Attitudes among students and teachers on vertical integration between clinical medicine and basic science within a problem-based undergraduate medical curriculum.

PubMed

Brynhildsen, J; Dahle, L O; Behrbohm Fallsberg, M; Rundquist, I; Hammar, M

2002-05-01

Important elements in the curriculum at the Faculty of Health Sciences in Linköping are vertical integration, i.e. integration between the clinical and basic science sections of the curriculum, and horizontal integration between different subject areas. Integration throughout the whole curriculum is time-consuming for both teachers and students and hard work is required for planning, organization and execution. The aim was to assess the importance of vertical and horizontal integration in an undergraduate medical curriculum, according to opinions among students and teachers. In a questionnaire 102 faculty teachers and 106 students were asked about the importance of 14 different components of the undergraduate medical curriculum including vertical and horizontal integration. They were asked to assign between one and six points to each component (6 points = extremely important for the quality of the curriculum; 1 point = unimportant). Students as well as teachers appreciated highly both forms of integration. Students scored horizontal integration slightly but significantly higher than the teachers (median 6 vs 5 points; p=0.009, Mann-Whitney U-test), whereas teachers scored vertical integration higher than students (6 vs 5; p=0.019, Mann-Whitney U-test). Both students and teachers considered horizontal and vertical integration to be highly important components of the undergraduate medical programme. We believe both kinds of integration support problem-based learning and stimulate deep and lifelong learning and suggest that integration should always be considered deeply when a new curriculum is planned for undergraduate medical education.

Can India’s primary care facilities deliver? A cross-sectional assessment of the Indian public health system’s capacity for basic delivery and newborn services

PubMed Central

Leslie, Hannah H; Regan, Mathilda; Nambiar, Devaki; Kruk, Margaret E

2018-01-01

Objectives To assess input and process capacity for basic delivery and newborn (intrapartum care hereafter) care in the Indian public health system and to describe differences in facility capacity between rural and urban areas and across states. Design Cross-sectional study. Setting Data from the nationally representative 2012–2014 District Level Household and Facility Survey, which includes a census of community health centres (CHC) and sample of primary health centres (PHC) across 30 states and union territories in India. Participants 8536 PHCs and 4810 CHCs. Outcome measures We developed a summative index of 33 structural and process capacity items matching the Indian Public Health Standards for PHCs as a metric of minimum facility capacity for intrapartum care. We assessed differences in performance on this index across facility type and location. Results About 30% of PHCs and 5% of CHCs reported not offering any intrapartum care. Among those offering services, volumes were low: median monthly delivery volume was 8 (IQR=13) in PHCs and 41 (IQR=73) in CHCs. Both PHCs and CHCs failed to meet the national standards for basic intrapartum care capacity. Mean facility capacity was low in PHCs in both urban (0.64) and rural (0.63) areas, while in CHCs, capacity was slightly higher in urban areas (0.77vs0.74). Gaps were most striking in availability of skilled human resources and emergency obstetric services. Poor capacity facilities were more concentrated in the more impoverished states, with 37% of districts from these states receiving scores in the lowest third of the facility capacity index (<0.70), compared with 21% of districts otherwise. Conclusions Basic intrapartum care capacity in Indian public primary care facilities is weak in both rural and urban areas, especially lacking in the poorest states with worst health outcomes. Improving maternal and newborn health outcomes will require focused attention to quality measurement, accountability mechanisms and quality improvement. Policies to address deficits in skilled providers and emergency service availability are urgently required. PMID:29866726

Can India's primary care facilities deliver? A cross-sectional assessment of the Indian public health system's capacity for basic delivery and newborn services.

PubMed

Sharma, Jigyasa; Leslie, Hannah H; Regan, Mathilda; Nambiar, Devaki; Kruk, Margaret E

2018-06-04

To assess input and process capacity for basic delivery and newborn (intrapartum care hereafter) care in the Indian public health system and to describe differences in facility capacity between rural and urban areas and across states. Cross-sectional study. Data from the nationally representative 2012-2014 District Level Household and Facility Survey, which includes a census of community health centres (CHC) and sample of primary health centres (PHC) across 30 states and union territories in India. 8536 PHCs and 4810 CHCs. We developed a summative index of 33 structural and process capacity items matching the Indian Public Health Standards for PHCs as a metric of minimum facility capacity for intrapartum care. We assessed differences in performance on this index across facility type and location. About 30% of PHCs and 5% of CHCs reported not offering any intrapartum care. Among those offering services, volumes were low: median monthly delivery volume was 8 (IQR=13) in PHCs and 41 (IQR=73) in CHCs. Both PHCs and CHCs failed to meet the national standards for basic intrapartum care capacity. Mean facility capacity was low in PHCs in both urban (0.64) and rural (0.63) areas, while in CHCs, capacity was slightly higher in urban areas (0.77vs0.74). Gaps were most striking in availability of skilled human resources and emergency obstetric services. Poor capacity facilities were more concentrated in the more impoverished states, with 37% of districts from these states receiving scores in the lowest third of the facility capacity index (<0.70), compared with 21% of districts otherwise. Basic intrapartum care capacity in Indian public primary care facilities is weak in both rural and urban areas, especially lacking in the poorest states with worst health outcomes. Improving maternal and newborn health outcomes will require focused attention to quality measurement, accountability mechanisms and quality improvement. Policies to address deficits in skilled providers and emergency service availability are urgently required. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

External-beam radiation therapy combined with limb-sparing surgery in elderly patients (>70 years) with primary soft tissue sarcomas of the extremities : A retrospective analysis.

PubMed

Andrä, Claudia; Klein, Alexander; Dürr, Hans Roland; Rauch, Josefine; Lindner, Lars Hartwin; Knoesel, Thomas; Angele, Martin; Baur-Melnyk, Andrea; Belka, Claus; Roeder, Falk

2017-08-01

To report our experience with EBRT combined with limb-sparing surgery in elderly patients (>70 years) with primary extremity soft tissue sarcomas (STS). Retrospectively analyzed were 35 patients (m:f 18:17, median 78 years) who all presented in primary situation without nodal/distant metastases (Charlson score 0/1 in 18 patients; ≥2 in 17 patients). Median tumor size was 10 cm, mainly located in lower limb (83%). Stage at presentation (UICC7th) was Ib:3%, 2a:20%, 2b:20%, and 3:57%. Most lesions were high grade (97%), predominantly leiomyosarcoma (26%) and undifferentiated pleomorphic/malignant fibrous histiocytoma (23%). Limb-sparing surgery was preceded (median 50 Gy) or followed (median 66 Gy) by EBRT. Median follow-up was 37 months (range 1-128 months). Margins were free in 26 patients (74%) and microscopically positive in 9 (26%). Actuarial 3‑ and 5‑year local control rates were 88 and 81% (4 local recurrences). Corresponding rates for distant control, disease-specific survival, and overall survival were 57/52%, 76/60%, and 72/41%. The 30-day mortality was 0%. Severe postoperative complications were scored in 8 patients (23%). Severe acute radiation-related toxicity was observed in 2 patients (6%). Patients with Charlson score ≥2 had a significantly increased risk for severe postoperative complications and acute radiation-related side effects. Severe late toxicities were found in 7 patients (20%), including fractures in 3 (8.6%). Final limb preservation rate was 97%. Combination of EBRT and limb-sparing surgery is feasible in elderly patients with acceptable toxicities and encouraging but slightly inferior outcome compared to younger patients. Comorbidity correlated with postoperative complications and acute toxicities. Late fracture risk seems slightly increased.

Preliminary Compositional Comparisons of H-Chondrite Falls to Antarctic H-Chondrite Populations

NASA Astrophysics Data System (ADS)

Kallemeyn, G. W.; Krot, A. N.; Rubin, A. E.

1993-07-01

In a series of papers [e.g., 1,2], Lipschutz and co-workers compared trace- element RNAA data from Antarctic and non-Antarctic H4-6 chondrites and concluded that the two populations have significantly different concentrations of several trace elements including Co, Se, and Sb. They interpreted their data as indicating that these Antarctic H chondrites form different populations than observed H falls and may have originated in separate parent bodies. Recent work by Sears and co-workers [e.g., 3] has shown that there seem to be distinct populations of Antarctic H chondrites, distinguishable on the bases of induced thermoluminescence (TL) peak temperature, metallographic cooling rate, and cosmic ray exposure age. They showed that a group of Antarctic H chondrites having abnormally high induced TL peak temperatures (>=190 degrees C) also has cosmic ray exposure ages <20 Ma (mostly ~8 Ma) and fast metallographic cooling rates (~100 K/Ma). Another group having induced TL peak temperatures <190 degrees C has exposure ages >20 Ma and slower cooling rates (~10-20 K/Ma). We studied 24 H4-6 chondrites from Victoria Land (including 12 previously analyzed by the Lipschutz group) by optical microscopy and electron microprobe. Many of the Antarctic H chondrites studied by Lipschutz and co- workers are unsuitable for proper compositional comparisons with H chondrite falls: Four are very weathered, five are extensively shocked, and two are extensively brecciated. Furthermore, at least five of the samples contain solar-wind gas (and hence are regolith breccias) [4]. These samples were rejected because of possible compositional modification by secondary processes. For our INAA study we chose a suite of relatively unweathered and unbrecciated Antarctic H chondrites (including nine from the Lipschutz set): ALHA 77294 (H5, S3); ALHA 79026 (H5, S3); ALHA 79039 (H5, S3); ALHA 80131 (H5, S3); ALHA 80132 (H5, S4); ALHA 81037 (H6, S3); EETA 79007 (H5, S4); LEW 85320 (H6, S4); LEW 85329 (H6, S3); RKPA 78002 (H5, S2); and RKPA 78004 (H4, S4). Single samples were each analyzed for 27 elements. Only four of our samples have been analyzed by TL. Concentrations of siderophile elements (Fe, Co, Ni, Ga, As, Au) in the Antarctic H chondrites tend to scatter more than those of 24 H falls studied in replicate at UCLA. This is probably due in part to the fact that replicate samples of the Antarctic chondrites have not yet been analyzed. The median concentrations of siderophile elements also tend to be slightly lower in Antarctic H chondrites, although 95% confidence intervals on the medians overlap with those of H falls for every element. Concentration ranges and median values of two chalcophile elements, Se and Zn, are nearly identical between the Antarctic H chondrites and H falls. Kolmogorov-Smirnov two-tailed tests on these elements show no significant differences between the two populations. Three of the elements analyzed in this study (Co, Se, Sb) are among those reported to vary significantly between Antarctic H chondrites and H falls by Dennison and Lipschutz [1], who found that median concentrations of these elements were slightly higher in Antarctic H chondrites. As noted earlier, we determined slightly lower median concentrations for Co and Sb in Antarctic H chondrites than in H falls; median Se concentrations were identical. The slightly lower median concentration values that we found for siderophile elements in general are probably indicative of a slight weathering loss of metal. Based on our compositional data, the Victoria Land H chondrites and non-Antarctic H falls do not require derivation from separate parent populations. References: [1] Dennison J. E. and Lipschutz M. E. (1987) GCA, 51, 741-754. [2] Lipschutz M. E. and Samuels S. M. (1991) GCA, 55, 19-34. [3] Benoit P. H. and Sears D. W. G. (1993) Icarus, 101, 188-200. [4] Schultz L. et al. (1991) GCA, 55, 59-66.

Selected ground-water data for Yucca Mountain region, southern Nevada and eastern California, through December 1999

USGS Publications Warehouse

Locke, G.L.

2001-01-01

The U.S. Geological Survey, in support of the U.S. Department of Energy, Yucca Mountain Site Characterization Project, collects, compiles, and summarizes hydrologic data in the Yucca Mountain region. The data are collected to allow assessments of ground-water resources during studies to determine the potential suitability of Yucca Mountain for storing high-level nuclear waste. Data on ground-water levels at 34 wells and a fissure (Devils Hole), ground-water discharge at 5 springs and a flowing well, and total reported ground-water withdrawals within Crater Flat, Jackass Flats, Mercury Valley, and the Amargosa Desert are presented for calendar year 1999. Data collected prior to 1999 are graphically presented and data collected by other agencies (or as part of other Geological Survey programs) are included to further indicate variations of ground-water levels, discharges, and withdrawals through time. A statistical summary of ground-water levels at seven wells in Jackass Flats is presented to indicate potential effects of ground-water withdrawals associated with U.S. Department of Energy activities near Yucca Mountain. The statistical summary includes the number of measurements, the maximum, minimum, and median water-level altitudes, and the average deviation of measured water-level altitudes for selected baseline periods and for calendar years 1992-99. At two water-supply wells median water levels for calendar year 1999 were unchanged from their respective baseline periods. At a nearby observation well, the 1999 median water level was slightly lower (0.1 foot) than its baseline period. At the remaining four wells in Jackass Flats, median water levels for 1999 were slightly higher (0.2 foot to 1.6 feet) than for their respective baseline periods.

Groundwater quality in the Chemung River Basin, New York, 2008

USGS Publications Warehouse

Risen, Amy J.; Reddy, James E.

2011-01-01

The second groundwater quality study of the Chemung River Basin in south-central New York was conducted as part of the U.S. Geological Survey 305(b) water-quality-monitoring program. Water samples were collected from five production wells and five private residential wells from October through December 2008. The samples were analyzed to characterize the chemical quality of the groundwater. Five of the wells are screened in sand and gravel aquifers, and five are finished in bedrock aquifers. Two of these wells were also sampled for the first Chemung River Basin study of 2003. Samples were analyzed for 6 physical properties and 217 constituents, including nutrients, major inorganic ions, trace elements, radionuclides, pesticides, volatile organic compounds, phenolic compounds, organic carbon, and four types of bacterial analyses. Results of the water-quality analyses for individual wells are presented in tables, and summary statistics for specific constituents are presented by aquifer type. The results are compared with Federal and New York State drinking-water standards, which typically are identical. Water quality in the study area is generally good, but concentrations of some constituents equaled or exceeded current or proposed Federal or New York State drinking-water standards; these were: sodium (one sample), total dissolved solids (one sample), aluminum (one sample), iron (one sample), manganese (four samples), radon-222 (eight samples), trichloroethene (one sample), and bacteria (four samples). The pH of all samples was typically neutral or slightly basic (median 7.5); the median water temperature was 11.0 degrees Celsius (?C). The ions with the highest median concentrations were bicarbonate (median 202 milligrams per liter [mg/L]) and calcium (median 59.0 mg/L). Groundwater in the study area is moderately hard to very hard, but more samples were hard or very hard (121 mg/L as calcium carbonate (CaCO3) or greater) than were moderately hard (61-120 mg/L as CaCO3); the median hardness was 205 mg/L as CaCO3. The maximum concentration of nitrate plus nitrite was 3.67 mg/L as nitrogen, which did not exceed established drinking-water standards for nitrate plus nitrite (10 mg/L as nitrogen). The trace elements with the highest median concentrations were strontium (median 196.5 micrograms per liter [(u or mu)g/L]), barium (median 186 (u or mu)g/L), and iron (median 72.5 (u or mu)g/L in unfiltered water). Five pesticides and pesticide degradates were detected among four samples at concentrations of 0.11 (u or mu)g/L or less; they included herbicides and herbicide degradates. Six volatile organic compounds (VOCs) were detected among four samples; these included four solvents, methyl tert-butyl ether, and one trihalomethane. Trichloroethene, a solvent, was detected in one production well at 5.5 (u or mu)g/L; the Federal and New York State Maximum Contaminant Level (MCL) (5 (u or mu)g/L) was exceeded. The highest radon-222 activities were in samples from bedrock wells [maximum 1,740 picocuries per liter (pCi/L)]; eight of the wells sampled exceeded a proposed U.S. Environmental Protection Agency (USEPA) drinking-water standard of 300 pCi/L. Any detection of coliform bacteria indicates a potential violation of New York State health regulations; total coliform bacteria were detected in four samples, and fecal coliform bacteria were detected in one sample.μμμ

Cultural Resources Survey and Literature Review of Planned Drainage Improvements Along and Adjacent to Ditch 1, Mississippi and Poinsett Counties, Arkansas

DTIC Science & Technology

1983-01-01

Mississippi River through the backswamp to the St. Francis River Basin. A slight gradient advantage allowed diversion of suf- ficient Mississippi River...a Late Pleistocene environment that may already have been shifting into the 3 26 I I Holocene. In addition to exploiting Pleistocene megafauna , these... megafauna , their basic pattern of hunting and gatheringwas to persist in slightly less mobile lifestyles throughout the Archaic Stage and probably into

Development of Wing Inlets

NASA Technical Reports Server (NTRS)

Racisz, Stanley F.

1946-01-01

Lift, drag, internal flow, and pressure distribution measurements were made on a low-drag airfoil incorporating various air inlet designs. Two leading-edge air inlets are developed which feature higher lift coefficients and critical Mach than the basic airfoil. Higher lift coefficients and critical speeds are obtained for leading half of these inlet sections but because of high suction pressures near exist, slightly lower critical speeds are obtained for the entire inlet section than the basic airfoil.

Ground-water quality in the central part of the Passaic River basin, northeastern New Jersey, 1959-88

USGS Publications Warehouse

Czarnik, T.S.; Kozinski, Jane

1994-01-01

Ground-water samples were collected from 71 wells screened in or open to three aquifers in the central part of the Passaic River basin during 1959-88. Water samples from aquifers in glacial sediments and aquifers in sedimentary and igneous bedrock of the Newark Supergroup were analyzed for major ions. Most samples were analyzed for metals, nutrients, and tritium; 38 samples were analyzed for purgeable organic compounds. Calcium and bicarbonate were the predominant ions in ground water in the study area. Ground water was dilute (median dissolved-solids concentration 239 milligrams per liter) and slightly basic (median pH 7.89). Concentrations of inorganic constituents were within U.S. Environmental Protection Agency (USEPA) primary drinking-water regulations. Concentrations of benzene, tetrachloroethylene, and trichloroethylene, however, were greater than USEPA primary drinking-water regulations in six samples. Ground-water samples from aquifers in sedimentary bedrock were enriched in barium, calcium, magnesium, strontium,and sulfate relative to samples form the other aquifers. Such ion enrichment can be attributed either to disolution of carbonate and sulfate-containing minerals or to human activities. Ground-water samples from two wells screened in glacial sediments near swamps contained sulfate in concentrations higher than the median for the aquifer. Sulfate enrichment could result from downward leaching of water enriched in sulfur from the decay of organic matter in the swamps, from the disolution of sulfate-containing minerals, or from human activities. No regional trends in the chemical composition of the ground water in the study area were identified. Sulfate concentrations in ground- water samples from the sedimentary bedrock tended to increase with decreasing altitude of the deepest opening of the well; the correlation coefficient for the ranks of sulfate concentration and the altitude of the deepest opening of the well for 17 pairs of data is -0.690. Concentrations of tritium were greater than the detection limit in 33 of 35 ground-water samples, indicating that most ground water in the study area is more recent than 1953.

Gallbladder cancer: South American experience.

PubMed

Arroyo, Gerardo F; Gentile, Alberto; Parada, Luis A

2016-10-01

Large differences in terms of incidence and mortality due to gallbladder cancer (GBC) have been reported worldwide. Moreover, it seems that GBC has unique characteristics in South America. We surveyed the literature looking for information about the epidemiology, basic and translational research, and clinical trials performed in South America in order to critically analyze the magnitude of this health problem in the region. Compared to other geographic areas, age-standardized mortality rates (ASMR) for GBC in women are very high, particularly in many western areas of South America. Genetic, as well as dietary and environmental factors likely contribute to the pathogenesis of this disease in the area. Compared to other regions the profile of abnormalities of key genes such as KRAS and TP53 in GBC seems to slightly differ in South America, while the clinical behavior appears to be similar with a median overall survival (OS) of 6.5 to 8 months in advanced GBC. In contrast to Europe and USA, prophylactic cholecystectomy is a common practice in western areas of South America. GBC particularly affects women in South America, and represents a significant public health problem. It appears to have peculiarities that pose an urgent need for additional research aimed to discover risk factors, molecular events associated with its development and new treatment options for this lethal disease.

Water quality assessment of the Eastern Iowa Basins: Basic water chemistry of rivers and streams, 1996-98

USGS Publications Warehouse

Barnes, Kimberlee K.

2001-01-01

Basic water-quality differences related to physiographic differences and seasonality were evident in streams and rivers in the Eastern Iowa Basins. Of the three major landforms, water samples from sites within the Des Moines Lobe, the youngest landform in the study area, had significantly higher median concentrations of calcium (85 mg/L), magnesium (28 mg/L), sulfate (28 mg/L), fluoride (0.31 mg/L), and silica (16 mg/L). The Des Moines Lobe region is calcium magnesium bicarbonate-rich due to the Paleozoic source rocks (limestones and shales) in the bedrock. Water samples from sites within the Southern Iowa Drift Plain had higher median concentrations of sodium (12 mg/L), potassium (3.2 mg/L), and chloride (21 mg/L). Concentrations also varied according to the time of year. Grouping the data into four seasonal periods, water samples collected during the months of October, November, and December, had higher median concentrations of calcium, magnesium, and chloride, then samples collected during other quarters of the year. Water quality in the streams during this low-flow period (October through December) is representative of that in the contributing aquifers.

Groundwater quality in the Lower Hudson River Basin, New York, 2008

USGS Publications Warehouse

Nystrom, Elizabeth A.

2010-01-01

Water samples were collected from 32 production and domestic wells in the study area from August through November 2008 to characterize the groundwater quality. The study area, which covers 5,607 square miles, encompasses the part of the Lower Hudson River Basin that lies within New York plus the parts of the Housatonic, Hackensack, Bronx, and Saugatuck River Basins that are in New York. The study area is underlain by mainly clastic bedrock, predominantly shale, with carbonate and crystalline rock present locally. The bedrock is generally overlain by till, but surficial deposits of saturated sand and gravel are present in some areas. Of the 32 wells sampled, 16 were finished in sand and gravel deposits and 16 were finished in bedrock. The samples were collected and processed by standard U.S. Geological Survey procedures and were analyzed for 225 physiochemical properties and constituents, including major ions, nutrients, trace elements, radon-222, pesticides, and volatile organic compounds (VOCs); indicator bacteria were collected and analyzed by New York State Department of Health procedures. Water quality in the study area is generally good, but concentrations of some constituents exceeded current or proposed Federal or New York State primary or secondary drinking-water standards; the standards exceeded were color (2 samples), pH (6 samples), sodium (8 samples), fluoride (1 sample), aluminum (3 samples), arsenic (1 sample), iron (7 samples), manganese (14 samples), radon-222 (17 samples), tetrachloroethene (1 sample), and bacteria (7 samples). The pH of all samples was typically neutral or slightly basic (median 7.2); the median water temperature was 11.8 degrees C. The ions with the highest concentrations were bicarbonate [median 167 milligrams per liter (mg/L)] and calcium (median 38.2 mg/L). Groundwater in the study area ranged from very soft to very hard, but more samples were classified as very hard (181 mg/L as CaCO3 or more) than soft (60 mg/L as CaCO3 or less); the median hardness was 140 mg/L as CaCO3. The maximum concentration of nitrate plus nitrite was 2.38 mg/L as nitrogen, which did not exceed established drinking-water standards for nitrate plus nitrite (10 mg/L as nitrogen). The trace elements with the highest concentrations were strontium [median 189 micrograms per liter ((u or mu)g/L)] and barium (median 50.6 (u or mu)g/L). The highest radon-222 activities were in samples from crystalline bedrock wells [maximum 13,800 picocuries per liter (pCi/L)]. Seventeen samples had radon-222 activities that exceeded a proposed U.S. Environmental Protection Agency (USEPA) drinking-water standard of 300 pCi/L; activities in two samples exceeded a proposed alternative drinking-water standard of 4,000 pCi/L. Ten pesticides and pesticide degradates were detected among 14 samples at concentrations of 0.183 (u or mu)g/L or less; most were herbicides or their degradates. Eight VOCs were detected among six samples; these included solvents, gasoline components, and a trihalomethane. Total coliform bacteria were detected in seven samples; fecal coliform bacteria, including Escherichia coli, were detected in one sample.

Long-term follow-up of astigmatic keratotomy for corneal astigmatism after penetrating keratoplasty.

PubMed

Böhringer, Daniel; Dineva, Nina; Maier, Philip; Birnbaum, Florian; Kirschkamp, Thomas; Reinhard, Thomas; Eberwein, Philipp

2016-11-01

To report the long-term stability of paired arcuate corneal keratotomies (AKs) in patients with high regular postpenetrating keratoplasty astigmatism. Retrospective chart review of best-corrected visual acuity, refraction and keratometric values of 41 eyes with AK between 2003 and 2012. Magnitude of median target induced astigmatism vector was 9.2 dioptres (Dpt). We reached a median magnitude of surgically induced astigmatism vector of 9.81 Dpt and a median magnitude of difference vector of 5.5 Dpt. In keratometry, we achieved a net median astigmatism reduction by 3.3 Dpt. The average correction index was 1.14, showing a slight overcorrection. Irregularity of keratometric astigmatism increased by 0.6 Dpt, and spherical equivalent changed by 1.75 Dpt. Monocular best spectacle corrected visual acuity increased from preoperatively 20/63 (0.5 logMAR) to 20/40 (0.3 logMAR) postoperatively. Median gain on the ETDRS chart was two lines. Long-term follow-up showed a median keratometric astigmatic increase by 0.3 Dpt per year. Arcuate corneal keratotomies is a safe and effective method to reduce high regular corneal astigmatism following penetrating keratoplasty but has limited predictability. The long-term follow-up shows an increase of keratometric astigmatism by 0.3 Dpt/year, equalizing the surgical effect after 10 years. © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Effect of a low-carbohydrate diet on respiratory quotient of infants with chronic lung disease.

PubMed

Suteerojntrakool, Orapa; Sanguanrungsirikul, Sompol; Sritippayawan, Suchada; Jantarabenjakul, Watsamon; Sirimongkol, Pathama; Chomtho, Sirinuch

2015-01-01

To compare the respiratory quotient in infants with chronic lung disease before and after receiving a modular diet with slightly lower carbohydrate content. Infants with chronic lung disease from the King Chulalongkorn Memorial Hospital were enrolled and assessed for nutritional status, severity of chronic lung disease and dietary intake. Indirect calorimetry was performed using a custom-made airtight canopy with O2 and CO2 sensors. Respiratory quotient (RQ) was calculated from VCO2/VO2 during the period they were fed low carbohydrates (37% of total calories) for at least 24 hours vs. a standard diet (47% carbohydrate). These two formulas were similar in terms of caloric density and protein content. Each patient received at least 100-150 kcal/ kg/day during the study period. Respiratory quotients of the same patient receiving the two diets were compared by using Wilcoxon signed-rank test. A total of 14 patients (median age 7 months, range 1-26 months) were recruited. Twelve children had weight for age Z-score below-2SD. Their median weight for age Z-score, length for age Z-score and weight for length Z-score were -2.89, -3.08 and -1.24, respectively. The median RQ measured during the low carbohydrate diet was 0.96 (interquartile range 0.95-0.97), significantly lower than the median RQ during the standard diet, which was 1.04 (0.97-1.10). However, the respiratory rate revealed no significant difference. Two participants with underlying gastroesophageal reflux disease showed higher RQ after low carbohydrate formula feeding, which might be a result of hypersecretion due to its high fat content. Diet with slightly lower carbohydrate content can reduce the RQ in infants with chronic lung disease compared to the standard enteral formula. A 10-percent reduction of carbohydrate content may provide a sizeable effect in this group of patients. Nevertheless, the clinical significance of this finding requires further investigation.

Safety performance evaluation of cable median barriers on freeways in Florida.

PubMed

Alluri, Priyanka; Haleem, Kirolos; Gan, Albert; Mauthner, John

2016-07-03

This article aims to evaluate the safety performance of cable median barriers on freeways in Florida. The safety performance evaluation was based on the percentages of barrier and median crossovers by vehicle type, crash severity, and cable median barrier type (Trinity Cable Safety System [CASS] and Gibraltar system). Twenty-three locations with cable median barriers totaling about 101 miles were identified. Police reports of 6,524 crashes from years 2005-2010 at these locations were reviewed to verify and obtain detailed crash information. A total of 549 crashes were determined to be barrier related (i.e., crashes involving vehicles hitting the cable median barrier) and were reviewed in further detail to identify crossover crashes and the manner in which the vehicles crossed the barriers; that is, by either overriding, underriding, or penetrating the barriers. Overall, 2.6% of vehicles that hit the cable median barrier crossed the median and traversed into the opposite travel lane. Overall, 98.1% of cars and 95.5% of light trucks that hit the barrier were prevented from crossing the median. In other words, 1.9% of cars and 4.5% of light trucks that hit the barrier had crossed the median and encroached on the opposite travel lanes. There is no significant difference in the performance of cable median barrier for cars versus light trucks in terms of crossover crashes. In terms of severity, overrides were more severe compared to underrides and penetrations. The statistics showed that the CASS and Gibraltar systems performed similarly in terms of crossover crashes. However, the Gibraltar system experienced a higher proportion of penetrations compared to the CASS system. The CASS system resulted in a slightly higher percentage of moderate and minor injury crashes compared to the Gibraltar system. Cable median barriers are successful in preventing median crossover crashes; 97.4% of the cable median barrier crashes were prevented from crossing over the median. Of all of the vehicles that hit the barrier, 83.6% were either redirected or contained by the cable barrier system. Barrier crossover crashes were found to be more severe compared to barrier noncrossover crashes. In addition, overrides were found to be more severe compared to underrides and penetrations.

Numerous Connections.

ERIC Educational Resources Information Center

Western Sydney Inst. of TAFE, Blacktown (Australia).

This resource includes units of work developed by different practitioners that integrate the teaching of literacy with the teaching of numeracy in adult basic education. It is designed to provide models of integration for teachers to develop similar resources on different contexts or themes. The units follow slightly different formats. Unit…

Water quality of arctic rivers in Finnish Lapland.

PubMed

Niemi, Jorma

2010-02-01

The water quality monitoring data of eight rivers situated in the Finnish Lapland above the Arctic Circle were investigated. These rivers are icebound annually for about 200 days. They belong to the International River Basin District founded according to the European Union Water Framework Directive and shared with Norway. They are part of the European river monitoring network that includes some 3,400 river sites. The water quality monitoring datasets available varied between the rivers, the longest comprising the period 1975-2003 and the shortest 1989-2003. For each river, annual medians of eight water quality variables were calculated. In addition, medians and fifth and 95th percentiles were calculated for the whole observation periods. The medians indicated good river water quality in comparison to other national or foreign rivers. However, the river water quality oscillated widely. Some rivers were in practice in pristine state, whereas some showed slight human impacts, e.g., occasional high values of hygienic indicator bacteria.

Youth Sport-Related Concussions: Perceived and Measured Baseline Knowledge of Concussions Among Community Coaches, Athletes, and Parents.

PubMed

Nanos, Katherine N; Franco, John M; Larson, Dirk; Mara, Kristin; Laskowski, Edward R

2017-12-01

To assess concussion knowledge of athletes, coaches, and parents/guardians in a community setting and to understand trends/gaps in knowledge among subgroups to tailor efforts toward creating educational interventions. This prospective cross-sectional study involved 262 individuals (142 [55%] female): 115 athletes participating in noncontact and contact sports (ages 13-19 years), 15 coaches, and 132 parents. Recruitment occurred from August 30, 2015, through August 30, 2016, at 3 local high schools. Participants completed a questionnaire developed by the investigators to assess concussion experience and basic knowledge. Females, health care employees, and parents showed stronger concern for potential long-term sequelae of concussion, whereas athletes were most concerned about not being able to return to sport. Those with higher perceived concussion knowledge were slightly older (median age, 42.5 vs 33 years), more educated (college or higher: 42 [70%] vs 100 [50%]), and more likely to be health care workers (22 [37.9%] vs 34 [17.7%]) and scored higher on knowledge questions (average correct: 75.5% vs 60%). Most participants could identify potential concussion sequelae, but only 86 (34.3%) identified a concussion as a brain injury. Of the subgroups, coaches scored highest on knowledge questions. Those with a concussion history tended to consider themselves more knowledgeable but were also less concerned about sequelae. Overall, those with a concussion history scored slightly higher on knowledge questions (average correct: 69.8% vs 61.9%). Participants involved in contact sports were more likely to have had a concussion vs those in noncontact sports (57 [26%] vs 4 [10.3%]). Significant differences in perceived and actual concussion knowledge across different subgroups of study participants involved in high school sports were identified. Copyright © 2017 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Percentiles of the run-length distribution of the Exponentially Weighted Moving Average (EWMA) median chart

NASA Astrophysics Data System (ADS)

Tan, K. L.; Chong, Z. L.; Khoo, M. B. C.; Teoh, W. L.; Teh, S. Y.

2017-09-01

Quality control is crucial in a wide variety of fields, as it can help to satisfy customers’ needs and requirements by enhancing and improving the products and services to a superior quality level. The EWMA median chart was proposed as a useful alternative to the EWMA \\bar{X} chart because the median-type chart is robust against contamination, outliers or small deviation from the normality assumption compared to the traditional \\bar{X}-type chart. To provide a complete understanding of the run-length distribution, the percentiles of the run-length distribution should be investigated rather than depending solely on the average run length (ARL) performance measure. This is because interpretation depending on the ARL alone can be misleading, as the process mean shifts change according to the skewness and shape of the run-length distribution, varying from almost symmetric when the magnitude of the mean shift is large, to highly right-skewed when the process is in-control (IC) or slightly out-of-control (OOC). Before computing the percentiles of the run-length distribution, optimal parameters of the EWMA median chart will be obtained by minimizing the OOC ARL, while retaining the IC ARL at a desired value.

Replacing Alpha-Fetoprotein With Alpha-Fetoprotein-L3 Increases the Sensitivity of Prenatal Screening for Trisomy 21.

PubMed

Huai, Lei; Leng, Jianhang; Ma, Shenglin; Huang, Fang; Shen, Junya; Ding, Yu

This study aimed to investigate the serum concentration of alpha-fetoprotein (AFP)-L3 in midterm pregnancies and its potential application in prenatal trisomy screening. The serum samples from 27 women with trisomy 21 fetuses and 800 women with normal fetuses were examined to measure the concentrations of AFP, AFP-L3, human chorionic gonadotropin (hCG), unconjugated estriol (uE3), and inhibin-A. The screening results of various tests consisting of these markers were analyzed. In normal pregnancies within 15-20 weeks of gestation, the medians of serum AFP-L3 were 4.63, 5.70, 5.78, 6.58, 7.03, and 7.25 pg/mL. The median of AFP-L3 MoM in the trisomy 21 group was 0.46, which was significantly lower than the value of 1 in the normal group (P < 0.05). When using a cutoff value of 1/270, the sensitivity of the triple marker test (AFP, hCG, uE3) was improved from 74% to 81% by replacing AFP with AFP-L3, with the false-positive rate slightly increased from 5.4% to 6.8%. Similarly, the sensitivity of the quad marker test (AFP, hCG, uE3, inhibin-A) was improved from 81% to 89% by replacing AFP with AFP-L3, with the false-positive rate slightly increased from 4.6% to 5.6%. Serum AFP-L3 concentration increases along with more weeks of gestation in the midterm pregnancies. Trisomy 21 screening tests with AFP replaced by AFP-L3 have higher sensitivities at the expense of slightly increased false-positive rates. This improvement in screening may help to better prepare the parents and caregivers for the special needs of newborns with trisomy 21.

Gonad morphology, oocyte development and spawning cycle of the calanoid copepod Acartia clausi

NASA Astrophysics Data System (ADS)

Eisfeld, Sonja M.; Niehoff, Barbara

2007-09-01

Information on gonad morphology and its relation to basic reproductive parameters such as clutch size and spawning frequency is lacking for Acartia clausi, a dominant calanoid copepod of the North Sea. To fill this gap, females of this species were sampled at Helgoland Roads from mid March to late May 2001. Gonad structure and oogenesis were studied using a combination of histology and whole-body-analysis. In addition, clutch size and spawning frequency were determined in incubation experiments, during which individual females were monitored at short intervals for 8 and 12 h, respectively. The histological analysis revealed that the ovary of A. clausi is w-shaped with two distinct tips pointing posteriorly. It is slightly different from that of other Acartia species and of other copepod taxa. From the ovary, two anterior diverticula extend into the head region, and two posterior diverticula extend to the genital opening in the abdomen. Developing oocytes change in shape and size, and in the appearance of the nucleus and the ooplasm. Based on these morphological characteristics, different oocyte development stages (OS) were identified. Mitotically dividing oogonia and young oocytes (OS 0) were restricted to the ovary, whereas vitellogenic oocytes (OS 1 4) were present in the diverticula. The development stage of the oocytes increased with distance to the ovary in both, anterior and posterior diverticula. Most advanced oocytes were situated ventrally, and their number varied between 1 and 18, at a median of 4. All oocyte development stages co-occur indicating that oogenesis in A. clausi is a continuous process. These morphological features reflect the reproductive traits of this species. In accordance with the low numbers of mature oocytes in the gonads, females usually produced small clutches of one to five eggs. Clutches were released throughout the entire observation period at intervals of 90 min (median) resulting in mean egg production rates of 18 28 eggs female-1 day-1.

Sports Participation, Functional Outcome, and Complications After Ankle Arthrodesis: Midterm Follow-up.

PubMed

Kerkhoff, Yvonne R A; Keijsers, Noël L W; Louwerens, Jan Willem K

2017-10-01

Ankle arthrodesis provides satisfactory functional outcome based on basic daily activities, but information regarding more demanding tasks is limited. Also, studies reporting longer term survival and complication rates are sparse and concern small study populations. This study reports functional outcome with more focus on demanding tasks and sports and reports the mid- to long-term union and complication rates in a large study population. Between 2005 and 2010, an ankle arthrodesis was performed on 185 ankles. Clinical results were retrospectively assessed with the Foot Function Index (FFI), visual analog scale (VAS) for pain, and the Foot and Ankle Ability Measure (FAAM). Information regarding sports pre- and postoperatively was obtained through a questionnaire. In addition, postoperative complications, reoperations, and failures (defined as nonunion of the ankle arthrodesis) were determined. Mean follow-up time was 8 years. FFI scores significantly improved, the FAAM ADL score was 70%, and the mean VAS for pain at the ankle/hindfoot at follow-up was 20. Sports participation slightly diminished from 79.5% prior to the onset of disabling complaints to 68.9% postoperatively. Of the patients, 73.1% were able to hike with a median hiking time of 40 minutes (range, 2-600 minutes). Kneeling could be performed on average 10 minutes (range, 2-60 minutes) in 39.8% and jumping down from steps by 23.5% of the patients. A small selection of patients was able to sprint (14%), and 16.8% of the patients were able to run a median distance of 60 meters (range, 3-1000 meters). Failure occurred in 9.2% and other postoperative complications were present in 21.6%, requiring reoperation in 8.6% of the cases. Ankle arthrodesis led to satisfactory functional outcome and pain reduction. Most patients remained active in sports, but a transition to less demanding sporting activities was seen. The complication and failure rates were similar with previous literature, and the incidence of nonrevision secondary surgery was relatively low. Level III, retrospective comparative study.

Creativity and Education: An American Retrospective

ERIC Educational Resources Information Center

Feldman, David Henry; Benjamin, Ann C.

2006-01-01

Although early childhood education in America has always had the creative child at the core of its approach, the field itself has generated little systematic research on the topic. In contrast, the scholarly field of creativity studies, with its focus on basic research and theoretical questions, has impacted education only slightly. Creativity and…

Attention Performance in Young Adults with Learning Disabilities

ERIC Educational Resources Information Center

Sterr, Annette M.

2004-01-01

Attention acts as the mind's "gatekeeper" by regulating and prioritizing the stimuli processed by the central nervous system. It is essential for cognitive performance, memory, and behavior, and we know that even slight deficiencies in attention compromise learning. Basic neuroscience research further indicates that attention consists of (fairly)…

Treatment adherence and outcome in women with inflammatory breast cancer: does race matter?

PubMed

Andic, Fundagul; Godette, Karen; O'Regan, Ruth; Zelnak, Amelia; Liu, Tian; Rizzo, Monica; Gabram, Sheryl; Torres, Mylin

2011-12-15

The authors compared treatment adherence rates and outcome in Caucasian and African American patients with inflammatory breast cancer (IBC). The records of 55 (25 Caucasian and 30 African American) IBC patients treated with curative intent from 1995 to 2009 were reviewed. All patients received neoadjuvant doxorubicin (Adriamycin) and/or taxane-based chemotherapy, and mastectomy with or without radiotherapy. The median follow-up period for Caucasian and African American patients was similar (39.5 months and 36.1 months, respectively). There was no difference between races in median age, tumor size, grade, and receptor status at diagnosis. The number of patients who completed neoadjuvant chemotherapy, surgery, and radiotherapy did not differ by race (84% of Caucasians vs 86.7% of African Americans) nor did the median length of time to complete trimodality treatment (263 [range, 207-422] days for Caucasians vs 262 [range, 165-371] days for African Americans). There was a trend toward slightly higher pathological complete response rates in Caucasian than African American women (20% in Caucasians vs 6.7% in African Americans, P = .23). Despite slightly better response rates to neoadjuvant chemotherapy, Caucasian patients did not have higher 3-year local control rates (70% in Caucasians vs 64% in African Americans, P = .73). However, there was a trend toward higher 3-year overall survival in Caucasian versus African American patients (73% in Caucasians vs 55% in African Americans, P = .09) and higher distant metastasis-free survival (60% in Caucasians vs 40% in African Americans, P = .19). This study is among the largest to examine patients with IBC by race. Being Caucasian or African American did not appear to impact treatment adherence. However, African American patients tended to have poorer response to standard treatment and worse outcome than Caucasian patients. Copyright © 2011 American Cancer Society.

Clinical evaluation of the Spiral Pump® after improvements to the original project in patients submitted to cardiac surgeries with cardiopulmonary bypass.

PubMed

Dinkhuysen, Jarbas Jakson; Andrade, Aron Jose Pazin de; Leme, Juliana; Silva, Cibele; Medina, Claudia Sanches; Pereira, Cristiane Célia; Biscegli, José Francisco

2014-01-01

The objective of this paper is to present the results from Spiral Pump clinical trial after design modifications performed at its previous project. This pump applies axial end centrifugal hydraulic effects for blood pumping during cardiopulmonary bypass for patients under cardiac surgery. This study was performed in 52 patients (51% males), between 20 to 80 (67±14.4) years old weighing 53 to 102 (71.7±12.6) kg, mostly under myocardial revascularization surgery (34.6%) and valvular surgery (32.8%). Besides the routine evaluation of the data observed in these cases, we monitored pump rotational speed, blood flow, cardiopulmonary bypass duration, urine free hemoglobin for blood cell trauma analysis (+ to 4+), lactate desidrogenase (UI/L), fibrinogen level (mg/dL) and platelet count (nº/mm3). Besides maintaining appropriate blood pressure and metabolic parameters it was also observed that the Free Hemoglobin levels remained normal, with a slight increase after 90 minutes of cardiopulmonary bypass. The Lactate Dehydrogenase showed an increase, with medians varying between 550-770 IU/L, whereas the decrease in Fibrinogen showed medians of 130-100 mg/dl. The number of platelets showed a slight decrease with the medians ranging from 240,000 to 200,000/mm3. No difficulty was observed during perfusion terminations, nor were there any immediate deaths, and all patients except one, were discharged in good condition. The Spiral Pump, as blood propeller during cardiopulmonary bypass, demonstrated to be reliable and safe, comprising in a good option as original and national product for this kind of application.

Clinical evaluation of the Spiral Pump® after improvements to the original project in patients submitted to cardiac surgeries with cardiopulmonary bypass

PubMed Central

Dinkhuysen, MD, PhD, Jarbas Jakson; de Andrade, Aron Jose Pazin; Leme, MsC, Juliana; Silva, Cibele; Medina, Claudia Sanches; Pereira, Cristiane Célia; Biscegli, PhD, José Francisco

2014-01-01

Objective The objective of this paper is to present the results from Spiral Pump clinical trial after design modifications performed at its previous project. This pump applies axial end centrifugal hydraulic effects for blood pumping during cardiopulmonary bypass for patients under cardiac surgery. Methods This study was performed in 52 patients (51% males), between 20 to 80 (67±14.4) years old weighing 53 to 102 (71.7±12.6) kg, mostly under myocardial revascularization surgery (34.6%) and valvular surgery (32.8%). Besides the routine evaluation of the data observed in these cases, we monitored pump rotational speed, blood flow, cardiopulmonary bypass duration, urine free hemoglobin for blood cell trauma analysis (+ to 4+), lactate desidrogenase (UI/L), fibrinogen level (mg/dL) and platelet count (nº/mm3). Results Besides maintaining appropriate blood pressure and metabolic parameters it was also observed that the Free Hemoglobin levels remained normal, with a slight increase after 90 minutes of cardiopulmonary bypass. The Lactate Dehydrogenase showed an increase, with medians varying between 550-770 IU/L, whereas the decrease in Fibrinogen showed medians of 130-100 mg/dl. The number of platelets showed a slight decrease with the medians ranging from 240,000 to 200,000/mm3. No difficulty was observed during perfusion terminations, nor were there any immediate deaths, and all patients except one, were discharged in good condition. CONCLUSION The Spiral Pump, as blood propeller during cardiopulmonary bypass, demonstrated to be reliable and safe, comprising in a good option as original and national product for this kind of application. PMID:25372905

Selected ground-water data for Yucca Mountain region, southern Nevada and eastern California, through December 1998

USGS Publications Warehouse

Locke, Glenn L.

2001-01-01

The U.S. Geological Survey, in support of the U.S. Department of Energy, Yucca Mountain Site Characterization Project, collects, compiles, and summarizes hydrologic data in the Yucca Mountain region. The data are collected to allow assessments of ground-water resources during studies to determine the potential suitability of Yucca Mountain for storing high-level nuclear waste. Data on ground-water levels at 34 wells and a fissure (Devils Hole), ground-water discharge at 5 springs and a flowing well, and total reported ground-water withdrawals within Crater Flat, Jackass Flats, Mercury Valley, and the Amargosa Desert are presented for calendar year 1998. Data collected prior to 1998 are graphically presented and data collected by other agencies (or as part of other Geolgical Survey programs) are included to further indicate variations of ground-water levels, discharges, and withdrawals through time. A statistical summary of ground-water levels at seven wells in Jackass Flats is presented to indicate potential effects of ground-water withdrawals associated with U.S. Department of Energy activities near Yucca Mountain. The statistical summary includes the number of measurements, the maximum, minimum, and median water-level altitudes, and the average deviation of measured water-level altitudes for selected baseline periods and for calendar years 1992-98. At two water-supply wells and a nearby observation well, median water levels for calendar year 1998 were slightly lower (0.2 to 0.3 foot) than for their respective baseline periods. At the remaining four wells in Jackass Flats, median water levels for 1998 were unchanged at two wells and slightly higher (0.4 and 1.4 foot) at two wells than those for their respective baseline periods.

Chromosome number variation of the Italian endemic vascular flora. State-of-the-art, gaps in knowledge and evidence for an exponential relationship among even ploidy levels.

PubMed

Bedini, Gianni; Garbari, Fabio; Peruzzi, Lorenzo

2012-01-01

The Italian endemic vascular flora is composed of 1,286 specific and subspecific taxa. From the critical analysis of "Chrobase.it", 711 of them (about 55%) have been studied from a karyological point of view. These taxa belong to 52 out of 56 families and 204 out of 284 genera. These data suggest that endemic species are more studied than the flora as a whole. Mean chromosome number for Italian endemics is 2n = 30.68 ± 20.27 (median: 2n = 26, mode: 2n = 18). These values are very close to those known for the whole flora. Similar variation ranges, among endemics and species with wider distribution, are likely to reflect similar evolutionary trends. Known chromosome numbers in Italian endemics range from 2n = 8 to 2n = 182. About 9% of taxa show more than one cytotype and the frequency of Bs in the Italian endemic vascular flora is 3.3%. These values are slightly smaller compared with the whole Italian flora. Finally, for the basic chromosome numbers x = 7, 8, 9, the proportion of diploids (2n = 2x) to even polyploids (2n = 4x, 6x, 8x and 10x) can be described by the exponential function f(p) = e((5.539 - 0.637p)) (R(2) = 0.984).

The Soluble Plasminogen Activator Receptor as a Biomarker on Monitoring the Therapy Progress of Pulmonary TB-AFB(+) Patients

PubMed Central

Mardining Raras, Tri Yudani; Noor Chozin, Iin

2010-01-01

The role of soluble soluble urokinase-type plasminogen activator receptor (suPAR) as a biological marker for TB treatment efficacy on active pulmonary TB-AFB(+) patients was investigated. Twenty pulmonary TB-AFB(+) patients participated in a cohort study for six months. The plasma suPAR level was measured using ELISA method before treatment, two months, four months and six months after treatment. At the same time clinical parameters were also measured. Results indicated that all patients (n = 20) showed highest plasma suPAR levels before treatment (median 12.775 ng/mL) and significantly decreased ( P = .0001<.05, R 2 = .890) after 2 months (median 8.019 ng/mL) and 4 months (median 5.771 ng/mL) of treatment, respectively. However, only slightly declined after 6 months therapy (median 5.009 ng/mL), near control group level (median 4.772 ng/mL). Interestingly, the significant reduced of suPAR level was parallel to treatment efficacy and correlated with other clinical and laboratory parameters, that is, decreasing of patients' complaints, increasing of BMI (r = −0.281), thoracic imaging improvement, sputum conversion, decreasing of ESR (r = 0.577) and monocytes count (r = 0.536) with exception the width of lesion in thoracic imaging. In conclusion, the suPAR level in could reflect the progress of TB therapy. PMID:22567258

An Exploration of WFC3/IR Dark Current Variation

NASA Astrophysics Data System (ADS)

Sunnquist, B.; Baggett, S.; Long, K. S.

2017-02-01

We use a collection of darks spanning September 2009 to June 2016 to study variations in the dark current in the IR detector on WFC3. Although the darks possess a similar signal pattern across the detector, we find that their median dark rates vary by as much as 0.014 DN/s (0.032 e-/s). The distribution of these median values has a triangular shape with a mean and standard deviation of 0.021 ± 0.0029 DN/s (0.049 ± 0.0069 e-/s). We observe a long term time-dependence in the inboard vertical reference pixel and zeroth read signals; however, these differences do not noticeably affect the calibrated dark signals, and we conclude that the WFC3/IR dark current levels continue to remain stable since launch. The inboard reference pixel signals exhibit a unique, but consistent, pattern around the detector, but this pattern does not evolve noticeably with the median of the science pixels, and a quadrant or row-based reference pixel subtraction strategy does not reduce the spread between the median dark rates. We notice a slight drift in the inboard reference pixel signals up the dark ramps, and the intensity of this drift is related to the median dark current in the science pixels. This holds true using either the horizontal or vertical reference pixels and for darks with a variety of sample sequences.

Decadal Trends of Atlantic Basin Tropical Cyclones (1950-1999)

NASA Technical Reports Server (NTRS)

Wilson, Robert M.

2001-01-01

Ten-year moving averages of the seasonal rates for 'named storms,' tropical storms, hurricanes, and major (or intense) hurricanes in the Atlantic basin suggest that the present epoch is one of enhanced activity, marked by seasonal rates typically equal to or above respective long-term median rates. As an example, the 10-year moving average of the seasonal rates for named storms is now higher than for any previous year over the past 50 years, measuring 10.65 in 1994, or 2.65 units higher than its median rate of 8. Also, the 10-year moving average for tropical storms has more than doubled, from 2.15 in 1955 to 4.60 in 1992, with 16 of the past 20 years having a seasonal rate of three or more (the median rate). For hurricanes and major hurricanes, their respective 10-year moving averages turned upward, rising above long-term median rates (5.5 and 2, respectively) in 1992, a response to the abrupt increase in seasonal rates that occurred in 1995. Taken together, the outlook for future hurricane seasons is for all categories of Atlantic basin tropical cyclones to have seasonal rates at levels equal to or above long-term median rates, especially during non-El Nino-related seasons. Only during El Nino-related seasons does it appear likely that seasonal rates might be slightly diminished.

Management strategies, early results, benefits, and risk factors of laparoscopic repair of perforated peptic ulcer.

PubMed

Lunevicius, Raimundas; Morkevicius, Matas

2005-10-01

The primary goal of this study was to describe epidemiology and management strategies of the perforated duodenal ulcer, as well as the most common methods of laparoscopic perforated duodenal ulcer repair. The secondary goal was to demonstrate the value of prospective and retrospective studies regarding the early results of surgery and the risk factors. The tertiary goal was to emphasize the benefits of this operation, and the fourth goal was to clarify the possible risk factors associated with laparoscopic repair of the duodenal ulcer. The Medline/Pubmed database was used. Review was done after evaluation of 96 retrieved full-text articles. Thirteen prospective and twelve retrospective studies were selected, grouped, and summarized. The spectrum of the retrospective studies' results are as follows: median overall morbidity rate 10.5 %, median conversion rate 7%, median hospital stay 7 days, and median postoperative mortality rate 0%. The following is the spectrum of results of the prospective studies: median overall morbidity rate was slightly less (6%); the median conversion rate was higher (15%); the median hospital stay was shorter (5 days) and the postoperative mortality was higher (3%). The risk factors identified were the same. Shock, delayed presentation (> 24 hours), confounding medical condition, age > 70 years, poor laparoscopic expertise, ASA III-IV, and Boey score should be considered preoperative laparoscopic repair risk factors. Each of these factors independently should qualify as a criterion for open repair due to higher intraoperative risks as well as postoperative morbidity. Inadequate ulcer localization, large perforation size (defined by some as > 6 mm diameter, and by others as > 10 mm), and ulcers with friable edges are also considered as conversion risk factors.

Community Colleges' Use of the Web to Communicate Their Mission: Slights of Commission and Omission

ERIC Educational Resources Information Center

Hegeman, Diane L.; Davies, Timothy Gray; Banning, James H.

2007-01-01

This basic interpretive qualitative study identified, described, and interpreted community college mission statement messages as they appeared in print and on the web site. The study analyzed each institution's similar, different, unique, and unintended messages. The within-case inductive analysis found emergent mission statement messages in the…

The addition of locust bean gum but not water delayed the gastric emptying rate of a nutrient semisolid meal in healthy subjects

PubMed Central

Darwiche, Gassan; Björgell, Ola; Almér, Lars-olof

2003-01-01

Background Most of the previous studies regarding the effects of gel-forming fibres have considered the gastric emptying of liquid or solid meals after the addition of pectin or guar gum. The influence of locust bean gum, on gastric emptying of nutrient semisolid meals in humans has been less well studied, despite its common occurrence in foods. Using a standardised ultrasound method, this study was aimed at investigating if the gastric emptying in healthy subjects could be influenced by adding locust been gum, a widely used thickening agent, or water directly into a nutrient semisolid test meal. Methods The viscosity of a basic test meal (300 g rice pudding, 330 kcal) was increased by adding Nestargel (6 g, 2.4 kcal), containing viscous dietary fibres (96.5%) provided as seed flour of locust bean gum, and decreased by adding 100 ml of water. Gastric emptying of these three test meals were evaluated in fifteen healthy non-smoking volunteers, using ultrasound measurements of the gastric antral area to estimate the gastric emptying rate (GER). Results The median value of GER with the basic test meal (rice pudding) was estimated at 63 %, (range 47 to 84 %), (the first quartile = 61 %, the third quartile = 69 %). Increasing the viscosity of the rice pudding by adding Nestargel, resulted in significantly lower gastric emptying rates (p < 0.01), median GER 54 %, (range 7 to 71 %), (the first quartile = 48 %, the third quartile = 60 %). When the viscosity of the rice pudding was decreased (basic test meal added with water), the difference in median GER 65 %, (range 38 to 79 %), (the first quartile = 56 %, the third quartile = 71 %) was not significantly different (p = 0.28) compared to the GER of the basic test meal. Conclusions We conclude that the addition of locust bean gum to a nutrient semisolid meal has a major impact on gastric emptying by delaying the emptying rate, but that the addition of water to this test meal has no influence on gastric emptying in healthy subjects. PMID:12793910

The addition of locust bean gum but not water delayed the gastric emptying rate of a nutrient semisolid meal in healthy subjects.

PubMed

Darwiche, Gassan; Björgell, Ola; Almér, Lars-Olof

2003-06-06

Most of the previous studies regarding the effects of gel-forming fibres have considered the gastric emptying of liquid or solid meals after the addition of pectin or guar gum. The influence of locust bean gum, on gastric emptying of nutrient semisolid meals in humans has been less well studied, despite its common occurrence in foods. Using a standardised ultrasound method, this study was aimed at investigating if the gastric emptying in healthy subjects could be influenced by adding locust been gum, a widely used thickening agent, or water directly into a nutrient semisolid test meal. The viscosity of a basic test meal (300 g rice pudding, 330 kcal) was increased by adding Nestargel (6 g, 2.4 kcal), containing viscous dietary fibres (96.5%) provided as seed flour of locust bean gum, and decreased by adding 100 ml of water. Gastric emptying of these three test meals were evaluated in fifteen healthy non-smoking volunteers, using ultrasound measurements of the gastric antral area to estimate the gastric emptying rate (GER). The median value of GER with the basic test meal (rice pudding) was estimated at 63%, (range 47 to 84%), (the first quartile = 61%, the third quartile = 69%). Increasing the viscosity of the rice pudding by adding Nestargel, resulted in significantly lower gastric emptying rates (p < 0.01), median GER 54%, (range 7 to 71%), (the first quartile = 48%, the third quartile = 60%). When the viscosity of the rice pudding was decreased (basic test meal added with water), the difference in median GER 65%, (range 38 to 79%), (the first quartile = 56%, the third quartile = 71%) was not significantly different (p = 0.28) compared to the GER of the basic test meal. We conclude that the addition of locust bean gum to a nutrient semisolid meal has a major impact on gastric emptying by delaying the emptying rate, but that the addition of water to this test meal has no influence on gastric emptying in healthy subjects.

Mobilizing peripheral blood stem cells with high-dose G-CSF alone is as effective as with Dexa-BEAM plus G-CSF in lymphoma patients.

PubMed

Kröger, N; Zeller, W; Fehse, N; Hassan, H T; Krüger, W; Gutensohn, K; Lölliger, C; Zander, A R

1998-09-01

We compared retrospectively the efficacy of granulocyte colony stimulating factor (G-CSF) alone with chemotherapy plus G-CSF in mobilizing CD34-positive cells in patients with malignant lymphoma. 35 patients underwent peripheral blood stem cell (PBSC) collection following mobilization either with 24 microg/kg G-CSF for 4 consecutive days (n = 18) or Dexa-BEAM chemotherapy plus 5 microg/kg G-CSF (n = 17). High-dose G-CSF was well tolerated with only slight bone pain and/or myalgia. The Dexa-BEAM therapy required hospitalization with a median duration of 21 d. The median number of apheresis procedures in both groups was two (range two to four), resulting in a median of 5.3 and 5.1 x 10(6) CD34+ cells/kg. No patients in the G-CSF group, but one in the Dexa-BEAM group, failed to reach the target of collecting >2.0 x 10(6) CD34+ cells/kg. The number of CFU-GM (10.4 v 6.0 x 10(5)/kg) and of BFU-E (10.6 v 4.5 x 10(5)/kg; P = 0.04) was higher in the G-CSF group than in the Dexa-BEAM group. A subset analysis of CD34+ cells was performed in 16 patients showing a higher mean of Thy-1 (CD90w) coexpression in the G-CSF than in the Dexa-BEAM group (4.8 v 1.8%, P = 0.12). Additionally the percentage of CD34+/CD38- cells was higher in the G-CSF group (10.66% v 8.8%). However, these differences were not statistically significant. The median time to leucocyte and platelet engraftment after high-dose chemotherapy was slightly shorter in the G-CSF than in the Dexa-BEAM group (9 v 10 and 12 v 13.5 d, respectively). These results demonstrate that high-dose G-CSF is as effective as Dexa-BEAM plus G-CSF in mobilizing peripheral blood stem cells and produces prompt engraftment. The major advantages of G-CSF mobilization were the safe outpatient self-application and the fixed-day apheresis.

Quantum image median filtering in the spatial domain

NASA Astrophysics Data System (ADS)

Li, Panchi; Liu, Xiande; Xiao, Hong

2018-03-01

Spatial filtering is one principal tool used in image processing for a broad spectrum of applications. Median filtering has become a prominent representation of spatial filtering because its performance in noise reduction is excellent. Although filtering of quantum images in the frequency domain has been described in the literature, and there is a one-to-one correspondence between linear spatial filters and filters in the frequency domain, median filtering is a nonlinear process that cannot be achieved in the frequency domain. We therefore investigated the spatial filtering of quantum image, focusing on the design method of the quantum median filter and applications in image de-noising. To this end, first, we presented the quantum circuits for three basic modules (i.e., Cycle Shift, Comparator, and Swap), and then, we design two composite modules (i.e., Sort and Median Calculation). We next constructed a complete quantum circuit that implements the median filtering task and present the results of several simulation experiments on some grayscale images with different noise patterns. Although experimental results show that the proposed scheme has almost the same noise suppression capacity as its classical counterpart, the complexity analysis shows that the proposed scheme can reduce the computational complexity of the classical median filter from the exponential function of image size n to the second-order polynomial function of image size n, so that the classical method can be speeded up.

Phenomena and characteristics of barrier river reaches in the middle and lower Yangtze River, China

NASA Astrophysics Data System (ADS)

You, Xingying; Tang, Jinwu

2017-06-01

Alluvial river self-adjustment describes the mechanism whereby a river that was originally in an equilibrium state of sediment transport encounters some disturbance that destroys the balance and results in responses such as riverbed deformation. A systematic study of historical and recent aerial photographs and topographic maps in the Middle and Lower Reaches of the Yangtze River (MLYR) shows that river self-adjustment has the distinguishing feature of transferring from upstream to downstream, which may affect flood safety, waterway morphology, bank stability, and aquatic environmental safety over relatively long reaches downstream. As a result, it is necessary to take measures to control or block this transfer. Using the relationship of the occurrence time of channel adjustments between the upstream and downstream, 34 single-thread river reaches in the MLYR were classified into four types: corresponding, basically corresponding, basically not corresponding, not corresponding. The latter two types, because of their ability to prevent upstream channel adjustment from transferring downstream, are called barrier river reaches in this study. Statistics indicate that barrier river reaches are generally single thread and slightly curved, with a narrow and deep cross-sectional morphology, and without flow deflecting nodes in the upper and middle parts of reaches. Moreover, in the MLYR, barrier river reaches have a hydrogeometric coefficient of {<}{4}, a gradient {>}1.2‱, a silty clay content of the concave bank {>}{9.5}%, and a median diameter of the bed sediment {>}{0.158} mm. The barrier river reach mechanism lies in that can effectively centralise the planimetric position of the main stream from different upstream directions, meaning that no matter how the upper channel adjusts, the main stream shows little change, providing relatively stable inflow conditions for the lower reaches. Regarding river regulation, it is necessary to optimise the benefits of barrier river reaches; long river reaches without barrier properties should be systematically planned and regulated; drastic bank collapse and sandbar shrinking should be urgently controlled to prevent the loss of barrier effects.

The galaxy-dark matter halo connection: which galaxy properties are correlated with the host halo mass?

NASA Astrophysics Data System (ADS)

Contreras, S.; Baugh, C. M.; Norberg, P.; Padilla, N.

2015-09-01

We demonstrate how the properties of a galaxy depend on the mass of its host dark matter subhalo, using two independent models of galaxy formation. For the cases of stellar mass and black hole mass, the median property value displays a monotonic dependence on subhalo mass. The slope of the relation changes for subhalo masses for which heating by active galactic nuclei becomes important. The median property values are predicted to be remarkably similar for central and satellite galaxies. The two models predict considerable scatter around the median property value, though the size of the scatter is model dependent. There is only modest evolution with redshift in the median galaxy property at a fixed subhalo mass. Properties such as cold gas mass and star formation rate, however, are predicted to have a complex dependence on subhalo mass. In these cases, subhalo mass is not a good indicator of the value of the galaxy property. We illustrate how the predictions in the galaxy property-subhalo mass plane differ from the assumptions made in some empirical models of galaxy clustering by reconstructing the model output using a basic subhalo abundance matching scheme. In its simplest form, abundance matching generally does not reproduce the clustering predicted by the models, typically resulting in an overprediction of the clustering signal. Using the predictions of the galaxy formation model for the correlations between pairs of galaxy properties, the basic abundance matching scheme can be extended to reproduce the model predictions more faithfully for a wider range of galaxy properties. Our results have implications for the analysis of galaxy clustering, particularly for low abundance samples.

Fast State-Space Methods for Inferring Dendritic Synaptic Connectivity

DTIC Science & Technology

2013-08-08

the results of 100 simulations with the same parameters as in Figures 4 and 5. As expected, the LARS/LARS+ results are (downward) biased and have low...with a strength slightly biased toward lower values. To measure the variability of the results across the 20 simulations , we computed for each...are downward biased and have low variance, and the OLS results are unbiased but have high variance. Note that for LARS+ the values above the median are

Teaching Univariate Measures of Location-Using Loss Functions

ERIC Educational Resources Information Center

Paolino, Jon-Paul

2018-01-01

This article presents a new method for introductory teaching of the sample mean, median and mode(s) from a univariate dataset. These basic statistical concepts are taught at various levels of education from elementary school curriculums to courses at the tertiary level. These descriptive measures of location can be taught as optimized solutions to…

Keeping the Future Bright: Department of Defense (DOD) Sustainable Energy Strategy for Installations

DTIC Science & Technology

2016-04-04

solar photovoltaic ( PV ) energy from a novelty to a mainstream energy source represents another one of the biggest clean energy stories of the past...still slightly more expensive to install than utility-scale PV , distributed solar installation costs decreased in half since 2008, and this power source...capacity will increase in the coming years (See Figure 3)6 Figure 3: Solar PV (Utility Scale) Utility-Scale Median Sy5tem Price —12 10 6 Ibid. Ibid. 9 up

Trends in marriage and time spent single in sub-Saharan Africa: a comparative analysis of six population-based cohort studies and nine Demographic and Health Surveys.

PubMed

Marston, M; Slaymaker, E; Cremin, I; Floyd, S; McGrath, N; Kasamba, I; Lutalo, T; Nyirenda, M; Ndyanabo, A; Mupambireyi, Z; Zaba, B

2009-04-01

To describe trends in age at first sex (AFS), age at first marriage (AFM) and time spent single between events and to compare age-specific trends in marital status in six cohort studies. Cohort data from Uganda, Tanzania, South Africa, Zimbabwe and Malawi and Demographic and Health Survey (DHS) data from Uganda, Tanzania and Zimbabwe were analysed. Life table methods were used to calculate median AFS, AFM and time spent single. In each study, two surveys were chosen to compare marital status by age and identify changes over time. Median AFM was much higher in South Africa than in the other sites. Between the other populations there were considerable differences in median AFS and AFM (AFS 17-19 years for men and 16-19 years for women, AFM 21-24 years and 18-19 years, respectively, for the 1970-9 birth cohort). In all surveys, men reported a longer time spent single than women (median 4-7 years for men and 0-2 years for women). Median years spent single for women has increased, apart from in Manicaland. For men in Rakai it has decreased slightly over time but increased in Kisesa and Masaka. The DHS data showed similar trends to those in the cohort data. The age-specific proportion of married individuals has changed little over time. Median AFS, AFM and time spent single vary considerably among these populations. These three measures are underlying determinants of sexual risk and HIV infection, and they may partially explain the variation in HIV prevalence levels between these populations.

Trends in marriage and time spent single in sub-Saharan Africa: a comparative analysis of six population-based cohort studies and nine Demographic and Health Surveys

PubMed Central

Marston, M; Slaymaker, E; Cremin, I; Floyd, S; McGrath, N; Kasamba, I; Lutalo, T; Nyirenda, M; Ndyanabo, A; Mupambireyi, Z; Żaba, B

2009-01-01

Objectives: To describe trends in age at first sex (AFS), age at first marriage (AFM) and time spent single between events and to compare age-specific trends in marital status in six cohort studies. Methods: Cohort data from Uganda, Tanzania, South Africa, Zimbabwe and Malawi and Demographic and Health Survey (DHS) data from Uganda, Tanzania and Zimbabwe were analysed. Life table methods were used to calculate median AFS, AFM and time spent single. In each study, two surveys were chosen to compare marital status by age and identify changes over time. Results: Median AFM was much higher in South Africa than in the other sites. Between the other populations there were considerable differences in median AFS and AFM (AFS 17–19 years for men and 16–19 years for women, AFM 21–24 years and 18–19 years, respectively, for the 1970–9 birth cohort). In all surveys, men reported a longer time spent single than women (median 4–7 years for men and 0–2 years for women). Median years spent single for women has increased, apart from in Manicaland. For men in Rakai it has decreased slightly over time but increased in Kisesa and Masaka. The DHS data showed similar trends to those in the cohort data. The age-specific proportion of married individuals has changed little over time. Conclusions: Median AFS, AFM and time spent single vary considerably among these populations. These three measures are underlying determinants of sexual risk and HIV infection, and they may partially explain the variation in HIV prevalence levels between these populations. PMID:19307343

Control of African swine fever epidemics in industrialized swine populations.

PubMed

Halasa, Tariq; Bøtner, Anette; Mortensen, Sten; Christensen, Hanne; Toft, Nils; Boklund, Anette

2016-12-25

African swine fever (ASF) is a notifiable infectious disease with a high impact on swine health. The disease is endemic in certain regions in the Baltic countries and has spread to Poland constituting a risk of ASF spread toward Western Europe. Therefore, as part of contingency planning, it is important to explore strategies that can effectively control an epidemic of ASF. In this study, the epidemiological and economic effects of strategies to control the spread of ASF between domestic swine herds were examined using a published model (DTU-DADS-ASF). The control strategies were the basic EU and national strategy (Basic), the basic strategy plus pre-emptive depopulation of neighboring swine herds, and intensive surveillance of herds in the control zones, including testing live or dead animals. Virus spread via wild boar was not modelled. Under the basic control strategy, the median epidemic duration was predicted to be 21days (5th and 95th percentiles; 1-55days), the median number of infected herds was predicted to be 3 herds (1-8), and the total costs were predicted to be €326 million (€256-€442 million). Adding pre-emptive depopulation or intensive surveillance by testing live animals resulted in marginal improvements to the control of the epidemics. However, adding testing of dead animals in the protection and surveillance zones was predicted to be the optimal control scenario for an ASF epidemic in industrialized swine populations without contact to wild boar. This optimal scenario reduced the epidemic duration to 9days (1-38) and the total costs to €294 million (€257-€392 million). Export losses were the driving force of the total costs of the epidemics. Copyright © 2016 Elsevier B.V. All rights reserved.

Prices and availability of locally produced and imported medicines in Ethiopia and Tanzania.

PubMed

Ewen, M; Kaplan, W; Gedif, T; Justin-Temu, M; Vialle-Valentin, C; Mirza, Z; Regeer, B; Zweekhorst, M; Laing, R

2017-01-01

To assess the effect of policies supporting local medicine production to improve access to medicines. We adapted the WHO/HAI instruments measuring medicines availability and prices to differentiate local from imported products, then pilot tested in Ethiopia and Tanzania. In each outlet, prices were recorded for all products in stock for medicines on a country-specific list. Government procurement prices were also collected. Prices were compared to an international reference and expressed as median price ratios (MPR). The Ethiopian government paid more for local products (median MPR = 1.20) than for imports (median MPR = 0.84). Eight of nine medicines procured as both local and imported products were cheaper when imported. Availability was better for local products compared to imports, in the public (48% vs. 19%, respectively) and private (54% vs. 35%, respectively) sectors. Patient prices were lower for imports in the public sector (median MPR = 1.18[imported] vs. 1.44[local]) and higher in the private sector (median MPR = 5.42[imported] vs. 1.85[local]). In the public sector, patients paid 17% and 53% more than the government procurement price for local and imported products, respectively. The Tanzanian government paid less for local products (median MPR = 0.69) than imports (median MPR = 1.34). In the public sector, availability of local and imported products was 21% and 32% respectively, with patients paying slightly more for local products (median MPR = 1.35[imported] vs. 1.44[local]). In the private sector, local products were less available (21%) than imports (70%) but prices were similar (median MPR = 2.29[imported] vs. 2.27[local]). In the public sector, patients paid 135% and 65% more than the government procurement price for local and imported products, respectively. Our results show how local production can affect availability and prices, and how it can be influenced by preferential purchasing and mark-ups in the public sector. Governments need to evaluate the impact of local production policies, and adjust policies to protect patients from paying more for local products.

An Experiment in Basic Airborne Electronics Training. Part 5: Evaluation of the Revised Courses.

ERIC Educational Resources Information Center

Baldwin, Robert O.; Johnson, Kirk A.

This is the fifth in a series on shortened versions of the Avionics Fundamentals and Aviation Electronics Technician R (Radar) Courses. The first four studies indicated that the initial revisions of the courses led to substantial savings in training time, but that the graduates from the revised courses were slightly inferior to graduates from the…

Basic Language Comprehension and Production in Greater than 100,000 Young Children from Sixteen Developing Nations

ERIC Educational Resources Information Center

Bornstein, Marc H.; Hendricks, Charlene

2012-01-01

Using the Multiple Indicator Cluster Survey, language comprehension and production were compared in a sample of 101,250 children aged 2 ; 00 to 9 ; 11 and a focus subsample of 38,845 children aged 2 ; 00 to 4 ; 11 from sixteen under-researched developing nations. In the whole sample, comprehension slightly exceeded production; correlations between…

Correlation between substratum roughness and wettability, cell adhesion, and cell migration.

PubMed

Lampin, M; Warocquier-Clérout; Legris, C; Degrange, M; Sigot-Luizard, M F

1997-07-01

Cell adhesion and spreading of chick embryo vascular and corneal explants grown on rough and smooth poly (methyl methacrylate) (PMMA) were analyzed to test the cell response specificity to substratum surface properties. Different degrees of roughness were obtained by sand-blasting PMMA with alumina grains. Hydrophilic and hydrophobic components of the surface free energy (SFE) were calculated according to Good-van Oss's model. Contact angles were determined using a computerized angle meter. The apolar component of the SFE gamma s(LW), increased with a slight roughness whereas the basic component, gamma s-, decreased. The acido-basic properties disappeared as roughness increased. Incubation of PMMA in culture medium, performed to test the influence if the biological environment, allowed surface adsorption of medium proteins which annihilated roughness effect and restored hydrophilic properties. An organotypic culture assay was carried out in an attempt to relate the biocompatibility to substratum surface state. Cell migration was calculated from the area of cell layer. Cellular adhesion was determined by measuring the kinetic of release of enzymatically dissociated cells. A slight roughness raised the migration are to an upper extent no matter which cell type. Enhancement of the cell adhesion potential was related to the degree of roughness and the hydrophobicity.

Comparative virulence and competition between Nosema apis and Nosema ceranae in honey bees (Apis mellifera).

PubMed

Milbrath, Meghan O; van Tran, Toan; Huang, Wei-Fong; Solter, Leellen F; Tarpy, David R; Lawrence, Frank; Huang, Zachary Y

2015-02-01

Honey bees (Apis mellifera) are infected by two species of microsporidia: Nosema apis and Nosemaceranae. Epidemiological evidence indicates that N. ceranae may be replacing N. apis globally in A. mellifera populations, suggesting a potential competitive advantage of N. ceranae. Mixed infections of the two species occur, and little is known about the interactions among the host and the two pathogens that have allowed N. ceranae to become dominant in most geographical areas. We demonstrated that mixed Nosema species infections negatively affected honey bee survival (median survival=15-17days) more than single species infections (median survival=21days and 20days for N. apis and N. ceranae, respectively), with median survival of control bees of 27days. We found similar rates of infection (percentage of bees with active infections after inoculation) for both species in mixed infections, with N. apis having a slightly higher rate (91% compared to 86% for N. ceranae). We observed slightly higher spore counts in bees infected with N. ceranae than in bees infected with N. apis in single microsporidia infections, especially at the midpoint of infection (day 10). Bees with mixed infections of both species had higher spore counts than bees with single infections, but spore counts in mixed infections were highly variable. We did not see a competitive advantage for N. ceranae in mixed infections; N. apis spore counts were either higher or counts were similar for both species and more N. apis spores were produced in 62% of bees inoculated with equal dosages of the two microsporidian species. N. ceranae does not, therefore, appear to have a strong within-host advantage for either infectivity or spore growth, suggesting that direct competition in these worker bee mid-guts is not responsible for its apparent replacement of N. apis. Copyright © 2014 Elsevier Inc. All rights reserved.

Accuracy of iodine quantification using dual energy CT in latest generation dual source and dual layer CT.

PubMed

Pelgrim, Gert Jan; van Hamersvelt, Robbert W; Willemink, Martin J; Schmidt, Bernhard T; Flohr, Thomas; Schilham, Arnold; Milles, Julien; Oudkerk, Matthijs; Leiner, Tim; Vliegenthart, Rozemarijn

2017-09-01

To determine the accuracy of iodine quantification with dual energy computed tomography (DECT) in two high-end CT systems with different spectral imaging techniques. Five tubes with different iodine concentrations (0, 5, 10, 15, 20 mg/ml) were analysed in an anthropomorphic thoracic phantom. Adding two phantom rings simulated increased patient size. For third-generation dual source CT (DSCT), tube voltage combinations of 150Sn and 70, 80, 90, 100 kVp were analysed. For dual layer CT (DLCT), 120 and 140 kVp were used. Scans were repeated three times. Median normalized values and interquartile ranges (IQRs) were calculated for all kVp settings and phantom sizes. Correlation between measured and known iodine concentrations was excellent for both systems (R = 0.999-1.000, p < 0.0001). For DSCT, median measurement errors ranged from -0.5% (IQR -2.0, 2.0%) at 150Sn/70 kVp and -2.3% (IQR -4.0, -0.1%) at 150Sn/80 kVp to -4.0% (IQR -6.0, -2.8%) at 150Sn/90 kVp. For DLCT, median measurement errors ranged from -3.3% (IQR -4.9, -1.5%) at 140 kVp to -4.6% (IQR -6.0, -3.6%) at 120 kVp. Larger phantom sizes increased variability of iodine measurements (p < 0.05). Iodine concentration can be accurately quantified with state-of-the-art DECT systems from two vendors. The lowest absolute errors were found for DSCT using the 150Sn/70 kVp or 150Sn/80 kVp combinations, which was slightly more accurate than 140 kVp in DLCT. • High-end CT scanners allow accurate iodine quantification using different DECT techniques. • Lowest measurement error was found in scans with largest photon energy separation. • Dual-source CT quantified iodine slightly more accurately than dual layer CT.

A cost comparison of laparoscopic and open colon surgery in a publicly funded academic institution.

PubMed

Hardy, Krista M; Kwong, Josephine; Pitzul, Kristen B; Vergis, Ashley S; Jackson, Timothy D; Urbach, David R; Okrainec, Allan

2014-04-01

The objective of this study was to compare the total hospital cost of laparoscopic (lap) and open colon surgery at a publicly funded academic institution. Patients undergoing elective laparoscopic or open colon surgery for all indications at the University Health Network, Toronto, Canada, from April 2004 to March 2009 were included. Patient demographic, operative, and outcome data were reviewed retrospectively. Hospital costs were determined from the Ontario Case Costing Initiative, adjusted for inflation, and compared using the Mann-Whitney U test. Linear regression was used to analyze the relationship between length of stay and total hospital cost. There were 391 elective colon resections (223 lap/168 open, 15.4 % conversion). There was no difference in median age, gender, or Charlson score. Body mass index was slightly higher for laparoscopic surgery (27.5/25.9 lap/open; p = 0.008), while the American Society of Anesthesiologists score was slightly higher for open surgery. Median operative time was greater for laparoscopic surgery (224/196 min, lap/open; p = 0.001). There was no difference in complication rates (21.6/22.5 % lap/open; p = 0.900), reoperations (5.8/6.5 % lap/open; p = 0.833) or 30-day readmissions (7.6/12.5 % lap/open; p = 0.122). Number of emergency room visits was greater with open surgery (12.6/20.8 % lap/open; p = 0.037). Operative cost was higher for laparoscopic surgery ($4,171.37/3,489.29 lap/open; p = 0.001), while total hospital cost was significantly reduced ($9,600.22/12,721.41 lap/open; p = 0.001). Median length of stay was shorter for laparoscopic surgery (5/7 days lap/open; p = 0.000), and this correlated directly with hospital cost. Laparoscopic colon surgery is associated with increased operative costs but significantly lower total hospital costs. The cost savings is related, in part, to reduced length of stay with laparoscopic surgery.

Building Damage Extraction Triggered by Earthquake Using the Uav Imagery

NASA Astrophysics Data System (ADS)

Li, S.; Tang, H.

2018-04-01

When extracting building damage information, we can only determine whether the building is collapsed using the post-earthquake satellite images. Even the satellite images have the sub-meter resolution, the identification of slightly damaged buildings is still a challenge. As the complementary data to satellite images, the UAV images have unique advantages, such as stronger flexibility and higher resolution. In this paper, according to the spectral feature of UAV images and the morphological feature of the reconstructed point clouds, the building damage was classified into four levels: basically intact buildings, slightly damaged buildings, partially collapsed buildings and totally collapsed buildings, and give the rules of damage grades. In particular, the slightly damaged buildings are determined using the detected roof-holes. In order to verify the approach, we conduct experimental simulations in the cases of Wenchuan and Ya'an earthquakes. By analyzing the post-earthquake UAV images of the two earthquakes, the building damage was classified into four levels, and the quantitative statistics of the damaged buildings is given in the experiments.

Treatment of varicoceles in childhood and adolescence with Tauber's antegrade scrotal sclerotherapy.

PubMed

Fette, A; Mayr, J

2000-08-01

The aim of this study was to evaluate surgical complications and the outcome of grade II and III varicoceles treated with Tauber's antegrade scrotal sclerotherapy. A total of 21 patients with a median age of 13 (range, 10 to 21) years and left-sided grade II and III varicoceles were treated with Tauber's antegrade scrotal sclerotherapy and underwent follow-up over a median period of 23 months (range, 9 to 35). One grade II varicocele persisted after antegrade sclerotherapy for 6 months. After a second sclerotherapy 6 months later, no further recurrence was detected. One patient with a grade II to III varicocele had a grade I varicocele recurrence 14 months after operation. Three patients showed a slight hydrocele postoperatively. This limited series indicates that Tauber's antegrade scrotal sclerotherapy is a safe and effective treatment for grade II and III varicoceles in children and adolescents.

Inclusion of extremes of prematurity in ventricular index centile charts.

PubMed

Boyle, M; Shim, R; Gnanasekaran, R; Tarrant, A; Ryan, S; Foran, A; McCallion, N

2015-06-01

To assess the relationship between ventricular index (VI) measurements and postmenstrual age in preterm infants and to generate centile charts and normal ranges for frontal horn ratio (FHR) for a large contemporary cohort of preterm infants. A retrospective cohort study of 253 infants with birth gestation less than 32 weeks admitted between January 2009 and December 2011 to a tertiary NICU in Ireland. A total of 816 cranial ultrasounds were reviewed. Data collected were grouped according to postmenstrual age at the time of scan from 23 weeks to 45 weeks. Median values for VI show a general trend to increase with gestation. FHR did not significantly change with postmenstrual age at scan with a median value of 0.31. There is a slight increase in VI as gestation at the time of scans increases. These results provide the basis for updated centile charts which we propose for current practice.

Endoscopic versus open bursectomy of lateral malleolar bursitis.

PubMed

Choi, Jae Hyuck; Lee, Kyung Tai; Lee, Young Koo; Kim, Dong Hyun; Kim, Jeong Ryoul; Chung, Woo Chull; Cha, Seung Do

2012-06-01

Compare the result of endoscopic versus open bursectomy in lateral malleolar bursitis. Prospective evaluation of 21 patients (22 ankles) undergoing either open or endoscopic excision of lateral malleolar bursitis. The median age was 64 (38-79) years old. The median postoperative follow-up was 15 (12-18) months. Those patients undergoing endoscopic excision showed a higher satisfaction rate (excellent 9, good 2) than open excision (excellent 4, good 3, fair 1). The wounds also healed earlier in the endoscopic group although the operation time was slightly longer. One patient in the endoscopic group had recurrence of symptoms but complications in the open group included one patient with skin necrosis, one patient with wound dehiscence, and two patients of with superficial peroneal nerve injury. Endoscopic resection of the lateral malleolar bursitis is a promising technique and shows favorable results compared to the open resection. Therapeutic studies-Investigating the result of treatment, Level II.

Teaching and Assessment Methods in Undergraduate Economics: A Fourth National Quinquennial Survey

ERIC Educational Resources Information Center

Watts, Michael; Schaur, Georg

2011-01-01

Surveys in 1995, 2000, 2005, and 2010 investigated teaching and assessment methods in different undergraduate courses. In this article, the authors offer basic results from the 2010 survey. "Chalk and talk" remains the dominant teaching style, but there were drops in mean (although not median) values for those pedagogies and some growth in the use…

Selenium stable isotope investigation into selenium biogeochemical cycling in a lacustrine environment: Sweitzer Lake, Colorado.

PubMed

Clark, Scott K; Johnson, Thomas M

2010-01-01

We present a comprehensive set of Se concentration and isotope ratio data collected over a 3-yr period from dissolved, sediment-hosted, and organically bound Se in a Se-contaminated lake and littoral wetland. Median isotope ratios of these various pools of Se spanned a narrow isotopic range (delta80/76Se(SRM-3149)) = 1.14-2.40 per thousand). Selenium (VI) reduction in the sediments is an important process in this system, but its isotopic impact is muted by the lack of direct contact between surface waters and reduction sites within sediments. This indicates that using Se isotope data as an indicator of microbial or abiotic Se oxyanion reduction is not effective in this or other similar systems. Isotopic data suggest that most Se(IV) in the lake originates from oxidation of organically bound Se rather than directly through Se(VI) reduction. Mobilization of Se(VI) from bedrock involves only a slight isotopic shift. Temporally constant isotopic differences observed in Se(VI) from two catchment areas suggest the potential for tracing Se(VI) from different source areas. Phytoplankton isotope ratios are close to those of the water, with a small depletion in heavy isotopes (0.56 per thousand). Fish tissues nearly match the phytoplankton, being only slightly depleted in the heavier isotopes. This suggests the potential for Se isotopes as migration indicators. Volatile, presumably methylated Se was isotopically very close to median values for phytoplankton and macrophytes, indicating a lack of isotopic fractionation during methylation.

[Urinary iodine levels and its influencing factors among residents over age of 15 years in Shenzhen City].

PubMed

Luo, Yiqi; Xu, Jian; He, Shan; Wang, Jun; Fang, Xiaoheng

2014-11-01

To understand the status of iodine nutrition and the affective factors of urinary iodine concentration among residents over age of 15 years in Shenzhen City. Totally 8152 residents from 73 communities were selected with stratified cluster random sampling. The morning urinary iodine was determined and the dietary assessment of iodine using a food frequency questionnaire were carried out. The range of urinary iodine was 9. 65 - 4039.09 μg/L and the median of urinary iodine was 194.59 μg/L among the residents. The percentages of the residents with urinary iodine < 50,50 - 100,100 - 199, 200 - 300, and ≥ 300 μg/L were 2.49%, 12.12%, 40.16%, 26.94% and 20.78%, respectively. There was significant difference in the medians of iodine between different gender (P = 0.0001), the medians of urinary iodine of men (201.32 μg/L) was slightly higher. There was no significant difference in urinary iodine levels (186.59 - 197.44 μg/L) among all age groups, the medians of urinary iodine of all age groups were within the recommended adequate intake. Along with the increase in age, the medians of urinary iodine of all age groups was gradually decreased. Sex, alcohol consumption and daily dietary iodine intake was significant in the final regression model. The iodine nutrition of residents in Shenzhen City was in good condition, populations with low or high iodine still exist. The monitoring is needed and the influencing factors of the urine iodine levels need much exploration.

Fluvial geochemistry in São Miguel Island (Azores, Portugal): source and fluxes of inorganic solutes in an active volcanic environment.

PubMed

Freire, P; Andrade, C; Coutinho, R; Cruz, J V

2013-06-01

River water chemistry in two of the major rivers in São Miguel Island (Azores archipelago, Portugal) has been characterized monthly between June 2010 and October 2011 in order to estimate the main geochemical processes that explain water composition and to estimate solute fluxes and the thermal water input to rivers. Both rivers (Ribeira Grande - RRG, and Ribeira Quente - RRQ) drain active trachytic central volcanoes. The number of sampling stations is seven in RRG and six in RRQ. Rivers are mainly slightly acid to basic in nature (pH in the range 5.41-8.70 in RRG and 5.90-8.10 in RRQ) and from the Na-HCO3 and Na-HCO3-Cl water types. In both cases water temperature increases towards the river mouth and median values are slightly higher in Ribeira Quente (15.5-22.4°C) comparing to Ribeira Grande river (15.2-19.7°C). Electrical conductivity suggests poorly mineralized waters (139-456 μS/cm in RRG and 209-402 μS/cm in RRQ, and values increase downstream. Higher solute fluxes are associated to HCO3 and Na, and the total CO2 flux is equal to 3647 t/yr in RRQ and 7546 t/yr in RRG. Mixture with thermal water discharges also influences river water chemistry and in RRQ the contribution to the annual average discharge rate was estimated in 2.96×10(6)m(3)/yr (12.8% of overall discharge rate in the watershed). In RRG thermal water discharges were estimated in 2.4×10(6)m(3)/yr (14.9% of the discharge rate). The minimum total CO2-consumption associated with low-temperature weathering is equal to 0.58×10(6)mol/km(2)/yr in Ribeira Quente river and equal to 0.78×10(6)mol/km(2)/yr in Ribeira Grande river. Copyright © 2013 Elsevier B.V. All rights reserved.

Groundwater quality in the Mohawk River Basin, New York, 2011

USGS Publications Warehouse

Nystrom, Elizabeth A.; Scott, Tia-Marie

2013-01-01

Water samples were collected from 21 production and domestic wells in the Mohawk River Basin in New York in July 2011 to characterize groundwater quality in the basin. The samples were collected and processed using standard U.S. Geological Survey procedures and were analyzed for 148 physiochemical properties and constituents, including dissolved gases, major ions, nutrients, trace elements, pesticides, volatile organic compounds (VOCs), radionuclides, and indicator bacteria. The Mohawk River Basin covers 3,500 square miles in New York and is underlain by shale, sandstone, carbonate, and crystalline bedrock. The bedrock is overlain by till in much of the basin, but surficial deposits of saturated sand and gravel are present in some areas. Nine of the wells sampled in the Mohawk River Basin are completed in sand and gravel deposits, and 12 are completed in bedrock. Groundwater in the Mohawk River Basin was typically neutral or slightly basic; the water typically was very hard. Bicarbonate, chloride, calcium, and sodium were the major ions with the greatest median concentrations; the dominant nutrient was nitrate. Methane was detected in 15 samples. Strontium, iron, barium, boron, and manganese were the trace elements with the highest median concentrations. Four pesticides, all herbicides or their degradates, were detected in four samples at trace levels; three VOCs, including chloroform and two solvents, were detected in four samples. The greatest radon-222 activity, 2,300 picocuries per liter, was measured in a sample from a bedrock well, but the median radon activity was higher in samples from sand and gravel wells than in samples from bedrock wells. Coliform bacteria were detected in five samples with a maximum of 92 colony-forming units per 100 milliliters. Water quality in the Mohawk River Basin is generally good, but concentrations of some constituents equaled or exceeded current or proposed Federal or New York State drinking-water standards. The standards exceeded are color (1 sample), pH (1 sample), sodium (9 samples), chloride (1 sample), sulfate (2 samples), dissolved solids (7 samples), aluminum (3 samples), iron (8 samples), manganese (6 samples), radon-222 (10 samples), and bacteria (5 samples). Fecal coliform bacteria and Escherichia coli (E. coli) were each detected in one sample. Concentrations of fluoride, nitrate, nitrite, antimony, arsenic, barium, beryllium, cadmium, chromium, copper, lead, mercury, selenium, silver, thallium, zinc, and uranium, and gross alpha activities, did not exceed existing drinking-water standards in any of the samples collected. Methane concentrations in two samples were greater than 28 milligrams per liter, and the maximum measured concentration was 44.3 milligrams per liter.

Converting baker's waste into alcohol. Revised final progress report

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

Halsey, R.; Wilson, P.B.

All types of baker's waste (including waste from candy manufacturers) can be converted into alcohol to be used as a fuel. All types of waste at any stage in process can be converted, such as: basic ingredients (including floor sweepings); dry mixes (including floor sweepings); dough at any stage; partially or fully cooked products; and day old returned products. The basic steps are the same, only the initial preparation will vary slightly. The variation will be: amount of water to be added and amount and type of nutrients (if any) to be added. The basic steps are: slurrying, liquefying tomore » put starch into liquid state, saccharifying to convert starch into fermentable sugars, fermentation to convert sugars into alcohol, and distillation to separate the alcohol from the mash. Each step is discussed in detail along with problems that may arise. Directions are given and materials (enzymes, yeast, etc.) and equipment are descibed briefly.« less

Mortality in British military participants in human experimental research into chemical warfare agents at Porton Down: cohort study

PubMed Central

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

2009-01-01

Objective To investigate any long term effects on mortality in participants in experimental research related to chemical warfare agents from 1941 to 1989. Design Historical cohort study. Data sources Archive of UK government research facility at Porton Down, UK military personnel records, and national death and cancer records. Participants 18 276 male members of the UK armed forces who had spent one or more short periods (median 4 days between first and last test) at Porton Down and a comparison group of 17 600 non-Porton Down veterans followed to 31 December 2004. Main outcome measures Mortality rate ratio of Porton Down compared with non-Porton Down veterans and standardised mortality ratio of each veteran group compared with the general population. Both ratios adjusted for age group and calendar period. Results Porton Down veterans were similar to non-Porton Down veterans in year of enlistment (median 1951) but had longer military service (median 6.2 v 5.0 years). After a median follow-up of 43 years, 40% (7306) of Porton Down and 39% (6900) of non-Porton Down veterans had died. All cause mortality was slightly greater in Porton Down veterans (rate ratio 1.06, 95% confidence interval 1.03 to 1.10, P<0.001), more so for deaths outside the UK (1.26, 1.09 to 1.46). Of 12 cause specific groups examined, rate ratios in Porton Down veterans were increased for deaths attributed to infectious and parasitic (1.57, 1.07 to 2.29), genitourinary (1.46, 1.04 to 2.04), circulatory (1.07, 1.01 to 1.12), and external (non-medical) (1.17, 1.00 to 1.37) causes and decreased for deaths attributed to in situ, benign, and unspecified neoplasms (0.60, 0.37 to 0.99). There was no clear relation between type of chemical exposure and cause specific mortality. The mortality in both groups of veterans was lower than that in the general population (standardised mortality ratio 0.88, 0.85 to 0.90; 0.82, 0.80 to 0.84). Conclusions Mortality was slightly higher in Porton Down than non-Porton Down veterans. With lack of information on other important factors, such as smoking or service overseas, it is not possible to attribute the small excess mortality to chemical exposures at Porton Down. PMID:19318699

Ten-Year Change in the Scientific Literacy of Primary Science Teachers in China: Reflections on Training Programs and Personnel Policies

ERIC Educational Resources Information Center

Zhang, Hongshia; Shamsi, Imran Haider; Batool, Iffat; Wan, Dongsheng; Yu, Bo

2016-01-01

Using two rounds in 2003 and 2013 of large sample longitudinal surveys of science teachers in primary schools from 21 provinces and autonomous regions of China, results suggest that Chinese teachers' basic scientific literacy was still low with only a slight increase in the procedural knowledge of science. The evidence also suggests little…

Frequency Diverse Array Receiver Architectures

DTIC Science & Technology

2015-06-29

completely associated with FDA, the Hybrid MIMO phased array (HMPAR) concept presented in [18] developed the basic beam patern synthesis theory for an...20], that analyzed beam paterns of chirp waveforms with slightly 6 different starting frequencies. In [21] and [11] they investigated using FDA for...forward-looking radar GMTI benefits. This research showed the ability of the range-dependent energy distribution characteristics of the FDA beam patern

Patient-specific academic detailing for smoking cessation

PubMed Central

Jin, Margaret; Gagnon, Antony; Levine, Mitchell; Thabane, Lehana; Rodriguez, Christine; Dolovich, Lisa

2014-01-01

Abstract Objective To describe and to determine the feasibility of a patient-specific academic detailing (PAD) smoking cessation (SC) program in a primary care setting. Design Descriptive cohort feasibility study. Setting Hamilton, Ont. Participants Pharmacists, physicians, nurse practitioners, and their patients. Interventions Integrated pharmacists received basic academic detailing training and education on SC and then delivered PAD to prescribers using structured verbal education and written materials. Data were collected using structured forms. Main outcome measures Five main feasibility criteria were generated based on Canadian academic detailing programs: PAD coordinator time to train pharmacists less than 40 hours; median time of SC education per pharmacist less than 20 hours; median time per PAD session less than 60 minutes for initial visit; percentage of prescribers receiving PAD within 3 months greater than 50%; and number of new SC referrals to pharmacists at 6 months more than 10 patients per 1.0 full-time equivalent (FTE) pharmacist (total of approximately 30 patients). Results Eight pharmacists (5.8 FTE) received basic academic detailing training and education on SC PAD. Forty-eight physicians and 9 nurse practitioners consented to participate in the study. The mean PAD coordinator training time was 29.1 hours. The median time for SC education was 3.1 hours. The median times for PAD sessions were 15 and 25 minutes for an initial visit and follow-up visit, respectively. The numbers of prescribers who had received PAD at 3 and 6 months were 50 of 64 (78.1%) and 57 of 64 (89.1%), respectively. The numbers of new SC referrals at 3 and 6 months were 11 patients per FTE pharmacist (total of 66 patients) and 34 patients per FTE pharmacist (total of 200 patients), respectively. Conclusion This study met the predetermined feasibility criteria with respect to the management, resources, process, and scientific components. Further study is warranted to determine whether PAD is more effective than conventional academic detailing. PMID:24452574

When Statistical Literacy Really Matters: Understanding Published Information about the HIV/AIDS Epidemic in South Africa

ERIC Educational Resources Information Center

Hobden, Sally

2014-01-01

Information on the HIV/AIDS epidemic in Southern Africa is often interpreted through a veil of secrecy and shame and, I argue, with flawed understanding of basic statistics. This research determined the levels of statistical literacy evident in 316 future Mathematical Literacy teachers' explanations of the median in the context of HIV/AIDS…

An acute toxicity study of Heliotropium scottae Rendle in mice.

PubMed

Wahome, W M; Muchiri, D J; Mugera, G M

1994-08-01

Twenty-four hour ip median lethal doses (LD50) of freeze-dried aqueous extracts of Heliotropium scottae Rendle leaves and stems in mice were determined and clinical signs noted. The LD50 of the leaf extract was 3.0 g/kg, while that of the stems was 3.5 g/kg. Clinical signs were excitement, prostration, rapid breathing, gasping for breath and death. The signs were the same for both the leaf and stem extracts. It was concluded that both the leaves and stems of H scottae have slight acute toxicity.

Acceleration of Apoptosis by Extracellular Basic pH in a 3D Human Skin Equivalent System.

PubMed

Park, Gunhyuk; Oh, Dal-Seok; Kim, Yong-Ung; Park, Moon Ki

2017-01-01

Previously, we have shown that extracellular basic pH plays a significant role in both the direct and indirect regulation of cellular processes in a wound; this in turn affects the wound-healing process. Several studies have demonstrated the importance of apoptosis modulation in the wound-healing process, especially in removing inflammatory cells and in inhibiting scar formation. However, the effects of extracellular basic pH on wound healing-related skin damage are yet to be examined. Therefore, we investigated the induction of accelerated apoptosis by extracellular basic pH in skin. Apoptosis-related protein levels were measured using an array kit, target protein expression levels were detected by immunostaining, lactate dehydrogenase was analyzed spectrophotometrically, and Annexin V levels were measured by fluorescence staining. Basic pH (8.40) strongly upregulated extrinsic apoptosis proteins (Fas, high temperature requirement A, and p21) and slightly upregulated intrinsic apoptosis proteins (cytochrome c, B-cell lymphoma 2 [Bcl-2], Bcl-2-associated death promoter, and Bcl-2-like protein 4) in a 3D human skin equivalent system. Moreover, basic pH (8.40) induced heat shock protein (HSP) 60 and 70. In addition, basic pH-exposed Fas- and HSP60-knockdown cells showed significantly decreased levels of apoptosis. Taken together, these results indicate that extracellular basic pH increases early-stage apoptosis through Fas/FasL via modulation of HSP60 and HSP70. © 2017 S. Karger AG, Basel.

Functional properties of protein isolates extracted from stabilized rice bran by microwave, dry heat, and parboiling.

PubMed

Khan, Saima Hafeez; Butt, Masood Sadiq; Sharif, Mian Kamran; Sameen, Ayesha; Mumtaz, Semee; Sultan, Muhammad Tauseef

2011-03-23

Protein isolates extracted from differently stabilized rice bran were analyzed to work out the food use potential. Bulk density remained higher for isolates obtained from heat stabilized bran, the treatments were found to have positive impact on the oil absorption properties, while the water absorption was slightly impaired owing to some possible configurational changes. Surface hydrophobicity and emulsion properties were improved with bran stabilization. Isolates exhibited better foaming properties owing to the flexible nature of protein molecules, with less intensive disulfide bonding, that were slightly affected by the stabilization treatment. Nitrogen solubility index followed a curved pattern with the least value near isoelectric point that showed an increasing trend toward basic pH, and parboiled protein isolates exhibited better gelling properties among the isolates.

Influence of water-filtered infrared-A (wIRA) on reduction of local fat and body weight by physical exercise

PubMed Central

Möckel, Frank; Hoffmann, Gerd; Obermüller, Roy; Drobnik, Wolfgang; Schmitz, Gerd

2006-01-01

Aim of the study: Investigation, whether water-filtered infrared-A (wIRA) irradiation during moderate bicycle ergometer endurance exercise has effects especially on local fat reduction and on weight reduction beyond the effects of ergometer exercise alone. Methods: Randomised controlled study with 40 obese females (BMI 30-40 (median: 34.5), body weight 76-125 (median: 94.9) kg, age 20-40 (median: 35.5) years, isocaloric nutrition), 20 in the wIRA group and 20 in the control group. In both groups each participant performed 3 times per week over 4 weeks for 45 minutes bicycle ergometer endurance exercise with a constant load according to a lactate level of 2 mmol/l (aerobic endurance load, as determined before the intervention period). In the wIRA group in addition large parts of the body (including waist, hip, and thighs) were irradiated during all ergometries of the intervention period with visible light and a predominant part of water-filtered infrared-A (wIRA), using the irradiation unit “Hydrosun® 6000” with 10 wIRA radiators (Hydrosun® Medizintechnik, Müllheim, Germany, radiator type 500, 4 mm water cuvette, yellow filter, water-filtered spectrum 500-1400 nm) around a speed independent bicycle ergometer. Main variable of interest: change of “the sum of circumferences of waist, hip, and both thighs of each patient” over the intervention period (4 weeks). Additional variables of interest: body weight, body mass index BMI, body fat percentage, fat mass, fat-free mass, water mass (analysis of body composition by tetrapolar bioimpedance analysis), assessment of an arteriosclerotic risk profile by blood investigation of variables of lipid metabolism (cholesterol, triglycerides, high density lipoproteins HDL, low density lipoproteins LDL, apolipoprotein A1, apolipoprotein B), clinical chemistry (fasting glucose, alanin-aminotransferase ALT (= glutamyl pyruvic transaminase GPT), gamma-glutamyl-transferase GGT, creatinine, albumin), endocrinology (leptin, adiponectin (= adipo Q), homocysteine, insulin). All variables were at least measured before and after the intervention period. Ergometry (ECG, blood pressure behaviour, lactate curve with power at 2, 3 and 4 mmol/l) before the intervention period. In addition: nutrition training ahead of and during the intervention period with a nutrition protocol over one week for assessment of the daily energy intake; calculation of basic metabolic rate and total energy requirement. Assessment of undesired effects. Only methods of non-parametric statistics were used, both descriptive (median, percentiles of 25 and 75 (= interquartile range), minimum, maximum) and confirmatory (two-sided Mann-Whitney U test for unpaired samples for the only one main variable of interest). Total error probability: .05 (5%). An intention to treat analysis ITT with last observed carry forward method was used preferably (presented results) and in addition an on treatment analysis OT. Only 2 (treatment group) and 4 (control group) drop-outs occurred (mostly due to lack of time). Results: The “sum of circumferences of waist, hip, and both thighs of each patient” decreased during the 4 weeks significantly more (p<.001) in the wIRA group than in the control group: medians and interquartile ranges: -8.0 cm (-10.5 cm/-4.1 cm) vs. -1.8 cm (-4.4 cm/0.0 cm). As well “body weight of each patient” decreased during the 4 weeks markedly more in the wIRA group than in the control group: medians and interquartile ranges: -1.9 kg (-4.0 kg/0.0 kg) vs. 0.0 kg (-1.5 kg/+0.4 kg); median of body weight changed from 99.3 kg to 95.6 kg (wIRA) vs. 89.9 kg to 89.6 kg (control). A similar effect showed the body mass index BMI. Blood variables of interest remained unchanged or showed some slight improvements during the treatment period, concerning most variables with no obvious differences between the two groups; insulin showed a slight trend to decrease in the wIRA group and to increase in the control group. Undesired effects of the treatment were not seen. Discussion: The results of the study suggest, that wIRA – during moderate bicycle ergometer endurance exercise as lipolytic stimulus – increases local lipolysis with a local fat reduction (thighs) in the otherwise bradytrophic fatty tissue. The presumably underlying mechanisms of wIRA have already been proven: wIRA acts both by thermal effects and by non-thermal effects. Thermal effects of wIRA are the generation of a therapeutic field of warmth with the increase of tissue temperature, tissue oxygen partial pressure, and tissue blood flow, and by this regional metabolism. As fatty tissue normally has a slow metabolism (bradytrophic and hypothermic tissue) with a low rate of lipolysis, wIRA can increase lipolysis in fatty tissue and the mobilized fats are burned in musculature during the ergometer exercise. Conclusion: The results of the study indicate, that wIRA irradiation during moderate ergometer endurance exercise can be used – in combination with an appropriate nutrition – to improve body composition, especially local fat distribution, and the reduction of fat and body weight in obese persons. PMID:19675696

Quantitative Maximum Shear-Wave Stiffness of Breast Masses as a Predictor of Histopathologic Severity.

PubMed

Berg, Wendie A; Mendelson, Ellen B; Cosgrove, David O; Doré, Caroline J; Gay, Joel; Henry, Jean-Pierre; Cohen-Bacrie, Claude

2015-08-01

The objective of our study was to compare quantitative maximum breast mass stiffness on shear-wave elastography (SWE) with histopathologic outcome. From September 2008 through September 2010, at 16 centers in the United States and Europe, 1647 women with a sonographically visible breast mass consented to undergo quantitative SWE in this prospective protocol; 1562 masses in 1562 women had an acceptable reference standard. The quantitative maximum stiffness (termed "Emax") on three acquisitions was recorded for each mass with the range set from 0 (very soft) to 180 kPa (very stiff). The median Emax and interquartile ranges (IQRs) were determined as a function of histopathologic diagnosis and were compared using the Mann-Whitney U test. We considered the impact of mass size on maximum stiffness by performing the same comparisons for masses 9 mm or smaller and those larger than 9 mm in diameter. The median patient age was 50 years (mean, 51.8 years; SD, 14.5 years; range, 21-94 years), and the median lesion diameter was 12 mm (mean, 14 mm; SD, 7.9 mm; range, 1-53 mm). The median Emax of the 1562 masses (32.1% malignant) was 71 kPa (mean, 90 kPa; SD, 65 kPa; IQR, 31-170 kPa). Of 502 malignancies, 23 (4.6%) ductal carcinoma in situ (DCIS) masses had a median Emax of 126 kPa (IQR, 71-180 kPa) and were less stiff than 468 invasive carcinomas (median Emax, 180 kPa [IQR, 138-180 kPa]; p = 0.002). Benign lesions were much softer than malignancies (median Emax, 43 kPa [IQR, 24-83 kPa] vs 180 kPa [IQR, 129-180 kPa]; p < 0.0001). Usual benign lesions were soft, including 62 cases of fibrocystic change (median Emax, 32 kPa; IQR, 24-94 kPa), 51 cases of fibrosis (median Emax, 36 kPa; IQR, 22-102 kPa), and 301 fibroadenomas (median Emax, 45 kPa; IQR, 30-79 kPa). Eight lipomas (median Emax, 14 kPa; IQR, 8-15 kPa), 154 cysts (median Emax, 29 kPa; IQR, 10-58 kPa), and seven lymph nodes (median Emax, 17 kPa; IQR, 9-40 kPa) were softer than usual benign lesions (p < 0.0001 for lipomas and cysts; p = 0.007 for lymph nodes). Risk lesions were slightly stiffer than usual benign lesions (p = 0.002) but tended to be softer than DCIS (p = 0.14). Fat necrosis and abscesses were relatively stiff. Conclusions were similar for both small and large masses. Despite overlap in Emax values, maximum stiffness measured by SWE is a highly effective predictor of the histopathologic severity of sonographically depicted breast masses.

Using Extended Huckel Theory as a Platform to Introduce Jahn-Teller Distortion: The Spontaneous Distortion of 1,3,5,7-Cyclooctatetraene from a Perfect Octagon

ERIC Educational Resources Information Center

Sohlberg, Karl; Liu, Xiang

2013-01-01

Herein, a slightly enhanced version of extended Huckel molecular orbital theory is applied to demonstrate the spontaneous distortion of 1,3,5,7-cyclooctatetraene from a perfect octagon, a consequence of the Jahn-Teller effect. The exercise is accessible to students who have been introduced to basic quantum mechanics and extended Huckel molecular…

Comparison of pharmacy students' perceived and actual knowledge using the Pharmacy Curricular Outcomes Assessment.

PubMed

Naughton, Cynthia A; Friesner, Daniel L

2012-05-10

To determine whether a correlation exists between third-year PharmD students' perceived pharmacy knowledge and actual pharmacy knowledge as assessed by the Pharmacy Curricular Outcomes Assessment (PCOA). In 2010 and 2011, the PCOA was administered in a low-stakes environment to third-year pharmacy students at North Dakota State University College of Pharmacy, Nursing, and Allied Sciences (COPNAS). A survey instrument was also administered on which students self-assessed their perceived competencies in each of the core areas covered by the PCOA examination. The pharmacy students rated their competencies slightly higher than average. Performance on the PCOA was similar to but slightly higher than national averages. Correlations between each of the 4 content areas (basic biomedical sciences, pharmaceutical sciences, social/administrative sciences, and clinical sciences) mirrored those reported nationally by the National Association of Boards of Pharmacy (NABP). Student performance on the basic biomedical sciences portion of the PCOA was significantly correlated with students' perceived competencies in the biomedical sciences. No other correlations between actual and perceived competencies were significant. A lack of correlation exists between what students perceive they know and what they actually know in the areas of pharmaceutical science; social, behavioral, and administrative science; and clinical science. Therefore, additional standardized measures are needed to assess curricular effectiveness and provide comparisons among pharmacy programs.

Arthroscopic R-LCL plication for symptomatic minor instability of the lateral elbow (SMILE).

PubMed

Arrigoni, Paolo; Cucchi, Davide; D'Ambrosi, Riccardo; Menon, Alessandra; Aliprandi, Alberto; Randelli, Pietro

2017-07-01

Minor instability has been proposed as a possible aetiology of lateral elbow pain. This study presents the results of the arthroscopic plication of the radial component of the lateral collateral ligament (R-LCL) to reduce minor instability of the lateral elbow. Twenty-seven patients with recalcitrant lateral epicondylitis who had failed conservative therapy and who had no previous trauma or overt instability, were included. R-LCL plication was performed in the presence of at least one sign of lateral ligamentous patholaxity and one intra-articular abnormal finding. Single-assessment numeric evaluation (SANE), Oxford Elbow Score (OES), quickDASH (Disabilities of the Arm, Shoulder, Hand), patient satisfaction and post-operative range of motion were evaluated. SANE improved from a median of 30 [2-40] points pre-operatively to 90 [80-100] at final follow-up (p < 0.0001), and 96.3% patients obtained good or excellent subjective results. Post-operative median quickDASH was 9.1 [0-25] points and OES 42 [34-48]. Median post-operative flexion was 145°, and extension was 0°. Post-operative flexion was restrained in seven patients and extension in eight patients; 59% of patients reached full ROM at final follow-up. R-LCL plication produces subjective satisfaction and positive clinical results in patients presenting with a symptomatic minor instability of the lateral elbow (SMILE) at 2-year median follow-up. A slight limitation in range of motion is a possible undesired consequence of this intervention. Retrospective case series, Level IV.

Technical note: Examining ozone deposition over seawater

NASA Astrophysics Data System (ADS)

Sarwar, Golam; Kang, Daiwen; Foley, Kristen; Schwede, Donna; Gantt, Brett; Mathur, Rohit

2016-09-01

Surface layer resistance plays an important role in determining ozone deposition velocity over sea-water and can be influenced by chemical interactions at the air-water interface. Here, we examine the effect of chemical interactions of iodide, dimethylsulfide, dissolved organic carbon, and bromide in seawater on ozone deposition. We perform a series of simulations using the hemispheric Community Multiscale Air Quality model for summer months in the Northern Hemisphere. Our results suggest that each chemical interaction enhances the ozone deposition velocity and decreases the atmospheric ozone mixing ratio over seawater. Iodide enhances the median deposition velocity over seawater by 0.023 cm s-1, dissolved organic carbon by 0.021 cm s-1, dimethylsulfide by 0.002 cm s-1, and bromide by ∼0.0006 cm s-1. Consequently, iodide decreases the median atmospheric ozone mixing ratio over seawater by 0.7 ppb, dissolved organic carbon by 0.8 ppb, dimethylsulfide by 0.1 ppb, and bromide by 0.02 ppb. In a separate model simulation, we account for the effect of dissolved salts in seawater on the Henry's law constant for ozone and find that it reduces the median deposition velocity by 0.007 cm s-1 and increases surface ozone mixing ratio by 0.2 ppb. The combined effect of these processes increases the median ozone deposition velocity over seawater by 0.040 cm s-1, lowers the atmospheric ozone mixing ratio by 5%, and slightly improves model performance relative to observations.

Validation of a novel basic virtual reality simulator, the LAP-X, for training basic laparoscopic skills.

PubMed

Kawaguchi, Koji; Egi, Hiroyuki; Hattori, Minoru; Sawada, Hiroyuki; Suzuki, Takahisa; Ohdan, Hideki

2014-10-01

Virtual reality surgical simulators are becoming popular as a means of providing trainees with an opportunity to practice laparoscopic skills. The Lap-X (Epona Medical, Rotterdam, the Netherlands) is a novel VR simulator for training basic skills in laparoscopic surgery. The objective of this study was to validate the LAP-X laparoscopic virtual reality simulator by assessing the face and construct validity in order to determine whether the simulator is adequate for basic skills training. The face and content validity were evaluated using a structured questionnaire. To assess the construct validity, the participants, nine expert surgeons (median age: 40 (32-45)) (>100 laparoscopic procedures) and 11 novices performed three basic laparoscopic tasks using the Lap-X. The participants reported a high level of content validity. No significant differences were found between the expert surgeons and the novices (Ps > 0.246). The performance of the expert surgeons on the three tasks was significantly better than that of the novices in all parameters (Ps < 0.05). This study demonstrated the face, content and construct validity of the Lap-X. The Lap-X holds real potential as a home and hospital training device.

Chiropractic spinal manipulation and the risk for acute lumbar disc herniation: a belief elicitation study.

PubMed

Hincapié, Cesar A; Cassidy, J David; Côté, Pierre; Rampersaud, Y Raja; Jadad, Alejandro R; Tomlinson, George A

2017-09-18

Chiropractic spinal manipulation treatment (SMT) is common for back pain and has been reported to increase the risk for lumbar disc herniation (LDH), but there is no high quality evidence about this. In the absence of good evidence, clinicians can have knowledge and beliefs about the risk. Our purpose was to determine clinicians' beliefs regarding the risk for acute LDH associated with chiropractic SMT. Using a belief elicitation design, 47 clinicians (16 chiropractors, 15 family physicians and 16 spine surgeons) that treat patients with back pain from primary and tertiary care practices were interviewed. Participants' elicited incidence estimates of acute LDH among a hypothetical group of patients with acute low back pain treated with and without chiropractic SMT, were used to derive the probability distribution for the relative risk (RR) for acute LDH associated with chiropractic SMT. Chiropractors expressed the most optimistic belief (median RR 0.56; IQR 0.39-1.03); family physicians expressed a neutral belief (median RR 0.97; IQR 0.64-1.21); and spine surgeons expressed a slightly more pessimistic belief (median RR 1.07; IQR 0.95-1.29). Clinicians with the most optimistic views believed that chiropractic SMT reduces the incidence of acute LDH by about 60% (median RR 0.42; IQR 0.29-0.53). Those with the most pessimistic views believed that chiropractic SMT increases the incidence of acute LDH by about 30% (median RR 1.29; IQR 1.11-1.59). Clinicians' beliefs about the risk for acute LDH associated with chiropractic SMT varied systematically across professions, in spite of a lack of scientific evidence to inform these beliefs. These probability distributions can serve as prior probabilities in future Bayesian analyses of this relationship.

Selected Ground-Water Data for Yucca Mountain Region, Southern Nevada and Eastern California, January-December 2004

USGS Publications Warehouse

La Camera, Richard J.; Locke, Glenn L.; Habte, Aron M.; Darnell, Jon G.

2006-01-01

The U.S. Geological Survey, in support of the U.S. Department of Energy, Office of Repository Development, collects, compiles, and summarizes hydrologic data in the Yucca Mountain region of southern Nevada and eastern California. These data are collected to allow assessments of ground-water resources during activities to determine the potential suitability or development of Yucca Mountain for storing high-level nuclear waste. Data on ground-water levels at 35 boreholes and 1 fissure (Devils Hole), ground-water discharge at 5 springs, both ground-water levels and discharge at 1 flowing borehole, and total reported ground-water withdrawals within Crater Flat, Jackass Flats, Mercury Valley, and the Amargosa Desert are tabulated from January through December 2004. Also tabulated are ground-water levels, discharges, and withdrawals collected by other agencies (or collected as part of other programs) and data revised from those previously published at monitoring sites. Historical data on water levels, discharges, and withdrawals are presented graphically to indicate variations through time. A statistical summary of ground-water levels at seven boreholes in Jackass Flats is presented for the period 1992-2004 to indicate potential effects of ground-water withdrawals associated with U.S. Department of Energy activities near Yucca Mountain. The statistical summary includes the annual number of measurements, maximum, minimum, and median water-level altitudes, and average deviation of measured water-level altitudes compared to the 1992-93 baseline period. At six boreholes in Jackass Flats, median water levels for 2004 were slightly higher (0.3-2.7 feet) than their median water levels for 1992-93. At one borehole in Jackass Flats, median water level for 2004 equaled the median water level for 1992-93.

Synthesis of monthly and annual streamflow records (water years 1950-2003) for Big Sandy, Clear, Peoples, and Beaver Creeks in the Milk River basin, Montana

USGS Publications Warehouse

Parrett, Charles

2006-01-01

To address concerns expressed by the State of Montana about the apportionment of water in the St. Mary and Milk River basins between Canada and the United States, the International Joint Commission requested information from the United States government about water that originates in the United States but does not cross the border into Canada. In response to this request, the U.S. Geological Survey synthesized monthly and annual streamflow records for Big Sandy, Clear, Peoples, and Beaver Creeks, all of which are in the Milk River basin in Montana, for water years 1950-2003. This report presents the synthesized values of monthly and annual streamflow for Big Sandy, Clear, Peoples, and Beaver Creeks in Montana. Synthesized values were derived from recorded and estimated streamflows. Statistics, including long-term medians and averages and flows for various exceedance probabilities, were computed from the synthesized data. Beaver Creek had the largest median annual discharge (19,490 acre-feet), and Clear Creek had the smallest median annual discharge (6,680 acre-feet). Big Sandy Creek, the stream with the largest drainage area, had the second smallest median annual discharge (9,640 acre-feet), whereas Peoples Creek, the stream with the second smallest drainage area, had the second largest median annual discharge (11,700 acre-feet). The combined median annual discharge for the four streams was 45,400 acre-feet. The largest combined median monthly discharge for the four creeks was 6,930 acre-feet in March, and the smallest combined median monthly discharge was 48 acre-feet in January. The combined median monthly values were substantially smaller than the average monthly values. Overall, synthesized flow records for the four creeks are considered to be reasonable given the prevailing climatic conditions in the region during the 1950-2003 base period. Individual estimates of monthly streamflow may have large errors, however. Linear regression was used to relate logarithms of combined annual streamflow to water years 1950-2003. The results of the regression analysis indicated a significant downward trend (regression line slope was -0.00977) for combined annual streamflow. A regression analysis using data from 1956-2003 indicated a slight, but not significant, downward trend for combined annual streamflow.

Perturbation and Nonlinear Dynamic Analysis of Different Singing Styles

PubMed Central

Butte, Caitlin J.; Zhang, Yu; Song, Huangqiang; Jiang, Jack J.

2012-01-01

Summary Previous research has used perturbation analysis methods to study the singing voice. Using perturbation and nonlinear dynamic analysis (NDA) methods in conjunction may provide more accurate information on the singing voice and may distinguish vocal usage in different styles. Acoustic samples from different styles of singing were compared using nonlinear dynamic and perturbation measures. Twenty-six songs from different musical styles were obtained from an online music database (Rhapsody, RealNetworks, Inc., Seattle, WA). One-second samples were selected from each song for analysis. Perturbation analyses of jitter, shimmer, and signal-to-noise ratio and NDA of correlation dimension (D2) were performed on samples from each singing style. Percent jitter and shimmer median values were low normal for country (0.32% and 3.82%), musical theater (MT) (0.280% and 2.80%), jazz (0.440% and 2.34%), and soul (0.430% and 6.42%). The popular style had slightly higher median jitter and shimmer values (1.13% and 6.78%) than other singing styles, although this was not statistically significant. The opera singing style had median jitter of 0.520%, and yielded significantly high shimmer (P = 0.001) of 7.72%. All six singing styles were measured reliably using NDA, indicating that operatic singing is notably more chaotic than other singing styles. Median correlation dimension values were low to normal, compared to healthy voices, in country (median D2 = 2.14), jazz (median D2 = 2.24), pop (median D2 = 2.60), MT (median D2 = 2.73), and soul (mean D2 = 3.26). Correlation dimension was significantly higher in opera (P < 0.001) with median D2 = 6.19. In this study, acoustic analysis in opera singing gave significantly high values for shimmer and D2, suggesting that it is more irregular than other singing styles; a previously unknown quality of opera singing. Perturbation analysis also suggested significant differences in vocal output in different singing styles. This preliminary study using acoustic analysis with nonlinear dynamic measures and perturbation measures may represent a valuable procedure in quantitatively describing the properties of the singing voice. Further research with human test subjects may allow us to characterize singing styles and diagnose vocal dysfunction in the singing voice. PMID:18504114

Improvement and Decline in D.C. Public Schools: CTBS Test Scores, 1987-1990. Research Notes on Education No. 7.

ERIC Educational Resources Information Center

Institute for Independent Education, Inc., Washington, DC.

Median test scores on the Comprehensive Tests of Basic Skills (CTBS) for many District of Columbia public schools declined substantially in 1990, although this decline was not evident in reports from school officials. These declines occurred at elementary, junior high, and senior high school levels, in grades 6, 9, and 11, respectively. They also…

The Utility and Accuracy of Oral Reading Fluency Score Types in Predicting Reading Comprehension

ERIC Educational Resources Information Center

Petscher, Yaacov; Kim, Young-Suk

2011-01-01

This study used data from the Dynamic Indicators of Basic Early Literacy Skills (DIBELS; Good & Kaminski, 2002) oral reading fluency (ORF) probes to examine variation among different ORF score types (i.e., the median of three passages, the mean of all three passages, the mean of passages 2 and 3, and the score from passage 3) in predicting…

A comparison of three macroinvertebrate sampling devices for use in conducting rapid-assessment procedures of Delmarva Peninsula wetlands

USGS Publications Warehouse

Lowe, Terrence (Peter); Tebbs, Kerry; Sparling, Donald W.

2016-01-01

Three types of macroinvertebrate collecting devices, Gerking box traps, D-shaped sweep nets, and activity traps, have commonly been used to sample macroinvertebrates when conducting rapid biological assessments of North American wetlands. We compared collections of macroinvertebrates identified to the family level made with these devices in 6 constructed and 2 natural wetlands on the Delmarva Peninsula of Maryland. We also assessed their potential efficacy in comparisons among wetlands using several proportional and richness attributes. Differences in median diversity among samples from the 3 devices were significant; the sweep-net samples had the greatest diversity and the activity-trap samples had the least diversity. Differences in median abundance were not significant between the Gerking box-trap samples and sweep-net samples, but median abundance among activity-trap samples was significantly lower than among samples of the other 2 devices. Within samples, the proportions of median diversity composed of major class and order groupings were similar among the 3 devices. However the proportions of median abundance composed of the major class and order groupings within activity-trap samples were not similar to those of the other 2 devices. There was a slight but significant increase in the total number of families captured when we combined activity-trap samples with Gerking box-trap samples or with sweep-net samples, and the per-sample median numbers of families of the combined activity-trap and sweep-net samples was significantly higher than that of the combined activity-trap and Gerking box-trap samples. We detected significant differences among wetlands for 4 macroinvertebrate attributes with the Gerking box-trap data, 6 attributes with sweep-net data, and 5 attributes with the activity-trap data. A small, but significant increase in the number of attributes showing differences among wetlands occurred when we combined activity-trap samples with those of the Gerking boxtrap or sweep net.

Long-term outcomes after primary failures of artificial urinary sphincter implantation.

PubMed

Wang, Rou; McGuire, Edward J; He, Chang; Faerber, Gary J; Latini, Jerilyn M

2012-04-01

To assess our institutional outcomes after primary artificial urinary sphincter (AUS) failures. From 1985 to 2010, a total of 149 patients underwent 318 primary and additional AUS procedures. We classified additional procedures as revisions, replacements, or explantations. At a median of 52 months (range, 6-250 months), 53% of patients had required at least 1 additional procedure beyond their initial implantation. These included 106 (63%) revisions, 42 (24.9%) explantations, and 21 (12.4%) replacements. The most common revision was reservoir upsizing (37/106). Reasons for first revision included recurrent incontinence (56.7%), mechanical malfunction (22%), and infection or erosion (18.6%). Explantations were performed primarily for infection and erosion (64.3%). Median time to first revision was 20.1 months (range, 0.1-173 months) after implantation, with a median of 9.5 months (range, 1-102 months) between revisions. Explantation occurred at a median of 22 months (range, 1-221 months) after implant, and subsequent replacement at a median of 33.6 months (range, 2-138 months). At 5 years, 28/83 (33.7%) patients had undergone no additional procedures. Patients with previous radiation were more likely to experience infection (P = .03; OR 3.99; 95% CI 1.03-15.42). Patients with previous myocardial infarction were more likely to experience erosion (P = .04; OR 2.29; 95% CI 1.05-5.02), and obese patients were more likely to experience mechanical malfunction (P = .04; OR 2.62; 95% CI 1.07-6.4). More than half of patients with an AUS will require additional procedures, most likely revision. Radiation, previous myocardial infarction, and obesity are linked to complications. Median time to first revision or explantation is slightly less than 2 years, indicating that long-term follow-up is required after initial implantation. Copyright © 2012 Elsevier Inc. All rights reserved.

Examining validity evidence for a simulation-based assessment tool for basic robotic surgical skills.

PubMed

Havemann, Maria Cecilie; Dalsgaard, Torur; Sørensen, Jette Led; Røssaak, Kristin; Brisling, Steffen; Mosgaard, Berit Jul; Høgdall, Claus; Bjerrum, Flemming

2018-05-14

Increasing focus on patient safety makes it important to ensure surgical competency among surgeons before operating on patients. The objective was to gather validity evidence for a virtual-reality simulator test for robotic surgical skills and evaluate its potential as a training tool. Surgeons with varying experience in robotic surgery were recruited: novices (zero procedures), intermediates (1-50), experienced (> 50). Five experienced surgeons rated five exercises on the da Vinci Skills Simulator. Participants were tested using the five exercises. Participants were invited back 3 times and completed a total of 10 attempts per exercise. The outcome was the average simulator performance score for the 5 exercises. 32 participants from 5 surgical specialties were included. 38 participants completed all 4 sessions. A moderate correlation between the average total score and robotic experience was identified for the first attempt (Spearman r = 0.58; p = 0.0004). A difference in average total score was observed between novices and intermediates [median score 61% (IQR 52-66) vs. 83% (IQR 75-91), adjusted p < 0.0001], as well as novices and experienced [median score 61% (IQR 52-66) vs. 80 (IQR 69-85), adjusted p = 0.002]. All three groups improved their performance between the 1st and 10th attempts (p < 0.00). This study describes validity evidence for a virtual-reality simulator for basic robotic surgical skills, which can be used for assessment of basic competency and as a training tool. However, more validity evidence is needed before it can be used for certification or high-stakes assessment.

Use of a web-based education program improves nurses' knowledge of breastfeeding.

PubMed

Deloian, Barbara J; Lewin, Linda Orkin; O'Connor, Mary E

2015-01-01

To evaluate the baseline knowledge and knowledge gained of nurses, nursing students, midwives, and nurse practitioners who completed Breastfeeding Basics, an online educational program. This study reports on an anonymous evaluation of an online breastfeeding education program developed and maintained to promote evidence-based breastfeeding practice. Included in the study were 3736 nurses, 728 nurse practitioners/midwives, and 3106 nursing students from the United States who completed ≥ one pretest or posttest on the Breastfeeding Basics website between April 1999 and December 31, 2011. Baseline scores were analyzed to determine if nurses' baseline knowledge varied by selected demographic variables such as age, gender, professional level, personal or partner breastfeeding experience, and whether they were required to complete the website for a job or school requirement and to determine knowledge gaps. Pretest and posttest scores on all modules and in specific questions with low pretest scores were compared as a measure of knowledge gained. Lower median pretest scores were found in student nurses (71%), males (71%), those required to take the course (75%), and those without personal breastfeeding experience (72%). The modules with the lowest median pretest scores were Anatomy/Physiology (67%), Growth and Development of the Breastfed Infant (67%), the Breastfeeding Couple (73%), and the Term Infant with Problems (60%). Posttest scores in all modules increased significantly (p < .001). Breastfeeding Basics was used by a large number of nurses and nursing students. Gaps exist in nurses' breastfeeding knowledge. Knowledge improved in all areas based on comparison of pretest and posttest scores. © 2015 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

The impact factor and journals in laboratory medicine.

PubMed

Lippi, Giuseppe; Favaloro, Emmanuel J; Guidi, Gian Cesare

2009-01-01

The impact factor, originally devised by Eugene Garfield, offsets the advantages of journal size and age, and is a tool often used for the evaluation of journals and scientists, and is considered to provide a reliable trend of basic and clinical research worldwide. Overall, the median impact factor of all medical laboratory journals increased by 23% from 2001 to 2007, but it was slightly decreased from that of the previous year (-4.1%). Moreover, the aggregate impact factor of all these journals, which takes into account the number of citations for all journals in this category and the number of articles from all journals in the same category, increased from 2.042 in 2003 to 2.153 in 2004, but decreased to 2.060 in 2005 and has remained fairly stable in subsequent years (2.054 in 2006 and 2.080 in 2007), reflecting remarkable increases and substantial reductions observed for individual journals. This trend mirrored that of biochemistry and molecular biology journals, whereas journals listed under the subject categories "pathology", "surgery" and "Medicine, general and internal" substantially increased their aggregate impact factor from 2003 to 2007. According to the impact factor trend of laboratory medicine journals, it appears that medical laboratory science has reached a steady state. This might be partially due to the radical changes that have occurred within medical laboratory science since the beginning of the last millennium and raises the question of whether laboratory professionals should consider embracing new areas of research, such as the role of laboratory diagnostics in surgery and internal medicine.

Deployment of Large-Size Shell Constructions by Internal Pressure

NASA Astrophysics Data System (ADS)

Pestrenin, V. M.; Pestrenina, I. V.; Rusakov, S. V.; Kondyurin, A. V.

2015-11-01

A numerical study on the deployment pressure (the minimum internal pressure bringing a construction from the packed state to the operational one) of large laminated CFRP shell structures is performed using the ANSYS engineering package. The shell resists both membrane and bending deformations. Structures composed of shell elements whose median surface has an involute are considered. In the packed (natural) states of constituent elements, the median surfaces coincide with their involutes. Criteria for the termination of stepwise solution of the geometrically nonlinear problem on determination of the deployment pressure are formulated, and the deployment of cylindrical, conical (full and truncated cones), and large-size composite shells is studied. The results obtained are shown by graphs illustrating the deployment pressure in relation to the geometric and material parameters of the structure. These studies show that large pneumatic composite shells can be used as space and building structures, because the deployment pressure in them only slightly differs from the excess pressure in pneumatic articles made from films and soft materials.

A clinical and radiostereometric study of the cemented PFC-sigma prosthesis: a 5-year study of 29 cases with a fixed bearing.

PubMed

von Schewelov, Thord; Besjakov, Jack; Sanzén, Lennart; Carlsson, Ake

2009-07-01

The press-fit condylar (PFC) cruciate-retaining total knee prosthesis is well documented in the literature. In 1997, a modification of the femoral component was introduced, and the prosthesis was renamed PFC-Sigma. The alteration may influence the migratory and rotational pattern of the tibial component and thus long-time survival rate. In this radiostereometric analysis, we found that the micromotion of the PFC-Sigma prosthesis differs slightly from the original PFC design, an advantage of the PFC-Sigma prosthesis. The median maximum total point motion at 5 years was 0.64 mm for the PFC-Sigma design and 0.79 mm for the previous version of PFC (P = .9). However, the PFC-Sigma rotated less around the transverse (x) axis than did the PFC (medians, 0.22 mm and 0.48 mm, respectively; P = .04). From the radiostereometric, radiographic, and clinical data, we conclude that the PFC-Sigma knee prosthesis can be used with confidence.

Duration and functional outcome of spinal cord injury rehabilitation in the Netherlands.

PubMed

Post, Marcel W M; Dallmeijer, Annet J; Angenot, Edmond L D; van Asbeck, Floris W A; van der Woude, Lucas H V

2005-01-01

This study describes the length of stay (LOS) and functional outcome of spinal cord injury (SCI) in the Netherlands and its determinants. Data of 157 patients from eight rehabilitation centers were available. Mean age was 40.0 years and 76.4% were traumatic injuries, 39.8% had tetraplegia, and 69.9% had a motor complete SCI. Median LOS was 240 days (interquartile range 164-322). Median motor Functional Independence Measure (FIM) scores at discharge were 37.3 for persons with complete tetraplegia and 69.7 for persons with complete paraplegia. Level and completeness of injury, bed rest because of pressure sores, and LOS were predictors of motor FIM scores. Duration of SCI rehabilitation in the Netherlands is long compared with the literature. Functional outcome appears slightly better in persons with complete tetraplegia, but not in persons with complete paraplegia when compared with data from the United States. International studies are necessary to reveal strengths and weaknesses of SCI rehabilitation systems in different countries.

Looking for gall bladder disease in the patient's iris.

PubMed Central

Knipschild, P.

1988-01-01

In alternative health care iridology is used as a diagnostic aid. The diagnosis of gall bladder disease was used to study its validity and interperformer consistency. The presence of an inflamed gall bladder containing gall stones is said to be easily recognised by certain signs in the lower lateral part of the iris of the right eye. Stereo colour slides were made of the right eye. Stereo colour slides were made of the right eye of 39 patients with this disease and 39 control subjects of the same sex and age. The slides were presented in a random order to five leading iridologists without supplementary information. The prevalence of the disease was estimated at 56%. The median validity was 51% with 54% sensitivity and 52% specificity. These results were close to chance validity (iota = 0.03). None of the iridologists reached a high validity. The median interperformer consistency was 60%. This was only slightly higher than chance consistency (kappa = 0.18). This study showed that iridology is not a useful diagnostic aid. PMID:3147081

Looking for gall bladder disease in the patient's iris.

PubMed

Knipschild, P

1988-12-17

In alternative health care iridology is used as a diagnostic aid. The diagnosis of gall bladder disease was used to study its validity and interperformer consistency. The presence of an inflamed gall bladder containing gall stones is said to be easily recognised by certain signs in the lower lateral part of the iris of the right eye. Stereo colour slides were made of the right eye. Stereo colour slides were made of the right eye of 39 patients with this disease and 39 control subjects of the same sex and age. The slides were presented in a random order to five leading iridologists without supplementary information. The prevalence of the disease was estimated at 56%. The median validity was 51% with 54% sensitivity and 52% specificity. These results were close to chance validity (iota = 0.03). None of the iridologists reached a high validity. The median interperformer consistency was 60%. This was only slightly higher than chance consistency (kappa = 0.18). This study showed that iridology is not a useful diagnostic aid.

Impaired pubertal development and testicular hormone function in males with sickle cell anemia.

PubMed

Martins, Paulo Roberto Juliano; Kerbauy, José; Moraes-Souza, Helio; Pereira, Gilberto de Araújo; Figueiredo, Maria Stella; Verreschi, Ieda Therezinha

2015-01-01

Changes in weight/height ratio, delayed sexual maturation, hypogonadism and impaired fertility have been demonstrated in sickle cell disease (SCD). This study aimed to evaluate the clinical and laboratory views of the Leydig cells function after stimulation with hCG in adults with sickle cell disease. We studied 15 patients with SCD (18 to 40 years; median=27 years old), fourteen homozygous S, and one with SC disease. The control group, composed by adult males, was divided into two groups: I - 10 relatives (18-39 years, median=26 years) with the same socioeconomic level of the patients, and II - 9 normal individuals (23-28, median=31 years) randomly chosen. Clinically it was observed a slight degree of malnutrition, important puberty delay, rarefaction of chest, underarm and pubic hair, and important reduction of the testis and penis size, featuring a mild hypogonadism in patients with SCD. The hormonal level assessment of testosterone at baseline and at 24, 48 and 72 h after hCG stimulation showed no significant differences between the groups studied. We can presume that adult men with SCD showed clinical hypoandrogenism with normal testicular hormonal function, a fact inconsistent with the hypothesis of primary hypogonadism. Copyright © 2014 Elsevier Inc. All rights reserved.

Muscle optimization techniques impact the magnitude of calculated hip joint contact forces.

PubMed

Wesseling, Mariska; Derikx, Loes C; de Groote, Friedl; Bartels, Ward; Meyer, Christophe; Verdonschot, Nico; Jonkers, Ilse

2015-03-01

In musculoskeletal modelling, several optimization techniques are used to calculate muscle forces, which strongly influence resultant hip contact forces (HCF). The goal of this study was to calculate muscle forces using four different optimization techniques, i.e., two different static optimization techniques, computed muscle control (CMC) and the physiological inverse approach (PIA). We investigated their subsequent effects on HCFs during gait and sit to stand and found that at the first peak in gait at 15-20% of the gait cycle, CMC calculated the highest HCFs (median 3.9 times peak GRF (pGRF)). When comparing calculated HCFs to experimental HCFs reported in literature, the former were up to 238% larger. Both static optimization techniques produced lower HCFs (median 3.0 and 3.1 pGRF), while PIA included muscle dynamics without an excessive increase in HCF (median 3.2 pGRF). The increased HCFs in CMC were potentially caused by higher muscle forces resulting from co-contraction of agonists and antagonists around the hip. Alternatively, these higher HCFs may be caused by the slightly poorer tracking of the net joint moment by the muscle moments calculated by CMC. We conclude that the use of different optimization techniques affects calculated HCFs, and static optimization approached experimental values best. © 2014 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

Descriptive Statistics: Reporting the Answers to the 5 Basic Questions of Who, What, Why, When, Where, and a Sixth, So What?

PubMed

Vetter, Thomas R

2017-11-01

Descriptive statistics are specific methods basically used to calculate, describe, and summarize collected research data in a logical, meaningful, and efficient way. Descriptive statistics are reported numerically in the manuscript text and/or in its tables, or graphically in its figures. This basic statistical tutorial discusses a series of fundamental concepts about descriptive statistics and their reporting. The mean, median, and mode are 3 measures of the center or central tendency of a set of data. In addition to a measure of its central tendency (mean, median, or mode), another important characteristic of a research data set is its variability or dispersion (ie, spread). In simplest terms, variability is how much the individual recorded scores or observed values differ from one another. The range, standard deviation, and interquartile range are 3 measures of variability or dispersion. The standard deviation is typically reported for a mean, and the interquartile range for a median. Testing for statistical significance, along with calculating the observed treatment effect (or the strength of the association between an exposure and an outcome), and generating a corresponding confidence interval are 3 tools commonly used by researchers (and their collaborating biostatistician or epidemiologist) to validly make inferences and more generalized conclusions from their collected data and descriptive statistics. A number of journals, including Anesthesia & Analgesia, strongly encourage or require the reporting of pertinent confidence intervals. A confidence interval can be calculated for virtually any variable or outcome measure in an experimental, quasi-experimental, or observational research study design. Generally speaking, in a clinical trial, the confidence interval is the range of values within which the true treatment effect in the population likely resides. In an observational study, the confidence interval is the range of values within which the true strength of the association between the exposure and the outcome (eg, the risk ratio or odds ratio) in the population likely resides. There are many possible ways to graphically display or illustrate different types of data. While there is often latitude as to the choice of format, ultimately, the simplest and most comprehensible format is preferred. Common examples include a histogram, bar chart, line chart or line graph, pie chart, scatterplot, and box-and-whisker plot. Valid and reliable descriptive statistics can answer basic yet important questions about a research data set, namely: "Who, What, Why, When, Where, How, How Much?"

Equilibrium and kinetic adsorption study of Basic Yellow 28 and Basic Red 46 by a boron industry waste.

PubMed

Olgun, Asim; Atar, Necip

2009-01-15

In this study, the adsorption characteristics of Basic Yellow 28 (BY 28) and Basic Red 46 (BR 46) onto boron waste (BW), a waste produced from boron processing plant were investigated. The equilibrium adsorption isotherms and kinetics were investigated. The adsorption equilibrium data were analyzed by using various adsorption isotherm models and the results have shown that adsorption behavior of two dyes could be described reasonably well by a generalized isotherm. Kinetic studies indicated that the kinetics of the adsorption of BY 28 and BR 46 onto BW follows a pseudo-second-order model. The result showed that the BW exhibited high-adsorption capacity for basic dyes and the capacity slightly decreased with increasing temperature. The maximum adsorption capacities of BY 28 and BR 46 are reported at 75.00 and 74.73mgg(-1), respectively. The dye adsorption depended on the initial pH of the solution with maximum uptake occurring at about pH 9 and electrokinetic behavior of BW. Activation energy of 15.23kJ/mol for BY 28 and 18.15kJ/mol for BR 46 were determined confirming the nature of the physisorption onto BW. These results indicate that BW could be employed as low-cost material for the removal of the textile dyes from effluents.

Study of dynamics of glucose-glucose oxidase-ferricyanide reaction

NASA Astrophysics Data System (ADS)

Nováková, A.; Schreiberová, L.; Schreiber, I.

2011-12-01

This work is focused on dynamics of the glucose-glucose oxidase-ferricyanide enzymatic reaction with or without sodium hydroxide in a continuous-flow stirred tank reactor (CSTR) and in a batch reactor. This reaction exhibits pH-variations having autocatalytic character and is reported to provide nonlinear dynamic behavior (bistability, excitability). The dynamical behavior of the reaction was examined within a wide range of inlet parameters. The main inlet parameters were the ratio of concentrations of sodium hydroxide and ferricyanide and the flow rate. In a batch reactor we observed an autocatalytic drop of pH from slightly basic to medium acidic values. In a CSTR our aim was to find bistability in the presence of sodium hydroxide. However, only a basic steady state was found. In order to reach an acidic steady state, we investigated the system in the absence of sodium hydroxide. Under these conditions the transition from the basic to the acidic steady state was observed when inlet glucose concentration was increased.

Ground-water movement and effects of coal strip mining on water quality of high-wall lakes and aquifers in the Macon-Huntsville area, north- central Missouri

USGS Publications Warehouse

Hall, D.C.; Davis, R.E.

1986-01-01

Glacial drift and Pennsylvanian bedrock were mixed together forming spoil during pre-reclamation strip mining for coal in north-central Missouri. This restructuring of the land increases the porosity of the material, and increases aqueous concentrations of many dissolved constituents. Median sodium and bicarbonate concentrations were slightly greater, calcium 5 times greater, magnesium 6 times greater, manganese 15 times greater, iron 19 times greater, and sulfate 24 times greater in water from spoil than in water from glacial drift. Median potassium concentrations were slightly greater, and chloride concentrations were two times greater in water from glacial drift than in water from spoil. Water types in glacial drift and bedrock were mostly sodium bicarbonate and calcium bicarbonate; in spoil and lakes in the spoil, the water types were mostly calcium sulfate. Median pH values in water from spoil were 6.6, as compared to 7.4 in water from glacial drift and 9.0 in water from bedrock. Neutralization of acid by carbonate rocks causes the moderate pH values in water from spoil; a carbonate system closed to the atmosphere may result in alkaline pH values in bedrock. Transmissivities generally are greatest for spoil, and decrease in the following order: alluvium, glacial drift, and bedrock. Recharge to spoil is from precipitation, lateral flow from glacial drift, and lateral and vertical flow from bedrock. The rate of recharge to the aquifers is unknown, but probably is small. Groundwater discharge from the glacial drift, bedrock, and spoil is to alluvium. The direction of flow generally was from high-wall lakes in the spoil toward East Fork Little Chariton River or South Fork Claybank Creek. Significant differences (95% confidence level) in values and concentrations of aqueous constituents between spoil areas mined at different times (1940, 1952, and 1968) were obtained for pH, calcium, magnesium, manganese, sulfate, chloride, and dissolved solids, but not for iron. These differences are attributed to local variations in the geohydrologic system rather than spoil age. (Lantz-PTT)

Herpes simplex virus-induced anti-N-methyl-d-aspartate receptor encephalitis: a systematic literature review with analysis of 43 cases.

PubMed

Nosadini, Margherita; Mohammad, Shekeeb S; Corazza, Francesco; Ruga, Ezia Maria; Kothur, Kavitha; Perilongo, Giorgio; Frigo, Anna Chiara; Toldo, Irene; Dale, Russell C; Sartori, Stefano

2017-08-01

To conduct a systematic literature review on patients with biphasic disease with herpes simplex virus (HSV) encephalitis followed by anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. We conducted a case report and systematic literature review (up to 10 December 2016), focused on differences between herpes simplex encephalitis (HSE) and anti-NMDAR encephalitis phases, age-related characteristics of HSV-induced anti-NMDAR encephalitis, and therapy. For statistical analyses, McNemar's test, Fisher's test, and Wilcoxon rank sum test were used (two-tailed significance level set at 5%). Forty-three patients with biphasic disease were identified (31 children). Latency between HSE and anti-NMDAR encephalitis was significantly shorter in children than adults (median 24 vs 40.5d; p=0.006). Compared with HSE, anti-NMDAR encephalitis was characterized by significantly higher frequency of movement disorder (2.5% vs 75% respectively; p<0.001), and significantly lower rate of seizures (70% vs 30% respectively; p=0.001). Compared with adults, during anti-NMDAR encephalitis children had significantly more movement disorders (86.7% children vs 40% adults; p=0.006), fewer psychiatric symptoms (41.9% children vs 90.0% adults; p=0.025), and a slightly higher median modified Rankin Scale score (5 in children vs 4 in adults; p=0.015). During anti-NMDAR encephalitis, 84.6 per cent of patients received aciclovir (for ≤7d in 22.7%; long-term antivirals in 18.0% only), and 92.7 per cent immune therapy, but none had recurrence of HSE clinically or using cerebrospinal fluid HSV polymerase chain reaction (median follow-up 7mo). Our review suggests that movement disorder may help differentiate clinically an episode of HSV-induced anti-NMDAR encephalitis from HSE relapse. Compared with adults, children have shorter latency between HSE and anti-NMDAR encephalitis and, during anti-NMDAR encephalitis, more movement disorder, fewer psychiatric symptoms, and slightly more severe disease. According to our results, immune therapy given for HSV-induced anti-NMDAR encephalitis does not predispose patients to HSE recurrence. © 2017 Mac Keith Press.

Lithotripsy of gallstones by means of a quality-switched giant-pulse neodymium:yttrium-aluminum-garnet laser. Basic in vitro studies using a highly flexible fiber system.

PubMed

Hochberger, J; Gruber, E; Wirtz, P; Dürr, U; Kolb, A; Zanger, U; Hahn, E G; Ell, C

1991-11-01

The quality-switched neodymium:yttrium-aluminum-garnet laser represents a new instrument for athermal fragmentation of gallstones by transformation of optical energy into mechanical energy in the form of shock waves via local plasma formation. A highly flexible 300-micron fiber transmission system was used in basic investigations to determine the influence of varying pulse repetition rates (5-30 Hz) and pulse energies (15 and 20 mJ) on shock wave intensity and stone fragmentation in vitro for 105 biliary calculi of known size and chemical composition. After performance of 1200 shock wave pressure measurements using polyvinylidenefluoride hydrophones, stone fragmentation was analyzed by determination of fragment removal rates (volume of fragments removed per fragmentation time), ablation rates (mean volume removed per laser pulse), and median fragment sizes for each laser setting. With the quality-switched neodymium:yttrium-aluminum-garnet laser system, all concrements could be reliably disintegrated into small fragments (median diameter, 0.7-1.7 mm). Compared with pure cholesterol stones, a significantly higher fragment removal rate was achieved in cholesterol stones containing 30% calcium phosphate (P = 0.039), in cholesterol stones containing 20% pigment (P = 0.015), and in pure pigment stones (P = 0.007). Fragment removal rates, local shock wave pressures, and median grain sizes were significantly higher at a pulse energy of 20 mJ than with 15 mJ. Shock wave pressures showed a distinct dependence on pulse repetition rates at 20 mJ, yet not at 15 mJ. Because there is no evident hazard of thermal damage to tissue using the quality-switched neodymium:yttrium-aluminum-garnet laser, it appears to be a promising device for nonsurgical biliary stone therapy.

Retention Indices for Frequently Reported Compounds of Plant Essential Oils

NASA Astrophysics Data System (ADS)

Babushok, V. I.; Linstrom, P. J.; Zenkevich, I. G.

2011-12-01

Gas chromatographic retention indices were evaluated for 505 frequently reported plant essential oil components using a large retention index database. Retention data are presented for three types of commonly used stationary phases: dimethyl silicone (nonpolar), dimethyl silicone with 5% phenyl groups (slightly polar), and polyethylene glycol (polar) stationary phases. The evaluations are based on the treatment of multiple measurements with the number of data records ranging from about 5 to 800 per compound. Data analysis was limited to temperature programmed conditions. The data reported include the average and median values of retention index with standard deviations and confidence intervals.

[Social, economic and psychological issues as cardiovascular disease risk factors].

PubMed

Spácil, J

2009-11-01

The highest mortality in developed countries is, according to the data from our as well as international literature, among people from low socioeconomic backgrounds. No recent data are available for the Czech Republic. We compared the estimated median life expectancy in 2001-2005 with the proportion of people with basic education only and with the proportion of unemployed in all regions within the Czech Republic. We confirmed significant negative correlation--people in regions with low socioeconomic status had lower estimated median life expectancy. Despite the decline in the total and cardiovascular mortality in particular in the Czech Republic over the last 20 years, the highest mortality and shortest medium life expectancy continue to persist in the regions with the lowest socioeconomic status as measured by the educational status and unemployment.

Functional independence of residents in urban and rural long-term care facilities in Taiwan.

PubMed

Lin, Kwan-Hwa; Wu, Shiao-Chi; Hsiung, Chia-Ling; Hu, Ming-Hsia; Hsieh, Ching-Lin; Lin, Jau-Hong; Kuo, Mei-Ying

2004-02-04

To compare the score of functional independence measure (FIM) between urban and rural residents living in long-term care facilities (LTCF) in Taiwan. A total of 437 subjects in 112 licensed LTCF in Taiwan were randomly selected by stratification strategy. Physical therapists interviewed the subjects in nursing homes (NH) and intermediate care facilities (ICF) to obtain the basic data, and the FIM score. (1) There was no significant difference in basic demographic data between urban and rural LTC subjects. (2) Most of the subjects in urban and rural LTCF were males, less than 80 years old, single/widowed, having multiple diseases, using more than one assistive devices, and having social welfare financial support. (3) Motor abilities (eating, grooming, and transfer) and cognition (comprehension, social interaction and problem solving) in rural LTCF subjects were significantly (p < 0.05) higher than those in urban areas as revealed by the FIM assessment. (4) The median of FIM total score of rural LTCF subjects was 90.5, which was significantly (p < 0.05) higher than that of urban LTCF subjects (median = 76). Some of the functional performance of subjects in rural long-term care institutions is better than those in urban areas. Our results may provide guidelines for the manpower and equipment supply estimation.

AntiClustal: Multiple Sequence Alignment by antipole clustering and linear approximate 1-median computation.

PubMed

Di Pietro, C; Di Pietro, V; Emmanuele, G; Ferro, A; Maugeri, T; Modica, E; Pigola, G; Pulvirenti, A; Purrello, M; Ragusa, M; Scalia, M; Shasha, D; Travali, S; Zimmitti, V

2003-01-01

In this paper we present a new Multiple Sequence Alignment (MSA) algorithm called AntiClusAl. The method makes use of the commonly use idea of aligning homologous sequences belonging to classes generated by some clustering algorithm, and then continue the alignment process ina bottom-up way along a suitable tree structure. The final result is then read at the root of the tree. Multiple sequence alignment in each cluster makes use of the progressive alignment with the 1-median (center) of the cluster. The 1-median of set S of sequences is the element of S which minimizes the average distance from any other sequence in S. Its exact computation requires quadratic time. The basic idea of our proposed algorithm is to make use of a simple and natural algorithmic technique based on randomized tournaments which has been successfully applied to large size search problems in general metric spaces. In particular a clustering algorithm called Antipole tree and an approximate linear 1-median computation are used. Our algorithm compared with Clustal W, a widely used tool to MSA, shows a better running time results with fully comparable alignment quality. A successful biological application showing high aminoacid conservation during evolution of Xenopus laevis SOD2 is also cited.

Long-term Analysis of Lip Augmentation With Superficial Musculoaponeurotic System (SMAS) Tissue Transfer Following Biplanar Extended SMAS Rhytidectomy.

PubMed

Richardson, Matthew Allen; Rousso, Daniel Elliott; Replogle, William H

2017-01-01

To our knowledge, long-term, objective results of lip augmentation using superficial musculoaponeurotic system (SMAS) tissue transfer beyond 1 year have not been previously described. To evaluate the efficacy, longevity, and safety of lip augmentation using SMAS tissue transfer. A retrospective single-blind cohort study was designed to evaluate all patients who underwent surgical lip augmentation using SMAS following rhytidectomy between January 1, 2000, and November, 16, 2015, at a private facial plastic surgery practice in Birmingham, Alabama. Preoperative photographs of each patient served as controls and were compared with postoperative photographs at 3 months, 1 year, and 5 years after lip augmentation. A total of 104 images (from 26 individual patients) were reviewed by 12 blinded observers using a validated lip augmentation grading scale. Lip augmentation using SMAS. Median lip volumes of all patients at each postoperative interval (3 months, 1 year, and 5 years) compared with preoperative lip volumes. Secondary outcome measures included postoperative complications. A total of 423 patients were identified who underwent surgical lip augmentation using SMAS. Sixty patients with approximately 5 years or more of postoperative photographs were reviewed for complications. Twenty-six patients had 3-month, 1-year, and 5-year postoperative follow-up photographs and were included in the photographic evaluation. The mean age of these patients at the time of surgery was 54.6 years (range, 41.2-80.6 years. Fifty-nine of the 60 patients (98.3%) were female. Two of 60 patients (3.3%) with 5 years or more of postoperative follow-up developed complications requiring intervention. Both the superior lip and the inferior lip showed statistically significant increases in volume at 3 months, 1 year, and 5 years (P ≤ .004 for the superior lip after 5 years; P ≤ .001 for all other comparisons) after SMAS lip augmentation. The greatest median increase was observed in the superior lip at 3 months, while the smallest median increase was observed for the inferior lip at 5 years. The degree of increase in median volume seemed to weaken slightly over time, but remained statistically significant even at 5 years. SMAS lip augmentation is an effective and safe method for lip augmentation that can yield natural, long-lasting results with minimal risk. The degree of augmentation tends to fade slightly over time, but remains significant for at least 5 years postoperatively. 3.

Quantum Metric of Classic Physics

NASA Astrophysics Data System (ADS)

Machusky, Eugene

2017-09-01

By methods of differential geometry and number theory the following has been established: All fundamental physical constants are the medians of quasi-harmonic functions of relative space and relative time. Basic quantum units are, in fact, the gradients of normal distribution of standing waves between the points of pulsating spherical spiral, which are determined only by functional bonds of transcendental numbers PI and E. Analytically obtained values of rotational speed, translational velocity, vibrational speed, background temperature and molar mass give the possibility to evaluate all basic quantum units with practically unlimited accuracy. Metric of quantum physics really is two-dimensional image of motion of waves in three-dimensional space. Standard physical model is correct, but SI metric system is insufficiently exact at submillimeter distances.

Selection vector filter framework

NASA Astrophysics Data System (ADS)

Lukac, Rastislav; Plataniotis, Konstantinos N.; Smolka, Bogdan; Venetsanopoulos, Anastasios N.

2003-10-01

We provide a unified framework of nonlinear vector techniques outputting the lowest ranked vector. The proposed framework constitutes a generalized filter class for multichannel signal processing. A new class of nonlinear selection filters are based on the robust order-statistic theory and the minimization of the weighted distance function to other input samples. The proposed method can be designed to perform a variety of filtering operations including previously developed filtering techniques such as vector median, basic vector directional filter, directional distance filter, weighted vector median filters and weighted directional filters. A wide range of filtering operations is guaranteed by the filter structure with two independent weight vectors for angular and distance domains of the vector space. In order to adapt the filter parameters to varying signal and noise statistics, we provide also the generalized optimization algorithms taking the advantage of the weighted median filters and the relationship between standard median filter and vector median filter. Thus, we can deal with both statistical and deterministic aspects of the filter design process. It will be shown that the proposed method holds the required properties such as the capability of modelling the underlying system in the application at hand, the robustness with respect to errors in the model of underlying system, the availability of the training procedure and finally, the simplicity of filter representation, analysis, design and implementation. Simulation studies also indicate that the new filters are computationally attractive and have excellent performance in environments corrupted by bit errors and impulsive noise.

Acidic ammonothermal growth of gallium nitride in a liner-free molybdenum alloy autoclave

NASA Astrophysics Data System (ADS)

Malkowski, Thomas F.; Pimputkar, Siddha; Speck, James S.; DenBaars, Steven P.; Nakamura, Shuji

2016-12-01

This paper discusses promising materials for use as internal, non-load bearing components as well as molybdenum-based alloys for autoclave structural components for an ammonothermal autoclave. An autoclave was constructed from the commercial titanium-zirconium-molybdenum (TZM) alloy and was found to be chemically inert and mechanically stable under acidic ammonothermal conditions. Preliminary seeded growth of GaN was demonstrated with negligible incorporation of transition metals (including molybdenum) into the grown material (<1017 cm-3). Molybdenum and TZM were exposed to a basic ammonothermal environment, leading to slight degradation through formation of molybdenum nitride powders on their surface at elevated temperatures (T>560 °C). The possibility of a 'universal', inexpensive, liner-free ammonothermal autoclave capable of exposure to basic and acidic chemistry is demonstrated.

Impact of treatment protocol on outcome of localized Ewing's sarcoma.

PubMed

Nasaka, Srividya; Gundeti, Sadashivudu; Ganta, Ranga Raman; Arigela, Ravi Sankar; Linga, Vijay Gandhi; Maddali, Lakshmi Srinivas

2016-01-01

The outcome of localized Ewing's sarcoma has improved with multi-disciplinary approach. Survivals of Ewing's sarcoma from the Asian countries differed between centers. We retrospectively analyzed the records of newly diagnosed localized Ewing's sarcoma patients from 2002 to 2012. The patients were analyzed in three groups; Group 1(2002-2004) who received non-ifosfomide based regimens, Group 2(2005-2008) who received VDC/IE for 12 cycles, and Group 3(2009-2012), who received VDC/IE for 17 cycles. The groups were compared for their baseline characteristics, treatment protocol and outcome. Seventy three patients were included in the study. The median age of presentation was 15 years, with slight male predominance. Axial primary was seen in 62%. The median RFS of the three groups was 26.4, 31.4 and 36.8 months respectively ( P = 0.0018). The median OS was 27.9, 35 and 43 months respectively ( P = 0.0007). At a median follow-up of 35 months, the 3 year RFS and OS for the three treatment groups were 17%, 31%, 60% and 35%, 45% and 70% respectively. Larger tumor size, axial primary, high LDH were associated with poorer survival. Radiotherapy was associated with inferior local control and survival. We found that the survival of our ESFT patients improved over time with intensified multiagent chemotherapy and with lesser time to local therapy. But the results were still inferior to those reported in literature. We had majority of patients presenting in axial site and radiotherapy as the predominant mode of local control. The outcome may further improve with surgery as local control procedure.

The General Movement Optimality Score – a detailed assessment of general movements during preterm and term age

PubMed Central

Einspieler, Christa; Marschik, Peter B.; Urlesberger, Berndt; Pansy, Jasmin; Scheuchenegger, Anna; Krieber, Magdalena; Yang, Hong; Kornacka, Maria K.; Rowinska, Edyta; Soloveichick, Marina; Ferrari, Fabrizio; Guzzetta, Andrea; Cioni, Giovanni; Bos, Arend F.

2018-01-01

Aim To explore the appropriateness of applying a detailed assessment of general movements (GMs) and characterise the relationship between global and detailed assessment. Method The analysis was based on 783 video-recordings of 233 infants (79 females) who had been videoed from 27 to 45 weeks postmenstrual age. Apart from assessing the global GM categories (normal, poor repertoire [PR], cramped-synchronised [CS] or chaotic GMs), we scored the amplitude, speed, spatial range, proximal and distal rotations, onset and offset, tremulous and cramped components of the upper and lower extremities. Applying the optimality concept, the maximum GM optimality score of 42 indicates the optimal performance. Results GM optimality scores differentiated between normal GMs (Median=39; P75=41, P25=37); PR GMs (Median=25; P75=29, P25=22), and CS GMs (Median=12; P75=14, P25=10; p<0.01). The optimality score for chaotic GMs (mainly occurring at late preterm age) was similar to those for CS GMs (Median=14; P75=17, P25=12). Short-lasting tremulous movements occurred from very preterm age to postterm age across all GM categories, including normal GMs. The detailed score at postterm age was slightly lower compared to the scores at preterm and term age for both normal (p=0.02) and PR GMs (p<0.01). Interpretation Further research might demonstrate that the GM optimality score provides a solid base for the prediction of improvement vs. deterioration within an individual GM trajectory. PMID:26365130

Brain mass estimation by head circumference and body mass methods in neonatal glycaemic modelling and control.

PubMed

Gunn, Cameron Allan; Dickson, Jennifer L; Pretty, Christopher G; Alsweiler, Jane M; Lynn, Adrienne; Shaw, Geoffrey M; Chase, J Geoffrey

2014-07-01

Hyperglycaemia is a common complication of stress and prematurity in extremely low-birth-weight infants. Model-based insulin therapy protocols have the ability to safely improve glycaemic control for this group. Estimating non-insulin-mediated brain glucose uptake by the central nervous system in these models is typically done using population-based body weight models, which may not be ideal. A head circumference-based model that separately treats small-for-gestational-age (SGA) and appropriate-for-gestational-age (AGA) infants is compared to a body weight model in a retrospective analysis of 48 patients with a median birth weight of 750g and median gestational age of 25 weeks. Estimated brain mass, model-based insulin sensitivity (SI) profiles, and projected glycaemic control outcomes are investigated. SGA infants (5) are also analyzed as a separate cohort. Across the entire cohort, estimated brain mass deviated by a median 10% between models, with a per-patient median difference in SI of 3.5%. For the SGA group, brain mass deviation was 42%, and per-patient SI deviation 13.7%. In virtual trials, 87-93% of recommended insulin rates were equal or slightly reduced (Δ<0.16mU/h) under the head circumference method, while glycaemic control outcomes showed little change. The results suggest that body weight methods are not as accurate as head circumference methods. Head circumference-based estimates may offer improved modelling accuracy and a small reduction in insulin administration, particularly for SGA infants. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Relationship between diffusion tensor fractional anisotropy and motor outcome in patients with hemiparesis after corona radiata infarct.

PubMed

Koyama, Tetsuo; Marumoto, Kohei; Miyake, Hiroji; Domen, Kazuhisa

2013-11-01

This study examined the relationship between fractional anisotropy (FA) values of magnetic resonance-diffusion tensor imaging (DTI) and motor outcome (1 month after onset) in 15 patients with hemiparesis after ischemic stroke of corona radiata lesions. DTI data were obtained on days 14-18. FA values within the cerebral peduncle were analyzed using a computer-automated method. Motor outcome of hemiparesis was evaluated according to Brunnstrom stage (BRS; 6-point scale: severe to normal) for separate shoulder/elbow/forearm, wrist/hand, and lower extremity functions. The ratio of FA values in the affected hemisphere to those in the unaffected hemisphere (rFA) was assessed in relation to the BRS data (Spearman rank correlation test, P<.05). rFA values ranged from .715 to 1.002 (median=.924). BRS ranged from 1 to 6 (median=4) for shoulder/elbow/forearm, from 1 to 6 (median=5) for wrist/hand, and from 2 to 6 (median=4) for the lower extremities. Analysis revealed statistically significant relationships between rFA and upper extremity functions (correlation coefficient=.679 for shoulder/elbow/forearm and .706 for wrist/hand). Although slightly less evident, the relationship between rFA and lower extremity function was also statistically significant (correlation coefficient=.641). FA values within the cerebral peduncle are moderately associated with the outcome of both upper and lower extremity functions, suggesting that DTI may be applicable for outcome prediction in stroke patients with corona radiata infarct. Copyright © 2013 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Withdrawal-associated injury site pain (WISP): a descriptive case series of an opioid cessation phenomenon.

PubMed

Rieb, Launette Marie; Norman, Wendy V; Martin, Ruth Elwood; Berkowitz, Jonathan; Wood, Evan; McNeil, Ryan; Milloy, M-J

2016-12-01

Withdrawal pain can be a barrier to opioid cessation. Yet, little is known about old injury site pain in this context. We conducted an exploratory mixed-methods descriptive case series using a web-based survey and in-person interviews with adults recruited from pain and addiction treatment and research settings. We included individuals who self-reported a past significant injury that was healed and pain-free before the initiation of opioids, which then became temporarily painful upon opioid cessation-a phenomenon we have named withdrawal-associated injury site pain (WISP). Screening identified WISP in 47 people, of whom 34 (72%) completed the descriptive survey, including 21 who completed qualitative interviews. Recalled pain severity scores for WISP were typically high (median: 8/10; interquartile range [IQR]: 2), emotionally and physically aversive, and took approximately 2 weeks to resolve (median: 14; IQR: 24 days). Withdrawal-associated injury site pain intensity was typically slightly less than participants' original injury pain (median: 10/10; IQR: 3), and more painful than other generalized withdrawal symptoms which also lasted approximately 2 weeks (median: 13; IQR: 25 days). Fifteen surveyed participants (44%) reported returning to opioid use because of WISP in the past. Participants developed theories about the etiology of WISP, including that the pain is the brain's way of communicating a desire for opioids. This research represents the first known documentation that previously healed, and pain-free injury sites can temporarily become painful again during opioid withdrawal, an experience which may be a barrier to opioid cessation, and a contributor to opioid reinitiation.

The contribution of two ears to the perception of vertical angle in sagittal planes.

PubMed

Morimoto, M

2001-04-01

Because the input signals to the left and right ears are not identical, it is important to clarify the role of these signals in the perception of the vertical angle of a sound source at any position in the upper hemisphere. To obtain basic findings on upper hemisphere localization, this paper investigates the contribution of each pinna to the perception of vertical angle. Tests measured localization of the vertical angle in five planes parallel to the median plane. In the localization tests, the pinna cavities of one or both ears were occluded. Results showed that pinna cavities of both the near and far ears play a role in determining the perceived vertical angle of a sound source in any plane, including the median plane. As a sound source shifts laterally away from the median plane, the contribution of the near ear increases and, conversely, that of the far ear decreases. For saggital planes at azimuths greater than 60 degrees from midline, the far ear no longer contributes measurably to the determination of vertical angle.

Groundwater quality in the Upper Hudson River Basin, New York, 2012

USGS Publications Warehouse

Scott, Tia-Marie; Nystrom, Elizabeth A.

2014-01-01

Water samples were collected from 20 production and domestic wells in the Upper Hudson River Basin (north of the Federal Dam at Troy, New York) in New York in August 2012 to characterize groundwater quality in the basin. The samples were collected and processed using standard U.S. Geological Survey procedures and were analyzed for 148 physiochemical properties and constituents, including dissolved gases, major ions, nutrients, trace elements, pesticides, volatile organic compounds (VOCs), radionuclides, and indicator bacteria. The Upper Hudson River Basin covers 4,600 square miles in upstate New York, Vermont, and Massachusetts; the study area encompasses the 4,000 square miles that lie within New York. The basin is underlain by crystalline and sedimentary bedrock, including gneiss, shale, and slate; some sandstone and carbonate rocks are present locally. The bedrock in some areas is overlain by surficial deposits of saturated sand and gravel. Eleven of the wells sampled in the Upper Hudson River Basin are completed in sand and gravel deposits, and nine are completed in bedrock. Groundwater in the Upper Hudson River Basin was typically neutral or slightly basic; the water typically was moderately hard. Bicarbonate, chloride, calcium, and sodium were the major ions with the greatest median concentrations; the dominant nutrient was nitrate. Methane was detected in 7 samples. Strontium, iron, barium, boron, and manganese were the trace elements with the highest median concentrations. Two pesticides, an herbicide degradate and an insecticide degredate, were detected in two samples at trace levels; seven VOCs, including chloroform, four solvents, and the gasoline additive methyl tert-butyl ether (MTBE) were detected in four samples. The greatest radon-222 activity, 2,900 picocuries per liter, was measured in a sample from a bedrock well; the median radon activity was higher in samples from bedrock wells than in samples from sand and gravel wells. Coliform bacteria were detected in one sample with a maximum of 2 colony-forming units per 100 milliliters. Water quality in the Upper Hudson River Basin is generally good, but concentrations of some constituents equaled or exceeded current or proposed Federal or New York State drinking-water standards. The standards exceeded are color (1 sample), pH (3 samples), sodium (3 samples), chloride (1 sample), dissolved solids (1 sample), arsenic (1 sample), iron (2 samples), manganese (2 samples), uranium (1 sample), radon-222 (12 samples), and gross beta activities (3 samples). Total coliform bacteria were each detected in one sample. Concentrations of fluoride, sulfate, nitrate, nitrite, aluminum, antimony, barium, beryllium, cadmium, chromium, copper, lead, mercury, selenium, silver, thallium, zinc, and gross alpha activities did not exceed existing drinking-water standards in any of the samples collected. Methane concentration in one sample was greater than 28 milligrams per liter, with a concentration of 35.1 milligrams per liter.

The Evaporation and Degradation of N-Nitroso Dimethyl Amine in Aqueous Solutions.

DTIC Science & Technology

The fate of N-Nitroso Dimethyl Amine ( NDMA ) in aqueous solutions and in a 25 percent caustic waste stream which is produced in the manufacture of...degradation of NDMA in an open lagoon. It was found that for basic solutions, the removal was primarily evaporation, whereas, evaporation is low for...that nitrite severely inhibits the photolysis of NDMA in acid and neutral pHs, and an increase in ionic strength slightly increases the evaporation rate

Comparison of Pharmacy Students’ Perceived and Actual Knowledge Using the Pharmacy Curricular Outcomes Assessment

PubMed Central

Friesner, Daniel L.

2012-01-01

Objective. To determine whether a correlation exists between third-year PharmD students’ perceived pharmacy knowledge and actual pharmacy knowledge as assessed by the Pharmacy Curricular Outcomes Assessment (PCOA). Methods. In 2010 and 2011, the PCOA was administered in a low-stakes environment to third-year pharmacy students at North Dakota State University College of Pharmacy, Nursing, and Allied Sciences (COPNAS). A survey instrument was also administered on which students self-assessed their perceived competencies in each of the core areas covered by the PCOA examination. Results. The pharmacy students rated their competencies slightly higher than average. Performance on the PCOA was similar to but slightly higher than national averages. Correlations between each of the 4 content areas (basic biomedical sciences, pharmaceutical sciences, social/administrative sciences, and clinical sciences) mirrored those reported nationally by the National Association of Boards of Pharmacy (NABP). Student performance on the basic biomedical sciences portion of the PCOA was significantly correlated with students’ perceived competencies in the biomedical sciences. No other correlations between actual and perceived competencies were significant. Conclusion. A lack of correlation exists between what students perceive they know and what they actually know in the areas of pharmaceutical science; social, behavioral, and administrative science; and clinical science. Therefore, additional standardized measures are needed to assess curricular effectiveness and provide comparisons among pharmacy programs. PMID:22611272

Cultural similarities and differences in perceiving and recognizing facial expressions of basic emotions.

PubMed

Yan, Xiaoqian; Andrews, Timothy J; Young, Andrew W

2016-03-01

The ability to recognize facial expressions of basic emotions is often considered a universal human ability. However, recent studies have suggested that this commonality has been overestimated and that people from different cultures use different facial signals to represent expressions (Jack, Blais, Scheepers, Schyns, & Caldara, 2009; Jack, Caldara, & Schyns, 2012). We investigated this possibility by examining similarities and differences in the perception and categorization of facial expressions between Chinese and white British participants using whole-face and partial-face images. Our results showed no cultural difference in the patterns of perceptual similarity of expressions from whole-face images. When categorizing the same expressions, however, both British and Chinese participants were slightly more accurate with whole-face images of their own ethnic group. To further investigate potential strategy differences, we repeated the perceptual similarity and categorization tasks with presentation of only the upper or lower half of each face. Again, the perceptual similarity of facial expressions was similar between Chinese and British participants for both the upper and lower face regions. However, participants were slightly better at categorizing facial expressions of their own ethnic group for the lower face regions, indicating that the way in which culture shapes the categorization of facial expressions is largely driven by differences in information decoding from this part of the face. (c) 2016 APA, all rights reserved).

Ochratoxin A in raisins and currants: basic extraction procedure used in two small marketing surveys of the occurrence and control of the heterogeneity of the toxins in samples.

PubMed

Möller, T E; Nyberg, M

2003-11-01

A basic extraction procedure for analysis of ochratoxin A (OTA) in currants and raisins is described, as well as the occurrence of OTA and a control of heterogeneity of the toxin in samples bought for two small marketing surveys 1999/2000 and 2001/02. Most samples in the surveys were divided into two subsamples that were individually prepared as slurries and analysed separately. The limit of quantification for the method was estimated as 0.1 microg kg(-1) and recoveries of 85, 90 and 115% were achieved in recovery experiments at 10, 5 and 0.1 microg kg(-1), respectively. Of all 118 subsamples analysed in the surveys, 96 (84%) contained ochratoxin A at levels above the quantification level and five samples (4%) contained more than the European Community legislation of 10 microg kg(-1). The OTA concentrations found in the first survey were in the range < 0.1-19.0 microg kg(-1) with a median concentration of 0.9 microg kg(-1). In the 2001/02 study, the range was < 0.1-34.6 microg kg(-1) with a median of 0.2 microg kg(-1). Big differences were often achieved between individual subsamples of the original sample, which indicate a wide heterogeneous distribution of the toxin. Data from the repeatability test as well as recovery experiments from the same slurries showed that preparation of slurries as described here seemed to give a homogeneous and representative sample. The extraction with the basic sodium bicarbonate-methanol mixture used in the surveys gave similar or somewhat higher OTA values on some samples tested in a comparison with a weak phosphoric acid water-methanol extraction mixture.

Concordance of Barthel Index, ECOG-PS, and Palliative Performance Scale in the assessment of functional status in patients with advanced medical diseases.

PubMed

Hernández-Quiles, C; Bernabeu-Wittel, M; Pérez-Belmonte, L M; Macías-Mir, P; Camacho-González, D; Massa, B; Maiz-Jiménez, M; Ollero-Baturone, M

2017-09-01

Analysing most relevant clinical features and concordance between different functional scales in patients with advanced medical diseases (PAMD). Cross-sectional multicentre study that included PAMD (heart, lung, kidney, liver, and neurological diseases) in hospital settings from February 2009 to October 2010. We analysed clinical, biological and functional features in performing activities of daily living (ADL) by medians of Barthel Index (BI); additionally we assessed their performance status by medians of Eastern Cooperative Oncology Group-Performance Status (ECOG-PS) and Palliative Performance Scale (PPS) scores. We evaluated the concordance of these instruments in assessing functional impairment by κ and intraclass correlation coefficient tests. 1847 patients were included (average age 79 years, 50.1% men). Most common symptoms were dyspnoea (62.31%), asthenia (23%) and delirium (20.14%). Functional assessment showed a high prevalence of severe or total impairment in performing basic ADL by medians of used instruments (BI median=35 (IQR=70), and 52.1% of patients with severe-total impairment; ECOG-PS median=2 (IQR 30), and 44% of patients with severe-total impairment; and PPS median=50 (IQR 30), and 32% of patients with severe-total impairment). Concordance among these instruments was acceptably good ( κ indexes ranging from 0.653 to 0.745 (p<0.0001)). PAMD represent a population with severe functional impairment, which requires a multidisciplinary approach for proper management. Assessment of functional ability in this population by BI, ECOG-PS, and PPS showed good concordance. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Prospective change control analysis of transfer of platelet concentrate production from a specialized stem cell transplantation unit to a blood transfusion center.

PubMed

Sigle, Joerg-Peter; Medinger, Michael; Stern, Martin; Infanti, Laura; Heim, Dominik; Halter, Joerg; Gratwohl, Alois; Buser, Andreas

2012-01-01

Specialized centers claim a need for blood component production independent from the general blood transfusion services. We performed a prospective change control analysis of the transfer of platelet (PLT) production for hematological patients at the University Hospital Basel from the Department of Hematology to the Blood Transfusion Centre, Swiss Red Cross, Basel in February 2006. We wanted to demonstrate that neither quality nor transfusion outcome was affected. Production quantity and efficiency, product quality and transfusion outcome were systematically recorded. A 2-year pretransfer period was compared to a 2 year post-transfer period. After transfer production quantity at the Blood Transfusion Centre increased from 4,483 to 6,190 PLT concentrates. Production efficiency increased with a significant decrease in the rate of expired products (18% vs. 8%; P < 0.001). Product quality showed a slight decrease in median PLT count per unit (2.84 vs. 2.75 × 10(11); P < 0.001) and a slight increase in mean storage time prior to transfusion (3.18 vs. 3.30 days; P < 0.001). Transfusion outcome measured as median corrected count increment one hour post-transfusion (10.5 vs. 10.7; P = 0.3) and the rate of patients with inadequate post-transfusion increment (31.5% vs. 32.1%; P = 0.6) did not differ. Supply and quality of PLT products was maintained after the transfer of PLT production to the Blood Transfusion Centre. An optimization of the supply chain process with markedly decreased expiration rates was achieved. These results argue against the need of specialized PLT production sites for selected patient groups. Copyright © 2012 Wiley Periodicals, Inc.

[Prospective randomized study of HMVP, MVP, and HVP regimens in treatment of advanced non-small cell lung cancer].

PubMed

Gao, Jian-Fei; Li, Chang-Sheng; Zhang, Bi-Cheng; Du, Guang-Zu; Zhang, Xin-Hua; Wang, Jun; Zhu, Yu-Ze; Ou, Wu-Ling; Yang, Bo

2004-04-01

Non-small cell lung cancer (NSCLC) is hyposensitive to the normal first and second-line chemotherapy regimens. Camptothecin derivative is becoming a hot point in the treatment of advanced NSCLC. The objective of this article was to evaluate the response, toxicity, and survival time of HMVP, MVP, and HVP regimens (detail in below) in the treatment of advanced NSCLC. A total of 134 cases with advanced NSCLC was randomized into three groups: HMVP group [46 patients, hydroxycamptothecin (HCPT) 12 mg/m(2) from d1 to d5, mitomycin C (MMC) 6 mg/m(2) d1, vindesine (VDS) 2.5-3 mg/m(2) d1 and d8, cisplatin (DDP) 50 mg/m(2) d2 and d3], MVP group (44 patients, MMC, VDS and DDP were the same as HMVP group) and HVP group (44 patients, HCPT, VDS, DDP were the same as HMVP group). The response rates were 39.54% (17/43), 35.57% (15/42), and 26.19% (11/42) in HMVP, MVP, and HVP groups, respectively; no significant difference was detected among the three groups (P >0.05). No significant difference was detected in the median time of remission, median survival time, and 1-, 2-year survival rates among the three groups. Moreover, no significant difference was detected in grade III-IV leukopenia, grade III-IV thrombocytopenia, grade III-IV nausea and vomiting and grade III-IV constipation among the three groups. The response rate of MVP regimen is slightly lower than that of HMVP regimen, but HMVP regimen do not show obvious superiority. It may increase toxicities such as leukopenia, nausea/vomiting, and constipation. The response rate of HVP regimen is slightly lower than that of MVP regimen.

Five-year change in morphological and functional alterations of the thyroid gland: the Study of Health in Pomerania.

PubMed

Völzke, Henry; Ittermann, Till; Albers, Martin; Friedrich, Nele; Nauck, Matthias; Below, Harald; Kramer, Axel

2012-07-01

While cross-sectional data on thyroid epidemiology are common, few longitudinal data on the incidence and progression of thyroid disorders exist. The aim of this study was to analyze the 5-year change and the incidence of morphological and functional alterations of the thyroid gland in a previously iodine-deficient area. We used 5-year follow-up data based on 2941 participants (20-79 years) of the population-based Study of Health in Pomerania. The thyroid structure and size were measured by ultrasonography. Thyroid function and serum autoantibodies to thyroperoxidase (anti-TPO-Ab) were evaluated. During follow-up, the median iodine/creatinine ratio decreased slightly from 134.2 to 130.4 μg/g. The mean thyroid volume was nonsignificantly increased by 0.73 mL [confidence interval (CI) -1.68-3.41 mL]. The incidence rate of goiter was 34.0 [CI 30.7-37.7] per 1000 person-years (py), the incident rate of nodules was 16.6 [CI 14.5-19.1] per 1000 py. Median serum thyrotropin levels increased slightly (0.10 [CI -0.10-0.34 mIU/L]). The incidence of positive anti-TPO-Ab was 3.4 [CI 2.6-4.7] per 1000 py. For all thyroid parameters, the regression rates were higher than the incidence rates. After iodine fortification became effective in this previously iodine-deficient region, there is a negative net balance between occurring and reverting goiter and nodules. Along with balanced incidences of hyper- and hypothyroid dysfunction and the low incidence of autoimmune-related findings, these findings indicate that the current iodine status is sufficient to prevent iodine deficiency-related disorders in the adult population of the study region.

The prevalence and correlates of binge eating disorder in the WHO World Mental Health Surveys

PubMed Central

Kessler, Ronald C.; Berglund, Patricia A.; Chiu, Wai Tat; Deitz, Anne C.; Hudson, James I.; Shahly, Victoria; Aguilar-Gaxiola, Sergio; Alonso, Jordi; Angermeyer, Matthias C.; Benjet, Corina; Bruffaerts, Ronny; de Girolamo, Giovanni; de Graaf, Ron; Haro, Josep Maria; Kovess-Masfety, Viviane; O’Neill, Siobhan; Posada-Villa, Jose; Sasu, Carmen; Scott, Kate; Viana, Maria Carmen; Xavier, Miguel

2013-01-01

Background Little population-based data exist outside the United States on the epidemiology of binge eating disorder (BED). Cross-national data on BED are presented and compared to bulimia nervosa (BN) based on the WHO World Mental Health Surveys. Methods Community surveys with 24,124 respondents (ages 18+) across 14 mostly upper-middle and high income countries assessed lifetime and 12-month DSM-IV mental disorders with the WHO Composite International Diagnostic Interview. Physical disorders were assessed with a chronic conditions checklist. Results Country-specific lifetime prevalence estimates are consistently (median; inter-quartile range) higher for BED (1.4%;0.8–1.9%) than BN (0.8%;0.4–1.0%). Median age-of-onset is in the late teens to early 20s for both disorders but slightly younger for BN. Persistence is slightly higher for BN (6.5 years; 2.2–15.4) than BED (4.3 years; 1.0–11.7). Lifetime risk of both disorders is elevated for women and recent cohorts. Retrospective reports suggest that comorbid anxiety, mood, and disruptive behavior disorders predict subsequent onset of BN somewhat more strongly than BED and that BN predicts subsequent comorbid psychiatric disorders somewhat more strongly than does BED. Significant comorbidities with physical conditions are due almost entirely to BN and BED predicting subsequent onset of these conditions, again with BN somewhat stronger than BED. Role impairments are similar for BN and BED. Fewer than half of lifetime BN or BED cases receive treatment. Conclusions BED represents a public health problem at least equal to BN. Low treatment rates highlight the clinical importance of questioning patients about eating problems even when not included among presenting complaints. PMID:23290497

Dynamic Analysis of Soil Erosion in Songhua River Watershed

NASA Astrophysics Data System (ADS)

Zhang, Yujuan; Li, Xiuhai; Wang, Qiang; Liu, Jiang; Liang, Xin; Li, Dan; Ni, Chundi; Liu, Yan

2018-01-01

In this paper, based on RS and GIS technology and Revised Universal Soil Loss Equation (RUSLE), the soil erosion dynamic changes during the two periods of 1990 and 2010 in Bin County was analyzed by using the Landsat TM data of the two periods, so as to reveal the soil erosion spatial distribution pattern and spatial and temporal dynamic evolution rule in the region. The results showed that: the overall patterns of soil erosion were basically the same in both periods, mainly featuring slight erosion and mild erosion, with the area proportions of 80.68% and 74.71% respectively. The slight and extremely intensive erosion changing rates showed a narrowing trend; mild, moderate and intensive erosion was increasing, with a trend of increased soil erosion; mild and intensive erosion were developing towards moderate erosion and moderate and extremely intensive erosion were progressing towards intensive erosion.

Influence of Basicity on High-Chromium Vanadium-Titanium Magnetite Sinter Properties, Productivity, and Mineralogy

NASA Astrophysics Data System (ADS)

Zhou, Mi; Yang, Songtao; Jiang, Tao; Xue, Xiangxin

2015-05-01

The effect of basicity on high-chromium vanadium-titanium magnetite (V-Ti-Cr) sintering was studied via sintering pot tests. The sinter rate, yield, and productivity were calculated before determining sinter strength (TI) and reduction degradation index (RDI). Furthermore, the effect of basicity on V-Ti-Cr sinter mineralogy was clarified using metallographic microscopy, x-ray diffraction, and scanning electron microscopy-energy-dispersive x-ray spectroscopy. The results indicate that increasing basicity quickly increases the sintering rate from 25.4 mm min-1 to 28.9 mm min-1, yield from 75.3% to 87.2%, TI from 55.4% to 64.8%, and productivity from 1.83 t (m2 h)-1 to 1.94 t (m2 h)-1 before experiencing a slight drop. The V-Ti-Cr sinter shows complex mineral composition, with main mineral phases such as magnetite, hematite, silicate (dicalcium silicate, Ca-Fe olivine, glass), calcium and aluminum silico-ferrite (SFCA/SFCAI) and perovskite. Perovskite is notable because it lowers the V-Ti sinter strength and RDI. The well intergrowths between magnetite and SFCA/SFCAI, and the decrease in perovskite and secondary skeletal hematite are the key for improving TI and RDI. Finally, a comprehensive index was calculated, and the optimal V-Ti-Cr sinter basicity also for industrial application was 2.55.

Combined first-trimester Down syndrome screening in HIV-infected women.

PubMed

Chougrani, Imène; Muller, Françoise; Marcelin, Louis; Tsatsaris, Vassilis; Abric, Judith; Luton, Dominique; Guibourdenche, Jean; Azria, Elie

2016-08-01

To determine if human immunodeficiency virus (HIV) infection or antiretroviral therapy interferes with maternal levels of free human β-chorionic gonadotrophin (hCGβ) and pregnancy-associated plasma protein-A (PAPP-A) and whether any such influence alters first-trimester Down syndrome (DS) screening in HIV-infected women. We performed a multicenter 1:2 matched case-control study comparing 84 HIV-infected women with singleton pregnancies with controls randomly selected among uninfected women, delivered and screened in the same center and matched for maternal age, geographical origin and fetal sex. Groups did not differ significantly in screening results, although case women showed a slightly lower median free hCGβ multiple of the median (MoM) (1.11 versus 1.24 MoM, p=0.32) and higher median PAPP-A MoM (1.45 versus 1.32 MoM, p=0.23) than control women. The false-positive rate was similar in the case and control groups (5% versus 6.5%, p=0.5). Biomarker levels did not differ when comparing treated and untreated patients with their respective controls, and with one another. First-trimester DS combined screening biomarker levels and calculated risk do not seem to be significantly altered by HIV infection or antiretroviral treatment. This screening strategy appears to be suitable for HIV-infected women. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Histogram analysis parameters of apparent diffusion coefficient reflect tumor cellularity and proliferation activity in head and neck squamous cell carcinoma.

PubMed

Surov, Alexey; Meyer, Hans Jonas; Winter, Karsten; Richter, Cindy; Hoehn, Anna-Kathrin

2018-05-04

Our purpose was to analyze associations between apparent diffusion coefficient (ADC) histogram analysis parameters and histopathologicalfeatures in head and neck squamous cell carcinoma (HNSCC). The study involved 32 patients with primary HNSCC. For every tumor, the following histogram analysis parameters were calculated: ADCmean, ADCmax, ADC min , ADC median , ADC mode , P10, P25, P75, P90, kurtosis, skewness, and entropy. Furthermore, proliferation index KI 67, cell count, total and average nucleic areas were estimated. Spearman's correlation coefficient (p) was used to analyze associations between investigated parameters. In overall sample, all ADC values showed moderate inverse correlations with KI 67. All ADC values except ADCmax correlated inversely with tumor cellularity. Slightly correlations were identified between total/average nucleic area and ADC mean , ADC min , ADC median , and P25. In G1/2 tumors, only ADCmode correlated well with Ki67. No statistically significant correlations between ADC parameters and cellularity were found. In G3 tumors, Ki 67 correlated with all ADC parameters except ADCmode. Cell count correlated well with all ADC parameters except ADCmax. Total nucleic area correlated inversely with ADC mean , ADC min , ADC median , P25, and P90. ADC histogram parameters reflect proliferation potential and cellularity in HNSCC. The associations between histopathology and imaging depend on tumor grading.

Use of Folic Acid Supplements in Early Pregnancy in Relation to Maternal Plasma Levels in Week 18 of Pregnancy

PubMed Central

Roth, Christine; Monsen, Anne Lise B.; Reichborn-Kjennerud, Ted; Nilsen, Roy M.; Smith, George Davey; Stoltenberg, Camilla; Surén, Pål; Susser, Ezra; Ueland, Per Magne; Vollset, Stein Emil; Magnus, Per

2013-01-01

We compared plasma-folate at week 18 of gestation with self-reported use of supplements containing folic acid from before pregnancy to 17 weeks gestation. Birth cohorts typically measure plasma-folate in mid-gestation, but effects of folic acid supplementation are sometimes specific to the periconceptional period. The relationship between mid-gestation plasma-folate and periconceptional supplementation is not known. The sample comprised 2911 women from The Norwegian Mother and Child Cohort Study. For women reporting continuous supplementation from gestational week -4-17 (N=238), median plasma-folate was 15.72 at week 18 (in nmol/L). This was about threefold higher than the median plasma-folate of 5.67 for women reporting no supplementation from week -4-17 (N=844), but only slightly higher than the median plasma-folate of 13.34 for all women reporting supplementation in week 13-17 (N=1158). Reported supplementation before week 8 was not associated with plasma-folate at week 18, in an analysis that adjusted for continued supplementation after week 8. Overall we found a strong and coherent relationship between self-reported folic acid use and plasma-folate at week 18. We also found that plasma-folate at week 18 did not reflect self-reported supplementation before 8 weeks. For periconceptional supplementation per se, self-report data may offer a better measure. PMID:23065724

A new ichnospecies of Nereites from carboniferous tidal-flat facies of Eastern Kansas, USA: Implications for the Nereites-Neonereites debate

USGS Publications Warehouse

Mangano, M.G.; Buatois, L.A.; Maples, C.G.; West, R.R.

2000-01-01

Predominantly horizontal, gently curved to slightly sinuous traces constituting uniserial rows of imbricated, subspherical sediment pads occur in Pennsylvanian tidal-flat facies of eastern Kansas. These traces exhibit a complex, actively filled internal structure. The presence of a median tunnel enveloped by overlapping pads of reworked sediment indicates that these biogenic structures should be included in the ichnogenus Nereites MacLeay in Murchison, 1839. A new ichnospecies, N. imbricata, is erected. Externally, Nereites imbricata differs from the other Nereites ichnospecies by the large, tightly packed, imbricated pads that commonly result in an annulated appearance on bedding-planes. Internally, obliquely arranged, arcuate lamiliae envelope the median tunnel and tend to follow the outline of the external semispherical pads. Additionally, the behavioral pattern reflected by N. imbricata is less specialized than that of the other Nereites ichnospecies. Eione monoliformis Tate, 1859 resembles N. imbricata in general appearance, but lack the diagnostic Nereites internal structure, and is invariably preserved as positive epireliefs. Occurrence of Nereites imbricata as both median tunnels surrounded by reworked sediment (Nereites preservation) and uniserial rows of imbricated sediment pads (Neonereites preservation) supports the notion that Neonereites Seilacher, 1960 is a preservational variant of Nereites. The ichnogenus Nereites is an eurybathic form and is a common component of Paleozoic shallow-marine facies.

Electromyographic analysis of repeated bouts of eccentric exercise.

PubMed

McHugh, M P; Connolly, D A; Eston, R G; Gartman, E J; Gleim, G W

2001-03-01

The repeated bout effect refers to the protective effect provided by a single bout of eccentric exercise against muscle damage from a similar subsequent bout. The aim of this study was to determine if the repeated bout was associated with an increase in motor unit activation relative to force production, an increased recruitment of slow-twitch motor units or increased motor unit synchronization. Surface electromyographic (EMG) signals were recorded from the hamstring muscles during two bouts of submaximal isokinetic (2.6 rad x s(-1)) eccentric (11 men, 9 women) or concentric (6 men, 4 women) contractions separated by 2 weeks. The EMG per unit torque and median frequency were analysed. The initial bout of eccentric exercise resulted in strength loss, pain and muscle tenderness, while the repeated eccentric bout resulted in a slight increase in strength, no pain and no muscle tenderness (bout x time effects, P < 0.05). Strength, pain and tenderness were unaffected by either bout of concentric exercise. The EMG per unit torque and median frequency were not different between the initial and repeated bouts of eccentric exercise. The EMG per unit torque and median frequency increased during both bouts of eccentric exercise (P < 0.01) but did not change during either concentric bout. In conclusion, there was no evidence that the repeated bout effect was due to a neural adaptation.

Aging Enhances Indirect Flight Muscle Fiber Performance yet Decreases Flight Ability in Drosophila

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

Miller, Mark S.; Lekkas, Panagiotis; Braddock, Joan M.

2008-10-02

We investigated the effects of aging on Drosophila melanogaster indirect flight muscle from the whole organism to the actomyosin cross-bridge. Median-aged (49-day-old) flies were flight impaired, had normal myofilament number and packing, barely longer sarcomeres, and slight mitochondrial deterioration compared with young (3-day-old) flies. Old (56-day-old) flies were unable to beat their wings, had deteriorated ultrastructure with severe mitochondrial damage, and their skinned fibers failed to activate with calcium. Small-amplitude sinusoidal length perturbation analysis showed median-aged indirect flight muscle fibers developed greater than twice the isometric force and power output of young fibers, yet cross-bridge kinetics were similar. Large increasesmore » in elastic and viscous moduli amplitude under active, passive, and rigor conditions suggest that median-aged fibers become stiffer longitudinally. Small-angle x-ray diffraction indicates that myosin heads move increasingly toward the thin filament with age, accounting for the increased transverse stiffness via cross-bridge formation. We propose that the observed protein composition changes in the connecting filaments, which anchor the thick filaments to the Z-disk, produce compensatory increases in longitudinal stiffness, isometric tension, power and actomyosin interaction in aging indirect flight muscle. We also speculate that a lack of MgATP due to damaged mitochondria accounts for the decreased flight performance.« less

Thermally stable booster explosive and process for manufacture

DOEpatents

Quinlin, William T [Amarillo, TX; Thorpe, Raymond [Amarillo, TX; Lightfoot, James M [Amarillo, TX

2006-03-21

A thermally stable booster explosive and process for the manufacture of the explosive. The product explosive is 2,4,7,9-tetranitro-10H-benzo[4,5]furo[3,2-b]indole (TNBFI). A reactant/solvent such as n-methylpyrrolidone (NMP) or dimethyl formamide (DMF) is made slightly basic. The solution is heated to reduce the water content. The solution is cooled and hexanitrostilbene is added. The solution is heated to a predetermined temperature for a specific time period, cooled, and the product is collected by filtration.

JPRS Report, China

DTIC Science & Technology

1993-02-16

regions (including the model regions) are now mostly inclined to have "one boy , one girl" in terms of child-bearing. It is proper to argue that if the...survey questions are slightly modified, the real inclination can be found to be having "two children, one boy " (to want to have two children and to...have at least one boy ). 3. The model regions have basically reached the targets set in the policy in terms of fertility levels. 4. Models of the

VKI Activities in Support of AFOSR Basic Research Interests: Steady State Pyrolysis and Ablation Investigation

DTIC Science & Technology

2008-03-31

flux with and without chocking flows above 0.04 g/ s, the heat flux becomes more constant, only slightly de- creasing with increased transpiration...the flowfield species and the injected species. For air, the initial species are N2 and 02. As the flow passes through the shock wave surrounding the...fiber. The captured light is then sent to an Ocean Optics HR4000CG-UV-NIR spectrometer for dispersion and recording of the spectra. The main

Anterior ankle arthroscopy, distraction or dorsiflexion?

PubMed

de Leeuw, Peter A J; Golanó, Pau; Clavero, Joan A; van Dijk, C Niek

2010-05-01

Anterior ankle arthroscopy can basically be performed by two different methods; the dorsiflexion- or distraction method. The objective of this study was to determine the size of the anterior working area for both the dorsiflexion and distraction method. The anterior working area is anteriorly limited by the overlying anatomy which includes the neurovascular bundle. We hypothesize that in ankle dorsiflexion the anterior neurovascular bundle will move away anteriorly from the ankle joint, whereas in ankle distraction the anterior neurovascular bundle is pulled tight towards the joint, thereby decreasing the safe anterior working area. Six fresh frozen ankle specimens, amputated above the knee, were scanned with computed tomography. Prior to scanning the anterior tibial artery was injected with contrast fluid and subsequently each ankle was scanned both in ankle dorsiflexion and in distraction. A special device was developed to reproducibly obtain ankle dorsiflexion and distraction in the computed tomography scanner. The distance between the anterior border of the inferior tibial articular facet and the posterior border of the anterior tibial artery was measured. The median distance from the anterior border of the inferior tibial articular facet to the posterior border of the anterior tibial artery in ankle dorsiflexion and distraction was 0.9 cm (range 0.7-1.5) and 0.7 cm (range 0.5-0.8), respectively. The distance in ankle dorsiflexion significantly exceeded the distance in ankle distraction (P = 0.03). The current study shows a significantly increased distance between the anterior distal tibia and the overlying anterior neurovascular bundle with the ankle in a slightly dorsiflexed position as compared to the distracted ankle position. We thereby conclude that the distracted ankle position puts the neurovascular structures more at risk for iatrogenic damage when performing anterior ankle arthroscopy.

Anterior ankle arthroscopy, distraction or dorsiflexion?

PubMed Central

Golanó, Pau; Clavero, Joan A.; van Dijk, C. Niek

2010-01-01

Anterior ankle arthroscopy can basically be performed by two different methods; the dorsiflexion- or distraction method. The objective of this study was to determine the size of the anterior working area for both the dorsiflexion and distraction method. The anterior working area is anteriorly limited by the overlying anatomy which includes the neurovascular bundle. We hypothesize that in ankle dorsiflexion the anterior neurovascular bundle will move away anteriorly from the ankle joint, whereas in ankle distraction the anterior neurovascular bundle is pulled tight towards the joint, thereby decreasing the safe anterior working area. Six fresh frozen ankle specimens, amputated above the knee, were scanned with computed tomography. Prior to scanning the anterior tibial artery was injected with contrast fluid and subsequently each ankle was scanned both in ankle dorsiflexion and in distraction. A special device was developed to reproducibly obtain ankle dorsiflexion and distraction in the computed tomography scanner. The distance between the anterior border of the inferior tibial articular facet and the posterior border of the anterior tibial artery was measured. The median distance from the anterior border of the inferior tibial articular facet to the posterior border of the anterior tibial artery in ankle dorsiflexion and distraction was 0.9 cm (range 0.7–1.5) and 0.7 cm (range 0.5–0.8), respectively. The distance in ankle dorsiflexion significantly exceeded the distance in ankle distraction (P = 0.03). The current study shows a significantly increased distance between the anterior distal tibia and the overlying anterior neurovascular bundle with the ankle in a slightly dorsiflexed position as compared to the distracted ankle position. We thereby conclude that the distracted ankle position puts the neurovascular structures more at risk for iatrogenic damage when performing anterior ankle arthroscopy. PMID:20217392

[Investigation of noise hazards and hearing status of workers in outdoor quarries].

PubMed

Zhang, Guoying; Tang, Zhifeng; Yao, Yongping; Wang, Haiying

2014-08-01

To investigate the noise hazards in open quarries and to provide a basis for further control of noise hazards. An investigation was performed during 2010 to 2011 among all open quarries in Deqing County of Zhejiang Province, China. The investigation included basic information of the quarries, the occupational health situation and noise intensity at the workplace, and the hearing loss of workers exposed to noise in quarry enterprises. The hearing test results were evaluated based on the Diagnostic criteria of occupational noise-induced hearing loss (GBZ 49-2007). A total of 25 enterprises with open quarries were investigated, of which only 30.4% (17/56) workplaces met the national standard. The median noise level was 92.5 dB (A). Fifty-four (10.6%) out of 508 workers in the 25 enterprises were diagnosed with binaural hearing loss in the initial physical examination, with 18.3% (93/508) under surveillance. The rate of normal hearing among crushing workers, mechanists, drilling workers, and blasting workers ranged between 27.6% and 41.4%, which was significantly lower than that among workers exposed to slight noise hazards (80.0%) or other workers (63.7%) (P < 0.05). With increasing working years, the binaural hearing loss of crushing workers became serious. Serious occupational noise hazards existed in most jobs in open quarries, with crushing workers, mechanists, drilling workers, and blasting workers most seriously jeopardized. Among crushing workers, those working in the first-line or unprotected second?line positions suffered more than the others. Further measures should be taken by the supervision department and the enterprises to control the noise hazards in open quarries.

Wait times in the emergency department for patients with mental illness

PubMed Central

Atzema, Clare L.; Schull, Michael J.; Kurdyak, Paul; Menezes, Natasja M.; Wilton, Andrew S.; Vermuelen, Marian J.; Austin, Peter C.

2012-01-01

Background: It has been suggested that patients with mental illness wait longer for care than other patients in the emergency department. We determined wait times for patients with and without mental health diagnoses during crowded and noncrowded periods in the emergency department. Methods: We conducted a population-based retrospective cohort analysis of adults seen in 155 emergency departments in Ontario between April 2007 and March 2009. We compared wait times and triage scores for patients with mental illness to those for all other patients who presented to the emergency department during the study period. Results: The patients with mental illness (n = 51 381) received higher priority triage scores than other patients, regardless of crowding. The time to assessment by a physician was longer overall for patients with mental illness than for other patients (median 82, interquartile range [IQR] 41–147 min v. median 75 [IQR 36–140] min; p < 0.001). The median time from the decision to admit the patient to hospital to ward transfer was markedly shorter for patients with mental illness than for other patients (median 74 [IQR 15–215] min v. median 152 [IQR 45–605] min; p < 0.001). After adjustment for other variables, patients with mental illness waited 10 minutes longer to see a physician compared with other patients during noncrowded periods (95% confidence interval [CI] 8 to 11), but they waited significantly less time than other patients as crowding increased (mild crowding: −14 [95% CI −12 to −15] min; moderate crowding: −38 [95% CI −35 to −42] min; severe crowding: −48 [95% CI −39 to −56] min; p < 0.001). Interpretation: Patients with mental illness were triaged appropriately in Ontario’s emergency departments. These patients waited less time than other patients to see a physician under crowded conditions and only slightly longer under noncrowded conditions. PMID:23148052

The longitudinal study of turnover and the cost of turnover in emergency medical services.

PubMed

Patterson, P Daniel; Jones, Cheryl B; Hubble, Michael W; Carr, Matthew; Weaver, Matthew D; Engberg, John; Castle, Nicholas

2010-01-01

Few studies have examined employee turnover and associated costs in emergency medical services (EMS). To quantify the mean annual rate of turnover, total median cost of turnover, and median cost per termination in a diverse sample of EMS agencies. A convenience sample of 40 EMS agencies was followed over a six-month period. Internet, telephone, and on-site data-collection methods were used to document terminations, new hires, open positions, and costs associated with turnover. The cost associated with turnover was calculated based on a modified version of the Nursing Turnover Cost Calculation Methodology (NTCCM). The NTCCM identified direct and indirect costs through a series of questions that agency administrators answered monthly during the study period. A previously tested measure of turnover to calculate the mean annual rate of turnover was used. All calculations were weighted by the size of the EMS agency roster. The mean annual rate of turnover, total median cost of turnover, and median cost per termination were determined for three categories of agency staff mix: all-paid staff, mix of paid and volunteer (mixed) staff, and all-volunteer staff. The overall weighted mean annual rate of turnover was 10.7%. This rate varied slightly across agency staffing mix (all-paid = 10.2%, mixed = 12.3%, all-volunteer = 12.4%). Among agencies that experienced turnover (n = 25), the weighted median cost of turnover was $71,613.75, which varied across agency staffing mix (all-paid = $86,452.05, mixed = $9,766.65, and all-volunteer = $0). The weighted median cost per termination was $6,871.51 and varied across agency staffing mix (all-paid = $7,161.38, mixed = $1,409.64, and all-volunteer = $0). Annual rates of turnover and costs associated with turnover vary widely across types of EMS agencies. The study's mean annual rate of turnover was lower than expected based on information appearing in the news media and EMS trade magazines. Findings provide estimates of two key workforce measures--turnover rates and costs--where previously none have existed. Local EMS directors and policymakers at all levels of government may find the results and study methodology useful toward designing and evaluating programs targeting the EMS workforce.

Ustekinumab for patients with primary biliary cholangitis who have an inadequate response to ursodeoxycholic acid: A proof-of-concept study.

PubMed

Hirschfield, Gideon M; Gershwin, M Eric; Strauss, Richard; Mayo, Marlyn J; Levy, Cynthia; Zou, Bin; Johanns, Jewel; Nnane, Ivo P; Dasgupta, Bidisha; Li, Katherine; Selmi, Carlo; Marschall, Hanns-Ulrich; Jones, David; Lindor, Keith

2016-07-01

The interleukin (IL)-12 signaling cascade has been associated with primary biliary cholangitis (PBC). This multicenter, open-label, proof-of-concept study evaluated the anti-IL12/23 monoclonal antibody, ustekinumab (90 mg subcutaneous at weeks 0 and 4, then every 8 weeks through week 20), in adults with PBC and an inadequate response to ursodeoxycholic acid therapy (i.e., alkaline phosphatase [ALP] >1.67× upper limit of normal [ULN] after ≥6 months). ALP response was defined as a >40% decrease from baseline and ALP remission as ALP normalization (if baseline ALP 1.67×-2.8× ULN) or <1.67× ULN (if baseline ALP >2.8× ULN). Changes in Enhanced Liver Fibrosis (ELF) scores and serum bile acids were also assessed. At baseline, patients had median disease duration of 3.2 years, median ELF score of 9.8, and highly elevated total bile acid concentration (median, 43.3 μmol/L); 13 of 20 (65%) patients had baseline ALP >3× ULN. Although steady-state serum ustekinumab concentrations were reached by week 12, no patient achieved ALP response or remission. Median percent ALP reduction from baseline to week 28 was 12.1%. ELF score decreased slightly from baseline to week 28 (median reduction: 0.173), and total serum bile acid concentrations decreased from baseline to week 28 (median reduction: 8.8 μmol/L). No serious infections or discontinuations resulting from adverse events were reported through week 28. One patient had a serious upper gastrointestinal hemorrhage considered unrelated to test agent by the investigator. Open-label ustekinumab therapy, though associated with a modest decrease in ALP after 28 weeks of therapy, did not otherwise appreciably change ALP and overt proof-of-concept was not established as per prespecified primary endpoint of proposed efficacy. No new ustekinumab safety signals were observed. (Hepatology 2016;64:189-199). © 2015 by the American Association for the Study of Liver Diseases.

Mega-dose phenobarbital therapy for super-refractory status epilepticus.

PubMed

Byun, Jung-Ick; Chu, Kon; Sunwoo, Jun-Sang; Moon, Jangsup; Kim, Tae-Joon; Lim, Jung-Ah; Jun, Jin-Sun; Lee, Han Sang; Lee, Woo-Jin; Lee, Doo Young; Jeon, Daejong; Lee, Soon-Tae; Jung, Keun-Hwa; Jung, Ki-Young; Lee, Sang Kun

2015-12-01

To evaluate the efficacy and safety of mega-dose phenobarbital (MDPB; enteral or parenteral phenobarbital >10 mg/kg/day) for treating super-refractory status epilepticus (SRSE; continuous or recurrent status epilepticus for ≥24 hours after the onset of continuous anaesthetic treatment) in adult patients. Adult patients with SRSE who were treated with MDPB in our institution from March 2005 to September 2014 were reviewed. We collected data on basic demographics, clinical features, functional status, anticonvulsant treatment, and possible adverse events. SRSE outcome was divided into six categories: successful therapy, initial failure, breakthrough seizures, withdrawal seizures, intolerable side effects, and death during treatment. Ten adult patients with SRSE received MDPB. Median age at seizure onset was 38 years (range: 18-59), and half were male. All patients had no history of seizures and had symptoms suggestive of viral encephalitis. Median duration of status epilepticus was 17.5 days (range: 6-60) and anaesthetics were used for a median of 14.0 days (range: 2-54) before MDPB. Successful control of SRSE was achieved in half of the patients, however, only one of ten patients was able to fully recover at discharge. Median duration of the MDPB was 45.5 days and the maximum serum phenobarbital level reached a median of 151.5 μg/ml. Patients with successful MDPB therapy had normal brain imaging (80% vs. 0%; p=0.048) and better functional outcome at discharge and after three months of follow-up. Infection was the most critical complication, along with cardiorespiratory depression. MDPB is a therapeutic option for control of SRSE when other choices are exhausted.

Training Laparoscopic Skills at Home: Residents' Opinion of a New Portable Tablet Box Trainer.

PubMed

van der Aa, Jessica E; Schreuder, Henk W R

2016-04-01

To determine residents' opinion about a new portable box trainer, to see if they would be interested in using this for training at home, and to give an overview of the box trainers that could be used at home. An expert opinion study was performed among 27 gynecology residents to determine the value of the portable box trainer in training their laparoscopic skills and the value of using it at home. Their opinions were scored on a 5-point Likert scale. Gynecology residents very much appreciated the portable box trainer in its design, size, visualization, light source, ability to record, and instruments (all median 4). They felt that the portable box trainer would be effective in training laparoscopic skills in general; in training hand-eye coordination, 3D perception, and tying knots (all median 4); and especially in training basic skills (median 5). Almost all residents would use the portable box trainer if they had one at home (median 5). The literature supports the hypothesis that training laparoscopic skills at home using a box trainer may be effective in acquiring and maintaining laparoscopic skills. Training laparoscopic skills at home using a portable box trainer may be of added value in the laparoscopic training of surgical residents. Residents feel positive about using the new portable box trainer that is presented and appreciate the possibility of training at home. © The Author(s) 2015.

Enhanced Vertical Perception through Head-Related Impulse Response Customization Based on Pinna Response Tuning in the Median Plane

NASA Astrophysics Data System (ADS)

Shin, Ki Hoon; Park, Youngjin

Human's ability to perceive elevation of a sound and distinguish whether a sound is coming from the front or rear strongly depends on the monaural spectral features of the pinnae. In order to realize an effective virtual auditory display by HRTF (head-related transfer function) customization, the pinna responses were isolated from the median HRIRs (head-related impulse responses) of 45 individual HRIRs in the CIPIC HRTF database and modeled as linear combinations of 4 or 5 basic temporal shapes (basis functions) per each elevation on the median plane by PCA (principal components analysis) in the time domain. By tuning the weight of each basis function computed for a specific height to replace the pinna response in the KEMAR HRIR at the same height with the resulting customized pinna response and listening to the filtered stimuli over headphones, 4 individuals with normal hearing sensitivity were able to create a set of HRIRs that outperformed the KEMAR HRIRs in producing vertical effects with reduced front/back ambiguity in the median plane. Since the monaural spectral features of the pinnae are almost independent of azimuthal variation of the source direction, similar vertical effects could also be generated at different azimuthal directions simply by varying the ITD (interaural time difference) according to the direction as well as the size of each individual's own head.

Basic statistics with Microsoft Excel: a review.

PubMed

Divisi, Duilio; Di Leonardo, Gabriella; Zaccagna, Gino; Crisci, Roberto

2017-06-01

The scientific world is enriched daily with new knowledge, due to new technologies and continuous discoveries. The mathematical functions explain the statistical concepts particularly those of mean, median and mode along with those of frequency and frequency distribution associated to histograms and graphical representations, determining elaborative processes on the basis of the spreadsheet operations. The aim of the study is to highlight the mathematical basis of statistical models that regulate the operation of spreadsheets in Microsoft Excel.

Basic statistics with Microsoft Excel: a review

PubMed Central

Di Leonardo, Gabriella; Zaccagna, Gino; Crisci, Roberto

2017-01-01

The scientific world is enriched daily with new knowledge, due to new technologies and continuous discoveries. The mathematical functions explain the statistical concepts particularly those of mean, median and mode along with those of frequency and frequency distribution associated to histograms and graphical representations, determining elaborative processes on the basis of the spreadsheet operations. The aim of the study is to highlight the mathematical basis of statistical models that regulate the operation of spreadsheets in Microsoft Excel. PMID:28740690

Chromosomal Aberrations in Wild Mice Captured in Areas Differentially Contaminated by the Fukushima Dai-Ichi Nuclear Power Plant Accident.

PubMed

Kubota, Yoshihisa; Tsuji, Hideo; Kawagoshi, Taiki; Shiomi, Naoko; Takahashi, Hiroyuki; Watanabe, Yoshito; Fuma, Shoichi; Doi, Kazutaka; Kawaguchi, Isao; Aoki, Masanari; Kubota, Masahide; Furuhata, Yoshiaki; Shigemura, Yusaku; Mizoguchi, Masahiko; Yamada, Fumio; Tomozawa, Morihiko; Sakamoto, Shinsuke H; Yoshida, Satoshi

2015-08-18

Following the Fukushima Dai-ichi Nuclear Power Plant accident, radiation effects on nonhuman biota in the contaminated areas have been a great concern. The induction of chromosomal aberrations in splenic lymphocytes of small Japanese field mice (Apodemus argenteus) and house mice (Mus musculus) inhabiting Fukushima Prefecture was investigated. In mice inhabiting the slightly contaminated area, the average frequency of dicentric chromosomes was similar to that seen in mice inhabiting a noncontaminated control area. In contrast, mice inhabiting the moderately and heavily contaminated areas showed a significant increase in the average frequencies of dicentric chromosomes. Total absorbed dose rate was estimated to be approximately 1 mGy d(-1) and 3 mGy d(-1) in the moderately and heavily contaminated areas, respectively. Chromosomal aberrations tended to roughly increase with dose rate. Although theoretically, the frequency of chromosomal aberrations was considered proportional to the absorbed dose, chromosomal aberrations in old mice (estimated median age 300 days) did not increase with radiation dose at the same rate as that observed in young mice (estimated median age 105 days).

Overview of recent trends in diagnosis and management of leptomeningeal multiple myeloma.

PubMed

Yellu, Mahender R; Engel, Jessica M; Ghose, Abhimanyu; Onitilo, Adedayo A

2016-03-01

Neurological complications related to multiple myeloma (MM) are not uncommon; however, direct involvement of the central nervous system (CNS) is extremely rare and represents a diagnostic and therapeutic challenge. Significant survival difference has been noted with the introduction of novel therapy in patients with MM, but their effect on the incidence and their use for management of leptomeningeal myeloma (LMM) is uncertain. Analysis of published data demonstrates its recent increased incidence, median time to CNS presentation, and slight improvement in median survival after diagnosis of LMM. Less common MM isotypes have been overrepresented in LMM. CNS relapse occurred mostly in patients with Durie-Salmon stage III MM. Despite treatments, standard or experimental, the survival rates of LMM remain dismal. Monitoring high risk patients closely, even after achieving complete remission, may be useful in early detection of LMM. As we gain better understanding of LMM, we recommend that future research and clinical care focus on earlier diagnosis and development of more efficient CNS-directed therapy to improve survival in this patient population. Copyright © 2014 John Wiley & Sons, Ltd.

Failure to pay for social health insurance premiums: Acts of protest or desperation?

PubMed

von Wyl, Viktor; Beck, Konstantin

2015-01-01

In Switzerland, basic health insurance is mandatory for all inhabitants, but a rising number of insured have arrears in premium payments, potentially leading to coverage suspension. We aimed at characterizing insured with debt enforcement proceedings with respect to socio-demographic and health utilization aspects. Cross-sectional analysis of 508.000 insured with basic health insurance contracts in 2013, of whom 14,000 (2.8%) with debt enforcement proceedings, from 11 Swiss cantons. Groups were characterized using logistic regression and latent class analysis. Insured with debt enforcement proceedings were more likely to be young, male and without dependents (partner, kids). Having no supplementary insurance and receiving partial premium subsidies was associated with an increased debt enforcement proceedings risk. Within the debt enforcement proceedings group, three subgroups were identified: 60% were young and seemingly healthy, with a below-average fraction of premium subsidy recipients (18%) and low out-of-pocket payments in prior year (median Swiss Francs 0). Two groups consisted of relatively ill elderly persons (22%, 99% of whom with chronic illnesses) or families (18%), many of whom (29% and 51%) were recipients of premium subsidies. Median out-of-pocket payments in the prior year were high (Swiss Francs 625 and 688, respectively). Sixty percent of premium arrears derive from young insured without apparent financial problems; 40% are owed by elderly and families, which are potentially hurt by coverage loss.

[Genealogy of the Books of Practica medicinae in Europe before the End of 18th Century: From the Origin to the Disappearance].

PubMed

Sakai, Tatsuo

2015-09-01

The Practica medicinae represented the books written in Europe before the end of 18th century that dealt with individual deseases. In total, 100 Practica books, written by 95 authors, were collected and divided into four periods from the early 11th to the end of 18th century. The first Practica book was written at the Salernitan medical school on the basis of ancient medical books in the basic style, dealing with regional deseases arranged in "a capite ad calcem" manner, as well as with the fevers. The basic style comprised a majority in the first period and decreased gradually, becoming a minority in the 3rd and 4th periods. Sennert's practica was the largest and it elaborated with precise construction. The additional categories, such as female, children, and surgical deseases increased in the later periods. Those written in non-basic style based on pathogenesis or in alphabetical order also increased in the later periods. The practica books changed slightly and gradually, indicating the essential consistency of the concepts of diseases in these periods.

Robot-Assisted Thoracoscopic Surgery versus Video-Assisted Thoracoscopic Surgery for Lung Lobectomy: Can a Robotic Approach Improve Short-Term Outcomes and Operative Safety?

PubMed

Mahieu, Julien; Rinieri, Philippe; Bubenheim, Michael; Calenda, Emile; Melki, Jean; Peillon, Christophe; Baste, Jean-Marc

2016-06-01

Background Minimally invasive surgery has been recently recommended for treatment of early-stage non-small cell lung cancer. Despite the recent increase of robotic surgery, the place and potential advantages of the robot in thoracic surgery has not been well defined until now. Methods We reviewed our prospective database for retrospective comparison of our first 28 video-assisted thoracoscopic surgery lobectomies (V group) and our first 28 robotic lobectomies (R group). Results No significant difference was shown in median operative time between the two groups (185 vs. 190 minutes, p = 0.56). Median preincision time was significantly longer in the R group (80 vs. 60 minutes, P < 0.0001). The rate of emergency conversion for uncontrolled bleeding was lower in the R group (one vs. four). Median length of stay was comparable (6 days in the R group vs. 7 days in the V group, p = 0.4) with no significant difference in the rate of postoperative complications (eight Grade I in both groups, four Grade III or IV in the V group vs. six in the R group, according to the Clavien-Dindo classification, p = 0.93). No postoperative cardiac morbidity was observed in the R group. Median drainage time was similar (5 days, p = 0.78), with a rate of prolonged air leak slightly higher in the R group (25 vs. 17.8%, p = 0.74). Conclusion Perioperative outcomes are similar even in the learning period but robotic approach seems to offer more operative safety with fewer conversions for uncontrolled bleeding. Georg Thieme Verlag KG Stuttgart · New York.

Long-term adherence to daily controller medication in children with asthma: The role of outpatient clinic visits.

PubMed

Keemink, Yvette S; Klok, Ted; Brand, Paul L P

2015-11-01

To investigate changes in inhaled corticosteroids adherence, both before and after a scheduled follow-up visit, in young children in a comprehensive asthma management program. One-year prospective follow-up study in 104 asthmatic children (mean age 4.8 years). Adherence to inhaled corticosteroids was assessed using electronic (Smartinhaler®) devices. We assessed changes in adherence before and after clinic visits. A  > 10% increase in adherence in the 3 days preceding a clinic visit was considered to reflect clinically relevant white coat adherence (WCA) if it exceeded background variation in adherence (median change >0, and increase larger than adherence changes after a clinic visit). Overall adherence was high (median 85%). A pre-visit increase in adherence of >10% was demonstrated in 17 patients (22%), but the median change in adherence around a clinic visit was 0. There were no significant differences in changes in adherence between the days before or after a visit (P > 0.2). The median coefficient of variation in adherence was 9%, and did not significantly differ between children with and without a pre-visit increase in adherence (P = 0.12). Twelve patients (15.4%) showed an increase of adherence in the month following a clinic visit; their overall mean (SE) adherence was slightly lower (73% (4.6%)) than those without such an increase (80% (2.2%), P = 0.054). There was no WCA in children with asthma enrolled in a comprehensive asthma management program with high overall adherence. This suggests that WCA in pediatric chronic conditions primarily occurs against the background of low overall adherence. © 2014 Wiley Periodicals, Inc.

Randomized trial comparing adriamycin vincristine (av) cyclophosphamide methotrexate 5-Fluorouracil prednisone (cmfp) hybrid versus av-cmfp monthly alternated in metastatic breast-cancer.

PubMed

Vallejo, C; Bianco, A; Perez, J; Machiavelli, M; Leone, B; Romero, A; Rabinovich, M; Alvarez, L; Rodriguez, R; Cuevas, M; Hannois, A; Lacava, J

1993-03-01

194 metastatic breast cancer patients with no prior chemotherapy for advanced disease were randomized to one of two alternating schedules, fulfilling the requisites of Goldie and Coldman's hypothesis to evaluate if the earlier alternation of two non-cross resistant regimens is superior in terms of response (R), duration of R (DR), and survival (SV). arm A: Adriamycin (A) 60 mg/m2 IV day (d) 1 and vincristine (V) 1.4 mg/m2 IV d 1 and 8 monthly alternated with cyclophosphamide (C) 100 mg/m2 p.o. d 1-14; methotrexate (M) 30 mg/m2 IV d 1 and 8; 5-fluorouracil (F) 600 mg/m2 IV d 1 and 8 and prednisone (Pr) 40 mg/m2 p.o. d 1-14. Arm B (hybrid): A 60 mg/m2 IV d 1; V 1.4 mg/m2 IV d 1; C 100 mg/m2 p.o. d 8-14; M 30 mg/m2 IV d 8; F 600 mg/m2 IV d 8 and Pr 40 mg/m2 p.o. d 8-14. 87 and 89 patients are evaluable for R. Arm A: R= 59% (51/87); median DR= 13 months (m); median SV= 25 m. Arm B: R= 69% (61/89); median DR= 15 m.; median SV= 29 m. Myelosuppression was slightly more marked in arm B. Three patients had toxic-related deaths (arm A: 1; arm B: 2). a trend favoring an earlier alternation and higher dose intensity (DI) was found regarding to R, DR and SV. However, differences were not statistically significant.

Serum C-reactive protein concentrations in healthy Miniature Schnauzer dogs.

PubMed

Wong, Valerie M; Kidney, Beverly A; Snead, Elisabeth C R; Myers, Sherry L; Jackson, Marion L

2011-09-01

C-reactive protein (CRP) is a sensitive marker for inflammation in people and dogs. In people, an association between CRP concentration and atherosclerosis has been reported. Atherosclerosis is rare in dogs, but the Miniature Schnauzer breed may be at increased risk for developing this vascular disease. It is not known if CRP concentrations in Miniature Schnauzer dogs differ from those in other dog breeds. Our objectives were to validate an automated human CRP assay for measuring CRP in dogs and compare CRP concentrations in healthy Miniature Schnauzer dogs with those in non-Miniature Schnauzer breeds. Sera from 37 non-Miniature Schnauzer dogs with inflammatory disease were pooled and used to validate a human CRP immunoturbidimetric assay for measuring canine CRP. Blood was collected from 20 healthy Miniature Schnauzer dogs and 41 healthy dogs of other breeds. Median serum CRP concentration of healthy Miniature Schnauzer dogs was compared with that of healthy non-Miniature Schnauzer dogs. The human CRP assay measured CRP reliably with linearity between 0 and 20 mg/L. CRP concentration for healthy Miniature Schnauzer dogs (median 4.0 mg/L, minimum-maximum 0-18.2 mg/L) was significantly higher than for the healthy non-Miniature Schnauzer dogs (median 0.1 mg/L, minimum-maximum 0-10.7 mg/L); 17 of the 20 Miniature Schnauzer dogs had values that overlapped with those of the non-Miniature Schnauzer dogs. Median CRP concentration of Miniature Schnauzer dogs was slightly higher than that of other breeds of dogs. A relationship between higher CRP concentration in Miniature Schnauzer dogs and idiopathic hyperlipidemia, pancreatitis, and possible increased risk for atherosclerosis remains to be determined. ©2011 American Society for Veterinary Clinical Pathology.

Early post-operative magnetic resonance imaging in glioblastoma: correlation among radiological findings and overall survival in 60 patients.

PubMed

Majós, Carles; Cos, Mònica; Castañer, Sara; Gil, Miguel; Plans, Gerard; Lucas, Anna; Bruna, Jordi; Aguilera, Carles

2016-04-01

To evaluate early post-operative magnetic resonance (EPMR) as a prognostic tool after resection of glioblastoma. Sixty EPMR examinations were evaluated for perioperative infarct, tumour growth between diagnosis and EPMR, contrast enhancement pattern, and extent of resection (EOR). The EOR was approached with the subjective evaluation of radiologists and by quantifying volumes. These parameters were tested as predictors of survival using the Kaplan-Meier method. Contrast enhancement was found in 59 patients (59/60; 98 %). Showing a thin-linear pattern of enhancement was the most favourable finding. Patients with this pattern survived longer than patients with thick-linear (median overall survival (OS) thin-linear=609 days; thick-linear=432 days; P = .023) or nodular (median OS = 318 days; P = .001) enhancements. The subjective evaluation of the EOR performed better than its quantification. Patients survived longer when resection was total (median OS total resection=609 days; subtotal=371 days; P = .001). When resection was subtotal, patients survived longer if it was superior to 95 % (median OS resection superior to 95 %=559 days; inferior to 95 %=256 days; P = .034). EPMR provides valuable prognostic information after surgical resection of glioblastomas. A thin-linear pattern of contrast enhancement is the most favourable finding. Further prognostic stratification may be obtained by assessing the EOR. • Some kind of contrast enhancement may be found in most EPMR examinations. • Thin-linear enhancements in the EPMR may be considered benign findings. • The EOR evaluated in the EPMR may stratify prognostic groups of patients. • The subjective evaluation of the EOR performs slightly better than its quantification.

A review of the patterns of docetaxel use for hormone-resistant prostate cancer at the Princess Margaret Hospital.

PubMed

Chin, S N; Wang, L; Moore, M; Sridhar, S S

2010-04-01

Based on the TAX 327 phase III trial, docetaxel-based chemotherapy is the standard first-line treatment for hormone-resistant prostate cancer (HRPC); however, there is some heterogeneity in the use of this agent in routine clinical practice. The aim of the present study was to examine the patterns of docetaxel use in routine clinical practice at our institution and to compare them with docetaxel use in the TAX 327 clinical trial. We conducted a retrospective chart review of HRPC patients treated with first-line docetaxel between 2005 and 2007 at the Princess Margaret Hospital. In the first-line setting, 88 patients with HRPC received docetaxel. The main reasons for initiating docetaxel were rising prostate-specific antigen (PSA, 98%) and progressive symptoms (77%). The PSA response rate was 67%; median time to response was 1.5 months, and duration of response was 6.8 months. Median survival was 15.9 months (95% confidence interval: 12.4 to 20.5 months). Patients received a median of 7 cycles of treatment, and the main toxicities were fatigue (35%) and neuropathy (24%). Post docetaxel, 36 patients received second-line treatment with a 22% response rate. In routine clinical practice, HRPC patients received docetaxel mainly because of symptomatic disease progression. Overall response rates and toxicities were comparable to those in the TAX 327 trial. However, our patients received a median of only 7 cycles of treatment versus the 9.5 administered on trial, and survival was slightly shorter in our single-institution study. A larger prospective multicentre analysis, including performance status and quality-of-life parameters, may be warranted to determine if docetaxel performs as well in routine clinical practice as it does in the clinical trial setting.

Evaluation of factors affecting CGMS calibration.

PubMed

Buckingham, Bruce A; Kollman, Craig; Beck, Roy; Kalajian, Andrea; Fiallo-Scharer, Rosanna; Tansey, Michael J; Fox, Larry A; Wilson, Darrell M; Weinzimer, Stuart A; Ruedy, Katrina J; Tamborlane, William V

2006-06-01

The optimal number/timing of calibrations entered into the CGMS (Medtronic MiniMed, Northridge, CA) continuous glucose monitoring system have not been previously described. Fifty subjects with Type 1 diabetes mellitus (10-18 years old) were hospitalized in a clinical research center for approximately 24 h on two separate days. CGMS and OneTouch Ultra meter (LifeScan, Milpitas, CA) data were obtained. The CGMS was retrospectively recalibrated using the Ultra data varying the number and timing of calibrations. Resulting CGMS values were compared against laboratory reference values. There was a modest improvement in accuracy with increasing number of calibrations. The median relative absolute deviation (RAD) was 14%, 15%, 13%, and 13% when using three, four, five, and seven calibration values, respectively (P < 0.001). Corresponding percentages of CGMS-reference pairs meeting the International Organisation for Standardisation criteria were 66%, 67%, 71%, and 72% (P < 0.001). Nighttime accuracy improved when daytime calibrations (pre-lunch and pre-dinner) were removed leaving only two calibrations at 9 p.m. and 6 a.m. (median difference, -2 vs. -9 mg/dL, P < 0.001; median RAD, 12% vs. 15%, P = 0.001). Accuracy was better on visits where the average absolute rate of glucose change at the times of calibration was lower. On visits with average absolute rates <0.5, 0.5 to <1.0, 1.0 to <1.5, and >or=1.5 mg/dL/min, median RAD values were 13% versus 14% versus 17% versus 19%, respectively (P = 0.05). Although accuracy is slightly improved with more calibrations, the timing of the calibrations appears more important. Modifying the algorithm to put less weight on daytime calibrations for nighttime values and calibrating during times of relative glucose stability may have greater impact on accuracy.

Evaluation of Factors Affecting CGMS Calibration

PubMed Central

2006-01-01

Background The optimal number/timing of calibrations entered into the Continuous Glucose Monitoring System (“CGMS”; Medtronic MiniMed, Northridge, CA) have not been previously described. Methods Fifty subjects with T1DM (10–18y) were hospitalized in a clinical research center for ~24h on two separate days. CGMS and OneTouch® Ultra® Meter (“Ultra”; LifeScan, Milpitas, CA) data were obtained. The CGMS was retrospectively recalibrated using the Ultra data varying the number and timing of calibrations. Resulting CGMS values were compared against laboratory reference values. Results There was a modest improvement in accuracy with increasing number of calibrations. The median relative absolute deviation (RAD) was 14%, 15%, 13% and 13% when using 3, 4, 5 and 7 calibration values, respectively (p<0.001). Corresponding percentages of CGMS-reference pairs meeting the ISO criteria were 66%, 67%, 71% and 72% (p<0.001). Nighttime accuracy improved when daytime calibrations (pre-lunch and pre-dinner) were removed leaving only two calibrations at 9p.m. and 6a.m. (median difference: −2 vs. −9mg/dL, p<0.001; median RAD: 12% vs. 15%, p=0.001). Accuracy was better on visits where the average absolute rate of glucose change at the times of calibration was lower. On visits with average absolute rates <0.5, 0.5-<1.0, 1.0-<1.5 and ≥1.5mg/dL/min, median RAD values were 13% vs. 14% vs. 17% vs. 19%, respectively (p=0.05). Conclusions Although accuracy is slightly improved with more calibrations, the timing of the calibrations appears more important. Modifying the algorithm to put less weight on daytime calibrations for nighttime values and calibrating during times of relative glucose stability may have greater impact on accuracy. PMID:16800753

Inhibition of Photocatalytic Activity of Basic Blue-41 by ZnO Modified Surface with Amino Silane

NASA Astrophysics Data System (ADS)

Limsapapkasiphon, S.; Sirisaksoontorn, W.; Songsasen, A.

2018-03-01

The reduction of the photo catalytic efficiency of ZnO can be achieved by modifying its surface with amino silane, which synthesized through condensation reaction under basic condition. The pH of solution was varied from 8 to 14 during the synthesis and was found that pH 12 was the most suitable pH for the preparation. All of ZMAS were characterized by Elemental Analysis which showed the highest percentage of nitrogen at 3.1064% and IR technique which indicated the Si-O-Zn bond at about 1000 cm-1. The photodegradation property of ZMAS prepared at pH 8-12 toward basic blue 41 was retarded when compared with the unmodified ZnO. Effect of mole ratio of ZnO:APTES (1:0.1, 1:0.5, 1:1, and 1:2) in the preparation of ZMAS was investigated. The photodegration activity of ZMAS prepared at mole ratio of ZnO:APTES as 1:0.5 to 1:2 toward basic blue 41 was retarded when compared with the unmodified ZnO. The coating of amino silane on ZnO surface did not have much effect on the band gap energy of modified ZnO. The absorption edge of ZMAS was only slightly shifted from 392 to 397 nm.

The effect of weight, body mass index, age, sex, and race on plasma concentrations of subcutaneous sumatriptan: a pooled analysis.

PubMed

Munjal, Sagar; Gautam, Anirudh; Rapoport, Alan M; Fisher, Dennis M

2016-01-01

Factors such as body size (weight and body mass index [BMI]), age, sex, and race might influence the clinical response to sumatriptan. We evaluated the impact of these covariates on the plasma concentration (Cp) profile of sumatriptan administered subcutaneously. We conducted three pharmacokinetic studies of subcutaneous sumatriptan in 98 healthy adults. Sumatriptan was administered subcutaneously (236 administrations) as either DFN-11 3 mg, a novel 0.5 mL autoinjector being developed by Dr. Reddy's Laboratories; Imitrex(®) (Sumatriptan) injection 3 mg or 6 mg (6 mg/0.5 mL); or Imitrex STATdose 4 mg or 6 mg (0.5 mL). Blood was sampled for 12 hours to determine sumatriptan Cp. Maximum Cp (Cmax), area under the curve during the first 2 hours (AUC0-2), and total area under the curve (AUC0-∞) were determined using noncompartmental methods. Post hoc analyses were conducted to determine the relationship between these exposure metrics and each of body weight, BMI, age, sex, and race (categorized as white, black, or others). Both weight and BMI correlated negatively with each exposure metric for each treatment group. Across all treatment groups, AUC0-2 for subjects with BMI less than or equal to median value was 1.03-1.12 times the value for subjects with BMI more than median value. For subjects with BMI less than or equal to median value receiving DFN-11, median AUC0-2 was slightly less than that for subjects with BMI more than median value receiving Imitrex 4 mg and larger than that for subjects with BMI more than median value receiving Imitrex 3 mg. Results were similar for the other exposure metrics and for weight. Exposure was higher in women than in men, which can be attributed in part to differences in weight. There was no relationship between exposure and age. For DFN-11, AUC0-2 and AUC0-∞ were lower in nonwhites compared with whites; the ratio of median values was 0.84 and 0.89, respectively. A similar, nonstatistically significant, trend was observed in the other products (ratio of median values ranging from 0.84 to 0.89). Weight and BMI appear to be important covariates for sumatriptan exposure: subjects with lower values for either metric of body size have higher systemic exposure compared with subjects with higher values. Additional studies are required to determine if doses of subcutaneous sumatriptan may be adjusted based on BMI for comparable efficacy and a potentially improved tolerability profile.

Dose escalation can maximize therapeutic potential of sunitinib in patients with metastatic renal cell carcinoma.

PubMed

Maráz, Anikó; Cserháti, Adrienn; Uhercsák, Gabriella; Szilágyi, Éva; Varga, Zoltán; Révész, János; Kószó, Renáta; Varga, Linda; Kahán, Zsuzsanna

2018-03-15

In patients with metastatic renal cell cancer, based on limited evidence, increased sunitinib exposure is associated with better outcome. The survival and toxicity data of patients receiving individualized dose escalated sunitinib therapy as compared to standard management were analyzed in this study. From July 2013, the data of metastatic renal cell cancer patients with slight progression but still a stable disease according to RECIST 1.1 criteria treated with an escalated dose of sunitinib (first level: 62.5 mg/day in 4/2 or 2 × 2/1 scheme, second level: 75 mg/day in 4/2 or 2 × 2/1 scheme) were collected prospectively. Regarding characteristics, outcome, and toxicity data, an explorative retrospective analysis of the register was carried out, comparing treatments after and before July 1, 2013 in the study (selected patients for escalated dose) and control (standard dose) groups, respectively. The study involved 103 patients receiving sunitinib therapy with a median overall and progression free survival of 25.36 ± 2.62 and 14.2 ± 3.22 months, respectively. Slight progression was detected in 48.5% of them. First and second-level dose escalation were indicated in 18.2% and 4.1% of patients, respectively. The dosing scheme was modified in 22.2%. The median progression free survival (39.7 ± 5.1 vs 14.2 ± 1.3 months (p = 0.037)) and the overall survival (57.5 ± 10.7 vs 27.9 ± 2.5 months (p = 0.044)) were significantly better in the study group (with dose escalation) than in the control group. Patients with nephrectomy and lower Memorial Sloan Kettering Cancer Center (MSKCC) scores showed more favorable outcomes. After dose escalation, the most common adverse events were worsening or development of fatigue, hypertension, stomatitis, and weight loss of over 10%. Escalation of sunitinib dosing in selected patients with metastatic renal cell cancer, especially in case of slight progression, based on tolerable toxicity is safe and improves outcome. Dose escalation in 12.5 mg steps may be recommended for properly educated patients.

Pozzolanic filtration/solidification of radionuclides in nuclear reactor cooling water

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

Englehardt, J.D.; Peng, C.

1995-12-31

Laboratory studies to investigate the feasibility of one- and two-step processes for precipitation/coprecipitating radionuclides from nuclear reactor cooling water, filtering with pozzolanic filter aid, and solidifying, are reported in this paper. In the one-step process, ferrocyanide salt and excess lime are added ahead of the filter, and the resulting filter cake solidifies by a pozzolanic reaction. The two-step process involves addition of solidifying agents subsequent to filtration. It was found that high surface area diatomaceous synthetic calcium silicate powders, sold commercially as functional fillers and carriers, adsorb nickel isotopes from solution at neutral and slightly basic pH. Addition of themore » silicates to cooling water allowed removal of the tested metal isotopes (nickel, iron, manganese, cobalt, and cesium) simultaneously at neutral to slightly basic pH. Lime to diatomite ratio was the most influential characteristic of composition on final strength tested, with higher lime ratios giving higher strength. Diatomaceous earth filter aids manufactured without sodium fluxes exhibited higher pozzolanic activity. Pozzolanic filter cake solidified with sodium silicate and a ratio of 0.45 parts lime to 1 part diatomite had compressive strength ranging from 470 to 595 psi at a 90% confidence level. Leachability indices of all tested metals in the solidified waste were acceptable. In light of the typical requirement of removing iron and desirability of control over process pH, a two-step process involving addition of Portland cement to the filter cake may be most generally applicable.« less

[Impact of an asthma educational intervention programme on teachers].

PubMed

Korta Murua, J; Pérez-Yarza, E G; Pértega Díaz, S; Aldasoro Ruiz, A; Sardón Prado, O; López-Silvarrey Varela, A; Corcuera Elósegui, P; Mintegui Aramburu, F J

2012-10-01

Our objective was to measure the impact of an educational intervention program on teacher's knowledge about asthma and its management. Before and after quasi-experimental study, with control group, of an educational intervention, which had as its aim to improve the teacher's knowledge of asthma and its management, was conducted in some schools of San Sebastian (Gipuzkoa), Spain. The Newcastle Asthma knowledge Questionnaire (NAKQ) was used as a measuring tool, and an adaptation of the asthma, sport and health program was used as an educational intervention. The Wilcoxon signed rank test was used to compare the total score of the questionnaire before and after the intervention, and the McNemar test was performed to compare the percentages of correct answers to each item. The Mann-Whitney U test was also performed to compare the baseline score and the score at three months between the intervention group and control group. The size of the effect and the standardised mean response were studied. A total of 138 teachers from 6 schools, which were chosen at random (study group), and 43 teachers in the control group participated in the study. In the study group, the mean score of the NAKQ before the educational intervention was 16.1±3.4 points, with a median of 16 (range 7 to 23). After the intervention the mean score increased to 22.3±4.1, with a median of 23 (range, 6 to 29). The mean difference in the overall score of the NAKQ was 7.0±4.2 points, with a median of 8 (range, -2 to17). Furthermore, the size of the effect was 2.0 (> 0.8) and the standardised mean response was 1.7. After 3 months of the intervention the mean score of the NAKQ was 21.4±3.0 points, with a median of 22 (range, 12 to 29) which was significantly higher than the score obtained before the intervention (P<.001) and slightly lower than the score obtained immediately after the intervention, assuming a size of the effect of 1.6 and a standardised mean response of 1.2. In the control group, the level of knowledge did not change modified and was lower than the level of the intervention group (P<.001). An educational intervention program conducted among teachers significantly increases their knowledge of asthma. Moreover, the increase reduces slightly but maintains its higher level for at least 3 months. In spite of the fact that some aspects of knowledge improved with the educational intervention, they were not optimal. Copyright © 2012 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

A software-based tool for video motion tracking in the surgical skills assessment landscape.

PubMed

Ganni, Sandeep; Botden, Sanne M B I; Chmarra, Magdalena; Goossens, Richard H M; Jakimowicz, Jack J

2018-01-16

The use of motion tracking has been proved to provide an objective assessment in surgical skills training. Current systems, however, require the use of additional equipment or specialised laparoscopic instruments and cameras to extract the data. The aim of this study was to determine the possibility of using a software-based solution to extract the data. 6 expert and 23 novice participants performed a basic laparoscopic cholecystectomy procedure in the operating room. The recorded videos were analysed using Kinovea 0.8.15 and the following parameters calculated the path length, average instrument movement and number of sudden or extreme movements. The analysed data showed that experts had significantly shorter path length (median 127 cm vs. 187 cm, p = 0.01), smaller average movements (median 0.40 cm vs. 0.32 cm, p = 0.002) and fewer sudden movements (median 14.00 vs. 21.61, p = 0.001) than their novice counterparts. The use of software-based video motion tracking of laparoscopic cholecystectomy is a simple and viable method enabling objective assessment of surgical performance. It provides clear discrimination between expert and novice performance.

The HI HOPES data set of deaf children under the age of 6 in South Africa: maternal suspicion, age of identification and newborn hearing screening.

PubMed

Störbeck, Claudine; Young, Alys

2016-03-22

Identification of deafness before 3 months of age substantially improves the socio-linguistic and cognitive development of deaf children. Existing studies demonstrating the feasibility of newborn hearing screening in South Africa have used small samples unrepresentative of general population characteristics. This study establishes the characteristics of the largest data set of deaf infants and their families in South Africa on which there is baseline and longitudinal data (n = 532); explores its representativeness in terms of socio-demographic features and reports on access to and quality of newborn hearing screening within the sample. It examines specifically the relationship between age of maternal suspicion of childhood deafness and age of identification of deafness by cohort characteristics. Secondary analysis, using descriptive and inferential statistics, of a pre-existing longitudinal data set (n = 532) of deaf infants under 6 years of age, and their families, collected as routine monitoring of the HI HOPES (HH) early intervention programme. The HH cohort is representative in terms of racial profile and private/public health care use but displays slightly higher level of maternal education and slightly lower socio-economic status than national comparators. 102 out of 532 infants had undergone newborn hearing screening, resulting in 29 true positives, 15 of whom would have met the criteria for targeted screening. Later onset deafness does not account for the 73 false negatives. The median age of maternal suspicion (n = 247) of infant deafness was 18 months; the median age of identification of 28 months. Age of identification was unrelated to private/public health care status. The median delay between age of suspicion and age of identification was significantly longer in the public sector (7 m; IQR 0-15 m) compared to the private sector (2 m; IQR 0-8.5 m) (p = 0.035). Age of suspicion was unrelated to level of maternal education. Earlier age of suspicion did not predict earlier identification. Targeted screening as timely response to maternal suspicion offers a viable means to reduce substantially the age of identification of deafness in South Africa until implementation of newborn hearing screening on a population-wide basis can be justified.

Comparison of Cardiopulmonary Resuscitation Quality Between Standard Versus Telephone-Basic Life Support Training Program in Middle-Aged and Elderly Housewives: A Randomized Simulation Study.

PubMed

Kim, Tae Han; Lee, Yu Jin; Lee, Eui Jung; Ro, Young Sun; Lee, KyungWon; Lee, Hyeona; Jang, Dayea Beatrice; Song, Kyoung Jun; Shin, Sang Do; Myklebust, Helge; Birkenes, Tonje Søraas

2018-02-01

For cardiac arrests witnessed at home, the witness is usually a middle-aged or older housewife. We compared the quality of cardiopulmonary resuscitation (CPR) performance of bystanders trained with the newly developed telephone-basic life support (T-BLS) program and those trained with standard BLS (S-BLS) training programs. Twenty-four middle-aged and older housewives without previous CPR education were enrolled and randomized into two groups of BLS training programs. The T-BLS training program included concepts and current instruction protocols for telephone-assisted CPR, whereas the S-BLS training program provided training for BLS. After each training course, the participants simulated CPR and were assisted by a dispatcher via telephone. Cardiopulmonary resuscitation quality was measured and recorded using a mannequin simulator. The primary outcome was total no-flow time (>1.5 seconds without chest compression) during simulation. Among 24 participants, two (8.3%) who experienced mechanical failure of simulation mannequin and one (4.2%) who violated simulation protocols were excluded at initial simulation, and two (8.3%) refused follow-up after 6 months. The median (interquartile range) total no-flow time during initial simulation was 79.6 (66.4-96.9) seconds for the T-BLS training group and 147.6 (122.5-184.0) seconds for the S-BLS training group (P < 0.01). Median cumulative interruption time and median number of interruption events during BLS at initial simulation and 6-month follow-up simulation were significantly shorter in the T-BLS than in the S-BLS group (1.0 vs. 9.5, P < 0.01, and 1.0 vs. 10.5, P = 0.02, respectively). Participants trained with the T-BLS training program showed shorter no-flow time and fewer interruptions during bystander CPR simulation assisted by a dispatcher.

Access to a simulator is not enough: the benefits of virtual reality training based on peer-group-derived benchmarks--a randomized controlled trial.

PubMed

von Websky, Martin W; Raptis, Dimitri A; Vitz, Martina; Rosenthal, Rachel; Clavien, P A; Hahnloser, Dieter

2013-11-01

Virtual reality (VR) simulators are widely used to familiarize surgical novices with laparoscopy, but VR training methods differ in efficacy. In the present trial, self-controlled basic VR training (SC-training) was tested against training based on peer-group-derived benchmarks (PGD-training). First, novice laparoscopic residents were randomized into a SC group (n = 34), and a group using PGD-benchmarks (n = 34) for basic laparoscopic training. After completing basic training, both groups performed 60 VR laparoscopic cholecystectomies for performance analysis. Primary endpoints were simulator metrics; secondary endpoints were program adherence, trainee motivation, and training efficacy. Altogether, 66 residents completed basic training, and 3,837 of 3,960 (96.8 %) cholecystectomies were available for analysis. Course adherence was good, with only two dropouts, both in the SC-group. The PGD-group spent more time and repetitions in basic training until the benchmarks were reached and subsequently showed better performance in the readout cholecystectomies: Median time (gallbladder extraction) showed significant differences of 520 s (IQR 354-738 s) in SC-training versus 390 s (IQR 278-536 s) in the PGD-group (p < 0.001) and 215 s (IQR 175-276 s) in experts, respectively. Path length of the right instrument also showed significant differences, again with the PGD-training group being more efficient. Basic VR laparoscopic training based on PGD benchmarks with external assessment is superior to SC training, resulting in higher trainee motivation and better performance in simulated laparoscopic cholecystectomies. We recommend such a basic course based on PGD benchmarks before advancing to more elaborate VR training.

Relapse prevention and smoking cessation.

PubMed

Davis, J R; Glaros, A G

1986-01-01

A multicomponent smoking relapse prevention treatment based on Marlatt and Gordon's (1980) model of the relapse process was developed and evaluated. Behavior-analytic methods were used to develop assessment instruments, training situations, and coping responses. The prevention components were presented in the context of a basic broad-spectrum stop-smoking program, and were compared with the basic program plus discussion control, and the basic program alone. Smoking-related dependent variables generally did not differ between groups at any time from pre-treatment to 12 month follow-up. Only the subjects in the relapse prevention condition improved problem-solving and social skills needed to cope with high-risk situations. These subjects also tended to take longer to relapse and smoke fewer cigarettes at the time of relapse. Subjects above the median level of competence on measures of social skill at post-treatment remained abstinent significantly longer. Maintenance of non-smoking was found to be related to the degree of competence with which individuals deal with high-risk situations. Results are discussed in relation to models of compliance with therapeutic regimens.

Needs Assessment for Electrosurgery Training of Residents and Faculty in Obstetrics and Gynecology

PubMed Central

Green, Isabel; Modest, Anna Merport; Milad, Magdy; Huang, Edwin; Ricciotti, Hope

2014-01-01

Background and Objectives: Effective application of electrosurgical techniques requires knowledge of energy sources and electric circuits to produce desired tissue effects. A lack of electrosurgery knowledge may negatively affect patient outcomes and safety. Our objective was to survey obstetrics-gynecology trainees and faculty to assess their basic knowledge of electrosurgery concepts as a needs assessment for formal electrosurgery training. Methods: We performed an observational study with a sample of convenience at 2 academic hospitals (Beth Israel Deaconess Medical Center and Mount Auburn Hospital). Grand rounds dedicated to electrosurgery teaching were conducted at each department of obstetrics and gynecology, where a short electrosurgery multiple-choice examination was administered to attendees. Results: The face validity of the test content was obtained from a gynecologic electrosurgery specialist. Forty-four individuals completed the examination. Test scores were analyzed by level of training to investigate whether scores positively correlated with more advanced career stages. The median test score was 45.5% among all participants (interquartile range, 36.4%–54.5%). Senior residents scored the highest (median score, 54.5%), followed by attendings (median score, 45.5%), junior residents and fellows (median score in both groups, 36.4%), and medical students (median score, 27.3%). Conclusion: Although surgeons have used electrosurgery for nearly a century, it remains poorly understood by most obstetrician-gynecologists. Senior residents, attendings, junior residents, and medical students all show a general deficiency in electrosurgery comprehension. This study suggests that there is a need for formal electrosurgery training. A standardized electrosurgery curriculum with a workshop component demonstrating clinically useful concepts essential for safe surgical practice is advised. PMID:25392632

Logistics and safety of extracorporeal membrane oxygenation in medical retrieval.

PubMed

Burns, Brian J; Habig, Karel; Reid, Cliff; Kernick, Paul; Wilkinson, Chris; Tall, Gary; Coombes, Sarah; Manning, Ron

2011-01-01

This article reviews the logistics and safety of extracorporeal membrane oxygenation (ECMO) medical retrieval in New South Wales, Australia. We describe the logistics involved in ECMO road and rotary-wing retrieval by a multidisciplinary team during the H1N1 influenza epidemic in winter 2009 (i.e., June 1 to August 31, 2009). Basic patient demographics and key retrieval time lines were analyzed. There were 17 patients retrieved on ECMO, with their ages ranging from 22 to 55 years. The median weight was 110 kg. Four critical events were recorded during retrieval, with no adverse outcomes. The retrieval distance varied from 20.8 to 430 km. There were delays in times from retrieval booking to both retrieval tasking and retrieval team departure in 88% of retrievals. The most common reasons cited were "patient not ready" 23.5% (4/17); "vehicle not available," 23.5% (4/17); and "complex retrieval," 41.2% (7/17). The median time (hours:minutes) from booking with the medical retrieval unit (MRU) to tasking was 4:35 (interquartile range [IQR] 3:27-6:15). The median time lag from tasking to departure was 1:00 (IQR 00:10-2:20). The median stabilization time was 1:30 (IQR 1:20-1:55). The median retrieval duration was 7:35 (IQR 5:50-10:15). The process of development of ECMO retrieval was enabled by the preexistence of a high-volume experienced medical retrieval service. Although ECMO retrieval is not a new concept, we describe an entire process for ECMO retrieval that we believe will benefit other retrieval service providers. The increased workload of ECMO retrieval during the swine flu pandemic has led to refinement in the system and process for the future.

Operative experience of surgery residents: trends and challenges.

PubMed

Malangoni, Mark A; Biester, Thomas W; Jones, Andrew T; Klingensmith, Mary E; Lewis, Frank R

2013-01-01

To evaluate trends in operative experience and to determine the effect of establishing the Surgical Council on Resident Education (SCORE) operative classification system on changes in operative volume among graduating surgery residents. The general surgery operative logs of graduating surgery residents from 2005 were retrospectively compared with residents who completed training in 2010 and 2011. Nonparametric statistical analyses were used (Mann-Whitney and median test) with significance set at p<0.01. A total of 1022 residents completing residency in 2005 were compared with 1923 residents completing training in 2010-2011. Total operations reported increased from a median of 1023 to 1238 (21%) between 2005 and 2010-2011 (p<0.001). Cases increased in most SCORE categories. The median numbers of total, basic, and complex laparoscopic operations increased by 49%, 37%, and 82%, respectively, over the 5-year interval (p<0.001). Open cavitary (thoracic + abdominal) operations decreased by 5%, whereas other major operations increased by 35% (both p<0.001). The frequency of discrete operations done at least 10 times during residency did not change. The median number of SCORE essential-common operations performed ranged from 1 to 107, whereas essential-uncommon operations ranged from 0 to 4. Twenty-three of 67 SCORE essential-common operations (34%) had a median of less than 5 and 4 had a median of 0. The operative volume of graduating surgical residents has increased by 21% since 2005; however, the number of operations done 10 times or greater has not changed. Although open cavitary procedures continue to decline, there has been a large increase in endoscopy, complex laparoscopic, and other major operations. Some essential-common operations continue to be performed infrequently. These results suggest that education in the operating room must improve and alternate methods for teaching infrequently performed procedures are needed. © 2013 Published by Association of Program Directors in Surgery on behalf of Association of Program Directors in Surgery.

Differential Brain Development with Low and High IQ in Attention-Deficit/Hyperactivity Disorder

PubMed Central

de Zeeuw, Patrick; Schnack, Hugo G.; van Belle, Janna; Weusten, Juliette; van Dijk, Sarai; Langen, Marieke; Brouwer, Rachel M.; van Engeland, Herman; Durston, Sarah

2012-01-01

Attention-Deficit/Hyperactivity Disorder (ADHD) and intelligence (IQ) are both heritable phenotypes. Overlapping genetic effects have been suggested to influence both, with neuroimaging work suggesting similar overlap in terms of morphometric properties of the brain. Together, this evidence suggests that the brain changes characteristic of ADHD may vary as a function of IQ. This study investigated this hypothesis in a sample of 108 children with ADHD and 106 typically developing controls, who participated in a cross-sectional anatomical MRI study. A subgroup of 64 children also participated in a diffusion tensor imaging scan. Brain volumes, local cortical thickness and average cerebral white matter microstructure were analyzed in relation to diagnostic group and IQ. Dimensional analyses investigated possible group differences in the relationship between anatomical measures and IQ. Second, the groups were split into above and below median IQ subgroups to investigate possible differences in the trajectories of cortical development. Dimensionally, cerebral gray matter volume and cerebral white matter microstructure were positively associated with IQ for controls, but not for ADHD. In the analyses of the below and above median IQ subgroups, we found no differences from controls in cerebral gray matter volume in ADHD with below-median IQ, but a delay of cortical development in a number of regions, including prefrontal areas. Conversely, in ADHD with above-median IQ, there were significant reductions from controls in cerebral gray matter volume, but no local differences in the trajectories of cortical development. In conclusion, the basic relationship between IQ and neuroanatomy appears to be altered in ADHD. Our results suggest that there may be multiple brain phenotypes associated with ADHD, where ADHD combined with above median IQ is characterized by small, more global reductions in brain volume that are stable over development, whereas ADHD with below median IQ is associated more with a delay of cortical development. PMID:22536435

An interactive internet-based plate for assessing lunchtime food intake: a validation study on male employees.

PubMed

Svensson, Madeleine; Bellocco, Rino; Bakkman, Linda; Trolle Lagerros, Ylva

2013-01-18

Misreporting food intake is common because most health screenings rely on self-reports. The more accurate methods (eg, weighing food) are costly, time consuming, and impractical. We developed a new instrument for reporting food intake--an Internet-based interactive virtual food plate. The objective of this study was to validate this instrument's ability to assess lunch intake. Participants were asked to compose an ordinary lunch meal using both a virtual and a real lunch plate (with real food on a real plate). The participants ate their real lunch meals on-site. Before and after pictures of the composed lunch meals were taken. Both meals included identical food items. Participants were randomized to start with either instrument. The 2 instruments were compared using correlation and concordance measures (total energy intake, nutritional components, quantity of food, and participant characteristics). A total of 55 men (median age: 45 years, median body mass index [BMI]: 25.8 kg/m(2)) participated. We found an overall overestimation of reported median energy intake using the computer plate (3044 kJ, interquartile range [IQR] 1202 kJ) compared with the real lunch plate (2734 kJ, IQR 1051 kJ, P<.001). Spearman rank correlations and concordance correlations for energy intake and nutritional components ranged between 0.58 to 0.79 and 0.65 to 0.81, respectively. Although it slightly overestimated, our computer plate provides promising results in assessing lunch intake.

An Interactive Internet-Based Plate for Assessing Lunchtime Food Intake: A Validation Study on Male Employees

PubMed Central

Bellocco, Rino; Bakkman, Linda; Trolle Lagerros, Ylva

2013-01-01

Background Misreporting food intake is common because most health screenings rely on self-reports. The more accurate methods (eg, weighing food) are costly, time consuming, and impractical. Objectives We developed a new instrument for reporting food intake—an Internet-based interactive virtual food plate. The objective of this study was to validate this instrument’s ability to assess lunch intake. Methods Participants were asked to compose an ordinary lunch meal using both a virtual and a real lunch plate (with real food on a real plate). The participants ate their real lunch meals on-site. Before and after pictures of the composed lunch meals were taken. Both meals included identical food items. Participants were randomized to start with either instrument. The 2 instruments were compared using correlation and concordance measures (total energy intake, nutritional components, quantity of food, and participant characteristics). Results A total of 55 men (median age: 45 years, median body mass index [BMI]: 25.8 kg/m2) participated. We found an overall overestimation of reported median energy intake using the computer plate (3044 kJ, interquartile range [IQR] 1202 kJ) compared with the real lunch plate (2734 kJ, IQR 1051 kJ, P<.001). Spearman rank correlations and concordance correlations for energy intake and nutritional components ranged between 0.58 to 0.79 and 0.65 to 0.81, respectively. Conclusion Although it slightly overestimated, our computer plate provides promising results in assessing lunch intake. PMID:23335728

Technology-assisted language intervention for children who are deaf or hard-of-hearing; a pilot study of augmentative and alternative communication for enhancing language development.

PubMed

Meinzen-Derr, Jareen; Wiley, Susan; McAuley, Rose; Smith, Laura; Grether, Sandra

2017-11-01

Pilot study to assess the effect of augmentative and alternative communication technology to enhance language development in children who are deaf or hard-of-hearing. Five children ages 5-10 years with permanent bilateral hearing loss who were identified with language underperformance participated in an individualized 24-week structured program using the application TouchChat WordPower on iPads ® . Language samples were analyzed for changes in mean length of utterance, vocabulary words and mean turn length. Repeated measures models assessed change over time. The baseline median mean length of utterance was 2.41 (range 1.09-6.63; mean 2.88) and significantly increased over time (p = 0.002) to a median of 3.68 at final visit (range 1.97-6.81; mean 3.62). At baseline, the median total number of words spoken per language sample was 251 (range 101-458), with 100 (range 36-100) different words spoken. Total words and different words significantly increased over time (β = 26.8 (7.1), p = 0.001 for total words; β = 8.0 (2.7), p = 0.008 for different words). Mean turn length values also slightly increased over time. Using augmentative and alternative communication technology on iPads ® shows promise in supporting rapid language growth among elementary school-age children who are deaf or hard-of-hearing with language underperformance.

Melanocytoma of the optic disk in the Korean population.

PubMed

Lee, Christopher S; Bae, Jeong H; Jeon, Ik H; Byeon, Suk H; Koh, Hyoung J; Lee, Sung C

2010-01-01

To report on the clinical features and the natural course of optic disk melanocytoma in the Korean population. A retrospective review of medical records was performed on 27 consecutive patients with optic disk melanocytoma. In cases with tumor enlargement, surface area and diameter of tumors were measured from fundus images using computer software. The median age at diagnosis was 46 years with a slight female predominance (63%). The median tumor diameter and height were 3.1 mm and 1.9 mm, respectively. There were no cases with tumor-related visual loss for a median follow-up of 2 years. Tumor enlargement was observed in 4 of 21 patients (19%) that had follow-up of 1 year or more with no malignant transformation. The mean change of tumor surface area was 2.4 mm (52% increase), and the mean change of tumor diameter was 1.8 mm over a mean follow-up of 53 months in 4 cases with tumor growth. Only tumor vascularization on fluorescent angiography correlated with tumor growth (Log-rank test; P = 0.049). Kaplan-Meier survival estimated that the tumor growth was 0% at 1 year, 14% at 5 years, and 57% at 8 years. Optic disk melanocytoma in the Korean population tends to be superiorly located in the optic disk, and visual prognosis was excellent. Periodic ocular examination is warranted because 57% of patients were estimated to show tumor enlargement by 8 years of follow-up.

Surgical treatment of acute acromioclavicular joint dislocations: hook plate versus minimally invasive reconstruction.

PubMed

Metzlaff, S; Rosslenbroich, S; Forkel, P H; Schliemann, B; Arshad, H; Raschke, M; Petersen, W

2016-06-01

This study was performed to compare the clinical results of a minimally invasive technique for acute acromioclavicular (AC) joint dislocation repair with the traditional hook plate fixation. Forty-four patients with an acute (within 2 weeks after trauma) complete AC joint separation (35 male, nine female; median age 36.2 years, range 18-56) underwent surgical repair with either a minimally invasive AC joint repair or a conventional hook plate. Functional outcome was evaluated using the Constant-Murley Score (CMS), the TAFT score and the AC joint instability score (ACJI). Radiographic evaluation was performed with bilateral anterior-posterior (a.p.) stress and Alexander views. All patients were available after a median follow-up of 32 months (range 24-51). There were no significant differences in the mean CMS, Taft score and the ACJI between the two groups. The radiological assessment revealed no significant difference in the coracoclavicular distance. In both groups, a slight loss of reduction was observed. Periarticular ossification was seen in 11 patients of the minimally invasive AC joint repair and eight patients of the hook plate group but this did not affect the final outcome. Hook plates were removed after a median interval of 11.9 weeks (range 10-13). Good clinical results can be achieved with both minimally invasive AC joint repair and hook plate fixation. However, in the hook plate group a second operation is mandatory for plate removal. III.

A maximally selected test of symmetry about zero.

PubMed

Laska, Eugene; Meisner, Morris; Wanderling, Joseph

2012-11-20

The problem of testing symmetry about zero has a long and rich history in the statistical literature. We introduce a new test that sequentially discards observations whose absolute value is below increasing thresholds defined by the data. McNemar's statistic is obtained at each threshold and the largest is used as the test statistic. We obtain the exact distribution of this maximally selected McNemar and provide tables of critical values and a program for computing p-values. Power is compared with the t-test, the Wilcoxon Signed Rank Test and the Sign Test. The new test, MM, is slightly less powerful than the t-test and Wilcoxon Signed Rank Test for symmetric normal distributions with nonzero medians and substantially more powerful than all three tests for asymmetric mixtures of normal random variables with or without zero medians. The motivation for this test derives from the need to appraise the safety profile of new medications. If pre and post safety measures are obtained, then under the null hypothesis, the variables are exchangeable and the distribution of their difference is symmetric about a zero median. Large pre-post differences are the major concern of a safety assessment. The discarded small observations are not particularly relevant to safety and can reduce power to detect important asymmetry. The new test was utilized on data from an on-road driving study performed to determine if a hypnotic, a drug used to promote sleep, has next day residual effects. Copyright © 2012 John Wiley & Sons, Ltd.

Selected Ground-Water Data for Yucca Mountain Region, Southern Nevada and Eastern California, January-December 2005

USGS Publications Warehouse

Locke, Glenn L.

2008-01-01

The U.S. Geological Survey, in cooperation with the U.S. Department of Energy, Office of Civilian Radioactive Waste Management, collected, compiled, and summarized hydrologic data in the Yucca Mountain region of southern Nevada and eastern California. These data were collected to allow assessments of ground-water resources during activities to determine the potential suitability or development of Yucca Mountain for storing high-level nuclear waste. Data collected from January through December 2005 are provided for ground-water levels at 35 boreholes and 1 fissure (Devils Hole), ground-water discharge at 5 springs, ground-water levels and discharge at 1 flowing borehole, and total reported ground-water withdrawals within Crater Flat, Jackass Flats, Mercury Valley, and the Amargosa Desert. Ground-water level, discharge, and withdrawal data collected by other agencies, or as part of other programs, are provided. A statistical summary of ground-water levels at seven boreholes in Jackass Flats is presented for 1992-2005 to indicate potential effects of ground-water withdrawals associated with U.S. Department of Energy activities near Yucca Mountain. The statistical summary includes the annual number of measurements; maximum, minimum, and median water-level altitudes; and average deviation of measured water-level altitudes compared to the 1992-93 baseline period. At seven boreholes in Jackass Flats, median water levels for 2005 were slightly higher (0.4-2.7 feet) than the median water levels for 1992-93.

Treatment of periprosthetic femoral fractures of the knee.

PubMed

Ehlinger, Matthieu; Adam, Philippe; Abane, Lamine; Rahme, Michel; Moor, Beat Kaspar; Arlettaz, Yvan; Bonnomet, François

2011-09-01

We report a continuous series of periprosthetic femoral fractures after knee arthroplasty treated with a locking plate. We hypothesize that minimally invasive surgery and immediate weight-bearing improve functional recovery. From June 2002 to December 2008, 15 patients with 16 fractures were treated. Median age was 81 years. The autonomy level according to the mobility score of Parker and Palmer showed a median of 5 (0-9). Osteosynthesis was performed mainly through a minimally invasive approach using a locking compression plate. The rehabilitation protocol consisted of immediate mobilization and, whenever possible, immediate unrestricted weight-bearing. Five patients died during follow-up, more than 1 year after osteosynthesis. Their results were included. Autonomy and mobility were preserved with a median postoperative score of 4 (0-9) according to Parker and Palmer. The consolidation rate was 93.8%, which was obtained within 10 weeks. There were no mechanical or infectious complications. Fourteen cases were treated with minimally invasive surgery without fracture exposition; the remaining 2 required a slightly more extended approach. Full weight-bearing occurred 10 times; 20-kg partial weight-bearing was advised twice; and on 4 occasions, no weight-bearing was allowed for 6 weeks. Osteosynthesis with a minimally invasive bridge-plating technique is effective in the treatment of periprosthetic, distal femoral fractures without component loosening. Immediate full weight-bearing is possible if certain rules are respected. The surgical management presented herein is beneficial for these challenging fractures, and it may help reduce the complication rate and improve functional outcome.

The genus curve of the Abell clusters

NASA Technical Reports Server (NTRS)

Rhoads, James E.; Gott, J. Richard, III; Postman, Marc

1994-01-01

We study the topology of large-scale structure through a genus curve measurement of the recent Abell catalog redshift survey of Postman, Huchra, and Geller (1992). The structure is found to be spongelike near median density and to exhibit isolated superclusters and voids at high and low densities, respectively. The genus curve shows a slight shift toward 'meatball' topology, but remains consistent with the hypothesis of Gaussian random phase initial conditions. The amplitude of the genus curve corresponds to a power-law spectrum with index n = 0.21(sub -0.47 sup +0.43) on scales of 48/h Mpc or to a cold dark matter power spectrum with omega h = 0.36(sub -0.17 sup +0.46).

The genus curve of the Abell clusters

NASA Astrophysics Data System (ADS)

Rhoads, James E.; Gott, J. Richard, III; Postman, Marc

1994-01-01

We study the topology of large-scale structure through a genus curve measurement of the recent Abell catalog redshift survey of Postman, Huchra, and Geller (1992). The structure is found to be spongelike near median density and to exhibit isolated superclusters and voids at high and low densities, respectively. The genus curve shows a slight shift toward 'meatball' topology, but remains consistent with the hypothesis of Gaussian random phase initial conditions. The amplitude of the genus curve corresponds to a power-law spectrum with index n = 0.21-0.47+0.43 on scales of 48/h Mpc or to a cold dark matter power spectrum with omega h = 0.36-0.17+0.46.

An experimental measurement of galactic cosmic radiation dose in conventional aircraft between San Francisco and London compared to theoretical values for conventional and supersonic aircraft

NASA Technical Reports Server (NTRS)

Wallace, R.; Boyer, M. F.

1972-01-01

These direct measurements are in fair agreement with computations made using a program which considers both basic cosmic ray atmospheric physics and the focusing effect of the earth's magnetic field. These measurements also agree with those made at supersonic jet aircraft altitudes in Rb-57 aircraft. It is concluded that experiments and theory show that the doses received at conventional jet aircraft altitudes are slightly higher than those encountered in supersonic flights at much higher altitudes.

Most science spared big budget bite

NASA Astrophysics Data System (ADS)

Richman, Barbara T.

Most science budgets emerged unscathed from President Ronald Reagan's fiscal 1983 budget proposal. Total funding for research and development came out slightly ahead of inflation, as did funding for basic research (Eos, February 16, p. 162). The National Science Foundation (NSF) edged past the projected 7.3% inflation rate for 1982, and the National Aeronautics and Space Administration (NASA) budget is to be increased by 10.6%. However, the U.S. Geological Survey (USGS) is budgeted for a 4.2% increase in funding, and the National Oceanic and Atmospheric Administration (NOAA) will take an 8.3% cut.

The development of science during this century

NASA Astrophysics Data System (ADS)

Weisskopf, V. F.

1993-12-01

This is a slightly revised version of a talk delivered at the meeting of the American Association for the Advancement of Science, in Boston, on 14 February 1993, and at a CERN Colloquium, on 5 August 1993, entitled 'Science -yesterday, today and tomorrow'. It describes the tremendous growth of scientific knowledge and insights acquired since the beginning of this century. The changes in the character, sociology and support, of science are discussed, including the growing predominance of American science and the recent trend away from basic science towards applied research.

Directed educational training improves coding and billing skills for residents.

PubMed

Benke, James R; Lin, Sandra Y; Ishman, Stacey L

2013-03-01

To determine if coding and billing acumen improves after a single directed educational training session. Case-control series. Fourteen otolaryngology practitioners including trainees each completed two clinical scenarios before and after a directed educational session covering basic skills and common mistakes in otolaryngology billing and coding. Ten practitioners had never coded before; while, four regularly billed and coded in a clinical setting. Individuals with no previous billing experience had a mean score of 54% (median 55%) before the educational session which was significantly lower than that of the experienced billers who averaged 82% (median 83%, p=0.002). After the educational billing and coding session, the inexperienced billers mean score improved to 62% (median, 67%) which was still statistically lower than that of the experienced billers who averaged 76% (median 75%, p=0.039). The inexperienced billers demonstrated a significant improvement in their total score after the intervention (P=0.019); however, the change observed in experienced billers before and after the educational intervention was not significant (P=0.469). Billing and coding skill was improved after a single directed education session. Residents, who are not responsible for regular billing and coding, were found to have the greatest improvement in skill. However, providers who regularly bill and code had no significant improvement after this session. These data suggest that a single 90min billing and coding education session is effective in preparing those with limited experience to competently bill and code. Copyright © 2012. Published by Elsevier Ireland Ltd.

Patients with primary diffuse large B-cell lymphoma of female genital tract have high risk of central nervous system relapse.

PubMed

Cao, Xin-xin; Li, Jian; Zhang, Wei; Duan, Ming-hui; Shen, Ti; Zhou, Dao-bin

2014-06-01

The objective of this study was to evaluate retrospectively the clinical characteristics, treatments, and outcomes of patients with primary diffuse large B-cell lymphoma (DLBCL) of the female genital tract. The basic characteristics, treatments, and outcomes of six patients diagnosed with primary DLBCL of the female genital tract, including the ovary, uterine cervix, and vagina, treated in our hospital between 2000 and 2012, were analyzed retrospectively. Seven of 323 (2.2 %) newly diagnosed DLBCLs were diagnosed as primary female genital tract DLBCL. Six patients with complete medical data were included in the analysis. The median age at diagnosis was 52.5 years (range 20-65). The presenting symptoms included abnormal vaginal bleeding, increased vaginal discharge, abdominal fullness, and abdominal pain. Two patients had stage IE disease and four patients had stage IIE disease. Treatment included chemotherapy only in five patients, and combined chemotherapy and localized radiation in one patient. After a median follow-up of 58 months, four patients showed relapse in the central nervous system and two had died from progressive disease. The median progression-free survival was 27 months and the median overall survival for this group has not been reached. Patients with primary female genital tract DLBCL may have poor outcomes and a high risk of central nervous system relapse. Central nervous system prophylaxis might be considered in addition to systemic chemotherapy for DLBCL of the female genital tract.

Numerical study of canister filters with alternatives filter cap configurations

NASA Astrophysics Data System (ADS)

Mohammed, A. N.; Daud, A. R.; Abdullah, K.; Seri, S. M.; Razali, M. A.; Hushim, M. F.; Khalid, A.

2017-09-01

Air filtration system and filter play an important role in getting a good quality air into turbo machinery such as gas turbine. The filtration system and filter has improved the quality of air and protect the gas turbine part from contaminants which could bring damage. During separation of contaminants from the air, pressure drop cannot be avoided but it can be minimized thus helps to reduce the intake losses of the engine [1]. This study is focused on the configuration of the filter in order to obtain the minimal pressure drop along the filter. The configuration used is the basic filter geometry provided by Salutary Avenue Manufacturing Sdn Bhd. and two modified canister filter cap which is designed based on the basic filter model. The geometries of the filter are generated by using SOLIDWORKS software and Computational Fluid Dynamics (CFD) software is used to analyse and simulates the flow through the filter. In this study, the parameters of the inlet velocity are 0.032 m/s, 0.063 m/s, 0.094 m/s and 0.126 m/s. The total pressure drop produce by basic, modified filter 1 and 2 is 292.3 Pa, 251.11 Pa and 274.7 Pa. The pressure drop reduction for the modified filter 1 is 41.19 Pa and 14.1% lower compared to basic filter and the pressure drop reduction for modified filter 2 is 17.6 Pa and 6.02% lower compared to the basic filter. The pressure drops for the basic filter are slightly different with the Salutary Avenue filter due to limited data and experiment details. CFD software are very reliable in running a simulation rather than produces the prototypes and conduct the experiment thus reducing overall time and cost in this study.

An evidence-based virtual reality training program for novice laparoscopic surgeons.

PubMed

Aggarwal, Rajesh; Grantcharov, Teodor P; Eriksen, Jens R; Blirup, Dorthe; Kristiansen, Viggo B; Funch-Jensen, Peter; Darzi, Ara

2006-08-01

To develop an evidence-based virtual reality laparoscopic training curriculum for novice laparoscopic surgeons to achieve a proficient level of skill prior to participating in live cases. Technical skills for laparoscopic surgery must be acquired within a competency-based curriculum that begins in the surgical skills laboratory. Implementation of this program necessitates the definition of the validity, learning curves and proficiency criteria on the training tool. The study recruited 40 surgeons, classified into experienced (performed >100 laparoscopic cholecystectomies) or novice groups (<10 laparoscopic cholecystectomies). Ten novices and 10 experienced surgeons were tested on basic tasks, and 11 novices and 9 experienced surgeons on a procedural module for dissection of Calot triangle. Performance of the 2 groups was assessed using time, error, and economy of movement parameters. All basic tasks demonstrated construct validity (Mann-Whitney U test, P < 0.05), and learning curves for novices plateaued at a median of 7 repetitions (Friedman's test, P < 0.05). Expert surgeons demonstrated a learning rate at a median of 2 repetitions (P < 0.05). Performance on the dissection module demonstrated significant differences between experts and novices (P < 0.002); learning curves for novice subjects plateaued at the fourth repetition (P < 0.05). Expert benchmark criteria were defined for validated parameters on each task. A competency-based training curriculum for novice laparoscopic surgeons has been defined. This can serve to ensure that junior trainees have acquired prerequisite levels of skill prior to entering the operating room, and put them directly into practice.

Failure to pay for social health insurance premiums: Acts of protest or desperation?

PubMed Central

von Wyl, Viktor; Beck, Konstantin

2015-01-01

Background In Switzerland, basic health insurance is mandatory for all inhabitants, but a rising number of insured have arrears in premium payments, potentially leading to coverage suspension. We aimed at characterizing insured with debt enforcement proceedings with respect to socio-demographic and health utilization aspects. Methods Cross-sectional analysis of 508.000 insured with basic health insurance contracts in 2013, of whom 14,000 (2.8%) with debt enforcement proceedings, from 11 Swiss cantons. Groups were characterized using logistic regression and latent class analysis. Results Insured with debt enforcement proceedings were more likely to be young, male and without dependents (partner, kids). Having no supplementary insurance and receiving partial premium subsidies was associated with an increased debt enforcement proceedings risk. Within the debt enforcement proceedings group, three subgroups were identified: 60% were young and seemingly healthy, with a below-average fraction of premium subsidy recipients (18%) and low out-of-pocket payments in prior year (median Swiss Francs 0). Two groups consisted of relatively ill elderly persons (22%, 99% of whom with chronic illnesses) or families (18%), many of whom (29% and 51%) were recipients of premium subsidies. Median out-of-pocket payments in the prior year were high (Swiss Francs 625 and 688, respectively). Conclusions Sixty percent of premium arrears derive from young insured without apparent financial problems; 40% are owed by elderly and families, which are potentially hurt by coverage loss. PMID:26844060

Examining HIV Viral Load in a Matched Cohort of HIV Positive Individuals With and Without Psoriasis.

PubMed

Wu, Jashin J; Gilbert, Kathleen E; Batech, Michael; Manalo, Iviensan F; Towner, William J; Raposo, Rui André Saraiva; Nixon, Douglas F; Liao, Wilson

2017-04-01

BACKGROUND: HIV-associated psoriasis is well-documented. Genetic, cellular, and cytokine profiles have been used as evidence to suggest psoriasis activates antiviral pathways. There has been a lack of epidemiologic evidence investigating whether psoriasis patients have lower HIV viral counts compared to non-psoriasis patients.

OBJECTIVE: Compare the viral load set point of HIV positive patients with and without psoriasis.

METHODS: A retrospective matched cohort study of HIV positive patients with and without psoriasis using the Kaiser Permanente Southern California Health Plan database.

RESULTS: We identified 101 HIV-positive psoriasis cases; 19 met inclusion criteria and were matched with 3-5 control patients; 94 total patients were analyzed. The mean age was 41.4 (12.07) years and 83% were male. Overall, the median log of the viral load of cases was slightly higher than controls (4.3 vs 4.2; P less than 0.01).

CONCLUSIONS: The serum viral load set point of patients with HIV and psoriasis was slightly higher than the viral load set point of HIV patients without psoriasis.

J Drugs Dermatol. 2017;16(4):372-377.

Master plans for pedestrian and bicycle transportation: community characteristics.

PubMed

Steinman, Lesley; Doescher, Mark; Levinger, David; Perry, Cynthia; Carter, Louise; Eyler, Amy; Aytur, Semra; Cradock, Angie L I; Evenson, Kelly R; Heinrich, Katie; Kerr, Jacqueline; Litt, Jill; Severcan, Yucel; Voorhees, Carolyn

2010-03-01

Recent research demonstrates the importance of targeting the built environment to support individual physical activity, particularly for people experiencing health disparities. Master plans to promote biking and/or pedestrians (BPMPs) are a potential method for environmental change. This descriptive study aims to provide a snapshot of plan attributes and better understand demographic, social and transportation characteristics of communities with BPMPs. We collected a census sample of BPMPs from 4 states. Population and commuting data were obtained from national statistics. 294 master plans were included, with most plans representing municipalities. 62% of plans targeted biking only, one-fifth targeted biking and walking, and 15% targeted walking only. The sampled locations have a similar demographic profile as the overall U.S. for median age and household income, people of color, high school education, and income inequality. The degree of racial diversity of sampled communities is slightly less than the U.S. average and the percentage of people who walk to work were slightly higher. Given that communities with master plans have a similar profile as the overall U.S., BPMPs could feasibly be spread to communities throughout the country. Further research is planned to describe BPMPs in detail toward informing future plan development.

Impacts on Emergency Department Visits from Personal Responsibility Provisions: Evidence from West Virginia's Medicaid Redesign.

PubMed

Gurley-Calvez, Tami; Kenney, Genevieve M; Simon, Kosali I; Wissoker, Douglas

2016-08-01

To examine the impact of a 2007 redesign of West Virginia's Medicaid program, which included an incentive and "nudging" scheme intended to encourage better health care behaviors and reduce Emergency Department (ED) visits. West Virginia Medicaid enrollment and claims data from 2005 to 2010. We utilized a "differences in differences" technique with individual and time fixed effects to assess the impact of redesign on ED visits. Starting in 2007, categorically eligible Medicaid beneficiaries were moved from traditional Medicaid to the new Mountain Health Choices (MHC) Program on a rolling basis, approximating a natural experiment. Members chose between a Basic plan, which was less generous than traditional Medicaid, or an Enhanced plan, which was more generous but required additional enrollment steps. Data were obtained from the West Virginia Bureau for Medical Services. We found that contrary to intentions, the MHC program increased ED visits. Those who selected or defaulted into the Basic plan experienced increased overall and preventable ED visits, while those who selected the Enhanced plan experienced a slight reduction in preventable ED visits; the net effect was an increase in ED visits, as most individuals enrolled in the Basic plan. © Health Research and Educational Trust.

The longitudinal study of turnover and the cost of turnover in EMS

PubMed Central

Patterson, P. Daniel; Jones, Cheryl B.; Hubble, Michael W.; Carr, Matthew; Weaver, Matthew D.; Engberg, John; Castle, Nicholas

2010-01-01

Purpose Few studies have examined employee turnover and associated costs in emergency medical services (EMS). The purpose of this study was to quantify the mean annual rate of turnover, total median cost of turnover, and median cost per termination in a diverse sample of EMS agencies. Methods A convenience sample of 40 EMS agencies was followed over a 6 month period. Internet, telephone, and on-site data collection methods were used to document terminations, new hires, open positions, and costs associated with turnover. The cost associated with turnover was calculated based on a modified version of the Nursing Turnover Cost Calculation Methodology (NTCCM). The NTCCM identified direct and indirect costs through a series of questions that agency administrators answered monthly during the study period. A previously tested measure of turnover to calculate the mean annual rate of turnover was used. All calculations were weighted by the size of the EMS agency roster. The mean annual rate of turnover, total median cost of turnover, and median cost per termination were determined for 3 categories of agency staff mix: all paid staff, mix of paid and volunteer (mixed), and all-volunteer. Results The overall weighted mean annual rate of turnover was 10.7%. This rate varied slightly across agency staffing mix: (all-paid=10.2%, mixed=12.3%, all-volunteer=12.4%). Among agencies that experienced turnover (n=25), the weighted median cost of turnover was $71,613.75, which varied across agency staffing mix: (all-paid=$86,452.05, mixed=$9,766.65, and all-volunteer=$0). The weighted median cost per termination was $6,871.51 and varied across agency staffing mix: (all-paid=$7,161.38, mixed=$1,409.64, and all-volunteer=$0). Conclusions Annual rates of turnover and costs associated with turnover vary widely across types of EMS agencies. The study’s mean annual rate of turnover was lower than expected based on information appearing in the news media and EMS trade magazines. Findings provide estimates of two key workforce measures – turnover rates and costs – where previously none have existed. Local EMS directors and policymakers at all levels of government may find the results and study methodology useful towards designing and evaluating programs targeting the EMS workforce. PMID:20199235

Accuracy of GIPSY PPP from version 6.2: a robust method to remove outliers

NASA Astrophysics Data System (ADS)

Hayal, Adem G.; Ugur Sanli, D.

2014-05-01

In this paper, we figure out the accuracy of GIPSY PPP from the latest version, version 6.2. As the research community prepares for the real-time PPP, it would be interesting to revise the accuracy of static GPS from the latest version of well established research software, the first among its kinds. Although the results do not significantly differ from the previous version, version 6.1.1, we still observe the slight improvement on the vertical component due to an enhanced second order ionospheric modeling which came out with the latest version. However, in this study, we rather turned our attention into outlier detection. Outliers usually occur among the solutions from shorter observation sessions and degrade the quality of the accuracy modeling. In our previous analysis from version 6.1.1, we argued that the elimination of outliers was cumbersome with the traditional method since repeated trials were needed, and subjectivity that could affect the statistical significance of the solutions might have been existed among the results (Hayal and Sanli, 2013). Here we overcome this problem using a robust outlier elimination method. Median is perhaps the simplest of the robust outlier detection methods in terms of applicability. At the same time, it might be considered to be the most efficient one with its highest breakdown point. In our analysis, we used a slightly different version of the median as introduced in Tut et al. 2013. Hence, we were able to remove suspected outliers at one run; which were, with the traditional methods, more problematic to remove this time from the solutions produced using the latest version of the software. References Hayal, AG, Sanli DU, Accuracy of GIPSY PPP from version 6, GNSS Precise Point Positioning Workshop: Reaching Full Potential, Vol. 1, pp. 41-42, (2013) Tut,İ., Sanli D.U., Erdogan B., Hekimoglu S., Efficiency of BERNESE single baseline rapid static positioning solutions with SEARCH strategy, Survey Review, Vol. 45, Issue 331, pp.296-304, (2013)

Serum peroxiredoxin 4: a marker of oxidative stress associated with mortality in type 2 diabetes (ZODIAC-28).

PubMed

Gerrits, Esther G; Alkhalaf, Alaa; Landman, Gijs W D; van Hateren, Kornelis J J; Groenier, Klaas H; Struck, Joachim; Schulte, Janin; Gans, Reinold O B; Bakker, Stephan J L; Kleefstra, Nanne; Bilo, Henk J G

2014-01-01

Oxidative stress plays an underlying pathophysiologic role in the development of diabetes complications. The aim of this study was to investigate peroxiredoxin 4 (Prx4), a proposed novel biomarker of oxidative stress, and its association with and capability as a biomarker in predicting (cardiovascular) mortality in type 2 diabetes mellitus. Prx4 was assessed in baseline serum samples of 1161 type 2 diabetes patients. Cox proportional hazard models were used to evaluate the relationship between Prx4 and (cardiovascular) mortality. Risk prediction capabilities of Prx4 for (cardiovascular) mortality were assessed with Harrell's C statistic, the integrated discrimination improvement and net reclassification improvement. Mean age was 67 and the median diabetes duration was 4.0 years. After a median follow-up period of 5.8 years, 327 patients died; 137 cardiovascular deaths. Prx4 was associated with (cardiovascular) mortality. The Cox proportional hazard models added the variables: Prx4 (model 1); age and gender (model 2), and BMI, creatinine, smoking, diabetes duration, systolic blood pressure, cholesterol-HDL ratio, history of macrovascular complications, and albuminuria (model 3). Hazard ratios (HR) (95% CI) for cardiovascular mortality were 1.93 (1.57 - 2.38), 1.75 (1.39 - 2.20), and 1.63 (1.28 - 2.09) for models 1, 2 and 3, respectively. HR for all-cause mortality were 1.73 (1.50 - 1.99), 1.50 (1.29 - 1.75), and 1.44 (1.23 - 1.67) for models 1, 2 and 3, respectively. Addition of Prx4 to the traditional risk factors slightly improved risk prediction of (cardiovascular) mortality. Prx4 is independently associated with (cardiovascular) mortality in type 2 diabetes patients. After addition of Prx4 to the traditional risk factors, there was a slightly improvement in risk prediction of (cardiovascular) mortality in this patient group.

Bilateral varicocele: single transscrotal approach for Tauber antegrade sclerotherapy.

PubMed

Mazzoni, Guglielmo; Minucci, Sergio; Gentile, Vincenzo

2003-03-01

To describe the results of a new simple technique of single transscrotal approach for Tauber antegrade sclerotherapy in bilateral varicocele. During the period March 1998-June 2001, overall 341 patients were treated for varicocele using Tauber antegrade sclerotherapy. In 39 of these patients, sclerotherapy was performed bilaterally in the same session whilst in 34, rather than making two incisions at the root of the two hemiscrotums, a single incision was made on the median raphe. During this period, the same approach was used in 4 patients with left varicocele and right hydrocele, 2 patients with left varicocele and right epididymis cyst, 1 patient with bilateral varicocele and bilateral hydrocele, 1 patient with bilateral hydrocele and left varicocele. Maximum ray exposure time was 58 seconds (mean 30). Oro-tracheal intubation was not necessary in any of the patients. In 12 patients, besides local anesthesia, additional sedation was given. Slight bleeding of the wound, occurring in 3 patients, was medicated in the outpatient department. Patients prefer a single incision. When the incision is made on the median raphe, no scars remain. In bilateral varicocele, the single approach reduces invasiveness and increases patient satisfaction.

Selected markers of cardiovascular disease in a population exposed to arsenic from drinking water.

PubMed

Bošnjak, Zinka; Cavar, Suzana; Klapec, Tomislav; Milić, Marija; Klapec-Basar, Mirta; Toman, Miroslav

2008-09-01

This study examined prevalence and serum levels of selected markers of cardiovascular disease in 34 subjects from a Croatian rural population exposed to high levels of arsenic (As) from drinking water (611.89±10.06μg/l). The prevalences of overweight and obese subjects in the population were 32% and 35%. Half the subjects had hypertension, 29% had increased fasting serum glucose level and two were diabetic. Median total cholesterol (5.82mmol/l) and triglycerides (2.15mmol/l) were above the desirable margins. The median C-reactive protein level (1.20mg/l) was slightly higher than previously reported for healthy subjects. Serum Hsp70 level was significantly higher in nonsmokers. Total urinary As levels were positively correlated with age-adjusted serum levels of cobalamin. Near significance were also serum total bilirubin, antibodies to Hsp60 and folate. Tentative investigation of risk factors among subjects classified by tumor necrosis factor-α -308G/A and interleukin-6-174G/C gene polymorphisms was also performed. Collectively, the results are in agreement with the hypothesis of As-induced and/or compounded cardiovascular disease. Copyright © 2008 Elsevier B.V. All rights reserved.

A new species of Physalaemus (Anura, Leptodactylidae) from the Atlantic Forest of Misiones, northeastern Argentina.

PubMed

Cardozo, Dario E; Pereyra, Martin O

2018-02-27

A new species of Physalaemus from Misiones province, Argentina, in the Atlantic forest domain is described. The new species is a member of the P. gracilis group, based on its phylogenetic position and the occurrence of a putative morphological synapomorphy (occurrence of an unpigmented median stripe on throat, chest, and/or abdomen). Physalaemus sp. nov. is characterized by a long advertisement call composed of non-pulsed notes with slightly descendant modulation, large size (mean SVL = 32.0 mm males, 34.0 mm females), slender body aspect, head longer than wide, supratympanic fold developed, an unpigmented median stripe on venter, medium sized inguinal glands, tarsal tubercle present, and supernumerary tubercles on hands and feet, which are character states that combined distinguish the new species from all the members of the genus. In this study, we provide its formal description based on external morphology, advertisement call, and 16S genetic distance. In addition, the distribution ranges for the new species and P. gracilis are revisited, the advertisement call of P. gracilis is redescribed, and a discussion about the available names which could be applicable to the new species is provided.

Rapamycin Increases Mortality in db/db Mice, a Mouse Model of Type 2 Diabetes.

PubMed

Sataranatarajan, Kavithalakshmi; Ikeno, Yuji; Bokov, Alex; Feliers, Denis; Yalamanchili, Himabindu; Lee, Hak Joo; Mariappan, Meenalakshmi M; Tabatabai-Mir, Hooman; Diaz, Vivian; Prasad, Sanjay; Javors, Martin A; Ghosh Choudhury, Goutam; Hubbard, Gene B; Barnes, Jeffrey L; Richardson, Arlan; Kasinath, Balakuntalam S

2016-07-01

We examined the effect of rapamycin on the life span of a mouse model of type 2 diabetes, db/db mice. At 4 months of age, male and female C57BLKSJ-lepr (db/db) mice (db/db) were placed on either a control diet, lacking rapamycin or a diet containing rapamycin and maintained on these diets over their life span. Rapamycin was found to reduce the life span of the db/db mice. The median survival of male db/db mice fed the control and rapamycin diets was 349 and 302 days, respectively, and the median survival of female db/db mice fed the control and rapamycin diets was 487 and 411 days, respectively. Adjusting for gender differences, rapamycin increased the mortality risk 1.7-fold in both male and female db/db mice. End-of-life pathological data showed that suppurative inflammation was the main cause of death in the db/db mice, which is enhanced slightly by rapamycin treatment. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Plasma Electrolyte Distributions in Humans-Normal or Skewed?

PubMed

Feldman, Mark; Dickson, Beverly

2017-11-01

It is widely believed that plasma electrolyte levels are normally distributed. Statistical tests and calculations using plasma electrolyte data are often reported based on this assumption of normality. Examples include t tests, analysis of variance, correlations and confidence intervals. The purpose of our study was to determine whether plasma sodium (Na + ), potassium (K + ), chloride (Cl - ) and bicarbonate [Formula: see text] distributions are indeed normally distributed. We analyzed plasma electrolyte data from 237 consecutive adults (137 women and 100 men) who had normal results on a standard basic metabolic panel which included plasma electrolyte measurements. The skewness of each distribution (as a measure of its asymmetry) was compared to the zero skewness of a normal (Gaussian) distribution. The plasma Na + distribution was skewed slightly to the right, but the skew was not significantly different from zero skew. The plasma Cl - distribution was skewed slightly to the left, but again the skew was not significantly different from zero skew. On the contrary, both the plasma K + and [Formula: see text] distributions were significantly skewed to the right (P < 0.01 zero skew). There was also a suggestion from examining frequency distribution curves that K + and [Formula: see text] distributions were bimodal. In adults with a normal basic metabolic panel, plasma potassium and bicarbonate levels are not normally distributed and may be bimodal. Thus, statistical methods to evaluate these 2 plasma electrolytes should be nonparametric tests and not parametric ones that require a normal distribution. Copyright © 2017 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

Pharmacokinetic profile and clinical efficacy of a once-daily ondansetron suppository in cyclophosphamide-induced emesis: a double blind comparative study with ondansetron tablets.

PubMed Central

de Wit, R.; Beijnen, J. H.; van Tellingen, O.; Schellens, J. H.; de Boer-Dennert, M.; Verweij, J.

1996-01-01

We investigated the pharmacokinetic profile and the efficacy of ondansetron (day 1) given as 16 mg suppository once a day, as compared with ondansetron 8 mg tablets twice daily, in patients receiving moderately emetogenic chemotherapy. The study was primarily aimed at investigating the pharmacokinetics and was part of a large multinational, randomised, double-blind, double-dummy efficacy trial. Pharmacokinetic data were obtained in a total of 20 patients, 11 of whom had received a suppository containing ondansetron, and nine patients had received the oral formulation. The median area under the plasma concentration curve (AUC) obtained with the oral formulation was 226 ng ml-1h-1 (range 91-750), and the median maximum plasma level (Cmax) was 50.5 ng ml-1 (range 24.7-199.6) after a dose of 8 mg. For the ondansetron suppository the median AUC was 140 ng ml-1h-1 range (77-405) and the median Cmax was 17.1 ng ml-1 (range 13-48.3) after a dose of 16 mg. The systemic exposure after correction for the dose difference after the suppository was on average 70% lower than after the tablet. The median time to reach the maximum level (Tmax) was 60 min (range 28-120) with the oral formulation and 209 min (range 90-420) with the suppository. For both the tablet and suppository, there was no apparent relationship between either Cmax or AUC, and efficacy. Although the patient numbers were too small for a formal exposure-response relationship to be derived, the slightly poorer pharmacokinetic performance of the suppository did not appear to be associated with a lessening of control of emesis following chemotherapy. The study demonstrates that the pharmacokinetic analysis of a once-daily 16 mg ondansetron suppository results in appropriate plasma concentrations and AUC, and that this rectal formulation is effective in the protection against nausea and vomiting associated with cyclophosphamide chemotherapy. This formulation will provide a useful alternative to the currently available oral formulation. PMID:8688345

Pharmacokinetic profile and clinical efficacy of a once-daily ondansetron suppository in cyclophosphamide-induced emesis: a double blind comparative study with ondansetron tablets.

PubMed

de Wit, R; Beijnen, J H; van Tellingen, O; Schellens, J H; de Boer-Dennert, M; Verweij, J

1996-07-01

We investigated the pharmacokinetic profile and the efficacy of ondansetron (day 1) given as 16 mg suppository once a day, as compared with ondansetron 8 mg tablets twice daily, in patients receiving moderately emetogenic chemotherapy. The study was primarily aimed at investigating the pharmacokinetics and was part of a large multinational, randomised, double-blind, double-dummy efficacy trial. Pharmacokinetic data were obtained in a total of 20 patients, 11 of whom had received a suppository containing ondansetron, and nine patients had received the oral formulation. The median area under the plasma concentration curve (AUC) obtained with the oral formulation was 226 ng ml-1h-1 (range 91-750), and the median maximum plasma level (Cmax) was 50.5 ng ml-1 (range 24.7-199.6) after a dose of 8 mg. For the ondansetron suppository the median AUC was 140 ng ml-1h-1 range (77-405) and the median Cmax was 17.1 ng ml-1 (range 13-48.3) after a dose of 16 mg. The systemic exposure after correction for the dose difference after the suppository was on average 70% lower than after the tablet. The median time to reach the maximum level (Tmax) was 60 min (range 28-120) with the oral formulation and 209 min (range 90-420) with the suppository. For both the tablet and suppository, there was no apparent relationship between either Cmax or AUC, and efficacy. Although the patient numbers were too small for a formal exposure-response relationship to be derived, the slightly poorer pharmacokinetic performance of the suppository did not appear to be associated with a lessening of control of emesis following chemotherapy. The study demonstrates that the pharmacokinetic analysis of a once-daily 16 mg ondansetron suppository results in appropriate plasma concentrations and AUC, and that this rectal formulation is effective in the protection against nausea and vomiting associated with cyclophosphamide chemotherapy. This formulation will provide a useful alternative to the currently available oral formulation.

Dietary calcium intake, serum copper concentration and bone density in postmenopausal women

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

Strause, L.; Andon, M.B.; Howard, G.

1991-03-11

Data from experimental animal nutrition and animal husbandry indicate that several trace minerals, including copper (Cu) are involved in bone metabolism. In addition, a large body of data suggests that low dietary calcium (Ca) intake is a risk factor for age related bone loss. The authors measured the serum (Cu), dietary Ca intake (dCa) and bone mineral density (BMD) in the spine of 225 postmenopausal women. The median dCa and serum (Cu) were 562 mg/d and 9.73 umoles/L, respectively. Serum (Cu) but, not dCa, was greater in subjects with a history of estrogen therapy (ERT). BMD was higher in subjectsmore » with above median dCa and serum (Cu) (group 1) compared to those with below median values (group 2). BMD was intermediate for subjects with either Low serum (Cu):High dCa or High serum (Cu):Low dCa. This relationship was observed in the subject group as a whole, as well as in subgroups partitioned according to history of ERT. Groups 1 and 2 did not differ in basic demographic characteristics such as age, age at menopause, body weight and height. These data support the hypothesis that Ca and Cu nutriture are determinants of skeletal health in postmenopausal women.« less

Do brain lesions in stroke affect basic emotions and attachment?

PubMed

Farinelli, Marina; Panksepp, Jaak; Gestieri, Laura; Maffei, Monica; Agati, Raffaele; Cevolani, Daniela; Pedone, Vincenzo; Northoff, Georg

2015-01-01

The aim of the current study was to investigate basic emotions and attachment in a sample of 86 stroke patients. We included a control group of 115 orthopedic patients (matched for age and cognitive status) without brain lesions to control for unspecific general illness effects of a traumatic recent event on basic emotions and attachment. In order to measure basic emotions and attachment style we applied the Affective Neuroscience Personality Scale (ANPS) and the Attachment Style Questionnaire (ASQ). The stroke patients showed significantly different scores in the SEEKING, SADNESS, and ANGER subscales of the ANPS as well as in the Relationship as Secondary Attachment dimension of the ASQ when compared to the control group. These differences show a pattern influenced by lesion location mainly as concerns basic emotions. Anterior, medial, left, and subcortical patients provide scores significantly lower in ANPS-SEEKING than the control group; ANPS-SADNESS scores in anterior, right, medial, and subcortical patients were significantly higher than those of the control group. ANPS-ANGER scores in posterior, right, and lateral patients were significantly higher than those in the control group; finally, the ANPS-FEAR showed slightly lower scores in posterior patients than in the control group. Minor effects on brain lesions were also individuated in the attachment style. Anterior lesion patients showed a significantly higher average score in the ASQ-Need for Approval subscale than the control group. ASQ-Confidence subscale scores differed significantly in stroke patients with lesions in medial brain regions when compared to control subjects. Scores at ANPS and ASQ subscales appear significantly more correlated in stroke patients than in the control group. Such finding of abnormalities, especially concerning basic emotions in stroke brain-lesioned patients, indicates that the effect of brain lesions may enhance the interrelation between basic emotions and attachment with respect to the control group.

Sorption Behavior of Dye Compounds onto Natural Sediment of Qinghe River.

PubMed

Liu, Ruixia; Liu, Xingmin; Tang, Hongxiao; Su, Yongbo

2001-07-15

The objective of this study is to assess the adsorption behavior of C.I. Basic Yellow X-5GL, C.I. Basic Red 13, C.I. Direct Blue 86, C.I. Vat Yellow 2, and C.I. Mordant Black 11 on natural sediment and to identify sediment characteristics that play a predominant role in the adsorption of the dyes. The potentiometric titration experiment is used to investigate acid-base properties of the sediment surface with a constant capacitance surface complexation model. The parameters controlling the sorption such as solution pH and ion strength, as well as the influence of organic carbon and Ca(2+) ion on the adsorption, are evaluated. It is shown that the titration data can be successfully described by the surface protonation and deprotonation model with the least-squares FITEQL program 2.0. The sorption isotherm data are fitted to the Freundlich equation in a nonlinear form (1/n=0.3-0.9) for all tested dyes. With increasing pH value, the sorption of C.I. Mordant Black 11 and C.I. Direct Blue 86 on the sediment decreases, while for C.I. Basic Yellow X-5GL and C.I. Basic Red 13, the extent of sorption slightly increases. In addition, ion strength also exhibits a considerably different effect on the sorption behavior of these dye compounds. The addition of Ca(2+) can greatly reduce the sorption of C.I. Basic Red 13 on the sediment surface, while it enhances the sorption of C.I. Direct Blue 6. The removal of organic carbon decreases the sorption of C.I. Mordant Black 11 and C.I. Direct Blue 86. In contrast, the sorption of C.I. Basic Red 13 and C.I. Basic Yellow X-5GL is obviously enhanced after the removal of organic carbon. The differences in adsorption behavior are mainly attributed to the physicochemical properties of these dye compounds. Copyright 2001 Academic Press.

Assessing the experience in complex hepatopancreatobiliary surgery among graduating chief residents: Is the operative experience enough?

PubMed Central

Sachs, Teviah E.; Ejaz, Aslam; Weiss, Matthew; Spolverato, Gaya; Ahuja, Nita; Makary, Martin A.; Wolfgang, Christopher L.; Hirose, Kenzo; Pawlik, Timothy M.

2015-01-01

Introduction Resident operative autonomy and case volume is associated with posttraining confidence and practice plans. Accreditation Council for Graduate Medical Education requirements for graduating general surgery residents are four liver and three pancreas cases. We sought to evaluate trends in resident experience and autonomy for complex hepatopancreatobiliary (HPB) surgery over time. Methods We queried the Accreditation Council for Graduate Medical Education General Surgery Case Log (2003–2012) for all cases performed by graduating chief residents (GCR) relating to liver, pancreas, and the biliary tract (HPB); simple cholecystectomy was excluded. Mean (±SD), median [10th–90th percentiles] and maximum case volumes were compared from 2003 to 2012 using R2 for all trends. Results A total of 252,977 complex HPB cases (36% liver, 43% pancreas, 21% biliary) were performed by 10,288 GCR during the 10-year period examined (Mean = 24.6 per GCR). Of these, 57% were performed during the chief year, whereas 43% were performed as postgraduate year 1–4. Only 52% of liver cases were anatomic resections, whereas 71% of pancreas cases were major resections. Total number of cases increased from 22,516 (mean = 23.0) in 2003 to 27,191 (mean = 24.9) in 2012. During this same time period, the percentage of HPB cases that were performed during the chief year decreased by 7% (liver: 13%, pancreas 8%, biliary 4%). There was an increasing trend in the mean number of operations (mean ± SD) logged by GCR on the pancreas (9.1 ± 5.9 to 11.3 ± 4.3; R2 = .85) and liver (8.0 ± 5.9 to 9.4 ± 3.4; R2 = .91), whereas those for the biliary tract decreased (5.9 ± 2.5 to 3.8 ± 2.1; R2 = .96). Although the median number of cases [10th:90th percentile] increased slightly for both pancreas (7.0 [4.0:15] to 8.0 [4:20]) and liver (7.0 [4:13] to 8.0 [5:14]), the maximum number of cases preformed by any given GCR remained stable for pancreas (51 to 53; R2 = .18), but increased for liver (38 to 45; R2 = .32). The median number of HPB cases that GCR performed as teaching assistants (TAs) remained at zero during this time period. The 90th percentile of cases performed as TA was less than two for both pancreas and liver. Conclusion Roughly one-half of GCR have performed fewer than 10 cases in each of the liver, pancreas, or biliary categories at time of completion of residency. Although the mean number of complex liver and pancreatic operations performed by GCR increased slightly, the median number remained low, and the number of TA cases was virtually zero. Most GCR are unlikely to be prepared to perform complex HPB operations. PMID:24953270

Kendall-Theil Robust Line (KTRLine--version 1.0)-A Visual Basic Program for Calculating and Graphing Robust Nonparametric Estimates of Linear-Regression Coefficients Between Two Continuous Variables

USGS Publications Warehouse

Granato, Gregory E.

2006-01-01

The Kendall-Theil Robust Line software (KTRLine-version 1.0) is a Visual Basic program that may be used with the Microsoft Windows operating system to calculate parameters for robust, nonparametric estimates of linear-regression coefficients between two continuous variables. The KTRLine software was developed by the U.S. Geological Survey, in cooperation with the Federal Highway Administration, for use in stochastic data modeling with local, regional, and national hydrologic data sets to develop planning-level estimates of potential effects of highway runoff on the quality of receiving waters. The Kendall-Theil robust line was selected because this robust nonparametric method is resistant to the effects of outliers and nonnormality in residuals that commonly characterize hydrologic data sets. The slope of the line is calculated as the median of all possible pairwise slopes between points. The intercept is calculated so that the line will run through the median of input data. A single-line model or a multisegment model may be specified. The program was developed to provide regression equations with an error component for stochastic data generation because nonparametric multisegment regression tools are not available with the software that is commonly used to develop regression models. The Kendall-Theil robust line is a median line and, therefore, may underestimate total mass, volume, or loads unless the error component or a bias correction factor is incorporated into the estimate. Regression statistics such as the median error, the median absolute deviation, the prediction error sum of squares, the root mean square error, the confidence interval for the slope, and the bias correction factor for median estimates are calculated by use of nonparametric methods. These statistics, however, may be used to formulate estimates of mass, volume, or total loads. The program is used to read a two- or three-column tab-delimited input file with variable names in the first row and data in subsequent rows. The user may choose the columns that contain the independent (X) and dependent (Y) variable. A third column, if present, may contain metadata such as the sample-collection location and date. The program screens the input files and plots the data. The KTRLine software is a graphical tool that facilitates development of regression models by use of graphs of the regression line with data, the regression residuals (with X or Y), and percentile plots of the cumulative frequency of the X variable, Y variable, and the regression residuals. The user may individually transform the independent and dependent variables to reduce heteroscedasticity and to linearize data. The program plots the data and the regression line. The program also prints model specifications and regression statistics to the screen. The user may save and print the regression results. The program can accept data sets that contain up to about 15,000 XY data points, but because the program must sort the array of all pairwise slopes, the program may be perceptibly slow with data sets that contain more than about 1,000 points.

Pharmacokinetics and bioavailability of denaverine hydrochloride in healthy subjects following intravenous, oral and rectal single doses.

PubMed

Staab, Alexander; Schug, Barbara S; Larsimont, Véronique; Elze, Martina; Thümmler, Daniela; Mutschler, Ernst; Blume, Henning

2003-02-01

The neurotropic-musculotropic spasmolytic agent denaverine hydrochloride is used mainly in the treatment of smooth muscle spasms of the gastrointestinal and urogenital tract. Despite its commercial availability as a solution for intravenous or intramuscular administration (ampoule) and as a suppository formulation, no pharmacokinetic data in man was available to date. Therefore, the objectives of this clinical trial were to determine the basic pharmacokinetic parameters of denaverine after intravenous administration, to assess the feasibility of using the oral route of administration and to characterise the bioavailability of the suppository formulation. To achieve this, healthy subjects received 50 mg denaverine hydrochloride intravenously, orally and rectally in aqueous solutions and rectally as suppository in an open, randomised crossover design. Total body clearance, volume of distribution at steady-state and half-life of denaverine are 5.7 ml/min per kg, 7.1 l/kg and 33.8 h, respectively. The absolute bioavailability after oral administration of an aqueous solution is 37%. First-pass metabolism leading to the formation of N-monodemethyl denaverine was found to be one reason for the incomplete bioavailability after oral administration. Rectal administration of an aqueous solution of denaverine hydrochloride resulted in a decreased rate (median of C(max) ratios: 26%, difference in median t(max) values: 1.9 h) and extent (31%) of bioavailability compared to oral administration. Using the suppository formulation led to a further reduction in rate (median of C(max) ratios: 30%, difference in median t(max) values: 3 h) and extent (42%) of bioavailability compared to the rectal solution.

Zika plasma viral dynamics in nonhuman primates provides insights into early infection and antiviral strategies

PubMed Central

Best, Katharine; Guedj, Jeremie; Madelain, Vincent; de Lamballerie, Xavier; Lim, So-Yon; Osuna, Christa E.; Whitney, James B.; Perelson, Alan S.

2017-01-01

The recent outbreak of Zika virus (ZIKV) has been associated with fetal abnormalities and neurological complications, prompting global concern. Here we present a mathematical analysis of the within-host dynamics of plasma ZIKV burden in a nonhuman primate model, allowing for characterization of the growth and clearance of ZIKV within individual macaques. We estimate that the eclipse phase for ZIKV, the time between cell infection and viral production, is most likely short (∼4 h), the median within-host basic reproductive number R0 is 10.7, the rate of viral production is rapid (>25,000 virions d−1), and the lifetime of an infected cell while producing virus is ∼5 h. We also estimate that the minimum number of virions produced by an infected cell over its lifetime is ∼5,500. We assess the potential effect of an antiviral treatment that blocks viral replication, showing that the median time to undetectable plasma viral load (VL) can be reduced from ∼5 d to ∼3 d with a drug concentration ∼15 times the drug’s EC50 when treatment is given prophylactically starting at the time of infection. In the case of favipiravir, a polymerase inhibitor with activity against ZIKV, we predict a dose of 150 mg/kg given twice a day initiated at the time of infection can reduce the peak median VL by ∼3 logs and shorten the time to undetectable median VL by ∼2 d, whereas treatment given 2 d postinfection is mostly ineffective in accelerating plasma VL loss in macaques. PMID:28765371

Developmental tempo in children aged 0-5 years living under unfavourable environmental conditions.

PubMed

Lejarraga, Horacio; Kelmansky, Diana M; Nunes, Fernando

2018-04-01

To describe the dynamics of development along the early years of life among children living under unfavorable socioeconomic conditions. In 5401 children younger than 6 years old living in Florencio Varela and in the Matanza-Riachuelo River Basin (Matanza, Villa 21-24, Wilde, Villa Inflamable and Acuba), areas with a high proportion of families with unmet basic needs, a logistic regression analysis was used to estimate the median age at attainment of 13 psychomotor developmental milestones; differences between these ages and median age at attainment of milestones as per the national reference were plotted on the y-axis, while the median age as per the national reference was plotted on the x-axis. Three stages were observed: the first one between 0 and 270 days with normal development, in which the median age at attainment was similar to that of the national reference; a second one of progressive development delay; and a third one of recovery at 1260 days. Adjusted linear spline slopes were 0.06 (not significant), -0.26 (p < 0.0001) and 0.26 (p < 0.01) for stages 1, 2 and 3, respectively. The three slopes were statistically different from each other. The stage of normal development (stage 1) was attributed to the protective effect of the mother and the family environment; stage 2 of progressive delay, to the unfavorable impact of the environment, and stage 3 of partial recovery was attributed to attending a daycare center. These findings allow the implementation of effective interventions at each stage. Three periods with different developmental tempos were identified. Sociedad Argentina de Pediatría.

Temporal Trends (1999-2015) in the Impact Factor of Biomedical Journals Published by US and EU Scientific Societies.

PubMed

Falagas, Matthew E; Kyriakidou, Margarita; Spais, George; Argiti, Efstathia; Vardakas, Konstantinos Z

2018-04-19

The impact factor has emerged as the most popular index of scientific journals' resonance. In this study we aimed to examine the impact factor trends of journals published by scientific bodies in the United States of America (USA) and Europe (EU). We randomly chose 11 categories of Journal of Citation Reports and created three research classes: clinical medicine, laboratory medicine, and basic science. The impact factor values for the years 1999-2015 were abstracted, and the impact factor of US and EU journals was studied through the years. A total of 265 journals were included in the final analysis. The impact factor of US journals was higher than that of EU journals throughout the study period. In addition, for both US and EU journals the median impact factor increased throughout the study period. The rate of annual change in the impact factor throughout the study period was lower for US than EU journals (1.85% versus 3.55%, P=0.019). A higher median annual increase was seen in the impact factor during the period 1999-2008 compared to the period 2009-2015 for both US (P<0.001) and EU (P=0.001) journals. In fact, during the second period the US median impact factor value did not show significant changes (P=0.31), while the EU median impact factor continued to increase (P<0.001). The impact factor of EU journals increased at a significantly higher rate than and approached that of the US journals during the last 16 years.

Web-based education for placental complications of pregnancy.

PubMed

Walker, Melissa G; Windrim, Catherine; Ellul, Katie N; Kingdom, John C P

2013-04-01

The objective of this study was to determine whether a web-based education strategy could improve maternal knowledge of placental complications of pregnancy and reduce maternal anxiety in high risk-pregnancies. Prospective study in the Placenta Clinic at Mount Sinai Hospital, Toronto, Ontario. Maternal demographics and Internet usage were recorded at the patient's baseline appointment. Placental knowledge was determined using structured verbal and illustrative assessments. The six-item State-Trait Anxiety Inventory (STAI) was administered to assess baseline maternal anxiety. Women were asked to visit the Placenta Clinic website for a minimum of 15 minutes before their follow-up appointment, at which time their placental knowledge and STAI assessments were repeated. Eighteen women were included in the study. Patient knowledge at the baseline appointment was generally poor (median score 10.5 out of a maximum score of 27, range 1 to 22), with major deficits in basic placental knowledge, placenta previa/increta, and preeclampsia. At the follow-up appointment, placental knowledge was significantly improved (median score 23, range 10 to 27; P < 0.001). Educational status (high school or less vs. college or more) had no effect on either baseline knowledge or knowledge improvement. Maternal anxiety at baseline (median score 12 out of a maximum score of 24, range 6 to 23) was significantly reduced at the follow-up appointment (median score 8.5, range 6 to 20; P = 0.005). Deficits in maternal knowledge of placental complications of pregnancy in high-risk pregnant women were substantial but easily rectified with a disease-targeted web-based educational resource. This intervention significantly improved patient knowledge and significantly reduced maternal anxiety.

Causes of sudden death in young female military recruits.

PubMed

Eckart, Robert E; Scoville, Stephanie L; Shry, Eric A; Potter, Robert N; Tedrow, Usha

2006-06-15

This study sought to examine the incidence of sudden death in a large, multiethnic cohort of young women. Approximately 852,300 women entered basic military training from 1977 to 2001. During this period, there were 15 sudden deaths in female recruits (median age 19 years, 73% African-American), occurring at a median of 25 days after arrival for training. Of the sudden deaths, 13 (81%) were due to reasons that may have been cardiac in origin. Presumed arrhythmic sudden death in the setting of a structurally normal heart was seen in 8 recruits (53%), and anomalous coronary origins were found in 2 recruits (13%). The mortality rate was 11.4 deaths per 100,000 recruit-years (95% confidence interval 6.9 to 18.9). The rate was significantly higher for African-American female recruits (risk ratio 10.2, p <0.001). Sudden death with a structurally normal heart was the leading cause of death in female recruits during military training.

CAN'T MISS--conquer any number task by making important statistics simple. Part 1. Types of variables, mean, median, variance, and standard deviation.

PubMed

Hansen, John P

2003-01-01

Healthcare quality improvement professionals need to understand and use inferential statistics to interpret sample data from their organizations. In quality improvement and healthcare research studies all the data from a population often are not available, so investigators take samples and make inferences about the population by using inferential statistics. This three-part series will give readers an understanding of the concepts of inferential statistics as well as the specific tools for calculating confidence intervals for samples of data. This article, Part 1, presents basic information about data including a classification system that describes the four major types of variables: continuous quantitative variable, discrete quantitative variable, ordinal categorical variable (including the binomial variable), and nominal categorical variable. A histogram is a graph that displays the frequency distribution for a continuous variable. The article also demonstrates how to calculate the mean, median, standard deviation, and variance for a continuous variable.

Triple galaxies and a hidden mass problem

NASA Technical Reports Server (NTRS)

Karachentsev, I. D.; Karachentseva, V. E.; Lebedev, V. S.

1990-01-01

The authors consider a homogeneous sample of 84 triple systems of galaxies with components brighter than m = 15.7, located in the northern sky and satisfying an isolation criterion with respect to neighboring galaxies in projection. The distributions of basic dynamical parameters for triplets have median values as follows: radial velocity dispersion 133 km/s, mean harmonic radius 63 kpc, absolute magnitude of galaxies M sub B equals -20.38, crossing time tau = 0.04 H(sup minus 1). For different ways of estimation the median mass-to-luminosity ratio is (20 - 30). A comparison of the last value with the ones for single and binary galaxies shows the presence of a virial mass excess for triplets by a factor 4. The mass-to-luminosity ratio is practically uncorrelated with linear size of triplets or with morphological types of their components. We note that a significant part of the virial excess may be explained by the presence of nonisolated triple configurations in the sample, which are produced by debris of more populous groups of galaxies.

Spatially variant morphological restoration and skeleton representation.

PubMed

Bouaynaya, Nidhal; Charif-Chefchaouni, Mohammed; Schonfeld, Dan

2006-11-01

The theory of spatially variant (SV) mathematical morphology is used to extend and analyze two important image processing applications: morphological image restoration and skeleton representation of binary images. For morphological image restoration, we propose the SV alternating sequential filters and SV median filters. We establish the relation of SV median filters to the basic SV morphological operators (i.e., SV erosions and SV dilations). For skeleton representation, we present a general framework for the SV morphological skeleton representation of binary images. We study the properties of the SV morphological skeleton representation and derive conditions for its invertibility. We also develop an algorithm for the implementation of the SV morphological skeleton representation of binary images. The latter algorithm is based on the optimal construction of the SV structuring element mapping designed to minimize the cardinality of the SV morphological skeleton representation. Experimental results show the dramatic improvement in the performance of the SV morphological restoration and SV morphological skeleton representation algorithms in comparison to their translation-invariant counterparts.

Construction of an evidence-based, graduated training curriculum for D-box, a webcam-based laparoscopic basic skills trainer box.

PubMed

Debes, Anders J; Aggarwal, Rajesh; Balasundaram, Indran; Jacobsen, Morten B J

2012-06-01

Surgical training programs are now including simulators as training tools for teaching laparoscopic surgery. The aim of this study was to develop a standardized, graduated, and evidence-based curriculum for the newly developed D-box (D-box Medical, Lier, Norway) for training basic laparoscopic skills. Eighteen interns with no laparoscopic experience completed a training program on the D-box consisting of 8 sessions of 5 tasks with assessment on a sixth task. Performance was measured by the use of 3-dimensional electromagnetic tracking of hand movements, path length, and time taken. Ten experienced surgeons (>100 laparoscopic surgeries, median 250) were recruited for establishing benchmark criteria. Significant learning curves were obtained for all construct valid parameters for tasks 4 (P < .005) and 5 (P < .005) and reached plateau levels between the fifth and sixth session. Within the 8 sessions of this study, between 50% and 89% of the interns reached benchmark criteria on tasks 4 and 5. Benchmark criteria and an evidence-based curriculum have been developed for the D-box. The curriculum is aimed at training and assessing surgical novices in basic laparoscopic skills. Copyright © 2012 Elsevier Inc. All rights reserved.

Long term effect of breast feeding: cognitive function in the Caerphilly cohort

PubMed Central

Elwood, P; Pickering, J.; Gallacher, J; Hughes, J.; Davies, D.

2005-01-01

Study objective: There is evidence suggesting that artificial feeding is associated with a reduction in cognitive function in infants and children, in contrast with breast feeding, but the available evidence suffers from confounding by social and educational factors. An opportunity arose in the Caerphilly cohort study to examine relations between cognitive function in older men and their feeding as infants, when breast feeding was usual. Design: A prospective cohort study. Setting: Caerphilly, South Wales, UK, was a deprived coal mining community when the men had been born in 1920–35. Most had been breast fed as infants. Participants: 779 men aged 60–74 years when tested. The men had earlier been asked to obtain from their mothers their birth weight, and how they had been fed as infants. Results: Complete data were obtained for 779 men. In those whose birth weight had been at or above the median, the adjusted mean cognitive function was only slightly and non-significantly lower in those who had been artificially fed. In the men whose birth weight had been below the median, having been artificially fed was associated with significantly lower results in both a test of reasoning (the AH4) and word power (the national adult reading test (NART)). Two standard deviations below the median birth weight, artificial feeding was associated with a reduction of six points (70% of a SD) on word power (the NART). Conclusions: In men whose birth weight had been low, having been artificially fed is associated with poorer cognitive function in late adult life. PMID:15650144

Insulin Resistance and Glucose Levels in Subjects with Subclinical Hypothyroidism.

PubMed

Khan, Sikandar Hayat; Fazal, Nadeem; Ijaz, Aamir; Manzoor, Syed Mohsin; Asif, Naveed; Rafi, Tariq; Yasir, Muhammad; Niazi, Najmusaquib Khan

2017-06-01

To compare insulin resistance and glycemic indicators among subjects with euthyroidism and subclinical hypothyroidism. Comparative cross-sectional study. Department of Pathology and Medicine, PNS Hafeez, Islamabad, in collaboration with the Department of Chemical Pathology and Endocrinology at the Armed Forces Institute of Pathology (AFIP), Rawalpindi, from December 2015 to September 2016. Subjects referred for executive screening of apparently healthy population (without any known history of diabetes, hypertension, heart disease or other chronic ailments), were included. Subjects were grouped as euthyroidism and subclinical hypothyroidism. Median (IQR) insulin resistance indices including fasting insulin and Homeostasis Model Assessment for Insulin Resistance in subjects with group-1 (n=176, 87%, Thyroid Stimulating Hormone: 0.5 - 3.5 mIU/L) and group-2 (n=26, 13%, Thyroid Stimulating Hormone: 3.51 - 15 mIU/L) were 7.6 (6.70) vs. 11.4 (13.72, p=0.040) and 1.77 (1.79) vs. 2.8 (3.07, p=0.071). The median differences for fasting plasma glucose were 5.0 (1.0) in group-1 vs. 5.0 (1.47) for Group-2 [p=0.618], and glycated hemoglobin was 5.60 (1.1) vs. 5.60 (1.7, p=0.824). Homeostasis Model Assessment for beta sensitivity index in paradox showed slightly higher values for group-2 [median (IQR) 86.67 (92.94)] than group-1 [111.6 (189.64, p= 0.040)]. Measures of insulin resistance including Homeostasis Model Assessment for Insulin Resistance and fasting insulin levels were significantly different between subjects with euthyroidism and having subclinical hypothyroidism.

Selected Ground-Water Data of Yucca Mountain Region, Southern Nevada and Eastern California, January 2000-December 2002

USGS Publications Warehouse

Locke, Glenn L.; La Camera, Richard J.

2003-01-01

The U.S. Geological Survey, in support of the U.S. Department of Energy, Yucca Mountain Project, collects, compiles, and summarizes hydrologic data in the Yucca Mountain region. The data are collected to allow assessments of ground-water resources during activities to determine the potential suitability or development of Yucca Mountain for storing high-level nuclear waste. Data on ground-water levels at 35 wells and a fissure (Devils Hole), ground-water discharge at 5 springs and a flowing well, and total reported ground-water withdrawals within Crater Flat, Jackass Flats, Mercury Valley, and the Amargosa Desert are tabulated from January 2000 through December 2002. Historical data on water levels, discharges, and withdrawals are graphically presented to indicate variations through time. A statistical summary of ground-water levels at seven wells in Jackass Flats is presented for 1992-2002 to indicate potential effects of ground-water withdrawals associated with U.S. Department of Energy activities near Yucca Mountain. The statistical summary includes the annual number of measurements, maximum, minimum, and median water-level altitudes, and average deviation of measured water-level altitudes compared to selected baseline periods. Baseline periods varied for 1985-93. At six of the seven wells in Jackass Flats, the median water levels for 2002 were slightly higher (0.3-2.4 feet) than for their respective baseline periods. At the remaining well, data for 2002 was not summarized statistically but median water-level altitude in 2001 was 0.7 foot higher than that in its baseline period.

Mini-Bentall: An Interesting Approach for Selected Patients.

PubMed

Mikus, Elisa; Micari, Antonio; Calvi, Simone; Salomone, Maria; Panzavolta, Marco; Paris, Marco; Del Giglio, Mauro

Minimally invasive surgery through an upper hemisternotomy for aortic valve replacement has become the routine approach with excellent results. Actually, the same minimally invasive access is used for complex ascending aorta procedures only in few centers. We report our experience with minimally invasive approach for aortic valve and ascending aorta replacement using Bentall technique. From January 2010 to November 2015, a total of 238 patients received ascending aorta and aortic valve replacement using Bentall De Bono procedure at our institution. Low- and intermediate-risk patients underwent elective surgery with a minimally invasive approach. The "J"-shaped partial upper sternotomy was performed through a 6-cm skin incision from the notch to the third right intercostal space. Patients who had previous cardiac surgery or affected by active endocarditis were excluded. The study included 53 patients, 44 male (83 %) with a median age of 63 years [interquartile range (IQR), 51-73 years]. A bicuspid aortic valve was diagnosed in 27 patients (51%). A biological Bentall using a pericardial Mitroflow or Crown bioprosthesis implanted in a Valsalva graft was performed in 49 patents. The remaining four patients were treated with a traditional mechanical conduit. Median cardiopulmonary bypass time and median cross-clamp time were respectively 84 (IQR, 75-103) minutes and 73 (IQR, 64-89) minutes. Hospital mortality was zero as well as 30-day mortality. Median intensive care unit and hospital stay were 1.9 and 8 days, respectively. The study population compared with patients treated with standard full sternotomy and similar preoperative characteristics showed similar results in terms of postoperative outcomes with a slightly superiority of minimally invasive group mainly regarding operative times, incidence of atrial fibrillation, and postoperative ventilation times. A partial upper sternotomy is considered a safe option for aortic valve replacement. Our experience confirms that a minimally invasive approach using a partial upper J-shaped sternotomy can be a safe alternative approach to the standard in selected patients presenting with complex aortic root pathology.

Imaging of adrenal incidentalomas with PET using (11)C-metomidate and (18)F-FDG.

PubMed

Minn, Heikki; Salonen, Anna; Friberg, Johan; Roivainen, Anne; Viljanen, Tapio; Långsjö, Jaakko; Salmi, Jorma; Välimäki, Matti; Någren, Kjell; Nuutila, Pirjo

2004-06-01

Our aim was to evaluate the use of PET with (11)C-metomidate and (18)F-FDG for the diagnosis of adrenal incidentalomas. Twenty-one patients underwent hormonal screening before dynamic imaging of the upper abdomen with (11)C-metomidate, and for 19 of these 21 patients, static (18)F-FDG imaging followed. Uptake of (11)C-metomidate and (18)F-FDG in incidentalomas was quantified and correlated with the hormonal work-up and the mass size on CT (median, 2.5 cm; range, 2-10 cm). The final diagnoses were hormonally active adenoma (n = 7), nonsecretory adenoma (n = 5), adrenocortical carcinoma (n = 1), pheochromocytoma (n = 2), benign noncortical tumor (n = 2), normal adrenal (n = 1), and malignant noncortical tumor (n = 3). Diagnosis was established at surgery (n = 9), percutaneous biopsy (n = 4), or follow-up (n = 8). The highest uptake of (11)C-metomidate, expressed as standardized uptake value (SUV), was found in adrenocortical carcinoma (SUV = 28.0), followed by active adenomas (median SUV = 12.7), nonsecretory adenomas (median SUV = 12.2), and noncortical tumors (median SUV = 5.7). Patients with adenomas had significantly higher tumor-to-normal-adrenal (11)C-metomidate SUV ratios than did patients with noncortical tumors. (18)F-FDG detected 2 of 3 noncortical malignancies but failed to detect adrenal metastases from renal cell carcinoma. All inactive and most active adenomas were difficult to detect with (18)F-FDG against background activity, whereas both pheochromocytomas and adrenocortical carcinoma showed slightly increased uptake of (18)F-FDG. There was no correlation between uptake of (11)C-metomidate or (18)F-FDG and mass size. (11)C-Metomidate is a promising PET tracer to identify incidentalomas of adrenocortical origin. (18)F-FDG should be reserved for patients with a moderate to high likelihood of neoplastic disease.

Pregnancy Associated Plasma Protein-A and Placental Growth Factor in a Sub-Saharan African Population: A Nested Cross-Sectional Study

PubMed Central

Klipstein-Grobusch, Kerstin; Koster, Maria P. H.; Ramamoorthy, Dhivya; Antwi, Edward; Belmouden, Idder; Franx, Arie; Grobbee, Diederick E.; Schielen, Peter C. J. I.

2016-01-01

Background Baseline distributions of pregnancy disorders’ biomarkers PlGF and PAPP-A levels are primarily based on Western European populations of Caucasian ethnicity. Differences in PAPP-A and PlGF concentrations by ethnicity have been observed, with increased levels in Afro-Caribbean, East Asian, and South Asian women. Baseline concentrations of sub-Saharan African women have not been evaluated. Objectives To investigate PlGF and PAPP-A in a sub-Saharan African population and assess the performance of existing reference values of PAPP-A and PlGF. Methods A nested cross-sectional study was conducted in two public hospitals in Accra, Ghana. Out of the original 1010 women enrolled in the cohort, 398 participants were eligible for inclusion with a normotensive singleton gestation and serum samples taken between 56–97 days of pregnancy. PAPP-A and PlGF concentrations were measured with an automated immunoassay. Multiple of the median (MoM) values corrected for gestation and maternal weight for PAPP-A and PlGF were calculated using reference values of a Dutch perinatal screening laboratory based on over 10.000 samples, and PlGF manufacturer reference values, respectively. Results The PAPP-A median MoM was 2.34 (interquartile range (IQR) 1.24–3.97). Median PlGF MoM was 1.25 (IQR 0.95–1.80). Median MoM values for PAPP-A and PlGF tended to be slightly different for various Ghanaian ethnic subgroups. Conclusions PAPP-A and PlGF MoM values appear to be substantially higher in a sub-Saharan African population compared to the Caucasian or Afro-Caribbean MoM values previously reported. The difference suggests the need for a specific correction factor for this population to avoid underestimation of risk for fetal aneuploidies or placental disorders when using PAPP-A and PlGF MoM for screening purposes. PMID:27532602

Comparison of drinking water, raw rice and cooking of rice as arsenic exposure routes in three contrasting areas of West Bengal, India.

PubMed

Mondal, Debapriya; Banerjee, Mayukh; Kundu, Manjari; Banerjee, Nilanjana; Bhattacharya, Udayan; Giri, Ashok K; Ganguli, Bhaswati; Sen Roy, Sugata; Polya, David A

2010-12-01

Remediation aimed at reducing human exposure to groundwater arsenic in West Bengal, one of the regions most impacted by this environmental hazard, are currently largely focussed on reducing arsenic in drinking water. Rice and cooking of rice, however, have also been identified as important or potentially important exposure routes. Quantifying the relative importance of these exposure routes is critically required to inform the prioritisation and selection of remediation strategies. The aim of our study, therefore, was to determine the relative contributions of drinking water, rice and cooking of rice to human exposure in three contrasting areas of West Bengal with different overall levels of exposure to arsenic, viz. high (Bhawangola-I Block, Murshidibad District), moderate (Chakdha Block, Nadia District) and low (Khejuri-I Block, Midnapur District). Arsenic exposure from water was highly variable, median exposures being 0.02 μg/kg/d (Midnapur), 0.77 μg/kg/d (Nadia) and 2.03 μg/kg/d (Murshidabad). In contrast arsenic exposure from cooked rice was relatively uniform, with median exposures being 0.30 μg/kg/d (Midnapur), 0.50 μg/kg/d (Nadia) and 0.84 μg/kg/d (Murshidabad). Cooking rice typically resulted in arsenic exposures of lower magnitude, indeed in Midnapur, median exposure from cooking was slightly negative. Water was the dominant route of exposure in Murshidabad, both water and rice were major exposure routes in Nadia, whereas rice was the dominant exposure route in Midnapur. Notwithstanding the differences in balance of exposure routes, median excess lifetime cancer risk for all the blocks were found to exceed the USEPA regulatory threshold target cancer risk level of 10(-4)-10(-6). The difference in balance of exposure routes indicate a difference in balance of remediation approaches in the three districts.

Evaluation of statistical models for forecast errors from the HBV model

NASA Astrophysics Data System (ADS)

Engeland, Kolbjørn; Renard, Benjamin; Steinsland, Ingelin; Kolberg, Sjur

2010-04-01

SummaryThree statistical models for the forecast errors for inflow into the Langvatn reservoir in Northern Norway have been constructed and tested according to the agreement between (i) the forecast distribution and the observations and (ii) median values of the forecast distribution and the observations. For the first model observed and forecasted inflows were transformed by the Box-Cox transformation before a first order auto-regressive model was constructed for the forecast errors. The parameters were conditioned on weather classes. In the second model the Normal Quantile Transformation (NQT) was applied on observed and forecasted inflows before a similar first order auto-regressive model was constructed for the forecast errors. For the third model positive and negative errors were modeled separately. The errors were first NQT-transformed before conditioning the mean error values on climate, forecasted inflow and yesterday's error. To test the three models we applied three criterions: we wanted (a) the forecast distribution to be reliable; (b) the forecast intervals to be narrow; (c) the median values of the forecast distribution to be close to the observed values. Models 1 and 2 gave almost identical results. The median values improved the forecast with Nash-Sutcliffe R eff increasing from 0.77 for the original forecast to 0.87 for the corrected forecasts. Models 1 and 2 over-estimated the forecast intervals but gave the narrowest intervals. Their main drawback was that the distributions are less reliable than Model 3. For Model 3 the median values did not fit well since the auto-correlation was not accounted for. Since Model 3 did not benefit from the potential variance reduction that lies in bias estimation and removal it gave on average wider forecasts intervals than the two other models. At the same time Model 3 on average slightly under-estimated the forecast intervals, probably explained by the use of average measures to evaluate the fit.

Increased serum C-reactive protein concentrations in dogs with congestive heart failure due to myxomatous mitral valve disease.

PubMed

Reimann, M J; Ljungvall, I; Hillström, A; Møller, J E; Hagman, R; Falk, T; Höglund, K; Häggström, J; Olsen, L H

2016-03-01

Cardiovascular disease in humans and dogs is associated with mildly increased circulating concentrations of C-reactive protein (CRP). Few studies have evaluated associations between circulating CRP and canine myxomatous mitral valve disease (MMVD) and the results reported have been divergent. The aim of this study was to investigate whether serum concentrations of CRP, determined using a novel automated canine-specific high-sensitivity CRP assay (Gentian hsCRP), were associated with severity of MMVD and selected clinical variables in dogs. The study included 188 client-owned dogs with different severities of MMVD. Dogs were classified based on ACVIM consensus statement guidelines (group A, n = 58; group B1, n = 56; group B2, n = 38; group C, n = 36). Data were analysed using descriptive statistics and multiple regression analysis. Dogs with congestive heart failure (CHF; group C) had significantly higher CRP concentrations (median, 2.65 mg/L; quartile 1-quartile 3, 1.09-5.09) compared to dogs in groups A (median, 0.97 mg/L; quartile 1-quartile 3, <0.50-1.97; P = 0.001), B1 (median, 0.78 mg/L; quartile 1-quartile 3, <0.50-1.73, P <0.0001) and B2 (median, 0.60 mg/L; quartile 1-quartile 3, <0.50-1.23; P <0.0001). Other variables reflecting disease severity, including left atrial to aortic root ratio (P = 0.0002, adjusted r(2) = 0.07) and left ventricular end-diastolic diameter normalised for bodyweight (P = 0.0005, adjusted r(2) = 0.06), were positively associated with CRP concentration, but the association disappeared if dogs with CHF were excluded from analysis. In conclusion, slightly higher CRP concentrations were found in dogs with CHF whereas severity of asymptomatic MMVD showed no association with CRP concentrations. Copyright © 2016 Elsevier Ltd. All rights reserved.

Chromospherically Active Stars. XXV. HD 144110=EV Draconis, a Double-lined Dwarf Binary

NASA Astrophysics Data System (ADS)

Fekel, Francis C.; Henry, Gregory W.; Lewis, Ceteka

2005-08-01

New spectroscopic and photometric observations of HD 144110 have been used to obtain an improved orbital element solution and determine some basic properties of the system. This chromospherically active, double-lined spectroscopic binary has an orbital period of 1.6714012 days and a circular orbit. We classify the components as G5 V and K0 V and suggest that they are slightly metal-rich. The photometric observations indicate that the rotation of HD 144110 is synchronous with the orbital period. Despite the short orbital period, no evidence of eclipses is seen in our photometry.

Measurement of control system response using an analog operational circuit

NASA Technical Reports Server (NTRS)

Lalli, V. R.

1978-01-01

Ten basic steps are established for an analog method that measures control system response parameters. An example shows how these steps were used on a speed control portion of an auxiliary power unit. The equations and calculations necessary to describe this subsystem are given. The mechanization schematic and simulation diagram for obtaining the measured response parameters of the control system using an analog circuit are explained. Methods for investigating the various effects of the control parameters are described. It is concluded that the optimum system should be underdamped enough to be slightly oscillatory during transients.

Plant growth and gas balance in a plant and mushroom cultivation system

NASA Astrophysics Data System (ADS)

Kitaya, Y.; Tani, A.; Kiyota, M.; Aiga, I.

1994-11-01

In order to obtain basic data for construction of a plant cultivation system incorporating a mushroom cultivation subsystem in the CELSS, plant growth and atmospheric CO2 balance in the system were investigated. The plant growth was promoted by a high level of CO2 which resulted from the respiration of the mushroom mycelium in the system. The atmospheric CO2 concentration inside the system changed significantly due to the slight change in the net photosynthetic rate of plants and/or the respiration rate of the mushroom when the plant cultivation system combined directly with the mushroom cultivation subsystem.

A trial-based economic evaluation of 2 nurse-led disease management programs in heart failure.

PubMed

Postmus, Douwe; Pari, Anees A Abdul; Jaarsma, Tiny; Luttik, Marie Louise; van Veldhuisen, Dirk J; Hillege, Hans L; Buskens, Erik

2011-12-01

Although previously conducted meta-analyses suggest that nurse-led disease management programs in heart failure (HF) can improve patient outcomes, uncertainty regarding the cost-effectiveness of such programs remains. To compare the relative merits of 2 variants of a nurse-led disease management program (basic or intensive support by a nurse specialized in the management of patients with HF) against care as usual (routine follow-up by a cardiologist), a trial-based economic evaluation was conducted alongside the COACH study. In terms of costs per life-year, basic support was found to dominate care as usual, whereas the incremental cost-effectiveness ratio between intensive support and basic support was found to be equal to €532,762 per life-year; in terms of costs per quality-adjusted life-year (QALY), basic support was found to dominate both care as usual and intensive support. An assessment of the uncertainty surrounding these findings showed that, at a threshold value of €20,000 per life-year/€20,000 per QALY, basic support was found to have a probability of 69/62% of being optimal against 17/30% and 14/8% for care as usual and intensive support, respectively. The results of our subgroup analysis suggest that a stratified approach based on offering basic support to patients with mild to moderate HF and intensive support to patients with severe HF would be optimal if the willingness-to-pay threshold exceeds €45,345 per life-year/€59,289 per QALY. Although the differences in costs and effects among the 3 study groups were not statistically significant, from a decision-making perspective, basic support still had a relatively large probability of generating the highest health outcomes at the lowest costs. Our results also substantiated that a stratified approach based on offering basic support to patients with mild to moderate HF and intensive support to patients with severe HF could further improve health outcomes at slightly higher costs. Copyright © 2011 Mosby, Inc. All rights reserved.

Rumination in posttraumatic stress and growth after a natural disaster: a model from northern Chile 2014 earthquakes

PubMed Central

Leal-Soto, Francisco; Carmona-Halty, Marcos; Ferrer-Urbina, Rodrigo

2016-01-01

Background Traumatic experiences, such as natural disasters, produce multiple and serious impacts on people. Despite the traditional focus on negative consequences, in many cases there are also positive consequences, such as posttraumatic growth. Tedeschi and Calhoun proposed a model of posttraumatic growth that emphasizes the role of rumination after the basic beliefs breakdown due to the occurrence of a traumatic experience. Method A total of 238 volunteers affected by two major earthquakes and tsunami alerts in northern Chile on April 1 and 2, 2014, responded to an online survey measuring subjective severity, basic beliefs change, social share of emotion, rumination, posttraumatic stress, and posttraumatic growth. Results Path analyses reveal that posttraumatic stress goes through a negative change in basic beliefs, intrusive rumination, and deliberated rumination, meanwhile posttraumatic growth is only achieved directly from a positive change in basic beliefs and deliberated rumination. Discussion The model is consistent with the empirical model obtained in Chilean people affected by the earthquake and tsunami that occurred on 27 February, 2010, but it is slightly different and in a form that is more consistent with Tedeschi and Calhoun’s theoretical model. Both models remark on the role of deliberated rumination in posttraumatic growth and failure to progress from intrusive to deliberated rumination in posttraumatic stress, but the proposed one is more parsimonious and assumes subjective severity as an antecedent to basic belief changes. These conclusions must be considered in light of limitations that a cross-sectional design and the correlational nature of the statistical analysis carried out impose. Highlights of the article Role of subjective severity, change of basic beliefs, social sharing of emotion, and rumination on posttraumatic stress and growth were modeled from responses of people affected by the April 1–2, 2014, northern Chilean earthquakes.Posttraumatic stress goes through negative changes in basic beliefs, intrusive rumination, and deliberated rumination.Posttraumatic growth is achieved from positive changes in basic beliefs and deliberated rumination.Deliberated rumination and moving from intrusive to deliberated rumination appear as cornerstones in posttraumatic processing. PMID:27900935

Prevalence of smoking and BMI differences between smokers and non-smokers among children and adolescents aged 7-18 years in south-east Poland.

PubMed

Wandycz, Artur; Jankowiak, Łukasz; Jerzak, Izabela

2018-05-01

Objectives : The aim of the study was to determine the prevalence of smoking among children and adolescents aged 7-18 years, and also to determine the relationship between this addiction and the Body Mass Index (BMI). Methods : Basic anthropometric measurements were performed, and information concerning cigarette smoking and basic SES was gathered using the questionnaire method. Results : More than 5% of boys admit to smoking at the age of 10-11 years, and as many as 22% 18-year-olds admit to doing so. With regard to girls, the situation is slightly better because it is only among 14-year-olds that the percentage of smokers exceeds 5%. Smoking may affect average BMIs. Smoking had a negative impact on the magnitude of physical development indices among children between 8 and 12 years old. Conclusions : The percentage of smokers increases with age. Boys smoke more often than girls. Tobacco smoking in middle childhood (8-12 years) is associated with lower BMIs.

Basic language comprehension and production in >100,000 young children from sixteen developing nations

PubMed Central

BORNSTEIN, MARC H.; HENDRICKS, CHARLENE

2013-01-01

Using the Multiple Indicator Cluster Survey, language comprehension and production were compared in a sample of 101,250 children aged 2;00 to 9;11 and a focus subsample of 38,845 children aged 2;00 to 4;11 from sixteen under-researched developing nations. In the whole sample, comprehension slightly exceeded production; correlations between comprehension and production by country were positive and significant, but varied in size, and the average correlation was positive, significant, and small to medium. Mean comprehension and production varied with child age, reaching an asymptote at 5;00, and correlations between comprehension and production by age were positive, significant, and similar at each age. In the focus subsample, comprehension exceeded production; correlations between comprehension and production by country were positive and significant, but varied in size, and the average correlation was positive, significant, and medium in size. Children in countries with lower standards of living were less likely to demonstrate basic language comprehension or production. PMID:22129486

External quality-assurance results for the National Atmospheric Deposition Program/National Trends Network, 1995-96

USGS Publications Warehouse

Gordon, John D.

1999-01-01

The U.S. Geological Survey operated four external quality-assurance programs for the National Atmospheric Deposition Program/National Trends Network (NADP/NTN) in 1995 and 1996: the intersite-comparison program, the blind-audit program, the interlaboratory- comparison program, and the collocated-sampler program. The intersite-comparison program assessed the precision and bias of pH and specific-conductance determinations made by NADP/NTN site operators. The analytical bias introduced during routine handling, processing, and shipping of wet-deposition samples and precision of analyte values was estimated using a blind-audit program. An interlaboratory-comparison program was used to evaluate differences between analytical results and to estimate the analytical precision of five North American laboratories that routinely analyzed wet deposition. A collocated-sampler program estimated the precision of the overall precipitation collection and analysis system from initial sample collection through final storage of the data. Results of two intersite-comparison studies completed in 1995 indicated 94.6 and 94.4 percent of the onsite pH determinations met the NADP/NTN accuracy goals, whereas 97.2 and 98.3 percent of the specific-conductance determinations were within the established limits. The percentages of onsite determinations that met the accuracy goals in 1996 were slightly less for both pH and specific-conductance than in 1995. In 1996, 93.2 and 87.5 percent of onsite pH determinations met the accuracy goals, whereas the percentage of onsite specific-conductance measurements that met the goals was 93.9 and 94.9 percent.The blind audit program utilizes a paired sample design to evaluate the effects of routine sample handling, processing and shipping on the chemistry of weekly precipitation samples. The portion of the blind audit sample subject to all of the normal onsite handling and processing steps of a regular weekly precipitation sample is referred to as the bucket portion, whereas the portion receiving only minimal handling is referred to as the bottle portion. Throughout the report, the term positive bias in regard to blind-audit results indicates that the bucket portion had a higher concentration than the bottle portion. The paired t-test of 1995 blind-audit data indicated that routine sample handling, processing, and shipping introduced a very small positive bias (a=0.05) for hydrogen ion and specific conductance and a slight negative bias (a =0.05) for ammonium and sodium. In 1995, the median paired differences between the bucket and bottle portions ranged from -0.02 milligram per liter for both ammonium and nitrate to +0.002 milligram per liter for calcium. Although the paired t-test indicated a very small positive bias for hydrogen ion, the median paired difference between the bucket and bottle portions was 0.00 microequivalents per liter, whereas for specific conductance, the median paired difference between the bucket and bottle portions was 0.200 microsiemens per centimeter in 1995. The paired t-test of blind-audit results in 1996 indicated statistically significant bias for 6 of the 10 analytes. Only chloride, nitrate, hydrogen ion, and specific conductance were not biased in 1996. However, the magnitude of the bias in 1996 was very small and only of limited importance from the viewpoint of an analytical chemist or data user. The median paired differences between the bucket and bottle portions ranged from -0.02 milligram per liter for both ammonium and chloride to +0.006 milligram per liter for calcium. For hydrogen ion, the median paired difference between the bucket and bottle portions was -0.357 microequivalent per liter; for specific conductance, the median paired difference between the bucket and bottle portions was 0.00 microsiemens per centimeter in 1996. Surface-chemistry effects due to different amounts of precipitation contacting the sample collection and shipping container surfac

Ground and excited state properties of high performance anthocyanidin dyes-sensitized solar cells in the basic solutions

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

Prima, Eka Cahya; Computational Material Design and Quantum Engineering Laboratory, Engineering Physics, Institut Teknologi Bandung; International Program on Science Education, Universitas Pendidikan Indonesia

2015-09-30

The aglycones of anthocyanidin dyes were previously reported to form carbinol pseudobase, cis-chalcone, and trans-chalcone due to the basic levels. The further investigations of ground and excited state properties of the dyes were characterized using density functional theory with PCM(UFF)/B3LYP/6-31+G(d,p) level in the basic solutions. However, to the best of our knowledge, the theoretical investigation of their potential photosensitizers has never been reported before. In this paper, the theoretical photovoltaic properties sensitized by dyes have been successfully investigated including the electron injections, the ground and excited state oxidation potentials, the estimated open circuit voltages, and the light harvesting efficiencies. Themore » results prove that the electronic properties represented by dyes’ LUMO-HOMO levels will affect to the photovoltaic performances. Cis-chalcone dye is the best anthocyanidin aglycone dye with the electron injection spontaneity of −1.208 eV, the theoretical open circuit voltage of 1.781 V, and light harvesting efficiency of 56.55% due to the best HOMO-LUMO levels. Moreover, the ethanol solvent slightly contributes to the better cell performance than the water solvent dye because of the better oxidation potential stabilization in the ground state as well as in the excited state. These results are in good agreement with the known experimental report that the aglycones of anthocyanidin dyes in basic solvent are the high potential photosensitizers for dye-sensitized solar cell.« less

Individualized deliberate practice on a virtual reality simulator improves technical performance of surgical novices in the operating room: a randomized controlled trial.

PubMed

Palter, Vanessa N; Grantcharov, Teodor P

2014-03-01

The purpose of this study was to investigate whether individualized deliberate practice on a virtual reality (VR) simulator results in improved technical performance in the operating room. Training on VR simulators has been shown to improve technical performance in the operating room (OR). Currently described VR curricula consist of trainees practicing the same tasks until expert proficiency is reached. It has yet to be investigated whether the individualized deliberate practice, where curricula tasks vary depending on prior levels of technical proficiency, would translate into the OR. This single-blinded prospective trial randomized 16 novice surgical residents to a deliberate practice (DP) group and a conventional residency training group. Both groups performed a laparoscopic cholecystectomy in the OR that was video-recorded. Technical performance of DP group residents in the OR was assessed using 3 validated assessment tools. A score of less than 60% on any component of the assessment tool resulted in the trainee practicing a specific task on the VR simulator. The DP group practiced on the simulator as per their individualized schedule. Both groups then performed another laparoscopic cholecystectomy. A blinded expert assessed the OR recordings using a validated global rating scale. Although both groups had similar technical abilities preintervention [DP: median score, 13.5 (9.3-15.0); control: median score, 14.5 (9.3-17.8); P = 0.45], the DP residents had a superior technical performance postintervention [DP: median score, 17.0 (15.3-18.5); control: median score, 12.5 (7.5-14.0); P = 0.03]. Of 8 DP residents, 6 practiced 5 basic VR tasks (median 1 trial to pass), and 7 of 8 practiced 2 advanced tasks (median 4 trials to pass). A curriculum of deliberate individualized practice on a VR simulator improves technical performance in the OR. This has implications to greatly improve the feasibility of implementing simulation-based curricula in residency training programs, rather then having them being limited to research protocols.

Does spending on refugees make a difference? A cross-sectional study of the association between refugee program spending and health outcomes in 70 sites in 17 countries.

PubMed

Tan, Timothy M; Spiegel, Paul; Haskew, Christopher; Greenough, P Gregg

2016-01-01

Numerous simultaneous complex humanitarian emergencies strain the ability of local governments and the international community to respond, underscoring the importance of cost-effective use of limited resources. At the end of 2011, 42.5 million people were forcibly displaced, including 10.4 million refugees under the mandate of the United Nations High Commissioner for Refugees (UNHCR). UNHCR spent US$1.65 billion on refugee programs in 2011. We analyze the impact of aggregate-level UNHCR spending on mortality of refugee populations. Using 2011 budget data, we calculated purchasing power parity adjusted spending, disaggregated by population planning groups (PPGs) and UNHCR Results Framework objectives. Monthly mortality reported to UNHCR's Health Information System from 2011 to 2012 was used to calculate crude (CMR) and under-5 (U5MR) mortality rates, and expressed as ratios to country of asylum mortality. Log-linear regressions were performed to assess correlation between spending and mortality. Mortality data for 70 refugee sites representing 1.6 million refugees in 17 countries were matched to 20 PPGs. Median 2011 spending was $623.27 per person (constant 2011 US$). Median CMR was 2.4 deaths per 1,000 persons per year; median U5MR was 18.1 under-5 deaths per 1,000 live births per year. CMR was negatively correlated with total spending ( p =  0.027), and spending for fair protection processes and documentation ( p =  0.005), external relations ( p =  0.034), logistics and operations support ( p =  0.007), and for healthcare ( p =  0.046). U5MR ratio was negatively correlated with total spending ( p =  0.015), and spending for favorable protection environment ( p =  0.024), fair protection processes and documentation ( p =  0.003), basic needs and essential services ( p =  0.027), and within basic needs, for healthcare services ( p =  0.007). Increased UNHCR spending on refugee populations is correlated with lower mortality, likely reflecting unique refugee vulnerabilities and dependence on aid. Future analyses using more granular data can further elucidate the health impact of humanitarian sector spending, thereby guiding policy choices.

Reference Values for the Marx Activity Rating Scale in a Young Athletic Population: History of Knee Ligament Injury Is Associated With Higher Scores.

PubMed

Cameron, Kenneth L; Peck, Karen Y; Thompson, Brandon S; Svoboda, Steven J; Owens, Brett D; Marshall, Stephen W

2015-01-01

Activity-related patient-reported outcome measures are an important component of assessment after knee ligament injury in young and physically active patients; however, normative data for most activity scales are limited. To present reference values by sex for the Marx Activity Rating Scale (MARS) within a young and physically active population while accounting for knee ligament injury history and sex. Cross-sectional study. Level 2. All incoming freshman entering a US Service Academy in June of 2011 were recruited to participate in this study. MARS was administered to 1169 incoming freshmen (203 women) who consented to participate within the first week of matriculation. All subjects were deemed healthy and medically fit for military service on admission. Subjects also completed a baseline questionnaire that asked for basic demographic information and injury history. We calculated means with standard deviations, medians with interquartile ranges, and percentiles for ordinal and continuous variables, and frequencies and proportions for dichotomous variables. We also compared median scores by sex and history of knee ligament injury using the Kruskal-Wallis test. MARS was the primary outcome of interest. The median MARS score was significantly higher for men when compared with women (χ(2) = 13.22, df = 1, P < 0.001) with no prior history of knee ligament injury. In contrast, there was no significant difference in median MARS scores between men and women (χ(2) = 0.47, df = 1, P = 0.493) who reported a history of injury. Overall, median MARS scores were significantly higher among those who reported a history of knee ligament injury when compared with those who did not (χ(2) = 9.06, df = 1, P = 0.003). Assessing activity as a patient-reported outcome after knee ligament injury is important, and reference values for these instruments need to account for the influence of prior injury and sex. © 2015 The Author(s).

[Characteristics and its forming mechanism on grain size distribution of suspended matter at Changjiang Estuary].

PubMed

Pang, Chong-guang; Yu, Wei; Yang, Yang

2010-03-01

In July of 2008, under the natural condition of sea water, the Laser in-situ scattering and transmissometry (LISST-100X Type C) was used to measure grain size distribution spectrum and volume concentration of total suspended matter in the sea water, including flocs at different layers of 24 sampling stations at Changjiang Estuary and its adjacent sea. The characteristics and its forming mechanism on grain size distribution of total suspended matter were analyzed based on the observation data of LISST-100X Type C, and combining with the temperature, salinity and turbidity of sea water, simultaneously observed by Alec AAQ1183. The observation data showed that the average median grain size of total suspended matter was about 4.69 phi in the whole measured sea area, and the characteristics of grain size distribution was relatively poor sorted, wide kurtosis, and basically symmetrical. The conclusion could be drawn that vertically average volume concentration decreased with the distance from the coastline, while median grain size had an increase trend with the distance, for example, at 31.0 degrees N section, the depth-average median grain size had been increased from 11 microm up to 60 microm. With the increasing of distance from the coast, the concentration of fine suspended sediment reduced distinctly, nevertheless some relatively big organic matter or big flocs appeared in quantity, so its grain size would rise. The observation data indicated that the effective density was ranged from 246 kg/m3 to 1334 kg/m, with average was 613 kg/m3. When the concentration of total suspended matter was relatively high, median grain size of total suspended matter increased with the water depth, while effective density decreased with the depth, because of the faster settling velocity and less effective density of large flocs that of small flocs. As for station 37 and 44, their correlation coefficients between effective density and median grain size were larger than 0.9.

Use of biorelevant media for assessment of a poorly soluble weakly basic drug in the form of liquisolid compacts: in vitro and in vivo study.

PubMed

Badawy, Mahmoud A; Kamel, Amany O; Sammour, Omaima A

2016-01-01

The purpose of this work is to use biorelevant media to evaluate the robustness of a poorly water soluble weakly basic drug to variations along the gastrointestinal tract (GIT) after incorporation in liquisolid compacts and to assess the success of these models in predicting the in vivo performance. Liquisolid tablets were prepared using mosapride citrate as a model drug. A factorial design experiment was used to study the effect of three factors, namely: drug concentration at two levels (5% and 10%), carriers at three levels (avicel, mannitol and lactose) and powder excipients ratio (R) of the coating material at two levels (25 and 30). The in vitro dissolution media utilized were 0.1 N HCl, hypoacidic stomach model and a transfer model simulating the transfer from the stomach to the intestine. All compacts released above 95% of drug after 10 min in 0.1 N HCl. In the hypoacidic model, the compacts with R 30 were superior compared to R 25, where they released >90% of drug after 10 min compared to 80% for R 25. After the transfer of the optimum compacts from Simulated gastric fluid fast (SGFfast) to fasted state simulated intestinal fluid, slight turbidity appeared after 30 min, and the amount of drug dissolved slightly decreased from 96.91% to 90.59%. However, after the transfer from SGFfast to fed state simulated intestinal fluid, no turbidity or precipitation occurred throughout time of the test (60 min). In vivo pharmacokinetic study in human volunteers proved the success of the in vitro models with enhancement of the oral bioavailability (121.20%) compared to the commercial product.

Kinetic and thermodynamic study of the thorium phosphate-diphosphate dissolution

NASA Astrophysics Data System (ADS)

Thomas, A. C.; Dacheux, N.; Le Coustumer, P.; Brandel, V.; Genet, M.

2000-10-01

The dissolution of the thorium phosphate-diphosphate (TPD), which was proposed for the actinides immobilization, was systematically studied as a function of several parameters such as surface, leaching flow, temperature, acidity or basicity of the leachate and phosphate concentration. The dependence of the normalized leaching rate on the temperature leads to an activation energy equal to about 42±3 kJ mol -1. The normalized leaching rate is slightly increased when increasing the acidity or the basicity of the leachate. The partial orders related to proton and hydroxide ions are equal to 0.31-0.35 and 0.35, respectively. For the pH range studied, i.e., 1

Liver Match, a prospective observational cohort study on liver transplantation in Italy: study design and current practice of donor-recipient matching.

PubMed

Angelico, Mario; Cillo, Umberto; Fagiuoli, Stefano; Gasbarrini, Antonio; Gavrila, Caius; Marianelli, Tania; Costa, Alessandro Nanni; Nardi, Alessandra; Strazzabosco, Mario; Burra, Patrizia; Agnes, Salvatore; Baccarani, Umberto; Calise, Fulvio; Colledan, Michele; Cuomo, Oreste; De Carlis, Luciano; Donataccio, Matteo; Ettorre, Giuseppe M; Gerunda, Giorgio E; Gridelli, Bruno; Lupo, Luigi; Mazzaferro, Vincenzo; Pinna, Antonio; Risaliti, Andrea; Salizzoni, Mauro; Tisone, Giuseppe; Valente, Umberto; Rossi, Giorgio; Rossi, Massimo; Zamboni, Fausto

2011-02-01

The Liver Match is an observational cohort study that prospectively enrolled liver transplantations performed at 20 out of 21 Italian Transplant Centres between June 2007 and May 2009. Aim of the study is to investigate the impact of donor/recipient matching on outcomes. In this report we describe the study methodology and provide a cross-sectional description of donor and recipient characteristics and of graft allocation. Adult primary transplants performed with deceased heart-beating donors were included. Relevant information on donors and recipients, organ procurement and allocation were prospectively entered in an ad hoc database within the National Transplant Centre web-based Network. Data were blindly analysed by an independent Biostatistical Board. The study enrolled 1530 donor/recipient matches. Median donor age was 56 years. Female donors (n = 681, median 58, range 12-92 years) were older than males (n = 849, median 53, range 2-97 years, p < 0.0001). Donors older than 60 years were 42.2%, including 4.2% octogenarians. Brain death was due to non-traumatic causes in 1126 (73.6%) cases. Half of the donor population was overweight, 10.1% was obese and 7.6% diabetic. Hepatitis B core antibody (HBcAb) was present in 245 (16.0%) donors. The median Donor Risk Index (DRI) was 1.57 (>1.7 in 35.8%). The median cold ischaemia time was 7.3h (≥ 10 in 10.6%). Median age of recipients was 54 years, and 77.7% were males. Hepatocellular carcinoma (HCC) was the most frequent indication overall (44.4%), being a coindication in roughly 1/3 of cases, followed by viral cirrhosis without HCC (28.2%) and alcoholic cirrhosis without HCC (10.2%). Hepatitis C virus infection (with or without HCC) was the most frequent etiologic factor (45.9% of the whole population and 71.4% of viral-related cirrhosis), yet hepatitis B virus infection accounted for 28.6% of viral-related cirrhosis, and HBcAb positivity was found in 49.7% of recipients. The median Model for End Stage Liver Disease (MELD) at transplant was 12 in patients with HCC and 18 in those without. Multivariate analysis showed a slight but significant inverse association between DRI and MELD at transplant. The deceased donor population in Italy has a high-risk profile compared to other countries, mainly due to older donor age. Almost half of the grafts are transplanted in recipients with HCC. Higher risk donors tend to be preferentially allocated to recipients with HCC, who are usually less ill and older. No other relevant allocation strategy is currently adopted at national level. Copyright © 2010 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

C-reactive protein reference percentiles among pre-adolescent children in Europe based on the IDEFICS study population.

PubMed

Schlenz, H; Intemann, T; Wolters, M; González-Gil, E M; Nappo, A; Fraterman, A; Veidebaum, T; Molnar, D; Tornaritis, M; Sioen, I; Mårild, S; Iacoviello, L; Ahrens, W

2014-09-01

C-reactive protein (CRP) is involved in a wide range of diseases. It is a powerful marker for inflammatory processes used for diagnostic and monitoring purposes. We aimed to establish reference values as data on the distribution of serum CRP levels in young European children are scarce. Reference values of high-sensitivity CRP concentrations were calculated for 9855 children aged 2.0-10.9 years, stratified by age and sex. The children were recruited during the population-based European IDEFICS study (Identification and prevention of Dietary- and lifestyle-induced health Effects in Children and infantS) with 18 745 participants recruited from 2007 to 2010. In 44.1% of the children, CRP values were below or equal the detection limit of 0.2 mg/l. Median CRP concentrations showed a slight negative age trend in boys and girls, whereas serum CRP values were slightly higher in girls than in boys across all age groups. Our population-based reference values of CRP may guide paediatric practice as elevated values may require further investigation or treatment. Therefore, the presented reference values represent a basis for clinical evaluation and for future research on risk assessment of diseases associated with increased CRP levels among children.

Analysis of the costs and payments of a coordinated stroke center and regional stroke network.

PubMed

Rymer, Marilyn M; Armstrong, Edward P; Meredith, Neil R; Pham, Sissi V; Thorpe, Kevin; Kruzikas, Denise T

2013-08-01

An earlier study demonstrated significantly improved access, treatment, and outcomes after the implementation of a progressive, comprehensive stroke program at a tertiary care community hospital, Saint Luke's Neuroscience Institute (SLNI). This study evaluated the costs associated with implementing such a program. Retrospective analysis of total hospital costs and payments for treating patients with ischemic stroke at SLNI (n=1570) as program enhancement evolved over time (2005, 2007, and 2010) and compared with published national estimates. Analyses were stratified by patient demographic characteristics, patient outcomes, treatments, time, and comorbidities. Controlling for inflation, there was no difference in SLNI total costs between 2005 and either 2007 or 2010, suggesting that while SLNI provided an increased level of services, any additional expenditures were offset by efficiencies. SLNI total costs were slightly lower than published benchmarks. Consistent with previous stroke care cost estimates, the median overall differential between total hospital costs and payments for all ischemic stroke cases was negative. SLNI total costs remained consistent over time and were slightly lower than previously published estimates, suggesting that a focused, streamlined stroke program can be implemented without a significant economic impact. This finding further demonstrates that providing comprehensive stroke care with improved access and treatment may be financially feasible for other hospitals.

Selective toxicity of the mesoionic insecticide, triflumezopyrim, to rice planthoppers and beneficial arthropods.

PubMed

Zhu, Jun; Li, Yao; Jiang, Hua; Liu, Chen; Lu, Weiwei; Dai, Wei; Xu, Jianxiang; Liu, Fang

2018-05-01

The novel mesoionic insecticide triflumezopyrim was highly effective in controlling both imidacloprid-susceptible and resistant planthopper populations in Malaysia. However, the toxicity of triflumezopyrim to planthopper populations and their natural enemies has been under-investigated in China. In this study, the median lethal concentrations (LC 50 ) of triflumezopyrim were determined in eight field populations of Nilaparvata lugens and one population of Sogatella furcifera from China under laboratory conditions. Triflumezopyrim showed higher toxicity to planthopper populations than the commonly-used insecticide, imidacloprid. Furthermore, the lethal effect of triflumezopyrim on eight beneficial arthropods of planthoppers was investigated in the laboratory and compared with three commonly-used insecticides, thiamethoxam, chlorpyrifos and abamectin. Triflumezopyrim was harmless to Anagrus nilaparvatae, Cyrtorhinus lividipennis and Paederus fuscipes, while thiamethoxam, chlorpyrifos and abamectin were moderately harmful or harmful to the insect parasitoid and predators. Triflumezopyrim and thiamethoxam were harmless to the predatory spiders Pirata subpiraticus, Ummeliata insecticeps, Hylyphantes graminicola and Pardosa pseudoannulata, and slightly harmful to Theridion octomaculatum. Chlorpyrifos caused slight to high toxicity to four spider species except U. insecticeps. Abamectin was moderately to highly toxic to all five spider species. Our results indicate that triflumezopyrim has high efficacy for rice planthoppers populations and is compatibile with their natural enemies in China.

Hypothyroidism and hyperthyroidism and breast cancer risk: a nationwide cohort study.

PubMed

Søgaard, Mette; Farkas, Dóra Körmendiné; Ehrenstein, Vera; Jørgensen, Jens Otto Lunde; Dekkers, Olaf M; Sørensen, Henrik Toft

2016-04-01

The association between thyroid disease and breast cancer risk remains unclear. We, therefore examined the association between hypothyroidism, hyperthyroidism and breast cancer risk. This was a population-based cohort study. Using nationwide registries, we identified all women in Denmark with a first-time hospital diagnosis of hypothyroidism or hyperthyroidism, 1978-2013. We estimated the excess risk of breast cancer among patients with hypothyroidism or hyperthyroidism compared with the expected risk in the general population, using standardized incidence ratios (SIRs) as a measure of risk ratio. Breast cancer diagnoses in the first 12 months following diagnosis of thyroid disease were excluded from the calculations to avoid diagnostic work-up bias. We included 61, 873 women diagnosed with hypothyroidism and 80, 343 women diagnosed with hyperthyroidism. Median follow-up time was 4.9 years (interquartile range (IQR): 1.8-9.5 years) for hypothyroidism and 7.4 years (IQR: 3.1-13.5 years) for hyperthyroidism. Hyperthyroidism was associated with a slightly increased breast cancer risk compared with the general population (SIR: 1.11, 95% CI: 1.07-1.16), which persisted beyond 5 years of follow-up (SIR: 1.13, 95% CI: 1.08-1.19). In comparison, hypothyroidism was associated with a slightly lower risk of breast cancer (SIR: 0.94, 95% CI: 0.88-1.00). Stratification by cancer stage at diagnosis, estrogen receptor status, age, comorbidity, history of alcohol-related disease and clinical diagnoses of obesity produced little change in cancer risk. We found an increased risk of breast cancer in women with hyperthyroidism and a slightly decreased risk in women with hypothyroidism indicating an association between thyroid function level and breast cancer risk. © 2016 European Society of Endocrinology.

Earth and Space Science Ph.D. Class of 2003 Report released

NASA Astrophysics Data System (ADS)

Keelor, Brad

AGU and the American Geological Institute (AGI) released on 26 July an employment study of 180 Earth and space science Ph.D. recipients who received degrees from U.S. universities in 2003. The AGU/AGI survey asked graduates about their education and employment, efforts to find their first job after graduation, and experiences in graduate school. Key results from the study include: The vast majority (87%) of 2003 graduates found work in the Earth and space sciences, earning salaries commensurate with or slightly higher than 2001 and 2002 salary averages. Most (64%) graduates were employed within academia (including postdoctoral appointments), with the remainder in government (19%), industry (10%), and other (7%) sectors. Most graduates were positive about their employment situation and found that their work was challenging, relevant, and appropriate for someone with a Ph.D. The percentage of Ph.D. recipients accepting postdoctoral positions (58%) increased slightly from 2002. In contrast, the fields of physics and chemistry showed significant increases in postdoctoral appointments for Ph.D.s during the same time period. As in previous years, recipients of Ph.D.s in the Earth, atmospheric, and ocean sciences (median age of 32.7 years) are slightly older than Ph.D. recipients in most other natural sciences (except computer sciences), which is attributed to time taken off between undergraduate and graduate studies. Women in the Earth, atmospheric,and ocean sciences earned 33% of Ph.D.s in the class of 2003, surpassing the percentage of Ph.D.s earned by women in chemistry (32%) and well ahead of the percentage in computer sciences (20%), physics (19%), and engineering (17%). Participation of other underrepresented groups in the Earth, atmospheric, and ocean sciences remained extremely low.

Hormonal Evidence Supports the Theory of Selection in Utero

PubMed Central

Catalano, RA; Saxton, KB; Bruckner, TA; Pearl, M; Anderson, E; Goldman-Mellor, S; Margerison-Zilko, C; Subbaraman, M; Currier, RJ; Kharrazi, M

2012-01-01

Objectives Antagonists in the debate over whether the maternal stress response during pregnancy damages or culls fetuses have invoked the theory of selection in utero to support opposing positions. We describe how these opposing arguments arise from the same theory and offer a novel test to discriminate between them. Our test, rooted in reports from population endocrinology that human chorionic gonadotropin (hCG) signals fetal fitness, contributes not only to the debate over the fetal origins of illness, but also to the more basic literature concerned with whether and how natural selection in utero affects contemporary human populations. Methods We linked maternal serum hCG measurements from prenatal screening tests with data from the California Department of Public Health birth registry for the years 2001–2007. We used time series analysis to test the association between the number of live born male singletons and median hCG concentration among males in monthly gestational cohorts. Results Among the 1.56 million gestations in our analysis, we find that median hCG levels among male survivors of monthly conception cohorts rise as the number of male survivors falls. Conclusions Elevated median hCG among relatively small male birth cohorts supports the theory of selection in utero and suggests that the maternal stress response culls cohorts in gestation by raising the fitness criterion for survival to birth. PMID:22411168

Environmental contexts of menopause in Spain: comparative results from recent research.

PubMed

Bernis, Cristina; Reher, David Sven

2007-01-01

This study had two main objectives: (1) to detect the differences in basic aspects of the reproductive aging process (age at menopause, menopausal symptoms, the medicalization of aging) among women from the region of Madrid, who at the time of the study were living in three different environmental contexts (rural, semiurban, and urban), and (2) to identify the main factors responsible for these differences. Data from two different research projects have been pooled for the DAMES project (Decisions At MEnopause Study), and the Ecology of Reproductive Aging Project. The sample size was 1,142, women 45 to 55 years of age (103 rural, 744 semiurban, 295 urban). Probit analysis was used to estimate median age at natural menopause in the three contexts. Rural women have a later onset of menopause (rural, 52.07 y; semiurban, 51.9 y; urban, 51.23 y) and significantly higher levels of the symptoms related to declines in estrogen, eg, hot flashes (rural, 56%; semiurban, 43%; urban, 46%; chi2=6.717, P=0.035) or loss of sexual desire (rural, 51%; semiurban, 44%; urban, 41%; chi2=24.934, P=0.001). Conversely, urban women suffer more from symptoms related to stress, eg, impatience (rural, 34%; semiurban, 25%; urban, 45%; chi2=41.328, P<0.001). The medicalization of menopause, measured in terms of both surgical menopause and the use of hormone therapy, is significantly higher in the urban population (surgical menopause: rural, 5.8%; semiurban, 8.7; urban, 10%; chi2=16.009, P<0.001). Despite these differences, levels of postmenopausal hormone therapy use are still somewhat lower than in other West European and North American populations. Two different logistic regression analyses were carried out to identify (1) factors associated with differences in ovarian aging, measured through menopausal status, and (2) factors associated with prevalence of hot flashes with respect to ovarian aging. Parity, body mass index, age, environmental context, and, slightly less so, smoking, alcohol consumption, age, education, age at menarche, and marital status all contribute significantly or nearly significantly and independently to the explanation of differences found. For the likelihood of having hot flashes, environmental context, age, education, age at menarche, menopausal status, and postmenopausal hormone therapy use all hae a significant or borderline significant effect. Significant differences have been shown to exist in rural, semiurban and urban settings in the median age at menopause, in basic symptom frequency and type, and in the levels of medicalization of the process of reproductive aging. Within multivariate regression models, it has been shown that body mass index, age, and environmental context all contribute to differences in reproductive aging. The factors associated with ovarian aging and hot flashes are comparable to those in other industrialized populations, although standard interpretations should be expanded to include context-based realities, including (1) the higher levels of modernization of urban women that influence differential behavior with respekt to risk factors at menopausal age; (2) the different ecological realities surrounding nutrition, physical activity, and social support that characterize women's period of development; and (3) the differential construction of their identity as women in terms of assertiveness, aesthetic perceptions, and the use of health services. Context does, indeed, matter.

Adrenal steroid inhibition of the vasopressin-neurophysin neurosecretory system to the median eminence of the rat. Differential effects of corticosterone and deoxycorticosterone administration after adrenalectomy.

PubMed

Silverman, A J; Hoffman, D; Gadde, C A; Krey, L C; Zimmermann, E A

1981-03-01

Neurophysin and vasopressin-containing terminals in the zona externa of the median eminence (ZE) show a large increase in immunoreactive peptide following adrenalectomy which can be prevented by dexamethazone replacement therapy. The present study was undertaken to determine the effectiveness of a glucocorticoid (corticosterone; CS) and a mineralocorticoid (deoxycorticosterone: DOC) in exerting negative feedback on this system. Animals were adrenalectomized and implanted with various sized pellets of either steroid or cholesterol. The amount of neurophysin-immunoreactivity in the ZE 2 weeks after adrenalectomy was estimated on a zero to four rank scale independently by three observers. The data were analyzed by the X2 statistic. Low doses of CS (50 mg) reduced the amount of staining in comparison to cholesterol-replaced animals by approximately 50%. The ZE of animals receiving higher doses (100--200 mg) were identical to those of intact animals. DOC, however, at the 50 or 100 mg level produced only a slight inhibition of the response to adrenalectomy. Larger pellets (150--200 mg) did not result in a level of ZE staining as low as for intact animals. These findings suggest that the vasopressin neurosecretory system to the ZE is regulated by glucocorticoids.

Expression of Toll-Like Receptors 2 and 4 and Related Cytokines in Patients with Hepatic Cystic and Alveolar Echinococcosis

PubMed Central

Tuxun, Tuerhongjiang; Ma, Hai-Zhang; Apaer, Shadike; Zhang, Heng; Aierken, Amina; Li, Yu-Peng; Lin, Ren-Yong; Zhao, Jin-Ming; Zhang, Jin-Hui; Wen, Hao

2015-01-01

Several studies have demonstrated the important role of Toll-like receptors in various parasitic infections. This study aims to explore expression of Toll-like receptors (TLRs) and related cytokines in patients with human cystic echinococcosis (CE) and alveolar echinococcosis (AE). 78 subjects including AE group (N = 28), CE group (N = 22), and healthy controls (HC, N = 28) were enrolled in this study. The mRNA expression levels of TLR2 and TLR4 in blood and hepatic tissue and plasma levels related cytokines were detected by using ELISA. Median levels of TLR2 mRNA in AE and CE groups were significantly elevated as compared with that in healthy control group. Median levels of TLR4 expression were increased in AE and CE. Plasma concentration levels of IL-5, IL-6, and IL-10 were slightly increased in AE and CE groups compared with those in HC group with no statistical differences (p > 0.05). The IL-23 concentration levels were significantly higher in AE and CE groups than that in HC subjects with statistical significance. The increased expression of TLR2 and IL-23 might play a potential role in modulating tissue infiltrative growth of the parasite and its persistence in the human host. PMID:26635448

Clostridium difficile colitis in patients after kidney and pancreas–kidney transplantation

PubMed Central

Keven, K.; Basu, A.; Re, L.; Tan, H.; Marcos, A.; Fung, J.J.; Starzl, T.E.; Simmons, R.L.; Shapiro, R.

2010-01-01

Limited data exist about Clostridium difficile colitis (CDC) in solid organ transplant patients. Between 1/1/99 and 12/31/02, 600 kidney and 102 pancreas–kidney allograft recipients were transplanted. Thirty-nine (5.5%) of these patients had CDC on the basis of clinical and laboratory findings. Of these 39 patients, 35 have information available for review. CDC developed at a median of 30 days after transplantation, and the patients undergoing pancreas–kidney transplantation had a slightly higher incidence of CDC than recipients of kidney alone (7.8% vs. 4.5%, P> 0.05). All but one patient presented with diarrhea. Twenty-four patients (64.9%) were diagnosed in the hospital, and CDC occurred during first hospitalization in 14 patients (40%). Treatment was with oral metronidazole (M) in 33 patients (94%)and M + oral vancomycin (M + V) in 2 patients. Eight patients had recurrent CDC, which occurred at a median of 30 days (range 15–314) after the first episode. Two patients (5.7%) developed fulminant CDC, presented with toxic megacolon, and underwent colectomy. One of them died; the other patient survived after colectomy. CDC should be considered as a diagnosis in transplant patients with history of diarrhea after antibiotic use, and should be treated aggressively before the infection becomes complicated. PMID:15225221

Speeds of coronal mass ejections: SMM observations from 1980 and 1984-1989

NASA Technical Reports Server (NTRS)

Hundhausen, A. J.; Burkepile, J. T.; St. Cyr, O. C.

1994-01-01

The speeds of 936 features in 673 coronal mass ejections have been determined from trajectories observed with the Solar Maximum Mission (SMM) coronagraph in 1980 and 1984 to 1989. The distribution of observed speeds has a range (from 5th to 95th percentile) of 35 to 911 km/s; the average and median speeds are 349 and 285 km/s. The speed distributions of some selected classes of mass ejections are significantly different. For example, the speeds of 331 'outer loops' range from 80 to 1042 km/s; the average and median speeds for this class of ejections are 445 and 372 km/s. The speed distributions from each year of SMM observations show significant changes, with the annual average speeds varying from 157 (1984) to 458 km/s (1985). These variations are not simply related to the solar activity cycle; the annual averages from years near the sunspot maxima and minimum are not significantly different. The widths, latitudes, and speeds of mass ejections determined from the SMM observations are only weakly correlated. In particular, mass ejection speeds vary only slightly with the heliographic latitudes of the ejection. High-latitude ejections, which occur well poleward of the active latitudes, have speeds similar to active latitude ejections.

Comparative susceptibility of introduced forest-dwelling mosquitoes in Hawai'i to avian malaria, Plasmodium relictum

USGS Publications Warehouse

Lapointe, D.A.; Goff, M.L.; Atkinson, C.T.

2005-01-01

To identify potential vectors of avian malaria in Hawaiian native forests, the innate susceptibility of Aedes albopictus, Wyeomyia mitchellii, and Culex quinquefasciatus from 3 geographical sites along an altitudinal gradient was evaluated using local isolates of Plasmodium relictum. Mosquitoes were dissected 5-8 and 9-13 days postinfective blood meal and microscopically examined for oocysts and salivary-gland sporozoites. Sporogony was completed in all 3 species, but prevalence between species varied significantly. Oocysts were detected in 1-2% and sporozoites in 1-7% of Aedes albopictus that fed on infected ducklings. Wyeomyia mitchellii was slightly more susceptible, with 7-19% and 7% infected with oocysts and sporozoites, respectively. In both species, the median oocyst number was 5 or below. This is only the second Wyeomyia species reported to support development of a malarial parasite. Conversely, Culex quinquefasciatus from all 3 sites proved very susceptible. Prevalence of oocysts and sporozoites consistently exceeded 70%, regardless of gametocytemia or origin of the P. relictum isolate. In trials for which a maximum 200 oocysts were recorded, the median number of oocysts ranged from 144 to 200. It was concluded that Culex quinquefasciatus is the primary vector of avian malaria in Hawai'i. ?? American Society of Parasitologists 2005.

The Physician Payments Sunshine Act: Data Evaluation Regarding Payments to Ophthalmologists

PubMed Central

Chang, Jonathan S.

2014-01-01

Objective/Purpose To review data for ophthalmologists published online from the Physician Payments Sunshine Act. Design Retrospective data review using a publicly available electronic database Methods: Main Outcome Measures A database was downloaded from the Centers for Medicare and Medicaid Services (CMS) Website under Identified General Payments to Physicians and a primary specialty of ophthalmology. Basic statistical analysis was performed including mean, median and range of payments for both single payments and per provider. Data were also summarized by category of payment, geographic region and compared with other surgical subspecialties. Results From August 1, 2013 to December 31, 2013, a total of 55,996 individual payments were reported to 9,855 ophthalmologists for a total of $10,926,447. The mean amount received in a single payment was $195.13 (range $0.04–$193,073). The mean amount received per physician ID was $1,108 (range $1–$397,849) and median amount $112.01. Consulting fees made up the largest percentage of fees. There was not a large difference in payments received by region. The mean payments for the subspecialties of dermatology, neurosurgery, orthopedic surgery and urology ranged from $954–$6,980, and median payments in each field by provider identifier ranged from $88–$173. Conclusions A large amount of data was released by CMS for the Physician Payment Sunshine Act. In ophthalmology, mean and median payments per physician did not vary greatly from other surgical subspecialties. Most single payments were under $100, and most physicians received less than $500 in total payments. Payments for consulting made up the largest category of spending. How this affects patient perception, patient care and medical costs warrants further study. PMID:25578254

Electrosurgery reduces blood loss and immediate postoperative inflammation compared to cold instruments for midline celiotomy in dogs: A randomized controlled trial

PubMed Central

Meakin, Lee B.; Murrell, Jo C.; Doran, Ivan C. P.; Knowles, Toby G.; Tivers, Michael S.

2017-01-01

Abstract Objectives To compare the use of an electrosurgical device with traditional cold instruments (scalpel and scissors) for midline celiotomy incision. Study design Prospective randomized controlled clinical trial. Sample population: One hundred and twenty client‐owned dogs undergoing abdominal surgery. Methods Dogs were prospectively recruited and randomized to receive electroincision or cold instrument incision. For cold incision, surgeons used basic surgical instruments including scalpel and scissors. For electroincision, surgeons only used the electrosurgical device in cutting mode. Time for the approach, blood loss, and the incision length were recorded. A blinded observer assessed pain and incision redness, swelling, and discharge at 24 and 48 hours postoperative (graded 0‐3). Owner assessment of incision healing was recorded by telephone interview. Results Blood loss during surgery was significantly lower for electroincision (mean 0.7, SD 1.7 mL) than cold incision (mean 3.0, SD 4.3 mL, P < .0001) with no significant difference in incision length or time for approach. Electroincision was associated with significantly less incision redness (cold median 1, range 0‐3; electroincision median 0, range 0‐2, P = .02) and less incision discharge (cold median 0.5 range 0‐3; electroincision median 0, range 0‐1, P = .006) at 24 hours postoperative. There was no significant difference in pain scores or incision healing in dogs receiving the two techniques. No incisional hernias were reported. A surgical site infection occurred in 1 dog (cold incision). Conclusions Electroincision for a celiotomy approach in the dog reduces blood loss, and incision redness and discharge in the immediate postoperative period without affecting the occurrence of wound complications such as infection and dehiscence (including linea alba). PMID:28314089

Temporal Trends (1999–2015) in the Impact Factor of Biomedical Journals Published by US and EU Scientific Societies

PubMed Central

Falagas, Matthew E.; Kyriakidou, Margarita; Spais, George; Argiti, Efstathia; Vardakas, Konstantinos Z.

2018-01-01

Objective The impact factor has emerged as the most popular index of scientific journals’ resonance. In this study we aimed to examine the impact factor trends of journals published by scientific bodies in the United States of America (USA) and Europe (EU). Methods We randomly chose 11 categories of Journal of Citation Reports and created three research classes: clinical medicine, laboratory medicine, and basic science. The impact factor values for the years 1999–2015 were abstracted, and the impact factor of US and EU journals was studied through the years. Results A total of 265 journals were included in the final analysis. The impact factor of US journals was higher than that of EU journals throughout the study period. In addition, for both US and EU journals the median impact factor increased throughout the study period. The rate of annual change in the impact factor throughout the study period was lower for US than EU journals (1.85% versus 3.55%, P=0.019). A higher median annual increase was seen in the impact factor during the period 1999–2008 compared to the period 2009–2015 for both US (P<0.001) and EU (P=0.001) journals. In fact, during the second period the US median impact factor value did not show significant changes (P=0.31), while the EU median impact factor continued to increase (P<0.001). Conclusion The impact factor of EU journals increased at a significantly higher rate than and approached that of the US journals during the last 16 years. PMID:29517962

Opsins in Limulus eyes: characterization of three visible light-sensitive opsins unique to and co-expressed in median eye photoreceptors and a peropsin/RGR that is expressed in all eyes

PubMed Central

Battelle, Barbara-Anne; Kempler, Karen E.; Saraf, Spencer R.; Marten, Catherine E.; Dugger, Donald R.; Speiser, Daniel I.; Oakley, Todd H.

2015-01-01

The eyes of the horseshoe crab Limulus polyphemus have long been used for studies of basic mechanisms of vision, and the structure and physiology of Limulus photoreceptors have been examined in detail. Less is known about the opsins Limulus photoreceptors express. We previously characterized a UV opsin (LpUVOps1) that is expressed in all three types of Limulus eyes (lateral compound eyes, median ocelli and larval eyes) and three visible light-sensitive rhabdomeric opsins (LpOps1, -2 and -5) that are expressed in Limulus lateral compound and larval eyes. Physiological studies showed that visible light-sensitive photoreceptors are also present in median ocelli, but the visible light-sensitive opsins they express were unknown. In the current study we characterize three newly identified, visible light-sensitive rhabdomeric opsins (LpOps6, -7 and -8) that are expressed in median ocelli. We show that they are ocellar specific and that all three are co-expressed in photoreceptors distinct from those expressing LpUVOps1. Our current findings show that the pattern of opsin expression in Limulus eyes is much more complex than previously thought and extend our previous observations of opsin co-expression in visible light-sensitive Limulus photoreceptors. We also characterize a Limulus peropsin/RGR (LpPerOps1). We examine the phylogenetic relationship of LpPerOps1 with other peropsins and RGRs, demonstrate that LpPerOps1 transcripts are expressed in each of the three types of Limulus eyes and show that the encoded protein is expressed in membranes of cells closely associated with photoreceptors in each eye type. These finding suggest that peropsin was in the opsin repertoire of euchelicerates. PMID:25524988

Estimating the basic reproduction rate of HFMD using the time series SIR model in Guangdong, China

PubMed Central

Du, Zhicheng; Zhang, Wangjian; Zhang, Dingmei; Yu, Shicheng

2017-01-01

Hand, foot, and mouth disease (HFMD) has caused a substantial burden of disease in China, especially in Guangdong Province. Based on notifiable cases, we use the time series Susceptible-Infected-Recovered model to estimate the basic reproduction rate (R0) and the herd immunity threshold, understanding the transmission and persistence of HFMD more completely for efficient intervention in this province. The standardized difference between the reported and fitted time series of HFMD was 0.009 (<0.2). The median basic reproduction rate of total, enterovirus 71, and coxsackievirus 16 cases in Guangdong were 4.621 (IQR: 3.907–5.823), 3.023 (IQR: 2.289–4.292) and 7.767 (IQR: 6.903–10.353), respectively. The heatmap of R0 showed semiannual peaks of activity, including a major peak in spring and early summer (about the 12th week) followed by a smaller peak in autumn (about the 36th week). The county-level model showed that Longchuan (R0 = 33), Gaozhou (R0 = 24), Huazhou (R0 = 23) and Qingxin (R0 = 19) counties have higher basic reproduction rate than other counties in the province. The epidemic of HFMD in Guangdong Province is still grim, and strategies like the World Health Organization’s expanded program on immunization need to be implemented. An elimination of HFMD in Guangdong might need a Herd Immunity Threshold of 78%. PMID:28692654

Adoption of recommended practices and basic technologies in a low-income setting

PubMed Central

English, Mike; Gathara, David; Mwinga, Stephen; Ayieko, Philip; Opondo, Charles; Aluvaala, Jalemba; Kihuba, Elesban; Mwaniki, Paul; Were, Fred; Irimu, Grace; Wasunna, Aggrey; Mogoa, Wycliffe; Nyamai, Rachel

2014-01-01

Objective In global health considerable attention is focused on the search for innovations; however, reports tracking their adoption in routine hospital settings from low-income countries are absent. Design and setting We used data collected on a consistent panel of indicators during four separate cross-sectional, hospital surveys in Kenya to track changes over a period of 11 years (2002–2012). Main outcome measures Basic resource availability, use of diagnostics and uptake of recommended practices. Results There appeared little change in availability of a panel of 28 basic resources (median 71% in 2002 to 82% in 2012) although availability of specific feeds for severe malnutrition and vitamin K improved. Use of blood glucose and HIV testing increased but remained inappropriately low throughout. Commonly (malaria) and uncommonly (lumbar puncture) performed diagnostic tests frequently failed to inform practice while pulse oximetry, a simple and cheap technology, was rarely available even in 2012. However, increasing adherence to prescribing guidance occurred during a period from 2006 to 2012 in which efforts were made to disseminate guidelines. Conclusions Findings suggest changes in clinical practices possibly linked to dissemination of guidelines at reasonable scale. However, full availability of basic resources was not attained and major gaps likely exist between the potential and actual impacts of simple diagnostics and technologies representing problems with availability, adoption and successful utilisation. These findings are relevant to debates on scaling up in low-income settings and to those developing novel therapeutic or diagnostic interventions. PMID:24482351

Compression stockings for treating venous leg ulcers: measurement of interface pressure under a new ulcer kit.

PubMed

Partsch, B; Partsch, H

2008-01-01

The aim of this study was to measure the interface pressure of a newly designed two-layer compression stocking (Mediven ulcer kit Medi QMBH, Bayreuth, Germany) in different body positions and to compare the values with those obtained with another two-layer product. Interface pressure was measured on the distal medial leg in 16 legs of volunteers, with the basic layer alone and with the whole stocking kit in the supine, sitting and standing position for both stocking systems. The literature concerning ulcer-healing rates is reviewed. Mediven ulcerkit produced statistically significant higher pressure values than the ulcer stocking with a median resting value of 35.5 mmHg in the supine and 42.5 mmHg in the standing position. The pressure while standing comes close to values exerted by bandages. The basic layer alone applies a pressure of 20.5 mmHg. Especially designed compression stockings exerting sufficient interface pressure may be indicated in patients with small ulcers of short duration.

The Basic Surgical Skills Course in Sub-Saharan Africa: An Observational Study of Effectiveness.

PubMed

Fergusson, Stuart J; Sedgwick, David M; Ntakiyiruta, Georges; Ntirenganya, Faustin

2018-04-01

The Basic Surgical Skills (BSS) course is a common component of postgraduate surgical training programmes in sub-Saharan Africa, but was originally designed in a UK context, and its efficacy and relevance have not been formally assessed in Africa. An observational study was carried out during a BSS course delivered to early-stage surgical trainees from Rwanda and the Democratic Republic of the Congo. Technical skill in a basic wound closure task was assessed in a formal Objective Structured Assessment of Technical Skills (OSAT) before and after course completion. Participants completed a pre-course questionnaire documenting existing surgical experience and self-perceived confidence levels in surgical skills which were to be taught during the course. Participants repeated confidence ratings and completed course evaluation following course delivery. A cohort of 17 participants had completed a pre-course median of 150 Caesarean sections as primary operator. Performance on the OSAT improved from a mean of 10.5/17 pre-course to 14.2/17 post-course (mean of paired differences 3.7, p < 0.001). Improvements were seen in 15/17 components of wound closure. Pre-course, only 47% of candidates were forming hand-tied knots correctly and 38% were appropriately crossing hands with each throw, improving to 88 and 76%, respectively, following the course (p = 0.01 for both components). Confidence levels improved significantly in all technical skills taught, and the course was assessed as highly relevant by trainees. The Basic Surgical Skills course is effective in improving the basic surgical technique of surgical trainees from sub-Saharan Africa and their confidence in key technical skills.

Abandoning the ship: spontaneous mass exodus of Clinostomum complanatum (Rudolphi, 1814) progenetic metecercariae from the dying intermediate host Trichogaster fasciatus (Bloch & Schneider, 1801).

PubMed

Rizvi, Asim; Alam, Md Maroof; Parveen, Saltanat; Saleemuddin, M; Abidi, S M A

2012-04-01

The dramatic and spontaneous exodus of live Clinostomum complanatum progenetic metacercaria from the gill slits of the dying intermediate host, Trichogaster fasciatus is reported. Basic water parameter tests for dissolved oxygen, pH and temperature revealed slightly lower level of dissolved oxygen in tank water used for water change. To the best of our knowledge, it is the first report of a digenean metacercariae, en mass leaving their intermediate host, upon its death in search of an alternative host to support their survival and help in continuing their life cycle.

Bragg spectroscopy of strongly interacting Fermi gases

NASA Astrophysics Data System (ADS)

Lingham, M. G.; Fenech, K.; Peppler, T.; Hoinka, S.; Dyke, P.; Hannaford, P.; Vale, C. J.

2016-10-01

This article provides an overview of recent developments and emerging topics in the study of two-component Fermi gases using Bragg spectroscopy. Bragg scattering is achieved by exposing a gas to two intersecting laser beams with a slight frequency difference and measuring the momentum transferred to the atoms. By varying the Bragg laser detuning, it is possible to measure either the density or spin response functions which characterize the basic excitations present in the gas. Specifically, one can measure properties such as the dynamic and static structure factors, Tan's universal contact parameter and observe signatures for the onset of pair condensation locally within a gas.

Inclined Zenith Aurora over Kyoto on 17 September 1770: Graphical Evidence of Extreme Magnetic Storm

NASA Astrophysics Data System (ADS)

Kataoka, Ryuho; Iwahashi, Kiyomi

2017-10-01

Red auroras were observed in Japan during an extreme magnetic storm that occurred on 17 September 1770. We show new evidence that the red aurora extended toward the zenith of Kyoto around midnight. The basic appearance of the historical painting of the red aurora is geometrically reproduced based on the inclination of the local magnetic field and a detailed description in a newly discovered diary. The presence of the inclined zenith aurora over Kyoto suggests that the intensity of the September 1770 magnetic storm is comparable to, or slightly larger than that of the September 1859 Carrington storm.

An Antifungal Exo-α-1,3-Glucanase (AGN13.1) from the Biocontrol Fungus Trichoderma harzianum

PubMed Central

Ait-Lahsen, Hassane; Soler, Andrés; Rey, Manuel; de la Cruz, Jesús; Monte, Enrique; Llobell, Antonio

2001-01-01

Trichoderma harzianum secretes α-1,3-glucanases when it is grown on polysaccharides, fungal cell walls, or autoclaved mycelium as a carbon source (simulated antagonistic conditions). We have purified and characterized one of these enzymes, named AGN13.1. The enzyme was monomeric and slightly basic. AGN13.1 was an exo-type α-1,3-glucanase and showed lytic and antifungal activity against fungal plant pathogens. Northern and Western analyses indicated that AGN13.1 is induced by conditions that simulated antagonism. We propose that AGN13.1 contributes to the antagonistic response of T. harzianum. PMID:11722942

[A preliminary analysis of the high birth rate in India].

PubMed

Shao, N

1981-01-01

The author first provides some basic demographic data for India and points out that the current annual rate of population growth of 2.45 percent is slightly higher than the annual increase in food production. Problems in the areas of employment, education, housing, and transportation, as well as the general problem of poverty, are seen as a consequence of this imbalance. The lack of success of the national family planning program is attributed primarily to the failure to achieve a satisfactory rate of economic growth. Contributory factors include early marriage, the low status of women, the desire for large families, and administrative problems associated with the family planning program.

Feedback circuit design of an auto-gating power supply for low-light-level image intensifier

NASA Astrophysics Data System (ADS)

Yang, Ye; Yan, Bo; Zhi, Qiang; Ni, Xiao-bing; Li, Jun-guo; Wang, Yu; Yao, Ze

2015-11-01

This paper introduces the basic principle of auto-gating power supply which using a hybrid automatic brightness control scheme. By the analysis of current as image intensifier to special requirements of auto-gating power supply, a feedback circuit of the auto-gating power supply is analyzed. Find out the reason of the screen flash after the auto-gating power supply assembled image intensifier. This paper designed a feedback circuit which can shorten the response time of auto-gating power supply and improve screen slight flicker phenomenon which the human eye can distinguish under the high intensity of illumination.

Observational Park-based Physical Activity Studies: A Systematic Review of the Literature

PubMed Central

Joseph, Rodney P.; Maddock, Jay E.

2016-01-01

This article reports the outcomes of a systematic review of observational park-based physical activity (PA) studies. Five electronic databases and the Active Living Research website were searched in July 2015 to identify relevant articles. Studies were included if they: a) reported observational data collected at outdoor park-based settings during free living conditions, b) reported results of a park audit, c) included PA as an outcome measure of the park audit, and d) were published after 1990 in English-language peer-review journals. Thirty-two articles, reporting outcomes of 26 unique studies, met inclusion criteria for review. Most studies (n=20, 87%) had cross-sectional or non-interventional study designs, while 6 (23%) employed quasi-experimental designs. Studies were predominately conducted in the U.S. (n=19, 76%). The median number of park users across studies was 4,558 (Range= 815 to 76,632). Approximately half (51%) of all park users were female. Eighty-one percent of studies (n=21) reported PA outcomes for individuals of all ages, while 4 studies (15%) reported PA outcomes for children only and 1 study (4%) for adults only. Moderate-to-vigorous physical activity (MVPA) of park users ranged from 31% to 85% (Median=55.0%). Studies conducted in the U.S. reported a slightly higher median number of park-users engaging in MVPA than those outside the U.S. (60.5% vs. 52.8%). Fifteen studies examined gender differences in MVPA. Among these, 12 (87%) reported more males engaging in MVPA than females. Results of this review highlight the need for innovative strategies to promote MVPA among park users and to increase park use among children. PMID:27311337

Observational Park-based physical activity studies: A systematic review of the literature.

PubMed

Joseph, Rodney P; Maddock, Jay E

2016-08-01

This article reports the outcomes of a systematic review of observational park-based physical activity (PA) studies. Five electronic databases and the Active Living Research website were searched in July 2015 to identify relevant articles. Studies were included if they: a) reported observational data collected at outdoor park-based settings during free living conditions, b) reported results of a park audit, c) included PA as an outcome measure of the park audit, and d) were published after 1990 in English-language peer-review journals. Thirty-two articles, reporting outcomes of 26 unique studies, met inclusion criteria for review. Most studies (n=20, 87%) had cross-sectional or non-interventional study designs, while 6 (23%) employed quasi-experimental designs. Studies were predominately conducted in the U.S. (n=19, 76%). The median number of park users across studies was 4558 (Range=815 to 76,632). Approximately half (51%) of all park users were female. Eighty-one percent of studies (n=21) reported PA outcomes for individuals of all ages, while 4 studies (15%) reported PA outcomes for children only and 1 study (4%) for adults only. Moderate-to-vigorous physical activity (MVPA) of park users ranged from 31% to 85% (Median=55.0%). Studies conducted in the U.S. reported a slightly higher median number of park-users engaging in MVPA than those outside the U.S. (60.5% vs. 52.8%). Fifteen studies examined gender differences in MVPA. Among these, 12 (87%) reported more males engaging in MVPA than females. Results of this review highlight the need for innovative strategies to promote MVPA among park users and to increase park use among children. Copyright © 2016 Elsevier Inc. All rights reserved.

Population pharmacokinetics of levamisole in children with steroid-sensitive nephrotic syndrome

PubMed Central

Kreeftmeijer-Vegter, A R; Dorlo, T P C; Gruppen, M P; de Boer, A; de Vries, P J

2015-01-01

Aim The aim was to investigate the population pharmacokinetics of levamisole in children with steroid-sensitive nephrotic syndrome. Methods Non-linear mixed effects modelling was performed on samples collected during a randomized controlled trial. Samples were collected from children who were receiving 2.5 mg kg–1 levamisole (or placebo) orally once every other day. One hundred and thirty-six plasma samples were collected from 38 children from India and Europe and included in the analysis. A one compartment model described the data well. Results The apparent clearance rate (CL/F) and distribution volume (V/F) were 44 l h–1 70 kg–1 and 236 l 70 kg–1, respectively; estimated interindividual variability was 32–42%. In addition to allometric scaling of CL/F and V/F to body weight, we identified a significant proportional effect of age on CL/F (–10.1% per year). The pharmacokinetics parameters were not affected by gender, tablet strength or study centre. The median (interquartile range) maximum plasma concentration of levamisole was 438.3 (316.5–621.8) ng ml–1, and the median area under the concentration–time curve was 2847 (2267–3761) ng ml–1 h. Median tmax and t½ values were 1.65 (1.32–2.0) h and 2.60 (2.06–3.65) h, respectively. Conclusions Here, we present the first pharmacokinetic data regarding levamisole in children with steroid-sensitive nephrotic syndrome. The pharmacokinetic profile of levamisole in children was similar to findings reported in adults, although the elimination rate was slightly higher in children. PMID:25677380

The prognostic impact of supraclavicular lymph node in N3-IIIB stage non-small cell lung cancer patients treated with definitive concurrent chemo-radiotherapy.

PubMed

Oh, Dongryul; Ahn, Yong Chan; Park, Hee Chul; Lim, Do Hoon; Noh, Jae Myoung; Cho, Won Kyung; Pyo, Hongryull

2017-05-30

This study aimed to investigate the prognostic impact of supraclavicular lymph node (SCN) metastasis in patients who were treated with definitive chemoradiotherapy for N3-IIIB stage non-small cell lung cancer (NSCLC). The 2- and 5-year overall survival (OS) rates were 57.3% and 35.7% in patients without SCN metastasis and 56.4% and 26.7% in patients with SCN metastasis, respectively. The median OS was 34 months in both groups. There was no significant difference in OS between the two groups (p = 0.679). The 2- and 5-year progression-free survival (PFS) rates were 24.1% and 12.6% in patients without SCN metastasis and 18.0% and 16.0% in patients with SCN metastasis, respectively. Patients without SCN metastasis had slightly longer median PFS (10 months vs. 8 months), but the difference was not statistically significant (p = 0.223). In multivariate analysis, SCN metastasis was not a significant factor for OS (p = 0.391) and PFS (p = 0.149). This retrospective analysis included 204 consecutive patients who were treated with chemoradiotherapy for N3-IIIB stage NSCLC between May 2003 and December 2012. A median RT dose of 66 Gy was administered over 6.5 weeks. Of these, 119 patients (58.3%) had SCN metastasis and 85 (41.7%) had another type of N3 disease: mediastinal N3 nodes in 84 patients (98.8%) and contralateral hilar node in one (1.2%). The patients were divided into two groups according to SCN metastasis. SCN metastasis does not compromise treatment outcomes compared to other mediastinal metastasis in the setting of definitive chemoradiotherapy.

Validating the Use of ICD-9 Code Mapping to Generate Injury Severity Scores

PubMed Central

Fleischman, Ross J.; Mann, N. Clay; Dai, Mengtao; Holmes, James F.; Wang, N. Ewen; Haukoos, Jason; Hsia, Renee Y.; Rea, Thomas; Newgard, Craig D.

2017-01-01

The Injury Severity Score (ISS) is a measure of injury severity widely used for research and quality assurance in trauma. Calculation of ISS requires chart abstraction, so it is often unavailable for patients cared for in nontrauma centers. Whether ISS can be accurately calculated from International Classification of Diseases, Ninth Revision (ICD-9) codes remains unclear. Our objective was to compare ISS derived from ICD-9 codes with those coded by trauma registrars. This was a retrospective study of patients entered into 9 U.S. trauma registries from January 2006 through December 2008. Two computer programs, ICDPIC and ICDMAP, were used to derive ISS from the ICD-9 codes in the registries. We compared derived ISS with ISS hand-coded by trained coders. There were 24,804 cases with a mortality rate of 3.9%. The median ISS derived by both ICDPIC (ISS-ICDPIC) and ICDMAP (ISS-ICDMAP) was 8 (interquartile range [IQR] = 4–13). The median ISS in the registry (ISS-registry) was 9 (IQR = 4–14). The median difference between either of the derived scores and ISS-registry was zero. However, the mean ISS derived by ICD-9 code mapping was lower than the hand-coded ISS in the registries (1.7 lower for ICDPIC, 95% CI [1.7, 1.8], Bland–Altman limits of agreement = −10.5 to 13.9; 1.8 lower for ICDMAP, 95% CI [1.7, 1.9], limits of agreement = −9.6 to 13.3). ICD-9-derived ISS slightly underestimated ISS compared with hand-coded scores. The 2 methods showed moderate to substantial agreement. Although hand-coded scores should be used when possible, ICD-9-derived scores may be useful in quality assurance and research when hand-coded scores are unavailable. PMID:28033134

Histological evaluation of vertical laser channels from ablative fractional resurfacing: an ex vivo pig skin model.

PubMed

Skovbølling Haak, Christina; Illes, Monica; Paasch, Uwe; Hædersdal, Merete

2011-07-01

Ablative fractional resurfacing (AFR) represents a new treatment potential for various skin conditions and new laser devices are being introduced. It is important to gain information about the impact of laser settings on the dimensions of the created laser channels for obtaining a safe and efficient treatment outcome. The aim of this study was to establish a standard model to document the histological tissue damage profiles after AFR and to test a new laser device at diverse settings. Ex vivo abdominal pig skin was treated with a MedArt 620, prototype fractional carbon dioxide (CO(2)) laser (Medart, Hvidovre, Denmark) delivering single microbeams (MB) with a spot size of 165 μm. By using a constant pulse duration of 2 ms, intensities of 1-18 W, single and 2-4 stacked pulses, energies were delivered in a range from 2-144 mJ/MB. Histological evaluations included 3-4 high-quality histological measurements for each laser setting (n = 28). AFR created cone-shaped laser channels. Ablation depths varied from reaching the superficial dermis (2 mJ, median 41 μm) to approaching the subcutaneous fat (144 mJ, median 1,943 μm) and correlated to the applied energy levels in an approximate linear relation (r(2) = 0.84, p < 0.001). The dermal ablation width increased slightly within the energy range of 4-144 mJ (median 163 μm). The thickness of the coagulation zone reached a plateau around 65 μm at energies levels above 16 mJ. The calculated volumes of ablated tissue increased with increasing energies. We suggest this ex vivo pig skin model to characterize AFR laser channels histologically.

Heat exposure of Cannabis sativa extracts affects the pharmacokinetic and metabolic profile in healthy male subjects.

PubMed

Eichler, Martin; Spinedi, Luca; Unfer-Grauwiler, Sandra; Bodmer, Michael; Surber, Christian; Luedi, Markus; Drewe, Juergen

2012-05-01

The most important psychoactive constituent of CANNABIS SATIVA L. is Δ (9)-tetrahydrocannabinol (THC). Cannabidiol (CBD), another important constituent, is able to modulate the distinct unwanted psychotropic effect of THC. In natural plant extracts of C. SATIVA, large amounts of THC and CBD appear in the form of THCA-A (THC-acid-A) and CBDA (cannabidiolic acid), which can be transformed to THC and CBD by heating. Previous reports of medicinal use of cannabis or cannabis preparations with higher CBD/THC ratios and use in its natural, unheated form have demonstrated that pharmacological effects were often accompanied with a lower rate of adverse effects. Therefore, in the present study, the pharmacokinetics and metabolic profiles of two different C. SATIVA extracts (heated and unheated) with a CBD/THC ratio > 1 were compared to synthetic THC (dronabinol) in a double-blind, randomized, single center, three-period cross-over study involving 9 healthy male volunteers. The pharmacokinetics of the cannabinoids was highly variable. The metabolic pattern was significantly different after administration of the different forms: the heated extract showed a lower median THC plasma AUC (24 h) than the unheated extract of 2.84 vs. 6.59 pmol h/mL, respectively. The later was slightly higher than that of dronabinol (4.58 pmol h/mL). On the other hand, the median sum of the metabolites (THC, 11-OH-THC, THC-COOH, CBN) plasma AUC (24 h) was higher for the heated than for the unheated extract. The median CBD plasma AUC (24 h) was almost 2-fold higher for the unheated than for the heated extract. These results indicate that use of unheated extracts may lead to a beneficial change in metabolic pattern and possibly better tolerability. © Georg Thieme Verlag KG Stuttgart · New York.

[Diuretic treatment in patients with acute pulmonary edema did not produces severe hyponatremia or hypokalemia].

PubMed

Kalužay, Jozef; Pokorná, Veronika; Bodíková, Svetlana; Vahančíková, Natália; Ponťuch, Peter

2016-04-01

One of the risks of diuretic therapy for pulmonary edema is the development of hyponatremia and hypokalemia with pro-arrhythmic potential. The aim of our study was to analyze the incidence of hyponatremia and hypokalemia after the first day of treatment in a real clinical practice. We performed a retrospective analysis of data obtained from medical records. We included all patients with pulmonary edema admitted to the coronary care unit, only patients which died within the first day of treatment were excluded. Absolute dose of administered furosemide, total fluid intake and urine output, saline and pottasium intake were analyzed. Nonparametric paired Wilcoxon test was used to compare natrium and pottasium levels changes. 37 patients were included into analysis. The median dose of furosemide administered during the first day of treatment was 120 mg (IQR 20-300 mg). Median diuresis was 2 400 ml (IQR 1 425-3 225 ml). The median of difference between diuresis and total fluid intake was 315 ml (IQR 538-1 380 ml). Wilcoxon test confirmed a prevailing statistically significant trend of slight rise in serum sodium within the first day of treatment (serum sodium 138.0 IQR 132.8-139.6 vs 138.1 IQR 134,0-141,7 mmol/l, p = 0.0046). The difference in serum potassium was not statistically significant (serum potassium 4.2 IQR 3.9-4.8 vs 4.2, IQR 3.8-4.8 mmol/l). Results did not confirmed the need for a substitution of sodium and potassium losses during the first day of diuretic therapy to prevent hyponatriemia and hypokalemia in patients with pulmonary edema.

Variability of cannabis potency in the Venice area (Italy): a survey over the period 2010-2012.

PubMed

Zamengo, Luca; Frison, Giampietro; Bettin, Chiara; Sciarrone, Rocco

2014-01-01

Cannabis is the most widely used illicit substance globally, with an estimated annual prevalence in 2010 of 2.6-5.0% of the adult population. Concerns have been expressed about increases in the potency of cannabis products. A high tetrahydrocannabinol (THC) content can increase anxiety, depression, and psychotic symptoms, and can increase the risk of dependence and adverse effects on the respiratory and cardiovascular systems in regular users. The aim of this study was to report statistical data about the potency of cannabis products seized in the north-east of Italy, in a geographical area centred in Venice and extending for more than 10,000  km(2) with a population of more than two million, by investigating the variability observed in THC levels of about 4000 samples of cannabis products analyzed over the period 2010-2012. Overall median THC content showed an increasing trend over the study period from about 6.0% to 8.1% (6.2-8.9% for cannabis resin, 5.1-7.6% for herbal cannabis). The variation in the THC content of individual samples was very large, ranging from 0.3% to 31% for cannabis resin and from 0.1 to 19% for herbal cannabis. Median CBN:THC ratios showed a slightly decreasing trend over the study period, from 0.09 (2010) to 0.03 (2012), suggesting an increasing freshness of submitted materials. Median CBD:THC ratios also showed a decreasing trend over the study from about 0.52 (2010) to 0.18 (2012), likely due to the increase in submissions of materials from indoor and domestic cultivation with improved breeding methods. Copyright © 2013 John Wiley & Sons, Ltd.

Postgraduate Education in Quality Improvement Methods: Initial Results of the Fellows' Applied Quality Training (FAQT) Curriculum.

PubMed

Winchester, David E; Burkart, Thomas A; Choi, Calvin Y; McKillop, Matthew S; Beyth, Rebecca J; Dahm, Phillipp

2016-06-01

Training in quality improvement (QI) is a pillar of the next accreditation system of the Accreditation Committee on Graduate Medical Education and a growing expectation of physicians for maintenance of certification. Despite this, many postgraduate medical trainees are not receiving training in QI methods. We created the Fellows Applied Quality Training (FAQT) curriculum for cardiology fellows using both didactic and applied components with the goal of increasing confidence to participate in future QI projects. Fellows completed didactic training from the Institute for Healthcare Improvement's Open School and then designed and completed a project to improve quality of care or patient safety. Self-assessments were completed by the fellows before, during, and after the first year of the curriculum. The primary outcome for our curriculum was the median score reported by the fellows regarding their self-confidence to complete QI activities. Self-assessments were completed by 23 fellows. The majority of fellows (15 of 23, 65.2%) reported no prior formal QI training. Median score on baseline self-assessment was 3.0 (range, 1.85-4), which was significantly increased to 3.27 (range, 2.23-4; P = 0.004) on the final assessment. The distribution of scores reported by the fellows indicates that 30% were slightly confident at conducting QI activities on their own, which was reduced to 5% after completing the FAQT curriculum. An interim assessment was conducted after the fellows completed didactic training only; median scores were not different from the baseline (mean, 3.0; P = 0.51). After completion of the FAQT, cardiology fellows reported higher self-confidence to complete QI activities. The increase in self-confidence seemed to be limited to the applied component of the curriculum, with no significant change after the didactic component.

Water-jet dissection for parenchymal division during hepatectomy1

PubMed Central

Dixon, Elijah; Sahajpal, Ajay; Cattral, Mark S.; Grant, David R.; Gallinger, Steven; Taylor, Bryce R.; Greig, Paul D.

2006-01-01

Background. High-pressure water-jet dissection was originally developed for industry where ultra-precise cutting and engraving were desirable. This technology has been adapted for medical applications with favorable results, but little is understood about its performance in hepatic resections. Blood loss may be limited by the thin laminar liquid-jet effect that provides precise, controllable, tissue-selective dissection with excellent visualization and minimal trauma to surrounding fibrous structures. Patients and methods. The efficacy of the Water-jet system for hepatic parenchymal dissection was examined in a consecutive case series of 101 hepatic resections (including 22 living donor transplantation resections) performed over 11 months. Perioperative outcomes, including blood loss, transfusion requirements, complications, and length of stay (LOS), were assessed. Results. Three-quarters of the cases were major hepatectomies and 22% were cirrhotic. Malignancy was the most common indication (77%). Median operative time was 289 min. Median estimated blood loss (EBL) was 900 ml for all cases, and only 14% of patients had >2000 ml EBL. Furthermore, EBL was 1000 ml for major resections, 775 ml for living donor resections, 600 ml in cirrhotic patients, and 1950 ml for steatotic livers. In all, 14% of patients received heterologous packed red blood cell (PRBC) transfusions for an average of 0.59 units per case. Median LOS was 7 days. EBL, transfusion requirements, and LOS were slightly increased in the major resection cohort. There was one mortality (1%) overall. These results are equivalent to, or better than, those from our contemporary series of resections performed with ultrasonic dissection. Conclusion. Water-jet dissection minimizes large blood volume loss, requirements for transfusion, and complications. This initial experience suggests that this precision tool is safe and effective for hepatic division, and compares favorably to other established methods for hepatic parenchymal transection. PMID:18333091

[Lupus erythematosus treatment with belimumab in daily practice: Retrospective study of 15 patients].

PubMed

Garval, E; Pennaforte, J-L; Jaussaud, R; Servettaz, A; Bernard, P; Reguiai, Z

2018-01-01

Belimumab (an anti-BLyS monoclonal antibody) was recently approved for the treatment of systemic lupus erythematosus (SLE). The aim of the study was to describe efficacy and safety of the drug as well as its impact on serologic parameters and the role of long-term systemic sparing of treatment in clinical practice in LE. We conducted a retrospective study at Reims University Hospital between 2012 and 2016 including consecutive patients with LE treated with belimumab. Efficacy was evaluated in terms of clinical progression, and normalisation of laboratory factors (anti-DNA antibody and C3 serum levels) and sparing of associated long-term systemic therapies for LE. Among the 15 patients included, a therapeutic response was obtained in 9 patients (60%), with partial remission in 8 of 9 cases. The median titre of anti-DNA antibody was 50IU/mL (range: 4-50) and the median C3 level was 0.82g/L (range: 0.36-1.23) before initiation of belimumab, vs. 25.5IU/mL (range: 2-50) and 0.89g/L (range: 0.34-1.22) at the last evaluation, respectively, without significant modification (P=0.12 and P=0.45). The median dose of prednisone at the time of the first belimumab infusion was reduced from 9.5mg/day (range: 0-18) to 6mg/day (range: 0-20) at the last clinical evaluation. Eight patients (53%) experienced adverse events, and these were very slight or moderate in all cases. Belimumab appears to be an effective and well-tolerated treatment for moderately severe systemic LE, allowing sparing of maintenance corticosteroid therapy in order to decrease its frequent adverse events. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Pelvic radiotherapy in the setting of rheumatoid arthritis: Refining the paradigm.

PubMed

Felefly, T; Mazeron, R; Huertas, A; Canova, C H; Maroun, P; Kordahi, M; Morice, P; Deutsch, É; Haie-Méder, C; Chargari, C

2017-04-01

Conflicting results concerning the toxicity of radiotherapy in the setting of rheumatoid arthritis were reported in literature. This work describes the toxicity profiles of patients with rheumatoid arthritis undergoing pelvic radiotherapy for gynecologic malignancies at our institution. Charts of patients with rheumatoid arthritis who underwent pelvic radiotherapy for cervical or endometrial cancer in a curative intent at the Gustave-Roussy Cancer Campus between 1990 and 2015 were reviewed for treatment-related toxicities. Acute and late effects were graded as per the Common Terminology Criteria for Adverse Events version 4.0 scoring system. Eight patients with cervical cancer and three with endometrial cancer were identified. Median follow-up was 56 months. Median external beam radiotherapy dose was 45Gy. All patients received a brachytherapy boost using either pulse- or low-dose rate technique. Concomitant chemotherapy was used in seven cases. Median time from rheumatoid arthritis diagnosis to external beam radiation therapy was 5 years. No severe acute gastrointestinal or genitourinary toxicity was reported. One patient had grade 3 dermatitis. Any late toxicity occurred in 7 /11 patients, and one patient experienced severe late toxicities. One patient with overt systemic rheumatoid arthritis symptoms at the time of external beam radiation therapy experienced late grade 3 ureteral stenosis, enterocolitis and lumbar myelitis. Pelvic radiotherapy, in the setting of rheumatoid arthritis, appears to be feasible, with potentially slight increase in low grade late events compared to other anatomic sites. Patients with overt systemic rheumatoid arthritis manifestation at the time of radiotherapy might be at risk of potential severe toxicities. Copyright © 2017 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

Randomized controlled trial of zonisamide for the treatment of refractory partial-onset seizures.

PubMed

Faught, E; Ayala, R; Montouris, G G; Leppik, I E

2001-11-27

Zonisamide is a sulfonamide antiepilepsy drug with sodium and calcium channel-blocking actions. Experience in Japan and a previous European double-blind study have demonstrated its efficacy against partial-onset seizures. A randomized, double-blind, placebo-controlled trial enrolling 203 patients was conducted at 20 United States sites to assess zonisamide efficacy and dose response as adjunctive therapy for refractory partial-onset seizures. Zonisamide dosages were elevated by 100 mg/d each week. The study design allowed parallel comparisons with placebo for three dosages and a final crossover to 400 mg/d of zonisamide for all patients. The primary efficacy comparison was change in seizure frequency from a 4-week placebo baseline to weeks 8 through 12 on blinded therapy. At 400 mg/d, zonisamide reduced the median frequency of all seizures by 40.5% from baseline, compared with a 9% reduction (p = 0.0009) with placebo treatment, and produced a > or =50% seizure reduction (responder rate) in 42% of patients. A dosage of 100 mg/d produced a 20.5% reduction in median seizure frequency (p = 0.038 compared with placebo) and a dosage of 200 mg/d produced a 24.7% reduction in median seizure frequency (p = 0.004 compared with placebo). Dropouts from adverse events (10%) did not differ from placebo (8.2%, NS). The only adverse event differing significantly from placebo was weight loss, though somnolence, anorexia, and ataxia were slightly more common with zonisamide treatment. Serum zonisamide concentrations rose with increasing dose. Zonisamide is effective and well tolerated as an adjunctive agent for refractory partial-onset seizures. The minimal effective dosage was 100 mg/d, but 400 mg/d was the most effective dosage.

Sorption of pure N2O to biochars and other organic and inorganic materials under anhydrous conditions

USGS Publications Warehouse

Cornelissen, Gerard; Rutherford, David W.; Arp, Hans Peter H.; Dorsch, Peter; Kelly, Charlene N.; Rostad, Colleen E.

2013-01-01

Suppression of nitrous oxide (N2O) emissions from soil is commonly observed after amendment with biochar. The mechanisms accounting for this suppression are not yet understood. One possible contributing mechanism is N2O sorption to biochar. The sorption of N2O and carbon dioxide (CO2) to four biochars was measured in an anhydrous system with pure N2O. The biochar data were compared to those for two activated carbons and other components potentially present in soils—uncharred pine wood and peat—and five inorganic metal oxides with variable surface areas. Langmuir maximum sorption capacities (Qmax) for N2O on the pine wood biochars (generated between 250 and 500 °C) and activated carbons were 17–73 cm3 g–1 at 20 °C (median 51 cm3 g–1), with Langmuir affinities (b) of 2–5 atm–1 (median 3.4 atm–1). Both Qmaxand b of the charred materials were substantially higher than those for peat, uncharred wood, and metal oxides [Qmax 1–34 cm3 g–1 (median 7 cm3 g–1); b 0.4–1.7 atm–1 (median 0.7 atm–1)]. This indicates that biochar can bind N2O more strongly than both mineral and organic soil materials. Qmax and b for CO2 were comparable to those for N2O. Modeled sorption coefficients obtained with an independent polyparameter—linear free-energy relationship matched measured data within a factor 2 for mineral surfaces but underestimated by a factor of 5–24 for biochar and carbonaceous surfaces. Isosteric enthalpies of sorption of N2O were mostly between −20 and −30 kJ mol–1, slightly more exothermic than enthalpies of condensation (−16.1 kJ mol–1). Qmax of N2O on biochar (50000–130000 μg g–1 biochar at 20 °C) exceeded the N2O emission suppressions observed in the literature (range 0.5–960 μg g–1 biochar; median 16 μg g–1) by several orders of magnitude. Thus, the hypothesis could not be falsified that sorption of N2O to biochar is a mechanism of N2O emission suppression.

Readability assessment of online patient education materials provided by the European Association of Urology.

PubMed

Betschart, Patrick; Zumstein, Valentin; Bentivoglio, Maico; Engeler, Daniel; Schmid, Hans-Peter; Abt, Dominik

2017-12-01

To assess the readability of the web-based patient education material provided by the European Association of Urology. English patient education materials (PEM) as available in May 2017 were obtained from the EAU website. Each topic was analyzed separately using six well-established readability assessment tools, including Flesch-Kincaid Grade Level (FKGL), SMOG Grade Level (SMOG), Coleman-Liau Index (CLI), Gunning Fog Index (GFI), Flesch Reading Ease Formula (FRE) and Fry Readability Graph (FRG). A total of 17 main topics were identified of which separate basic and in-depth information is provided for 14 topics. Calculation of grade levels (FKGL, SMOG, CLI, GFI) showed readability scores of 7th-13th grade for basic information, 8th-15th grade for in-depth information and 7th-15th grade for single PEM. Median FRE score was 54 points (range 45-65) for basic information and 56 points (41-64) for in-depth information. The FRG as a graphical assessment revealed only 13 valid results with an approximate 8th-17th grade level. The EAU provides carefully worked out PEM for 17 urological topics. Although improved readability compared to similar analyses was found, a simplification of certain chapters might be helpful to facilitate better patient understanding.

Ethnic Differences in Poststroke Quality of Life in the Brain Attack Surveillance in Corpus Christi (BASIC) Project.

PubMed

Reeves, Sarah L; Brown, Devin L; Baek, Jonggyu; Wing, Jeffrey J; Morgenstern, Lewis B; Lisabeth, Lynda D

2015-10-01

Mexican Americans (MAs) have an increased risk of stroke and experience worse poststroke disability than non-Hispanic whites, which may translate into worse poststroke quality of life (QOL). We assessed ethnic differences in poststroke QOL, as well as potential modification of associations by age, sex, and initial stroke severity. Ischemic stroke survivors were identified through the biethnic, population-based Brain Attack Surveillance in Corpus Christi (BASIC) Project. Data were collected from medical records, baseline interviews, and 90-day poststroke interviews. Poststroke QOL was measured at ≈90 days by the validated short-form stroke-specific QOL in 3 domains: overall, physical, and psychosocial (range, 0-5; higher scores represent better QOL). Tobit regression was used to model associations between ethnicity and poststroke QOL scores, adjusted for demographics, clinical characteristics, and prestroke cognition and function. Among 290 eligible stroke survivors (66% MA, 34% non-Hispanic whites, median age=69 years), median scores for overall, physical, and psychosocial poststroke QOL were 3.3, 3.8, and 2.7, respectively. Poststroke QOL was lower for MAs than non-Hispanic whites both overall (mean difference, -0.30; 95% confidence interval, -0.59, -0.01) and in the physical domain (mean difference, -0.47; 95% confidence interval, -0.81, -0.14) after multivariable adjustment. No ethnic difference was found in the psychosocial domain. Age modified the associations between ethnicity and poststroke QOL such that differences were present in older but not in younger ages. Disparities exist in poststroke QOL for MAs and seem to be driven by differences in older stroke patients. Targeted interventions to improve outcomes among MA stroke survivors are urgently needed. © 2015 American Heart Association, Inc.

Ethnic Differences in Post-Stroke Quality of Life in the Brain Attack Surveillance in Corpus Christi (BASIC) Project

PubMed Central

Reeves, Sarah L; Brown, Devin L; Baek, Jonggyu; Wing, Jeffrey J; Morgenstern, Lewis B; Lisabeth, Lynda D

2015-01-01

Background and Purpose Mexican Americans (MAs) have an increased risk of stroke and experience worse post-stroke disability than non-Hispanic whites (NHWs), which may translate into worse post-stroke quality of life (QOL). We assessed ethnic differences in post-stroke QOL, as well as potential modification of associations by age, sex, and initial stroke severity. Methods Ischemic stroke survivors were identified through the biethnic, population-based Brain Attack Surveillance in Corpus Christi (BASIC) Project. Data were collected from medical records, baseline interviews, and 90-day post-stroke interviews. Post-stroke QOL was measured at approximately 90 days by the validated short-form stroke-specific QOL in 3 domains: overall, physical, and psychosocial (range 0–5; higher scores represent better QOL). Tobit regression was used to model associations between ethnicity and post-stroke QOL scores, adjusted for demographics, clinical characteristics, and pre-stroke cognition and function. Results Among 290 eligible stroke survivors (66% MA, 34% NHW, median age=69 years), median scores for overall, physical, and psychosocial post-stroke QOL were 3.3, 3.8 and 2.7, respectively. Overall post-stroke QOL was lower for MAs than NHWs (mean difference = −0.30, 95%CI:−0.59,−0.01) and in the physical domain (mean difference = −0.47, 95%CI:−0.81,−0.14) after multivariable adjustment. No ethnic difference was found in the psychosocial domain. Age modified the associations between ethnicity and post-stroke QOL such that differences were present in older but not younger ages. Conclusions Disparities exist in post-stroke QOL for MAs and appear to be driven by differences in older stroke patients. Targeted interventions to improve outcomes among MA stroke survivors are urgently needed. PMID:26286542

Effects of a mandatory basic life support training programme on the no-flow fraction during in-hospital cardiac resuscitation: an observational study.

PubMed

Müller, Michael P; Richter, Torsten; Papkalla, Norbert; Poenicke, Cynthia; Herkner, Carsten; Osmers, Anne; Brenner, Sigrid; Koch, Thea; Schwanebeck, Uta; Heller, Axel R

2014-07-01

Many hospitals have basic life support (BLS) training programmes, but the effects on the quality of chest compressions are unclear. This study aimed to evaluate the no-flow fraction (NFF) during BLS provided by standard care nursing teams over a five-year observation period during which annual participation in the BLS training was mandatory. All healthcare professionals working at Dresden University Hospital were instructed in BLS and automated external defibrillator (AED) use according to the current European Resuscitation Council guidelines on an annual basis. After each cardiac arrest occurring on a standard care ward, AED data were analyzed. The time without chest compressions during the period without spontaneous circulation (i.e., the no-flow fraction) was calculated using thoracic impedance data. For each year of the study period (2008-2012), a total of 1454, 1466, 1487, 1432, and 1388 health care professionals, respectively, participated in the training. The median no-flow fraction decreased significantly from 0.55 [0.42; 0.57] (median [25‰; 75‰]) in 2008 to 0.3 [0.28; 0.35] in 2012. Following revision of the BLS curriculum after publication of the 2010 guidelines, cardiac arrest was associated with a higher proportion of patients achieving ROSC (72% vs. 48%, P=0.025) but not a higher survival rate to hospital discharge (35% vs. 19%, P=0.073). The NFF during in-hospital cardiac resuscitation decreased after establishment of a mandatory annual BLS training for healthcare professionals. Following publication of the 2010 guidelines, more patients achieved ROSC after in-hospital cardiac arrest. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Development of a comprehensive survey of sexuality issues including a self-report version of the International Spinal Cord Injury sexual function basic data sets.

PubMed

New, P W; Currie, K E

2016-08-01

Questionnaire development, validation and completion. Develop comprehensive survey of sexuality issues including validated self-report versions of the International Spinal Cord Injury male sexual function and female sexual and reproductive function basic data sets (SR-iSCI-sexual function). People with spinal cord damage (SCD) living in the community, Australia from August 2013 to June 2014. An iterative process involving rehabilitation medicine clinicians, a nurse specialising in sexuality issues in SCD and people with SCD who developed a comprehensive survey that included the SR-iSCI-sexual function. Participants recruitment through spinal rehabilitation review clinic and community organisations that support people with SCD. Surveys completed by 154 people. Most were male (n=101, 65.6%). Respondents' median age was 50 years (interquartile range (IQR) 38-58), and they were a median of 10 years (IQR 4-20) after the onset of SCD. Sexual problems unrelated to SCD were reported by 12 (8%) respondents, and 114 (n=75.5%) reported sexual problems because of SCD. Orgasms were much less likely (χ(2)=13.1, P=0.006) to be normal in males (n=5, 5%) compared with females (n=11, 22%). Males had significantly worse (χ(2)=26.0, P=0.001) psychogenic genital functioning (normal n=9, 9%) than females (normal n=13, 26%) and worse (χ(2)=10.8, P=0.013) reflex genital functioning. Normal ejaculation was reported in only three (3%) men. Most (n=26, 52%) women reported reduced or absent menstruation pattern since SCD. The SR-iSCI-sexual function provides a useful tool for researchers and clinicians to collect information regarding patient-reported sexual functioning after SCD and to facilitate comparative studies.

Gender effect on well-being of the oldest old: a survey of nonagenarians living in Tuscany: the Mugello study.

PubMed

Padua, Luca; Pasqualetti, Patrizio; Coraci, Daniele; Imbimbo, Isabella; Giordani, Alessandro; Loreti, Claudia; Marra, Camillo; Molino-Lova, Raffaello; Pasquini, Guido; Simonelli, Ilaria; Vannetti, Federica; Macchi, Claudio

2018-03-01

The population of industrialized nations is progressively aging, with Italy having one of the most elderly populations in the world. Natural aging may be associated with physical and cognitive impairments, often straining public resources. The present study aims to investigate the influence of gender on wellness of the nonagenarians. We evaluated quality of life among nonagenarians living in the Mugello area, an Italian location with a large population of individuals > 90 years, using the Health Survey Scoring SF-12. The 15-item Geriatric Depression Scale and Basic and Instrumental Activity of Daily Living scales were also assessed. The Mini-Mental State Examination was used to evaluate the cognitive status. In the current survey, women outnumbered men 2.7:1 confirming their higher longevity. However, on the basis of SF-12 scores, nonagenarian women felt worse than men, both physically (mean: women = 41.8 vs men = 44.4, p = 0.004) and mentally (mean: women = 46.7 vs men =48.5, p = 0.034), and their depression rates were higher: considering a General Depression Scale score ≥ 5 as a possible depression status; 37.5% of men reported depression vs. 48.5% of women (p = 0.021). Significant differences were observed also in daily activities, both basic (median: woman = 3 vs men = 5, p < 0.001) and instrumental (median woman = 1 vs me = 3, p < 0.001). Despite prior reports showing that women perform better than men in aging, our study confirms data reported in most national and European surveys: women live longer than men, but with poorer quality of life. The current study confirms the phenomenon known as the "male-female health-survival paradox."

The Montreal Cognitive Assessment-Basic (MoCA-B) is not a reliable screening tool for cognitive decline in HIV patients receiving combination antiretroviral therapy in rural South Africa.

PubMed

Hakkers, C S; Beunders, A J M; Ensing, M H M; Barth, R E; Boelema, S; Devillé, W L J; Tempelman, H A; Coutinho, R A; Hoepelman, A I M; Arends, J E; van Zandvoort, M J E

2018-02-01

HIV-associated neurocognitive disorders (HAND) are frequently occurring comorbidities in HIV-positive patients, diagnosed by means of a neuropsychological assessment (NPA). Due to the magnitude of the HIV-positive population in Sub-Saharan Africa, easy-to-use cognitive screening tools are essential. This was a cross-sectional clinical trial involving 44 HIV-positive patients (on stable cART) and 73 HIV-negative controls completing an NPA, the International HIV Dementia Scale (IHDS), and a culturally appropriate cognitive screening tool, the Montreal Cognitive Assessment-Basic (MoCA-B). HAND were diagnosed by calculating Z-scores using internationally published normative data on NPA, as well as by using data from the HIV-negative group to validate the MoCA-B. One hundred and seventeen patients were included (25% male, median age 35 years, median 11 years of education). A moderate correlation was found between the MoCA-B and NPA total Z-score (Pearson's r=0.36, p=0.02). Area under the curve (AUC) values for MoCA-B and IHDS were 0.59 and 0.70, respectively. The prevalence of HAND in HIV-positive patients was 66% when calculating Z-scores using published normative data versus 48% when using the data from the present HIV-negative cohort. The MoCA-B appeared not to be a valid screening tool for HAND in this setting. The prevalence of HAND in this setting is high, but appeared overestimated when using published norms. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

E-learning in pediatric basic life support: a randomized controlled non-inferiority study.

PubMed

Krogh, Lise Qvirin; Bjørnshave, Katrine; Vestergaard, Lone Due; Sharma, Maja Bendtsen; Rasmussen, Stinne Eika; Nielsen, Henrik Vendelbo; Thim, Troels; Løfgren, Bo

2015-05-01

Dissemination of pediatric basic life support (PBLS) skills is recommended. E-learning is accessible and cost-effective, but it is currently unknown whether laypersons can learn PBLS through e-learning. The hypothesis of this study was to investigate whether e-learning PBLS is non-inferior to instructor-led training. Participants were recruited among child-minders and parents of children aged 0-6 years. Participants were randomized to either 2-h instructor-led training or e-learning using an e-learning program (duration 17 min) including an inflatable manikin. After training, participants were assessed in a simulated pediatric cardiac arrest scenario. Tests were video recorded and PBLS skills were assessed independently by two assessors blinded to training method. Primary outcome was the pass rate of the PBLS test (≥8 of 15 skills adequately performed) with a pre-specified non-inferiority margin of 20%. In total 160 participants were randomized 1:1. E-learning was non-inferior to instructor-led training (difference in pass rate -4%; 95% CI -9:0.5). Pass rates were 100% among instructor-led trained (n=67) and 96% among e-learned (n=71). E-learners median time spent on the e-learning program was 30 min (range: 15-120 min) and the median number of log-ons was 2 (range: 1-5). After the study, all participants felt that their skills had improved. E-learning PBLS is non-inferior to instructor-led training among child-minders and parents with children aged 0-6 years, although the pass rate was 4% (95% CI -9:0.5) lower with e-learning. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Teaching of clinical ultrasonography to undergraduates: students as mentors.

PubMed

García de Casasola Sánchez, G; González Peinado, D; Sánchez Gollarte, A; Muñoz Aceituno, E; Peña Vázquez, I; Torres Macho, J

2015-05-01

Ultrasonography is a highly useful diagnostic technique that supplements traditional physical examinations. To demonstrate that students previously trained in clinical ultrasonography are capable of instructing other students in a similar manner in a short period of time ("peer mentoring"). Five medical students in their 5th year, trained in abdominal and cardiac ultrasonography by physicians with experience, instructed 24 other students in the same procedure. The training consisted of an online theoretical course and practical training lasting about 12hours, in which each student had to perform 6 basic abdominal planes and 4 basic cardiac planes on 20 healthy volunteers. Subsequently, the students underwent an objective assessment test on healthy models performed by expert physicians in clinical ultrasonography. The students managed to correctly identify 90.2% of the basic abdominal planes, except for the left coronal (spleen and left kidney) and subcostal (gallbladder) planes, with slightly lower success rates of 82.5% and 80%, respectively. Due to the greater difficulty of obtaining cardiac planes, the success rate was lower: 70.3%, in the subxiphoid, short parasternal and four chamber planes. The cardiac plane with the fewest errors in identification was the parasternal long plane (90% success). We observed no statistically significant differences between the results (teaching capacity) of the various mentors. Medical students are capable of instructing other colleagues (peer mentoring) on the basic aspects of abdominal and cardiac ultrasonography after a relatively short training period. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Medicina Interna (SEMI). All rights reserved.

Incidence and predictive factors of isolated neonatal penile glanular torsion.

PubMed

Sarkis, Pierrot E; Sadasivam, Muthurajan

2007-12-01

To determine the incidence of isolated neonatal penile glanular torsion, describe the basic characteristics, and explore the relationship between foreskin and glans torsion. A prospective survey was conducted of all male newborns admitted to nursery after delivery, or neonates less than 3 months presenting for circumcision. Cases with associated genital malformations were excluded. The incidence of isolated neonatal penile torsion was 27% (95% CI: 22.2%-31.84%), to the left in 99% of cases. In 3.5% of cases, the penis had an angle <10 degrees, and 9.5% >20 degrees. Using Spearman's correlational coefficient, deviation of penile raphe from the midline at the foreskin tip had a better correlation with glans torsion than deviation of raphe at the coronal sulcus (0.727 vs 0.570; both significant at p<0.01). Isolated neonatal penile torsion is more common than reported. The median raphe of the penis may be normal and mask unexpected glans torsion. Median raphe torsion at foreskin tip can be used as a predictor for glans torsion. Clinical significance and relation to adult penile torsion are beyond the scope of the study.

Are people who have a better smell sense, more affected from satiation?

PubMed

Ulusoy, Seckin; Dinc, Mehmet Emre; Dalgic, Abdullah; Topak, Murat; Dizdar, Denizhan; İs, Abdulhalim

The olfactory system is affected by the nutritional balance and chemical state of the body, serving as an internal sensor. All bodily functions are affected by energy loss, including olfaction; hunger can alter odour perception. In this study, we investigated the effect of fasting on olfactory perception in humans, and also assessed perceptual changes during satiation. The "Sniffin' Sticks" olfactory test was applied after 16h of fasting, and again at least 1h after Ramadan supper during periods of satiation. All participants were informed about the study procedure and provided informed consent. The study protocol was approved by the local Ethics Committee of Gaziosmanpaşa Taksim Education and Research Hospital (09/07/2014 no: 60). The study was conducted in accordance with the basic principles of the Declaration of Helsinki. This prospective study included 48 subjects (20 males, 28 females) with a mean age of 33.6±9.7 (range 20-72) years; their mean height was 169.1±7.6 (range 150.0-185.0)cm, mean weight was 71.2±17.6 (range 50.0-85.0)kg, and average BMI was 24.8±5.3 (range 19.5-55.9). Scores were higher on all items pertaining to olfactory identification, thresholds and discrimination during fasting vs. satiation (p<0.05). Identification (I) results: Identification scores were significantly higher during the fasting (median=14.0) vs. satiation period (median=13.0). Threshold (T) results: Threshold scores were significantly higher during the fasting (median=7.3) vs. satiation period (median=6.2). Discrimination (D) results: Discrimination scores were significantly higher during the fasting (median=14.0) vs. satiation period (median=13.0). The total TDI scores were 35.2 (fasting) vs. 32.6 (satiation). When we compared fasting threshold value of >9 and ≤9, the gap between the fasting and satiety thresholds was significantly greater in >9 (p<0.05). Olfactory function improved during fasting and declined during satiation. The olfactory system is more sensitive, and more reactive to odours, under starvation conditions, and is characterised by reduced activity during satiation. This situation was more pronounced in patients with a better sense of smell. Olfaction-related neurotransmitters should be the target of further study. Copyright © 2016 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Variations in intensity statistics for representational and abstract art, and for art from the Eastern and Western hemispheres.

PubMed

Graham, Daniel J; Field, David J

2008-01-01

Two recent studies suggest that natural scenes and paintings show similar statistical properties. But does the content or region of origin of an artwork affect its statistical properties? We addressed this question by having judges place paintings from a large, diverse collection of paintings into one of three subject-matter categories using a forced-choice paradigm. Basic statistics for images whose caterogization was agreed by all judges showed no significant differences between those judged to be 'landscape' and 'portrait/still-life', but these two classes differed from paintings judged to be 'abstract'. All categories showed basic spatial statistical regularities similar to those typical of natural scenes. A test of the full painting collection (140 images) with respect to the works' place of origin (provenance) showed significant differences between Eastern works and Western ones, differences which we find are likely related to the materials and the choice of background color. Although artists deviate slightly from reproducing natural statistics in abstract art (compared to representational art), the great majority of human art likely shares basic statistical limitations. We argue that statistical regularities in art are rooted in the need to make art visible to the eye, not in the inherent aesthetic value of natural-scene statistics, and we suggest that variability in spatial statistics may be generally imposed by manufacture.

The results of a low-speed wind tunnel test to investigate the effects of the Refan JT8D engine target thrust reverser on the stability and control characteristics of the Boeing 727-200 airplane

NASA Technical Reports Server (NTRS)

Kupcis, E. A.

1974-01-01

The effects of the Refan JT8D side engine target thrust reverser on the stability and control characteristics of the Boeing 727-200 airplane were investigated using the Boeing-Vertol 20 x 20 ft Low-Speed Wind Tunnel. A powered model of the 727-200 was tested in groud effect in the landing configuration. The Refan target reverser configuration was evaluated relative to the basic production 727 airplane with its clamshell-deflector door thrust reverser design. The Refan configuration had slightly improved directional control characteristics relative to the basic airplane. Clocking the Refan thrust reversers 20 degrees outboard to direct the reverser flow away from the vertical tail, had little effect on directional control. However, clocking them 20 degrees inboard resulted in a complete loss of rudder effectiveness for speeds greater than 90 knots. Variations in Refan reverser lip/fence geometry had a minor effect on directional control.

Properties of the solar nebula and the origin of the moon.

NASA Technical Reports Server (NTRS)

Cameron, A. G. W.

1973-01-01

The basic geochemical model of the structure of the moon proposed by Anderson, in which the moon is formed by differentiation of the calcium, aluminium, and titanium-rich inclusions in the Allende meteorite, is accepted, and the conditions for formation of this moon within the solar nebula models of Cameron and Pine are discussed. The basic material condenses while iron remains in the gaseous phase, which places the formation of the moon slightly inside the orbit of Mercury. Some condensed metallic iron is likely to enter the moon in this position, and since the moon is assembled at a very high temperature, it is likely to have been fully molten, so that the iron can remove the iridium from the silicate material and carry it down to form a small core. Interactions between the moon and Mercury lead to the present rather eccentric Mercury orbit and to a much more eccentric orbit for the moon, reaching past the orbit of the earth, establishing conditions which are necessary for capture of the moon by the earth.

Simulations of the Viking Gas Exchange Experiment using palagonite and Fe-rich montmorillonite as terrestrial analogs: implications for the surface composition of Mars.

PubMed

Quinn, R; Orenberg, J

1993-10-01

Simulations of the Gas Exchange Experiment (GEX), one of the Viking Lander Biology Experiments, were run using palagonite and Fe-rich montmorillonite as terrestrial analogs of the Martian soil. These terrestrial analogs were exposed to a nutrient solution of the same composition as that of the Viking Landers under humid (no contact with nutrient) and wet (intimate contact) conditions. The headspace gases in the GEX sample cell were sampled and then analyzed by gas chromatography under both humid and wet conditions. Five gases were monitored: CO2, N2, O2, Ar, and Kr. It was determined that in order to simulate the CO2 gas changes of the Viking GEX experiment, the mixture of soil analog mineral plus nutrient medium must be slightly (pH = 7.4) to moderately basic (pH = 8.7). This conclusion suggests constraints upon the composition of terrestrial analogs to the Mars soil; acidic components may be present, but the overall mixture must be basic in order to simulate the Viking GEX results.

Simulations of the Viking gas exchange experiment using palagonite and Fe-rich montmorillonite as terrestrial analogs - Implications for the surface composition of Mars

NASA Astrophysics Data System (ADS)

Quinn, Richard; Orenberg, James

1993-10-01

Simulations of the Gas Exchange Experiment (GEX), one of the Viking Lander Biology Experiments, were run using palagonite and Fe-rich montmorillonite as terrestrial analogs of the Martian soil. These terrestrial analogs were exposed to a nutrient solution of the same composition as that of the Viking Landers under humid (no contact with nutrient) and wet (intimate contact) conditions. The headspace gases in the GEX sample cell were sampled and then analyzed by gas chromatography under both humid and wet conditions. Five gases were monitored: CO2, N2, O2, Ar, and Kr. It was determined that in order to simulate the CO2 gas changes of the Viking GEX experiment, the mixture of soil analog mineral plus nutrient medium must be slightly (pH = 7.4) to moderately basic (pH = 8.7). This conclusion suggests constraints upon the composition of terrestrial analogs of the Mars soil; acidic components may be present, but the overall mixture must be basic in order to simulate the Viking GEX results.

An evaluation of the problem-solving ability of diplomates from a comprehensive nursing programme.

PubMed

Makhathini, J T; Uys, L R

1996-10-01

The aim of this South African study was to obtain a measurement of the problem-solving ability of diplomates from a basic nursing programme with this skill included in its programme objectives. The problem-solving skills of diplomates from this programme were compared with those of first years to determine if there is an improvement in the problem-solving skills. A comparison was also made with a different basic programmes not claiming to teach problem-solving. The research design selected for this study was the ex post facto design. Data were collected using the Triple Jump Method which is an interview technique. The findings suggested that the level of the problem-solving skills of the comprehensive nursing programme diplomate is not satisfactory. There was, however, some improvement in the problem-solving ability from the first to the fourth year. The level of performance of the fourth years was slightly higher than that of the third years of the three-year nursing programme, who were used as the control group. Recommendations on selection teaching and evaluation of students, as well as further research, were made.

Biodegradation of 2,4,6-trinitrophenol by Rhodococcus sp. isolated from a picric acid-contaminated soil.

PubMed

Shen, Jinyou; Zhang, Jianfa; Zuo, Yi; Wang, Lianjun; Sun, Xiuyun; Li, Jiansheng; Han, Weiqing; He, Rui

2009-04-30

A picric acid-degrading bacterium, strain NJUST16, was isolated from a soil contaminated by picric acid and identified as a member of Rhodococcus sp. based on 16S rRNA sequence. The degradation assays suggested that the strain NJUST16 could utilize picric acid as the sole source of carbon, nitrogen and energy. The isolate grew optimally at 30 degrees C and initial pH 7.0-7.5 in the mineral salts medium supplemented with picric acid. It was basically consistent with degradation of picric acid by the isolate. Addition of nitrogen sources such as yeast extract and peptone accelerated the degradation of picric acid. However, the stimulation was concentration dependent. The degradation was accompanied by release of stoichiometric amount of nitrite and acidification. The degradation of picric acid at relatively high concentrations (>3.93 mM) demonstrated that the degradation was both pH and nitrite dependent. Neutral and slightly basic pH was crucial to achieve high concentrations of picric acid degradation by the NJUST16 strain.

Proximal hypospadias repair with bladder mucosal graft: Our 10 years experience.

PubMed

Lanciotti, Michele; Betti, Marta; Elia, Antonio; Landi, Luca; Taverna, Maria; Cini, Chiara; Masieri, Lorenzo

2017-06-01

A great variety of different surgical techniques has been described for proximal hypospadias repair and an ideal tissue has not been determined yet. We present our 10 years of surgical experience using a bladder mucosal graft for urethroplasty. Bladder mucosal graft urethroplasty was performed between 2005 and 2015 in 50 patients with severe proximal hypospadias. The mean age of patients was 45.1 months (range 24-164 months). Hypospadias were perineal in 18 patients, scrotal in 22, and penoscrotal in 10. In all cases a chordee correction was performed and median time between the first and the second stages was 12 months (mean 17 months, range 4-68 months). Both foley catheter and a suprapubic cystostomy were positioned and maintained for 2-4 weeks. Follow-up was performed at 1-3 and 6-12 months after surgery, and afterwards annually with clinical examination and flowmetry test. Mean follow-up was 5.3 years (median 5, range 1-10 years). Mean graft length was 57.4 mm (median 55 mm, range 35-85 mm). Among all the only early complication registered was a postoperative infection in one patient (2%) at the site of anastomosis. The long-term complications observed were urethrocutaneous fistula in nine patients (18%), urethral stricture in 15 patients (30%), meatal stricture in four patients (8%), and prolapse of meatus in seven patients (14%). The mean time of complication occurrence was 15 months (median 15.5 months, range 1-96 months). The functional and cosmetic appearance after surgery was satisfactory in 42/50 patients (84%) during the follow-up period. There is still an open debate regarding the optimal surgical approach for management of severe proximal hypospadias. Compared with other approaches, our technique showed acceptable results even though encumbered by slightly higher complication rates. Our results show that bladder mucosal graft for primary severe proximal hypospadias in selected patients is a possible alternative to other commonly used techniques, with the aim of restoring recovery of the normal continuity of the distal urinary tract see figure below. Copyright © 2017 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Pathological characteristics of low risk prostate cancer based on totally embedded prostatectomy specimens.

PubMed

Swanson, Gregory P; Epstein, Jonathan I; Ha, Chul S; Kryvenko, Oleksandr N

2015-03-01

Surveillance and focal therapy are increasingly considered for low risk prostate cancer (PC). We describe pathological characteristics of low risk PC at radical prostatectomy in contemporary patients. Five-hundred-fifty-two men from 2008 to 2012 with low risk (stage T1c/T2a, PSA ≤ 10 ng/ml, Gleason score ≤6) PC underwent radical prostatectomy. Slides were re-reviewed to grade and stage the tumor, map separate tumor nodules, and calculate their volumes. Ninety-three (16.9%) men had prostatectomy Gleason score 3 + 4 = 7 or higher and were excluded. Five (0.9%) men had no residual carcinoma. Remaining 454 patients composed the study cohort. The median age was 57 years (36-73) and median PSA 4.4 ng/ml (0.4-9.9). Racial distribution was 77.5% Caucasian, 15.5% African American, and 7% other. The median total tumor volume was 0.38 cm(3) (0.003-7.22). Seventy percent of the patients had bilateral tumor and 34% had a tumor nodule >0.5 cm(3) . The index lesion represented 89% (median) of the total tumor volume. Extraprostatic extension and positive margin were present in 5.7% and 9% of cases, respectively. The tumor nodules measuring >0.5 cm(3) were located almost equally between the anterior (53%) and peripheral (47%) gland. The relationship between PSA and total tumor volume was weak (r = 0.13, P = 0.005). The relationship between PSA density and total tumor volume was slightly better (r = 0.26, P < 0.001). Low risk prostate cancer is generally a low volume disease. Gleason score upgrade is seen in 16.9% of cases at radical prostatectomy. While the index lesion accounts for the bulk of the disease, the cancer is usually multifocal and bilateral. Neither PSA nor PSA density correlates well with the total tumor volume. Prostate size has a significant contribution to PSA level. These factors need to be considered in treatment planning for low risk prostate cancer. © 2014 Wiley Periodicals, Inc.

Water-Quality Conditions and Constituent Loads, Water Years 1996-2002, and Water-Quality Trends, Water Years 1983-2002, in the Scituate Reservoir Drainage Area, Rhode Island

USGS Publications Warehouse

Nimiroski, Mark T.; DeSimone, Leslie A.; Waldron, Marcus C.

2008-01-01

The Scituate Reservoir is the primary source of drinking water for more than 60 percent of the population of Rhode Island. Water-quality data and streamflow data collected at 37 surface-water monitoring stations in the Scituate Reservoir drainage area, Rhode Island, from October 1, 1995 through September 30, 2002, (water years (WY) 1996-2002) were analyzed to determine water-quality conditions and constituent loads in the drainage area. Trends in water quality, including physical properties and concentrations of constituents, were investigated for the same period and for a longer period from October 1, 1982 through September 30, 2002 (WY 1983-2002). Water samples were collected and analyzed by Providence Water Supply Board, the agency that manages the Scituate Reservoir. Streamflow data were collected by the U.S. Geological Survey. Median values and other summary statistics were calculated for WY 1996-2002 for all 37 monitoring stations for pH, color, turbidity, alkalinity, chloride, nitrite, nitrate, total coliform bacteria, Escherichia coli (E. coli) bacteria, orthophosphate, iron, and manganese. Instantaneous loads and yields (loads per unit area) of total coliform and E. coli bacteria (indicator bacteria), chloride, nitrite, nitrate, orthophosphate, iron, and manganese were calculated for all sampling dates during WY 1996-2002 for the 23 stations with streamflow data. Values of physical properties and concentrations of constituents were compared to State and Federal water-quality standards and guidelines, and were related to streamflow, land-use characteristics, and road density. Tributary stream water in the Scituate Reservoir drainage area for WY 1996-2002 was slightly acidic (median pH of all stations equal to 6.1) and contained low concentrations of chloride (median 13 milligrams per liter (mg/L)), nitrate (median 0.04 mg/L as N), and orthophosphate (median 0.04 mg/L as P). Turbidity and alkalinity values also were low with median values of 0.62 nephelometric turbidity units and 4.8 mg/L as calcium carbonate, respectively. Indicator bacteria were detected in samples from all stations, but median concentrations were low, 23 and 9 colony-forming units per 100 mL for total coliform and E. coli bacteria, respectively. Median values of several physical properties and median concentrations of several constituents that can be related to human activities correlated positively with the percentages of developed land and correlated negatively with the percentages of forest cover in the drainage areas of the monitoring stations. Median concentrations of chloride also correlated positively with the density of roads in the drainage areas of monitoring stations, likely reflecting the effects of road-salt applications. Median values of color correlated positively with the percentages of wetlands in the drainage areas of monitoring stations, reflecting the natural sources of color in tributary stream waters. Negative correlations of turbidity, indicator bacteria, and chloride with streamflow likely reflect seasonal patterns, in which higher values and concentrations of these properties and constituents occur during low-flow conditions at the ends of water years. Similar seasonal patterns were observed for pH, alkalinity, and color. Loads and yields of chloride, nitrate, orthophosphate, and bacteria varied among monitoring stations in the Scituate Reservoir drainage area. Loads generally were higher at stations with larger drainage areas and at stations in the eastern, more developed parts of the Scituate Reservoir drainage area. Yields generally were higher at stations in the eastern parts of the drainage area. Upward trends in pH were identified for nearly half the monitoring stations and may reflect regional reductions in acid precipitation. Upward and downward trends were identified in chloride concentrations at various stations; upward trends may reflect the effects of increasing development, whereas strong downward trends at

Information literacy skills retention over the first professional year of pharmacy school.

PubMed

Chiarella, Deborah; Khadem, Tina M; Brown, Jack E; Wrobel, Mark J

2014-01-01

The authors aimed to determine if first-professional-year pharmacy students retain library literature search skills throughout the school year. Students (n = 61 consented) were given an identical seven-item quiz on basic library search skills prior to library instruction in the fall semester and at the end of the spring semester. There was no significant difference between median scores on the two quizzes, nor were any significant differences noted in subgroup analyses. Search competency may be retained to a higher degree if library instruction is moved later in the pharmacy curriculum when literature search skills are used more often.

A chronicle of Tessier no. 0 and 1 facial cleft and its surgical management.

PubMed

Jhamb, Aakarsh; Mohanty, Sujata

2009-06-01

Description and successful management of a patient with Tessier no. 0 and 1 facial cleft is being presented. This bizarre coexistence of two of the rare facial clefts in a single patient deserves a place in the cleft database. Appropriate evaluation was done to rule out the presence of median cleft face syndrome. Lip cleft was repaired by straight line technique with staggering at the vermilion border. Nasal cleft was reconstructed by replacing the missing lower lateral cartilage with conchal cartilage via endonasal approach. Satisfactory outcome was achieved for this singular deformity by conforming to the basic tenets of plastic surgery.

Infantile and early childhood masturbation: Sex hormones and clinical profile

PubMed Central

Ajlouni, Heitham K.; Daoud, Azhar S.; Ajlouni, Saleh F.; Ajlouni, Kamel M.

2010-01-01

BACKGROUND AND OBJECTIVES: Few studies have explored the hormonal triggers for masturbation in infants and young children. Thus, we aimed to study the sex hormones and clinical profiles of masturbating infants and young children. METHODS: This case-control study involved infants and young children who masturbate and were referred to three pediatric neurology clinics between September 2004 and 2006 (n=13), and a similar control group. All children underwent basic laboratory investigations prior to referral. Other tests included electroencephalography (n=8) and brain neuroimaging (n=9). We measured dehydroepiandrosterone sulfate, 17-hydroxyprogesterone, free testosterone, estradiol, dehydroepiandrosterone, sex hormone-binding globulin (SHBG), and androstenedione in all participants. RESULT: The median age at the first incident was 19.5 months (range, 4-36 months); the median masturbation frequency, 4 times/day; and the median duration of each event, 3.9 min. The subjects masturbated in both prone (n=10) and supine positions (n=3); two subjects used the knee-chest position. All subjects showed facial flushing; 6, friction between the thighs; 5, sweating; 9, sleeping after the event; and 12, disturbance on interruption. EEG was abnormal in one of eight subjects tested, and neuroimages were normal in all of nine subjects examined. The case and control groups had comparable levels of all sex hormones, except estradiol, which showed significantly lower levels in the case group (P=.02). CONCLUSION: Masturbation in children seems to be associated with reduced estradiol levels, but not with other sex hormones. Further studies are needed to confirm our findings. PMID:21060161

Infantile and early childhood masturbation: Sex hormones and clinical profile.

PubMed

Ajlouni, Heitham K; Daoud, Azhar S; Ajlouni, Saleh F; Ajlouni, Kamel M

2010-01-01

Few studies have explored the hormonal triggers for masturbation in infants and young children. Thus, we aimed to study the sex hormones and clinical profiles of masturbating infants and young children. This case-control study involved infants and young children who masturbate and were referred to three pediatric neurology clinics between September 2004 and 2006 (n=13), and a similar control group. All children underwent basic laboratory investigations prior to referral. Other tests included electroencephalography (n=8) and brain neuroimaging (n=9). We measured dehydroepiandrosterone sulfate, 17-hydroxyprogesterone, free testosterone, estradiol, dehydroepiandrosterone, sex hormone-binding globulin (SHBG), and androstenedione in all participants. The median age at the first incident was 19.5 months (range, 4-36 months); the median masturbation frequency, 4 times/day; and the median duration of each event, 3.9 min. The subjects masturbated in both prone (n=10) and supine positions (n=3); two subjects used the knee-chest position. All subjects showed facial flushing; 6, friction between the thighs; 5, sweating; 9, sleeping after the event; and 12, disturbance on interruption. EEG was abnormal in one of eight subjects tested, and neuroimages were normal in all of nine subjects examined. The case and control groups had comparable levels of all sex hormones, except estradiol, which showed significantly lower levels in the case group (P=.02). Masturbation in children seems to be associated with reduced estradiol levels, but not with other sex hormones. Further studies are needed to confirm our findings.

Laboratory-scale bioremediation of oil-contaminated soil of Kuwait with soil amendment materials.

PubMed

Cho, B H; Chino, H; Tsuji, H; Kunito, T; Nagaoka, K; Otsuka, S; Yamashita, K; Matsumoto, S; Oyaizu, H

1997-10-01

A huge amount of oil-contaminated soil remains unremediated in the Kuwait desert. The contaminated oil has the potentiality to cause pollution of underground water and to effect the health of people in the neighborhood. In this study, laboratory scale bioremediation experiments were carried out. Hyponex (Hyponex, Inc.) and bark manure were added as basic nutrients for microorganisms, and twelve kinds of materials (baked diatomite, microporous glass, coconut charcoal, an oil-decomposing bacterial mixture (Formula X from Oppenheimer, Inc.), and eight kinds of surfactants) were applied to accelerate the biodegradation of oil hydrocarbons. 15% to 33% of the contaminated oil was decomposed during 43 weeks' incubation. Among the materials tested, coconut charcoal enhanced the biodegradation. On the contrary, the addition of an oil-decomposing bacterial mixture impeded the biodegradation. The effects of the other materials were very slight. The toxicity of the biodegraded compounds was estimated by the Ames test and the tea pollen tube growth test. Both of the hydrophobic (dichloromethane extracts) and hydrophilic (methanol extracts) fractions showed a very slight toxicity in the Ames test. In the tea pollen tube growth test, the hydrophobic fraction was not toxic and enhanced the growth of pollen tubes.

Conceptual astronomy: A novel model for teaching postsecondary science courses

NASA Astrophysics Data System (ADS)

Zeilik, Michael; Schau, Candace; Mattern, Nancy; Hall, Shannon; Teague, Kathleen W.; Bisard, Walter

1997-10-01

An innovative, conceptually based instructional model for teaching large undergraduate astronomy courses was designed, implemented, and evaluated in the Fall 1995 semester. This model was based on cognitive and educational theories of knowledge and, we believe, is applicable to other large postsecondary science courses. Major components were: (a) identification of the basic important concepts and their interrelationships that are necessary for connected understanding of astronomy in novice students; (b) use of these concepts and their interrelationships throughout the design, implementation, and evaluation stages of the model; (c) identification of students' prior knowledge and misconceptions; and (d) implementation of varied instructional strategies targeted toward encouraging conceptual understanding in students (i.e., instructional concept maps, cooperative small group work, homework assignments stressing concept application, and a conceptually based student assessment system). Evaluation included the development and use of three measures of conceptual understanding and one of attitudes toward studying astronomy. Over the semester, students showed very large increases in their understanding as assessed by a conceptually based multiple-choice measure of misconceptions, a select-and-fill-in concept map measure, and a relatedness-ratings measure. Attitudes, which were slightly positive before the course, changed slightly in a less favorable direction.

The brominated flame retardants, PBDEs and HBCD, in Canadian human milk samples collected from 1992 to 2005; concentrations and trends.

PubMed

Ryan, John Jake; Rawn, Dorothea F K

2014-09-01

Human milk samples were collected from individuals residing in various regions across Canada mostly in the years 1992 to 2005. These included five large cities in southern Canada as well as samples from Nunavik in northern Quebec. Comparative samples were also collected from residents of Austin, Texas, USA in 2002 and 2004. More than 300 milk samples were analysed for the brominated flame retardants (BFRs), PBDEs and HBCD, by extraction, purification and quantification using either isotope dilution gas chromatography-mass spectrometry (GC-MS) or liquid chromatography-MS. The Canadian total PBDE values in the years 2002-2005 show median levels of about 20μg/kg on a lipid basis; a value significantly higher than in the 1980s and 1990s. Milk samples from Inuit donors in the northern region of Nunavik were slightly lower in PBDE concentrations than those from populated regions in the south of Quebec. Milk samples from Ontario contained slightly lower amounts of PBDEs in two time periods than those from Texas. HBCD levels in most milk samples were usually less than 1ppb milk lipid and dominated by the α-isomer. This large data set of BFRs in Canadian human milk demonstrates an increase in the last few decades in human exposure to BFRs which now appears to have stabilized. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

Morphological and phenological shoot plasticity in a Mediterranean evergreen oak facing long-term increased drought.

PubMed

Limousin, Jean-Marc; Rambal, Serge; Ourcival, Jean-Marc; Rodríguez-Calcerrada, Jesus; Pérez-Ramos, Ignacio M; Rodríguez-Cortina, Raquel; Misson, Laurent; Joffre, Richard

2012-06-01

Mediterranean trees must adjust their canopy leaf area to the unpredictable timing and severity of summer drought. The impact of increased drought on the canopy dynamics of the evergreen Quercus ilex was studied by measuring shoot growth, leaf production, litterfall, leafing phenology and leaf demography in a mature forest stand submitted to partial throughfall exclusion for 7 years. The leaf area index rapidly declined in the throughfall-exclusion plot and was 19% lower than in the control plot after 7 years of treatment. Consequently, leaf litterfall was significantly lower in the dry treatment. Such a decline in leaf area occurred through a change in branch allometry with a decreased number of ramifications produced and a reduction of the leaf area supported per unit sapwood area of the shoot (LA/SA). The leafing phenology was slightly delayed and the median leaf life span was slightly longer in the dry treatment. The canopy dynamics in both treatments were driven by water availability with a 1-year lag: leaf shedding and production were reduced following dry years; in contrast, leaf turnover was increased following wet years. The drought-induced decrease in leaf area, resulting from both plasticity in shoot development and slower leaf turnover, appeared to be a hydraulic adjustment to limit canopy transpiration and maintain leaf-specific hydraulic conductivity under drier conditions.

Experiences with preventing carpal tunnel syndrome in an automotive plant.

PubMed

Žídková, Věra; Nakládalová, Marie; Zapletalová, Jana; Nakládal, Zdeněk; Kollárová, Helena

2017-02-21

Carpal tunnel syndrome (CTS) is a common occupational disease. The aim was to assess the effect of preventive measures in automotive assembly workers. The analysis summarizes data from annual crosssectional studies. The 7-year analysis of data was based on medical records obtained from an occupational physician and inspections carried out at the workplace where targeted preventive measures were introduced, including better ergonomic arrangement of the workplace, technical adjustments facilitating the work, preventive nerve conduction studies (NCS) testing of the median nerve once a year, switching of workers and their targeted rotation within the workplace. The NCS testing of median nerve conduction at the wrist was the basic objective method for assessment of the prevalence and severity of CTS. Over the study period, the sample comprised 1804 workers at risk for repetitive overuse of the upper extremities, of whom 281 were females with a mean age of 38.5 years and 1523 were males with a mean age of 31.4 years. Over the study period, a total of 13 cases of CTS were recognized as an occupational disease in the plant, 8 of which occurred within the first 2 years from the initiation of production. Introduction of preventive measures decreased the prevalence of median neuropathy from 18.3% of examined extremities in 2011 to 10.5% in 2013 (p = 0.003). In early 2014, the production pace increased and this was accompanied by a rise in abnormal NCS findings to 16.9%. Over the study period, the rate of sensorimotor neuropathy decreased in favor of merely sensory neuropathies, which have been most frequent since 2013. The percentage of employees whose contracts were terminated due to median neuropathy decreased steadily from 5.5% to 0.4%. Targeted prevention of work-related CTS is effective as evidenced by the decrease in the prevalence of median neuropathy detected by NCS. Int J Occup Med Environ Health 2017;30(1):45-54. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Clarifying concepts and gaining a deeper understanding of ideal transformers

NASA Astrophysics Data System (ADS)

Ng, Chiu-King

2018-05-01

Even in ideal transformers, the input and output powers are never exactly equal, thereby causing the familiar ratio between the primary and secondary currents, namely I p :I s = N s :N p, to be slightly incorrect. In this paper, we explain why this is so and derive the correct ratio, as well as clarifying the related prevailing concepts. We conclude that a theory of an ideal transformer without a magnetising current is deficient and self-contradictory. Further, methods to locate the two black (phase) dots in a transformer symbol are elucidated. This paper is suitable for those who are pursuing a deeper understanding on this subject after learning the basics from the literature.

Two-parameter partially correlated ground-state electron density of some light spherical atoms from Hartree-Fock theory with nonintegral nuclear charge

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

Cordero, Nicolas A.; March, Norman H.; Alonso, Julio A.

2007-05-15

Partially correlated ground-state electron densities for some spherical light atoms are calculated, into which nonrelativistic ionization potentials represent essential input data. The nuclear cusp condition of Kato is satisfied precisely. The basic theoretical starting point, however, is Hartree-Fock (HF) theory for the N electrons under consideration but with nonintegral nuclear charge Z{sup '} slightly different from the atomic number Z (=N). This HF density is scaled with a parameter {lambda}, near to unity, to preserve normalization. Finally, some tests are performed on the densities for the atoms Ne and Ar, as well as for Be and Mg.

Experimental investigation of contamination prevention techniques to cryogenic surfaces on board orbiting spacecraft

NASA Technical Reports Server (NTRS)

Hetrick, M. A.; Rantanen, R. O.; Ress, E. B.; Froechtenigt, J. F.

1978-01-01

Within the simulation limitations of on-orbit conditions, it was demonstrated that a helium purge system could be an effective method for reducing the incoming flux of contaminant species. Although a generalized purge system was employed in conjunction with basic telescope components, the simulation provided data that could be used for further modeling and design of a specific helium injection system. Experimental telescope pressures required for 90% attenuation appeared to be slightly higher (factor of 2 to 5). Cooling the helium purge gas and telescope components from 300 to 140 K had no measurable effect on stopping efficiency of a given mass flow of helium from the diffuse injector.

Modeling no-jam traffic in ant trails: a pheromone-controlled approach

NASA Astrophysics Data System (ADS)

Guo, Ning; Hu, Mao-Bin; Jiang, Rui; Ding, Jianxun; Ling, Xiang

2018-05-01

The experiment in John et al (2009 Phys. Rev. Lett. 102 108001) shows that when ants move in a single-file trail, no jam emerges even at very high densities. We propose a self-propelled model of ant traffic to reproduce the fundamental diagram without a jammed branch. In this model, ants can adjust their desired velocities actively by perceiving pheromone concentration near the front of the trail. Moreover, ants will bear the repulsive force when they have physical contact with neighbors. The velocity in the simulation decreases slightly with increasing density, which captures the main feature observed in the experiment. Distributions of velocity and distance headway basically also conform to the experimental ones.

Investigation of pH and Temperature Profiles in the GI Tract of Fasted Human Subjects Using the Intellicap(®) System.

PubMed

Koziolek, Mirko; Grimm, Michael; Becker, Dieter; Iordanov, Ventzeslav; Zou, Hans; Shimizu, Jeff; Wanke, Christoph; Garbacz, Grzegorz; Weitschies, Werner

2015-09-01

Gastrointestinal (GI) pH and temperature profiles under fasted-state conditions were investigated in two studies with each 10 healthy human subjects using the IntelliCap(®) system. This telemetric drug delivery device enabled the determination of gastric emptying time, small bowel transit time, and colon arrival time by significant pH and temperature changes. The study results revealed high variability of GI pH and transit times. The gastric transit of IntelliCap(®) was characterized by high fluctuations of the pH with mean values ranging from pH 1.7 to pH 4.7. Gastric emptying was observed after 7-202 min (median: 30 min). During small bowel transit, which had a duration of 67-532 min (median: 247 min), pH values increased slightly from pH 5.9-6.3 in proximal parts to pH 7.4-7.8 in distal parts. Colonic pH conditions were characterized by values fluctuating mainly between pH 5 and pH 8. The pH profiles and transit times described in this work are highly relevant for the comprehension of drug delivery of solid oral dosage forms comprising ionizable drugs and excipients with pH-dependent solubility. © 2014 Wiley Periodicals, Inc. and the American Pharmacists Association.

Mitochondrial control-region sequence variation in aboriginal Australians.

PubMed Central

van Holst Pellekaan, S; Frommer, M; Sved, J; Boettcher, B

1998-01-01

The mitochondrial D-loop hypervariable segment 1 (mt HVS1) between nucleotides 15997 and 16377 has been examined in aboriginal Australian people from the Darling River region of New South Wales (riverine) and from Yuendumu in central Australia (desert). Forty-seven unique HVS1 types were identified, varying at 49 nucleotide positions. Pairwise analysis by calculation of BEPPI (between population proportion index) reveals statistically significant structure in the populations, although some identical HVS1 types are seen in the two contrasting regions. mt HVS1 types may reflect more-ancient distributions than do linguistic diversity and other culturally distinguishing attributes. Comparison with sequences from five published global studies reveals that these Australians demonstrate greatest divergence from some Africans, least from Papua New Guinea highlanders, and only slightly more from some Pacific groups (Indonesian, Asian, Samoan, and coastal Papua New Guinea), although the HVS1 types vary at different nucleotide sites. Construction of a median network, displaying three main groups, suggests that several hypervariable nucleotide sites within the HVS1 are likely to have undergone mutation independently, making phylogenetic comparison with global samples by conventional methods difficult. Specific nucleotide-site variants are major separators in median networks constructed from Australian HVS1 types alone and for one global selection. The distribution of these, requiring extended study, suggests that they may be signatures of different groups of prehistoric colonizers into Australia, for which the time of colonization remains elusive. PMID:9463317

Breast-feeding practices in Mexico: results from the Second National Nutrition Survey 1999.

PubMed

González-Cossío, Teresa; Moreno-Macías, Hortensia; Rivera, Juan A; Villalpando, Salvador; Shamah-Levy, Teresa; Monterrubio, Eric A; Hernández-Garduño, Adolfo

2003-01-01

To assess breast-feeding (BF) practices and determinants of exclusive BF (EBF) < 4 and < 6 months (mo) among women and infants < 23 mo in the NNS-1999. BF practices from the day and night before the interview were ascertained, and median duration estimated. Determinants of EBF < 4 and < 6 mo were analysed by logistic regression models for complex surveys. Prevalence of EBF < 4 mo was 25.7%, and of < 6 mo 20.3%. The overall rate of continued BF (second year) was 30.9%, median duration of BF 9 mo, and the national proportion of children ever breast-fed 92.3%. The probability (p) of EBF < 4 mo was determined by infant age and sex, by maternal socio-economic level (SEL) and ethnicity, and by the interaction between infant sex and SEL. The pEBF < 6 mo was determined by infant age and length, by maternal ethnicity, and employment. EBF rates and duration are low in Mexico and have improved only slightly in the last 20 y. Infant and maternal characteristics determine the pEBF. If improvements in infant health are a national priority, aggressive interventions to promote and protect BF are urgently needed in Mexico, as well as formal evaluation of current initiatives. The English version of this paper is available too at: http://www.insp.mx/salud/index.html.

Comparison of age distributions estimated from environmental tracers by using binary-dilution and numerical models of fractured and folded karst: Shenandoah Valley of Virginia and West Virginia, USA

USGS Publications Warehouse

Yager, Richard M.; Plummer, Niel; Kauffman, Leon J.; Doctor, Daniel H.; Nelms, David L.; Schlosser, Peter

2013-01-01

Measured concentrations of environmental tracers in spring discharge from a karst aquifer in the Shenandoah Valley, USA, were used to refine a numerical groundwater flow model. The karst aquifer is folded and faulted carbonate bedrock dominated by diffuse flow along fractures. The numerical model represented bedrock structure and discrete features (fault zones and springs). Concentrations of 3H, 3He, 4He, and CFC-113 in spring discharge were interpreted as binary dilutions of young (0–8 years) water and old (tracer-free) water. Simulated mixtures of groundwater are derived from young water flowing along shallow paths, with the addition of old water flowing along deeper paths through the model domain that discharge to springs along fault zones. The simulated median age of young water discharged from springs (5.7 years) is slightly older than the median age estimated from 3H/3He data (4.4 years). The numerical model predicted a fraction of old water in spring discharge (0.07) that was half that determined by the binary-dilution model using the 3H/3He apparent age and 3H and CFC-113 data (0.14). This difference suggests that faults and lineaments are more numerous or extensive than those mapped and included in the numerical model.

Source levels of social sounds in migrating humpback whales (Megaptera novaeangliae).

PubMed

Dunlop, Rebecca A; Cato, Douglas H; Noad, Michael J; Stokes, Dale M

2013-07-01

The source level of an animal sound is important in communication, since it affects the distance over which the sound is audible. Several measurements of source levels of whale sounds have been reported, but the accuracy of many is limited because the distance to the source and the acoustic transmission loss were estimated rather than measured. This paper presents measurements of source levels of social sounds (surface-generated and vocal sounds) of humpback whales from a sample of 998 sounds recorded from 49 migrating humpback whale groups. Sources were localized using a wide baseline five hydrophone array and transmission loss was measured for the site. Social vocalization source levels were found to range from 123 to 183 dB re 1 μPa @ 1 m with a median of 158 dB re 1 μPa @ 1 m. Source levels of surface-generated social sounds ("breaches" and "slaps") were narrower in range (133 to 171 dB re 1 μPa @ 1 m) but slightly higher in level (median of 162 dB re 1 μPa @ 1 m) compared to vocalizations. The data suggest that group composition has an effect on group vocalization source levels in that singletons and mother-calf-singing escort groups tend to vocalize at higher levels compared to other group compositions.

Deep-Sea Macrobenthos Community Structure Proximal to the 2010 Macondo Well Blowout (2010-2011)

NASA Astrophysics Data System (ADS)

Briggs, K. B.; Brunner, C. A.; Yeager, K. M.

2017-12-01

Macrobenthos, polycyclic aromatic hydrocarbons (PAH) and sedimentary organic carbon (SOC) were sampled by multicorer in the vicinity of the Deepwater Horizon well head in October 2010 and 2011 to assess the effects of the April 2010 spill. Four stations were sampled east of the well head, four stations were sampled west of the well head, and "control" stations were sampled 58 and 65 km to the southwest. The macrobenthos community, as expected for continental slope/bathyal (water depth 1160-1760 m) benthos, was highly diverse. Polychaetes dominated at all stations, with either crustaceans or mollusks comprising the next most abundant taxon. The stations within five km of the well head showed slightly lower diversity than the more distal stations six months after the blowout. Compared to the "control" station, proportions of suspension feeders were generally depressed at stations with high PAH concentrations. Anomalously high values for abundance and diversity (and PAH) were found at one station 20 km west of the well head. The median body size of macrobenthos was negatively correlated with total PAH concentration, with 74% of the variation in median size explained by variation in PAH, when the anomalous station was excluded. Macrobenthos abundance did not appear to be influenced by SOC. Abundance and diversity of the macrobenthos was generally higher 18 months after the blowout, with measured PAH concentrations diminished to below background level.

Epidemiology of musculoskeletal injuries among Norwegian conscripts undergoing basic military training.

PubMed

Heir, T; Glomsaker, P

1996-06-01

Compulsory military service entails a change in the patterns of physical activity of many conscripts, and an accompanying risk of musculoskeletal injury. The present study was carried out to determine the incidence and types of musculoskeletal injury among Norwegian conscripts, and their consequences in the form of sick leave and discharge from the service. The study population consisted of 6488 conscripts in all, drawn from the Army, the Air Force and the Navy. They were monitored through an initial 6-10-week period of basic military and physical training. Every injury for which a conscript had to consult a doctor was registered. Slightly more than every fourth Army, every fifth Air Force and every eighth Navy conscript suffered one or more injuries during basic training. Incidence rates for the Army, Air Force and Navy respectively were 15.3, 13.4 and 9.3 injuries per 100 conscripts-months. The sites of the majority of the injuries were in the lower limbs (63%). The most common types of injury were low back pain; overuse knee injuries; Achilles tendinitis; sprains of joint capsules or ligaments; and periostitis or compartment syndromes of lower leg. In the doctors' opinions, contributory or triggering causes of the injuries could be attributed to organized service activities in 67% of the cases. The number of days of partial or total sick leave as a result of injury amounted to 3.4% and 0.2% respectively of the total basic training period. Of Army, Air Force and Navy conscripts, 23%, 16% and 11% respectively had sick leave. Injury was also the direct cause of the discharge of 2.1% of the Army conscripts and 0.1% of the Air Force and Navy conscripts. The results of the study show that musculoskeletal injuries occur frequently during basic training and that injuries contribute to lost training time.

Adsorption of a reactive dye on chemically modified activated carbons--influence of pH.

PubMed

Orfão, J J M; Silva, A I M; Pereira, J C V; Barata, S A; Fonseca, I M; Faria, P C C; Pereira, M F R

2006-04-15

The surface chemistry of a commercial activated carbon with a slightly basic nature was modified by appropriate treatments in order to obtain two additional samples, respectively with acidic and basic properties, without changing its textural parameters significantly. Different techniques (N2 adsorption at 77 K, temperature programmed desorption, and determination of acidity, basicity, and pH at the point of zero charge) were used to characterize the adsorbents. Kinetic and equilibrium adsorption data of a selected textile reactive dye (Rifafix Red 3BN, C.I. reactive red 241) on the mentioned materials were obtained at the pH values of 2, 7, and 12. The kinetic curves are fitted using the second-order model. The respective rate constants seem to diminish progressively with the initial concentration for the more diluted solutions tested, reaching a constant value at higher concentrations, which depends on the experimental system under consideration (adsorbent and pH). In general, the Langmuir model provides the best fit for the equilibrium data. The different uptakes obtained are discussed in relation to the surface chemical properties of the adsorbents. It is shown that the adsorption of the reactive (anionic) dye on the basic sample (prepared by thermal treatment under H2 flow at 700 degrees C) is favored. This conclusion is explained on the basis of the dispersive and electrostatic interactions involved. Moreover, it is also shown that the optimal adsorption condition for all the activated carbons tested corresponds to solution pH values not higher than the pH(pzc) of the adsorbents, which may be interpreted by taking into account the electrostatic forces present.

Changes in phosphorus concentrations and loads in the Assabet River, Massachusetts, October 2008 through April 2014

USGS Publications Warehouse

Savoie, Jennifer G.; DeSimone, Leslie A.; Mullaney, John R.; Zimmerman, Marc J.; Waldron, Marcus C.

2016-10-24

Treated effluent discharged from municipal wastewater-treatment plants to the Assabet River in central Massachusetts includes phosphorus, which leads to increased growth of nuisance aquatic plants that decrease the river’s water quality and aesthetics in impounded reaches during the growing season. To improve the river’s water quality and aesthetics, the U.S. Environmental Protection Agency approved a total maximum daily load for phosphorus in 2004 that directed the wastewater-treatment plants to reduce the amount of total phosphorus discharged to the river by 2012. The permitted total phosphorus monthly average of 0.75 milligrams per liter during the aquatic plant growing season (April 1 through October 31) was reduced by the total maximum daily load to a target of 0.1 milligrams per liter by 2012, and the nongrowing-season limit was unchanged at 1.0 milligrams per liter.From October 2008 through April 2014, the U.S. Geological Survey, in cooperation with the Massachusetts Department of Environmental Protection, measured streamflow and collected weekly flow-proportional, composite samples of water from the Assabet River for analysis of concentrations of total phosphorus and orthophosphate. Streamflow and concentration data were used to estimate total phosphorus and orthophosphate loads in the river. The purpose of this monitoring effort was to evaluate phosphorus concentrations and loads in the river before, during, and after the wastewater-treatment-plant upgrades and to assess the effects of seasonal differences in permitted discharges. The locations of water-quality-monitoring stations, with respect to the Hudson and Ben Smith impoundments, enabled examination of effects of phosphorus entering and leaving the impoundments.Annual median concentrations of total phosphorus in wastewater-treatment plants were reduced by more than 80 percent with the plant upgrades. Measured instream annual median concentrations of total phosphorus in the Assabet River decreased by about 38 to 50 percent at three of the four monitoring stations following the wastewater-treatment-plant upgrades. At the station farthest upstream, the median total phosphorus concentration remained unchanged throughout the study; this may be attributed to the site location and potential resuspension of particulate organic matter during periods of increased streamflow. Annual median loads from the wastewater-treatment plants were reduced by up to 91 percent following the upgrades, instream annual median total phosphorus loads at the three downstream stations decreased by 71 to 76 percent, and instream orthophosphate loads at the three downstream stations decreased by 79 to 87 percent.Seasonal fluctuations (growing versus nongrowing) of total phosphorus and orthophosphate were observed instream before the upgrades. However, after the upgrades, fluctuations in phosphorus released from the treatment plants were slight and seasonal changes were typically not observed instream.Annual loads entering and leaving the two impoundments were inconclusive in determining whether the impoundments were sources or sinks of total phosphorus during the study. Total phosphorus loads entering the Hudson impoundment were consistently greater than those leaving; however, there was uncertainty about the loads at the monitoring station upstream from this impoundment. At the Ben Smith impoundment, total phosphorus and orthophosphate loads downstream were slightly greater than those upstream from the impoundment, but the differences may reflect additions from tributaries and overland runoff.Estimated instream total phosphorus concentrations and loads indicated that the decreases in total phosphorus in wastewater-treatment-plant discharges were accompanied by reductions measured in the Assabet River. A statistical analysis which incorporates the effect of varying flow conditions demonstrated significant reductions in total phosphorus concentrations after the wastewater-treatment-plant upgrades at three of the four instream monitoring stations. No significant change was observed at the most upstream location, the Assabet River at Port Street at Hudson, Massachusetts (station number 01096835), which may have been affected by flow-related resuspension of particulate phosphorus.

Serum creatine kinase after exercise: drawing the line between physiological response and exertional rhabdomyolysis.

PubMed

Kenney, Kimbra; Landau, Mark E; Gonzalez, Rodney S; Hundertmark, Julie; O'Brien, Karen; Campbell, William W

2012-03-01

In this investigation we assessed the spectrum of creatine kinase (CK) responses in military recruits undergoing basic training. Musculoskeletal examination data, questionnaire findings, and CK levels were obtained from 499 recruits at days 0, 3, 7, and 14 of training. Correlations of CK with ethnicity, age, body mass index, exercise, muscle pain, and climate were obtained. None of the subjects developed clinical exertional rhabdomyolysis (ER). The mean/median serum CK values were 223/157, 734/478, 1226/567, and 667/486 IU/L at days 0, 3, 7, and 14, respectively, with a wide overall range (34-35,056 IU/L). African-American subjects had higher mean CK levels. CK elevations and muscle pain are common during basic training. Widely accepted laboratory diagnostic values for ER are routinely exceeded in this military recruits, suggesting that CK levels >50 times the upper limit of normal are more specific. The findings support using CK as a marker for ER. Normal laboratory reference ranges for CK should be published by ethnicity. Copyright © 2011 Wiley Periodicals, Inc.

Abacavir/Lamivudine plus Rilpivirine Is an Effective and Safe Strategy for HIV-1 Suppressed Patients: 48 Week Results of the SIMRIKI Retrospective Study

PubMed Central

Troya, Jesús; Ryan, Pablo; Ribera, Esteban; Podzamczer, Daniel; Hontañón, Victor; Terrón, Jose Alberto; Boix, Vicente; Moreno, Santiago; Barrufet, Pilar; Castaño, Manuel; Carrero, Ana; Galindo, María José; Suárez-Lozano, Ignacio; Knobel, Hernando; Raffo, Miguel; Solís, Javier; Yllescas, María; Esteban, Herminia

2016-01-01

Objectives Based on data from clinical practice, we evaluated the effectiveness and safety of switching to abacavir/lamivudine plus rilpivirine (ABC/3TC+RPV) treatment in virologically suppressed HIV-1-infected patients. Methods We performed a multicenter, non-controlled, retrospective study of HIV-1-infected patients who switched treatment to ABC/3TC+RPV. Patients had an HIV-RNA <50 copies/mL for at least 24 weeks prior to changing treatments. The primary objective was HIV-1 RNA <50 copies/mL at week 48. Effectiveness was analyzed by intention-to-treat (ITT), missing = failure and on-treatment (OT) analyses. The secondary objectives analyzed were adverse effects changes in renal, hepatic or lipid profiles, changes in CD4+ cell count and treatment discontinuations. Results Of the 205 patients included, 75.6% were men and the median age was 49. At baseline, before switching to ABC/3TC+RPV, median time since HIV diagnosis was 13.1 years, median time with undetectable HIV-1 RNA was 6.2 years and median time of previous antiretroviral regimen was 3.1 years (48.3% patients were taking efavirenz and ABC/3TC was the most frequent backbone coformulation in 69.7% of patients). The main reasons for switching were drug toxicity/poor tolerability (60.5%) and simplification (20%). At week 48, the primary objective was achieved by 187 out of 205 (91.2%) patients by ITT analysis, and 187 out of 192 (97.4%) patients by OT analysis. The CD4+ lymphocyte count and CD4+ percentage increased significantly from baseline to week 48 by a median of 48 cells/μL (−50 to 189) and 1.2% (−1.3% to 4.1%), respectively, P<0.001. Thirty-eight adverse events (AE) were detected in 32 patients. Of these, 25 had no clear association with treatment. Three patients interrupted therapy due to AE. We observed a decrease in all lipid parameters, P<0.001, and a slight improvement in the glomerular filtration rate, P<0.01. Therapy was considered to have failed in 18 patients owing to virological failure (5 [2.4%]), toxicity/poor tolerability (4 [2%]), clinical decision (3 [1.5%]), loss to follow-up (3 [1.5%]), death (1 [0.5%]), and no clinical data (2 [1%]). Conclusions The results of this study confirms that ABC/3TC+RPV is an effective, safe, and cost-effective option for the treatment of patients with virologically stable HIV-1 infection. PMID:27727331

A Framework for Measuring the Progress in Exoskeleton Skills in People with Complete Spinal Cord Injury

PubMed Central

van Dijsseldonk, Rosanne B.; Rijken, Hennie; van Nes, Ilse J. W.; van de Meent, Henk; Keijsers, Noel L. W.

2017-01-01

For safe application of exoskeletons in people with spinal cord injury at home or in the community, it is required to have completed an exoskeleton training in which users learn to perform basic and advanced skills. So far, a framework to test exoskeleton skills is lacking. The aim of this study was to develop and test the hierarchy and reliability of a framework for measuring the progress in the ability to perform basic and advanced skills. Twelve participants with paraplegia were given twenty-four training sessions in 8 weeks with the Rewalk-exoskeleton. During the 2nd, 4th, and 6th training week the Intermediate-skills-test was performed consisting of 27 skills, measured in an hierarchical order of difficulty, until two skills were not achieved. When participants could walk independently, the Final-skills-test, consisting of 20 skills, was performed in the last training session. Each skill was performed at least two times with a maximum of three attempts. As a reliability measure the consistency was used, which was the number of skills performed the same in the first two attempts relative to the total number. Ten participants completed the training program. Their number of achieved intermediate skills was significantly different between the measurements XF2(2) = 12.36, p = 0.001. Post-hoc analysis revealed a significant increase in the median achieved intermediate skills from 4 [1–7] at the first to 10.5 [5–26] at the third Intermediate-skills-test. The rate of participants who achieved the intermediate skills decreased and the coefficient of reproducibility was 0.98. Eight participants met the criteria to perform the Final-skills-test. Their median number of successfully performed final skills was 16.5 [13–20] and 17 [14–19] skills in the first and second time. The overall consistency of >70% was achieved in the Intermediate-skills-test (73%) and the Final-skills-test (81%). Eight out of twelve participants experienced skin damage during the training, in four participants this resulted in missed training sessions. The framework proposed in this study measured the progress in performing basic and advanced exoskeleton skills during a training program. The hierarchical ordered skills-test could discriminate across participants' skill-level and the overall consistency was considered acceptable. PMID:29311780

A Framework for Measuring the Progress in Exoskeleton Skills in People with Complete Spinal Cord Injury.

PubMed

van Dijsseldonk, Rosanne B; Rijken, Hennie; van Nes, Ilse J W; van de Meent, Henk; Keijsers, Noel L W

2017-01-01

For safe application of exoskeletons in people with spinal cord injury at home or in the community, it is required to have completed an exoskeleton training in which users learn to perform basic and advanced skills. So far, a framework to test exoskeleton skills is lacking. The aim of this study was to develop and test the hierarchy and reliability of a framework for measuring the progress in the ability to perform basic and advanced skills. Twelve participants with paraplegia were given twenty-four training sessions in 8 weeks with the Rewalk-exoskeleton. During the 2nd, 4th, and 6th training week the Intermediate-skills-test was performed consisting of 27 skills, measured in an hierarchical order of difficulty, until two skills were not achieved. When participants could walk independently, the Final-skills-test, consisting of 20 skills, was performed in the last training session. Each skill was performed at least two times with a maximum of three attempts. As a reliability measure the consistency was used, which was the number of skills performed the same in the first two attempts relative to the total number. Ten participants completed the training program. Their number of achieved intermediate skills was significantly different between the measurements X F 2 (2) = 12.36, p = 0.001. Post-hoc analysis revealed a significant increase in the median achieved intermediate skills from 4 [1-7] at the first to 10.5 [5-26] at the third Intermediate-skills-test. The rate of participants who achieved the intermediate skills decreased and the coefficient of reproducibility was 0.98. Eight participants met the criteria to perform the Final-skills-test. Their median number of successfully performed final skills was 16.5 [13-20] and 17 [14-19] skills in the first and second time. The overall consistency of >70% was achieved in the Intermediate-skills-test (73%) and the Final-skills-test (81%). Eight out of twelve participants experienced skin damage during the training, in four participants this resulted in missed training sessions. The framework proposed in this study measured the progress in performing basic and advanced exoskeleton skills during a training program. The hierarchical ordered skills-test could discriminate across participants' skill-level and the overall consistency was considered acceptable.

Early neonatal mortality and neurological outcomes of neonatal resuscitation in a resource-limited setting on the Thailand-Myanmar border: A descriptive study.

PubMed

Janet, Sophie; Carrara, Verena I; Simpson, Julie A; Thin, Nant War War; Say, Wah Wah; Paw, Naw Ta Mlar; Chotivanich, Kesinee; Turner, Claudia; Crawley, Jane; McGready, Rose

2018-01-01

Of the 4 million neonatal deaths worldwide yearly, 98% occur in low and middle-income countries. Effective resuscitation reduces mortality and morbidity but long-term outcomes in resource-limited settings are poorly described. This study reports on newborn neurological outcomes following resuscitation at birth in a resource-limited setting where intensive newborn care including intubation is unavailable. Retrospective analysis of births records from 2008 to 2015 at Shoklo Malaria Research Unit (SMRU) on the Thailand-Myanmar border. From 21,225 newbonrs delivered, 15,073 (71%) met the inclusion criteria (liveborn, singleton, ≥28 weeks' gestation, delivered in SMRU). Neonatal resuscitation was performed in 460 (3%; 422 basic, 38 advanced) cases. Overall early neonatal mortality was 6.6 deaths per 1000 live births (95% CI 5.40-8.06). Newborns receiving basic and advanced resuscitation presented an adjusted rate for death of 1.30 (95%CI 0.66-2.55; p = 0.442), and 6.32 (95%CI 3.01-13.26; p<0.001) respectively, compared to newborns given routine care. Main factors related to increased need for resuscitation were breech delivery, meconium, and fetal distress (p<0.001). Neurodevelopmental follow-up to one year was performed in 1,608 (10.5%) of the 15,073 newborns; median neurodevelopmental scores of non-resuscitated newborns and those receiving basic resuscitation were similar (64 (n = 1565) versus 63 (n = 41); p = 0.732), while advanced resuscitation scores were significantly lower (56 (n = 5); p = 0.017). Newborns requiring basic resuscitation at birth have normal neuro-developmental outcomes at one year of age compared to low-risk newborns. Identification of risk factors (e.g., breech delivery) associated with increased need for neonatal resuscitation may facilitate allocation of staff to high-risk deliveries. This work endorses the use of basic resuscitation in low-resource settings, and supports on-going staff training to maintain bag-and-mask ventilation skills.

Basic life support: knowledge and attitude of medical/paramedical professionals.

PubMed

Roshana, Shrestha; Kh, Batajoo; Rm, Piryani; Mw, Sharma

2012-01-01

Basic life support (BLS), a key component of the chain of survival decreases the arrest - cardiopulmonary resuscitation interval and increases the rate of hospital discharge. The study aimed to explore the knowledge of and attitude towards basic life support (BLS) among medical/paramedical professionals. An observational study was conducted by assessing response to self prepared questionnaire consisting of the demographic information of the medical/paramedical staff, their personnel experience/attitude and knowledge of BLS based on the 2005 BLS Guidelines of European Resuscitation Council. After excluding incomplete questionnaires, the data from 121 responders (27 clinical faculty members, 21 dental and basic sciences faculty members, 29 house officers and 44 nurses and health assistants) were analyzed. Only 9 (7.4%) of the 121 responders answered ≥11, 53 (43%) answered 7-10, and 58 (48%) answered <7 of 15 questions correctly. The clinical faculty members, house officers and nurses/HA had a mean score of 7.4±3.15, 7.37±2.02 and 6.63±2.16 respectively, while dental/basic sciences faculty members attained a least mean score of 4.52 ±2.13 (P<0.001). Those who had received cardiopulmonary resuscitation (CPR) training within 5 years obtained a highest mean score of 8.62±2.49, whereas those who had the training more than 5 years back or no training obtained a mean score of 5.54±2.38 and 6.1±2.29 respectively (P=0.001). Those who were involved in resuscitation frequently had a higher median score of 8 in comparison to those who were seldom involved or not involved at all (P<0.001). The average health personnel in our hospital lack adequate knowledge in CPR/BLS. Training and experience can enhance knowledge of CPR of these personnel. Thus standard of CPR/BLS training and assessment are recommended at our hospital.

A 1-year randomized study to evaluate the effects of a dose reduction in oral contraceptives on lipids and carbohydrate metabolism: 20 microg ethinyl estradiol combined with 100 microg levonorgestrel.

PubMed

Skouby, Sven O; Endrikat, Jan; Düsterberg, Bernd; Schmidt, Werner; Gerlinger, Christoph; Wessel, Jens; Goldstein, Henri; Jespersen, Joergen

2005-02-01

To evaluate the impact on lipid and carbohydrate variables of a combined one-third ethinyl estradiol (EE)/levonorgestrel (LNG) dose reduction in oral contraceptives. In an open-label, randomized study, a dose-reduced oral contraceptive containing 20 microg EE and 100 microg LNG (20 EE/100 LNG) was compared with a reference preparation containing 30 microg EE and 150 microg LNG (30 EE/150 LNG). One-year data from 48 volunteers were obtained. We found a decrease of HDL2 cholesterol and increases of low-density lipoprotein cholesterol, very low-density lipoprotein cholesterol and total triglycerides in both treatment groups from baseline to the 13th treatment cycle. Although for four of six variables, the changes in the 20 EE group were lower compared with the 30 EE group, none of the differences between the two treatments were statistically significant. The median values for the fasting levels of insulin, C-peptide and free fatty acids slightly increased or remained unchanged while the fasting glucose levels slightly decreased after 13 treatment cycles. While the glucose area under the curve (AUC) (0-3 h) was similar in both groups during the OGTT, the insulin AUC(0-3 h) was less increased in the 20 EE/100 LNG group compared with the 30 EE/150 LNG group. None of the differences between the treatment groups for any of the carbohydrate metabolism variables were statistically significant at any time point. Both study treatments were safe and well tolerated by the volunteers. Similar effects on the lipid and carbohydrate profiles were found for both preparations. The balanced one-third EE dose reduction in this new oral contraceptive caused slightly lower, but insignificant, changes in the lipid and carbohydrate variables compared with the reference treatment.

Developmental charts for children with osteogenesis imperfecta, type I (body height, body weight and BMI).

PubMed

Graff, Krzysztof; Syczewska, Malgorzata

2017-03-01

Osteogenesis imperfecta (OI) is a rare genetic disorder of type I collagen. Type I is the most common, which is called a non-deforming type of OI, as in this condition, there are no major bone deformities. This type is characterised by blue sclera and vertebral fractures, leading to mild scoliosis. The body height of these patients is regarded as normal, or only slightly reduced, but there are no data proving this in the literature. The aim of this study is the preparation of the developmental charts of children with OI type I. The anthropometric data of 117 patients with osteogenesis imperfecta were used in this study (61 boys and 56 girls). All measurements were pooled together into one database (823 measurements in total). To overcome the problem of the limited number of data being available in certain age classes and gender groups, the method called reverse transformation was used. The body height of the youngest children, aged 2 and 3 years, is less than that of their healthy peers. Children between 4 and 7 years old catch up slightly, but at later ages, development slows down, and in adults, the median body height shows an SDS of -2.7. These results show that children with type I OI are smaller from the beginning than their healthy counterparts, their development slows down from 8 years old, and, ultimately, their body height is impaired. What is Known: • The body height of patients with osteogenesis imperfecta type I is regarded as normal, or only slightly reduced, but in the known literature, there is no measurement data supporting this opinion. What is New: • Children with type I osteogenesis imperfecta are smaller from the beginning than their healthy counterparts, their development slows down from 8 years old and, ultimately, their final body height is impaired. • The developmental charts for the body height, body weight and BMI of children with type I osteogenesis imperfecta are shown.

Summary of surface-water-quality data collected for the Northern Rockies Intermontane Basins National Water-Quality Assessment Program in the Clark Fork-Pend Oreille and Spokane River basins, Montana, Idaho, and Washington, water years 1999-2001

USGS Publications Warehouse

Beckwith, Michael A.

2003-01-01

Water-quality samples were collected at 10 sites in the Clark Fork-Pend Oreille and Spokane River Basins in water years 1999 – 2001 as part of the Northern Rockies Intermontane Basins (NROK) National Water-Quality Assessment (NAWQA) Program. Sampling sites were located in varied environments ranging from small streams and rivers in forested, mountainous headwater areas to large rivers draining diverse landscapes. Two sampling sites were located immediately downstream from the large lakes; five sites were located downstream from large-scale historical mining and oreprocessing areas, which are now the two largest “Superfund” (environmental remediation) sites in the Nation. Samples were collected during a wide range of streamflow conditions, more frequently during increasing and high streamflow and less frequently during receding and base-flow conditions. Sample analyses emphasized major ions, nutrients, and selected trace elements. Streamflow during the study ranged from more than 130 percent of the long-term average in 1999 at some sites to 40 percent of the long-term average in 2001. River and stream water in the study area exhibited small values for specific conductance, hardness, alkalinity, and dissolved solids. Dissolved oxygen concentrations in almost all samples were near saturation. Median total nitrogen and total phosphorus concentrations in samples from most sites were smaller than median concentrations reported for many national programs and other NAWQA Program study areas. The only exceptions were two sites downstream from large wastewater-treatment facilities, where median concentrations of total nitrogen exceeded the national median. Maximum concentrations of total phosphorus in samples from six sites exceeded the 0.1 milligram per liter threshold recommended for limiting nuisance aquatic growth. Concentrations of arsenic, cadmium, copper, lead, mercury, and zinc were largest in samples from sites downstream from historical mining and ore-processing areas in the upper Clark Fork in Montana and the South Fork Coeur d’Alene River in Idaho. Concentrations of dissolved lead in all 32 samples from the South Fork Coeur d’Alene River exceeded the Idaho chronic criterion for the protection of aquatic life at the median hardness level measured during the study. Concentrations of dissolved zinc in all samples collected at this site exceeded both the chronic and acute criteria at all hardness levels measured. When all data from all NROK sites were combined, median concentrations of dissolved arsenic, dissolved and total recoverable copper, total recoverable lead, and total recoverable zinc in the NROK study area appeared to be similar to or slightly smaller than median concentrations at sites in other NAWQA Program study areas in the Western United States affected by historical mining activities. Although the NROK median total recoverable lead concentration was the smallest among the three Western study areas compared, concentrations in several NROK samples were an order of magnitude larger than the maximum concentrations measured in the Upper Colorado River and Great Salt Lake Basins. Dissolved cadmium, dissolved lead, and total recoverable zinc concentrations at NROK sites were more variable than in the other study areas; concentrations ranged over almost three orders of magnitude between minimum and maximum values; the range of dissolved zinc concentrations in the NROK study area exceeded three orders of magnitude.

Utilization of case presentations in medical microbiology to enhance relevance of basic science for medical students.

PubMed

Chamberlain, Neal R; Stuart, Melissa K; Singh, Vineet K; Sargentini, Neil J

2012-01-01

Small-group case presentation exercises (CPs) were created to increase course relevance for medical students taking Medical Microbiology (MM) and Infectious Diseases (ID) METHODS: Each student received a unique paper case and had 10 minutes to review patient history, physical exam data, and laboratory data. Students then had three minutes to orally present their case and defend why they ruled in or out each of the answer choices provided, followed by an additional three minutes to answer questions. Exam scores differed significantly between students who received the traditional lecture-laboratory curriculum (Group I) and students who participated in the CPs (Group II). In MM, median unit exam and final exam scores for Group I students were 84.4% and 77.8%, compared to 86.0% and 82.2% for Group II students (P<0.018; P<0.001; Mann-Whitney Rank Sum Test). Median unit and final ID exam scores for Group I students were 84.0% and 80.0%, compared to 88.0% and 86.7% for Group II students (P<0.001; P<0.001). Students felt that the CPs improved their critical thinking and presentation skills and helped to prepare them as future physicians.

Publication rates following pancreas meetings.

PubMed

Timmer, A; Blum, T; Lankisch, P G

2001-08-01

Publication rates and determinants of publication were studied based on abstracts presented at pancreatic meetings. All abstracts presented at the 1994 and 1995 annual meetings of the European Pancreatic Club (EPC) and the American Pancreatic Association (APA) were followed up by searching MEDLINE. Publication rates were compared using log-rank tests and multiple logistic regression. The prestige of the publishing journals was compared using Kruskal-Wallis tests on scientific impact factors (SIF). Overall, 340 abstracts were presented at the EPC, and 254 were presented at the APA. Of these, 203 (59.7%, EPC) and 138 (54.3%, APA) were later published in peer-reviewed journals. Publication rates did not differ by study type or country region of origin. In addition, median SIFs were similar by conference (APA vs. EPC) and research type (basic science vs. clinical studies) (overall, 1.7). However, North American and North/West European articles were published in higher impact journals as compared with those from other countries. Publication rates and median journal SIFs in pancreas research are similar to those reported from other medical specialty meetings. There is no difference by conference, type of research, or origin (North American vs. European).

Management of orthodontic emergencies in primary care - self-reported confidence of general dental practitioners.

PubMed

Popat, H; Thomas, K; Farnell, D J J

2016-07-08

Objective To determine general dental practitioners' (GDPs) confidence in managing orthodontic emergencies.Design Cross-sectional study.Setting Primary dental care.Subjects and methods An online survey was distributed to dentists practicing in Wales. The survey collected basic demographic information and included descriptions of ten common orthodontic emergency scenarios.Main outcome measure Respondents' self-reported confidence in managing the orthodontic emergency scenarios on a 5-point Likert scale. Differences between the Likert responses and the demographic variables were investigated using chi-squared tests.Results The median number of orthodontic emergencies encountered by respondents over the previous six months was 1. Overall, the self-reported confidence of respondents was high with 7 of the 10 scenarios presented scoring a median of 4 indicating that GDPs were 'confident' in their management. Statistical analysis revealed that GDPs who saw more orthodontic emergencies in the previous six months were more confident when managing the presented scenarios. Other variables such as age, gender, geographic location of practice and number of years practising dentistry were not associated with self-reported confidence.Conclusions Despite GDPs encountering very few orthodontic emergencies in primary care, they appear to be confident in dealing with commonly arising orthodontic emergency situations.

Alkylsulfonic acid phenylesters (ASEs, Mesamoll®) in dust samples of German residences and daycare centers (LUPE 3).

PubMed

Fromme, Hermann; Schwarzbauer, Jan; Lahrz, Thomas; Kraft, Martin; Fembacher, Ludwig

2017-04-01

For decades, plasticizers have been produced in high quantities to improve the flexibility and durability of products. One possible replacement product is alkylsulfonic acid phenylesters (ASEs), marketed as Mesamoll ® . This study aimed to quantify the ASE dust contamination of residences and daycare centers to obtain insight into the recent exposure situation. ASEs were quantified in dust samples collected from 25 residences and 25 daycare centers using GC/MS measurements. Median (95th percentile) values of the sum of tetra- to heptadecylphenylesters are higher in daycare centers, with a value of 19.6mg/kg (216mg/kg), compared to residences, with a value of 7.6mg/kg (171mg/kg). A daily non-dietary intake of 0.08 and 0.86μg/kg b.w., respectively, was observed using the median and 95th percentile values obtained from dust samples. These levels are 1250 and 115 times below a previously set temporary tolerable daily intake value. Nevertheless, the fact that basic data on toxicity and exposure via other pathways are limited or unavailable at present has to be considered. Copyright © 2016 Elsevier GmbH. All rights reserved.

A new species of freshwater crab of the genus Oziotelphusa Müller, 1887 (Crustacea: Decapoda: Brachyura: Gecarcinucidae) from Tamil Nadu, southern India.

PubMed

Raj, Smrithy; Kumar, Appukuttannair Biju; Ng, Peter K L

2017-12-10

A new species of gecarcinucid freshwater crab of the genus Oziotelphusa Müller, 1887, is described from stationary or slow-flowing bodies of water in Keeriparai near Nagercoil, in the state of Tamil Nadu in southern India. Oziotelphusa ravi, new species, is distinguished from its congeners by several distinct characters: the median tooth of the posterior margin of epistome forms a distinct bilobed tip in frontal view, the male pleonal somite 6 is narrowly trapezoidal and slightly wider than long with the lateral margins concave, the terminal segment of the male first gonopod is distinctly bent laterally (along the longitudinal axis) at an angle of about 45°, and the proximal part of the outer margin of the subterminal segment of the male first gonopod has a prominent deep concavity.

Further karyosystematic studies of the Boreonectesgriseostriatus (De Geer) group of sibling species (Coleoptera, Dytiscidae)-characterisation of B.emmerichi (Falkenström, 1936) and additional European data.

PubMed

Angus, Robert B; Angus, Elizabeth M; Jia, Fenglong; Chen, Zhen-Ning; Zhang, Ying

2015-01-01

A lectotype is designated for the Tibetan species Deronectesemmerichi Falkenström, 1936 (Currently Boreonectesemmerichi (Falkenström)), and its habitus, as well as the median lobe and parameres of its aedeagus, are figured along with additional comparative material. Material of Boreonectesemmerichi from Sikkim (BMNH) represents the first record of a Boreonectes Angus, 2010 species from India. The karyotype of Boreonectesemmerichi is described as having 26 pairs of autosomes plus sex chromosomes which are X0 (♂), XX (♀). The karyotype is most like that of Boreonectesmacedonicus (Géuorguiev, 1959), but with slight differences. Additional chromosomal information is given for Boreonectesgriseostriatusgriseostriatus (De Geer, 1774) in the French Alps, Boreonectesgriseostriatusstrandi (Brinck, 1943) on the Kola Peninsula, Boreonectesmultilineatus (Falkenström, 1922) in the Pyrenees and Boreonectesibericus (Dutton & Angus, 2007) in the Spanish Picos de Europa.

Comparison of assessment of personality disorder by patients and informants.

PubMed

Modestin, J; Puhan, A

2000-01-01

The present study evaluated the pathology of personality disorder in a group of 8 nonpatient volunteers and 32 psychiatric in- and outpatients, most of them suffering from substance abuse disorder. The patient self-reports were compared with the reports by 2 informants for each proband. All probands and informants completed the Structured Interview for DSM-III-R Axis II Personality Questionnaire. Patient self-reports and informant reports yielded the same number of diagnoses. The diagnostic agreement between the three sets of data was generally poor; however, the concordance was slightly better between both groups of informants than between patients and informants: Median kappa were 0.13 for patients versus parents, 0.14 for patients versus brothers/sisters and 0.29 for parents versus brothers/sisters. Patient and informant evaluations represent two different assessment approaches of the personality, and a complete agreement is not to be expected. Copyright 2000 S. Karger AG, Basel.

Vertical muscle transposition with silicone band belting in VI nerve palsy

PubMed Central

Freitas, Cristina

2016-01-01

A woman aged 60 years developed a Millard-Gubler syndrome after a diagnosis of a cavernous angioma in the median and paramedian areas of the pons. In this context, she presented a right VI nerve palsy, right conjugate gaze palsy, facial palsy and left hemiparesis. To improve the complete VI nerve palsy, we planned a modified transposition approach, in which procedure we made a partial transposition of vertical rectus with a silicone band that was fixated posteriorly. After the procedure, the patient gained the ability to slightly abduct the right eye. We found no compensatory torticollis in the primary position of gaze. There was also an improvement of elevation and depression movements of the right eye. We obtained satisfactory results with a theoretically reversible technique, which is adjustable intraoperatively with no need of muscle detachment, preventing anterior segment ischaemia and allowing simultaneous recession of the medial rectus muscles, if necessary. PMID:27974341

Channel Measurement and Modeling for 5G Urban Microcellular Scenarios.

PubMed

Peter, Michael; Weiler, Richard J; Göktepe, Barış; Keusgen, Wilhelm; Sakaguchi, Kei

2016-08-20

In order to support the development of channel models for higher frequency bands, multiple urban microcellular measurement campaigns have been carried out in Berlin, Germany, at 60 and 10 GHz. In this paper, the collected data is uniformly analyzed with focus on the path loss (PL) and the delay spread (DS). It reveals that the ground reflection has a dominant impact on the fading behavior. For line-of-sight conditions, the PL exponents are close to free space propagation at 60 GHz, but slightly smaller (1.62) for the street canyon at 10 GHz. The DS shows a clear dependence on the scenario (median values between 16 and 38 ns) and a strong distance dependence for the open square and the wide street canyon. The dependence is less distinct for the narrow street canyon with residential buildings. This behavior is consistent with complementary ray tracing simulations, though the simplified model tends to overestimate the DS.

Synergistic effect of piperonyl butoxide on acute toxicity of pyrethrins to Hyalella azteca.

PubMed

Giddings, Jeffrey; Gagne, James; Sharp, Janice

2016-08-01

A series of acute toxicity tests with the amphipod Hyalella azteca was performed to quantify the synergistic effect of piperonyl butoxide (PBO) on pyrethrin toxicity. Concentrations of PBO <4 µg/L caused no toxicity enhancement, whereas toxicity increased with PBO concentrations between 4 µg/L and 15 µg/L. Additive toxicity calculations showed that true synergism accounted for an increase in pyrethrin toxicity (decrease in median lethal concentration) of 1.4-fold to 1.6-fold and varied only slightly between 4 µg/L and 15 µg/L PBO, whereas direct toxicity of PBO accounted for an additional increase in mixture toxicity (up to 3.2-fold) that was proportional to PBO concentration. The results can be used to assess the risk of measured or predicted co-occurring concentrations of PBO and pyrethrins in surface waters. Environ Toxicol Chem 2016;35:2111-2116. © 2016 SETAC. © 2016 SETAC.

Patterns of breast cancer mortality trends in Europe.

PubMed

Amaro, Joana; Severo, Milton; Vilela, Sofia; Fonseca, Sérgio; Fontes, Filipa; La Vecchia, Carlo; Lunet, Nuno

2013-06-01

To identify patterns of variation in breast cancer mortality in Europe (1980-2010), using a model-based approach. Mortality data were obtained from the World Health Organization database and mixed models were used to describe the time trends in the age-standardized mortality rates (ASMR). Model-based clustering was used to identify clusters of countries with homogeneous variation in ASMR. Three patterns were identified. Patterns 1 and 2 are characterized by stable or slightly increasing trends in ASMR in the first half of the period analysed, and a clear decline is observed thereafter; in pattern 1 the median of the ASMR is higher, and the highest rates were achieved sooner. Pattern 3 is characterised by a rapid increase in mortality until 1999, declining slowly thereafter. This study provides a general model for the description and interpretation of the variation in breast cancer mortality in Europe, based in three main patterns. Copyright © 2013 Elsevier Ltd. All rights reserved.

[Effect of educational level on the prognosis of acute myocardial infarction].

PubMed

Nazzal, Carolina; Corbalán, Ramón; Díaz, Claudia; Sepúlveda, Pablo; Schacht, Eliana

2015-07-01

Socioeconomic status is associated with cardiovascular mortality. To evaluate the effect of educational level, on the prognosis of patients with acute myocardial infarction in Chile. Cohort study of 3,636 patients aged 63.1 ± 13.2 years, 27% women, hospitalized in 16 centers participating in the Chilean Myocardial Infarction Registry (GEMI) between 2009 and 2012. Vital status was obtained from the National Mortality Database. Patients were divided, according to educational level, in four groups, namely none (no formal education), basic (< 8 years), secondary (8-12 years) and tertiary (> 12 years). Crude and adjusted (age, sex, cardiovascular risk factors and treatments) hazard ratios (HR) were estimated using Cox regression models. The distribution by educational level was 3.2% none, 31.8% basic, 43.0% secondary and 22.0% tertiary. During a median follow-up period of 22 months (interquartile range 11-37 years), 631 patients died (17.3%), of whom 198 died during hospitalization (5.5%). The 30 day case-fatality rate according to educational level was 3.4% in tertiary, 4.7% in secondary, 11.9% in basic, 19.1% in none (p < 0.0001). Among patients surviving the first 30 days, the case-fatality rate was 4.4%, 8.6%, 14.6% and 27.0%, respectively (p < 0.0001). The increased risk of death for groups with lower education compared with individuals with tertiary education, persisted in the multivariate analysis with a hazard ratio for secondary education 1.58 (95% confidence intervals (CI), 1.18-2.10); for basic education 1.90 (95% CI, 1.41-2.47) and for none 3.50 (95% CI, 2.35-5.21). A lower educational level was associated with a worse prognosis in patients with myocardial infarction, even after controlling for potential confounding factors.

Effect of mobile phone proliferation on crash notification times and fatality rates.

PubMed

Stickles, Jimmy L; Kempema, James M; Brown, Lawrence H

2018-01-01

The purpose of this study was to evaluate whether increased proliferation of mobile telephones has been associated with decreased MVC notification times and/or decreased MVC fatality rates in the United States (US). We used World Bank annual mobile phone market penetration data and US Fatality Analysis Reporting System (FARS) fatal MVC data for 1994-2014. For each year, phone proliferation was measured as mobile phones per 100 population. FARS data were used to calculate MVC notification time (time EMS notified - time MVC occurred) in minutes, and to determine the MVC fatality rate per billion vehicle miles traveled (BVMT). We used basic vector auto-regression modeling to explore relationships between changes in phone proliferation and subsequent changes in median and 90th percentile MVC notification times, as well as MVC fatality rates. From 1994 to 2014, larger year-over-year increases in phone proliferation were associated with larger decreases in 90th percentile notification times for MVCs occurring during daylight hours (p=0.004) and on the national highway system (p=0.046) two years subsequent, and crashes off the national highway system three years subsequent (p=0.023). There were no significant associations between changes in phone proliferation and subsequent changes in median crash notification times, nor with subsequent changes in MVC fatality rates. Between 1994 and 2014 increased mobile phone proliferation in the U.S. was associated with shorter 90th percentile EMS notification times for some subgroups of fatal MVCs, but not with decreases in median notification times or overall MVC fatality rates. Copyright © 2017 Elsevier Inc. All rights reserved.

A program to provide antiretroviral therapy to residents of an urban slum in Nairobi, Kenya.

PubMed

Marston, Barbara J; Macharia, Doris K; Nga'nga, Lucy; Wangai, Mary; Ilako, Festus; Muhenje, Odylia; Kjaer, Mette; Isavwa, Anthony; Kim, Andrea; Chebet, Kenneth; DeCock, Kevin M; Weidle, Paul J

2007-06-01

To evaluate retention in care and response to therapy for patients enrolled in an antiretroviral treatment program in a severely resource-constrained setting. We evaluated patients enrolled between February 26, 2003, and February 28, 2005, in a community clinic in Kibera, an informal settlement, in Nairobi, Kenya. Midlevel providers offered simplified, standardized antiretroviral therapy (ART) regimens and monitored patients clinically and with basic laboratory tests. Clinical, immunologic, and virologic indicators were used to assess response to ART; adherence was determined by 3-day recall. A total of 283 patients (70% women; median baseline CD4 count, 157 cells/ mm(3); viral load, 5.16 log copies/mL) initiated ART and were followed for a median of 7.1 months (n = 2384 patient-months). At 1 year, the median CD4 count change was +124.5 cells/mm(3) (n = 74; interquartile range, 42 to 180), and 71 (74%) of 96 patients had viral load <400 copies/mL. The proportion of patients reporting 100% adherence over the 3 days before monthly clinic visits was 94% to 100%. As of February 28, 2005, a total of 239 patients (84%) remained in care, 22 (8%) were lost to follow-up, 12 (4%) were known to have died, 5 (2%) had stopped ART, 3 (1%) moved from the area, and 2 (< 1% ) transferred care. Response to ART in this slum population was comparable to that seen in industrialized settings. With government commitment, donor support, and community involvement, it is feasible to implement successful ART programs in extremely challenging social and environmental conditions.

Examination of Industry Payments to Radiation Oncologists in 2014 Using the Centers for Medicare and Medicaid Services Open Payments Database.

PubMed

Jairam, Vikram; Yu, James B

2016-01-01

To use the Centers for Medicare and Medicaid Services Open Payments database to characterize payments made to radiation oncologists and compare their payment profile with that of medical and surgical oncologists. The June 2015 release of the Open Payments database was accessed, containing all payments made to physicians in 2014. The general payments dataset was used for analysis. Data on payments made to medical, surgical, and radiation oncologists was obtained and compared. Within radiation oncology, data regarding payment category, sponsorship, and geographic distribution were identified. Basic statistics including mean, median, range, and sum were calculated by provider and by transaction. Among the 3 oncologic specialties, radiation oncology had the smallest proportion (58%) of compensated physicians and the lowest mean ($1620) and median ($112) payment per provider. Surgical oncology had the highest proportion (84%) of compensated physicians, whereas medical oncology had the highest mean ($6371) and median ($448) payment per physician. Within radiation oncology, nonconsulting services accounted for the most money to physicians ($1,042,556), whereas the majority of the sponsors were medical device companies (52%). Radiation oncologists in the West accepted the most money ($2,041,603) of any US Census region. Radiation oncologists in 2014 received a large number of payments from industry, although less than their medical or surgical counterparts. As the Open Payments database continues to be improved, it remains to be seen whether this information will be used by patients to inform choice of providers or by lawmakers to enact policy regulating physician-industry relationships. Copyright © 2016 Elsevier Inc. All rights reserved.

Interconversion of CO2 and formic acid by bio-inspired Ir complexes with pendent bases.

PubMed

Fujita, Etsuko; Muckerman, James T; Himeda, Yuichiro

2013-01-01

Recent investigations of the interconversion of CO2 and formic acid using Ru, Ir and Fe complexes are summarized in this review. During the past several years, both the reaction rates and catalyst stabilities have been significantly improved. Remarkably, the interconversion (i.e., reversibility) has also been achieved under mild conditions in environmentally benign water solvent by slightly changing the pH of the aqueous solution. Only a few catalysts seem to reflect a bio-inspired design such as the use of proton responsive ligands, ligands with pendent bases or acids for a second-coordination-sphere interaction, electroresponsive ligands, and/or ligands having a hydrogen bonding function with a solvent molecule or an added reagent. The most successful of these is an iridium dinuclear complex catalyst that at least has the first three of these characteristics associated with its bridging ligand. By utilizing an acid/base equilibrium for proton removal, the ligand becomes a strong electron donor, resulting in Ir(I) character with a vacant coordination site at each metal center in slightly basic solution. Complemented by DFT calculations, kinetic studies of the rates of formate production using a related family of Ir complexes with and without such functions on the ligand reveal that the rate-determining step for the CO2 hydrogenation is likely to be H2 addition through heterolytic cleavage involving a "proton relay" through the pendent base. The dehydrogenation of formic acid, owing to the proton responsive ligands changing character under slightly acidic pH conditions, is likely to occur by a mechanism with a different rate-determining step. This article is part of a Special Issue entitled: Metals in Bioenergetics and Biomimetics Systems. Copyright © 2012 Elsevier B.V. All rights reserved.

Average Skin-Friction Drag Coefficients from Tank Tests of a Parabolic Body of Revolution (NACA RM-10)

NASA Technical Reports Server (NTRS)

Mottard, Elmo J; Loposer, J Dan

1954-01-01

Average skin-friction drag coefficients were obtained from boundary-layer total-pressure measurements on a parabolic body of revolution (NACA rm-10, basic fineness ratio 15) in water at Reynolds numbers from 4.4 x 10(6) to 70 x 10(6). The tests were made in the Langley tank no. 1 with the body sting-mounted at a depth of two maximum body diameters. The arithmetic mean of three drag measurements taken around the body was in good agreement with flat-plate results, but, apparently because of the slight surface wave caused by the body, the distribution of the boundary layer around the body was not uniform over part of the Reynolds number range.

Data on the sensory evaluation of potatoes (Solanum tuberosum) from different areas of Hokkaido, Japan, performed by untrained young adults.

PubMed

Sato, Hiroaki; Koizumi, Ryosuke; Nakazawa, Yozo; Yamazaki, Masao; Itoyama, Ryuichi; Ichisawa, Megumi; Negishi, Junko; Sakuma, Rui; Furusho, Tadasu; Sagane, Yoshimasa; Takano, Katsumi

2017-12-01

This data article describes a sensory evaluation of potatoes used in food processing from the Tokachi, Kamikawa, and Abashiri geographic areas of Hokkaido, Japan, performed by untrained young adults. We gathered sensory data on potatoes from the four cultivars 'Toyoshiro,' 'Kitahime,' 'Snowden,' and 'Poroshiri.' The sensory evaluation was performed on steamed potatoes from each cultivar; these potatoes were harvested from each of the three geographic areas. Table 1 provides the data from the evaluation of the five basic tastes (sweet, salty, sour, bitter, and umami), as well as the evaluation of the egumi taste, which is a Japanese term indicating a taste that is acrid, astringent, and slightly bitter.

Efficacy of clobetasol spray: factors beyond patient compliance.

PubMed

Bhutani, Tina; Koo, John; Maibach, Howard I

2012-02-01

Clobetasol 0.05% spray, a topical clobetasol propionate, is a non-greasy formulation that has shown increased clinical efficacy in a head-to-head comparison with foam formulation. Moreover, available data from randomized, controlled, double-blind trials suggests that clobetasol spray is, in fact, slightly more effective than most, if not all, other preparations of clobetasol. The fact that clobetasol spray is exceptionally easy to comply with may have played a major role in this outcome; however, other factors must be considered. These include vehicle metamorphosis post-application as well as vehicle and excipient effects on stratum corneum permeability. Basic concepts in topical drug delivery and how they apply to this spray vehicle may further explain the greater efficacy of clobetasol spray.

On the Mass Distribution of Animal Species

NASA Astrophysics Data System (ADS)

Redner, Sidney; Clauset, Aaron; Schwab, David

2009-03-01

We develop a simple diffusion-reaction model to account for the broad and asymmetric distribution of adult body masses for species within related taxonomic groups. The model assumes three basic evolutionary features that control body mass: (i) a fixed lower limit that is set by metabolic constraints, (ii) a species extinction risk that is a weakly increasing function of body mass, and (iii) cladogenetic diffusion, in which daughter species have a slight tendency toward larger mass. The steady-state solution for the distribution of species masses in this model can be expressed in terms of the Airy function. This solution gives mass distributions that are in good agreement with data on 4002 terrestrial mammal species from the late Quaternary and 8617 extant bird species.

A Reference Database of Cartilage 3 Tesla MRI T2 Values in Knees without Diagnostic Evidence of Cartilage Degeneration: Data from the Osteoarthritis Initiative

PubMed Central

Joseph, Gabby B.; McCulloch, Charles E.; Nevitt, Michael C.; Heilmeier, Ursula; Nardo, Lorenzo; Lynch, John A.; Liu, Felix; Baum, Thomas; Link, Thomas M.

2015-01-01

Objective The purpose of this study was 1) to establish a gender- and BMI-specific reference database of cartilage T2 values, and 2) to assess the associations between cartilage T2 values and gender, age, and BMI in knees without radiographic osteoarthritis or MRI-based (WORMS 0/1) evidence of cartilage degeneration. Design 481 subjects between the ages of 45-65 years with Kellgren-Lawrence Scores 0/1 in the study knee were selected from the Osteoarthritis Initiative database. Baseline morphologic cartilage 3T MRI readings (WORMS scoring) and T2 measurements (resolution=0.313mmx0.446mm) were performed in the medial femur, lateral femur, medial tibia, lateral tibia, and patella compartments. In order to create a reference database, a logarithmic transformation was applied to the data to obtain the 5th-95th percentile values for T2. Results Significant differences in mean cartilage T2 values were observed between joint compartments. Although females had slightly higher T2 values than males in a majority of compartments, the differences were only significant in the medial femur (p<0.0001). A weak positive association was seen between age and T2 in all compartments, and was most pronounced in the patella (3.27% increase in median T2/10 years, p=0.009). Significant associations between BMI and T2 were observed, and were most pronounced in the lateral tibia (5.33% increase in median T2/5 kg/m2 increase in BMI, p<0.0001), and medial tibia (4.81% increase in median T2 /5 kg/m2 increase in BMI, p<0.0001). Conclusions This study established the first reference database of T2 values in a large sample of morphologically normal cartilage plates in knees without radiographic knee osteoarthritis. While cartilage T2 values were weakly associated with age and gender, they had the highest correlations with BMI. PMID:25680652

Coated and uncoated self-expanding metal stents for malignant stenosis in the upper GI tract: preliminary clinical experiences with Wallstents.

PubMed

Ell, C; Hochberger, J; May, A; Fleig, W E; Hahn, E G

1994-09-01

The clinical feasibility of self-expanding metal stents with respect to the technical success, complications, and reintervention rate should be tested. Five coated and 26 uncoated prototype Wallstents, especially designed for stenosis of the upper GI tract, were implanted in 23 patients. All patients with dysphagia suffered from inoperable tumor stenosis of the esophagus or the cardia. Stent implantation was performed under slight i.v. sedoanalgesia. Technical success was achieved in all 31 implanted stents. Forty-eight hr after implantation, dysphagia was improved in 21/23 patients. Acute problems observed within 1 wk were stent migration (1 patient, uncoated stent), oblique position of the stent (3 patients), epigastric or retrosternal pain (9 patients), insufficient stent expansion (4 patients), and pouch formation at the upper rim of the stent (4 patients). An uncomplicated follow-up (median 66 days, range 10-139 days) was seen in 12 patients (52%). Major problems in the follow-up period were stent migration in three patients (three coated stents, two stent migrations in one patient) and stent obstruction by tumor ingrowth/overgrowth and/or food impaction in eight patients (35%). Most of these problems could be successfully resolved by implantation of a second stent or electrocoagulation of overgrowing tumor tissue. By the 1st of March, 1994, three patients were still alive with a follow-up period of 530 days (median range, 336-880 days); 20 patients were decreased with a follow-up period of 70 days (median range, 3-374 days). Implantation of esophageal Wallstents is safe and has a low risk of acute complications and mortality for the patient. Early complications such as perforation and bleeding did not occur. Tumor ingrowth/overgrowth are the major reasons for the high reintervention rate in the follow-up period. Coated stents can resolve this problem, provided that stent migration can be avoided by improvement of the coating technology.

The distribution of blood eosinophil levels in a Japanese COPD clinical trial database and in the rest of the world.

PubMed

Barnes, Neil; Ishii, Takeo; Hizawa, Nobuyuki; Midwinter, Dawn; James, Mark; Hilton, Emma; Jones, Paul W

2018-01-01

Blood eosinophil measurements may help to guide physicians on the use of inhaled corticosteroids (ICS) for patients with chronic obstructive pulmonary disease (COPD). Emerging data suggest that COPD patients with higher blood eosinophil counts may be at higher risk of exacerbations and more likely to benefit from combined ICS/long-acting beta 2 -agonist (LABA) treatment than therapy with a LABA alone. This analysis describes the distribution of blood eosinophil count at baseline in Japanese COPD patients in comparison with non-Japanese COPD patients. A post hoc analysis of eosinophil distribution by percentage and absolute cell count was performed across 12 Phase II-IV COPD clinical studies (seven Japanese studies [N=848 available absolute eosinophil counts] and five global studies [N=5,397 available eosinophil counts] that included 246 Japanese patients resident in Japan with available counts). Blood eosinophil distributions were assessed at baseline, before blinded treatment assignment. Among Japanese patients, the median (interquartile range) absolute eosinophil count was 170 cells/mm 3 (100-280 cells/mm 3 ). Overall, 612/1,094 Japanese patients (56%) had an absolute eosinophil count ≥150 cells/mm 3 and 902/1,304 Japanese patients (69%) had a percentage eosinophil ≥2%. Among non-Japanese patients, these values were 160 (100-250) cells/mm 3 , 2,842/5,151 patients (55%), and 2,937/5,155 patients (57%), respectively. The eosinophil distribution among Japanese patients was similar to that among non-Japanese patients. Within multi-country studies with similar inclusion criteria, the eosinophil count was numerically lower in Japanese compared with non-Japanese patients (median 120 vs 160 cells/mm 3 ). The eosinophil distribution in Japanese patients seems comparable to that of non-Japanese patients; although within multi-country studies, there was a slightly lower median eosinophil count for Japanese patients compared with non-Japanese patients. These findings suggest that blood eosinophil data from global studies are of relevance in Japan.

HER2 mutations in lung adenocarcinomas: A report from the Lung Cancer Mutation Consortium.

PubMed

Pillai, Rathi N; Behera, Madhusmita; Berry, Lynne D; Rossi, Mike R; Kris, Mark G; Johnson, Bruce E; Bunn, Paul A; Ramalingam, Suresh S; Khuri, Fadlo R

2017-11-01

Human epidermal growth factor receptor 2 (HER2) mutations have been reported in lung adenocarcinomas. Herein, the authors describe the prevalence, clinical features, and outcomes associated with HER2 mutations in 1007 patients in the Lung Cancer Mutation Consortium (LCMC). Patients with advanced-stage lung adenocarcinomas were enrolled to the LCMC. Tumor specimens were assessed for diagnosis and adequacy; multiplexed genotyping was performed in Clinical Laboratory Improvement Amendments (CLIA)-certified laboratories to examine 10 oncogenic drivers. The LCMC database was queried for patients with HER2 mutations to access demographic data, treatment history, and vital status. An exploratory analysis was performed to evaluate the survival of patients with HER2 mutations who were treated with HER2-directed therapies. A total of 920 patients were tested for HER2 mutations; 24 patients (3%) harbored exon 20 insertion mutations (95% confidence interval, 2%-4%). One patient had a concurrent mesenchymal-epithelial transition factor (MET) amplification. The median age of the patients was 62 years, with a slight predominance of females over males (14 females vs 10 males). The majority of the patients were never-smokers (71%) and presented with advanced disease at the time of diagnosis. The median survival for patients who received HER2-targeted therapies (12 patients) was 2.1 years compared with 1.4 years for those who did not (12 patients) (P = .48). Patients with HER2 mutations were found to have inferior survival compared with the rest of the LCMC cohort with other mutations: the median survival was 3.5 years in the LCMC population receiving targeted therapy and 2.4 years for patients not receiving targeted therapy. HER2 mutations were detected in 3% of patients with lung adenocarcinoma in the LCMC. HER2-directed therapies should be investigated in this subgroup of patients. Cancer 2017;123:4099-4105. © 2017 American Cancer Society. © 2017 American Cancer Society.

Contralateral suppression of aldosterone at adrenal venous sampling predicts hyperkalemia following adrenalectomy for primary aldosteronism.

PubMed

Shariq, Omair A; Bancos, Irina; Cronin, Patricia A; Farley, David R; Richards, Melanie L; Thompson, Geoffrey B; Young, William F; McKenzie, Travis J

2018-01-01

We aimed to determine whether a greater degree of contralateral suppression of aldosterone secretion at adrenal venous sampling predicted the development of postoperative hyperkalemia after unilateral adrenalectomy for primary aldosteronism. A retrospective analysis of patients undergoing unilateral adrenalectomy for primary aldosteronism between 2004-2015 was performed. Clinical and biochemical parameters of patients who developed hyperkalemia (≥5.2 mmol/L) after unilateral adreanlectomy were compared with those who remained normokalemic. The contralateral suppression index was defined as the aldosterone-to-cortisol ratio from the nondominant adrenal vein divided by the aldosterone-to-cortisol ratio from the external iliac vein. Of 192 patients who met criteria for inclusion, 12 (6.3%) developed hyperkalemia (median serum potassium 5.5 mmol/L, range 5.2-6.2 mmol/L), with a median time to onset of 13.5 days (range 7-55 days). Five patients had transiently increased serum potassium concentrations that normalized spontaneously. Four patients received mineralocorticoid replacement therapy with fludrocortisone. On univariate analysis, hyperkalemic patients had slightly greater preoperative serum creatinine levels (1.2 vs 1.0 mg/dL, P = .01), higher postoperative creatinine (1.3 vs 1.0 mg/dL, P = .02), lesser median contralateral suppression index (0.14 vs 0.27, P = .03), and larger adenomas (1.9 vs 1.4 cm, P = .02). On multivariable logistic regression, the contralateral suppression index remained the only significant predictor of postoperative hyperkalemia (P = .04) with an optimal cut-off of <0.47. Hyperkalemia after unilateral adrenalectomy for primary aldosteronism is uncommon and usually transient, but may require mineralocorticoid supplementation. Patients with a contralateral suppression index of <0.47 require meticulous follow-up and monitoring of serum potassium concentrations after unilateral adrenalectomy. Copyright © 2017 Elsevier Inc. All rights reserved.

Recurrence and death from breast cancer after complete treatments: an experience from hospitals in Northern Thailand.

PubMed

Chairat, Rungnapa; Puttisri, Adisom; Pamarapa, Asani; Wongrach, Nongnoot; Tawichasri, Chamaiporn; Patumanond, Jayanton; Tantraworasin, Apichat; Charoentum, Chaiyut

2014-09-01

To describe the pattern of disease progression and to describe locoregional recurrence, distant recurrence, and death rates in breast cancer patients after complete treatment. Medical records of women diagnosed with breast cancer at two university affiliated tertiary care hospitals in the Northern Thailand that had complete treatments between 2006 and 2010 were traced. Extracted key information included patient clinical profiles and documented recurrence of cancer The causes of death were verified from breast cancer case registration database, death certificates through The Ministry of Internal Affairs'civil registration, by direct telephone contact, or by distributed prepaid postcards. Medical records of 829 women diagnosed with breast cancer without prior evidence ofdistant metastasis, and had complete recommended treatment were included. Six hundred thirty seven women had not experienced any events up to the end of the follow-up (76.8%). The first occurring events were focused and categorized into three distinct types, locoregional recurrence (n = 83, median follow-up time = 34.2 months), distant recurrence (n = 78, median follow-up time = 35.4 months), and death without any evidences of locoregional or distant recurrences (n = 12, median follow-up time = 36.7 months). Distant recurrence after locoregional recurrence was reported (n = 33). There were 109 patient who had died (breast cancer related death) up to the end of the follow-up (13.2%). The three types of consecutively occurring deaths were death after locoregional recurrence without any distant recurrences (n = 15), death after distant recurrence with locoregional recurrence (n = 21), and death after documenited distant recurrence without any locoregional recurrences (n = 61). The trend was that the rate of the first occurring locoregional recurrence was slightly higher than that of distant recurrence, The death rate in patients without any recurrences was much lower than in those experiencing prior recurrences. The rates of disease progression from local recurrence to distant recurrence and to death were approximately 5 to 7 times faster in patients who had experienced earlierprogressions.

X-ray induced formation of γ-H2AX foci after full-field digital mammography and digital breast-tomosynthesis.

PubMed

Schwab, Siegfried A; Brand, Michael; Schlude, Ina-Kristin; Wuest, Wolfgang; Meier-Meitinger, Martina; Distel, Luitpold; Schulz-Wendtland, Ruediger; Uder, Michael; Kuefner, Michael A

2013-01-01

To determine in-vivo formation of x-ray induced γ-H2AX foci in systemic blood lymphocytes of patients undergoing full-field digital mammography (FFDM) and to estimate foci after FFDM and digital breast-tomosynthesis (DBT) using a biological phantom model. The study complies with the Declaration of Helsinki and was performed following approval by the ethic committee of the University of Erlangen-Nuremberg. Written informed consent was obtained from every patient. For in-vivo tests, systemic blood lymphocytes were obtained from 20 patients before and after FFDM. In order to compare in-vivo post-exposure with pre-exposure foci levels, the Wilcoxon matched pairs test was used. For in-vitro experiments, isolated blood lymphocytes from healthy volunteers were irradiated at skin and glandular level of a porcine breast using FFDM and DBT. Cells were stained against the phosphorylated histone variant γ-H2AX, and foci representing distinct DNA damages were quantified. Median in-vivo foci level/cell was 0.086 (range 0.067-0.116) before and 0.094 (0.076-0.126) after FFDM (p = 0.0004). In the in-vitro model, the median x-ray induced foci level/cell after FFDM was 0.120 (range 0.086-0.140) at skin level and 0.035 (range 0.030-0.050) at glandular level. After DBT, the median x-ray induced foci level/cell was 0.061 (range 0.040-0.081) at skin level and 0.015 (range 0.006-0.020) at glandular level. In patients, mammography induces a slight but significant increase of γ-H2AX foci in systemic blood lymphocytes. The introduced biological phantom model is suitable for the estimation of x-ray induced DNA damages in breast tissue in different breast imaging techniques.

A project to unveil the population of Low-Mass Star-Forming Galaxies of the Universe

NASA Astrophysics Data System (ADS)

Gallego, Jesus; Rodriguez-Muñoz, Lucía; Tresse, Laurence; Pacifici, Camilla; Charlot, Stéphane; Gil de Paz, Armando; Gomez-Guijarro, Carlos; Villar, Víctor; Barro, Guillermo

2015-08-01

Dwarf galaxies play a key role in galaxy formation and evolution: (1) hierarchical models predict that low-mass systems merged to form massive galaxies (building block paradigm; Dekel & Silk 1986); (2) dwarf systems might have been responsible for the reionization of the Universe (Wyithe & Loeb 2006); (3) theoretical models are particularly sensitive to the density of low-mass systems at diferent redshifts (Mamon et al. 2011), being one of the key science cases for the future E-ELT (Evans et al. 2013). While the history of low-mass dark matter halos is relatively well understood, the formation history of dwarf galaxies is still poorly reproduced by the models due to the distinct evolution of baryonic and dark matter.We present constraints on the star formation histories (SFHs) of a sample of low-mass Star-Forming Galaxies (LMSFGs; 7.3 < log M∗/Mo < 8.0, at 0.3 < zspec < 0.9) selected by photometric stellar mass and apparent magnitude. The SFHs were obtained through the analysis of their spectral energy distributions using a novel approach (Pacifici et al. 2012) that (1) consistently combines photometric (HST and ground-based multi-broadband) and spectroscopic (equivalent widths of emission lines from VLT and GTC spectroscopy) data, and (2) uses physically motivated SFHs with non-uniform variations of the star formation rate (SFR) as a function of time.The median SFH of our LMSFGs appears to form 90% of the median stellar mass inferred for the sample in the ˜0.5-1.8 Gyr immediately preceding the observation. These results suggest a recent stellar mass assembly for dwarf SFGs, consistent with the cosmological downsizing trends. We find similar median SFH timescales for a slightly more massive secondary sample 8.0 < log M∗/Mo < 9.1).This is a pilot study for future surveys on dwarf galaxies at high redshift.

On the formation redshift of Low-Mass Star-Forming Galaxies at intermediate redshifts

NASA Astrophysics Data System (ADS)

Gallego, Jesus; Rodriguez-Muñoz, Lucía; Pacifici, Camilla; Tresse, Laurence; Charlot, Stéphane; Gil de Paz, Armando; Barro, Guillermo; Gomez-Guijarro, Carlos; Villar, Víctor

2015-08-01

Dwarf galaxies play a key role in galaxy formation and evolution: (1) hierarchical models predict that low-mass systems merged to form massive galaxies (building block paradigm; Dekel & Silk 1986); (2) dwarf systems might have been responsible for the reionization of the Universe (Wyithe & Loeb 2006); (3) theoretical models are particularly sensitive to the density of low-mass systems at diferent redshifts (Mamon et al. 2011), being one of the key science cases for the future E-ELT (Evans et al. 2013). While the history of low-mass dark matter halos is relatively well understood, the formation history of dwarf galaxies is still poorly reproduced by the models due to the distinct evolution of baryonic and dark matter.We present constraints on the star formation histories (SFHs) of a sample of low-mass Star-Forming Galaxies (LMSFGs; 7.3 < log M∗/Mo < 8.0, at 0.3 < zspec < 0.9) selected by photometric stellar mass and apparent magnitude. The SFHs were obtained through the analysis of their spectral energy distributions using a novel approach (Pacifici et al. 2012) that (1) consistently combines photometric (HST and ground-based multi-broadband) and spectroscopic (equivalent widths of emission lines from VLT and GTC spectroscopy) data, and (2) uses physically motivated SFHs with non-uniform variations of the star formation rate (SFR) as a function of time.The median SFH of our LMSFGs appears to form 90% of the median stellar mass inferred for the sample in the ˜0.5-1.8 Gyr immediately preceding the observation. These results suggest a recent stellar mass assembly for dwarf SFGs, consistent with the cosmological downsizing trends. We find similar median SFH timescales for a slightly more massive secondary sample 8.0 < log M∗/Mo < 9.1).This is a pilot study for future surveys on dwarf galaxies at high redshift.

Optic Nerve Tilt, Crescent, Ovality, and Torsion in a Multi-Ethnic Cohort of Young Adults With and Without Myopia

PubMed Central

Marsh-Tootle, Wendy L.; Harb, Elise; Hou, Wei; Zhang, Qinghua; Anderson, Heather A.; Weise, Katherine; Norton, Thomas T.; Gwiazda, Jane; Hyman, Leslie

2017-01-01

Purpose The purpose of this article is to evaluate optic nerve head (ONH) characteristics in an ethnically diverse cohort of young U.S. adults. Methods In this study, 409 myopes and 206 nonmyopes (median age 22 years) completed measures including biometry and spectral domain optical coherence tomography from enface (ovality and torsion) and cross-sectional (tilt and crescent width) scans. Associated factors were evaluated using multivariable models. Results In myopic versus nonmyopic right eyes, median tilt (6.0° vs. 2.4°; P < 0.0001) and frequency of crescents (49% vs. 10%; P < 0.0001) were higher in myopes. Right eyes with crescents had higher median tilts (8.8° [myopic], 9.0° [nonmyopic]) than those without crescent (2.5° [myopic], 2.1° [nonmyopic]), irrespective of refractive group (both P < 0.0001). Torsion was similar between groups, with a slight difference in ovality (0.89 vs. 0.91; P < 0.03). Data in the left eyes were similar, and modeling was done only for the right myopic eyes. Multivariable models showed that an increased tilt was associated with ethnicity (P < 0.001), the presence of crescent (P < 0.001), and smaller ONH diameter (P < 0.0031), with interactions between ethnicity and crescent (P = 0.002). Specifically, ONH tilt was significantly higher in Asian eyes without crescent (P < 0.0001 for all comparisons), and crescent width was associated with increased tilt in non-Asian eyes (P < 0.02). Crescent width was associated with ethnicity (greatest in Asians) and disc tilt. Interactions were observed between tilt and ethnicity, whereby tilt had a greater effect on crescent width in non-Asian eyes, and crescent width was associated with increased tilt in non-Asian eyes. Conclusions The data clarify the influence of ethnicity and myopia on ONH characteristics in young adults and may inform future studies of biomechanical properties or of retinal pathology of the myopic eye. PMID:28654981

Effect of treatment on titer, function, and antigen recognition of serum antibodies to Actinobacillus actinomycetemcomitans in patients with rapidly progressive periodontitis.

PubMed Central

Sjöström, K; Ou, J; Whitney, C; Johnson, B; Darveau, R; Engel, D; Page, R C

1994-01-01

Although periodontal treatment by scaling and root planing (SCRP) is known to induce bacteremia, the effect of this procedure on the host immune response is not known. We have determined pre- and post-SCRP immunoglobulin G antibody titers to antigens of Actinobacillus actinomycetemcomitans in the sera of 22 patients with rapidly progressive periodontitis. We also assessed the ability of these sera to enhance phagocytosis and killing of A. actinomycetemcomitans by human polymorphonuclear leukocytes by using a polymorphonuclear leukocyte chemiluminescence (CL) assay. Specific anti-A. actinomycetemcomitans antibody titers were significantly increased at 6 and 12 months after beginning treatment, and CL values were significantly increased at 12 months, whereas mean interproximal pocket depths were significantly decreased at 12 months after beginning treatment. When patients were classified as either seropositive (twice the median titer of control subjects; n = 10) or seronegative (n = 12), both median titers and CL values were significantly increased for the seronegative group at 6 and 12 months after treatment. In the seropositive group, only the median titer was significantly increased at 12 months. Western blot (immunoblot) patterns for six seronegative and six seropositive patients differed remarkably at the baseline. Before treatment, all of the seropositive patients recognized high-molecular-mass lipopolysaccharide (LPS) and a large number of protein components. Patterns were virtually unaffected by therapy. Before treatment, only one of the seronegative patients recognized the LPS smear and none reacted strongly with protein components. Following treatment, slight LPS staining was observed for five of six seronegative patients and detection of protein bands was enhanced in all cases. We conclude that treatment by SCRP induces a humoral immune response, especially in seronegative patients, and that response may play a role in the observed beneficial effects of periodontal treatment. Images PMID:8262620

The results of low-speed wind tunnel tests to investigate the effects of the NASA refan JT8D engine nacelles on the stability and control characteristics of the Boeing 727-200

NASA Technical Reports Server (NTRS)

Shirkey, M. D.

1973-01-01

The results from two low-speed wind tunnel tests of the Boeing 727-200 airplane as configured with the NASA refan JT8D-109 turbofan engines are presented. The objective of these tests was to determine the effects of the refan installation on the low-speed stability and control characteristics of the 727 airplane. Four side nacelle locations were tested to insure that aerodynamic interactions of the nacelles and empennage would be optimized. The optimum location was judged to be the same as that of the production JT8D-9 engines; the current production engine mounts can be used for this location. Some small changes in the basic airplane characteristics are attributable to the refan nacelles. The flaps up longitudinal and lateral-directional stability are both slightly increased for low angles of attack and sideslip respectively. The longitudinal stability at stall is improved for both the flaps up and landing flap configurations. The high attitude characteristics of the basic airplane are not significantly altered by the refan nacelle installation. Directional control capability is not affected by the refan nacelles.

Dynamic chest radiography: flat-panel detector (FPD) based functional X-ray imaging.

PubMed

Tanaka, Rie

2016-07-01

Dynamic chest radiography is a flat-panel detector (FPD)-based functional X-ray imaging, which is performed as an additional examination in chest radiography. The large field of view (FOV) of FPDs permits real-time observation of the entire lungs and simultaneous right-and-left evaluation of diaphragm kinetics. Most importantly, dynamic chest radiography provides pulmonary ventilation and circulation findings as slight changes in pixel value even without the use of contrast media; the interpretation is challenging and crucial for a better understanding of pulmonary function. The basic concept was proposed in the 1980s; however, it was not realized until the 2010s because of technical limitations. Dynamic FPDs and advanced digital image processing played a key role for clinical application of dynamic chest radiography. Pulmonary ventilation and circulation can be quantified and visualized for the diagnosis of pulmonary diseases. Dynamic chest radiography can be deployed as a simple and rapid means of functional imaging in both routine and emergency medicine. Here, we focus on the evaluation of pulmonary ventilation and circulation. This review article describes the basic mechanism of imaging findings according to pulmonary/circulation physiology, followed by imaging procedures, analysis method, and diagnostic performance of dynamic chest radiography.

Charactering lidar optical subsystem using four quadrants method

NASA Astrophysics Data System (ADS)

Tian, Xiaomin; Liu, Dong; Xu, Jiwei; Wang, Zhenzhu; Wang, Bangxin; Wu, Decheng; Zhong, Zhiqing; Xie, Chenbo; Wang, Yingjian

2018-02-01

Lidar is a kind of active optical remote sensing instruments , can be applied to sound atmosphere with a high spatial and temporal resolution. Many parameter of atmosphere can be get by using different inverse algorithm with lidar backscatter signal. The basic setup of a lidar consist of a transmitter and a receiver. To make sure the quality of lidar signal data, the lidar must be calibrated before being used to measure the atmospheric variables. It is really significant to character and analyze lidar optical subsystem because a well equiped lidar optical subsystem contributes to high quality lidar signal data. we pay close attention to telecover test to character and analyze lidar optical subsystem.The telecover test is called four quadrants method consisting in dividing the telescope aperture in four quarants. when a lidar is well configured with lidar optical subsystem, the normalized signal from four qudrants will agree with each other on some level. Testing our WARL-II lidar by four quadrants method ,we find the signals of the four basically consistent with each other both in near range and in far range. But in detail, the signals in near range have some slight distinctions resulting from overlap function, some signals distinctions are induced by atmospheric instability.

Self-assembled multilayers and photoluminescence properties of a new water-soluble poly(para-phenylene)

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

Shi, X.; Li, D.; Luett, M.

1998-07-01

This paper reports the synthesis and characterizations of a new water-soluble poly(paraphenylene) (PPP) and its applications in preparing self-assembled multi-layer films. This new water-soluble conducting polymer was prepared through the sulfonation reaction of poly(p-quarterphenylene-2,2{prime}-dicarboxylic acid). The incorporation of sulfonate groups has dramatically improved PPP's solubility in water at a wide pH range, whereas previous PPP is only slightly soluble in basic solutions. Dilute aqueous solutions of this polymer with acidic, neutral or basic pH emit brilliant blue light while irradiated with UV light. The sulfonated PPP emits from 350 nm to 455 nm with a maximum intensity at 380 nm.more » Self-assembled multilayers of this sulfonated PPP were constructed with a positively charged polymer poly(diallyl dimethyl ammonium chloride) and characterized with various surface analyses. Conductive (RuO{sub 2} and ITO), semiconductive (Si wafer), and non-conductive (SiO{sub 2}) substrates were used in the preparation of self-assembled multilayers. Electrical, optical and structural properties of these novel self-assembled thin films will be discussed.« less

Self-assembled multilayers and photoluminescence properties of a new water-soluble poly(para-phenylene)

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

Shi, X.; Li, D.Q.; Luett, M.

1998-03-01

This paper reports the synthesis and characterizations of a new water-soluble poly(para-phenylene) (PPP) and its applications in preparing self-assembled multilayer films. This new water-soluble conducting polymer was prepared through the sulfonation reaction of poly(p-quarterphenylene-2,2{prime}-dicarboxylic acid). The incorporation of sulfonate groups has dramatically improved PPP`s solubility in water at a wide pH range, whereas previous PPP is only slightly soluble in basic solutions. Dilute aqueous solutions of this polymer with acidic, neutral or basic pH emit brilliant blue light while irradiated with UV light. The sulfonated PPP emits from 350 nm to 455 nm with a maximum intensity at 380 nm.more » Self-assembled multilayers of this sulfonated PPP were constructed with a positively charged polymer poly(diallyl dimethyl ammonium chloride) and characterized with various surface analyses. Conductive (RuO{sub 2} and ITO), semiconductive (Si wafer), and non-conductive (SiO{sub 2}) substrates were used in the preparation of self-assembled multilayers. Electrical, optical and structural properties of these novel self-assembled thin films will be discussed.« less

Kinematic analysis of basic rhythmic movements of hip-hop dance: motion characteristics common to expert dancers.

PubMed

Sato, Nahoko; Nunome, Hiroyuki; Ikegami, Yasuo

2015-02-01

In hip-hop dance contests, a procedure for evaluating performances has not been clearly defined, and objective criteria for evaluation are necessary. It is assumed that most hip-hop dance techniques have common motion characteristics by which judges determine the dancer's skill level. This study aimed to extract motion characteristics that may be linked to higher evaluations by judges. Ten expert and 12 nonexpert dancers performed basic rhythmic movements at a rate of 100 beats per minute. Their movements were captured using a motion capture system, and eight judges evaluated the performances. Four kinematic parameters, including the amplitude of the body motions and the phase delay, which indicates the phase difference between two joint angles, were calculated. The two groups showed no significant differences in terms of the amplitudes of the body motions. In contrast, the phase delay between the head motion and the other body parts' motions of expert dancers who received higher scores from the judges, which was approximately a quarter cycle, produced a loop-shaped motion of the head. It is suggested that this slight phase delay was related to the judges' evaluations and that these findings may help in constructing an objective evaluation system.

A Piezoelectric Micromotor with a Stator of φ=1.6 mm and l=4 mm Using Bulk PZT

NASA Astrophysics Data System (ADS)

Cagatay, Serra; Koc, Burhanettin; Moses, Paul; Uchino, Kenji

2004-04-01

The smallest discrete piezoelectric ultrasonic motor using bulk ceramics was developed. We are proposing basically a two-part motor: stator and rotor. The stator of the present motor consists of a hollow metal brass tube with outer diameter of 1.6 mm, inner diameter of 0.8 mm and length of only 4 mm with 2 PZT plates bonded onto it. Owing to the asymmetrical stator surface, two degenerated orthogonal bending modes were slightly split, resulting in a wobbling motion. Thus, the motor can be driven by a single driving source. The rotor is a spring, which is basically different from previous designs, pressed at both ends to the stator by a pair of ferrules. Consequently, the length of the whole motor assembly was reduced significantly; a final motor length of only 5 mm was obtained. The working frequency under zero load was approximately 227-233 kHz. Although the size is small, relatively high power was obtained under an optimized load condition: torque of 0.06 mNm, maximum power of 3.2 mW with a speed of 118 rad/s, and maximum efficiency of 11% under 48 Vrms at 221 kHz.

PAN AIR application to the F-106B

NASA Technical Reports Server (NTRS)

Ghaffari, F.

1986-01-01

The PAN AIR computer code was employed in the present study to investigate the aerodynamic effects of the various geometrical changes and flow conditions on a configuration similar to the F-106B half-airplane tested in the Langley 30x60-foot wind tunnel. The various geometries studied included two forebodies (original and shortened), two inlet flow conditions (open and closed) two vortex flap situations (off and on). The attached flow theoretical solutions were obtained for Mach number of 0.08 and angle of attack of 8 deg., 10 deg., 12 deg., and 14 deg. In general this investigation revealed that the shortening of the forebody or closing of the inlet produced only a small change in the overall aerodynamic coefficients of the basic F-106B configuration throughout the examined angles of attack. However, closing the inlet of the configuration resulted in a slightly higher drag level at low angles of attack. Furthermore, at and above 10 deg. angle of attack, it was shown that the presence of the vortex flap causes an increase in the total lift and drag. Also, these theoretical results showed the expected reduction in longitudinal stability level with addition of the vortex flap to the basic F-106B configuration.

The bead on a rotating hoop revisited: an unexpected resonance

NASA Astrophysics Data System (ADS)

Raviola, Lisandro A.; Véliz, Maximiliano E.; Salomone, Horacio D.; Olivieri, Néstor A.; Rodríguez, Eduardo E.

2017-01-01

The bead on a rotating hoop is a typical problem in mechanics, frequently posed to junior science and engineering students in basic physics courses. Although this system has a rich dynamics, it is usually not analysed beyond the point particle approximation in undergraduate textbooks, nor empirically investigated. Advanced textbooks show the existence of bifurcations owing to the system's nonlinear nature, and some papers demonstrate, from a theoretical standpoint, its points of contact with phase transition phenomena. However, scarce experimental research has been conducted to better understand its behaviour. We show in this paper that a minor modification to the problem leads to appealing consequences that can be studied both theoretically and empirically with the basic conceptual tools and experimental skills available to junior students. In particular, we go beyond the point particle approximation by treating the bead as a rigid spherical body, and explore the effect of a slightly non-vertical hoop's rotation axis that gives rise to a resonant behaviour not considered in previous works. This study can be accomplished by means of digital video and open source software. The experience can motivate an engaging laboratory project by integrating standard curriculum topics, data analysis and experimental exploration.

Red and orange laser operation of Pr:KYF4 pumped by a Nd:YAG/LBO laser at 469.1 nm and a InGaN laser diode at 444 nm.

PubMed

Xu, B; Starecki, F; Pabœuf, D; Camy, P; Doualan, J L; Cai, Z P; Braud, A; Moncorgé, R; Goldner, Ph; Bretenaker, F

2013-03-11

We report the basic luminescence properties and the continuous-wave (CW) laser operation of a Pr(3+)-doped KYF(4) single crystal in the Red and Orange spectral regions by using a new pumping scheme. The pump source is an especially developed, compact, slightly tunable and intra-cavity frequency-doubled diode-pumped Nd:YAG laser delivering a CW output power up to about 1.4 W around 469.1 nm. At this pump wavelength, red and orange laser emissions are obtained at about 642.3 and 605.5 nm, with maximum output powers of 11.3 and 1 mW and associated slope efficiencies of 9.3% and 3.4%, with respect to absorbed pump powers, respectively. For comparison, the Pr:KYF(4) crystal is also pumped by a InGaN blue laser diode operating around 444 nm. In this case, the same red and orange lasers are obtained, but with maximum output powers of 7.8 and 2 mW and the associated slope efficiencies of 7 and 5.8%, respectively. Wavelength tuning for the two lasers is demonstrated by slightly tilting the crystal. Orange laser operation and laser wavelength tuning are reported for the first time.

Basic imaging properties of an indirect flat-panel detector system employing irradiation side sampling (ISS) technology for chest radiography: comparison with a computed radiographic system.

PubMed

Tanaka, Nobukazu; Yano, Yuki; Yabuuchi, Hidetake; Akasaka, Tsutomu; Sasaki, Masayuki; Ohki, Masafumi; Morishita, Junji

2013-01-01

The image quality and potential usefulness for patient skin-dose reduction of a newly developed flat-panel detector (FPD) system employing irradiation side sampling (ISS) were investigated and compared to a conventional computed radiography (CR) system. We used the X-ray beam quality of RQA 9 as noted in the standard evaluation method by the International Electrotechnical Commission 62220-1 to evaluate the image quality of the detector for chest radiography. The presampled modulation transfer function (MTF) of the ISS-FPD system was slightly higher than that of the CR system in the horizontal direction at more than 2.2 cycles/mm. However, the presampled MTF of the ISS-FPD system was slightly lower than that of the CR system in the vertical direction. The Wiener spectrum of the ISS-FPD system showed a 50-65 % lesser noise level than that of the CR system under the same exposure condition. The detective quantum efficiency of the ISS-FPD system was at least twice as great as that of the CR system. We conclude that the ISS-FPD system has the potential to reduce the patient skin dose compared to a conventional CR system for chest radiography.

Keywords image retrieval in historical handwritten Arabic documents

NASA Astrophysics Data System (ADS)

Saabni, Raid; El-Sana, Jihad

2013-01-01

A system is presented for spotting and searching keywords in handwritten Arabic documents. A slightly modified dynamic time warping algorithm is used to measure similarities between words. Two sets of features are generated from the outer contour of the words/word-parts. The first set is based on the angles between nodes on the contour and the second set is based on the shape context features taken from the outer contour. To recognize a given word, the segmentation-free approach is partially adopted, i.e., continuous word parts are used as the basic alphabet, instead of individual characters or complete words. Additional strokes, such as dots and detached short segments, are classified and used in a postprocessing step to determine the final comparison decision. The search for a keyword is performed by the search for its word parts given in the correct order. The performance of the presented system was very encouraging in terms of efficiency and match rates. To evaluate the presented system its performance is compared to three different systems. Unfortunately, there are no publicly available standard datasets with ground truth for testing Arabic key word searching systems. Therefore, a private set of images partially taken from Juma'a Al-Majid Center in Dubai for evaluation is used, while using a slightly modified version of the IFN/ENIT database for training.

Application of GA-SVM method with parameter optimization for landslide development prediction

NASA Astrophysics Data System (ADS)

Li, X. Z.; Kong, J. M.

2013-10-01

Prediction of landslide development process is always a hot issue in landslide research. So far, many methods for landslide displacement series prediction have been proposed. Support vector machine (SVM) has been proved to be a novel algorithm with good performance. However, the performance strongly depends on the right selection of the parameters (C and γ) of SVM model. In this study, we presented an application of GA-SVM method with parameter optimization in landslide displacement rate prediction. We selected a typical large-scale landslide in some hydro - electrical engineering area of Southwest China as a case. On the basis of analyzing the basic characteristics and monitoring data of the landslide, a single-factor GA-SVM model and a multi-factor GA-SVM model of the landslide were built. Moreover, the models were compared with single-factor and multi-factor SVM models of the landslide. The results show that, the four models have high prediction accuracies, but the accuracies of GA-SVM models are slightly higher than those of SVM models and the accuracies of multi-factor models are slightly higher than those of single-factor models for the landslide prediction. The accuracy of the multi-factor GA-SVM models is the highest, with the smallest RSME of 0.0009 and the biggest RI of 0.9992.

[Strength, flexibility, balance, resistance and flexibility assessment according to body mass index in active older women].

PubMed

Vaquero-Cristóbal, Raquel; Martínez González-Moro, Ignacio; Alacid Cárceles, Fernando; Ros Simón, Esperanza

2013-01-01

Overweight and obesity are increasing at an alarming rate among older people. This is mainly because this population is predominantly sedentary. The aim of this study was to classify, according to the body mass index (BMI), a group of older active women and to evaluate the different basic physical abilities as a function of this. The BMI and fitness were evaluated in 60 elderly active women (mean age: 66.14 ± 6.59 years) using the 2-minute step test, arm curl test, chair stand test, back scratch test, chair-sit and reach-test, flamenco test, and 8-foot up-and-go test. It was found that 52.23% of the women studied had a normal BMI and 47.76% were slightly overweight. There were no cases of obesity or underweight. Women with normal BMI had better values in all tests than overweight women. Significant differences were found in the flamenco test (P<.05), and 8-foot up-and-go test (P<.01). Older women who usually do physical activity had a normal or slightly overweight BMI. It was also found that women with lower BMI have better resistance, flexibility, balance and strength. Copyright © 2012 SEGG. Published by Elsevier Espana. All rights reserved.

Effects of prenatal exposure to diesel exhaust particles on postnatal development, behavior, genotoxicity and inflammation in mice

PubMed Central

Hougaard, Karin S; Jensen, Keld A; Nordly, Pernille; Taxvig, Camilla; Vogel, Ulla; Saber, Anne T; Wallin, Håkan

2008-01-01

Background Results from epidemiological studies indicate that particulate air pollution constitutes a hazard for human health. Recent studies suggest that diesel exhaust possesses endocrine activity and therefore may affect reproductive outcome. This study in mice aimed to investigate whether exposure to diesel exhaust particles (DEP; NIST 2975) would affect gestation, postnatal development, activity, learning and memory, and biomarkers of transplacental toxicity. Pregnant mice (C57BL/6; BomTac) were exposed to 19 mg/m3 DEP (~1·106 particles/cm3; mass median diameter ≅ 240 nm) on gestational days 9–19, for 1 h/day. Results Gestational parameters were similar in control and diesel groups. Shortly after birth, body weights of DEP offspring were slightly lower than in controls. This difference increased during lactation, so by weaning the DEP exposed offspring weighed significantly less than the control progeny. Only slight effects of exposure were observed on cognitive function in female DEP offspring and on biomarkers of exposure to particles or genotoxic substances. Conclusion In utero exposure to DEP decreased weight gain during lactation. Cognitive function and levels of biomarkers of exposure to particles or to genotoxic substances were generally similar in exposed and control offspring. The particle size and chemical composition of the DEP and differences in exposure methods (fresh, whole exhaust versus aged, resuspended DEP) may play a significant role on the biological effects observed in this compared to other studies. PMID:18331653

Library instruction in medical education: a survey of current practices in the United States and Canada.

PubMed

Nevius, Amanda M; Ettien, A'Llyn; Link, Alissa P; Sobel, Laura Y

2018-01-01

The most recent survey on instruction practices in libraries affiliated with accredited medical institutions in the United States was conducted in 1996. The present study sought to update these data, while expanding to include Canadian libraries. Additional analysis was undertaken to test for statistically significant differences between library instruction in the United States and Canada and between libraries affiliated with highly ranked and unranked institutions. A twenty-eight-question survey was distributed to libraries affiliated with accredited US and Canadian medical schools to assess what and how often librarians teach, as well as how librarians are involved in the curriculum committee and if they are satisfied with their contact with students and faculty. Quantitative data were analyzed with SAS, R, and MedCalc. Most of the seventy-three responding libraries provided instruction, both asynchronously and synchronously. Library instruction was most likely to be offered in two years of medical school, with year one seeing the most activity. Database use was the most frequently taught topic, and libraries reported a median of five librarians providing instruction, with larger staffs offering slightly more education sessions per year. Libraries associated with highly ranked schools were slightly more likely to offer sessions that were integrated into the medical school curriculum in year four and to offer sessions in more years overall. In US and Canadian libraries, regardless of the rank of the affiliated medical school, librarians' provision of instruction in multiple formats on multiple topics is increasingly common.

Observations on a cucullanid nematode of marine fishes from Taiwan Strait, Dichelyne (Cucullanellus) jialaris n. sp.

PubMed

Luo, Damin; Guo, Shulin; Fang, Wenzhen; Huang, Heqin

2004-06-01

During a helminthological examination of marine fishes from south of the Minnan-Taiwan Bank Fishing Ground, Taiwan Strait, Fujian, China, a new cucullanid nematode, Dichelyne (Cucullanellus) jialaris n. sp., was removed from the intestine of the red seabream, Pagrus major (Temminck & Schlegel, 1834). The new species differs from its congeners mainly in the following characters: body size medium but with relative long spicules of 1.01 mm (0.97-1.06) in length or 20.0% (18.21-21.8%) of the body length; proximal end of spicules somewhat expanded and distal end rounded; gubernaculum I-shaped, slightly narrow in the middle part, both ends rounded; both anterior and posterior cloaca lips round or oval, prominent and unequal in size. The anterior cloaca lip is at least 2 times larger than the posterior one. There is a conspicuous papilliform structure within the central of anterior and posterior cloacal lip. Vulva of female is not prominent, slightly postequatorial; distance from vulva to anterior end of body is 4.3 (3.0-5.5) mm or 58.0% (54.0-62.0%) of the body length. Considering the result of comparing the structure of so-called unpaired median papilla with the 10 pairs of caudal petiolated papillae in the body of the same individual. the papilliform structures are just a backstop for the cloacal lips, this new species represents the first record of a nematode of the Dichelyne, subgenus Cucullanellus in marine fishes of China Sea.

Factors predicting recurrence of chronic subdural haematoma: the influence of intraoperative irrigation and low-molecular-weight heparin thromboprophylaxis.

PubMed

Tahsim-Oglou, Yasemin; Beseoglu, Kerim; Hänggi, Daniel; Stummer, Walter; Steiger, Hans-Jakob

2012-06-01

Burr-hole drainage has become the accepted treatment of choice for chronic subdural haematoma (cSDH), although still burdened with a major recurrence rate. The current analysis was initiated to determine management-related risk factors for recurrence, i.e. postoperative low-molecular-weight heparin thromboprophylaxis, and the importance of rinsing the subdural space. Two-hundred and forty-seven patients with computerised tomography (CT) defined symptomatic cSDH were managed by two burr-hole trepanations and drainage between January 2005 and November 2008. Postoperative thromboprophylaxis with 40 mg enoxaparine daily was given only during the first half of the study period. For the current analysis the amount of rinsing fluid, postoperative low-dose thromboprophylaxis, as well as age and gender, bilaterality, preoperative and postoperative blood coagulation studies, platelet counts and decrease of subdural fluid on early postoperative CT, were recorded and correlated with recurrence. Statistical calculation was done by univariate and multivariate analysis. A total of 62 of 247 patients needed revision surgery for recurrence (25.1 %). Recurrence rates were significantly lower in the patients treated without postoperative enoxaparine (18.84 %) than in the group with postoperative low-dose enoxaparine thromboprophylaxis (32.11 %) and enoxaparine was administered in a higher proportion of the patients suffering recurrence (P = 0.013). A median intraoperative irrigation volume of 863 ml saline was used in the patients suffering recurrence and 1,500 ml in patients without recurrence (P < 0.001). The median age was slightly higher in the patients suffering from recurrence. Male gender predominated in both groups but was slightly more pronounced in the recurrence group. Preoperative and postoperative platelet counts and plasmatic coagulation indices did not differ significantly between the groups. Relative residual subdural fluid collection on early postoperative CT remained larger in patients finally suffering recurrence (P = 0.03). Multivariate analysis confirmed a small amount of rinsing fluid, male gender and the use of enoxaparine as the most important risk factors for recurrence, although that latter factor did not reach statistical significance in the multivariate analysis. The investigation provides evidence that copious intraoperative irrigation and avoidance of postoperative low-molecular-weight heparin thromboprophylaxis may reduce the recurrence rate of cSDH.

Effects of Jefferson Road stormwater-detention basin on loads and concentrations of selected chemical constituents in East Branch of Allen Creek at Pittsford, Monroe County, New York

USGS Publications Warehouse

Sherwood, Donald A.

2004-01-01

Discharge and water-quality data collection at East Branch Allen Creek from 1990 through 2000 provide a basis for estimating the effect of the Jefferson Road detention basin on loads and concentrations of chemical constituents downstream from the basin. Mean monthly flow for the 5 years prior to construction of the detention basin (8.71 ft3/s) was slightly lower than after (9.08 ft3/s). The slightly higher mean monthly flow after basin construction may have been influenced by the peak flow for the period of record that occurred in July 1998 or variations in flow diverted from the canal. No statistically significant difference in average monthly mean flow before and after basin installation was indicated.Total phosphorus was the only constituent to show no months with significant differences in load after basin construction. Several constituents showed months with significantly smaller loads after basin construction than before, whereas some constituents showed certain months with smaller and some months with greater loads, after basin construction. Statistical analysis of the "mean monthly load" for all months before and all months after construction of the detention basin showed only one constituent (ammonia + organic nitrogen) with a significantly lower load after construction and none with higher loads.Median concentrations of ammonia + organic nitrogen showed a statistically significant decrease (from 0.78 mg/L to 0.60 mg/L) after basin installation, as did nitrite + nitrate (from 1.50 mg/L to 0.96 mg/L); in contrast, the median concentration of dissolved chloride increased from 95.5 mg/L before basin installation to 109 mg/L thereafter. A trend analysis of constituent concentrations before and after installation of the detention basin showed that total phosphorus had a downward trend after installation.Analysis of the data collected at East Branch Allen Creek indicates that the Jefferson Road detention basin, in some cases, provides an improvement (reduction) in loads of some constituents. These results are uncertain, however, because hydrologic conditions before basin installation differed from those in the 5 years that followed, and because inflow from the Erie-Barge canal may alter the water quality in the 1-mi reach between the basin outflow and the gaging station.

CHARACTERISTICS OF RANGE HOODS IN CALIFORNIA HOMES DATA COLLECTED FROM A REAL ESTATE WEB SITE

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

Klug, Victoria; Singer, Brett; Bedrosian, Tod

2011-09-02

Venting range hoods are important residential ventilation components that remove pollutants generated by cooking activities and natural gas cooking burners. To address the lack of data on range hood installations in California, we conducted a survey by examining photographs of homes for sale or rent listed on a popular real estate web site. The survey was conducted in November 2010 and April–May 2011. Posted photos of the homes were reviewed to determine if a hood was installed, the type of hood, and two installation details that can impact performance, namely the height above the cooktop and the degree to whichmore » the hood covers the cooktop burners. We additionally collected information about the homes, including asking price for purchase or rent, type of building (e.g. detached house, townhouse or apartment), building age, floor area, and cooktop fuel type. Listings were first sampled to focus on homes built since 2005, then randomly sampled to include varied prices and locations around the state. Data were obtained for 1002 homes built between 1865 and 2011 (median year built 1989). Homes for sale varied in asking price from $16,000 to $16,500,000 (median $353,000) and homes for rent varied from $500 to $25,000 (median $2125) per month. Approximately 74% of the sample had natural gas cooktops. In this sample, natural gas cooktops were more prevalent in more expensive homes than in less expensive homes. Across the entire sample, 7.4 % appeared to have no hood installed, 33% had a short hood, 13% had a deep hood and 47% had a microwave over the range. The percentage of these hoods that vent to the outdoors could not be determined. Hood type was related to coverage of the cooktop. For deep hoods, 76% appeared to cover most or all of the cooktop burners. For short hoods, 70% covered about three quarters of the cooktop. And for microwaves the vast majority (96%) covered the back burners but not the front burners. Hood type was also correlated with asking price or monthly rent, with deep hoods most common in the most expensive homes. Hood type was also correlated with home age, with microwave hoods more common in newer homes. Installation height was related to device type with microwaves installed lower (closer) to the cooktop (median 18 inches), and short hoods (median 28 inches) and deep hoods (median 30 inches) installed higher. Deep range hoods are more common with natural gas cooktops than with electric cooktops, and slightly fewer homes with natural gas cooktops lack a range hood (7%) than homes with electric cooktops (9%). This study provides limited but useful information about the characteristics of range hoods in California homes and demonstrates the potential value of non-traditional forms of data collection.« less

Short communication: comparing real-time PCR and bacteriological cultures for Streptococcus agalactiae and Staphylococcus aureus in bulk-tank milk samples.

PubMed

Zanardi, G; Caminiti, A; Delle Donne, G; Moroni, P; Santi, A; Galletti, G; Tamba, M; Bolzoni, G; Bertocchi, L

2014-09-01

For more than 30 yr, a control plan for Streptococcus agalactiae and Staphylococcus aureus has been carried out in more than 1,500 dairy herds of the province of Brescia (northern Italy). From 2010 to 2011, the apparent prevalence of Strep. agalactiae has been relatively stable around 10%, but the apparent prevalence of Staph. aureus has been greater than 40% with an increasing trend. The aim of this paper was to estimate and compare the diagnostic accuracy of 3 assays for the detection of Strep. agalactiae and Staph. aureus in bulk-tank milk samples (BTMS) in field conditions. The assays were a qualitative and a quantitative bacteriological culture (BC) for each pathogen and a homemade multiplex real-time PCR (rt-PCR). Because a gold standard was not available, the sensitivities (Se) and specificities (Sp) were evaluated using a Bayesian latent class approach. In 2012 we collected one BTMS from 165 dairy herds that were found positive for Strep. agalactiae in the previous 2-yr campaigns of eradication plan. In most cases, BTMS collected in these herds were positive for Staph. aureus as well, confirming the wide spread of this pathogen. At the same time we also collected composite milk samples from all the 8,624 lactating cows to evaluate the within-herd prevalence of Strep. agalactiae. Streptococcus agalactiae samples were cultured using a selective medium Tallium Kristalviolette Tossin, whereas for Staph. aureus, we used Baird Parker modified medium with added Rabbit Plasma Fibrinogen ISO-Formulation. In parallel, BTMS were tested using the rt-PCR. Regarding Strep. agalactiae, the posterior median of Se and Sp of the 2 BC was similar [qualitative BC: Se=98%, posterior credible interval (95%PCI): 94-100%, and Sp=99%, 95%PCI: 96-100%; quantitative BC: Se=99%, 95%PCI: 96-100%, and Sp=99%, 95%PCI: 95-100%] and higher than those of the rt-PCR (at 40 cycle threshold, Se=92%, 95%PCI: 85-97%; Sp=94%, 95%PCI: 88-98%). Also in case of Staph. aureus, the posterior medians of BC were generally higher than those of rt-PCR. In fact, although the Se of BC was slightly lower (rt-PCR at 40 cycle threshold, median Se=99%, 95%PCI: 97-100%, and qualitative BC, median Se=94%, 95%PCI: 87-99%), the Sp was much higher (rt-PCR at 40 cycle threshold, median Sp=67%, 95%PCI: 38-97%; qualitative BC, median Sp=95%; 95%PCI: 76-100%). Our study confirms that BC and rt-PCR are reliable diagnostic tools to detect Strep. agalactiae and Staph. aureus, and rt-PCR results should be confirmed by BC carried out on BTMS and possibly on composite milk samples. Copyright © 2014 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Resident involvement in laparoscopic procedures does not worsen clinical outcomes but may increase operative times and length of hospital stay.

PubMed

Jolley, Jennifer; Lomelin, Daniel; Simorov, Anton; Tadaki, Carl; Oleynikov, Dmitry

2016-09-01

Surgical procedures have a learning curve regarding the number of cases required for proficiency. Consequently, involvement of less experienced resident surgeons may impact patients and the healthcare system. This study examines basic and advanced laparoscopic procedures performed between 2010 and 2011 and evaluates the resident surgeon participation effect. Basic laparoscopic procedures (BL), appendectomy (LA), cholecystectomy (LC), and advanced Nissen fundoplication (LN) were queried from the American College of Surgeons National Surgical Quality Improvement Program database. Cases were identified using Current Procedural Terminology codes. Analyses were performed using IBM SPSS Statistics v.22, α-level = 0.05. Multiple logistic regression was used, accounting for age, race, gender, admission status, wound classification, and ASA classification. In total, 71,819 surgeries were reviewed, 66,327 BL (37,636 LC and 28,691 LA) and 5492 LN. Median age was 48 years for LC and 37 years for LA. In sum, 72.2 % of LC and 49.5 % of LA patients were female. LN median age was 59 years, and 67.7 % of patients were female. For BL, resident involvement was not significantly associated with mortality, morbidity, and return to the OR. Readmission was not related to resident involvement in LC. In LA, resident-involved surgeries had increased readmission and longer OR time, but decreased LOS. In LC, resident involvement was associated with longer LOS and OR time. Resident involvement was not a significant factor in the odds of mortality, morbidity, return to OR, or readmission in LN. Surgeries involving residents had increased odds of having longer LOS, and of lengthier surgery time. We demonstrate resident involvement is safe and does not result in poorer patient outcomes. Readmissions and LOS were higher in BL, and operative times were longer in all surgeries. Resident operations do appear to have real consequences for patients and may impact the healthcare system financially.

Simulation of in-hospital pediatric medical emergencies and cardiopulmonary arrests: highlighting the importance of the first 5 minutes.

PubMed

Hunt, Elizabeth A; Walker, Allen R; Shaffner, Donald H; Miller, Marlene R; Pronovost, Peter J

2008-01-01

Outcomes of in-hospital pediatric cardiopulmonary arrest are dismal. Recent data suggest that the quality of basic and advanced life support delivered to adults is low and contributes to poor outcomes, but few data regarding pediatric events have been reported. The objectives of this study were to (1) measure the median elapsed time to initiate important resuscitation maneuvers in simulated pediatric medical emergencies (ie, "mock codes") and (2) identify the types and frequency of errors committed during pediatric mock codes. A prospective, observational study was conducted of 34 consecutive hospital-based mock codes. A mannequin or computerized simulator was used to enact unannounced, simulated crisis situations involving children with respiratory distress or insufficiency, respiratory arrest, hemodynamic instability, and/or cardiopulmonary arrest. Assessment included time elapsed to initiation of specific resuscitation maneuvers and deviation from American Heart Association guidelines. Among the 34 mock codes, the median time to assessment of airway and breathing was 1.3 minutes, to administration of oxygen was 2.0 minutes, to assessment of circulation was 4.0 minutes, to arrival of any physician was 3.0 minutes, and to arrival of first member of code team was 6.0 minutes. Among cardiopulmonary arrest scenarios, elapsed time to initiation of compressions was 1.5 minutes and to request for defibrillator was 4.3 minutes. In 75% of mock codes, the team deviated from American Heart Association pediatric basic life support protocols, and in 100% of mock codes there was a communication error. Alarming delays and deviations occur in the major components of pediatric resuscitation. Future educational and organizational interventions should focus on improving the quality of care delivered during the first 5 minutes of resuscitation. Simulation of pediatric crises can identify targets for educational intervention to improve pediatric cardiopulmonary resuscitation and, ideally, outcomes.

Driving under the influence of cocaine: Quantitative determination of basic drugs in oral fluid obtained during roadside controls and a controlled study with cocaine users.

PubMed

Di Fazio, Vincent; Wille, Sarah M R; Toennes, Stefan W; van Wel, Janelle H P; Ramaekers, Johannes G; Samyn, Nele

2018-03-10

Using the Belgian Drugs and Driving procedure, 36% of the cocaine-positive oral fluid (OF) screening results were not confirmed in plasma. This study investigates the impact of the choice of screening devices and confirmation matrix on the detection of cocaine use. An ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method quantifying cocaine, benzoylecgonine (BZE), and other basic drugs in OF was developed and validated. This method monitored OF samples obtained either from a roadside (n = 12) or a double-blind controlled study with cocaine users (n = 10) who were given either a capsule containing 300 mg of cocaine-HCl or a placebo. The OF data were compared to plasma concentrations to obtain concentration-time profiles. In addition, the sensitivity and accuracy of the Drugwipe5S® was assessed. A significant difference between the OF volume collected at baseline/placebo (median 0.93 mL [range 0.43-1.92 mL]) or after cocaine-HCL intake (0.79 mL [0.30-1.21 mL]) was observed. The median OF/Plasma at the 3 collection time points were 10.7, 13.8, 6.7 for cocaine and 0.8, 1.7, 0.8 for BZE, respectively. The Drugwipe5S® detected cocaine use until at least 4 hours after intake. When applying the Belgian legal confirmation decision limit of 10 ng/mL in OF, an accuracy of 75%-98% was observed, depending on the study setting. Cocaine concentrations in OF were much higher and were detected longer as compared to plasma, when applying the same decision limit. From a toxicological viewpoint, the longer detection window with the higher sensitivity of Cocaine and BZE is beneficial to detect drivers in the crash/fatigue phase. Copyright © 2018 John Wiley & Sons, Ltd.

Official lay basic life support courses in Germany: is delivered content up to date with the guidelines? An observational study.

PubMed

Wagner, Patrick; Lingemann, Christian; Arntz, Hans-Richard; Breckwoldt, Jan

2015-07-01

Educating the lay public in basic life support (BLS) is a cornerstone to improving bystander cardiopulmonary resuscitation (CPR) rates. In Germany, the official rescue organisations deliver accredited courses based on International Liaison Committee on Resuscitation (ILCOR) guidelines to up to 1 million participants every year. However, it is unknown how these courses are delivered in reality. We hypothesised that delivered content might not follow the proposed curriculum, and miss recent guideline updates. We analysed 20 official lay BLS courses of 240 min (which in Germany are always embedded into either a 1-day or a 2-day first aid course). One expert rated all courses as a participating observer, remaining incognito throughout the course. Teaching times for specific BLS elements were recorded on a standardised checklist. Quality of content was rated by 5-point Likert scales, ranging from -2 (not mentioned) to +2 (well explained). Median total course time was 101 min (range 48-138) for BLS courses if part of a 1-day first aid course, and 123 min (53-244) if part of a 2-day course. Median teaching time for CPR was 51 min (range 20-70) and 60 min (16-138), respectively. Teaching times for recovery position were 44 min (range 24-66) and 55 min (24-114). Quality of content was rated worst for 'agonal gasping' (-1.35) and 'minimising chest compression interruptions' (-1.70). Observed lay BLS courses lasted only half of the assigned curricular time. Substantial teaching time was spent on non-evidence-based interventions (eg, recovery position), and several important elements of BLS were not included. The findings call for curriculum revision, improved instructor training and systematic quality management. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Nutritional status of community-dwelling elderly with newly diagnosed Alzheimer's disease: prevalence of malnutrition and the relation of various factors to nutritional status.

PubMed

Droogsma, E; van Asselt, D Z B; Schölzel-Dorenbos, C J M; van Steijn, J H M; van Walderveen, P E; van der Hooft, C S

2013-07-01

To determine the prevalence of malnutrition and its relation to various factors in community-dwelling elderly with newly diagnosed Alzheimer's disease (AD). Retrospective cross-sectional study. Memory clinic in a rural part of the Netherlands. 312 Community-dwelling AD patients, aged 65 years or older, were included. At the time the diagnosis AD was made, socio-demographic characteristics and data on nutritional status (Mini Nutritional Assessment (MNA)), cognitive function (Mini Mental State Examination (MMSE), Cambridge Cognitive Examination (Camcog)), functional status (Interview for Deterioration in Daily Living Activities in Dementia (IDDD), Barthel Index (BI)) and behaviour (Revised Memory and Behaviour Problems Checklist (RMBPC)) were assessed. Characteristics of well-nourished patients (MNA score >23.5) were compared to characteristics of patients at risk of malnutrition (MNA score 17-23.5). Linear regression analysis was performed to assess the effect of various factors on nutritional status. The prevalence of malnutrition was 0% and 14.1% was at risk of malnutrition. AD patients at risk of malnutrition were more impaired in basic and complex daily functioning than well-nourished AD patients (median IDDD score 41.5 [25th -75th percentile 38.8-48.0] versus median IDDD score 40.0 [25th -75th percentile 37.0-43.0], p = 0.028). The degree of impairment in basic and complex daily functioning (IDDD) was independently related to nutritional status (MNA) (p = 0.001, B = -0.062). One in seven community-dwelling elderly with newly diagnosed AD is at risk of malnutrition. The degree of impairment in daily functioning is independently related to nutritional status. Therefore, assessment of the nutritional status should be included in the comprehensive assessment of AD patients. The relation between daily functioning, nutritional status and AD warrants further investigation.

[Contralateral Recession of the Inferior Oblique Muscle in Grave's Disease Patients with Mild M. rectus inferior fibrosis].

PubMed

Eckstein, A; Raczynski, S; Dekowski, D; Esser, J

2015-10-01

The aim of this study was to evaluate the dose effect and the resulting binocular single vision for inferior oblique muscle recession in patients with Grave's orbitopathy. The evaluation covered all patients (n = 13) between 2010-2013 treated with recession of the inferior oblique muscle for vertical deviation caused by inferior fibrosis of the contralateral eye. The inclusion criterion was a small vertical squint angle with excyclotorsion. The corrected vertical squint angle was 3.75° [7 pdpt] (median, min 1.5° [3 pdpt], max 8° [16 pdpt]) in primary position and 5.5° in adduction [11pdpt] (median, min 3°[6 pdpt], max 9°[18pdpt]). Excyclotorsion was 4° [8 pdpt] (median, min 1° [2 pdpt], max 9° [18 pdpt]). Elevation was only slightly impaired and the side difference was 5° (median). The recession distance was preoperatively determined: 0.5° squint angle reduction per mm recession distance (calculation from patients who received surgery before 2010). Inferior oblique recession generated a good field of binocular single vision (BSV) for all patients. All patients reached BSV in the central area (20°) and within 30° of downgaze. Sixty nine percent of the patients were completely diplopia free in downgaze. Diplopia persisted in more than half of the patients in up gaze outside 15°. Squint reduction was 0.5° [1 pdpt] [0.45-0.67]/per mm recession distance in primary position and 0.65° [1.3 pdpt] [0.55-0.76]/per mm for the vertical deviation in adduction. Excyclotorsion was reduced to ≤ 2° in 77 % of the patients. Inferior oblique muscle recession can be very successfully performed on the contralateral eye in patients with mild inferior rectus muscle fibrosis. Surgery at the contralateral yoke muscle prevents the risk of overeffect with resulting diplopia in downgaze, which could occur if small distance recession had been performed at the inferior rectus muscle. An overeffect in relation to inferior oblique recession will only cause diplopia in upgaze, which is much less troublesome in daily routine. Georg Thieme Verlag KG Stuttgart · New York.

Robotic Assisted Simple Prostatectomy versus Holmium Laser Enucleation of the Prostate for Lower Urinary Tract Symptoms in Patients with Large Volume Prostate: A Comparative Analysis from a High Volume Center.

PubMed

Umari, Paolo; Fossati, Nicola; Gandaglia, Giorgio; Pokorny, Morgan; De Groote, Ruben; Geurts, Nicolas; Goossens, Marijn; Schatterman, Peter; De Naeyer, Geert; Mottrie, Alexandre

2017-04-01

We report a comparative analysis of robotic assisted simple prostatectomy vs holmium laser enucleation of the prostate in patients who had benign prostatic hyperplasia with a large volume prostate (greater than 100 ml). A total of 81 patients underwent robotic assisted simple prostatectomy and 45 underwent holmium laser enucleation of the prostate in a 7-year period. Patients were preoperatively assessed with transrectal ultrasound and uroflowmetry. Functional parameters were assessed postoperatively during followup. Perioperative outcomes included operative time, postoperative hemoglobin, catheterization time and hospitalization. Complications were reported according to the Clavien-Dindo classification. Compared to the holmium laser enucleation group, patients treated with prostatectomy were significantly younger (median age 69 vs 74 years, p = 0.032) and less healthy (Charlson comorbidity index 2 or greater in 62% vs 29%, p = 0.0003), and had a lower rate of suprapubic catheterization (23% vs 42%, p = 0.028) and a higher preoperative I-PSS (International Prostate Symptom Score) (25 vs 21, p = 0.049). Both groups showed an improvement in the maximum flow rate (15 vs 11 ml per second, p = 0.7), and a significant reduction in post-void residual urine (-73 vs -100 ml, p = 0.4) and I-PSS (-20 vs -18, p = 0.8). Median operative time (105 vs 105 minutes, p = 0.9) and postoperative hemoglobin (13.2 vs 13.8 gm/dl, p = 0.08) were similar for robotic assisted prostatectomy and holmium laser enucleation, respectively. Median catheterization time (3 vs 2 days, p = 0.005) and median hospitalization (4 vs 2 days, p = 0.0001) were slightly shorter in the holmium laser group. Complication rates were similar with no Clavien grade greater than 3 in either group. Our results from a single center suggest comparable outcomes for robotic assisted simple prostatectomy and holmium laser enucleation of the prostate in patients with a large volume prostate. These findings require external validation at other high volume centers. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Influence of recombinant human granulocyte colony-stimulating factor (filgrastim) on hematopoietic recovery and outcome following allogeneic bone marrow transplantation (BMT) from volunteer unrelated donors.

PubMed

Berger, C; Bertz, H; Schmoor, C; Behringer, D; Potthoff, K; Mertelsmann, R; Finke, J

1999-05-01

Effects of recombinant human granulocyte colony-stimulating factor (rhG-CSF, filgrastim) on hematopoietic recovery and clinical outcome in patients undergoing allogeneic bone marrow transplantation (BMT) from volunteer unrelated donors (VUD) were analyzed retrospectively. Additionally, the influence of baseline patient and transplant characteristics on hematopoietic recovery was evaluated. From January 1994 to March 1996, 47 consecutive adult patients received VUD-BMT. GVHD prophylaxis was cyclosporin A/short course methotrexate/prednisolone, and in four patients additional ATG. Post-transplantation, cohorts of patients received rhG-CSF (5 microg/kg/day) (n = 22) or no rhG-CSF (n = 25) in a non-randomized manner. The patient groups with and without rhG-CSF were rather comparable with respect to baseline patient and transplant characteristics. Median time to neutrophil counts (ANC) >500/microl was 14 days with rhG-CSF vs 16 days without rhG-CSF (P = 0.048), to ANC >1000/microl was 15 vs 18 days (P = 0.084). Neutrophil recovery was accelerated in patients receiving more than the median MNC dose of 2.54 x 10(8)/kg with a median time to ANC >1000/microl of 13 days vs 19 days (P = 0.017). RhG-CSF did not influence platelet recovery and incidence of infectious complications. Incidence of acute GVHD II-IV was 50% with rhG-CSF and 28% without rhG-CSF (P = 0.144), but death before acute GVHD II-IV occurred in 9% of patients with and 20% of patients without rhG-CSF. The median follow-up time was 38 and 36 months in patients with and without rhG-CSF, respectively. Survival at 2 years post-transplant was 39% (95% confidence interval (18%, 60%)) in patients with rhG-CSF and 24% (95% confidence interval (7%, 41%)) in patients without rhG-CSF. Administration of rhG-CSF after VUD-BMT may lead to more rapid neutrophil recovery, but did not influence the incidence of infectious complications. Patients receiving rhG-CSF showed a slightly higher incidence of acute GVHD II-IV. Higher numbers of MNC in the marrow graft accelerated hematopoietic engraftment.

Volumetric changes and peri-implant health at implant sites with or without soft tissue grafting in the esthetic zone, a retrospective case-control study with a 5-year follow-up.

PubMed

Bienz, Stefan P; Jung, Ronald E; Sapata, Vitor M; Hämmerle, Christoph H F; Hüsler, Jürg; Thoma, Daniel S

2017-11-01

To evaluate the volumetric changes and peri-implant health at implant sites with and without previous soft tissue grafting over a 5-year observation period. In 18 partially edentulous patients, dental implants were placed in the esthetic zone (15-25) with simultaneous guided bone regeneration, followed by submerged healing. During the healing phase, eight patients (test) received a subepithelial connective tissue graft, whereas 10 patients (control) did not receive any soft tissue augmentation. Subsequently, abutment connection was performed and final reconstructions were inserted. Impressions were taken 1 week after crown insertion and at 5 years. Obtained casts were scanned and superimposed for volumetric and linear measurements. The mean distance (MD) in the mid-buccal area between the two surfaces and the differences in buccal marginal mucosal level (bMML change ) and in ridge width (RW change ) were evaluated. Peri-implant health was assessed using probing pocket depth (PPD) values, plaque index (PlI) and bleeding on probing (BOP). At a median follow-up time of 60.5 months a median MD of -0.38 mm (Min: -0.94; Max: -0.03) (test) and of -0.51 mm (Min: -0.76; Max: 0.05) (control) was calculated. The level of the margo mucosae (bMML change ) demonstrated a median loss of -0.42 mm (Min: -1.1; Max: -0.01) (test) and of -0.33 mm (Min: -1.02; Max: 0.00) (control). The median RW change ranged between -0.44 mm and -0.73 mm (test) and between -0.49 mm and -0.54 mm (control). Mean PPD values slightly increased, whereas PlI and BOP remained stable over time in both groups. None of the comparisons between the groups revealed statistically significant differences (P > 0.35). A small sample size must be considered, however. Limited by a retrospective case-control study design, implant sites with and without soft tissue grafting on the buccal side revealed only minimal volumetric and linear changes and stability of peri-implant parameters over 5 years. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Oral microbiota, dental caries and periodontal status in smokeless tobacco chewers in Karnataka, India: a case-control study.

PubMed

Nagarajappa, Sandesh; Prasad, Kakarla V V

2010-01-01

The aim of the present study was to compare dental caries and periodontal disease status associated with oral microflora among smokeless tobacco chewers and non-chewers. Forty-two smokeless tobacco chewers and 42 non-chewers (age 20 to 60 years) were assessed for dental caries and periodontal disease status using the Decayed Missing Filled Surface (DMFS) Index, Community Periodontal Index (CPI) and Loss of Attachment (LA) Index. Stimulated saliva and subgingival plaque samples were collected from each subject for performing a culture-based analysis of 20 types of oral microorganisms. Qualitative and semi-quantitative culture-based analysis using MacConkey agar, and aerobic and anaerobic blood agar was carried out to determine the total cultivable microflora. Mutans-Sanguis agar, Pfizer selective Enterococcus agar and Rogosa SL agar were used for the culture of microorganisms associated with dental caries. Mann–Whitney U test and Student t test were employed to compare colony-forming units (CFUs) and caries experience between smokeless tobacco chewers and nonchewers. Z proportionality test was used to compare the periodontal disease status. Caries experience among chewers (26 of 42), that is those subjects who were affected by caries, was significantly less at 61.9% (mean DMFS = 3.5) compared to non-chewers (38 of 42, 90.5%) (mean DMFS = 5.5) (P < 0.05). Deep pockets measuring > 5.5 mm on a CPI probe were found among 26.2% of chewers and 19.1% of nonchewers, with no statistically significant differences (P > 0.05). Counts of Lactobacillus species were significantly lower among chewers (median CFU = 0.788 x 10⁵) than among non-chewers (median CFU = 1.52 x 10⁵) (P < 0.05). Prevotella and Porphyromonas species had a median CFU of 0.04 x 105 in chewers and 0.15 x 10⁵ in non-chewers, whereas Fusobacterium species had a median CFU of 0.02 x 10⁵ in chewers and 0.1 x 10⁵ in non-chewers (P < 0.05). A higher percentage of caries among non-chewers can be explained by greater numbers of Lactobacillus species in this population. Chewers experienced a slightly higher incidence of periodontal disease than non-chewers, but the difference was not significant. These clinical observations suggest a lower ability of Gram-negative bacteria to mediate more periodontal disease in this population.

Developing a tool for observing group critical thinking skills in first-year medical students: a pilot study using physiology-based, high-fidelity patient simulations.

PubMed

Nguyen, Khoa; Ben Khallouq, Bertha; Schuster, Amanda; Beevers, Christopher; Dil, Nyla; Kay, Denise; Kibble, Jonathan D; Harris, David M

2017-12-01

Most assessments of physiology in medical school use multiple choice tests that may not provide information about a student's critical thinking (CT) process. There are limited performance assessments, but high-fidelity patient simulations (HFPS) may be a feasible platform. The purpose of this pilot study was to determine whether a group's CT process could be observed over a series of HFPS. An instrument [Critical Thinking Skills Rating Instrument CTSRI)] was designed with the IDEAS framework. Fifteen groups of students participated in three HFPS that consisted of a basic knowledge quiz and introduction, HFPS session, and debriefing. HFPS were video recorded, and two raters reviewed and scored all HFPS encounters with the CTSRI independently. Interrater analysis suggested good reliability. There was a correlation between basic knowledge scores and three of the six observations on the CTSRI providing support for construct validity. The median CT ratings significantly increased for all observations between the groups' first and last simulation. However, there were still large percentages of video ratings that indicated students needed substantial prompting during the HFPS. The data from this pilot study suggest that it is feasible to observe CT skills in HFPS using the CTSRI. Based on the findings from this study, we strongly recommend that first-year medical students be competent in basic knowledge of the relevant physiology of the HFPS before participating, to minimize the risk of a poor learning experience. Copyright © 2017 the American Physiological Society.

Two rare species of tylenchids, Discotylenchus biannulatus n. sp. and Labrys chinensis Qing Bert, 2018 (Nematoda: Tylenchidae) from western Iran.

PubMed

Konani, Ehsan; Panahandeh, Yousef; Pourjam, Ebrahim; Álvarez-Ortega, Sergio; Pedram, Majid

2018-04-23

Two rare species of the family Tylenchidae are described and illustrated based on morphological and morphometric characters. Scanning electron microscope (SEM) studies provided details of anterior end structures, helpful in generic identification of the studied populations. Discotylenchus biannulatus n. sp. is characterized by its dorso-ventrally flattened smooth cephalic region having two proximal annuli and a rectangular perioral disc, short longitudinal amphidial slits, lateral field with four incisures, stylet 9-10 μm long, with the conus shorter than half the total stylet length and with posteriorly directed knobs, well-developed median bulb, mono-prodelphic reproductive system with rounded empty spermatheca and short postvulval uterine sac (PUS), and filiform tail with pointed end. It is compared with other species of Discotylenchus having four lines in the lateral field. The Iranian population of Labrys chinensis is characterized by its long and slender (a = 45.2-57.2) body, smooth rounded cephalic region and an offset disc-like apical labial plate, short longitudinal lateral amphidial slits, lateral field with two incisures, moderately developed stylet with the conus less than half the total length and posteriorly directed knobs, median bulb fusiform with distinct but weak valve, gradually joining the isthmus, vulva at 57.2-59.1% with small flaps, elongate conoid tail, uniformly and slightly narrowing toward end with broadly rounded terminus and rare males. The minor morphological differences of the recovered population with the type population are discussed.

Elevated CO2 and O3 effects on fine-root survivorship in ponderosa pine mesocosms.

PubMed

Phillips, Donald L; Johnson, Mark G; Tingey, David T; Storm, Marjorie J

2009-07-01

Atmospheric carbon dioxide (CO(2)) and ozone (O(3)) concentrations are rising, which may have opposing effects on tree C balance and allocation to fine roots. More information is needed on interactive CO(2) and O(3) effects on roots, particularly fine-root life span, a critical demographic parameter and determinant of soil C and N pools and cycling rates. We conducted a study in which ponderosa pine (Pinus ponderosa) seedlings were exposed to two levels of CO(2) and O(3) in sun-lit controlled-environment mesocosms for 3 years. Minirhizotrons were used to monitor individual fine roots in three soil horizons every 28 days. Proportional hazards regression was used to analyze effects of CO(2), O(3), diameter, depth, and season of root initiation on fine-root survivorship. More fine roots were produced in the elevated CO(2) treatment than in ambient CO(2). Elevated CO(2), increasing root diameter, and increasing root depth all significantly increased fine-root survivorship and median life span. Life span was slightly, but not significantly, lower in elevated O(3), and increased O(3) did not reduce the effect of elevated CO(2). Median life spans varied from 140 to 448 days depending on the season of root initiation. These results indicate the potential for elevated CO(2) to increase the number of fine roots and their residence time in the soil, which is also affected by root diameter, root depth, and phenology.

Stoichiometry of hydrological C, N, and P losses across climate and geology: An environmental matrix approach across New Zealand primary forests

NASA Astrophysics Data System (ADS)

McGroddy, M. E.; Baisden, W. T.; Hedin, L. O.

2008-03-01

Hydrologic losses can play a key role in regulating ecosystem nutrient balances, particularly in regions where baseline nutrient cycles are not augmented by industrial deposition. We used first-order streams to integrate hydrologic losses at the watershed scale across unpolluted old-growth forests in New Zealand. We employed a matrix approach to resolve how stream water concentrations of dissolved organic carbon (DOC), organic and inorganic nitrogen (DON and DIN), and organic and inorganic phosphorus (DOP and DIP) varied as a function of landscape differences in climate and geology. We found stream water total dissolved nitrogen (TDN) to be dominated by organic forms (medians for DON, 81.3%, nitrate-N, 12.6%, and ammonium-N, 3.9%). The median stream water DOC:TDN:TDP molar ratio of 1050:21:1 favored C slightly over N and P when compared to typical temperate forest foliage ratios. Using the full set of variables in a multiple regression approach explained approximately half of the variability in DON, DOC, and TDP concentrations. Building on this approach we combined a simplified set of variables with a simple water balance model in a regression designed to predict DON export at larger spatial scales. Incorporating the effects of climate and geologic variables on nutrient exports will greatly aid the development of integrated Earth-climate biogeochemical models which are able to take into account multiple element dynamics and complex natural landscapes.

Epidemiological and Clinical Features of Severe Fever with Thrombocytopenia Syndrome in Japan, 2013–2014

PubMed Central

Shimada, Tomoe; Matsui, Tamano; Shimojima, Masayuki; Saijo, Masayuki; Oishi, Kazunori

2016-01-01

Although severe fever with thrombocytopenia syndrome (SFTS) was first reported from Japan in 2013, the precise clinical features and the risk factors for SFTS have not been fully investigated in Japan. Ninety-six cases of severe fever with thrombocytopenia syndrome (SFTS) were notified through the national surveillance system between April 2013 and September 2014 in Japan. All cases were from western Japan, and 82 cases (85%) had an onset between April and August. A retrospective observational study of the notified SFTS cases was conducted to identify the clinical features and laboratory findings during the same period. Of 96 notified cases, 49 (51%) were included in this study. Most case-patients were of advanced age (median age 78 years) and were retired or unemployed, or farmers. These case-patients had a history of outdoor activity within 2 weeks before the onset of illness. The median serum C-reactive protein concentration was slightly elevated at admission. Fungal infections such as invasive aspergilosis were found in 10% of these case-patients. Hemophagocytosis was observed in 15 of the 18 case-patients (83%) whose bone marrow samples were available. Fifteen cases were fatal, giving a case-fatality proportion of 31%. The proportion of neurological abnormalities and serum concentrations of lactate dehydrogenase and aspartate aminotransferase were significantly higher in the fatal cases than in the nonfatal cases during hospitalization. Appearance of neurological abnormality may be useful for predicting the prognosis in SFTS patients. PMID:27776187

Epidemiological and Clinical Features of Severe Fever with Thrombocytopenia Syndrome in Japan, 2013-2014.

PubMed

Kato, Hirofumi; Yamagishi, Takuya; Shimada, Tomoe; Matsui, Tamano; Shimojima, Masayuki; Saijo, Masayuki; Oishi, Kazunori

2016-01-01

Although severe fever with thrombocytopenia syndrome (SFTS) was first reported from Japan in 2013, the precise clinical features and the risk factors for SFTS have not been fully investigated in Japan. Ninety-six cases of severe fever with thrombocytopenia syndrome (SFTS) were notified through the national surveillance system between April 2013 and September 2014 in Japan. All cases were from western Japan, and 82 cases (85%) had an onset between April and August. A retrospective observational study of the notified SFTS cases was conducted to identify the clinical features and laboratory findings during the same period. Of 96 notified cases, 49 (51%) were included in this study. Most case-patients were of advanced age (median age 78 years) and were retired or unemployed, or farmers. These case-patients had a history of outdoor activity within 2 weeks before the onset of illness. The median serum C-reactive protein concentration was slightly elevated at admission. Fungal infections such as invasive aspergilosis were found in 10% of these case-patients. Hemophagocytosis was observed in 15 of the 18 case-patients (83%) whose bone marrow samples were available. Fifteen cases were fatal, giving a case-fatality proportion of 31%. The proportion of neurological abnormalities and serum concentrations of lactate dehydrogenase and aspartate aminotransferase were significantly higher in the fatal cases than in the nonfatal cases during hospitalization. Appearance of neurological abnormality may be useful for predicting the prognosis in SFTS patients.

Serum VEGF-A concentrations in patients with central nervous system (CNS) tumors

PubMed Central

2018-01-01

Angiogenesis plays an essential role in tumors development. In case of central nervous system tumors, the most important role in this process plays VEGF-A. The purpose of this study was to determine the plasma concentration of this agent in patients treated surgically because of intracranial tumors. The study involved 48 adult patients, both sexes, treated surgically because of a brain tumor. The control group consisted of 50 adult volunteers of both sexes, without cancer diagnosis. Based on the studies, it was found that serum VEGF-A levels before surgery are higher in patients with central nervous system tumors (10.39–150.57 pg/ml, median 41.70 pg/ml) than in non-cancer patients (0.00–130.77 pg/ml, median 22.56 pg/ml). The association between serum VEGF-A level and malignancy and histological type of intracranial tumor has not beed confirmed. The highest average preoperative serum VEGF-A level was found in patients with low grade gliomas, slightly lower (close to each other) in those with high grade gliomas and meningiomas, while the lowest level was characteristic for metastatic tumors. High variation in results was observed in patients with low grade gliomas (52.56 pg/ml)—higher than those reported in patients with high grade gliomas (32.38 pg/ml). In the rest types of tumors the differentiation was similar and oscillated within 23.08–27.50 pg/ml. PMID:29590109

Morphology and identification of fly eggs: application in forensic entomology.

PubMed

Sanit, S; Sribanditmongkol, P; Sukontason, K L; Moophayak, K; Klong-Klaew, T; Yasanga, T; Sukontason, K

2013-06-01

Fly eggs found in corpses can be used as entomological evidence in forensic investigation. This study aims to investigate the morphology of forensically important fly eggs. Eggs of Chrysomya rufifacies, Chrysomya megacephala, Chrysomya pinguis, Chrysomya nigripes, Hypopygiopsis tumrasvini, Lucilia cuprina, Lucilia porphyrina and Musca domestica were examined using 1% potassium permanganate solution for 1 min. Morphometric analysis revealed that the mean length of Hy. tumrasvini (1.63 mm) and C. pinguis (1.65 mm) eggs was the longest, followed by that of L. porphyrina (1.45 mm), C. rufifacies (1.34 mm). The egg length, width of median area and darkness staining of hatching pleats were distinctive features. Four categories of median area were proposed, based on width; (1) distinctly wide (Megaselia scalaris, Synthesiomyia nudiseta); (2) wide (C. nigripes, M. domestica); (3) slightly widening (Hy. tumrasvini, L. cuprina, L. porphyrina); and (4) narrow (C. rufifacies, C. albiceps, C. megacephala, C. pinguis). Four species were examined using SEM, i.e., C. megacephala, C. pinguis, Hy. tumrasvini and L. porphyrina. The eggs of C. megacephala demonstrated swollen hatching pleats. Inside, the hexagon of the chorion appeared as a sponging bumpy feature. The egg of C. pinguis was similar to C. megacephala, except for the sponging bumpy feature on the outer surface of the hatching pleats. Regarding Hy. tumrasvini and L. porphyrina, their island structure was apparent at the inner surface of the upright hatching pleats. The key for identifying these eggs together with other reported species in Thailand has been updated.

Alterations in inflammatory biomarkers and energy intake in cancer cachexia: a prospective study in patients with inoperable pancreatic cancer.

PubMed

Bye, Asta; Wesseltoft-Rao, Nima; Iversen, Per Ole; Skjegstad, Grete; Holven, Kirsten B; Ulven, Stine; Hjermstad, Marianne J

2016-06-01

Chronic systemic inflammatory response is proposed as an underlying mechanism for development of cancer cachexia. We conducted a prospective study to examine changes in inflammatory biomarkers during the disease course and the relationship between inflammatory biomarkers and cachexia in patients with inoperable pancreatic cancer. Twenty patients, median (range) age 67.5 (35-79) years, 5 females, were followed for median 5.5 (1-12) months. Cachexia was diagnosed according to the 2011 consensus-based classification system (weight loss >5 % past six months, BMI < 20 kg/m(2) and weight loss >2 %, or sarcopenia) and the modified Glasgow Prognostic score (mGPS) that combines CRP and albumin levels. Inflammatory biomarkers were measured by enzyme immunoassays. The patients had increased levels of most inflammatory biomarkers, albeit not all statistically significant, both at study entry and close to death, indicating ongoing inflammation. According to the consensus-based classification system, eleven (55 %) patients were classified as cachectic upon inclusion. They did not differ from non-cachectic patients with regard to inflammatory biomarkers or energy intake. According to the mGPS, seven (35 %) were defined as cachectic and had a higher IL-6 (p < 0.001) than the non-cachectic patients. They also had a slightly, but insignificantly longer survival than non-cachectic patients (p = 0.08). The mGPS should be considered as an additional framework for identification of cancer cachexia.

A regional strategy for ecological sustainability: A case study in Southwest China.

PubMed

Wu, Xue; Liu, Shiliang; Cheng, Fangyan; Hou, Xiaoyun; Zhang, Yueqiu; Dong, Shikui; Liu, Guohua

2018-03-01

Partitioning, a method considering environmental protection and development potential, is an effective way to provide regional management strategies to maintain ecological sustainability. In this study, we provide a large-scale regional division approach and present a strategy for Southwest China, which also has extremely high development potential because of the "Western development" policy. Based on the superposition of 15 factors, including species diversity, pattern restriction, agricultural potential, accessibility, urbanization potential, and topographical limitations, the environmental value and development benefit in the region were quantified spatially by weighting the sum of indicators within environmental and development categories. By comparing the scores with their respective median values, the study area was divided into four different strategy zones: Conserve zones (34.94%), Construction zones (32.95%), Conflict zones (16.96%), and Low-tension zones (15.16%). The Conflict zones in which environmental value and development benefit were both higher than the respective medians were separated further into the following 5 levels: Extreme conflict (36.20%), Serious conflict (28.07%), Moderate conflict (12.28%), Minor conflict (6.55%), and Slight conflict (16.91%). We found that 9.04% of nature reserves were in Conflict zones, and thus should be given more attention. This study provides a simple and feasible method for regional partitioning, as well as comprehensive support that weighs both the environmental value and development benefit for China's current Ecological Red Line and space planning and for regional management in similar situations. Copyright © 2017 Elsevier B.V. All rights reserved.

Evaluation of dog bones in the indirect assessment of environmental contamination with trace elements.

PubMed

Lanocha, Natalia; Kalisinska, Elzbieta; Kosik-Bogacka, Danuta I; Budis, Halina

2012-06-01

The aim of this paper was to determine the level of five elements, two essential for life [zinc (Zn) and copper (Cu)] and three distinctly toxic [lead (Pb), cadmium (Cd), and mercury (Hg)], in four types of biological material in bones of the dog Canis lupus familiaris. The experiment was carried out on bones from the hip joints of dogs. The samples of cartilage, compact bone, spongy bone, and cartilage with adjacent compact bone came from 26 domestic dogs from northwestern Poland. Concentrations of Cu, Zn, Pb, and Cd were determined by ICP-AES (atomic absorption spectrophotometry) in inductively coupled argon plasma, using a Perkin-Elmer Optima 2000 DV. Determination of Hg concentration was performed by atomic absorption spectroscopy. In the examined bone material from the dog, the greatest concentrations (median) were observed for Zn and the lowest for Hg (98 mg Zn/kg and 0.0015 mg Hg/kg dw, respectively). In cartilage and spongy bone, metal concentrations could be arranged in the following descending order: Zn > Pb > Cu > Cd > Hg. In compact bone, the order was slightly different: Zn > Pb > Cd > Cu > Hg (from median 70 mg/kg dw to 0.002 mg/kg dw). The comparisons of metal concentrations between the examined bone materials showed distinct differences only in relation to Hg: between concentrations in spongy bone, compact bone, and in cartilage, being greater in cartilage than in compact bone, and lower again in spongy bone.

The Black Hole Masses and Eddington Ratios of Type 2 Quasars

NASA Astrophysics Data System (ADS)

Kong, Minzhi; Ho, Luis C.

2018-06-01

Type 2 quasars are an important constituent of active galaxies, possibly representing the evolutionary precursors of traditionally studied type 1 quasars. We characterize the black hole (BH) mass (M BH) and Eddington ratio (L bol/L Edd) for 669 type 2 quasars selected from the Sloan Digital Sky Survey, using BH masses estimated from the M BH–σ * relation and bolometric corrections scaled from the extinction-corrected [O III] λ5007 luminosity. When stellar velocity dispersions cannot be measured directly from the spectra, we estimate them from the core velocity dispersions of the narrow emission lines [O II] λλ3726, 3729, [S II] λλ6716, 6731, and [O III] λ5007, which are shown to trace the gravitational potential of the stars. Energy input from the active nucleus still imparts significant perturbations to the gas kinematics, especially to high-velocity, blueshifted wings. Nonvirial motions in the gas become most noticeable in systems with high Eddington ratios. The BH masses of our sample of type 2 quasars range from M BH ≈ 106.5 to 1010.4 M ⊙ (median 108.2 M ⊙). Type 2 quasars have characteristically large Eddington ratios (L bol/L Edd ≈ 10‑2.9–101.8 median 10‑0.7), slightly higher than in type 1 quasars of similar redshift; the luminosities of ∼20% of the sample formally exceed the Eddington limit. The high Eddington ratios may be consistent with the notion that obscured quasars evolve into unobscured quasars.

Long term curative effects of sequential therapy with all-trans retinoic acid, arsenious oxide and chemotherapy on patients with acute promyelocytic leukemia.

PubMed

Pei, Renzhi; Cao, Junjie; Ma, Junxia; Zhang, Pisheng; Liu, Xuhui; Du, Xiaohong; Chen, Dong; Sha, Keya; Chen, Lieguang; Li, Shuangyue; Wu, Jingyi; Fan, Zhen; Lin, Li; Ye, Peipei; Tang, Shanhao; Zhang, Bibo

2012-11-01

Both all-trans retinoic acid (ATRA) and arsenic trioxide (As(2)O(3)) have proven to be very effective in obtaining high clinical complete remission (CR) rates in acute promyelocytic leukemia (APL). In this study, 73 newly diagnosed APL subjects were treated with an ATRA and As(2)O(3) combination treatment in remission induction and post remission therapy. Tumor burden was examined with PCR of the PML-RAR fusion transcripts, and side effects were evaluated by means of clinical examination. The results showed that ATRA/As(2)O(3) combination therapy yielded a CR rate of 94.5% (69/73) with a shorter time to enter CR (median: 27 days; range: 21-43 days). Four cases failed to enter CR; three of these died of cerebral hemorrhage and disseminated intravascular coagulation (DIC) within 72 hours of starting induction therapy, one older patient died of severe pulmonary infection. The early death rate was 5.5% (4/73). All 69 cases that obtained CR remained in good clinical remission after a follow-up of 35-74 months (median: 52 months).The drug toxicity profile with the use of As(2)O(3) showed mainly hepatotoxicity. Liver dysfunction was slight in most cases. There were no severe side effects in long term follow-up. We conclude that APL patients may benefit from the use of the combination of ATRA and As(2)O(3) in either remission induction or consolidation/maintenance.

A regional analysis of epidermal growth factor receptor (EGFR) mutated lung cancer for HSE South.

PubMed

Kelly, D; Mc Sorley, L; O'Shea, E; Mc Carthy, E; Bowe, S; Brady, C; Sui, J; Dawod, M A; O'Brien, O; Graham, D; McCarthy, J; Burke, L; Power, D; O'Reilly, S; Bambury, R M; Mahony, D O

2017-11-01

EGFR mutated lung cancer represents a subgroup with distinct clinical presentations, prognosis, and management requirements. We investigated the survival, prognostic factors, and real-world treatment of NSCLC patients with EGFR mutation in clinical practice. A retrospective review of all specimens sent for EGFR analysis from December 2009 to September 2015 was performed. Patient demographics, specimen type, EGFR mutation status/type, stage at diagnosis, treatment, response rate, and survival data were recorded. 27/334 (8%) patient specimens sent for EGFR testing tested positive for a sensitising EGFR mutation. The median age was 65 years (40-85 years). Exon 19 deletion represented the most commonly detected alteration, accounting for 39% (n = 11). First-line treatment for those with Exon 18, 19, or 21 alterations (n = 24) was with an EGFR tyrosine kinase inhibitor (TKI) in 79% (n = 19). Objective response rate among these patients was 74% and median duration of response was 13 months (range 7-35 months). The incidence of EGFR mutation in our cohort of NSCLC is 9% which is consistent with mutation incidence reported in other countries. The rate of EGFR mutation in our population is slightly below that reported internationally, but treatment outcomes are consistent with published data. Real-world patient data have important contributions to make with regard to quality measurement, incorporating patient experience into guidelines and identifying safety signals.

Second Trimester Maternal Serum Screening for Fetal Down Syndrome: as a Screening Test for Hemoglobin Bart's Disease: A Prospective Population-based Study.

PubMed

Wanapirak, Chanane; Piyamomgkol, Wirawit; Sirichotiyakul, Supatra; Tongprasert, Fuanglada; Srisupundit, Kasemsri; Luewan, Suchaya; Traisrisilp, Kuntharee; Jatavan, Phudit; Tongsong, Theera

2018-06-21

To determine the effectiveness of second-trimester maternal serum screening (MSS) for Down syndrome as a screening test for fetal hemoglobin (Hb) Bart's disease among an unselected population. A secondary analysis of a large prospective database (20,254 pregnancies) was conducted to compare the levels of MSS, alpha-fetoprotein (AFP), free beta-human chorionic gonadotropin (hCG) and unconjugated estriol (uE3) between pregnancies with Hb Bart's disease and unaffected pregnancies. The median AFP levels were much higher among affected fetuses, (1.96 vs. 1.12 multiple of the median (MoM); p<0.001), yielding a sensitivity of 81.6% and specificity of 86.4%. Thus, AFP measurement is effective in predicting fetal Hb Bart's disease among an unselected population when using a cut-off value of 1.5 MoM. The serum free b-hCG levels were slightly, but significantly, higher in the affected pregnancies, while the serum uE3 levels were minimally, but significantly, lower among the affected pregnancies. Second trimester maternal serum AFP levels were significantly elevated in cases of fetal Hb Bart's disease. Pregnancies with unexplained elevated serum AFP levels in areas of high prevalence of Hb Bart's disease should always undergo a detailed ultrasound examination to detect any early signs of fetal anemia before development of hydrops fetalis. This article is protected by copyright. All rights reserved.

Lightning Optical Pulse Statistics from Storm Overflights During the Altus Cumulus Electrification Study

NASA Technical Reports Server (NTRS)

Mach, D. M.; Blakeslee, R. J.; Bailey, J. C.; Farrell, W. M.; Goldberg, R. A.; Desch, M. D.; Houser, J. G.

2004-01-01

The Altus Cumulus Electrification Study (ACES) was conducted during the month of August, 2002 in an area near Key West, Florida. One of the goals of this uninhabited aerial vehicle (UAV) study was to collect time resolved optical pulse data from thunderstorms. During the month long campaign, we acquired 5294 lightning generated optical pulses. Most of these observations were made while close to the top of the storms. We divided our data into two amplitude groups based on prior NASA U2 aircraft optical data and our pulse characteristics. The group of large pulses with radiance greater than 2.1 mW /sq m sr had mean and median 10 - 10% optical pulse widths of 765 and 735 microns respectively, the 50-50% pulse widths of 396 and 355 microns respectively, and 10-90% rise times of 290 and 260 microns. These values are very similar to the previous U2 based optical results The other group of pulses consisting of slightly more than a quarter of the total pulses observed had radiances less than the minimum values detected in the U2 study. The small pulses were narrower than the large pulses with 5040% mean and median values of 198 and 160 ps respectively. Only 12 % of the flashes contained only small pulses, minimizing the impact of this data on the estimates of detection efficiencies of the orbital instruments, the Lightning Imaging Sensor and Optical Transient Detector.

Outbreak of Cutaneous Leishmaniasis in Peruvian Military Personnel Undertaking Training Activities in the Amazon Basin, 2010

PubMed Central

Oré, Marianela; Sáenz, Eliana; Cabrera, Rufino; Sanchez, Juan F.; De Los Santos, Maxy B.; Lucas, Carmen M.; Núñez, Jorge H.; Edgel, Kimberly A.; Sopan, Justino; Fernández, Jorge; Carnero, Andres M.; Baldeviano, G. Christian; Arrasco, Juan C.; Graf, Paul C. F.; Lescano, Andres G.

2015-01-01

Military personnel deployed to the Amazon Basin are at high risk for cutaneous leishmaniasis (CL). We responded to an outbreak among Peruvian Army personnel returning from short-term training in the Amazon, conducting active case detection, lesion sample collection, and risk factor assessment. The attack rate was 25% (76/303); the incubation period was 2–36 weeks (median = 8). Most cases had one lesion (66%), primarily ulcerative (49%), and in the legs (57%). Real-time polymerase chain reaction (PCR) identified Leishmania (Viannia) braziliensis (59/61 = 97%) and L. (V.) guyanensis (2/61 = 3%). Being male (risk ratio [RR] = 4.01; P = 0.034), not wearing long-sleeve clothes (RR = 1.71; P = 0.005), and sleeping in open rooms (RR = 1.80; P = 0.009) were associated with CL. Sodium stibogluconate therapy had a 41% cure rate, less than previously reported in Peru (∼ 70%; P < 0.001). After emphasizing pre-deployment education and other basic prevention measures, trainees in the following year had lower incidence (1/278 = 0.4%; P < 0.001). Basic prevention can reduce CL risk in deployed militaries. PMID:26078320

Relative or Absolute Standards for Child Poverty: A State-Level Analysis of Infant and Child Mortality

PubMed Central

Hillemeier, Marianne M.; Lynch, John; Harper, Sam; Raghunathan, Trivellore; Kaplan, George A.

2003-01-01

Objectives. The purpose of the present study was to compare the associations of state-referenced and federal poverty measures with states’ infant and child mortality rates. Methods. Compressed mortality and Current Population Survey data were used to examine relationships between mortality and (1) state-referenced poverty (percentage of children below half the state median income) and (2) percentage of children below the federal poverty line. Results. State-referenced poverty was not associated with mortality among infants or children, whereas poverty as defined by national standards was strongly related to mortality. Conclusions. Infant and child mortality is more closely tied to families’ capacity for meeting basic needs than to relative position within a state’s economic hierarchy. PMID:12660213

Karyology and nuclear DNA quantification of four species of Chaetomorpha (Cladophorales, Chlorophyta) from the western Atlantic

NASA Astrophysics Data System (ADS)

Hinson, Todd K.; Kapraun, Donald F.

1991-09-01

Chromosome numbers are given for four species of Chaetomorpha from the warm temperate and tropical western Atlantic. The basic chromosome number is six, with three median and three submedian chromosomes. Chaetomorpha species represent a polyploid series, with numbers of 12, 18 and 24 found in the present study. Microspectrophotometry data for each species were quantified by reference to standards with known DNA contents. Results indicate similar 2X =1C=12 genome sizes for C. aerea (0.20 pg) and C. brachygona (0.26 pg), and for C. antennina (0.53 pg) and C. melagonium (0.58 pg). These findings are compared with karyological features of Cladophora species to characterize the karyology of the cladophoralean genome.

[Dynamics of amino acid and protein metabolism in laying hens after the administration of 15N-labeled wheat protein. 11. Incorporation of 15N in the tissues and the amino acids of the muscles].

PubMed

Gruhn, K; Zander, R

1989-03-01

Over a period of 4 days 12 colostomized laying hens daily received 36 g 15N labelled wheat with 15N excess (15N') of 14.37 atom-% together with a conventional feed mixture for laying hens. The labelling of the lysine N in the wheat was 13.58 atom-%, that of histidine N 14.38 and that of arginine 15N' 13.63 atom-% 15N'. Three hens each were butchered 12, 36, 60 and 108 h after the last 15N' feeding. The first three hens did not receive any feed before being butchered. The following three hens each received the unlabelled feed ration for another 1, 2 or 4 days resp. after the main period until they were butchered. The total of skeleton muscles, the heart and the stomach muscle (without inner skin) of each hen were combined into one sample, cut thinly, drenched with fluid nitrogen and pulverized. N, 15N' and the basic and non-basic amino acids as well as their 15N' were determined in the individual samples. In contrast to the organs, the proteins in the muscle tissue have a long half life so that a slight decrease of atom-% 15N' in the muscles could only be detected after 108 h. The 14N and 15N' quota of the non-basic amino acids in the total nitrogen of the muscles is 50%. The 14N quota of the basic amino acids is 30% and the 15N' quota only 22.5% in the total muscle N. The heavy nitrogen of the free lysine in the TCA soluble N fraction is hardly detectable 36 h and 60 h after the last 15N' supply and not at all after 108 h. In contrast to this, the other two free basic amino acids remain significantly higher labelled in dependence on the last butchering time.

Service readiness, health facility management practices, and delivery care utilization in five states of Nigeria: a cross-sectional analysis.

PubMed

Gage, Anastasia J; Ilombu, Onyebuchi; Akinyemi, Akanni Ibukun

2016-10-06

Existing studies of delivery care in Nigeria have identified socioeconomic and cultural factors as the primary determinants of health facility delivery. However, no study has investigated the association between supply-side factors and health facility delivery. Our study analyzed the role of supply-side factors, particularly health facility readiness and management practices for provision of quality maternal health services. Using linked data from the 2005 and 2009 health facility and household surveys in the five states in which the Community Participation for Action in the Social Sector (COMPASS) project was implemented, indices of health service readiness and management were developed based on World Health Organization guidelines. Multilevel logistic regression models were run to determine the association between these indices and health facility delivery among 2710 women aged 15-49 years whose last child was born within the five years preceding the surveys and who lived in 51 COMPASS LGAs. The health facility delivery rate increased from 25.4 % in 2005 to 44.1 % in 2009. Basic amenities for antenatal care provision, readiness to deliver basic emergency obstetric and newborn care, and management practices supportive of quality maternal health services were suboptimal in health facilities surveyed and did not change significantly between 2005 and 2009. The LGA mean index of basic amenities for antenatal care provision was more positively associated with the odds of health facility delivery in 2009 than in 2005, and in rural than in urban areas. The LGA mean index of management practices was associated with significantly lower odds of health facility delivery in rural than in urban areas. The LGA mean index of facility readiness to deliver basic emergency obstetric and neonatal care declined slightly from 5.16 in 2005 to 3.98 in 2009 and was unrelated to the odds of health facility delivery. Supply-side factors appeared to play a role in health facility delivery after controlling for socio-demographic factors. Improving uptake of delivery care would require greater attention to rural-urban inequities and health facility management practices, and to increasing the number of health facilities with fundamental elements for delivery of basic emergency obstetric and neonatal care.

Payment methods for outpatient care facilities.

PubMed

Yuan, Beibei; He, Li; Meng, Qingyue; Jia, Liying

2017-03-03

Outpatient care facilities provide a variety of basic healthcare services to individuals who do not require hospitalisation or institutionalisation, and are usually the patient's first contact. The provision of outpatient care contributes to immediate and large gains in health status, and a large portion of total health expenditure goes to outpatient healthcare services. Payment method is one of the most important incentive methods applied by purchasers to guide the performance of outpatient care providers. To assess the impact of different payment methods on the performance of outpatient care facilities and to analyse the differences in impact of payment methods in different settings. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), 2016, Issue 3, part of the Cochrane Library (searched 8 March 2016); MEDLINE, OvidSP (searched 8 March 2016); Embase, OvidSP (searched 24 April 2014); PubMed (NCBI) (searched 8 March 2016); Dissertations and Theses Database, ProQuest (searched 8 March 2016); Conference Proceedings Citation Index (ISI Web of Science) (searched 8 March 2016); IDEAS (searched 8 March 2016); EconLit, ProQuest (searched 8 March 2016); POPLINE, K4Health (searched 8 March 2016); China National Knowledge Infrastructure (searched 8 March 2016); Chinese Medicine Premier (searched 8 March 2016); OpenGrey (searched 8 March 2016); ClinicalTrials.gov, US National Institutes of Health (NIH) (searched 8 March 2016); World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (searched 8 March 2016); and the website of the World Bank (searched 8 March 2016).In addition, we searched the reference lists of included studies and carried out a citation search for the included studies via ISI Web of Science to find other potentially relevant studies. We also contacted authors of the main included studies regarding any further published or unpublished work. Randomised trials, non-randomised trials, controlled before-after studies, interrupted time series, and repeated measures studies that compared different payment methods for outpatient health facilities. We defined outpatient care facilities in this review as facilities that provide health services to individuals who do not require hospitalisation or institutionalisation. We only included methods used to transfer funds from the purchaser of healthcare services to health facilities (including groups of individual professionals). These include global budgets, line-item budgets, capitation, fee-for-service (fixed and unconstrained), pay for performance, and mixed payment. The primary outcomes were service provision outcomes, patient outcomes, healthcare provider outcomes, costs for providers, and any adverse effects. At least two review authors independently extracted data and assessed the risk of bias. We conducted a structured synthesis. We first categorised the comparisons and outcomes and then described the effects of different types of payment methods on different categories of outcomes. We used a fixed-effect model for meta-analysis within a study if a study included more than one indicator in the same category of outcomes. We used a random-effects model for meta-analysis across studies. If the data for meta-analysis were not available in some studies, we calculated the median and interquartile range. We reported the risk ratio (RR) for dichotomous outcomes and the relative change for continuous outcomes. We included 21 studies from Afghanistan, Burundi, China, Democratic Republic of Congo, Rwanda, Tanzania, the United Kingdom, and the United States of health facilities providing primary health care and mental health care. There were three kinds of payment comparisons. 1) Pay for performance (P4P) combined with some existing payment method (capitation or different kinds of input-based payment) compared to the existing payment methodWe included 18 studies in this comparison, however we did not include five studies in the effects analysis due to high risk of bias. From the 13 studies, we found that the extra P4P incentives probably slightly improved the health professionals' use of some tests and treatments (adjusted RR median = 1.095, range 1.01 to 1.17; moderate-certainty evidence), and probably led to little or no difference in adherence to quality assurance criteria (adjusted percentage change median = -1.345%, range -8.49% to 5.8%; moderate-certainty evidence). We also found that P4P incentives may have led to little or no difference in patients' utilisation of health services (adjusted RR median = 1.01, range 0.96 to 1.15; low-certainty evidence) and may have led to little or no difference in the control of blood pressure or cholesterol (adjusted RR = 1.01, range 0.98 to 1.04; low-certainty evidence). 2) Capitation combined with P4P compared to fee-for-service (FFS)One study found that compared with FFS, a capitated budget combined with payment based on providers' performance on antibiotic prescriptions and patient satisfaction probably slightly reduced antibiotic prescriptions in primary health facilities (adjusted RR 0.84, 95% confidence interval 0.74 to 0.96; moderate-certainty evidence). 3) Capitation compared to FFSTwo studies compared capitation to FFS in mental health centres in the United States. Based on these studies, the effects of capitation compared to FFS on the utilisation and costs of services were uncertain (very low-certainty evidence). Our review found that if policymakers intend to apply P4P incentives to pay health facilities providing outpatient services, this intervention will probably lead to a slight improvement in health professionals' use of tests or treatments, particularly for chronic diseases. However, it may lead to little or no improvement in patients' utilisation of health services or health outcomes. When considering using P4P to improve the performance of health facilities, policymakers should carefully consider each component of their P4P design, including the choice of performance measures, the performance target, payment frequency, if there will be additional funding, whether the payment level is sufficient to change the behaviours of health providers, and whether the payment to facilities will be allocated to individual professionals. Unfortunately, the studies included in this review did not help to inform those considerations.Well-designed comparisons of different payment methods for outpatient health facilities in low- and middle-income countries and studies directly comparing different designs (e.g. different payment levels) of the same payment method (e.g. P4P or FFS) are needed.

Colon Transit Time Test in Korean Children with Chronic Functional Constipation

PubMed Central

Yoo, Ha Yeong; Kim, Mock Ryeon; Park, Hye Won; Son, Jae Sung

2016-01-01

Purpose Each ethnic group has a unique life style, including diets. Life style affects bowel movement. The aim of this study is to describe the results of colon transit time (CTT) tests in Korean children who had chronic functional constipation based on highly refined data. Methods One hundred ninety (86 males) out of 415 children who performed a CTT test under the diagnosis of chronic constipation according to Rome III criteria at Konkuk University Medical Center from January 2006 through March 2015 were enrolled in this study. Two hundreds twenty-five children were excluded on the basis of CTT test result, defecation diary, and clinical setting. Shapiro-Wilk and Mann-Whitney U, and chi-square tests were used for statistical analysis. Results The median value and interquartile range (IQR) of CTT was 54 (37.5) hours in Encopresis group, and those in non-encopresis group was 40.2 (27.9) hours (p<0.001). The frequency of subtype between non-encopresis group and encopresis was statistically significant (p=0.002). The non-encopresis group (n=154, 81.1%) was divided into normal transit subgroup (n=84, 54.5%; median value and IQR of CTT=26.4 [9.6] hours), outlet obstruction subgroup (n=18, 11.7%; 62.4 [15.6] hours), and slow transit subgroup (n=52, 33.8%; 54.6 [21.0] hours]. The encopresis group (n=36, 18.9%) was divided into normal transit subgroup (n=8, 22.2%; median value and IQR of CTT=32.4 [9.9] hours), outlet obstruction subgroup (n=8, 22.2%; 67.8 [34.8] hours), and slow transit subgroup (n=20, 55.6%; 59.4 [62.7]hours). Conclusion This study provided the basic pattern and value of the CTT test in Korean children with chronic constipation. PMID:27064388

Establishing a preoperative evaluation system for lumboperitoneal shunt: Approach to attenuate the risk of shunt failure.

PubMed

Sun, Tong; Yuan, Yikai; Zhang, Qiuming; Zhou, Yicheng; Li, Xuepei; Yu, Hang; Tian, Meng; Guan, Junwen

2018-06-12

Lumboperitoneal shunt (LPS) has been demonstrated an effective method for the treatment of communicating hydrocephalus in the presence of frequent shunt failure. To determine if establishing a preoperative evaluation system could benefit patients thus attenuating the risk of LPS failure. In this three-year study, treated by LPS, patients undergoing preoperative evaluation were included into study group and others without preoperative evaluation were included into control group. Perioperative conditions, including Keifer's hydrocephalus score (KHS), symptomatic control rate (SCR), Evans index, complications, long-term shunt revision rate, and quality of life (QOL), were synchronously investigated. 93 eligible patients were included in the study (study group: 51, control group: 42). The baseline characteristics of two groups were basically similar. The results showed patients in study group had better short-term improvement in symptoms and imageology, including higher SCR (Median, 62.5% vs 50%, P=0.001), more reduction in Evans index (0.08±0.05 vs 0.05±0.04, P=0.002), and lower incidence of postoperative complications (Median, 35.3% vs 57.1%, P=0.04). Similarly, the incidence of shunt revision in study group was dramatically lower than control group (Median, 15.7% vs 40.9%, P=0.006) in line with the revision-free curve (P=0.002), in which suggested most of patients received revision, if needed, within 3 months. Additionally, patients in study group had better QOL. In conclusion, patients who underwent the evaluation before LPS had better short-term and long-term outcomes, suggesting it would be a promising strategy to correctly select patients for LPS with prolonged favorable shunt outcomes. Copyright © 2018 Elsevier Inc. All rights reserved.

Examination of Industry Payments to Radiation Oncologists in 2014 Using the Centers for Medicare and Medicaid Services Open Payments Database

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

Jairam, Vikram; Yu, James B., E-mail: james.b.yu@yale.edu

Purpose: To use the Centers for Medicare and Medicaid Services Open Payments database to characterize payments made to radiation oncologists and compare their payment profile with that of medical and surgical oncologists. Methods and Materials: The June 2015 release of the Open Payments database was accessed, containing all payments made to physicians in 2014. The general payments dataset was used for analysis. Data on payments made to medical, surgical, and radiation oncologists was obtained and compared. Within radiation oncology, data regarding payment category, sponsorship, and geographic distribution were identified. Basic statistics including mean, median, range, and sum were calculated by providermore » and by transaction. Results: Among the 3 oncologic specialties, radiation oncology had the smallest proportion (58%) of compensated physicians and the lowest mean ($1620) and median ($112) payment per provider. Surgical oncology had the highest proportion (84%) of compensated physicians, whereas medical oncology had the highest mean ($6371) and median ($448) payment per physician. Within radiation oncology, nonconsulting services accounted for the most money to physicians ($1,042,556), whereas the majority of the sponsors were medical device companies (52%). Radiation oncologists in the West accepted the most money ($2,041,603) of any US Census region. Conclusions: Radiation oncologists in 2014 received a large number of payments from industry, although less than their medical or surgical counterparts. As the Open Payments database continues to be improved, it remains to be seen whether this information will be used by patients to inform choice of providers or by lawmakers to enact policy regulating physician–industry relationships.« less

Appraisal and standardization of curvilinear velocity (VCL) cut-off values for CASA analysis of Japanese quail (Coturnix japonica) sperm.

PubMed

Farooq, U; Malecki, I A; Mahmood, M; Martin, G B

2017-06-01

One of the basic steps in objective analysis of sperm motility is the subdivision of a motile sperm population into slow, medium and rapid categories based on their velocity. However, for CASA analysis of quail sperm, the velocity values for categorization of slow, medium and rapid sperm have not yet been standardized. To identify the cut-off values of "velocity curvilinear" (VCL) for quail sperm categorization, we captured and analysed 22,300 tracks of quail sperm using SCA ® -CASA. The median and mean VCL values were 85 and 97 μm/s. To define the VCL cut-off values, we used two methods. In the first, we identified the upper (rapid sperm) and lower (slow sperm) cut-off values using: (i) median VCL ± 25% or ± 50% or ± 75% of median VCL value; (ii) first and third quartile values of VCL data (i.e. 25% cut-off setting); and (iii) 33% and 66% of VCL data. Among these settings, sperm categories and their corresponding motility characteristics recorded using the "25%" setting (i.e. slow ≤36 ≤ medium ≤154 ≤ rapid) were found the most realistic and coherent with male ranking by fertility. In the second method, we calculated heteroscedasticity in the total VCL data using PCA and the two-step clustering method. With this approach, the mean of the high and low clusters was 165 and 51 μm/s, respectively. Together, the mean from two methods suggested that, for SCA ® -CASA categorization of quail sperm, sperm should be classed as "rapid" at VCL ≥160 μm/s and "slow" at VCL ≤45 μm/s. © 2017 Blackwell Verlag GmbH.

Comparison between micellar liquid chromatography and capillary zone electrophoresis for the determination of hydrophobic basic drugs in pharmaceutical preparations.

PubMed

Torres-Cartas, S; Martín-Biosca, Y; Sagrado, S; Villanueva-Camañas, R M; Medina-Hernández, M J

2007-01-01

The determination of highly hydrophobic basic compounds by means of conventional reversed-phase liquid chromatographic methods has several drawbacks. Owing to the characteristics of micellar liquid chromatography (MLC) and capillary electrophoresis (CE), these techniques could be advantageous alternatives to reversed-phase chromatographic methods for the determination of these kinds of compounds. The objective of this study was to develop and compare MLC and CE methods for the determination of antipsychotic basic drugs (amitryptiline, haloperidol, perphenazine and thioridazine) in pharmaceutical preparations. The chromatographic determination of the analytes was performed on a Kromasil C(18) analytical column; the mobile phase was 0.04 m cetyltrimethylammonium bromide (CTAB), at pH 3, containing 5% 1-butanol, at a flow rate of 1 mL/min. The CE separation was performed in a fused-silica capillary with a 50 mm tris-(hydroxymethyl)-aminomethane buffer, pH 7, at an applied voltage of 20 kV, using barbital as internal stardard. The proposed methods are suitable for a reliable quantitation of these compounds in the commercial tablets and drops in terms of accuracy and precision and require a very simple pre-treatment of the samples. By comparing the performance characteristics and experimental details of the MLC and CE methods we conclude that CE seems to be slightly better than MLC in the determination of highly hydrophobic compounds in pharmaceuticals in terms of resolution and economy, taking into account that the limits of detection are not a handicap in pharmaceutical samples. Copyright 2006 John Wiley & Sons, Ltd.

Protein Conformation and Supercharging with DMSO from Aqueous Solution

NASA Astrophysics Data System (ADS)

Sterling, Harry J.; Prell, James S.; Cassou, Catherine A.; Williams, Evan R.

2011-07-01

The efficacy of dimethyl sulfoxide (DMSO) as a supercharging reagent for protein ions formed by electrospray ionization from aqueous solution and the mechanism for supercharging were investigated. Addition of small amounts of DMSO to aqueous solutions containing hen egg white lysozyme or equine myoglobin results in a lowering of charge, whereas a significant increase in charge occurs at higher concentrations. Results from both near-UV circular dichroism spectroscopy and solution-phase hydrogen/deuterium exchange mass spectrometry indicate that DMSO causes a compaction of the native structure of these proteins at low concentration, but significant unfolding occurs at ~63% and ~43% DMSO for lysozyme and myoglobin, respectively. The DMSO concentrations required to denature these two proteins in bulk solution are ~3-5 times higher than the concentrations required for the onset of supercharging, consistent with a significantly increased concentration of this high boiling point supercharging reagent in the ESI droplet as preferential evaporation of water occurs. DMSO is slightly more basic than m-nitrobenzyl alcohol and sulfolane, two other supercharging reagents, based on calculated proton affinity and gas-phase basicity values both at the B3LYP and MP2 levels of theory, and all three of these supercharging reagents are significantly more basic than water. These results provide additional evidence that the origin of supercharging from aqueous solution is the result of chemical and/or thermal denaturation that occurs in the ESI droplet as the concentration of these supercharging reagents increases, and that proton transfer reactivity does not play a significant role in the charge enhancement observed.

Exploratory Investigation of Advanced-Temperature Nickel-Base Alloys

NASA Technical Reports Server (NTRS)

Freche, John C.; Waters, William J.

1959-01-01

An investigation was conducted to provide an advanced-temperature nickel-base alloy with properties suitable for aircraft turbine blades as well as for possible space vehicle applications. An entire series of alloys that do not require vacuum melting techniques and that generally provide good stress-rupture and impact properties was evolved. The basic-alloy composition of 79 percent nickel, 8 percent molybdenum, 6 percent chromium, 6 percent aluminum, and 1 percent zirconium was modified by a series of element additions such as carbon, titanium, and boron, with the nickel content adjusted to account for the additives. Stress-rupture, impact, and swage tests were made with all the alloys. The strongest composition (basic alloy plus 1.5 percent titanium plus 0.125 percent carbon) displayed 384- and 574-hour stress-rupture lives at 1800 F and 15,000 psi in the as-cast and homogenized conditions, respectively. All the alloys investigated demonstrated good impact resistance. Several could not be broken in a low-capacity Izod impact tester and, on this basis, all compared favorably with several high-strength high-temperature alloys. Swaging cracks were encountered with all the alloys. In several cases, however, these cracks were slight and could be detected only by zyglo examination. Some of these compositions may become amenable to hot working on further development. On the basis of the properties indicated, it appears that several of the alloys evolved, particularly the 1.5 percent titanium plus 0.125 percent carbon basic-alloy modification, could be used for advanced- temperature turbine blades, as well as for possible space vehicle applications.

Multistage quantum absorption heat pumps.

PubMed

Correa, Luis A

2014-04-01

It is well known that heat pumps, while being all limited by the same basic thermodynamic laws, may find realization on systems as "small" and "quantum" as a three-level maser. In order to quantitatively assess how the performance of these devices scales with their size, we design generalized N-dimensional ideal heat pumps by merging N-2 elementary three-level stages. We set them to operate in the absorption chiller mode between given hot and cold baths and study their maximum achievable cooling power and the corresponding efficiency as a function of N. While the efficiency at maximum power is roughly size-independent, the power itself slightly increases with the dimension, quickly saturating to a constant. Thus, interestingly, scaling up autonomous quantum heat pumps does not render a significant enhancement beyond the optimal double-stage configuration.

Clay Mineral Crystal Structure Tied to Composition

NASA Image and Video Library

2016-12-13

This diagram illustrates how the dimensions of clay minerals' crystal structure are affected by which ions are present in the composition of the mineral. Different clay minerals were identified this way at two sites in Mars' Gale Crater: "Murray Buttes" and "Yellowknife Bay." In otherwise identical clay minerals, a composition that includes aluminum and ferric iron ions (red dots) results in slightly smaller crystalline unit cells than one that instead includes magnesium and ferrous iron ions (green dots). Ferric iron is more highly oxidized than ferrous iron. Crystalline cell units are the basic repeating building blocks that define minerals. X-ray diffraction analysis, a capability of the Chemistry and Mineralogy (CheMin) instrument on NASA's Curiosity Mars rover, identifies minerals from their crystalline structure. http://photojournal.jpl.nasa.gov/catalog/PIA21148

Employment, Production and Consumption model: Patterns of phase transitions

NASA Astrophysics Data System (ADS)

Lavička, H.; Lin, L.; Novotný, J.

2010-04-01

We have simulated the model of Employment, Production and Consumption (EPC) using Monte Carlo. The EPC model is an agent based model that mimics very basic rules of industrial economy. From the perspective of physics, the nature of the interactions in the EPC model represents multi-agent interactions where the relations among agents follow the key laws for circulation of capital and money. Monte Carlo simulations of the stochastic model reveal phase transition in the model economy. The two phases are the phase with full unemployment and the phase with nearly full employment. The economy switches between these two states suddenly as a reaction to a slight variation in the exogenous parameter, thus the system exhibits strong non-linear behavior as a response to the change of the exogenous parameters.

Relations between the functions of autobiographical memory and psychological wellbeing.

PubMed

Waters, Theodore E A

2014-01-01

Researchers have proposed that autobiographical memory serves three basic functions in everyday life: self-definition, social connection, and directing behaviour (e.g., Bluck, Alea, Habermas, & Rubin, 2005). However, no research has examined relations between the functions of autobiographical memory and healthy functioning (i.e., psychological wellbeing). The present research examined the relations between the self, social, and directive functions of autobiographical memory and three factors of psychological wellbeing in single and recurring autobiographical memories. A total of 103 undergraduate students were recruited and provided ratings of each function for four autobiographical memories (two single, two recurring events). Results found that individuals who use their autobiographical memories to serve self, social, and directive functions reported higher levels of Purpose and Communion and Positive Relationships, and that these relations differ slightly by event type.

Summary of NASA Langley's pilot scan behavior research

NASA Technical Reports Server (NTRS)

Spady, A. A., Jr.; Harris, R. L., Sr.

1983-01-01

The present investigation is concerned with the information acquired in a series of basic studies designed to obtain an understanding of the pilot's scanning behavior. In the studies, use was made of an oculometer system which operates by shining a beam of collimated infrared light at the subject's eyes. A number of oculometer software modifications have been made to make the oculometer user-friendly and versatile. Scanning is found to be a subconscious conditioned activity. The conditioned activity of scanning is different for each pilot. There are also slight variations between test runs for the same conditions for the same pilot. This indicates that scanning is situation dependent. Attention is given to the rate of information transfer, the possibility that scanning can be disrupted, the visual approach look-point, and workload sensitive measures.

Monitoring and Evaluation of Yearling Fall Chinook Salmon (Oncorhynchus tshawytscha) Released from Acclimation Facilities Upstream of Lower Granite Dam; 1999 Annual Report.

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

Rocklage, Stephen J.; Kellar, Dale S.

2005-07-01

The Nez Perce Tribe, in cooperation with the U.S. Fish and Wildlife Service and Washington Department of Fish and Wildlife, conducted monitoring and evaluation studies on Lyons Ferry Hatchery reared yearling fall Chinook salmon Oncorhynchus tshawytscha that were acclimated and released at three Fall Chinook Acclimation Project (FCAP) sites upstream of Lower Granite Dam along with yearlings released on-station from Lyons Ferry Hatchery in 1999. This was the fourth year of a long-term project to supplement natural spawning populations of Snake River stock fall Chinook salmon upstream of Lower Granite Dam. The 453,117 yearlings released from the Fall Chinook Acclimationmore » Project facilities not only slightly exceeded the 450,000 fish quota, but a second release of 76,386 yearlings (hereafter called Surplus) were acclimated at the Big Canyon facility and released about two weeks after the primary releases. We use Passive Integrated Transponder (PIT) tag technology to monitor the primary performance measures of survival to mainstem dams and migration timing. We also monitor size, condition and tag/mark retention at release. We released 9,941 PIT tagged yearlings from Pittsburg Landing, 9,583 from Big Canyon, 2,511 Big Canyon Surplus and 2,494 from Captain John Rapids. The Washington Department of Fish and Wildlife released 983 PIT tagged yearlings from Lyons Ferry Hatchery. Fish health sampling indicated that, overall, bacterial kidney disease levels could be considered relatively low and did not appear to increase after transport to the acclimation facilities. Compared to prior years, Quantitative Health Assessment Indices were relatively low at Pittsburg Landing and Lyons Ferry Hatchery and relatively high at Big Canyon and Captain John Rapids. Mean fork lengths (95% confidence interval) of the release groups ranged from 147.4 mm (146.7-148.1 mm) at Captain John Rapids to 163.7 mm (163.3-164.1 mm) at Pittsburg Landing. Mean condition factors ranged from 1.04 at Pittsburg Landing to 1.23 at Captain John Rapids. Estimated survival (95% confidence interval) of PIT tagged yearlings from release to Lower Granite Dam ranged from 87.8% (82.1-93.4%) for Big Canyon Surplus to 94.1% (90.1-98.1%) for Captain John Rapids. Estimated survival from release to McNary Dam ranged from 58.7% (49.3-68.1%) for Big Canyon Surplus to 71.3% (60.1-82.5%) for Captain John Rapids. Median migration rates to Lower Granite Dam, based on all observations of PIT tagged yearlings from the FCAP facilities, ranged from 9.3 river kilometers per day (rkm/d) for Captain John Rapids to 18.7 rkm/d for Pittsburg Landing. Median migration rates to McNary Dam ranged from 9.0 rkm/d for Lyons Ferry Hatchery to 17.3 rkm/d for Pittsburg Landing. Median travel times from the FCAP facilities were about 7-10 days to Lower Granite Dam and 21-23 days to McNary Dam. Median arrival dates at Lower Granite Dam, based on all observations of PIT tagged yearling groups from the FCAP facilities, were all from April 23-25. The median arrival date for Big Canyon Surplus was May 4. Median arrival dates at McNary Dam for Pittsburg Landing, Big Canyon and Captain John Rapids groups were all from May 7-8. Median arrival dates at McNary Dam were May 17 for Big Canyon Surplus and April 26 for Lyons Ferry Hatchery.« less

Mindfulness Therapy for Maladaptive Interpersonal Dependency: A Preliminary Randomized Controlled Trial.

PubMed

McClintock, Andrew S; Anderson, Timothy; Cranston, Saryn

2015-11-01

Existing treatments for maladaptive interpersonal dependency and dependent personality disorder do not meet basic scientific standards for effectiveness. The present investigation tested the efficacy of a mindfulness-based approach: mindfulness therapy for maladaptive interpersonal dependency (MT-MID). Forty-eight participants who reported consistently high levels of maladaptive dependency (i.e., scored higher than 1 standard deviation above the mean on the Interpersonal Dependency Inventory at two separate assessments) were randomized to either 5 sessions of MT-MID or a minimal contact control. Five self-reported outcomes (mindfulness, maladaptive interpersonal dependency, helplessness, fears of negative evaluation, and excessive reassurance seeking) were assessed at pretreatment, posttreatment, and a 4-week follow-up. Intent-to-treat analyses indicated that MT-MID yielded greater improvements than the control on all 5 outcomes at posttreatment (median d=1.61) and follow-up (median d=1.51). Participants assigned to MT-MID were more likely than control participants to meet criteria for clinically significant change at posttreatment (56.5% vs. 0%) and follow-up (42.9% vs. 0%). There was also evidence that increases in mindfulness mediated the dependency-related improvements. These results provide preliminary support for the efficacy of a mindfulness-based approach for treating the symptoms of maladaptive dependency. Copyright © 2015. Published by Elsevier Ltd.

Retinal Toxicity of Acai Fruit (Euterpe Oleracea) Dye Concentrations in Rabbits: Basic Principles of a New Dye for Chromovitrectomy in Humans.

PubMed

Caiado, Rafael R; Peris, Cristiane S; Lima-Filho, Acácio Alves Souza; Urushima, Joao Guilherme Palma; Novais, Eduardo; Badaró, Emmerson; Maia, André; Sinigaglia-Coimbra, Rita; Watanabe, Sung Eun S; Rodrigues, Eduardo B; Farah, Michel Eid; Maia, Mauricio

2017-08-01

Evaluate toxicity of acai fruit (Euterpe oleracea) dye concentrations in a rabbit model. Rabbits were injected intravitreously with 10%, 25%, and 35% acai dye concentrations. Control eyes received balanced salt solution (BSS). Electroretinogram (ERG), fundus imaging, fluorescein angiography (FA), optical coherence tomography (OCT), and light and transmission electron microscopy (LM/TEM) were performed. Fundus imaging showed increased vitreous opacity with increased dye concentrations. FA and OCT showed normality with all concentrations. Comparisons between BSS and dye concentrations were analyzed using Kruskal-Wallis and Mood's median test (p < 0.05). At 24 h, ERGs showed reduced amplitudes from baseline in all eyes. Median b-wave amplitudes nonsignificantly decreased and latency increased with 10% and 25%; findings were significant (p < 0.05) for 35%. LM and TEM showed no abnormalities for 10% and 25%. With 35%, TEM showed ganglion cell edema at 24 h that resolved after 7 days. Vacuolization, multilamellar bodies, and nerve bundle damage occurred at 24 h/7 days in the inner nuclear layer. Mitochondrial cristae disruption occurred in the inner photoreceptor segment at 24 h that decreased by 7 days. Ten and twenty-five percent concentrations were safe and may improve identification of the posterior hyaloid and internal limiting membrane during chromovitrectomy in humans.

Utilization of case presentations in medical microbiology to enhance relevance of basic science for medical students

PubMed Central

Chamberlain, Neal R.; Stuart, Melissa K.; Singh, Vineet K.; Sargentini, Neil J.

2012-01-01

Background Small-group case presentation exercises (CPs) were created to increase course relevance for medical students taking Medical Microbiology (MM) and Infectious Diseases (ID) Methods Each student received a unique paper case and had 10 minutes to review patient history, physical exam data, and laboratory data. Students then had three minutes to orally present their case and defend why they ruled in or out each of the answer choices provided, followed by an additional three minutes to answer questions. Results Exam scores differed significantly between students who received the traditional lecture-laboratory curriculum (Group I) and students who participated in the CPs (Group II). In MM, median unit exam and final exam scores for Group I students were 84.4% and 77.8%, compared to 86.0% and 82.2% for Group II students (P<0.018; P<0.001; Mann-Whitney Rank Sum Test). Median unit and final ID exam scores for Group I students were 84.0% and 80.0%, compared to 88.0% and 86.7% for Group II students (P<0.001; P<0.001). Conclusion Students felt that the CPs improved their critical thinking and presentation skills and helped to prepare them as future physicians. PMID:22435014

Evaluation of a cardiopulmonary resuscitation curriculum in a low resource environment.

PubMed

Chang, Mary P; Lyon, Camila B; Janiszewski, David; Aksamit, Deborah; Kateh, Francis; Sampson, John

2015-11-07

To evaluate whether a 2-day International Liaison Committee on Resuscitation (ILCOR) Universal Algorithm-based curriculum taught in a tertiary care hospital in Liberia increases local health care provider knowledge and skill comfort level. A combined basic and advanced cardiopulmonary resuscitation (CPR) curriculum was developed for low-resource settings that included lectures and low-fidelity manikin-based simulations. In March 2014, the curriculum was taught to healthcare providers in a tertiary care hospital in Liberia. In a quality assurance review, participants were evaluated for knowledge and comfort levels with resuscitation before and after the workshop. They were also videotaped during simulation sessions and evaluated on standardized performance metrics. Fifty-two hospital staff completed both pre-and post-curriculum surveys. The median score was 45% pre-curriculum and 82% post-curriculum (p<0.00001). The median provider comfort level score was 4 of 5 pre-curriculum and 5 of 5 post-curriculum (p<0.00001). During simulations, 93.2% of participants performed the pulse check within 10 seconds, and 97.7% performed defibrillation within 180 seconds. Clinician knowledge of and comfort level with CPR increased significantly after participating in our curriculum. A CPR curriculum based on lectures and low-fidelity manikin simulations may be an effective way to teach resuscitation in this low-resource setting.

Fatigue and pain limit independent mobility and physiotherapy after hip fracture surgery.

PubMed

Münter, Kristine H; Clemmesen, Christopher G; Foss, Nicolai B; Palm, Henrik; Kristensen, Morten T

2018-07-01

The patient's ability to complete their planned physiotherapy session after hip fracture surgery has been proposed as an independent predictor for achieving basic mobility independency upon hospital discharge. However, knowledge of factors limiting mobility is sparse. We therefore examined patient reported factors limiting ability to complete planned physiotherapy sessions as well as limitations for not achieving independency in basic mobility early after hip fracture surgery. A total of 204 consecutive patients with a hip fracture (mean (SD) age of 80 (9.9) years, 47 patients were admitted from a nursing home) were treated in accordance with a multimodal program. The Cumulated Ambulation Score was used to evaluate the patient's independency in three basic mobility activities: getting in and out of bed, sit-to-stand-to-sit from a chair and indoor walking. Pre-defined limitations; pain, motor blockade, dizziness, fatigue, nausea, acute cognitive dysfunction and "other limitations", for not achieving a full Cumulated Ambulation Score or inability to complete planned physiotherapy sessions were noted by the physiotherapist on each of the three first postoperative days. This period was chosen, because of its importance on how well the patients had regained their pre-fracture functional level. Fatigue and hip fracture-related pain were the most frequent reasons for patients not achieving an independent basic mobility level (> 85%) or not fully completing their planned physiotherapy (> 42%) on all three days. At hospital discharge (median day 10), only 54% of the patients had regained their pre-fracture basic mobility level. Based on the patient's perception, fatigue and pain are the most frequent limitations in not achieving independent basic mobility and not completing physiotherapy after hip fracture surgery. This raises questions whether multimodal peri-operative programs can be further optimized to enhance the early recovery of these frail patients. Implications for rehabilitation Early postoperative mobilization is essential for patients undergoing hip fracture surgery to regain the pre-fracture functional level, in not only the short but also in the long term. The most frequent reasons for not achieving an independent Cumulated Ambulation Score or completing physiotherapy, early after hip fracture surgery, are fatigue, pain, and the habitual cognitive status of patients. Knowledge concerning postoperative fatigue is important for rehabilitation professionals and should contribute as an essential factor when planning physiotherapy.

Early neonatal mortality and neurological outcomes of neonatal resuscitation in a resource-limited setting on the Thailand-Myanmar border: A descriptive study

PubMed Central

Carrara, Verena I.; Simpson, Julie A.; Thin, Nant War War; Say, Wah Wah; Paw, Naw Ta Mlar; Chotivanich, Kesinee; Turner, Claudia; Crawley, Jane; McGready, Rose

2018-01-01

Background Of the 4 million neonatal deaths worldwide yearly, 98% occur in low and middle-income countries. Effective resuscitation reduces mortality and morbidity but long-term outcomes in resource-limited settings are poorly described. This study reports on newborn neurological outcomes following resuscitation at birth in a resource-limited setting where intensive newborn care including intubation is unavailable. Methods Retrospective analysis of births records from 2008 to 2015 at Shoklo Malaria Research Unit (SMRU) on the Thailand-Myanmar border. Findings From 21,225 newbonrs delivered, 15,073 (71%) met the inclusion criteria (liveborn, singleton, ≥28 weeks’ gestation, delivered in SMRU). Neonatal resuscitation was performed in 460 (3%; 422 basic, 38 advanced) cases. Overall early neonatal mortality was 6.6 deaths per 1000 live births (95% CI 5.40–8.06). Newborns receiving basic and advanced resuscitation presented an adjusted rate for death of 1.30 (95%CI 0.66–2.55; p = 0.442), and 6.32 (95%CI 3.01–13.26; p<0.001) respectively, compared to newborns given routine care. Main factors related to increased need for resuscitation were breech delivery, meconium, and fetal distress (p<0.001). Neurodevelopmental follow-up to one year was performed in 1,608 (10.5%) of the 15,073 newborns; median neurodevelopmental scores of non-resuscitated newborns and those receiving basic resuscitation were similar (64 (n = 1565) versus 63 (n = 41); p = 0.732), while advanced resuscitation scores were significantly lower (56 (n = 5); p = 0.017). Interpretations Newborns requiring basic resuscitation at birth have normal neuro-developmental outcomes at one year of age compared to low-risk newborns. Identification of risk factors (e.g., breech delivery) associated with increased need for neonatal resuscitation may facilitate allocation of staff to high-risk deliveries. This work endorses the use of basic resuscitation in low-resource settings, and supports on-going staff training to maintain bag-and-mask ventilation skills. PMID:29304139

Inflight Emergencies During Eurasian Flights.

PubMed

Kesapli, Mustafa; Akyol, Can; Gungor, Faruk; Akyol, Angelika Janitzky; Guven, Dilek Soydam; Kaya, Gokhan

2015-01-01

This study evaluated the incidence and status of urgent medical conditions, the attitudes of health professionals who encounter such conditions, the adequacy of medical kits and training of cabin crew in data-received-company aircrafts suggested by Aerospace Medical Association, and the demographic data of patients. Data were collected from medical records of a major flight company from 2011 through 2013. All patients with complete records were included in the study. Numerical variables were defined as median and interquartiles (IQR) for median, while categorical variables were defined as numbers and percentage. During the study period, 10,100,000 passengers were carried by the company flights, with 1,312 (0.013%) demands for urgent medical support (UMS). The median age of the passengers who requested UMS was 45 years (IQR: 29-62). Females constituted 698 (53.2%) among the patients, and 721 (55%) patients were evaluated by medical professionals found among passengers. The most common nontraumatic complaints resulting in requests for UMS were flight anxiety (311 patients, 23.7%) and dyspnea (145 patients, 11%). The most common traumatic complaint was burns (221 patients, 16.8%) resulting from trauma during flight. A total of 22 (1.67%) emergency landings occurred for which the most frequent reasons were epilepsy (22.7%) and death (18.2%). Deaths during flights were recorded in 13 patients, whose median age was 77 years (IQR: 69-82), which was significantly higher compared to the age of patients requiring UMS (p < 0.0001). A total of 592 (45%) patients did not require any treatment for UMS. Medical kits and training were found to be sufficient according to the symptomatic treatments. Most of the urgent cases encountered during flights can be facilitated with basic medical support. "Traumatic emergency procedures inflight medical care" would be useful for additional training. Medical professionals as passengers are significantly involved in encountered emergency situations. Adding automated external defibrillator and pulse oximetry to recommended kits and training can help facilitate staff decisions such as emergency landings and tele-assistance. © 2015 International Society of Travel Medicine.

The bile acid turnover rate assessed with the (75)SeHCAT test is stable in chronic diarrhoea but slightly decreased in healthy subjects after a long period of time.

PubMed

Bajor, Antal; Kilander, Anders; Sjövall, Henrik; Rudling, Mats; Ung, Kjell-Arne

2008-11-01

The stability of bile acid turnover rate was evaluated retrospectively using repeat SeHCAT tests in patients with chronic diarrhoea and prospectively for 16 years in healthy subjects. The SeHCAT values were stable in 39 patients with chronic diarrhoea, as shown by a comparison of the test results [data presented as median and (25th-75th percentile)]: 18% (8-23) in the first test versus 14% (9-21) in the second test [n = 39, P = 0.37, time interval 44 months (16-68), repeatability index >95%]. In contrast, they were reduced after 16 years in healthy subjects: 38% (30-49.5) in the first test versus 31% (21-49.5) in the second test (P < 0.03). In healthy subjects, the body mass index increased by 13% from 23.2 kg/m(2) (21-24.6) to 26.2 kg/m(2) (22.5-27.8) (P < 0.01) during the 16 years. There was a negative correlation between hepatic bile acid synthesis and the SeHCAT values (r = -0.615, P = 0.02, n = 14). In conclusion, the turnover rate of bile acids is stable over a long period of time in patients with chronic diarrhoea irrespective of bile acid malabsorption, suggesting that a repeat SeHCAT test is dispensable. There is a significant negative correlation between bile acid synthesis and SeHCAT test results in healthy subjects. The SeHCAT test values are slightly reduced in healthy subjects after 16 years.

Library instruction in medical education: a survey of current practices in the United States and Canada

PubMed Central

Nevius, Amanda M.; Ettien, A’Llyn; Link, Alissa P.; Sobel, Laura Y.

2018-01-01

Objective The most recent survey on instruction practices in libraries affiliated with accredited medical institutions in the United States was conducted in 1996. The present study sought to update these data, while expanding to include Canadian libraries. Additional analysis was undertaken to test for statistically significant differences between library instruction in the United States and Canada and between libraries affiliated with highly ranked and unranked institutions. Methods A twenty-eight-question survey was distributed to libraries affiliated with accredited US and Canadian medical schools to assess what and how often librarians teach, as well as how librarians are involved in the curriculum committee and if they are satisfied with their contact with students and faculty. Quantitative data were analyzed with SAS, R, and MedCalc. Results Most of the seventy-three responding libraries provided instruction, both asynchronously and synchronously. Library instruction was most likely to be offered in two years of medical school, with year one seeing the most activity. Database use was the most frequently taught topic, and libraries reported a median of five librarians providing instruction, with larger staffs offering slightly more education sessions per year. Libraries associated with highly ranked schools were slightly more likely to offer sessions that were integrated into the medical school curriculum in year four and to offer sessions in more years overall. Conclusions In US and Canadian libraries, regardless of the rank of the affiliated medical school, librarians’ provision of instruction in multiple formats on multiple topics is increasingly common. PMID:29339939

Evaluating a complex system-wide intervention using the difference in differences method: the Delivering Choice Programme

PubMed Central

Round, Jeff; Drake, Robyn; Kendall, Edward; Addicott, Rachael; Agelopoulos, Nicky; Jones, Louise

2015-01-01

Objectives We report the use of difference in differences (DiD) methodology to evaluate a complex, system-wide healthcare intervention. We use the worked example of evaluating the Marie Curie Delivering Choice Programme (DCP) for advanced illness in a large urban healthcare economy. Methods DiD was selected because a randomised controlled trial was not feasible. The method allows for before and after comparison of changes that occur in an intervention site with a matched control site. This enables analysts to control for the effect of the intervention in the absence of a local control. Any policy, seasonal or other confounding effects over the test period are assumed to have occurred in a balanced way at both sites. Data were obtained from primary care trusts. Outcomes were place of death, inpatient admissions, length of stay and costs. Results Small changes were identified between pre- and post-DCP outputs in the intervention site. The proportion of home deaths and median cost increased slightly, while the number of admissions per patient and the average length of stay per admission decreased slightly. None of these changes was statistically significant. Conclusions Effects estimates were limited by small numbers accessing new services and selection bias in sample population and comparator site. In evaluating the effect of a complex healthcare intervention, the choice of analysis method and output measures is crucial. Alternatives to randomised controlled trials may be required for evaluating large scale complex interventions and the DiD approach is suitable, subject to careful selection of measured outputs and control population. PMID:24644163

Difference in resource utilization between patients with acute and chronic heart failure from Japanese administrative database.

PubMed

Kuwabara, Kazuaki; Matsuda, Shinya; Anan, Makoto; Fushimi, Kiyohide; Ishikawa, Koichi B; Horiguchi, Hiromasa; Hayashida, Kenshi; Fujimori, Kenji

2010-06-11

Many studies have reported economic evaluation of evolving agents or therapies for patients with heart failure (HF). However, little is known whether the disease progression category (acute or chronic HF) would be considered as a risk adjustment in health service research. This study profiles the difference in resource use or medical care for acute versus chronic HF. This study analyzed 17,912 HF patients treated in 62 academic hospitals and 351 community hospitals. Study variables included demographic variables, comorbid status, physical activity or disease progression at admission, procedures and laboratory tests, type and dose of heart-related medications, length of stay (LOS), and total charges (TC; 1 US$= 100 yen) for acute and chronic HF. The independent contributions of disease progression categories on LOS and TC were identified using multivariate analysis. We identified 9813 chronic and 8099 acute HF patients. Median LOS was 18 days for both chronic and acute HF, whereas TC was US$5731 and US$6447, respectively. Regression analysis revealed that acute HF was associated with a slightly greater TC, whereas performance of procedures was the most prominent factor. As NYHA class was the next most influential factor, class 3 or 4 resulted in longer LOS or greater TC, than did class 1. This study suggests that acute HF increased resource use slightly, whereas use of some practices indicated in critical care was affected more by the procedures performed. Disease progression category should remain an indicator for appropriateness of medical care. Copyright (c) 2008 Elsevier Ireland Ltd. All rights reserved.

Modification of cardiometabolic profile in obese diabetic patients after bariatric surgery: changes in cardiovascular risk.

PubMed

Pujante, Pedro; Hellín, María D; Fornovi, Aisa; Martínez Camblor, Pablo; Ferrer, Mercedes; García-Zafra, Victoria; Hernández, Antonio M; Frutos, María D; Luján-Monpeán, Juan; Tébar, Javier

2013-10-01

Bariatric surgery is a valuable tool for metabolic control in obese diabetic patients. The aim of this study was to determine changes in weight and carbohydrate and lipid metabolism in obese diabetic patients during the first 4 years after bariatric surgery. A retrospective study was performed in 104 patients (71 women; mean age, 53.0 [0.9] years; mean body mass index, 46.8 [0.7]) with type 2 diabetes mellitus (median duration, 3 years) who underwent laparoscopic proximal gastric bypass. Blood glucose levels and glycated hemoglobin concentrations decreased during the first 1-3 postoperative months. Values stabilized for the rest of the study period, allowing hypoglycemic treatment to be discontinued in 80% of the patients. No significant differences were observed as a function of the body mass index, diabetes mellitus duration, or previous antidiabetic treatment. Weight decreased during the first 15-24 months and slightly increased afterward. Levels of total cholesterol, triglycerides, and low-density lipoprotein significantly decreased, and target values were reached after 12 months in 80% of the patients. No correlation was found between these reductions and weight loss. Similarly, high-density lipoprotein concentrations decreased until 12 months after surgery. Although concentrations showed a subsequent slight increase, target or lower high-density lipoprotein values were achieved at 24 months postintervention in 85% of the patients. Bariatric surgery is effective for the treatment of obese diabetic patients, contributing to their metabolic control and reducing their cardiovascular risk. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

Pulmonary involvement in long-term mixed connective tissue disease: functional trends and image findings after 10 years.

PubMed

Kawano-Dourado, Leticia; Baldi, Bruno G; Kay, Fernando U; Dias, Olivia M; Gripp, Thais E H; Gomes, Paula S; Fuller, Ricardo; Caleiro, Maria T C; Kairalla, Ronaldo A; Carvalho, Carlos R R

2015-01-01

Interstitial lung disease (ILD) is highly prevalent in patients with mixed connective tissue disease (MCTD). However, little is known about the long-term progression of ILD in MCTD. The aims of this study were to describe pulmonary function test (PFT) and high-resolution computed tomography (HRCT) results in long-term MCTD patients, to measure changes in PFT and HRCT results over a 10-year period, and to ascertain correlations in functional and imaging data. In this retrospective cohort study, comparison between baseline and follow-up PFT and HRCT data was performed for 39 unselected consecutive MCTD patients. At baseline, 51% of the patients had abnormal PFTs. Forced vital capacity (FVC) was slightly reduced at baseline (77% of predicted), but remained stable after 10 years. A relative decrease of 15% in the diffusion capacity for carbon monoxide (DLCO) was detected (from 84% to 71% of predicted, p<0.001). The median lower lobes ILD-HRCT score progressed from 7.5% at baseline to 11.2% at follow-up (p=0.02), and findings of traction bronchiolectasis and honeycombing increased (p<0.05). A moderate negative correlation was observed between functional parameters and quantification of image findings. Functional and radiologic alterations suggestive of ILD in long-term MCTD patients are prevalent, mild, and progressed slightly over time. The most sensitive parameters for detecting subtle progression of ILD in MCTD patients are trends in DLCO, quantification of lower-lobes disease by HRCT (lower-lobes %ILD-HRCT score), and qualitative analysis of HRCT imaging.

Gender Differences in Verbal and Visuospatial Working Memory Performance and Networks.

PubMed

Zilles, David; Lewandowski, Mirjana; Vieker, Henning; Henseler, Ilona; Diekhof, Esther; Melcher, Tobias; Keil, Maria; Gruber, Oliver

2016-01-01

Working memory (WM) has been a matter of intensive basic and clinical research for some decades now. The investigation of WM function and dysfunction may facilitate the understanding of both physiological and pathological processes in the human brain. Though WM paradigms are widely used in neuroscientific and psychiatric research, conclusive knowledge about potential moderating variables such as gender is still missing. We used functional magnetic resonance imaging to investigate the effects of gender on verbal and visuospatial WM maintenance tasks in a large and homogeneous sample of young healthy subjects. We found significant gender effects on both the behavioral and neurofunctional level. Females exhibited disadvantages with a small effect size in both WM domains accompanied by stronger activations in a set of brain regions (including bilateral substantia nigra/ventral tegmental area and right Broca's area) independent of WM modality. As load and task difficulty effects have been shown for some of these regions, the stronger activations may reflect a slightly lower capacity of both WM domains in females. Males showed stronger bilateral intraparietal activations next to the precuneus which were specific for the visuospatial WM task. Activity in this specific region may be associated with visuospatial short-term memory capacity. These findings provide evidence for a slightly lower capacity in both WM modalities in females. © 2016 S. Karger AG, Basel.

Optimizing conditions for utilization of an H 2 oxidation catalyst with outer coordination sphere functionalities

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

Dutta, Arnab; Ginovska, Bojana; Raugei, Simone

2016-01-01

Hydrogenase enzymes use abundant metals such as nickel and iron to efficiently interconvert H2 and protons. In this work, we demonstrate that a Ni-based catalyst can exceed the rates of enzymes with only slightly higher overpotentials using [Ni(PCy2Narginine2)2]7, containing an amino acid-based outer coordination sphere. Under conditions of high pressure, elevated temperature, and aqueous acidic solutions, conditions similar to those found in fuel cells, this electrocatalyst exhibits the fastest H2 oxidation reported to date for any homogeneous catalyst (TOF 1.1×106 s-1) operating at a moderate overpotential (240 mV). Control experiments demonstrate that both the appended outer coordination sphere and watermore » are important to achieve this impressive catalytic performance. This work was funded by the Office of Science Early Career Research Program through the US Department of Energy, Office of Science, Office of Basic Energy Sciences (AD, WJS), and the Center for Molecular Electrocatalysis, an Energy Frontier Research Center funded by the US Department of Energy, Office of Science, Office of Basic Energy Sciences (JASR) located at Pacific Northwest National Laboratory (PNNL). PNNL is operated by Battelle for the US Department of Energy.« less

The Power of Edutainment: Alliance for Climate Education's Assembly Presentation: Impact on Student Knowledge, Attitude and Behavior

NASA Astrophysics Data System (ADS)

Lappe, M. D.

2011-12-01

The Alliance for Climate Education (ACE) is a national nonprofit that delivers an in-school multi-media assembly presentation to high school students about climate science and solutions. In two years of operation, ACE has reached 870,000 students in over 1400 schools. Throughout spring 2011 and fall 2012, the Alliance for Climate Education (ACE) will survey approximately 2000 high school students in 100 classrooms at 20 schools before and after its assembly to assess impact on knowledge, attitude and behavior related to global warming and climate science. The survey instrument has been designed in partnership with experts at the Yale School of the Environment and Stanford University's Precourt Energy Center. The knowledge section of the survey queries students' factual understanding of basic climate science. The behavior section asks students about basic climate-related habits related to waste, transportation and energy consumption. The attitude section is comprised of a 15-question subset of the national survey reported in Global Warming's Six Americas. Preliminary results from approximately 200 pre and post-presentation surveys suggest that after viewing the ACE Assembly, climate friendly behaviors increase slightly; correct answers to climate knowledge questions increase by 8%; and attitudes shift away from "Disengaged, Doubtful and Dismissive" toward "Alarmed, Concerned and Cautious."

Macroarray expression analysis of barley susceptibility and nonhost resistance to Blumeria graminis.

PubMed

Eichmann, Ruth; Biemelt, Sophia; Schäfer, Patrick; Scholz, Uwe; Jansen, Carin; Felk, Angelika; Schäfer, Wilhelm; Langen, Gregor; Sonnewald, Uwe; Kogel, Karl-Heinz; Hückelhoven, Ralph

2006-04-01

Different formae speciales of the grass powdery mildew fungus Blumeria graminis undergo basic-compatible or basic-incompatible (nonhost) interactions with barley. Background resistance in compatible interactions and nonhost resistance require common genetic and mechanistic elements of plant defense. To build resources for differential screening for genes that potentially distinguish a compatible from an incompatible interaction on the level of differential gene expression of the plant, we constructed eight dedicated cDNA libraries, established 13.000 expressed sequence tag (EST) sequences and designed DNA macroarrays. Using macroarrays based on cDNAs derived from epidermal peels of plants pretreated with the chemical resistance activating compound acibenzolar-S-methyl, we compared the expression of barley gene transcripts in the early host interaction with B. graminis f.sp. hordei or the nonhost pathogen B. graminis f.sp. tritici, respectively. We identified 102 spots corresponding to 94 genes on the macroarray that gave significant B. graminis-responsive signals at 12 and/or 24 h after inoculation. In independent expression analyses, we confirmed the macroarray results for 11 selected genes. Although the majority of genes showed a similar expression profile in compatible versus incompatible interactions, about 30 of the 94 genes were expressed on slightly different levels in compatible versus incompatible interactions.

Analysis of current density and specific absorption rate in biological tissue surrounding an air-core type of transcutaneous transformer for an artificial heart.

PubMed

Shiba, Kenji; Nukaya, Masayuki; Tsuji, Toshio; Koshiji, Kohji

2006-01-01

This paper reports on the specific absorption rate (SAR) and the current density analysis of biological tissue surrounding an air-core type of transcutaneous transformer for an artificial heart. The electromagnetic field in the biological tissue surrounding the transformer was analyzed by the transmission-line modeling method, and the SAR and current density as a function of frequency (200k-1 MHz) for a transcutaneous transmission of 20 W were calculated. The model's biological tissue has three layers including the skin, fat and muscle. As a result, the SAR in the vicinity of the transformer is sufficiently small and the normalized SAR value, which is divided by the ICNIRP's basic restriction, is 7 x 10(-3) or less. On the contrary, the current density is slightly in excess of the ICNIRP's basic restrictions as the frequency falls and the output voltage rises. Normalized current density is from 0.2 to 1.2. In addition, the layer in which the current's density is maximized depends on the frequency, the muscle in the low frequency (<700 kHz) and the skin in the high frequency (>700 kHz). The result shows that precision analysis taking into account the biological properties is very important for developing the transcutaneous transformer for TAH.

Mutagenicity of nitrogen compounds from synthetic crude oils: collection, separation and biological testing

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

Rao, T K; Epler, J L; Guerin, M R

1980-01-01

In order to determine the long range health effects such as carcinogenicity/mutagenicity/teratogenicity/toxicity, associated with the newly emerging energy technologies, we have utilized the Ames Salmonella assay to evaluate mutagenic properties of synthetic fuels. Coupling with class fractionation was necessary. Organic extraction and liquid/liquid partitioning was used to separate acidic and basic fraction. The neutral material was separated using Sephadex LH-20 gel filtration into saturated and aromatic fractions of various ring sizes. The alkaline fraction was subfractionated eluting with benzene and ethanol on a basic alumina column and then with isopropanol and acetone using a Sephadex LH-20 gel column. The frameshiftmore » strain TA-98 was utilized along with Aroclor-induced rat liver homogenate (S-9 mix) for the mutagenicity assay. The natural crude oils were slightly mutagenic, the polynucleararomatics constituting the activity, while the coal-derived fuels indicated mutagenicity associated with alkaline constituents as well as polyaromatics. Hydrotreated coal (H-coal, HDT) or Shale (Paraho-Shale oil, HDT) derived fuels were not mutagenic. Ninety percent of the mutagenic activity in alkaline fraction was recovered in the acetone subfraction. High resolution spectroscopy of this fraction indicates polycyclic aromatic primary amines along with azaarenes as organic constituents responsible for the mutagenic activity associated with shale- and coal-derived fuels.« less

Temperature dependent CO2 behavior in microporous 1-D channels of a metal-organic framework with multiple interaction sites

PubMed Central

Kim, Dongwook; Park, Jaehun; Kim, Yung Sam; Lah, Myoung Soo

2017-01-01

The MOF with the encapsulated CO2 molecule shows that the CO2 molecule is ligated to the unsaturated Cu(II) sites in the cage using its Lewis basic oxygen atom via an angular η1-(OA) coordination mode and also interacts with Lewis basic nitrogen atoms of the tetrazole ligands using its Lewis acidic carbon atom. Temperature dependent structure analyses indicate the simultaneous weakening of both interactions as temperature increases. Infrared spectroscopy of the MOF confirmed that the CO2 interaction with the framework is temperature dependent. The strength of the interaction is correlated to the separation of the two bending peaks of the bound CO2 rather than the frequency shift of the asymmetric stretching peak from that of free CO2. The encapsulated CO2 in the cage is weakly interacting with the framework at around ambient temperatures and can have proper orientation for wiggling out of the cage through the narrow portals so that the reversible uptake can take place. On the other hand, the CO2 in the cage is restrained at a specific orientation at 195 K since it interacts with the framework strong enough using the multiple interaction sites so that adsorption process is slightly restricted and desorption process is almost clogged. PMID:28128298

Iridium clusters in KLTL zeolite: Structure and catalytic selectivity for n-hexane aromatization

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

Triantafillou, N.D.; Miller, J.T.; Gates, B.C.

Catalysts consisting of Ir clusters in zeolite KLTL were prepared by reduction of [Ir(NH{sub 3}){sub 5}Cl]Cl{sub 2} in the zeolite with H{sub 2} at temperatures 300 or 500{degrees}C. The catalysts were tested for reactions of n-hexane and H{sub 2} at 400, 440 and 480{degrees}C and were characterized by temperature-programmed reduction, hydrogen chemisorption, transmission electron microscopy, infrared spectroscopy of adsorbed CO, and extended X-ray absorption fine structure spectroscopy. The clusters consist of 4 to 6 Ir atoms on average and are sufficiently small to reside within the pores of the zeolite. The infrared spectra characteristic of terminal CO suggest that themore » support environment is slightly basic and that the Ir clusters are electron rich relative to the bulk metal. Notwithstanding the small cluster size, the support basicity, and the confining geometry of the LTL zeolite pore structure, the catalytic performance is similar to those of other Ir catalysts, with a poor selectivity for aromatization and a high selectivity for hydrogenolysis. These results are consistent with the inference that the principal requirements for selective naphtha aromatization catalysts are both a nonacidic support and a metal with a low hydrogenolsis activity, i.e., Pt. 47 refs., 6 figs., 3 tabs.« less

Using a high-fidelity patient simulator with first-year medical students to facilitate learning of cardiovascular function curves.

PubMed

Harris, David M; Ryan, Kathleen; Rabuck, Cynthia

2012-09-01

Students are relying on technology for learning more than ever, and educators need to adapt to facilitate student learning. High-fidelity patient simulators (HFPS) are usually reserved for the clinical years of medical education and are geared to improve clinical decision skills, teamwork, and patient safety. Finding ways to incorporate HFPS into preclinical medical education represents more of a challenge, and there is limited literature regarding its implementation. The main objective of this study was to implement a HFPS activity into a problem-based curriculum to enhance the learning of basic sciences. More specifically, the focus was to aid in student learning of cardiovascular function curves and help students develop heart failure treatment strategies based on basic cardiovascular physiology concepts. Pretests and posttests, along with student surveys, were used to determine student knowledge and perception of learning in two first-year medical school classes. There was an increase of 21% and 22% in the percentage of students achieving correct answers on a posttest compared with their pretest score. The median number of correct questions increased from pretest scores of 2 and 2.5 to posttest scores of 4 and 5 of a possible total of 6 in each respective year. Student survey data showed agreement that the activity aided in learning. This study suggests that a HFPS activity can be implemented during the preclinical years of medical education to address basic science concepts. Additionally, it suggests that student learning of cardiovascular function curves and heart failure strategies are facilitated.

Can basic life support personnel safely determine that advanced life support is not needed?

PubMed

Cone, D C; Wydro, G C

2001-01-01

To determine whether firefighter/emergency medical technicians-basic (FF/EMT-Bs) staffing basic life support (BLS) ambulances in a two-tiered emergency medical services (EMS) system can safely determine when advanced life support (ALS) is not needed. This was a prospective, observational study conducted in two academic emergency departments (EDs) receiving patients from a large urban fire-based EMS system. Runs were studied to which ALS and BLS ambulances were simultaneously dispatched, with the patient transported by the BLS unit. Prospectively established criteria for potential need for ALS were used to determine whether the FF/EMT-B's decision to cancel the ALS unit was safe, and simple outcomes (admission rate, length of stay, mortality) were examined. In the system studied, BLS crews may cancel responding ALS units at their discretion; there are no protocols or medical criteria for cancellation. A convenience sample of 69 cases was collected. In 52 cases (75%), the BLS providers indicated that they cancelled the responding ALS unit because they did not feel ALS was needed. Of these, 40 (77%) met study criteria for ALS: 39 had potentially serious chief complaints, nine had abnormal vital signs, and ten had physical exam findings that warranted ALS. Forty-five (87%) received an intervention immediately upon ED arrival that could have been provided in the field by an ALS unit, and 16 (31%) were admitted, with a median length of stay of 3.3 days (range 1.1-73.4 days). One patient died. Firefighter/EMT-Bs, working without protocols or medical criteria, cannot always safely determine which patients may require ALS intervention.

Ground-water, surface-water, and water-chemistry data, Black Mesa area, Northeastern Arizona: 1999

USGS Publications Warehouse

Thomas, Blakemore E.; Truini, Margot

2000-01-01

The N aquifer is the major source of water in the 5,400-square-mile area of Black Mesa in northeastern Arizona. Availability of water is an important issue in this area because of continued industrial and municipal use, a growing population, and a precipitation of only about 6 to 12 inches per year. The monitoring program in Black Mesa has been operating since 1971 and is designed to determine the long-term effects of ground-water withdrawals from the N aquifer for industrial and municipal uses. The monitoring program includes measurements of (1) ground-water pumping, (2) ground-water levels, (3) spring discharge, (4) surface-water discharge, and (5) ground-water chemistry. In 1999, total ground-water withdrawals were 7,110 acre-feet, industrial use was 4,210 acre-feet, and municipal use was 2,900 acre-feet. From 1998 to 1999, total withdrawals increased by 0.7 percent, industrial use increased by 4 percent, and municipal use decreased by 4 percent. From 1998 to 1999, water levels declined in 11 of 15 wells in the unconfined part of the aquifer, and the median decline was 0.7 foot. Water levels declined in 14 of 16 wells in the confined part of the aquifer, and the median decline was 1.2 feet. From the prestress period (prior to 1965) to 1999, the median water-level decline in 31 wells was 10.6 feet. Median water-level changes were 0.0 foot for 15 wells in the unconfined part of the aquifer and a decline of 45.5 feet in 16 wells in the confined part. From 1998 to 1999, discharges were measured annually at four springs. Discharges declined 30 percent and 3 percent at 2 springs, did not change at 1 spring, and increased by 11 percent at 1 spring. For the past 10 years, discharges from the four springs have fluctuated; however, an increasing or decreasing trend was not observed. Continuous records of surface-water discharge have been collected from July 1976 to 1999 at Moenkopi Wash, July 1996 to 1999 at Laguna Creek, June 1993 to 1999 at Dinnebito Wash, and April 1994 to 1999 at Polacca Wash. Median flows for November, December, January, and February of each water year are used as an index of ground-water discharge to those streams. Increasing or decreasing trends are not apparent in these median winter flows for the periods of record. In 1999, water samples were collected from 12 wells and 4 springs and analyzed for selected chemical constituents. Dissolved-solids concentrations ranged from 91 to 630 milligrams per liter. Water samples from 10 of the wells and the 4 springs had less than 350 milligrams per liter of dissolved solids. Water-chemistry data are available for nine wells and four springs from about the mid-1980s. For that time period, the data from those sites have remained fairly stable. From 1987 to 1999, concentrations of dissolved solids, chloride, and sulfate may have increased slightly in samples from Moenkopi School Spring.

Impact of 2003 State Regulation on Raw Oyster–associated Vibrio vulnificus Illnesses and Deaths, California, USA

PubMed Central

Tabnak, Farzaneh; Newton, Anna E.; Hernandez, Michael; Griffin, Patricia M.

2013-01-01

US vibriosis rates have increased since 1996, and many Vibrio vulnificus infections are fatal. In April 2003, California implemented a regulation restricting the sale of raw oysters harvested from the Gulf of Mexico during April 1–October 31, unless they were processed to reduce V. vulnificus to nondetectable levels. We analyzed California cases of V. vulnificus infection before and after the regulation’s implementation and compared case data with data from other states. The annual number of reported V. vulnificus infections and deaths in California with patient’s sole exposure to raw oysters dropped from 0 to 6 cases and 0 to 5 deaths per year during 1991–2002, before implementation, to 0 during 2003–2010, after implementation (p = 0.0005 for both). In other states, median annual numbers of similar cases and deaths increased slightly after 2002. The data strongly suggest that the 2003 regulation led to a significant reduction in reported raw oyster–associated V. vulnificus illnesses and deaths. PMID:23876744

Issues relating to long-term follow-up in hip arthroplasty surgery: a review of 598 cases at 7 years comparing 2 prostheses using revision rates, survival analysis, and patient-based measures.

PubMed

Dawson, J; Jameson-Shortall, E; Emerton, M; Flynn, J; Smith, P; Gundle, R; Murray, D

2000-09-01

We reviewed 598 cemented Charnley and Hi-nek total hip arthroplasties at 7 years. Data were obtained from general practitioners, hospital medical notes, microfilm, and patient questionnaires. Outcome measures were revision rates, survival analysis, 12-item Oxford Hip Score, and satisfaction ratings. There were 471 Charnley (79%) and 127 Hi-nek (21%) total hip arthroplasties; 139 deaths (23%) occurred, and 5 (<1%) were lost to follow-up. Characteristics of the Charnley and Hi-nek patient groups were similar, with more information missing for Charnley cases. Revision rates were Charnley, 37 (8%), and Hi-nek, 6 (5%) (not significant). Survival analysis revealed no difference between the 2 groups (P = .23). The patients' median Oxford Hip Score was low/good (19), slightly worse for the Hi-nek group (not significant). Taking all evidence together, neither implant was outperforming the other at 7 years.

Further karyosystematic studies of the Boreonectes griseostriatus (De Geer) group of sibling species (Coleoptera, Dytiscidae)–characterisation of B. emmerichi (Falkenström, 1936) and additional European data

PubMed Central

Angus, Robert B.; Angus, Elizabeth M.; Jia, Fenglong; Chen, Zhen-ning; Zhang, Ying

2015-01-01

Abstract A lectotype is designated for the Tibetan species Deronectes emmerichi Falkenström, 1936 (Currently Boreonectes emmerichi (Falkenström)), and its habitus, as well as the median lobe and parameres of its aedeagus, are figured along with additional comparative material. Material of Boreonectes emmerichi from Sikkim (BMNH) represents the first record of a Boreonectes Angus, 2010 species from India. The karyotype of Boreonectes emmerichi is described as having 26 pairs of autosomes plus sex chromosomes which are X0 (♂), XX (♀). The karyotype is most like that of Boreonectes macedonicus (Géuorguiev, 1959), but with slight differences. Additional chromosomal information is given for Boreonectes griseostriatus griseostriatus (De Geer, 1774) in the French Alps, Boreonectes griseostriatus strandi (Brinck, 1943) on the Kola Peninsula, Boreonectes multilineatus (Falkenström, 1922) in the Pyrenees and Boreonectes ibericus (Dutton & Angus, 2007) in the Spanish Picos de Europa. PMID:25893080

[Intramedullary spinal cord metastasis from gastric adenocarcinoma: Case report and review of literature].

PubMed

Pérez-Suárez, Javier; Barrio-Fernández, Patricia; Ibáñez-Plágaro, Francisco Javier; Ribas-Ariño, Teresa; Calvo-Calleja, Pablo; Mostaza-Saavedra, Antonio Luis

2016-01-01

Intramedullary spinal cord metastases are very rare and usually associated with lung or breast cancer, with gastric origin being exceptional. Their clinical onset tends to be faster than that of primary intramedullary tumours. The most common early symptoms of intramedullary spinal cord metastasis are motor deficit in one or more limbs, pain, sensory loss, and sphincter disturbances. The appearance of a rapidly progressive Brown-Séquard syndrome in an oncology patient should orientate the diagnosis of this condition. The prognosis is very poor, with a median survival of 4 months. However, recent research has shown that surgery could offer a slight benefit in survival and functionality. The case is reported of a 61-year-old man with an intramedullary spinal cord metastasis from a gastric carcinoma, as well as a literature review of this topic. It has been found that this case is the fourth one reported in the literature. Copyright © 2015. Published by Elsevier España.

[Uranium Concentration in Drinking Water from Small-scale Water Supplies in Schleswig-Holstein, Germany].

PubMed

Ostendorp, G

2015-04-01

In this study the drinking water of 212 small-scale water supplies, mainly situated in areas with intensive agriculture or fruit-growing, was analysed for uranium. The median uranium concentration amounted to 0.04 µg/lL, the 95(th) percentile was 2.5 µg/L. The maximum level was 14 µg/L. This sample exceeded the guideline value for uranium in drinking water. The uranium concentration in small-scale water supplies was found to be slightly higher than that in central water works in Schleswig-Holstein. Water containing more than 10 mg/L nitrate showed significantly higher uranium contents. The results indicate that the uranium burden in drinking water from small wells is mainly determined by geological factors. An additional anthropogenic effect of soil management cannot be excluded. Overall uranium concentrations were low and not causing health concerns. However, in specific cases higher concentrations may occur. © Georg Thieme Verlag KG Stuttgart · New York.

Review of certain low-level ionizing radiation studies in mice and guinea pigs

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

Congdon, C.C.

1987-05-01

Starting in the early 1940s, Egon Lorenz and collaborators at the National Cancer Institute began an extended study of chronic low-level ionizing radiation effects in what was then the tolerance range for man. Observations on life span, body weight and radiation carcinogenesis, among others, were made in mice, guinea pigs and rabbits. At the then-permissible exposure level, 0.1 R** per 8-h day until natural death, experimental mice and guinea pigs had a slightly greater mean life span compared to control animals. In addition, there was marked weight gain during the growth phase in both species. Increased tumor incidence was alsomore » observed at the 0.1-R level in mice. The primary hypothesis for increased median life span has been rebound regenerative hyperplasia during the early part of the exposure; in the presence of continuing injury, there is physiological enhancement of defense mechanisms against intercurrent infection. The body weight gain has not been explained. 32 references.« less

Love, Trust, and HIV Risk Among Female Sex Workers and Their Intimate Male Partners

PubMed Central

Bazzi, Angela Robertson; Martinez, Gustavo; Rangel, M. Gudelia; Ulibarri, Monica D.; Fergus, Kirkpatrick B.; Amaro, Hortensia; Strathdee, Steffanie A.

2015-01-01

Objectives. We examined correlates of love and trust among female sex workers and their noncommercial male partners along the Mexico–US border. Methods. From 2011 to 2012, 322 partners in Tijuana and Ciudad Juárez, Mexico, completed assessments of love and trust. Cross-sectional dyadic regression analyses identified associations of relationship characteristics and HIV risk behaviors with love and trust. Results. Within 161 couples, love and trust scores were moderately high (median 70/95 and 29/40 points, respectively) and correlated with relationship satisfaction. In regression analyses of HIV risk factors, men and women who used methamphetamine reported lower love scores, whereas women who used heroin reported slightly higher love. In an alternate model, men with concurrent sexual partners had lower love scores. For both partners, relationship conflict was associated with lower trust. Conclusions. Love and trust are associated with relationship quality, sexual risk, and drug use patterns that shape intimate partners’ HIV risk. HIV interventions should consider the emotional quality of sex workers’ intimate relationships. PMID:26066947

Love, Trust, and HIV Risk Among Female Sex Workers and Their Intimate Male Partners.

PubMed

Syvertsen, Jennifer L; Bazzi, Angela Robertson; Martinez, Gustavo; Rangel, M Gudelia; Ulibarri, Monica D; Fergus, Kirkpatrick B; Amaro, Hortensia; Strathdee, Steffanie A

2015-08-01

We examined correlates of love and trust among female sex workers and their noncommercial male partners along the Mexico-US border. From 2011 to 2012, 322 partners in Tijuana and Ciudad Juárez, Mexico, completed assessments of love and trust. Cross-sectional dyadic regression analyses identified associations of relationship characteristics and HIV risk behaviors with love and trust. Within 161 couples, love and trust scores were moderately high (median 70/95 and 29/40 points, respectively) and correlated with relationship satisfaction. In regression analyses of HIV risk factors, men and women who used methamphetamine reported lower love scores, whereas women who used heroin reported slightly higher love. In an alternate model, men with concurrent sexual partners had lower love scores. For both partners, relationship conflict was associated with lower trust. Love and trust are associated with relationship quality, sexual risk, and drug use patterns that shape intimate partners' HIV risk. HIV interventions should consider the emotional quality of sex workers' intimate relationships.

Phase II Evaluation of IPI-926, an Oral Hedgehog Inhibitor, in Patients with Myelofibrosis

PubMed Central

Sasaki, Koji; Gotlib, Jason R.; Mesa, Ruben A.; Newberry, Kate J.; Ravandi, Farhad; Cortes, Jorge E.; Kelly, Patrick; Kutok, Jeffery L.; Kantarjian, Hagop M.; Verstovsek, Srdan

2016-01-01

The clinical safety and efficacy of IPI-926 was evaluated in 14 patients with myelofibrosis in a phase II study. Patients received 160-mg IPI-926 orally in continuous 28-day cycles. The median treatment duration was 5.1 months, and all patients had discontinued treatment by 7.5 months. Nine patients discontinued due to lack of response as determined by the treating physician, two after developing acute leukemia and one due to disease progression/loss of response. Twelve patients had slight reductions in spleen size (less than 50% from baseline), but symptoms did not improve consistently. One patient achieved transfusion independence lasting 5 months. Reductions in GLI1 mRNA and protein levels, JAK2V617F allele burden, degree of fibrosis, or cytokine levels were observed in some patients, but were not significant when evaluated for the cohort. Low-grade gastrointestinal/liver abnormalities were the most common toxicities. The results did not support continued evaluation of IPI-926 as a monotherapy in myelofibrosis. PMID:25641433

Ecotoxicological effects of buprofezin on fecundity, growth, development, and predation of the wolf spider Pirata piratoides (Schenkel).

PubMed

Deng, Lingling; Xu, Muqi; Cao, Hong; Dai, Jiayin

2008-11-01

The toxicological effects of buprofezin, an insect growth regulator, on the fecundity, development, and pest control potential of the wolf spider Pirata piratoides (Schenkel) (Araneae: Lycosidae) were investigated in the laboratory. It was shown that buprofezin had low toxicity to P. piratoides and that the median lethal dosage (LD(50)) 48 h and 10% lethal dosage (LD(10)) after topical application for female spiders were 653 and 316 mg buprofezin/mg fresh weight of spider, respectively. Buprofezin significantly reduced the percent hatching of spiders' eggs but had only a slight effect on egg production. No negative effects on the development and growth were observed. However, spider predation rates were strongly affected: Insecticide-treated females predated on fewer prey than the controls, and their predation rate did not recover even 5 days after insecticide application. This indicated that their pest control potential might be influenced by buprofezin, and the use of buprofezin in biological control of insects is discussed.

Noncutaneous head and neck cancer in solid organ transplant patients: single center experience.

PubMed

Nelissen, Charlotte; Lambrecht, Maarten; Nevens, Frederik; Van Raemdonck, Dirk; Vanhaecke, Johan; Kuypers, Dirk; Pirenne, Jacques; Nuyts, Sandra

2014-04-01

We investigated the incidence and survival of non-cutaneous head and neck cancer (HNC) after solid organ transplantation and identified prognostic factors impacting the outcome after treatment. A retrospective analysis of patients who underwent solid organ transplantation in our institution between 1987 and 2012. Of 5255 organ transplant patients, 48 recipients (0.9%) developed HNC in the posttransplant follow-up period. Liver transplant recipients showed the highest risk. Median follow-up of cancer patients was 46.7 months (range 2.9-256.2 months). Three-year overall survival and disease free survival (DFS) were 70% and 53%. Locoregional control was 67% and 48% at 3 and 5 years, respectively. Smoking and initial AJCC stage were two significant prognostic factors influencing DFS. Non-cutaneous HNC is rare in transplant recipients, but slightly more common after liver transplantation. Outcome after treatment is poor with locoregional recurrence being the main problem. Screening of high risk groups might be relevant. Copyright © 2013 Elsevier Ltd. All rights reserved.

Foreign object detection via texture recognition and a neural classifier

NASA Astrophysics Data System (ADS)

Patel, Devesh; Hannah, I.; Davies, E. R.

1993-10-01

It is rate to find pieces of stone, wood, metal, or glass in food packets, but when they occur, these foreign objects (FOs) cause distress to the consumer and concern to the manufacturer. Using x-ray imaging to detect FOs within food bags, hard contaminants such as stone or metal appear darker, whereas soft contaminants such as wood or rubber appear slightly lighter than the food substrate. In this paper we concentrate on the detection of soft contaminants such as small pieces of wood in bags of frozen corn kernels. Convolution masks are used to generate textural features which are then classified into corresponding homogeneous regions on the image using an artificial neural network (ANN) classifier. The separate ANN outputs are combined using a majority operator, and region discrepancies are removed by a median filter. Comparisons with classical classifiers showed the ANN approach to have the best overall combination of characteristics for our particular problem. The detected boundaries are in good agreement with the visually perceived segmentations.

Impact of 2003 state regulation on raw oyster-associated Vibrio vulnificus illnesses and deaths, California, USA.

PubMed

Vugia, Duc J; Tabnak, Farzaneh; Newton, Anna E; Hernandez, Michael; Griffin, Patricia M

2013-08-01

US vibriosis rates have increased since 1996, and many Vibrio vulnificus infections are fatal. In April 2003, California implemented a regulation restricting the sale of raw oysters harvested from the Gulf of Mexico during April 1-October 31, unless they were processed to reduce V. vulnificus to nondetectable levels. We analyzed California cases of V. vulnificus infection before and after the regulation's implementation and compared case data with data from other states. The annual number of reported V. vulnificus infections and deaths in California with patient's sole exposure to raw oysters dropped from 0 to 6 cases and 0 to 5 deaths per year during 1991-2002, before implementation, to 0 during 2003-2010, after implementation (p = 0.0005 for both). In other states, median annual numbers of similar cases and deaths increased slightly after 2002. The data strongly suggest that the 2003 regulation led to a significant reduction in reported raw oyster-associated V. vulnificus illnesses and deaths.

Comparison of pencil beam–based homogeneous vs inhomogeneous target dose planning for stereotactic body radiotherapy of peripheral lung tumors through Monte Carlo–based recalculation

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

Ohtakara, Kazuhiro, E-mail: ohtakara@murakami.asahi-u.ac.jp; Hoshi, Hiroaki

2015-10-01

This study was conducted to ascertain whether homogeneous target dose planning is suitable for stereotactic body radiotherapy (SBRT) of peripheral lung cancer under appropriate breath-holding. For 20 peripheral lung tumors, paired dynamic conformal arc plans were generated by only adjusting the leaf margin to the planning target volume (PTV) edge for fulfilling the conditions such that the prescription isodose surface (IDS) encompassing exactly 95% of the PTV (PTV D{sub 95}) corresponds to 95% and 80% IDS, normalized to 100% at the PTV isocenter under a pencil beam (PB) algorithm with radiologic path length correction. These plans were recalculated using themore » x-ray voxel Monte Carlo (XVMC) algorithm under otherwise identical conditions, and then compared. Lesions abutting the parietal pleura or not were defined as edge or island tumors, respectively, and the influences of the target volume and its location relative to the chest wall on the target dose were examined. The median (range) leaf margin required for the 95% and 80% plans was 3.9 mm (1.3 to 5.0) and −1.2 mm (−1.8 to 0.1), respectively. Notably, the latter was significantly correlated negatively with PTV. In the 80% plans, the PTV D{sub 95} was slightly higher under XVMC, whereas the PTV D{sub 98} was significantly lower, irrespective of the dose calculation algorithm used. Other PTV and all gross tumor volume doses were significantly higher, while the lung doses outside the PTV were slightly lower. The target doses increased as a function of PTV and were significantly lower for island tumors than for edge tumors. In conclusion, inhomogeneous target dose planning using smaller leaf margin for a larger tumor volume was deemed suitable in ensuring more sufficient target dose while slightly reducing lung dose. In addition, more inhomogeneous target dose planning using <80% IDS (e.g., 70%) for PTV covering would be preferable for island tumors.« less

Incidence and Duration of Cumulative Bisphosphonate Use among Community-Dwelling Persons with or without Alzheimer's Disease.

PubMed

Tiihonen, Miia; Taipale, Heidi; Tanskanen, Antti; Tiihonen, Jari; Hartikainen, Sirpa

2016-01-01

We studied the incidence and duration of cumulative bisphosphonate use among older Finnish women and men with or without Alzheimer's disease (AD). The MEDALZ-2005 cohort is a nationwide sample of all persons with clinically diagnosed AD on 31 December 2005 and their age-, gender-, and region of residence-matched control persons without AD. Information on bisphosphonate use by persons with an AD diagnosis and their controls without AD during 2002-2009 was obtained from the prescription register database containing reimbursed medications. A total of 6,041 (11.8%) persons used bisphosphonates during the 8-year follow-up. Bisphosphonates were more commonly used among persons without AD (n = 3121, 12.3%) than among persons with AD (n = 2,920, 11.2%) (p = 0.001). The median duration of bisphosphonate use was 743 days (IQR). Among persons with AD, the median duration of use was 777 days (IQR) and among persons without AD, 701 days (IQR) (p = 0.011). People without AD more often used bisphosphonate combination preparations including vitamin D than did people with AD (p <  0.0001). Bisphosphonate use was more common among people without AD who had comorbidities, asthma/COPD, or rheumatoid arthritis compared with users with AD. Short-term users were more likely to be male, at least 80 years old, and not having AD. Although the incidence of bisphosphonate use was slightly higher among persons without AD, the cumulative duration of bisphosphonate use was longer in persons with AD. Short-term use was associated with male gender, older age, and not having AD.

A traditional Sami diet score as a determinant of mortality in a general northern Swedish population.

PubMed

Nilsson, Lena Maria; Winkvist, Anna; Brustad, Magritt; Jansson, Jan-Håkan; Johansson, Ingegerd; Lenner, Per; Lindahl, Bernt; Van Guelpen, Bethany

2012-05-04

To examine the relationship between "traditional Sami" dietary pattern and mortality in a general northern Swedish population. Population-based cohort study. We examined 77,319 subjects from the Västerbotten Intervention Program (VIP) cohort. A traditional Sami diet score was constructed by adding 1 point for intake above the median level of red meat, fatty fish, total fat, berries and boiled coffee, and 1 point for intake below the median of vegetables, bread and fibre. Hazard ratios (HR) for mortality were calculated by Cox regression. Increasing traditional Sami diet scores were associated with slightly elevated all-cause mortality in men [Multivariate HR per 1-point increase in score 1.04 (95% CI 1.01-1.07), p=0.018], but not for women [Multivariate HR 1.03 (95% CI 0.99-1.07), p=0.130]. This increased risk was approximately equally attributable to cardiovascular disease and cancer, though somewhat more apparent for cardiovascular disease mortality in men free from diabetes, hypertension and obesity at baseline [Multivariate HR 1.10 (95% CI 1.01-1.20), p=0.023]. A weak increased all-cause mortality was observed in men with higher traditional Sami diet scores. However, due to the complexity in defining a "traditional Sami" diet, and the limitations of our questionnaire for this purpose, the study should be considered exploratory, a first attempt to relate a "traditional Sami" dietary pattern to health endpoints. Further investigation of cohorts with more detailed information on dietary and lifestyle items relevant for traditional Sami culture is warranted.

Safety and efficacy of the addition of simvastatin to panitumumab in previously treated KRAS mutant metastatic colorectal cancer patients.

PubMed

Baas, Jara M; Krens, Lisanne L; Bos, Monique M; Portielje, Johanneke E A; Batman, Erdogan; van Wezel, Tom; Morreau, Hans; Guchelaar, Henk-Jan; Gelderblom, Hans

2015-09-01

Panitumumab has proven efficacy in patients with metastatic or locally advanced colorectal cancer patients, provided that they have no activating KRAS mutation in their tumour. Simvastatin blocks the mevalonate pathway and thereby interferes with the post-translational modification of KRAS. We hypothesize that the activity of the RAS-induced pathway in patients with a KRAS mutation might be inhibited by simvastatin. This would theoretically result in increased sensitivity to panitumumab, potentially comparable with tumours with wild-type KRAS. A Simon two-stage design single-arm, phase II study was designed to test the safety and efficacy of the addition of simvastatin to panitumumab in colorectal cancer patients with a KRAS mutation after failing fluoropyrimidine-based, oxaliplatin-based and irinotecan-based therapy. The primary endpoint of this study was the proportion of patients alive and free from progression 11 weeks after the first administration of panitumumab, aiming for at least 40%, which is comparable with, although slightly lower than, that in KRAS wild-type patients in this setting. If this 40% was reached, then the study would continue into the second step up to 46 patients. Explorative correlative analysis for mutations in the KRAS and related pathways was carried out. One of 14 patients was free from progression at the primary endpoint time. The median progression-free survival was 8.4 weeks and the median overall survival status was 19.6 weeks. We conclude that the concept of mutant KRAS phenotype expression modulation with simvastatin was not applicable in the clinic.

Reference Centile Curves for Body Fat Percentage, Fat-free Mass, Muscle Mass and Bone Mass Measured by Bioelectrical Impedance in Asian Indian Children and Adolescents.

PubMed

Chiplonkar, Shashi; Kajale, Neha; Ekbote, Veena; Mandlik, Rubina; Parthasarathy, Lavanya; Borade, Ashwin; Patel, Pinal; Patel, Prerna; Khadilkar, Vaman; Khadilkar, Anuradha

2017-12-15

To create gender-specific percentile curves for percent body fat (%BF) by Bio electrical Impedance Analysis (BIA) for screening adiposity and risk of hypertension in Indian children and generate reference curves for percent fat-free mass (%FFM), muscle mass (%LM) and bone mineral content (BMC) by using bioelectrical impedance. Secondary analysis of data from previous multicenter cross-sectional studies. Private schools from five regions of India. A random sample of 3850 healthy school children (2067 boys) (5-17 yr) from private schools in five major Indian cities. Anthropometry, blood pressure (BP) and body composition were measured by bioelectrical impedance. Reference curves were generated by the LMS method. %BF, %FFM, %LM, BMC and BP. Median %BF increased by 6% from 5 to 13 years of age and declined (around 2%) up to 17 years in boys. In girls, %BF increased by 8% from 5 to 14 years and thereafter declined by 3%. Based upon the risk of hypertension, the new cut-offs of 75th and 85th percentile of %BF were proposed for detecting over fatness and excess fatness in children. Median %FFM was 90% at 5 yrs and decreased till 12 years, and then showed a slight increase to 84% at 17 yrs in boys. In girls, it was 86% at 5 yrs and decreased till 15 yrs, and plateaued at 71.8% at 17 yrs. Reference curves for percent body fat for Indian children would be useful to screen children for health risk in clinical set up.

Zoledronic acid as compared with observation in multiple myeloma patients at biochemical relapse: results of the randomized AZABACHE Spanish trial

PubMed Central

García-Sanz, Ramón; Oriol, Albert; Moreno, María J.; de la Rubia, Javier; Payer, Angel R.; Hernández, Miguel T.; Palomera, Luis; Teruel, Ana I.; Blanchard, María J.; Gironella, Mercedes; Ribas, Paz; Bargay, Joan; Abellá, Eugenia; Granell, Miquel; Ocio, Enrique M.; Ribera, Josep M.; San Miguel, Jesús F.; Mateos, María V.

2015-01-01

This study analyzed the anti-myeloma effect of zoledronic acid monotherapy by investigating patients at the time of asymptomatic biochemical relapse. One hundred patients were randomized to receive either zoledronic acid (4 mg iv/4 weeks, 12 doses) (n=51) or not (n=49). Experimental and control groups were well balanced for disease and prognostic features. Zoledronic acid did not show an antitumor effect according to changes in M-component. However, there were fewer symptomatic progressions in the experimental group than in the control group (34 versus 41, respectively; P=0.05) resulting in a median time to symptoms of 16 versus 10 months (P=0.161). The median time to next therapy was also slightly longer for the treated group than the untreated, control group (13.4 versus 10.1 months), although the difference was not statistically significant (P=0.360). The pattern of relapses was different for treated versus control patients: progressive bone disease (8 versus 20), anemia (24 versus 18), renal dysfunction (1 versus 2), and plasmacytomas (1 versus 1, respectively). This concurred with fewer skeletal-related events in the treated group than in the control group (2 versus 14), with a projected 4-year event proportion of 6% versus 40% (P<0.001). In summary, zoledronic acid monotherapy does not show an antitumor effect on biochemical relapses in multiple myeloma, but does reduce the risk of progression with symptomatic bone disease and skeletal complications. This trial was registered in the ClinicalTrials.gov database with code NCT01087008 PMID:26069291

Occupational exposure of air crews to tricresyl phosphate isomers and organophosphate flame retardants after fume events.

PubMed

Schindler, Birgit Karin; Weiss, Tobias; Schütze, Andre; Koslitz, Stephan; Broding, Horst Christoph; Bünger, Jürgen; Brüning, Thomas

2013-04-01

Aircraft cabin air can possibly be contaminated by tricresyl phosphates (TCP) from jet engine oils during fume events. o-TCP, a known neurotoxin, has been addressed to be an agent that might cause the symptoms reported by cabin crews after fume events. A total of 332 urine samples of pilots and cabin crew members in common passenger airplanes, who reported fume/odour during their last flight, were analysed for three isomers of tricresyl phosphate metabolites as well as dialkyl and diaryl phosphate metabolites of four flame retardants. None of the samples contained o-TCP metabolites above the limit of detection (LOD 0.5 μg/l). Only one sample contained metabolites of m- and p-tricresyl phosphates with levels near the LOD. Median metabolite levels of tributyl phosphate (TBP), tris-(2-chloroethyl) phosphate (TCEP) and triphenyl phosphate (TPP) (DBP 0.28 μg/l; BCEP 0.33 μg/l; DPP 1.1 μg/l) were found to be significantly higher than in unexposed persons from the general population. Median tris-(2-chloropropyl) phosphate (TCPP) metabolite levels were significantly not higher in air crews than in controls. Health complaints reported by air crews can hardly be addressed to o-TCP exposure in cabin air. Elevated metabolite levels for TBP, TCEP and TPP in air crews might occur due to traces of hydraulic fluid in cabin air (TBP, TPP) or due to release of commonly used flame retardants from the highly flame protected environment in the airplane. A slight occupational exposure of air crews to organophosphates was shown.