together, these results suggest minimal requirements for nucleation of hybridization between the siRNA guide strand and mRNA and that both mRNA and guide strand structure should be considered when choosing candidate siRNAs. PMID:18306428

Facial growth and development in unilateral cleft lip and palate: comparison between secondary alveolar bone grafting and primary periosteoplasty.

PubMed

Cagáňová, Veronika; Borský, Jiří; Smahel, Zbyněk; Velemínská, Jana

2014-01-01

To describe the effect of secondary alveolar bone grafting in patients with unilateral cleft lip and palate by comparison with a sample of patients who have undergone primary periosteoplasty. Cephalometric analysis of lateral x-ray films in a retrospective semilongitudinal study. Lateral x-ray films of 18 secondary alveolar bone grafting patients and 48 primary periosteoplasty patients at 10 years of age and again at 15 years of age. The treatment of secondary alveolar bone grafting patients included lip repair according to Tennison, palatoplasty including retropositioning, pharyngeal flap surgery, and secondary alveolar bone grafting. The lips of primary periosteoplasty patient were repaired using the methods of Tennison and Veau, followed by primary periosteoplasty, palatoplasty including retropositioning, and pharyngeal flap surgery. Lateral radiographs were assessed using classical morphometry. There were few significant differences at 10 years of age between the secondary alveolar bone grafting and primary periosteoplasty patients. At 15 years of age, there were several significant differences. Compared with primary periosteoplasty patients, subsequent development in patients who had undergone secondary alveolar bone grafting was characterized by a significantly better position of the upper and lower dentoalveolar components in relation to the facial plane, a higher increase in the global convexity of the soft profile, a significantly better maxillary inclination, and a more favorable development of vertical intermaxillary relationships. Craniofacial development in secondary alveolar bone grafting patients was better than that in primary periosteoplasty patients due to the more marked facial convexity, the increased prominence of the nose, and better vertical intermaxillary relationships.

Reduced Intensity Donor Peripheral Blood Stem Cell Transplant in Treating Patients With De Novo or Secondary Acute Myeloid Leukemia in Remission

ClinicalTrials.gov

2018-05-24

Acute Myeloid Leukemia With Multilineage Dysplasia Following Myelodysplastic Syndrome; Adult Acute Megakaryoblastic Leukemia (M7); Adult Acute Minimally Differentiated Myeloid Leukemia (M0); Adult Acute Monoblastic Leukemia (M5a); Adult Acute Monocytic Leukemia (M5b); Adult Acute Myeloblastic Leukemia With Maturation (M2); Adult Acute Myeloblastic Leukemia Without Maturation (M1); Adult Acute Myeloid Leukemia in Remission; Adult Acute Myeloid Leukemia With 11q23 (MLL) Abnormalities; Adult Acute Myeloid Leukemia With Del(5q); Adult Acute Myeloid Leukemia With Inv(16)(p13;q22); Adult Acute Myeloid Leukemia With t(16;16)(p13;q22); Adult Acute Myeloid Leukemia With t(8;21)(q22;q22); Adult Acute Myelomonocytic Leukemia (M4); Adult Erythroleukemia (M6a); Adult Pure Erythroid Leukemia (M6b); Secondary Acute Myeloid Leukemia

Electrospray ion source with reduced analyte electrochemistry

DOEpatents

Kertesz, Vilmos [Knoxville, TN; Van Berkel, Gary [Clinton, TN

2011-08-23

An electrospray ion (ESI) source and method capable of ionizing an analyte molecule without oxidizing or reducing the analyte of interest. The ESI source can include an emitter having a liquid conduit, a working electrode having a liquid contacting surface, a spray tip, a secondary working electrode, and a charge storage coating covering partially or fully the liquid contacting surface of the working electrode. The liquid conduit, the working electrode and the secondary working electrode can be in liquid communication. The electrospray ion source can also include a counter electrode proximate to, but separated from, said spray tip. The electrospray ion source can also include a power system for applying a voltage difference between the working electrodes and a counter-electrode. The power system can deliver pulsed voltage changes to the working electrodes during operation of said electrospray ion source to minimize the surface potential of the charge storage coating.

Electrospray ion source with reduced analyte electrochemistry

DOEpatents

Kertesz, Vilmos; Van Berkel, Gary J

2013-07-30

An electrospray ion (ESI) source and method capable of ionizing an analyte molecule without oxidizing or reducing the analyte of interest. The ESI source can include an emitter having a liquid conduit, a working electrode having a liquid contacting surface, a spray tip, a secondary working electrode, and a charge storage coating covering partially or fully the liquid contacting surface of the working electrode. The liquid conduit, the working electrode and the secondary working electrode can be in liquid communication. The electrospray ion source can also include a counter electrode proximate to, but separated from, said spray tip. The electrospray ion source can also include a power system for applying a voltage difference between the working electrodes and a counter-electrode. The power system can deliver pulsed voltage changes to the working electrodes during operation of said electrospray ion source to minimize the surface potential of the charge storage coating.

New student-designed research and demonstration drop tower

NASA Astrophysics Data System (ADS)

Bell, Donald; Weislogel, Mark

A new drop tower has been designed and constructed at Portland State University. The ap-proach incorporates innovative features to increase throughput and microgravity quality in a highly public facility. Push button operation with full wireless CCTV coverage and passive magnetic deceleration provides quiet, safe operation from a single control station with low re-cycle time. A two-stage coaxial release mechanism decouples the payload from the drag shield to minimize disturbances to the experiment during release. This is especially important for fluids experiments that are highly sensitive to initial conditions. Performance of the new tower is presented including release, free fall, and deceleration accelerometer data. The two second tower is used for research and educational outreach. The research efforts focus on capillary flows and phenomena relevant to spacecraft fluid systems. The outreach efforts utilize partnerships with local primary, secondary and post-secondary institutions to promote the fields of science, technology, engineering and mathematics.

Idarubicin, Cytarabine, and Tipifarnib in Treating Patients With Newly Diagnosed Myelodysplastic Syndromes or Acute Myeloid Leukemia

ClinicalTrials.gov

2014-05-09

Adult Acute Basophilic Leukemia; Adult Acute Eosinophilic Leukemia; Adult Acute Megakaryoblastic Leukemia (M7); Adult Acute Minimally Differentiated Myeloid Leukemia (M0); Adult Acute Monoblastic Leukemia (M5a); Adult Acute Monocytic Leukemia (M5b); Adult Acute Myeloblastic Leukemia With Maturation (M2); Adult Acute Myeloblastic Leukemia Without Maturation (M1); Adult Acute Myeloid Leukemia With 11q23 (MLL) Abnormalities; Adult Acute Myeloid Leukemia With Inv(16)(p13;q22); Adult Acute Myeloid Leukemia With t(16;16)(p13;q22); Adult Acute Myeloid Leukemia With t(8;21)(q22;q22); Adult Acute Myelomonocytic Leukemia (M4); Adult Erythroleukemia (M6a); Adult Pure Erythroid Leukemia (M6b); Childhood Myelodysplastic Syndromes; Chronic Myelomonocytic Leukemia; de Novo Myelodysplastic Syndromes; Refractory Anemia With Excess Blasts; Refractory Anemia With Excess Blasts in Transformation; Secondary Acute Myeloid Leukemia; Secondary Myelodysplastic Syndromes; Untreated Adult Acute Myeloid Leukemia

Motivation for DOC III: 64-bit digital optical computer

NASA Astrophysics Data System (ADS)

Guilfoyle, Peter S.

1991-09-01

This paper suggests a new class of digital logic. OptiComp has focused on a digital optical logic family in order to capitalize on the inherent benefits of optical computing, which include (1) high FAN-IN and FAN-OUT, (2) low power consumption, (3) high noise margin, (4) high algorithmic efficiency using 'smart' interconnects, (5) free space leverage of GIBP (gate interconnect bandwidth product). Other well-known secondary advantages of optical logic include (but are not limited to) zero capacitive loading of signals at a detector, zero cross-talk between signals, zero signal dispersion, minimal clock skew (a few picoseconds or less in an imaging system). The primary focus of this paper is to demonstrate how each of the five advantages can be used to leverage other logic family performance such as GaAs; the secondary attributes will be discussed only in the context of introducing the DOC III architecture.

Motivation for DOC III: 64-bit digital optical computer

NASA Astrophysics Data System (ADS)

Guilfoyle, Peter S.

1991-09-01

The objective of this paper is to motivate a new class of digital logic. OptiComp has focused on a digital optical logic family in order to capitalize on the inherent benefits of optical computing, which include: (1) high FAN-IN and FAN-OUT, (2) low power consumption, (3) high noise margin, (4) high algorithmic efficiency using 'smart' interconnects, (5) free space leverage of GIBP (gate interconnect bandwidth product). Other well-known secondary advantages of optical logic include (but are not limited to): zero capacitive loading of signals at a detector, zero cross-talk between signals, zero signal dispersion, and minimal clock skew (a few picoseconds or less in an imaging system). The primary focus of this paper is on demonstrating how each of the five advantages can be used to leverage other logic family performance such as GaAs; the secondary attributes will be discussed only in the context of introducing the DOC III architecture.

Comprehensive surgical. Orthodontic treatment of class III malocclusion in cleft patient involving minimally invasive surgery Case report and literature review.

PubMed

Stojkovic, Goran; Stojkovic, Miodrag; Stojkovic, Jasna; Nikolic, Dejan; Stajcic, Zoran

2016-12-19

Surgical and orthodontic treatment of a teenage cleft patient. Authors describe the case of a 13 year old female cleft patient presented with class III malocclusion RESULT: The patient underwent comprehensive surgical secondary bone grafting and orthodontic treatment. Stable skeletal and occlusal class I relationship was achived and maintained in the post treatment observation period till the age of 16. Although several authors suggests primary gingivoperiosteoplasty, other advocates that such early intervention can cause later restrictions in maxillary growth. For alveolar reconstruction, maxillary growth and dental age were the main considerations in determining the timing of surgical intervention. This case showed that borderline cases of complex dentoalveolar and skeletal anomaly in cleft patients could be successfully treated with comprehensive secondary bone grafting and orthodontic treatment thus avoiding the need for orthognatic surgery. Alveolar bone grafting, Cleft, Malocclusion.

Synthesis and antibacterial activity of Schiff bases and amines derived from alkyl 2-(2-formyl-4-nitrophenoxy)alkanoates.

PubMed

Goszczyńska, Agata; Kwiecień, Halina; Fijałkowski, Karol

A series of novel Schiff bases and secondary amines were obtained in good yields, as a result of the reductive amination of alkyl 2-(2-formyl-4-nitrophenoxy)alkanoates with both aniline and 4-methoxyaniline under established mild reaction conditions. Sodium triacetoxyborohydride as well as hydrogen in the presence of palladium on carbon were used as efficient reducing agents of the Schiff bases, in both direct and stepwise reductive amination processes. The Schiff bases, amines, and amine hydrochlorides were designed as potential antibacterial agents, and structure-activity relationship could be established following in vitro assays against Gram-positive and Gram-negative bacteria. The minimal inhibitory concentration and zone of inhibition were also determined. In these tests, some of Schiff bases and secondary amine hydrochlorides showed moderate-to-good activity against Gram-positive bacteria, including S. aureus , M. luteus , and S. mutans .

Prospects for a Muon Spin Resonance Facility in the MuCool Test Area

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

Johnstone, John A.

2017-04-12

This paper investigates the feasibility of re-purposing the MuCool Test Area beamline and experimental hall to support a Muon Spin Resonance facility, which would make it the only such facility in the US. This report reviews the basic muon production concepts studied and operationally implemented at TRIUMF, PSI, and RAL and their application to the MTA facility. Two scenarios were determined feasible. One represents an initial minimal-shielding and capital-cost investment stage with a single secondary muon beamline that transports the primary beam to an existing high-intensity beam absorber located outside of the hall. Another, upgraded stage, involves an optimized productionmore » target pile and high-intensity absorber installed inside the experimental hall and potentially multiple secondary muon lines. In either scenario, with attention to target design, the MTA can host enabling and competitive Muon Spin Resonance experiments« less

The cause of death in smallpox: an examination of the pathology record.

PubMed

Martin, David Barrett

2002-07-01

Because the cause of death in smallpox remains controversial, the human pathology record was examined. The surviving case series of smallpox pathology in humans as well as other review articles from English language journals written during the last 200 years were reviewed. The skin lesions in smallpox developed as a result of viral damage and inflammation. Secondary bacterial infection did not occur until the scabs started shedding. During the papular stage of skin eruption, a secondary viremia caused focal lesions in the pharynx, larynx, tongue, trachea, and esophagus in descending frequency. The virus also caused potentially lethal interstitial pneumonitis as well as tubulointerstitial nephritis. The cytopathic effects of smallpox cause death. The data did not support previously promulgated theories attributing death to a bacterial sepsis syndrome seeded from the pustules or immune complex deposition. In a future outbreak, antibiotic therapy would minimally influence mortality.

Under-Representation in Nationally Representative Secondary Data

ERIC Educational Resources Information Center

Frederick, Karen; Barnard-Brak, Lucy; Sulak, Tracey

2012-01-01

There has been a significant increase in the use of secondary data sets. Many such data sets purport to be nationally representative. Secondary data sets include research commissioned by the National Center for Education Statistics, the Centers for Disease Control, and other public entities. Research increasingly utilizes these secondary data in…

Clinical study on minimally invasive liquefaction and drainage of intracerebral hematoma in the treatment of hypertensive putamen hemorrhage.

PubMed

Liang, Ke-Shan; Ding, Jian; Yin, Cheng-Bin; Peng, Li-Jing; Liu, Zhen-Chuan; Guo, Xiao; Liang, Shu-Yu; Zhang, Yong; Zhou, Sheng-Nian

2017-12-04

This study aims to compare the curative effect of different treatment methods of hypertensive putamen hemorrhage, in order to determine an ideal method of treatment; and to explore the curative effect of the application of soft channel technology-minimally invasive liquefaction and drainage of intracerebral hematoma in the treatment of hypertensive putamen hemorrhage. Patients with hypertensive cerebral hemorrhage, who were treated in our hospital from January 2015 to January 2016, were included into this study. Patients were divided into three groups: minimally invasive drainage group, internal medical treatment group and craniotomy group. In the minimally invasive drainage group, puncture aspiration and drainage were performed according to different hematoma conditions detected in brain CT, the frontal approach was selected for putamen and intracerebral hemorrhage, and drainage was reserved until the hematoma disappeared in CT detection. Drug therapy was dominated in the internal medical treatment group, while surgery under general anesthesia was performed to remove the hematoma in the craniotomy group. Post-treatment neurological function defect scores in minimally invasive drainage group and internal medical group were 16.14 ± 11.27 and 31.43 ± 10.42, respectively; and the difference was remarkably significant (P< 0.01). Post-treatment neurological function defect scores in the minimally invasive drainage group and craniotomy group were 16.14 ± 11.27 and 24.20 ± 12.23, respectively; and the difference was statistically significant (P< 0.05). There was a remarkable significant difference in ADL1-2 level during followed-up in survival patients between the minimally invasive drainage group and internal medical treatment group (P< 0.01), and there was a significant difference in followed-up mortality between these two groups (P< 0.01). Clinical observation and following-up results revealed that minimally invasive drainage treatment was superior to internal medical treatment and craniotomy.

The cost of conversion in robotic and laparoscopic colorectal surgery.

PubMed

Cleary, Robert K; Mullard, Andrew J; Ferraro, Jane; Regenbogen, Scott E

2018-03-01

Conversion from minimally invasive to open colorectal surgery remains common and costly. Robotic colorectal surgery is associated with lower rates of conversion than laparoscopy, but institutions and payers remain concerned about equipment and implementation costs. Recognizing that reimbursement reform and bundled payments expand perspectives on cost to include the entire surgical episode, we evaluated the role of minimally invasive conversion in total payments. This is an observational study from a linked data registry including clinical data from the Michigan Surgical Quality Collaborative and payment data from the Michigan Value Collaborative between July 2012 and April 2015. We evaluated colorectal resections initiated with open and minimally invasive approaches, and compared reported risk-adjusted and price-standardized 30-day episode payments and their components. We identified 1061 open, 1604 laparoscopic, and 275 robotic colorectal resections. Adjusted episode payments were significantly higher for open operations than for minimally invasive procedures completed without conversion ($19,489 vs. $15,518, p < 0.001). The conversion rate was significantly higher with laparoscopic than robotic operations (15.1 vs. 7.6%, p < 0.001). Adjusted episode payments for minimally invasive operations converted to open were significantly higher than for those completed by minimally invasive approaches ($18,098 vs. $15,518, p < 0.001). Payments for operations completed robotically were greater than those completed laparoscopically ($16,949 vs. $15,250, p < 0.001), but the difference was substantially decreased when conversion to open cases was included ($16,939 vs. $15,699, p = 0.041). Episode payments for open colorectal surgery exceed both laparoscopic and robotic minimally invasive options. Conversion to open surgery significantly increases the payments associated with minimally invasive colorectal surgery. Because conversion rates in robotic colorectal operations are half of those in laparoscopy, the excess expenditures attributable to robotics are attenuated by consideration of the cost of conversions.

Oxidative DNA damage and repair in children exposed to low levels of arsenic in utero and during early childhood: application of salivary and urinary biomarkers.

PubMed

Hinhumpatch, Pantip; Navasumrit, Panida; Chaisatra, Krittinee; Promvijit, Jeerawan; Mahidol, Chulabhorn; Ruchirawat, Mathuros

2013-12-15

The present study aimed to assess arsenic exposure and its effect on oxidative DNA damage and repair in young children exposed in utero and continued to live in arsenic-contaminated areas. To address the need for biological specimens that can be acquired with minimal discomfort to children, we used non-invasive urinary and salivary-based assays for assessing arsenic exposure and early biological effects that have potentially serious health implications. Levels of arsenic in nails showed the greatest magnitude of difference between exposed and control groups, followed by arsenic concentrations in saliva and urine. Arsenic levels in saliva showed significant positive correlations with other biomarkers of arsenic exposure, including arsenic accumulation in nails (r=0.56, P<0.001) and arsenic concentration in urine (r=0.50, P<0.05). Exposed children had a significant reduction in arsenic methylation capacity indicated by decreased primary methylation index and secondary methylation index in both urine and saliva samples. Levels of salivary 8-OHdG in exposed children were significantly higher (~4-fold, P<0.01), whereas levels of urinary 8-OHdG excretion and salivary hOGG1 expression were significantly lower in exposed children (~3-fold, P<0.05), suggesting a defect in hOGG1 that resulted in ineffective cleavage of 8-OHdG. Multiple regression analysis results showed that levels of inorganic arsenic (iAs) in saliva and urine had a significant positive association with salivary 8-OHdG and a significant negative association with salivary hOGG1 expression. © 2013.

Less invasive stabilization system (LISS) in the treatment of distal femoral fractures.

PubMed

Schütz, M; Müller, M; Kääb, M; Haas, N

2003-01-01

The treatment of distal femoral fractures has been associated with a high rate of complications for a long time. Although implants and surgical techniques have improved, plate osteosynthesis and intramedullary nailing have been accompanied by a high occurrence of infection, non-union and malalignment. The treatment of soft tissue envelopes using "biological" osteosynthesis and minimally invasive approaches has resulted in a decrease in complication rates and ultimately led to the concept of the less invasive stabilization system (LISS). This is an extramedullary-applied, internal fixator shaped according to the implantation site anatomy, with minimal invasiveness. The purpose of this study was to present this new surgical technique and draw attention to its advantages and importance. Although this is not a scientific paper, we hope to provide enough evidence of the LISS usefulness. The main LISS components include multiple-fixed angle screws and an insertion handle for submuscular sliding of a fixator and placement of percutaneous, self-drilling, unicortical screws for fixation of the diaphyseal fracture fragments. The LISS has been designed to preserve periosteal perfusion and to facilitate a minimally invasive application. Since the first implantation of the LISS, only a few studies have been published on its use in treatment of distal femoral fractures. The rate of infection has been low, ranging from 0 to 4%. The rate of delayed union has been between 2.4 and 6.1%, but delayed unions do not necessarily lead to secondary bone grafting or repeat osteosynthesis as the LISS has a high and lasting stability. When the LISS is used, bone grafting is rarely necessary (0 to 1.6% in primary and 0 to 5% in secondary grafting). Also implant failure differs from the failure of plate osteosynthesis because, with the use of LISS, no screw loosening or secondary malalignment occurs. Implant failures (up to 7.4%) were recorded particularly at the time of LISS introduction in surgical practice and were attributed to the technique of implantation rather than to the implant itself. Good treatment outcomes have been reported. The average knee flexion has been 103 degrees and 107 degrees. In 72.5% of the patients, flexion has been more than 90 degrees and an extension lag of > or = 10 degrees has been found in only 7.5% of all cases. The average Neer score has ranged from 73.9 to 77.2 points. In conclusion, the LISS is a useful implant for treatment of distal femoral fractures, especially when bone quality is poor. Infection, delayed union and non-union rates are low, as shown by yet unpublished data from our clinic. Primary bone grafting, which is rarely necessary with this system, is carried out only when there is a great bone loss. Implant failure, such as screw loosening or secondary malalignment, is not seen.

The cycle characteristics of clomiphene with clomiphene and menotropins in polycystic ovary syndrome and non polycystic ovary syndrome infertile patients.

PubMed

Ghasemi, M; Ashraf, H; Koushyar, H; Mousavifar, N

2013-06-01

This study compares the cycle characteristics of clomiphene (CC) with CC+HMG (Human Menopausal Gonadotropin or Menotropins) in Polycystic Ovary Syndrome (PCOS) and non-PCOS infertile patients. Patients were treated by CC + minimal HMg protocol. The cancellation rate, the mean number of different follicle sizes and endometrial thickness and pattern were compared. The cancelled cycles due to non-responsiveness were significantly higher in CC compared to CC+ minimal HMg protocol. PCOS patients are significantly nonresponsive in CC cycle and hyperresponsive in CC+ minimal HMg cycles. The mean number of different sizes of follicles and the endometrial thickness were significantly higher in CC+ minimal HMg. PCOS patients were significantly different from non-PCOS regarding the number of mature follicle and endometrial thickness. The pregnancy rate was 11% (10.2% in non-PCOS and 12.2% in PCOS). CC+ minimal HMg is a viable alternative to HMg /FSH only protocol in CC failure or resistant patients, and its efficacy can be mostly attributed to improvement of endometrial quality and increase in follicle number. Moreover, due to high cancellation of PCOS patients treated by this protocol, seemingly other alternatives should be found; perhaps sequential letrozole+HMg/FSH that have been shown to improve the ovarian response in this group of patients.

Improved Productivity of Neutral Lipids in Chlorella sp. A2 by Minimal Nitrogen Supply

PubMed Central

Zhu, Junying; Chen, Weixian; Chen, Hui; Zhang, Xin; He, Chenliu; Rong, Junfeng; Wang, Qiang

2016-01-01

Nitrogen starvation is an efficient environmental pressure for increasing lipid accumulation in microalgae, but it could also significantly lower the biomass productivity, resulting in lower lipid productivity. In this study, green alga Chlorella sp. A2 was cultivated by using a minimal nitrogen supply strategy under both laboratory and outdoor cultivation conditions to evaluate biomass accumulation and lipid production. Results showed that minimal nitrogen supply could promote neutral lipid accumulation of Chlorella sp. A2 without a significant negative effect on cell growth. In laboratory cultivation mode, alga cells cultured with 18 mg L−1 d−1 urea addition could generate 74 and 416% (w/w) more neutral lipid productivity than cells cultured with regular BG11 and nitrogen starvation media, respectively. In outdoor cultivation mode, lipid productivity of cells cultured with 18 mg L−1 d−1 urea addition is approximately 10 and 88% higher than the one with regular BG11 and nitrogen starvation media, respectively. Notably, the results of photosynthetic analysis clarified that minimal nitrogen supply reduced the loss of photosynthetic capacity to keep CO2 fixation during photosynthesis for biomass production. The minimal nitrogen supply strategy for microalgae cultivation could promote neutral lipid accumulation without a significant negative effect on cell growth, resulting in a significant improvement in the lipid productivity. PMID:27148237

The use of cochlear's SCAN and wireless microphones to improve speech understanding in noise with the Nucleus6® CP900 processor.

PubMed

De Ceulaer, Geert; Pascoal, David; Vanpoucke, Filiep; Govaerts, Paul J

2017-11-01

The newest Nucleus CI processor, the CP900, has two new options to improve speech-in-noise perception: (1) use of an adaptive directional microphone (SCAN mode) and (2) wireless connection to MiniMic1 and MiniMic2 wireless remote microphones. An analysis was made of the absolute and relative benefits of these technologies in a real-world mimicking test situation. Speech perception was tested using an adaptive speech-in-noise test (sentences-in-babble noise). In session A, SRTs were measured in three conditions: (1) Clinical Map, (2) SCAN and (3) MiniMic1. Each was assessed for three distances between speakers and CI recipient: 1 m, 2 m and 3 m. In session B, the benefit of the use of MiniMic2 was compared to benefit of MiniMic1 at 3 m. A group of 13 adult CP900 recipients participated. SCAN and MiniMic1 improved performance compared to the standard microphone with a median improvement in SRT of 2.7-3.9 dB for SCAN at 1 m and 3 m, respectively, and 4.7-10.9 dB for the MiniMic1. MiniMic1 improvements were significant. MiniMic2 showed an improvement in SRT of 22.2 dB compared to 10.0 dB for MiniMic1 (3 m). Digital wireless transmission systems (i.e. MiniMic) offer a statistically and clinically significant improvement in speech perception in challenging, realistic listening conditions.

Treatment of irradiated graphite from French Bugey reactor

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

Stevens, Howard; Laurent, Gerard

In 2008, following the general French plan for nuclear waste management, Electricite de France attempted to find for irradiated graphite an alternative solution to direct storage at the low-activity long-life storage center in France managed by the national agency for wastes (ANDRA). EDF management requested that its engineering arm, EDF CIDEN, study the graphite treatment alternatives to direct storage. In mid-2008, this study revealed the potential advantage for EDF to use a steam reforming process known as Thermal Organic Reduction, 'THOR' (owned by Studsvik, Inc., USA), to treat or destroy the graphite matrix and limit the quantity of secondary wastemore » to be stored. In late 2009, EDF began a test program with Studsvik to determine if the THOR steam reforming process could be used to destroy the graphite. The program also sought to determine if the graphite could be treated to release the bulk of activity while minimizing the gasification of the bulk mass of the graphite. In October 2009, tests with non-irradiated graphite were completed and demonstrated destruction of a graphite matrix by the THOR process at satisfactory rates. After gasifying the graphite, focus shifted to the effect of roasting graphite at high temperatures in inert gases with low concentrations of oxidizing gases to preferentially remove volatile radionuclides while minimizing the graphite mass loss to 5%. A radioactive graphite sleeve was imported from France to the US for these tests. Completed in April 2010, 'Phase I' of testing showed that the process removed >99% of H-3 and 46% of C-14 with <6% mass loss. Completed in September 2011, 'Phase II' testing achieved increased removals as high as 80% C-14. During Phase II, it was also discovered that roasting in a reducing atmosphere helped to limit the oxidation of the graphite. Future work seeks to explore the effects of reducing gases to limit the bulk oxidation of graphite. If the graphite could be decontaminated of long-lived radionuclides up to 95% for C-14 while minimizing mass loss to <5%, this would minimize the volume of any secondary waste streams and potentially lower the waste class of the larger bulk of graphite. Alternatively, if up to 95% decontamination of C-14 is achieved, the graphite may be completely gasified which could result in lower disposal. (authors)« less

Overcoming double-step CO2 adsorption and minimizing water co-adsorption in bulky diamine-appended variants of Mg2(dobpdc)† †Electronic supplementary information (ESI) available: Additional experimental details, and full characterization (powder X-ray diffraction, infrared spectra, diamine loadings, dry N2 decomposition profiles, and CO2 adsorption data) for all new adsorbents. CCDC 1577354. For ESI and crystallographic data in CIF or other electronic format see DOI: 10.1039/c7sc04266c

PubMed Central

Milner, Phillip J.; Martell, Jeffrey D.; Siegelman, Rebecca L.; Gygi, David; Weston, Simon C.

2017-01-01

Alkyldiamine-functionalized variants of the metal–organic framework Mg2(dobpdc) (dobpdc4– = 4,4′-dioxidobiphenyl-3,3′-dicarboxylate) are promising for CO2 capture applications owing to their unique step-shaped CO2 adsorption profiles resulting from the cooperative formation of ammonium carbamate chains. Primary,secondary (1°,2°) alkylethylenediamine-appended variants are of particular interest because of their low CO2 step pressures (≤1 mbar at 40 °C), minimal adsorption/desorption hysteresis, and high thermal stability. Herein, we demonstrate that further increasing the size of the alkyl group on the secondary amine affords enhanced stability against diamine volatilization, but also leads to surprising two-step CO2 adsorption/desorption profiles. This two-step behavior likely results from steric interactions between ammonium carbamate chains induced by the asymmetrical hexagonal pores of Mg2(dobpdc) and leads to decreased CO2 working capacities and increased water co-adsorption under humid conditions. To minimize these unfavorable steric interactions, we targeted diamine-appended variants of the isoreticularly expanded framework Mg2(dotpdc) (dotpdc4– = 4,4′′-dioxido-[1,1′:4′,1′′-terphenyl]-3,3′′-dicarboxylate), reported here for the first time, and the previously reported isomeric framework Mg-IRMOF-74-II or Mg2(pc-dobpdc) (pc-dobpdc4– = 3,3′-dioxidobiphenyl-4,4′-dicarboxylate, pc = para-carboxylate), which, in contrast to Mg2(dobpdc), possesses uniformally hexagonal pores. By minimizing the steric interactions between ammonium carbamate chains, these frameworks enable a single CO2 adsorption/desorption step in all cases, as well as decreased water co-adsorption and increased stability to diamine loss. Functionalization of Mg2(pc-dobpdc) with large diamines such as N-(n-heptyl)ethylenediamine results in optimal adsorption behavior, highlighting the advantage of tuning both the pore shape and the diamine size for the development of new adsorbents for carbon capture applications. PMID:29629084

Engineering design constraints of the lunar surface environment

NASA Technical Reports Server (NTRS)

Morrison, D. A.

1992-01-01

Living and working on the lunar surface will be difficult. Design of habitats, machines, tools, and operational scenarios in order to allow maximum flexibility in human activity will require paying attention to certain constraints imposed by conditions at the surface and the characteristics of lunar material. Primary design drivers for habitat, crew health and safety, and crew equipment are: ionizing radiation, the meteoroid flux, and the thermal environment. Secondary constraints for engineering derive from: the physical and chemical properties of lunar surface materials, rock distributions and regolith thicknesses, topography, electromagnetic properties, and seismicity. Protection from ionizing radiation is essential for crew health and safety. The total dose acquired by a crew member will be the sum of the dose acquired during EVA time (when shielding will be least) plus the dose acquired during time spent in the habitat (when shielding will be maximum). Minimizing the dose acquired in the habitat extends the time allowable for EVA's before a dose limit is reached. Habitat shielding is enabling, and higher precision in predicting secondary fluxes produced in shielding material would be desirable. Means for minimizing dose during a solar flare event while on extended EVA will be essential. Early warning of the onset of flare activity (at least a half-hour is feasible) will dictate the time available to take mitigating steps. Warning capability affects design of rovers (or rover tools) and site layout. Uncertainty in solar flare timing is a design constraint that points to the need for quickly accessible or constructible safe havens.

Engineering design constraints of the lunar surface environment

NASA Astrophysics Data System (ADS)

Morrison, D. A.

1992-02-01

Living and working on the lunar surface will be difficult. Design of habitats, machines, tools, and operational scenarios in order to allow maximum flexibility in human activity will require paying attention to certain constraints imposed by conditions at the surface and the characteristics of lunar material. Primary design drivers for habitat, crew health and safety, and crew equipment are: ionizing radiation, the meteoroid flux, and the thermal environment. Secondary constraints for engineering derive from: the physical and chemical properties of lunar surface materials, rock distributions and regolith thicknesses, topography, electromagnetic properties, and seismicity. Protection from ionizing radiation is essential for crew health and safety. The total dose acquired by a crew member will be the sum of the dose acquired during EVA time (when shielding will be least) plus the dose acquired during time spent in the habitat (when shielding will be maximum). Minimizing the dose acquired in the habitat extends the time allowable for EVA's before a dose limit is reached. Habitat shielding is enabling, and higher precision in predicting secondary fluxes produced in shielding material would be desirable. Means for minimizing dose during a solar flare event while on extended EVA will be essential. Early warning of the onset of flare activity (at least a half-hour is feasible) will dictate the time available to take mitigating steps. Warning capability affects design of rovers (or rover tools) and site layout. Uncertainty in solar flare timing is a design constraint that points to the need for quickly accessible or constructible safe havens.